The Words That Heal: Conversation, Care, and Consciousness with Dr. Allie Hope King

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About the Episode

In this episode of Etymologies of Care, host Paul Lichtenberg speaks with Dr. Allie Hope King, a scholar of applied linguistics and conversation analysis whose personal experience with breast cancer profoundly transformed her understanding of patient–doctor communication. Allie shares how recordings of her medical appointments became both a survival tool and a research catalyst, revealing how language can either empower or diminish patients—sometimes shaping the trajectory of healing itself.

Together, Paul and Allie explore how medical conversations create (or limit) collaboration, the difference between being explicit and being responsive, and how reimagining “patient” as an active participant can shift care from hierarchical to relational. Their dialogue moves fluidly between scholarship and lived experience—between language as theory and language as life—offering deep insight into how words can literally become medicine.

Topics Discussed:

• What conversation analysis reveals about how humans create meaning together

• How language in medical settings can empower or diminish patients

• Allie’s experience of breast cancer and how communication shaped her care

• The impact of being asked, “What do you understand about why you’re here?”

• Recording medical appointments as both a survival tool and research method

• The difference between explicit communication and relational responsiveness

• The role of vulnerability and mutuality in healing relationships

• How small conversational choices can alter medical outcomes

• Language as both a source of harm and a medium of healing

Suggested Practices:

• Reflect on your own communication experiences — especially in healthcare or other high-stakes conversations.

• Notice empowering vs. diminishing language – Pay attention to whether your conversations create space for collaboration or reinforce hierarchy.

• Record important conversations – When appropriate (and with permission), record significant dialogues to notice dynamics, tone, and responsiveness.

Episode Resources:

• Join the LANSI Group 

• Learn more about the annual LANSI conference 

About Allie:

Allie Hope King received her doctorate in Applied Linguistics at Teachers College, Columbia University. A former Co-President of the Language and Social Interaction Working Group (LANSI) there, she also holds an Ed.M. in Applied Linguistics from TC, an M.Ed. in Foreign Language Education and TESOL from the University of Pittsburgh, a B.A. in Spanish from Shenandoah University, and a B.A. in Modern Languages from Carnegie Mellon University. Her dissertation focused on classroom discourse, specifically examining co-teacher interaction through a conversation analytic lens. She is also deeply intrigued by doctor-patient interaction, an interest sparked by her experience surviving cancer during graduate school and realizing how tightly intertwined interaction and health outcomes can be. While she currently runs the Community Language Program at TC, she is also interested in academic projects and collaborations that might give back meaningfully to society.

• Click here to view a raw, unedited transcript

  Paul (00:36.179)

  Hi everyone and welcome to etymologies of care. I'm Paul Lichtenberg and today we're exploring something profound. How the words spoken in medical appointments can either empower or diminish patients in ways that directly affect healing outcomes. When we first reached out to today's guest about joining us for a conversation on applied linguistics and integrative relational health, something remarkable happened.

  We were taken aback in the most positive ways by her pure humanity, openness, and excitement about potential collaboration. We immediately felt a kind of kinship in our shared purpose without even having met. This speaks to that liminal aspect of language communication, even synchronicity, that comes as a felt sense of familiarity. Though familiarity here must be understood

  at its deepest levels of consciousness. Sometimes the most meaningful connections happen before formal introduction, when shared commitment to healing and understanding creates instant field recognition. I'm sure you've all experienced these moments in your lives. Maybe you've met someone at a conference and within minutes felt like you'd known them for years, or started reading a book that perfectly articulated something you'd been thinking.

  but couldn't express or walked into a space and immediately felt this is where I belong. This connects directly to what we're exploring today, how language and medical settings actually shapes patient experience and reality itself and how certain ways of communicating can create immediate trust and collaborative possibility. Today's guest is Ali King, a doctor of applied linguistics.

  scholar and acting program director at Columbia University's Teacher College. She brings a unique focus on conversation analysis and her personal health journey has completely transformed how she understands patient-doctor communication. Recordings of Allie's medical appointments during her battle with breast cancer would become both a survival tool to remember crucial information and an unexpected inspiration for research.

  Paul (03:03.751)

  that revealed profound insights about healthcare interactions. We are honored to have the opportunity to explore this pivotal moment in your life, Allie, this intersection of academic expertise and lived experience, simultaneously experiencing medical care as patient while maintaining a researcher's eye for the nuances of conversation that can either empower or diminish a person.

  in their most challenging and vulnerable moments. We're hoping through this conversation to explore how language used in medical settings, healthcare context in general, and I would say in all relational fields, actually shapes our deepest experiences and reality. Ali, welcome to the podcast.

  Allie Hope King (03:53.75)

  Hi, Paul, thank you.

  Paul (03:56.463)

  Okay, so let's start with the fun question. What do you think about our title, Etymologies of Care?

  Allie Hope King (04:07.499)

  I love it. First, I'm fascinated by etymology. For me, understanding the origin of words and expressions helps me realize their power, part of which comes from the history and culture that's embedded in them. I remember being relatively young and learning that the word hysterical comes from the Greek word for uterus or womb. That discovery helped me see how language is never really neutral.

  Paul (04:34.163)

  Hmm.

  Allie Hope King (04:34.463)

  Even a single word can carry within it centuries of assumptions about gender, emotion, or authority. So we need to pay attention to the cultural legacies that can be implicit in everyday speech. I especially appreciate the idea of extending the lens of etymology to the notion of care, because it gets at something that we don't usually examine, how the language of care itself has been constructed over time.

  Words like patient and treatment carry histories that shape what becomes possible in healthcare relationships before we even start talking. When you really reflect, you see how much of language is actually shaped by rigid binary thinking that is very much wrapped up in hierarchy and power dynamics.

  The etymological approach offers something unique because it works at the foundational level where reality gets constructed through language. When you excavate how words like care or anxiety have been shaped to serve binary thinking, you're providing tools for people to recognize and reconstruct their own meaning-making process.

  Paul (05:49.917)

  Mmm, beautiful, beautiful. You know, we speak a lot about binary thinking at IRH. From a survival perspective, binary thinking evolved as a rapid threat assessment system.

  However, when this survival mechanism gets applied to complex social realities, it creates artificial categories that then potentially become tools and even weapons for organizing power, as we can readily see. The hierarchy is built into the structure because once you establish a binary, one side invariably gets valued, the other diminished and worse, dehumanized.

  And those who control the definitions of binary categories control social organization. So can you talk a little bit about what conversation analysis is and what the focus of your work has been?

  Allie Hope King (06:48.269)

  Sure. Conversation analysis, or CA for short, is an empirical way to look at how people do things with interaction. Do that again. Conversation analysis, or CA for short, is an empirical way to look at how people do things with language in interaction. We transcribe interaction from video or audio data.

  and then we analyze both the talk and the nonverbal behavior together at the most detailed level possible. This helps us to identify the mechanisms people use to create meaning and to accomplish action while interacting with each other. We look at things like turn-taking, repair sequences, how understanding gets negotiated in real time, and so on. Through both my master's and my doctorate,

  I studied co-teaching, or the arrangement of two teachers teaching together at the same time. I spent years examining this type of collaboration on an interactional level. I first became interested in this topic when I had two doctoral student teachers for a course during my master's.

  While I was impressed with the mechanics I was witnessing, like how they finished each other's sentences or supplemented each other's explanations to improve the instruction, I realized a lot of my fascination actually came from watching a professional relationship unfold right in front of my eyes. As someone who wanted to do the same program as these doctoral teachers, I wondered how I would feel or perform sharing the teaching floor with someone else.

  I could also tell as a student that this collaboration was bringing more to the table than what a single teacher could do alone, but it was just a sense. So I decided to study it. And listeners can read my dissertation if they want to, but I can give away one of the major findings, which is that, yes, the collaborative nature of co-teacher talk in the classroom can definitely contribute some unique and pedagogically advantageous things.

  Allie Hope King (08:58.977)

  that just aren't possible in a solo teacher arrangement. But despite all the years of formal training and research in institutional interaction, perhaps the biggest thing that really worked to bridge the gap between theory and practice for me was actually a major disruption in my studies when I suddenly had to do a year of cancer treatment during the last leg of writing my dissertation. The experience of being both a researcher of interaction

  and a patient at the same time made me realize somewhat drastically how crucial each moment of interaction is in a medical setting like I was in. That experience shifted both my academic interests as well as my goals in studying interaction.

  Paul (09:48.113)

  Wow, that is a powerful insight right there.

  You said you realized that a lot of your fascination came from watching a professional relationship unfolding right in front of your eyes, including and especially when faced with cancer and medical professionals. In other words, if I understand this, you connected your own subjectivity, your own internal experience to bridging the gap between theory and practice, between theory.

  Allie Hope King (10:19.391)

  Absolutely. Yes.

  Paul (10:20.807)

  between theory and relationship. So how can understanding conversation analysis transform how we show up in our most important relationships?

  Allie Hope King (10:32.757)

  I love this question. When I first encountered CA as a master's student, I had no idea how my training in this theory and methodology would literally change how I experience the world and especially how I experienced interacting with others. Conversation analysis gives me the tools to pinpoint things like exactly where communication breaks down or where confusion is caused.

  In truth, we all are proficient in and use these tools subconsciously. Everyone with interactional competence relies on them. But having CA as a tool helps me make them visible and describable. That awareness helps me to recognize and change my own patterns and even helps me to have harder conversations with others.

  Paul (11:21.831)

  Totally, totally. So walk us through what your world was like during that season of 2023 when you were delivered this diagnosis.

  Allie Hope King (11:34.574)

  Yeah, well, I was diagnosed with breast cancer in August 2023. Actually, my story is somewhat of a cautionary tale. In spring 2022, I thought somebody fell off during my self-exam, and so I went for a mammogram and an ultrasound, and it was given the all clear. Fast forward a whole year, and you could see a lump in my breast through my shirt.

  Paul (11:43.634)

  Mmm.

  Allie Hope King (12:00.939)

  My gynecologist agreed that it seemed concerning. So I once again went for a mammogram and an ultrasound. During that process, I was so petrified that my legs were shaking. I had told the tech that my mother also had had breast cancer. Sorry, I'm gonna start over with this one, sorry.

  Paul (12:11.891)

  Hmm.

  Paul (12:16.029)

  Mm-hmm. Sure. Of course, of course.

  Allie Hope King (12:20.333)

  So I was diagnosed with breast cancer in August, 2023. Actually, my story is somewhat of a cautionary tale. In spring of 2022, I thought something fell off during my breast exam. And so I was sent for a mammogram and an ultrasound and I was given the all clear.

  Paul (12:26.631)

  So.

  Allie Hope King (12:37.161)

  Fast forward a year and you could see a lump in my breast through my shirt. My gynecologist agreed that it seemed concerning, so I once again went for a mammogram and ultrasound. During that process, I was so petrified that my legs were shaking. I told the tech that my mother had had breast cancer. The tech was kind and supportive. After the images were done, she came out and handed me the all clear paperwork and said to me, it's just a cyst.

  Paul (13:07.187)

  Mm.

  Allie Hope King (13:07.285)

  I remember that word just, standing out and holding so much relief like it's no big deal. So even though I had been completely convinced before those scans that I had breast cancer based on what I could see with my own eyes, I took the professional's words to heart. I was about to continue with my busy life. So my unsolicited advice here is to push for more tests if you feel like something isn't right.

  Paul (13:09.873)

  Mm-hmm.

  Paul (13:25.376)

  you

  Allie Hope King (13:37.9)

  I'm so lucky that my gynecologist was not convinced by those scans because she pushed for a biopsy. A few days after that procedure, I got an email from the portal saying that my results were available. So I opened it thinking it was going to be a case closed kind of thing. So that's how I found out I had cancer while I was in a laundromat at 7 a.m. in the morning. A month later, just before I was getting ready to start treatment, my mother died unexpectedly.

  Paul (13:50.653)

  Mm-hmm.

  Paul (13:54.109)

  Totally, yeah.

  Paul (14:00.049)

  Mmm.

  Paul (14:05.435)

  Okay.

  Allie Hope King (14:08.043)

  And my dad, who had been diagnosed with Parkinson's years before this, didn't want to live the state of Virginia where they had lived. Start over.

  Paul (14:10.259)

  Thank

  Allie Hope King (14:19.597)

  So that's how I found out I had cancer while I was in the laundromat at 7 a.m. A month later, just before I was ready to start treatment, my mother died unexpectedly. And my dad, who had been diagnosed with Parkinson's years before this, didn't want to leave the state of Virginia where they lived. So my siblings and I moved him into a facility and I ended up in charge of most of his life from afar.

  So there I was, single, trying to finish my doctorate, and suddenly I was a caretaker and navigating cancer treatment pretty much alone.

  Paul (14:48.775)

  Mm-hmm.

  Paul (14:53.971)

  Hmm. Let's just take a pause if we can. Wow. That's a lot.

  Allie Hope King (15:00.215)

  Yes.

  Allie Hope King (15:07.693)

  It is a lot.

  Paul (15:10.191)

  Is this the first time you shared the story in this way?

  Allie Hope King (15:17.259)

  Maybe the whole thing. I I've shared bits and pieces and the part about, so I like to take a little bit of responsibility for a major change at the hospital because when I got that email saying your results are ready, I assumed that I got the email because it was negative, right? That everything's fine. They're not gonna send you an email.

  Paul (15:19.955)

  That's a

  Paul (15:34.589)

  Mm-hmm.

  Paul (15:39.495)

  Yeah,

  Allie Hope King (15:43.212)

  telling you have cancer. So I'm there and I'm just like, okay, it must be something else. I was just being, you and so I open it and like, it's that complicated, you know, results and it says like carcinoma and you know, da da. And I was like, it's just gotta be like a mistake. They just wouldn't tell you over email. And so when I called the office,

  Paul (15:50.606)

  Thank

  Paul (15:56.691)

  Totally. Yeah. Yeah, yeah, yeah.

  Paul (16:10.355)

  And yet they would, and yet they do.

  Allie Hope King (16:13.525)

  And yet they wouldn't, do. so plus it was 7 a.m. so I had to wait for the offices to open and called my best friend, called my sister. But when I finally talked to the office, said, is this actually my results? And the woman said, I am so sorry. It's a New York state law that the institution must release the results immediately to the patient.

  Paul (16:20.117)

  my

  Paul (16:31.443)

  Yeah, you're right.

  Allie Hope King (16:42.657)

  And I get that, I understand that as a benefit that I'm sure patients pushed for to have their own information accessible. so now, cause I went around telling everybody at the hospital, I was like, yeah, that really sucked. I was like, thank God I have some tools to manage my.

  Paul (16:50.386)

  Yeah.

  Paul (17:00.21)

  Yeah.

  I mean, we don't have more creativity how to deliver such significant and frightening news. It has to be done on an email.

  Allie Hope King (17:12.95)

  Or even...

  Right, or even just, it's dangerous.

  Paul (17:18.963)

  It's dangerous. It is absolutely dangerous.

  Allie Hope King (17:23.854)

  and you and I think also that because it's

  Paul (17:26.927)

  It's actually, for me, it feels cruel.

  Allie Hope King (17:31.17)

  Yeah, yeah, because not only it's news, and in this case it's negative news, but it's also a lot of complicated information that you're going to try to understand because it's so paramount, it's so big. But now, at least in this system, this portal, you can choose. You can say, want my results immediately, or I would rather...

  Paul (17:40.851)

  100 %

  Paul (17:53.105)

  Yes. Yes.

  Paul (17:59.453)

  There you go. There you go. Yeah.

  Allie Hope King (17:59.63)

  So they changed that and I like to think it's because I went around the hospital telling everybody that I found out I had cancer at 7 a.m. in a laundromat.

  Paul (18:06.833)

  Yes, yes. Wow, that's powerful. And you know what? This segues so beautifully into our next session, the section two language is the reality we speak, right? Because it shows like we're indoctrinated to believe like that's okay. This is the way the system work and that's okay. But guess what? It's not okay.

  and it connects with what I'm about to say. So why don't we just continue with that. Okay. So Ali, the idea that there's nothing wrong with you as a human person, even when your body needs medical attention, how does that land with you?

  Allie Hope King (18:37.365)

  Excellent.

  Allie Hope King (18:53.741)

  As a woman who is not only neurodivergent, but who's also struggled with mental health challenges her entire life, I am acutely aware of the feeling or the implication that there is something wrong with me. With respect to medical things, I have seen firsthand how when you have different diagnoses, whether it be breast cancer or mental illness, there are a lot of forces in our society that seem to push you to become this thing.

  Paul (19:23.155)

  Mm-hmm.

  Allie Hope King (19:23.637)

  It's not only because of how these experiences impact your daily life. It's that the world, including the medical authorities you're working with, frames it that way. The typical medical model problematize. The typical medical model locates problems within the patients. You have cancer, you're non-compliant, you're anxious. So I really appreciate the effort to reframe this.

  Paul (19:43.569)

  Mm-hmm.

  Allie Hope King (19:52.384)

  I was dealing with cancer. I experience anxiety. My brain works differently than many. But I am not these labels. And there's nothing wrong with me as a human because of these traits or situations. Ironically, though, in my particular cancer journey, I have to say that some parts of the experience actually made me feel more valuable as a human, which I would say is in contrast to the idea of there being something wrong with me.

  I participated in a huge medical trial as well as another research study on the use of a post-surgical medication dispensing device. So not only did getting to participate in this research really fire up my nerdiness, but I got to frame my illness and treatment as contributing to society. And a big part of why I felt that way was how I was treated by the medical staff and the researchers.

  Paul (20:29.779)

  Mm-hmm. Mm-hmm.

  Paul (20:48.179)

  Mmm. I got to frame my illness and treatment as contributing to society. I just want to pause for a moment here. It's not just that you got to frame your illness and treatment.

  but that you had in the very core of your being, the wisdom and desire to reframe and reconstitute a pathologized core belief that there's something wrong with you. I would like the therapists and clients out there to think about what Ali just shared. We fundamentally have the wisdom, resilience and desire

  Allie Hope King (21:22.295)

  Absolutely.

  Paul (21:33.755)

  to reveal and engage our core health despite what happened to us and what we've been taught. We must make this explicit. So let's unpack how this works. Ali, how did you witness language literally creating different versions of your medical reality?

  Allie Hope King (21:42.925)

  You

  Allie Hope King (21:59.406)

  So I'd like to mention a couple of examples because I had many occasions where the way an interaction went with a doctor was paramount in making my experience positive and healing. But there were a few occasions where the interaction nearly led to what I would categorize as an undesirable medical outcome.

  Paul (22:10.259)

  Mm-hmm.

  Paul (22:18.215)

  Hmm.

  Allie Hope King (22:19.233)

  The positive one happened at the very beginning of my first medical appointment of the whole journey. A hematology fellow was my first interaction. And he asked me a question that, when I thought about it later, really floored me. And it seemed brilliant in the way to start a long-term relationship with their department.

  Paul (22:42.173)

  So what exactly did the fellow ask you in that first appointment?

  Allie Hope King (22:47.789)

  So was pretty much the very first thing he said. And he asked, so why don't you tell me a little bit about what you understand about why you are here? To be honest, my mother had died only days before this appointment. So I barely remember most of that day.

  But as I got a chance to process and reflect, particularly as someone whose life is much about analyzing interaction, I realized later that the way the fellow opened the interaction was extraordinary.

  Paul (23:22.525)

  Hmm. You know, I remember when I first read the fellows question and your response as it being transformative. This very question is actually how we begin a therapy journey with clients. So what felt extraordinary to you?

  Allie Hope King (23:39.661)

  yeah.

  Paul (23:44.717)

  and it was by the way, that's the whole point, is actually an ordinary opening to authentic relating. That it feels extraordinary speaks to a larger cultural phenomenon regarding relational literacy that we are studying and aspiring to address. The need to cultivate relational literacy and authentic relating across cultural fields.

  Right? So, so how did this question for you construct a different reality than typical medical interactions?

  Allie Hope King (24:15.402)

  Yeah.

  Allie Hope King (24:25.344)

  Well, most medical interactions seem to begin with closed questions or expert statements that position the doctor as the knowledge holder and the patient as a passive recipient. In my situation, however, I was being given the floor right away to report on what I understood so far about this giant medical situation.

  As a patient, I appreciated this approach because it gave me lot of agency at a time that I felt literally everything was outside my control.

  Paul (24:58.227)

  Mmm.

  Allie Hope King (24:59.126)

  But as a researcher of interaction and a former teacher, I realized that starting this way is also an excellent opportunity for the fellow to witness my frame of mind, to glean how much I'd understood about my brand new diagnosis, to perhaps assess a bit about things like my intelligence or my personality that might inform how he talked to me during the rest of the interaction.

  Paul (25:08.22)

  Mmm.

  Allie Hope King (25:25.576)

  So I saw it as such a useful way to start for both parties, making a collaborative field where I could contribute to constructing the reality of my own medical situation.

  Paul (25:27.571)

  Thank

  Paul (25:37.405)

  phenomenal, just phenomenal. And how did it give you agency at that moment?

  Allie Hope King (25:43.181)

  Well, the question essentially shifted me from a passive recipient to an active participant. It made me feel like I was a part of my medical team because I was co-creating understanding with someone who had medical expertise. It honored my lived experience first before any of the doctor's clinical knowledge was brought into the context.

  Paul (25:50.439)

  Mm-hmm. Mm-hmm.

  Paul (26:07.985)

  Yeah, yeah. And what social dynamic did this language create between you and your care team?

  Allie Hope King (26:15.786)

  I genuinely feel that it helped to create a sense of partnership in a context that is far more typically one of hierarchy and power differential. The appointments where I experienced this collaborative approach, I left feeling more capable of managing my treatment, more connected to my body's wisdom, and more able to make informed decisions. I would say these conversations literally affected my capacity to heal.

  Paul (26:45.619)

  That is simply brilliant. These conversations literally affected my capacity to heal. You know, from an IRH perspective, conversation etymologically refers to how individuals are relationally constituted. That is, in conversation, we're not just speaking with, we are living and turning with the other.

  We are co-creating reality as opposed to an expert or someone in power dictating what my reality is. The empowerment in that truth and fundamental reality must be made explicit. So, you you mentioned that there was an instance where you felt the language nearly led you to an undesirable outcome. you share that situation?

  Allie Hope King (27:29.184)

  Yes, yes, absolutely.

  Allie Hope King (27:41.034)

  Yeah.

  Yeah, so following the medical trial, I had a double mastectomy with reconstruction. So that's a handful of surgeries. After the one where I got my implants, I was not happy at all with what I saw in the mirror. The medical term is semastia, but I called it uniboob. So my implants were so close together. I felt like it looked kind of ridiculous.

  Paul (27:53.395)

  Mm-hmm.

  Paul (28:09.767)

  Mm-hmm.

  Allie Hope King (28:10.092)

  In a post-op appointment, first explained how I felt to the physician's assistant. When the surgeon came in, the PA reported to her, Allie said that she notices a little bit of semastia.

  What followed were the two of them speaking to each other about my body in front of me. And my takeaway by the end was that they really didn't see a problem. I remember walking out the door pretty unhappy and thinking, I guess this is as good as it's going to get. But then when my oncologist saw my surgical results for the first time, she mentioned that she thought my breasts were rather close together.

  Paul (28:34.771)

  Mm. Mm. Mm-hmm.

  Paul (28:49.084)

  Hmm

  Mm-hmm.

  Paul (28:55.815)

  Yeah.

  Allie Hope King (28:59.922)

  That validation encouraged me to mention the issue to the surgeon right before my next scheduled surgery. While I didn't want to criticize her work, being able to say, Dr. So-and-so also thought they were too close together, somehow made it possible for me, and I got my whole surgery changed. The issue was fixed and I ended up happy with the results. So in the end, it was a positive outcome.

  However, I looked back and I realized how on the one hand, just a tiny bit of interaction in that first appointment nearly led to a very negative outcome for me. But on the other hand, just a tiny bit of interaction in the next appointment gave me the validation I needed to advocate for myself and change the trajectory completely.

  Paul (29:39.752)

  Mm-hmm.

  Paul (29:53.381)

  I need another pause. Wow, what you are sharing.

  Allie Hope King (29:55.456)

  Go for it.

  Paul (30:03.058)

  is

  It's so deeply moving to me. just need you to know that.

  You know, I don't want to use the word the courage because it's it's so it's actually so much deeper than that. I'm just so deeply moved by by your openness and and I truly believe and we spoke about this last time, right? And this is kind of why.

  Allie Hope King (30:34.795)

  Mm-hmm.

  Paul (30:39.505)

  disclosure, sharing personal information, which I do. mean, anybody could just read my sub stack and see, wow, he's really sharing a lot of personal. And I do it because it serves the relationship. I don't do it because of how I'm going to look or anything like that, or that it is courageous or hero. I do it because.

  Allie Hope King (30:54.945)

  Yeah.

  Paul (31:05.927)

  people need to hear that they are not alone and that we're all in this together, you know? We really are, we're all in this together. And so these profound personal stories that we have,

  Paul (31:28.211)

  They're just not healing for us in our being able to witness our own experience, but they help us to connect on a much, deeper level. So I just needed to share that right in the middle of our podcast.

  Allie Hope King (31:43.117)

  Well, no, it's interesting because it makes me think of right now I have a therapist and I have a nurse practitioner, psychiatrist, and they... I know nothing about my therapist. I know nothing about her. except one time she did relate with the fact that she worked in a hospital. And it's like it just, for me, makes the relationship less successful.

  Paul (31:52.284)

  Yeah.

  Paul (31:58.983)

  Yeah.

  Allie Hope King (32:11.882)

  whereas the NP psychiatrists just occasionally they'll just relate in a way that makes me feel like, I just unloaded all of these things that are quote unquote, like we're talking about wrong with me. And then they respond like, I can relate. And just seeing that, it makes me feel like this isn't such a unidirectional relationship. We are collaborating. And I recognize why.

  Paul (32:36.755)

  Yeah.

  Allie Hope King (32:38.462)

  It's important for therapists to have boundaries and I completely get all of that. But I know that I respond so much more when the person who's in charge of helping me is able to share a bit about themselves because otherwise I feel like they're just too different from me or they're better than me or whatever.

  Paul (32:42.501)

  Of course.

  Paul (33:01.949)

  Yeah, yeah. You philosophically, we could use language such as it levels the hierarchy, you know, what it does is it deepens relationship. You know, because that's what leveling hierarchy actually means that we're now in relationship, that we are now co-creating this profound healing journey. And

  Allie Hope King (33:09.515)

  Yeah.

  Allie Hope King (33:13.46)

  Exactly.

  Allie Hope King (33:18.43)

  Exactly. Yes.

  Paul (33:29.669)

  Anyway, there's so much more to talk about that and we will in later in later episodes for sure. But this is this is it's funny because this is actually the essence of the podcast. OK, so section three is connection is healing, of course. At at IRH, we focus on relational health instead of mental health.

  Allie Hope King (33:36.385)

  Excellent.

  Allie Hope King (33:44.128)

  Yeah, yeah.

  Ahem.

  Allie Hope King (33:52.62)

  You

  Paul (34:00.167)

  What do you make of that distinction?

  Allie Hope King (34:03.38)

  I think the distinction is really powerful. I've struggled for my entire life with my mental health. I was about seven the first time I was sent to therapy. When I look back on my life, I now believe that a lot of what was framed as a quote, mental health problem in my childhood was actually about relational disconnection. I grew up in a home where we did not communicate well and we definitely did not talk about emotions.

  As a wildly sensitive and empathic kid, I always felt isolated and misunderstood. Therapy was perhaps helpful, but what I really needed was love, communication, and connection. As an adult, I've seen over and over that my own ability to face major challenges, whether mental health struggles, cancer, losing my parents, not my patients, ha! As an adult,

  Paul (34:54.515)

  Mm-hmm.

  Allie Hope King (35:00.608)

  I've seen over and over that my ability to face major challenges, whether mental health struggles, cancer, losing my parents, or even finishing my doctorate, has depended so much on the quality of my relationships. Feeling surrounded by care, but especially from people with a shared experience, makes my struggle survivable in a way that isolation never does. For me,

  Paul (35:00.829)

  Yeah.

  Paul (35:09.235)

  Bye.

  Allie Hope King (35:28.938)

  Relational health is the foundation. It's what makes both healing and growth possible.

  Paul (35:35.635)

  So.

  Okay, so we're going to pause here for a second and I'm going to tell you why.

  Allie Hope King (35:41.31)

  Okay.

  Paul (35:47.633)

  my natural response to what you shared is actually different than the next question. The next question is, did your conversation analysis background change how you experienced it? I don't know how that happened. yeah, but you know, what you just shared is like everything for me. And so I'm gonna figure out a way

  Allie Hope King (35:55.499)

  Okay.

  Allie Hope King (36:01.098)

  Yeah, kind of jump.

  It's okay.

  Paul (36:17.649)

  to insert something else in there. And so we're gonna pause that and let's go to, I'm gonna figure it out and bring what you just shared into this next question, okay? But I'm gonna do it later.

  Allie Hope King (36:23.564)

  Okay, that makes sense.

  Allie Hope King (36:32.148)

  Okay, so you'll just do that later.

  Mm-hmm.

  Allie Hope King (36:40.596)

  Okay. Okay, got it.

  Paul (36:44.721)

  What literally impresses me so deeply is how you intuitively knew what you needed and for the most part, what you presented was respected, recognized and honored in your medical care. This is foundational for integrative relational psychotherapy. Again, how we honor and make explicit that the relationship is the medium of healing.

  Allie Hope King (37:01.292)

  Mm.

  Paul (37:13.584)

  and the paradox of that principle is that true autonomy is intimate. When a person's individuality is honored, the relational simply blossoms. As you say, you had both a right and a responsibility to participate in these conversations about your own health and body. I'm curious, what made you decide to start

  recording your appointments and how did this change your experience as a patient?

  Allie Hope King (37:49.677)

  So initially it was just practical. I could not remember what the doctors were saying due to the stress and the medications, so a lot of people recommended it. I too would recommend this to anyone, but especially people who are going to their appointments alone. But then as I settled into the process of being a patient, while still attending conferences and still working on my dissertation, I also began to see these recordings as a data goldmine.

  Paul (38:02.515)

  Mm-hmm.

  Yeah.

  Allie Hope King (38:18.218)

  And I started wanting to do some type of formal research or other work with this data to really delve into how language was shaping my treatment and healing process.

  Paul (38:29.917)

  Hmm. So what did you discover when listening back about how language was shaping your experience?

  Allie Hope King (38:38.774)

  Well, I have yet to go through all the recordings as a researcher. I had to finish my dissertation and graduate first. And these days, I'm mostly still trying to just focus on my health as much as I can outside of my job. But I did listen back to some of it. And there were a few incidents that really stood out where

  Paul (38:42.61)

  Mm-hmm.

  You

  Paul (38:52.755)

  Mm-hmm.

  Allie Hope King (38:59.232)

  What was being said made a lasting impression on me as a patient and will be really interesting to examine further as a researcher. So I've already talked about the incident where I felt like my complaint was, rewind, I've already talked about feeling like my complaint with the reconstruction results was diminished. There was another.

  Paul (39:08.083)

  Mm-hmm.

  Paul (39:20.711)

  Yeah.

  Allie Hope King (39:22.024)

  interesting thing that I thought a lot about that was said during a couple initial visits with plastic surgery. So there's this one surgical procedure that people can get where they take belly fat and they construct breasts from that. And to be eligible, you have to have enough belly fat. So during the part of the appointment where I was being measured to see if I was eligible,

  Paul (39:35.987)

  Mm-hmm.

  Allie Hope King (39:46.241)

  The PA let me know that I didn't have enough belly fat to do the surgery and multiple times she told me, that's a good problem to have. On the one hand, that's framed as a problem because the medical intervention is not an option for me. But on the other hand, it's good because what? Well, you have to extrapolate that, but the comment is basically saying that not having belly fat or being thin is preferable.

  Paul (40:02.387)

  Mm-hmm.

  Paul (40:06.705)

  What?

  Paul (40:15.866)

  Absolutely.

  Allie Hope King (40:17.024)

  I'll be honest, I felt complimented because she was saying that I wasn't overweight, which in our society is still stigmatized. As much as the feminist in me may have cringed when listening back to that, in the moment, it felt as though she were constructing a genuine consolation. So it was this really layered way that the professional's language shaped my experience in that case. But at the time, it worked to make me feel like

  Paul (40:25.363)

  Hmm.

  Paul (40:30.183)

  Mm-hmm.

  Paul (40:35.699)

  Yeah.

  Allie Hope King (40:45.418)

  At least there's some positive aspect to not being qualified for this surgical option.

  Paul (40:51.181)

  Mm-hmm my there's so so so so much to say about that one and I'm just thinking about all of the mixed messages we get in culture

  Allie Hope King (41:07.286)

  Yes.

  Paul (41:09.715)

  How can we not be confused?

  about identity. How can we not be confused about relational intimacy, relational literacy, authentic relating when we have all of these profoundly mixed messages coming from these systems that we depend on and have such power.

  Allie Hope King (41:33.097)

  Absolutely.

  Allie Hope King (41:42.292)

  Right? And the mixture of feeling like I was being complimented and yet feeling good about that even for one second made me feel like I needed to turn in my feminist card, you know? But when you're in the moment of you're losing part of your body and you're facing all of that.

  Paul (41:48.051)

  Thank

  Yes.

  Paul (41:57.893)

  Exactly.

  Paul (42:04.563)

  you

  Allie Hope King (42:07.549)

  it hits differently to be told, but maybe this other thing looks nice on you. And yeah, it's very confusing and conflicting.

  Paul (42:16.869)

  and conflicting for sure. Hopefully, actually, hopefully it's conflicting because that means we're in awareness and we know something is, yeah, something's off, something's not aligned, something's, yeah, something needs to be addressed.

  Allie Hope King (42:22.698)

  Great.

  Absolutely.

  Allie Hope King (42:34.194)

  Absolutely.

  Paul (42:37.293)

  Ali, how did you balance being a patient with being a researcher? In other words, how did you navigate being both observer and observed?

  Allie Hope King (42:50.215)

  I guess I would say the researcher perspective never went away. And I think my awareness of the mechanics of institutional interaction actually helped me advocate for better communication. I even started telling the doctors about that fellow's question and about the importance of how they structured our interactions.

  Paul (42:54.279)

  Mm-hmm.

  Mm-hmm.

  Paul (43:13.318)

  Yeah. And how did the doctors respond when you shared your expertise with them?

  Allie Hope King (43:20.779)

  I probably came across as the biggest nerd ever, but I think they were intrigued. It seemed to me that most hadn't considered how their conversational choices were affecting patient experience and outcomes, at least in the way I think about it. My oncologist told me that she was going around at conferences telling other doctors about me and all the stuff I was telling her.

  Paul (43:28.957)

  Uh-huh.

  Paul (43:48.979)

  Yeah, you know, I want to I want to just take another moment here because as we were just sharing that like how did they respond to your expertise? I'm thinking of the many many many people who don't have the ability or sense of empowerment to self-advocate

  Allie Hope King (44:15.441)

  It's interesting because after my mom passed away, and you reflect and you process and all this stuff, but one of the things my mom did in her many, many jobs, she was a big volunteer and everything, she was a patient, I think back then they called it a patient representative, but maybe now it's a patient advocate. And her father was a physician and her mother a nurse. And so I think I realized that perhaps

  Paul (44:20.719)

  Mm-hmm.

  Paul (44:31.219)

  Mm-hmm.

  Paul (44:38.664)

  Yeah.

  Allie Hope King (44:45.821)

  subliminally or very implicitly in my young years, I also had it reinforced that, you know, patients have rights and people need to be looking out for them. So perhaps even before all of this awareness of how that happens in interaction, just understanding about rights and fairness and, you know, advocacy, perhaps that also was just sort of, I inherited some of that.

  Paul (45:03.079)

  Yes.

  Paul (45:16.435)

  You most certainly did. You internalized that for sure. Yeah. You mentioned that these interactions quote unquote saved your life. How did specific language patterns become, I love this, healing elements?

  Allie Hope King (45:20.297)

  Yes.

  Allie Hope King (45:37.77)

  Definitely healing elements. You know, I feel like I lucked out because not only were my doctors all highly skilled and I got to do a trial that was extremely successful in shrinking my tumor, but I also genuinely felt emotionally supported and respected most of the time by most of the team. When the doctors created conversational space for my understanding and agency,

  Paul (45:56.851)

  Mmm.

  Allie Hope King (46:04.723)

  I think it activated something beyond medical treatment. It became collaboration, one that I really hope to make something out of going forward. It would be nice to have something positive come out of having cancer.

  Paul (46:20.231)

  Yeah, for sure. And coming out of cancer, as you say, personally, when I hear to make something out of going forward, I think of like this podcast episode, know, something to help others going forward. Right. And I know that's that is absolutely in your heart of hearts. Yeah. Yeah.

  Allie Hope King (46:36.864)

  Mm-hmm.

  Allie Hope King (46:41.493)

  Yes.

  Allie Hope King (46:46.621)

  Absolutely.

  Paul (46:49.743)

  Okay, so let's examine the etymology here. Let's have some more fun with that. The word patient comes from Latin, patience, meaning suffering or enduring. It embeds passivity into the identity before dialogue begins. What would medical conversations look like if they were designed around

  Allie Hope King (46:55.145)

  Yay.

  He

  Paul (47:17.341)

  how humans actually create meaning together.

  Allie Hope King (47:23.115)

  Yeah, so piggybacking on your etymological thread, this question actually makes me think of the word binary that you brought up in our first meeting. So its origin is from the Latin binarius, or consisting of two. So binary thinking, for example, reduces people to either or, doctor or patient, teacher or student.

  Paul (47:24.44)

  Hahaha.

  Paul (47:34.055)

  Yeah.

  Paul (47:47.731)

  Mm-hmm.

  Allie Hope King (47:52.95)

  But patients hold the most knowledge about their own experience, so solutions require collaboration. That's why I prefer the notion of dialogue, which is from the Greek, dialogos, which means to speak across or between. So medical conversation should be about dialogue.

  not a unidirectional force with rigid rules, but rather a two-way exchange based on the shared creation of meaning and solutions.

  Paul (48:26.131)

  Wow-wee. I will say amen.

  Allie Hope King (48:27.915)

  Absolutely. I love words.

  Paul (48:34.909)

  So, so cool. Okay. For all listeners who want to experiment with these ideas that we are playing with today, very seriously, what are some concrete steps they can take?

  Allie Hope King (48:54.923)

  Well, I think since patients usually already have a lot on their plate, I would love it if the medical professionals would take the lead in this initiative. Give the patient the floor first. Let them feel like a participant in their own care because they are. Better yet, tell them this explicitly.

  Paul (48:59.585)

  huh.

  Allie Hope King (49:17.233)

  It may feel stressful due to time management concerns or may slow down your typical pace, but in the end, it may lead to more positive outcomes for both of you.

  Paul (49:29.181)

  Hmm. Allie, you mentioned considering writing for lay audiences rather than academic journals. And that is actually my prayer, by the way. What do you hope to accomplish by making these insights accessible to everyone?

  Allie Hope King (49:51.605)

  Well, just in case my dissertation advisor listens to this, I should clarify that I'm considering writing for lay audiences in addition to trying to publish in academic journals. But I really do feel that while we applied linguists are studying what humans do with language, how we report on it is not so accessible to most humans.

  Paul (49:54.683)

  Hahahaha

  Allie Hope King (50:18.067)

  If I'm a busy surgeon or oncologist or I'm a person dealing with cancer, I need something clear, digestible, and especially relatable. I don't know what this will look like, but I feel that there's a way to create something that will reach people more widely.

  Paul (50:36.691)

  You know, one of the IRH principles that I mentioned in my last episode with Lauren Barigan and throughout this episode is the practice of being explicit that you just mentioned. In medical conversations, we often assume and hope that understanding is shared when it may not be.

  Your experience showed how that fellow's explicit question created completely different possibilities than typical implicit medical encounters. Can you talk about how explicit versus remaining implicit shapes conversation analysis dynamics?

  Allie Hope King (51:24.331)

  Sure. So there is just so much nuance to conversation, regardless of whether it's institutional talk like doctor-patient interaction or everyday conversation like at the family dinner table. In either context, there will always be parts of the meaning that are conveyed explicitly and parts that are conveyed implicitly. A lot of conversation analysis is about identifying how the participants orient.

  Paul (51:53.299)

  Mmm.

  Allie Hope King (51:53.353)

  to what's been said. And that's the space where you can figure out if understanding has been achieved. In the experience that I had where I felt like the PA and the plastic surgeon were diminishing the physical problem that I had, I recognized that I did a lot of reading between the lines there.

  If I had spoken up in that moment and perhaps been more explicit with my dissatisfaction, perhaps things would have been sorted earlier and I wouldn't have walked away thinking I was stuck with this problem. But the key thing here is that I did not feel comfortable doing that, bold as I may be. It's not an easy thing to critique a surgeon's work, even if it's on your body. So perhaps more explicit...

  Paul (52:23.784)

  Mm-hmm.

  Paul (52:29.518)

  Mm-hmm.

  Allie Hope King (52:38.268)

  explicit questions on behalf of the surgeon would have helped. I understand that a question like, are you completely happy with the results? May feel like it opens the door for complaints, but I think that's the point. In this kind of power dynamic, I don't know that patients feel the best about complaining unless that door is opened for them.

  Paul (52:51.869)

  Yes.

  Paul (53:00.753)

  Yeah, for sure. There's something else important and related I want to explore here. The difference between being explicit and responsiveness. This distinction is crucial for understanding relational care. Being explicit actually operates in a kind of binary term. Something is either made explicit or remains implicit.

  Allie Hope King (53:12.614)

  Mm-hmm.

  Paul (53:27.685)

  You either state your expectations clearly or you don't. You either make the relational frame explicit or you leave it assumed. Responsiveness, however, is more nuanced and involves layers of complexity that resist binary categorization. It includes perceptual and emotional sensitivity, what someone notices in the relational field, processing capacity.

  how they metabolize what they perceive, cultural frameworks, how their background shapes appropriate response patterns, emotional availability, their capacity for engagement in the moment, very much what you're talking about here, and systemic constraints, what their context allows or inhibits, timing and pacing, when and how responses emerge and embodied attunement.

  Allie Hope King (54:09.299)

  Right.

  Paul (54:22.309)

  somatic responsiveness beyond verbal engagement. This suggests that while you can teach someone to be more explicit, right, state your boundaries, clarify expectations, name what you're observing, developing responsiveness requires addressing multiple interconnected factors simultaneously. Someone might master explicit communication, but still struggle with responsiveness

  Allie Hope King (54:42.109)

  it does, yeah.

  Paul (54:50.279)

  due to overwhelm, cultural misalignment, or compromised nervous system capacity. So what can see a capture about explicit moves versus these more complex dimensions of responsiveness? That's a big one right there, but it's really beautiful and important. It really matters.

  Allie Hope King (54:56.852)

  Yeah.

  Allie Hope King (55:15.802)

  Yes, it really does. You know, I have a friend who's an ER psychiatrist and also a professor of medicine. So he works with and trains doctors. I brought my idea up to him of in some way using both my analytical mind and my cancer survivor mind to help change some of the ways that medical professionals interact with patients. And he made a similar point.

  Paul (55:21.683)

  hunt.

  Paul (55:28.305)

  Yeah.

  Allie Hope King (55:45.349)

  Sure, you can teach med students some of these explicit practices that they could essentially memorize and execute, but it won't make up for the inherent ability that some people have, but some people lack, to naturally engage and be responsive. So it's a fair point. But...

  Paul (56:00.211)

  Mm-hmm. Mm-hmm.

  Allie Hope King (56:03.698)

  You know, I suspect that any medical professionals who are not yet great at being responsive and interaction could really benefit from at least becoming aware of how their approach influences the conversation. In my field, we use video recording as a training tool in education. And this is so that novice teachers can not only get a more objective sense of what they're doing while they're teaching, but they can also see how their students

  Paul (56:14.429)

  Yeah.

  Hmm.

  Allie Hope King (56:33.612)

  students are responding. We also have in CA what's called CA-based interventions. This is when the practitioner, say a doctor or a teacher, for example, gets recorded while practicing. And they may also be trained a little bit in CA transcription and analysis. And there's evidence that participating in this kind of research can really open someone's eyes about their own interactional

  Paul (56:40.442)

  Mm-hmm.

  Allie Hope King (57:03.082)

  and patterns, and there's also longitudinal work that shows it can help them change over time. So I really think that there's something there that could be adapted to, the very least, help people start to see what responsiveness looks like, what happens when it's missing, and so on.

  Paul (57:05.203)

  Mm-hmm.

  Paul (57:10.705)

  Hmm.

  Paul (57:14.567)

  Mm-hmm.

  Paul (57:22.109)

  Yeah.

  Yeah, yeah. You know, it's so cool for me. Is that what you are describing is what I would actually call therapeutic. It's not therapy. It's therapeutic because because of what we're creating in the relational field.

  Allie Hope King (57:40.068)

  Mm-hmm. Makes sense.

  Allie Hope King (57:50.205)

  And part of that is the relationship with yourself, right? Like I think when you're a practitioner, I mean, they've done all sorts of studies about this, but you know, we think we remember what we did when we taught or when we had, we think we remember, but our memory isn't perfect ever. And it's always subjective. And so having a video recording for you to be able to see yourself doing whatever it is that you do.

  Paul (57:53.171)

  Absolutely.

  Yeah.

  Paul (58:15.367)

  Yes. Yes.

  Allie Hope King (58:17.962)

  I like to think it creates a little person that stands on your shoulder so that when, if you're a teacher who talks too much or you know, your volume's too low or anything, then you get this little other person that can kind of objectively remind you, there's that thing that you do again.

  Paul (58:26.469)

  and

  Paul (58:30.483)

  Mm-hmm.

  Paul (58:35.431)

  Yeah.

  It's like the Metta witness.

  Allie Hope King (58:40.318)

  Yes, yeah. And it's just, it's, you know, with technology, we didn't have this in the past, but now we do. And I think that technology can help us just, the recording at least, can help us become more objective.

  Paul (58:46.653)

  Right,

  Paul (58:54.195)

  Yeah, and this is great because technology can become more relational.

  Allie Hope King (59:02.975)

  Yes.

  It's not gonna go away, so I think... Yeah.

  Paul (59:05.553)

  I believe that to be true. Yeah. So what message do you want to leave listeners about the power of language in their own healing and growth?

  Allie Hope King (59:20.05)

  Okay, so I'll start with a little poem that I recently found in one of my childhood notebooks when I moved. There I wrote, sticks and stones may break my bones, but words, they can destroy me. So can you tell I was bullied as a kid? But seriously, I think I've always understood the power of language. My little poem is obviously read

  Paul (59:26.31)

  the

  Allie Hope King (59:48.86)

  reacting to how language can hurt people. But as an adult, I've also had the opportunity to see how language can be crucial in healing as well, from cancer, from trauma, from isolation. So I want to highlight for people that interaction is not a secondary part of any situation, especially in medical interactions. For patients, I would emphasize that your voice is paramount.

  Paul (01:00:11.837)

  Mm-hmm.

  Allie Hope King (01:00:17.616)

  Even if you're not a medical professional, try to speak up, write questions down in advance, especially if you struggle to be explicit. You are an agent in your own healing, and a big part of this comes from making yourself heard. For the medical professionals, start by listening, please. Even though it may feel like you're pressured to make an appointment swift and efficient,

  Paul (01:00:40.403)

  Hmm.

  Allie Hope King (01:00:46.844)

  Framing your work with a patient as more of a partnership and less like a binary hierarchy can make those in your care feel like they have agency and some semblance of control, which can make tough journeys easier and healing more positive.

  Paul (01:01:05.447)

  Yeah, you know, there are two things that you and I share. this we've always had this sense of the power of language. And so, you know, I was also wildly sensitive.

  Allie Hope King (01:01:20.074)

  I think when you're sensitive you can't help but because you get so impacted and then you digest it and you obsess over it sometimes but yeah.

  Paul (01:01:33.949)

  So, Ali, I want to thank you for sharing both your expertise and your very personal experience. I honor the tremendous courage it takes to transform your own trauma, our own trauma, into a way of helping others navigate their own challenging moments. This reveals something about consciousness development that goes beyond individual insight.

  In our transdisciplinary approach, we recognize that conversations don't happen between separate individuals, but emerge from living dynamics between people. Your work demonstrates how rigorous attention to conversational dynamics can reveal the relational foundations of healing itself.

  Where can our listeners learn more about you and your work?

  Allie Hope King (01:02:36.98)

  So for now, you can find all of my publications on Google Scholar. I think I'm the only Allie Hope King there. But I would also like to highlight a research group that I'm a part of here at Teachers College called LANCY. And that stands for Language and Social Interaction Working Group. So we hold monthly data sessions online that

  Anyone can join. You don't have to have experience in the field at all. And we also have an annual conference in the fall where researchers from all kinds of backgrounds come and share work that examines interaction. So you should check us out. It's really the conference. It's a small boutique conference that meets all in one room. So you get to hear all of the papers and interact with everyone. It's the best.

  Paul (01:03:08.071)

  Mm-hmm.

  Paul (01:03:17.906)

  Mmm.

  Paul (01:03:30.888)

  ha ha ha

  Allie Hope King (01:03:32.702)

  I mean, I have to say it's the best, but it really is.

  Paul (01:03:34.301)

  Good, yes. All right, I invite all listeners to reflect on your own communication experiences. And I'm sure Ali will agree with me here, right? Whether in a healthcare setting or some other high stakes conversation you may be having in your life right now. How are you advocating for yourself? What tools can you use to help you be an active agent in your own care?

  Allie Hope King (01:03:46.506)

  Mm-hmm

  Paul (01:04:04.915)

  For viewers, some action, well, I'm sorry, there are no viewers here. Okay, here are some action steps this week. Notice empowering versus diminishing language. Pay attention to whether your conversations create space for collaboration or reinforce hierarchy. Practice genuine curiosity.

  Allie Hope King (01:04:09.29)

  Listeners!

  Allie Hope King (01:04:28.436)

  Mmm.

  Paul (01:04:32.601)

  Start one conversation this week with curiosity about the other person's understanding rather than immediately sharing your expertise. Consider recording important conversations, right? When appropriate and with permission, record crucial conversations to better understand the dynamics at play. A great exercise for couples, by the way. Right?

  Allie Hope King (01:04:45.642)

  Mm-hmm.

  Allie Hope King (01:04:57.898)

  yeah. Yeah.

  Paul (01:05:01.103)

  Subscribe and share. this exploration resonates, subscribe to etymologies of care and share with someone who might benefit. Remember, every conversation is an opportunity to practice the kind of language awareness that supports both individual flourishing and collective consciousness development. Thank you all for continuing this inquiry until next time.

  This is etymologies of care.

  Allie Hope King (01:05:34.676)

  You

  
  
  Paul (00:36.179)

  Hi everyone and welcome to etymologies of care. I'm Paul Lichtenberg and today we're exploring something profound. How the words spoken in medical appointments can either empower or diminish patients in ways that directly affect healing outcomes. When we first reached out to today's guest about joining us for a conversation on applied linguistics and integrative relational health, something remarkable happened.

  We were taken aback in the most positive ways by her pure humanity, openness, and excitement about potential collaboration. We immediately felt a kind of kinship in our shared purpose without even having met. This speaks to that liminal aspect of language communication, even synchronicity, that comes as a felt sense of familiarity. Though familiarity here must be understood

  at its deepest levels of consciousness. Sometimes the most meaningful connections happen before formal introduction, when shared commitment to healing and understanding creates instant field recognition. I'm sure you've all experienced these moments in your lives. Maybe you've met someone at a conference and within minutes felt like you'd known them for years, or started reading a book that perfectly articulated something you'd been thinking.

  but couldn't express or walked into a space and immediately felt this is where I belong. This connects directly to what we're exploring today, how language and medical settings actually shapes patient experience and reality itself and how certain ways of communicating can create immediate trust and collaborative possibility. Today's guest is Ali King, a doctor of applied linguistics.

  scholar and acting program director at Columbia University's Teacher College. She brings a unique focus on conversation analysis and her personal health journey has completely transformed how she understands patient-doctor communication. Recordings of Allie's medical appointments during her battle with breast cancer would become both a survival tool to remember crucial information and an unexpected inspiration for research.

  Paul (03:03.751)

  that revealed profound insights about healthcare interactions. We are honored to have the opportunity to explore this pivotal moment in your life, Allie, this intersection of academic expertise and lived experience, simultaneously experiencing medical care as patient while maintaining a researcher's eye for the nuances of conversation that can either empower or diminish a person.

  in their most challenging and vulnerable moments. We're hoping through this conversation to explore how language used in medical settings, healthcare context in general, and I would say in all relational fields, actually shapes our deepest experiences and reality. Ali, welcome to the podcast.

  Allie Hope King (03:53.75)

  Hi, Paul, thank you.

  Paul (03:56.463)

  Okay, so let's start with the fun question. What do you think about our title, Etymologies of Care?

  Allie Hope King (04:07.499)

  I love it. First, I'm fascinated by etymology. For me, understanding the origin of words and expressions helps me realize their power, part of which comes from the history and culture that's embedded in them. I remember being relatively young and learning that the word hysterical comes from the Greek word for uterus or womb. That discovery helped me see how language is never really neutral.

  Paul (04:34.163)

  Hmm.

  Allie Hope King (04:34.463)

  Even a single word can carry within it centuries of assumptions about gender, emotion, or authority. So we need to pay attention to the cultural legacies that can be implicit in everyday speech. I especially appreciate the idea of extending the lens of etymology to the notion of care, because it gets at something that we don't usually examine, how the language of care itself has been constructed over time.

  Words like patient and treatment carry histories that shape what becomes possible in healthcare relationships before we even start talking. When you really reflect, you see how much of language is actually shaped by rigid binary thinking that is very much wrapped up in hierarchy and power dynamics.

  The etymological approach offers something unique because it works at the foundational level where reality gets constructed through language. When you excavate how words like care or anxiety have been shaped to serve binary thinking, you're providing tools for people to recognize and reconstruct their own meaning-making process.

  Paul (05:49.917)

  Mmm, beautiful, beautiful. You know, we speak a lot about binary thinking at IRH. From a survival perspective, binary thinking evolved as a rapid threat assessment system.

  However, when this survival mechanism gets applied to complex social realities, it creates artificial categories that then potentially become tools and even weapons for organizing power, as we can readily see. The hierarchy is built into the structure because once you establish a binary, one side invariably gets valued, the other diminished and worse, dehumanized.

  And those who control the definitions of binary categories control social organization. So can you talk a little bit about what conversation analysis is and what the focus of your work has been?

  Allie Hope King (06:48.269)

  Sure. Conversation analysis, or CA for short, is an empirical way to look at how people do things with interaction. Do that again. Conversation analysis, or CA for short, is an empirical way to look at how people do things with language in interaction. We transcribe interaction from video or audio data.

  and then we analyze both the talk and the nonverbal behavior together at the most detailed level possible. This helps us to identify the mechanisms people use to create meaning and to accomplish action while interacting with each other. We look at things like turn-taking, repair sequences, how understanding gets negotiated in real time, and so on. Through both my master's and my doctorate,

  I studied co-teaching, or the arrangement of two teachers teaching together at the same time. I spent years examining this type of collaboration on an interactional level. I first became interested in this topic when I had two doctoral student teachers for a course during my master's.

  While I was impressed with the mechanics I was witnessing, like how they finished each other's sentences or supplemented each other's explanations to improve the instruction, I realized a lot of my fascination actually came from watching a professional relationship unfold right in front of my eyes. As someone who wanted to do the same program as these doctoral teachers, I wondered how I would feel or perform sharing the teaching floor with someone else.

  I could also tell as a student that this collaboration was bringing more to the table than what a single teacher could do alone, but it was just a sense. So I decided to study it. And listeners can read my dissertation if they want to, but I can give away one of the major findings, which is that, yes, the collaborative nature of co-teacher talk in the classroom can definitely contribute some unique and pedagogically advantageous things.

  Allie Hope King (08:58.977)

  that just aren't possible in a solo teacher arrangement. But despite all the years of formal training and research in institutional interaction, perhaps the biggest thing that really worked to bridge the gap between theory and practice for me was actually a major disruption in my studies when I suddenly had to do a year of cancer treatment during the last leg of writing my dissertation. The experience of being both a researcher of interaction

  and a patient at the same time made me realize somewhat drastically how crucial each moment of interaction is in a medical setting like I was in. That experience shifted both my academic interests as well as my goals in studying interaction.

  Paul (09:48.113)

  Wow, that is a powerful insight right there.

  You said you realized that a lot of your fascination came from watching a professional relationship unfolding right in front of your eyes, including and especially when faced with cancer and medical professionals. In other words, if I understand this, you connected your own subjectivity, your own internal experience to bridging the gap between theory and practice, between theory.

  Allie Hope King (10:19.391)

  Absolutely. Yes.

  Paul (10:20.807)

  between theory and relationship. So how can understanding conversation analysis transform how we show up in our most important relationships?

  Allie Hope King (10:32.757)

  I love this question. When I first encountered CA as a master's student, I had no idea how my training in this theory and methodology would literally change how I experience the world and especially how I experienced interacting with others. Conversation analysis gives me the tools to pinpoint things like exactly where communication breaks down or where confusion is caused.

  In truth, we all are proficient in and use these tools subconsciously. Everyone with interactional competence relies on them. But having CA as a tool helps me make them visible and describable. That awareness helps me to recognize and change my own patterns and even helps me to have harder conversations with others.

  Paul (11:21.831)

  Totally, totally. So walk us through what your world was like during that season of 2023 when you were delivered this diagnosis.

  Allie Hope King (11:34.574)

  Yeah, well, I was diagnosed with breast cancer in August 2023. Actually, my story is somewhat of a cautionary tale. In spring 2022, I thought somebody fell off during my self-exam, and so I went for a mammogram and an ultrasound, and it was given the all clear. Fast forward a whole year, and you could see a lump in my breast through my shirt.

  Paul (11:43.634)

  Mmm.

  Allie Hope King (12:00.939)

  My gynecologist agreed that it seemed concerning. So I once again went for a mammogram and an ultrasound. During that process, I was so petrified that my legs were shaking. I had told the tech that my mother also had had breast cancer. Sorry, I'm gonna start over with this one, sorry.

  Paul (12:11.891)

  Hmm.

  Paul (12:16.029)

  Mm-hmm. Sure. Of course, of course.

  Allie Hope King (12:20.333)

  So I was diagnosed with breast cancer in August, 2023. Actually, my story is somewhat of a cautionary tale. In spring of 2022, I thought something fell off during my breast exam. And so I was sent for a mammogram and an ultrasound and I was given the all clear.

  Paul (12:26.631)

  So.

  Allie Hope King (12:37.161)

  Fast forward a year and you could see a lump in my breast through my shirt. My gynecologist agreed that it seemed concerning, so I once again went for a mammogram and ultrasound. During that process, I was so petrified that my legs were shaking. I told the tech that my mother had had breast cancer. The tech was kind and supportive. After the images were done, she came out and handed me the all clear paperwork and said to me, it's just a cyst.

  Paul (13:07.187)

  Mm.

  Allie Hope King (13:07.285)

  I remember that word just, standing out and holding so much relief like it's no big deal. So even though I had been completely convinced before those scans that I had breast cancer based on what I could see with my own eyes, I took the professional's words to heart. I was about to continue with my busy life. So my unsolicited advice here is to push for more tests if you feel like something isn't right.

  Paul (13:09.873)

  Mm-hmm.

  Paul (13:25.376)

  you

  Allie Hope King (13:37.9)

  I'm so lucky that my gynecologist was not convinced by those scans because she pushed for a biopsy. A few days after that procedure, I got an email from the portal saying that my results were available. So I opened it thinking it was going to be a case closed kind of thing. So that's how I found out I had cancer while I was in a laundromat at 7 a.m. in the morning. A month later, just before I was getting ready to start treatment, my mother died unexpectedly.

  Paul (13:50.653)

  Mm-hmm.

  Paul (13:54.109)

  Totally, yeah.

  Paul (14:00.049)

  Mmm.

  Paul (14:05.435)

  Okay.

  Allie Hope King (14:08.043)

  And my dad, who had been diagnosed with Parkinson's years before this, didn't want to live the state of Virginia where they had lived. Start over.

  Paul (14:10.259)

  Thank

  Allie Hope King (14:19.597)

  So that's how I found out I had cancer while I was in the laundromat at 7 a.m. A month later, just before I was ready to start treatment, my mother died unexpectedly. And my dad, who had been diagnosed with Parkinson's years before this, didn't want to leave the state of Virginia where they lived. So my siblings and I moved him into a facility and I ended up in charge of most of his life from afar.

  So there I was, single, trying to finish my doctorate, and suddenly I was a caretaker and navigating cancer treatment pretty much alone.

  Paul (14:48.775)

  Mm-hmm.

  Paul (14:53.971)

  Hmm. Let's just take a pause if we can. Wow. That's a lot.

  Allie Hope King (15:00.215)

  Yes.

  Allie Hope King (15:07.693)

  It is a lot.

  Paul (15:10.191)

  Is this the first time you shared the story in this way?

  Allie Hope King (15:17.259)

  Maybe the whole thing. I I've shared bits and pieces and the part about, so I like to take a little bit of responsibility for a major change at the hospital because when I got that email saying your results are ready, I assumed that I got the email because it was negative, right? That everything's fine. They're not gonna send you an email.

  Paul (15:19.955)

  That's a

  Paul (15:34.589)

  Mm-hmm.

  Paul (15:39.495)

  Yeah,

  Allie Hope King (15:43.212)

  telling you have cancer. So I'm there and I'm just like, okay, it must be something else. I was just being, you and so I open it and like, it's that complicated, you know, results and it says like carcinoma and you know, da da. And I was like, it's just gotta be like a mistake. They just wouldn't tell you over email. And so when I called the office,

  Paul (15:50.606)

  Thank

  Paul (15:56.691)

  Totally. Yeah. Yeah, yeah, yeah.

  Paul (16:10.355)

  And yet they would, and yet they do.

  Allie Hope King (16:13.525)

  And yet they wouldn't, do. so plus it was 7 a.m. so I had to wait for the offices to open and called my best friend, called my sister. But when I finally talked to the office, said, is this actually my results? And the woman said, I am so sorry. It's a New York state law that the institution must release the results immediately to the patient.

  Paul (16:20.117)

  my

  Paul (16:31.443)

  Yeah, you're right.

  Allie Hope King (16:42.657)

  And I get that, I understand that as a benefit that I'm sure patients pushed for to have their own information accessible. so now, cause I went around telling everybody at the hospital, I was like, yeah, that really sucked. I was like, thank God I have some tools to manage my.

  Paul (16:50.386)

  Yeah.

  Paul (17:00.21)

  Yeah.

  I mean, we don't have more creativity how to deliver such significant and frightening news. It has to be done on an email.

  Allie Hope King (17:12.95)

  Or even...

  Right, or even just, it's dangerous.

  Paul (17:18.963)

  It's dangerous. It is absolutely dangerous.

  Allie Hope King (17:23.854)

  and you and I think also that because it's

  Paul (17:26.927)

  It's actually, for me, it feels cruel.

  Allie Hope King (17:31.17)

  Yeah, yeah, because not only it's news, and in this case it's negative news, but it's also a lot of complicated information that you're going to try to understand because it's so paramount, it's so big. But now, at least in this system, this portal, you can choose. You can say, want my results immediately, or I would rather...

  Paul (17:40.851)

  100 %

  Paul (17:53.105)

  Yes. Yes.

  Paul (17:59.453)

  There you go. There you go. Yeah.

  Allie Hope King (17:59.63)

  So they changed that and I like to think it's because I went around the hospital telling everybody that I found out I had cancer at 7 a.m. in a laundromat.

  Paul (18:06.833)

  Yes, yes. Wow, that's powerful. And you know what? This segues so beautifully into our next session, the section two language is the reality we speak, right? Because it shows like we're indoctrinated to believe like that's okay. This is the way the system work and that's okay. But guess what? It's not okay.

  and it connects with what I'm about to say. So why don't we just continue with that. Okay. So Ali, the idea that there's nothing wrong with you as a human person, even when your body needs medical attention, how does that land with you?

  Allie Hope King (18:37.365)

  Excellent.

  Allie Hope King (18:53.741)

  As a woman who is not only neurodivergent, but who's also struggled with mental health challenges her entire life, I am acutely aware of the feeling or the implication that there is something wrong with me. With respect to medical things, I have seen firsthand how when you have different diagnoses, whether it be breast cancer or mental illness, there are a lot of forces in our society that seem to push you to become this thing.

  Paul (19:23.155)

  Mm-hmm.

  Allie Hope King (19:23.637)

  It's not only because of how these experiences impact your daily life. It's that the world, including the medical authorities you're working with, frames it that way. The typical medical model problematize. The typical medical model locates problems within the patients. You have cancer, you're non-compliant, you're anxious. So I really appreciate the effort to reframe this.

  Paul (19:43.569)

  Mm-hmm.

  Allie Hope King (19:52.384)

  I was dealing with cancer. I experience anxiety. My brain works differently than many. But I am not these labels. And there's nothing wrong with me as a human because of these traits or situations. Ironically, though, in my particular cancer journey, I have to say that some parts of the experience actually made me feel more valuable as a human, which I would say is in contrast to the idea of there being something wrong with me.

  I participated in a huge medical trial as well as another research study on the use of a post-surgical medication dispensing device. So not only did getting to participate in this research really fire up my nerdiness, but I got to frame my illness and treatment as contributing to society. And a big part of why I felt that way was how I was treated by the medical staff and the researchers.

  Paul (20:29.779)

  Mm-hmm. Mm-hmm.

  Paul (20:48.179)

  Mmm. I got to frame my illness and treatment as contributing to society. I just want to pause for a moment here. It's not just that you got to frame your illness and treatment.

  but that you had in the very core of your being, the wisdom and desire to reframe and reconstitute a pathologized core belief that there's something wrong with you. I would like the therapists and clients out there to think about what Ali just shared. We fundamentally have the wisdom, resilience and desire

  Allie Hope King (21:22.295)

  Absolutely.

  Paul (21:33.755)

  to reveal and engage our core health despite what happened to us and what we've been taught. We must make this explicit. So let's unpack how this works. Ali, how did you witness language literally creating different versions of your medical reality?

  Allie Hope King (21:42.925)

  You

  Allie Hope King (21:59.406)

  So I'd like to mention a couple of examples because I had many occasions where the way an interaction went with a doctor was paramount in making my experience positive and healing. But there were a few occasions where the interaction nearly led to what I would categorize as an undesirable medical outcome.

  Paul (22:10.259)

  Mm-hmm.

  Paul (22:18.215)

  Hmm.

  Allie Hope King (22:19.233)

  The positive one happened at the very beginning of my first medical appointment of the whole journey. A hematology fellow was my first interaction. And he asked me a question that, when I thought about it later, really floored me. And it seemed brilliant in the way to start a long-term relationship with their department.

  Paul (22:42.173)

  So what exactly did the fellow ask you in that first appointment?

  Allie Hope King (22:47.789)

  So was pretty much the very first thing he said. And he asked, so why don't you tell me a little bit about what you understand about why you are here? To be honest, my mother had died only days before this appointment. So I barely remember most of that day.

  But as I got a chance to process and reflect, particularly as someone whose life is much about analyzing interaction, I realized later that the way the fellow opened the interaction was extraordinary.

  Paul (23:22.525)

  Hmm. You know, I remember when I first read the fellows question and your response as it being transformative. This very question is actually how we begin a therapy journey with clients. So what felt extraordinary to you?

  Allie Hope King (23:39.661)

  yeah.

  Paul (23:44.717)

  and it was by the way, that's the whole point, is actually an ordinary opening to authentic relating. That it feels extraordinary speaks to a larger cultural phenomenon regarding relational literacy that we are studying and aspiring to address. The need to cultivate relational literacy and authentic relating across cultural fields.

  Right? So, so how did this question for you construct a different reality than typical medical interactions?

  Allie Hope King (24:15.402)

  Yeah.

  Allie Hope King (24:25.344)

  Well, most medical interactions seem to begin with closed questions or expert statements that position the doctor as the knowledge holder and the patient as a passive recipient. In my situation, however, I was being given the floor right away to report on what I understood so far about this giant medical situation.

  As a patient, I appreciated this approach because it gave me lot of agency at a time that I felt literally everything was outside my control.

  Paul (24:58.227)

  Mmm.

  Allie Hope King (24:59.126)

  But as a researcher of interaction and a former teacher, I realized that starting this way is also an excellent opportunity for the fellow to witness my frame of mind, to glean how much I'd understood about my brand new diagnosis, to perhaps assess a bit about things like my intelligence or my personality that might inform how he talked to me during the rest of the interaction.

  Paul (25:08.22)

  Mmm.

  Allie Hope King (25:25.576)

  So I saw it as such a useful way to start for both parties, making a collaborative field where I could contribute to constructing the reality of my own medical situation.

  Paul (25:27.571)

  Thank

  Paul (25:37.405)

  phenomenal, just phenomenal. And how did it give you agency at that moment?

  Allie Hope King (25:43.181)

  Well, the question essentially shifted me from a passive recipient to an active participant. It made me feel like I was a part of my medical team because I was co-creating understanding with someone who had medical expertise. It honored my lived experience first before any of the doctor's clinical knowledge was brought into the context.

  Paul (25:50.439)

  Mm-hmm. Mm-hmm.

  Paul (26:07.985)

  Yeah, yeah. And what social dynamic did this language create between you and your care team?

  Allie Hope King (26:15.786)

  I genuinely feel that it helped to create a sense of partnership in a context that is far more typically one of hierarchy and power differential. The appointments where I experienced this collaborative approach, I left feeling more capable of managing my treatment, more connected to my body's wisdom, and more able to make informed decisions. I would say these conversations literally affected my capacity to heal.

  Paul (26:45.619)

  That is simply brilliant. These conversations literally affected my capacity to heal. You know, from an IRH perspective, conversation etymologically refers to how individuals are relationally constituted. That is, in conversation, we're not just speaking with, we are living and turning with the other.

  We are co-creating reality as opposed to an expert or someone in power dictating what my reality is. The empowerment in that truth and fundamental reality must be made explicit. So, you you mentioned that there was an instance where you felt the language nearly led you to an undesirable outcome. you share that situation?

  Allie Hope King (27:29.184)

  Yes, yes, absolutely.

  Allie Hope King (27:41.034)

  Yeah.

  Yeah, so following the medical trial, I had a double mastectomy with reconstruction. So that's a handful of surgeries. After the one where I got my implants, I was not happy at all with what I saw in the mirror. The medical term is semastia, but I called it uniboob. So my implants were so close together. I felt like it looked kind of ridiculous.

  Paul (27:53.395)

  Mm-hmm.

  Paul (28:09.767)

  Mm-hmm.

  Allie Hope King (28:10.092)

  In a post-op appointment, first explained how I felt to the physician's assistant. When the surgeon came in, the PA reported to her, Allie said that she notices a little bit of semastia.

  What followed were the two of them speaking to each other about my body in front of me. And my takeaway by the end was that they really didn't see a problem. I remember walking out the door pretty unhappy and thinking, I guess this is as good as it's going to get. But then when my oncologist saw my surgical results for the first time, she mentioned that she thought my breasts were rather close together.

  Paul (28:34.771)

  Mm. Mm. Mm-hmm.

  Paul (28:49.084)

  Hmm

  Mm-hmm.

  Paul (28:55.815)

  Yeah.

  Allie Hope King (28:59.922)

  That validation encouraged me to mention the issue to the surgeon right before my next scheduled surgery. While I didn't want to criticize her work, being able to say, Dr. So-and-so also thought they were too close together, somehow made it possible for me, and I got my whole surgery changed. The issue was fixed and I ended up happy with the results. So in the end, it was a positive outcome.

  However, I looked back and I realized how on the one hand, just a tiny bit of interaction in that first appointment nearly led to a very negative outcome for me. But on the other hand, just a tiny bit of interaction in the next appointment gave me the validation I needed to advocate for myself and change the trajectory completely.

  Paul (29:39.752)

  Mm-hmm.

  Paul (29:53.381)

  I need another pause. Wow, what you are sharing.

  Allie Hope King (29:55.456)

  Go for it.

  Paul (30:03.058)

  is

  It's so deeply moving to me. just need you to know that.

  You know, I don't want to use the word the courage because it's it's so it's actually so much deeper than that. I'm just so deeply moved by by your openness and and I truly believe and we spoke about this last time, right? And this is kind of why.

  Allie Hope King (30:34.795)

  Mm-hmm.

  Paul (30:39.505)

  disclosure, sharing personal information, which I do. mean, anybody could just read my sub stack and see, wow, he's really sharing a lot of personal. And I do it because it serves the relationship. I don't do it because of how I'm going to look or anything like that, or that it is courageous or hero. I do it because.

  Allie Hope King (30:54.945)

  Yeah.

  Paul (31:05.927)

  people need to hear that they are not alone and that we're all in this together, you know? We really are, we're all in this together. And so these profound personal stories that we have,

  Paul (31:28.211)

  They're just not healing for us in our being able to witness our own experience, but they help us to connect on a much, deeper level. So I just needed to share that right in the middle of our podcast.

  Allie Hope King (31:43.117)

  Well, no, it's interesting because it makes me think of right now I have a therapist and I have a nurse practitioner, psychiatrist, and they... I know nothing about my therapist. I know nothing about her. except one time she did relate with the fact that she worked in a hospital. And it's like it just, for me, makes the relationship less successful.

  Paul (31:52.284)

  Yeah.

  Paul (31:58.983)

  Yeah.

  Allie Hope King (32:11.882)

  whereas the NP psychiatrists just occasionally they'll just relate in a way that makes me feel like, I just unloaded all of these things that are quote unquote, like we're talking about wrong with me. And then they respond like, I can relate. And just seeing that, it makes me feel like this isn't such a unidirectional relationship. We are collaborating. And I recognize why.

  Paul (32:36.755)

  Yeah.

  Allie Hope King (32:38.462)

  It's important for therapists to have boundaries and I completely get all of that. But I know that I respond so much more when the person who's in charge of helping me is able to share a bit about themselves because otherwise I feel like they're just too different from me or they're better than me or whatever.

  Paul (32:42.501)

  Of course.

  Paul (33:01.949)

  Yeah, yeah. You philosophically, we could use language such as it levels the hierarchy, you know, what it does is it deepens relationship. You know, because that's what leveling hierarchy actually means that we're now in relationship, that we are now co-creating this profound healing journey. And

  Allie Hope King (33:09.515)

  Yeah.

  Allie Hope King (33:13.46)

  Exactly.

  Allie Hope King (33:18.43)

  Exactly. Yes.

  Paul (33:29.669)

  Anyway, there's so much more to talk about that and we will in later in later episodes for sure. But this is this is it's funny because this is actually the essence of the podcast. OK, so section three is connection is healing, of course. At at IRH, we focus on relational health instead of mental health.

  Allie Hope King (33:36.385)

  Excellent.

  Allie Hope King (33:44.128)

  Yeah, yeah.

  Ahem.

  Allie Hope King (33:52.62)

  You

  Paul (34:00.167)

  What do you make of that distinction?

  Allie Hope King (34:03.38)

  I think the distinction is really powerful. I've struggled for my entire life with my mental health. I was about seven the first time I was sent to therapy. When I look back on my life, I now believe that a lot of what was framed as a quote, mental health problem in my childhood was actually about relational disconnection. I grew up in a home where we did not communicate well and we definitely did not talk about emotions.

  As a wildly sensitive and empathic kid, I always felt isolated and misunderstood. Therapy was perhaps helpful, but what I really needed was love, communication, and connection. As an adult, I've seen over and over that my own ability to face major challenges, whether mental health struggles, cancer, losing my parents, not my patients, ha! As an adult,

  Paul (34:54.515)

  Mm-hmm.

  Allie Hope King (35:00.608)

  I've seen over and over that my ability to face major challenges, whether mental health struggles, cancer, losing my parents, or even finishing my doctorate, has depended so much on the quality of my relationships. Feeling surrounded by care, but especially from people with a shared experience, makes my struggle survivable in a way that isolation never does. For me,

  Paul (35:00.829)

  Yeah.

  Paul (35:09.235)

  Bye.

  Allie Hope King (35:28.938)

  Relational health is the foundation. It's what makes both healing and growth possible.

  Paul (35:35.635)

  So.

  Okay, so we're going to pause here for a second and I'm going to tell you why.

  Allie Hope King (35:41.31)

  Okay.

  Paul (35:47.633)

  my natural response to what you shared is actually different than the next question. The next question is, did your conversation analysis background change how you experienced it? I don't know how that happened. yeah, but you know, what you just shared is like everything for me. And so I'm gonna figure out a way

  Allie Hope King (35:55.499)

  Okay.

  Allie Hope King (36:01.098)

  Yeah, kind of jump.

  It's okay.

  Paul (36:17.649)

  to insert something else in there. And so we're gonna pause that and let's go to, I'm gonna figure it out and bring what you just shared into this next question, okay? But I'm gonna do it later.

  Allie Hope King (36:23.564)

  Okay, that makes sense.

  Allie Hope King (36:32.148)

  Okay, so you'll just do that later.

  Mm-hmm.

  Allie Hope King (36:40.596)

  Okay. Okay, got it.

  Paul (36:44.721)

  What literally impresses me so deeply is how you intuitively knew what you needed and for the most part, what you presented was respected, recognized and honored in your medical care. This is foundational for integrative relational psychotherapy. Again, how we honor and make explicit that the relationship is the medium of healing.

  Allie Hope King (37:01.292)

  Mm.

  Paul (37:13.584)

  and the paradox of that principle is that true autonomy is intimate. When a person's individuality is honored, the relational simply blossoms. As you say, you had both a right and a responsibility to participate in these conversations about your own health and body. I'm curious, what made you decide to start

  recording your appointments and how did this change your experience as a patient?

  Allie Hope King (37:49.677)

  So initially it was just practical. I could not remember what the doctors were saying due to the stress and the medications, so a lot of people recommended it. I too would recommend this to anyone, but especially people who are going to their appointments alone. But then as I settled into the process of being a patient, while still attending conferences and still working on my dissertation, I also began to see these recordings as a data goldmine.

  Paul (38:02.515)

  Mm-hmm.

  Yeah.

  Allie Hope King (38:18.218)

  And I started wanting to do some type of formal research or other work with this data to really delve into how language was shaping my treatment and healing process.

  Paul (38:29.917)

  Hmm. So what did you discover when listening back about how language was shaping your experience?

  Allie Hope King (38:38.774)

  Well, I have yet to go through all the recordings as a researcher. I had to finish my dissertation and graduate first. And these days, I'm mostly still trying to just focus on my health as much as I can outside of my job. But I did listen back to some of it. And there were a few incidents that really stood out where

  Paul (38:42.61)

  Mm-hmm.

  You

  Paul (38:52.755)

  Mm-hmm.

  Allie Hope King (38:59.232)

  What was being said made a lasting impression on me as a patient and will be really interesting to examine further as a researcher. So I've already talked about the incident where I felt like my complaint was, rewind, I've already talked about feeling like my complaint with the reconstruction results was diminished. There was another.

  Paul (39:08.083)

  Mm-hmm.

  Paul (39:20.711)

  Yeah.

  Allie Hope King (39:22.024)

  interesting thing that I thought a lot about that was said during a couple initial visits with plastic surgery. So there's this one surgical procedure that people can get where they take belly fat and they construct breasts from that. And to be eligible, you have to have enough belly fat. So during the part of the appointment where I was being measured to see if I was eligible,

  Paul (39:35.987)

  Mm-hmm.

  Allie Hope King (39:46.241)

  The PA let me know that I didn't have enough belly fat to do the surgery and multiple times she told me, that's a good problem to have. On the one hand, that's framed as a problem because the medical intervention is not an option for me. But on the other hand, it's good because what? Well, you have to extrapolate that, but the comment is basically saying that not having belly fat or being thin is preferable.

  Paul (40:02.387)

  Mm-hmm.

  Paul (40:06.705)

  What?

  Paul (40:15.866)

  Absolutely.

  Allie Hope King (40:17.024)

  I'll be honest, I felt complimented because she was saying that I wasn't overweight, which in our society is still stigmatized. As much as the feminist in me may have cringed when listening back to that, in the moment, it felt as though she were constructing a genuine consolation. So it was this really layered way that the professional's language shaped my experience in that case. But at the time, it worked to make me feel like

  Paul (40:25.363)

  Hmm.

  Paul (40:30.183)

  Mm-hmm.

  Paul (40:35.699)

  Yeah.

  Allie Hope King (40:45.418)

  At least there's some positive aspect to not being qualified for this surgical option.

  Paul (40:51.181)

  Mm-hmm my there's so so so so much to say about that one and I'm just thinking about all of the mixed messages we get in culture

  Allie Hope King (41:07.286)

  Yes.

  Paul (41:09.715)

  How can we not be confused?

  about identity. How can we not be confused about relational intimacy, relational literacy, authentic relating when we have all of these profoundly mixed messages coming from these systems that we depend on and have such power.

  Allie Hope King (41:33.097)

  Absolutely.

  Allie Hope King (41:42.292)

  Right? And the mixture of feeling like I was being complimented and yet feeling good about that even for one second made me feel like I needed to turn in my feminist card, you know? But when you're in the moment of you're losing part of your body and you're facing all of that.

  Paul (41:48.051)

  Thank

  Yes.

  Paul (41:57.893)

  Exactly.

  Paul (42:04.563)

  you

  Allie Hope King (42:07.549)

  it hits differently to be told, but maybe this other thing looks nice on you. And yeah, it's very confusing and conflicting.

  Paul (42:16.869)

  and conflicting for sure. Hopefully, actually, hopefully it's conflicting because that means we're in awareness and we know something is, yeah, something's off, something's not aligned, something's, yeah, something needs to be addressed.

  Allie Hope King (42:22.698)

  Great.

  Absolutely.

  Allie Hope King (42:34.194)

  Absolutely.

  Paul (42:37.293)

  Ali, how did you balance being a patient with being a researcher? In other words, how did you navigate being both observer and observed?

  Allie Hope King (42:50.215)

  I guess I would say the researcher perspective never went away. And I think my awareness of the mechanics of institutional interaction actually helped me advocate for better communication. I even started telling the doctors about that fellow's question and about the importance of how they structured our interactions.

  Paul (42:54.279)

  Mm-hmm.

  Mm-hmm.

  Paul (43:13.318)

  Yeah. And how did the doctors respond when you shared your expertise with them?

  Allie Hope King (43:20.779)

  I probably came across as the biggest nerd ever, but I think they were intrigued. It seemed to me that most hadn't considered how their conversational choices were affecting patient experience and outcomes, at least in the way I think about it. My oncologist told me that she was going around at conferences telling other doctors about me and all the stuff I was telling her.

  Paul (43:28.957)

  Uh-huh.

  Paul (43:48.979)

  Yeah, you know, I want to I want to just take another moment here because as we were just sharing that like how did they respond to your expertise? I'm thinking of the many many many people who don't have the ability or sense of empowerment to self-advocate

  Allie Hope King (44:15.441)

  It's interesting because after my mom passed away, and you reflect and you process and all this stuff, but one of the things my mom did in her many, many jobs, she was a big volunteer and everything, she was a patient, I think back then they called it a patient representative, but maybe now it's a patient advocate. And her father was a physician and her mother a nurse. And so I think I realized that perhaps

  Paul (44:20.719)

  Mm-hmm.

  Paul (44:31.219)

  Mm-hmm.

  Paul (44:38.664)

  Yeah.

  Allie Hope King (44:45.821)

  subliminally or very implicitly in my young years, I also had it reinforced that, you know, patients have rights and people need to be looking out for them. So perhaps even before all of this awareness of how that happens in interaction, just understanding about rights and fairness and, you know, advocacy, perhaps that also was just sort of, I inherited some of that.

  Paul (45:03.079)

  Yes.

  Paul (45:16.435)

  You most certainly did. You internalized that for sure. Yeah. You mentioned that these interactions quote unquote saved your life. How did specific language patterns become, I love this, healing elements?

  Allie Hope King (45:20.297)

  Yes.

  Allie Hope King (45:37.77)

  Definitely healing elements. You know, I feel like I lucked out because not only were my doctors all highly skilled and I got to do a trial that was extremely successful in shrinking my tumor, but I also genuinely felt emotionally supported and respected most of the time by most of the team. When the doctors created conversational space for my understanding and agency,

  Paul (45:56.851)

  Mmm.

  Allie Hope King (46:04.723)

  I think it activated something beyond medical treatment. It became collaboration, one that I really hope to make something out of going forward. It would be nice to have something positive come out of having cancer.

  Paul (46:20.231)

  Yeah, for sure. And coming out of cancer, as you say, personally, when I hear to make something out of going forward, I think of like this podcast episode, know, something to help others going forward. Right. And I know that's that is absolutely in your heart of hearts. Yeah. Yeah.

  Allie Hope King (46:36.864)

  Mm-hmm.

  Allie Hope King (46:41.493)

  Yes.

  Allie Hope King (46:46.621)

  Absolutely.

  Paul (46:49.743)

  Okay, so let's examine the etymology here. Let's have some more fun with that. The word patient comes from Latin, patience, meaning suffering or enduring. It embeds passivity into the identity before dialogue begins. What would medical conversations look like if they were designed around

  Allie Hope King (46:55.145)

  Yay.

  He

  Paul (47:17.341)

  how humans actually create meaning together.

  Allie Hope King (47:23.115)

  Yeah, so piggybacking on your etymological thread, this question actually makes me think of the word binary that you brought up in our first meeting. So its origin is from the Latin binarius, or consisting of two. So binary thinking, for example, reduces people to either or, doctor or patient, teacher or student.

  Paul (47:24.44)

  Hahaha.

  Paul (47:34.055)

  Yeah.

  Paul (47:47.731)

  Mm-hmm.

  Allie Hope King (47:52.95)

  But patients hold the most knowledge about their own experience, so solutions require collaboration. That's why I prefer the notion of dialogue, which is from the Greek, dialogos, which means to speak across or between. So medical conversation should be about dialogue.

  not a unidirectional force with rigid rules, but rather a two-way exchange based on the shared creation of meaning and solutions.

  Paul (48:26.131)

  Wow-wee. I will say amen.

  Allie Hope King (48:27.915)

  Absolutely. I love words.

  Paul (48:34.909)

  So, so cool. Okay. For all listeners who want to experiment with these ideas that we are playing with today, very seriously, what are some concrete steps they can take?

  Allie Hope King (48:54.923)

  Well, I think since patients usually already have a lot on their plate, I would love it if the medical professionals would take the lead in this initiative. Give the patient the floor first. Let them feel like a participant in their own care because they are. Better yet, tell them this explicitly.

  Paul (48:59.585)

  huh.

  Allie Hope King (49:17.233)

  It may feel stressful due to time management concerns or may slow down your typical pace, but in the end, it may lead to more positive outcomes for both of you.

  Paul (49:29.181)

  Hmm. Allie, you mentioned considering writing for lay audiences rather than academic journals. And that is actually my prayer, by the way. What do you hope to accomplish by making these insights accessible to everyone?

  Allie Hope King (49:51.605)

  Well, just in case my dissertation advisor listens to this, I should clarify that I'm considering writing for lay audiences in addition to trying to publish in academic journals. But I really do feel that while we applied linguists are studying what humans do with language, how we report on it is not so accessible to most humans.

  Paul (49:54.683)

  Hahahaha

  Allie Hope King (50:18.067)

  If I'm a busy surgeon or oncologist or I'm a person dealing with cancer, I need something clear, digestible, and especially relatable. I don't know what this will look like, but I feel that there's a way to create something that will reach people more widely.

  Paul (50:36.691)

  You know, one of the IRH principles that I mentioned in my last episode with Lauren Barigan and throughout this episode is the practice of being explicit that you just mentioned. In medical conversations, we often assume and hope that understanding is shared when it may not be.

  Your experience showed how that fellow's explicit question created completely different possibilities than typical implicit medical encounters. Can you talk about how explicit versus remaining implicit shapes conversation analysis dynamics?

  Allie Hope King (51:24.331)

  Sure. So there is just so much nuance to conversation, regardless of whether it's institutional talk like doctor-patient interaction or everyday conversation like at the family dinner table. In either context, there will always be parts of the meaning that are conveyed explicitly and parts that are conveyed implicitly. A lot of conversation analysis is about identifying how the participants orient.

  Paul (51:53.299)

  Mmm.

  Allie Hope King (51:53.353)

  to what's been said. And that's the space where you can figure out if understanding has been achieved. In the experience that I had where I felt like the PA and the plastic surgeon were diminishing the physical problem that I had, I recognized that I did a lot of reading between the lines there.

  If I had spoken up in that moment and perhaps been more explicit with my dissatisfaction, perhaps things would have been sorted earlier and I wouldn't have walked away thinking I was stuck with this problem. But the key thing here is that I did not feel comfortable doing that, bold as I may be. It's not an easy thing to critique a surgeon's work, even if it's on your body. So perhaps more explicit...

  Paul (52:23.784)

  Mm-hmm.

  Paul (52:29.518)

  Mm-hmm.

  Allie Hope King (52:38.268)

  explicit questions on behalf of the surgeon would have helped. I understand that a question like, are you completely happy with the results? May feel like it opens the door for complaints, but I think that's the point. In this kind of power dynamic, I don't know that patients feel the best about complaining unless that door is opened for them.

  Paul (52:51.869)

  Yes.

  Paul (53:00.753)

  Yeah, for sure. There's something else important and related I want to explore here. The difference between being explicit and responsiveness. This distinction is crucial for understanding relational care. Being explicit actually operates in a kind of binary term. Something is either made explicit or remains implicit.

  Allie Hope King (53:12.614)

  Mm-hmm.

  Paul (53:27.685)

  You either state your expectations clearly or you don't. You either make the relational frame explicit or you leave it assumed. Responsiveness, however, is more nuanced and involves layers of complexity that resist binary categorization. It includes perceptual and emotional sensitivity, what someone notices in the relational field, processing capacity.

  how they metabolize what they perceive, cultural frameworks, how their background shapes appropriate response patterns, emotional availability, their capacity for engagement in the moment, very much what you're talking about here, and systemic constraints, what their context allows or inhibits, timing and pacing, when and how responses emerge and embodied attunement.

  Allie Hope King (54:09.299)

  Right.

  Paul (54:22.309)

  somatic responsiveness beyond verbal engagement. This suggests that while you can teach someone to be more explicit, right, state your boundaries, clarify expectations, name what you're observing, developing responsiveness requires addressing multiple interconnected factors simultaneously. Someone might master explicit communication, but still struggle with responsiveness

  Allie Hope King (54:42.109)

  it does, yeah.

  Paul (54:50.279)

  due to overwhelm, cultural misalignment, or compromised nervous system capacity. So what can see a capture about explicit moves versus these more complex dimensions of responsiveness? That's a big one right there, but it's really beautiful and important. It really matters.

  Allie Hope King (54:56.852)

  Yeah.

  Allie Hope King (55:15.802)

  Yes, it really does. You know, I have a friend who's an ER psychiatrist and also a professor of medicine. So he works with and trains doctors. I brought my idea up to him of in some way using both my analytical mind and my cancer survivor mind to help change some of the ways that medical professionals interact with patients. And he made a similar point.

  Paul (55:21.683)

  hunt.

  Paul (55:28.305)

  Yeah.

  Allie Hope King (55:45.349)

  Sure, you can teach med students some of these explicit practices that they could essentially memorize and execute, but it won't make up for the inherent ability that some people have, but some people lack, to naturally engage and be responsive. So it's a fair point. But...

  Paul (56:00.211)

  Mm-hmm. Mm-hmm.

  Allie Hope King (56:03.698)

  You know, I suspect that any medical professionals who are not yet great at being responsive and interaction could really benefit from at least becoming aware of how their approach influences the conversation. In my field, we use video recording as a training tool in education. And this is so that novice teachers can not only get a more objective sense of what they're doing while they're teaching, but they can also see how their students

  Paul (56:14.429)

  Yeah.

  Hmm.

  Allie Hope King (56:33.612)

  students are responding. We also have in CA what's called CA-based interventions. This is when the practitioner, say a doctor or a teacher, for example, gets recorded while practicing. And they may also be trained a little bit in CA transcription and analysis. And there's evidence that participating in this kind of research can really open someone's eyes about their own interactional

  Paul (56:40.442)

  Mm-hmm.

  Allie Hope King (57:03.082)

  and patterns, and there's also longitudinal work that shows it can help them change over time. So I really think that there's something there that could be adapted to, the very least, help people start to see what responsiveness looks like, what happens when it's missing, and so on.

  Paul (57:05.203)

  Mm-hmm.

  Paul (57:10.705)

  Hmm.

  Paul (57:14.567)

  Mm-hmm.

  Paul (57:22.109)

  Yeah.

  Yeah, yeah. You know, it's so cool for me. Is that what you are describing is what I would actually call therapeutic. It's not therapy. It's therapeutic because because of what we're creating in the relational field.

  Allie Hope King (57:40.068)

  Mm-hmm. Makes sense.

  Allie Hope King (57:50.205)

  And part of that is the relationship with yourself, right? Like I think when you're a practitioner, I mean, they've done all sorts of studies about this, but you know, we think we remember what we did when we taught or when we had, we think we remember, but our memory isn't perfect ever. And it's always subjective. And so having a video recording for you to be able to see yourself doing whatever it is that you do.

  Paul (57:53.171)

  Absolutely.

  Yeah.

  Paul (58:15.367)

  Yes. Yes.

  Allie Hope King (58:17.962)

  I like to think it creates a little person that stands on your shoulder so that when, if you're a teacher who talks too much or you know, your volume's too low or anything, then you get this little other person that can kind of objectively remind you, there's that thing that you do again.

  Paul (58:26.469)

  and

  Paul (58:30.483)

  Mm-hmm.

  Paul (58:35.431)

  Yeah.

  It's like the Metta witness.

  Allie Hope King (58:40.318)

  Yes, yeah. And it's just, it's, you know, with technology, we didn't have this in the past, but now we do. And I think that technology can help us just, the recording at least, can help us become more objective.

  Paul (58:46.653)

  Right,

  Paul (58:54.195)

  Yeah, and this is great because technology can become more relational.

  Allie Hope King (59:02.975)

  Yes.

  It's not gonna go away, so I think... Yeah.

  Paul (59:05.553)

  I believe that to be true. Yeah. So what message do you want to leave listeners about the power of language in their own healing and growth?

  Allie Hope King (59:20.05)

  Okay, so I'll start with a little poem that I recently found in one of my childhood notebooks when I moved. There I wrote, sticks and stones may break my bones, but words, they can destroy me. So can you tell I was bullied as a kid? But seriously, I think I've always understood the power of language. My little poem is obviously read

  Paul (59:26.31)

  the

  Allie Hope King (59:48.86)

  reacting to how language can hurt people. But as an adult, I've also had the opportunity to see how language can be crucial in healing as well, from cancer, from trauma, from isolation. So I want to highlight for people that interaction is not a secondary part of any situation, especially in medical interactions. For patients, I would emphasize that your voice is paramount.

  Paul (01:00:11.837)

  Mm-hmm.

  Allie Hope King (01:00:17.616)

  Even if you're not a medical professional, try to speak up, write questions down in advance, especially if you struggle to be explicit. You are an agent in your own healing, and a big part of this comes from making yourself heard. For the medical professionals, start by listening, please. Even though it may feel like you're pressured to make an appointment swift and efficient,

  Paul (01:00:40.403)

  Hmm.

  Allie Hope King (01:00:46.844)

  Framing your work with a patient as more of a partnership and less like a binary hierarchy can make those in your care feel like they have agency and some semblance of control, which can make tough journeys easier and healing more positive.

  Paul (01:01:05.447)

  Yeah, you know, there are two things that you and I share. this we've always had this sense of the power of language. And so, you know, I was also wildly sensitive.

  Allie Hope King (01:01:20.074)

  I think when you're sensitive you can't help but because you get so impacted and then you digest it and you obsess over it sometimes but yeah.

  Paul (01:01:33.949)

  So, Ali, I want to thank you for sharing both your expertise and your very personal experience. I honor the tremendous courage it takes to transform your own trauma, our own trauma, into a way of helping others navigate their own challenging moments. This reveals something about consciousness development that goes beyond individual insight.

  In our transdisciplinary approach, we recognize that conversations don't happen between separate individuals, but emerge from living dynamics between people. Your work demonstrates how rigorous attention to conversational dynamics can reveal the relational foundations of healing itself.

  Where can our listeners learn more about you and your work?

  Allie Hope King (01:02:36.98)

  So for now, you can find all of my publications on Google Scholar. I think I'm the only Allie Hope King there. But I would also like to highlight a research group that I'm a part of here at Teachers College called LANCY. And that stands for Language and Social Interaction Working Group. So we hold monthly data sessions online that

  Anyone can join. You don't have to have experience in the field at all. And we also have an annual conference in the fall where researchers from all kinds of backgrounds come and share work that examines interaction. So you should check us out. It's really the conference. It's a small boutique conference that meets all in one room. So you get to hear all of the papers and interact with everyone. It's the best.

  Paul (01:03:08.071)

  Mm-hmm.

  Paul (01:03:17.906)

  Mmm.

  Paul (01:03:30.888)

  ha ha ha

  Allie Hope King (01:03:32.702)

  I mean, I have to say it's the best, but it really is.

  Paul (01:03:34.301)

  Good, yes. All right, I invite all listeners to reflect on your own communication experiences. And I'm sure Ali will agree with me here, right? Whether in a healthcare setting or some other high stakes conversation you may be having in your life right now. How are you advocating for yourself? What tools can you use to help you be an active agent in your own care?

  Allie Hope King (01:03:46.506)

  Mm-hmm

  Paul (01:04:04.915)

  For viewers, some action, well, I'm sorry, there are no viewers here. Okay, here are some action steps this week. Notice empowering versus diminishing language. Pay attention to whether your conversations create space for collaboration or reinforce hierarchy. Practice genuine curiosity.

  Allie Hope King (01:04:09.29)

  Listeners!

  Allie Hope King (01:04:28.436)

  Mmm.

  Paul (01:04:32.601)

  Start one conversation this week with curiosity about the other person's understanding rather than immediately sharing your expertise. Consider recording important conversations, right? When appropriate and with permission, record crucial conversations to better understand the dynamics at play. A great exercise for couples, by the way. Right?

  Allie Hope King (01:04:45.642)

  Mm-hmm.

  Allie Hope King (01:04:57.898)

  yeah. Yeah.

  Paul (01:05:01.103)

  Subscribe and share. this exploration resonates, subscribe to etymologies of care and share with someone who might benefit. Remember, every conversation is an opportunity to practice the kind of language awareness that supports both individual flourishing and collective consciousness development. Thank you all for continuing this inquiry until next time.

  This is etymologies of care.

  Allie Hope King (01:05:34.676)

  You