Discourse Analysis and Public Life: The Political Interview and Doctor-Patient Conversation. Papers from the Groningen Conference on Medical and Political Discourse 9783110870497, 9783110132908

Citation preview

Discourse Analysis and Public Life

T. Ensink, A. van Essen and T. van der Geest (eds.)

DISCOURSE ANALYSIS AND PUBLIC LIFE Papers of the Groningen Conference on Medical and Political Discourse

¥

1986 FORIS P U B L I C A T I O N S Dordrecht - Holland/Providence - U.S.A.

Published by: Foris Publications Holland P.O. Box 509 3300 A M Dordrecht, The Netherlands Sole Distributor for the U.S.A. and Canada: Foris Publications USA, Inc. P.O. Box 5904 Providence RI 02903 U.S.A. CIP-DATA Discourse Discourse Analysis and Public Life: Papers of the Groningen Conference on Medical and Political Discourse / Titus Ensink, Arthur van Essen, Ton van der Geest (eds.). - Dordrecht [etc.]: Foris With index, ref. ISBN 90-6765-149-4 SISO 499.4 UDC 371.334:[614.253+32-057.1] Subject headings: medical discourse / political discourse.

ISBN 90 67651494 © 1986 By the authors No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retreival system, without permission from the copyright owner. Printed in the Netherlands by ICG Printing, Dordrecht.

CONTENTS

Contributors T. Ensink, A. van Essen and T. van der Geest The relevance of discourse analysis 1 MEDICAL DISCOURSE 1

C.N. Candlin and J. Lucas Interpretations and explanations in discourse: modes of 'advising' in family planning 13 P. ten Have Comments

2

S. Fisher and A. D. Todd Friendly persuasion: the negotiation of decisions to use oral contraceptives 45

3

T. van der Geest A quatitative pragmatic analysis of discourse: Some theoretical and practical implications 73 J.H.M. Ettema Comments

4

M. Bax Feelings for feelings: expressive information and its role in doctorpatient communication 101 M. Fahrenfort Comments

5

J. Berenst Conversation control in doctor patient interaction D. Springorum Comments

123

VI 6

D.M. van Bijsterveld Notes on 'privacy' in conversations with schizophrenic patients

147

A. van Berkel Comments 7

D. Fehlenberg The evaluation of discourse structures with a probablistic approach. The case of the psychosomatic ward round

sequential 167

P. ten Have Comments 8

H. Houtkoop-Steenstra Summarizing in doctor-patien interaction

201

M. Fahrenfort Comments

POLITICAL DISCOURSE 9

W. Labov and T. Labov Public discourse and the problem of social order

225

D. Franck Comments 10

J. Schwitalla Conversational analysis ofpoltical A diachronic survey 255

interviews.

R. Grootendorst Comments 11

E.G. Bormann Fantasy theme analysis of presidential debates

289

D. Springorum Comments 12

F. van Eemeren The normative reconstruction of argumentative discourse. An illustration of its efficacy in the analysis of the confrontation stage in a political discussion 310 A. van Berkel Comments

VII

13 T. Ensink Political interviews

331

R. Grootendorst Comments 14 P. van Lint The expressive strategy in the political interviews: A system error 15

J.G. Stappers General discussion of Political Discourse

REFERENCES

385

379

359

The relevance of discourse analysis Titus Ensink, Arthur van Essen and Ton van der Geest

Up to a point a good many social problems may be regarded as c o m m u n i c a t i v e problems. Thus in psychiatry the problem of s c h i z o p h r e n i a m a y be v i e w e d as a d i s o r d e r f o u n d in the schizophrenic individual. Alternatively, it may be seen as a c o m m u n i c a t i v e problem to be found in the c o m m u n i c a t i v e network between the individual who is considered a schizophrenic and people in his environment (Bateson 1972: 201-227). Similary, the problem of getting opportunities in education may be regarded as a problem of intelligence and abilities of the individual pupil. It may, however, also be understood as a problem occurring in the c o m m u n i c a t i o n between the school and the pupil. More specifically, the problem may be the result of discrepancies between the c o m m u n i c a t i v e system of the school on the one hand, and the c o m m u n i c a t i v e system to which the pupil is accustomed, on the other. However, c o m m u n i c a t i o n may break d o w n not only as a result of discrepancies between the communicative systems of the participants involved in a conversation. The quality of the c o m m u n i c a t i o n itself may be another contributory factor, as it m a y d i v e r g e f r o m w h a t m a y be c a l l e d a d e q u a t e , a p p r o priate, or effective standards of s p e c i f i c c o m m u n i c a t i o n types. Other areas of social life may be mentioned here as well. In interethnic contacts, in contacts between citizens and the authorities, in contacts between doctors and patients, or in business negotiations, the problems that may arise may be taken either as problems that are peculiar to the situation concerned, or as problems that are caused by discrepancies in the communicative means which are used by those involved in the situation. It is clear, then, that one point of view calls for other solutions to the problems at issue than does the other point of view. If o n e a d o p t s the p o i n t of v i e w t h a t m a n y of the s o c i a l

2 problems mentioned so far are c o m m u n i c a t i v e in nature, several questions present themselves. The first is whether c o m municative problems are the core of the social problem or just a manifestation of other problems, be they psychologic a l , c u l t u r a l , t e c h n o l o g i c a l , or w h a t e v e r . In the f o r m e r case, a change in c o m m u n i c a t i v e habits might offer a solution; in the latter, c o m m u n i c a t i v e habits as they interact with other aspects of the social organization have to be the focus of attention. The second question is which aspects of c o m m u n i c a t i o n are involved in the problem. The use of different c o m m u n i c a t i v e codes (without one party noticing the use of a different code by the other party); discrepancies between the different channels of c o m m u n i c a t i o n (as between the verbal channel and the paraverbal or behavioural channel); different s t o r e s of k n o w l e d g e or e x p e r t i s e t h a t are d r a w n u p o n in c o m m u n i c a t i o n (again: without one party noticing that the other party has different knowledge at his disposal): all these are communicative if different causes of social problems. And while one cause may be operative in one social area, it may be absent from another. A third point may concern the question as to whether appropriate or inappropriate means (both in a c o m m u n i c a t i v e and in a social sense) are used for a specific c o m m u n i c a t i v e situation. As most c o m m u n i c a t i o n is organized in forms of verbal interaction, an analysis of the social problems as they occur in c o m m u n i c a t i o n should be directed t o w a r d s these forms. Verbal i n t e r a c t i o n , or d i s c o u r s e , is the s p e c i f i c d o m a i n of Sociolinguistics. During the last two decades Sociolinguistics has evolved into an important subfield of both Linguistics and the Social Sciences, and in it, several approaches converge. One trend in Sociolinguistics -the 'macro' trendis directed towards the establishment of relations b e t w e e n society at large and aspects of language structure, notably those aspects which exhibit stratification across relevant s o c i a l g r o u p s . A f r e s h a n d c o n s i d e r a b l e i m p e t u s to the growth of Sociolinguistics was given when the stratification of different linguistic b e h a v i o u r s a c r o s s s o c i a l c l a s s e s became a central concern of investigators. Especially when attempts were made to bring the results of these investigations to bear on educational policies, the feasibility to develop a discipline that would have a good deal of social

3 a p p l i c a b i l i t y s e e m e d to c o m e in sight. That g a v e a p o w e r f u l boost to S o c i o l i n g u i s t i c s , w h i c h from then on b e g a n to attract an i n c r e a s i n g n u m b e r of students. H y m e s , a d m i t t e d l y the m o s t e l o q u e n t p r o g r a m m a t i c author in the field of S o c i o l i n g u i s t i c s , in h i s paper "The scope of S o c i o l i n g u i s t i c s " d r e w a d i s t i n c t i o n b e t w e e n a 'socially r e a l i s t i c linguistics' on the one hand (under w h i c h heading w o u l d c o m e the t y p e of m a c r o - s o c i o l i n g u i s t i c s r e f e r r e d to above, as well as the kind of m i c r o - s o c i o l i n g u i s t i c s w h i c h is o r i e n t e d t o w a r d s the a n a l y s i s of m e a n i n g and s p e e c h a c t s in t h e i r d e p e n d e n c e u p o n s o c i a l c o n t e x t ) and a ' s o c i a l l y c o n s t i t u t e d 1 inguistics' on the other. H y m e s h i m s e l f came d o w n on the side of the latter, in w h i c h the social f u n c t i o n a l i t y of l a n g u a g e u s e w a s t o o c c u p y a c e n t r a l p o s i t i o n . From a r e a l i s t i c p o i n t of v i e w such an a p p r o a c h has a d e c i d ed a d v a n t a g e : the f u n c t i o n a l p e r s p e c t i v e e n a b l e s one to adopt a t h e o r e t i c a l p o s i t i o n w h i c h , at l e a s t in p r i n c i p l e , i s e m p i r i c a l l y c o r r e c t . B u t it a l s o p r o v i d e s a b a s i s o n w h i c h a s o c i a l l y r e l e v a n t d i s c i p l i n e c a n be e r e c t e d : "The g o a l s of social r e l e v a n c e a n d social r e a l i s m can i n d e e d be a c c o m p l i s h e d only f r o m the s t a n d p o i n t of the n e w c o n c e p t i o n (i.e. s o c i a l l y c o n s t i t u t e d l i n g u i s tics), for m u c h of w h a t m u s t be t a k e n into a c c o u n t , m u c h of w h a t is there, o r g a n i z e d and used, in actual s p e e c h , c a n o n l y b e s e e n , l e t a l o n e be u n d e r s t o o d , w h e n one s t a r t s f r o m f u n c t i o n and l o o k s for the s t r u c ture

that

serves

it." Hymes (1977:

197)

R e v i e w i n g the p r e s e n t state of the art, one can only c o n c l u d e that s o c i o l i n g u i s t i c s h a s e v o l v e d into a b r a n c h of a 'socially r e a l i s t i c linguistics': r e s e a r c h is being c a r r i e d out on i s s u e s b e a r i n g on the r e l a t i o n s h i p b e t w e e n 'sociological' and 'linguistics' facts, be it at a m a c r o - or a m i c r o - l e v e l . This d e v e l o p m e n t m a y be v i e w e d as an e v o l u t i o n into what Kuhn has t e r m e d a 'normal paradigm'. Seen from t h i s point of v i e w , the d e v e l o p m e n t s e e m s s o u n d enough. On the other hand, it w o u l d seem that the m o t i v e of seeking p r a c t i c a l social r e l e v a n c e has r e c e d e d into the b a c k g r o u n d ; that the idea of a 'socially c o n s t i t u t e d linguistics' has not c a u g h t on to the e x t e n t that H y m e s h o p e d for, and, in part, p r e d i c t e d . One sector of s o c i o l i n g u i s t i c s , however, m i g h t be r e g a r d e d as an exception.

4 A s a s u b f i e l d of s o c i o l i n g u i s t i c s D i s c o u r s e A n a l y s i s h a s g r o w n out of an i n t e r e s t in s o c i a l l y and interactionally a c c o m p l i s h e d f o r m s of l a n g u a g e b e h a v i o u r . L e s s so than soc i o l i n g u i s t i c s , D i s c o u r s e A n a l y s i s has had the p r e t e n c e of d e v e l o p i n g practical t o o l s that c o u l d be a p p l i e d in social i n t e r a c t i o n . The m e t h o d of D i s c o u r s e A n a l y s i s is r e c o n s t r u c tive: the p o s i t i o n of those i n v o l v e d in the i n t e r a c t i o n or d i s c o u r s e at the m o m e n t of i n t e r a c t i o n is r e c o n s t r u c t e d and used as the b a s i s for e x p l a i n i n g the verbal b e h a v i o u r d i s played. Since t h i s b a s i s also c o n t a i n s i n t e r s u b j e c t i v e elem e n t s , to be d o c u m e n t e d in the j u d g e m e n t of all m e m b e r s of a c o m m u n i t y or c u l t u r e , an a n a l y s i s will reveal c u l t u r a l ass u m p t i o n s t h a t are part and p a r c e l of the i n t e r a c t i o n . A typical r e p r e s e n t a t i v e of this a p p r o a c h is S c h e g l o f f (1972): the c h o i c e of f o r m u l a t i n g r e f e r e n c e to place is d i s s e c t e d in t e r m s of d e p e n d e n c e on t h e w a y p a r t i c i p a n t s ( S c h e g l o f f ' s ' m e m b e r s ' ) i n t h e d i s c o u r s e a n a l y s e t h e l o c a t i o n of d i s c o u r s e , the m e m b e r s h i p of the p a r t i c i p a n t s , and the t o p i c of discourse. A l t h o u g h in its m e t h o d and scope D i s c o u r s e A n a l y sis k e e p s c l o s e to the m o m e n t of i n t e r a c t i o n , and to the p o s i t i o n of t h o s e t a k i n g p a r t i n i t , t h e m o t i v e f o r t h i s a p p r o a c h is p r o v i d e d by r e a l i s m and m u c h l e s s by the w i s h to d e v e l o p t o o l s for use in p r o c e s s e s of verbal i n t e r a c t i o n . For the v e r y r e a s o n that D i s c o u r s e A n a l y s i s k e e p s c l o s e to i n t e r a c t i o n , the q u e s t i o n m a y well be a s k e d w h e t h e r the r e s u l t s of D i s c o u r s e A n a l y s i s c a n n o t be b r o u g h t to bear on it. As it is, m a n y i n v e s t i g a t i o n s in D i s c o u r s e A n a l y s i s are in fact d i r e c t e d t o w a r d s verbal i n t e r a c t i o n in i n s t i t u t i o n a l s e t t i n g s , such as c l a s s r o o m i n t e r a c t i o n ( M e h a n 1979) i n t e r ethnic c o m m u n i c a t i o n in d i f f e r e n t s e t t i n g s ( G u m p e r z 1 9 8 2 a and b), m e d i c a l i n t e r v i e w s (special i s s u e s of the J o u r n a l of Pragmatics 5 ( 1 9 8 1 ) , nr. 2 / 3 a n d D i s c o u r s e P r o c e s s e s 7 (1984) nr. 2) i n t e r a c t i o n in the c o u r t r o o m ( A t k i n s o n & D r e w 1979). It is this c o m b i n a t i o n of c l o s e a t t e n t i o n to the d e v e l o p m e n t of i n t e r a c t i o n and a keen i n t e r e s t in i n t e r a c t i o n in i n s t i tutional s e t t i n g s that s u g g e s t s the p o s s i b i l i t y of a p p l y i n g the r e s u l t s of one's analysis. T h i s w a s the central q u e s t i o n p u t b e f o r e a c o n f e r e n c e t h a t w a s h e l d in G r o n i n g e n in J a n u a r y 1985, and t h e m e around w h i c h the p a p e r s p r e s e n t e d h e r e revolve. T w o t y p e s of i n s t i t u t i o n a l s e t t i n g s w e r e sel e c t e d for d e t a i l e d d i s c u s s i o n d u r i n g the c o n f e r e n c e . A r o u n d

5 one of these, the medical interview, a rather extensive body of literature has g r o w n up. The other type of situation, the political interview, has been investigated to a lesser extent, at least from the point of view of Discourse Analysis. B o t h s e t t i n g s p l a y an i m p o r t a n t p a r t in s o c i a l l i f e . In m e d i c a l i n t e r v i e w s , in w h i c h a l m o s t every individual is involved from time to time, decisions are prepared which are vital to the health care of people. In political interviews a good deal of the image-building of politicians takes place and information about politics and policies is presented to the public; hence these interviews play a substantial role in the functioning of politics and democracy. Contributors to the conference were invited to present their v i e w s on the possibilities of analysing discourse in either of these two settings, for the purpose of discussing the feasibility of translating the results of the analysis into p r a c t i c a l a p p l i c a t i o n s * It h a s not b e e n the o r g a n i z e r s ' intention to restrict Discourse Analysis to a single app r o a c h . To p r e v e n t s u c h a t h i n g f r o m h a p p e n i n g , s c h o l a r s from a number of different disciplines were asked to present their v i e w s on the central issue of the conference. It will be seen that, even if the subject matter is invariably discourse, not every paper constitutes an example of Discourse Analysis in a narrow sense. As for the m e d i c a l i n t e r v i e w , s e v e r a l f o r m s of d o c t o r patient conversation are discussed. Thus Bax, Berenst, and Houtkoop report on investigations as to general practitioners; Fehlenberg and Van der Geest analyse conversations in psychosomatic ward rounds. Van der Geest also discusses psychotherapeutic conversations. Fisher & Todd, and Candlin 4 Lucas, finally, deal with medical conversations with regard to family planning. Another interesting issue concerns the different topics relating to discourse analysis raised by the participants. S y m m e t r y or asymmetry between GP and patient is discussed not only with respect to its specific contents and linguistic and discourse forms but also with regard to its acceptability in terms of social norms. Fisher & Todd, for example, point to some negative medical effects of asymmetry with respect to the prescription of contraceptives and seem to assume that asymmetry for that reason cannot be accepted. Berenst, Fehlenberg and Van der Geest, on the other hand,

6 adopt a more cautious position in that they accept the view that asymmetry is inherent in institutional contexts and therefore cannot be rejected as such, but should be regarded as an essential or at least unavoidable factor. This fact, however, requires that both GP and patient participate in such a way that the medical as well as the relational aspects of conversation are adequately taken into account. Another aspect of discourse treated with varying degrees of systematicness and detail by at least some authors concerns the emotional side of conversation in medical contexts as a c o m p l i c a t i n g f a c t o r in m e d i c a t i o n . As the p a t i e n t i n t r o d u c e s at l e a s t t w o p r o b l e m s i n t o the c o n v e r s a t i o n , namely his medical problem and his anxiety about the former, Bax demands from the GP that he also responds appropriately to the latter problem, whenever it is signalled to him by his patients. For this conversational problem Bax offers a theoretical framework to properly deal with the description of emotions. Other points of interest which, however, are only discussed in passing in this volume, concern 1) the analysis of private topics in conversations with schizophrenic patients by Van Bijsterveld, 2) the analysis of summarizing or f o r m u lating techniques in the Rogerian sense as employed by GPs (Houtkoop), and 3) the prescription of contraceptives as a social and micropolitical reflection of society (Fisher & Todd) . The methods of analysis used and/or proposed by the contributors also show remarkable and interesting differences. Bax, Van Bijsterveld, and Candlin & Lucas, for example, present their data in a pragmatic perspective. The analyses of o t h e r c o n t r i b u t o r s , h o w e v e r , ( B e r e n s t , F i s h e r & T o d d , Houtkoop) are probably best characterized as discourse-analytic and ethnomethodological. All these studies -both pragmatic and ethnomethodological- are interpretive in character and try to detect some qualitative and inherent aspects of only a small set of data in order to arrive at a more detailed insight into what is going on in the special type of medical conversation under investigation. The question of how much an analysis may contribute to or can be brought to bear on society, however, is less explicitly dealt with. The latter question is central in the studies by Fehlenberg and Van der Geest. In order to cope with this very problem these scholars applied certain statistical procedures to a larger set of data in order to find out which conversational tech-

7 niques may be more functional and meet more effectively the a i m s of the medical conversation types they investigated. To this end they extracted from pragmatics, linguistics, and ethnomethodology those variables that they considered to be essential for the purpose. In s u m , it m a y be s a i d t h a t , as for that part of t h i s v o l u m e that deals with the medical interview, and for all the diversity in the topics and the lack of total agreement between the researchers as to theory, norms, and analytic procedures, individual contributions show enough overlap to enable the reader to compare the various studies, to differentiate between them, and to arrive at a carefully considered standpoint, for example, as to the direction research ought to take. The contributions that are brought together in this volume under the heading of Political Discourse show a varied picture. First of all, there is the diversity of forms in which political discourse manifests itself. In contributions by Bormann, Ensink, Van Lint, and Schwitalla, political disc o u r s e is c o n c e i v e d of as h a v i n g the f o r m of a s p e c i f i c genre. Bormann looks at the 1984 American Presidential debates between the candidates Mondale and Reagan; Ensink, Van L i n t , and S c h w i t a l l a d i s c u s s p o l i t i c a l i n t e r v i e w s , i.e. interactional settings specially arranged for the purpose, where some person holding a political office is questioned by a r e p o r t e r . The c o n t r i b u t i o n by Van E e m e r e n is a l s o oriented towards a specific genre, namely that of argumentative disputes. Van Eemeren tries to establish a normative basis to which this genre should be oriented. His contribution results in a normative model to be applied to f o r m s of debate; as such, his paper does not confine itself to political discourse. An application of the normative model to a (non-naturalistic) political debate is also presented in the paper. Labov & Labov address themselves to the question of the nature of discourse in formal, public settings, as opposed to discourse in informal, everyday situations. In this respect, their paper is very general in scope, and directed t o w a r d s a pivotal question of sociolinguistics: what is the relation between forms and styles of speech and situations of speech productions? Their approach is demonstrated in the discourse materials of the public hearings on juvenile delinquency by a U.S. Senate C o m m i t t e e in 1975.

8 A s e c o n d a s p e c t in w h i c h the c o n t r i b u t i o n s on p o l i t i c a l discourse differ concerns matters of method. The contribution by Labov & Labov is the most strictly sociolinguistic one in character. Their contribution aims at describing the behaviour of a few linguistic categories in public speech, namely quantifiers and attributives. The observed behaviour of these categories, notably some inconsistencies in the use of quantifiers and the specific distribution in the occurrence of non-restrictive attributives, is explained by assuming an orientation of speakers in public discourse towards a set of socially shared moral premises. It appears, then, that the method applied by Labov & Labov, c o m b i n e s descriptive linguistic data with interpretive socio-semantic data within a single analytic framework. The contributions by Schwitalla and Ensink are closely related to Discourse Analysis. In both papers, e x a m p l e s of political interviews are analysed from the point of view of the o r g a n i z a t i o n of t h e v e r b a l i n t e r a c t i o n . R i g h t s and duties of the participants, their orientation towards the public in whose behalf the interview occurs, and the 'strategic 1 aims that participants try to achieve, are introduced into the analysis. Schwitalla pursues a line of research which aims at comparing the behaviour displayed in interv i e w s taken from different periods of recent W e s t - G e r m a n political history. Ensink aims at showing the peculiarities of political interviews with regard to t w o central issues in Discourse Analysis, namely cooperation and orientation tow a r d s 'face 1 . In h i s c o n t r i b u t i o n , B o r m a n n t r i e s to s h o w h o w , in the d i s c o u r s e of the 1 9 8 4 P r e s i d e n t a l D e b a t e s , candidates were oriented towards so-called 'fantasy themes': socially shared, recognizable schemes which organize experience. In his analysis Bormann shows fantasy themes that are t y p i c a l of the D e m o c r a t i c , ' N e w - D e a l ' t r a d i t i o n , as opposed to those typical of the Republican rhetorical style. Lack of consistency in his orientation towards D e m o c r a t i c f a n t a s y t h e m e s on t h e part of M o n d a l e m a y be one of the causes of the letter's defeat in the elections. Van Lint in his paper discusses political interviews from the p o i n t of v i e w of a 'purist' t y p o l o g y of t e x t s . H i s approach concerns a search for principles which would make a 'pure' case of text-type of some kind, and then proceed and confront actually occuring interviews with these principles. Van E e m e r e n also s h o w s a n o r m a t i v e approach. From the function that should be performed by an argumentative dis-

9 pute -that is to offer a solution to a difference of opinion between parties- a normative model is derived which should w a r r a n t the s o l u t i o n of the c o n f l i c t . The a r g u m e n t a t i v e model appears as an a priori model here: it is not derived f r o m an e m p i r i c a l c o r p u s , but is i n t e n d e d to s e r v e as a g u i d e l i n e for b o t h a n a l y s i n g a r g u m e n t a t i o n and a c t u a l l y arguing. By and large, two questions pertaining to method appear to be important in the papers on political discourse presented here • Firstly, there is the question as to whether to start from a descriptive or from a normative standpoint. Descriptive approaches can at best describe things as they occur or as they are done. To derive prescriptions from such an approach is to d e m a n d a t h e o r e t i c a l s u r p l u s w h i c h c a n n o t a u t o m a t i c a l l y be d e r i v e d f r o m the d e s c r i p t i v e apparatus. Normative approaches start from standards that are to be lived up to. Whether or not it is practically feasible to l i v e up to t h o s e s t a n d a r d s , w h e t h e r or not the p r o p o s e d standards are the best that can be conceived of, whether or n o t the s t a n d a r d i t s e l f is s u s c e p t i b l e of e v a l u a t i o n , change, or improvement, are questions that are crucial, even if they are not completely answered here. The second question bears on the distinction between process and product. Discourse is accomplished as an interact i o n a l , o n g o i n g p r o c e s s , e v o l v i n g in t i m e . W h a t c a n be recorded, observed, analysed, talked about, however, is the frozen product - i n the shape of a text- resulting from this p r o c e s s . T h i s s t a t e of a f f a i r s is an i n e v i t a b l e one: the process itselfs is less open to recording and observation. A good deal of reflection on methodology in the social sciences is devoted to, or taken up by, this question. The point at issue here, however, concerns another aspect of the same question: if the results of one's analysis are to be useful in developing tools that can be i m p l e m e n t e d in interaction, then it would be important to know whether an easy 'fit' is possible between these tools and subsequent interaction. Steppers, in his general c o m m e n t a r y on the papers collected here, is rather pessimistic on this point. In fact, none of the authors presented here express themselves clearly on this issue. Those starting from a descriptive standpoint present analyses of discourse, without, however, pursuing their analysis further in the direction of practi-

10 cal applicability. Those starting from a normative point of view do not yet seem prepared to tackle the question of how practicable an orientation towards their norms would turn out to be in actual interaction. All things considered, the conference was a lot more productive in providing answers to questions which it did not want to ask in the first place than in answering the central question itself -that of the practical applicability of the analysis of discourse. As yet no satisfactory answer to the question seems to be forthcoming.

Acknowledgements It will be seen that several of the contributions to this volume contain translated excerpts from discourse in languag e s o t h e r t h a n E n g l i s h . N a t u r a l l y the a u t h o r s h a v e t a k e n great pains to ensure a faithful rendering of these passages. On our part it would be a gross underestimation of the complexities of translating discourse, however, if we d i d not r e c o g n i z e t h a t s u c h r e n d e r i n g s c a n be b u t r o u g h approximations of the original. The conference received financial support from the Netherlands Organization for the A d v a n c e m e n t of P u r e R e s e a r c h , Z.W.O., f r o m the U n i v e r s i t y of G r o n i n g e n , and f r o m the Faculty of Arts of Groningen University. Contributions that are co-authored were presented at the conference by the author whose name appears in first position. The contribution by Fisher & Todd is different from the paper which Professor Fisher presented at the conference. For this reason no formal discussion of this paper is included in this volume. The conference was co-organized by 3. Berenst. M. Achterhof w a s e x t r e m e l y h e l p f u l in c o m p i l i n g t h e b i b l i o g r a p h y . W e greatfully acknowledge their valuable and indispensable contributions. Titus Ensink Arthur van Essen Ton van der Geest

1 Interpretations and explanations in discourse Modes of 'advising'

in family

planning

C.N. Candlin and J. Lucas

0.1 Purposes The particular purpose of this study is to offer an account of the interaction between professional and client in the Family Planning Counselling interview. More specifically, to examine critically the roles and frames of reference of the counsellor as she seeks to offer information and counsel to her client. Central to this activity is the concept of "advising", and the study seeks to elucidate what its modes are and how they are realised in terms of pragmatic principle, d i s c o u r s a l s t r u c t u r e and l i n g u i s t i c feature. Within this a c c o u n t , it w i l l be a r g u e d that " a d v i s i n g " is a c o m p l e x discoursal activity and one which gives rise to conflicting ideological interpretation. In the course of exploring this activity the study will suggest a number of hypotheses conc e r n i n g the i n t e r p r e t a t i o n of t h e s e and o t h e r d a t a f r o m similar encounters, wich may, in addition, have more general relevance to discourse analysis. Finally, the study suggests how its results might form part of counsellor and, conceivably, client training, in order thereby, incidentally, to verify its own argument.

0.2 Setting and Participants H a l e Ho'ola H o u ( H o u s e of N e w Life) w a s f o u n d e d in A p r i l 1975, in Kaumakapili Church "out of concern for the lack of affordable medical care for the urban poor of the KalihiPalama (Honolulu, Hawaii) area" (see Hale Ho'ola Hou KalihiP a l a m a H e a l t h C l i n i c A n n u a l R e p o r t 1983). Three criteria guide its action according to the Annual Report, viz. service must be provided (i) at low cost; (ii) in a non-institutional setting, and (iii) by a multi-lingual staff. The clinic is incorporated in the State of Hawaii as a private

14 n o n - p r o f i t c o r p o r a t i o n and, in 1 9 8 3 , had 17 f u l l - t i m e employees and 4 part-time employees providing family planning, dental and nutrition services in addition to primary medical care, (see Annual Report op.cit.) The above constitute the four m a i n service components of Hale Ho'ola Hou, viz. Primary Medical Care, Family Planning, Dental Care, and the Special Supplemental Food Program for W o m e n , Infants, and Children (WIC). 0.3 Preliminaries In the context of FPC it seemed to us that the non-authorit a r i a n r e l a t i o n s h i p b e t w e e n p r o f e s s i o n a l and c l i e n t (as opposed to that, for example, holding between doctor and patient) within a context in which knowledge was being drawn upon to offer information as well as education, might produce discourse which fluctuated along a continuum, the poles of w h i c h w e r e i n f o r m a t i o n - g i v i n g and s e e k i n g on the one hand, and the specifying of contra-indicated behavior on the other. If this were so, then to be a cousellor w a s pragm a t i c a l l y and d i s c o u r s a l l y d i f f i c u l t , s i n c e n e i t h e r t h e authoritarian nor the libertarian role would capture what counselling might turn out to be. This "hunch" was one which initial and subsequent discussions both within and outside the c l i n i c c o n f i r m e d as w a r r a n t e d , as i n d e e d d i d the available background literature on the practice of Family Planning Counselling. 1.0 The ideology of Family Planning counselling Why ideology, and what is its relevance to the analysis of discourse? In offering some answer, we take the position that any analysis of language in use has to see such language as the skilled accomplishment of participants in the service of some social goal and not merely in terms of a textas-object. Such an approach is interpretive, therefore, not merely descriptive, and implies an assessment by the analyst of t h e d e g r e e to w h i c h p a r t i c i p a n t s feel t h a t t h e y h a v e achieved these particular goals. For some exemplification from the world of psychiatric counselling we m a y look to Labov and Fanshel (1977). Nonetheless, such an interpretive account will remain inadequate if we cannot, through what is s a i d and m e a n t , i n f e r and e x p l o r e the s o c i a l c o n d i t i o n s w h i c h i m b u e b o t h p a r t i c u l a r p e r f o r m a n c e s and particular

15 i n t e r p r e t a t i o n s . To p u r s u e t h i s any study will n e e d to accommodate not only the distinct perceptions of the participants of the nature, purpose and proceedings of the encounters in which they engage, but, we contend, will also h a v e to u n d e r s t a n d t h a t d i s c o u r s e r e g u l a r l y n a t u r a l i s e s participants' values and beliefs in an unconscious manner. This constitutes our warrant for taking ideology into account and motivates our interest in explanation. In sum, we take the view that participants use language, employ c o m m u nication strategies and infer particular meanings without often any conscious awareness of how such usages, in given social conditions, act to betray personal, professional and sectional beliefs and values. Ideology in discourse, following Berger & Luckmann (1966) and, especially, de Souza (1983), reflects a view that talk maintains the reality of its participants through the taken-for-grantedness of its realisations and their value. The routines of conversation, in Berger and Luckmann's terms, reinforce the routines and relationships of everyday life, and confirm participants in r o l e s , b e h a v i o u r s and b e l i e f s . L a n g u a g e , in de Souza's (1983) sense, guides action and c o m m i t s participants to particular values and intentions. Ideology in discourse analysis, following Candlin (1983c) begins from the point that it is c r u c i a l , in s u c h a n a l y s i s , to d i s p l a y and e x p l a i n h o w language can work indirectly and under what conditions it c a n t a k e e f f e c t . W h a t t h i s v i e w of d i s c o u r s e d o e s is to capitalise on the suggestion of Berger & Luckmann (1966) and of Habermas (1972) that the presence of an underlying ideology in talk is revealed at m o m e n t s of c o m m u n i c a t i v e crux where participants' subjective realities are guestioned, and t u r n s t h a t i n t o a p r i n c i p l e d p r o c e d u r e . I d e o l o g y in t h i s sense implies critique, that is to expose values and bel i e f s , m a k e e x p l i c i t r o l e and f u n c t i o n , a n d a t t e m p t to explore the degree of speaker's control over presuppositions and implicatures. In short, this approach seeks to demystify hidden yardsticks against which meanings are constructed. It d o e s so by s u b j e c t i n g the use of p a r t i c u l a r t e r m s , the choice of phonological and l e x i c o - s y n t a c t i c r e a l i s a t i o n s , the selection of certain conversational strategies and routines, the uptake of force, the awareness by participants of the norms of interaction and interpretation in encounters, to analysis and to critique. Contradictions within FPC are referrable to the relationship of FPC to forces/factors in the social formation. These contradictions, as we shall see,

16

u

(D

U1 LJ lo LJ x i— o CL. >-

3 O •H 4-> •v ti CD LO CL LLI HCTI 1—1 C to •H > X PH c i O CE > «t LU c HH 1/5

(0 -M C ai E O E 1)

u

01 -C s lies o _J o o o X 1— LJ

Z£.

1

X • P XI C 3 u •H "D C ü O) a 01 • C > 4-> JC. -P •H •H -p a S a ^H o a a •H 01 •H c •H n 3 ai E •O c E o o O • P •H O •P 03 ai D O i—t i—1 a

Of

1 UJ ce

V. CD -P a. ai a> o • c u ai o • u CD "O . a •H

> OD E ai r-l >O • p C3 • P IO o 01 > >> c c •H o CD •H ai UJ CD Ol a ai i—i O ai 3 - P rH -p ai ai ai 01 > LO o •o c 3 O (-1 oi

•

O •H -P CD E Ol ai

_

1 o en M -p Ü c CD CD a. E •H M u •H •H ai - P jC U -p ai Q.

o X C_1 >m a.

en "O co ai ai C C-l Q . CD r H i—i >> o X •P h a. ai < >s u • o cc -P 3 ai •H - P • p a o > U u •H z 3 ai -P X U CL 1— CJ - P X u < 01 ai

•e

u

a. N r-1 CD co

u

CJ I—1 1— IO 1—1

=>

C3 z 1—1

3 O u en •H Q N U • c ai •H c Ol •H c CD • H

A o

co ai E ai

u

u-

_

co -p c ai

CJ t—1 U o

• 1—1 "O ai ai

>

>

i u 3 (J -P -a CO c ai CO c Pi co ai ai •p co -P 3 CD ai a. u

,—.

T3 u o c CD -p SI X -p ai -P c ai c > o ai Cl

c •H .C +J •H S

«

o 4->

•H i—i X o "O a) > 1—1 c c o ci- •H oi m (4 0) M •o m ai •p c a i i—i o r .c «r CO 3 ai h CL) c co a>

ai j= -p

x: •H - p •P U CL. ai o

a> (-i 3 Ol

-P O C

>.

rH

t-i m

u •H •p •H Pl U -o u 3 ai •H

>

>> rH ai

>

•H -P Q. •H

U

u ai ai 73

>> ri C o

-p c ai E JZ co •H rH CL E O O o CD

0) ai Pi 3 •P CD ai C|_ u •H -p

ai

-P U ai

•H 3 CP C •H H ai •p uo

•H U o co

o

•o ai co 3

o i— Q LJ Z t—I _1

•o 01 rH »—i r H h - •H

•a ai a. ai

s:

co

>.

z o

z "-> o n 1—1 o 1— -'

•H •H

CQ

T3 C CD


co

C •H -M C o o c •o o a> •H u 4-> co c D 0) C Ü •H 1 H- •M 1—1 C ai o co u

CD >

•M (—1 -P tl CD CL

CO C o CL CO QJ ti

Cl_ O C o •l-t •M CD C •H •M C O u o-

•

ai CL *

ai

>

•H co c o a co u ti i c o c

>. a> •C oi c •H •H tl O co u •o co a) •H tl o Ol ai -M co

a 31 ti 4-> C o o

co •H co >N I—1 co c co ,—, ti a) a> > o co •Q i-H co cu co -C c 4-> o Uo O >. •cH ti o CD cu •H

c ai •H

-C •H S

a a. rH H •H

en > i ai en M CD D C O •H O E en M •H a i -o c c o -H •H a> 4-> 4 J ü n D eu •o o cu c M D

\

\ \ \ \ \ \\ o

LO

•

1

CT ai n

>.

i-H CD C 0) c o •H

*J m

E h O uc hH vo •

i o CM

Ol •H Cl-

179 The n e x t s t e p in t e s t i n g for the h y p o t h e s i z e d f o r m of s e q u e n t i a l o r g a n i z a t i o n is the a s s e s s m e n t of the r e l e v a n t structural c o m p o n e n t s u n d e r l y i n g the p r o c e s s of speakers' sequencing. Since w e h a v e d e t e r m i n e d the p r o c e s s as being o n e of 2 n d o r d e r , w e h a v e t o l o o k at a 3 - d i m e n s i o n a l c o n t i n g e n c y table, or t r a n s i t i o n a l m a t r i x w h e r e the r e l a t i v e serial p o s i t i o n s are the d i m e n s i o n s and m a y be i n d i c a t e d as T 0 , T - l , T - 2 . T h e r e a r e 4 p o s s i b l e s t r u c t u r a l m o d e l s of d e p e n d e n c e as g i v e n s c h e m a t i c a l l y in fig. 7 .

model of s e q u e n t i a l

independence

d e p e n d e n c e of n e i g h b o u r i n g (1st order Markov c h a i n )

positions

s i m p l e d e p e n d e n c e a c r o s s two

fig.

lags

c o m p l e x d e p e n d e n c e : the s p e c i f i c c o n s t e l l a t i o n with T-l i n f l u e n c e s T0 (2nd order Markov chain)

of

7 : M o d e l s of s e q u e n t i a l d e p e n d e n c e (processual

part

a p r o b a b i l i s t i c m o d e l of

T-2

of

analysis)

Model (2) is that of a first order d e p e n d e n c e w h i c h w e h a v e a l r e a d y d i s c a r d e d . M o d e l (4) i s t h a t of a f u l l 2 n d o r d e r d e p e n d e n c e , i.e. w h o m a k e s t h e n e x t m o v e d e p e n d s on t h e s p e c i f i c s e q u e n c e of s p e a k e r s at the p r e v i o u s t w o p o s i t i o n s . Model (3) l i e s s o m e w h e r e in b e t w e e n . T0 is i n f l u e n c e d by w h o w a s m a k i n g a m o v e at T-l and at T-2, but the s p e c i f i c c o n s t e l l a t i o n of w h o w a s speaking at T-2 and T-l is not e s s e n tial. These m o d e l s can be tested w i t h a g e n e r a l i z e d f a c t o r i al c h i s q u a r e a n a l y s i s as is g i v e n by the l o g - l i n e a r m o d e l c o n c e p t u a l i z e d by L. G o o d m a n and a s s o c i a t e s (cf. B i s h o p et. al., 1980). Fig. 8 g i v e s the r e s u l t s of the t e s t s c o m p u t e d s e p a r a t e l y for the g r o u p s of the t e r m i n a l l y ill and the n o n t e r m i n a l l y ill patients.(fig.8, pag.178)

180

ao c o CM vo vo ir\ CT*

è« a

CM N

o o • t o o

o « o

0.

CT,• r -• c_> ce

CM •H C_) en _i

ON VO 00

—I

^

o ^

i—1 (S CD "O

•>

CM «M

vO lA

O vO

rH

rA

1

•

•

•

C2T 1

O vO

co co

rA 0\

es

à?

—'

•

o

0. 1

•

O

•

o

•

O

•

o

•

CM O

rA co

rA —1

CM o\

VO Os

VO

•

O

•

•

o

•

•

o

•

IA VO

•


A

VO 00

1A VO

CM Qv

00 00

•5t »-H

o CM CM

CM O lA

vO fA Ov

•alA

IA co

LA LA VO

o VO CM

-H i-H VO ai > o t—

••

O i—)

E

or

184

i i— •H T3

SS Ov

CSI 1 1—

rH

'

\ a N X cu i

1

1

1

i

CN

CSI

I

« l

•p o c

•

M •H "D

(—

CSI

,,

1—

SO

CSI

CT\

rH

1—

^—'

•a a> -t-> ci ai a. X ai

-o ai

£

CM

1

SO

so

I

1

1

O -H •o c 3 O M

SO OS >H \ N

•H \ Ci- *— C o CO CI c o •H ep 4J o o •ri h *0 ai ai xi u E a. 3

CO

SO

co rH

CM

•a-

CO

O lA

a

so

o 1—1

CSI rH

CSI

o-

•a-

•aSO

f—(

c CD 4-> CO •O 3 !S>

co a. •rH .c co c o •H 4-> CD i—| ai p S•P o •P

i—t ai •iH •P C ai

O" CI 01 ai co a. co — co ai p LI ai j* CD ai •ri Q. s CO

+

••

4J C ai •H 14- • P CD o Qa c ai o .c •H 4-> 4-» CD "D PH C H CD ai •P C CO CD •iH c o o •ri a CO >s ai c. •d CL •H CO • p CO o a . s

i—) X

ai • a 3 c CJl CD o rH •P CD C •H ai • o •H •P rH CD CD O . •H \ -P C CD c CD •H •P a CO • H CO n >s 3 CO • C a P o -p co ai rH rH A c CD a i ai -P CO s 4-> ai O c n

1 ••

ep Cp s •C a

T3 c CM

CO ai Ql ¿t C CD •H I E cp ep ai •P co

\

••

•

i-t rH o CI-

•

CO ••H

co p 3 C

•M • iH

c CI M •rH CO + J >s JE r H CL CD •iH T3 C c CSI CD 4J CO ai n -M 3 CO ct•rH ai

+ ••

c IH 3 -p

\

Q.

O •H CO

£

CL

+J CO i-H ai

c ai ai X ai JD

I ••

CIUCO -M CO

ai 3 CTI • O CO rH (H CD 3 •iH C •o N . U a i •H rH CO X XI ai a +J co •o e o CSI c

co u ai x CD ai a. CI)

CO c bt 3 4-> X ai rH a E O o

o

+J 3 n 4-* IH a

CL

rH CD •H 4-> C ai 3

CT

ai a

co JJ •H c •H SO rH ai •a o E

Clo

•o ai co 4-* CD a . ai •o u J3 a E ai CD rH ai •D ai N •H •o u CD "O c eo

«

rH rH CD

U O Cl-

Clo co a. •H r. a c o •H 4-> ai >-H ai u

+

rH ai •o o E

fri eo ai c CI •H r H •H 1 •P CD a i o E rH o j; o>> a i £ •p a ai c. •p

C

e» c o •H 4-> . 4-1 -H •P » 1)

U

o •

a.

• à? C3T i a LA

SO •

-p

* * CM Os CO • a

(0 o •H Q.

•

•

so Os O

-H rH m

-p

rH

-t-> C

:

•

•H -P a

01 o •H Q. o -p 01 h o -P O O -o

LL. O

•

o

u

CL E •H C O C D

ai u "O c C D (U +> Ol U T33 O CL ••"J E •H t—t

eo •H — i l •D ai •o •o o E CI •M D rH C C ai i—l bai 0) - — ' h s j-> C a> 1 O XI M •H aj 4-> a V •H a) o m o m o a. c a) CL M a a> «c u- X a) •H •o 4) •o Li_ u a> u £ r—f 4J 1 c a — a> 1 M C D II C O

_

,,

•H +J C D — i 1 a> ce

DI et-

h

a> > o

E CJ* C •H co 3 C •H C O a> u c V

u

eu Cl-

«-

•H -o •o ai

a S hf—i m h C O 1 •H u +J a) •rt n o a Q. a) a r en J-> C 0) X cr a> en (0 c ISi o Ü — i

a> , £ lA i—

•—•

—

_

u

ri

.—,

•lA —•

lA O •

X en

^ _

0Ì

•H O 0) h V Q. 4-1 >> C ! +J ai >>

0) a> a. >s

TS — i

+ —

X

Ll. -H 1 I— ~

II

co 1

,—, lA '—'

V/ CL C O

ai u

c eu h eu 4CL•H •o

c ai u •H Cl•H C C31 •H co *

c

OL

u.

>s •—I O c •H e U

•

— ,,

—, O

(0

co r-

íA co

-H lA

O •rH Q. O -P

•

CM

—,

o

vo 0\

•

rt