Psychotherapy is polyphonic – it is science, craft, and art. Consequently, its exposition swings between two principles or poles of knowledge – metaphor and measurement. As suggested in its title, the Conversational Model of psychotherapy (CM) draws on language both as an instrument of rational, forensic enquiry, and as a mode of healing, which demands acts of insight. Forms of language are central to the theory and to the techniques that practitioners share (the techne/ τέχνη in the debates of Socrates). But the terminology and the complex experiences that motivate the concepts of the CM are not drawn directly from the science of linguistics. We can set out by asking: is this a problem, or even a limiting condition, for the plausibility and the development of the theory in psychiatry?
This discussion will examine the ‘language’ of the model, seeking the mutual relations between terms adopted and whether or not there are congruent concepts from the linguistic theory developed by M.A.K. Halliday (1925-2017) – ie Systemic Functional Linguistics (SFL). Halliday referred to “ineffability” in a technical sense: specifically, the problems in establishing categories of function or meaning in the grammar of a natural language. There is a strong parallel here with conundrums in proposing and applying categories in all human sciences, in particular in sciences of the mind. Nevertheless, tasks of description must be managed, and the efficacy of actions (even actions with words) needs to be evaluated.
The review of concepts and terms will include a spectrum of ideas from Meares’s writings on personal being, for example: the interactional moves amplification, coupling, and representation; the distinctions around narrative; various ideas around metaphor/metonymy; the uses of analogy vs homology; “analogical fit”; dissociation, and the growing emphasis on cohesion (carrying us back to the “co-ordination” of Hughlings Jackson and Ribot in the mid C19th). I will link these to the growing emphasis on language metaphors in the work of neuroscientists (eg. biological idiom; leitmotif: Damasio on the “self”). I broaden the discussion to include the shifts of grammar that Halliday has characterized as “grammatical metaphor”. Also considered are how non-worded aspects of interaction (viz. context and silences) might be incorporated in a linguistic theory that addresses the complexity of therapeutic contexts.