This study describes the ways in which professionals in two contexts of health care: general practice and homeopathic consultations, respond to patients' affective expressions of a trouble or a problem. The focus is on the turns of professionals that display understanding, compassion or agreement with the patient's account. Different types of affiliative turns are described and their consequences for the following interaction are scrutinized in relation to the institutional task of solving the patients' health-related problems. It is shown that in both contexts, affiliation is oriented to as working towards closing the sequence of troubles-telling and serves to shift back to problem-solving activity, whilst in homeopathy, it may also serve as a means to problem-solving and thus help to complete the institutional task at hand. Some implications of these observations for professional—client interaction will be described. To conclude, the role of emotion in institutional interaction will also be discussed.
Beach, W. and Dixson, C. (2001) `Revealing Moments: Formulating Understandings of Adverse Experiences in a Health Appraisal Interview', Social Science & Medicine52: 25—44.
2.
Beach, W. and LeBaron, C. (2002) `Body Disclosures: Attending to Personal Problems and Reported Sexual Abuse during a Medical Encounter', Journal of Communication September: 617—39.
3.
Branch, W.T. and Malik, T.K. (1993) `Using ``Windows of Opportunities'' in Brief Interviews to Understand Patients' Concerns', Journal of American Medical Association269: 1667—8.
4.
Clark, C. (1987) `Sympathy Biography and Sympathy Margin', American Journal of Sociology93: 290—321.
5.
Clark, C. (1990) `Emotions and Micropolitics in Everyday Life: Some Patterns and Paradoxes of ``Place''', in T.D. Kemper (ed.) Research Agendas in the Sociology of Emotions , pp. 305—33. New York: State University of New York Press.
6.
Clark, J.A. and Mishler, E. (1992) `Attending to Patients' Stories: Reframing the Clinical Task', Sociology of Health & Illness14(3): 344—72.
7.
Collins, S. (2005) `Communication and Strategy in Health Care Consultations ', unpublished PhD thesis, University of York.
8.
Couper-Kühlen, E. (2006) `A Sequential Approach to Affect: The Case of Disappointment .' Plenary Speech at the International Conference on Conversation Analysis (ICCA), Helsinki, May 10—14, 2006.
9.
Drew, P. and Heritage, J. (1992) `Analyzing Talk at Work: An Introduction', in P. Drew and J. Heritage (eds) Talk at Work. Interaction in Institutional Settings, pp. 3—65. Cambridge: Cambridge University Press.
10.
Duan, C. and Hill, C.E. (1996) `The Current State of Empathy Research', Journal of Counseling Psychology43(3): 261—74.
11.
Edwards, D. (1997) Discourse and Cognition. London : Sage.
12.
Edwards, D. (2000) `Extreme Case Formulations: Softeners, Investment, and Doing Nonliteral', Research on Language & Social Interaction33(4): 347—27.
13.
Frankel, R.M. (1995) `Emotion and the Physician—Patient Relationship ', Motivation and Emotion19(3): 163—73.
14.
Goodwin, C. and Goodwin, M. (2000) `Emotion within Situated Activity', in A. Duranti (ed.) Linguistic Anthropology. A Reader, pp. 239—57. Oxford: Blackwell .
15.
Haakana, M. (2001) `Laughter as a Patient's Resource: Dealing with Delicate Aspects of Medical Interaction', TEXT21(1/2): 187—219.
16.
Hakulinen, A. (2001) 'Sisäänhengitys kulttuurisena vuorovaikutusilmiönä' [Inbreath as a Cultural and Interactive Phenomenon], in L. Laitinen, P. Nuolijärvi , M.-L. Sorjonen and M. Vilkuna (eds) Lukemisto: kirjoituksia kolmelta vuosikymmeneltä [Articles of Three Decades: A Reader], pp. 326—77. Helsinki: Suomalaisen Kirjallisuuden Seura.
17.
Hari, R. (2003) 'Sosiaalisen kognition hermostollinen perusta' [The Neural Basis of Social Cognition], Duodecim119: 1465—70.
18.
Harris, J. (2006) `The Interactional Significance of Tears: A Conversation Analytic Study', PhD thesis, University of Queensland.
19.
Hepburn, A. and Potter, J. (2007) `Crying Receipts: Time, Empathy and Institutional Practice', Research on Language and Social Interaction40(1): 89—116.
20.
Heritage, J. (1984) Garfinkel and Ethnomethodology. Cambridge: Polity Press.
21.
Hochschild, A. (1979) `Emotion Work, Feeling Rules and Social Structure ', American Journal of Sociology85: 551—75.
22.
Hutchby, I. and Wooffit, R. (2003 [1998]) Conversation Analysis. Cambridge: Polity Press .
23.
Jefferson, G. (1978) `Sequential Aspects of Storytelling in Conversation ', in J. Schenkein (ed.) Studies in the Organization of Conversational Interaction, pp. 219—48. New York: Academic Press.
24.
Jefferson, G. (1984) `On Stepwise Transition from Talk about a Trouble to Inappropriately Next-Positioned Matters', in J.M. Atkinson and J. Heritage (eds) Structures of Social Action, pp. 191—221. Cambridge : Cambridge University Press.
25.
Jefferson, G. and Lee, J. (1992) `The Rejection of Advice: Managing the Problematic Convergence of a ``Troubles-telling'' and a ``Service Encounter'', in P. Drew and J. Heritage (eds) Talk at Work. Interaction in Institutional Settings, pp. 521—48. Cambridge: Cambridge University Press.
26.
Kohut, H. (1984) How Does Analysis Cure?Chicago, IL: The University of Chicago Press.
27.
Laitinen, L. (1995) 'Nollapersoona' [`Zero-Person Construction '], Virittäjä3: 337—58.
28.
Mishler, E. (1984) The Discourse of Medicine: Dialectics of Medical Interviews. Norwood, NJ: Ablex.
29.
Pomerantz, A. (1986) `Extreme Case Formulations: A Way of Legitimizing Claims', Human Studies9: 219—29.
30.
Potter, J. and Hepburn, A. (2003) ` “I'm a Bit Concerned'': Early Actions and Psychological Constructions in a Child Protection Helpline', Research on Language and Social Interaction36(3): 197—241.
31.
Rogers, C.R. (1957) `The Necessary and Sufficient Conditions of Therapeutic Personality Change', Journal of Consulting Psychology21(2): 95—103.
32.
Ruusuvuori, J. (2005) `“Empathy” and ``Sympathy'' in Action: Attending to Patients' Troubles in Finnish Homeopathic and General Practice Consultations', Social Psychology Quarterly68(3): 204—22.
33.
Sacks, H. (1992) Lectures on Conversation, 2 vols. Oxford: Basil Blackwell.
34.
Sandlund, E. (2004) Feeling by Doing. The Social Organization of Everyday Emotions in Academic Talk-in-interaction. Karlstad: Karlstad University Studies36.
Sorjonen, M.-L. (2001) Responding in Conversation. A Study of Response Particles in Finnish. Amsterdam: John Benjamins.
37.
Sorjonen, M.-L. (2006a) `Tunteet pinnassa. Affektista puhetta Kelan asioinneista' [`Affective Talk about Visits in Social Security Office'], in M.-L Sorjonen and L. Raevaara (eds) Arjen asiointia. Keskusteluja Kelan tiskin äärellä , pp. 191—221. Helsinki: Suomalaisen Kirjallisuuden Seura.
38.
Sorjonen, M.-L. (2006b) `Ymmärrystä ja empatiaa. Ammattilainen asiakkaan tuntemusten vastaanottajana' [`Understanding and Empathy'], in M.-L Sorjonen and L. Raevaara (eds) Arjen asiointia. Keskusteluja Kelan tiskin äärellä , pp. 222—40. Helsinki: Suomalaisen Kirjallisuuden Seura.
39.
Suchman, A., Markakis, K., Beckman, H. and Frankel, R. (1997) `A Mode of Empathic Communication in the Medical Interview', Journal of the American Medical Association4(277): 1680—1.
40.
Vithoulkas, G. (1991) Homeopatian perusteet [Homeopathy]. Helsinki: WSOY.
41.
Waitzkin, H. (1991) The Politics of Medical Encounters. New York: Yale University Press.
