Working the Difference: Science, Spirit, and the Spread of Motivational Interviewing

A history of motivational interviewing and what its rise reveals about how cultural forms emerge and spread. Motivational interviewing (MI) is a professional practice, a behavioral therapy, and a self-professed conversation style that encourages clients to talk themselves into change. Originally developed to treat alcoholics, MI quickly spread into a variety of professional fields including corrections, medicine, and sanitation. In Working the Difference, E. Summerson Carr focuses on the training and dissemination of MI to explore how cultural forms—and particularly forms of expertise—emerge and spread. The result is a compelling analysis of the American preoccupations at MI’s core, from democratic autonomy and freedom of speech to Protestant ethics and American pragmatism.

Table of Contents:
List of Illustrations Prologue Introduction: Motivating Americans, Defusing Difference Chapter 1 American Democracy (Or, How to Direct Autonomous Subjects) Chapter 2 American Rhetoric: Therapeutic Performance and the Poetics of Behavior Change Chapter 3 American Spirit: Presence, Profit, and Professional Reenchantment Chapter 4 American Science: Faith and the Spirited Economy of Evidence-Based Practice Chapter 5 American Pragmatism: Learning to Work the Difference (Or, the Life and Death of MI) Conclusion: Dealing with Difference and the Movement of Method Acknowledgments Appendix: Some Notes on the Study of (In)experts Notes Works Cited Index

About the Author :
E. Summerson Carr is associate professor of social work and anthropology at the University of Chicago. She is the author of Scripting Addiction: The Politics of Therapeutic Talk and American Sobriety and co-editor of Scale: Discourse and Dimensions of Social Life.

Review :
“An ethnography that is both sweeping and meticulously fine-grained as it follows the remarkable dissemination of MI across fields of professional practice. . . . In Working the Difference, Carr brings together a dazzling array of literatures to speak to audiences across multiple anthropological subfields—linguistic, medical, psychological, and sociocultural—as well as practitioner–researchers like her interlocutors. In speaking directly to this latter audience, the author makes a profound contribution to the anthropology of expertise and ethnographic endeavors to ‘study up’ . . . Despite the author's modest self-deprecation about her own Motivational Interviewing skill, Carr's skill as an ethnographic interviewer is on full display.” “Working the Difference is a tour de force in the study of language and culture and an acute analysis of the compulsive force of contradictions at the heart of American normative ideals. Writing with beauty, clarity, and a seductive blend of modesty and sass, Carr has proven herself once again to be one of the most cogent and creative thinkers in anthropology. Working the Difference is unsettling in the best possible way." “With boldness and ambition, Carr fixes the lens of linguistic anthropology on the helping professions, moving in scalewise analytic fashion from training sessions in small rooms to the worldwide adoption of a communicative technology for effecting behavioral change. Her elucidation of ideological and rhetorical strategies for the neutralization of difference is a highly illuminating contribution to the understanding of scalar dynamics in the dissemination of innovation.” “In this fascinating study, Carr explains how motivational interviewing is transforming fields like social work by changing how professionals talk to their clients. An accomplished scholar of expertise as an interactional process—as something done rather than owned—Carr shows how MI adopters relearn how to speak even while dancing around the idea that MI requires expertise to perform. This exemplary study brings paradox and contradiction to the fore, revealing how invocations of science coexist with appeals to faith in the rhetoric of professionalism today.” "This beautifully written, incisive book maps the hidden structures of Motivational Interviewing (MI), a method now so widespread in the American helping professions it is practically the water we swim in. Carr’s attention to linguistic detail captures the paradoxes and enchantments of MI, from its carefully cultivated naturalism to the verbal nudges that coax interlocutors to 'talk themselves into change.' Contributing to the nexus of linguistic, medical, and psychological anthropology, this elegant volume also situates MI in the American historical zeitgeist, with all its befuddling aspirations."