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Gerhardt And Borton's Patient Begins Her Response To An Inter-pretation with the word “actually.” The authors point out that this word has no meaning in and of itself, but acquires one only in the context of the conversation in which it's used. In this particular conversation, it conveys a disagreement with and mild criticism of the therapist. It conveys this on a visceral level. The word, itself, through its sound and its context of use, and not because it stands for something deeper, communicates disagreement. Because linguistic “discourse markers” such as “actually” can communicate disagreement, Gerhardt and Borton think that they qualify as examples of what I called the “patient-specific responses” that a therapist could use to know if an interpretation is on the right track. They call this a “soft measure of validation”; because these markers are intrinsically context-dependent, it's a kind of validation that is true to the spirit of postmodern epistemology.
Although analysts might learn something about linguistics from Gerhardt and Borton's paper, I don't think it can help us clinically. Translating the visceral effects of words such as “actually” or “well” into a useful cognitive assessment of the accuracy of an interpretation isn't a practical form of clinical listening. In Gerhardt and Borton's case, for instance, it would be trivial or irrelevant because it's immediately obvious that their patient is asserting a point of view different from the therapists'. She plainly states it. She probably does so with a gusto conveyed by her tone, facial expression, body posture, and general energy level. But she also directly tells the therapist what she's thinking and feeling. It seems odd to tease out the subliminal workings of a discourse marker to explain a meaning that is otherwise transparent.