To speak with the other's voice: reducing asymmetry and social distance in professional–client communication

Abstract

The aim of this article is to examine the case of adoption of characteristic features of the interlocutor's ‘voice’ in mental health care admission interviews at a public hospital in Buenos Aires, Argentina. We observed ethnographically that ‘speaking with the Other's voice’ is a strategy adopted by psychoanalysts to achieve clinical goals, though they overlook its wider implications and contradictions as it involves both professionals and patients. We will argue that patients adopt bureaucratic and psychiatric terms in order to decrease asymmetry and reorient the activity conducted between the professional and the client. On the other hand, professionals tend to consider social class, age, ethnicity or religion when adopting the patient's voice in an attempt to decrease social distance. These strategies are employed to accomplish different goals during the interview: to the patient, it is a way to show competence in the activity of medical consultation, indexing the highly valued voices of state institutions and psychiatric knowledge; to the professional, it is a strategy to achieve clinical goals by decreasing social distance and enhancing transference. Analysis will show the unequal distribution of voicing options for participants: while patients attempt to reduce asymmetry despite social distance, psychotherapists try to decrease social distance but maintain asymmetry. In conclusion, wider implications will be discussed for intergroup communication between professionals and clients.

Keywords:

• communicative competence
• interaction
• inequality
• psychotherapy
• voice

Acknowledgements

I would like to thank professionals and patients at the hospital for their help in collecting and in interpreting the data analysed here. I would also like to thank Virginia Unamuno, the anonymous referees and Dr Shi-xu for their helpful suggestions to a prior version of this article.

Notes on contributor

Juan Eduardo Bonnin teaches Semiotics at the University of Moreno (UNM) and the University of San Martín (UNSAM) and is a researcher at the Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina. His interests include interdisciplinary research on language, inequality and access to civil rights. His last books are Génesis política del discurso religioso: ‘Iglesia y comunidad nacional’ (1981) entre la dictadura y la democracia en Argentina (Buenos Aires, Eudeba, 2012) and Discurso religioso y discurso político en América Latina. Leyendo los borradores de Medellín (1968) (Buenos Aires, Santiago Arcos, 2013).

Notes

1. This relation has been appropriately pointed out by one of the anonymous reviewers of this article.

2. We have adopted the transcription symbols proposed by Richards and Seedhouse (2005).

3. As many idioms, hesitations and word separations are idiosyncratic of Spanish, we have decided not to translate word by word but to offer an orthographically and syntactically normalised version in English. We always offer both versions in the analysis.