After Interpretation: Third-Position Utterances in Psychoanalysis

Abstract

Using 58 audio-recorded sessions of psychoanalysis (coming from two analysts and three patients) as data and conversation analysis as method, this article shows how psychoanalysts deal with patients' responses to interpretations. After the analyst offers an interpretation, the patient responds. At that point (in the third position), the analysts recurrently modify the tenor of the description from what it was in the patients' responses. They intensify the emotional valence of the description, or they reveal layers of the patients' experience other than those that the patient reported. Both are usually accomplished in an implicit, nonmarked way, and they discreetly index possible opportunities for the patients to modify their understandings of the initial interpretation. Although the patients usually do not fully endorse these modifications, the data available suggest that during the sessions that follow, the participants do work with the aspects of patients' experience that the analyst highlighted. In discussion, it is suggested that actions that the psychoanalysts produce in therapy, such as choices of turn design in third position, may be informed by working understanding of the minds and mental conflicts of individual patients, alongside the more general therapeutic model of the mind they hold to.

Acknowledgments

I wish to thank Jukka Aaltonen and Pirkko Niemelä for invaluable help, the members of the Helsinki Social Science CA group for the inspiring working environment, and the three anonymous reviewers for many helpful comments. Research was funded by the Academy of Finland and the International Psychoanalytic Association.

Notes

¹A point about silences is due. The 7.1-s length of the silence in line 16 (between the completion of the interpretation and the beginning of the patient's elaboration) in Extract 1 is not exceptional in our data. In all the other extracts to be shown following, silences of comparable length occur between the first-, second-, and/or third-position utterances; the longest one of them is the 57-s gap between the interpretation and the elaboration in Extract 2. The speech-exchange system in psychoanalysis clearly tolerates these silences. One aspect facilitating this tolerance may be the seating of the participants (patient lying on a couch, not seeing the analyst, and the analyst sitting behind the patient, posturally oriented about 90 degrees away from the patient): a setting that can accommodate participants' orientation to a “continuous state of incipient talk” (Schegloff, 2007, p. 26) as well as to more focused conversation. However, in psychoanalysis (unlike what we know about states of incipient talk) the silences can occur between first and second pair-parts (see especially Extract 2, line 12). More elaborate examination has to be left to future studies.

²Elsewhere (Peräkylä, 2005) I have shown how in this case (and in many others in our data) the patient remains silent through a number of transition-relevance places (see lines 4, 8, 12, 16, 18, 22) where the interpretation could be treated as completed. The analyst deals with the lack of patient uptake by adding increments to the interpretation, thereby pursuing response and also revising the interpretation. In lines 19–25, the analyst eventually offers an account of a father's conventional duties, as evidence for his initial interpretative statement regarding the displacement of disappointment from father to mother. By focusing his elaboration on this final incremental part of the interpretation, the patient avoids elaborating the material offered in the earlier parts of the interpretation (the displacement of the disappointment from mother to father).