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"The
central or pivotal issue in [a]
patient's life is not to be discovered in her
'unconscious'; it is lying quite open for her to
see (as well as for us) though this is not to
say that there are not many things about herself
that this patient does not realize" (Laing,
1960/1990, p. 56).
"The sense of a text is not behind the text, but
in front of it. It is not something hidden, but
something disclosed. What has I' to be
understood is not the initial situation of
discourse, but what points towards a possible
world, thanks to the non-ostensive reference of
the text" (Ricoeur, 1976, p. 87).
One
of the challenges in psychotherapy research has
been finding ways to investigate not just the
outcomes of therapy but the process whereby those
outcomes are achieved. This challenge is becoming
increasingly pressing as the need to demonstrate
the effectiveness of therapeutic approaches has
increased with the growth, and what some see as the
encroachment, of managed care. This special issue
of Methods contains a set of papers that, both
individually and collectively, illustrate one
approach to the study of therapeutic process. It is
a hermeneutic approach, employing an interpretive
methodology. This approach focuses on what people
do: on the phenomena of human action and
interaction. Such action is, we presume, situated
in its character, practical before it is
theoretical, organized by ongoing tacit concerns
rather than reflective plans, negotiated and
improvisatory, and open to historical and cutural
contingencies.
In
broad terms our hermeneutic approach seeks to
uncover and elucidate the ontological work that
people accomplish in their everyday practical
activity, including the interchange that takes
place in therapy. This work includes the ongoing
construction and reconstruction of social reality,
and especially the production and reproduction of
persons. Much of this work is done by means of
(through the medium of) language, and so our
interpretive methodology incorporates the analysis
of language pragmatics: the conversational actions
that make up discourse.
The
papers in this issue of Methods apply this
interpretive methodology to the video recording of
an interaction between psychiatrist R. D. Laing and
a volunteer named Leila. The interaction provides
an example of Laing's particular existential
psychotherapy, however the tools of our analysis
and the logic of our inquiry can be used to
illuminate what is happening in any therapeutic
process. In this introduction I will locate our
approach within postmodem inquiry, introduce the
notion of "ontological work," describe the occasion
of Laing's demonstration, sketch a quick overview
of the way we have utilized conversation analysis,
explain how we have drawn on Heidegger's analysis
of Dasein to articulate the ontology of
conversation, and finally give a brief summary of
each of the four papers that follow.
THE PRAGMATICS OF DISCOURSE
Jean-François
Lyotard has proposed that the way to address the
crisis of knowledge that marks postmodernism is by
attention to pragmatics. He writes that he has
"favored a certain procedure: emphasizing facts of
language and in particular their pragmatic aspect"
(1979/1997, p. 9). According to Lyotard, in the
postmodern perspective on society what "governs our
analysis" is the principle "that the observable
social bond is composed of language 'moves'" (p.
11). And he has suggested that pragmatics has
profound implications for our understanding not
just of knowledge but of the knowing subject, the
human being.
Pragmatics
is, in a nutshell, the study of what is done with
language (see Levinson, 1983, p. 5ff for discussion
of the difficulties in defining the term). Talk is
used to do things; utterances are actions, what
Austin ( 1975) called performatives. Pragmatics
attends to what Wittgenstein (1953) called
"language games," the "forms of life" in which
people participate (see Bernstein, 1983). The
postmodem project, then, is one in which:
"language
itself [is seen] as an unstable
exchange between its speakers, whose
utterances are now seen less as a process of
transmission of infonnation or messages, or
in terms of some network of signs or even
signifying systems, than as (to use one of
Lyotard's favorite figures) the 'taking of
tricks,' the trumping of a communicational
adversary, an essentially conflictual
relationship between tricksters" (Jameson,
1997, p. xi).
INTERPRETIVE
INQUIRY
For
a number of years I have been developing a
hermeneutic approach to the study of human
interaction, one that would enable me, as a
developmental psychologist, to understand how
people change. It is an approach that grants both
the semantic character of human action (this was
the emphasis in, for example, Packer, 1984) and its
pragmatic character: the ways in which words move
and change us. In this introduction my intention is
not to provide a detailed explanation of
interpretive research, for such can be found in my
own and others' writing (see Packer, 1985; Packer
& Addison, 1989a; Thompson, 1990; Hiley, Bohman
& Shusterman, 1991). I will content myself with
a few general remarks about the interpretive
analysis of psychotherapy.
The
difficulty that confronts any study of the process
of psychotherapy, one that seeks to open the black
box of therapy and peer inside, not content with
efforts merely to measure its inputs and outputs,
is that therapeutic conversations are not readily
coded. and categorized. Or, to put it more
accurately, this can be done, with greater or
lesser degree of ease, but at the cost of
destroying the temporality and contextuality of
what is going on. A hermeneutic approach, in
contrast, aims to hold on to both these
characteristics, in part by recognizing the
"text-like" character of action, and in part by
recognizing the way that texts, and talk, have
effects. Texts, and text-analogs, are used to act,
It is a method, or more accurately a methodology, a
logic of inquiry, that takes the "interpretive
turn" that many of the social sciences have
undergone in the past twenty years (see Rabinow
& Sullivan, 1979).
An
interpretive methodology seeks not to replace our
everyday understanding of people and events, but
rather to mine, articulate, and where necessary
critique this understanding, Its procedures are not
primarily those of quantification (though this has
its place), but those of careful exegesis. Its
products are typically not abstract
conceptualizations, but detailed and situated
accounts, The result is an expanded understanding,
such that we can begin to appreciate the
constituted character of things we have become
accustomed to considering natural. Our society, and
its institutions and practices, may appear natural
and inevitable to us, but in actuality it is an
ongoing achievement, the product of continual human
activity. Interpretive inquiry enables us to go
beyond the first glance and articulate this
productive activity. It is a matter of articulating
what I call the "ontological work" with which
society is produced and reproduced.
The
social construction of reality is however nothing,
in my opinion, compared with the social
construction of we who live in it. People are
constituted too, and it is surely the task of
psychologists to figure out how this is done. For
the most part we take gender, ethnicity, even
class, perhaps personality, surely cognition, as
natural properties of the biological species we
callhuman, but again on closer examination, all of
these are evidently cultured characteristics, the
results of human activity. Our children (and of
course we ourselves) are social products, raised t
to contribute to the ongoing reproduction of our
society. We still know very little about the way
this happens. The aim of an interpretive
investigation of this matter is to again elucidate
the ontological work that is done. In this case it
is the work accomplished in everyday interaction
that determines who and what people are.
As
I noted earlier, I approach this last matter as a
developmental psychologist and educational
researcher (see Packer, 2001; Packer &
Greco-Brooks, 1999; Packer & Goicoechea, 2000),
with minimal expertise in clinical phenomena. But
the clients of psychotherapy are the products of
society too; and surely the conduct of
psychotherapy is a social process in which,
hopefully, the client changes. The same
interpretive approach that I have used to study
children on the preschool playground (Packer, 1994)
and the way school changes who children are
(Packer, 2001) can bring us a fresh understanding
of psychotherapy too.
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