“Should I ask if you drink?”

In my clinical experience, luckily enough, I have not (yet) encountered a client questioning whether or not I have been in a similar situation he or she is currently struggling with.  I always have this concern hovering in the back of my mind ever since I took my first counseling class in which the instructor shared her experience as a substance abuse counselor.  She mentioned that questions along this line were what she had had to grapple with on a regular basis, so she posted the following question to the class: What would you do in this scenario?  Most of us agreed that we would make explicit the client’s motivation of asking the question by engaging the client in a discussion rather than becoming defensive and trying to justify our competencies in working with something we do not have first hand experience in.  We assumed that when clients have this concern, basically their inner monologue is that this counselor can never understand what I am going through and thus is not qualified to help me.  Is that the case?

Let me share an excerpt taken from a demonstration session featuring motivational interviewing that I intend to analyze in my final paper.  The counselor’s name is Miller, and the client’s name is Mike.  Mike said that he is struggling with alcohol and cigarette, emphasizing that for him, cigarette is more difficult to control compared with alcohol.

[Start of Excerpt]

1. MIKE: Should I ask if you drink?
2. MILLER: I do. Yes, I do.
3. MIKE: Well, you know how the judgment goes. And let’s face it, it goes. It goes on everyone, you know. They always say oh we alcoholics are different. No, no, no, no. You feed someone six beers and their judgment is going to go down .
4. MILLER: It’s going to have that effect.
5. MIKE: It’s a physiological reaction to a toxic drug. You know, let’s face it.
6. MILLER: Yep.
7. MIKE: So, it is.
8. MILLER: So, you really would be talking about stopping cigarettes and alcohol then.
9. MIKE: Well, yeah.
10. MILLER: In order to breathe.
11. MIKE: But I don’t want to think about it. Huh? What’s this?
12. MILLER: Oh.
13. MIKE: I don’t want to think about that.
14. MILLER: Meaning you just want to do it and not think about it, or you don’t want to get serious?
15. MIKE: Well, I would rather do it and not think about it.
16. MILLER: Yep. Not much point in thinking about it.
17. MIKE: Well, I mean, is there’
18. MILLER: No, no.
19. MIKE: Do I think about working out every day? Do I think about brushing my teeth? If I did I wouldn’t want to brush my teeth. I gotta brush my teeth tomorrow. That’s going to be pretty bad, you know that. I gotta brush my teeth. You know what I’m saying?

[End of Excerpt]

As we can see, our expert counselor Miller was put on the spot.  His reaction was quite different from what I learned from the class, which piqued my interest.  He briefly admitted that he does drink (I do) and indicated that he has finished his turn by repeating what he just said (Yes, I do) without using any words that signal his intention to continue. Mike oriented to Mill’s completion of his utterance and kept on describing how alcohol impairs “everyone’s” judgments.  What was Mike doing here?  It seems to me that he was not simply casting doubt on Miller’s competency.  Here comes my thought.

I think Mike was doing “stake inoculation” here.  The main purpose of Mike’s question is to seek agreement from Miller as a way to increase the factuality of his claim that alcohol undermines “everyone’s” judgment.  This is especially important because Mike was positioned as a person with problematic alcohol and cigarettes use.  Therefore, the credibility of Mike’s statement can be compromised if it is perceived as self-defending.  Mike strategically asked this question to align his claim with Miller’s personal experience such that he could fend off the potential threat to the validity of his account.  To put it differently, Mike utilized this strategy to strengthen the veracity of the universal impact of alcohol on judgment and to attenuate the distinction of “alcoholic” and “non-alcoholic,” a dichotomy he had been trying to fight against in previous utterances.  Since Miller, presumably not an alcoholic, drinks himself and has personally experienced the influence of alcohol, Mike could argue that there is not much difference between the two positions (alcoholics versus non-alcoholics) and his impaired judgement after drinking was not a deficit in his willpower or personality.  Interestingly, see also Line 5 for further evidence: “MIKE: It’s a physiological reaction to a toxic drug. You know, let’s face it.”  Again, here Mike was avoiding accountability and deflecting possible accusation of his willpower by evoking the explanation that alcohol effects everyone, regardless of individual differences, through physiological routes.  Last, I would go further and suggest that Mike oriented to the discourse on an autonomous self in the broader social cultural context.  Mike discursively preserved his identity as an autonomous person whose willpower is not in question albeit his difficulty in controlling his alcohol and cigarette use.

When I look at the interactions in a therapy session through a conversation and discourse analysis lens, I get a very different picture.  However, to what degree are my findings grounded in the data?  Am I imposing my thoughts on the interlocutors?  Coming more from a quantitative background, I am not so comfortable making claims without 95% confidence level.