The piano lesson: An autoethnography about changing clinical paradigms in aphasia practice

Background: Managing the clinical relationship in the therapeutic process is a dificult issue to study, because it is based on cognitive knowledge as well as emotional processing. Addressing the emotional work of the clinician is particularly important in developing expertise as a therapist. In order to effectively change between therapeutic schools of thought, emotional aspects must be acknowledged, because different therapeutic schools of thought rely more or less on the authoritative role of the clinician. Aims: The purpose of this paper is to discuss narrative autoethnography as a qualitative research tool with potential applications in aphasiology, and to demonstrate its usefulness through an example. Methods& Procedures: An evocative story about a single aphasia therapy session is presented, written according to introspective autoethnographic techniques. The narrative reflects the inner emotional processes of a clinician and illustartes the emotional aspects of negotiating clinical roles. The story is an example of an autoethnographic narrative. Outcomes &Results: One of the interpretive themes that can be identified in this autoethnography is the emotional work and experience of the clinician. The clinicians emotional processing is discussed in the context of cultural expectations and influences. Narratives in general and narrative autoethnography in particular are tools that can be used to explore the emotional experiences of clinicians. Conclusions: The emotional work and experiences of clinicians are an important part of the therapeutic process. Narrative autoethnography may be one technique that clinical alphasiologists can use to discuss this aspect of the clinical process and with which research questions can be generated.