Kommunikative Praktiken des Widerstands in psychotherapeutischen Gesprächen: Patientenwiderstand durch reaktive Ich-weiß-nicht-Konstruktionen / Communicative practices of resistance in psychotherapy interactions: Patients' resistance through reactive Ich-weiß-nicht-constructions

Abstract

In recent years, there has been an increase in conversation analytic research on psychotherapeutic interactions (Marciniak, Nikendei, Ehrenthal, & Spranz-Fogasy, 2016), particularly on the practices of patient resistance (Ekberg & LeCouter, 2015; Vehviläinen 2008). While some studies have identified broader strategies in patients' responses, few interactional practices have been discussed in detail. Using conversation analytic techniques, I identify and analyze one such practice patients use when resisting in German psychotherapeutic interaction, namely reactive (stand-alone and turn-initial) Ich-weiß-nicht-constructions (IWN). Fourteen psychotherapeutic sessions involving five therapists, fourteen patients and a total of 148 cases of IWN have been analyzed. Stand-alone IWN were rare (12/148) and occurred after presupposing questions prompting self reflection or concerning the patients private life. I identify four increasingly resistant pattern of use in stand-alone IWN: They functioned (1) as markers of epistemic trouble, (2) to resist therapists wording (3) to avoid a topic, (4) as indicators of solidified resistance. Turn-initial IWN were more common (53/148), less often resistant and occurred after similar questions as stand-alone ones. They were used (1) without resistance function, (2) as preface to an avoiding answer, (3) as en epistemic block. I only briefly consider turn-medial and turn-final IWN; patients primarily use the former as problem markers. The latter can assume a resistant position in topic closings.