Dialogical Sequence Analysis

The conceptual tools of dialogical sequence analysis are grounded in Vygotsky's theory of sign-mediated activity and Mikhail Bakhtin's theory of expression. Expression is sign-mediated activity that, according to Bakhtin, always has two objects. One is the referent of expression — what the speaker is talking about. The other is the addressee — the person to whom the speaker directs their words. This is the fundamental structure of all expression. Speaker, addressee, and referent form a force field that regulates the content and progression of expression.

The core idea is that when describing a referent and expressing their attitude toward it, the speaker always takes into account who they are speaking to. They choose their topic and arrange their words according to how they expect the addressee to respond to what they have to say. The connection between addressee and referent is, from the speaker's perspective, reciprocal.

The addressee does indeed have their own relationship to the object and to the speaker. The speaker can learn about it if the addressee expresses their own attitude. In client work, however, the addressee — that is, the professional — must remain in their professional role. What they themselves think about the object is not what matters. Their task is to help the client clarify their own relationship to the object and the various consequences of that attitude.

The referent of expression — what is spoken about — always contains a unity of object and attitude. We cannot describe anything without simultaneously expressing our relationship to it. Word choices contain the most important clues about the speaker's orientation toward the referent of their speech. The content of words also helps us perceive how the object or web of objects appears to the speaker themselves and what they focus their attention on.

What is said and how it is said form the endlessly varying, temporally unfolding flow of verbal expression. From this stream we form hypotheses about the objects important to the speaker, how those objects appear to them, how they relate to them, and how we as addressees participate in shaping the expression of referents and attitudes.

We have countless ways of expressing both objects and our attitudes toward objects through words. We tend not to think about this, because we are inclined to treat word meanings as merely naming the object in one way or another. That very 'in one way or another' points to the speaker's attitude.

Take the word 'house'. It is a neutral way of referring. 'Shack', 'dump', and 'hovel' reveal the speaker's way of seeing the house as insignificant and wretched. If they call an ordinary home a palace or a fortress, the discrepancy between object and expression reflects an attitude involving irony, sarcasm, or perhaps envy. Because word choices can simultaneously express both the object and the relationship to it, they are always worth attending to when listening to a client.

Speech prosody is an essential clue to the speaker's attitude toward the referent, especially its emotional tone. The patient's first attitude toward the object is contained in the formulation 'catching a little flu bug'. It is a social cliché expressing a coping, symptom-minimising orientation. The patient's way of stretching 'Thursday' may reflect uncertainty about the timing. The minimising relationship to flu symptoms is repeated in the patient's assumption that it would pass.

Yet the patient directs the description to the doctor. Patients also justify their visit through symptom descriptions. An ordinary flu does not usually require a doctor's visit. By describing new symptoms, the patient justifies the visit. The word choices for the referent are now more dramatic. The standard 'sores' is supplemented by 'bumps'. A slight emphatic stretch in 'so:res' contains shades of uncertain worry. By using additional description, the patient expresses their uncertainty more clearly — they cannot assess what the symptom is.

When retrospectively interpreting the patient's attitude toward the referent and addressee, one must be cautious. Only in the course of living dialogue is it possible to find additional clues that emerge in the patient's way of responding to the doctor's turn or action.