Abstract
Diabetes education is a type of institutional communication that is often regarded as unpleasant, even stressful by those affected—with a corresponding negative impact on its success. In public discussion it is only slowly that we are beginning to realize how crucial concrete linguistic practice (consisting of linguistic actions) is for successfully coping with a disease of which the prevalence is steadily increasing. For this reason, we examine what actually happens communicatively in situations which are often referred to as “Beratung” (counselling) in German and as “education” in English. Based on Functional Pragmatics, we show that communication in our multilingual corpus is quite typically affected by a “directive drift” and thus may be reconstructed rather as prescribing than counselling, which may adversely affect patient compliance. As more and more people with a migration background are affected by diabetes, we include interpreting as an additional factor in our discussion.
Paper dedicated to Professor Dr. Dr. h.c. mult. Ludwig Maximilian Eichinger on the occasion of his 65th birthday.
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Notes
- 1.
According to the differentiation of various actor roles in institutional communication, introduced by Ehlich and Rehbein in 1977a, ‘agent’ should be taken to mean the representative of an institution.
- 2.
The relevance of these quotes to the present research becomes apparent when compared with accounts of patients’ experiences published in Language Matters (NHS England 2018).
- 3.
According to the approach of critical discourse analysis it can be assumed that ‘discourse formations’ (cf. Foucault 1974) of guilt and transgression establish a conceptual background for treating the topic diabetes in the public opinion. In addition, historical semantics as a field of interest in CDA, sheds light on the relevance of variable disease concepts in changing societies.
- 4.
These kinds of scenarios are of course taken up in the media, often with a very specific purpose—from simple provision of information to guides in book form or infotainment on television. Today, there are about 108 million hits relating to health on Google; Amazon sells approximately 10,000 books on the topic of diabetes; over 160 pages on health and psychology were published in FOCUS magazine in 2006 (Müller 2009, p. 2). Within these discourse formations, specific roles for affected persons emerge: Guilty parties, obedient and disobedient students, fighters, victims etc., in any case target groups for rules, instructions and controlling access.—Identifying and describing these ascription mechanisms would be one aspect of a research project that we have planned which is oriented to the media diversity of communication on the topic of diabetes and weight; it plays an important role in allowing the constellation of dietary consultations to be evaluated.
- 5.
Berger’s (2018) publication may serve as an example which on the one hand emphasizes the importance of adequate communication with the patients, be it with or without a migration background. On the other hand, this publication neither discusses empirical communication nor does it discuss any concrete communicative consequences.
- 6.
These discussions originate from the corpus “Dolmetschen im Krankenhaus” (“Interpreting in hospitals”) (https://www.corpora.uni-hamburg.de/sfb538/de_k2_dik.html; cf. also Bührig et al. 2012). However, the involvement of interpreters is not intended to be the focus of this article, but is reserved for a separate publication.
- 7.
This term is also used by the actors themselves and is retained as a second ‘ethno category’ in this article.
- 8.
- 9.
- 10.
We choose this term tentatively and out of necessity ex negativo, complementing the concept of ‘non-directivity’ of therapeutic discussions introduced by Rogers (1942), which has been used many times since then for the optimisation of discussions with advisory natures.
- 11.
Of course, this is not an exhaustive list. With a view to the process of reconstructive analysis, the listed elements can be best understood as subjects of heuristic questions and are mainly based on the findings of the formative and distinctive variables of the use of language.
- 12.
- 13.
The professional ‘maxim knowledge’ (Ehlich and Rehbein 1977a) of the agent can be explored as the origin of this third-party will, which comes into effect due to the patient’s increased blood sugar levels.
- 14.
For a detailed determination of the power of the conjunctive form in German, cf. Redder (1992).
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Bührig, K., Fienemann, J., Schlickau, S. (2020). On Certain Characteristics of ‘Diabetes Consultations’. In: Hohenstein, C., Lévy-Tödter, M. (eds) Multilingual Healthcare. FOM-Edition(). Springer Gabler, Wiesbaden. https://doi.org/10.1007/978-3-658-27120-6_4
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