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Conversation analysis : ritual in experimental systemic couples therapy involving alcohol dependence Dubberley-Habich , Patricia A. 1992

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CONVERSATION ANALYSIS: RITUAL IN EXPERIENTIAL SYSTEMICCOUPLES THERAPY INVOLVING ALCOHOL DEPENDENCEbyPATRICIA A. DUBBERLEY-HABICHB.A., The University of British Columbia, 1988A THESIS SUBMITTED IN PARTIAL FULFILLMENT OFTHE REQUIREMENTS FOR THE DEGREE OFMASTER OF ARTSinTHE FACULTY OF GRADUATE STUDIESCounselling PsychologyWe accept this thesis as conformingto the required standardTHE UNIVERSITY OF BRITISH COLUMBIASeptember 1992©Patricia A. Dubberley-Habich, 1992In presenting this thesis in partial fulfilment of the requirements for an advanceddegree at the University of British Columbia, I agree that the Library shall make itfreely available for reference and study. I further agree that permission for extensivecopying of this thesis for scholarly purposes may be granted by the head of mydepartment or by his or her representatives. It is understood that copying orpublication of this thesis for financial gain shall not be allowed without my writtenpermission.(Signature)Department of  Counselling PsychologyThe University of British ColumbiaVancouver, CanadaDate  September 28, 1992DE-6 (2/88)ABSTRACTThis study was intended to fulfill three goals which will be described. Itsmethod, subjects, results, and limitations will also be discussed.Following Gale's (1989) lead, the first goal, was to contribute to applicationof the ethnomethodological technique of conversation analysis to the field of familytherapy, specifically experiential systemic couples therapy.The second goal was to discover themes emergent from the data. Thesecharacterized the process of therapeutic change, particularly with an alcohol-involved couple. This was achieved by noting details of conversational interaction,both verbal and nonverbal, between the members of the therapeutic system.The third goal, was to highlight the nature of a ritual through theseparation, liminal, and integration stages. The couple's problems wereexternalized, experienced, and resolved in the present through ritually burningsymbols.Conversation analysis was conducted on one session with an alcohol-involved couple. The session was videotaped, audiotaped, and then transcribedfor intensive analysis. All other sessions with the couple and therapist werereviewed to add context to the interview on which this study focussed.Twelve themes emerged from the analysis. These were the central themeof ritualization and its constitutive subthemes of personal and family myths,symbolization, experiential, externalization, intensification, contextual/systemic,constructivist meaning shifts, therapist empathy, therapist genuineness,collaboration, and therapist artistry. Each was discussed and supported withquotes from the transcript. These quotes demonstrated both positive or successfulexemplars and deviant or unsuccessful examples.Possible limitations which might be ameliorated by adding related studiesto this line of research involve several points. These include the degree ofrepresentativeness of the participants, lack of random sampling, small samplesize, reactivity to videotaping, and researcher biases.In summary this investigation used conversation analysis with an alcohol-involved couple participating in ritualization in experiential systemic therapy. Ithas as its goal to add to the research regarding each of these topics so as to guideresearchers and therapists in conceptualizing change through therapeuticinterventions.TABLE OF CONTENTSABSTRACT 	iiACKNOWLEDGEMENTS 	 xiiiI. INTRODUCTION  	 1Statement of the Problem 	 1Definitions 	 2Conversation Analysis 	2Experiential Systemic Therapy 	 2Therapeutic Ritual 	 3Alcohol Dependent  	 3Delimitations 	 3Hypotheses  	 4Significance of the Study 	 4II. REVIEW OF THE RELEVANT LITERATURE 	 5Conversation Analysis 	 5CA and Related Ethnomethodological ResearchMethods 	 6Basic Premises of CA Theory 	 7Findings in CA Research of Everyday Talk 	 8Turn-taking 	 8Paired actions 	 9Adjacency 	 9Silence  	 9Preference, Pre-sequences, Delay, andAccounts 	 10CA Research in Institutional Contexts . . . . .	 10The Nature of Institutional vs. EverydayTalk 	 10i vTransferability of Types of Talk AcrossSettings  	11CA Research with Psychotherapy 	 11Experiential Systemic Therapy 	 11ExST and CA: Congruence of Approach 	 12ExST and the Symptom of Alcohol Dependence 	 12Alcohol Dependence, Family Stress, andRigid Roles  	 12Symptoms as Impetus for Change 	 13The Nature of Symptoms 	 13ExST's View of Alcohol Dependence andPersonality 	14ExST's View of Symptoms as Messengers 	 14ExST's Central Theoretical Dimensions  	14Systemic Dimension 	 15Experiential Dimension 	 15Symbolic Dimension 	 15Guiding Principles of ExST 	 16Collaboration 	 16Therapeutic Mandate 	 16Here and Now Focus 	 16Developmental Perspective 	 16Novelty and Creativity 	 17Generalizability 	 17Systemic 	 17Transactional Classes of ExST 	 17Therapist-Client Relationship Enabling Class  	 17Process Facilitation Transactional Class  	17Expressive Transactional Class  	18Symbolic Externalizing Transactional Class . . 	 18Meaning Shift Transactional Class  	 18Invitational Transactional Class  	 18Ceremonial Transactional Class 	 18Ritualization 	 18Definition of Ritual 	 19Rituals in Anthropological Investigations  	 19Rituals in Therapeutic Interventions  	 19Removal of Labels with Externalization in Rituals. 	 20Constructivist Perspective: Meaning Shifts 	 20Personal and Family Mythology and Ritual 	 21Mythology as a Unifying Force 	 21Mythology unifies individual, culture,and nature 	 21Mythology integrates parts of theindividual psyche 	 21The Alienating Modern Mythology ofRationalism 	 22Family Myths Altered through RitualPerformance 	22The ideational plane 	 22The material plane 	22Altered States of Consciousness in Ritual 	 23The Anthropological Viewpoint 	 23The Psychological Viewpoint 	23Generalizability of Ritual Effects AcrossContexts 	 23General Qualities and Functions of Rituals  	 24Qualities of Rituals  	 24Experiential  	 24Beyond language to symbol 	 24viJoining analogic and digitalcommunication 	 25Functions of Rituals 	 25Realizing Goals 	 25Entering the next stage of family lifecycle 	 25Restoring equilibrium during transitionalcrisis  	 25Emotional expression and solace  	 25Provision of symbols 	 26Development of Ritual Symbols 	 26Stages of Ritual 	 26Separation Stage 	 27Liminal Stage 	27Integration Stage 	 27Disruption and Assessment of Family Rituals  	 27Disruption of Regular Constructive RitualObservances 	 27Assessment of Ritualization in Families  	 28Symptoms, AA Meetings, and Ritual  	 28Symptomatic Behaviour as Ritual 	 29AA and Associate Organizations asRitualization 	 29Designing Personalized Therapeutic Rituals  	 29Therapist as Guide 	 30Clients as Owners of the Ritual Experience	 30Aspects to Consider in Designing Rituals  	 30Specific Applications of Therapeutic Rituals  	 30Loss through Death or Ending aRelationship 	 31Developmental Growth of a Family 	 31viiCross-cultural Issues 	 31Women's Rites of Passage 	 31Healing Past Abuse 	 32Belated Acceptance and Celebration 	 32Development of Healthful Family Relations 	 32Children's Symptoms and Rituals 	 32Adults' Symptoms and Rituals  	 33Couples' Symptoms, MaintainingRelationships, and Ritual  	 33III METHODOLOGY AND PROCEDURES 	 34Method 	 34Conversation Analysis  	 34CA in Contrast to Traditional EmpiricalApproach 	 34CA as Related to Giorgi's Method 	 34Highly Intensive Nature of CA Research 	 35CA is Grounded in Participants'Understanding of Interaction 	 35CA Seeks and Supports Themes Emergentfrom Data 	 35Validity: Derivation of Exemplars and DeviantExamples 	 36Reliability: Comparison Across Contexts  	 36Procedures 	 36Client Sample 	 36Therapist Sample 	37Selection of the Therapeutic Session Studied 	 37Post Session Review Forms: Partial Guides toSession Selection 	 37Transcription 	 39Analysis  	 40viiiIV. PRELIMINARY ANALYSIS 	 41Background to the Case 	 41Earlier Successes in Addiction Control  	 41Central Role of Alcohol to Other Relationships 	 41The Husband's Struggle and Treatment 	 41The Affair 	 42The Husband's Parents 	 42The Couple's Relationship 	 42The Couple's Therapeutic Goals 	 42The Husband's Goals 	 43The Wife's Goals 	 43The Flow of the Therapeutic Process 	 43The Couple's Relational Themes in Session Seven 	 44Divisive Relational Themes 	 44Betrayal 	 44Hostility 	 44Distancing 	 45Rejection 	 45Unifying Relational Themes 	 45Attentiveness 	 45Caring 	 45Honesty 	 45Trust 	 46Interactive Styles in the Therapeutic System 	 46The Wife 	 46The Husband 	 46Therapist as Guide to Change 	 47Evidence of Client Growth 	 48ixV. DISCUSSION 	 49Ritualization 	 49General Effects of Ritual 	 49Alcohol Dependence and Ritualization 	 50Overview of the Ritual Enacted in this Session 	 50Stages of the Ritualization 	 51Separation Stage of Entering Ritual Space andTime 	 51First Exemplar 	 51Second Exemplar 	 52Liminal Stage of Planning and Enactment . . .  	 53First Exemplar 	 53Second Exemplar 	 53Third Exemplar 	 54Fourth Exemplar 	 55Integration Stage of Incorporating ChangedRoles into Life 	 56First Exemplar 	 56Second Exemplar 	 57Third Exemplar 	 58Deviant Examples of Ritualization Theme. . . .	 58First Deviant Example 	 58Second Deviant Example 	 59Third Deviant Example 	 60Personal and Family Myths 	 61Exemplars 	 62First Exemplar 	 62Second Exemplar 	 63Deviant Examples 	 63First Deviant Example 	 63Second Deviant Example 	 64Symbolization 	 65Exemplars 	 65First Exemplar 	 65Second Exemplar 	 67Third Exemplar 	 67Deviant Examples 	 68First Deviant Example 	 69Second Deviant Example 	 69Experiential 	 71Exemplars 	 71First Exemplar 	 71Second Exemplar 	 72Third Exemplar 	 73Deviant Examples 	 74First Deviant Example 	 74Second Deviant Example 	 74Externalization 	 76Exemplars 	 76First Exemplar 	 76Second Exemplar 	 77Third Exemplar 	 78Deviant Examples 	 79First Deviant Example 	 79Second Deviant Example 	 80Intensification of Experience  	 81Exemplars 	 81xiFirst Exemplar 	 82Second Exemplar 	 82Third Exemplar 	 83Deviant Examples 	 83First Deviant Example 	 83Second Deviant Example 	 84Contextual/Systemic 	 85Exemplars 	 85First Exemplar 	 86Second Exemplar 	 86Third Exemplar 	 87Deviant Examples 	 88First Deviant Example 	 88Second Deviant Example 	 89ConstructivistiMeaning Shift 	 89Exemplars 	 90First Exemplar 	 90Second Exemplar 	 91Third Exemplar 	 93Deviant Example 	 93Therapist Empathy 	 94Exemplars 	 94First Exemplar 	 94Second Exemplar 	 95Deviant Example 	 96Therapist Genuineness 	 96Exemplars 	 97First Exemplar 	 97x i iSecond Exemplar 	 97Deviant Example 	 98Collaboration 	 99Exemplars 	 99First Exemplar 	 99Second Exemplar 	 100Third Exemplar 	 101Deviant Examples 	 102First Deviant Example 	 102Second Deviant Example 	 103Therapist Artistry 	 104Exemplars 	 104First Exemplar 	 104Second Exemplar 	 105Deviant Example 	 105Assumptions and Limitations  	 106Recommendations  	 108Application to Clinicians  	 108Learning from the Themes 	 108Using Rituals in Therapy 	 109REFERENCES 	 111APPENDIX A: TRANSCRIPT NOTATION 	 119ACKNOWLEDGEMENTSI am fortunate to have had a great deal of support toward completion of thisproject. Though not all of you will be mentioned specifically, I would like toexpress my thanks to those who have helped me in various ways to realize thisdream.Dr. John Friesen has tirelessly guided me in refining myconceptualizations. His inspirational and challenging teaching style has gentlyenhanced my theoretical and therapeutic skills.Dr. Larry Cochrane and Dr. Mary Westwood have offered valuableinformation and encouragement.Darryl Grigg and Jennifer Newman, along with the other members of theAlcohol Recovery Project, have given me thoughtful input in designing the study.I would also like to extend my appreciation to the therapist and clients whomade available their therapeutic ritual session.My family, friends, and colleagues have believed in me through every stageof this process. I would especially like to thank my friends Sheila and Shelagh,my sister Dale, and my parents for their caring and support.My husband Ray deserves special mention for all the sacrifices he hasmade so that I might achieve this goal. His loving presence and dependabilitytouch me deeply and will never be forgotten. I look forward to the joys of ourfuture together.Conversation Analysis 1CHAPTER IINTRODUCTIONResearch into the characterization and evolution of therapeuticconversation is currently only beginning and promises to be a fruitfulinvestigation. Conversation analysis (CA) is one of many contemporaryethnographic techniques used to research therapeutic interventions. CA isparticularly well suited to examining the nature of collaborative problemresolution and healing occurring in Experiential Systemic Therapy (ExST) bynoting the interactive patterns in conversation between members of thetherapeutic system of clients and therapists.CA can also be employed to reveal therapeutic concerns specific to alcohol-involved couples and be a guide toward potential resolution of difficulties incommunication which tend to correlate with alcohol dependence and co-dependent behaviours.The study offers a microanalysis of one counselling session with a malealcoholic, his wife and a female therapist who have taken part in ExST. Thesession analyzed consists of a representative ExST intervention of a ritualizationof the couple's problems following the husband having an affair. CA researchwith therapeutic encounters is as yet quite novel. Consequently the results areboth exploratory and descriptive, providing an initial contribution to theunderstanding of the process of change in ExST specifically with ritualization.This chapter will elaborate the statement of the problem, definitions,delimitations, assumptions and limitations, hypotheses, and the significance ofthe study.Statement of the ProblemThis investigation will discover, with the help of CA, the specific ways inwhich an ExST therapist uses "speech acts" or "utterances" (Heritage, 1984, p.139) such as questions, statements, commands, and requests as well as non-verbal sounds or actions to create therapeutic interventions. Possibleinterventions include summaries, tracking, probing, empathy, self disclosure,immediacy, blocking, coaching, framing, expressing underlying feelings, roleplaying, sculpting, metaphor, empty chair work, present and desired statesymbols, reframing, and rituals. The clients' understanding of the therapist'sverbal and nonverbal communications will be also be investigated. This will besuggested by noting the way clients respond, for example, by following theConversation Analysis 2therapist's lead, disagreeing, changing the topic, ignoring, or hesitating torespond. As well, the clients' speech acts and nonverbal communications will benoted along with the therapist's understanding of their intent indicated by thetherapist's response. This interrelated circle of acts and understandings willform the shape of the larger therapeutic intervention of the ritual burning ofsymbols of the couple's past discord.In the final analysis recurrent themes which have emerged from the abovedetailed analysis of interactive sequences will be elaborated and supported withpositive or successful exemplars and deviant or unsuccessful examples selectedfrom the session's transcript. These themes and quotes will help to guidetherapists in learning the concrete characteristics of the therapist's style in thesuccessful application of rituals in ExST.DefinitionsConversation Analysis CA is an ethnographic method for interpreting conversation as raw data.It inquires into the structural rules of verbal interaction which are understood byall societal members and which together represent conventions for producing orreceiving communication. An example of such rules is that a request requiresone of three possible responses. These are an acceptance, a refusal including anirrefutable excuse, or postponement of response. Another example is that aquestion requires an answer. Other such patterns will be described in theliterature review. These rules are learned in childhood and are often usedwithout conscious awareness.The following two authors describe the nature of CA. Gale (1990) noted thatCA views "talk itself' as "a performative action that helps to both interpret andproduce behaviors" (p. 6). Heritage (1984) made a related point that each sentenceis produced by and productive of its context.Experiential Systemic TherapyExST views the therapist and clients in an egalitarian relationship, ortherapeutic system, in which each member is mutually affected by and responsiveto each other member. ExST is based on humanistic principles so thatresponsibility for the outcome of therapy is shared by all members. The systemicaspect of ExST also refers to the understanding that the therapeutic system is partof many larger levels of relationship with the extended family, community,nation, and the world.Conversation Analysis 3Sessions are framed by the therapist as set apart from day to dayinteractions and involve a symbolic act, in this case a ritual. Clients'dysfunctional interactive patterns towards self and others are perturbed byvarious experiential interventions which are dramatic, active, and symbolic andwhich bypass clients' earlier cognitive and behavioural rigidity.Friesen, Grigg, Peel, & Newman (1989b) noted that an important aspect ofExST is the attention to symbols "which hold a density of meaning" known to theclients "which words cannot capture". These symbols chosen by the clientembody the positive goals of therapy. As well, symptoms in ExST are consideredto be messengers of desired change or "communicative acts" so that "presentingproblems are viewed compassionately" (p. 2). This therapy is brief, usuallylasting 4 months.Therapeutic Ritual A ritual in the ExST context involves clients and therapist collaborativelycreating a ceremony which uses symbols to externalize a problem requiringresolution. Clients interact with, experience, and manipulate the symbols so asto let go of past difficulties and embrace relational novelty in the future.Alcohol DependentFor the purpose of this study, an alcohol dependent will be defined as amale client who has been self-selected as physically dependent on alcohol byrequesting treatment and entering the Alcohol Recovery Project (TARP).DelimitationsAs with other qualitative research projects, several delimitations areinherent in the design. These include the demographic characteristics of thesample, the author's personality, and the use of a videotaped session. First, thegeneralizability of the results will apply best to populations of alcohol dependentmen and their wives, who are of approximately normal intelligence, who havechildren, and who reside in B.C.Second, the author's personality will likely affect the direction taken in theanalysis so that 2 more raters might have lent a balance to the interpretation.LeCompte and Goetz (1982) noted that "ethnographic process is personalistic; noethnographer works just like another" (p. 36).Third, conversely, the internal reliability should be enhanced by the use ofvideotaped data, thus preserving it for future confirmation or reanalysis. In theConversation Analysis 4long term, Gale (1991) noted that the reliability of findings can be tested bycomparison with exemplars in investigations with similar samples, authors, andcontexts.HypothesesDue to the nature of this analytic method, it is difficult to hypothesize aboutthe data before it is examined. It is possible to predict that conversation in thesample will share some characteristics with that generally described in theliterature of CA research, hence it will likely demonstrate turn-taking, pairedactions, adjacency, silence, preference, pre-sequences, delay and accounts. Itwill also include characteristics specific to the therapeutic setting.Significance of the StudyThe results of the study could guide future research into this therapeuticmodel, allow comparison with other models, and inform therapists of effectivetechniques as evidenced by the data. Parallel benefits of this study could be acontribution to the literature regarding C.A., treating alcoholism, and healingrelationships between partners.Now that the basic intent of the study has been introduced, the next chapterwill provide a review of the relevant literature.Conversation Analysis 5CHAPTER IIREVIEW OF THE RELEVANT LITERATUREThis study weaves three threads of areas of inquiry into a strong commoncord. These threads are those of the research method Conversation Analysis(CA), literature regarding Experiential Systemic Therapy (ExST), and literatureabout Ritualization in therapy. Literature describing several aspects related tothis investigation will be provided in this chapter. Each of these three aspects ofthe research will be discussed in turn.The first research thread concerns CA. It involves transcription andmicroanalysis of each line of dialogue in the session looking for patterns ofrelationship with earlier and later statements. As a result of this ongoingintensive analysis, emergent themes are developed, described and exemplified.Several issues in CA research will be presented.The second research thread is that of ExST. It involves the collaborationbetween the therapist and clients in experiences intended to intensify andtransform clients' problems into novel relational patterns. The flavor of ExSTtherapy will be alluded to through discussion of several key concepts discussed inthe literature.The third thread and the central focus of this particular session isRitualization, an intervention often used in ExST in numerous forms. Varioussources from the literature which attend to aspects of applying ritual totherapeutic encounters will be presented.These three theoretical threads will be discussed in turn in the followingsections.Conversation AnalysisCA is a research method which is relatively new to psychologicalinvestigations. Discussion of several aspects of its characteristics will be providedin the following sections. In the first section, background to related researchmethods will be given and CA will be compared with one other research methodin some detail. In the next section, the basic premises of CA theory will beelaborated. The third section describes topics studied in CA's attention toeveryday conversation. CA's application to institutional settings, specifically topsychotherapy, is the focus of the final section.Conversation Analysis 6CA and Related Ethnomethodological Research Methods CA is one example of process research which has been developing overseveral decades especially within ethnomethodology but also in psychology. Otherrelated streams of research have also been developed as will be highlighted in thefollowing section, especially discourse analysis (DA). As well, CA and DA will becompared and contrasted.Several authors have pioneered research into various aspects of the processof therapy using methods other than CA. They attended to therapist behaviours(Rogers, 1942), coding and rating systems and therapist and client self-reports(Kiesler, 1973), interaction between therapist and clients (Gottman & Markman,1978), task analysis (Rice and Greenberg 1984a, 1984b), interpersonal processrecall (Bergin and Strupp, 1972; Kiesler, 1973; Rice and Greenberg, 1984b; Elliot,1983, 1984, 1986), good moments in therapy (Mahrer, 1986) and paralinguisticfeatures of conversation (Rice & Kerr, 1986).Another technique of process research which has often been used inethnomethodology and study of therapeutic interactions is discourse analysis(DA). It shares several features with CA. Labov and Fanshel (1977), proponentsof this method, cite as their forerunners similar sociologist authors as those whohave informed CA theory. First, they note the contribution of Sacks, Schegloff,and Jefferson (1974) in determining the general rules of sequencing inconversations. Second, they refer to Goffman (1971) in that "actions andutterances are regularly linked together in chains of exchanges" (Labov &Fanshel, 1977, p. 30). Third, DA is similar to CA in that it noted paralinguisticcues of tempo, volume and breathing especially with laughter. These ideas aresome of the ways in which the two research methods are related.DA investigations differed from CA research in several ways. First, DAexamined the data at the level of a sequence of words bounded by topic shifts andattended to several minute details of paralinguistic aspects of speech such aspitch and quality of voice. This entailed a more expansive analysis than that ofCA researchers who focus on the level of sentences. Second, Labov & Fanshel(1977) described how DA differed from CA in that the analysis involved expandingthe notation of the meaning of the text, inclusion of references of pronouns,addition of related facts from other areas of the text and explicit statement ofshared knowledge gleaned from conversations. Third, CA and ExST are lesscontent-oriented and more process-oriented than DA, so that what is investigatedis client experiences more than the topic discussed. Fourth, Heritage (1984) notedthat with CA preconceived linguistic theory does not guide the analysis, unlikeConversation Analysis 7with DA, but a fresh approach to the data is valued. The above points differentiatethe two research methods quite clearly.In summary, CA and DA share some features and diverge in otheraspects. For the purpose of this study, CA offers the method of choice which canshrink discourse information into smaller manageable categories so as to seepatterns of ExST themes in style of interventions and their relative successes.Basic Premises of CA TheorySeveral authors have contributed to the development of the basic premises ofCA theory, each of which are described in this section. Attention to both verbaland nonverbal cues are then discussed. Following this discussion, specific areasof CA research and findings are touched upon. Finally, CA's application tospecific conversational arenas is explored.The basic premises of CA theory have been developed since approximately1960 by a core group of authors whose individual contributions will be describedbelow. Garfinkel (1967) has supplied the notion that common sense knowledge ofsocial structure is evident in human interaction. Goffman (1971) has highlightedthe social structure in which conversation takes place and described the joining ofthe verbal and nonverbal parts of conversations in related sequences. Thesetheorists provided the initial premises.Other theorists have added to the aforementioned ideas by describing theorganizational rules of conversation. Sacks, Schegloff, and Jefferson (1974) havepioneered the method's attention to turn-taking in conversation. Levinson (1983)has contrasted CA to content analysis in that CA pays scant attention to contentand places "emphasis on the interactional and inferential consequences of thechoice between alternative utterances" (p. 287). He also described some details ofthe manner in which individuals are selected to speak. These initial premiseshave been developed into rules by Heritage as described in the following quote.Heritage (1984) summarized the basic assumptions of CA that:1. Interaction is structurally organized.2. The significance of each turn at talk is double contextual in that(a) each turn is shaped by the context of prior talk and(b) each turn establishes a context to which the next turn will beoriented.3. No order of detail in interaction can be dismissed a priori as irrelevantto the parties' understandings of what is occurring (p. 241).Nonverbal and verbal cues are noted in CA. It first studied audiotapes ofConversation Analysis 8telephone conversations, attempting to avoid confounding effects of visual cues ondiscourse. Current CA research recognizes, as do ExST studies, the importanceof visual and auditory nonverbal cues so that it attends to all possible modes ofcommunication. The notation of details of movements and several aspects of thequality of voices is integral to the process of videotape transcription.In conducting an analysis of the transcribed information, themes areelaborated and supported with exemplars in the form of quotes. As well,according to Heritage (1984), "the analysis of deviant cases - in which someproposed regular conversational procedure or form is not implemented - isregularly undertaken" (p. 244). This allows further understanding of thestructure of conversational procedures by examining what differed fromsuccessful exemplars.CA's attention to detail has advantages over such traditional ethnographicand psychological research methods as interviews, paper and pencil tests, fieldnotes, recollection of conversation, pre-coded schedules, or experimentalbehavioural manipulation. This is accomplished through detailed transcriptionof the conversation and the use of videotapes to preserve the data's complexity forfuture study. These features helped to avoid inadvertent influences on theparticipants or data by coders or experimenters. They also eliminated recallbiases so that the analysis is relatively unaffected by linguistic conventions,intuition, common-sense, or theoretical preconceptions. As ExST studies theuniqueness of each family within the framework of systems theory, CA examineseach piece of data from a fresh perspective and seeks to draw parallels betweenthe findings it offers and the larger body of research findings.Findings in CA Research of Everyday TalkVarious areas of CA research have illuminated conversationalorganizations including turn-taking, paired actions, adjacency, silence,preference, pre-sequences, delay, and accounts.Turn-takingTurn-taking is a basic aspect of all human communication in which the rules forwho may speak and in what order may be informal or predetermined. In oursociety, and specifically in therapy, first speakers allow others to speak by pausingto let them self-select for the next turn, or by requesting comment from aparticular individual. Overlap between speakers is rare and is soon repaired byparticular conversational conventions. Levinson (1983) noted that in such a case,Conversation Analysis 9one member speaks louder or faster than the others, who pause to let the firstspeaker complete the idea.Paired actionsPaired actions, which structure turn-taking, are evident in such sequencesas greetings, question-answer, request-grant/rejection, invitation-acceptance/refusal, and assessment-reassessment. Research by Schegloff andSacks (1973) has shown that the first speaker will usually provide the first pair-part, then hesitate for the second speaker to present the second pair-part.Pomerantz (1988) has studied the way a questioner can provide one or morecandidate answers from which the respondent can select. This guides therespondent in the type of information the questioner is requesting. Candidateanswers might give a model for, show knowledge of, or present an attitude towardthe preferred response. Finally, Levinson (1983) has described "insertionsequences" through "which one question-answer pair is embedded withinanother" (p. 304), thus clarifying information before an answer is given. Thisstudy will also address such ubiquitous paired actions.AdjacencyAdjacency has purpose in conversation besides indicating polite responses.Usually a statement is interpreted as related to the previous one, but may beunderstood in various ways as shown by the response given. For example, it maybe heard as a question and given an answer, or taken to be a criticism and givenan apology. After a misunderstanding, a first speaker will show the intendedmeaning by correcting or 'repairing' the statement, then allowing the respondentto react. The meaning of discourse is thus developed in terms of linked adjacentturns.SilenceSilence in response to a question also has meaning as Heritage (1988) hasdescribed. It could mean that the rules for response do not apply in thatcircumstance. More commonly, it indicates "deafness, failure to recognize thequestion, rudeness, lack of willingness to answer," or "inability to answer withoutself-incrimination", and "the failure is treated as requiring explanation " (p. 140).As this phenomena is expressed in ExST, one might expect the counsellor to allowclients time to remain silent so as to process their emotions and formulate aresponse. If the client looked confused, the counsellor might rephrase theConversation Analysis 10question or comment, or summarize and invite information on the clientsemotional state in reaction to the stimulus.Preference, Pre-sequences, Delay, and Accounts Finally four other topics have been addressed in CA research to date. Theyare preference, pre-sequences, delay, and accounts. Preference refers to anaffirmative response to a question, offer, invitation, or assessment which is givenimmediately, briefly, and without qualification. In contrast, Levinson (1983) notedthat a negative response is often preceded by delay, pre-sequences such asappreciation of the former statement, a tentative negation, and an irrefutableaccount for the negation since it is beyond the speaker's control. In furtherelaborating on the complexity of framing a first pair part, Levinson (1983) hasdelineated such presequences as "prerequests" (p.327) and "preclosings" (p. 317).These conversational rituals advise the respondent that a proposal or closing isforthcoming. They allow individuals to 'save face' thus support social solidarity.This section has highlighted several areas of attention in CA research witheveryday conversations. The next section will address CA research applied tovarious institutional contexts, especially its use in psychotherapy.CA Research in Institutional Contexts Topics of institutional talk, transferability, and psychotherapy follow.The Nature of Institutional vs. Everyday TalkC A research in institutional contexts has indicated that talk is constrainedby participants' unequal social roles and by specific activities in the setting.Heritage (1984) has proposed that:institutional interaction involves two related phenomena: (1) a selectivereduction in the full range of conversational practices available for use inmundane interaction; and (2) a degree of concentration on, andspecialization of, particular procedures which have their 'home' or baseenvironment in ordinary talk. (p. 239-241)For example, one might expect certain aspects of conversation to beemphasized by an ExST therapist such as open-ended questions, offeringcandidate responses, reflective responses, invitations, requests, summaries,assessments and metacognitive statements. In a complementary manner onemight expect clients to provide more personal information, answers, acceptancesor refusals, and reassessments of their problems than in ordinary conversation.Conversation Analysis 11Transferability of Types of Talk Across Settings Heritage has also noted that activities specific to institutional setting suchas cross examination or pedagogical dialogue may occur outside legal oreducational settings respectively. Conversely he also noted that peer conversationmay be heard in these specialized locales, positing that context is "endogenouslygenerated within the talk of the participants" (p. 283). This point likely alsoapplies to therapeutic discussions in that for example empathy can be used in adiscussion between friends and therapists might also occasionally engage ineveryday conversations with their clients before and after sessions.CA Research with PsychotherapyRecently CA has been adapted to interactions during psychotherapy. Threeexamples are presented here. Bilmes (1985), regarding an interaction in couplestherapy, has argued that both "conversationally grounded analyst'sinterpretations" and the meaning understood by the hearer can be 'correct' sothat any one comment has no absolute meaning. Davis (1986) examined how apsychiatrist restated and hence reformulated his female client's problem,although perhaps distorting the client's needs and wishes.Finally, Gale (1990) used CA to describe O'Hanlon's solution-orientedtherapy with a couple. Gale elaborated nine themes which characterizedO'Hanlon's therapeutic conversational style. Gale found that O'Hanlon adheredto his previous description of therapeutic method in some regards, but that he alsoused techniques of which he had been unaware until they were noted by Gale.The planned study will add to the varied body of knowledge about therapeuticinteractions developed through the use of the CA method. This method will beapplied to an ExST session to discover themes which represent the process of thisparticular style of therapy.This section has review various aspects of CA research as compared withother methods, its basic premises, areas of study of everyday conversations, andapplication to institutional contexts emphasizing psychotherapy. The next majorarea of review to be addressed will be that of ExST.Experiential Systemic TherapyExST is a new branch of systemic family therapy which emphasizes theexperiential nature of the therapy encounter. The following compilation oftheoretical issues related to ExST will first discuss the similarities between ExSTand CA theory. Second, the issues related to the symptom of alcohol dependencewill be noted. Next, ExST's three basic dimensions; symbolic, experiential, andConversation Analysis 12systemic will be described. Fourth, the five basic principles of ExST;developmental perspective, present tense therapeutic focus, ecologicalassessment, collaborative therapist stance, and therapist spontaneity will beelaborated. Finally the seven ExST Transactional classes of therapeuticinterventions will be highlighted.ExST and CA: Congruence of Approach Both ExST and CA emphasize the relational context of the interactionsstudied. ExST seeks to identify and to change repetitive damaging behaviouralsequences and to bring new meaning into the relationship. In a similar vein, CArecognizes the recursive nature of each sentence; that it both affects, and isshaped by, its previous and subsequent contexts. Heritage (1985) has emphasizedthe close interrelationship between conversational components which allows fortheir constantly evolving meaning. Similarly, rather than imposing preconceivedtheoretical expectations of effects upon the data, both ExST and CA researcherslook for patterns to emerge which are meaningful to the participants. In theseways, the theories are naturally compatible and complementary in thisinvestigation.ExST and the Symptom of Alcohol DependenceExST is a relatively new example of systemic treatments for alcohol abuse.The interrelationship of alcohol dependence and family stress, the impetus forchange provoked by the symptoms, the rigidity of family roles, the nature ofsymptoms as ostensibly involuntary, and the ExST view of the symptom will bediscussed.Alcohol Dependence. Family Stress. and Rigid RolesSystemic treatment of alcohol dependence, as well as the treatment ofrelated symptoms which tend to interfere with healthful and satisfying familyfunctioning, recognize the inherent emotional and behavioural interrelatednessof family members and of these symptoms. As Davis, Berenson, Steinglass, andDavis (1987) wrote that "in the family system of an alcoholic there is an unusualrisk of disruption in members' lives and of morbidity" (p. 26). They quote researchwhich indicates the causation is bidirectional; "that marriages do improve whenan alcoholic simply stops drinking" (Burton & Kaplan, 1968; Paolino & McCrady,1977) and "that interpersonal stress (such as marital stress) is more likely thanother life stresses to lead to a renewed bout of heavy drinking among abstinentalcoholics" (Hore, 1971a, 1971b).Conversation Analysis 13A relatively well-adjusted family will tend to exhibit flexibility in roles and,even after an unpredictable event such as a death or illness, will join forces toreturn to healthful and balanced functioning. In contrast, when one part of atroubled family system is disturbed or healed, another part of the family will tendto exhibit a symptom which will restore the negative status quo.As an example of symptomatic rigid roles, Bowen presented the alcoholicas tending to "underfunction" while the partner tending to "overfunction" (Bepko,1985, p. 16). Similarly the partner is often described as "overresponsible" inattending to the physical and emotional needs of others at the expense of his/herown needs and in maintaining the relationship. In summary, as Bepko (1985)wrote, the action of "ingesting a psychoactive drug affects and is affected bychange and adaptation at many different systemic levels including the genetic,physiological, psychological, interpersonal, and spiritual" (p.5).Symptoms as Impetus for ChangeSuch painful, seemingly intractable communication patterns withinalcohol-involved couples bring a sense of despair to both members and are often astrong impetus for therapeutic change. Barnard (1981) noted the "prominence oftension, fear, isolation, rejection, incongruence, blaming, denial and inhumanrules which are operational" (p. 49). Howard and Howard (1978) wrote that "as thecondition of the problem drinker deteriorates, the family suffers through lack of ordistorted communication and decreasing levels of self-worth; the family patternbecomes less nurturing and more disturbed" (p. 140).The Nature of Svmntoms As part of the systemic zeitgeist, ExST is a contemporary treatment whichexamines the relationship between the alcohol dependent, the co-dependent(s),and the substance as they relate to the symptom of alcohol dependence. Elkin(1984) defined a symptom as "any behaviour which" . . . "controls or defines thecontext in which interaction takes place" and "directly or indirectly makes theclaim "I can't help it" (p. 90). Elkin (1984) noted that in such interactions "thenormally accepted rules of human intercourse do not apply. . . and there is noclear substitute set of rules". The new context is therefore established by theperson with the symptom. In such a case, the partner "often feels bothresponsible for the welfare of the person and totally helpless" (p. 91).Elkin (1984) continued that if a "behaviour either (a) failed to control thecontext of interaction or (b) was admitted to be voluntary, then it would not operateas a symptom" (p. 92). The effect of the symptom controlling family interaction isConversation Analysis 14often the case for family members of an alcohol dependent. In keeping with thisargument, ExST seeks to perturb the family system particularly by externalizingsymptoms and allowing the couple to visualize themselves in a satisfyingrelationship without the interference of alcohol. In this way, ExST emphasizesthe clients' potential health, rather than an immutable disease of alcoholism.ExST's View of Alcohol Dependence and PersonalityExST theorists view alcohol dependence as a core syndrome within a broadrange of alcohol-related problems such as relational difficulties in the marriage,family, work, or community. In describing personality, Friesen (1992b) statedthat "the self is divided into subpersonalities or parts" which "interact in wayssimilar to external families or other human systems" and which "areexperienced in a number of ways such as thoughts, feelings and sensations" (p.1). Friesen (1992b) noted that these parts develop over time and might consist ofinjured child or abusive adult components. Each part requires recognition. Ifthis is not accomplished, parts may "become polarized" or "rigidly extreme anddestructive" . . . "in relationship to the core self ". Symptoms of such polarizationinclude "sexual deviance, alcohol dependency, eating disorders, etc".ExST's View of Symptoms as Messengers A last important issue regarding alcohol dependence as a symptominvolves the ExST viewpoint of the symptom as messenger. Friesen et al (1989b)described that a function of symptoms is to teach the therapist and clients aboutrelationships in need of attention" (p. 42). It is as if the symptom takes on a life ofits own and is treated with respect. For this reason, unless the symptom is lifethreatening, it's meaning is first thoroughly explored before impetus for thesymptom's removal is begun. ExST techniques then externalize the symptomfrom the client thereby circumventing blaming the individual and allowingresolution of the problem.This section has discussed the nature of symptoms from the ExSTperspective. The next will elaborate the central theoretical dimensions of ExST.ExST's Central Theoretical DimensionsExST theory is based upon three central dimensions; the systemic,experiential and the symbolic. They will each be described in the following text.Conversation Analysis 15Systemic DimensionExST, as presented by Friesen, Grigg, and Newman (1991), is based on thepremise that "relationships" are "the bedrock of human existence" (p. 2). Theserelationships exist not only with immediate family and friends but with the largercommunity and world, as well as within the individual as related psychologicalparts. The therapeutic system is a special example. ExST comes from the secondorder cybernetic perspective that the clients and therapist are equal partners fortherapeutic change. Though therapists have expert understanding of thetherapeutic process, they consider themselves as participants in, rather thanobservers of, therapeutic change. ExST theorists and therapists remain aware ofall of these levels of systems as they affect and are affected by individual clients.Experiential DimensionThe second, or experiential, dimension can best be expressed in a quotefrom Friesen et al (1991) that "clients do not need an explanation, they need anexperience" (p. 6). Because of this awareness, clients in ExST are encouraged toact out their psychological experiences physically so that they can be experiencedin the 'here and now'. Spontaneous and creative externalization of "aspects of selfin relationship", "symptoms, problems, relational themes or relationshippatterns" (p. 7) can bring the emergence of new heartfelt understandings andrelational novelty for clients. In a similar manner, family histories are alsoexplored in the present context so that clients can experience the effects ofintergenerational themes in ExST sessions. In these ways, through experiencecomes transformation.Symbolic DimensionMetaphoric symbols are a third powerful aspect of change in ExST. Friesenet al (1991) noted that they may be represented as "words, actions", "projects"(p. 4), "feelings, thoughts and deeds" (p. 5). Friesen (1992a) described a symbol as"a term, a name, or even a picture that may be familiar in daily life, yet possessesspecific connotations in addition to its conventional and obvious meaning".Friesen (1992a) continued that in exploring symbols clients' thoughts go "beyondthe grasp of reason", "evoke attitudes and emotions", "are sensory", connect "tothe unconscious" and "help bypass reflexive objections" (p. 1). Friesen et al(1989b) stated that a symbolic act offers a novel healing experience "whichsynthesizes behavior, cognition, perception, and affect" and that this experience"is deepened and enhanced in the therapeutic setting" (p. 3). Relational noveltycan then be translated into change outside the therapy setting.Conversation Analysis 16The characteristics of ExST have been presented in this section. The nextsection's presentation of the principles of ExST will add yet more of it's flavor tothe discussion.Guiding Principles of ExSTFriesen et al (1991) demarcated principles which combine to form theuniqueness of ExST as a therapeutic approach. These are; collaboration,therapeutic mandate, here and now focus, developmental perspective,novelty/creativity, generalizability, and systemic viewpoint.CollaborationFirst, the ExST therapist and clients share ownership of the therapeuticprocess and responsibility for the evolution of their relationship. Together theyelaborate the clients' story. Friesen et al (1991) noted that with " mutual trust,respect and caring" the therapist "honours the clients' world" (p. 13) and acceptsclients as they are. Through this approach, what might be called 'resistance' byother therapists is viewed as a necessary self protective stance by ExSTpractitioners.Therapeutic MandateA second principle is that clients are guided by the therapist to view theirdifficulties relationally. Friesen et al (1991) described that clients develop atherapeutic mandate which is expressed as a "desired state metaphor", andwhich portends future change (p. 14).Here and Now Focus The 'here and now' focus is the third guiding principle. Clients exploreevents from the past or future by deeply experiencing their manifestations to thepoint of saturation in the present moment.Developmental PerspectiveA fourth principle, ExST's developmental perspective, views both hesitancyabout and engagement in therapy as valuable examples of clients' relationalpatterns. Friesen et al (1991) noted that a practioner of ExST "conveysappreciation and respect for the clients' potential" (p. 16) and helps them to growthrough life cycle transitions.Conversation Analysis 17Novelty and CreativityA fifth aspect of ExST is that the counsellor, rather than developing rigidtreatment plans, is open to co-creating novel modes of healing which will helpclients transform painful recursive interactive patterns into mutually nurturingsatisfying relational patterns.GeneralizabilityA sixth important issue is that the relational novelty, developed in therapymeetings, is closely linked to extrasessional client activities. In this way, ExSTtheorists expect therapeutic change to generalize to the clients' wider context.vstemicThe final principle is that ExST highlights the many ways in which clientsare systemically interconnected. Friesen et al (1991) noted that aspects of theclients' context include the "intrapersonal, interpersonal, familial, sociopoliticaland spiritual relevance" (p. 18) of therapy. The quality of these relationships isexamined and transformed through the process of therapy.This section has touched upon the principles of ExST. The actualtherapeutic interventions which can be part of ExST encounters will be the topic ofthe next section.Transactional Classes of ExSTExST utilizes techniques drawn from seven transactional classes,elaborated in Friesen et al (1991), which roughly approximate the order of theiremergence in the process of therapy. Each will be named and given examples.Therapist-Client Relationship Enabling Class Friesen et al (1991) described this class of interventions as concerned with"the creation and maintenance of the therapeutic alliance" characterized by"trust" (p. 25) and "commitment to the therapeutic process" (p. 26).The quality of this relationship might be expressed through empathy, selfdisclosure, and immediacy.Process Facilitation Transactional ClassFriesen et al (1991) wrote that clients are lead to be "spontaneously" and"directly involved with one another during the session" (p. 26) in theseinterventions. Examples are blocking, coaching, marking boundaries, framingexpression of underlying feelings, role reversal, and repetition.Conversation Analysis 18Expressive Transactional Class Friesen et al (1991) described how the private is made public through"exploration, naming and owning of experiences" (p. 26) as they are expressed.Art, dance, storytelling, baking, and metaphor are representative examples.Symbolic Externalizing . Transactional Class Various things or individuals are represented through externalizedsymbols and interacted with by the clients. Some examples are empty chair work,two chair work, and symbolic representations.Meaning Shift Transactional ClassThese conceptualizations of problems view clients as deserving ofcompassion at the same time as they perceive possibilities for change.Reframing, normalizing, circular questioning, and regressions belong to thisclass.Invitational Transactional ClassThese transactions are intended for enactment between sessions to promotenew behaviours or to consolidate change. The results of the invited activity canalso indicate how well changes are being incorporated into clients daily lives.Ideas for perturbation of the clients' system between sessions include prescribingsymptoms, homework, quests, journal writing, and self-monitoring.Ceremonial Transactional Class These transactions use ritualization to formally honour changes clientshave made during counselling. Ceremonies can take on many forms includingclosing celebrations, burials, penance, confessions, and handshakes.This last section has described the seven transactional classes of ExST. Ageneral introduction to the nature of ExST has been provide by this informationalong with that in the earlier sections about harmony between the premises ofExST and CA, ExST and the symptom of alcohol dependence, ExST's threedimensions, and the five principles of ExST. The next section deals in detail withmany aspects of ceremonial transactions or ritualizations in therapy.Ritualizati onNumerous aspects of ritualization in therapy are alluded to in theliterature. In the following section the areas of the definition of ritual, removal oflabels by externalization, constructivism and meaning shifts, ritual andConversation Analysis 19mythology, altered states of consciousness, qualities and functions of rituals,development of ritual symbols, stages of ritual, disruption and assessment,designing therapeutic rituals, and applications to specific problems will becovered.Definition of Ritual Ritual has been used in both the wider cultural context and in therapy tosymbolically externalize and alter or reinforce the meaning of various troublingor joyful experiences to the participants.Rituals in Anthronological InvestigationsCooper (1987) summarized some characteristics of ritual found in theanthropological literature including "symbolism, enactment," and "repetition"(p. 12). She noted that acts in ritual are abstract or symbolic representations ofanother act, idea or belief. Cooper stated that the participant's belief system maybe "culturally defined and shared by others" or can "refer to a more idiosyncraticset of assumption and beliefs influencing a person's thoughts, perceptions, andbehavior" (p. 12).Regarding repetition of rituals in the wider culture, Cooper drew attentionto the concept that "even when performed only once," for given participants "aritual can still convey a sense of tradition by stylistic performance, utilization ofestablished symbols in a new context, and evocative presentation conveying asense of unquestionable validity" (p. 16). A therapist may utilize similar but notidentical ritual enactments for various couples as each enactment has andistinctly personal nature. In the next paragraph, it can be noted that ExST usesritualization to realize similar goals.Rituals in Therapeutic Interventions In ExST, ceremonial transactions, or ritualizations, tend to occur near themiddle or end of the therapeutic process when the therapeutic system is welldeveloped. These interactions embody the spirit of ExST's approach to therapy asthey externalize and bid farewell to problems in a solemn, playful andcollaborative manner. The enactment of rituals can entail aspects of othertransactional classes such as empathy, immediacy, marking boundaries,storytelling, metaphor, empty chair work, symbolic representations, refrainingand normalizing. Rituals serve to perturb, summarize, or consolidate thechanges realized within therapy, help pave the way for the disbanding of thetherapeutic alliance, and facilitate integration of changes.Conversation Analysis 20Removal of Labels with Externalization in Rituals Externalization of inner processes is an important aspect of all ritual.Specifically couple's therapeutic rituals involve the creation of externalizedsymbols which represent problems as separate from the innate and desirablecharacteristics of the relationship and individuals. This goal is importantbecause problems brought to therapy are often initially perceived by the clients asfatalistic immutable grounds for mutual blame. White (1989) found that forfamilies "the continuing survival of the problem, and the failure of correctivemeasures, served to confirm. . . the presence of various negative personal andrelationship qualities or attributes" (p. 5).White (1989) supported the above stance by citing Foucault (1965, 1973), asystems theoretician, who traced the phenomenon of labelling problems as if theyresided within individuals. White (1989) paraphrased that the "modern history ofthe objectification of persons, and of the bodies of persons, coincides with theproliferation of what can be referred to as the 'dividing practices' and thepractices of 'scientific classification" (p. 24). Foucault, as quoted by White (1989),argued that they had the effect of "subjugation' of persons . . . as 'docile bodies"(p. 24) which could be easily controlled. In this way individuals weredisempowered.Both White's ideas about treatment and those of ExST have among theirgoals to remove the effect of this labelling function and to place the responsibilityfor and control of change back within the power of the clients by externalizing theproblem. They differ on the point that White discusses the metaphor of theproblem with his clients while Friesen et al (1991), as ExST practitioners, haveclients interact in a myriad of ways with the symbolized problem. ExST alsoexternalizes various relationships. Nonetheless, both paradigms useexternalization to engender joint optimistic refashioning of the relationship byclients and therapist.Constructivist Perspective: Meaning Shifts The alteration of meaning is a central goal of ritualization. White (1991)referred to meaning shifts in therapy generally as "deconstruction". White (1991)proposed that "deconstruction is premised on" . . . "a critical constructivist" ora constitutionalist' perspective"; that "persons' lives are shaped by the meaningthat they ascribe to their experience, by their situation in social structures, and bythe language practices and cultural practices of self and of relationship that theselives are recruited into" (p. 27). ExST theorists agreed that the way an individualConversation Analysis 21describes her/himself or a group, their relationship, or their narrative, has realimpact on the way their lives are lived.Other authors have also emphasized the importance of the meaning of theritual to participants. Regarding the enactment of therapeutic ritual, Buckland's(1982) contention was cited by Cooper (1987) that "the purpose and meaning of theritual to the practitioner is the most important element in the outcome of ritualpractice" (p. 15). ExST theorists would stress the importance of both the therapistand the clients' belief in the efficacy of the ritualization process. Wallace (1966)was also paraphrased by Cooper (1987) that "when symbols are shared, ritualswill not have the same meaning for all participants" (p. 15). Likely the importantissue is that clients do experience through ritualization a construction of a newmeaning to guide their future roles and behaviours.Personal and Family Mythology and Ritual Mythology is a topic which has recently been embraced as a healing sourceby researchers, therapists and laypeople. It is highly congruent with ExSTtheory. The topics of myth as a unifying force of clients' external and internalworlds, the stifling effects of the myth of rationality, and changing family mythsin therapy will be discussed next.Mythology as a Unifying ForceMythology can not only unite individuals with their social and naturalcontext, but it can also integrate parts of the individual psyche. The effect of mythgoes beyond rational thought. According to Feinstein (1990), myth can "embracethe intuitive and spiritual dimensions of human consciousness that elude manyof the constructs psychologists have used to describe the core components ofexperience" (p. 163).Mythology unifies individual, culture. and nature.  A first effect ofmythology is that it serves to let the individual feel part of a larger whole.Campbell (1988) stated that "every mythology has to do with the wisdom of life asrelated to a specific culture at a specific time. It integrates the individual into hissociety and the society into the field of nature. It unites the field of nature with mynature. It's a harmonizing force" (p. 66)Mythology integrates Darts of the individual psyche.  Mythology can alsounify the psyche and guide individual lives with a spiritual anchor in the midst ofchaos. May (1991) stated that myth guides our lives and unifies the conscious andunconscious. He held that "myth refers to the quintessence of humanexperience, the meaning and significance of human life " (p. 26). May (1991)Conversation Analysis 22stated that the purposes of myth are to give a "sense of personal identity" and a"sense of community ", to "undergird our moral values " and to give us a way of"dealing with the inscrutable mystery of creation " (p. 26). As will now bediscussed, the myth of rationalism stands in contrast to these healing myths.The Alienating Modern Mythology of RationalismThe lack of functionality of the modern myth of rationality has beendescribed by several authors. Marlan (1981) contended that it "is not that modernman (sic) has become any less mythic, but that he has unconsciously lived themyths of logic and science" which "unduly restrict the deepening of humanconsciousness and help to foster the feelings of alienation and 'exile' so commonin modern times" (p. 227).May (1991) agreed with this viewpoint and noted that we have largely beentaught to think rationalistically and believe that this method is the most correct.He continued that in rationalistic communication the "persons who are speakingthe words are irrelevant to the truth or falsehood of what they say " (p. 26). Thusthe myth of rationality has alienated thought from its personal context and leftsome individuals bereft of spirituality.To restore a wholistic approach through psychotherapy, May (1973)highlighted the importance of examining and refashioning the client's myths. Inthe next section, one formalized approach to changing family myths is described.Family Myths Altered Through Ritual Performance van der Hart, Witztum, and de Voogt (1988) described ritual performance asthe "material plane" which symbolically represents the "ideational plane" of aculture or family; it's "beliefs, values, and affects shared wholly or in part bymembers" (p. 58).The ideational plane. These authors attend to "family myths" which are"shared traditional oral tales told by the family and its members aboutthemselves". They continued that, when there is conflict with reality, myths mayslowly naturally evolve or change more rapidly when given impetus in therapy.Interventions on the ideational plane are "elaborating existing family myths . . .presenting the therapeutic myth . . . relabling and reframing" (p. 60).The material plane. This aspect of family myths can be seen when day today rituals are acted out by the family, van der Hart et al, (1988) suggested thatinterventions directed to changing the material plane are "the prescription of one-time rituals" (transitional ritual) or "the prescription or modification of repeatedrituals" (daily patterns) (p. 60). Interestingly, these therapists develop ritualsConversation Analysis 23aparently without incorporating the families' input into their design. In contrast,ExST practitioners guide families in joint reponsibility for creating meaning inritual form.The positive effects of myths, rationality and changing family myths havebeen discussed. Next, attention will be given to altered states of consciousness inritual.Altered States of Consciousness in Ritual Altered states of consciousness will be discussed from the anthropologicaland psychological perspectives, and generalizability across contexts.The Anthropological ViewpointCooper (1987) first emphasized altered states of consciousness (ASC), fromthe anthropological literature, as a central vehicle for changing belief systems inritual. According to Ludwig (1969), quoted in Cooper (1987), ASC might appear as"alteration in thinking, disturbed time sense, loss of control, change in emotionalexpression, change in body image, perceptual distortions, changes in meaning orsignificance, a sense of the ineffable, feelings of rejuvenation, andhypersuggestibility" (p. 60). Besides ritual, Cooper cited other healing processeswhich use ASC's such as hypnotism, guided imagery, and meditation.The Psychological ViewnointSecond, Cooper (1987) described the study of consciousness in psychologywhich posited "a set of learned assumptions which limit experience, behaviors,and feelings" (p. 52-53). This field suggested that mental processing can be"sequential", "analytic" and "focal", or "wholistic" and "diffuse" (p. 54). Coopercontinued that cognitive maps, influenced by culture, language, and socialgroups, tend to filter out some information during analytic processing. Thesemaps may be incoherent, misperceive the world, and bring intrapersonal conflict.This echoes Marlan's (1981) and May's (1991) thoughts that rationalism caninterfere with personal integration. Conversely, ritual tends to unify processing.Generalizabilitv of Ritual Effects Across ContextsSome writers would emphasize the idea of state/context dependence; that'earnings in one state are most easily recalled in that state, while other writerssupport the generalizability of effects. Regarding the latter position, Cooper drewattention to the substantial changes in behavior, cognition, and affect whichfollow transition rituals. Cooper (1987) noted that reduction in or suspension ofConversation Analysis 24defenses through ritual can free individuals to experience powerful positive ornegative emotions and to behave in novel ways. When an ASC experience ispositive, new ways of seeing the world and integration of the client's personalityand belief system can be the result. Cooper (1987) held that ritual may serve toboth induce such states, structure the experience, and maintain related changes.This point of view is parallel to that of ExST.Other theorists support this position. Kiefer and Cowan (1979) describedrituals reducing state/context-dependence through the exclusion of other stimuli,using many of the senses, and repeating certain messages. In a similar vein,Turner (1969), as quoted by Cooper (1987), described "cross-linking" to other statesby utilizing "an array of symbols, actions, words, and ritual objects that convergearound a central theme and reinforce it in different ways" (p. 74), and whichprovide cues for retrieval. Finally, Weingartner, Hall, Murphy, and Weinstein(1976) noted that emotional arousal would tend to reduce state/context-dependencewhen paired with familiar stimuli. In these various ways ritual effects will likelybe carried over into everyday experiences.This section has described the anthropological and psychologicalapproaches to ASC and the reduction of state/context dependence. The next areaaddressed will be the functions of ritual.General Qualities and Functions of RitualsRituals have certain qualities and functions which distinguish them fromother types of social intercourse. The following discussion will highlight somespecific aspects of ritual.Qualities of Rituals Some qualities of rituals described in the literature will be discussed.Exneriential. Positive qualities of rituals have been alluded to by the nextauthors to be cited. Each of these ideas is also part of ExST theory. One desirableaspect of rituals was noted by Imber-Black (1988b) who emphasized theirparticipant quality in that roles, rules, relationships and world views are changedthrough experiences rather than verbalization. Rando (1985) also highlighted the"power of acting out" (p. 237) and "learning. . . through doing" (p. 238).Beyond language to symbol.  A related positive quality, written by Laird andHartman (1988), said that ritual can take participants "beyond language andbeyond our conscious, cognitive categories because of its powerful use of myth,metaphor, and symbol" (p. 157). This is reminiscent of May's (1991) description ofmyth.Conversation Analysis 25Joining analogic and digital communication.  A third quality noted byImber-Black (1988b) is "joining the analogic and digital aspects ofcommunication" (p. 22) to provide a wholistic experience.Related to these qualities are the functions of rituals which will beelaborated in the next discussion.Functions of Rituals Various authors have noted specific functions of ritual, some of which willbe alluded to below.Realizing goals. Cooper (1987) noted that therapeutic rituals are intended tomaximize individual goals which have been "developed by the client, rather thanexternally imposed" (p. 41), an attitude concurred with by ExST theorists.Entering the next stage of family life cycle. Second, van der Hart andEbbers (1985) suggest that traditional and modern therapeutic rituals are usefulin negotiating the next stage in the family life cycle. This issue is related toImber-Black's (1988b) description of its purpose as linking the past, present andfuture." (p. 22).Restoring equilibrium during transitional crisis.  Third, ritual can center aperson or restore equilibrium. Laird and Hartman witnessed that rituals broughtorder to our lives, controlled "the chaos of potential choices", held "paradoxicalelements" with "opposite truths" and minimized or disguised "differences,inequities or injustices" (p. 159). Imber-Black (1988b) echoed this function of"holding duality" (p. 21). In a similar vein, Cooper (1987) stated that "bothpsychotherapy and ritual can function to restore equilibrium in times of crisis"(p. 41) when "old behavioral repertoires are no longer adequate for the newdemands of the situation" (p. 42).Emotional expression and solace. Emotional discharge and comforting is afourth central function of ritual. Scheff (1979) noted that ritual could sooth anxietyregarding uncertainty. On a related issue, Imber-Black (1988b) described theexpression of strong emotion in a safe setting to be part of the use of ritual. Rando(1985) agreed that ritual offers "legitimization of emotional and physicalventilation" (p. 237). In concurrence with this idea, Scheff (1979) said that oursociety tends to punish the expression of intense emotion. He proposed that ritualis one forum in which the expression of repressed emotion is encouraged. Scheff(1979) found that the collective catharsis through ritual will provide "relief fromtension, increased clarity of thought and perception", a sense of community, and"will produce forces of cohesion and group solidarity" (p.53).Conversation Analysis 26Provision of symbols. Rando (1985) noted the importance of "the provision ofoutlets and symbols upon which the griever" or participants in other rites "canfocus" (p. 237). Rando said they provide "structure and form for ambivalent,nebulous, or poorly defined affect and cognition" (p. 238).The functions of ritual described above were reaching goals, negotiatingentrance into a new stage of life, regaining balance, emotional catharsis, andprovision of symbols. These properties echo those of ExST interventions. Thequalities and functions of ritual are achieved through symbolization, the nextarea of discussion.Development of Ritual SymbolsThis topic is related to the earlier discussion of the ExST dimension ofsymbolization. When effectively framed in ritual, the manipulation of symbols byclients can have powerful effect. As van der Hart et al (1988b) noted, "the way inwhich one treats the symbol is analogical to the way in which one would like totreat that which is symbolized "(p. 62). Cooper (1987) interviewed therapists whospecified various manners of developing therapeutic symbols which will now bedescribed for use in clients' healing rituals.First, symbols might arise spontaneously to the client. Cooper (1987) statedthat they may emerge from metaphors arising from client's descriptions of theirtroubles which can be intensified by enactment, focusing, drawing, meditation",or "assuming the posture of the metaphor" (p. 136). Second, dreams may suggestready-made symbols. A third source is "linking objects" which representrelationships or "connect . . . to a particular attitude or behaviour of the past"(Cooper, 1987, p. 137). Finally, Cooper (1987) noted that clients' "power objects"associated with "success, empowerment, wisdom, joy or some other positiveexperience may be used as ritual symbols (p. 137).Ritual symbols are experienced in the context of the three stages of ritualwhich will be described next.Stages of Ritual Rituals are composed of three stages which were originally described byVan Gennep (1909) and Turner (1969) in anthropology. Cooper (1987) quoted theseas "separation"; "marge" or "liminality", and "aggregation", "reintegration" or"integration" (p. 27). Each of these stages is found in therapeutic rituals and willbe described below.Conversation Analysis 27Separation StageAccording to Cooper (1987), in the first phase, separation, "ritual space andaction is set apart from everyday affairs. . . spatial and temporal as well aspsychological" (p. 27). She suggested that this is achieved through apredetermined time and place, conditions of confidentiality and prevention ofinterruption. When these measures have been ensured, clients can be open to amore emotional than rational experience.Liminal StageThe second or liminal phase encompasses the beginning of transition intonew roles and attributes up to the end of the enactment of the ceremony. Cooper(1987) stated that in therapy some social rules are set aside so that small talk givesway to "expression of intense and often suppressed emotions" and "clients setaside defenses and become open and vulnerable". She continued that elements ofthe "symbolic", "nonverbal" and "fantasy" take precedence over rationality (p. 47).Integration stage The integration or third stage emerges with the participants incorporatingtheir new state into their world view and re-entering the wider society to applytheir learnings and fulfill their new status. Cooper (1987) suggested that"integration is probably not so much a separate stage as it is a guiding value inthe therapeutic process" (p. 49) so that insights are continually amalgamated intoclients' world views.These three ritual stages; separation, liminality and integration, tend toflow from one to another without clear demarcation between them. In the nextsection the use of rituals in family therapy will be discussed.Disruption and Assessment of Family RitualsThis section will discuss disruption and assessment of certain aspects offamily ritualization.Disruption of Regular Constructive Ritual Observance Several contemporary forces tend to interfere with the positive effects ofrituals in bringing families members closer to each other and to the largercommunity in times of happiness and loss, van der Hart and Ebbers (1985)described some rituals as potentially "stultifying" when they are "dissonant withthe times or with personal choices" (p. 157). For this reason, family rituals needConversation Analysis 28to embrace aspects of tradition as well as the quality of flexibility to allow them tochange to fit the times and individuals taking part in them.Some examples of forces which can disrupt the potential stabilizing effectsof family rituals will follow. Wolin and Bennett (1979, 1984) have studied familiesin which one parent's drinking has disrupted the regular observance of rituals.Winslow (1990) demarcated another exception to the desired state which can occurwhen celebrations have been tainted by sexual abuse or incest. Rando (1985) notedanother force, that of "geopolitical and social psychological trends" which tend toseparate extended family and leave a nuclear family "isolated within the urbanenvironment" (p. 237). These deleterious effects tend to break the continuity andinterfere with the healing inherent in traditional rituals. The results of suchdisruptions can be assessed by therapists as described in the next section.Assessment of Ritualization in Families Imber-Black (1988b) recommended that therapists assess the types ofrituals engaged in by families outside the therapeutic setting. This approach is inkeeping with the work done by Wolin and Bennett (1984), who view family ritualsas "symbolic forms of communication" which are repeated over time and canstabilize "family identity" (p. 401).In assessing their clients, Wolin and Bennett suggested that therapists canlook for ways in which families may not use ritual effectively. Imber-Black (1988b)summarized the aforementioned authors' work in that families might beunderitualized", engaging in few regular family activities or ceremonies;"rigidly ritualized", lacking flexibility of input from family members; or show"skewed ritualization", so that the style of only one family of origin is followed.Imber-Black (1988b) also described "hollow ritual", an event rather than aprocess; "ritual process interrupted" or not openly experienced; or limited"flexibility to adapt to rituals" (p. 25). As Imber-Black (1988b) noted, in-sessionrituals are particularly important for clients who are under-ritualized.Disruption and assessment of rituals have been discussed.. The next areawill describe symptoms and Alcoholics Anonymous (AA) as forms of ritual.Symptoms. AA Meetings. and Ritual Several authors have conceptualized symptomatic behaviour as ritualistic,albeit destructive and stultifying. Other authors have proposed that AA andrelated groups might serve to replace negative rituals with the regular consolingand healing rituals which are part of these group meetings.Conversation Analysis 30Therapist as Guide Effective therapeutic rituals, in contrast to every day rituals, religiousobservances, or generally celebrated rites of passage, emphasize personalmeanings chosen by the clients. Such personalized ceremonies allow thetherapist to both witness and take part in the clients' change. (Cooper, 1987) drewattention to the therapist's responsibility for timing the ritual according to theclients' readiness, and for ensuring that the effect will be growth enhancing.Clients as Owners of the Ritual ExDerienceBoth proponents of ExST and Whiting (1988) noted that in an effective ritualthe therapist will shift from conducting to witnessing the clients create theceremony. Whiting (1988) wrote that the hierarchy of the therapeutic system willideally be either "eliminated" or "reversed" when clients take charge of their ownhealing process (p. 92). Whiting (1988) expected in-session rituals to "utilize thetherapy session in an unusual and unexpected way to engage families, to breakup rigid frames, and to introduce change" (p. 90).Aspects to Consider in Designing Rituals In 1988, development of therapeutic rituals was carefully detailed byWhiting in a generic plan which takes into account details regarding "designelements (symbols, open and closed aspects and time and space)", "ritualtechniques and symbolic actions (letting go, utilizing differences, giving andreceiving, ritualizing the game or prescribing the symptom and documenting)".Whiting (1988) also noted "other design considerations (alternations, repetition,combining themes and actions and use of teams)" (p. 85).In the above discussion, therapists were characterized as guides but notdirectors, clients were viewed as authors of their own change, and ideas forcreating rituals were noted. The next portion of the discussion relates to theapplication of rituals to various client problems.Specific Applications of Therapeutic RitualsReview of the literature reveals that rituals have been successfully appliedto many types of therapeutic issues. Imber-Black (1988b) gave examples of theprocess of healing, identity, belief expression and negotiation, and celebrationwhich are interwoven in the following specific themes of therapeutic rituals.These themes include loss, developmental growth of the family, cross-culturalissues, celebrations of women's rites of passage, healing past abuse, belatedConversation Analysis 31acceptance and celebration, developing healthful family relations, transformationof symptoms in children, adults, and couples, and strengthening couples bonds.Loss throueh Death or Ending a RelationshipThe first theme of loss can be seen with shared grief over the deaths of lovedones. Examples were related to the death of a young child (Laird, 1984; van derHart, 1983) or designing personalized therapeutic rituals for the bereaved as aresult of suicide, auto accident, illness or old age (Rando, 1985). Otherapplications surrounding deaths involved partners audiotaping messages tochildren and staging funeral service in hospital for a bed-ridden spouse (Tomko,1983), grieving a long-dead mother (Imber-Black, 1988b), and saying goodbye aftermissing a father's funeral (Burford Mason, 1992; van der Hart, 1988)Coming to terms with loss is also a central part of resolving the end ofrelationships and is often the focus of rituals. In the therapeutic setting this caninvolve the release of hurtful relationship memories (Imber-Black, 1988a; van derHart & Ebbers, 1985; Whiting, 1988), adjustment to an unexpected divorce (Imber-Black, 1988c), and processing emotions about a long-past divorce (van der Hart,1983). In the larger community, holding a formal parting ritual to end amarriage and begin a new form of relationship can be an important step for thecouple especially when parenthood is shared (Hardy-Lewis, 1983).Developmental Growth of a FamilyA second theme relates to the developmental growth of the family.Examples are of support for a handicapped young adult moving out to live withpeers (Imber-Black, 1988a), a teenage daughter's individuation from her parentsand permission of a son to be seen as a young adult by his sister and mother(Quinn et al, 1985), and a teenage daughter's departure, without malice, to livewith her natural father (Whiting, 1988).Cross-cultural IssuesCross-cultural themes, a third issue, can also be externalized in ritualwhich might allow family members to become part of their new country, yet stillhonour their original culture (Imber-Black, 1988b).Women's Rites of PassageRituals have addressed women's needs to celebrate accomplishments andmovement through life stages. Successes might exist both within the traditionalfeminine roles of caretaking and nurturing, and beyond these into the male-Conversation Analysis 32dominated public sphere. Formalized ceremonies might be incorporated intofamily therapy. Laird and Hartman (1988) recommended celebration of the onsetof menstruation, leaving home, becoming a leader rather than a follower ofparents' dictates, getting the first job, childbirth, becoming a mother, christening,marriage, and divorce. These are only some rituals which might be created ormodified to mark changes in women's lives.Healing Past AbusePromotion of healing past abuse is possible in rituals for prevention ofgenerational transmission of alcohol dependence (Wolin, Bennett and Noonan,1979), relinquishment of guilt about and symptoms of bulimia (Protinsky, 1987),and recovery from incest (Winslow, 1990). For a related issue, Agger and Jensen(1990) used the client's creation and eventual ownership of a written transcript oftestimony regarding political torture as a form of healing ritual.Belated Acceptance and CelebrationThe celebration of the joyful aspects of various family life cycle changes,such as adoption, birth, or forming a couple, can be overshadowed by societalsanctions. Belated acceptance and celebration of the inclusion of children and ofpartners' unions may be needed. Examples include ceremonially marking ason's earlier adoption (Imber-Black,1988a), transformation of shame about apremarital pregnancy to acceptance and honouring the birth and the marriage(Imber-Black, 1988c), and celebrating relationships of committed same-sexcouples (Laird & Hartman, 1988).Development of Healthful Family Relations Still other rituals emphasize healthful family relations in place ofdestructive symptomatic behaviours. They may use playful encouragement of afamily's truthfulness and relational change (Kobak and Waters, 1984), openingcommunication of negative emotions in family with an anorexic daughter(Selvini-Palazzoli, Boscolo, Cecchin, & Prata, 1977), reframing fasting as apuberty transition ritual for an anorexic daughter (van der Hart, 1983), andremoval of the label of 'eating disordered' from a daughter (Imber-Black, 1988b).Children's Symptoms and RitualsSeveral applications to children have also been described. Imber-Black(1988b) used limit-setting with children and reframed 'hyperactivity' as'naughtiness'. Roberts (1988) employed ritual to encourage self-responsibilityConversation Analysis 33with an infantilized child. White (1989) used ritual to make childhood monstershumorous, and to include children and adolescents, who had exhibiteduncontrolled behaviour, into their families.Adults' Symptoms and Rituals Ritual might also help improve other types of relationships and symptomsin adults. Cooper (1987) described the uses of symbolic objects to help a clienttransform fear of criticism to self-confidence in relations with his boss. van derHart (1983) described a ritual of detoxification of heroin addicts.Couples' Symptoms. Maintaining Relationships. and Ritual Couples may experience a renewal of marital relationship between parentsor replacement of name-calling with humour (Imber-Black, 1988b). Other resultsmight be the replacement of destructive with constructive couples rituals, thegain of emotional distance from an past affair, or the processing of many years ofa couple's resentments (Imber-Black, 1988c). Finally, family rituals can serve tomaintain satisfying relationships between members using planned shared timesfor dual-career couples (Paddock and Schwartz, 1986), to release a couple fromoutdated rigid sex-roles (Whiting, 1988), to allow time for solitude andtogetherness on holidays (Imber-Black, 1988c), and to represent therapeutic goalswith concrete symbols (Cox, 1989).This section on ritual has discussed ritual's definition, use ofexternalization, meaning shifts, relation to mythology, altered states ofconsciousness, qualities and functions, development of symbols, stages,disruption and assessment, design, and specific applications. The next chapterwill describe the methodology of the study.Conversation Analysis 34CHAPTER III.METHODOLOGY AND PROCEDURESThis chapter will first present various characteristics of CA, including itscontrast to empirical research, similarity to Giorgi's method, intensive nature,groundedness in participants' understanding, emergent themes, validity, andreliability. Second, the procedures of this study will be described. The sample ofclients and therapists, the basis for the selection of the session, and finally theprocesses of transcription and analysis will be highlighted.MethodCA as a distinctive method will be characterized in the following sections.Conversation AnalysisCA was applied to one counselling session with a male alcoholic, his wifeand a female therapist, centering on ritualization in the context of ExST. Aspectsof CA to be described include its contrast with empirical research, relation toGiorgi's method, general description of the CA method, groundedness inparticipants' understanding, the development of themes, validity, and reliability.CA in Contrast to Traditional Empirical ResearchCA is a qualitative research method which originated as aethnomethodological technique. As Sacks (1987) has noted, it is quite unliketypical empirical research which first develops hypotheses, then tests them undercontrolled conditions. CA, according to Levinson (1983), "avoids premature theoryconstruction" (p. 287). It is similar to the style of research described next.CA as Related to Giorgi's MethodCA is related to the method recommended by Giorgi (1985) who stated:(1) One reads the entire description in order to get a general sense of thewhole statement.(2) . . . the researcher. . . reads through the text once more with the specificaim of discriminating "meaning units" from within a psychologicalperspective and with a focus on the phenomenon being researched.(3) . . . the researcher then goes through all of the meaning units andexpresses the psychological insight contained in them more directly.(4) Finally, the researcher synthesizes all of the transformed meaningunits into a consistent statement regarding the subject's experience. . . the structure of the experience. (p. 10)As will be seen in the next segment, the CA research method, thoughrelated, appears to be more intensive than Giorgi's method.Conversation Analysis 35Highly Intensive Nature of CA Research CA research requires highly intensive analysis of the conversation studied.This process involves reviewing the conversation dozens of times to becomefamiliar with the conversation and to attend to details of both verbal and nonverbalcommunication. The second stage of data interpretation requires numerousuntallied hours to discover and support themes or patterns which represent themicro-process of therapeutic discourse. Each of these levels of data examination,as noted in the next segment, is dependent on the participants' interpretation ofthe talk in which they took part.CA is Grounded in Participants' Understanding of InteractionThis method, as Levinson (1983) has suggested, rigorously reviews the datato distill from it "methods of production and interpretation of social interaction"(p. 295). The types of conversationally interactive patterns described were found byattention to the transcript as understood by the participants in this context.Further specifics of analytical categories depended on the nature of the dataobtained, the author's frame of reference, and the awareness of emergentelemental, or noncontext-laden themes.CA Seeks and Supports Themes Emergent from DataFollowing Gale's (1989) method, the data was formed into descriptivethemes which suggested qualities of the interactions between therapist andclients. Gale (1989) quoted Pomerantz's (1988) description of the "analytic processas beginning with observation of the details of interactions", the development of aproposal concerning an aspect of the social organization" and examination of"all relevant cases to see if the proposal needs to be modified" (p. 36). In caseswhere exemplars and examples provided insufficient support for the proposedtheme, it was either modified or discarded. When the theme seemed to reoccurseveral times in the session, it was retained and developed with the evidence of therelated quotes. This continual sweep from data to theme and back to datacharacterized the analytic process. The next section will address the validity ofthis process.Validity: Derivation of Exemplars and Deviant ExamplesTo lend validity to the CA method, Gale (1991) noted the process of derivingexemplars and deviant, or negative, examples from the raw data of the transcript.With a similar goal, no aspect of the data is discarded, rather it is reported inConversation Analysis 36great detail so as to preserve its entire meaning. The same method was followedin this analysis.Analysts look for themes or patterns, taken from the richness of the data,which are then tested for falsification against each new case. Exemplars,derivedin a manner both intuitive and analytical, provide evidence of successfulexamples of the themes. Likewise, "deviant cases" are "sought to indicate whereestablished patterns are departed from" (p. 29), how the participants reacted tosuch deviations, and how they may have repaired their talk in order to follow thetheme. Exemplars and deviant examples are published in the text of thediscussion to provide concrete instances of the categories in the analysis. In thisway, as Sacks (1987) described, each reader can see the raw data from whichthemes emerged and "verify the analysis in his/her own way" (p. 53). As will beseen in the next segment, the reliability of CA is determined through a similarprocess.Reliability: Comparison Across Contexts The reliability of findings in CA can also be determined through theexamination of exemplars. In this case, exemplars are compared betweencontexts to look for similar patterns. In this way the possibility of the effect of theidiosyncratic view of a researcher is avoided. This issue supports replication ofGale's and this study.This section has attended to various aspects of the CA method. The nextwill elaborate details of the procedures.ProceduresA detailed description of the sample, therapist training, the purpose of thePost Session Review Forms, selection of the session studied, transcription, andanalysis will now be given.Client SamplePotential consenting participants in this investigation, presented to one oftwo B.C. Drug and Alcohol Treatment Centres to be involved in the AlcoholRecovery Project (TARP) and in treatment related to alcohol dependence. Thosefamilies who met the project's screening criteria; alcoholic husband, non-addicted partner, living together for a minimum of 2 years, with at least one childover 4 years of age, and a normal range of intelligence (Friesen, Grigg, Newman,& Wier, 1990), were invited to join the research project.Conversation Analysis 37Therapist Sample Therapists included in TARP hold degrees of MEd or MA in CounsellingPsychology, or MSW. All have several years of experience in the treatment ofsubstance abuse and related issues and were trained in ExST for at least 2 years.Senior members of the research training team assessed each participanttherapist as competent in the model, thus enhancing treatment fidelity.Selection of the Therapeutic Session StudiedSeveral parameters were used to ensure that the session selected was ofhigh quality.Therapists taking part in TARP were asked to provide examples of sessionswhich involved the use of ritual. The individual who conducted this sessionsuggested it as a focus of study.Another indication of the quality of the session was given in the therapist'sand clients' assessments of each session's impact written on the Post-SessionReview Forms. They indicated that this seventh session was rated as importantand successful by all parties.Further support for the selection of the session was that it came from themiddle of treatment. This allowed time for sufficient rapport to be developed inthe therapeutic system.Increased insurance was also sought of the session's representativeness ofthe spirit of ExST theory and interventions. The session was reviewed andapproved by Dr. John Friesen, Project Director, TARP.Details of the contents of the post session review form will be noted next.Post Session Review Forms: Partial Guides to Session SelectionA brief assessment of each session was requested of all participantsimmediately following each meeting. Friesen et al (1990) titled the documents thePost-Session Review Form for Therapist and the Post-Session Review Form forClient. They utilize a 7-point Likert scale ranging from completely agree = 1 tocompletely disagree = 7. The participants' high ratings of the session selectedindicate that it was successful in their opinion. The responses of the wife,husband, and therapist are provided below.Conversation Analysis 38Session 7 was rated by the wife in the following manner:1. I have made some valuable changes in this session. (2)2. I was open with my feelings/thoughts in this session. (2)3. In this session, I became more aware of how my usual ways offeeling, thinking or behaving are connected to the problem. (2)4. This session has helped me make significant changes in mypersonal relationships. (2)5. This session will help me deal more effectively with the problem inmy everyday life. (2)6. What was the most significant part of today's session? (Be specific)(The burning of the book and basket (symbol))7. 	 Please give your session a "title": (New beginnings)Session 7 was rated by the husband in the following manner:1. I have made some valuable changes in this session. (1)2. I was open with my feelings/thoughts in this session. (2)3. In this session, I became more aware of how my usual ways offeeling, thinking or behaving are connected to the problem. (2)4. This session has helped me make significant changes in mypersonal relationships. (3)5. This session will help me deal more effectively with the problem inmy everyday life. (2)6. What was the most significant part of today's session? (Be specific)(Burning of symbols)7. 	 Please give your session a "title": (Eagles)Session 7 was rated by the therapist in the following manner:1. My client has made some valuable changes in this session. (Male 2)(Female 3)2. My client was open with his/her feelings/thoughts in this session.(Male 2) (Female 2)3. In this session, my client became more aware of how his/her usualways of feeling, thinking or behaving are connected to theproblem. (Male 3) (Female 3)4. This session has helped my client make significant changes inhis/her personal relationships. (Male 3) (Female 3)5. This session will help my client deal more effectively with theproblem in his/her everyday life. (Male 3) (Female 3)6. What was the most significant part of today's session? (Be specific)(Fear of letting go)7. 	 Please give your session a "title": (Letting go)The next section describes the process of transcribing the conversation.Conversation Analysis 39TranscriptionOnce the videotaped session was selected, it was viewed by the researcher inthe video format on two occasions to gain a general impression of the session'sprocess. It was then recorded in audio format and transcribed using a portableaudio tape player. Gale's (1991) transcript notations were used as a guide. Onlythe length of time of pauses were measured differently in that they were estimatedin .5 rather than .1 second intervals. Although Gale used .1 second intervals,equipment was not available for this degree of precision which was not consideredimportant for purposes of this study.The initial transcription, which was completed over the period of fourweeks, included dialogue, overlapping comments, some notation of quietness orloudness of talk, phrases which were emphasized by speakers audible inhalingand exhaling and the location of pauses. More complete notations of lengthenedvowels, timing of pauses, clarifying information, rising inflections, animatedtones, stopping falls in tones and quicker talk were then added. Notations weredouble checked in the original transcription copy for correctness andcompleteness. Details of these notations used are provided in Appendix A.At this point of familiarity with the session, the videotape was viewed forthe final time and most gestures were noted on a printout of the transcript. Theywere then typed into the computer and a second transcript was printed out. Theaddition of this information stands in contrast to early conversation analysts'attempts to avoid or give cursory attention to intentional or inadvertent nonverbalcommunication. Watzlawick, Beavin and Jackson (1967) have noted theimportance of attending to both digital, or verbal, and analogic, or gestural,aspects of communication. They emphasize that analogic information, unlike thedigital mode, has neither morphology nor syntax and cannot be interpreted withconfidence as having any particular concrete meaning. It only suggests thesender's intended message which, in translating analogic into digital messages,must be supplied by the translator.The last stage of transcription involved timing the pauses, noting these inincrements of .5 sec on the transcript, and printing out the third copy. Finally,louder talk, rising inflection, animated tone and stopping fall in tone were notedand a fourth and final copy was printed. All these indications of changes in thenature of the conversation were later used to support assessment of theconversation. They indicated interrelationships between the key ideas andpositions taken by the therapist and clients. The total process of transcriptionnoted above took approximately 90 hours to complete.The next section will give details of the process of analysis.Conversation Analysis 40Analysis All identifying information about the participants, their activities, andlocation were substituted for generic terms in the transcript. As interpretivenotations were made of impressions which arose during transcription, a roughcopy of these ideas was formed. Such aspects as overlapping talk, topic changes,emphasized phrases, emotional expression, quieter talk, pauses and fasterspeech were also studied.At this stage, the six videotaped sessions which preceded session sevenwere each viewed once, and notes were taken. This additional step to Gale'smethod provided further insight into the fuller contextual meaning of the sessionstudied.The data was then analyzed in more exacting detail for themes. FollowingGale (1992), each theme arising from the transcript was described and supportedwith "repeated exemplars" and "deviant examples" (p. 155). This section reviewedseveral facets of the procedures employed in this study.This chapter presented several detailed characteristics of both the generalmethod of conversation analysis and the procedures utilized in this particularapplication of the method. The next chapter will provide the content of apreliminary analysis of the session.Conversation Analysis 41CHAPTER IV.PRELIMINARY ANALYSISThe ceremonial transaction upon which this study focused was used to healthe effects of the husband's extramarital affairs with both alcohol and anotherwoman. Before the details of this session are addressed, this chapter will affordinformation to frame the case. Topics to be covered are background to the case,the couple's therapeutic goals, the flow of the first six sessions, the couple'srelational themes, the styles of the wife, the husband, and the therapist, theinteractive style of the therapeutic system, and evidence of client growth.Background to the CaseThis review will cover earlier successes in addiction control, alcohol'scentral role in relationships, and the nature of the couple's relationship. Someinformation has been left out or changed to maintain the anonymity of the clients.Earlier Successes in Addiction Control Both individuals had a history of successful addiction control. Thehusband proudly reported having quit smoking completely but said that drinkingpresented a much more difficult habit to overcome. The wife had also quitsmoking several years earlier and had cut down her alcohol consumption manyyears ago from a high to a very low amount.Central Role of Alcohol to Other Relationships Alcohol affected all aspects of the husband's life including his self-image,his associations with friends, the affair, his interactions with his parents, and themarital relationship. Each of these issues will be discussed in turn.The Husband's Struggle and TreatmentBoth partners had acknowledged the central role alcohol played in thehusband's life. The husband first entered a detoxification centre some yearsearlier and reported this to be a positive experience. At the time of the firsttherapy appointment, the husband had stopped drinking for several months,having 'slipped' on three occasions. He said that his memory was better but thathe was troubled by strong emotions. His wife reported that he would not discussthese inner struggles with her. The husband reported much peer pressure to gofor a drink. Both spouses described most of his friends as 'drinking buddies'.Conversation Analysis 42The AffairCompounding his drinking pattern, the husband had engaged in an affairwith a woman he also described as a 'drinking buddy'. Recently, the wife hadgiven him an ultimatum to choose between herself and the girlfriend. Though hecontinued seeing the girlfriend, the husband told his wife the affair was over.The Husband's Parents The husband's visiting parents also strongly enabled his alcoholdependence by criticizing him, by lecturing him to stop going out to drink with hisgirlfriend, and by supplying him with beer which the family drank together athome. By the sixth session the wife reported that her husband's alcoholconsumption had returned to its highest level.Tbe Couple's RelationshipAt the time they entered therapy, the couple's relationship with each otherwas tenuous. Disagreements between the pair involved the ongoing affair,finances, and the dangers and lack of dependability brought on by drinking. Thewife criticized and tried to control various aspects of her husband's behaviour.These attempts by the wife to influence her husband paradoxically helped toenable his drinking.As relationship building activities the partners had gone away on two tripstogether in the previous year. They reported usually being too busy or angry tospend time together as is typical of alcoholics and their spouses. Both agreed thatthey needed more time together having never been without children in the home.To summarize the background to the case, the husband's and couple'sproblems all interacted with his alcohol dependence to form a longstandingnegative and painful pattern for the couple. Next the goals of each partner will beelaborated.The Couple's Therapeutic GoalsThe couple stated different goals for therapy. At first the husband plannedto control his alcohol consumption while the wife desired abstinence. Later intherapy they reversed these positions. The husband also wanted to engage in selfreflection and enhance his self-esteem. He voiced that his interest in these goalswas greater than his concern for his relationship with his wife. In contrast, thewife placed improvement in their relationship at the top of her goals. She tendedto focus on the husband's issues at the expense of self-examination.Conversation Analysis 43The Husband's Goals The husband said he wished to control his alcohol consumption but voiceddoubt that this would be possible. Later he said that he wanted alcohol out of hislife completely, but that choosing between it and his wife would be difficult.He also said he wanted to understand his motivations for drinking andhaving the affair. He speculated that drinking allowed him relaxation, an excuseto go out, time away from his wife and children, a cultural tradition, and areaction to depression and stress.Finally he said that he wanted to feel good about himself before beingconcerned about their relationship. He wished to gain peace, quiet andhappiness.The Wife's Goals The wife initially wanted to gain 'peace and quiet' as a result of therapy.She voiced a desire for a stable relationship characterized by no fighting, lying ordeception and with sharing, loving, companionship, honesty, and understanding.In the last session she summarized these desires into the main goals of closenessand trust with her husband.She initially also wanted her husband to stop drinking completely, but laterrequested that he control his consumption, citing his ability to control smoking.She suggested they might go to a gym together as a substitute activity.These two sets of goals, though not contradictory, held different prioritiesfor each spouse. The next section will describe the flow in the therapeutic processover the seven sessions.The Flow of the Therapeutic ProcessOptimism and emotional closeness within the couple's and therapeuticsystems had appeared to be steadily growing from sessions one to five. Thecharacteristic of 'structured unpredictability' was very much in evidence. Thepossible outcomes of therapy seemed alternately positive or negative to varyingdegrees during the process, thus allowing for many forms of change. In the firstfour sessions the husband appeared to place his own healing before the survival ofthe relationship. The fifth session provided a remarkable change in that it wasfull of warmth, optimism and evidence of cooperation and pleasure between thepartners.In sharp contrast, session six saw the husband unable to attend. The wiferevealed to the therapist that she had recently discovered that the affair was stillConversation Analysis 44continuing. She also disclosed that her husband's drinking was again heavy.,After completion of the seventh session the couple dropped out of the researchproject and, although they picked up the post-treatment questionnaire package,did not provide any more information about the outcome of their goals. Theresearch data collector attempted unsuccessfully to contact them for theirimpressions of the process of therapy on at least eight occasions by telephone andtwice by mail.The following section will discuss the couple's relational themes whichwere evident in session seven.The Couple's Relational Themes in Session SevenExST theorists propose that negative themes are evident in early sessionswith clients. In the same vein, Frye's (1966) model of "narrative themes" of"tragedy, irony, romance, and comedy" (p. 210) was referred to by Pieracci (1990)who also listed several themes emergent from his analysis of clients. In theprocess of therapy clients are encouraged to take another look at their lives and,through healing experiences, move toward positive themes such as "love,nurturance, acceptance and belonging" (J. D. Friesen, personal communication,June 30, 1992). Both divisive and unifying themes evident in session seven will bediscussed below.Divisive Relational ThemesThis couple, at the beginning of the session, powerfully portrayed thethemes of betrayal, hostility, distancing, and rejection.Betrayal In this session, one of the strongest evident themes was that of the wife'sfeelings of betrayal and lack of trust toward her husband for having the affair.The wife seemed to expect that the girlfriend would betray her. The wife revealedboth of these deep betrayals and related feelings of hurt and sadness during thesculpt.HostilityEqually intense was the anger and hostility the wife directed toward herhusband regarding the affair. Her critical approach matched his defensivepattern of withdrawl so that the behaviour of each partner became more extreme.Conversation Analysis 45DistancingThe husband's central relational theme appeared to be insecurity and hisneed for distance rather than psychological intimacy. He seemed quite adamantabout keeping his secrets safe from his wife's knowledge. He tended to tease herabout their inaccessibility in his security box, thus exacerbating her suspicion.On several occasions he avoided discussion of painful topics by remaining quiet.A third manner in which the husband attempted to maintain distance wasthrough discussing concrete topics rather than his experience.RejectionDespite the husband's apparent wish for security and distance, he was alsoequally concerned with avoiding feelings of loneliness, hurt, abandonment, andrejection. He showed this theme during the sculpt when markedly troubled by thetherapist moving away from him to sit beside his wife. He also described hisfeelings of rejection by his wife and her mother who had served him a summonsto be removed from the family home.Unifying Relational Themes New relational themes were beginning to be generated near the end of thesession. After many previously unshared emotions had been experienced, thecouple's sense of betrayal, hostility, distancing, and rejection gave way toincreased attentiveness, caring, honesty, and trust.Attentiveness 'Listening' was emphasized by both the wife and husband in theirdiscussion after the ritual. The husband recognized his tendency to not attend tohis wife and he committed to change this pattern.CaringWhen the husband disclosed, with difficulty, that he cared about his wife'sfeelings and was getting rid of the book for this reason, another new relationaltheme was born between them. The wife appreciated hearing this feedback.HonestyThe therapist provided a positive reframe or new relational theme for thehusband's disclosure of his angry and hurt feelings as 'being real'. It supportedthe couple's discussion of emotions rather than acting to hurt each other.Conversation Analysis 46TrustThe wife's renewed sense of trust was indicated by her playful rather thanridiculing laughter. This resulted from her debriefing the affair with herhusband, having her husband listen, and enacting of the ritual.In summary, the negative themes evident at first between the pair evolvedinto more unifying themes by the end of the session. They enabled the couple tohave an initial experience of safety and closeness. The next section will note theparticipants' interactive styles in the therapeutic relationship.Interactive Styles in the Therapeutic SystemEach member of the therapeutic system exhibited a personal interactivestyle, described below, which affected, and was affected by that of the others.The Wife This woman, like many married to alcohol dependent men, at first showeda limited range of emotions. She tended to be critical, threatening, angry, andridiculing toward her husband. In the therapeutic setting, she appeared cold toher husband, showing few smiles and little tenderness. In session seven, sheshowed another aspect of her persona when she appeared sensitive, injured,quiet, and teary in describing her reaction to the affair. Also, after the ritual shesometimes laughed in a playful rather than a rueful manner.The wife's behaviour involved frequent caretaking or overfunctioning,allowing her husband to underfunction. She behaved as directive, controlling andparental toward him, apparently in an attempt to prevent his drinking, spending,and seeing the girlfriend. Other examples of her attempts to control him involvedher husband's insurance documentation and appointment times.Finally, she seemed comfortable in the therapeutic setting and wasarticulate, concise, and able to express and describe emotions with ease. She wasaware of the symbolic aspects of their behaviours, and entered wholeheartedlyinto the symbolic elimination of the couple's troubles.The HusbandThe husband's personality contrasted with that of his wife in several ways.He showed mostly positive emotions generally presenting as chatty, playful, andcarefree. He tended to lie or avoid discussion of problematic behaviours oremotions. Seeming to function as an entertainment committee and storyteller forhis wife, he placated her anger and watched closely for her approval orConversation Analysis 47disapproval. At times the husband used anger to avoid both his feelings of shameand his wife's relentless demands for atonement.The huband's behaviour was both destructive and constructive. Byengaging in drinking, spending, and the affair, he tended to underfunctionrelative to his wife. Conversely, he demonstrated successful negotiating skillsduring the planning of the ritual.Appearing uncomfortable in therapy, the husband displayed a concreteworld view. In sessions, he showed a limited willingness to describe or expressemotions except occasionally showing some anger or nervousness.The Therapist as Guide to Change Generally this therapist exhibited a very high skill in the ExST model. Shedemonstrated empathy, respect, positive regard, support and gentleness for theclients. On some occasions she was directive. Some conversations were mademore challenging by both the husband's and the therapist's accents which eachoccasionally misunderstood. Aspects of the therapist's approach will be notedbelow.The therapist engaged in a collaborative approach to guide clients in settingtheir therapeutic agenda. She showed her belief in the capabilities of the clients,welcomed their input, and gently rejected the self-abrogating labels they voicedwhich indicated their low self-esteem. She tended to lead them to a new endeavorwith a respectful invitation.The therapist avoided alliances to one or the other spouse by balancing herallegiance to the spouses. The couple's original communicative patterndemonstrated symmetrical blaming, ridicule and hurt. In response, thetherapist modelled and encouraged nonconfrontive communication andexpression of emotion.Specifically, she helped the husband to learn to hear his wife's emotions, toavoid defensiveness, to comment on his understanding and to empathize with hiswife's pain. Originally his feelings of guilt seemed to result in his angrilyemphasizing his own complaints, withdrawing, or laughing about issues.The therapist also short-circuited the wife's criticism and blaming of thehusband. Discouraging the wife's emotional withdrawl from her husband andher refusal to talk, the therapist regularly engaging the wife's reactions. Thetherapist encouraged the wife to look for the positive changes the husband madeor intended to implement in the future.On some rare occasions, the therapist seemed to be a little too directive withthe clients. An example was indicated by the wife's reaction of givingConversation Analysis 48explanations for not fulfilling an invitational transaction for a desired statesymbol. This also occurred during the ritual when the therapist clarified overseveral turns with the husband his understanding of the meaning of the act ofburning the symbolic paper book.Generally the therapist's level of collaboration, balanced allegiance, andencouragement for each partner was very high. The clients responded with trust,cooperation and creativity.Evidence of Client GrowthExemplars of good moments in therapy, characterized by positive growthfultransformation, were evident in this session. Their qualities and outcomes will benoted below.Moments of change were especially evident during the ritual enactments.They were indicated by speech paced by long pauses, moderate volume, slowertalk, few interruptions and few topic switches.Their effects was seen in the more jocular, optimistic, introspective, andconcessional discussions at the end of the session. After the ritual the wifereadily laughed at the husband's jokes in contrast to her previous reservednessand minimal movement. She also voiced her expectation that her husband wouldlisten to her more carefully.Optimism and introspection were also expressed in the husband's positivecomments about the process of therapy. As well, the husband had begun toconcede his trespasses in the affair and to encourage their discussion with hiswife. By the end of the session, he had declared his intent to relinquish allvestiges of the affair. Finally, the husband demonstrated relational novelty byadmitting that he failed to listen to his wife on occasion and that he intended tochange this pattern. In summary, the clients demonstrated much growth in thissession.This chapter has provided some information gleaned from the initialanalysis of this therapeutic interaction. They include, background to the case, thecouple's therapeutic goals, the flow of the first six sessions, the interactive stylesof the participants in the therapeutic system, and evidence of client growth. Thenext chapter will deal in minute detail with the process of development of theritual. Quotes from the transcript will examine the way in which burning thesymbols represented putting the affair in the past and starting afresh as a couple.Characteristics of each of the other themes derived from the session will also berelated and supported.Conversation Analysis 49CHAPTER V.DISCUSSIONThis chapter will provide the heart of the analysis of the process of changethrough ritual in which the couple and therapist engaged. It will identify thethemes which have emerged from the data, provide a conceptual background foreach, and discuss the specific process evident in each exemplar and deviantexample provided for each theme.As described in the third chapter, themes were gleaned from the datathrough an intensive analytic method. Those discovered include ritualization,personal and family myths, symbolization, experiential, externalization,intensification of experience, contextual/systemic, constructivist/meaning shift,therapist empathy, therapist genuiness, collaboration, and therapist artistry.Each of these themes, which will be discussed in turn, was representedseveral times in the session. As described earlier, several successful exemplarsand deviant or negative examples were quoted. The first theme to be addressedwill be ritualization.RitualizationThe first theme of ritualization occurred most frequently in this session asit is the focus of this study. For this reason, the other themes might be consideredto be subthemes. The first section below will describe the variety of effects of ritualacts or ceremonies. Next, alcohol dependence as a special case of the need forritualization will be noted. In the third part, an overview of the process of thisritual will be given. The stages will be described and exemplified in the fourthsection. Finally the deviant or negative examples will be provided and discussed.General Effects of Ritual In addressing the general anthropological uses of ritual, Campbell (1988)wrote that "a ritual is the enactment of a myth and that by participating in aritual, you are participating in a myth" (p. 103). In this case, the ritual isintended to transform the couple's myths so that the pair are reconnected in anew, constuctive, nurturing relationship. In fact, taking part in the process oftherapy, whether formally identified as such or not, can be seen inherently as aritual act which is emotionally, relationally, physically and temporally set asidefrom everyday activities and can hence have such a strong effect of change (Kobakand Waters, 1984; Blom, 1988; & Imber-Black et al, 1988).Conversation Analysis 50Alcohol Dependence and RitualizationAn issue which lends itself to ritualization is that of alcohol dependence.Imber-Black (1988b) recommended in-session rituals for under-ritualizedfamilies. In fact, Imber-Black (1988b) characterized symptomatic behaviouritself as ritual. This conceptualization applies to the clients studied here. Theregularly enacted symptoms of the husband's drinking, the wife's demands andcriticisms, and the couples frequent arguments over the husband's recent affairserved to prevent them from either confronting or distancing from this painfulexperience. The symptoms also prevented the day to day ritual contact betweenfamily members which might have helped heal this rift. The in-session ritualwas a good choice of intervention as it filled the couple's need for structure andhealing positive contact.Overview of the Ritual Enacted in this SessionThe particular ritual which is the focus of this thesis culminated incremation of representations of marital infidelity through burning paper symbolsof gifts which had been given to the husband by the girlfriend. This permitted the'letting go' of the painfully divisive effects of the affair and enabled joining thehusband and wife in a renewed relationship.It was important that the husband fashioned and burned each of the ritualobjects to expunge the affair. The book symbolized the girlfriend's and husband'sfriendship. For the husband, the eagles in the book were a powerful symbol offreedom and nature. The basket represented the husband's and girlfriend'saffair. For the wife, both symbols stood for the depth of pain and disillusionmentthe wife suffered after this violation of the marriage. In the ritual, the couplediscussed this rift between them for the first time.In planning the ritual, the husband committed to end the affair saying thatpart of his life was over and that he felt no further connection with the girlfriend.During the ritual he was relieved of some of his guilt by attending to his wife'semotions and needs and sharing his own process with her and the therapist.Significantly, when asked to by his wife, the husband gave up the book which hehighly valued. The therapist emphasized that the husband keep the eagles in hisheart. To the wife's great satisfaction, the husband also apologized to her.The wife expressed her hurt, resentment, and wishes for both retributionand reconciliation with her husband. Through listening to each other, jointlynegotiating plans, and performing the ritual burning they symbolically cleansedthe effects of the affair from their relationship. The wife allowed that she couldConversation Analysis 51now let this painful experience go from her thoughts. Each showed playfulnessand relief after the burning which can be taken as a positive sign of growth.Stages of the RitualizationThe symbolic externalizing interventions as preamble to the ritual or'separation phase', the planning and enactment or 'liminal phase', andprocessing and resolution or 'integration phase' collectively constituted all but afew minutes of the total interview. Because of the central nature of theritualization theme to the session it will be described below by stages and ingreater detail than the other themes. Exemplars will highlight the manysuccessful aspects of the ritual's conception, introduction, planning, enactment,processing and initial integration. Finally, deviant examples will demonstratedsome less successful parts of ritualization.Separation Phase of Entering Ritual Space and TimeBy attending therapy sessions, clients open themselves up for experienceswhich are set apart by time and space from mundane concerns and experiencedas special and memorable. This part of the ritual saw the members set asideeveryday ways of interacting to prepare for the ritual.A guide to transcript notation used in quotes cited and discussed can bereferenced in appendix A.First exemplar of separation stage of ritualization. The ritual began withthe emergence of the symbols of the book and the basket. The following excerptattested to the different and powerful meanings of these symbols for the spouses.The wife's agitation regarding these symbols was evident in her faster talk andfew pauses. The husband demonstrated the strength of his feeling about the bookin emphasizing certain words and his leaning away from his wife.564 W: =but part of G is still in your bo' in your around your box(.5) you've still got that book from her.H: 	 Yes I do. ((nods))W: >And the basket ((nods)) and everything else I askedyou to please get rid ofk.H: 	 Well the basket I don't need but the bo' the book I wanna570 	 keepW: But there's more books in the store you can buy a newone. (.5) I don't want any part of her in my life.T: 	 So you wanna keep her book this particular bookH: Mmm ((nods))T: 	 becauseH: 	 ((opens arms and leans R)) Not because she bought it forme it's because it's a book I really like it's a thing IConversation Analysis 52578 	 really like.Second exemplar of separation stage of ritualization.  Here the therapistnoted the meaning of the newly conceived symbols, introduced the the ritual, andreceived the clients' agreement. She used emphasized words, frequent pauses,and moderate volume. Collectively, these respectfully set the tone for ritual.	830 T: 	 ((moves a chair between her two other chairsequidistant from spouses)) (It's only a book that's hard)(2) You see I hear (.5) I hear that for W it has anothermeaning (1.5) ((H puts chin on R hand and looks at W))I hear that for W it has ((W puts R hand behind headand strokes hair)) another meaning (1) and (2) when Iwent into W's shoes (3.5) you know what I feel like doingright now (1.5) symbolically I don't know if you feel readyto do this but I want you to answer from your heart (1.5)from your heart (1) symbolically burning the food pardon840 	 me the food the book and the basket here right (1.5) If youLel ready to let go of that both of you from your own (2)experience ((H nods twice)) because the book and thebasket have very different meanings to both of you (2) for(.5) you H the book ((makes circles at shoulder level)) isjust a book ((again)) and it has a love note.	H: 	 [pretty bookpretty book.	T: 	 a pretty book (.5) and it has the love note.	850 H: 	 I'm not worried about that	T: 	 [and you W it has very deep meaning.	H:	 ((puts R hand on forehead, chin and looks at W))W: a symbol of the tababetrayal 	T:	 [a symbol of the betrayal of themarriage (4) and I (.5) I I feel like a I want to I'mwondering whether you feel ready to to burn (1.5) thatobject that has kept you apart (1) and the meaning of a of860		 those of those objects that have that keep you apart thatkeep you in pain.W: (I always wanted to burn it).	H: 	 ((laughs and places forehead in R hand then lowershand)) (I always wanted to get rid of the basket) why nottell me about it (1) just haven't gotten around to it but the866 	 book I wasn't going to throw away.Once the ritual was proposed and accepted, the separation stage wascomplete and the liminal stage was entered.Conversation Analysis 53Liminal Staae of Planning and EnactmentThis stage permits defenses being let down, suppressed emotions beingexpressed, and symbolic rather than rational thought being engaged in. At thistime, clients and therapist collaboratively plan and enact the ceremony.First exemplar of liminal stage of ritualization. The ritual planning wasappropriately lengthy, allowing the couple to process and relinquish pastexperiences. This excerpt involved generation of options. The wife attended to herhusband's wishes, presenting a more acceptable idea. Few pauses, overlappingtalk, faster talk, animated tone, and the husband's echoes of his wife's phrasesindicate the member's excitement in collaboratively planning.1204 	 [H: 	 [just to burn 'em (.5) that'd be a shame( 	 best).T: YeahW: 	 Let's leave it to somebody else.H: 	 Yeah we'll we'll do that that >why don't we just rip the1210 	 page out and give it to the library <(3) ((gestures outwardwith L hand)) or give it to a school=T: 	 =OK eh cut the pictures and give them to the school?H: 	 Cut the the the note ((motions L hand)) of the front.W: And burn it.H: 	 And burn it (.5) burn the note ((broad gesture L)) burnthe note (.5) ((repeats)) give the book to the school.((lowers L hand))T: 	 OK to one of the schools (.5) whichever school that youthink needs books that in your area.1220 W: Let the children enjoy it.H: 	 That's it why not let the children enjoy it ((motions toW)) it's a beautiful book.T: 	 So you've burned the front page is that[H: 	 ['s no problem((repeats gesture))T: 	 that that good and then you're gonna give it to the theschool!1229 W: YeahSecond exemplar of liminal stage of ritualization. Overlapping talk seemedto show excitement, nervousness, and unresolved emotion. The therapistemphasized key constructive words and summarized the couple's unresolvedpatterns. In this way, she soothed the couples' worries and received their finalconcurrence with the ritual enactment.1249 T: 	 Yeah (.5) yeah. (1) Now I want to Ra (2) to go through1250 	 that experience in our session right ((nods)) nowConversation Analysis 54symbolically (1.5) I want us to have a I want just toexperience that experience of letting go (1) sort of lettinggo and see what you think emerges and and >do youhave a lighter?<W: (Yes he does)	T: 	 Or matches?	H:	 >You're not gonna light a fire in here are ya<?	T: 	 (Well ah well we 	 ) ((rises, stands nearer W))	1260 H: 	 [Are ya?	T: 	 It's im' it's important this is=H: =OK=	T: 	 =It's a very important ceremony of letting go.H: What about if the smoke alarm goes off?	T: 	 [some something that is (.5)	H: 	 [OK. ((nods))1270	W: 	 [(She's only gonna' light a little fire).	T: 	 [Something thatthat is very meaningful in	H: 	 [OK (.5) Sure ((nods))	T: 	 your in your relationship it's very very important that(1) that we let go of of something that has kept you veryfar away. (1) ((to H)) ( 	 ) you don't want to continue1280		 being there ((points to H's former distant chair)) andlonely because=	H: 	 =((nods)) Alright let's do it.	T: 	 ((to W)) And you don't want to continue be there.((shakes L arm to far chair in mock reprimand)).	H: 	 Let's do it.	T: 	 [OK and hurting inside.1288 W: (You know I'm tired of that) ((strokes R side of head))Third exemplar of liminal stage of ritualization. In the enactment, thehusband fashioned symbols from paper, the couple debriefed related past events,and the husband cremated the symbols. The clients were relatively quiet andintrospective during the enactment of the ritual burning of the book. Later theyspoke slowly, in short phrases, with long pauses indicating the change of statethey experienced. Repetition of each other's phrases suggests a sense of unity.	1511 H: 	 not the birds, right? (.5) I's gone ((lights book on candle))	T: 	 (Here 	 ) (12) (( they watch the flames))Conversation Analysis 55	H: 	 I always wanted to do that. (3) ((looks at W, all threepeer into the bucket, H leans back, W leans forwardback))	T: 	 You always wanted to burn (a thing). (3)W: You said you smoked out the whole house one day. (3.5)	H: 	 I was tryin' to cook. (20) ((all watch the symbol burn))	H: 	 I's gone. (3) ((H looks at W)) ((W looks at wall))	T: 	 Just the ashes. (10.5)1520 W: Just the ashes. (2) ((looks down))	H: 	 (.hhh) (.hhh)	W: 	 And they can go wherever they want (.5) *A long wayaway* ((H nods))	T: 	 *Yes* (5.5) I's gone.H: Mmhm	T: 	 (Yeah but) how is that for you?	H: 	 I's not a problem.	T: 	 No.	1529 H: 	 No not not a problem at all. ((shakes head))Fourth exemplar of liminal stage of ritualization.  In this excerpt thetherapist first observed the couple speaking about the affair and did not intervene.The husband's overlapping talk suggested tension prior to the burning. Duringthe destruction of the symbolic basket, long pauses indicated the participants'reverence. At the last, the therapist's emphasis of certain words summarized themeaning of the act.	1589 H: 	 ((looks at W)) You you got to admit you know it'd be1590 	 pretty stupid it would've been very stupid of me to inviteyou around "holiday" if I'd knew she was going to bethere wouldn't it. (1) Pretty dumb, right? (1.5) So I didn'tknow she was (still around)!W: (Yeah how about the car)	H: 	 [(Ah) ((quickly lifts L arm to R shoulder, Rhand cutting motion to neck))W: ((looks at H and laughs))T: 	 Th' (hhh).1600 H: =No way I'm gonna I worried (about it you know) thatwould be a terrible thing for me to do.W: But the lies went along with it when I said how did sheget in (1) This is what the basket symbolizes all thosehorrible lies.H: 	 [Give ithere 'en. ((brings over candle, lights basket))T: 	 (your handle's not goin'ta stay there).H: 	 ( 	 ).1610 T: 	 Tuck it in.Conversation Analysis 56H: 	 Watch it it'll come all of a sudden. (1.5) It's governmentpaper it burns real quick (2) before they can get (wanted).(11) (( they all watch it burn)) ( 	 ) (30)W: (hhh) >The basket smells worse than the page did<. (3)((laughs, looks at T then H, waves L hand))H: 	 ((continues to look down))T: 	 The Leg. (5.5) ((W nods several time then looks down))Lies hurt more (1) than a note of a=W: Mmhm1620 T: 	 =appreciation (1.5) and eh (6) ((leans forward and backslightly))W: They do (1) ((looks up at T)) lies hurt alot more than the1623 	 note (3)Since the enactment of the cremation was complete the couple began thestage of integrating their learnings.Integration Stage of Incorporating Changed Roles into LifeIntegration begins by processing the ritual experience after the enactment,and continues as clients incorporate changes into roles outside the therapysetting.First exemplar of integration stage of ritualization. This quotedemonstrated processing the ceremony with the therapist's use of immediacy andopen-ended questions. All members were still and solemn, leaving several longpauses between phrases. The wife resolved her need to dwell on the affair andemphasized certain words to highlight the finality of the act. The circle of lettinggo of the issue was complete.1638 T: 	 How I w&uh I noticed that (4) that as if it was you (4)((raises L hand to H, leans back and forward)) you were1640 	 kind of a (3.5) ((leans back)) something was happeningfor you (2.5) ((leans forward)) You were deeply deeplyinto your thoughts. (4.5)H: 	 I always liked the fire I guess. (.5) ((leans forward)) Iwasn't (5.5) (hhh) (.hhh) I'm glad the basket's gone tooactually. (4)T: 	 You're glad the basket is gone too.H: 	 I'm glad it's gone too. ((nods three times))T:	 How (1) how (1) how is that for you so you're feelingsomewhat glad the things are gone.1650H: 	 [MmmT:	 (and for you) ((to W)).W: 	 =It's (just really) (4) (hhh) (.hhh) that's one thing (I can)put aside ((R hand gestures forward)) an' I don't have tothink about it.T: 	 *Yeah*Conversation Analysis 57W: There's other things that (1.5) You idle that get thoughtabout but those things I don't have to think about (2)1659 	 because with them (1) she goes.Second exemplar of integration stage of ritualization.  Further processingof cremation involved the therapist emphasizing key words in requesting clients'new symbols of change and growth. The wife provided a phrase. The husbandenvisioned eagles which he had seen in the wild and symbolized freedom for him.As the therapist had suggested they had stayed in his heart. The husband'sexcitement in sharing his inspirational vision of the eagles carrying the basketwas shown by emphasized words, laughter, overlapping turns, rising inflections,and animated tone.	1672 T: 	 =explore now. (1) And I just want to explore for oneminute (1.5) the new vmbol comes up for you afteryou've let go of that (1) now that you've (1) that that it'sgone from you're experience from your reality.	W: 	 ((lifts head a little, looks at T)) New beginnings.	T: 	 New beginnings.	H: 	 ((leans back, puts arms behind head)) You know what Isaw when I burned that thing in in the bucket?	1680 T:	 Pardon me yeah?	H: 	 I I 'k'sort of fibbed 'cause I did see something you knowwhat you know what I think I was thinking about?	T: 	 *What?*	H: 	 ((leans forward, arms on knees, turns to W)) I wasthinking about the eagle carrying the basket away!((laughs happily, L hand to W, looks at T and W))W: ((turns head away from H))	T: 	 Yeah (.5) yeah=H: =Yeah?1690 	 [	T: 	 [*So (4.5) That's what you were that was*[	H: 	 [Mmm that'swhat I was thinkin' about I had a picture (2) the basketand the eagle!.	T: 	 Yes[	H: 	 [holding the basket and flyin' off (1) ((R hand forwardand up)) but the basket was alot bigger! ((leans on R knee1700 	 away from W))	T: 	 *Yeah (1) yeah *(1) so they're gone. (2) that wa' that isyour metaphor that is your symbol for for thatexperience and they're gone. (1.5) and eh (6.5) Newbeginnings. (2.5) I like that (.5) I like, new beginnings I1705 	 likeConversation Analysis 58Third exemplar of integration stage of ritualization.  Integration beganwith the therapist extending a vowel, and emphasizing key words and gestures tocreate a final amalgamation of clients' optimistic metaphoric symbols.	1763 T: 	 Yeah nearly (.5) but there is not patches like? And andas the eagle was leaving I was left with this bi:g (1.5)strong blue sky (1) ((waves once after each of fourwords)) and (1) many opportunities (1) that's that's andand that suits like new beginnings is part of that (1)((waves hands)) of that blue well from my experienceI'm (surely) just sharing my experience in (.5) in your	1770 	 relationship because I am part of your (.5) (for only) thistime in therapy your process and your experience. (2.5)1771 W: Yeah ((nods))This concludes the exemplification of positive ritual interactions whichshow intense experiencing of pain and a promise of change. In the next sectiondeviant examples will be discussed.Deviant Examples of RitualizationDeviant examples occurred when the solemnness of the moment, in whichthe partners were deepening their experiences and strengthening their bond, wastemporarily supplanted by another agenda. On such occasions the therapist, touse CA terms, 'repaired her talk' to again guide the interaction smoothly towardtherapeutic goals. Illustrative excerpts will be given and explained.First deviant example of ritualization theme. This excerpt saw the coupleinvited to symbolically let go of the gifts with the therapist as witness and aid inprocessing the ritual. She emphasized important words and used long pauses toset the tone. The husband pragmatically suggested they throw out the actualobjects but the wife disagreed. The therapist misunderstood his intent (or accent).She successfully repaired her attempt by overlapping her talk, clarifying herunderstanding, and inviting other options.	1145 T: 	 I want to (5.5) I want to (2) symbolically (3.5)1 don'tknow if you feel ready and I want you to be honest withyour heart (1) ((nods to both)) you feel ready to (.5) to jetga and to have a ceremony (.5) ((H scratches L arm))symbolizing the letting go of the book and (1.5) and the	1150 	 basket.H: Why don't you just do the 1:01 thins why don't you justget rid of it. ((looks at W and T))T: 	 You do what?	H: 	 We just do the real thing and get rid of it (1.5) Wanna dothat (5) That's easyConversation Analysis 59[	T: 	 [I I didn't hear you I didn't hearanything.W: We can't do that.	1160 H: 	 We can do it together if you want ( 	 ) in the bag?(2.5) it's sitting in the same place you put it. (1.5) (	)[	T: 	 [Youwant to give it back to her you?.H: =No no=	T: 	 =Is that what you said ( 	 )[	H: 	 [No I said we'll get we'll get rid ofit (1.5) we'll throw it in the thing together ( 	 ) or1170 but if you wanna do it if you want if it's important let's dothat ((lowers head)) (.5) I don't mind (2) ((raises head))It doesn't mean anything to me anymore.	T: 	 So what options how can you let go (1) ((H lowers headand looks at W)) what options do you have let's explorethe options that you have to let go of of a	W: 	 I'd actually like to see it burn (2) >That's the way I feel	1177 	 I'd like to see it burn<=Second deviant example of ritualization theme.  Here, the therapistunsuccessfully probed the husband's emotional experience of giving up the book.He responded laconically. The therapist then very strongly emphasized herconfusion. The husband defensively and superficially explained, while nervouslymoving and pausing very briefly. The therapist repaired her approach bysoftening her tone and accepting his explanation without further probing.	1526 T: 	 (Yeah but) how is that for you?	H: 	 I's not a problem.	T: 	 No.	H: 	 No not not a problem at all. ((shakes head))	1530 T: 	 An' when you say it's not a problem I have no idea whatyou mean, 	H:	 ((spreads arms wide, crosses arms on chest then putsthem behind head)) It's not a problem I don't it's theway (.hhh) (hhh) (.5) the book was only important to mebecause I ((W looks at H)) l' liked the pictures in the book(.5) not by whom ((W lowers head again)) bought it forme or anything else (1) So it wasn't a problem destroyin'that uh the book or anything else but the book that upsetW (1.5) (hhh) ((W raises head)) So it wasn't a problem.1540 T:	 OK.	H: 	 I's just a problem that I have to destroy somethink sobeautiful.T: 	 Yeah (hhh) ((H lowers arms)) now do you feel like (1.5)	1544 	 (doing the) ((W lowers head))Conversation Analysis 60Third deviant example of ritualization theme.  In this quote, the therapistattempted to facilitate processing the ritual experience, but the wife spoke of theaffair's details. The therapist returned the topic to the husband's experience. Hefollowed suit by voicing satisfaction. The therapist finally elicited an optimistic,constructive response from the wife. The wife's excited gestures indicated heremotional intensity. The husband's silence, movement, and aversion of his eyessuggested his discomfort.1614 W: (hhh) >The basket smells worse than the page did<. (3)((laughs, looks at T then H, waves L hand))H: 	 ((continues to look down))T: 	 The lies. (5.5) ((W nods several time then looks down))Lies hurt more (1) than a note of a=W: Mmhm	1620 T: 	 =appreciation (1.5) and eh (6) ((leans forward and backslightly))W: They do (1) ((looks up at T)) lies hurt alot more than thenote (3)H: 	 ((looks at W, then quickly down))W: 	 ((looks at T)) 'Cause I know (1)H: 	 ((looks at W))W: even if he thinks I don't know (1) ((L hand gestures toH)) that the phone call that he received that night whileI was there was from her. (2)	1630 H: 	 ((looks down again leaning on R knee))W: He said it was from someone else but I knew (1.5) ((Lhand to head))H: 	 [((shuffles L foot, hand behind head))W: that it was her. (2) I'm not I'm I'm a woman (1) and Iknow (1) ((L hand points twice to head)) what was goingon I know ((nods, L hand twice to heart)) what she wasdoing.T: 	 How I wo'uh I noticed that (4) that as if it was you (4)((raises L hand to H, leans back and forward)) you were1640 kind of a (3.5) ((leans back)) something was happeningfor you (2.5) ((leans forward)) You were deeply deeplyinto your thoughts.(4.5)H: 	 I always liked the fire I guess. (.5) ((leans forward)) Iwasn't (5.5) (hhh) (.hhh) I'm glad the basket's gone tooactually. (4)T: 	 You're glad the basket is gone too.H: 	 I'm glad it's gone too. ((nods three times))T: 	 How (1) how (1) how is that for you so you're feelingsomewhat glad the things are gone.1650H: 	 [MmmT:	 (and for you) ((to W))=Conversation Analysis 61W: 	 =It's (just really) (4) (hhh) (.hhh) that's one thing (I can)put aside ((R hand gestures forward)) an' I don't haveto think about it.T: 	 *Yeah*W: There's other things that (1.5) You idle that get thoughtabout but those things I don't have to think about (2)1659 	 because with them (1) she goes.These deviant examples have demonstrated the manner of repairing talk tomeet a given purpose in ritual following an initially unsuccessful attempt. Theunsuccessful attempts might be due to either the therapist's inappropriateapproach or the clients' lack of understanding or differing agendas. Along withthe earlier exemplars of the separation, liminal, and integration stages of ritualthese negative examples provide a characterization of the process. The nextsection will address exemplars and deviant examples of myths.Personal and Family MythsThe second theme to arise from the analysis is that of personal and familymyths. Unlike the other themes which attend to the nature and effects of thetherapist's approach, it relates specifically to the interactions within the couple'srelational system. Myths can be defined as core beliefs about the individual or thefamily which guide clients' thinking, emotions, and behaviours.A myth which informs this case, described by May (1992), is of the"narcissistic" client as "the modern myth of lonely individualism"; one who has"few relationships and lacks the capacity for satisfaction or pleasure in thecontacts he does have" (p. 112). Both the husband and the wife in this case fit thispattern of limited intimate contacts. They were seldom psychologically intimatewith each other, clung to their views of the world, and struggled to defend theirpositions against the other.The husband held fast to the myth of his right to the privacy of his thoughtsand activities and to personal ownership. To him, it seemed imperative to remainseparate and keep secrets from his wife. On the other hand, the wife ascribed tothe belief that fidelity, revealing most emotions and experiences, loving eachother, and sharing bringing up children in a spirit of communion defined ahealthy and desirable relationship. She demanded that her husband share hisexperiences so that she could be sure he would remain faithful to her. Eachpartner could be seen as adopting a viable myth and role in the relationship todefend the important aspects of personal boundaries and of intimate sharingrespectively.Conversation Analysis 62The therapist, through examining these beliefs, seemed to have the goal ofeventually modifying each and blending them into a harmonious balance betweenindividuation and joining as a couple. In a similar vein, May (1992) discussed "abalance between individualism, with its perilous freedoms, and commitment tothe common good, which should lower depressions as well as make life moremeaningful" (p. 123). May (1992) also noted that such balance might amelioratethe negative effects of drug addiction. In this case both alcohol and the affair werecompeting with the wife for the husband's affections and a better balance was inorder. The ritual was one means toward this balance.The following exemplars will elaborate the clients' myths after whichdeviant examples will be offered.Exemplars of Personal and Family Myths ThemeThese exemplars contrast the husband's wish for distance with the wife'sneed for closeness.First exemplar of personal and family myths theme.  In this quote, thespouses demonstrated the struggle to defend their myths. Each time the wifeincreased pressure on her husband to reveal his secrets, he became more resolvedto securely conceal them. The intensity of their interactions can be seen in thecontent of the talk, the husband's louder, emphasized speech, his nervousmovements, and the wife's ridiculing laughter.	253 H: 	 Inside a drawer (.5) inside my toolbox so I got aDRAWER and it's on the side of my toolbox (1.5) I pullthe drawer out put that in (1) lock it (1) put it in (1) shutthe drawer (1) shut this flap (1) round the other one andlock it (1) it's NO WAY in the world anybody can get inthere 	T:	 Yeah	260 H:	 no way. ((turns head quickly to W and back, shakeshead from side to side and brushes R hand away frombody and back))	T: 	 Yeah yeah (.5) And when you say no way you look atyour wife.H: Oh=	T: 	 =What was that look about.	H: 	 Well you s' you said it mine.	T: 	 Yeah.	H: 	 so that's mine (1) that's the rest.270 W: But at some point in time you're going to have to shareyour secrets.	H: 	 Well ('m I can but that's) ffair enough uh=W: =((W turns to T)) Like this weekend I want to find outhow many tools he's got.Conversation Analysis 63H: 	 ((laughs nervously))W: and we have to tell the insurance company ((laughs))H: 	 ((leans forward)) 'Cause that's nothing so this weekendwe've gotta do an inventory on my toolbox (1) so what Ihave to do is I have to unlock my box (2) take out my box.280 T: 	 Yes.H: 	 ((leans back and crosses R leg over L knee again)) andput that somewhere else while we do the inventory onmy tools.W: 	 And I need photocopies of all your bills.H: 	 Oh I can take 'em out before you come. ((wiggles R foot))W: 	 [((laughs for some time288 	 with ridicule till her next turn))Second exemplar of personal and family myths theme.  The wife articulatedher myth of the ideal family life in this excerpt. Her difficulty in speaking isshown by her pauses and tears. The husband's discomfort is shown in hismovements.677 W: It hurts too much.T: 	 *Because*W: because he betrayed me (2) betrayed our marriage (3.5)680 	 ((H has R leg crossed over L knee, body still and formedcircles with R foot, now crosses arms over chest andcrosses ankles on floor)) betrayed everything that a (.5)marriage is supposed to mean.T: 	 *What it means to me talk what it married to himmeans to you* (1) He betrayed what we had togetherW: The sharing of bringing up children and loving eachother (1.5) You just you just can't (2) if I had (1) if I hadsomething that a man gave to me (1) ((wipes eyes)) he689	 wouldn't allow it wouldn't wouldn't accept it soDeviant Examples of Personal and Family MythsAlthough the husband and wife had chosen polarized positions regardingdistance and closeness, each member also wished for the aspect of therelationship for which the other was arguing. The therapist, through variousinterventions, highlighted these underlying myths as can be seen in the nextnegative examples.First deviant example of personal and family myths theme.  This quoteclarifies the husband's equal interest in remaining close to his wife and inremaining apart. This is shown by his stated fervent wish to sit near her, hisexcited talk, and his gestures. Similarly, the wife's lack of trust, withholding herfeelings, and wish to distance from her husband are suggested by her moving footand her silence.Conversation Analysis 64	760 T: 	 So (.5) it when it upsets you to see W hurt ((gestures toW)) you feel like going over there (1 ((points to originalchair)) or you feel like still staying here.W: ((bobs R foot up and down))	H: 	 No I won't be stupid I'll go over there ((to original chair))	T: 	 OK so where do you want then you feel when it upsetsyou you feel like going over there?H: Yeah!	T: 	 *OK Let's go* ((brings chair to R of H's old chair))	H: 	 ((moves back beside wife after the sculpt)) I'll get rid of it	770 	 (4) ((briefly touches W's R knee)) I didn't think it wasthat important. (2.5) ((waves R hand outward)) (.5) Ihaven't looked at it since its been back (1) ((waves Rhand)) (And I'm gonna) put all the toolbox (.5) in a bag(1) ((lifts left arm)) and I'm going to bag off my box (.5) onto the floor (1.5) ((points L hand downwards)) And that's	776 	 where its beenSecond deviant example of personal and family myths theme.  Though thewife expressed her wish to be close to her husband, her diatribes served toadvance a different agenda of distancing from him. Her rapid, loud speech,emphasized words, short pauses, gestures, and metaphor of 'stolen money forcandy' indicated her sense of violation and outrage.500 W: =NO (.5) HUSBAND ((gestures R hand toward H)) hasn'tapologized you know i it he's the one who was lying tome (.5) about everything that was going on and thatreally hurts (2) It's like the kids standing there takingmoney out of my wallet and saying that they didn't do it(.5) you know and yet they're standing there ((strokeshair once with R hand)) with ((holds fists up to level ofhead and shakes them)) two fist fulls of candy (1) andthey they've got all this candy and you're saying well>where'd you get the money from< (.5) and they're	510 	 saying (Oh well) Mom (1) >and then a couple of hourslater they come up and say Mommy I'm sorry I took itout of my wallet then I then I can turn around and talkto them about it (1) But I still ((gestures to H with Rarm)) can't talk to 'im about it <because he refuses to	515 	 acknowledge that it actually went on!This theme of personal and family myths has dealt with the contrastbetween the initial premises promoted by each partner and their coexistentopposite myths. While the husband spoke of his need for individuality and thewife for being in relationship, each also behaved in manners which showed theirpartial wish for the opposite positions of closeness and distancing respectively.Exploration of myths informs of their everpresent function to guide client choices.The next section will address the theme of symbolization.Conversation Analysis 65SymbolizationSymbolization is the third theme which emerged from the analysis of thissession and important part of the process of the clients' growth. Several sourcesdiscuss the use of symbolization in therapy. May (1973) held that "the underlyingfunction of psychotherapy is the indirect reinterpretation and remolding of thepatient's symbols and myths" (p. 324). ExST theorists agree with this premiseand add that in so doing client relationships are explored and altered toward apositive outcome.Jung (1964) defined a symbol as "a term, a name, or even a picture that maybe familiar in daily life, yet that possesses specific connotations in addition to itsconventional and obvious meaning. It implies something vague, unknown, orhidden from us" (p. 20). Jung (1964) continued that "we constantly use symbolicterms to represent concepts that we cannot define or fully comprehend" (p. 21).Important to both Jung's (1964) position and ExST is the concept that "noindividual symbolic image can be said to have a dogmatically fixed, generalizedmeaning" (p. 30) but that the individual coining the symbol is the one to bestinterpret it.In participating in ExST, clients use metaphors or symbols to bypass talkabout a problem or experience. They can anchor the issues in imaginal ortangible form which can provide solutions to dilemmas through the senses ratherthan the intellect. Symbols allow clients to deeply experience and clearly expresspassionate issues and hopes for the future in a manner unencumbered byreliance on language.Friesen et al (1989) remarked that ExST attends to both present state anddesired state symbols. Present state symbols represent current relationships andproblems in a palpable form. These manifestations often point to aspects of therelationship which need to be changed. Desired state symbols exhibit the goals oftherapy in a physical form and suggest the positive nature of these changes.Exemplars and negative examples of symbolization will be discussed below.Exemplars of symbolization themeThese exemplars will show the use of both present and desired statesymbols.First exemplar of symbolization theme. As a present state symbol, thehusband wrote out secrets and locked them in a security box. It paralleled hisfather's box, the subject of an earlier session, which he had opened when he wasyoung. He was punished then and labelled a 'bad boy'. The husband's boxrepresented his felt need for boundaries with his wife. The wife alluded to theConversation Analysis 66effectiveness of this symbol when she voiced her fear that it withheld secrets.Tension is suggested as both spouses use loud speech, few pauses, overlappedtalk, laughter, emphasized phrases, and punctuating gestures.216 H: 	 and there's other things in there too=T: 	 =So (1) ((T takes tissue box from H, W looks at T)) so thethe the secrets are here.H: 	 Yeah and other things well I put other things in there220 	 too.T: 	 And other things (.5) other secrets.H: 	 Well y' well you know other things.T: You know whatW: 	 [OTHER SECRETS. ((looks at H))H: 	 ((laughs)) Ah well (.5) yeahT: 	 [You know what I thinkH: 	 ((laughs)) yeah see230 T: 	 You know what I thinkW: 	 [OTHER SECRETS FROM ME.((laughs))H: 	 (and that)T: 	 Is that what it is?.H: 	 =Bills from my tool box (3) ((leans back in chair crossesR leg over L knee and gestures with hands while W stilllooks at H)) YOU SAID you said to me you said to mewell every time I think of something or look bury all my240 	 secrets put 'em in there (1.5) s:o if I went out and spent(.5) fifty bucks on tools I didn't tell W about (3) put that inthere (.hhh) take 'er out of my wallet you see 'cause (2)put 'em in the back there (.5) so its just like havin"em inmy wallet (2) (an' out of the way).T: 	 So all of the secrets from here to there.H: MmhmT: 	 and the wallet here.H: YeapT: 	 And then you lock it.250 H: 	 *Yeap*T: 	 And then you put (2) so this box box goes inside anotherbox.H: 	 Inside a drawer (.5) inside my toolbox so I got aDRAWER and it's on the side of my toolbox (1.5) I pullthe drawer out put that in (1) lock it (1) put it in (1) shutthe drawer (1) shut this flap (1) round the other one andlock it (1) it's NO WAY in the world anybody can get inthereT:	 Yeah260 H: 	 no way. ((turns head quickly to W and back, shakeshead from side to side and brushes R hand away from262 	 body and back))Conversation Analysis 67Second exemplar of symbolization theme.  The book, another present statesymbol, was a strong reminder to the wife of the affair as a betrayal. Thetherapist spoke very softly in short prompts. The wife exhibited relational noveltyin sharing the book's meaning and telling her husband about the hurt underlyingher anger. Quiet speech, moderate pauses, tears, gestures and content indicatethe wife's pain and shame.	667 T: 	 ((looks at W and gestures to H)) And that book is (2) thatbook keeps us apart. (2) that meanin' keeps us apart.	H: 	 Then I'll get rid of it.	670 T: 	 *( 	 talking 	 )*W: How do I feel?	T: 	 *(Try 	 )*	W: 	 [The part the book reminds me of what went onbetween you and her.	T: 	 4c( 	 memory of me)*W: It hurts too much.	T: 	 *Because*W: because he betrayed me (2) betrayed our marriage (3.5)680 	 ((H has R leg crossed over L knee, body still and formedcircles with R foot, now crosses arms over chest andcrosses ankles on floor)) betrayed everything that a (.5)marriage is supposed to mean.	T:	 *What it means to me talk what it married to himmeans to you* (1) He betrayed what we had togetherW: The sharing of bringing up children and loving eachother (1.5) You just you just can't (2) if I had (1) if I hadsomething that a man gave to me (1) ((wipes eyes)) hewouldn't allow it wouldn't wouldn't accept it so	690 T: 	 Just tell him ((gestures to H then to heart)) just tell him((same gestures))W: ((wiggles R foot up and down)) I'm hurt and I'm	T: 	 [TellW: ashamed that he doesn't think about how I feel I'm hurtand I'm ashamed that you don't think about me ((R foot697 	 motionless upwards)).Third exemplar of symbolization theme. Another present statesymbolization, the tissue, stood for the husband not forgiving his wife for thesummons. The therapist balanced the partners' discussion of hurt. She usedmuch emphasis, overlapping talk, and an animated tone to portray the husband'sstrength of conviction. The husband then discussed forgiveness.1019 T: 	 [so W was asking you to leave the house.1020	H: 	 [YeahConversation Analysis 68	T: 	 in that in that note in that envelope.=	H: 	 [Mmhm and her Mom too.	T: 	 and her Mom.	H: 	 ( 	 ) get out (1) We don't want you anymore.	T: 	 So so you that is painful and still with you.	H: 	 That'll always be with me.	T: 	 That will always be with you.1030[Yeah there's no way of gettingrid of that (3) ((W tips head to T)) I will never ever everforget that!.	T: 	 =So so you're really holding onto that=H: =Minhm that's in my box	T: 	 That is in your booksH: In my box at work=	T: 	 =In your box at yes that's in there	1040 H: 	 [that's in there	T: 	 You know what what you said it's like (1) can I just dosomething (4) ((reaches for a tissue and clutches it toheart with both hands)) That what W did with me it will stay with me and I will never let it go!  (1) and you'reholding to it very tight.H: Mmhm,	T: 	 So you're saying to W (1.5) you gave me this and I willnever (1) never forget you for what you did  the way youhurt me!=	1050 H: 	 =I don't forget that no (1) I don't hold it against her.	T: 	 [And I wonder	H: 	 ( 	 ) ((clears throat))	T:	 [And I will ne' >This is yours ah ah not mf< ((givestissue to H)) but you're holding tight to it ((H moves Rfoot several times)) (1) I will never for' forgive you (2.5)1will never forgive you for=	H: 	 =Ill never forget it ((W touches L cheek)) (1) I didn't say1060 	 I'd never forgive her for it.T: 	 *Oh*.	H: 	 I'll never forget it.T: 	 You'll never forget it (1.5) OK (1) And have you forgivenW for that ? (1.5) and it my hy	1066 H: 	 [sort of yeahDeviant examples of symbolization themeOn some occasions the clients declined to provide symbols when invited bythe therapist. This might have been due to a lack of desire, understanding, orConversation Analysis 69ideas. The therapist then repaired her request to encourage a response as seen inthese examples.First deviant example of symbolization theme.  In this quote, the wifesidetracked a request for a desired state symbol. Instead she provided a jokingaccount for her failure to comply. When the husband spoke of his symbol, thetherapist abandoned her request to the wife.123 T: Mmhm Now I want to come in an' go to some ehmoment eh (1) in our time that we've been together andeh I want to (2) kind of go back to that desired state thatyou had initially when you came here and eh eh I'mreminded that eh (1) I invited you to to bring that specialsymbol eh130 W: 	 [Yeah ((laughs))T: 	 and eh I'm curious that eh it's never arrivedW:	 [I keep on forgetting it.T: 	 it's never arrived and you keep on forgetting it=W: =yeah it sits there on the desk ((waves L and R armalternately as speaks)) well mine does anyway its sittingon my bedside and I just keep forgetting to take it causeI'm always in such a rush when I'm going I don't mymind doesn't think that today's the day you've gotta take140	 it today's the day cause I put it in the car (1) I mightnever find it again ((laughs)) it might disappear.Sometimes he cleans it out and >sometimes I have thewindows open and things go flying out the windows< soI just (1) I don't know what if he's drawn his I don'tknow what he's done (.5) he's done things at work I146 	 don't know what he's done.Second deviant example of symbolization theme.  In this excerpt, thoughthe therapist repaired her request in several ways, the wife was not able to providea desired state symbol for "closeness" between her husband and herself. The wifeseemed to misunderstand what was asked and the therapist eventually withdrewthe request. Likewise, the husband did not provide a response to a request formeaning.870 T:	 =So (.5) what if the two of you ((leans back then forward))burned the basket and the book (1.5) what will emergeout of that letting go (.5) letting go.W: 	 Well the closeness.T: 	 And what would symbolize that closeness for you.W: 	 His finally being real (2) trying to be realT: 	 No for you for your experience not him because what wedo not know.Conversation Analysis 70H: 	 ((lowers head))W: seeing him let go (.5) let go of what what (G's880T: 	 [and whatwould it mean for you when you see closeness.W: 	 Being able to to let it let it rest.T: 	 for you (1) So for you being able to come closer to yourhusband and trust in your husband moreW: Yeah.T: 	 Is that what it means?W: That's what it would mean.T: 	 That's what it would mean.890 W: Like I don't I don't need ( 	 ) I'm not like thatT: 	 You don't need (1) And what would symbolize for youtrusting your husband letting go of that (1) a little bit ofthat fear by burning (1) What would symbolize that newsense of trust (5.5) ( 	 ) *You don't know OK that's 0* you can just stay with that right. ((To H)) I'mwondering how do you feel about that invitation I'vegiven you?H: 	 No problem (1) no problem getting rid of it at allT: 	 About p_a (1) symbolically here (1.5) burning the book and900 	 the basket. (3) what would it mean for you in terms ofyour relationship to W ((gestures to H then W))H:		 Well for once I didn't think it was such a big problem soI don't ((holds L arm)).T: 	 =So this is all new for you=H: 	 =I didn't understand it being a problem (1) so if I I justdidn't see this as a big problem.T:	 YeahH: 	 and it obviously is a big problem (1) so ah (1) if it hurtsthat much then ah (1) um (2.5) I don't tie it to G anyway910 	 ((W picks up tissue, blows nose and straightens clothesfor some time))T: 	 *you don't tie it to G*H: any moreT: 	 *Yeah*H: 	 I don't even look at it don't even think about it (2) I justso (1) it's gone.	T: 	 *It's gone*H: 	 It's gone!	T:	 *It's gone*.	920 H: 	 =It's going to be in the bin tomorrow mornin' (1) it's apity cause it's a nice book (1.5) the other stuff didn'tmean anything to me in the first place anyway (2.5) I'mnot into baskets.	T: 	 You are into baskets?	H: 	 No.	T: 	 You're not into baskets.	H: 	 [the book no it doesn't mean anything929 	 to me anyway ((looks at W))Conversation Analysis 71The present and desired state symbols noted above emerged from theclients' ideas and engaged their creativity. They transferred the changes withintherapy to the clients' larger world, engendering clients' responsibility forchange, and suggested the development of relational novelty. The negativeexamples showed how the therapist repaired her request to receive a response. Inthe next section, the focus will be on this session's experiential theme.ExperientialThe fourth theme, which highlights the experiential nature or 'here andnow' focus of this session, provided increased awareness of the clients' problemand solutions in the present moment. Acting out the clients' relationships in the'here and now' powerfully manifested both their painful and pleasantcharacteristics.Houston (1982) paraphrased Pens, the originator of Gestalt therapy that"we can very effectively. . . learn our own best ways of dealing with the world, bybecoming more and more aware of what stands out for us from moment tomoment, right here in the present" (p. 9). ExST, which has a kinship to Gestalttherapy, involves clients experiencing past difficulties, current problems, andfuture hopes in a visceral experience in the present. In this way problems aretransformed to provide relational novelty and freedom from the tyranny of painfulmodes of interaction.This style of perturbing the family system stands in contrast to thehistorical focus and interpretations of Freudian analysis (Coren, 1986) or Bowentherapy (Kerr and Bowen, 1988) which discuss clients' past experience in theirfamilies of origin. In ExST the past is addressed as it relates to the now andexperienced in the present. It is also very different from O'Hanlon's style ofoffering his own solutions to the couple. ExST serves to promote clients' solutionsin the process of experiencing their difficulties.The exemplars which follow will provide a taste of the nature ofexperiential therapeutic techniques. Deviant examples will offer instances whendeepening of the clients' experience was not achieved.Exemolars of Experiential Theme This important theme is particularly evident in the exemplars to beprovided. They deal with the couples' relationships to the girlfriend, thetherapist, and each other.First exemplar of exneriential theme. This excerpt showed how real theexperience of the affair still was for the wife. She referred to the girlfriend'sConversation Analysis 72continued presence in the room and set the stage for another externalization as inan earlier session. The depth of her experience of mistrust was indicated by heremphasis of certain words, few pauses, and louder talk.	384 T: 	 It's very meaningful ((H places box on chair besidewallet)) eh in your from in your experience this this thisis (1) this ah (2) security box has become your securitybox and (.5) but I'm aware that there is alot of tensionhere between you two of you about eh (1.5) ((to W)) certainthings that are going on and and I'm wondering how390 	 are you feeling about the security box (exactly like)?W: (Well) if that's what he wants (.5) I just wonder youknow what other little secrets he's hiding that=	T: 	 ...*yeah*.	H: 	 ((H crosses arms on chest, looks at ceiling))W: =you know besides the secrets that's in the box like thesecrets of Girlfriend (1) came up a couple of weeks ago[	H: 	 ((moves R foot)) [0:h ((turns head away from W,turns head toward W))	400 W: 	 the old Gi:rlfriend (2) the chair that should have st'stayed right here (.5) instead of going to the back of theroom.	T: 	 The the chair is right here for you.W: Yea:uh	T:	 You wanna go and get's have a chair[	W: 	 [She kaels she feels IT FEELS LIKESHE'S STILL THERE (.5) you know things that are goingon things that he that are said it feels like she's still410 	 there (1) even tho' oh I don't know she doesn't phone thehouse anymore there's no more suspicious phone callsfrom people that are phoning and hanging up now!Second exemplar of experiential theme. In this piece, the therapist drewattention to the symbolic nature of the husband using the girlfriend's chair to holdhis possessions. The husband denied intending any such symbolism. The wifeexperienced disgust at the thought of the girlfriend's presence as shown by heruse of 'repulsed', her animated tone, and her overlapping talk.	413 H: 	 (hhh) (.hhh) ((pulls the girlfriend's chair to his R side))T:	 Now the chair the girlfriend chair was kind of at theback hnn (1.5) and (.5) and H pulled the chair kind of toput his box and his wallet (1) very important possessionsof his.	H: 	 I just didn't want to put them on the floor actually.((gestures to chair then rubs nose with R hand))T: 	 OK so you because it sounds (1) you want the ch' G=	420 W: 	 No I'd like G's chair completely totallyConversation Analysis 73	T: 	 [But it's it's here.	W: 	 [out of the425 	 room but I feel repulsed that she's still here!Third exemplar of experiential theme.  This quote followed the couple'sdeadlock about disposal of the book. The therapist began a sculpt by moving besidethe wife. That this had the desired experiential effect of unsettling the husbandwas noted in his louder, stammering speech, emphasized words, and nervousgestures. The therapist then role played the wife's position using several longsoothing pauses, emphasis of key meaningful words, and gestures toward bothpartners. Intensification of the experience of the the rift between the partnerswas achieved by having the husband sit in the far corner of the room. Thisresulted in the husband volunteering to dispose of the book.640 H: =and throwing it away (.5) WHAT ARE YOU MOVIN' FOR! ((still fidgets)) (3) (hhh) Is tha' is that symbolic too you're movin' next to W?	T: 	 *And you don' like it.*H: Hmm ?	T: 	 And you don' like it. ((nods slightly))	H: 	 E_Q (.5) no. ((R hand fidgets and shakes head far to R))	T: 	 ((looks at W)) *1 I want I want to be with W ((gestures toW with hands)) for a little while* ((looks at H)).	H: 	 =OK ((nods strongly and still moves R hand))	650 T: 	 and from W's shoes ((gestures to W)) (3) imagine that Iam (.5) you're wife (1) ((gestures to W)) that I am W rightnow (3) ((looks back and forth to H and W)) I feel veryhurt (2) because that book means things to me (2) itmeans to me that you're far away from me.	H: 	 I'll get rid of it.	T: 	 And I want to have you close to me.	H: 	 (hhh) (.hhh) ((wiggles R foot))	T: 	 To look at the basket (2.5) tells me that you're far awayfrom me ((W wipes eyes several times)) and I want you660 	 close to me (1.5)1 want you in my heart (1) I want to bepart of your heart (5) And that book means for me thatyou're far away (2) Can I just touch you for a minute? (2)*Can you just come.* ((holds H by R hand with bothhands and guides to chair at back of room behind hisplace on H's right)) (5.5) Can you sit there?H: OK.	T: 	 ((looks at W and gestures to H)) And that book is (2) thatbook keeps us apart. (2) that meanin' keeps us apart.	669 H: 	 Then I'll get rid of it.Conversation Analysis 74Deviant Examples of Experiential ThemeThese examples showed the therapist's attempts to deepen the clients' 'hereand now' experiences. In each case, this resulted was not achieved.First deviant example of experiential theme.  In this quote the therapist haddifficulty keeping the wife from blaming her husband. The therapist attempted tofocus on the present experience. Some confusion of the therapist's intent to roleplay the husband required that she repair her statements several times.718 W: ((wipes eyes and wiggles R foot))	T: 	 *OK* and tell I want you to tell W (1) W are you there are720 	 you listening to me?[	W: 	 [Yeah I'm listening. ((holds R foot up.stationary))	T: 	 ((both hand gesture near heart)) Do you hear that I amkind I am I never knew ((W lowers L foot)) howimportant this was to you?.W: =He didn't you didn't listen when I was telling you howimportant it was to me.	T: 	 Right now? You feel (important) to me?730 	 1	W: 	 [Before.	T: 	 Right now I'm listening.=W: =Yeah I'm listening now=	T: 	 =Right now I have listened to you W (1) and I'mrealizing how important it is to you. (2.5) It it's ((looks toH then back at W)) important to me what's goin' on rightnow for me (1) ((looks to H)) I want you to ( about givingup th' book).	H: 	 I'll give it up first thing in the morning (1) (	 ) it740	 obviously hurts with me to keep it so I'll get rid of it!741 W: ((wipes eyes and waves R foot from side to side))Second deviant example of experiential theme.  In this instance, thetherapist attempted to create an experience of deepening the husband's feeling ofrejection and the wife's feeling of betrayal. The wife negated this attempt bydescribing and defending her position. The therapist then attempted to frame theissue as a secret from the box. For some reason, both partners negated thisconceptualization as well.	1097 T: 	 [because you rejected me (1) you kicked meout=	1100 W:	 =( 	 )T: 	 No I just (.5) ( 	 ) I know it could be a million otherthings and (1) as (1.5) because in the same manner thatwhen you were in touch with my with your pain rightnow I became in touch with my own pain (2) and (2) IConversation Analysis 75haven't healed this wound that I feel that (.5) that you'vecreated in my soul in my heart (3) and in the samemanner that you, W that (2) you haven't healed thatwound that cre created in your heart and=[	1110 H:	((shifts in chair) [(hhh, .hhh)W: =that I gave to himT: MmhmW: that he's talking about he precipitated himself=	T: 	 =by ((leans back a little))W: by telling me he took spoke to a lawyer.	H: 	 ((lowers head and scratches head with L hand))W: and how he was going to make sure[	T: 	 [Yes	1120 W: 	 that I got nothing (	 ).[	T: 	 [YeahW: I wanted to protect myself and my children 'cause he'd(.5) all the time he was telling me he'd speak to lawyers.[	T: 	 [Yeah (.5) yeah sothere has been=	W: 	 =so I was protecting myself.	T: 	 So there has been alot of hurt=1130 W: =Yeah	T: 	 alot of hurt on both (1) ((W leans head to T)) both and (.5)and I'm aware that (1) that H you have shared a secretwith W right now ((W's L hand toys with hair, she looksunder L side of chair and leans body to T)) (1) one of thesecrets that was in the box. (3) Right?H: Actually it was on my mind yesterday and I mentioned ityesterday1138 T: 	 Yeah yeahThis section provided several quotes regarding the experiential theme. Thenegative examples were unsuccessful, through role playing, in deepening clients'experiences of rejection and betrayal. The earlier successful exemplars did offerhealing experiences related to the wife's feeling the girlfriend's presence, thewife's fear of the husband's relationship with the girlfriend, and the affair's effectof dividing the couple. Painful feelings of hurt, anger, and isolation emergedthrough these exemplars. These experiences later evolved into couple's relationscharacterized by forgiveness, reconciliation, attentiveness, humbleness, andtrust.Conversation Analysis 76ExternalizationExternalization, the fifth theme, allows clients to relate to aspects ofthemselves or other entities without the encumbrance of blame. In this session,externalization proved to be an effective technique to engage clients in resolvingpainful aspects of their relationship including the affair. The idea ofexternalization has been used by several schools of therapy to engender change.These contributions to the technique will be discussed and the unique aspects ofExST will also be presented.Gestalt therapists use two chair and empty chair techniques to heal "splits"within an individual to bring them to "integrity" (Pens, Heiferline, & Goodman,1980, p. xiv). Psychodrama and Gestalt interventions externalize anotherindividual or individuals with whom the client may then interact and resolvesome conflict (Corey, 1986; Houston, 1982).Similarly, White (1989) stated the importance of externalizing couples'conflicts. White (1989) noted externalization serves to "objectify" or "personify. . .the problem" which "becomes a separate entity and thus external to the personwho was, or the relationship that was, ascribed the problem (p. 5). Palazzoli(1974) concurred with this idea, noting the greater productivity of enacting ritualthan of problem discussion.The ExST approach expanded on White and Epston's (1990) approach.Friesen et al (1987) noted that " symptoms, objects, circumstances . . . events",relationships, emotions, behaviours, or thoughts can all be experienced inrelationship to clients. "By placing the symptom, object or person in the chair, theclient is able to bring feelings that are repressed, ignored or blocked into thepresent" (p. 56). In an earlier session with this couple, both alcohol and thegirlfriend were externalized. In this way impasses were experienced andresolved more thoroughly than if only discussed. These ideas will bedemonstrated in the following exemplars. Negative examples will show lesseffective attempts at externalization.Exemplars of Externalization Theme The following exemplars externalize the security box, the girlfriend'schair, and the therapist's balanced relationship with the clients.First exemplar of externalization theme. During the externalization of thehusband's security box, the therapist addressed the tension between the spousesand requested the wife's reaction. The wife referred to her current experience ofthe girlfriend's symbolic presence, emphasizing certain words. Meanwhile, thehusband remained quiet, shifted position and sighed.Conversation Analysis 77	384 T: 	 It's very meaningful ((H places box on chair besidewallet)) eh in your from in your experience this this thisis (1) this ah (2) security box has become your securitybox and (.5) but I'm aware that there is alot of tensionhere between you two of you about eh (1.5) ((to W)) certainthings that are going on and and I'm wondering how390 	 are you feeling about the security box (exactly like)?W: (Well) if that's what he wants (.5) I just wonder youknow what other little secrets he's hiding that=	T: 	 =*yeah*.....	H: 	 ((H crosses arms on chest, looks at ceiling))W: =you know besides the secrets that's in the box like thesecrets of Girlfriend (1) came up a couple of weeks ago	H: 	 ((moves R foot)) [0:h ((turns head away from W,turns head toward W))400 W: the old Gi:rlfriend (2) the chair that should have st'stayed right here (.5) instead of going to the back of theroom.Second exemplar of externalization theme. The continued tension as theexternalization of the girlfriend unfolded was shown by the frequent overlappingtalk by both therapist and wife. The wife's emphasis of words, very animatedtone, gestures, and short, infrequent pauses indicated the degree of the pain andrage which she felt. Her husband's quiet denial did not relieve her doubts. Thetherapist used a soft voice to deepen the experience of the externalization.	419 T: 	 OK so you because it sounds (1) you want the ch' G=420 W: No I'd like G's chair completely totally	T: 	 [But it's it's here.	W: 	 [out of theroom but I feel repulsed that she's still here!	T:	 [for for you for you=W: =Yes eh she's ONLY the only reason that I feel that	430 T: 	 [I want to invite you	W: 	 her she's still here (.5) is all the lies and the deceit thatwent to cover up everything that he was doing (1) whenhe was meeting her (.5) ((waves hand back and forth inlap)) and all the time he was saying he wasn't havinganything to do with her (.5) so that it's still there it stillbothers me! ((pats heart with R hand))	T: 	 [Right yes	H: 	 ((plays with hands during this discussion))440 W: an' it's this went on ((shakes R hand three times onceConversation Analysis 78for each word)) so these were big secrets (2.5) that hewas hiding (1) >so that h's got now ((gestures shape ofbox)) he's got this little tool box that he's hiding littlesecrets in<!H: 	 (Nothin' in there now).W: 	 [I'm wondering (.5) >what other kind of secretsmaybe a card from G that she's dropped off maybe thismaybe that what other secrets might there be (1) that 'e's450 	 slipped in there<!T: 	 [So I want to *invite you I want to invite you W to placethe chair right in between the two G's *because from youfrom your experience she's still she'sW: 	 [she's still she's still righthere. ((points to between H and W's chairs))T: 	 *Yeah*W: That's where she is.460 T: 	 *Yeah would you like to (.5) I want uh*H: 	 (hhh) (.hhh) ((opens up arms))W: Yeah ((R arm hanging from back of chair)) that'swhere she belongs still 'cause still still somethinghanging that's not finishedT: 	 [*Can can youW: 	 She still belongs right there.T: 	 *Yeah*469 W: ((rises and pulls chair between self and husband))Third exemplar of externalization theme. This piece showed thetherapist's balanced allegiance to the partners in her moving to the husband'sside. She helped him express to his wife that he was listening and cared abouther. Soon the husband was teary eyed and spoke quickly with animation,indicating his engagement in the externalization. He was visibly relieved to moveback beside his wife.	734 T: 	 =Right now I have listened to you W (1) and I'mrealizing how important it is to you. (2.5) It it's ((looks toH then back at W)) important to me what's goin' on rightnow for me (1) ((looks to H)) I want you to ( about givingup th' book).H: 	 I'll give it up first thing in the morning (1) (	 ) it740		 obviously hurts with me to keep it so I'll get rid of it!W: ((wipes eyes and waves R foot from side to side))	T: 	 It hurts you?	H: 	 It hurts W that I have it=	T: 	 =So and=	H: 	 =and that upsets me so I'll get rid of it!Conversation Analysis 79	T: 	 It upsets me to see you hurt.	H: 	 Aye that's right. (.5) >I didn't think it was thatimportant.<	T: 	 I never thought that it was important. *Now what does750 	 it mean to see her hurt* tell her.	H: 	 *( I don't know 	 )* (6) It does >I mean I don't like tosee her hurt< (.5) she's my wife.	T: 	 She's your my wife what else (2.5) so it upsets me to seeyou hurt=H: =Mmhm=	T: 	 =because you're my wife=H: =Mmhm=	T: 	 =because	H: 	 ((wipes eyes, places hands in lap, legs crossed)) (hhh)	760 T: 	 So (.5) it when it upsets you to see W hurt ((gestures toW)) you feel like going over there (1) ((points to originalchair)) or you feel like still staying here.W: ((bobs R foot up and down))	H: 	 No I won't be stupid I'll go over there (to original chair))	T: 	 OK so where do you want then you feel when it upsetsyou you feel like going over there?	767 H: 	 Yeah!Deviant Examples of Externalization Theme In these examples the therapist tried to engage the husband's strongemotions related to his externalized security box and the summons. In the firstexample he instead joked and in the second, withdrew his complaint.First deviant example of externalization theme.  Using a tissue box toexternalize the security box, the therapist attempted to circumvent the husband'steasing and concrete description. Though she solemnly presented it to him andemphasized words to create a deeper experience, he continued in a superficialvein.	348 H: 	 [Well you see I've got a (trick).T: 	 =This is	350 H:	 Actually uh I I enjoy that.T:	 [What what is. You you like your box=	H: 	 =Oh yeah I do I do that's a great idea.T:	 [An' as I was I was holding it eh Ithought it's it's almost like a 'Privilege for me to hold (.5)the box right now because (1) it (1) it keeps (.5) very verysignificant secrets very significant things verymeaningful things for you (1.5) and I almost feel like360 	 givin' it to youH: 	 ((laughs))Conversation Analysis 80	T:	 I want to give it to you because it's yours and I want youit's very important. ((does so))	H: 	 Yeah it's similar a pretty similar uh size too (2) but its agood idea because I think it's rea' it's a it's good It's likeI'm not all (1) you know when you ah (2) go swimmingor something to a locker you put stuff in the locker (1)and you know it's (	) you pin another key to yourswimming costume and you know its safe (1) still safe370 where you're going and I mean it's bizarre like it's alotlike it it's called a security box that's what it's called (2)It's called a security box.	T:	 Security box.	H: 	 It's made by the people who make my tools and it'ss'posed to be (1.5) where you put your you knowmechanics don't wear rings and watches when they'reworkin' or their wallet there's somewhere safe to put378 	 your things while you're workin'.Second deviant example of externalization theme.  Here the therapistattempted to externalize with a tissue the envelope holding the summons. Shetried to strengthen the experience, emphasizing words, and using gestures andan animated tone. The husband relinquished his position rather than enter theexperience more deeply.	1027 T: 	 So so you that is painful and still with you.	H: 	 That'll always be with me.	T:	 That will always be with you.1030[Yeah there's no way of gettingrid of that (3) ((W tips head to T)) I will never ever everforget that!.	T: 	 =So so you're really holding onto that=H: =Mmlun that's in my box	T: 	 That is in your booksH: In my box at work=	T: 	 =In your box at yes that's in there	1040 H: 	 [that's in thereT: 	 You know what what you said it's like (1) can I just dosomething (4) ((reaches for a tissue and clutches it toheart with both hands)) That what W did with me it will stay with me and I will never let it go!  (1) and you'reholding to it very tight.H: Mmhm.T: 	 So you're saying to W (1.5) you gave me this and I will never (1) never forget you for what you did the way youhurt me!=	1050 H: 	 =I don't forget that no (1) I don't hold it against her.T: 	 [And I wonderConversation Analysis 81	H: 	 ( 	 ) ((clears throat))[	T: 	 [And I will ne' >This is yours ah ah not mi'< ((givestissue to H)) but you're holding tight to it ((H moves Rfoot several times)) (1) I will never for' forgive you (2.5)1will never forgive you for=	H: 	 =I'll never forget it ((W touches L cheek)) (1) I didn't say1060 I'd never forgive her for it.	T: 	 *Oh*.	1062 H: 	 I'll never forget it.To summarize, the theme of externalization in ExST can allow the clients tosymbolically invite an entity into the room. Through interacting with it in thepresent, they can resolve relational conflicts. Positive exemplars showed quoteswhich successfully externalized the husband's need for security, the wife'scontinued experience of the aftermath of the affair, and the husband's caring forand attention to his wife. In negative examples, the therapist's lead to deepenexperiences through externalization of the security box and the summons was notfollowed by clients. The next section will show how the related effect ofintensification can be achieved.Intensification of ExperienceThe sixth theme, intensification, is a necessary part of any experientialtherapy. It was achieved to a high degree in this session. Friesen et al (1989)noted that intensification can identify "underlying emotions" and "dramatizerelationships" (p. 36). Friesen et al (1989) suggested using concrete words,,'externalizations, metaphors or "staying with a situation", amplifying "bodilyaspects", and use of "action oriented techniques" (p. 36).Friesen et al (1989) noted the significance of such deepening experience isthe "transformation of the rigid interpersonal or self pattern into a new form" (p.35). This "results in new behaviours", "reframing" of "the world", activation of"creative and adaptive potential", and attainment of a "precious moment" of"actualization" (p. 35).The effect of intensification can be achieved through various techniquesincluding repeating phrases, reframing meaning, self-disclosure, empathicresponding, sculpting, coaching, or immediacy. Some of these are shown in thefollowing exemplars and deviant examples.Exemplars of Intensification ThemeThese quotes show intensification through repeating words,externalization, role playing and empathy.Conversation Analysis 82First exemplar of intensification theme. In this excerpt, the therapistrepeated the issue of secrets which she had introduced earlier. After severalturns the wife aggressively stated her worry about secrets, overlapping thetherapist's turns and laughing critically. The husband defensively discussed thebox. By repeating words, the therapist had deepened the experience. The spousesshowed intensification with their loud talk and gestures.	217 T: 	 =So (1) ((T takes tissue box from H, W looks at T)) so thethe the secrets are here.	H: 	 Yeah and other things well I put other things in there220 	 too.	T: 	 And other things (.5) other secrets.	H: 	 Well y' well you know other things.T: You know what	W: 	 [OTHER SECRETS. ((looks at H))	H: 	 ((laughs)) Ah well (.5) yeah	T:	 [You know what I think	H: 	 ((laughs)) yeah see	230 T: 	 You know what I think	W: 	 [OTHER SECRETS FROM ME.((laughs))H: 	 (and that)T: 	 Is that what it is?.	H: 	 =Bills from my tool box (3) ((leans back in chair crosses Rleg over L knee and gestures with hands while W stilllooks at H)) YOU SAID you said to me you said to mewell everytime I think of something or look bury all my240 	 secrets put 'ern in there (1.5) so: if I went out and spent(.5) fifty bucks on tools I didn't tell W about (3) put that inthere ( hhh) take 'er out of my wallet you see 'cause (2)put 'em in the back there (.5) so its just like havin"em in244 	 my wallet (2) (an' out of the way).Second exemplar of intensification theme. After much expression of angershown by emphasis, animated tone, and short pauses, the wife voiced her deeperfeelings of 'hurt' and began to cry. Her long pause after saying the word and herself-soothing gestures indicate the intensity of the pain she experienced. Thetherapist summarized the betrayal.534 W: Maybe in a few months I won't bother with the=	T: 	 =Yes=W: =that anger but right now that's the way I feel (1) If Isaw, her on the street I would actually get out of the carand beat her up for all of the pain she put me through (2)and it's (.5) that's the way it is. (1.5) Right about now IConversation Analysis 83540	don't need that you know and I don't need any of thataggravation and I it just still hurts! ((strokes hair twicewith R hand)) (11)	T: 	 Yeah yeah (.5) So right now it's hurting.W: Mmhm	T: 	 The betrayal from (2.5) from your best friend[	W: 	 [Yeah	T:	 The betrayal from your (.5) from your husband (	)[	550 W: 	 [Yeah?My husband's supposed to be my best friend (2) G wasjust a friend (.5) she wasn't a best friend (1.5) She tried to553 	 be. ((wipes tears and rubs thighs))Third exemplar of intensification theme.  In the next quote, the therapistused role playing, empathy, emphasis of central words, long pauses, and severalnew phrases which the couple later repeated. Like the therapist, the wife latergestured to her heart. Her quiet tears indicated that she felt the therapistaccompanied her through the pain. The husband's quiet acceptance andmovements suggested his feelings of guilt.	650 T: 	 and from W's shoes ((gestures to W)) (3) imagine that Iam (.5) you're wife (1) ((gestures to W)) that I am W rightnow (3) ((looks back and forth to H and W)) I feel veryhurt (2) because that book means things to me (2) itmeans to me that you're far away from me.	H: 	 I'll get rid of it.	T: 	 And I want to have y_g_Li close to me.	H: 	 (hhh) ( hhh) ((wiggles R foot))	T: 	 To look at the basket (2.5) tells me that you're far awayfrom me ((W wipes eyes several times)) and I want you660 	 close to me (1.5) I want you in my heart (1) I want to bepart of your heart (5) And that book means for me thatyou're far away (2) Can I just touch you for a minute? (2)*Can you just come.* ((holds H by R hand with bothhands and guides to chair at back of room behind hisplace on H's right)) (5.5) Can you sit there?H: OK.T: 	 ((looks at W and gestures to H)) And that book is (2) thatbook keeps us apart. (2) that meanin' keeps us apart.	669 H: 	 Then I'll get rid of it.Deviant Examples of Intensification ThemeThese examples occurred when the clients avoided entering the depth oftheir feelings of anger or loss of friendship.First deviant example of intensification theme.  In this quote, the therapistaddressed the couple's relationship and the wife's anger. The wife switched toConversation Analysis 84unrelated facts and avoided the issue. For several turns she threatened to find outthe husband's secrets. The husband was quiet.287 W: 	 [((laughs for some timewith ridicule till her next turn))T: 	 And I and I hear you gettin' joy from this. (.5) What290 	 what is goin' on here.W: 	 [It's funny (1) ((continues laughing)) it's funny that he'she's he's trying to be so secretive about all these toolsbecause in the end I I'll find out in the end because (2)((H taps R hand on chair arm and wiggles R foot)) it'scosting just about eight hundred dollars now it's costing(1) he's got twenty thousand dollars worth of tools andH: 	 [at300 	 leastW: it's costing us (2) because the companies don't cover thethe (.5) the tools if they're stolen or lost or anything wehave to insure them ourselves.T: 	 *Yeah*.W: So I'm insuring them with our house.H: Mmhm.W: And they phoned me I didn't think that they wanted it(.5) but now they phoned and said we need an inventory.H: 	 (hhh) ((pulls chair up from behind to his R side and310 	 places wallet firmly on it))W: 	 and we need pictures (2) so they want (2.5) so now Ihave to go spend two hours (.5) writing down everythinghe has inside his box and what its worth.314 H:	 ((clears throat)) (Second deviant example of intensification theme.  On another occasion thetherapist attempted, by repeating statements, the husband's experience of givingup the book and losing the girlfriend's friendship. This failed to generate newinformation or intensity.908 H: 	 and it obviously is a big problem (1) so ah (1) if it hurtsthat much then ah (1) um (2.5)1 don't tie it to G anyway910 	 ((W picks up tissue, blows nose and straightens clothesfor some time))T: 	 *you don't tie it to G*H: any moreT: 	 *Yeah*H: 	 I don't even look at it don't even think about it (2) I justso (1) it's gone.T: 	 *It's gone*H: 	 It's gone!T: 	 *It's gone*.Conversation Analysis 85	920 H: 	 =It's going to be in the bin tomorrow mornin' (1) it's apity cause it's a nice book (1.5) the other stuff didn'tmean anything to me in the first place gnyway (2.5) I'mnot into baskets.	T: 	 You are into baskets?	H: 	 No.	T: 	 You're not into baskets.[	H: 	 [the book no it doesn't mean anything929 	 to me anyway ((looks at W))To summarize, intensification can be achieved through many qualities ofinteractions, all of which seek to strengthen the present experience of clients'concerns. The above exemplars showed clients responding to the therapist'sencouragement oto express their anger, hurt, and loneliness. Occasionally, as inthe deviant examples, clients may avoid exposing the strength of their anger orthe depth of their loss. The next section will highlight the contextual nature ofclients in therapy.Contextual/SystemicThe seventh theme is of the contextual/systemic embeddedness of clients. Itentails attention to the context of the social and physical systems in which clientslive, and plays an important part in family therapy. As Friesen et al (1989) stated,"the living process is characterized by a complex, multidimensional, dynamicinteractional process in which individuals are both affected by and affecting acontinually developing environment" (p. 21). ExST theory holds that relationshipsare the bedrock of human existence. Relationships can be with parts of self,people, experiences or objects. Therapists can use various linguistic techniques tobring clients to attend to the nature of their relationships.Clients' contexts might be accessed, for example, through Egan's (1986)"open-ended questions" (p. 113), summary, immediacy, behaviour description, orself-disclosure. Such techniques which elicit clients' present experience ofrelationships with various aspects of their context can ameliorate theserelationships. Therapists might draw attention to an emotional undercurrent,perturb the clients' interactive sequence in some manner, or blend newbehaviours into a new meaning or experience for the couple. Exemplars anddeviant examples of this process will be provided next.Exemplars of Contextual/Systemic Theme The following exemplars will attend to the couple's relationships with thehusband's parents, each other, and the girlfriend.Conversation Analysis 86First exemplar of contextual/systemic theme.  The therapist using circularquestioning and summary to ask clients about the involvement of the husband'sparents. The wife had suggested earlier that they were exacerbating thehusband's drinking problem by insisting the husband's end the affair and savemoney by drinking at home. The excerpt gives a positive connotation to the clientsas active agents in their own healing. The positive effect of this line of questioningwas reflected in the husband's noting the issue of his father's drinking at the endof the session.	90 H: 	 So they're now they're at the mall walking around((leans to L toward W)).	T:	 =So what did they say about your session about yourtherapy.	H: 	 ((turns head toward W))	W:	 ((laughs)) (nothing at all)II	H:	 [(W: They know we're having problems.	H: 	 Ye:ah didn't say too much.	100 T: 	 They weren't surprised though or not really which	W: 	 [I'd already told them	T: 	 WhichIi	W:	 [I told them	H: 	 Yeap.	T: 	 You're doing something real and concrete about (hhh)H: Yeah=	W: 	 =Well they don't realize its for H's drinking (1) you see.=	110 H:	 =YesW: they're from "another country" so drinking over there isOK (1.5) and (its I keep) trying to explain it.=T: 	 =You were saying to me yesterday that uh yesterday notyester but last week that (1) you're inlaws had beentalking with H about his drinking and (	W: 	 [Yeah they shouldn'tdrink too much they find his his father can't drinkeither you see and his ffather's got high blood pressure120		 so he's not supposed to drink too much beer (2) He's notsupposed to drink period but (1) being the stubborn man122 	 that he is he does it anyway.Second exemplar of contextual/systemic theme. In this piece, thehusband's loud statements and emphasized phrases about the impenetrability ofhis security box demonstrated his great need for protection, privacy, and safety.The therapist used behaviour description and immediacy to encourage him toConversation Analysis 87explain the import of this issue to the marital relationship. The couple'sdiscussion then alluded to the affair in a veiled manner as suggested by the wife'scriticism and the husband's hesitant, nervous response.253 H: 	 Inside a drawer (.5) inside my toolbox so I got aDRAWER and it's on the side of my toolbox (1.5)1 pullthe drawer out put that in (1) lock it (1) put it in (1) shutthe drawer (1) shut this flap (1) round the other one andlock it (1) it's NO WAY in the world anybody can get inthere T: Yeah260 H: no way. ((turns head quickly to W and back, shakeshead from side to side and brushes R hand away frombody and back))T: 	 Yeah yeah (.5) And when you say no way you look atyour wife.H: Oh=T: 	 =What was that look about.H: 	 Well you s' you said it mine.T: 	 Yeah.H: 	 so that's mine (1) that's the rest.270 W: But at some point in time you're going to have to shareyour secrets.272 H: 	 Well ('m I can but that's) ffair enough uh=Third exemplar of contextual/systemic theme.  In this excerpt, thetherapist asked if the husband discussed the affair with his wife. The therapist'ssoft tone of voice mitigated an interpretation that she was blaming the husband,and called out his honest response. The husband's extension of vowels indirectlyinvited the wife to discuss the contents of the box. Her quick response and rapidspeech suggest her agitation regarding the affair. This talk began the search forcommon ground, and set the stage for later resolution of the couple's differences.554 T: 	 ((brings W tissues,looks to H)) Have you talked anythingat all about G with a' (1) W, H?H: 	 ((has been mostly holding still now looks at T)) No notreally I try (.5) try and keep out of the way.T: 	 *Try to keep out*.H: 	 =I push it to one side. (.5) She's not mentioned in it she's560 	 not in (.5) she's not in my box.T: 	 *G is not in your box.*H: 	 My box goes back a lo:ng ti:me. ((T positions her chairfacing W and H equally))W: =but part of G is still in your bo' in your around your box(.5) you've still got that book from her.H: 	 Yes I do. ((nods))W: >And the basket ((nods)) and everything else I askedyou to please get rid ofk.Conversation Analysis 88	H: 	 Well the basket I don't need but the bo' the book I wanna570 	 keep.Deviant Examples of Contextual/Systemic Theme In these examples, the therapist tried and failed to elicit the couple'sattention to certain aspects of their relational context. The first was directed atthe husband's experience of losing the relationship with the girlfriend, and thesecond sought to note the positive aspects of the couple's relationship.First deviant example of contextual/systemic theme. Here the therapistasked the husband how burning the symbols might affect the marriage. Thehusband vaguely disclosed that he understood his wife's pain and denied residualthoughts of the girlfriend. He did not directly discuss the couple's relationship.	899 T: 	 About Ra (1) symbolically here (1.5) burning the book and900		the basket. (3) what would it mean for you in terms ofyour relationship to W ((gestures to H then W))	H: 	 Well for once I didn't think it was such a big problem soI don't ((holds L arm))=	T: 	 =So this is all new for you=	H: 	 =I didn't understand it being a problem (1) so if II justdidn't see this as a big problem.	T: 	 Yeah	H: 	 and it obviously is a big problem (1) so ah (1) if it hurtsthat much then ah (1) um (2.5) I don't tie it to G anyway910 	 ((W picks up tissue, blows nose and straightens clothesfor some time))	T:	 *you don't tie it to G*H: any more	T: 	 *Yeah*	H: 	 I don't even look at it don't even think about it (2) I justso (1) it's gone.	T: 	 *It's gone*	H: 	 It's gone!	T: 	 *It's gone*.	920 H: 	 =It's going to be in the bin tomorrow mornin' (1) it's apity cause it's a nice book (1.5) the other stuff didn'tmean anything to me in the first place anyway (2.5) I'mnot into baskets.	T: 	 You are into baskets?	H: 	 No.	T: 	 You're not into baskets.[	H: 	 [the book no it doesn't mean anything929 	 to me anyway ((looks at W))Conversation Analysis 89Second deviant example of contextual/systemic theme. In this example, thetherapist mentioned the couple's cooperative behaviour in the ritual. The attemptwas ineffectual as both spouses repeatedly focused on historical details of "lies".	1548 W:	 Yeah it's the "holiday" basket. (1.5) ((H picks up extrapaper)) the basket of deception. ( 	 )=	1550 H: 	 =It had a handle you know.	T: 	 The basket of deception.	W: 	 *Yes*.	T: 	 It had a handle.	H: 	 Alright H'h'here ((places handle on basket))W: Right.	H: 	 (A'right there there you go). ((Looks at T)) ((W still looksdown))	T: 	 ((gently)) You're doing this together (1) That's the firsttime that I see you doing something together.	1560 H: 	 That's not bad. ((Nods))	T: 	 *Yeah.*	W: 	 This basket's lied alot a lies ( 	 ).H: ((laughs quietly)) (hhh)W: I think you know (what all the lies are talking) about(4.5) of how she got into the apartment and how the bathwas drawn and ((lifts head and looks at H))	H: 	 No I actually didn't know about that (.5) That was a quitea surprise to me.	W: 	 0:h. (1) She had keys. ((lowers head))	1570 T: 	 Do you wanna' burn the the basket or do you feel like H=W: No H didn't didn't find the basket I did (1) I found thebasket.	T: 	 So you wanna burn it=W: ((looks at T)) =So I wanna burn it.	H: 	 Yeah she knew about the basket before I did.T: Mmhm	1577 H: 	 'Cause it was left in my apartment for meClients are part of many ever wider systems of their extended families,friends, communities, ethnicities, etc. Therapists need to attend to clients'contexts,as well as to parts of the individual. The above exemplars attended to thecouple's relationship with the husband's parents, their marital relationship, andtheir collective relationship with the affair. Deviant examples described efforts toexamine the impact of end of the affair on the husband and the cooperativeaspects of the couple's system. Constructivist/Meaning Shift is the next focus.Constructivist/Meaning ShiftConstructivist/meaning shift, the eighth theme which arose from thisanalysis, alluded to the idea that clients can understand their life experiences in aConversation Analysis 90multiplicity of ways. Individuals, in a therapeutic or everyday setting, constructtheir own reality from the information at hand. Clients are often locked in astalemated world view which allows them no hope for change. The therapist'stask is to help them experience alternative views of reality which can lead tohealing and opportunity for growth.According to Kvale's (1990) discussion of postmodernism, meaning isautomatically defined by the group considering it. Subtle shadings of meaningshifts, more dramatic reframing of the meaning of behaviour, and emphasis onspecific aspects of the client's message are all important themes evidenced bytherapists to help clients construct new understandings of their experiences.These might be achieved through positive connotation, reframing, roleplaying,feedforward, or framing to name a few techniques.In the following exemplars, meanings are reconstructed throughreframing and role playing. Reframing reworks the clients' perceived initialmeaning for certain behaviours giving them new labels and a positive valence.Friesen et al (1987) noted that the new frame also brings an "array of relatedthoughts and feelings" (p. 60). This has a parallel with Gale's (1991) elaboration ofO'Hanlon's reformulation procedure or "summarizing with a twist" "whichtransforms the facts of a previous assertion into something different", thusproviding "a new meaning that would be more suitable to achieving his agenda"(p. 81).Therapists role playing the clients' dilemmas serves a modelling function.It allows clients to observe someone else communicating their thoughts andsecret emotions openly, safely, and non-judgementally with their partner. Theycan also interact with the therapist playing the partner, imagine being thepartner, and gain insight into his/her experiences. This is somewhat related toO'Hanlon's style of Posing Questions or Possible Problems and then Answeringthese Questions Himself, though the latter style allows less input from clients.Exemplars and deviant examples of this theme will be provided in the followingdiscussion.Exemplars of Constructivist/Meaning Shift Theme These excerpts demonstrate how the therapist can redirect the focus ofclients' anger, demarcate relational novelty, and guide framing questions in apositive light.First exemplar of constructivist/meaning shift theme.  In this piece, thewife used a metaphor to represent her outrage at her husband for not speaking ofor apologizing for the affair. Several aspects of the wife's talk indicated her rageConversation Analysis 91including the increased volume, emphasized words, few and short pauses, andrapid speech. In reframing the situation using the word 'understand' thetherapist directed attention away from blaming the husband toward the wife'shatred and disgust for the girlfriend. She also framed the girlfriend as the activeagent who came between the spouses. The wife agreed with the summary andbegan to focus her ire toward the girlfriend.500 W: =NO (.5) HUSBAND ((gestures R hand toward H)) hasn'tapologized you know i it he's the one who was lying tome (.5) about everything that was going on and thatreally hurts (2) It's like the kids standing there takingmoney out of my wallet and saying that they didn't do it(.5) you know and yet they're standing there ((strokeshair once with R hand)) with ((holds fists up to level ofhead and shakes them)) two fist fulls of candy (1) andthey they've got all this candy and you're saying well>where'd you get the money from< (.5) and they're510 	 saying (Oh well) Mom (1) >and then a couple of hourslater they come up and say Mommy I'm sorry I took itout of my wallet then I then I can turn around and talkto them about it (1) But I still ((gestures to H with Rarm)) can't talk to 'im about it <because he refuses toacknowledge that it actually went on!T: 	 So you would like I hear you saying I want an apol'W: 	 (I'd loveT: 	 I want to understand you better and I want I feel that I520 	 deserve and apology (1) ((W stokes hair several timeswith R hand)) from you for what went on (2) between youand G (1.5) and I hear you sayin' (1) G I really hate youand I am disW: 	 (Oh yeahH: 	 ((continues to use L hand to toy with R foot))T: 	 disgusted by what you've done the way you've comebetween me and my husband.W: ((regularly nods head slightly and looks at T)) *Mhm*530 	 >'cause if I saw her on the street I wouldn't hesitate toget out of the car and beat her up< (2) I really wouldn't.532 	 because that's the way I feel right now!Second exemplar of constructivist/meaning shift theme.  This sampleshowed the use of open-ended questions about emotions, role playing, andcoaching. The wife's perceived meaning of the couple's current interaction wasshifted subtly by the therapist's choice of phrases. Examples included"acknowledging", "right now", and "you feel important to me", all of whichpositively connoted relational novelty and mitigated blame on the husband. TheConversation Analysis 92husband's use of faster speech, animated tone and louder speech indicated hisengagement with the discussion. The wife's overlapping talk showed hercontinued tension in this interaction. She later came to believe his concern forher.703 W: You don't you're not stopping to think of how I see it((holds R foot upwards)).T: OKW: 	 It hurts.T: 	 OK. (7) ((goes over to H's L side)) *Now what do you feel*What is your experience ((points to heart then W looks atH)) (that you are feeling) as you hear it?710 H:	 Well I didn't know it was that important to ya'(2.5) If it'sthat important to you I'll get rid of it.T: 	 II OK so I am acknowledging (1) ((R hand raised, Lhand draws circles near heart)) how it hurts you.H: Yeah, sure >I I didn't know it was that important (1) Imean I happen to like those pictures in the book I mean(but there's to)< NO SYMBOLIC VALUE TO ME WHATSO EVER.W: ((wipes eyes and wiggles R foot))T: 	 *OK* and tell I want you to tell W (1) W are you there are720 	 you listening to me?W: 	 [Yeah I'm listening. ((holds R foot upstationary))T: 	 ((both hands gesture near heart)) Do you hear that I amkind I am I never knew ((W lowers L foot)) howimportant this was to you?.W: =He didn't you didn't listen when I was telling you howimportant it was to me.T: 	 Right now? You feel (important) to me?730W: 	 [Before.T: 	 Right now I'm listening.=W: =Yeah I'm listening now=T: 	 =Right now I have listened to you W (1) and I'mrealizing how important it is to you. (2.5) It it's ((looks toH then back at W)) important to me what's goin' on rightnow for me (1) ((looks to H)) I want you to ( about givingup th' book).H: 	 I'll give it up first thing in the morning (1) (	 ) it740		 obviously hurts with me to keep it so I'll get rid of it!W: ((wipes eyes and waves R foot from side to side))T: 	 It hurts you?H: 	 It hurts W that I have it=T: 	 =So and=H: 	 =and that upsets me so I'll get rid of it!T: 	 It upsets me to see you hurt.H: 	 Aye that's right. (.5) >I didn't think it was thatimportant.<Conversation Analysis 93	T:	 I never thought that it was important. *Now what does750 	 it mean to see her hurt* tell her.	H: 	 *( I don't know 	 )* (6) It does >I mean I don't like tosee her hurt< (.5) she's my wife.	T: 	 She's your my wife what else (2.5) so it upsets me to seeyou hurt=H: =Mmhm=T: =because you're my wife=757 H: =Mmhm=Third exemplar of constructivist/meaning shift theme.  Reframing of anissue by role playing and coaching occurred when the therapist helped the wifecreate a question with two answers. Each answer positively connoted thehusband's motivation for giving up the book. In this way the wife's doubt andcriticism was circumvented and she appreciated her husband's caring response.This technique is related to Gale's (1991) explanation of O'Hanlon's Offering aCandidate Answer.	789 W: 	 [are790 	 you getting rid of it because we're discussing it now=	H: 	 ((touches R forehead))	T: 	 =or or=W: =or because you really want to?	T:	 You see because you see its meaningful for you to give itup (1) because you care for me and our marriage (1) isthat what ya that's what you want to know.[	W: 	 [Ye:ah ((faces H))	T: 	 I want you to ask him over again ( 	 )800 W: Are you are you gonna give are you giving it up (2)because its (5.5) (hhh) (.hhh) because its you don't careabout it (1) and our marriage is more important or areyou just giving it up because it bothers me?T: 	 and you care for me (1.5) you care about my feelings.W: and you care about my feelings yeah. ((raises R foot))	H: 	 ((leans away from W, nods looks at W)) I'm givin' it upbecause I care about your feelings and its obviously808 	 meaningful to you so I'm gonna give it I'll get rid of it.Deviant Example of Constructivist/Meaning Shift Theme.  This example offers aninstance in which the therapist attempted to shift the meaning to highlight thewife's constant thoughts of the affair in contrast to the husband wanting to forgetit. The wife did not concur with the therapist's contention.	476 W:	 I still she still it's still something (.5) I just know thatthere's there's st so'Conversation Analysis 94T: 	 [I almost feels like she's closer to you than (.5) to480 	 I-I=W: 	 .*Well I sort of looked like it was in the middle*.T: 	 Yeah (W: 	 [( 	 ) (.5) It's the middle to me (2.5)1 don'tknow but just (1) the what went on and I've got the lies486 	 that went with it really bothered me (.5) and it it still doesClients' development of new perceptions of meaning for their behaviours isa central part of healing their differences and transforming them intounderstanding. The exemplars showed how the therapist helped the clients toreconstruct their views of instigator of the affair, the husband's attentiveness tohis wife, and the husband's caring for his wife. The deviant example gave aninstance in which the client disagreed with the therapist's proposed meaningshift. Therapist empathy will be described in the next section.Therapist EmpathyEmpathy, the ninth theme and an important aspect of every form oftherapy, was particularly evident in this session. Egan (1986) defined empathy asbeing moved by another's emotional state, being able to understand their "point ofview" or "role" (p. 95), and communicating this knowledge to the client.Primary empathy links emotions with experiences. Advanced empathy, asdescribed by Egan (1986), proposes deeper meanings of the experiences by giving"expression to what the client only implies", "identifying themes", connectingissues, "helping clients draw conclusions from premises" , and statingconcretely" what has been stated "vaguely" (p. 214-218). Next, exemplars anddeviant examples of empathy will be provided.Exemplars of Therapist Empathy Theme At the beginning of the session both the husband and wife seemed self-protective. They later opened up to the therapist partly as a result of her showingunderstanding of their emotions and motivations through empathy. Theseexemplars will demonstrate this process.First exemplar of therapist empathy theme. In this piece, the therapistreflected the wife's wish for an apology and helped the client intensify heremotions by using strong words such as hate and disgust. The wife respondedaffirmatively, indicating her intensity by speaking quickly and excitedlyoverlapping her talk with the therapists.Conversation Analysis 95	516 T: 	 So you would like I hear you saying I want an apol'	W: 	 [I'd love	T: 	 I want to understand you better and I want I feel that I520 	 deserve and apology (1) ((W stokes hair several timeswith R hand)) from you for what went on (2) between youand G (1.5) and I hear you sayin' (1) G I really hate youand I am dis	W: 	 [Oh yeah	H: 	 ((continues to use L hand to toy with R foot))	T: 	 disgusted by what you've done the way you've comebetween me and my husband.W: ((regularly nods head slightly and looks at T)) *Ml*530 >'cause if I saw her on the street I wouldn't hesitate toget out of the car and beat her up< (2) I really wouldn'tbecause that's the way I feel right now!	T: 	 *OK*Second exemplar of therapist empathy theme.  In this quote, the therapistwas quick to leave her previous examination of desired state symbols anddemonstrate her empathy with the husband about the summons. The husbandemphasized certain words to show the depth of his feeling. The therapistvalidated his pain, highlighted their importance as equal and parallel to thewife's, and emphasized the words "important" and "betrayed".	966 H: 	 I wasn't thinkin' about that I was thinking aboutsomething else that happened (2) I was thinking aboutsomething else that she did to hurt me (1) I wasn'tthinking about when she was talking about her I was970		 thinking about something else that hurt me (1) and Iwas to I was off I drifted off.	W: 	 ((wipes eyes))	T:	 So you were in contact with your own pain.	H: 	 And I drifted off.T: 	 Yeah (.5) So you removed yourself from W's pain andwent into your own pain.H: Yeah I started to thinking you know and I think she saidthat really hurt me when you did this (1) and I was bein'a bit selfish and I said well ah it really hurt me when980 	 you did this (2.5) you know andT: 	 And your hurt is (.5) is very important ((both now haveheads lowered))H: MmmhmmT: 	 because W's hurt (1) and betrayal the way she's beenbetrayed is very important and your hurt is also very986 	 important.Conversation Analysis 96Deviant Example of Therapist Empathy ThemeIn this instance, the client's responses seemed to require more directempathic statements than voiced by the therapist. By echoing his comments, sheintended to guide the husband to communicate the depth of his emotions to hiswife. It seemed that the husband found it difficult to identify or express his deeperreactions and was close to tears and so was silent.	742 T: 	 It hurts you?	H: 	 It hurts W that I have it=	T: 	 =So and=	H: 	 =and that upsets me so I'll get rid of it!	T: 	 It upsets me to see you hurt.	H: 	 Aye that's right. (.5) >I didn't think it was thatimportant.<	T: 	 I never thought that it was important. *Now what does750 	 it mean to see her hurt* tell her.	H: 	 *( I don't know 	 )* (6) It does >I mean I don't like tosee her hurt< (.5) she's my wife.	T: 	 She's your my wife what else (2.5) so it upsets me to seeyou hurt=H: =Mmhm=T: =because you're my wife=H: =Mmhm=	T: 	 =because	759 H: 	 ((wipes eyes, places hands in lap, legs crossed)) (hhh)The therapist demonstrated empathy on many occasions throughsummary or through role playing and only a few of these instances have beenquoted here. This empathy allowed the clients to feel heard and understood. Inthe exemplars, the therapist's empathic responses served to intensify the wife'srage at the girlfriend and to validate the husband's pain about the summons. Thedeviant example gave details of a rare instance in which the therapist achievedless empathic effect than the husband needed. The related topic of therapistgenuiness will next be addressed.Therapist GenuinenessThe tenth theme emergent from this analysis was that of therapistgenuineness. Therapists constantly monitor both their own and clients'emotional, behavioural, and cognitive reactions within the therapeutic system.In being genuine or authentic with their clients, they need to occasionally givevoice to their inner process. As Rogers and Truax (1967) have described, "thetherapist is what he (sic) is, during the encounter . . . . openly being the feelingsand attitudes which at the moment are flowing in him (sic)". He or she "comesConversation Analysis 97into a direct personal encounter with his (sic) client, meeting him (sic) on aperson-to person basis . . . . being himself (sic) not denying himself (sic)" (p. 101).This self-disclosure is done in the spirit of respect for clients' needs and feelings.Exemplars and negative examples of genuiness in this session will be given.Exemplars of Therapist Genuineness ThemeThe following exemplars involve the therapist revealing her reaction to the"love note", and the husband sharing his feelings and listening during thesession.First exemplar of therapist eenuinRness theme.  In this quote, the therapistemphasized key words as she self-disclosed that she would be "very hurt" if herhusband had received a "love note" from a woman. The effect of this informationon the husband was shown by his movements, hesitant speech, and denial of thenote's import. This disclosure also resulted in the wife later revealing her hurt.629 T: =Is that a love note to you?630 H: Yeah. ((small nod and looks to W))T: (hhh) *I would be very hurt if I were you're wife.*((looks back and forth to H and W))H: I'd ((shakes head several times, looks at W glances at T))(1) I don't read i' it's just the book I care 'cause I only g'got the book back recently. (1.5)1 get th' the book wasgiven back to G and then she brought it back to where I637 work.Second exemplar of therapist genuineness theme. Debriefing the session,the therapist noted her positive reaction to the husband listening to his wife, andto his inner experience. The therapist voiced being "impressed" with the couple"being real" as the wife had earlier requested. The wife's nodding indicated thatshe concurred. The therapist emphasized many key words and made severalmoderate pauses. She reiterated her choice to move to the wife in the sculpt.	1804 T: 	 =((to W)) Yes I feel that today ah you were very real withyour feelings (1) and I'm very impressed that youbecame close to yom (1) to who you are (2) and eh (1) ((toH)) I am really impressed by (2) by you listening to (1.5)to your wife (1.5) and eh at times listening to you  and uh[	1810 H: 	 [Mhm=T: =but really listening to her heart (1.5) rather than eh((W scratches R hip)) to other things that's th th's toreally her heart and how her pain (1.5) and being real with one another I was really impressed with how (1)how real you became with one another an' with nie (1) soConversation Analysis 98that you were very real ((W nods)) (and I hear this)whv'd you going there! 	H:	 ((laughs, scratches L arm))	W: 	 ((tips head to T))	1820 T:	 you got mad with me!=H: Mmmhmm	T: 	 But I wanted to be beside your wife I really wanted to bebeside her (.hhh) (5.5) So how is anything that you'd like1824 	 to share?Deviant Example of Therapist Genuineness Theme. This is the only example ofthe therapist self-disclosing in a manner which was less gentle. The hint ofanger shown by her use of emphasis and choice of words, put the husbandtemporarily into a defensive stance. He assumed several postures, and seldompaused as he spoke.	1524 T: 	 *Yes* (5.5) I's gone.H: Mmhm	T: 	 (Yeah but) how is that for you?	H: 	 I's not a problem.	T:	 No.	H: 	 No not not a problem at all. ((shakes head))1530 T: 	 An' when you say it's not a problem I have no idea whatYou mean.	H:	 ((spreads arms wide, crosses arms on chest then putsthem behind head)) It's not a problem I don't it's the way(.hhh) (hhh) (.5) the book was only important to mebecause I ((W looks at H)) l' liked the pictures in the book(.5) not by whom ((W lowers head again)) bought it forme or anything else (1) So it wasn't a problem destroyin'that uh the book or anything else but the book that upsetW (1.5) (hhh) ((W raises head)) So it wasn't a problem.1540 T: 	 OK.	H: 	 I's just a problem that I have to destroy somethink sobeautiful.T: 	 Yeah (hhh) ((H lowers arms)) now do you feel like (1.5)1544 	 (doing the) ((W lowers head))Congruence or genuineness allows the therapist-client relationship to bebuilt on honesty and intimacy which encourage client growth. This was evidentin the above exemplars which served to support the husband's understanding ofhis wife's hurt feelings, and to encourage him to continue to listen and expresshis own emotions. The deviant example demonstrated an ineffective case of self-disclosure. The next section will attend to collaboration between therapist andclients.Conversation Analysis 99CollaborationThe eleventh theme is of collaboration between members of the therapeuticsystem in joint responsibility for process and outcome. Collaboration was integralto this session, and was noted by several theorists. May (1975) stated thatpsychotherapy involves collaboration between therapist and clients in exploringclients' awareness of selves and others. Peyrot (1987) held that the "client andcounselor collaborate in developing a new definition of the client's situation whichincorporates the input of the counselor" (p. 249).Practitioners of ExST demonstrate their collaborative approach in manycircumstances. They often have an impression which they wish to confirm. Aswell, they might suspect that clients need to address and intensify an issue ratherthan avoid it. In other cases, therapists may wish to emphasize aspects of clients'interpretations of events to give them new light. ExST therapists address each ofthese intentions by sharing joint responsibility with clients for the direction theconversation takes.This joint responsibility contrasts with the stances taken in O'Hanlon'ssolution-oriented therapy and in Ellis' rational emotive therapy (RET).O'Hanlon's greater tenacity and directiveness is evident in his theme of Pursuinga Response Over Many Turns. As Gale (1991) described this intervention,O'Hanlon "repeats this request many times throughout the session" (p.79) untilhe receives the desired client response. Similarly collaborative therapists do nottake an expert position relative to their clients as is done in cognitive approachessuch as RET which Corey (1986) described as "very directive" (p. 209). Thecollaborative theme will be supported by exemplars and deviant examples.Exemplars of Collaboration Theme Collaboration can take many forms which embody joint responsibility by thetherapist and clients for the direction and outcome of therapy. These exemplarsshow collaborative interactions in generating options, debriefing the deception inthe affair, and achieving consensus about desired state metaphors.First exemplar of collaboration theme. In this sample, the therapist guidedthe couple in taking time to explore and modify options, rather than fighting orforeclosing on the first idea. To achieve consensus, the therapist frequently askedquestions and summarized while the couple lead the discourse. In this process,the wife conceded a point very important for the husband, that the book be givenaway rather than destroyed.1192 W: I wanna see it burnConversation Analysis 100	T: 	 OK (.5) ((to H)) How would you like to see that go away(1) disappear.	H: 	 I don't mind burnin' them (1) ((looks at both W and T))The basket's no problem burnin' the basket its s' ashame to destroy some a that pretty pictures underneaththem birds ehh	T: 	 A'right (.5) So you're hurting for the birds.	1200 H: 	 Oh yeah the birds=	T: 	 =Your thinking of the birds.	H: 	 Yeah the pretty birds its a pity=	T: 	 =Pretty birds.[	H: 	 [just to burn 'em (.5) that'd be a shame( 	 best).T: Yeah	W: 	 Let's leave it to somebody else.	H: 	 Yeah we'll we'll do that that >why don't we just rip the1210		 page out and give it to the library <(3) ((gestures outwardwith L hand)) or give it to a school=	T:	 =OK eh cut the pictures and give them to the school?	H: 	 Cut the the the note ((motions L hand)) of the front.W: And burn it.	H: 	 And burn it (.5) burn the note ((broad gesture to L)) burnthe note (.5) ((repeats)) give the book to the school.((lowers L hand))	T: 	 OK to one of the schools (.5) whichever school that youthink needs books that in your area.1220 W: Let the children enjoy it.	H: 	 That's it why not let the children enjoy it ((motions toW)) it's a beautiful book.	T: 	 So you've burned the front page is that[	1226 H: 	 ['s no problem((repeats gesture))second exemplar of collaboration theme.  This quote involved jointresponsibility for the topic focus. At first, the therapist shifted the wife'sdiscussion away from blaming her spouse and toward letting go of the affair inthe ritual. When the couple returned to the topic of deception, the therapistsupported their choice to debrief, build trust, and bring closure to this issue.	1562 W:	 This basket's lied alot a lies (	 )	H: 	 ((laughs quietly)) (hhh)W: I think you know (what all the lies are talking) about(4.5) of how she got into the apartment and how the bathwas drawn and ((lifts head and looks at H))H: 	 No I actually didn't know about that (.5) That was a quitea surprise to me.	W: 	 0:h. (1) She had keys. ((lowers head))Conversation Analysis 101	1570 T: 	 Do you wanna' burn the the basket or do you feel like 11.W: No H didn't didn't find the basket I did. (1) I found thebasket.	T: 	 So you wanna burn it=W: .((looks at T)) So I wanna burn it.H: Yeah she knew about the basket before I did.T: Mmhm	H: 	 'Cause it was left in my apartment for me[	T: 	 (Mmhm	1580 H: 	 And balloons on the front porch ((quick look at W, T))W: Oh yes (.5) the balloons on the front porch and the (va')hot tub drawn. (2) ((looks down while H looks at her)) Allthe rest (	) an' the car parked discreetly ((H looksdown)) in the carpark (2) All on "holiday" the day wewere going to spend together (.5) ((W looks at H then T))well the day we did spend together after she ran out ofthe apartment frightened by me (.5) ((W looks down)) *toofrightened to face me*.	H: 	 ((looks at W)) You you got to admit you know it'd be1590 	 pretty stupid it would've been very stupid of me to inviteyou around "holiday" if I'd knew she was going to bethere wouldn't it. (1) Pretty dumb, right? (1.5) So I didn'tknow she was (still around)!W: (Yeah how about the car)[	H: 	 [(Ah) ((quickly lifts L arm to R shoulder, Rhand cutting motion to neck))W: ((looks at H and laughs))	T: 	 Th' (hhh).	1600 H: 	 =No way I'm gonna I worried (about it you know) thatwould be a terrible thing for me to do.W: But the lies went along with it when I said how did sheget in (1) This is what the basket symbolizes all thosehorrible lies.[	H: 	 [Give it1607 	 here 'en. ((brings over candle, lights basket))Third exemplar of collaboration theme.  In this example, the therapistattempted to achieve consensus about the wife's suggested desired statemetaphor. The husband, as described by Levinson (1983), used a delay, a pre-sequence, an account, and a politely tentative disagreement. Including thisinput, the therapist repaired her statement. The wife more directly contested thesummary by restating her phrase with emphasis, and without the tentativefeatures of negation. Later, the therapist again repaired the statement to satisfyboth partners.Conversation Analysis 102	1713 T: 	 *Yeah (.5) I like that new beginnings.* and I I'mwondering how does that feel for you? How does it feel?H: Mmm n'quite.	T: 	 Quiet?	H: 	 Not quite.	T: 	 Oh not quite.	H: 	 Not quite. ((leans back))	1720 T:	 ((leans back)) When I when I picture your your (3) ((bothhands at head height)) the eagle goin' away (1) leavin'(1.5) ((R hand to R, forward)) with the basket (2) I wasleft (2) ((shakes both hands)) with the (2) clear (2) I wasleft with the (4) clear sky (2) ((both hands in circle, backto lap)) and I was left with where there is somethinglike a clear sky an the English that come's to me is (1)((shakes hands)) many opportunities ((shakes hands)) Idon't know I can't don't ask me why because thesethings don't have explanation1730 W: New beginnings (and that's for there's).Deviant Examples of Collaboration ThemeThese two occasions involved the members of the therapeutic systemcompeting for leadership in determining the topic of discourse rather thancollaborating.First deviant example of collaboration theme.  The therapist had littlesuccess in achieving collaboration in this segment. Her reframe of reciprocalhurt as "sharing a secret" was disconfirmed by the husband, while the wife wassilent. The therapist did not invite further elaboration despite the husband's twoattempts to overlap her talk. Instead she shifted the topic back to a ceremonialburning.	1129 T: 	 So there has been alot of hurt=1130 W: =YeahT: 	 alot of hurt on both (1) ((W leans head to T)) both and (.5)and I'm aware that (1) that H you have shared a secretwith W right now ((W's L hand toys with hair, she looksunder L side of chair and leans body to T)) (1) one of thesecrets that was in the box. (3) Right?H: Actually it was on my mind yesterday and I mentioned ityesterdayT: 	 Yeah yeah	1140 H: 	 (but ahT: 	 So that is hurt. (1) Now I kind of want to finish before wemove into the envelope.H: 	 (MmmT: 	 I want to (5.5) I want to (2) symbolically (3.5) I don'tknow if you feel ready and I want you to be honest withConversation Analysis 103your heart (1) ((nods to both)) you feel ready to (.5) to ittgo and to have a ceremony (.5) ((H scratches L arm))symbolizing the letting go of the book and (1.5) and the1150 	 basket.Second deviant example of collaboration theme. In this quote, the wifedescribed the session as good, yet again noted her husband's inattentiveness toher feelings. Receiving no response, the wife softened her conviction by sayingshe expected him to improve. The therapist affirmed this expectation and thehusband concurred, gesturing expansively. The therapist then summarized thepositive changes in the session. Despite this optimism, the husband later againaddressed his own lack of attentiveness. These conflicting topics indicated that themembers were competing for leadership in this part of the session rather thatcollaborating.1791 W: 	 The session was good. (1) I realize that he doesn't listento me when I'm speaking (1.5) more than ever.T: 	 Pardon?.W: =He doesn't listen to me about or or ((gestures R hand toheart)) feel my feelings (1) I realize that (1) I was hopingthat he wouldH: 	 ((scratches R side of face))T: MmhmW: that he'd 'na maybe he'll understand now.1800 T:	 Yeah.W: more.T: 	 I feel=H: 	 =It's done.= ((L arm outstretched, gestures to W))T: 	 =((to W)) Yes I feel that today ah you were very real withyour feelings (1) and I'm very impressed that youbecame close to y_oL.0 (1) to who you are (2) and eh (1) ((toH)) I am really impressed by (2) by you listening to (1.5)1808 	 to your wife (1.5) and eh at times listening to you and uhCollaboration is a central theme of this session which is expressed in theabove exemplars of brainstorming, debriefing, and achieving consensus. Itexists, on the part of the therapist, in a basic view of clients as an equal partnerson the journey toward growth. In the best possible scenario the clients therebyadopt this philosophy in their dealings with each other. The negative examplesprovided quotes of occasions which were less successful collaboratively. The finaltheme to be elaborated is that of therapist artistry.Conversation Analysis 104Therapist ArtistryThis session offered several instances in which the therapist used thetwelfth theme of artistic creativity. In this way, she engaged the clients in adrama and helped them to visualize their goals. Evidence of this creativity can befound especially in the symbolization, experiential, externalization, andintensification sections. Visions and experiences combined to create and anchornovel impressions and interactive styles in the clients.This therapist's orientation toward visual imagination, artistry and actingmade this session a memorable experience for the participants and the reader.Such an approach is supported by Jung (1964), who stated "as the mind exploresthe symbol, it is led to ideas that lie beyond the grasp of reason" (p. 21).The artistic nature of this therapy contrasts with several cognitiveapproaches which seek to document behaviour, ask clients to plan each stage ofthe desired behavioural changes, and view the therapist as a scientist. Followingthese models, the therapist might have debated with the clients about theirerroneous cognitions in the style of Ellis' RET. Alternately, in using behaviouralmarital therapy, the therapist might have them reward each other with changesin behaviour (Corey, 1986). To support the theme of therapist artistry which wasused, two exemplars and one deviant example will be provided.Exemplars of Therapist Artistry ThemeIn the first exemplar, the therapist's acting skills served to exacerbate thetension between the spouses, and to later elicit solutions. The second exemplardemonstrated how the therapist painted an imaginary symbolic picture of hopefor the clients.First exemplar of therapist artistry theme. This quote showed the wife'sexperience of the girlfriend's symbolic presence. This was indicated by the wife'stalk, actions, ridiculing laughter, and animated tone. It echoed mention, in anearlier session, of her ultimatum to the husband to end the affair. The therapistincreased the tension by reverently handing the husband's possessions to him.469 W: ((rises and pulls chair between self and husband)) I'm470 	 taking your box and your wallet! ((laughs with ridicule))H: 	 ((places wallet in box and throws on table to R))T: 	 ((rises and brings tissue box to H, kneels and places itwith wallet)) But this is yours (	) your box your boxcan stay this is a part of you very precious andimportant.W: 	 I still she still it's still something (.5) I just know that477 	 there's there's st' so'Conversation Analysis 105Second exemplar of therapist artistry theme.  This quote offered a beautiful,solemn picture of hope for the couple as the therapist drew a mental picture of theclients' symbols. Gestures, laughter, emphasis of words, and moderate pausesadded to the effect.1732 T: 	 [When when the eagle left (1) ((handsabove head, R highest and forward)) when the eaglewent with the basket (1) in it's beak for some reason Idon't know why (2) ((laughs, R hand high circle)) eh (2) Iwas left ((circles again)) with just the clear sky blau((vibrates hands)) blue bright blue strong sky (1) that thatwas the image ((moves hands alternately)) that I whenyou described that image of of (2) ((hands to lap)) of eh (2)1740 	 the eagle gone (2) and eh but I want (1.5) I want to invite1742 	 you out of this experience to bring your symbols nextweek.Deviant Example of Therapist Artistry Theme  In this segment, the therapistattempted to clarify, with the laconic husband, his perceived meaning of theeagles for himself and his marital relationship. The therapist's goal seemed tohave been to permit him to keep the birds as a liberating symbol of freedom. Thehusband took the therapist to be dictating how he should view the symbol.1480 T: 	 No you're not destroyin' the birds (.5) no.W: 	 [Not the birdsH: 	 I'm just gettin' rid of th' the book.T: 	 Yes.H: 	 (Fine). ((nods and shakes book in R hand)) =T: 	 =Yes.=H: 	 =Fine. ((leans back, nods, moves R hand quickly away))T: 	 [You're not destroyin' the birds The birds are in1490 	 your heart.H: 	 Fine then that's no problem. ((leans forward))T: 	 [becauseH: 	 No problem (to me).T: 	 [because the birds do not come in between you and W.H: 	 Fine.T: 	 The birds do not come in between you and W do they?H: 	 No. ((looks to W))1500T: 	 [The birds are a part of your heart an' the birds are nothurtin' W (.5) right?Conversation Analysis 106	H: 	 [(Yes the that's) no problem. ((nodstwice))	T: 	 (See) (1.5) It's the meaning of the book	H: 	 [It's (.5) the book ((nods)) the book not	1510 T: 	 [yes.	1511 H: 	 the birds, right? (.5) I's gone! ((lights book on candle))The theme of therapist artistry, which appears throughout the session, hasbeen highlighted in the exemplars of her acting skills to dramatize the issues,and in her ability to paint an optimistic verbal picture. The negative exemplarshowed the use of visual metaphor with less fluidity, and resulted in amisunderstanding by the client.In this chapter, twelve themes which emerged from the analysis of thetranscribed session's conversation were examined in detail, discussed, andsupported with exemplars and deviant examples. They were the ritualization,personal and family myths, symbolization, experiential, externalization,intensification of experience, contextual/systemic, constructivist/meaning shift,therapist empathy, therapist genuiness, collaboration, and therapist artistrythemes. Each theme provided a characteristic which contributed to the success ofthe session. The next portion of this chapter will discuss assumptions andlimitations of the study.Assumptions and LimitationsSeveral points regarding assumptions and limitations will be addressed.These relate to the representativeness of the therapist and client participants,sampling issues, the effects of videotaping, the effects of the researchersacquaintance with the research project and with the therapist and herprofessional use of ExST, and possible biases introduced into the analysis by priortheoretical knowledge.Hopefully the session chosen for detailed study will be somewhatrepresentative of other sessions with therapists and clients of different gender,sexual orientation, colour, age, ethnicity and culture; though these assumptionscannot be accepted with complete confidence.The external validity of this study is limited by lack of random samplingand by the small sample size. Replication of this study or reanalysis of the data byanother researcher might increase confidence in the results.Conversation Analysis 107The internal validity of this study may be challenged on several fronts.Clients may respond unnaturally to being videotaped, though hopefully theywould have been accustomed to it when this session was taped.Researcher biases might also affect the internal validity. It should be notedthat this researcher has been involved with the initial production of the largerstudy's procedures manual, and consequently is acquainted with the therapistwhose work is studied. As well, the researcher utilizes ExST techniquesprofessionally.It could be argued from a traditional objective research stance that theseinvolvements pose a conflict of interest with her role as researcher, and hencecompromise her impartiality. Yet current trends especially in ethnographicresearch, noted by Lecourt (1975), suggest that complete control over such effectsis not possible, and emphasize the inherent interrelationship between theparticipant and researcher.The researcher believes, as do many feminists and ethnographicresearchers, that the above described relationships to the data have afforded her afuller understanding of the therapeutic intentions of the larger research projectand allowed more in-depth interpretation of the particular session selected fordetailed study. Some scholars (Peters & Robinson, 1984; Lather, 1984) nowrecommend that the researcher disclose any biases so that the reader can beaware of their influence on the published result.It is also possible that the having reviewed the literature on CA wouldinfluence the choice of analytical categories, also affecting internal validity.Hopefully, as in Gale's analysis, the thorough checking and rechecking ofexemplars against the categories they represent should serve to strengthen theinternal validity.Finally, Stacey (1988) noted that the choice of CA as a research tool, likemany current ethnographic techniques, is congruent with contemporary feministresearch in that each movement considers experience to be central to its premise.All these stances are deeply subjective and phenomenological, rather thanobjective as traditionally positivist approaches have aspired to be. In eachapproach, the personal experiences of the participants and researcher are vital tothe process of change and learning. Although theories previously studied by theresearcher cannot be unlearned when approaching an issue, it is best to set asideframes of reference so that the data can be seen from a fresh perspective. AsStacey (1988) had stated, the author of the research product, being the arbiter of itscontent, must therefore paradoxically maintain an approach of partiality in usingConversation Analysis 108a post- modern method. The next section will discuss resommendations arisingfrom the above discussion.RecommendationsSince the application of the CA method to therapeutic encounters is so new,several suggestions will be provided. It would be useful for other researchers toengage in related investigations. These might vary by looking at the work of othertherapists, studying different schools of couples therapy, examining ritualsdesigned for other types of presenting problems, focusing on other ExST sessions,attending to other client populations, or highlighting other family constellations.The CA technique might also reveal interesting information about thecharacteristics and the process of change in individual therapy.Another area of interest might involve more than one researcher analyzingthe same videotaped data. They could both use the CA method, or compareanother ethnographic technique to the use of CA. The results of the twoinvestigations could augment each other to provide a fuller picture of thetherapeutic conversation and its meaning for the participants. As an example,the data used for this study could be again examined by another investigator.The researchers would also be advised to express, in their final documents,their experiential biases and views of the topic under study. As well, they shouldtake care to devote enough time to the analysis and reanalysis of the themes,exemplars and deviant examples emergent from the data to ensure their validity.Finally, the session chosen for study should be selected with care asrepresentative of the style of therapy to be addressed. Ideally it should be part of aseries of sessions. It should be chosen after the participants have developedsufficient trust in each other, and comfort with being recorded, to enhance thedata's validity. It would be useful to have various experts rate the session'squality according to the parameters of the school of therapy studied. Thefollowing section will address ideas for clinicians regarding ExST and rituals intherapy.Application to CliniciansSuggestions for clinicians include those related to the use of the themeswhich emerged from this study and to the application of rituals to therapy.Learning from the ThemesTherapists might consider incorporating the spirit of the themes foundhere into their relationships with clients. Using the exemplars discussed aboveConversation Analysis 109as a guide, the themes of ritualization, personal and family myths, symbolization,experiential, externalization, intensification of experience, contextual/systemic,constructivist/meaning shift, therapist empathy, therapist genuineness,collaboration, and therapist artistry can be understood.One example of application of a theme is that of collaboration. ExST helpsto transform old patterns, in this case of hostility, anger, and attack on the part ofthe wife and of avoidance, guilt and defensiveness on the part of the husband, intonew nurturing patterns. The clients led the movement toward this change withsome guidance from the therapist. This aspect of ExST differs from O'Hanlon'sSolution-Oriented therapy and from everyday conversation in that, when arequested response is not received, therapists will not usually press so long for itsproduction, nor will they direct the conversation so frequently.Another theme through which change is effected is through intensificationof clients' status quo which gives way to novel experiences. In this way, thecouple broke out of old patterns and created alternative ways of being inrelationship which are self-replicating. This theme stands in contrast toO'Hanlon's focus on correcting the client's thinking and directing theconversation toward solutions.Using Rituals in TherapySeveral issues are related to the use of ritualization in therapy. First,therapists can be aware of the characteristics of the ritual stages, and engage inthem with solemnity and belief in positive change. Therapy sessions in generalwould be best characterized by setting apart a time for the clients in a privatesetting with no interruptions. Second, clients ideally have symbols emerge fromtheir own experience as Cooper (1987) has described. Third, rituals might becollaboratively designed by all members of the therapeutic system. Fourth,therapists can help clients to process their emotions thoroughly as they enact theceremony.From time to time, as issues suggest them, specific therapeutic ritualencounters can be planned. Clients will often be prepared for such ceremoniesafter trust and rapport has been established with the therapist following severalsessions. Some rituals are meant to honour, consecrate or bid farewell to asymbol of a beloved person, relationship, or experience. Others serve the purpose,for example, of distancing from, exculpating, or destroying a symbol of a painfulexperience, symptom, relationship, or experience.Therapeutic ceremonial transactions can take on many forms ofexpression. Ideas for forms of ritual enactment include manipulatingConversation Analysis 110metaphoric symbols by creating a monument, making commitments, burying,destroying, setting adrift on water, or, in this case, burning. The possible modesof ceremonial expression are limitless, and are best developed collaboratively byclients and therapists.An infinite number of other uses of rituals can likely be devised for variousother purposes using the combined input of clients and therapists. 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Family Process, 2,1( 3 ) , 401-419.Conversation Analysis 119APPENDIX ATRANSCRIPT NOTATION(.5) 	 A pause timed in half seconds.= 	 There is no discernable pause between the end of a speaker'sutterance and the stare of the next utterance.One or more colons indicate an extension of the precedingvowel sound.Under 	Underlining indicates words that were uttered with addedemphasis.CAPITAL 	 Words in capitals are uttered louder than the surroundingtalk.(.hhh) 	 Exhale of breath.(hhh) 	 Inhale of breath.( 	 ) 	 Material in parentheses are inaudible or there is doubt ofaccuracy.[ 	 Overlap of talk.(( 	 )) 	 Double parentheses indicate clarificatory information eg.((laughter)) or other nonverbal communication such as((moved toward spouse))?	 Indicates an rising inflection.! 	 Indicates an animated tone.Indicates a stopping fall in tone.Talk between *	 * is quieter than surrounding talk.Conversation Analysis 120> <	 Talk between >	 < is quicker than surrounding talk.„	 If Indicates a generic term substituted for personal information.


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