Trouble-talk in therapist–resident encounters

A case-study of an individual with acquired brain injury

Authors

  • Charlotte Marie Bisgaard Klemmensen Aalborg University

DOI:

https://doi.org/10.1558/cam.19660

Keywords:

acquired brain injury alignment, aphasia, person-centered institutional care, repair, trouble-talk

Abstract

This article focuses on what can be labelled ‘trouble-talk’, and in particular how it is initiated and responded to in therapist–resident encounters. It adopts the perspective of an individual with acquired brain injury. The study is based on a video ethnography of interaction, targeted at identifying trouble-talk and its interactional consequences, and it was carried out in a Danish care home facility for residents with this kind of injury. Encounters involving a case resident, an occupational therapist, a social worker (pædagog) and participant researchers were video recorded (totaling 30 hours) during fieldwork over one year, between 2012 and 2013. The dataset has been analyzed through a combination of discourse analysis and ethnomethodological conversation analysis.

The findings show that when the resident takes initiatives and/or makes criticisms, this may be heard by the occupational therapist as complaints about institutional life in general and/or as talking gibberish. Such perceived trouble-talk is responded to by the occupational therapist with misalignment and repair work. In general, trouble-talk is co-constructed; however, it is accentuated by the occupational therapist’s response, which suggests an undesired institutional ramification. In promoting awareness of the impact of impairments on interaction, I discuss how trouble-talk is emergent in the interaction itself and in what ways it can be resolved or minimized.

Author Biography

  • Charlotte Marie Bisgaard Klemmensen, Aalborg University

    Charlotte Marie Bisgaard Klemmensen is Visiting Researcher at Aalborg University. She does research on interaction and institutional discourse within interdisciplinary discourse studies, language psychology and integrational linguistics. She is author of Integrating the Participants’ Perspective in the Study of Language and Communication Disorders: Towards a New Analytical Approach (2018, Palgrave Macmillan).

References

Antaki, Charles and Ray Wilkinson (2013) Con­versation analysis and the study of atypical populations. In Jack Sidnell and Tanya Stivers (eds) Handbook of Conversation Analysis, 533–550. Oxford: Blackwell. https://doi.org/10.1002/9781118325001.ch26

Coulter, Jeff (1975) Perceptual accounts and inter­pretive asymmetries. Sociology 9 (3): 385–396. https://doi.org/10.1177/003803857500900301

Drew, Paul (1997) ‘Open’ class repair initiators in response to sequential sources of troubles in conversation. Journal of Pragmatics 28 (1): 69–101. https://doi.org/10.1016/S0378-2166(97)89759-7

Goffman, Erwin (1981) Forms of Talk. Philadelphia: University of Pennsylvania Press.

Goode, David (ed.) (1994) Quality of Life for Persons with Disabilities: International Perspectives and Issues. Cambridge, MA: Brookline Books.

Goodwin, Charles (1979) The interactive construction of a sentence in natural conversation. In George Psathas (ed.) Everyday Language: Studies in Ethnomethodology, 97–121. New York: Irvington.

Goodwin, Charles (1995) Co-constructing meaning in conversation with an aphasic man. Research on Language and Social Interaction 28 (3): 233–260. https://psycnet.apa.org/doi/10.1207/s15327973rlsi2803_4

Goodwin, Charles (2000) Action and embodiment within human interaction. Journal of Pragmatics 32 (10): 1489–1522. https://doi.org/10.1016/S0378-2166(99)00096-X

Goodwin, Charles (ed.) (2003) Conversation and Brain Damage. Oxford: Oxford University Press.

Goodwin, Charles and Marjorie Goodwin (2004) Participation. In Alessandro Duranti (ed.) A Companion to Linguistic Anthropology, 222–244. Oxford: Blackwell Publishing. https://doi.org/10.1002/9780470996522.ch10

Goodwin, Marjorie, Asta Cekaite and Charles Goodwin (2012) Emotion as stance. In Anssi Peräkylä and Marja-Leena Sorjonen (eds) Emotion in Interaction, 16–41. Oxford: Oxford University Press. https://doi.org/10.1093/acprof:oso/9780199730735.003.0002

Jefferson, Gail (1988) On the sequential organiza­tion of troubles-talk in ordinary conversation. Social Problems 35 (4): 418–441. https://doi.org/10.2307/800595

Jordan, Brigitte and Austin Henderson (1995) Interaction analysis: Foundations and practice. Journal of the Learning Sciences 4 (1): 39–103. https://psycnet.apa.org/doi/10.1207/s15327809jls0401_2

Klippi, Anu (2015) Pointing as an embodied practice in aphasic interaction. Aphasiology 29 (3): 337–354. https://doi.org/10.1080/02687038.2013.878451

Kupferberg, Irit and David Green (2005) Troubled Talk: Metaphorical Negotiation in Problem Discourse. Berlin: Mouton de Gruyter. https://doi.org/10.1515/9783110897630

Laurier, Eric (2014) Noticing talk, gestures, move­ment and objects in video analysis. In R. Lee, N. Castree, R. Kitchin, V. Lawson, A. Paasi, C. Philo, S. Radcliffe, S. Roberts and C. Withers (eds) The SAGE Handbook of Human Geography, 250–272. London: Sage. https://doi.org/10.1111/nzg.12090

Mondada, Lorenza (2014) Conventions for Multi­modal Transcription (version 3.0.1). Online: https://mainly.sciencesconf.org/conference/mainly/pages/Mondada2013_conv_multimodality_copie.pdf

National rapport [National Report] (2020) Indtryk udtryk kvartalsrapport 4. rapport 1. februar til 30. april – hele landet. [Impression Expression Quarterly Report: 4th Report. February 1 to April 30 – Nationwide]. Online: https://indtryk-og-udtryk.dk/wp-content/uploads/2020/06/National-rapport-1.5.19-30.4.20.pdf

Nielsen, Sarah, Kasper Boye, Roelien Bastiaanse and Violaine Lange (2019) The production of grammatical and lexical determiners in Broca’s aphasia. Language, Cognition and Neuroscience 34 (8): 1027–1040. https://doi.org/10.1080/23273798.2019.1616104

Perkins, Lisa (2003) Negotiating repair in aphasic conversation: Interactional issues. In Charles Goodwin (ed.) Conversation and Brain Damage, 147–162. Oxford: Oxford University Press.

Roberts, Celia and Srikant Sarangi (1999) Hybridity in gatekeeping discourse: Issues of practical relevance for the researcher. In Srikant Sarangi and Celia Roberts (eds) Talk, Work and Institutional Order: Discourse in Medical, Mediation and Management Settings, 473–504. Berlin: Mouton de Gruyter. https://doi.org/10.1515/9783110208375.4.473

Sacks, Harvey (1992) Lectures on Conversation (2 vols). Oxford: Blackwell.

Sacks, Harvey, Emanuel Schegloff and Gail Jefferson (1974) A simplest systematics for the organization of turn-taking for conversation. Language 50 (4): 696–735. https://doi.org/10.2307/412243

Schegloff, Emanuel (1992) Repair after next turn: The last structurally provided defense of inter­subjectivity in conversation. American Journal of Sociology 97 (5): 1295–1345. https://psycnet.apa.org/doi/10.1086/229903

Schegloff, Emanuel, Gail Jefferson and Harvey Sacks (1977) The preference for self-correction in the organization of repair in conversation. Language 53 (2): 361–382. https://doi.org/10.2307/413107

Scollon, Ron and Suzie Scollon (2004) Nexus Analysis: Discourse and the Emerging Internet. London: Routledge.

ten Have, Paul (2004) Understanding Qualitative Research and Ethnomethodology. London: Sage.

Tranekjær, Louise (2015) Gatekeeping – An inter­actional and ideological process. In Interactional Categorization and Gatekeeping: Institutional Encounters with Otherness, 53–88. Bristol, UK: Multilingual Matters. https://doi.org/10.21832/9781783093687

Wilkinson, Ray (2011) Changing interactional behavior: Using conversation analysis in inter­vention programmes for aphasic conversation. In Charles Antaki (ed.) Applied Conversation Analysis: Intervention and Change in Institutional Talk, 32–53. London: Palgrave Macmillan. https://doi.org/10.1057/9780230316874_3

Wilkinson, Ray, John Rae and Gitte Rasmussen (2020) Atypical interaction: An introduction. In Ray Wilkinson, John Rae and Gitte Rasmussen (eds) Atypical Interaction: The Impact of Communicat­ive Impairments within Everyday Talk, 1–36. Cham, Switzerland: Palgrave Macmillan. https://doi.org/10.1007/978-3-030-28799-3

Wong, Jean and David Olsher (2000) Reflections on conversation analysis and nonnative speaker talk: An interview with Emanuel A. Schegloff. Issues in Applied Linguistics 11 (1): 111–128. Online: https://escholarship.org/uc/item/3kk0j6w8

World Health Organization (1995) WHOQOL-100: Measuring Quality of Life. Geneva: WHO. Online: https://www.who.int/tools/whoqol/whoqol-100

World Health Organization (2001) International Classification of Functioning, Disability and Health (ICF). Geneva: WHO. Online: https://www.who.int/classifications/international-classification-of-functioning-disability-and-health

World Health Organization (2013) How to Use the ICF: A Practical Manual for Using the Inter­national Classification of Functioning, Dis­ability and Health (ICF). Geneva: WHO. Online: https://www.who.int/classifications/drafticfpracticalmanual.pdf

Published

2022-05-04

Issue

Section

Articles

How to Cite

Klemmensen, C. M. B. (2022). Trouble-talk in therapist–resident encounters: A case-study of an individual with acquired brain injury. Communication and Medicine, 17(3), 243–256. https://doi.org/10.1558/cam.19660