Steering interactions away from complaints about persistent symptoms in psychiatric consultations

Authors

  • Shuya Kushida Osaka Kyoiku University
  • Yuriko Yamakawa Ibraki Prefectural University of Health Sciences

DOI:

https://doi.org/10.1558/eap.34850

Keywords:

complaint, conversation analysis, psychiatry

Abstract

In medical encounters, doctors sometimes have to convey views of patients’ problems which are not in line with patients’ views and expectations. One such situation in psychiatric consultations is when the patient complains about symptoms which persist in spite of treatment, while the psychiatrist regards the patient’s condition as not serious enough to adjust treatment or has no satisfactory explanations or solutions. Based on an analysis of video-recorded psychiatric consultations in Japan, this study investigates how psychiatrists cope with such situations and shows that they steer the interaction away from the complaints using a series of moves with which they transform the reported symptoms into evidence that supports their view of the patients’ problems. It is argued that psychiatrists strike a balance between the two potentially conflicting goals of respecting patients’ epistemic authority on their symptoms and minimising inappropriate medication increases.

Author Biographies

  • Shuya Kushida, Osaka Kyoiku University

    Shuya Kushida received his PhD in human and environmental studies from Kyoto University and is currently a Professor at Osaka Kyoiku University, in Kashiwara. His research interests include doctor–patient interaction, conversation analysis, and sociology. He recently published ‘Patients’ practices for taking the initiative in decision-making in outpatient psychiatric consultations’, Communication & Medicine, 13(2): 169–184 (2016).

  • Yuriko Yamakawa, Ibraki Prefectural University of Health Sciences

    Yuriko Yamakawa received her MD and PhD from the University of Tsukuba and is currently a Professor at Ibaraki Prefectural University of Health Sciences, Ami. Her research interests include psychiatry, mental health, and rehabilitation psychology. She recently published ‘Patients’ practices for taking the initiative in decision-making in outpatient psychiatric consultations’, Communication & Medicine, 13(2): 169–184 (2016).

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Published

2018-04-17

How to Cite

Kushida, S., & Yamakawa, Y. (2018). Steering interactions away from complaints about persistent symptoms in psychiatric consultations. East Asian Pragmatics, 3(1), 91-123. https://doi.org/10.1558/eap.34850