Stefan Rinner, Lars Dänzer and Eugenia Kulakova
Affiliation: University of Duisburg-Essen
Category: Philosophy
Keywords: Scorekeeping model of language use, Psychotherapy, Linguistic accommodation
Date: Wednesday 3rd of September
Time: 14:30
Location: GSSR Plenary Hall (268)
View the full session: Psychotherapy & Psychiatry
Recent philosophy of language has seen a surge of interest in how language can change the attitudes and feelings of conversational parties, in particular when it comes to hate speech and political speech (see, e.g., Langton 2012, McGowan 2019). Another socially relevant area where language plays a key role in changing feelings and attitudes is psychotherapy. According to a definition endorsed by the American Psychological Association, the effectiveness of a therapeutic method/approach can be measured by the degree to which the participants have been able to modify their behaviors, cognitions, and/or emotions in the desired ways (Campbell, Norcross, Vasquez, & Kaslow 2013). Since a large number of therapeutic approaches is done verbally, in the form of a conversation between therapist and client, this raises the question: can the insights from philosophy of language also help shed light on the workings and the effectiveness of therapeutic conversations?
An approach to language use that has proven very fruitful in investigating the social aspects of language is David Lewis' (1979) scorekeeping model. According to this theory, conversations have a score which, together with rules for correct play, determines which utterances are acceptable in the course of a conversation. The paradigmatic example are presuppositions. For instance, an utterance of 'Fred's children are asleep' is only acceptable if its presupposition that Fred has children is already entailed by the common ground of the conversational parties, making the latter an important component of conversational score. However, conversations not only have rules stipulating how score determines what can be said in the course of a conversation. They also have rules stipulating how what is said determines score. A special type of such rules are so-called rules of accommodation. Accordingly, conversational score (usually) adjusts in such a way that the utterances made in the course of a conversation count as correct play. For example, if it is not already part of the common ground that Fred has children, an utterance of 'Fred's children are asleep' (usually) results in the common ground adjusting in such a way that the utterance is acceptable, i.e., the conversational parties start to believe that Fred has children. Other components of score that are subject to accommodation are boundaries between relevant possibilities and ignored ones, boundaries between the permissible and the impermissible, and the like.
The main thesis of the present talk is that the scorekeeping model enhances our understanding of the effectiveness and the linguistic workings of several core methods and interventions of talking therapy. Speaking on an abstract level, these methods and interventions are effective by changing the score of the therapeutic conversation, in particular in the form of accommodation. This can affect different components of conversational score. For example, the effectiveness of a therapeutic method can consist in a change in belief or an expansion of the possibility/permissibility range (to name just a few), all components of conversational score. In addition, therapeutic methods and interventions can be effective by making certain utterances of the client possible, utterances about certain events or one's attitudes and feelings (Pennebaker, Kiecolt-Glaser, Glaser 1988; Lieberman et al 2007). Using the scorekeeping model this is explained by the fact that the therapeutic method or intervention changes the conversational score so that new utterances count as correct play in the course of the therapeutic conversation. In this way, the scorekeeping approach to language use promises a completely new understanding of talking therapy and its effectiveness, one that has significant implications for the therapeutic practice, as it highlights the importance of training therapists in the linguistic aspects of therapeutic methods and interventions, in particular in the use of accommodation.
In our talk, we will support our thesis by applying the scorekeeping model to various methods of talking therapy, such as the use of transference and countertransference in psychodynamic approaches, techniques of empathic listening, such as paraphrasing, and motivational interviewing in person-centered therapy, and the application of the Socratic questioning in cognitive behavioral therapy. For the purposes of this abstract, we focus on the example of systemic questions as an illustration.
With the use of a systemic question the therapist usually wants to provide the client with an alternative, and possibly less problematic, description of reality (von Schlippe & Schweitzer 2016, 249–51). For example, if a mother utters the sentence 'My son is bad', the therapist could respond with the systemic question 'What is your son doing that you call 'bad'?'. With this question the therapist (implicitly) provides the mother with a less problematic description of reality, according to which a behavior of the son is perceived as bad, instead of the son having the property of being bad. If the mother responds with an utterance of 'He throws things around', then she has accepted the implicit offer of the therapist.
Systemic questions are often ascribed an almost hypnotic effect, since clients tend to tacitly accept their implicit offers. This is why Schmidt (1985) describes systemic questions as a kind of hypnotherapy. It is very likely that the almost hypnotic effect of systemic questions can be explained by the fact that their implicit offers are presuppositions that are accommodated by the client. In addition, the scorekeeping model provides an explanation of how, exactly, systemic questions open up alternative, and possibly less problematic, descriptions of reality on the part of the client. By changing the conversational score, the systemic question 'What is your son doing that you call 'bad'?' makes new utterances possible in the context of the therapeutic conversation, i.e., utterances that presuppose that a behavior of the son is perceived as bad (e.g., ''He throws things around''). Finally, the use of the systemic question also blocks the mother's conversational contribution 'My son is bad', preventing the score from changing in such a way that it includes that the son has the property of being bad.