Psychotherapy Talk Research Articles

Modeling Linguistic (A)Synchrony: A Case Study of Therapist-Client Interaction.

Interpersonal synchrony is the alignment of responses between social interactants, and is linked to positive outcomes including cooperative behavior, affiliation, and compassion in different social contexts. Language is noted as a key aspect of interpersonal synchrony, but different strands of existing work on linguistic (a)synchrony tends to be methodologically polarized. We introduce a more complementary approach to model linguistic (a)synchrony that is applicable across different interactional contexts, using psychotherapy talk as a case study. We define linguistic synchrony as similarity between linguistic choices that reflect therapists and clients’ socio-psychological stances. Our approach involves (i) computing linguistic variables per session, (ii) k-means cluster analysis to derive a global synchrony measure per dyad, and (iii) qualitative analysis of sample extracts from each dyad. This is demonstrated on sample dyads from psychoanalysis, cognitive-behavioral, and humanistic therapy. The resulting synchrony measures reflect the general philosophy of these therapy types, while further qualitative analyses reveal how (a)synchrony is contextually co-constructed. Our approach provides a systematic and replicable tool for research and self-reflection in psychotherapy and other types of purposive dialogic interaction, on more representative and limited datasets alike.

Pandemic Allows Vast Natural Experiment in Socially Distant Psychotherapy

Pandemic Allows Vast Natural Experiment in Socially Distant Psychotherapy

Negotiating the language(s) for psychotherapy talk: A mixed methods study from the perspective of multilingual clients

AbstractBackgroundMultilingual clients can benefit from expressing themselves in more than one language in psychotherapy. Yet, research suggests that language switching is typically instigated by clients, although some do not feel empowered to negotiate the language(s).MethodsThis paper addresses how language options, from the main therapy language(s) to language switching, were negotiated between client and therapist, as reported by 109 multilingual clients. All participants completed a web survey and five participated in follow‐on interviews. In addition, we reflect on the advantages of the mixed methods approach—particularly with regard to ethics and the explanatory sequential design. Analyses combine descriptive statistics and thematic analysis to elaborate on the trends identified in this international sample.Key ResultsWhereas some multilingual clients did not feel inhibited about using languages other than the main therapy language, for others the therapist played an important role in promoting multilingualism in the therapy room. Indeed, a lack of discussion surrounding language use—beyond such technical aspects as agreeing the main therapy language—was found to lead to assumptions about therapists' proficiency or the (non‐)acceptability of multilingual language practices. By contrast, metalinguistic discussions which explored process and meaning were welcomed by clients and typically opened up ways to use languages; the study itself was a catalyst for self‐reflection and productive discussions for one interviewee.Conclusions & InferencesThus, the research provides further evidence, from clients, that developing therapists' metalinguistic awareness and competence and empowering multilingual clients to share their insights has therapeutic benefits.

Surveying views of metaphor vs. literal language in psychotherapy

Abstract Five key therapeutic functions of metaphors are often discussed by psychotherapists. They (i) help clients express emotions and experiences, (ii) help therapists and clients explain difficult concepts, (iii) introduce new frames of reference, (iv) help work through client resistance, and (v) build a collaborative relationship between therapists and clients. Research on how these functions are enacted in psychotherapy talk tends to assume that they are indeed perceived as such by clients, and that metaphorical language is preferred to comparable literal language in performing them. This paper reports a survey study (N = 84) to critically interrogate these assumptions. Participants read two constructed therapy dialogues, controlled and counterbalanced for presentation sequence, where therapist and client discuss an issue using metaphorical and literal language respectively. Each dialogue is followed by a 15-item questionnaire to rate how well the presumed functions were performed (e.g. the therapist and client can work effectively together, the therapist is able to explain difficult concepts). A combined Confirmatory (CFA) and Exploratory Factor Analysis (EFA) suggests that, instead of the five distinct functions proposed in the literature, participants discerned three functions which reflect a more holistic view of what metaphors can do. A second EFA conducted on literal responses yielded only two factors. This contrast in factor structure further suggests that (i) literal language is less functionally nuanced, and (ii) metaphors are not simply perceived as an ‘add-on’ to literal language, but are evaluated across an extended narrative in fundamentally different ways. Within-subjects metaphor vs. literal ratings of the items under the emergent three-factor structure were then compared. Metaphor ratings were significantly higher in all factors (p < 0.01), suggesting that metaphorical language is indeed perceived as more effective than literal language when discussing clients’ issues. Implications, limitations, and future directions are discussed.

Exploring Conversational and Physiological Aspects of Psychotherapy Talk.

This study is part of a larger exploration of ‘talk and cure’ that combines the examination of talk-in-interaction with nonverbal displays and measurements of the client’s and therapist’s autonomic arousal during therapy sessions. A key assumption of the study is that psychotherapy entails processes of intersubjective meaning-making that occur across different modalities and take place in both verbal/explicit and nonverbal/implicit domains. A single session of a psychodynamic psychotherapy is analyzed with a focus on the expression and management of affect, with an aim to describe key interactive events that promote change in both semantic and procedural domains. The clinical dialog is analyzed discursively, with a focus on the conversational processes through which new meanings are jointly constructed and affective states shared; detailed attention is paid to nonverbal displays of affiliation and affect. Furthermore, we explore whether the interactional patterns implicated in joint meaning-making, as revealed by analyzing the therapeutic conversation, have correlates in the autonomic arousal of the two protagonists, as reflected in their heart rates. Conversation analysis has still untapped potential to illuminate interactional patterns that underlie the practice of psychotherapy. In this exploratory study we suggest that discursive analyses of talk-in-interaction can be enriched through detailed focus on nonverbal displays as well as measures of physiological arousal. Drawing upon the analysis, we suggest that bringing the methodological strengths of language-based analysis into fertile dialog with embodied quantitative data can help our explorations of what’s really going on in psychotherapy.

A Computerized Text and Cluster Analysis Approach to Psychotherapy Talk

This paper illustrates an analytical approach combining LIWC, a computer text-analytic application, with cluster analysis techniques to explore ‘language styles’ in psychotherapy across sessions in time. It categorizes session transcripts into distinct clusters or styles based on linguistic (di)similarity and relates them to sessional progression, thus providing entry points for further qualitative exploration. In the first step, transcripts of four illustrative therapist-client dyads were scored under ten LIWC variables including ‘analytic thinking’, ‘clout’, ‘authenticity’, ‘emotional tone’, and pronoun types. In the next step, agglomerative hierarchical clustering uncovered distinct session clusters that are differently distributed in each dyad. The relationships between these clusters and the chronological progression of sessions were then further discussed in context as contrastive exemplars. Applications, limitations and future directions are highlighted.

Metaphors of movement in psychotherapy talk

Metaphors of physical movement perform both substantive and organizational functions as they can represent things and construct cohesive links in discourse. This paper examines movement metaphors in psychotherapy talk, a context where both functions are equally salient. Categorical data and discourse analytic methods were used to investigate (i) types of target topics and metaphorical movement, (ii) relationships between topics, types of movement, and speaker, and (iii) how the substantive and organizational functions interact in proximity. There was no three-way interaction but all bivariate associations between topics, movement types, and speaker were significant. Key findings include (i) clients were more likely to use movement metaphors to discuss issues while therapists more likely to discuss therapeutic concepts and construct reference links; (ii) forward movement occurred less frequently than expected as a source for issues while backward movement more frequently than expected as a source for reference links; (iii) therapist metaphors were more likely to depict directions of movement associated with progress, while client metaphors were associated with stagnation, regression, or uncertainty. Clinical implications and directions for future research are highlighted.

Quantitative metaphor usage patterns in Chinese psychotherapy talk.

The study of metaphor in psychotherapy is undergoing a 'contextual turn', shifting emphasis from global mechanisms underlying metaphors and therapeutic change to their naturally occurring properties in therapist-patient interaction. While there have been rich qualitative and contextual descriptions of metaphors in psychotherapy, complementary quantitative accounts of metaphor usage patterns over larger amounts of talk have been less forthcoming. This paper reports metaphor usage patterns as associations between key contextual variables which characterize metaphors in a dataset of Chinese psychotherapy talk. A total of 2893 metaphor vehicle terms from 29.5 hours of talk were coded for SPEAKER, FUNCTION, TARGET, PHASE OF THERAPY, and DYAD. A loglinear analysis revealed significant higher order associations (DYAD*TARGET*FUNCTION*PHASE; DYAD*FUNCTION*PHASE*SPEAKER; TARGET*FUNCTION*SPEAKER), discussed as usage patterns which bear implications for the psychotherapeutic application of metaphor. Limitations and future research directions are discussed.

A variational approach to deliberate metaphors

While Deliberate Metaphor Theory is controversial from a psychological point of view, its advocates propose that the communicative notion of ‘deliberateness’ is valuable for structural-functional analyses of metaphors in the social world. Nevertheless, the inter-relationships between the linguistic, conceptual, and communicative dimensions of metaphor highlighted by Deliberate Metaphor Theory, and how these may vary across different discourse contexts, remains underexplored. This paper examines deliberate metaphor across four contrasting discourse categories of psychotherapy talk, news articles, popular science articles, and political speeches. 800 metaphor units were randomly sampled and coded under the variables DIRECT (direct/indirect), NOVEL (novel/conventional), DELIB (deliberate/non-deliberate), and CATEGORY. In the first part of the study, a hierarchical log-linear analysis identified three significant interaction effects: DELIB*DIRECT, CATEGORY*NOVEL*DIRECT, and CATEGORY *NOVEL*DELIB (χ2(7) = 0.0, p = 1). While generally reflecting the inter-relatedness of the three dimensions, the three-way interactions point towards underexplored patterns of variation which are discussed with respect to contrasting discourse objectives. In the second part of the study, six categories of deliberate metaphor features were inductively identified: elaboration, signal, analogy, stark novelty, topic-triggering, and repetition. They demonstrate diverse strategic ways in which ‘deliberateness’ is constructed across the four discourse categories.

Metaphor and Psychological Transference

ABSTRACTPsychotherapy is a mental health activity where therapists assist clients through verbal interaction. The phenomenon of transference, where clients superimpose their past experiences onto present life situations, occurs frequently in psychotherapy, and may have varied effects on treatment outcome depending on how it is managed or “worked through.” While previous work has linked transference to metaphor based on their theoretical similarity, this article explores the relationship on the basis of actual psychotherapy talk between a therapist–client dyad at a Chinese university counseling center. It combines clinical and discourse analytic observations to the model working through transference as an interactional process of constructing a “PRESENT IS PAST” conceptual metaphor, and suggests that the process involves guiding the client to move from an awareness of correspondences at the conceptual level (i.e., between entities, attributes, and relations), to the transferential level (between feelings, emotions, and attitudes). Methodological, theoretical, and practical implications for contemporary metaphor research and psychotherapy practice are discussed, and some directions offered for future research.

Psychotherapy talk as social control.

Psychotherapy talk as social control.