Anxiety-scenarios in communication during gynecological consultations

This article describes how patients express their anxiety during gynecological consultations and how gynecologists react to these anxiety expressions. Data for the interactional analysis consisted of 31 audiotaped gynecological consultations, which were transcribed literally. The results revealed that patients generally present their fear in very covert ways, e.g., by implicit allusions to the possibility of having malignancies or by pressure for more drastic medical intervention. Patients' anxiety was identified in speech disturbances, such as unfinished sentences and hesitations. Doctors had three types of reactions to patients' anxiety: they explored it, they started to reassure immediately or they negated the anxiety expressions of patients. Together these anxiety presentations and reactions form three interactional scenarios, which are illustrated by representative examples. Each observed consultation appeared to contain one of these three scenarios. The findings indicate that communication about emotions always takes place within a limited set of specific interactional patterns. The paper finishes with an examination of the relevance of the findings for medical practice.