Rejective proposals: Semi-professional speech and clients’ varieties in intercultural doctor-patient communication

As happens in counselling sessions, foreign clients also frequently have difficulty in accepting a doctor's proposed treatment. The reasons often lie not just in superficial misunderstandings but in far-reaching communicative structures (sectionl.2). As illustrations, two conflict discourses containing cooperative Opposition of the actors are discussed (sectionS). In the first case, a Turkish patient presents her complaints to the doctor, the doctor proposes concrete plans for therapy (section4). There follows a detailed analysis of the actors' different rates of progression through the pattern (asynchronicity), the doctor's linguistic procedures (politeness versus communicative apparatus) and the patient's speech act structures (sectionS). In the second example, a Spanish patient evinces resistance to the presuppositions behind the therapy proposal 'autogenic training' (sectiono). In both cases the German doctors' proposals contain the seeds of rejection within them; the discourses are characterized by the doctors' attempts to overcome the rejection and the patients' attempts to present their problems. Finally a list of the functional areas which are linguistically problematic in the field of intercultural communication is provided (section?). The article takes the approach of Functional Pragmatics by reconstructing the linguistic patterns and procedures present in the intercultural setting by means of the analysis of transcribed recordings. 1. Verständigung ('mutual understanding') Sociolinguistics is based on the premise that linguistic forms are modified according to social groups. Social groups have differing linguistic Stocks of knowledge, differing communicative practices, their own comprehensive modes of discourse, manners of speech, even their own languages. Pragmatics, which has developed from the analysis of single speech acts, on the one Mulülingua 13-1/2 (1994), 83-130 0167-8507/94/0013-0083 © Walter de Gruyter, Berlin