Body as mediator: Case understanding in salutogenic-oriented general practitioner consultation

An animate body offers itself in its material substrate as an object of causal-analytical thinking and, as such, requires an interpretative approach. In this regard, medicine and the health sciences are always hermeneutic, yet how is shared meaning constituted in the doctor-patient relationship if the patient does not verbalize the central questions of life? And what roles do caregivers' health concepts play? This paper uses sequence analysis (according to structural hermeneutics) to explore a video-documented conversation between a general practitioner and his patient, in which the overall shape of professional interactional patterns resulting from the rating procedure for solution-oriented interventions is evaluated. The case study illustrates how negotiating health goals goes beyond the patient's illness and touches upon their concerns and (life) goals. The paper suggests that shared decision-making must be preceded by mutual understanding, and that the health-promoting potential for a sense of coherence can be strengthened by interpreting symptom formation as a possible voice of the body if this expression is taken seriously.