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Part of
Relationships in Organized Helping: Analyzing interaction in psychotherapy, medical encounters, coaching and in social media
Edited by Claudio Scarvaglieri, Eva-Maria Graf and Thomas Spranz-Fogasy
[Pragmatics & Beyond New Series 331] 2022
► pp. 195–220

Relationship building in oncological doctor-patient interaction

The use of address forms as ‘Tie Signs’

| University of Muenster

This paper studies practices of relationship building between oncologists and their patients during consultations when a diagnosis of malignancy is communicated. The analysis – with its focus on physicians’ uses of terms of address – aims to provide a better understanding of the sequential construction of the doctor-patient relationship in highly sensitive consultations.

In our data, oncologists frequently address their patients by name – even when recipiency is not at issue. They use this communicative resource to contextualize the heightened attention they are giving their patients and to lend the interaction a more personal quality.

Drawing on methods of Conversation Analysis and Interactional Linguistics, I will show that relationship building is an ongoing task doctors are confronted with in the process of interactions.

Keywords: address forms, ‘tie-signs’, oncological consultations, affiliation, alignment
Article outline
  • 1.Introduction
  • 2.Methodological framework
  • 3.‘Doing social relationships’: The use of address forms as ‘Tie Signs’
  • 4.Addressing patients by name during oncological consultations
    • Post-positioned address term
    • Pivot-positioned address term
    • Pre-positioned address term
  • 5.Conclusion
  • Acknowledgements
  • Notes
  • Bibliography
Published online: 7 September 2022
DOI logo
https://doi.org/10.1075/pbns.331.09gun
References

Bibliography

Auer, Peter, and Jan Lindström
2016 “Left/Right Asymmetries and the Grammar of Pre- vs. Post-Positioning in German and Swedish Talk-in-Interaction.” Language Sciences 56: 68–92. DOI logoGoogle Scholar
Bentz, Martin, Martin Binnenhei, Georgios Coussious, Juliana Gruden, Wolfgang Imo, Lisa Korte, Thomas Rüdiger, Antonia Ruf-Dördelmann, Michael R. Schön, and Sebastian Stier
2016 “Von der Pathologie zum Patienten: Optimierung von Wissenstransfer und Verstehenssicherung in der medizinischen Kommunikation.” SpIn: Arbeitspapierreihe Sprache und Interaktion 72. [URL] (last access: 15.05.2020).Google Scholar
Berger, Peter, and Thomas Luckmann
1966 The Social Construction of Reality. New York: Free Press.Google Scholar
Bergmann, Jörg
2014 “Der Fall als epistemisches Objekt.” In ‘Der Fall’ – Studien zur epistemischen Praxis professionellen Handelns, ed. by Jörg Bergmann, Ulrich Dausendschön-Gay, and Frank Oberzaucher, 423–440. Bielefeld: Transcript.Google Scholar
Churchill, Lindsey
1971 “Ethnomethodology and Measurement.” Social Forces 50: 183. DOI logoGoogle Scholar
Clayman, Steven E.
2010 “Address Terms in the Service of Other Actions: The Case of News Interview Talk.” Discourse and Communication 4 (3): 161–183. DOI logoGoogle Scholar
2012 “Address Terms in the Organization of Turns at Talk: The Case of Pivotal Turn Extensions.” Journal of Pragmatics 44: 1853–1867. DOI logoGoogle Scholar
Couper-Kuhlen, Elizabeth, and Dagmar Barth-Weingarten
2011 “A System for Transcribing Talk-in-Interaction: GAT 2.” Gesprächsforschung – Online-Zeitschrift zur verbalen Interaktion 12: 1–51.Google Scholar
Couper-Kuhlen, Elizabeth, and Margret Selting
2018 Interactional Linguistics. Studying Language in Social Interaction. Cambridge: Cambridge University Press.Google Scholar
Deppermann, Arnulf, and Susanne Günthner
(eds) 2015 Temporality in Interaction. Amsterdam, Philadelphia: John Benjamins. DOI logoGoogle Scholar
Droste, Pepe, and Susanne Günthner
2020 “ ‘das mAchst du bestimmt AUCH du;’: Zum Zusammenspiel syntaktischer, prosodischer und sequenzieller Aspekte syntaktisch desintegrierter du-Formate.” In Prosodie und Konstruktionsgrammatik, ed. by Wolfgang Imo, and Jens Lanwer, 75–110. Berlin, Boston: De Gruyter. DOI logoGoogle Scholar
2021 “Enacting ‘Being with You’: Vocative Uses of du (‘you’) in German Everyday Interaction.” Pragmatics 31 (1): 87–113. DOI logoGoogle Scholar
Durkheim, Émile
1915 The Elementary Forms of the Religious Life: A Study in Religious Sociology. London: George Allen & Unwin.Google Scholar
Džanko, Minka
2020 Rollengebundene Asymmetrie in Arzt-Patient-Gesprächen. Ein Vergleich im Deutschen und Bosnischen. Heidelberg: Universitätsverlag Winter.Google Scholar
Enfield, Nick J.
2006 “Social Consequences of Common Ground.” In Roots of Human Sociality: Culture, Cognition, and Interaction, ed. by Nick J. Enfield, and Stephen C. Levinson, 399–430. London: Berg.Google Scholar
2009 “Relationship Thinking and Human Pragmatics.” Journal of Pragmatics 41(1): 60–78. DOI logoGoogle Scholar
Frommer, Jörg
2014 “Therapie als Fallarbeit: Über einige Grundprobleme und Paradoxien professionellen Handelns in der Medizin”. In ‘Der Fall’ – Studien zur epistemischen Praxis professionellen Handelns, ed. by Jörg Bergmann, Ulrich Dausendschön-Gay, and Frank Oberzaucher, 103–123. Bielefeld: Transcript.Google Scholar
Fruht, Christiane, and M. Vogelhuber
2016 Kommunikation in der Onkologie: Überbringen schlechter Nachrichten. Universitätsklinikum Regensburg. [URL] (last access: 15.12.2019).Google Scholar
Goffman, Erving
1967 Interaction Ritual: Essays on Face-to-Face Behavior. Chicago: Aldine.Google Scholar
1971 Relations in Public: Microstudies of the Public Order. New York: Basic Books.Google Scholar
1974/1982 Das Individuum im öffentlichen Austausch. Microstudien zur öffentlichen Ordnung. Frankfurt a. M: Suhrkamp.Google Scholar
Goodwin, Marjorie H.
2001 “Participation.” In Key Terms in Language and Culture, ed. by Alessandro Duranti, 172–175. Malden, Oxford: Blackwell.Google Scholar
Gumperz, John J.
1982 Discourse Strategies. Cambridge: Cambridge University Press. DOI logoGoogle Scholar
2001 “Interactional Sociolinguistics: A Personal Perspective.” In The Handbook of Discourse Analysis, ed. by Deborah Schiffrin, Deborah Tannen, and Heidi E. Hamilton, 215–228. Malden: Blackwell.Google Scholar
Günthner, Susanne
2008 “Projektorkonstruktionen im Gespräch: Pseudoclefts, die Sache ist-Konstruktionen und Extrapositionen mit es.” Gesprächsforschung – Online-Zeitschrift zur verbalen Interaktion 9: 86–114. [URL] (last access: 15.05.2020).Google Scholar
2016 “Praktiken erhöhter Dialogizität: Onymische Anredeformen als Gesten personifizierter Zuwendung.” Zeitschrift für Germanistische Linguistik 44 (3): 406–436. DOI logoGoogle Scholar
2017 “Sprachliche Verfahren bei der Übermittlung schlechter Nachrichten – sedimentierte Praktiken im Kontext onkologischer Aufklärungsgespräche.” SpIn: Arbeitspapierreihe Sprache und Interaktion 73. [URL] (last access: 09.10.2021).Google Scholar
2018 “Thomas Luckmanns Einfluss auf die Sprachwissenschaft – Kommunikative Gattungen im Alltagsgebrauch am Beispiel onkologischer Aufklärungsgespräche.” In Lebenswelt und Gesellschaft. Gedenkband für Thomas Luckmann, ed. by Alois Hahn, and Martin Endreß, 358–400. Konstanz: UVK.Google Scholar
2021 “Namentliche Anreden in onkologischen Aufklärungsgesprächen: Formen und Funktionen onymischer Anreden in der Interaktion.” In Linguistik und Medizin: Sprachwissenschaftliche Zugänge und interdisziplinäre Perspektiven, ed. by Marina Iakushevich, Yvonne Ilg, and Theresa Schnedermann, 71–92. Berlin, Boston: De Gruyter. DOI logoGoogle Scholar
Günthner, Susanne, and Thomas Luckmann
2001 “Asymmetries of Knowledge in Intercultural Communication: The Relevance of Cultural Repertoires of Communicative Genres.” In Culture in Communication: Analyses of Intercultural Situations, ed. by Aldo Di Luzio, Susanne Günthner, and Franca Orletti, 55–86. Amsterdam, Philadelphia: John Benjamins. DOI logoGoogle Scholar
Günthner, Susanne, and Qiang Zhu
2017 “Anredeformen im Kulturvergleich. Verwandtschaftsbezeichnungen als Mittel der kommunikativen Konstruktion sozialer Beziehungen in chinesischen und deutschen SMS-Interaktionen.” In Sprache und Beziehung, ed. by Angelika Linke, and Juliane Schröter, 119–149. Berlin, Boston: De Gruyter. DOI logoGoogle Scholar
Hanks, William F.
2007 “Person Reference in Yucatex Maya Conversation.” In Person Reference in Interaction: Linguistic, Cultural and Social Perspectives, ed. by Nick J. Enfield, and Tanya Stivers, 149–171. Cambridge: Cambridge University Press. DOI logoGoogle Scholar
Heath, Christian
1992 “The Delivery and Reception of Diagnosis in the General Practice Consultations.” In Talk at Work, ed. by Paul P. Drew, and John Heritage, 235–268. Cambridge: Cambridge University Press.Google Scholar
Heritage, John
1984 Garfinkel and Ethnomethodology. Cambridge: Polity.Google Scholar
2004 “Conversation Analysis and Institutional Talk: Analysing Data.” In Qualitative Research: Theory, Method and Practice, ed. by David Silverman, 222–245. London: Sage.Google Scholar
2011 “Territories of Knowledge, Territories of Experience: Empathic Moments in Interaction.” In The Morality of Knowledge in Conversation, ed. by Tanya Stivers, Lorenza Mondada, and Jan Steensig, 159–183. Cambridge: Cambridge University Press. DOI logoGoogle Scholar
Heritage, John, and George Raymond
2005 “The Terms of Agreement: Indexing Epistemic Authority and Subordination in Talk-in-Interaction.” Social Psychology Quarterly 68: 15–38. DOI logoGoogle Scholar
Imo, Wolfgang
2017 “Trösten: Eine professionelle Praktik in der Medizin.” In: Arbeitspapierreihe Sprache und Interaktion 71. [URL] (last access: 02.06.2021).Google Scholar
Imo, Wolfgang, and Jens Lanwer
2019 Interaktionale Linguistik: Eine Einführung. Berlin: Metzler. DOI logoGoogle Scholar
Keller, Reiner, Herbert Knoblauch, and Jo Reichertz
2012 “Kommunikativer Konstruktivismus.” In Kommunikativer Konstruktivismus: Theoretische und empirische Arbeiten zu einem neuen wissenssoziologischen Ansatz, ed. by Reiner Keller, Hubert Knoblauch, and Jo Reichertz, 3–22. Berlin: Springer.Google Scholar
Koerfer, Arnim, and Christian Albus
2018 Kommunikative Kompetenz in der Medizin. Ein Lehrbuch zur Theorie, Didaktik, Praxis und Evaluation der ärztlichen Gesprächsführung. Radolfzell: Verlag für Gesprächsforschung.Google Scholar
Kupetz, Maxi
2014 “Empathy Displays as Interactional Achievements – Multi-Modal and Sequential Aspects.” Journal of Pragmatics 61: 4–34. DOI logoGoogle Scholar
Lerner, Gene H.
2003 “Selecting Next Speaker: The Context-Sensitive Operation.” Language in Society 32 (2): 177–201. DOI logoGoogle Scholar
Linke, Angelika, and Juliane Schröter
2017 “Sprache in Beziehungen – Beziehungen in Sprache: Überlegungen zur Konstitution eines linguistischen Forschungsfeldes.” In: Sprache und Beziehung, ed. by Angelika Linke, and Juliane Schröter, 1–32. Berlin, Boston: De Gruyter. DOI logoGoogle Scholar
Luckmann, Thomas
1990 “Social Communication, Dialogue and Conversation.” In The Dynamics of Dialogue, ed. by Ivana Marková, and Klaus Foppa, 45–61. New York: Harvester Wheatsheaf.Google Scholar
2001 On the Methodology of (Oral) Genres. Plenary Talk at the Symposium on Genres. Oslo: University College.Google Scholar
Mandelbaum, Jenny
2003 “Interactive Methods for Constructing Relationships.” In Studies in Language and Social Interaction, ed. by Phillip J. Glenn, Curtis D. LeBaron, and Jenny Mandelbaum, 207–219. Mahwah, NJ, London: Lawrence Erlbaum. DOI logoGoogle Scholar
Maynard, Douglas W.
2003 Bad News, Good News. Conversational Order in Everyday Talk and Clinical Settings. Chicago: University of Chicago Press.Google Scholar
Muntigl, Peter, Naomi Knight, Adam O. Horvath, and Ashley Watkins
2012 “Client Affectual Stance and Therapist-Client Affiliation: A View from Grammar and Social Interaction.” Research in Psychotherapy: Psychopathology, Process and Outcome 15 (2): 117–130.Google Scholar
Muntigl, Peter, Naomi Knight, Ashley Watkins, Adam O. Horvath, and Lynne Angus
2013 “Active Retreating: Person-Centered Practices to Repair Disaffiliation in Therapy.” Journal of Pragmatics 53: 1–20. DOI logoGoogle Scholar
Muntigl, Peter, and Adam O. Horvath
2015 “The Therapeutic Relationship in Action: How Therapists and Clients Co-Manage Relational Disaffiliation”. In The Therapeutic Relationship: Innovative Investigations, ed. by Hadas Wiseman, and Orya Tishby, 41–59. London, New York: Routledge.Google Scholar
Nübling, Damaris, Fabian Fahlbusch, and Rita Heuser
2012 Namen. Eine Einführung in die Onomastik. Tübingen: Narr.Google Scholar
Noack, Thorsten, Heiner Fangerau, and Jörg Vögele
(eds) 2007 Querschnitt Geschichte, Theorie und Ethik der Medizin. München, Jena: Urban and Fischer.Google Scholar
Pomerantz, Anita, and Jenny Mandelbaum
2005 “Conversation Analytic Approaches to the Relevance and Uses of Relationship Categories in Interaction.” In Handbook of Language and Social Interaction, ed. by Kristine L. Fitch, and Robert E. Sanders, 149–171. Mahwah, NJ: Lawrence Erlbaum.Google Scholar
Raymond, Chase W.
2016 “Linguistic Reference in the Negotation of Identity and Action: Revisiting the T/V Distinction.” Language in Society 92 (3): 636–670.Google Scholar
Reineke, Silke, and Thomas Spranz-Fogasy
2013 “Arzt-Patient-Kommunikation: Allgemeine Merkmale und Besonderheiten bei Brustkrebspatienten.” In Krankheit: Lernen im Ausnahmezustand? Brustkrebs und Herzinfarkt aus interdisziplinärer Perspektive, ed. by Dieter Nittel, and Astrid Seltrech, 444–454. Berlin, Heidelberg: Springer. DOI logoGoogle Scholar
Rendle-Short, Johanna
2007 “’Catherine, You’re Wasting your Time’: Address Terms within the Australian Political Interview.” Journal of Pragmatics 39 (9): 1503–1525. DOI logoGoogle Scholar
2011 “Address Terms in the Australian Political News Interview.” In Talking Politics in Broadcast Media. Cross-Cultural Perspectives on Political Interviewing, Journalism and Accountability, ed. by Mats Ekström, and Marianna Patrona, 93–111. Amsterdam, Philadelphia: John Benjamins. DOI logoGoogle Scholar
Ribeiro, Eugenia, and Antonio P. Ribeiro, Miguel M. Goncalves, Adam O. Horvath, and William B. Stiles
2013 “How Collaboration in Therapy Becomes Therapeutic: The Therapeutic Collaboration Coding System.” Psychology and Psychotherapy 86 (3): 294–314. DOI logoGoogle Scholar
Sacks, Harvey, Emanuel Schegloff, and Gail Jefferson
1978 “A Simplest Systematics for the Organization of Turn-Taking for Conversation.” In Studies in the Organization of Conversational Interaction, ed. by Jim Schenkein, 7–55. New York: Academic Press. DOI logoGoogle Scholar
Sator, Marlene, and Thomas Spranz-Fogasy
2011 “Medizinische Kommunikation.” In Angewandte Linguistik – Ein Lehrbuch, ed. by Karlfried Knapp, 376–393. Tübingen, Basel: Francke.Google Scholar
Scarvaglieri, Claudio
2017 “Beraten und Psychotherapie: Zur Differenzierung zweier Formate helfenden Handelns.” In: Beraten in Interaktion. Eine gesprächslinguistische Typologie des Beratens, ed. by Ina Pick, S. 53–76. Frankfurt am Main: Peter Lang.Google Scholar
Schegloff, Emanuel A.
1996 “Some Practices for Referring to Persons in Talk-in-Interaction: A Partial Sketch of a Systematics.” In Studies in Anaphora, ed. by Barbara Fox, 437–486. Amsterdam: John Benjamins. DOI logoGoogle Scholar
2007 Sequence Organization in Interaction: A Primer in Conversation Analysis. Cambridge: Cambridge University Press. DOI logoGoogle Scholar
Schütz, Alfred, and Thomas Luckmann
1979 Strukturen der Lebenswelt. Band 1. Frankfurt a.M.: Suhrkamp.Google Scholar
Schwitalla, Johannes
1995 “Namen in Gesprächen.” In Handbücher zur Sprach- und Kommunikationswissenschaft. Band 11.1, ed. by Hugo Steger, and Herbert E. Wiegand, 498–504. Berlin, New York: De Gruyter.Google Scholar
2010 “Kommunikative Funktionen von Sprecher- und Adressatennamen in Gesprächen.” In Eigennamen in der gesprochenen Sprache, ed. by Nicolas Pepin, and Elwys de Stefani, 179–199. Tübingen: Francke.Google Scholar
Selting, Margret, and Elizabeth Couper-Kuhlen
(eds) 2001 Studies in Interactional Linguistics. Amsterdam: John Benjamins. DOI logoGoogle Scholar
Selting, Margret, Peter Auer, Dagmar Barth-Weingarten, Jörg R. Bergmann, Pia Bergmann, Karin Birkner, Elizabeth Couper-Kuhlen, Arnulf Deppermann, Peter Gilles, Susanne Günthner, Martin Hartung, Friederike Kern, Christine Mertzlufft, Christian Meyer, Miriam Morek, Frank Oberzaucher, Jörg Peters, Uta Quasthoff, Wilfried Schütte, Anja Stukenbrock, and Susanne Uhlmann
2009 “Gesprächsanalytisches Transkriptionssystem 2 (GAT 2).” Gesprächsforschung – Online-Zeitschrift zur verbalen Interaktion 10: 353–402.Google Scholar
Silverstein, Michael
1993 “Metapragmatic Discourse and Metapragmatic Function.” In Reflexive Language: Reported Speech and Metapragmatics, ed. by John Lucy, 33–58. Cambridge: Cambridge University Press. DOI logoGoogle Scholar
Spranz-Fogasy, Thomas
2005 “Kommunikatives Handeln in ärztlichen Gesprächen – Gesprächseröffnung und Beschwerdenexploration.” In Psychosomatische Gesprächsführung in der Frauenheilkunde – ein interdisziplinärer Ansatz zur verbalen Intervention, ed. by Mechthild Neises, Susanne Ditz, and Thomas Spranz-Fogasy, 17–47. Stuttgart: Wissenschaftliche Verlagsgesellschaft.Google Scholar
Stivers, Tanya
2008 “Stance, Alignment, and Affiliation during Storytelling: When Nodding is a Token of Affiliation.” Research on Language and Social Interaction 41 (1): 31–57. DOI logoGoogle Scholar
Stivers, Tanya, Nick J. Enfield, and Stephen C. Levinson
2007 “Person Reference in Interaction.” In Person Reference in Interaction: Linguistic, Cultural and Social Perspectives, ed. by Nick J. Enfield, and Tanya Stivers, 1–20. Cambridge: Cambridge University Press.Google Scholar
Stivers, Tanya, Lorenza Mondada, and Jakob Steensig
2011 “Knowledge, Morality and Affiliation in Social Interaction.” In The Morality of Knowledge in Conversation, ed. by Tanya Stivers, Lorenza Mondada, and Jakob Steensig, 3–26. Cambridge: Cambridge University Press. DOI logoGoogle Scholar
Tomasello, Michael, and Malinda Carpenter
2007 “Shared Intentionality.” Developmental Science 10 (1): 121–125. DOI logoGoogle Scholar
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