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Subjectivity in Psychotherapy

Subjectivity in Psychotherapy

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Social and Personality Psychology Compass 3/5 (2009): 654–670, 10.1111/j.1751-9004.2009.00196.

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Narrative and discursive approaches to the analysis of subjectivity in psychotherapy
Evrinomy Avdi* and Eugenie Georgaca
Aristotle University of Thessaloniki

Abstract

This paper reviews research that utilises language-based analyses (narrative analysis, discourse analysis and conversation analysis) to examine aspects of subjectivity in the context of psychotherapy. The studies reviewed fall broadly into two main groups. On the one hand, studies which share a view of subjectivity as the sum of internal ‘voices’ in dialogue adopt a narrative approach, examine subjectivity in terms of organisation, coherence and self-reflection, and consider psychotherapy a process of restoring an organised polyphony. On the other hand, studies which conceptualise subjectivity in terms of ‘subject positions’ adopt a discursive approach, emphasise the availability of subject positions and flexibility in adopting them and examine psychotherapy as a process of facilitating the flexible adoption by the client of a variety of subject positions. Theoretical, epistemological and methodological issues regarding each of the two approaches are discussed, along with representative studies. We finally examine the implications of these two approaches for understanding psychotherapeutic practice and for theorising and researching subjectivity.

In recent years, there has been a flourishing of qualitative research in the study of psychotherapy process (Frommer & Rennie, 2000; McLeod, 2001; Toukmanian & Rennie, 1992). In this paper, we focus on a subsection of qualitative research and review studies that utilise language-based analyses, i.e. conversation, discourse and narrative analysis (McLeod, 2001), to examine therapy talk. More specifically, we examine and evaluate how subjectivity has been theorised and analysed in the context of language-based analysis of psychotherapy. Our aim is twofold: on the one hand, we aim to review and critically evaluate the contribution of language-based analyses of therapy to our understanding of the construction of subjectivity in therapy, which we consider to be an important aspect of therapeutic work, and, on the other hand, to utilise this research to further discussions regarding subjectivity from a language-based perspective. In this review, we discuss studies that utilise language-based analyses to study therapy sessions and that explicitly study aspects of subjectivity. Correspondingly, we have chosen not to include analyses of psychotherapy which only implicitly deal with issues related to subjectivity, as well as studies that theorise psychotherapy from a narrative or constructionist perspective but do not analyse actual psychotherapy sessions. We focus on subjectivity here because discussions regarding subjective experience and one’s sense of self are central both to psychotherapeutic theory and practice and to narrative and constructionist approaches in psychology. In line with social constructionist views of therapy, we assume that psychotherapy constitutes an institutional practice, which occupies a significant position in late modernity, that both reflects dominant cultural views regarding ‘selfhood’ and also provides theories that further define these views and practices that implement them
ª 2009 The Authors Journal Compilation ª 2009 Blackwell Publishing Ltd

2002). which involve power and systems of meanings. The term ‘subjectivity’ has been historically linked to post-structuralism and psychoanalysis and has gained increased currency as these approaches inform current social constructionist. they all assume the centrality of meaning and view meaning as constructive of human experience and as constructed within interaction (McLeod. 1999). Cushman. stable and self-contained entity (Gough & McFadden. Subjective experience and one’s sense of self have been studied by different disciplines using a variety of perspectives. as they both take place through language. 2005. & Hook. mainstream psychological approaches refer to the ‘person’ or the ‘self’. Although there are many issues regarding the definition and boundaries between the language-based approaches. 2001. both emphasise the mutual negotiation and co-construction. Thus. Avdi & Georgaca.Narrative and Discursive Approaches 655 (e. which are concerned with the quality of one’s experience of oneself (e. 1999). we aim to highlight in this paper the processes through which subjectivity is constructed both in psychotherapy itself and in the processes of studying psychotherapy. and in particular with the recent constructionist and postmodern approaches to psychotherapy. Schneider. there are also significant differences between narrative.b. unified. Georgaca & Avdi. Subjectivity is seen as complex. Georgaca. 2001). the focus of this review reflects the authors’ longstanding interest in the links between psychotherapy and discursive approaches (Avdi. In addition. Branney. 10. 2001).g. This view is not shared by many of the psychotherapies and the approaches to psychotherapy research we will be reviewing. 2007a. as the subject invests these processes with desire and turns them to the very stuff of his or her being (Blackman. which often translates into examining the tensions between social constructionist approaches to understanding human distress and the actual practice of psychotherapy. they assume that a person is an individual. yet intimately personal. 1992. Language-based analysis is considered coextensive with the theory and practice of therapy. Willig. In broad terms.1111/j. 2008). 2001.2009. These two terms tend also to be used in many psychotherapeutic traditions and especially those that draw upon humanism and phenomenology (e. as well as the role of cultural narratives or discourses in both the production and alleviation of human distress (McNamee & Gergen. and phenomenological approaches. between therapist and client.g. On the other hand. throughout the paper. who they understand in terms of ‘personality’.1751-9004. Cain & Seeman. 2003. we view psychotherapy as a particularly fertile site for the exploration of subjectivity. Starting from this social constructionist viewpoint. distributed and fragmented. Parker. discourse and ª 2009 The Authors Social and Personality Psychology Compass 3/5 (2009): 654–670. What all of these approaches share is an understanding of identity and experience as constructed through social processes. deconstructive and discursive approaches. 2008.00196. but when presenting the different research trends we will retain the terms they use to refer to subjective experience and identity. Cromby. we will use the term ‘subjectivity’ when developing our own arguments. As such. 1995. & Pierson. 2008. Parker. we introduce briefly the main features of each of the language-based methods with a particular emphasis on how they analyse talk and then we outline how each method has approached subjectivity in the context of psychotherapy. Bugental. 2001).x Journal Compilation ª 2009 Blackwell Publishing Ltd . Subjectivity in narrative and discursive approaches Below. that is to say. and as lived through by individual subjects. forthcoming). The terms ‘self’ and ‘person’ are also linked to humanistic approaches. of the client’s problems and their solution. which place emphasis on the wholeness and originality of the self.g. permeated by social and discursive processes.

Riessman. Its aim is to highlight the rules of social organisation of everyday and institutional exchanges (Schegloff. Narrative psychology is a term that includes several approaches. and it examines both the content and the structure or organisation of the stories people narrate (e. which is based on the assumption that reality and experience are socially constructed through interpersonal processes and by socially available systems of meaning (discourses). Schegloff. Discourse analysis draws upon social constructionism. the notions of narrative identity and self-narratives are central to accounts of the human subject. whereby narrative characteristics are seen to reflect some aspect of the client’s inner mental state. 2003.2009. subjectivity ¨ ¨ ¨ is a notion that has been widely discussed and debated within narrative and discursive approaches. With regards to the process of analysis. 2007b).x Journal Compilation ª 2009 Blackwell Publishing Ltd . These studies focus on the representational aspect of language. With regards to approaching subjectivity. Silverman. see Avdi & Georgaca.656 Narrative and Discursive Approaches conversation analysis with regards to epistemology. In general. see Avdi & Georgaca. in the sense that this is continuously reconstructed through the stories we tell about our life. The lack of conversation analytic studies on subjectivity reflects its emphasis and epistemological commitments. In narrative psychological approaches. 1993). As already mentioned. conversation analysis is a detailed examination of the organisation and regularities of verbal interaction.1751-9004. Self-narratives also provide the means through which a person’s disrupted sense of self. In contrast. 2007b). underlying theory and actual methodology (for a discussion of these issues. The majority of studies assume a constructivist approach to narrative. 2000). 1997).00196. 2004. These divergent theoretical allegiances create tensions which are reflected in the diversity of approaches to analysing narrative (for a more detailed discussion. 2004). Self-narratives or macro-narratives refer to the main storyline that connects various micro-narratives (or stories about specific events) in a coherent whole. 1990). sustained by the appraisals of the individual and others and by the shared meanings that arise from social interaction. Perakyla & Vehvilainen. 2006). Narration is considered to be intimately linked with one’s sense of self. 2004). conversation analysis aims to detail the processes through which everyday and institutional practices are interactionally constituted and makes no claims regarding the speakers’ internal or psychological processes (Antaki. they rely on the assumption that the individual actively constructs their world and attributes meaning to it on the basis of narrative structures. With regards to the study of subjectivity. 10. subjectivity is conceptualised as a reflexive process. These function to reconstruct the past and anticipate the future in such a way as to provide life with meaning and coherence (McAdams. can be rebuilt (Neimeyer. i.1111/j. most of the language-based analyses of psychotherapy rely on narrative and discursive approaches to analysing language.e. 2001). two main trends can be discerned in the narrative research on therapy. associated with psychological difficulties or following a traumatic experience. These stories are shaped by previous experience. in narrative psychology. through interactional processes and the deployment of wider discourses (Willig. 1997. all of which centre on the notion of narratives. that is. 1997). and narrative coherence is considered to be a ª 2009 The Authors Social and Personality Psychology Compass 3/5 (2009): 654–670. stories that link events over time and provide a sense of temporal continuity and coherence in one’s life story (Bruner.g. as we briefly discuss below. current circumstances and the powerful presuppositions regarding selfhood and the ‘good life’ provided by specific cultures (McAdams & Janis. Narrative analysis focuses on the ways in which people make and use stories to interpret the world and their self in it. Narrative psychological approaches draw both from social constructionism and from phenomenology and existentialism (Crossley. It is a method of tracing the modes through which the phenomena under study have been constructed.

have questioned such attempts mainly in terms of issues regarding authorship and the limits of interpretation (e. More specifically. p. attempts to combine psychoanalysis with discursive analysis (e. that is to say they assume that the social and psychological world is produced and reproduced through interactions and practices. however. Frosh. & Pattman. jointly constructed in specific interactions and within the broader framework of culturally available systems of meaning. 2002). Others. 2005. practical living. This trend has produced several fruitful. language and discourse are seen as constructive. Hollway & Jefferson. Venn. These studies tend to focus more on the diversity. which take place in specific socio-historical contexts. reflexive. In addition to these main groups. agency and accountability. Over the years. several authors have turned to psychoanalysis. fluidity and complexity in narrative production rather than on coherence. 2004. runs the risk of reverting to some version of ‘blank’ or ‘uncomplicated subjectivity’ akin to a humanist version of the person as a reflective and autonomous agent (Georgaca. The first group of studies is based on the understanding of subjectivity as a set of ‘voices’ engaging in ‘dialogue’. Frosh & Emerson.g. dynamic. In this context. on the other hand.b). Phoenix. Discursive approaches. In addition to the different methodologies employed. the studies reviewed here also adopt different ways of conceptualising subjectivity (see Table A1).x Journal Compilation ª 2009 Blackwell Publishing Ltd . 1999. fragmented. Parker. while the second approaches subjectivity through the notion of ‘subject positions’. Hollway. yet contested. functional and variable (Wetherell. Moreover.1111/j. Discursive approaches have been criticised for being limited in terms of accounting for continuity. subjectivity is described as a discursive accomplishment. 2003. & Walkerdine. Branney. In other words. as an approach that may help explain individuals’ investments in particular discourses and subject positions.Narrative and Discursive Approaches 657 central aspect of effective or health-promoting narratives. 2005. A much smaller group of studies assume a social constructionist approach to narrative. and therefore shape subjectivity. vocabularies of motive. Gough. 2008. In these approaches. draw exclusively upon social constructionism. In line with this. there have been several attempts to examine the links between discourse and subjectivity. 338). One of the issues that has been debated relates to the limitations of discourse determinism. Urwin. 2002. the studies that examine the construction of subjectivity in the context of therapy can be organised in two main groups. 1998). culturally recognizable emotional performances and available stories for making sense’’ (Wetherell & Edley. using various linguistic and narrative markers of identity ª 2009 The Authors Social and Personality Psychology Compass 3/5 (2009): 654–670. Gavey. 10. subjectivity has been described as ‘‘the personal enactments of communal methods of self-accounting. 2001a.g.1751-9004. Discursive accounts of subjectivity have also been criticised for overplaying the disorderly. Frosh & Young. multiple and polyphonous. variable and flux-like nature of the self. and for tending to lose touch with the phenomenological and experiential realities of everyday. Søndergaard. 2000. 2005. 2000). Subjectivity is seen as fluid. on a theoretical level. that is the assumption that culturally available discourses define experience and identity. which views the self as a category in talk. Parker. chaotic. reflected in the observation that we tend to position ourselves in relation to particular discourses and experience a sense of continuity and coherence over time. Taylor. it has been argued that the turn to discourse. according to the main concept they utilise to theorise and analyse subjectivity.00196. & Yates.2009. fragmented. change and resistance to dominant discourses and their associated positions (Henriques. They emphasise the role of language and discourse in constituting reality and identity and attribute a functional role to language in negotiating reality. Georgaca. whereby most of us experience ourselves in terms of continuity and coherence (Crossley. 2008. there are several studies that utilise versions of language-based analysis and that focus on specific aspects of subjectivity. 1994). 2005a.b).

1997. 2000). the studies presented above are epistemologically constructivist and they focus exclusively on the client’s talk. they employ mainly narrative approaches to analysis. 2004. Hermans & Kempen. Linguistic markers of identity construction Several studies examine therapy sessions from a language-based perspective and focus on various aspects of the client’s talk. coherent and reflective. ª 2009 The Authors Social and Personality Psychology Compass 3/5 (2009): 654–670. Neimeyer. 2006. and sometimes opposing. 1993). On the other hand. Lysaker & Lysaker. Meier & Boivin. Levitt. 2006).658 Narrative and Discursive Approaches construction. Herrero. Central to this conceptualisation of the self are the notions of ‘voice’. One feature of the client’s subjectivity that has been examined from a language-based perspective relates to the self-analytic or self-reflective function. in line with the culturally dominant perspective of self-contained individualism (Sampson. As such.2009. Korman. Voices and self-dialogues A number of studies draw upon the notion of the dialogical self in approaching subjectivity as evidenced in. 1994. Laitila. they provide an analysis of therapy process which focuses on aspects of subjectivity and draws upon the notion of narrative.x Journal Compilation ª 2009 Blackwell Publishing Ltd . voices in interaction. ‘selfdialogue’ and. 2005. Neimeyer. 2006). 2004. These studies generally adopt a traditional psychological perspective on the self.1111/j. they assume that self-reflection and coherence. Wahlstrom. these studies do not make a significant contribution to discussions regarding either subjectivity as constructed in therapy or to wider contemporary debates regarding subjectivity. The studies attempt to demonstrate the ways in which the level of coherence of the client’s narrative increases in the course of therapy (Kuhnlein. In terms of methodology. Lewin. more recently. Bouffard. ¨ Meier. 1996) assume that good outcomes in therapy are associated with an increase in self-reflection. & Botella. Other studies of therapy focus on the notion of coherence. a dynamic multiplicity of different. Levitt. These studies (Nye. 2004. are integral parts of a ‘healthy’ self and set to demonstrate how this self is promoted through therapy. & Angus. We will start by briefly presenting this more mixed group of studies and then move to the two main groups. by virtue of their assumptions regarding the self. cited in Angus. as reflecting aspects of his or her subjectivity. while at the same time the analysis can be easily assimilated and implemented in clinical practice. 1999. In other words. 1999). Wodak. In this framework. & Hardtke. 10. which in turn is analysed in terms of specific linguistic features of the client’s talk.1751-9004. & Rotondi-Trevisan. Aaltonen. that psychological difficulties are associated with narrative rupture or disruption and that therapy facilitates and promotes narrative coherence. ¨ & Angus. the self is assumed to resemble a polyphonic novel that contains a multitude of internalised voices engaged in dialogue. 2000. Angus & Bouffard. the self is seen as the product of ongoing conversations both within and between persons. 1999. 2002. as internal. 1998. therapy talk (Hermans & Dimaggio.00196. These share the assumption that ‘good’ narratives are coherent. 1981. 2002. Particular emphasis for positive therapy outcome is placed in this approach on shifts in the use of reflexive sequences in the clients’ talk and a number of studies have documented how this takes place in the course of therapy (Angus et al. respectively. 2003). ‘self-position’ (Hermans. and constructed through. Although the term subjectivity is not used. In brief.. Self-reflection has also been studied through the Narrative Process Coding System (NPCS) a systematised method for analysing psychotherapy transcripts (Angus.

2001). i. Some dialogical self studies of psychotherapy draw on the assumption that psychological well-being is associated with a multiple or multi-voiced self and focus on the breadth of self-positions evidenced in the client’s narrative. More specifically. 2001. rather than one. conflicts and contradictions between voices are considered intrinsic features of a wellfunctioning multi-voiced self. which are assumed to reflect some underlying internal organisation or structure with virtually no analysis of the dynamics of actual dialogue as it unfolds in the therapeutic encounter.e. The analysis aims to identify the various voices involved in the narrative and the interactions between them in a rather descriptive way. Another theme in the dialogical self studies is that of the emergence. monological or cacophonous narratives. 2004). whereby the stories told in some superordinate voice have more authority in defining identity than those told by other voices. fluidity and coherence in the use of various voices and the existence of an organising and reflexive meta-position. unitary voice. Therefore. through the process of therapy. Epistemologically. the analysis relies on examination of both the content (in terms of what the various selfpositions say) as well as the organisation of the client’s talk (in terms of the interactions between the various self-positions). Finally. 1997. 2001. that it consists of many voices. Lancaster. which includes barren. 2006. 2004).1751-9004. of a reflexive ª 2009 The Authors Social and Personality Psychology Compass 3/5 (2009): 654–670.2009. 2006) typology of narrative disorganisation in schizophrenia. 10. is to facilitate a reconstruction and reorganisation of the client’s position repertoire in such a way that the client can move flexibly between positions (Hermans. another important notion regarding the self in this literature relates to the presence of a superordinate. 2006.g. Also important in this framework is the notion of organisation. Bateman & Fonagy. Several themes can be discerned in the research literature that utilises the notion of voice to analyse subjectivity in therapy talk. Lysaker. an approach that broadly belongs to the narrative tradition. Moreover. 2004) classification of ‘ineffective’ narratives into impoverished and disorganised narratives and Lysaker and Lysaker’s (2002. arguably. an important assumption regarding the self is that it is multiple.. & Lysaker. However. most analyses that employ the notion of voices to study psychotherapy tend to focus on the clients’ narratives. Psychopathology is considered to result from the fragmentation between the I-positions and ⁄ or the dominance of one I-position over others. In the dialogical self model. The aim of therapy. reflexive meta-position that can observe and talk about the other positions. thus.Narrative and Discursive Approaches 659 In this framework.00196. several studies demonstrate how therapy facilitates the articulation of different voices of the self and increased polyphony (Elliott & Greenberg. Other studies analyse disorganisation in client narratives as a marker of pathology and demonstrate the increased coherence and organisation in the clients’ narrative as a result of therapy (Dimaggio & Semerari. Lysaker & Lysaker. this is a notion closely linked to the psychological notions of metacognition. 2004. the dialogical self approach is based on both constructivist and social constructionist assumptions (Hermans. 2006). The experience of coherence and integrity of the self is seen to result from ongoing conversations (both internal and external) and as occurring in an ongoing interplay of competing and contradictory voices (Lysaker & Lysaker. 2003). rather than the result of a unitary voice that dominates all others. accordingly. Hermans. such as Dimaggio and Semerari’s (2001. psychological well-being is associated with the breadth. Salvatore et al. self reflection and. A considerable number of studies have recently been published that examine subjectivity explicitly within the framework of the dialogical self. 2004. mentalisation (e. tensions. the various voices are considered to be more or less organised in a hierarchical structure. Part of this trend is the formulation of typologies of disorganisation or dissociation between voices. 1997.1111/j.x Journal Compilation ª 2009 Blackwell Publishing Ltd . 1997).

while prohibiting others (Willig. as well as in the development of a reflexive. Initially. psychodynamic. In other words.660 Narrative and Discursive Approaches meta-position. integration and self-reflection. narrative and humanistic approaches to therapy. Finally. which can fairly easily be assimilated into cognitive constructivist. As such. Then. observing meta-position. and Catania (2003) and by Georgaca (2001). 1997. as the very notion of subject position is closely related to social constructionist attempts to formulate subjectivity (Burr. In summary. it is a notion that ostensibly makes intuitive sense to many practitioners and may thus be useful to clinicians. subject positions exist in a network of power relations that allow certain experiences and actions to take place. This approach is interesting. coherence. most of the research on therapy to date has failed to fully exploit its potential with regards to either the study of shifts in subjectivity through therapy or to wider contemporary debates regarding subjectivity. although not exclusively. expressed through and reflected in a variety of voices.2009. The dialogical self approach provides a clear system for conceptualising and studying subjectivity. This individualised and decontextualised view of narrative ignores the interpersonal nature of narrative production as well as the role of the wider sociocultural context in the content and form that narratives take. as it focuses on the interaction between therapist and client and is not restricted to the client’s talk.1751-9004. 1999). in practice many of these studies risk collapsing into a traditional psychological conceptualisation of subjectivity as an internal entity. This theme is explored. Importantly. Azzara. Most of the studies in this section draw on social constructionism and mostly. 1990).00196. The notion of voice provides a way of approaching and describing complexity in the client’s subjectivity. concerning cognitive constructivist and long-term psychodynamic therapy respectively. These studies generally suggest that the process of change in therapy can be evidenced in the development of richer dialogues between the main characters in the client’s narrative. This is not surprising. employ versions of discourse analysis. there exists a growing body of research that focuses on the dialogical aspects of the clients’ narrative. On the other hand. although we believe that the notion of the dialogical self provides a useful perspective in approaching subjectivity. we discuss studies that examine the breadth of the subject position repertoire available to individuals as well as the flexibility with which these positions are taken up.1111/j. as well as changes in the client’s sense of self. for example. The studies in this section are presented according to the main theme they address. which has the potential to highlight both its constructed and experienced aspects. As such. 2002). in most of this work. a notion that refers both to how a speaker is positioned in particular interactions and to how he or she is positioned through particular discourses. which draws upon cognitive analytic therapy and Bakhtin’s theory (Leiman. Salvatore. 1995). we turn to studies that employ the notion of subject positions to discuss issues ª 2009 The Authors Social and Personality Psychology Compass 3/5 (2009): 654–670. Despite their theoretical commitment to dialogism. although published studies to date have focused mostly on illustrating the system rather than making claims regarding the process of therapy. Subject positions The second main way in which subjectivity has been studied in language-based analyses ´ of therapy is through the notion of subject position (Davies & Harre.x Journal Compilation ª 2009 Blackwell Publishing Ltd . narrative is analysed as primarily an individual construction. a decrease in disorganisation or dissociation. in the process of therapy. 10. in the studies by Dimaggio. the aspects of subjectivity studied in this literature relate to narrative multiplicity. a systematic approach to identifying and analysing voices in therapy talk is the Dialogical Sequence Analysis.

Dallos & Hamilton-Brown. Strickland-Clark. Foucauldian analysis (Hodges. 2005. as such. 2000. 2002) persuasively demonstrates how psychotherapy functions to promote specific. 2003). 2005. More specifically. 1996. & Walkerdine. Finally. without. however. self-contained and over-controlled (Bayer. Other studies note the promotion of agency in therapy and make reference to the set of sociocultural assumptions regarding subjectivity thus evoked. These ª 2009 The Authors Social and Personality Psychology Compass 3/5 (2009): 654–670.00196. Frosh. Hollway. Strickland-Clark. Accordingly. Madill & Barkham. 1998). 1997. & Strouthos. Frosh. For example. Madill & Doherty. 2001). Strickland-Clark. in constructing versions of subjectivity in the process of therapy. given its theoretical affinity with the humanist tradition and the ‘modernist psychological subject’. 2002. & Morgan. Venn. Henriques. This brings us to the next group of studies that explore the role that systems of knowledge play in constructing subjectivity in therapy. and assume a critical stance towards the promotion of agency through therapy talk. 1996). on an ideological or political level. to hold more complex views and to accept others’ perspectives. of therapy furthering such assumptions (Avdi. Neale. This view is compatible with the emphasis of the dialogical self-approach on the significance of fluid interchange between multiple voices of the self. it is assumed that therapeutic change is related to an enhancement of the clients’ ability to flexibly adopt a wider range of discourses on the same theme. the various studies that examine the negotiation of agency in therapy talk assume different positions with regards to agency. & Morgan. Indeed. This group of studies uses the notion of positioning in relation to specific discourses and studies the role of these discourses in the construction of particular versions of subjectivity in the clinical dialogue.1751-9004. Dallos. 1997). it has been claimed that the flexibility with which clients position themselves can provide an outcome variable in psychotherapy research (Frosh. 2001. 2000) have also been used. Many of these studies employ post-structuralist discourse analysis (Willig. culturally sanctioned modes of subjectivity. & Morgan.Narrative and Discursive Approaches 661 relating to agency. Rose. Finally. Another issue regarding subjectivity that has been examined is that of agency. There are a number of discourse analytic studies that focus on the flexibility with which clients employ a diverse range of discourses and subject positions in the course of therapy (Avdi. a subject which is ahistorical. Urwin. a small number of studies approach therapy as part of the ‘psy-complex’ (Ingleby. These studies assume that psychological difficulties are established and maintained through a recursive process which involves a narrowing of the repertoire of available discourses and subject positions.2009. some assume that agentic subject positions are indeed associated with psychological well-being and. Guilfoyle (2001. Madill & Barkham. 1985). the emergence of such positions in the client’s talk is used as evidence of therapeutic change (Burck. The medical discourse is one of the hegemonic discourses examined in this literature (Avdi. Some of these studies also explicitly examine the implications these discourses have for the clients’ subjectivity. Burck. Agency is a thorny issue in social constructionist accounts. 1997). 10. in line with the ideal of self-contained individualism. They examine the ‘lay’ and ‘expert’ discourses participants employ in constructing their accounts and pursuing their respective discursive agendas and note the subject positions associated with these discourses. 2002) and constructionist narrative analysis (McLeod & Lynch. Burck. including discourses created and maintained through psychotherapy itself. 2005. 1985.x Journal Compilation ª 2009 Blackwell Publishing Ltd .1111/j. although other analytic approaches such as constructionist grounded theory (Hook. discussing the implications. 1998). an institution that promotes certain ideals regarding subjectivity. decontextualised. we present studies that examine the role of wider discourses. Consequently. 1994). over-psychologised.

Subjectivity here is studied in relation to the subject positions of ‘expert’ and ‘patient’ and the emergence of nonpathological.1111/j. Vehvilainen. often in an attempt to attain ‘ethnomethodological indifference’. Another set of studies investigate the role of psychotherapeutic discourses from a more critical position. 2003. Soal & Kottler. Moreover. Perakyla & Silverman. Psychotherapeutic discourses are systems of meaning which contain ideals regarding ‘healthy’ or ideal selves that have been constructed by psychotherapy as an institution and are maintained through its practices. examining and understanding oneself (Foucault. 1996). It has been argued that such conversation analyses can help clinicians examine how the therapeutic theories (or discourses) they adhere to are put into practice. Vehvilainen. they function as reference points. 2003). 1996). therapists are shown to selectively attend to and mould the issues brought by the client. 2008). 1997. which function to individualise and pathologise human distress and to limit possibilities for action. 2001). Soal & Kottler. The final group of studies we review examines the role played by psychotherapeutic discourses in the construction of the clients’ problems and their subjectivity. 2008). and many rely on Foucault’s view that versions of the self are produced through institutional complexes of power and knowledge and are subsequently internalised by individual subjects through professionally induced processes of talking about. with respect to which therapists organise their interventions and direct the therapeutic process. 1997. These studies do not make explicit claims with regards to subjectivity. Kogan. 1992. These ideals are not explicitly stated in many psychotherapeutic traditions and most often are not consciously acknowledged by therapists. 1994. given the focus of conversation analysis on interaction. 2003. 1995. 1992. Accordingly. Madill & Barkham. This ‘psychological subject’ is considered a prerequisite ª 2009 The Authors Social and Personality Psychology Compass 3/5 (2009): 654–670. & ¨ ¨ ¨ Leudar.1751-9004. Miller & Silverman. Another discourse relating to subjectivity that has been examined in several studies relates to gender and gender roles (Burman. Madill & Doherty. Perakyla & ¨ ¨ ¨ ¨ ¨ ¨ Vehvilainen. In a series of papers (Davis. These tend to use conversation analysis to describe in detail the linguistic and interactional practices that make up the institution of psychotherapy.662 Narrative and Discursive Approaches studies are generally critical towards the medical discourse. However. but assume that participants in therapy actively and competently engage in their respective institutionally defined tasks.00196. which most often complies to the ideal of the self-contained individual (Sampson. therapy produces a ‘psychological subject’. and aim to describe in detail how therapy gets done in practice. Again. as it is seen to define constraining subject positions for the ‘patient’. 1998). individual and pathological and at the same time decontextualises them from the interactional and social context of the client’s life (Hook. Perakyla. 1995. reformulating them and transforming them into ‘psychological problems’ in need of expert intervention.x Journal Compilation ª 2009 Blackwell Publishing Ltd . 1986.2009. This process usually entails the reframing of difficulties as psychological. Vehvilainen. Kogan & Gale. internal. 2003) and a recent edited volume on conversation ¨ ¨ analysis and psychotherapy (Perakyla. 1980). 2000) as well as discourses regarding family and culture (Roy-Chowdhury. In this framework. 1998. 2005. 10. Foreman & Dallos. several ¨ ¨ ¨ authors have attempted to link the theory of psychotherapy with the way it is actually practiced. studies differ with regards to the position they take with regards to psychotherapy. & Leudar. Some assume a neutral stance towards psychotherapeutic discourses. 2004. nonmedical accounts is generally seen to be associated with well-being. Antaki. Antaki. 1991. psychotherapy is approached as an institutional practice that produces certain types of subjectivity through inviting participants to talk about themselves in particular ways (Kogan & Brown. Other systems of knowledge that have been examined include ‘moral’ discourses regarding what constitutes a ‘good life’ (McLeod & Lynch. as well as situations where practice involves aspects of interaction not theorised or interactions that clearly diverge from that which theory advocates (Perakyla.

most studies employ discursive forms of analysis of therapy sessions. which restrict the range of subject positions that can be adopted and as a result the client experience and understanding of themselves. epistemological and methodological allegiances. which explicitly focuses on the reshaping of the understanding and experience of the client’s self. The nature of subjectivity has been extensively theorised and debated (see Blackman. while it is also arguably necessary for therapy to be effective (Guilfoyle. On the other hand. consistent with their theoretical. Our aim has been primarily to show how qualitative language-based analyses can be used. 1996. 2001). the issues raised by these studies have wider implications for theorising and researching subjectivity. 2001. and have been used. Kogan. the arguments developed and conclusions reached have implications for the practice of psychotherapy. 1992. positive and effective. aim and effectiveness of therapy. The implications of this are twofold. demonstrate the construction of subjectivity through the interactions between client and therapist and show how discourses of various kinds shape the understanding of the client’s self and problem throughout therapy. 2003.00196. although we would not claim it is exhaustive. On the one hand. Hook. 1997). they vary widely regarding the extent to which this process is seen as neutral. Soal & Kottler. 1995. This results in the adoption of more varied and empowering subject positions and therefore the enrichment of the client’s experience and self-understanding. to examine the processes through which subjectivity is articulated and understood in psychotherapeutic practice. Cromby. for example.x Journal Compilation ª 2009 Blackwell Publishing Ltd . Roy-Chowdhury. 1995. drawing upon a variety of discourses. view the replacement of pathologising discourses with more empowering ones as effectively the installation of psychotherapeutic discourse and the enhancement of the client’s agency in adopting a variety of discourses as the turning of the client to a psychotherapeutic self-contained individualist subject. 2008) and the study of psychotherapy.1111/j. This review has been comprehensive. The construction of subjectivity in psychotherapy We hope to have shown in this review the complexity and range of studies that address issues pertaining to subjectivity in the context of psychotherapy. the nature of pathology or client problems and consequently the direction. The majority of these studies. 10. Guilfoyle.2009. can be the field par excellence of studying the processes of the construction and reconstruction of subjectivity. & Hook. Stancombe & White. 1998. Some studies on the critical edge of the spectrum. Therapy is seen as a process of shifting the dominance of these discourses in a double move of replacing them with more empowering discourses and enabling the client to move flexibly. While all studies agree that the above is what takes place in therapy.Narrative and Discursive Approaches 663 for therapy to be rendered relevant and necessary. A number of discourse analytic studies explore the ways in which psychotherapeutic discourses regarding the source of client difficulties and ideal subjectivity are implicated in therapy sessions (Burman. 2002. Moreover. ª 2009 The Authors Social and Personality Psychology Compass 3/5 (2009): 654–670. the diversity in both the methodologies used and analytic notions employed in these studies makes it difficult for this body of work to be neatly organised. Hodges. the considerable body of research which analyses the construction of subjectivity in psychotherapy using the notion of subject positioning assumes a social constructionist view of subjectivity as constituted through interactions and shaped by discourses. Hak & de Boer. as these approaches carry assumptions regarding the characteristics of the ‘healthy’ self. 2001. Correspondingly. including studies which explicitly address aspects of subjectivity in their analysis of psychotherapy sessions. Client problems are seen in this approach as arising from the use of a limited range of discourses. usually culturally dominant pathologising discourses.1751-9004. beyond the therapeutic setting. In summary.

but. correspondingly. however. we would like to draw the reader’s attention to the links already made between the theoretical. the narrative and the discursive approaches respectively. Notwithstanding the variability within each approach. pathology results from restricted availability of subject positions.1111/j. Greece. that reviewing the literature which analyses the ways in which subjectivity is constructed in psychotherapy can provide very useful insights into theorising and researching subjectivity. This is turn has repercussions for the way in which language is approached – as a reflection of internal individual processes or as an interactional accomplishment – and for the focus of analysis – client narratives versus interaction between client and therapist. while in the latter as constituted in the course of therapeutic interaction and shaped by culturally available discourses. as also evidenced in this review. epistemological and methodological approaches intersect into producing and maintaining specific versions of subjectivity. multiple and contradictory. epistemological and methodological approaches adopted by the groups of studies presented above. Pathology is described by the first group of studies in terms of disorganisation of the internal dialogues or domination of the dialogue by a dominant voice. the narrative approaches. as they have been utilised in the analysis of therapy sessions. have tended to be more focused on the client. while in the latter the emphasis is on the availability of multiple subject positions and flexibility in adopting them. more emphasis is placed on organisation. We consider. on the contrary. to promote a more individualist view of subjectivity and to be either neutral with regard to the assumptions of psychotherapy and its power as a social institution or supportive of it. In the two main approaches we described. In the former approach. the constructivist epistemology tends to dominate the field. in particular psychotherapy ª 2009 The Authors Social and Personality Psychology Compass 3/5 (2009): 654–670.2009. thus. Georgaca & Avdi. Her research interests lie in the application of discourse and narrative analytic approaches to the study of various domains of clinical psychology practice. forthcoming). The aim of therapy.1751-9004.x Journal Compilation ª 2009 Blackwell Publishing Ltd . subjectivity is viewed as internalised by the client and expressed in the client’s speech. is to open up spaces for the introduction of other discourses and to enhance the client’s ability to adopt various subject positions. In the former approach. subjectivity is seen as fluid. subjectivity is conceptualised as voices in internal dialogue or as a set of subject positions. is to facilitate the development of richer internal dialogues through supporting an organised polyphony of voices and the emergence of a reflexive stance. tend to focus on the co-construction of subjectivity in the therapeutic encounter. 2007a. Short Biography Evrinomy Avdi is a Clinical Psychologist and Senior Lecturer in Clinical Psychology at the Psychology Department of the Aristotle University of Thessaloniki.664 Narrative and Discursive Approaches In this section. The studies presented above fall broadly into two theoretical ⁄ epistemological perspectives. to highlight the interpersonal and sociocultural aspects of both subjectivity and psychotherapeutic practice. the narrative approach includes both social constructionist and constructivist epistemologies. In both approaches. 10. The aim of therapy. while the discursive approach is on the whole epistemologically social constructionist. however. coherence and self-reflection. viewing it as an institution entrusted with the construction of dominant forms of subjectivity. Overall. The discursive approaches. and to be more critical of psychotherapy. and most importantly into the ways in which theoretical. and the repercussions these have for understanding psychotherapy and subjectivity.00196.b. mainly because of the dominance of particular pathologising discourses. The value of each of these approaches for psychotherapy and its usefulness for psychotherapy practitioners is a matter of debate (see Avdi & Georgaca. For the second group of studies.

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1111/j. and Botella (2006) Self-reflective function Self-reflective function Self-reflection (reflexive sequences) Self-reflection (reflexive sequences) Self-reflection (reflexive sequences) Self-reflection (reflexive sequences) Biographical continuity. polyphony Coherence and organisation ⁄ disorganisation Coherence and organisation ⁄ disorganisation Coherence and organisation ⁄ disorganisation Reflexive meta-position Reflexive meta-position Narrative approach Dialogical Self. 10. Strickland-Clark. narrative approach Narrative approach Narrative approach Studies employing the notion of ‘voices’ Elliott and Greenberg (1997) Hermans (1997. narrative approach Theme analysis. narrative approach Discourse analysis Studies employing the notion of subject positions Avdi (2005) Flexibility in subject positions and agency The role of the medical discourse in shaping subjectivity Flexibility in subject positions Flexibility in subject positions and agency The role of discourses regarding gender in shaping subjectivity Agency Discourse analysis Frosh. 2006) Lysaker.2009. 1998. Levitt. and Lysaker (2003) Dimaggio and Semerari (2001. the aspect of subjectivity they examine and the method of analysis they employ Author(s) Aspect of subjectivity studied Analysis employed Studies examining linguistic markers of identity construction Nye (1994) Wodak (1981. polyphony Breadth of self-positions. Salvatore. and Catania (2003) Georgaca (2001) Breadth of self-positions. polyphony Breadth of self-positions. and Angus (2005) Levitt.00196. narrative approach Narrative Process Coding System. Wahlstrom. narrative approach Dialogical Self.Narrative and Discursive Approaches 669 Appendix Table A1 Table of studies reviewed in the order they appear in the document. and Hardtke (1999) Angus and Bouffard (2002) ¨ Laitila. narrative approach Dialogical Self. and Angus (2000) Kuhnlein (1999) ¨ Meier (2002) Meier and Boivin (1997. and Morgan (1996) Madill and Barkham (1997) Discourse analysis Discourse analysis Burck.1751-9004. 2006) Dimaggio. Lancaster. Korman. 2004) Salvatore et al. narrative approach Narrative Process Coding System. Frosh. narrative coherence Narrative coherence Narrative coherence Narrative coherence Narrative coherence Discourse analysis Discourse analysis Narrative Process Coding System. 2001. 2004.x Journal Compilation ª 2009 Blackwell Publishing Ltd . Azzara. narrative approach Dialogical Self. Strickland-Clark. and Morgan (1998) Discourse analysis ª 2009 The Authors Social and Personality Psychology Compass 3/5 (2009): 654–670. (2006) Lysaker and Lysaker (2002. narrative approach Narrative approach Theme analysis. Herrero. Burck. narrative approach Dialogical Self. 2000) Neimeyer (2004) Neimeyer. narrative approach Narrative Process Coding System. narrative approach Dialogical Self. Aaltonen. 1996) Angus.

10. 1995) Discourse analysis Grounded theory Discourse analysis Narrative analysis Discourse analysis and Grounded theory Discourse analysis and Grounded theory Discourse analysis Foreman and Dallos (1992) Kogan (1998) Discourse analysis Discourse analysis and Conversation analysis Discourse analysis and Conversation analysis Discourse analysis Kogan and Gale (1997) Soal and Kottler (1996) Roy-Chowdhury (2003) Discourse analysis Davis (1986) Miller and Silverman (1995) ¨ ¨ Perakyla (2004) ¨ ¨ Perakyla (2005) ¨ ¨ Perakyla and Silverman (1991) ¨ ¨ ¨ Perakyla and Vehvilainen (2003) ¨ Vehvilainen (2003) Hak and de Boer (1995) Stancombe and White (1997) Kogan and Brown (1998) Conversation analysis Conversation analysis Conversation analysis Conversation analysis Conversation analysis Conversation analysis Conversation analysis Discourse analysis Discourse analysis Discourse analysis ª 2009 The Authors Social and Personality Psychology Compass 3/5 (2009): 654–670.670 Narrative and Discursive Approaches Table A1 Continued Author(s) Madill and Doherty (1994) Aspect of subjectivity studied Agency The role of discourses regarding gender in shaping subjectivity The role of psychotherapeutic discourses in shaping subjectivity The role of psychotherapeutic discourses in shaping subjectivity The role of psychotherapeutic discourses in shaping subjectivity The role of discourses regarding the ‘good life’ in shaping subjectivity The role of the medical discourse in shaping subjectivity The role of the medical discourse in shaping subjectivity The role of discourses regarding gender and psychotherapeutic discourses in shaping subjectivity The role of discourses regarding gender in shaping subjectivity The role of discourses regarding gender and psychotherapeutic discourses in shaping subjectivity The role of discourses regarding gender in shaping subjectivity The role of discourses regarding gender.00196.2009. and Strouthos (1997) Burman (1992.1751-9004.1111/j.x Journal Compilation ª 2009 Blackwell Publishing Ltd . Neale. family and culture and of psychotherapeutic discourses in shaping subjectivity The role of discourses regarding family and culture and of psychotherapeutic discourses in shaping subjectivity Engagement of clients in institutionally defined tasks Engagement of clients in institutionally defined tasks Engagement of clients in institutionally defined tasks Engagement of clients in institutionally defined tasks Engagement of clients in institutionally defined tasks Engagement of clients in institutionally defined tasks Engagement of clients in institutionally defined tasks The role of psychotherapeutic discourses in shaping subjectivity The role of psychotherapeutic discourses in shaping subjectivity The role of psychotherapeutic discourses in shaping subjectivity Analysis employed Discourse analysis Guilfoyle (2001) Hook (2001) Hodges (2002) McLeod and Lynch (2000) Dallos and Hamilton-Brown (2000) Dallos.

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