Can I tell just by myself? : Discussing a parental mental disorder with a child in a research interview

This is an elec onic ep in o he o iginal a icle. This ep in may di e om he o iginal in pagina ion and ypog aphic de ail. Au ho (s): Ti le: Yea : Ve sion: Please ci e he o iginal e sion: All ma e ial supplied ia JYX is p o ec ed by copy igh and o he in ellec ual p ope y igh s, and duplica ion o sale o all o pa o any o he eposi o y collec ions is no pe mi ed, excep ha ma e ial may be duplica ed by you o you esea ch use o educa ional pu poses in elec onic o p in o m. You mus ob ain pe mission o any o he use. Elec onic o p in copies may no be o e ed, whe he o sale o o he wise o anyone who is no an au ho ised use . Can I ell jus by mysel ? : Discussing a pa en al men al diso de wi h a child in a esea ch in e iew Leinonen, Anu; Seikkula, Jaakko; Alasuu a i, Maa i Leinonen, A., Seikkula, J., & Alasuu a i, M. (2016). Can I ell jus by mysel ? : Discussing a pa en al men al diso de wi h a child in a esea ch in e iew. In e na ional Jou nal o Child, You h and Family S udies, 7(1), 125-147. h ps://doi.o g/10.18357/ijcy s.71201615675 2016 In e na ional Jou nal o Child, You h and Family S udies (2016) 7(1): 125–147 CAN I TELL JUST BY MYSELF? DISCUSSING A PARENTAL MENTAL DISORDER WITH A CHILD IN A RESEARCH INTERVIEW Anu Leinonen, Jaakko Seikkula, and Maa i Alasuu a i Abs ac : In his single-case s udy, we ocus on how o ha e a dialogue in a esea ch in e iew wi h a child whose pa en has been diagnosed wi h a men al diso de . The in e ac ional con ex and he in e iewe ’s ole in co-cons uc ing he child’s accoun s ha e been la gely neglec ed in he quali a i e psychological esea ch on his subjec . S igma ela ed o men al diso de s is inc easingly being ecognized as a cen al issue o he en i e men al heal h ield. I is conside ed o ha e a - eaching e ec s on he social in e ac ion o he s igma ized pe son and also o con amina e he in e ac ions o hose a ound ha pe son. We examine how he s igma o a pa en al men al diso de a ises and is nego ia ed in he dialogue be ween an 8-yea -old gi l and a emale in e iewe . The pe spec i e o he s udy is mic o-sociological and cons uc ionis . Th ee ca ego ies o he child’s alk we e iden i ied: ac i ely desc ibing he posi ion and oice in he ongoing dialogue, no maliza ion o he pa en al p oblem and he sel , and alking abou shame and emba assmen . Keywo ds: child en, pa en al men al heal h, dialogue, esea ch in e iew, s igma Anu Leinonen, MA (co esponding au ho ) is p epa ing a doc o al hesis in psychology a Uni e si y o Jy äskylä. She wo ks a The Helsinki Mo he and Child Home Associa ion, Ensi- Kodin ie 4, 00510 Helsinki, Finland. Email: anukaleinone[email p o ec ed] Jaakko Seikkula, PhD is a P o esso o Psychology and Psycho he apy a he Uni e si y o Jy äskylä, PO 35, FI-40014, Uni e si y o Jy äskylä, Finland. Email: [email p o ec ed]u. i Maa i Alasuu a i, PhD is a P o esso o Ea ly Childhood a he Uni e si y o Jy äskylä, PO 35, FI-40014, Uni e si y o Jy äskylä, Finland. Email: maa i .alasuu a i@jyu. i In e na ional Jou nal o Child, You h and Family S udies (2016) 7(1): 125–147 126 In ou p e ious s udy, we in e iewed child en 8 o 12 yea s old who had a pa en wi h a men al heal h p oblem (Alasuu a i & Jä i, 2012). As in a g owing numbe o quali a i e s udies (e.g., Riebschlege , 2004; Ald idge, 2006; Mo doch & Hall, 2008; Ös man, 2008; Backe , 2011; Oskouie, Zeighami, & Joolaee, 2011), ou ocus was on child en’s iews o hei pa en ’s p oblem. In he in e iews, all he child en, wi hou being asked, epo ed eelings o shame abou hei pa en ’s p oblem, he eby demons a ing hei awa eness o he s igma a ached o men al heal h diso de s. Thei seemingly spon aneous alk abou he shame hey expe ienced p omp ed us o explo e he opic o s igma in ou da a. Howe e , i soon became e iden ha s igma could no be s udied ou side o he in e ac ion aking place in he in e iew. Ins ead, i eme ges in se e al, and o en aci ways in he alk o he in e iewe and he child. In his a icle, we examine how he s igma o a pa en al men al diso de eme ges and how i is nego ia ed in a esea ch in e iew be ween an 8-yea -old gi l and a emale in e iewe . In ou app oach, we depa om he exis ing li e a u e, which has mainly add essed con en in in e iews wi h child en (Mo doch & Hall, 2008; Ös man, 2008; Oskouie e al., 2011), and ocus explici ly on he dialogue be ween a child and an in e iewe . The pe spec i e o ou s udy is hus mic o-sociological and cons uc ionis . S igma, in he con ex o men al diso de s, is inc easingly being ecognized as a cen al issue o he en i e men al heal h ield. I has also been a gued ha psychia ic diagnoses a e always s igma izing, which makes hei use, especially when wo king wi h child en, bo h challenging and e hically ques ionable, (Hinshaw, 2005; Co igan, 2007). S igma can be de ined as a se e ely disc edi ing a ibu e ha has a - eaching e ec s ac oss he whole o a pe son’s social in e ac ion. Go man (1963, pp.3) s a es ha s igma is a linguis ic concep e e ing o ela ionships and ha he s igma izing a ibu e is nei he c edi able no disc edi able in i sel . I is con ex ual in i s na u e, al hough many s igma izing a ibu es seem o be qui e pe manen and cul u ally undesi able. Condi ions associa ed wi h s igma can be di e en ia ed in o h ee ca ego ies: physical anomalies, pe sonal weaknesses, and acial a ibu es. Men al heal h p oblems belong o he second ca ego y, since a ec ed pe sons a e o en seen as men ally o e en mo ally weake han o he s. In addi ion o a pe sonal s igma, he e is a so-called “cou esy s igma”, which socially con amina es hose a ound he s igma ized pe son (Go man, 1963). Thus, child en whose pa en s a e diagnosed wi h a men al diso de would also be a ec ed by he s igma a ached o i . The concep o an associa i e s igma co esponds o ha o a cou esy s igma (e.g., Chang & Ho ocks, 2006). Fo example, Koschade and Lynd-S e enson (2011) p opose ha child en wi h pa en al men al p oblems ha e o ind ways o cope wi h hei associa i e s igma; he old saying “like a he like son” may insidiously a ec he li e o hese child en. Mo eo e , Glads one, Boydell, and McKee e (2006) a gue ha being iden i ied as “a isk” o a men al diso de is a powe ul label o child en. Fu he mo e, Hinshaw (2005) poin s ou ha s igma In e na ional Jou nal o Child, You h and Family S udies (2016) 7(1): 125–147 127 inco po a es bo h social and psychological p ocesses owing o he s ong likelihood o deg ada ion being in e nalized by he s igma ized pe son. O e all, a s igma can be conside ed as p esen when he e is a nega i e gap be ween a pe son’s ac ual social iden i y and wha she o he would like o be. Since human beings p e e o p esen hemsel es as non-de ian , his gap en ails ha he pe son needs o manage he pa s o his o he iden i y ha a e seen as disc edi ed o spoiled (Go man, 1963). This has also been con i med in esea ch wi h young people. Fo example, adolescen s using counseling se ices seem o manage men al heal h s igma by esis ing, in hei a gumen a ion, being posi ioned in a discou se o men al illness (P io , 2012). Mo eo e , child en wi h pa en s su e ing om men al heal h p oblems s uggle ha d o p esen hemsel es as “no mal” and equal in hei pee g oup, and a oid alking abou hei pa en s in an un a o able ligh (Fjone, Y e hus, & Alm ik, 2009). Addi ionally, i has been demons a ed ha child en who li e in in o mal kinship ca e ca e ully manage o con ol s igma izing in o ma ion, such as se ious pa en al p oblems, keeping i om hei pee s (Fa me , Selwyn, & Meakings, 2013). In his classic s udy on s igma, Go man (1963) examined how s igma ized people desc ibe he managemen o hei spoiled iden i y in di e en social si ua ions. Law ence (1996) poin s ou , howe e , ha Go man’s w i ings do no explica e he me hods by which s igma ized ac i i ies a e no malized “in he span o eal in e ac ional ime”; Law ence himsel demons a es how, h ough neu alism, a news in e iewe collabo a es o no malize he in e iewee’s p ac ices in a house o p os i u ion. Fu he mo e, Os aldsson (2004) analyses how he “no mali y” o young people in a cus odial ins i u ion is cons uc ed in in e ac ion by eloca ing he no ion o de iance om he pe son o he social ci cums ances. In line wi h he wo la e s udies, he p esen a icle examines he in e ac ional managemen and nego ia ion o an associa i e s igma. While some au ho s unde line he s igma izing cha ac e o psychia ic diagnoses (Hinshaw, 2005; Co igan, 2007), ha ing knowledge abou hem is also seen as impo an o child en who ha e a pa en wi h a men al diso de . Se e al s udies a gue ha ha ing an unde s anding o he pa en ’s men al diso de inc eases a child’s esilience (Bea dslee, Glads one, W igh , & Coope , 2003; S alla d, No man, Huline-Dickens, Sal e , & C ibb, 2004; Backe , 2011). Pihkala, Sandlund, and Cede s öm (2012) also epo ha child en expe ience a sense o elie a e gaining mo e knowledge abou a pa en al men al p oblem. Thus, i seems o be impo an o child en o acqui e in o ma ion, and o be able o communica e abou pa en al men al p oblems (Foch -Bi ke s & Bea dslee, 2000; Riebschlege , 2004; S alla d e al., 2004). This p esen s a dilemma. On he one hand, opicalizing a pa en al men al diso de can be unde s ood as s igma izing he child and, on he o he hand, i can be seen as a elie o he o him. This con adic o y s a ing poin lea es us wi h a pa adox: how is i possible o ha e a dialogue wi h a child abou pa en al p oblems, o example in a esea ch in e iew, wi hou he child “losing ace” (Go man, 1963)? I he in e iew con ex and he in e ac ion a e amed by In e na ional Jou nal o Child, You h and Family S udies (2016) 7(1): 125–147 128 he child’s po en ially spoiled iden i y owing o pa en al men al p oblems, wha kind o dialogue would bes enable he in e iewee o con ol he o his no mali y and de iancy? In his a icle we conside hese ques ions and examine how a child’s po en ially spoiled iden i y is deal wi h in a esea ch in e iew ela ed o a pa en al men al p oblem, and wha con ibu ion is made o his p ocess by he in e iewe . We also s udy how he in e locu o s locally p oduce and co-cons uc he child’s “no mali y”. A e desc ibing he heo e ical amewo k o ou s udy — he dialogical app oach and he social s udy o childhood — we in oduce he me hodological app oach. The esul s a e hen p esen ed in h ee sec ions, each desc ibing a speci ic in e ac ional way o handling he associa i e s igma o he in e iewee, Tanja. The a icle concludes by d awing he main indings oge he and discussing hem mo e gene ally. A Dialogical Pe spec i e and Childhood S udies as he Theo e ical F amewo k Ou wo k d aws on a heo e ical iew o human ac ion as basically dialogical (Ma ko á, Linell, G ossen, & Salaza O ig, 2007). A dialogical app oach examines human communica ion as sequen ially o ganized and in e dependen ly and join ly cons uc ed (Linell, 1998). Ve y much he same assump ions a e also he s a ing poin o discu si e esea ch, which emphasizes dialogue and in e iews as si ua ed, co-cons uc ed, and nego ia ed by he in e locu o s (Po e & Hepbu n, 2005). In acco dance wi h dialogical p inciples, he in e locu o s cons uc hemsel es in a ying, nego iable posi ions in ela ion o each o he , o he cul u al con ex , and o hei own inne dialogue. This gi es ise o he no ion o “ he he e ogenei y o he speake ”, which means ha when one speaks i is done om a a ie y o pe spec i es. The subjec may use di e en oices in cons uc ing his o he a gumen a ion. These oices migh e e o di e en pieces o discou se(s), bu hey migh also indica e he he e ogenei y o he subjec (G ossen, 2007). Consequen ly, each oice con ains he oices o o he s and, he e o e, a oice ne e has i s o igin in one indi idual (P io , 2005). Dialogical analysis has mos ly been used in he apy and counseling wo k, which sha e simila i ies wi h an in e iew, since bo h con ex s a e cha ac e ized by asymme ical pa icipa ion. I is ypical o ins i u ional in e ac ion ha p o essionals ask ques ions which clien s a e expec ed o answe (Linell, 1998). The same pa e n is a he e y co e o in e iewing. Following he dialogical app oach, we can assume ha in hese con ex s “knowledge” is co-p oduced by bo h pa ies. The in e iewe main ains he ame and ocus o he in e iew and, hence, she o he pa icipa es in cons uc ing knowledge wi h he in e iewee. Mo eo e , alking in an in e iew is ne e he pu e e lec ion o hough s on he opic unde discussion. Ins ead, he pa ies con inuously moni o who hey a e in ela ion o each o he and o he opic o he in e iew, and adjus hei ac ions and alk acco dingly (Hols ein & Gub ium, 1995). In dialogical e ms, adjus ing one’s esponse o he o he speake ’s alk exempli ies lis ening. In dialogical dialogue, lis ening o one ano he becomes a basic ac ha enables gi ing In e na ional Jou nal o Child, You h and Family S udies (2016) 7(1): 125–147 129 and ecei ing a esponse. Recei ing a esponsi e esponse may, as such, be s eng hening o he in e locu o (Seikkula & T imble, 2005; Seikkula, Lai ila, & Robe , 2012). The opposi e o a dialogical ac is a monological one, whe e he speake does no adap his o he wo ds o hose o he o he pa y. Because o his, he o he pa y is le wi hou a esponse and new and sha ed meanings a e no co-cons uc ed. On he one hand, a esea ch in e iew can be unde s ood as monological dialogue: i aims a elici ing in o ma ion on he opics he in e iewe is in e es ed in. On he o he hand, a quali a i e in e iew o en ocuses on meanings and lis ening o he oices o he in o man s. The e o e, quali a i e in e iews a ely ollow a monological ques ion– answe pa e n. Ins ead, hey a e mo e con e sa ional and a ied in hei in e ac ional pa e ns (see Hols ein & Gub ium, 1995). In e es in lis ening o child en and, consequen ly, he use o quali a i e app oaches, a e cha ac e is ic o he social s udy o childhood (e.g., James, 2007; Spy ou, 2011), and a e ac o s which also p omp ed ou in es iga ion. Childhood s udies ha e unde lined he impo ance o he ole o he cul u al powe ela ions, bo h ins i u ional and gene a ional, ha exis be ween esea che and child (see Ch is ensen, 2004; Alanen, 2009). Howe e , in hese con ex s gene a ion does no p ima ily e e o di e en age ca ego ies. Ins ead, i is associa ed wi h a ela ional app oach o childhood and adul hood. This means ha he no ions o childhood and adul hood a e unde s ood as in e dependen and ela ional, and as nego ia ed in social p ac ices. The e m gene a ional o de has been adop ed o e e o hese social nego ia ions ha a ise on he innume able occasions when child en and adul s encoun e each o he (Alanen, 2009). Consequen ly, he asymme y be ween an adul and a child is no longe seen as p o o ypical bu ins ead as collabo a i ely achie ed (Hepbu n, 2005). In o he wo ds, powe does no eside in ca ego ical posi ions, such as adul o child, bu a he in he social ep esen a ions o he posi ions ha we nego ia e in social li e (Ch is ensen, 2004). Consequen ly, he child–adul ela ion as a gene a ional and hie a chical ela ionship bo h o e s oppo uni ies o and imposes limi a ions on child en’s agency (James, 2007). In his s udy, he esea ch in e iew can be seen as a con inuous nego ia ion o gene a ional ela ions ha akes place in e e y u e ance o he dialogue and ha can bo h suppo and up u e he adi ional gene a ional o de ing. Da a and me hodology This a icle d aws on a single esea ch in e iew om he da a ga he ed in ou p e ious s udy (Alasuu a i & Jä i, 2012 ); ha is, quali a i e in e iews wi h en child en, 8 o 12 yea s old. The child en had a ended a pee -g oup in e en ion o amilies wi h a pa en al men al diso de . The in e en ion was p o ided by a amily associa ion o men ally ill pe sons in Finland. The associa ion was a non-p o i , “ hi d sec o ” agen ha does no p o ide medical se ices bu ocuses on pee suppo . The in e en ion consis ed o sepa a e g oup mee ings o child en and hei pa en s. I s aim was o suppo pa en s in hei pa en ing and o inc ease child en’s unde s anding o hei pa en ’s men al heal h p oblem (Bea dslee e al., 2003). In e na ional Jou nal o Child, You h and Family S udies (2016) 7(1): 125–147 130 The amily associa ion in i ed one o he au ho s o ca y ou in e iews wi h he pa en s and child en o p o ide eedback on he in e en ion. The ep esen a i es o he associa ion ag eed o he esea che ’s sugges ion o b oaden he scope o he in e iews in such a way ha he da a could be used o esea ch. In he case o he child en, he esea ch in e es was in hei pe spec i es on he men al heal h p oblem o he pa en . The semi-s uc u ed in e iews wi h he child en s a ed wi h a con e sa ion abou he aims and he con ex o he in e iew. A e his, he child en we e asked abou hei expe iences o he pee -g oup in e en ion. This o en led o alk abou he child en’s iews o hei pa en ’s heal h s a us. The e e yday li e o he child en, o example, hei ypical day, hobbies, iends, and amily we e also discussed. The in e iews we e oice eco ded and ansc ibed e ba im1. We ha e chosen he e o epo a single case s udy, ha o “Tanja”, owing o he ichness o his pa icula in e iew. As was men ioned in he in oduc ion, he s igma o ha ing a pa en wi h a men al p oblem eme ged no only explici ly, bu also in mo e aci ways. Tanja’s in e iew is ep esen a i e in his sense. She p oduces leng hy na a i es on se e al opics, and he in e iew shows he ways o deploying all h ee o he discou se ypes (p o essional and empi ical discou ses and he discou se o conce n) ha we analyzed in ou p e ious s udy (Alasuu a i & Jä i, 2012). Mo eo e , he in e iew also ap ly illumina es di e en aspec s o adul –child in e ac ion in a esea ch in e iew, and when discussing pa en al p oblems. In i s ichness, i mee s he c i e ia o an ex eme case, examina ion o which can yield aluable gene al in o ma ion abou a pa icula phenomenon (Fly bje g, 2006; McLeod, 2010). Case s udies ha e an impo an unc ion in he ield o psycho he apy, especially in consul a i e wo k, in e ealing in e ac ional p ocesses. Such s udies a e no ca ied ou o he pu pose o making s a is ical gene aliza ions; ins ead, wha is po en ially gene alizable o ans e able o o he cases is he heo e ical cons uc ion (McLeod, 2010, p. 22). Fly bje g (2006, p. 237) s a es ha case s udies o en con ain a subs an ial elemen o na a i e and ha good na a i es ypically illumina e he complexi ies and con adic ions o eal li e. The e o e, a single-case s udy can also p o ide aluable insigh s o p o essional p ac ice. In he analyses, we i s di ided he in e iew alk in o episodes acco ding o he changes in he opic o he alk. Then we analysed bo h he changes in opic and he in e ac ion in each episode by applying he ideas o a dialogical analysis me hod, de eloped by Seikkula e al. (2012). The me hod has been used, in pa icula , in analyses o he dialogical quali ies and pa e ns o he apeu ic con e sa ions (Seikkula, 2002; Seikkula e al., 2012 ). In such analysis, 1 The esea ch p ojec , led by Alasuu a i, was ca ied ou in collabo a ion wi h he pa icula amily associa ion o he men ally ill. The in e iews had been g an ed he necessa y e hical app o als om he associa ion’s ep esen a i es and om he pa icipa ing amily membe s. The da a ga he ing and he analysis ollowed he guidelines o e hical esea ch (e.g., Ch is ians, 2000, pp. 138–140). Bo h child en and pa en s had he igh o wi hd aw om he esea ch a any ime. Be o e hey signed he in o med consen i was explained o hem how he in e iews would be used in he esea ch epo s and how hei anonymi y as in e iewees would be sa egua ded. The child en and he pa en s we e also in o med abou he con iden iali y aspec s o he in e iews; he child’s alk would no be e ealed o he pa en (s), and ice e sa. In e na ional Jou nal o Child, You h and Family S udies (2016) 7(1): 125–147 131 bo h he ques ions and he esponses a e examined ollowing he p inciples o dialogism and discu si e hinking (Po e & Hepbu n, 2005), in which an u e ance is conside ed in i s immedia e sequen ial con ex and as an answe o some hing p e iously said. The e o e, in he p esen ins ance, ou in e es was in which u e ance he speake is answe ing, wha he answe is like, and who changes he subjec . We also applied he concep s o seman ic, in e ac ional, and quan i a i e dominance in analyzing he u e ances (Linell, 1998; Seikkula, 2002; Seikkula e al., 2012). Seman ic dominance e e s o he in oduc ion o new wo ds and e ms, in e ac ional dominance o con ol o e a communica i e ac ion, and quan i a i e dominance o he amoun o alk p oduced in he in e ac ion. Resul s The in e iew consis s o 32 opical episodes. In 23 o hese, he in e iewe ini ia es he opic and in 9 Tanja is he ini ia o . O e all, he in e iewe has seman ic and Tanja quan i a i e dominance in he in e iew. Tanja’s ini ia i es conce n such opics as being bullied a school, a gumen s a home, and pe s. She also ini ia es alk abou how o he people migh see he amily si ua ion and abou shame. In hese pa s o he in e iew, she has seman ic, in e ac ional, and quan i a i e dominance in he discussion. One- hi d o he episodes include alk abou he pa en ’s men al heal h p oblems. The in e iewe ypically ini ia es hem by asking ques ions abou he pee -g oup in e en ion ha Tanja had a ended. Tanja alks abou he pa en ’s p oblems bo h di ec ly and indi ec ly. Fo example, she implici ly b ings up he impac o hese p oblems when alking abou he hobbies. Because o he a he ’s some imes luc ua ing abili y o wo k, he economic si ua ion o he amily is insecu e, and Tanja equen ly men ions how all he hobbies a e ei he e y cheap o ee. Mo eo e , she openly in oduces in o he discussion (and has all h ee ypes o dominance when alking abou ) he emo ions and conce ns ela ed o he po en ial e ela ion o he schoolma es o he a he ’s men al p oblems. In he ollowing sec ions, h ee ca ego ies o alk a e in oduced: ac i e posi ioning in an ongoing dialogue; no maliza ion o he pa en al p oblem and he sel ; and alking abou shame and emba assmen . A he same ime, in e ac ional means o dealing wi h he issue o Tanja’s spoiled iden i y a e in oduced. They a e he in e locu o s’ sha ed ways o alking abou Tanja’s expe iences and include, among o he hemes, he ways o making sense o a pa en al men al diso de . They can also be unde s ood as di e en oices in he dialogue. Ac i e Posi ioning in an Ongoing Dialogue Each in e iew commenced wi h a ew momen s o “se ling down” du ing which he con iden iali y o he in e iew was explained o he child. The eco ding was only s a ed a e his. In he beginning sequence o Tanja’s eco ding, he in e iewe has in e ac ional and seman ic dominance in he discussion, bu no quan i a i e dominance, since Tanja akes an ac i e posi ion in he in e ac ion ai ly ea ly on. In e na ional Jou nal o Child, You h and Family S udies (2016) 7(1): 125–147 132 Fi s , he in e iewe inqui es i Tanja has any ques ions abou he s udy. A e a sho exchange, he in e iewe con inues and asks how Tanja el abou coming o he in e iew. She ge s a b ie esponse, “All igh .” The dialogue ollowing his esponse is gi en below. Tanja has me he in e iewe once du ing a home isi and shows ha she is awa e ha he in e iewe knows abou he amily si ua ion2. Exce p 1: Co-cons uc ing alliance I: You knew who would be he e T: =Yeah I: wai ing ( o you) so T: Yeah I: Well (.) would i ha e been di e en i i had been (.) an unknown pe son T: Well yes i would ha e hen some (issues) would ha e like been unspoken (.) like i would ha e been a li le uhh (.) bu in a way (1) well (.) *cos* (.) well as you’ e amilia you know I: =Yes T: =cos you ha e isi ed us In he beginning o he ex ac he in e iewe pu s a he o ical ques ion o Tanja abou he knowing be o ehand he pe son she would be alking o. Following Tanja’s con i ma o y esponse, she con inues wi h he opic and asks whe he i would ha e made a di e ence i he in e iewe had been someone un amilia o he . In pu ing his ques ion, he in e iewe ma ks he in e iew as po en ially sensi i e. Tanja acknowledges he implici sugges ion and opicalizes i as a amily issue by e e ing o he in e iewe ’s p io isi o he home. A he same ime, she p oduces a speci ic alignmen wi h he in e iewe . On he whole, his pa o he in e iew can be seen as co-cons uc ion o an alliance be ween he pa ies, in which Tanja is also ac i e. The po en ial s igma and he po en ially spoiled iden i y o he child a e also sugges ed in he exce p , when amily ma e s a e cons uc ed as delica e. In keeping wi h he p inciples o dialogical dialogue, Tanja’s iden i y is managed and he agency suppo ed collabo a i ely as he dialogue e ol es. 2 In he exce p s, I indica es he in e iewe and T Tanja. The o he ansc ip ion symbols a e: = no pause be ween speake s’ u ns (.) a e y sho pause (less han one second) (3) leng h o pause in seconds * he s a ing o ending poin when speaking in a low oice [ s a o o e lapping alk ( o you) an explana o y addi ion In e na ional Jou nal o Child, You h and Family S udies (2016) 7(1): 125–147 139 In he ex ac , he in e iewe is ac i e in speci ying he consequences o he sp ead o in o ma ion. La e on she demons a es he in e es and he alida ion o Tanja’s eelings, mainly by gi ing minimum eedback. This p ocess seems o be esponsi e and dialogical om Tanja’s poin o iew. In he inal exce p Tanja b ings up an in e es ing example o s igma managemen , ha o ecognizing o he s wi h he same s igma. Tanja has alked abou he molding ac i i y in he g oup and he in e iewe has asked i Tanja has old any o he schoolma es o ano he child abou he g oup. She answe ed ha she has no old anyone, because “all my schoolma es wouldn’ necessa ily unde s and he eason o a ending a g oup like ha ”. She has also explained ha no e e yone would necessa ily unde s and pa en al men al heal h p oblems a all. By d awing his line she di e en ia es he sel om hem — she is wise enough o unde s and hem e en i hey don’ unde s and he . She con inues: Exce p 8: Well-kep sec e T: bu (1) ha (.) ha ’s why I ha en’ [ old abou i ] I: [yeah] T: bu (.) e a iend o mine she’s called Ada she does unde s and [ ha (.)] I: [Hmm] T: Bu I ha en’ alked abou i in ha way bu he a he has had (.) dep ession [o cou se (.)] I: [Hmm T: Bu (.) well i ’s ok o alk o he (.) [ ha ] I: [Yes] (.) yes T: [Well hen] I: [Do you] alk o Ada (.) mo e (.) [ hen] T: [Well] I: Abou hese kinds o hings [o wha ha e you alked abou ] T: [No we don’ eally no in ha way] we do alk [yes] I: [Yes] T: Bu we don’ ( alk) e ibly much (abou ) i (.) she knows how o handle i she doesn’ [sp ead] I: [Hmm] T: i a ound [(.)] In his exce p we see p ecisely how Tanja de e mines who is o be in o med abou po en ially s igma izing in o ma ion. I is ok o alk o Ada, because he a he has had dep ession, oo. A e his exce p , Tanja e en alks abou how Ada’s mo he also unde s ands, because she has expe ienced “ hose kinds o hings, oo”. A he same ime, she makes i clea In e na ional Jou nal o Child, You h and Family S udies (2016) 7(1): 125–147 140 ha “we don’ eally alk ha way”, sugges ing ha i is some hing ha is only men ioned and no eally sha ed. I is ob ious ha “ hese kinds o hings” a e o be concealed om o he s who don’ ha e simila p oblems, and consequen ly don’ unde s and. Ha ing a pa en wi h a men al heal h p oblem may ne e heless be some hing ha can be sha ed, a leas o a ce ain ex en , wi h someone who is acing he same issue in his o he li e, someone who unde s ands ha i is highly con iden ial. Discussion The indings o ou p e ious in e iew s udy wi h child en we e he s a ing poin o his a icle (Alasuu a i & Jä i, 2012). In he p e ious s udy, all he in e iewees desc ibed hei pa en al men al diso de as some hing ha hey wan o conceal, and ha e concealed, om hei pee s. In he li e a u e, his kind o s igma has been e med a cou esy s igma (Go man, 1963) o an associa i e s igma (Chang & Ho ocks, 2006) ha p oduces a “spoiled iden i y” (Go man, 1963) o he pe son. In his a icle, we ha e p esen ed a single, bu ich, case s udy, ha o “Tanja”. We examined how Tanja cons uc ed he no mali y o non-de iance in a esea ch in e iew ela ed o a pa en al men al p oblem, and how he in e iewe con ibu ed o he p ocess. Howe e , i should be kep in mind ha as a case s udy, he gene alizabili y o he indings is limi ed. We di e en ia ed h ee ca ego ies o cons uc ing no mali y: ac i e posi ioning o onesel in he dialogue, p oblem no maliza ion, and nego ia ing shame and emba assmen . By ac i e posi ioning, we e e ed o accoun s in which Tanja in e ened in he ame o he esea ch in e iew, o example, by exp essing he pe sonal iews and in e es s o by momen a ily adop ing he posi ion o an in e iewe . Ac i e posi ioning allowed he o ep esen he sel as an o dina y gi l wi h o dina y in e es s (like wan ing a pe ) despi e he pa en al men al p oblem. The no malizing alk ook di e en o ms and p oduced pa ly con adic o y desc ip ions o Tanja’s amily and he sel . Howe e , i s co e unc ion was o ep esen he a he and he o he amily membe s, as well as Tanja he sel and he ela ion o he pa en al di icul ies, as non-de ian . The no malizing accoun s also showed how challenging o a child he assump ions o psychia ic discou se may be. In se e al episodes, Tanja made i clea ha she is no oo in ol ed in he pa en al p oblems. The opic, amed by he conce n abou pa en i ica ion, had been discussed in he in e en ion she had pa icipa ed in. Howe e , she also cons uc ed an opposi e pic u e o he sel , ep esen ing he sel simul aneously as he a he ’s helpe . By posi ioning he sel as a helpe she was able o ep esen he sel as a esponsible and heal hy young pe son. Glads one e al. (2006, p. 2542) s a es ha child en's desi e o be ecognized as ‘‘impo an o hei pa en s well-being con lic s wi h adul s’ pe cep ions ha child en should be p o ec ed om oo much esponsibili y” (c . T ondsen, 2012). Howe e , p e ious s udies show In e na ional Jou nal o Child, You h and Family S udies (2016) 7(1): 125–147 141 ha child en can ind i sa is ying o be able o help hei amily membe s and ha i can enhance hei social skills (Backe , 2011; Fjone e al., 2009). In he i s wo ca ego ies o cons uc ing no mali y, he e e ences o associa i e s igma we e mainly implici , bu when nego ia ing shame and emba assmen Tanja explici ly e e ed o he po en ial s igma iza ion by he pee s. She also oiced he eelings ela ed o his and desc ibed hiding amily ma e s as he way o dealing wi h amily p oblems in pee ela ions. Ou indings co obo a e hose o p e ious s udies ha ha e demons a ed he expe ience o shame and associa i e s igma o child en wi h pa en al men al p oblems (Cogan, Riddel, & Mayes, 2005; Ös man, 2008; Fjone e al., 2009; Chan & Ying, 2010). They a e also in acco dance wi h he indings o P io (2012), who analysed how young use s o counseling se ices esis being posi ioned in a s igma izing discou se o men al illness, and wi h hose o Fjone e al. (2009), who a gue ha child en wi h pa en al men al diso de s wish o p esen hemsel es as no mal and equal in hei pee g oup. To achie e his end, he mos ob ious ac ion is o conceal he pa en al si ua ion (see also Oskouie e al., 2011). Fu he mo e, esea ch shows ha in seeking o gua d a amily sec e , child en o en isola e hemsel es psychologically om o he s (Riebschlege , 2004; Chan & Ying, 2010; Chang & Ho ocks, 2006). The p esen analysis also showed how he in e iewe pa icipa ed in he managemen o Tanja’s associa i e s igma and in p esen ing he sel as a non-de ian young pe son. An impo an aspec in he in e ac ion was he in e iewe ’s lexibili y in ela ion bo h o he agenda o he in e iew and he dominan ins i u ional and gene a ional o de p e ailing be ween he in e locu o s. She posi ioned he sel , i s , as a social pe son and, second, as a p o essional wi h a speci ic mission in he in e iew. Fo example, she was willing o e eal in o ma ion abou he li e when Tanja s a ed o in e iew he , despi e he unw i en ule in Finland ha a p o essional, a leas in psychia y, does no e eal pe sonal in o ma ion (see Ruusu uo i, 2005). In dialogical e ms, we can also hea he oices o a human being, a mo he , and an adul in he in e iewe ’s commen s (Seikkula & A nkil, 2014). The lexibili y o he in e iewe can also be ela ed o wha Ch is ensen (2004) e e s o as p esen ing onesel as an a ypical adul in esea ch wi h child en; ha is, enabling child en o ha e hei say by showing se ious in e es in hei pe spec i es and ye no p e ending o be a child. Mo eo e , he analysis demons a ed ac i e lis ening on he pa o he in e iewe . This was e iden , o example, in he way o dialogically e u ning o he issues aised by Tanja, some imes in a delayed manne . In his way, i was possible o bo h inish he opic unde discussion and explo e o he opics, such as shame, mo e ho oughly. Fu he mo e, he in e iewe ’s minimal eedback was impo an in he dialogue bo h in demons a ing ha she was paying a en ion o Tanja’s alk and in suppo ing Tanja when she wan ed o con inue alking on he opic. I also con eyed he in e iewe ’s accep ance o Tanja’s expe iences and emo ions (c . G aham & Fi zge ald, 2011). Finally, he in e iewe also o mula ed he commen s disc ee ly, especially when he alk conce ned Tanja’s pa en al p oblem. She did no emind Tanja abou he a he s’s uns able condi ion when Tanja spoke posi i ely abou he a he ’s In e na ional Jou nal o Child, You h and Family S udies (2016) 7(1): 125–147 142 ac i i ies. Ins ead o add essing Tanja’s expe iences and amily wo ies di ec ly, she chose o ask wha Tanja obse ed and hough abou he o he child en in he in e en ion. Wi h his o mula ion, Tanja could choose he own le el o in imacy in answe ing. Tanja’s desc ip ion o alking o he iend who is in a simila si ua ion (exce p 8) was also in e es ing. Tanya and he iend had no sha ed much, despi e he commonali y o hei expe ience. The di icul y o alking abou sensi i e amily issues may be some hing o ake in o accoun when a anging g oup in e en ions o child en. 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