In over 10 years of collaboration between psychotherapists working with the ‘Conversational Model’ (CM: Meares 2005) and Systemic Functional linguists (Webster 2015), the central purpose of our research (including an NHMRC project) was to make explicit the modes of talk which brought about change between traumatised patients (BPD) and their therapists. From the point of view of the linguists, the core language principles that emerged aligned in name and function with clinical ideas which themselves have drawn increasing emphasis from practitioners in the CM (Meares 2012; and Meares et al. 2012). These principles might be referred to as ‘cohesion’ and ‘construal in context’. These terms, as findings, are outlined in this talk.
The methods of analysis in the research included the detailed comparison of critical transitions in patient and therapist interactions, using transcripts marked by therapists for clinical significance (although with the potential to be construed in different ways). Details of this method are illustrated through examples (Butt, Moore, and Henderson-Brooks 2012). What concerns me most in this talk, however, is the degree to which the linguist’s view of language was itself renewed within a biological and pragmatist framework of the “self” (Meares 2012).
Adopt a new perspective on linguistic evidence in psychotherapeutic discourse, in particular with respect to the central concepts of the Conversational Model of Psychotherapy. For instance, the word ‘grammar’ is usually associated with prescriptivism; but here it is used as a means of evaluating the consistency of choices made by patient and therapist, and the way a conflicted self may develop a wider meaning potential both within the stages of a particular consultation and across a series of interactions.
The ‘grammar’ of empathy is a metaphor for the moves a therapist makes to open up these meaning spaces. Participants, even as students, will be able to introduce into their clinical work some aspects of textual comparison which can be quantified and invoked as evidence of the semantic ‘drift’ in an interaction. Such ‘drift’ can be graphed, and subject to explicit debate and interpretation. Examine the central notion of the duplex “self”, as argued by William James, and reconsider the role of grammar in constructing the mental pathways (the semiotic resources) for James’s ME/I distinction. James himself used grammar as a means of setting out his insight and this approach offers students and experts a fresh angle on a difficult concept.
Human beings develop in connected relationships, commencing with the touch, gaze, voice and affective tone of the proto-conversation and the sequencing of activities that tend to care, safety, comfort and play, extending to the therapeutic context where psychotherapy is the base for a healing relationship that fosters post-traumatic transformation, often mutual. Connectivity is constructed at every level of the individual and interpersonal systems: neurons fire and wire together, autonomic nervous systems are in conversation and the “soft wiring” and intrapersonal connections slowly unfold.
The Bare Essentials of the Conversational Model By Tony Korner Selves in Conversation Humans live in a language environment as much as they live in a physical one. Throughout life we are faced with decisions (or ‘motivated selections’) about whether to associate through language or to dissociate through non-communication. Each person’s life gets shaped by these decisions, many of which occur unconsciously under the influence of traumatic experience. Each self has the form of a story, an incomplete one. Dissociation, relating to trauma, is an important reason for this incompleteness.
The sense of self is inextricably connected to language, itself an intrinsically collective phenomenon with a life independent of individuals. If feeling provides an internal value system for self, then language can be thought of as providing an external value system, variably appropriated by individuals. Language consists of a network of differences; of relations within its own network; of shades of meaning. Its living qualities provide a gateway to “forms of life”. Communicative exchanges begin within a largely affective, indexical context: the proto-conversation.
The emergence and development of The Conversational Model of Psychotherapy over the last 35 or so years arose out of a belief that models of psychotherapy ought to have a scientific basis. The key elements of the conversational model are dependent upon some key assumptions. These are that normal development is dependent upon our early infant and childhood relationships being able to meet our age appropriate needs. In time these relational experiences allow us to generate particularly integrated, reflective states of mind that we can call self and identify as health. Disruptions to that development (trauma) prevent the normal development of our cohesive, integrated and reflective sense of self. As a result we and others experience ourselves/us as living in a variety of fragmented, dissociative states that generate symptom clusters that are identified as pathology.
To the layperson, narcissism is most often associated with arrogant, conceited, entitled behaviours which are captured by the term narcissistic grandiosity. This is consistent with common expressions of maladaptive behaviour such as self-enhancement and lack of empathy characterised by pathological narcissism. There is an emerging contemporary clinical model of pathological narcissism that combines grandiosity with clinically important regulatory impairment that leads to self, emotional and behavioural dysregulation in response to threats to self or failures of self-enhancement.