We provide an interactional analysis of a therapy session with a young child. Ina (pseudonym) is a 4-year-old girl. After giving birth to her, her mother left her in the care of a hospital. Ina was placed with a foster care family for half a year and then was adopted. She is brought to treatment because of frequent outbreaks of rage against other children and her adoptive parents. The clinical hypotheses for her are that she has a deep desire for her mother's love and in the same moment a strong hatred toward her for having left her alone. This is a strong emotional burden and a cognitive conundrum she cannot solve. A further clinical hypothesis is: parents in adoptive families often wish to be accepted as "genuine parents," addressed as "mom" and "dad." After some time, adoptive children often realize what a powerful position in family life they can achieve by not fulfilling their parent's wishes (Feder,; Nickman,; Haimes,):a generalized example of "doing contrariness." Ina's situation, as a child having suffered from traumatic losses in early years requires a different therapeutic approach than the one documented in Hutchby. The session has been recorded on video and audio. The parents have given their permission to use the material for publications.
How are the conventions of conversation adapted to the purpose of therapeutic talk between therapist and child? Do they use playing scenarios to negotiate and solve conflicts arising from the traumatic history of the child, and if so, how? How is their conversation affected by whether they have aligning and non-aligning interactional goals? We focus on one interactional practice (doing contrariness) and strategies to address it (remedying/avoiding doing contrariness) which we identify in various multimodal guises and show which role they play in answering these questions as well as for the therapeutic process of treating a child with traumatic experiences. We hope to contribute to a better understanding of therapeutic interactions, which has potential benefits also for therapy: applied analyses such as the one we are presenting can have a kind of supervisory function for therapeutic talk and for institutional conditions (Karim,). CA research has also contributed to a better understanding of the details of children's talk about traumatic experience (Bateman et al.,).
Although we are oriented toward CA in our analytical approach, we also make use of the toolbox of broader linguistic analysis as well as insights from psychotherapeutic research and clinical experience.
There are two main issues that are particularly important for our analysis of the interactional processes in child therapy and of how they influence therapy outcome, in our view. They concern the length of conversational stretches that are usually considered in analysis and the question of how to deal with less conventionalized language (here, of and toward young children).
Regarding the first issue, in CA, analyses are often conducted on sequences of only a few turns in length; this has produced the very influential concept of the adjacency pair (Schegloff and Sacks,). Certain adjacency pairs in specialized contexts have not only produced highly conventionalized linguistic forms, such as greeting-greetings, but also various kinds of offers, requests, invitations, and their respective responses. There is a preference bias for the production of positive responses over negative ones, and in perception, negative responses are also dispreferred in that they cause a higher cognitive load (Bogels et al.,; Kendrick and Torreira,), leading to conventionalization also in the type of response, not only its form. Sometimes, analytical attention in CA can seem to focus on short sequences and strict sequentiality. However, this is not so on principle: Sidnell discusses several types of evidence in CA that are not restricted in this way, and Schegloff substantially extends the notion of adjacency pair beyond immediate sequentiality via expansion. Recent pragmatic models also show the relevance of meaning dependencies across longer stretches of discourse in everyday conversation (Farkas and Bruce,; Ginzburg,; Roberts,; Goodwin,). Together, these approaches allow to take effects into consideration that arise from the interaction of the content and illocutionary force of the current turn with (the retrospective interpretation on behalf of the participants of) conversational acts having taken place many more turns before. This is particularly important for understanding conversation in a psychotherapeutic setting, where long-distance effects and their negotiation between therapist and patient are part and parcel of the interaction (Buchholz and Kachele,). One of the aims of CA has been to contribute to an understanding of how meaning is "achieved" in interaction (Garfinkel,; Heritage,). The understanding of meaning underlying this idea is that it
...lies not with the speaker nor the addressee nor the utterance alone as many philosophical arguments have considered, but rather with the interactional past, current, and projected next moment. The meaning of an entire utterance is a complex, not well-understood, algorithm of these emergent, non-linear, sense-making interactions (Schegloff et al.,, p. 40).
Since we here are also interested in this interactional aspect of meaning as something that arises out of the pragmatic negotiation between therapist and patient, we also adopt a methodological stance that considers more than the immediate context of a turn in order to make this meaning visible. Focusing on a single session and proceeding chronologically over a relatively long part of it (roughly 20 min), our analysis shows how certain topics occurring at the beginning resurface at a later stage and are then negotiated again in the light of the progressing discourse. Themes from the previous day's session are also continued.
The second issue concerns unconventional language. In close adherence to ethnomethodology (Garfinkel,), the action a turn performs can be interpreted in CA partially via the immediately ensuing response of the interlocutor, relatively independent of the formal linguistic content of the turn. That does not mean that the formal content is of no interest to CA analyses. As an example, if an interlocutor begins a conversation by saying, "I hate having to see your face again every morning," and this is met by a response along the lines of "Yeah, good to see you too, Bob," then by the principles of CA, the facts that these are the initial turns of a conversation and that the first turn is treated by the interlocutors as if it were a greeting, will make sure that such a sequence is correctly analyzed as a greeting-greeting pair, even though the first turn is a highly unconventional member of such a pair. Here, we are also interested in this unconventionality, and what effects it might have. While such an exchange might actually conform to the specialized greeting conventions established between a specific pair of coworkers, treating it as just any greeting-greeting would miss crucial aspects of the social actions performed by it, especially if it occurred in a therapeutic context. Heritage has pointed out the risks of concentrating on conventional language in the context of medical interactions1. This is at least as appropriate in the case of psychotherapy. Although psychotherapeutic theory has developed just as much specialized jargon as any profession, in the conversation between patient and therapist, there is no predefined set of conventionalized terms one has to learn in order to participate successfully. Pawelczyk talks of "personalized meanings." For each therapy, patient and therapist invent and locally conventionalize a set of terms and routines together. For the successful analysis of psychotherapeutic interaction, it is necessary to allow for the treatment of (in a global sense) unconventional linguistic and interactional behavior, including not only neologisms, creative imagery, and metaphors but also the omission or delay of expected responses and other forms of non-cooperative communication, as meaningful in its unconventionality. All of these forms of communicative behavior are means to expressing thought processes, intentions, and emotions which the interlocutors are not used to putting into words and for whose expression perhaps no conventionalized means exist, and which the goal of the therapy it is to negotiate and resolve in the personal interaction between therapist and patient. In child therapy, these challenges and difficulties are exacerbated many times. An individualized way of interaction has to be established between the interlocutors, only by means of which conversational meaning can be created. In the conversation we analyze, therapist and patient often ostensibly talk about some object in their surroundings, while at the same time they negotiate a personal issue of the patient in a therapeutically relevant way. In order to show that this is the case, we make use not only of CA methods but also of a broader range of pragmatic analysis as well as insights from clinical experience. However, our analysis is empirically anchored to the observables of the interaction. Psychotherapy talk-in-interaction is accessible to empirical methods beyond introspection.
We provide an interaction analysis of segments from the transcript of the first 20 min of a video-taped child therapy single session conducted in the private practice of the third author2. We present English translations of the German GAT-2 transcripts (Selting et al.,) including descriptions of the bodily behavior of both participants, additionally illustrated by pictures. The entire interaction was divided into segments that constitute therapeutically relevant episodes. We proceed chronologically through the segments, however omitting some of them for reasons of space. Those that are included were selected for showing how some therapeutically relevant development is related to instances of doing or resolving contrariness. For speech acoustic analyses of the same session, see Dreyer. Other analyses with the same material (a qualitative multimethod project) have been published (Brandstetter,; Dreyer,; Hamburger and Bleimling,; Heller,) as part of a collaborative effort from our Berlin-based research network to throw a light on the complexity and variety of information contained in such material by illuminating it from the angles of various disciplines and approaches.
In the first segment, directly from the beginning of the session, we witness how Ina uses conversational non-participation to do contrariness, with the effect of excluding her adopted father from the conversation. The session starts when Ina, just brought in by her adoptive father, puts her head around the door frame to look into the play therapy room:
The therapist offers several greetings to Ina (1-5), who does not respond with a greeting of her own. This constitutes an act of refusing to submit to what Goffman termed "mutual monitoring":
"Persons must sense that they are close enough to be perceived in whatever they are doing, including their experiencing of others, and close enough to be perceived in this sensing of being perceived." (Goffman,, p. 17)
That is just what the therapist attempts to initiate with Ina, after she has been brought in by her adoptive father. People take note of each other in greeting and give a conventionalized signal that they acknowledge the interaction as such. In adult life, greeting response is considered conditionally relevant (Sacks and Schegloff,). A refused greeting can be experienced as a violation of expectations by the greeter and this can potentially be exploited by the non-greeter. A non-greeter does more than just refuse greeting: s/he denies "mutual monitoring" by purposefully violating expectations. Such an omission has been termed a "noticeable absence" by Sacks and Jefferson. Omitting the greeting can here also be considered an instance of "doing contrariness."
Silently Ina takes off her coat (during a long pause, line 6). The therapist initiates the expectable process of saying good-bye to the father as a next step by articulating an expectation: "and NOW?" (line 10). After a pause the father responds with a second position utterance, his slightly extended "Yes" (12). This sequence seems to have no content. However, the situational context indicates that it is time to say good-bye to the father, so that Ina's session can begin. Both adults seem to expect Ina to initiate or at least to contribute to this procedure, none of which she does. Her continued conversational inactivity has strong effects on the "participation framework" (Goodwin,) of the two adults: the therapist now assumes Ina's role and starts the farewell sequence (line 13), indicated by adding "papa" after her "BYE." The therapist seems to "jump in" (Corrin,): she must have deemed a contribution by Ina to be so necessary that not only did she take it upon herself to provide it, but she also performed it as if she were Ina herself. Ina's "doing contrariness" by non-participation in the practice of saying goodbye amounts to refusing to acknowledge the father's presence at all.
The father tries four times, with pauses in between, to get Ina to say goodbye (14-20):but no response from Ina can be elicited although he uses a variety of prosodic contours and lexical expressions to say goodbye. His expectation to be responded to is not fulfilled, and yet he simply tries again and again, instead of explicitly addressing Ina's failure to conform to interactional expectations:we could call this "doing vulnerability," as counterpart to Ina's "doing contrariness." Both adults interpret Ina's "doing contrariness" as repairable via a silent but powerful communicative agreement to further ignore Ina's behavior. The therapist attempts to mitigate the affiliative damage caused by Ina's behavior by acting as a version of Ina that does comply with the adults' expectation. Their agreement is sealed by the father accepting to be vicariously addressed as "Papa" by the therapist:a rather unusual communication among adults. Father and therapist seem to agree to treat the therapists' response in Ina's stead as if it were sufficient "absence of evidence of misunderstanding" (Albert and Ruiter,, p. 281) to be able to treat the entire episode as constituting successful communication.
A new participation framework between Ina and the therapist is eventually established by Ina's first remark, "how good," after the father leaves. That she speaks for the first time only once he leaves, and gives a positive evaluation directly upon his departure indicates that her "doing contrariness" was directed against the father. She is willing to participate but only once he is gone.
We have seen in this first segment how "doing contrariness" (DC) is characterized by behavior that violates conversational expectations and uses this violation to affect the affiliation and emotional ties between participants. Fundamentally, DC makes a contrastive distinction, valuing one side as positive, the other as negative. In this first segment, it is the adoptive father as participant in the interaction who is valued negatively by Ina's refusal to participate until he is gone. Both the act(s) by which DC can be performed and its effects are highly contingent upon the existing affiliative network between the participants and the roles they take on in the conversation: if it had been the therapist who had performed a silent non-participation, this would certainly not have affected the father in the same way. Attempts at repairing DC (which we call "remedying contrariness") must be equally sensitive to the participants' network. The therapist's "jumping in" for Ina, and the father's going along with it, can be seen in this light. This is an action which only repairs the conversational dimension of the disruption Ina has produced in the sense that it at least allows the conversation to proceed in the direction projected by the father and the therapist. The therapist-as-Ina and the father use this role performance to eventually move on beyond Ina's non-participation, but by allowing his multiple attempts at saying goodbye to remain unreciprocated, the father shows that the affiliative damage is left unrepaired. However, under the circumstances, it might have been the least damaging course of action overall. Directly addressing Ina's non-participation and asking her to "correct" it would probably have caused further affiliative damage. Executing a correction implies that the preceding move is faulty or problematic in some aspect, and thus that the sequence is marked/unexpected from the perspective of a smooth discourse progression (Ginzburg et al.,; Lupkowski and Ginzburg,). Between adult speakers, and executed without face-saving actions, a correction would additionally violate conventional social expectations and thus threaten the affiliation between participants. It would be a claim to authority by the correcting speaker and reduce the other speaker's agency. It would thus also be what we call doing contrariness. The therapist (or the father) could have presented Ina's non-participation as such a disruption by attempting to "correct" it with a direct request toward her to participate. This might have "repaired" the conversation by forcing her to contribute, but given Ina's demonstrated contrariness, it would have likely been taken as a rebuke and, instead of repairing the affiliational disruption with Ina, would have instead exacerbated it. Foregoing the opportunity to assert their own deontic authority and power and to incurring some face loss themselves, the therapist and her father spare Ina the face-impairing and emotionally hurtful act of correction. ADC can therefore be distinguished from other repairs by targeting not only the communicative disruption but also the social-affiliative disruption caused by DC; it cannot be performed via an act of DC itself. The type of creative solution the therapist and father use to try to avoid the incurrence of further affiliation cost is often what is needed in psychotherapy in various modes and situations, and one of the reasons it can be so difficult.
"Doing repair," especially self-repair, can help to maintain or improve social relationships (Schegloff,). After one party has violated the other's expectation, repair acknowledges a failure in performing a relevant contribution and accepts the obligation to an undisturbed common sociality. The crucial aspect here consists of acknowledging the other's expectations. In Schegloff's words:
"This is the sense in which these repair positions provide a defense of intersubjectivity. They are the last structurally provided positions because after these positions there is no systematic provision for catching divergent understandings." (Schegloff,, p. 1325)
Young children in medical consultations have often been observed to not respond to greetings (Cahill,). In our case, several attempts at repair do not succeed and leave the affiliation partly damaged. Our analysis of this DC performed through silence shows that the new framework between therapist and Ina has a "history" burdened with this failed repair.
In the following segment, we will further explore the crucial dependence of DC on the role that a participant takes on in a conversation, in that we will see it creating a negative evaluation of part of one's self.
The therapist's question (24), prefaced with a playful interjection of surprise and amazement, is accompanied by a deictic gesture; via her gaze, she points at Ina's jumper. Slightly disparagingly, Ina calls it a baby dress (German "Babykleid") (26). This is contrasted by her subsequent assertion of the "bigness" of the jumper (29).
The therapist initiates the next sequence of questions, "how big?" (30 f.). She suggests a size via gesture (32) and Ina rejects the suggestion via a shaking of her head and a negative interjection (34). The following rhythmical copy of that interjection by the therapist uttered with question intonation (35) resonates at the affiliative level, while also conveying amazement and surprise. The epistemic question of how big the sweater is, repeated in abbreviated form, is replied to by Ina's embodied demonstration (36), responded to by the therapist's surprised response (37) again with a gestural demonstration of size. After a pause (38), suggesting the topic has closed, the therapist takes the topic up again: "And you fit in?" (40), explicitly establishing the link between the jumper's size and Ina's. Ina's strong embodied response (40) demonstrates her body control and strength, signaling that she is already big. Only then follows her spoken confirmation (41). Ina clearly shows a very different attitude to the attribute of "bigness" than to that of baby-like qualities from the beginning of the segment.
Moving to a more therapeutic aspect of the analysis, Ina's disparaging voice when talking about the "baby dress" indicates a distance to the "baby-self" in favor of a more grown-up "child-self," which is as "big" as the jumper. Talking about the size of the jumper implicitly has a bearing on Ina's status as either baby or older child. The jumper is used for a comparative contrast between two available selves, a "big" one and a baby one.
Ina clearly positions herself as being "big," and expresses a negative evaluation toward being "a baby." There are observable indications (disparaging prosody when discussing the "baby dress," augmentative repetition and emphatic prosody when discussing the "bigness," the explicit link made by the therapist between the sweater and Ina, agreed to by her) that the conversation is not only about the sweater, but also between two versions of Ina in play here. Ina distances herself from a version of herself that is "small." While children occasionally express wishes to be more grown up, in this specific case, we take this to be a clinically relevant observation, namely as an indication of a strong negative affect toward her own (past) self, probably related to her traumatic adoption experience. In this section, DC is mostly visible in the negative attitude Ina expresses toward her "baby-self." The contrariness that is being done, the hostile attitude Ina expresses toward herself and the repair efforts undertaken against it is best analyzed from a perspective which understands that Ina can act as either of these roles, the "baby-self" and a "child-self," that are in conflict with each other. We argue that this is an example for how therapeutic observations can work together with CA in an understanding of what happens in therapeutic conversation. An analysis of therapeutic conversation must be able to capture such aspects in order to establish a connection between interactional observation and clinical interpretation and outcome. We suggest that there exists a need in the analysis of child therapeutic conversation both for special attention to unconventional means of creating pragmatic meaning (talking about the sweater as a stand-in for talking about Ina) and for observing long-distance relationships within the discourse progression.
Conversational events and actions diverging from expectations have high epistemic ("novelty") value because they have the potential to increase knowledge by adding unexpected (i.e., new) information. However, they bear the risk of causing affiliative disruptions, especially when concerning issues that the participants are emotionally invested in. For therapeutic practice, this means a delicate balancing task: therapists aim at exploring expectation discrepancies not as disappointments (= violating their own affiliative expectations in order to achieve a high epistemic value) but instead work to combine their high informativity with an effort at restoring the affiliative dimension at the same time. We have seen an attempt at such an other-oriented affiliative repair already when the therapist stood in for Ina saying goodbye to her father. In the following segment, we will see how such an repair attempt can also be self-oriented to prevent a previous action from becoming a disruption and damaging affiliation, literally seeking to avoid doing contrariness. Such a task includes transforming the therapist's own affiliative disappointments (and other affects) into something that is epistemically relevant. We will see how such an attempt can fail.
Both move to play at the table. Ina indicates continuation of a play project from the past session (43). The therapist reformulates Ina's project (45), yet in a slightly different way. Ina declares that she wants to do "it" again with play dough (German "wir machen das wieder mit Knete"), but the therapist asks for confirmation about playing with the dough. It seems that for Ina, playdough is not the actual object of play, but a tool for another play activity. Her non-response to the therapist's clarification question is again a "noticeable absence," indicating a contrast between the two projects, or perhaps an objection to the therapist's question.
Ina tries to assign play roles (48), but her deontic authority is limited; now, it is the therapist who does not respond. Another obstacle materializes: Ina cannot find the playing equipment where she expected it to be (49-52). Noisily, she searches for the play dough baby, without success.
The therapist, after silently observing Ina's activities, starts an account (53), prefaced by "you know what, Ina?," responded to by an intense exchange of gazes. Then follows another preface after a self-repair:the turn construction is interrupted (54) by a reference to what Ina did (55) and a confirmation that the therapist understood what Ina was looking for, with a projected ending with a tag (56), to which Ina agrees by nodding. However, she crosses her arms, a gesture expressing a mood between expectation and defiance. By using several prefacing moves, the therapist attempts to avoid doing DC herself, because she probably suspects that her intention to inform Ina that the baby is "taken to safety" (58) is likely to become troublesome, since Ina is already signaling some discontent.
However, she cannot fully avoid DC here. By opening the can, presenting the playdough baby with "there it is" (63) and "you see" (65), the contrariness is exacerbated: Ina is informed that she was searching in vain while the therapist knew where the baby is, that the therapist did not cooperate in her project. The affiliation framework is at risk, Ina's disappointment might transform into defiance. The therapist attempts to restore a "common ground" by presenting the play dough baby, efforts designed at balancing their epistemic positions by sharing knowledge with her that had been privileged before.
The therapist clearly indicates that she appreciates the complexity of this interaction. She cannot entirely avoid doing contrariness directed at Ina, in the sense of taking an opposing position, because her actions of hiding the figure and only disclosing its location at her own discretion reveal that while Ina might make claims to authority, it is the therapist whose deontic (protecting the doll) and epistemic (determining and knowing its location) authority is actually superior. She tries to mitigate the force of this contrariness via special conversational means, by formulating cautiously, using tags like "right?," and by integrating Ina's perspective with phrases like "you mean...," "look" and "see." In this, she treats Ina as if Ina's and her own claims to authority (epistemic and deontic) were actually balanced, i.e., she affords Ina some authority as if she were an equal, e.g., another adult (Hagemann,; Jefferson,). Her hedges all gently ask for Ina's agreement to the goal that the baby figure should be protected, that in fact the therapist's project, while seemingly contrasted with Ina's, actually aligns with her interests too. In this way, she attempts to convey the epistemic content (the act of revealing the figure's location and her motives for hiding it) without incurring affiliative costs, and to point out ways of conversational negotiation that do not have to involve all the negative effects of "doing contrariness." Ina makes no indication of giving this agreement.
We suggest that the therapist's effort at not doing contrariness has parallels in other aspects of human interaction. Hutchby describes how the child in his case uses "I don't know" sometimes as a game or a strategy. He adds:
"However, at certain points in the child's talk we find evidence that, for him, answering with 'Don't know' is itself a way of producing serious talk. In other words, the child occasionally uses 'Don't know' in such a way as to display that he is not playing a game." (Hutchby,, p. 115)