Pawelczyk Joanna, Talarczyk Małgorzata
Adam Mickiewicz University.
Klinika Psychiatrii Dzieci i Modziezy UMP.
Commun Med. 2017;14(2):135-149. doi: 10.1558/cam.30380.
One of the goals of psychotherapy with bulimia patients is identification of the functions of the eating disorder in their lives. Thus, as in any psychotherapeutic approach, the therapist should facilitate the patient's disclosure of his or her experience of living with bulimia. Talking about one's dysphoric experiences and, particularly in the case of bulimia, symptoms and experiences that commonly deprive people with bulimia of dignity, constitutes an emotional challenge for the patient and an equally challenging interactional task for the therapist. Using the example of one therapy session with a female bulimia patient, we examine how the therapist and the patient interactionally engage in co-constructing the patient's expertise - involving epistemics of experience as well as epistemics of expertise - concerning the illness in the interactional here-and-now. Applying tools and insights from discourse and conversation analysis, we examine the sequences in which the patient shifts the topical focus from a general observation concerning bulimia to her personal experience, to be further pursued interactionally by the therapist. We also discuss how the therapist downgrades her epistemic position and (concurrently) foregrounds and bolsters the patient's voice as expert to accomplish the session's therapeutic goals.
对贪食症患者进行心理治疗的目标之一是确定饮食失调在他们生活中的作用。因此，与任何心理治疗方法一样，治疗师应促使患者披露其与贪食症共存的经历。谈论自己的烦躁不安经历，尤其是在贪食症患者的情况下，那些通常会剥夺贪食症患者尊严的症状和经历，对患者来说是一种情感挑战，对治疗师而言也是一项同样具有挑战性的互动任务。以与一位女性贪食症患者的一次治疗为例，我们考察治疗师和患者如何在此时此地的互动中共同构建患者关于疾病的专业知识——包括经验认知和专业认知。运用话语和对话分析的工具与见解，我们考察患者将话题焦点从关于贪食症的一般观察转移到她的个人经历的顺序，治疗师随后会在互动中进一步探讨这些经历。我们还讨论治疗师如何降低自己的认知地位，并（同时）突出和支持患者作为专家的声音，以实现该治疗阶段的治疗目标。
