Otherness in the Clinical Borderlands
Clinical practice represents a kind of cultural borderland territory bringing together people from different walks of life with distinctive social experiences and expectations related to gender, age, status, and health, to name a few, who otherwise might not encounter one another (Mattingly, 2010). In these borderland encounters, culture is realized and made relevant during moments of social differentiation. This paper focuses on how such social differences manifest themselves in clinical discourse through encounters with otherness—otherness referring to a negative cultural capacity to transform those who are different into devalued Others. Interrelated themes of space, change and transformation, group membership categorization, and the structuring of participation in clinical interaction are used as an exploratory framework to illuminate the construction of otherness. By conceiving of the clinical world as a territory where otherness is woven into the experiences of those we are seeking to help, it is hoped that practitioners will be encouraged to develop a more nuanced understanding of clinical practice as cultural borderlands.
Antaki, C. and Widdicombe, S. (1998). Identities in Talk. Thousand Oaks, CA: Sage.
Bammer, A. (1994). Displacements: Cultural identities in question. Bloomington, IN: Indiana University Press.
Bhabha, H. K. (1994). The Location of Culture. New York: Routledge.
Bucholtz, M. and Hall, K. (2005). Identity and interaction: A sociolinguistic approach. Discourse Studies 7 (4–5), 585–614. https://doi.org/10.1177/1461445605054407
Cotton, N. S. and Geraty, R. G. (1984). Therapeutic space design: Planning an inpatient children’s unit. American Journal of Orthopsychiatry 54 (4), 624–636. https://doi.org/10.1111/j.1939-0025.1984.tb01532.x
Chubrich, R. E. (1978). Session obsession: A former client looks at therapy. Journal of the National Student Speech and Hearing Association, 6, 70–78.
Clifford, J. (1988). The Predicament of Culture. Cambridge, MA: Harvard University Press.
Damico, J. S. (1990). Prescriptionism as a motivating mechanism: An ethnographic study in the public schools. Journal of Childhood Communication Disorders 13 (1), 85–92. https://doi.org/10.1177/152574019001300109
Damico, J. S. and Damico, S. K. (1997). The establishment of a dominant interpretive framework in language intervention. Language, Speech, and Hearing Services in Schools 28, 288–296. https://doi.org/10.1044/0161-1461.2803.288
Delpit, L. D. (1991). The silenced dialogue: Power and pedagogy in educating other people’s children. In M. Minami and B. P. Kennedy (Eds), Language Issues in Literacy and Bilingual/multicultural Education, 483–502. Cambridge, MA: Harvard Educational Review.
Duchan, J. F. (2001). Impairment and social views of speech-language pathology: Clinical practices re-examined. Advances in Speech-Language Pathology 3 (1), 37–45. https://doi.org/10.3109/14417040109003707
Foster-Galasso, M. L. (2005). Diagnosis as an aid and a curse in dealing with others. In J. Duchan and D. Kovarsky (Eds), Diagnosis as Cultural Practice, 17–32. New York: Mouton de Gruyter. https://doi.org/10.1515/9783110199802.17
Fourie, R. J., and Murphy, M. (2011). Alienation and therapeutic connection. Journal of Interactional Research in Communication Disorders 2 (1), 1–28. https://doi.org/10.1558/jircd.v2i1.1
Gilyard, K. (1991). Voices of the Self. Detroit, MI: Wayne State University Press.
Hymes, D. (1964). Toward ethnographies of communication. American Anthropologist, 66 (6), 1–34. https://doi.org/10.1525/aa.1964.66.suppl_3.02a00010
Johnson, W. (1948). Speech and personality. In L. Bryson (Ed.), The Communication of ideas, 53–78. New York: Institute for Religious and Social Studies.
Kilito, A. (1994). Dog words. In A. Bammer (Ed.), Cultural Identities in Question, xi–xx. Bloomington, IN: Indiana University Press.
Kovarsky, D. (2016). A retrospective look at the ethnography of communication disorders. Journal of Interactional Research in Communication Disorders, 7 (1), 1–25. https://doi.org/10.1558/jircd.v7i1.27511
Kovarsky, D. (2001). Ruminating on impairment-based assessment and intervention. Advances in Speech-Language Pathology, 3 (1), 59–62. https://doi.org/10.3109/14417040109003711
Kovarsky, D. and Maxwell, M. (1992). Ethnography and the clinical setting: Communicative expectancies and clinical discourse. Topics in Language Disorders, 12 (3), 76–84. https://doi.org/10.1097/00011363-199205000-00009
Kovarsky, D. and Walsh, I. (2011). The discursive construction of language disorders. In C. N. Candlin and J. Crichton (Eds), Discourses of Deficit, 195–214. Basingstoke: Palgrave Macmillan. https://doi.org/10.1057/9780230299023_11
Kovarsky, D., Curran, M., and Zobel Nichols, N. (2009). Laughter and communicative engagement in interaction. Seminars in Speech and Language, 30 (1), 27–36. https://doi.org/10.1055/s-0028-1104532
Kovarsky, D., Kimbarow, M., and Kastner, D. (1999). The construction of incompetence during group therapy with traumatically brain injured adults. In D. Kovarsky, J. Duchan, and M. Maxwell (Eds), Constructing (In)competence, 291–312. Mahwah, NJ: Erlbaum.
Kovarsky, D., Shaw, A., and Adingono-Smith, M. (2007). The construction of identity during group therapy among adults with traumatic brain injury. Communication and Medicine, 4 (1), 53–66. https://doi.org/10.1515/CAM.2007.029Mattingly, C. (1998). Healing Dramas and Clinical Plots. Cambridge: Cambridge University Press. https://doi.org/10.1017/CBO9781139167017
Mattingly, C. (2010). The Paradox of Hope. Journeys Through a Cultural Borderland. Berkeley, CA: University of California Press.
Maxwell, M. (1993). Conflict talk in a professional meeting. ASHA Monographs, 30, 68–91.
Maxwell, M., Poeppelmeyer, D., and Polich, L. (1999). Deaf members and nonmembers: The creation of culture through communication practices. In D. Kovarsky, J. Duchan and M. Maxwell (Eds), Constructing (In)competence, 125–148. Mahwah, NJ: Erlbaum.
Philips, S. (1972). Participant structures and communicative competence. In C. B. Cazden, V. P. John, and D. Hymes (Eds), Functions of Language in the Classroom, 370–394. New York: Teachers College Press.
Rickford, J. R., and Rickford, R. J. (2000). Education. In J. R. Rickford and R. J. Rickford, Spoken Soul: The Story of Black English, 163–180. New York: John Wiley and Sons.
Ripich, D. and Panagos, J. M. (1985). Assessing children’s knowledge of sociolinguistic rules for speech therapy lessons. Journal of Speech and Hearing Disorders, 50, 335–356. https://doi.org/10.1044/jshd.5004.335
Robillard, A. B. (1999). Meaning of a Disability: The Lived Experience of Paralysis. Philadelphia, PA: Temple University Press.
Rosaldo, R. (1989). Culture and Truth. Boston, MA: Beacon Press.
Shadden, B. (2005). Aphasia as identity theft: Theory and prctice. Aphasiology, 19 (3–5), 211–223. https://doi.org/10.1080/02687930444000697
Simmons-Mackie, N. and Damico, J. S. (1999). Social role negotiation in aphasia therapy. In D. Kovarsky, J. Duchan, and M. Maxwell (Eds), Constructing (In)competence, 313–342. Mahwah, NJ: Erlbaum.
Simmons-Mackie, N., and Damico, J. S. (2001). Intervention outcomes: A clinical application of qualitative methods. Topics in Language Disorders, 22 (1), 21–36. https://doi.org/10.1097/00011363-200111000-00004
Simmons-Mackie, N. and Damico, J. S. (2011). Counseling and aphasia treatment. Topics in Language Disorders, 31 (4), 336–351. https://doi.org/10.1097/TLD.0b013e318234ea9f
Simmons-Mackie, N., Elman, R., Holland, A., and Damico, J. (2007). Management of discourse in group therapy for adults. Topics in Language Disorders, 27 (1), 5–23. https://doi.org/10.1097/00011363-200701000-00003
Stichler, J. F. (2001). Creating healing environments in critical care units. Critical Care Nursing Quarterly, 24, 1–20. https://doi.org/10.1097/00002727-200111000-00002
Stillman, R., Snow, R., and Warren, K. (1999). ‘I used to be good with kids.’ Encounters between speech-language pathology students and children with pervasive developmental disorder. In D. Kovarsky, J. Duchan, and M. Maxwell (Eds), Constructing (In)competence, 313–341. Mahwah, NJ: Erlbaum.
Tomblin, J. B. (2008). Validating diagnostic standards for specific language impairments using adolescent outcomes. In C. Frazier Norbury, J. B. Tomblin, and D. V. M. Bishop (Eds), Understanding Developmental Language Disorders, 93–122. London: Psychology Press.
Van Riper, C. (1939). Speech Correction: Principles and Methods. New York: Prentice-Hall.
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