You and I listening to me: towards an understanding of the significance of personal pronoun usage in psychotherapy

The idea that clients need to take responsibility for the material they present in psychotherapy is commonly encountered in humanistic therapies. On the one hand, many therapies encourage the use of first person pronouns in order to achieve ownership and responsibility, yet on the other hand, excessive use of the first person is associated with unhelpful functioning such as poor interpersonal relating and narcissism. A large body of evidence exists which associates above-average levels of first person pronoun usage with unhelpful rumination depression, suicide and anxiety. This study explored this dichotomy, using a mixed methods approach to investigate first person pronoun usage in a sample of eight clients referred by their GPs for short to medium term therapy. For the qualitative phase, clients completed kept a journal in which they could recorded their experiences of therapy generally and interventions around their pronoun use specifically. Sessions were audio recorded and interventions concerning pronoun usage were transcribed. After the end of therapy, six out of the eight clients participated in interview in which they discussed their experiences of therapist pronoun interventions (such as invitations to ‘own’ statements in the first person) and the significance of these for their overall experience of the therapy. In the quantitative study, clients completed a CORE-OM at start and end of therapy. Also, changes in clients’ use of first, second and third person pronouns between beginning and end of therapy were determined using Linguistic Inquiry and Word Count (LIWC). Analysis looked for correlations between these two measures (outcome and pronoun use) as well as for potential relationships between therapist and client pronoun use in individual sessions.