Johanna Ruusuvuori

Facial and Verbal Expressions in Assessing Stories and Topics

This article examines the intertwining of facial and verbal expressions in assessing stories and topics. The main focus is on the facial expressions of the speaker of a story or telling that occur before their verbal evaluation. It is shown how speakers and recipients arrange face and talk in different configurations in order to display their stance toward what is being told. A key finding is that facial expression can stretch the temporal boundaries of an action. This temporal flexibility of the face enforces its role as a subtle device for securing shared understanding and affiliation. The data consist of 10 telling sequences that are closed up with assessments, drawn from Finnish two-party everyday conversations.

Recognition and Interpretation: Responding to Emotional Experience in Psychotherapy

Based on conversation analysis (CA) of audio-recorded therapy sessions, the article explicates practices of responding to the patients emotional experience in cognitive-constructivist psychotherapy. First, the article describes two types of therapists actions after the patients descriptions of an emotional experience: recognition and interpretation. In recognition, the therapist displays that she understands the patients experience and sees it as real and valid. In interpretation, the therapist points at something that can be heard as implicit in what the patient expressed. Second, the article shows that these two actions are combined in specific ways in the therapists turns at talk. It is suggested that recognition (emotional responsiveness) is a prerequisite of the therapists more interpretive actions that imply access to the patients experience. The empirical findings are discussed in relation to sociological studies on management of emotions in institutions and psychotherapeutic debates on cognitive and emotional aspects of therapeutic processes.

Influence of Turn-Taking in a Two-Person Conversation on the Gaze of a Viewer

In natural conversation, the minimal gaps and overlaps of the turns at talk indicate an accurate regulation of the timings of the turn-taking system. Here we studied how the turn-taking affects the gaze of a non-involved viewer of a two-person conversation. The subjects were presented with a video of a conversation while their eye gaze was tracked with an infrared camera. As a control, the video was presented without sound and the sound with still image of the speakers. Turns at talk directed the gaze behaviour of the viewers; the gaze followed, rather than predicted, the speakership change around the turn transition. Both visual and auditory cues presented alone also induced gaze shifts towards the speaking person, although significantly less and later than when the cues of both modalities were available. These results show that the organization of turn-taking has a strong influence on the gaze patterns of even non-involved viewers of the conversation, and that visual and auditory cues are in part redundant in guiding the viewers’ gaze.

Therapeutic change in interaction: Conversation analysis of a transforming sequence

Abstract A process of change within a single case of cognitive-constructivist therapy is analyzed by means of conversation analysis (CA). The focus is on a process of change in the sequences of interaction, which consist of the therapists conclusion and the patients response to it. In the conclusions, the therapist investigates and challenges the patients tendency to transform her feelings of disappointment and anger into self-blame. Over the course of the therapy, the patients responses to these conclusions are recast: from the patient first rejecting the conclusion, to then being ambivalent, and finally to agreeing with the therapist. On the basis of this case study, we suggest that an analysis that focuses on sequences of talk that are interactionally similar offers a sensitive method to investigate the manifestation of therapeutic change. It is suggested that this line of research can complement assimilation analysis and other methods of analyzing changes in a clients talk.

Patient resistance towards diagnosis in primary care: Implications for concordance

This article reports a conversation analytic study of patients’ resisting responses after doctors’ diagnostic statements. In these responses, patients bring forward information that confronts the doctor’s diagnostic information. We examine two turn formats — aligning and misaligning — with which patients initiate resistance displays, and describe conversational resources of resistance the patients resort to: their immediate symptoms, their past experiences with similar illness conditions, information received in past medical visits and their diagnostic expectations that have been established earlier in the consultation.Through the deployment of these resources, patients orient to the doctor’s diagnostic information as negotiable and seek to further a shared understanding with the doctor on their condition. The results are discussed with regard to concordance as a process in which patients and doctors arrive at a shared understanding on the nature of the illness and its proper treatment. Our analysis illuminates the mechanisms in interaction in and through which concordance can be realized. Thus, we suggest that concordance can be seen to encompass not only treatment discussion but also the process where participants reach agreement about the diagnosis. The data of the study consist of 16 sequences of patients’ resisting responses to diagnosis and is drawn from 86 Finnish primary care visits for upper respiratory tract infections.

How Listeners Use Facial Expression to Shift the Emotional Stance of the Speaker’s Utterance

This article examines how speakers and hearers collaborate to modify their shared emotional stances in mundane dyadic conversations. Our purpose is to determine how the recipient’s facial expression of emotion during or immediately following the speaker’s utterance contributes to the talk. Such facial expressions do not simply mirror the speaker’s stance or display understanding of the speaker’s talk; rather, they perform systematic operations on the projected course of the talk. Moreover, these facial displays of stance are well-timed and coordinated reactions that (in our sample) lead the way to a more light-hearted mode of discussion. Facial expressions that modify the shared emotional stance can: (a) reenact a past, previously shared emotional stance; (b) evoke a new, emotionally appropriate response to the talk; (c) establish a stance that is withheld and/or ambiguous in the talk; or (d) offer an alternative emotion to frame the talk. The data are in Finnish with English translation.

Engaging parents through gaze: Speaker selection in three-party interactions in maternity clinics

OBJECTIVE Describing and analyzing speaker selection in conversations between the health nurse and parents in maternity clinics. METHODS The data consisted of ten video-recorded encounters in maternity clinics. Using conversation analysis, we investigated 89 sequences of interaction in which the health nurse asks a question that is verbally addressed to both parents. RESULTS There was an observable pattern of selecting mothers as principal respondents by all participants of the encounters in maternity clinics. In a few deviant cases, fathers were selected as principal respondents. A typical practice of speaker selection was the gaze direction of the health nurse towards the recipient (usually the mother) at the closure of her question. Various situational elements also influenced which one of the parents answered the question. The deviant cases in which fathers were selected as principal respondents were mainly explainable by the use of the questionnaire designed to facilitate talking about psycho-social issues connected with the transition to parenthood. CONCLUSION Particular interactional circumstances and practices can break the pattern of selecting mothers as respondents to questions addressed to both parents. PRACTICE IMPLICATIONS Fathers could easily be engaged in conversations through gaze. Also the questionnaire seems promising in engaging fathers in conversations in clinics.

Using Formulations and Gaze to Encourage Parents to Talk About Their and Their Children's Health and Well-Being

In preventive health-care settings, professionals need to encourage clients to talk about their problems before they become critical. We use multimodal conversation analysis to demonstrate how public health nurses encourage parents to elaborate on their problems in a sample of preventive maternity and child health (MCH) clinics in Finland. The nurses topicalize the problem-relevant aspects of the parents’ problem-indicative talk by issuing a formulation of what the parent has just said (that is, by redescribing it in problem-related terms). This verbal practice is synchronized with a visual one—the nurse issues the formulation, receives the parents response, and then gazes directly at them. This has the effect of prompting the parent to take up the problem and talk about it. We discuss the findings in relation to the institutional tasks in MCH care and to the role of gaze in constituting actions, such as formulations. Data are in Finnish with English translation.

Misalignment as a Therapeutic Resource

The article reports conversation analysis of a single cognitive psychotherapy session in which an interactional misalignment between the therapist and the patient emerges, culminates, and is mitigated. Through this case study, the interactional practices leading to a rupture in therapeutic alliance and the practices leading to its mending are explored. In the session the therapist pursues investigative orientation in relation to the patients experience under discussion, whereas the patient maintains orientation to “troubles-telling.” The diverging projects of the participants amount to overt misalignment. Eventually, the therapist brings the relationship of the patient and herself as a topic of conversation in ways which turn the misalignment into a resource of therapeutic work. The microanalysis of actual interactional patterns in this single case is linked to discussions of therapeutic alliance in psychotherapeutic literature.

Professional non-neutrality: criticising the third party in psychotherapy

Using audio-recorded data from cognitive-constructivist psychotherapy, the article shows a particular institutional context in which successful professional action does not adhere to the pattern of affective neutrality which Parsons saw as an inherent component of medicine and psychotherapy. In our data, the professionals non-neutrality functions as a tool for achieving institutional goals. The analysis focuses on the psychotherapists actions that convey a critical stance towards a third party with whom the patient has experienced problems. The data analysis revealed two practices of this kind of critique: (1) the therapist can confirm the critique that the patient has expressed or (2) return to the critique from which the patient has focused away. These actions are shown to build grounds for the therapists further actions that challenge the patients dysfunctional beliefs. The article suggests that in the case of psychotherapy, actions that as such might be seen as apparent lapses from the neutral professional role can in their specific context perform the task of the institution at hand.