Stimulating patients to approach their pain from a biopsychosocial perspective is central to chronic pain rehabilitation. However, conversations between patients and their healthcare professionals about the social and psychological factors that may contribute to the continuation of pain and disability can be challenging. The current scientific literature does not sufficiently pinpoint the difficulties in patient–practitioner interaction on chronic pain, and it falls short of answering the question of how a joint exploration of the social and psychological factors that might be involved in the patient’s pain and evolving disability can be enhanced. In this theoretical article, we introduce discursive psychology as a potentially valuable research perspective to gain a better understanding of the difficulties in patient–practitioner interaction in the context of chronic pain rehabilitation. Discursive psychology focuses on features of people’s talk (e.g. that of patients and practitioners) and is concerned with the social practices that people perform as part of a specific interactional context. In this paper, we provide an introduction to the main theoretical notions of discursive psychology. We illustrate how discursive psychological analyses can inform our understanding of the specific sensitivities in conversations between patients with chronic pain and their practitioners. Finally, we address how a better understanding of these sensitivities offers a gateway towards improving these conversations. Een belangrijk principe in revalidatie bij chronische pijn is de benadering van de pijn vanuit een biopsychosociaal perspectief. Het blijkt echter een uitdaging voor patiënten en behandelaars om de sociale en psychologische factoren die een rol spelen bij chronische pijn te bespreken. In de huidige wetenschappelijke literatuur is hier nog niet voldoende aandacht voor; en wordt geen perspectief geboden voor verbetering van de gezamenlijke verkenning van sociale en psychologische factoren. In dit theoretische artikel introduceren we discursieve psychologie als een mogelijk waardevol onderzoeksperspectief om een beter begrip tot stand te brengen van de complexiteit van interactie in de context van chronische pijn revalidatie. Discursieve psychologie richt zich op kenmerken van interactie, in het bijzonder de sociale praktijken die tot stand worden gebracht binnen een specifieke interactionele context. We beschrijven de belangrijkste theoretische principes van discursieve psychologie en illustreren hoe een DP analyse licht kan werpen op de specifieke gevoeligheden in conversaties tussen patiënten met chronische pijn en hun behandelaars. Tot slot bespreken we hoe een beter begrip van deze gevoeligheden een ingang biedt tot het verbeteren van deze conversaties.
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In this study, the construction of rumour on Twitter during a specific crisis is analysed from a discursive psychological perspective. This perspective treats psychological concepts such as identities as discursive constructions. The selected case is the robbery of a jewellery store in Deurne, a village in the Netherlands. The jeweller’s wife was said to have shot two of the robbers. Although this fact was not officially confirmed, people used particular discursive strategies to present the act of the jeweller’s wife as factual, which influenced the way the media reported on this case, as well as the reaction of the prosecutor, which was described as premature. Four dominant discursive patterns were detected, that is: normalizing the act, evaluating the act, upgrading the act and anticipating on the consequences of the act. Furthermore, it is demonstrated how critical tweets, displaying a concern for nuancing the overall tendency of the tweets, were designed in a way that downplayed their overt critical character. Implications of the analysis for crisis communication professionals are discussed. In deze studie wordt geruchtvorming in kaart gebracht met behulp van discursieve psychologie, waarin psychologische concepten zoals identiteit worden behandeld als discursieve constructies. De casus betreft een juwelenrook in Deurne, Nederland, waarbij de vrouw van de juwelier ervan beschuldigd werd twee overvallers te hebben doodgeschoten. Deze beschuldiging werd als feit behandeld op sociale media, ook al was dit nog niet officieel bevestigd. Dit beïnvloedde zowel de nieuwsberichtgeving, als de reactie van de officier van justitie in de media. Vier dominante discursieve patronen werden ontdekt in de discussie over de vermeende daad: normaliseren, evalueren, upgraden en anticiperen op de gevolgen. Ook wordt gedemonstreerd hoe tweets die nuance aanbrengen in de discussie, voorzichtig worden geformuleerd, waardoor het kritische karakter ervan wordt geminimaliseerd. Implicaties voor professionals in risiscommunicatie worden besproken.
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Oncology healthcare professionals (HCPs) and cancer patients often have difficulties in navigating conversations about sexual changes and concerns due to cancer and its treatments. The present study draws on Discursive Psychology to analyze how the topic of sexuality is raised and managed in Dutch oncological consultations. Our corpus consists of 28 audio recordings. We analyzed the discursive practices used by cancer patients and oncology HCPs and to what effect. Patients, on the one hand, employ vagueness, pronouns, and ellipses, while HCPs attribute talk to others and use generalizations, and speech perturbations. Through these practices they collectively keep the topic of sexuality at a distance, thereby constructing it as a delicate topic. Moreover, we explicate the norms related to sexual behavior that cancer patients and oncology HCPs orient to in their talk. Finally, we address ways in which oncology HCPs can open the door on discussing sexual changes with their patients.
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Cancer and its treatments cause significant changes in sexuality that affect the quality of life of both patients and their partners. As these issues are not always discussed with healthcare professionals, cancer patients turn to online health communities to find answers to questions or for emotional support pertaining to sexual issues. By using a discursive psychological perspective, we explore the social actions that participants in online health forums perform when discussing sexuality. Data were collected by entering search terms in the search bars of three online health forums. Our analysis of 213 threads, containing 1,275 posts, provides insight into how participants who present themselves as women with cancer account for their sexual issues and, in doing so, orient to two intertwined norms: Having untroubled sex is part of a couple’s relationship, and male partners are entitled to having untroubled sex. We discuss the potential harmful consequences of orienting to norms related to sexual behaviour. Yet, our findings can also help healthcare professionals in broaching the topic of sexuality in conversations with cancer patients. The insights of this study into what female patients themselves treat as relevant can assist health professionals in better aligning with patients’ interactional concerns.
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Chronic pain rehabilitation programs are aimed at helping patients to increase their functioning despite being in pain, thereby improving their quality of life. However, conversations between patients and practitioners about how the patient could deal with his/her pain and pain-related disabilities in a different way can be interactionally challenging. This study adopts a discursive psychological perspective to explore how pain-related disability is negotiated by patients and practitioners during consultations. The analysis shows that pain-related disability is treated by both patients and practitioners as negotiable rather than a fixed reality. Moreover, it shows that patients’ and practitioners’ negotiations of disability are subject to issues of agency, accountability, and blame, and it provides insight into the interactional dilemmas that are at stake, both for patients and practitioners. Revalidatieprogramma’s voor patiënten met chronische pijn zijn gericht op het verbeteren van het functioneren ondanks de pijn, waardoor kwaliteit van leven wordt bevorderd. Conversaties tussen patiënten en behandelaars over de manier waarop de patiënt kan omgaan met de pijn en gerelateerde beperkingen kunnen interactionele uitdagingen met zich meebrengen. Dit hoofdstuk verkent vanuit discursief-psychologisch perspectief hoe beperkingen worden onderhandeld door patiënten en behandelaars in consulten. De analyse toont aan dat de beperkingen worden behandeld als onderhandelbaar in plaats van als een onveranderbare werkelijkheid. Bovendien toont de analyse dat in deze onderhandelingen bepaalde issues relevant worden gemaakt, zoals ‘agency’, verantwoordelijkheid en schuld. Inzicht wordt geboden in de interactionele dilemma’s die op het spel staan voor zowel patiënten als behandelaars.
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In this article, we show how elderly clients in Dutch dietary consultations adjust dietitians’ history taking questions that suggest a cause for weight loss. Using conversation analysis and discursive psychology, we analyzed the history taking phase of recorded primary care conversations of 7 dietitians with 17 clients with malnutrition (risk). In response to the dietitian's history taking question, clients repeatedly present: 1) a problem in which weight loss is presented as unexpected and a conscious reduction in dietary intake is (therefore) not an issue, 2) a problem for which they cannot be held responsible, but which at the same time acts as a reason for reduced dietary intake, 3) a problem in which higher dietary intakes have been recommended by a third party that have proved impracticable. In these adjusted diagnostic explanations, clients emphasize the multidimensionality of their weight loss, which concurrently provides an explanation as to why they cannot be (solely) held responsible for their reduced dietary intake. Clients’ adjusted diagnostic explanations make relevant an evaluation by the dietitian. Dietitians’ subsequent lack of uptake leads to clients recycling diagnostic explanations to still get a response from the dietitian. Our findings offer insight into improving client-centered counseling by paying attention to clients’ adjusted diagnostic explanations.
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The purpose of the paper is to describe the ways in which people use language to achieve mobilization. Recognizing and anticipating the discursive practices that are used online, for instance for mobilization, increasingly is a primary concern for professionals in crisis communication or issue management. Het doel van dit artikel is het beschrijven van de manieren waarop mensen taal gebruiken om mobilisatie mogelijk te maken. Het herkennen van en anticiperen op discursieve praktijken die online plaatsvinden, bijv. mobilisatie, is in toenemende mate een zorg voor professionals in crisiscommunicatie of issuemanagement
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Dit artikel presenteert de resultaten van een discursief psychologische analyse van geruchtvorming op social media. De analyse van Twitterberichten die zijn geplaatst tijdens de zoektocht naar twee vermiste kinderen heeft tot doel inzicht te verwerven in de manier waarop geruchten zich ten tijde van crisissituaties op social media ontwikkelen. In this article we present the results of our analysis of rumour construction on social media from a discursive psychological perspective. The analysis of tweets during a search for two missing kids aims to provide insight into the way rumours develop on social media during a crisis situation, as well as the interactional and rhetorical aspects of rumour construction.
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In this paper I describe the ways in which the communication discipline can make a hidden crisis transparent. For this purpose I examine the concept of crisis entrepreneurship from a communication point of view. Using discourse analysis, I analyse the discursive practices of crisis entrepreneurs in the domain of education in the Netherlands. This paper is part of my Ph.D. project in which I examine the dilemmas encountered by crisis entrepreneurs and the interactional solutions they choose in addressing a crisis. In my Ph.D. project I have analysed how crisis entrepreneurs use discursive practices: (1) to show the factuality of the problem. For example, the way the problem is presented is too theoretical and is not a problem in reality; (2) to present the credibility of the messenger as an authentic, legitimate spokesman. Crisis entrepreneurs may be accused of wanting to attract attention to their own cause; (3) to create the accountability for the problem and the solution. For example, crisis entrepreneurs can be accused of nursing personal grievances or of drawing attention to the issue without actively attempting to solve it. The conclusion is that a communication professional is able to recognize a problem raised by crisis entrepreneurs. Knowledge of interactional dilemmas helps communication professionals understand the potential of crisis entrepreneurs.
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In this paper I describe the ways in which the communication discipline can make a hidden crisis transparent. For this purpose I examine the concept of crisis entrepreneurship from a communication point of view. Using discourse analysis, I analyse the discursive practices of crisis entrepreneurs in the domain of education in the Netherlands. This paper is part of my Ph.D. project in which I examine the dilemmas encountered by crisis entrepreneurs and the interactional solutions they choose in addressing a crisis. In my Ph.D. project I have analysed how crisis entrepreneurs use discursive practices: (1) to show the factuality of the problem. For example, the way the problem is presented is too theoretical and is not a problem in reality; (2) to present the credibility of the messenger as an authentic, legitimate spokesman. Crisis entrepreneurs may be accused of wanting to attract attention to their own cause; (3) to create the accountability for the problem and the solution. For example, crisis entrepreneurs can be accused of nursing personal grievances or of drawing attention to the issue without actively attempting to solve it. The conclusion is that a communication professional is able to recognize a problem raised by crisis entrepreneurs. Knowledge of interactional dilemmas helps communication professionals understand the potential of crisis entrepreneurs. A communication professional can therefore contribute to the recognition of crises by acknowledging that a crisis entrepreneur is someone who can have a strong hand in the public agenda, i.e., public affairs that are important to the authorities.
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