Talking about paranoid experiences: Interactional dynamics of accomplishing disclosure of psychotic symptoms in triadic conversation

Authors

  • Pertti Olavi Hella Department of psychiatry, Kuopio University Hospital, POB 1777, 70211 Kuopio, Finland; Linguistics; University of Eastern Finland, Joensuu, Finland
  • Jussi Niemi University of Eastern Finland
  • Jani-Matti Tirkkonen University of Eastern Finland
  • Jukka Hintikka University of Tampere and Päijät-Häme Central Hospital
  • Hannu Koponen University of Helsinki and Helsinki University Hospital
  • Heli Koivumaa-Honkanen University of Eastern Finland

DOI:

https://doi.org/10.1558/cam.v12i1.20214

Keywords:

conversation analysis, disclosure of symptoms, family member participation, psychiatric assessment, schizophrenia

Abstract

The present study is the first to investigate, using conversation analysis, the effects of a family member’s participation in conversation regarding the assessment of need for treatment. We aim at describing the course of a treatment negotiation, focusing on interactional dynamics and on disclosure of paranoid symptoms in a clinically challenging situation characterized by an acutely psychotic patient with (1) disorganized discourse, (2) poor insight, (3) aspiration to avoid hospital treatment, and (4) a relative who was supporting in-patient care. In the triadic conversation, in which the patient, his relative, and the psychiatrist participated, different consecutive phases were distinguished. The Relative Prominent Information Phase (RIP) was characterized by the relative’s statements on the patient’s problematic behavior, and conflicting views between the patient and his relative led to denial of symptoms by the patient. When the patient was prominent in the latter Patient Prominent Information Phase (PIP), the display of several different social actions and corresponding linguistic devices were linked with more overt talk about paranoid experiences by the patient, albeit in a disorganized manner. RIP and PIP were followed by an Evaluation and Decision Phase (EDP).

Author Biographies

Jussi Niemi, University of Eastern Finland

Jussi Niemi received his PhD in Phonetics from the university of turku, and before his retirement in 2014 he held Professorship in Linguistics at the university of Eastern Finland at Joensuu. His research interests include psycho- and neuro-linguistic approaches into higher-order (grammatical) language disorders, especially those found in acquired aphasia, autism spectrum disorders, familial (genetic) language impairment, and schizophrenia. In 2007 he was awarded the title of Fellow of the Finnish academy of Science and Letters.

Jani-Matti Tirkkonen, University of Eastern Finland

Jani-Matti Tirkkonen M Ling is affiliated with the Department of Linguistics, University of Eastern Finland Joensuu, Finland.

Jukka Hintikka, University of Tampere and Päijät-Häme Central Hospital

Jukka Hintikka is currently Professor of Psychiatry in the University of Tampere. His research interests include major depression, alexithymia, suicidology, and pessimism.

Hannu Koponen, University of Helsinki and Helsinki University Hospital

Hannu Koponen is currently Professor of Old age Psychiatry in the university of Helsinki. His research interests include major depression and schizophrenia. address for correspondence:

Heli Koivumaa-Honkanen, University of Eastern Finland

Heli Koivumaa-Honkanen received her PhD from the university of turku and is currently Professor of Psychiatry in the University of Eastern Finland. Her research interests include social psychiatry, depression, subjective wellbeing, and public health.

Published

2016-06-07

How to Cite

Hella, P. O., Niemi, J., Tirkkonen, J.-M., Hintikka, J., Koponen, H., & Koivumaa-Honkanen, H. (2016). Talking about paranoid experiences: Interactional dynamics of accomplishing disclosure of psychotic symptoms in triadic conversation. Communication and Medicine, 12(1), 25-40. https://doi.org/10.1558/cam.v12i1.20214

Issue

Section

Articles