B: Uhuh And what do you see in your image right now?

16 C; Well hh (.) I see me (.) unable to get out of bed (.) being (.) at the end of (.) 17 cancer or something like that.

19 C: Yes. In bed. Definitely. Lying down. Unable to (.) even get the physical energy 20 to (.) do it.

In this extract the therapist introduces the topic of the client’s fear of physical disease. The client describes the feared scenario in increments and the therapist responds with acknowledgement tokens (“uhuh”) (lines 3-10). The client’s description refers to something that she is afraid of, and the description also has emotional valence in that she describes how the disease will “take me over” (line 3) and speaks of it “defeating me” (line 7). The client’s description is thereby similar to what is termed “troubles- telling”, in which one person complains of their difficulties to another (Jefferson,

1988). The minimal responses from the therapist could be interpreted as simply giving the client space to continue talking about her fear, but due to their brevity the

responses only signal receipt of talk. There is no attempt to communicate empathy, as could be accomplished by extending the client’s turns and thereby displaying

understanding and intersubjectivity (Antaki, 2008). The client may be pausing and subsequently providing another increment of her talk in order to invite the therapist to recognise that a more elaborate response is required. People will orient to the lack of a preferred response and give the listener further opportunities to respond by providing subsequent increments of talk (Sidnell, 2010).

When the therapist does finally give a more extensive response, it is in the form of questions rather than an empathie response to the troubles-talk. While the first question is somewhat vague and can be answered in various ways (“do you picture yourself’) the second question specifically enquires about an image (line 11). Instead of providing empathie reflection or in some other non-specific way encouraging the client to expand on her experience of anxiety, the therapist is directing the exploration of the client’s fear to considering the presence of related imagery. The therapist does not allow for fi*ee exploration of the emotional experience, instead the concept of imagery is introduced by the therapist and made the focus. Therefore the therapist’s response is not led by the idiosyncratic content of the client’s narrative but rather by some other agenda.

The client’s subsequent turn can be understood as a reaction to the therapist’s lack of responding to the troubles-telling. After a rather brief response to the question about

imagery (line 12), she provides an extension of her talk, marked as such by the conjunction “and”, which is a partial repetition of a segment of her earlier troubles- talk: “and again I’m defeated” (line 14). By restating part of her troubles-talk the client seems to be giving the therapist yet another opportunity to provide an empathie response. A question creates conditional relevance so that an answer is expected (Sidnell, 2010), and if it is not provided its absence will be treated as noticeable by the therapist. Therefore it is difficult in a conversation to refrain from providing an answer to a question without paying an interactional price, and because of this the use of questions is a very powerful tool for the therapist to steer the conversation (Antaki, 2008). When the client therefore answers the therapist’s question and then adds the troubles-talk to her answer, it can be interpreted as a solution to the competing actions of giving an answer and giving the therapist another opportunity to respond to her troubles-talk. However, as in the first few turns of this segment, the therapist does not respond to the troubles-talk but rather concentrates on pursuing the line of questioning that concerns imagery related to the fear of disease (line 15). This is in keeping with the previous lack of responsiveness to troubles-talk and seems to reflect a focus on investigating the client’s experience in accordance with theoretical assumptions about the role of imagery. The therapist’s actions are thus being led by theory rather than the particulars of the client’s narrative.

When the therapist continues to follow the thread of investigating imagery rather than responding empathically, the client provides further answers and ceases the attempts at troubles-talk (lines 15-20). The therapist’s questioning thereby directs the

exploration toward looking at imagery related to the client’s fear, and in so doing closes down any other avenues for exploration with regard to the client’s emotional experience. The conditional relevance of questions makes this strategy difficult for the client to resist without paying an interactional price.

Enquiring about and focusing on cognition

Apart from enquiring about related imagery, another way in which emotion is approached indirectly is through enquiring about thoughts related to emotional experience. By focusing on cognitions the emotionality of the client’s experience is thereby deemphasised. This is illustrated in the following extract, in which the

excavated thoughts are subsequently incorporated in a formulation which does not include talk of emotion.

Extract 4 (Beck, 1985)

1 B: And (.) you not only sense it but you hear the criticism. What is your immediate 2 reaction?

3 C: (5.5) Scared sad.