Society benefits from humanities research, whether conducted by universities in collaboration wit... more Society benefits from humanities research, whether conducted by universities in collaboration with external partners such as private companies or government agencies, or carried out using a more traditional approach. The knowledge generated is transferred to society in numerous formal and informal ways through verbal and written communication, business collaborations, networking, continuing education, public-sector services, etc. – not forgetting the enormous value represented by the knowledge and competencies of our graduates, of course.
Depression is defined by a list of symptoms. However, patients' experiences of these symptoms... more Depression is defined by a list of symptoms. However, patients' experiences of these symptoms and the ways they are represented in medical consultations are not well described. Applying the methods of systemic functional linguistics and conversation analysis, we aim to explore how patients diagnosed with depression represent their depressive symptoms in medical consultations, and how physicians respond to patients' representations.We analyzed 30 video-recorded consultations between general practitioners or psychiatrists and patients with moderate depression, and found that one third of the patients represented experiences of activity located in the head or brain. The patients' representations of such head/brain symptoms were instantiated through a delimited set of transitivity patterns - material Processes and relational Processes - without any specification of agency. The transitivity patterns reflected experiences of head/brain symptoms taking place outside the patient...
Abstract Therapists’ implicit mentalizing skills are essential in the treatment of mental disorde... more Abstract Therapists’ implicit mentalizing skills are essential in the treatment of mental disorders, and implicit mentalizing is considered a general social competence for understanding other people. However, no methods have been developed to tap into implicit mentalizing as a live or online process displayed in interactions. The aim of this article is to demonstrate how online implicit mentalizing processes can be explored by applying the method of conversation analysis (CA). CA uses a sequential approach to study the establishment of understanding in interactions between people. In this article, we show that a systematic exploration of implicit mentalizing processes can be done by applying this sequential approach and the underlying knowledge of CA on interactional phenomena and their functions and meanings. We demonstrate our method by thoroughly analyzing three extracts from recordings of dinner conversations at a residential care school. We make a theoretical link between mentalizing processes and the phenomenological understandings of intersubjectivity and empathy, and we suggest that this phenomenological understanding could develop the understanding of implicit mentalizing as a phenomenon. This would, in addition, be fully compatible with CA as a method for grasping implicit mentalization.
The diagnosis of depression is defined by psychiatrists, and guidelines for treatment of patients... more The diagnosis of depression is defined by psychiatrists, and guidelines for treatment of patients with depression are created in psychiatry. However, most patients with depression are treated exclusively in general practice. Psychiatrists point out that general practitioners ’ (GPs’) treatment of depression is insufficient and a collaborative care (CC) model between general practice and psychiatry has been proposed to overcome this. However, for successful implementation, a CC model demands shared agreement about the concept of depression and the diagnostic process in the two sectors. We aimed to explore how depression is understood by GPs and clinical psychiatrists. We carried out qualitative in-depth interviews with 11 psychiatrists and 12 GPs. Analysis was made by Interpretative Phenomenological Analysis. We found that the two groups of physicians differed considerably in their views on the usefulness of the concept of depression and in their language and narrative styles when te...
To investigate general practitioners' (GPs') and psychiatrists' responses... more To investigate general practitioners' (GPs') and psychiatrists' responses to emotional disclosures in consultations with patients with depression. Thirteen patient consultations with GPs and 17 with psychiatrists were video-recorded and then analyzed using conversation analysis (CA). Psychiatrists responded to patients' emotional disclosures by attempting to clarify symptoms, by rational argumentation, or by offering an interpretation of the emotions from their own perspectives. GPs responded by claiming to understand the emotions or by formulating the patients' statements, but without further exploring the emotions. GPs displayed a greater engagement with patients' emotions than psychiatrists. Their approach could be described as empathic, corresponding to a mentalizing stance. The different approaches taken by psychiatrists could represent conceptual differences and might affect fruitful interdisciplinary work. Psychiatric nurses' responses to patients' emotions must also be studied to complete our knowledge from psychiatry. Experiences from training in mentalization could be used to develop physicians' empathic or mentalizing approach. As most patients with depression are treated in primary care, developing GPs' mentalizing capacity instead of offering didactic training could have a substantial effect in the population.
Society benefits from humanities research, whether conducted by universities in collaboration wit... more Society benefits from humanities research, whether conducted by universities in collaboration with external partners such as private companies or government agencies, or carried out using a more traditional approach. The knowledge generated is transferred to society in numerous formal and informal ways through verbal and written communication, business collaborations, networking, continuing education, public-sector services, etc. – not forgetting the enormous value represented by the knowledge and competencies of our graduates, of course.
Depression is defined by a list of symptoms. However, patients' experiences of these symptoms... more Depression is defined by a list of symptoms. However, patients' experiences of these symptoms and the ways they are represented in medical consultations are not well described. Applying the methods of systemic functional linguistics and conversation analysis, we aim to explore how patients diagnosed with depression represent their depressive symptoms in medical consultations, and how physicians respond to patients' representations.We analyzed 30 video-recorded consultations between general practitioners or psychiatrists and patients with moderate depression, and found that one third of the patients represented experiences of activity located in the head or brain. The patients' representations of such head/brain symptoms were instantiated through a delimited set of transitivity patterns - material Processes and relational Processes - without any specification of agency. The transitivity patterns reflected experiences of head/brain symptoms taking place outside the patient...
Abstract Therapists’ implicit mentalizing skills are essential in the treatment of mental disorde... more Abstract Therapists’ implicit mentalizing skills are essential in the treatment of mental disorders, and implicit mentalizing is considered a general social competence for understanding other people. However, no methods have been developed to tap into implicit mentalizing as a live or online process displayed in interactions. The aim of this article is to demonstrate how online implicit mentalizing processes can be explored by applying the method of conversation analysis (CA). CA uses a sequential approach to study the establishment of understanding in interactions between people. In this article, we show that a systematic exploration of implicit mentalizing processes can be done by applying this sequential approach and the underlying knowledge of CA on interactional phenomena and their functions and meanings. We demonstrate our method by thoroughly analyzing three extracts from recordings of dinner conversations at a residential care school. We make a theoretical link between mentalizing processes and the phenomenological understandings of intersubjectivity and empathy, and we suggest that this phenomenological understanding could develop the understanding of implicit mentalizing as a phenomenon. This would, in addition, be fully compatible with CA as a method for grasping implicit mentalization.
The diagnosis of depression is defined by psychiatrists, and guidelines for treatment of patients... more The diagnosis of depression is defined by psychiatrists, and guidelines for treatment of patients with depression are created in psychiatry. However, most patients with depression are treated exclusively in general practice. Psychiatrists point out that general practitioners ’ (GPs’) treatment of depression is insufficient and a collaborative care (CC) model between general practice and psychiatry has been proposed to overcome this. However, for successful implementation, a CC model demands shared agreement about the concept of depression and the diagnostic process in the two sectors. We aimed to explore how depression is understood by GPs and clinical psychiatrists. We carried out qualitative in-depth interviews with 11 psychiatrists and 12 GPs. Analysis was made by Interpretative Phenomenological Analysis. We found that the two groups of physicians differed considerably in their views on the usefulness of the concept of depression and in their language and narrative styles when te...
To investigate general practitioners' (GPs') and psychiatrists' responses... more To investigate general practitioners' (GPs') and psychiatrists' responses to emotional disclosures in consultations with patients with depression. Thirteen patient consultations with GPs and 17 with psychiatrists were video-recorded and then analyzed using conversation analysis (CA). Psychiatrists responded to patients' emotional disclosures by attempting to clarify symptoms, by rational argumentation, or by offering an interpretation of the emotions from their own perspectives. GPs responded by claiming to understand the emotions or by formulating the patients' statements, but without further exploring the emotions. GPs displayed a greater engagement with patients' emotions than psychiatrists. Their approach could be described as empathic, corresponding to a mentalizing stance. The different approaches taken by psychiatrists could represent conceptual differences and might affect fruitful interdisciplinary work. Psychiatric nurses' responses to patients' emotions must also be studied to complete our knowledge from psychiatry. Experiences from training in mentalization could be used to develop physicians' empathic or mentalizing approach. As most patients with depression are treated in primary care, developing GPs' mentalizing capacity instead of offering didactic training could have a substantial effect in the population.
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Papers by Christina Fosgerau