John Benjamins Publishing Company
Neurologists' approaches to making psychosocial attributions in patients with functional neurological symptoms
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Abstract
Doctors perceive consultations with patients with functional neurological symptoms (FNS) as challenging because of the dichotomy between the psychosocial nature of the symptoms and patients’ perceptions that their condition is essentially physical. Through conversation analysis, we describe some communicative strategies neurologists employ to make psychosocial attributions, ranging from unilateral to more bilateral approaches. In unilateral approaches doctors employ general explanations about the psychosocial aetiology, thereby pre-empting any potential resistance. In bilateral approaches, doctors actively involve patients in discussing potential psychosocial causes, by also making direct and specific psychosocial attributions. These practices display doctors’ great caution in this communicative task; and they exhibit an hybridization with those employed by psychologists, which might be strictly linked to this type of patients.
Abstract
Doctors perceive consultations with patients with functional neurological symptoms (FNS) as challenging because of the dichotomy between the psychosocial nature of the symptoms and patients’ perceptions that their condition is essentially physical. Through conversation analysis, we describe some communicative strategies neurologists employ to make psychosocial attributions, ranging from unilateral to more bilateral approaches. In unilateral approaches doctors employ general explanations about the psychosocial aetiology, thereby pre-empting any potential resistance. In bilateral approaches, doctors actively involve patients in discussing potential psychosocial causes, by also making direct and specific psychosocial attributions. These practices display doctors’ great caution in this communicative task; and they exhibit an hybridization with those employed by psychologists, which might be strictly linked to this type of patients.
Chapters in this book
- Prelim pages i
- Table of contents v
- Discourses of helping professions 1
- How practitioners deal with their clients' "off-track" talk 13
- Empathic practices in client-centred psychotherapies 33
- The interactional accomplishment of feelings-talk in psychotherapy and executive coaching 59
- “Making one’s path while walking with a clear head” 91
- Form, function and particularities of discursive practices in one-on-one supervision in Germany 123
- "I mean is that right?" 157
- Professional roles in a medical telephone helpline 179
- Anticipatory reactions 205
- “Doctor vs. patient” 227
- Time pressure and digressive speech patterns in doctor-patient consultations 257
- Neurologists' approaches to making psychosocial attributions in patients with functional neurological symptoms 289
- Name index 315
- Subject index 319
Chapters in this book
- Prelim pages i
- Table of contents v
- Discourses of helping professions 1
- How practitioners deal with their clients' "off-track" talk 13
- Empathic practices in client-centred psychotherapies 33
- The interactional accomplishment of feelings-talk in psychotherapy and executive coaching 59
- “Making one’s path while walking with a clear head” 91
- Form, function and particularities of discursive practices in one-on-one supervision in Germany 123
- "I mean is that right?" 157
- Professional roles in a medical telephone helpline 179
- Anticipatory reactions 205
- “Doctor vs. patient” 227
- Time pressure and digressive speech patterns in doctor-patient consultations 257
- Neurologists' approaches to making psychosocial attributions in patients with functional neurological symptoms 289
- Name index 315
- Subject index 319
