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## Questioning questions in psychotherapeutic practice: The dialogical dynamics of change in therapy through clients questioning therapists

Line Brink Worsøe University of Southern Denmark

line.worsoe@sdu.dk

Th omas Wiben Jensen University of Southern Denmark twj@sdu.dk

## Abstract:

Th e focus of this study is a particular type of questioning in psychotherapy: Th e unusual, yet recurrent, phenomenon of clients asking questions or making requests to the therapist and the way this alters the dialogical dynamics and therapeutic  alliance  between  the  two.  Th us,  we  investigate  how  these  types of  question-answer  cycles  challenge  the  balance  of  the  dialogical  system  of therapy including the normally accepted asymmetrical power relation between therapist  and  client.  Th e  analysis  is  informed  by  an  ecological  perspective which views the dialogical collaboration of therapist and client as forming a distributed cognitive system. Th e study shows how disaffi liation to questioning cycles on one hand stress the dialogical system through changing the language game, yet on the other hand, also entertain a subtle form of cooperativeness. Th e questioning cycles inform the dyadic system of therapist and client so that precautions can be made in order to secure the therapeutic alliance. 1 *

Keywords: Questioning, psychotherapy, interaction, dis-alignment, collaboration, therapeutic alliance, ecological and distributed cognition.

## 1. Introduction

What happens to the dialogical system of therapy when the client unexpectedly asks questions and makes requests to the therapist instead of the other way around? Th is is the pivot question of this article. Investigating the phenomenon from an ecological perspective reveals that reversed question-response cycles change the condition for the dialogical system, as the phenomenon transform the institutional pattern of rights, responsibility, and obligations. Th is article focuses  on  the  interactive  and  distributed  dynamics  of  two  cases  of  client questioning in the psychotherapeutic encounter.

Th erapy  is  a  collaborative  practice  (Bercelli  et  al  2013).  As  shown  in recent studies on psychotherapy (therapeutic alliance (Ponsi 2000, Bartesaghi 2009ab,  Cornellius-white  et  al  2018,  Garcia  and  Di  Paolo  2018),  solution building (Froerer and Jordan 2013, Jordan et al 2013, Taylor and Simon 2014), and client resistance (Guilfoyle 2002, Ribeiro et al 2014, Muntigl et al 2017, Yao & Ma, 2017), psychotherapeutic conversing practices concern a multifold endeavor of 'talking to' and 'talking about' the client. Th is dialogical endeavor is characterized by activities of questioning and telling which is entangled in an interactive fi  eld (Bucholtz et al 2015). Questioning plays a vital role in both the  therapeutic  inquiry  phases  and  the  elaboration  phases  of  therapy.  Th e practice of questioning is an intervening tool and methodological technique to  guide  the  client  in  building  his/her  personal  narratives  and  to  help  the therapist to get a better understanding of the narrative and the problematic behavior of the client (Bercelli et al 2013) , yet as such it becomes a vital tool for conversational control, a way for the dialogical system to do asymmetry (Buttny, 1996; Bartesaghi, 2009a). Given that the client is the fulcrum of this type of activity, the primary responsibility of doing questioning lies on the therapist, in order to steer, control and qualify the therapy. Th is asymmetric pattern works as enabling conditions for therapy and thereby constitutes the therapeutic encounter as an institutional type of activity (Linell & Luckmann 1991, Sidnell 2009, Bartesaghi 2009, Heritage and Clayman 2010). Given the focus of  recent  psychotherapeutic  process  research  (PPR)  (Mörtl  and  Gelo 2015, Smoliak and Strong, 2018), most studies on questioning in psychotherapy concern the questioning practice of the therapists alone: how it is treated as interventions; how the clients align or misalign in their response; and what it does to the therapeutic process (McGee 1999, Voutilainen et al 2011, Yao & Ma, 2017). In this article, however, the focus is turned towards cases where the client poses questions or make question-like maneuvers directed at the therapist.

Th e framework for describing questions has traditionally been guided by and restricted to (the fi  eld of) pragmatics. Within a framework of pragmatics, the question as a phenomenon has been described as an illocutionary act that has a directive illocutionary point of attempting to get the addressee to supply information  (Crystal  1985).  Pragmatics  has  developed  within  structural linguistics, as a way to account for the contextual dependence of language, and  the  premise  of  doing  so  thus  entails  a  structural  perspective,  even  on context. To take a stance against structural linguistics, we take an ecological perspective on language, which entails that languaged coordinated behavior, however structural in appearance, is constituted through the complexities of contexts in which languaging happens. Th is fundamental shift   of perspective encourages  an  investigation  of  how  contextualized  systemic  behavior  of languaging enables question-like properties of action. We therefore seek to answer  following  question:  How  can  an  ecological  perspective  contribute to  the  understanding  and  investigation  of  questioning  as  a  phenomenal activity?    Th e  activity  of  questioning  transcends  many  diff  erent  types  of situations.  Situations  that  are  institutionalized  in  one  way  or  another,  are, due to their constrained characteristics, a preferred setting for investigations of  questions.  Here  we  investigate  one  specifi  c  type  of  institutionalized interaction, namely the psychotherapeutic encounter. Th e psychotherapeutic encounter is characterized by a special practice of contextualized languaged co-activity of questioning and is thus a privileged site to study questioning as  ecological  activity.  Questioning  in  psychotherapy  is  crucial  part  of  the asymmetrical  patterns, which  characterize or are associated with this particular type of institutional activity as a practice (Forrester & Reason, 2006; Bartesaghi, 2009a). Yet, within conversation analytic approaches, it has been pointed out how institutional activities carry out practices of everyday talk (Sacks,  1992),  and  thus  the  process  of  therapeutic  questioning  is  informed by  everyday  practice  of  doing  questioning  together.  As  such,  studying  the activities of questioning in psychotherapy can tell us much about questioning in general, just as the asymmetries engendered can tell us about the dynamics of asymmetry in general (Bartesaghi, 2009b). Th e smooth way both the clients and the therapists orient to the questioning activity of the therapeutic practice in general, is associated with a mutual acceptance of the institutional order.

During  our  study  of  questioning  in  psychotherapy,  however,  we  found interesting sequences in our data, in which an interactional clash questions the  degree  of  mutuality.  Th ese  particular  examples  involve  clients'  acts  of questioning the moral obligation and responsibility of the therapist, and thus thereby question the institutional order. When the institutional obligations and responsibilities of the therapist is questioned this way, it questions the institutional  relationship  and  potentially  stresses  the  therapeutic  alliance. Hence, we explore the client's question, which is questioning the institutional order of which the therapist's questioning is a constituting feature. We seek to do that by the following: what does this reverse questioning do to the ecology of therapeutic practice? In the words of Harvey Sacks (1992: 419), people no matter what happens, engage with every eff  ort possible in '(...) fi  nding only how it is that what is going on is usual' . What do the therapist and the client do with respect to each other to restore the institutional order of their mutual engagement?

## 2. Focus

Th e focus of the current issue is 'questions in language, culture and cognition' , including the meta-concept of 'questioning questions' . Accordingly, it seems appropriate to defi  ne and further explain what is meant by the social constructs of questions and questioning before clarifying how we approach this phenomenon here. Relying on pragmatic theory, asking is a speech act (Searle

1969), and how the interactants are co-operating in sense-making is relying on anticipatory illocutionary aspects (Grice 1963, 1975). Contrary to for instance physical actions, a speech act is considered to be done through language alone. Th e value of a speech act is derived from the linguistic prerequisites and rules agreed upon within a particular speech community. Speech acts consist of a propositional (locutionary) content conditions and an illocutionary point together with preparatory and sincerity conditions. Th e illocutionary force is comprised by combining the illocutionary point of an utterance, with particular presuppositions and attitudes that must accompany that point, including the strength of the illocutionary point, preparatory conditions, propositional content conditions, mode of achievement, sincerity conditions, and strength of  sincerity  conditions  (Crystal  1985).  Hence,  the  illocutionary  force  of  an utterance is its compiled expression, that is, the value it is ascribed in the particular situation by someone/somebody. 2 Th e question functions by activating a presuppositional force, that an empty frame (the absence of information) relative to and induced by the question, can be (and ought to be) fi  lled out and completed. As such, an illocutionary act that has a directive illocutionary point of attempting to get the addressee to supply information.

## 3. Questioning in psychotherapy

Th e  aim of psychotherapy is 'healing' dysfunctional thoughts and behavior through talk (hence 'the talking cure' , Peräkylä et al 2008). Ever since Freud's psychoanalysis,  the  analytical  priority  has  been  on  the  clients'  telling  and how the therapist facilitates these activities. Th e  activity  of  questioning has served as an engine for the therapist to get patients and clients to tell their stories  and  share  their  life  experiences  and  psychological  states  (Conte 2009):  ' Th e  therapist  actively  engages  in  how  the  client's  problems  get  told: what gets picked up on and made relevant for further discussion, and fi  nally, what becomes the problems for therapy ' (Buttny, 1996, p. 126). Th us, from an early  start,  the  psychotherapeutic  encounter  has  been  acknowledged  as  an asymmetric practice circling around the patient but steered and controlled by the professional therapist. Studies have shown some of the powerful strategies put into use by therapists to substitute clients' accounts. Th ese strategies are interactional moves in how the therapist does authority (Bartesaghi, 2009b; Pawelczyk,  2017).  Th us,  the  therapist  as  doing  being  professional  is  not  a neutral force in the psychotherapeutic interaction, though it is oft  en treated that way (Smoliak & Strong, 2018). Th e therapist is seen as a neutral means of the professional institution he/she represents (Bartesaghi, 2009a).

In  the  last  decades  diff  erent  therapeutic  methods  has  been  developed all formed around the individual as a dialogical social responsive organism, (Alberdi et al 2015). Th e aim here is not to discuss the diff  erent theoretical models  of  'sense,  mind,  and  self '  of  diff  erent  therapeutic  approaches,  and the features of various therapeutic approaches will not be described in detail in  this  article.  We  will  point  out,  however,  that  regardless  of  the  epistemic model underlying each type of therapy, the interactional framework, i.e. how the  diff  erent  knowledge  claims  are  realized  through  verbal  and  non-verbal gestures,  shows  similarities  in  form  (Lepper  &  Mergenthaler,  2007,  2008;

Peräkyla  et  al,  2008).  In  example,  signifi  cant  qua-declarative  formulations oft  en occurring in psychotherapy regardless of therapeutic method (McGee 1999), are playing a part in so-called interpretation cycles (Peräkylä et al 2011).

An organization or an institution is recurrently maintained, renewed, and transformed through the way in which its members coordinate social actions together and in respect of each other: 'it is within these local sequences of talk, and only there, that these institutions are ultimately and accountably talked into being' (Heritage, 1984, p. 290). Specifi  c sequential formats confi  gure and constrain the opportunities to speak and to initiate actions as they are shaped by the institutional context but also refl  exively construct it in a number of institutional  interactions  (Mondada,  2012).  Th is  happen  with  regards  to diff  erent  levels  of  organization  of  interaction  (i.e.  turn  taking,  sequence organization,  openings  and  closings,  etc.),  particular  designs  of  the  above (i.e.  wordings,  topic  management,  etc.),  and  underlying  expectations  and anticipations present in the settings and incarnated by participants (BenoîtBarné & Cooren, 2010).Th ough based on dialogical encounters, the therapist enjoys relative authority over the client, through membership of the institution. Th e psychotherapeutic session is a category-bound activity characteristic of a standardized pair, therapist/client, relying on a series of rights and obligations, and distributing epistemic claims, of which questioning constitutes a typical cyclic co-activity. Th e cyclic co-activity of questioning is most oft  en initiated by the therapist and addressed to the client, but can also be initiated by the client,  depending  on  epistemics  and  their  organization.  In  this  way,  the dynamic activity of questioning rest on a functional asymmetry of knowledge: For  the  clients  to  engage  in  therapy  means  they  need  help,  which  means accepting feeling helpless to a large degree while knowing less about how to be better. What should be noted here is that if psychotherapy is a category bound activity, the interactional dynamics is constrained by an asymmetric organization in the expectation of 'talking with/talking to/ talking about the client' (Buchholtz, Spiekermann & Käschele, 2015). Even if therapists engage through doing self-disclosure, it ought to be strategically directed towards the goal of guiding the client to take a refl  ective stance (Leudar, Antaki & Barnes, 2008).

Since the development of micro-sociological ethnomethodology and the fi  eld  of  conversation  analysis  in  the  sixties  and  seventies  (Sacks,  Jeff  erson &  Schegloff    1974),      the  dominant  view    on  questions  is,  briefl  y  put,  that they acquire   meaning in-and-through how they are treated in the fl  ow of conversation. Th is makes questioning in psychotherapy a complex matter as it is a way of controlling the conversation but at the same time is fully depending on the client's interpretation and complying. Th e encounter of therapist and client  is  seen  as  dialogical,  though  still  governed  by  institutional  norms, which get expressed through asymmetric patterns of behavior (Heritage & Clayman  2010).  In  the  therapeutic  encounter,  questioning  is  considered  a methodological tool for the therapist to intervene, to guide the patient and to control the therapeutic process (Adams, 1997; McGee et al, 2005; Bartesaghi, 2009a). Th ey are a way for the practitioner to display understanding of the client's situation, to narrow down the topics of enquiry, and thus at best to perform and unfold the therapeutic project by gentle steering without losing the client underway. Th e success of questioning as interventions depends on the fi  ne-tuning between therapist and client, that is, how well the therapist relate to the client as a unique person and as a 'client' , and how well the client relates to the therapist as a person and as an authority, as well as how both engage in cooperative behavior, which incarnates therapy as an institutional system with certain expectations, and patterns of rights and obligations. It is  a  delicate navigation between conversational control while involving and encouraging the agency of the client (Buttny, 1996).

In  this  article,  we  look  at  the  articulation  between  dialogical  and interactional  order  and  institutional  order  with  respect  to  questioning practice  in  psychotherapy.  Questioning  practice  as  a  form  of,  or  a  part  of, therapeutic intervention (Adams, 1997), happens to go on unnoticed, in that it is constitutive of the psychotherapeutic institution. Th rough our investigation of  the  situated  practices  and  interactional  formats  regarding  questioning practice, we came upon questioning sequences, which seemed to disturb the institutional order rather than support it. Th e sequences showed similarities in how a practice of questioning all of a sudden was initiated by the client directing  dialogical  and  moral  obligations  on  the  therapist  rather  than  the other way around. In this way, these questioning cycles seem to concern a negotiation of agency, which was characterized by a signifi  cant change of the dialogical dynamics. Th is change in dynamics stresses the ecology of therapy as a coordinated endeavor of therapist and client. In our data, the formats and design of the questioning practice is constrained by the inherent asymmetry of  knowledge  with  regards  to  the  therapist  as  professional  practitioners  of therapy. In this way, questioning rights and obligation through initiating these questioning cycles, the clients do not only question the dialogical authority of  the  therapists,  but  may  question  the  conditions  of  professional  practice, and thus the very project of therapy. Furthermore, as will be shown in the following, questioning is a matter of coordinated behavior, which is not relying on verbal language alone.

## 4. Th e ecological contribution

Traditional  pragmatic  approaches  have  contributed  signifi  cantly  to  our understanding  of  the  phenomenon  of  ' questions'  within  the  workings  of semiotic language-based systems. However, from an ecological perspective, it is necessary to include the environment to a larger degree in order to investigate how humans exploit diff  erent sign systems embedded in the environment to organize their sense making activities (Goodwin 2013, Jensen & Cuff  ari 2014). Cognition in example, from an ecological perspective, is seen, not as an inner mental ability, but as an active doing in an environment (Menary 2010). Th e focus of an ecological approach is on the profoundly relational character of the interaction between an organism/agent and its surrounding environment. Relations  in  this  sense  are  not  just  a  matter  of  confi  guration  but  has  an ontological character as defi  ning the status of the phenomenon under scrutiny. Th ings  and  phenomena  are  nothing  in  themselves;  rather,  they  emerge  as what they are in and through the relations, they are part of: Th eir relations are their 'conditions of existence' (Hackel 1866, quoted from Eliason 2015: 80). In this way, an ecological perspective implies the study of relations. Th at is, how diff  erent (human) eco-systems function as diff  erentiated, interdependent components  of  a  larger  whole  that  can  adapt  to  changing  circumstances. Following this, the study is informed by 4E cognition (Menary 2010), and the  concept  of  double  dialogicality  (Linell  2009),  where  the  therapeutic encounter does not only represent a distributed cognitive system of (doing) psychotherapy, but also forms a unique dialogical system (cf. Steff  ensen 2013) embedded in  the  ecological  niche  of  psychotherapy.  Doing  questioning  in psychotherapy is, from an ecological perspective, a highly heterogeneous and semiotically  laminated  co-action.  It  implies  reciprocity  and  constitutes  cooperative patterns of action cycles recurring over time. Doing questioning in psychotherapy rest on cognitive agents to recruit contextual resources from distributed social systems, which enables conditional changes of the situation. Such  a  perspective  relies  on  a  view  on  cognition  as  a  skull-and-body transcending  activity  that  emerges  from  the  relation  between  an  agent and the environment. Th e  basic  argument is that even though cognition is clearly dependent on neural activation in the brain, it cannot be thoroughly understood as just an internal process. Instead, cognition 'is something we do: we enact it, with the world's help, in our dynamic living activities. It is not something that happens inside us' (Noë 2009: 64). In this sense cognition is  not (an internal) precondition for action; it is not (just) an inner mental architecture  that  defi  nes  the  route  by  which  we  are  able  to  navigate  in  the world. Rather cognition is part of the navigation itself. In other words, we don't have or possess cognition (or cognitive abilities), instead we do cognition in our active and explorative sense-making (Linell 2009, Steff  ensen 2013). In this way cognition is re-conceptualized as part of an organism-environmentsystem  (Järvilehto  2009,  Steff  ensen  2013).  In  relation  to  the  present  study, human  bodies  are  situated  within  a  consequential  setting  involving  other human beings. Th is means that in order to investigate how multiple humans/ participants  negotiate  understandings  and  build  relevant  action  in  concert with  each  other  one  must  also  consider  the  inter-bodily  dynamics.  Like in  bio-ecological  niche  construction,  social  cognitive  organization  in  the psychotherapeutic encounter, creates a certain set of conditions that change the selective landscape, e.g. aff  ords particular ways of relating to the environment rather than others (Colombetti & Krueger 2015: 1-2).

## 5. Dialogical systems, social systems and 'the third party' of a dialogue

A general framework guiding this study is dialogism (Linell 2009), which deals with processes of human meaning-making in and through language, thinking, and  activities. As  a  meta-framework  dialogism  covers  epistemological assumptions about human actions, semiosis, cognition and communication. A core assumption is that our being in the world is socially guided, which means, it is  interdependent with the existence of others. Since our perceptual systems  are  instrumental  in  sense-making,  these  are  also  part  of  these dialogical  properties  of  human  beings.  Linell  refers  to  this  property  of  the subject matter of the human, as 'dialogicality' (ibid).

Dialogicality is a capacity to conceive, create and communicate in terms of  otherness.  Th is  capacity  is  multifaceted,  multivoiced  and  polyphasic  in nature and embedded in history and culture. Th is  means that dialogicality is concerned with more than the concrete encounter of individuals (e.g. the ego-alter, Markova 2003). Our fi  rst order activity, the dynamics of real time behavioral  events  that  are  co-constructed  by  co-acting  agents  (languaging, doing,  remembering,  conversing)  is  inevitably  linked  to  historical,  cultural and  biographical  conditions  of  a  second-order,  which  permeates  the  hereand-now with situation transcendent dimensions (Th ibault 2011). Th erefore, the essential capacity of humans is a 'double dialogicality' (Linell 2009).  Any human sense-making activity relies on a simultaneous relation between the local and multiple non-localities, therein being able to act in accordance with a population-level perspective (Steff  ensen & Harvey 2018).

Th e  complexity  of  double  dialogicality  might  be  more  tangible  when considering a distinction between the concrete dialogical system and a more abstract social system (Steff  ensen 2012). 3 When engaging in conversation, we relate ourselves and others to various temporal and spatial dimensions: the situated  interaction  -  the  localized  exchange  and  co-constructing  of  sense and meaning - and a situation-transcending practice - which is constituted by  socio-cultural  and  historical  resources,  presuppositions,  prejudices,  or pre-defi  ned characteristics of situations as particular communicative activity types (cf. Linell 2009). Th e situation-transcending practices emerge and are sustained with reference to a heterogeneity of temporal and spatial dimensions, and thus comprise what we here refer to as a 'social system' . Social systems are second order constructed organizational frames formed by patterns and sets of norms over larger timescales, which stands in relation to the situated fi  rst order activity, which is real-time, contextually determined creative process of investing behavior in the dialogical system (Th ibault 2011).

Th e  distinction  between  fi  rst-  and  second  order  is  used  to  designate how second-order cultural constructs arise out of fi  rst-order activity, rather than the other way around (Love 2007). It is easy to understand in relation to language, that fi  rst and second person always speak in the language of a third person: throughout our lives, we borrow meanings and expression from (languaged) activities in the world around us. ' Th   e world in language is half someone else's. It becomes 'one's own' only when the speaker populates it with his own intentions, his own accent, when he appropriates the world, adapting it to his own semantic and expressive intention ' (Bakhtin 1981). Furthermore, even when the encounter is only between two individuals, like a psychotherapist and a client, there is always at least one third-party present (Linell 2009, Bang & Døør 2007). Th e third party of a dialogical system might either be a specifi  c 'third' , a particular individual or community of individuals, or it might be an abstract  generalized  'third'  party,  norms  and  preferences  of  abstract  social systems, who in one way or another are given a voice through the actions of the participants (Linell 2009:100). It can be conceptualized as an 'observer' or an 'observed' . As an example, the concept of institutions, is understood as an abstract but oft  en highly specialized or formalized version of social system, yet it is realized in what the therapist and the client do in respect to each other. Th e implementation of third parties covers a wide range of norm-orientating practices in the here and now, some of which happen through verbalization and others through other bodily co-actions.  Sometimes they are scrutinized in the dialogical system, more oft  en they are not, and whether or not is in itself a practice. Th is 'incarnation' of people not present and practices not questioned serves a referencing function between the dialogical system and various social systems, of which the institution of psychotherapy is just one among many. Th e  synchronic  activities  of  the  agents  are  informed  and  qualifi  ed  by  the fact that institutions, corporations or communities frame a dialogue and the participating persons defi  ne and are defi  ned by their position to the respective organization (Bang & Døør 2007: 60).

## 6. Semiotic resourcing

In identifying how diff  erent social systems become enabling conditions for the dialogical system, we also need to consider which contextual and semiotic resources the agents of the dialogical system recruit as part of their coordinated practice.  When humans relate to their environment through their coordinated behavior they tend to recruit, on the spot, whatever mix of problem-solving resources will yield an acceptable result with a minimum of eff  ort (Clark 2008). Th e way semiotic resources relate to distant social system relies on the deictic capacity of their recruitment. Th e concept of deixis has been used to describe linguistic  features  that  refer  to  some  'extra-textual'  semantic  and  semiotic resources  to  inform  their  function  in  the  communicative  practice.  Within pragmatics, it  has  been  described  how  concepts  of  temporal,  spatial  and  personal references is lexicalized and grammaticalized in (most) languages (Levinson 1983, Comrie 1996). In example, most linguists agree that tense 'is a deictic category whose primary function is to relate the time of an event predicated in an utterance or discourse to some other time' (Fleischman 1989: 184, Binnick 1991), and that the aspectual feature of a verb refers to 'the internal temporal contour' , through which a situation is interpreted as perfective (completed), imperfective (not completed) or habitual (repeated), and so forth (Comrie [1985]1993). Words like 'me' , 'him' denote a personal dimension; 'now' , 'soon' , 'last Tuesday' denote a temporal dimension; and 'here' , 'there' , 'at the Johnson's' denote a spatial (but also a temporal) dimension.  Following Bang and Døør (2007)  this line of reasoning could be taken a step further. Apart from the deictic  categories  of  persons,  time  and  space,  Bang  and  Døør  broaden  the scope of deixis to also include reference to 'things' and 'media' (object deixis), as well as diff  erent kinds of logics, modality and lexis (logos deixis). Th is last group of logos deixis comprises 'the kind of relationships that exist between individualities or the kind of coherence between individualities or relations (i.e. relations of relations) that is a particular historical fact' (Bang & Døør 1996, cited in Steff  ensen 2007: 21). Th is concerns that diff  erent kinds of logics are related to diff  erent situations and diff  erent social systems. If the logics of one social system drawn upon in the dialogical system is diff  erent than the logics  of  another  social  system  drawn  upon  in  the  same  dialogical  system, then logics are just as context sensitive as person reference, and then logic is a deictic phenomenon(ibid:). Furthermore, the modality ascribed to what is said in the situation regards the language-reality relation and is tied to the situated practice and is therefore also related to a deictic process. Following Lepper (2009), the dialogical management of distance between the speakers in the psychotherapeutic dialogue, happens through the dynamic of deixis, as speakers regulate the intensity of in example emotive communication, through use of 'proximity devices' (Lepper 2009:1081). Proximity devices comprise a particular use of deictic referencing in relation to the degree of proximity, with which the interlocutors adhere (emotionally) to the telling (both the doing the telling and the event or experience being told). 4

Apart  from  wordings,  other  embodied  phenomena  can  be  ascribed  a deictic  function  in  the  psychotherapeutic  encounter.  Gestures  or  diff  erent form for bodily gesticulation can be investigated in terms of how they are recruited  and  combined  ('in  a  laminated  manner' ,  cf.  Goodwin  2013)  to contextualize  the  next  moment,  and  what  projections  they  make  in  their particular positions. Gestures can function as a foreshadowing for imminent action, and thereby facilitate the mutual anticipation of social acts. 'Diff  erent modes  of  gesticulation  (e.g.  depicting,  pointing,  displaying  an  illocution) diff  erentially  direct  and  focus  the  attention  of  the  participants  and  in  this fashion also contribute to the structuring of the interaction. ' (Streeck, 2010: 224). Th e positioning, actions, and orientation of the body in the environment are  crucial  to  how  participants  understand  what  is  happening  and  build action together (Goodwin 2013). From an ecological perspective however, it is important to note that even though the action of a gesticulation is grounded in the body, the formation and emergence of the gesticulation is intimately linked to and constituted by the ecological environment of the interlocutors. Th ough speech and gesture are routinely coordinated, gesture neither emerges in the speaker's mind nor just in the process of speaking. Gestures originate in the tactile contact that mindful human bodies have with the physical world. 'Hands are entangled in the world that they reach - touching objects, grasping tools, wielding instruments, managing matter' (LeBaron & Streeck 2000: 120). Following an ecological stance, rather than ascribing wordings and language primacy in the investigation, it is the wide variety and lamination of semiotic resources recruited and exploited which guide our study.

## 7. Analysis

In the analysis, attention will be paid to the interplay between the dialogical system, which is the actual dialogical situation in which dialogical activities happen,  and  possible  social  systems,  which  are  more  abstract  phenomena constituted by set of social norms, preferences and valued activity types, upon which the local dialogical system draws. Focus will be on the various semiotic resources that 'agents' tend to recruit on the spot in their doing of the activity, i.e.  physical  detectable  actions  (hand  gestures,  other  types  of  embodiment, verbal speech, tone speech and silence). Th e aim is to understand the dialogical dynamics  of  the  counter-questioning  in  the  therapist-client  encounter  on the micro-level. Th is means to investigate how the interlocutors select from various possible semiotic resources in co-constructing a sense of the situation. In  order  to  follow  an  ecological  perspective,  these  steps  also  represent diff  erent  degrees  of  contextualization  and  re-contextualization.  At  fi  rst  the narrow  exchange  in  which  the  questioning  is  embedded  will  be  described

1

Micro-level

Body

Gestures (hand)

Gesticulations (facial expressions)

Gesticulations (prosody)

Gesticulations (gaze)

Gesticulations (body posture)

Gesticulations (other body parts)

The dialogical system

Gesticulations (deictic markers)

Third parties

Concrete:

Concrete, present actors

Virtually present actors

(whose speech and thought are reported)

Absent concrete actors

(principals, remote audience)

Ecological grounding

Topos Streeck, 2010, 2011

Goodwin, 2013

Wordings (semantic potential)

Utterances (pragmatic action)

Sidnell, 2009

Leech, 1997

with regards to how various semiotic resources are recruited and exploited in a laminated manner (Goodwin 2013). Secondly, the dynamics described will be analyzed further in relation to how the dialogical system is informed by  distant  abstract  social  system  of  various  kinds  (cf.  double  dialogicality, Linell  2009)  in  and  through  relating  various  kinds  of  'third  parties'  to  the dialogue (ibid:). Whether a possible third party is physically represented in terms of artefacts, individuals or contextual settings, or whether it is absent and thus only covertly represented, the analysis is guided to identify possible instantiation  of  the  third  part  position  and  determine  how  these  possible third  parties  interfere  directly  or  indirectly  in  the  communication  (Bang and Døør 2007, p. 60, Cooren, 2010). Th is step involves a back and forward movement in the wider context of the questioning as it comprises how any action is enmeshed in potentially contextualizing semiotic resources referring to various timescales (Trasmundi & Steff  ensen 2015). Th e individual agents, as we shall see, represent in diff  erent ways various social systems or diff  erent aspects of the same social system. Th us, their coordinated dialogical actions show how they emerge as social actors in a dialogical system, which again rely upon how they relate to various distributed social systems. 5  Th e analysis will focus on the talk, gestures and actions, where embodiment will be investigated as  a  central  component of the sense making actions action within situated human interaction. In the table below (fi  g. 1), the various steps of our analysis will be presented in short form, informed by our theoretical stance above.

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Fig. 1 overview of objects of analysis

## 8. Data

We  look  at  specifi  c  cases,  in  which  the  client  initiates  question-response cycles instead of the therapist, which alter the conditions of the therapeutic dialogue. Th is analysis builds on a series of observations of authentic data from psychotherapy sessions. Th e study is guided by following pivotal questions: what  do  counter  question-response  cycles  do  to  the  therapeutic  system, i.e.  what  happens to the therapeutic alliance and interactional dynamics of therapy when the client unexpectedly asks questions and makes requests to the therapist?

Th e  therapists  in  our  data  all  adhere  to  Mentalization  Based  Th erapy (MBT). In MBT, a crucial goal is to enhance the client's ability to 'mentalize' , i.e.  to  become  aware  of  the  intentions  and  motivations  guiding  own  and other's actions (Bateman & Fonagy 2010, 2012). A methodological principle for MBT is for the therapist to continuously stimulate a mentalizing process in the client (ibid; Alberdi et al. 2015). Th is is oft  en done through therapist initiated questioning-response cycles directing the client towards practicing mentalizing  or  by  explicit involving  the client in the therapists'  own observations on how they interpret the behavior of the client. Contributions like  these,  though  therapist  centered,  show  a  questioning  force,  that  is,  a prompt for client refl  ection and acknowledgement. Th e therapeutic account of the account of what is being done 'to stimulate a mentalizing process' are supposed to go on unmentioned. Yet interventions like these of course apply an inherent asymmetry of knowledge to the dialogical system, at least in that they are therapist ideated and driven. Due to our distributed approach in this article,  we  will  not  discuss  the  theory  or  knowledge  claim  underlying  this epistemology further (see Jensen et al, forthcoming, for further discussion). Th is way, questioning practice can be tied to a notion of institutional authority as entrapment in discourse (Bartesaghi 2009ab).

Th e  analysis  is  twofold:  fi  rst  the  interactional  level,  then  the  dialogical and  the  systemic  level.  On  the  interactional  level,  the  analysis  concerns the  coordinated  actions  of  the  agents,  which  include  the  wordings  uttered together  with  prosodic  gestures  and  bodily  gesturing  including  movement and tension of body, hands, facial expression, and eye gaze. Th e analysis will concern case studies from two diff  erent dyads of client/therapist, in which the distribution of responsibility between therapist and client is altered through the  client  performing  interactional  authoritative  behavior  by  questioning action.  If  we  wish  to  understand  how  reversed  questioning  emerge  and  is being managed through interaction as well as how they end up having the kinds of consequence for the parties involved, we need to look closer at the inter-bodily and interactional details of the sequence. Th us, in the following analysis,  we  will  investigate  the  emergence  of  the  changes  by  focusing  on how the unfolding of reversed question-response cycles are intertwined with three interrelated dimension 1) interactional dynamics, 2) unbalance in the dialogical system, 3) confl  ation of time-scales.

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PT: hh but I brought the letter

TH:

TH:

TH:

TH: mm+

sounds like- then- wh- what is it you think you need help to in order to tackle

## 9. Analysis - part one

In a therapy session, a female client (a single mother to a 2-3 years old daughter) brings a letter with her, directed by her former therapist as 'a letter of concern' to the municipality 6 ,  and asks whether the psychotherapist wants to read it. In the following part of the sequence the therapist's resistance emerges in a particular way. Aft  er some hesitation, the therapist responds to the request with another question, which engenders a very negative emotional reaction from the client's request. Looking in depth at the interactional trajectory, it is clear how the coordinated maneuvers of the two enable a shift   of attention and thus change the condition for the dialogical dynamic.

When  investigating  something  from  an  ecological  perspective,  the  focus is  systemic,  i.e.  the  focus  lies  on  what  a  countering  question  does  for  the therapeutic system. Th is part of the analysis will concern a question-response cycle (  see fi  g. 2). Th is example is chosen because it represents a countering question initiated by the client, which turns out to re-organize the dialogical system and thus stress the therapeutic project through possibly harming the working alliance of therapist-client.

Fig. 2 transcript of question-response-cycles case 1 Participants: Th erapist (TH), Client (PT)

In order to be able to capture every relevant semiotic feature of the questionresponse cycle, its various parts are separated and treated in depth below in relation to their function within the cycle: the question (invitation of response (a),  ln.  1-3),  the  response  ((b),  ln.4-6),  and  the  reaction  to  the  response ((c,d,e),  ln.7-14).  Th e  question in focus  (ln. 1-2) is formally designed as a que-declarative with a modus deictic marker. As such, though designed as an assertion, the illocutionary force of request for a response, makes it function as a question. To get an idea of what real forces are brought about, though, it is necessary to see what it does in example, how it enables and constrains certain types of coordinating actions in the dialogical system.

[ (xx) ]

[hh m::::] I think that eh:m it- it

< (b)

Wordings

Prosody

Face

Hands

Body TH: -

## * Th e question:

PT: hh but I brought the letter

TH:

PT: ( (normal voice))

TH:

TH:

| PT: ((torso upright, tensed, neck and shoulder a bit forward))   |
|------------------------------------------------------------------|

Fig. 3 the request (ln. 1-2)

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Th e client relates a concrete but non-present third party, 'G' , to the dialogue, a former therapist of the client, through the deictic marker 'she' . Th ough the dialogue up until now has been concerned with past experiences of the client and a former therapist (G), this third party becomes physically represented by  the  artefact  (the  letter/the  paper).  Th is  is  done  verbally  and  by  deictic gesturing of both hand and eye glance. It seems to aff  ect the attention of the therapist (she looks at the client), yet she does not react further.

Th e client has introduced the artefact (the letter), physically placed it on the table between the therapist and the client, and the therapist's attention is further drawn to the gesture as the client refer to the personal deictic 'you' , the logos deictic 'if ' and the modus deictic 'want' ('I don't know if you want to hear what she has written to X municipality' . Here, another third party, is introduced through the lexical deictic of 'X municipality' . Th e municipality is an institution constituted by norms and responsibilities and thus is to be oriented to as an abstract social system. Th e two third parties are thus connected in and through the  artefact.  Th e  tensed  position  of  the  client's  body  together  with  a  direct insisting gaze supports the illocutionary force of questioning, in intensifying the responsibility of the therapist to react. Th e gaze of the therapist changes and the higher frequency of blinking might point to some sort of confusion or alertness. Th e conditional 'if ' opens up an empty frame, in encouraging the deictic logos frame of 'if…then' (Bang & Døør 2007). A conditional force in an in the tollowing (ng. + ana ng. 3, respectively):

Wordings

Prosody

Face

Hands

Body utterance can be used to communicate what the prerequisites are for a state or an event becomes possible. Th e state or the event refers to something outside the utterance, either some physical conditions or agentive behavior. Following the cooperative principle of conversation (Grice 1963, 1975), what is needed in interpretation is anticipatory illocutions relying on interpersonal relations and contextualization. In daily life exchanges, the conditional 'if'-utterances can be ambiguous in that the interactant might diverge on interpreting logical implicature,  which  depending  on  the  particularities  of  moral  and  valuerealizing engagement of agents (Brinkmann, 2005; Hodges). Th is makes a lot of 'if '-conditional speech acts heavily depending on contextual and situational aspects.

In  her  asking,  the  client  seems  to  make  use  of  the  commonly  known politeness strategy of hinting (Leech 1996). It is common to ask a question about an other's willingness or ability to perform an action X as a hint that you want them to do X - the fi  rst illocution does service for a second, unspoken one (ibid: 26). Th e hinting strategy exploits the maxim of relations (Grice 1963, 1975) in that in the context envisaged for an assertion about the other person's willingness or ability to do X will conceivable be relevant as a means of his/ her eventual performance of X. From a pragmatic perspective therefore, the countering action done by this client involves a prediction or a kind of assertion about a future happening, and therefore indicating the client's confi  dent belief that the future event will or could take place. Moreover, in having made vital prerequisites  for  X  possible  and  making  the  therapist  aware  of  it,  the  client seems to want the therapist to be aware that she wants her to do X.

## * Th e response

Th e immediate response to the request falls in two phases (ln. 4-6 (b) in the above transcription): a withdrawal or retreat; and a counter question, as seen in the following (fi  g. 4 and fi  g. 5, respectively):

Fig. 4 retreating (ln. 4)

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Wordings

Prosody

Face

Hands

Body PT:

PT:

TH: ( (flickering eye gaze, slight frown of forehead))

TH:

Th e immediate reaction of the therapist, even as the request is uttered, is a prolonged  minimal  response.  But  while  doing  so,  the  therapist  is  turning fi  rst  her  face,  her  gaze,  and  then  her  body  in  the  chair  slowly  to  the  right in a sweeping manner. Th e moving out of the responsive space both by the disconnected eye contact and physically by moving the body to face elsewhere than the client, expresses ambiguity 7 Th is sudden activity, together with the hesitating cues (prolonged nasals), and frowning enables an interpretation of uncertainty or even discomfort (Heldner & Edlund, 2010).

Th e therapist faces a great deal of pressure to answer the question within the parameters of the question. In her hesitating maneuvers, when answering, the therapist seems unclear on what terms and conditions, she ought to reply and the client continues her turn (' And then I have also written [a letter in response]'). By relating herself to the letter, the client further connects the dialogical system of therapist-client to the third party. Th is happens through the personal deictic 'I have written' in an activity like the one of the 'she has written' (G).

Fig. 5 counter question (ln. 5-6)

Aft  er this period of ambiguity expressed in and through spontaneous bodily gestures, the response continues. Th e therapist, now turning back and facing the  client,  responds  more  thoroughly  to  the  question  with  a  countering question.  Th is  contribution  exhibits  four  phases,  which  verbally  show diff  erent dimensions of engagement: 1) the choice of verb 'I think' refer to an ideo-logic; to a personal belief (assumption rather than presumption), which stands in opposition to the epistemics of the situation, or knowledge of the profession. Th is way to claim insuffi cient knowledge becomes a strategic move for the therapist to level out possible confl  icts; 2) Th e anaphoric reference of 'it' in the generic 'it sounds like' becomes blurred, which dissolves the liability of any agent, and the change of deictic mode realizes a interactional re-start evoking a certain degree of disfl  uency;  3) Th e change of agency in relation to 'you think' functions in opposition to the 'I think' earlier, which enables a shift   in focus from generics to the dialogical system of the dyad. Th e 'it' in this phase is elaboratively indeterminate as object of 'what' , and as before, there are several possible 'its' and thus several possible engagements of deixis. Yet though the therapist seems to appear to navigate blindly, due to hesitation cues and reformulation, she does more than just buying herself time to 'think a proper response through' . Th e dissolved liability of the generic 'it(s)' proves to be less face-threatening in the dialogical collaboration. Th is way it makes it safer for the therapist to delicately steering interaction towards concerning the client's obligation to the system, rather than the other way around. Th e alethic modality deictic function in 'need of help' is made to refer to an absence and a fulfi  lment (of something), of which diff  erent kinds of agencies are associated. Th ese  agencies  refer  to  the  norms  of  the  therapeutic  practice  as  a  social system (responsibilities, asymmetrical rights and obligations), and hence this phase dialogically commits the other part to this system; 4) In the last phase, however,  the  perspective  shift  s  to  the  interactive  domain  through  a  direct question 'what is the problem' . Th e responsibility for answering the question in 4) lies on the client, as she has been pointed out to the accountable party in 3) 'what is it you need' . Th e problem however is not defi  ned nor attached to an agent. Th e therapist's maneuver of omitting the ownership and character of the problem, expresses a gentle face-saving strategic behavior. Th e indeterminacy of the problem enables the client to be exempt from liability to a certain extent, yet  the  responsibility  is  redistributed  by  the  therapist.  Th e  four  phases  are furthermore characterized by turn-internal pauses, false starts, re-starts, and prolonged syllables, which can be associated with increase of cognitive load. Together with the bodily gestured retreat mentioned, the prosodic features marking for hesitation, and answering question with another question, show a  spontaneous  orientation  to  something  as  potentially  problematic  in  the dialogical system.

A  few  things  could  be  at  stake:  First,  the  abstract  social  system  of 'public authorities' also imply the (stately commissioned) psychotherapeutic treatment, which makes the responsibility of the therapist unclear. Secondly, by accepting the terms and conditions in answering the question, the therapist is obliged to evaluate the work of a colleague, since the author of 'the letter' ('G') is also a practicing therapist. Th is covertly implies a loyalty to another abstract social system, namely 'professional (therapeutic) practice' . Th ere are thus several factors playing a part in this questioning-response cycle. It is of much bigger importance though, whether allying at all costs will contribute positively in the long term to the original task of the dialogical system - the therapeutic project.

## 10. Change of interactional dynamics case 1

## * Th e reaction

In  her  questioning  initiative  above,  the  client  relies  on  the  therapist  to  do something. Th e therapist vaguely pushes the ball back, trying to get the client to account for what she thinks she needs, or account for what the problem is. Th ereby, she is assigning the client agency and responsibility for something not clearly defi  ned. As we shall see in the following, this maneuver makes the Wordings Prosody Face Hands Body TH:

client break down in desperation and crying. Th e reaction of the client to the therapist's response is very abrupt and emotional. It falls in three phases ((c, d, e), ln 7-17): 1) a resignation phase ((c), ln. 7); 2) a desperation phase ((d), ln. 12); and 3) an aggression phase ((e), ln.17). Th e analysis will concern these phases one by one in the following (fi  g. 6, fi  g. 7 and fi  g. 8).

((loudness, higher pitch, trembling voice, tearful voice))

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TH: ( (opens face, eyebrows up, chin up))

TH:

PT: ( (hands out in a resigning manner))

TH: ( (chin up))

PT: ( (shrug of shoulders, deflated torso))

7'

Fig. 6 Resignation (ln. 7)

Th e client promptly reacts to the therapist's response to the question. Her gaze starts to fl  icker, her eyes starts to be fi  lled with tears. In shift  ing her eye gaze, she withdraws from the responsive space with the therapist, thereby enacting being alone. Her face reddens and her voice changes: she talks louder and in a higher pitch, and her voice starts trembling. Her body, which up until now has been tensed and held upright slight forward in the chair, defl  ates and she cast her arms to the sides in a resigned manner. Th e resigning gesture of the client together with the defl  ation of her torso signify 'defeat' , or hopelessness, i.e. a loss of agency. Her attempt to drag the therapist in to be a co-active (allied) part of the confl  ict imposed by the letter has failed. Th e client has relied on the therapist to help. Yet based alone on the terms conducted in the dialogical system the therapist cannot provide the help the client thinks she needs.

Th e immediate bodily response of the therapist, however, involves lift  ing of  her  chin,  which together with the risen eyebrows engenders an opening of the face towards the client, which stands in stark contrast to her previous withdrawal.  Th e  following  rise  of  intonation  in  her  verbal  response  (ln. 8-9) together with the opened face works to build a positive framing of the dialogical  system.  Th is  positive  framing  works  complementary  to  the  very negative emotional cues expressed by the client. By coordinating her bodily and prosodic gestures to oppose the client's bodily and prosodic gestures, the therapist manages to steer the dialogical system away from being framed by the negative emotions.

Wordings

Prosody

Face

Wordings

Hands

Prosody

Face

Hands

Body PT: I DON'T want to be broken down [again!]

TH:

TH: ( (soft calm voice, rising intonation))

PT: | (flickering eye gaze in and out,

PT: =yes [because]

TH:

PT:

PT: ( (slight firm beat with left hand))

TH:

TH: ((calm voice, rising intonation))

TH: ( (serious

TH:

TH:

PT: ( (deflated torso))

Fig. 7 desperation (ln. 12)

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| face, eyebrows up, chin down, lower lip forward)) PT: ( (flickering eye gaze in and out, tears in eyes, tensed face muscles)) PT: ( (hands moving toward torso, palms inwards))   |
|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|

Th e client then makes an inward gesturing of the hands towards her abdomen, which metaphorically signals the proximity not only of the demands, but also of a concrete but non-present third party 'my child' (her daughter, who has been introduced earlier in the session). Th is third party comes to represent the  abstract  social  system  of  mother-child,  through  an  orientation  to  the obligation of a close relationship therein. Th e gesture presentifi  es the system in the client's body, i.e. the proximity to the abdomen becomes an embodiment of  the  child.  Th e  therapist  reacts  accordingly  by  lowering  her  chin,  which enables a fi  rm gaze, which together with rounding of the lips adds seriousness and empathy to the situation.

Fig. 8 aggression (ln. 14)

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Th e sudden fi  rmness of the client's bodily gestures and wordings 'I don't want  to  be  broken  down  again!' , is an attempt to regain agency. Th e modal deictic of the uttering imply not only the possibility of being broken down (a state, which is not preferred), but presupposes that certain events in the past were responsible for her breaking down. And now the letter (related to the third parties introduced) and the failed attempt to involve the therapist as  an  ally  becomes  threatening  to  the  client.  Th e  dialogical  system  gets saturated with the need for defense, thereby implicating 'attack' , and it needs to be explored further how this sense of 'attack' comes about.

Th is reaction tells us there is clearly a change of dynamics in the dialogical system. Th e client reacts very emotionally, fi  rst resigned, then desperate and then confrontative. Th e alliance between therapist and client up till now have been characterized by calm cooperative activity but is now altered due to the sudden change in the interactional dynamics. Th e  system has undergone a transformation and is re-organized by the question and the following emotional reaction. Th e  sudden strong negative reaction of the client bears signs of a clash of expectations. Either the negative emotions are reactions to not get help as she thought, or they are related the responsibilities and obligations she (all of a sudden) experience cause too much pressure and emotional stress. Th e emotional force with which the client suddenly reacts, is taking its toll on the dialogical system, yet, there has been no cues in the collaboration, which anticipated this serious change of dynamics prior to the questioning incident. Th e premises upon which the patient reacts so strongly lie not in the dialogical system alone, but is rather linked to another abstract social system, which at  the  time overrule the dialogical alliance with the therapist. Prior to this, there have been no cues to that the dialogical system poses pressure of this caliber on the client that could explain her reaction. Th is  is  also  evident in the immediate reaction of the therapist, who acts as if caught off   guard. Th e pressure may be an articulation of something else. Th e client reacts as to be negatively constrained by obligations she is subject to in relation to the system of (G) and the municipality. Th is way the obligations of the social system is presentifi  ed  in  the  reaction  of  the  client.  Diff  erent  institutional  orders  are emerging through the changing dynamics of the sequence. Th ere is a confl  ict between systems.

Th e immediate task of the dialogical system has transformed into repairing the alliance and restore the functional dynamics. Th e therapist's continuing of rising tone modulation (ln. 9, 13, 15) construes (or retrains) a positive framing. Th is positive framing works complementarily (and thereby possibly counterproductively) to the very negative emotional cues of the client. Th e emotional force with which the client suddenly reacts is rooted in the constraints and obligations she is subject to in relation to other abstract social systems (in example, the system of (G) and the municipality). By coordinating her bodily and prosodic gestures to oppose the client's ditto, the therapist manages to

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PT: yes

PT: yes

something here where it isn't perfect

TH: and you talk about this

PT: yes=

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here becomes such a spot on you (.) So there is

< (f)

avoid the dialogical  system  to  be  hijacked  by  the  negative  emotions.  Th us, aft  er having bought herself some time to refl  ect and act, the therapist manages to change the impact of the letter by metaphorically introducing it as a spot on the client's perfectionism as can be seen in the aft  ermath example below (fi  g. 9):

```
PT: like (the daughter's father) (.) does he get to know now (.) that now we have a spot like that attached to us TH: mm (.) so This spot here May I see your spot heh heh (.) it is this one, right? ( (picks up the letter)) PT: yes TH: there is your spot (.) Am I allowed?= PT: [yes] TH: [to 1ook] just now (.) May I skim it through? + (h) + (i)
```

TH: yes=

PT: yesyesyes And as soon as 'the  letter'  has  been  reduced  to  'a  spot'  ((f),  ln.5),  thereby establishing her condition for how to deal with it, the therapist takes initiative to skimming through it ((h, i), ln.18-24).

Fig. 9 the aft  ermath case 1

In  sum,  by  introducing  an  artefact  (the  letter),  which  not  only  represent  a confl  ict of the past (with the third party 'G'), but also represents an authority, the  dialogical  system  draws  upon  the  very  abstract  social  system  of  public authorities  (the  third  party  'the  municipality').  Th e  client  then  introduces another third party (the child), which makes references to the abstract social system of 'family' or more narrowly 'mother-child' . Th e importance of this is underlined in the rights and obligations (the norms) of the public authorities to  forcibly  remove  children  from  possible  harming  parents.  Th e  dialogical system becomes stressed by the confl  ict of these two social systems.

Summing up, the dialogical system is re-organized by the question in the following ways:

- (1) First, the question changes the power relationship of the therapeutic practice. Th erapy most oft  en implies the practitioner to do the questioning and the client to do the answering/telling (McGee 1999). Th is distribution of tasks, rights and obligations constitutes the therapeutic practice in an institutionalized social system, where the practitioner is the authority. When posing the question, the client changes the asymmetric setting, and a transformation of agency occur.

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anymore

PT: mm

TH: you are not afraid to lose her

PT: (2.0) and I can't figure out if I actually love her or if I'm just there for

PS: (1.0)

it

PS: (0.5)

PT: right? hh

can read it

PS: (0.5)

PT: right? [NAME]!

- (2) Positioning oneself in a certain manner, implies the other part to be positioned or counter-positioned as well (Harré & Langehove 1989). By adapting to a dominant fi  gure in the dialogical system, the client is constraining the behavior of the therapist. Th e interactional force of the question alone is posing increased responsibility upon the therapist - she is obliged to answer in order to keep the interactional alliance stable.
- (3) Finally,  the  invitation  to  read  the  letter  of  concern,  becomes  an  invitation to engage in the confl  ict between the various abstract social systems, drawn upon by the client. Responding in a preferred manner, could enable the client to treat the therapist as an allied in the confl  ict.

## 11. Analysis - Part two

In a therapy session, a female client, aft  er having raised fundamental doubts about her relationship with her partner, specifi  cally asks the therapist not to take any notes on this particular issue (see fi  g. 10). Aft  er some hesitation, the therapist accommodates this unusual request. Like in the sample above, the coordinated maneuvers of the two enable a shift   of attention and thus change the conditions for the interactional dynamics.

Fig. 10 transcript of question-response-cycles case 2

As in the previous example, this example is presented through the diff  erent parts being separated in relation to their function within the cycle: the question (invitation of response), the response, and the reaction to the response. Th e question in question here is a directive, disguised as an assertive with a modus deictic marker, and a tag-question marker. As such, though designed as an assertion, the illocutionary force of request for a response, makes it function as a question.

## *Th e question

In the above extract, we see how the client (PT) reveals serious doubts and raises fundamental questions about her relationship with her female partner

110· 14).

Wordings

Prosody

Face

Hands

Body TH: - TH: - TH: ( (hands rest in lap))

TH: I (body straight up in chair))

(ln.1-8). In the following, this sudden revelation of the client is immediately followed by her unusually straightforward demand to the therapist (fi  g. 11 and fi  g. 12).

Fig. 11 question phase-I ((a, b), ln. 9-12)

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Th e countering question falls in two phases: 'I will not be noted for it (0.5) right' ((a, b), ln. 9-12) and 'there cannot be noted anything anywhere where she can read it (0.5) right? [NAME]! ((c, d), ln. 1316) In her design, the client begins her question as a directive imperative disguised as  an  assertion,  and  aft  er  a  brief  pause,  the  client  adds  a  questioning  tag,  which mirrors the  negative  valence  of  the  verb.  Disguising  directives  or  imperatives  as assertions or even as weak questions (the tag sometimes treated as not more than a  discursive  marker)  is  a  very  common  politeness  strategy  (Leeds  1996),  yet  the maneuver can function as the opposite due to the implicature of need for politeness design  (Grice  1965).  A  directive  or  an  imperative,  would  enable  an  even  bigger threat to institutional norms of the dialogue and thus the authority of the therapist.

In the prior case example one, it was described how the presuppositional force of what otherwise looks like an assertion becomes 'asking someone to do something' (p. 21-22). In the same way, the current case example number two, though designed like a rather directive assertion, functions as encouraging someone to do (or in this case 'not to do') something. By this action, the client presupposes, that what she encourages the therapist 'not to do' is a possible future action, and that the therapist is able to comply. Of course, from the outside (and de-contextualized) it is up to the therapist, whether she will adhere to this obligation of 'not to do so' , but the presuppositional force of the client's action is an act of authority, which as we see in the following, stresses the dialogical system. Yet giving the global institutional prerequisites, where the therapist is expected to be in a power relation to the client, doing authority, the strong engagement of the client in for the particular action not to be one, the incitement rather becomes a supplication or a plea from  the  client  (Hansen  and  Heltoft    2011).  From  a  pragmatic  perspective therefore, the countering action done by this client involves a prediction or a kind of assertion about a future event X (the making a note by the therapist), and therefore indicating the client's confi  dent belief that there is a possibility of the future event X. It then follows, that by making the therapist aware of her resistance of X, the client wants to make the therapist aware that she wants her to do Y (which is non-X). In both cases, there is no determined agent of the action (noted vs. not noted). Th is is a politeness strategy, when conditioning other parties next action through directives. By not addressing the action to any  specifi  c  agent,  makes  it  less  face  threatening.  Y et,  in  the  second  phase question, the therapist's name is attached, which makes her responsibility of commitment covert. In committing the therapist to respond (in a preferred manner), this exchange like the prior example, also concerns a dialogically reverse  questioning-response  cycle,  which  stresses  the  therapeutic  alliance (Saff  ran et al 2011).

## 12. Change of interactional dynamics case 2

From  the  images  fi  g.  11,  it  is  equally  apparent  that  the  bodily  dynamics between  client  and  therapist  at  this  stage  is  characterized  by  and  outward expressive bodily style of the client - sitting with her side towards the therapist while leaning forward and looking directly, almost glaring, at her - whilst the therapist is put in a more passive position sitting still without gesturing while leaning back in her chair. Th ere is a signifi  cant change in the tone of voice of the client, when moving from the disclosure to the demand (ln. 9-10). When she comes to the second phase of the question ((c, d), ln.13-16), she changes the posture of the upper body and the tone changes to very fi  rm (see fi  g. 12).

Wordings

Prosody

Face

Hands

Body TH: - TH:

TH: -

TH: ( (lowering torso, chin down))

the side,

Fig. 12 question phase II ((c, d), ln. 13-16)

<!-- image -->

| PT: ( (smiles, raised eye brows, remain fixed eye contact)) PT: ((rest head in hand -> let arm rest on chair))   |
|------------------------------------------------------------------------------------------------------------------|
| PT: ( (chin down, rest head in hand -> let arm rest on chair, chin up, head slight to                            |
| turn on chair))                                                                                                  |

From the images it is apparent that the bodily dynamics between client and therapist at this stage are characterized by an outward expressive bodily style of the client - sitting with her side towards the therapist while leaning forward and looking directly,  almost  glaring,  at  her  -  whilst  the  therapist  is  put  in a more passive position sitting still without gesturing while leaning back in her chair. Th e bodily behavior of the client seems to reinforce the impact and seriousness of the demand that the therapist has to deal with. In short, the therapist is put on the spot.

Th e two phases of the question furthermore introduce diff  erent dimensions of engagement. In 1) 'I will not be noted for it (0.5) right' (ln.  9-10),  the  future  perfective  aspect  through  the  passive  case  of the verb, blurs the agent, while the dative referent of 'being noted' is the 'I' . Th e frame is ideological as it resembles the enabling prelude (the confession, ln. 9). In placing oneself in relation to an action of another person (though hidden), the agent of the action becomes a presupposition in relation to not only the dialogical system, but also the social system of therapy, in which the dialogical system relies. Th is happens through the modality deictic function in 'being possible' and the therapist being liable of the action 'making notes' due to her professional authority and rights. In the second phase, 2) 'there cannot be noted anything anywhere where she can read it (0.5)

right? [NAME]! (ln. 13-16) the frame is shift  ed into relying on socio-logic deictic  through  the  generic  epistemics  of  the  assertion.  Whatever  is  to  be noted does not refer to any agent nor object but has shift  ed into 'an absence' through the negative valence of the object ('not anything' ,  'not  anywhere'). Th e spatial deictic function of 'there' is here also understood as a temporal deixis, as it refers to a possible future. But this time, the implementation of the third party 'she' , relates the responsibilities of the dialogical system to be governed by the social system of 'emotional partnership' or 'marriage' . It is implied, that if anything is noted anywhere, there is an unavoidable possibility, that this becomes available for the partner to read. Th is stands in opposition to not only the confi  dentialities embedded in the dialogical alliance between therapist and client, but also the goal of the therapeutic project of becoming aware of and change dysfunctional thoughts, relations and behaviors. It thus creates stress between the systems.

As the presuppositional force of an assertion imposes a norm in the sociologics of the dialogical system, the client confronts the therapist directly by committing her to this new norm. Aft  er embedding the negative valence of the tag-question, the client even attaches the name of the therapist in the end of  the  request,  thus  demanding a confi  rming answer immediately. Such an extraordinary action from a client implicates a potential face threat (Goff  man, 1967)  for  the  therapist  since  it  can  easily  be  seen  as  a  challenge  of  her professional authority. Th us, the roles between therapist and client seem to be switched around for a short while in the sense that now the client conditions a certain type of action or behavior on behalf of the therapist, not the other way around as would be the ordinary 'division of labor' in psychotherapeutic practice. Th e client takes on a dominating and controlling role in demanding that the therapist should not take notes on what has just been said.

## * Th e response

As can be seen in the above, the therapist does not confront or challenge the client's behavior; rather, she sits still and seems to be awaiting the situation. However, if we look closer at the interactional and embodied details of the sequence it becomes apparent that the confronting behavior of the client in fact leads to a resistance strategy from the therapist. Looking closer at the trajectory of the client's demand, it is worth paying attention to the way it is structured encompassing  two  requests  followed  by  small  pauses  of  approximately  0.5 seconds (aft  er 'noted for it' , and after 'she can read it' ). Both pauses potentially  aff  ord  the  therapist  the  opportunity  to  confi  rm  or  acknowledge the requests made by P. However, none of these possible-completion-points (Sidnell 2009) are used to confi  rm or acknowledge the requests made by P , not even by use of minimal responses, such as in breaths or head nods as is usually  the  case  in  conversation.  Both  pauses  are  followed  by  tag-question markers, which emphasize the need for response, but the therapist remain

1

2

3

10

11

PT: (1.5) well I don't know=

TH: try and breathe=

PT: (yes) =

PT: yes

TH: yes still.  Th en, the client adds the therapist's name, making it a direct personal request. Such a direct personal request that is almost impossible to ignore in this close interpersonal setting. It is thus noteworthy that the therapist does not react - neither verbally or bodily - to the two initial requests made by the client, but only responds aft  er a third time when she gets 'called out' by the client using her fi  rst name. On an interactional level, this suggests a resistance from the therapist towards the behavior and request of the client; however, this resistance is not displayed directly but is shown in-and-through the initial passive role of the therapist. However, in the following part of the sequence the therapist's resistance emerges in another way by altering the focus of the client and thus for a brief while the topic of conversation (fi  g. 13).

Fig. 13 response case 2

To start with, the therapist in fact delivers the desired response to the client's demand: Th e fi  rst word uttered by the therapist is a 'no' as a response to the client's  negatively  framed request. As such, it follows the structure of a socalled preferred response 8 ,  in  which a response abiding to the expectations of the request is delivered right away. However, even though the 'no' of the therapist is delivered as an immediate response it is worth paying attention to how she contextualizes her response through three distinct semiotic features (see fi  g. 12) : facial expressions; bodily movement; and prosodic modulation. At the time, the client starts formulating her request with a fi  rm almost glaring gaze at the therapist, the therapist starts to form a sneer surrounding a wary almost sceptic gaze with one raised eyebrow. Th e sneering and the lowering of the non-raised eyebrow become more conspicuous leading to a squint of the eye, as the client state a reformulation of the request (see fi  g. 12). Meanwhile the body of the therapist become lowered almost into a crouching movement. At the time the client states the reformulation of her request, now in a changed position, lift  ed chin and posing a fi  rm challenging gaze and a grin, the therapist moves her head slight to the side. As the therapist spontaneous responds 'no' , she does it in a very low voice (almost impossible to hear on the recording), which could downgrade it to a mere discourse marker (aligning with the tag, but  not  affi liating  with  the  question).  Th ese  prosodic  and  bodily  gestures inform the environment circumscribing the response.

+ (e)

+ (f)

Immediately following her own minimal response, the therapist changes the topic of conversation in a subtle manner ((e), ln. 1). Rather than staying with the client's direct request, she asks the client in the fi  rst person to account for her immediate embodied and cognitive state: 'what  happened  right there when you said that' ((e), ln.1) and, 'what are you feeling right now' ((f),  ln.3).  It  seems  that  the  initial  resistance  of  the  therapist  towards the requests made by the client has now turned into a more straightforward attempt  to  regain  control  over  the  therapeutic  conversation.  Th e  therapist manages to change the focus and topic away from whether or not the therapist will  comply  to  the  above  demands  and  instead  steer  the  attention  towards the feelings and psychological state of the client. Furthermore, the therapist initiates  an  attempt  to  control  the  client's  embodied/psychological  state  by focusing  twice  on  her  breathing  and  verbally  trying  to  keep  her  attention focused: 'you are disappearing from me right now' ((g), ln. 9) . Yet, by drawing the attention away from the client's demands, the therapist does more than just that. By focusing on the demands as disruptive and the client as somehow alienated (' disappearing' ), the therapist ascribes the client a position  of  absence  from  the  situation.  Th is  attribution  subtly  signals  that what  the  client  is  doing  is  inadequate  in  relation  to  the  dialogical  alliance established and ought not to be taken as a valid contribution.

Clearly, this area of attention is more familiar terrain for the therapist (as it would be for any therapist) and it gains her the opportunity to

1. regain control over the conversation and re-establish a more conventional distribution of roles in which it is the therapist who asks the questions and the topic of conversation is the (behavior of the) client, not the therapist,
2. in continuation of this, to reclaim her professional authority as a therapist and thereby avoid another potentially face threatening situation, and fi  nally;
3. simply to buy herself some time to fi  gure out what to answer in a more defi  nite manner.

Th ese strategies are in fact available to anyone, but here they are conditioned by the functional asymmetry of the institutionalized system. When strategies like these are recruited by the therapist to enact this asymmetry, they take on the quality of therapeutic insights.

## *Th e aft  ermath

Th e client complies hesitatingly with the therapist taking control and give in to  the  therapeutic  alliance.  Th us,  aft  er  having  bought  herself  some  time  to refl  ect and act, the therapist in the last part of the sequence fi  nally delivers a more defi  nite answer to the initial requests of the client (fi  g. 14, ln. 5-8):

PT: yes

journal

PT: yes

TH: I won't do that

PT: good

```
1 PT: if I'm only there for the kids or if only there for sake of the anxiety so to 2 speak but fortunately it has been good and I have3 TH: you feel doubt about : what you really want 4 PT: yes 5 TH: and it is the first time you say it out aloud and you become nervous for me + (h) 6 7 writing it in your journal PT: yes 8 TH: I won't do that + (i)
```

Fig. 14 the a  ft  ermath case 2

## 13. Unbalance in the dialogical system

From a more systemic point of view, one can add that the initial face threatening behavior of the client (in both of these examples) creates an unbalance in the dialogical system (Steff  ensen 2012) that needed to be adjusted before the desired action or answer (giving the client an answer to her request) can be delivered. Th e therapist needed to regain her position in the system as an active agent that does something for the client and no just reacts on the needs and behavior of the client.

Regarding  the  eff  ect  of  the  client's  questioning  the  therapists  on  the therapeutic system, the point is that they cannot be treated or understood adequately separated from these dynamics; rather they should be regarded as embedded in the embodied and interactional environment from the very start.  Th us,  a  focus  on  keeping  the  client's autonomy is  deeply  constrained by the dynamics of the situation in which the client demands autonomy on behalf on herself, but at the same time potentially threatens the autonomy of  the  therapist  (in  telling  her  what  to  do  and  not  to  do  in  relation  to  the therapy session). Th e  point being that diff  erent needs for diff  erent types of autonomy must be balanced towards each other in situ during the course of the conversation which makes it indispensable to look at how stressing of the dialogical system emerges as part of an ongoing interaction.

All  of  these  elements  put  the  dynamics  of  the  therapeutic  project  into perspective and highlight how diffi cult it is in real life situations to balance the diff  erent concerns. In the end both therapists deliver the desired response (read  the  letter,  promise  not  to  write  it  down).  Even  though  the  therapists subsequently have expressed some doubts and regrets about their decision, these were made under pressure as a consequence of an unexpected request during the fast fl  ow of conversation. As stated by Trasmundi et al (forthcoming) it  is  oft  en the case with real life professional practice, there is little time to refl  ect on how to deal with challenges of trust related to past experiences and dysfunctional behavioral patterns in the present situation sitting face to face with another human being .

9 PT: good

## 14. Discussion and perspectives

## 14.1. Th e interrelated nature of timescales in therapy

Th erapy requires practitioners to create active constructive environments that promote, mobilize and value the role of the clients' ability to form complex thoughts  and  questions.  Analyzing  questioning  events  from  an  ecological perspective, it becomes clear that the conversations unfold on two diff  erent levels or dimensions: In both cases the client is 'doing telling of an event' but in doing so, she also re-enacts the event, by dis-aligning  herself to the behavior of  another  (distant)  agent  ('G'  in  the  fi  rst  example  and  'the  partner'  in  the second example), which for both clients cause an emotionally vulnerable state to appear. Th e therapists on the other hand, try to hold on to the emotional stance of the client in the here and now. In this way, both examples addresses the question of how  an event can involve diff  erent temporal dimension: Th e bio-mechanics of the bodies, which owes its capabilities to evolution and sociohistorical appropriation - the emic timescale, which of course is conditioned by both the lived life of the individual, but also the socio-cultural appropriation - the deontic timescale, which is informed by the double dialogicality of the two bodies in encounter.

Th us, the co-doing of therapy needs to be seen as embedded in diff  erent timescales. Th ere is the timescale of the here-and-now in which the interaction takes place, and which is highly infl  uenced by the inter-bodily dynamics of the situation. However, the dilemma of respecting the request of the client or adhere to it, is also to a very large degree constrained by the therapist knowledge of the client's previous pattern of behavior on a longer timescale. In example one, it is unclear whether the client will benefi  t in the long run, if the therapist engages in the confl  ict with her. Complying with the wish of the client might commit the therapist a pattern of dysfunctional behavior of the client. Th e therapist in example two knows that the client has severe diffi culties in setting the limits in her relationship to her partner. On the one hand this makes it likely that the partner of the client may indeed read the notes from the session since she has been allowed to do so before. On the other hand, abiding to the wish of the client is to reinforce a pattern of violating behavior. Th e ambition of the therapist is to get the client to see alternative ways of acting in which it is ok to maintain your own perspective, for instance by writing it in the journal and thereby acknowledge the problems in the relationship and trying to deal with it in a more constructive manner without subordinating the perspective of the other. Th us, on a shorter timescale the therapist may do good to the client by not writing anything down, however, on a longer timescale it will likely prove the exact opposite. As in the fi  rst example, the therapist might do good on the shorter timescale, by unconditionally reading the letter, but on a longer timescale, the conditions for complying need to be specifi  ed with regards to the therapeutic project. Again, there is no straightforward way to foresee the consequences.

## 14.2. Th e ecology of pragmatics

Taking an ecological perspective on pragmatics, descriptions based on traditional reference-predicate distinction in psycholinguistics (categorization-predication) cannot provide an adequate analysis of certain types of utterances that form a part of activities (Borchmann 2018). A basic pragmatic  assumption  is  that  performers  of  activities  share  the  states  of variations by means of utterances. Yet, how performers of activities attend to variations in the environment is not restricted to the utterance alone (ibid.). From a pragmatic point of view, then, an informative and accurate analysis of utterances that form a part of activities relies on two distinctions: a distinction between a convention-based regulation of attention through wordings and a convention-based specifi  cation of an aff  ordance, and a distinction between sharing information and nesting information.

Identifi  cation of invariants in and of the environment, however, relies on the entire perceptual systems of humans engaging and relating in and to the world on various timescales. As we have seen in this study on psychotherapy, questioning-response-cycles  aff  ord  diff  erent  forms  of  agency  and  plays  a role  as  a  capacity  for  managing  autonomies  and  coordinating  dynamics  of various dimensions. Th is points to the question of the conditions on which we  determine  the  degree  of  conventionalization,  when  specifi  cation  of  the aff  ordances of an activity or a situation is to be based on convention.

Following from this, pragmatics can be seen as a fi  eld which is concerned with  the  living  in  and  through  the  ecology  of  languaging  co-activity  and co-cognizing.  Th e  understanding  of  a  languaged  activity  such  as  question, we have argued,  depends  on  an  ecological  perspective  that      opens  up  for considering  questions  as  constituted  in  a  larger  question-response  cycle. In  our  cases,  the  question-response  cycle  always  involves  a  change  in  the system. As shown in the analysis, the dynamics between question-responsereaction  cause  the  environment  to  change,  thus  altering  the  conditions  for the distributed cognitive system. Th e main responsibility for sustaining the therapeutic system, due to the institutional norms of psychotherapy as a social system, is ascribed on the practitioner's part. Still, a single counter-question from the client makes a change in the conditions for fl  exible adaptive behavior of the system as a whole. Even more so, the change is diffi cult to anticipate and none of the participants can fully understand the possible consequences of this change.

To  sum  up,  in  the  psychotherapeutic  encounter,  the  dialogical  system emerges through the sense-saturated coordinated interactivity of the therapist-client  dyad.  Given  the  double  dialogicality  of  human  beings,  the dialogical dynamics of this system is defi  ned by the nature of how the agents relate  to  and  localize  otherwise  non-local  aspects.  Th is  is  indeed  the  case with psychotherapy. Not only is the dialogical system of therapist and client constrained by the abstract social system of therapy, which is represented both in practice, norms, and settings of the dyad, but also in the institutionalized features of these (interactional asymmetry, power-relations, goal-orientedness, obligations). An ecological perspective on therapeutic practice can contribute to a better understanding of the complexity of what kind of information is shared and how it is nested within diff  erent types of interrelated systems.

## Appendix A) Danish transcripts of excerpts

```
Case 1 [00:02:14.17] P: øhm (.) og så siger hun så til mig at øhm (.) det fordi der var en gang da jeg var ude i xxx det cirka et år siden [00:02:24.15] T: mm [00:02:25.14] P: øhm (.) og- og det var ikke godt for min stress jeg var ude i xxx i sådan et jobafk laring (.) og så s- (.) så øh var der en dag der opdagede jeg at- (.) jeg fi  k sindssyg meget energi og jeg tænkte bare (.) fuck det her det kører bare og (.) jeg kan bare køre i syvogtredive timer og (.) men alligevel så tænkte jeg bare der er et eller andet galt fordi sådan plejer jeg ikke og have det (.) altså det var som om at jeg var sådan helt øh høj eller hvad man siger [00:02:50.07] P: [altså jeg] kunne bare det her (.) og så ringer jeg til min mor for og høre eft  er om hun vil hente [navn] (.) jeg kontakter min mentor (.) og jeg kontakter g[navn] fordi jeg tænkte der er et eller andet fuldstændig galt med mig fordi sådan her plejer jeg ikke og have det [00:02:50.07] T: [mm] [00:03:05.07] T: så da du havde energi og overskud så ringede du eft  er dem [00:03:09.10] P: ja [00:03:09.25] T: til og tage over fordi du tænkte der var noget galt med dig [00:03:12.07] P: ja lige [00:03:12.26] T: [okay] (.) fordi [00:03:12.26] P: [nøjagtig] [00:03:14.16] P: og [navn] hun sagde det var fordi at min stress var så høj så jeg havde svært ved og (.) komme ned og slappe af [00:03:20.03] T: mm [00:03:21.24] P: og så blev min praktik stoppet ude i xxx og jeg har aldrig haft den der episode siden (.) men den skriver hun også i hendes bekymringsbrev (.) efoaeri eller sådan noget efoani- eufoari eller sådan noget (.) [00:03:33] men jeg har taget brevet med jeg ved ikke om du vil høre det hun har skrevet til xxx kommune [00:03:38.28] T: mm [00:03:39.26] P: og så har jeg også skrevet et brev tilbage [00:03:43.10] T: jeg tænker mm det det lyder- altså- hv- hvad er det du tænker du har brug for hjælp til i forhold til og tackle det her hvad er det øhm [00:03:50.01] P: [jamen det ved jeg ikke jeg har sagt mit] danse kursus op [00:03:50.01] T: [hvad er problemet lige nu] [00:03:53.05] T: [nå det har] du
```

```
[00:03:53.05] P: [fordi] [00:03:54.03] P: [ja fordi] (.) at det her det fylder så meget det mit barn [00:03:54.03] T: [simpelthen okay] [00:03:57.23] T: mm [00:03:58.26] P: og jeg vil ikke knækkes igen [00:04:00.15] T: nej (.) men je- det jeg hører her (Omitted: [00:04:00.15 - 00:06:55.09]) [00:06:55.09] T: og du er lidt perfektionistisk [00:06:56.27] P: ja [00:06:57.06] T: og du taler om at det her det bliver sådan en plet på dig (.) så der er noget her hvor at det ikke er perfekt [00:07:02.06] P: ja [00:07:03.03] T: så det er en (.) helt perfekt øvesituation (.) lige nu til at gøre noget andet (.) er du med på den [00:07:09.07] P: ja (Omitted: [00:07:09:20 - 00:13:21:25]) [00:13:21.25] P: ja og jeg sad også bare og tænkte prøv at se sådan en [00:13:24.12] T: ja [00:13:25.17] P: som bo (.) får han nu af vide (.) at nu har vi sådan en plet der på os [00:13:30.16] T: mm (.) så den her plet må jeg se din plet haha (.) det denne her ikke også [00:13:34.19] P: ja [00:13:35.01] T: der er din plet (.) må jeg have lov [00:13:36.06] T: [og kigge] lige sådan (.) må jeg have lov og skimme det [00:13:36.06] P: [ja] [00:13:38.14] P: jajaja Case 2 [00:28:14.25] P: og jeg kan ikke fi  nde ud af om jeg egentlig elsker hende eller om jeg kun er der [00:28:17.19] P: for børnenes skyld [00:28:20.24] P: det er første gang jeg har sagt højt og jeg vil ikke noteres for det (.) vel [00:28:25.17] P: der skal ikke være noge- komme til at stå noget om nogen steder hvor der m- nogen kan læse det [00:28:30.18] P: vel [navn] [00:28:31.14] T: nej hvad skete der lige inden i dig da du sagde det der [00:28:33.28] P: jamen det er fordi jeg har været i tvivl rigtig langt- i lang tid [00:28:37.20] T: hvad er det lige du mærker lige nu [navn] [00:28:43.26] P: jamen det ved jeg ikke [00:28:44.20] T: prøv lige at trække vejret
```

```
[00:28:45.08] P: tvivlen på mig selv tvivlen på om jeg kun er der [00:28:49.16] P: på grund af børnene [00:28:52.04] T: træ- træk lige vejret [00:28:53.14] P: ja [00:28:53:50] T: ja [00:28:55.11] T: du forsvinder fra mig lige nu [00:28:56.25] P: ja [00:28:57.02] T: ja [00:28:59.27] P: men det er fordi…
```

## Notes

- 1* Th is  work  was  supported  by  the  Velux  Foundation  (Grant  no.  10384).  Further, the work was carried out by in a close collaboration with Brønderslev Psychiatric Hospital, Denmark. We thank all employees, clients, and psychotherapists at the outpatient clinic for anxiety and personality disorders at. Without their time and expertise, this research would not have been possible
- 2 Th at  is,  the  illocutionary  force  refers  to  'speaker's  intentions'  whereas  how  the speech act is treated by the hearer is implied in the perlocutionary force (Searle 1969). Th e pragmatic framework of speech acts functions through giving primacy to language as a communicational system. However, according to the view presented in this article the dynamics associated with diff  erent speech acts are relying on contextual, circumstantial, and interactional aspects, which do not rest on language alone. Th e perlocutionary force of a speech act is not a given value but is a dynamic process of socio-cognitive negotiation and discrimination.
- 3 Not to be confused with the distinction made by Jakobson (1971) between 'speech event' (as the actual situation of speaking, in which the participants fi  nd themselves) and 'narrated event' (as the state of aff  airs being talked about). Th ough this distinction might seem relevant in the investigation of authentic psychotherapeutic practice, the distinction is seldom, if ever, a clear-cut possibility.
- 4 In  example,  spatial  markers  regulate  the  distances  between  'inner'  and  'outer' events; temporal markers (therein verb tense) regulate the metaphorical distances of immediate and non-immediate events; selective order devices (therein syntax) regulate distances between concepts or shift  s from agent status (active) to object status (passive)
- 5 As an example, a term like 'family' can both relate to a biological and social kinship as well as the 'family' as an institution, which has a social and cultural anchoring in history and is even kind of grounding the metaphoric use of 'family' as a caring system (as when gang members call each other 'brothers'). Yet 'family' can also relate to 'being a part' of a social system family, where becoming in the 'family' relies upon orienting to local sets of norms, value realizing activity and preferences (Hodges 2008). Th is  might even point to an actual constellation of parents and children, which engage in actual dialogical endeavor. Th is way diff  erent non-local aspects of a social system 'family' can become attractors for conditioning the dialogical system. Th ey are all connected across diff  erent timescales and thus there are interdependencies across the diff  erent 'levels' of abstraction.

- 6 ' A  letter  of  concern'  from  an  authoritative  regarding  a  citizen,  addressed  to  the municipality, can potentially be used against the citizen in lawsuit cases of parental authority and custody of children. Later in this session, it turns out, that this is exactly what the client fears are at stake.
- 7 Within therapeutic practice, the movement of body and gaze out of the dialogical responsive space is sometimes called a 'retreating to a refl  ective mind-space' - for either the client or the therapist '(…) to explore inner thoughts and feelings'(Ladany et al, 2004). Th is 'retreating' and the refl  ective 'mind-space' can be explained with reference to what within cognitive psychology is referred to as an increase of the 'cognitive load' of a situation. Such a practice is not uncommon in therapy as in other settings build on high asymmetry of knowledge, i.e. interview practice, and oft  en go on unnoticed. If not as in this example, actions like these are treated as fl  agging something unusual or potentially troublesome (Heldner & Edlund, 2010).
- 8 A preferred response is a second part of an adjacency pair that consists of a sort of response to the fi  rst part that is not avoided by participants, in example, an expected answer in response to a question (Levinson 1983).

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