Speaking on behalf of Patients in Group Interactions in an Intellectual Disability Medical Care Setting

• In Event: 146 - Regular Session. Asymmetries in Medical Care: Using Conversation Analysis to Understand the Practice of Medicine

Abstract

Although reported speech and constructed dialogue have been well researched, there has been significantly less investigation in conversation analytic literature of how interactants voice a non-present person’s internal monologue, and the actions this may accomplish. This paper explores this phenomenon in staff interactions during an intervention called Discovery Awareness (DA). DA aims to support staff who work with people with intellectual disabilities and challenging behaviour through video analysis of the person; the objective is to become more attuned to the patient and to try to see the world from their point of view. This research has found that this interactional context leads to the recurring use of ‘imagined constructed inner dialogue’ whereby the staff narrate using a first person pronoun what the patient may be thinking in a particular part of the video clip. This paper argues that the use of imagined constructed dialogue allows participants in DA session to engage in complex interactional work which builds vivid descriptions of the patient they are seeking to understand better. The participants use this form to make assessments, empathise with the patient, evidence their points and summarize the gist of what others say. In sum, it is an extremely versatile way of enacting a variety of complex epistemic and empathic actions.

Authors

• joseph webb, University of Nottingham

• Alison Pilnick, University of Nottingham

• Jennifer Clegg, University of Nottingham