Abstract
This chapter describes a discursive psychological study on how chronic pain-related disability is negotiated during interviews on admission to chronic pain rehabilitation. Nine patients participated in audio recordings of their admission interview at a rehabilitation unit. Six practitioners were involved in these consultations. The analysis shows that patients’ pain-related disability is not treated as a matter of course. Patients make an interactional effort to construct their disabilities as factual. They construct their inability to perform certain actions as consequential to their pain and present adjustments in their behaviour as inevitable. Practitioners, however, challenge such representations by constructing patients’ behaviour as insufficiently accounted for and by proposing treatment directions that imply that patients could become more active.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Åsbring, P., & Närvänen, A. (2002). Women’s experiences of stigma in relation to chronic fatigue syndrome and fibromyalgia. Qualitative Health Research, 12(2), 148–160. https://doi.org/10.1177/104973230201200202.
Burbaum, C., Stresing, A.-M., Fritzsche, K., Auer, P., Wirsching, M., & Lucius-Hoene, G. (2010). Medically unexplained symptoms as a threat to patients’ identity? A conversation analysis of patients’ reactions to psychosomatic attributions. Patient Education and Counseling, 79(2), 207–217. https://doi.org/10.1016/j.pec.2009.09.043.
Clarke, V., Kitzinger, C., & Potter, J. (2004). ‘Kids are just cruel anyway’: Lesbian and gay parents’ talk about homophobic bullying. British Journal of Social Psychology, 43(4), 531–550. https://doi.org/10.1348/0144666042565362.
Edwards. (1997). Discourse and cognition. Sage.
Edwards, D. (1994). Script formulations: An analysis of event descriptions in conversation. Journal of Language and Social Psychology, 13(3), 211–247. https://doi.org/10.1177/0261927X94133001.
Edwards, D. (2006). Facts, norms and dispositions: Practical uses of the modal verb would in police interrogations. Discourse Studies, 8(4), 475–501. https://doi.org/10.1177/1461445606064830.
Edwards, D. (2007). Managing subjectivity in talk. In A. Hepburn & S. Wiggins (Eds.), Discursive research in practice: New approaches to psychology and interaction (pp. 31–49). Cambridge University Press.
Edwards, D., & Potter, J. (1993). Language and causation: A discursive action model of description and attribution. Psychological Review, 100(1), 23–41. https://doi.org/10.1037/0033-295X.100.1.23.
Edwards, D., & Potter, J. (2001). Discursive psychology. In A. McHoul & M. Rapley (Eds.), How to analyse talk in institutional settings. A casebook of methods (pp. 12–14). Continuum International Publishing Group.
Edwards, D., & Potter, J. (2005). Discursive psychology, mental states and descriptions. In H. te Molder & J. Potter (Eds.), Conversation and cognition (pp. 241–259). Cambridge University Press.
Ellis, K., Garland-Thomson, R., Kent, M., & R, R. (2019). Interdisciplinary approaches to disabiliy. Routledge.
Fasulo, A., & Fiore, F. (2007). A valid person: non-competence as a conversational outcome. In A. Hepburn & S. Wiggins (Eds.), Discursive research in practice: New approaches to psychology and interaction (pp. 224–246). Cambridge University Press. https://doi.org/10.1017/CBO9780511611216.012.
Gatchel, R. J., Peng, Y. B., Peters, M. L., Fuchs, P. N., & Turk, D. C. (2007). The biopsychosocial approach to chronic pain: Scientific advances and future directions. Psychological Bulletin, 133(4), 581–624. https://doi.org/10.1037/0033-2909.133.4.581.
Goodley, D., Lawthom, R., Liddiard, K., & Runswick-Cole, K. (2019). Provocations for critical disability studies. Discourse & Society, 34(6), 972–997.
Hasenbring, M. I., Chehadi, O., Titze, C., & Kreddig, N. (2014). Fear and anxiety in the transition from acute to chronic pain: There is evidence for endurance besides avoidance. Pain Management, 4(5), 363–374. https://doi.org/10.2217/pmt.14.36.
Hepburn, A., & Potter, J. (2011). Designing the recipient: Managing advice resistance in institutional settings. Social Psychology Quarterly, 74(2), 216–241. https://doi.org/10.1177/0190272511408055.
Heritage, J. (2009). Negotiating the legitimacy of medical problems. In D. Brashers & D. Godsmith (Eds.), Communicating to manage health and illness (pp. 147–164). Routledge.
Heritage, J. (2011). Territories of knowledge, territories of experience: Empathic moments in interaction. In T. Stivers, L. Mondada, & J. Steensig (Eds.), The morality of knowledge in conversation (pp. 159–183). Cambridge University Press.
Heritage, J., & Robinson, J. D. (2006). Accounting for the visit: Giving reasons for seeking medical care. In J. Heritage & D. Maynard (Eds.), Communication in medical care: Interactions between primary care physicians and patients (pp. 48–85). Cambridge University Press.
Holloway, I., Sofaer-Bennett, B., & Walker, J. (2007). The stigmatisation of people with chronic back pain. Disability and Rehabilitation, 29(18), 1454–1464.
Horton-Salway, M. (2001). Narrative identities and the management of personal accountability in talk about me: A discursive psychology approach to illness narrative. Journal of Health Psychology, 6(2), 247–259.
Jefferson, G. (1990). List construction as a task and resource. In G. Psathas (Ed.), Interaction competence: Studies in ethnomethodology and conversation analysis (pp. 63–92). University Press of America.
Jefferson, G. (2004). Glossary of transcript symbols with an introduction. In G. Lerner (Ed.), Conversation analysis: Studies from the first generation (pp. 13–32). John Benjamins.
Lester, J. N. (2014). Negotiating abnormality/normality in therapy talk: A discursive psychology approach to the study of therapeutic interactions and children with autism. Qualitative Psychology, 1(2), 178–193. https://doi.org/10.1037/qup0000013.
Lupton, D., & Seymour, J. (2003). ‘I am Normal on the ‘Net’: Disability, computerised communication technologies and the embodied self. In J. Coupland & R. Gwyn (Eds.), Discourse, the body, and identity (pp. 246–265). Palgrave Macmillan.
Monzoni, C. M., Duncan, R., Grünewald, R., & Reuber, M. (2011). Are there interactional reasons why doctors may find it hard to tell patients that their physical symptoms may have emotional causes? A conversation analytic study in neurology outpatients. Patient Education and Counseling, 85(3), e189–e200. https://doi.org/10.1016/j.pec.2011.07.014.
Nettleton, S. (2006). ‘I just want permission to be ill’: Towards a sociology of medically unexplained symptoms. Social Science and Medicine, 62(5), 1167–1178. https://doi.org/10.1016/j.socscimed.2005.07.030.
Nicholas, M., & Blyth, F. (2016). Are self-management strategies effective in chronic pain treatment? Pain Management, 6(1), 75–88. https://doi.org/10.2217/pmt.15.57.
Nielsen, S. B. (2018). ‘And how long have you been sick?’: The discursive construction of symptom duration during acute general practice visits and its implications for ‘doctorability’. Time & Society, 37(3), 330–349. https://doi.org/10.1177/0961463X15609808.
Ong, B. N., Hooper, H., Dunn, K., & Croft, P. (2004). Establishing self and meaning in low back pain narratives. Sociological Review, 52(4), 532–549. https://doi.org/10.1111/j.1467-954X.2004.00494.x.
Pomerantz, A. (1986). Extreme case formulations: A way of legitimizing claims. Human Studies, 9(2–3), 219–229. https://doi.org/10.1007/BF00148128.
Potter, J. (1996). Representing reality: Discourse, rhetoric and social construction. Sage.
Potter, J. (1998). Discursive social psychology: From attitudes to evaluative practices. European Review of Social Psychology, 9(1), 233–266. https://doi.org/10.1080/14792779843000090.
Rapley, M., Kiernan, P., & Antaki, C. (1998). Invisible to themselves or negotiating identity? The interactional management of ‘being intellectually disabled’. Disability and Society, 13(5), 807–827. https://doi.org/10.1080/09687599826524.
Sidnell, J. (2012). “Who knows best?”: Evidentiality and epistemic asymmetry in conversation. Pragmatics and Society, 3(2), 294–320. https://doi.org/10.1075/ps.3.2.08sid.
Snelgrove, S., & Liossi, C. (2009). An interpretative phenomenological analysis of living with chronic low back pain. British Journal of Health Psychology, 14(4), 735–749. https://doi.org/10.1348/135910709X402612.
Speer, S. A. (2006). Gatekeeping gender: Some features of the use of hypothetical questions in the psychiatric assessment of transsexual patients. Discourse & Society, 17(6), 785–812. https://doi.org/10.1177/0957926506068433.
Stinesen, B., Sneijder, P., Köke, A., & Smeets, R. (2019). Improving patient–practitioner interaction in chronic pain rehabilitation: The merits of a discursive psychological approach. Scandinavian Journal of Pain, 19(4), 843–853. https://doi.org/10.1515/sjpain-2019-0034.
Swaan, J., Schiphorst Preuper, H., & Smeets, R. (2019). Multifactoriële analyse in de medisch-specialistische revalidatie [Multifactorial analysis in specialized medical rehabilitation]. In J. Verbunt, J. Swaan, H. Schiphorst Preuper, & K. Scheurs (Eds.), Handboek pijnrevalidatie: Voor de eerste-, tweede- en derdelijnsgezondheidszorg [Handbook of pain rehabilitation: For primary, second-line and third-line medical care] (pp. 69–85). Bohn Stafleu Van Loghum.
Verbeek, J., Sengers, M., Riemens, L., & Haafkens, J. (2004). Patient expectations of treatment for back pain: A systematic review of qualitative and quantitative studies. Spine, 29(20), 2309–2318. https://doi.org/10.1097/01.brs.0000142007.38256.7f.
Versteeg, W., & te Molder, H. (2019). Making expertise fit: On the use of certified versus experiential knowledge in becoming an informed patient. Journal of Health Psychology, 1–17. https://doi.org/10.1177/1359105319847255.
Werner, A., Isaksen, L., & Malterud, K. (2004). ‘I am not the kind of woman who complains of everything’: Illness stories on self and shame in women with chronic pain. Social Science and Medicine, 59(5), 1035–1045. https://doi.org/10.1016/j.socscimed.2003.12.001.
Werner, A., & Malterud, K. (2003). It is hard work behaving as a credible patient: Encounters between women with chronic pain and their doctors. Social Science and Medicine, 57(8), 1409–1419. https://doi.org/10.1016/S0277-9536(02)00520-8.
Wiggins, S. (2004). Good for ‘you’: Generic and individual healthy eating advice in family mealtimes. Journal of Health Psychology, 9(4), 535–548. https://doi.org/10.1177/1359105304044037.
Wiggins, S. (2014). On the accountability of changing bodies: Using discursive psychology to examine embodied identities in different research settings. Qualitative Psychology, 1(2), 144–162. https://doi.org/10.1037/qup0000012.
Wiggins, S. (2017). Discursive psychology. Theory, method and applications. Sage.
Wiggins, S., & Potter, J. (2017). Disursive psychology. In C. Willig & W. Stainton-Rogers (Eds.), The SAGE handbook of qualitative research in psychology (2nd ed., pp. 93–109). Sage.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Stinesen, B.B., Sneijder, P., Smeets, R.J. (2021). Negotiating (Dis)ability in the Context of Chronic Pain Rehabilitation: Challenges for Patients and Practitioners. In: Lester, J.N. (eds) Discursive Psychology and Disability. Palgrave Studies in Discursive Psychology. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-71760-5_4
Download citation
DOI: https://doi.org/10.1007/978-3-030-71760-5_4
Published:
Publisher Name: Palgrave Macmillan, Cham
Print ISBN: 978-3-030-71759-9
Online ISBN: 978-3-030-71760-5
eBook Packages: Behavioral Science and PsychologyBehavioral Science and Psychology (R0)