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The Dynamics Of Interviewing
56
PSYCHOSOMATICS
JANUARY-FEBRUARY
Book Reviews THE DYNAMICS OF INTERVIEWING: Theory, Technique, and Cases. By Robert L. Kahn and Charles F. Cannell. New York: John Wiley and Sons, Inc., 1959. 378 pgs. $7.75. This book begins with the discussion among three physicians who met to listen to recordings of interviews with the patients. Their consensus was that they had fallen into the habit of answering their own questions without really hearing what the patients had to say. Taking off from this point the two psychologists who were also present, who happen also to be on the faculty of the University of Michigan's Survey Research Center, have written a book especially useful to the physician who wants something more than a bag of tricks, but rather a basic understanding of what goes on between interviewer and respondent. The essence of the interview is seen as interaction between two people, each seeking in various ways to influence the other. The authors analyze this interaction in terms of recent research and experience and deal with the obstacles, conscious and unconscious, rational and irrational, that tend to restrict and distort communication. Several types of interviews are discussed, but the medical interview is presented as probably the most complex and demanding, combining as it does the techniques of the information-seeker and the counselor. Although the physician's knowledge of specific syndromes provides the background for formulating appropriate questions, how to obtain responses that include the minimum distortion is the main problem. Moreover, medical interviews, like those of the lawyer and the social worker, frequently do not permit advance planning; in the interaction proceeding from one response to another the interviewer must be in control without dominating the situation. Chapters V and VI point out some of the most common dangers of both open and closed questions, especially in approaching material that may be difficult for the respondent to verbalize or inaccessible to him because of its embarrassing or threatening connotation. One requisite is that the language of the interviewer conform to the "shared vocabulary" of the respondent. This does not mean that the interviewer jmitates the vocabulary of the respondent; what the patient wants from the doctor is language at the same time appropriate to his professional background and readily understood by the layman. But wording questions is by no means only a matter of vocabulary. Each person interprets what he hears according to his unique experience and in-
dividual viewpoint. Since the medical interview often puts the respondent in a position where he has much to win or lose, he may be expected to be ambivalent: on the one hand he wants the doctor to discover and remedy the cause of his difficulty; on the other he does not want anything discovered that will require radical or extensive treatment. Thus if in discussing a particular symptom the physician uses a choice of words or tone of voice that the patient interprets as suggestive of dire consequences, he is perhaps likely to repress his awareness of this symptom. Such behavior is less a matter of falsification than of bias in recollection and communication caused by emotional forces, in this instance mobilized for protection. Dynamics Of lnterl'iewil/[I is a well grounded analysis of the interview process based on the propositions that interviewing is a complex kind of communication and that it is a function of interpersonal relationships between two people. Emphasis is upon providing the psychological climate most conducive to unimpeded communication. Five transcripts of interviews from medicine, business, and social work with careful annotations go far to make the theoretical discussion concrete, to give body to the techniques presented, and in general to make the book satisfying and helpful. Eliznbetl1 Thoma
ROCKville Centre, N. Y.
PSYCHOSOMATIC METHODS IN PAINLESS CHILDBIRTH. By L. Chertok. (Translated from the Second French Edition by D. Leigh.) Printed in England, 1959. 260 pgs. $6.00. This textbook is unique and worthy of being owned for frequent reference by the obstetrician, gynecologist, nurse-midWife, internist, geneticist, anthropologist, biologist. sociologist, psychologist, medical hypnotist, veterinarian, or rural general pl·actitioner. To anyone interested in the science of reproduction, this book will provide an abundance of useful information. The reference to contemporary Russian research in psychophysiology would be difficult to match in any English-written text extant. The print is clear and easy to read, the pages are well bound, there is an author as well as a subject index. and the bibliography contains 587 references. Among the many facts that we learn, for example, is that the phylogenetically higher animals manifest the suffering of parturition by restlessness and contortions, not by cries and groans. (From Eligulochvili.) Recent studies on primitive people show that
PSYCHOSOMATICS
JANUARY-FEBRUARY
Book Reviews THE DYNAMICS OF INTERVIEWING: Theory, Technique, and Cases. By Robert L. Kahn and Charles F. Cannell. New York: John Wiley and Sons, Inc., 1959. 378 pgs. $7.75. This book begins with the discussion among three physicians who met to listen to recordings of interviews with the patients. Their consensus was that they had fallen into the habit of answering their own questions without really hearing what the patients had to say. Taking off from this point the two psychologists who were also present, who happen also to be on the faculty of the University of Michigan's Survey Research Center, have written a book especially useful to the physician who wants something more than a bag of tricks, but rather a basic understanding of what goes on between interviewer and respondent. The essence of the interview is seen as interaction between two people, each seeking in various ways to influence the other. The authors analyze this interaction in terms of recent research and experience and deal with the obstacles, conscious and unconscious, rational and irrational, that tend to restrict and distort communication. Several types of interviews are discussed, but the medical interview is presented as probably the most complex and demanding, combining as it does the techniques of the information-seeker and the counselor. Although the physician's knowledge of specific syndromes provides the background for formulating appropriate questions, how to obtain responses that include the minimum distortion is the main problem. Moreover, medical interviews, like those of the lawyer and the social worker, frequently do not permit advance planning; in the interaction proceeding from one response to another the interviewer must be in control without dominating the situation. Chapters V and VI point out some of the most common dangers of both open and closed questions, especially in approaching material that may be difficult for the respondent to verbalize or inaccessible to him because of its embarrassing or threatening connotation. One requisite is that the language of the interviewer conform to the "shared vocabulary" of the respondent. This does not mean that the interviewer jmitates the vocabulary of the respondent; what the patient wants from the doctor is language at the same time appropriate to his professional background and readily understood by the layman. But wording questions is by no means only a matter of vocabulary. Each person interprets what he hears according to his unique experience and in-
dividual viewpoint. Since the medical interview often puts the respondent in a position where he has much to win or lose, he may be expected to be ambivalent: on the one hand he wants the doctor to discover and remedy the cause of his difficulty; on the other he does not want anything discovered that will require radical or extensive treatment. Thus if in discussing a particular symptom the physician uses a choice of words or tone of voice that the patient interprets as suggestive of dire consequences, he is perhaps likely to repress his awareness of this symptom. Such behavior is less a matter of falsification than of bias in recollection and communication caused by emotional forces, in this instance mobilized for protection. Dynamics Of lnterl'iewil/[I is a well grounded analysis of the interview process based on the propositions that interviewing is a complex kind of communication and that it is a function of interpersonal relationships between two people. Emphasis is upon providing the psychological climate most conducive to unimpeded communication. Five transcripts of interviews from medicine, business, and social work with careful annotations go far to make the theoretical discussion concrete, to give body to the techniques presented, and in general to make the book satisfying and helpful. Eliznbetl1 Thoma
ROCKville Centre, N. Y.
PSYCHOSOMATIC METHODS IN PAINLESS CHILDBIRTH. By L. Chertok. (Translated from the Second French Edition by D. Leigh.) Printed in England, 1959. 260 pgs. $6.00. This textbook is unique and worthy of being owned for frequent reference by the obstetrician, gynecologist, nurse-midWife, internist, geneticist, anthropologist, biologist. sociologist, psychologist, medical hypnotist, veterinarian, or rural general pl·actitioner. To anyone interested in the science of reproduction, this book will provide an abundance of useful information. The reference to contemporary Russian research in psychophysiology would be difficult to match in any English-written text extant. The print is clear and easy to read, the pages are well bound, there is an author as well as a subject index. and the bibliography contains 587 references. Among the many facts that we learn, for example, is that the phylogenetically higher animals manifest the suffering of parturition by restlessness and contortions, not by cries and groans. (From Eligulochvili.) Recent studies on primitive people show that