STUDYING STUDYING INSTITUTIONAL INSTITUTIONAL INTERACTION: INTERACTION: THE CASE OF THE CASE OF

REPAIR REPAIR SEQUENCESSEQUENCES

Dr. Carles Roca CuberesDr. Carles Roca CuberesDepartment of Audiovisual Department of Audiovisual

CommunicationCommunicationUNIVERSITY POMPEU FABRAUNIVERSITY POMPEU FABRA

BarcelonaBarcelona

INTRODUCTIONINTRODUCTION

Study of interaction in psychiatric Study of interaction in psychiatric interviewsinterviews

Main task of the psychiatrist: assess the Main task of the psychiatrist: assess the patient’s behaviour and modify itpatient’s behaviour and modify it

Effectiveness of therapy: the patient gains Effectiveness of therapy: the patient gains insight according to some theoryinsight according to some theory

In practice: improvement must coincide In practice: improvement must coincide with the psychiatrist’s with the psychiatrist’s in situ in situ expectationsexpectations

How is this accomplished? A ‘repair’ How is this accomplished? A ‘repair’ sequencesequence

METHODOLOGY: CONVERSATON METHODOLOGY: CONVERSATON ANALYSISANALYSIS

Ethnomethodology’s cognate disciplineEthnomethodology’s cognate discipline Qualitative and inductiveQualitative and inductive Real interaction as the object of studyReal interaction as the object of study Special attention is paid to the sequential Special attention is paid to the sequential

organisation of interactional activitiesorganisation of interactional activities Employment of audio or video recordingsEmployment of audio or video recordings Transcription of dataTranscription of data

GoalGoal: detecting the sequential : detecting the sequential organisation of interaction in the organisation of interaction in the form of patternsform of patterns

Identifying a potential Identifying a potential phenomenonphenomenon

Building a collection of cases to Building a collection of cases to ascertain if it constitutes a ascertain if it constitutes a recurring interactional patternrecurring interactional pattern

THE BASIC UNIT OF THE BASIC UNIT OF INTERACION: ADJACENCY INTERACION: ADJACENCY

PAIRSPAIRS

A: Can you tell me the time?A: Can you tell me the time?

B: It’s five o’clockB: It’s five o’clock

* * Type of adjacency pairType of adjacency pair: : question-answerquestion-answer

ADJACENCY PAIRS: ADJACENCY PAIRS: PROPERTIESPROPERTIES

Two turns in sizeTwo turns in size Change of speaker after the Change of speaker after the

production of each turnproduction of each turn What is said in the first turn is What is said in the first turn is

relevant for the producer of the relevant for the producer of the second turnsecond turn

What is said in the second turn is What is said in the second turn is related to what is said in the first onerelated to what is said in the first one

ADJACENCY PAIRS: ADJACENCY PAIRS: IMPLICATIONSIMPLICATIONS

They suggest the presence of a wider They suggest the presence of a wider structure available for interactantsstructure available for interactants

They show how members can display a They show how members can display a public understanding of the preceding public understanding of the preceding talktalk

They demonstrate how shared meanings They demonstrate how shared meanings are created and sustainedare created and sustained

The form of analysis addressed to these The form of analysis addressed to these paired utterances can be applied to more paired utterances can be applied to more intricate and longer sequences of talkintricate and longer sequences of talk

ADJACENCY ADJACENCY PAIRS: PAIRS:

CONCLUSIONCONCLUSIONADJACENCY PAIRS AS THE ADJACENCY PAIRS AS THE

BUILDING BLOCKS OF BUILDING BLOCKS OF INTERSUBJECTIVITYINTERSUBJECTIVITY

CA AND INSTITUTIONAL TALKCA AND INSTITUTIONAL TALK

Different forms of communication Different forms of communication depending on the contextdepending on the context

Different types of interaction or ‘speech-Different types of interaction or ‘speech-exchange systems’exchange systems’

At one pole: ordinary conversationAt one pole: ordinary conversation At the other pole: debates, court At the other pole: debates, court

hearings, news interview, etc. hearings, news interview, etc. → → institutional talk → formal settingsinstitutional talk → formal settings

Somewhat in between: medical or Somewhat in between: medical or psychiatric environments, social psychiatric environments, social services, etc. → services, etc. → institutional talk institutional talk → → non-formal settingsnon-formal settings

REPAIR SEQUENCES IN REPAIR SEQUENCES IN CONVERSATIONCONVERSATION

Repair as an organised set of Repair as an organised set of practices through which practices through which participants are able to address participants are able to address and potentially resolve problems and potentially resolve problems of speaking, hearing or of speaking, hearing or understanding in talk.understanding in talk.

It involves two interrelated It involves two interrelated components: initiation and repaircomponents: initiation and repair

REPAIR: EXAMPLESREPAIR: EXAMPLES

REPAIR: INITIATED BY A PARTIAL REPAIR: INITIATED BY A PARTIAL REPEATREPEAT

ANALYSIS OF A REPAIR SEQUENCE IN A PSYCHIATRIC INTERVIEWANALYSIS OF A REPAIR SEQUENCE IN A PSYCHIATRIC INTERVIEW

1 T1: Cómo te encuentras de estado de ánimo Antonio

How do you feel about your state of mind Antonio

2 P8: Bien

Fine

3 T1: Bien del todo?

Perfectly fine?

4 P8: Sí

Yes

5

6

T1: Dirías que te falta algo? (1.4)

Would you say there’s something missing? (1.4)

[para estar bien del todo

[to feel perfectly fine

7 P8: [No

[No

8 T1: No

No

9 P8: Un poco de ánimo pero supongo que es estar aquí dentro

I might feel a bit low but I guess it’s being in here

10 T1: Mh hm

Mh hm

11 P8: Pero me falta un poco de ánimo sí

But I’m a bit low yes

12 T1: Y cuando saliste el fin de semana pasado ((continúa))

So when you were out last weekend ((continues))

CONCLUSIONCONCLUSION

1. 1. Repair is an ordinary occurrence in Repair is an ordinary occurrence in everyday encounters. In the context everyday encounters. In the context of a psychiatric interview, though, of a psychiatric interview, though, psychiatrists might exploit its psychiatrists might exploit its interactional properties to interactional properties to accomplish some therapy-related accomplish some therapy-related tasks: it can help therapists to tasks: it can help therapists to assess, probe and invite patients to assess, probe and invite patients to change their statementschange their statements..

CONCLUSIONCONCLUSION

2. 2. The concept of insight is conventionally The concept of insight is conventionally described in psychiatric theory as the ability described in psychiatric theory as the ability of patients to produce introspection, accept of patients to produce introspection, accept their mental condition and finally transform their mental condition and finally transform their cognitive state. This study reveals this their cognitive state. This study reveals this conceptualisation to be equivocal and conceptualisation to be equivocal and misleading. Transformations in the patients’ misleading. Transformations in the patients’ avowals appear to be the outcome of avowals appear to be the outcome of psychiatrists’ persuasion or even pressure, psychiatrists’ persuasion or even pressure, which materialises in the implementation of which materialises in the implementation of repair sequences.repair sequences.

CONCLUSIONCONCLUSION

3. 3. As a result of the implementation of As a result of the implementation of repair sequences (and other repair sequences (and other interactional devices) the psychiatric interactional devices) the psychiatric interview is characterised as an interview is characterised as an asymmetric interactional event.asymmetric interactional event.

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