Abstract
Less existing research explains why resonance as verbal engagement to establish an alignment in rural China’s medical consultations characterized by knowledge-power asymmetry between village doctors and patients, rural-urban schemata mismatch in disease conceptualization, and aged-related expression barriers in discovery accounts. In this article, we investigate the discursive strategies and functions of resonance by village doctors in China’s naturalistic rural medical consultations based on the demographically sampled regions of 32 rural medical institutions in 11 provinces of the P. R. China. The findings show two sets of strategies: explicit resonance in the form of content recurrence, structural replication and sentence-final particles, and implicit resonance in the form of backchanneling tokens, discourse markers and relevance acknowledgment. These strategies blend to form an allied voice that balances the clinician-patient epistemic gap, rural-urban cognitive divide, and intergenerational communicative dissonance by cognitive and affective alignment.
References
Adank, P., Hagoort, P., & Bekkering, H. (2010). Imitation improves language comprehension. Psychological Science, 21(12), 1903-1909. https://doi.org/10.1177/0956797610389192
Arbib, M. (2012). How the brain got language: The mirror system hypothesis. Oxford University Press.
Beisecker, A. E., & Beisecker, T. D. (1993). Using metaphors to characterize doctor patient relationships: Paternalism versus consumerism. Health Communication, 5(1), 41–58. https://doi.org/10.1207/s15327027hc0501_3
Bernstein, B (1996). Pedagogy, symbolic control and identity. Taylor & Francis.
Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research & Practice, 16(3), 252-260. https://doi.org/10.1037/h0085885
Cai, J., Wu, D., Sun, K. S., Yang, S., Lam, K. F., Li, L., Lam, P. T., & Zhou, X. (2021). Primary care physicians’ views on the factors for enhancing patients’ trust in rural areas of Zhejiang province, China: a cross-sectional study. BMJ Open, 11(7), e049114. https://doi.org/10.1136/bmjopen-2021-049114
Charmaz, K. (2000). Grounded theory methodology: Objectivist and constructivist qualitative methods. In N. K. Denzin, & Y. Lincoln (Eds.), Handbook of qualitative research (pp. 509–535). Sage.
Charmaz, K. (2008). Grounded theory as an emergent method. In S. N. Hesse-Biber, & P. Leavy (Eds.), Handbook of emergent methods, (pp. 155–172). The Guilford Press.
Chen, G., & Xu, Q. (2025). The evolution of “Acquaintance Society” in urban China. International Review of Economics & Finance, 98, 103914. https://doi.org/10.1016/j.iref.2025.103914
Cook, R., Bird, G., Lünser, G., Huck, S., & Heyes, C. (2012). Automatic imitation in a strategic context: players of rock–paper–scissors imitate opponents’ gestures. Proceedings of the Royal Society B: Biological Sciences, 279(1729), 780-786. https://doi.org/10.1098/rspb.2011.1024
Council for International Organizations of Medical Sciences (CIOMS). (2016). International ethical guidelines for health-related research involving humans. https://doi.org/10.56759/rgxl7405
Dingwall, R., & Pilnick, A. (2020). Shared decision making: doctors have expertise that patients want or need. British Medical Journal, 368, m128. https://doi.org/10.1136/bmj.m128
Du Bois, J. (2014). Towards a dialogic syntax. Cognitive Linguistics, 25(3), 359-410. https://doi.org/10.1515/cog-2014-0024
Fusaroli, R., Bahrami, B., Olsen, K., Roepstorff, A., Rees, G., Frith, C., & Tylén, K. (2012). Coming to terms: Quantifying the benefits of linguistic coordination. Psychological Science, 23(8), 931-939. https://doi.org/10.1177/0956797612436816
Gallotti, M., Fairhurst, M. T., & Frith, C. D. (2016). Alignment in social interactions. Consciousness and Cognition, 48, 253-261. https://doi.org/10.1016/j.concog.2016.12.002
Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. Adline de Gruyter.
He, X. (2000). Progress in the prevention of typhoid fever in China. Chinese Journal of Epidemiology, 21(1), 61-63.
Hobson, R. P., Hobson, J. A., Garcia-Perez, R., & Du Bois, J. (2012). Dialogic linkage and resonance in autism. Journal of Autism and Developmental Disorders, 42, 2718-2728. https://doi.org/10.1007/s10803-012-1528-6
Keller, F., Ludwig, U., & Huber-Lang, M. (2023). Enemy or friend: the personal and the factual patient-physician relationship. Frontiers in Medicine, 10, 1098305. https://doi.org/10.3389/fmed.2023.1098305
Kendrick, K. H. (2018). Adjusting epistemic gradients: The final particle ba in Mandarin Chinese conversation. East Asian Pragmatics, 3(1), 5-26. https://doi.org/10.1558/10.1558/eap.36120
Korsch, B. M., & Negrete, V. F. (1972). Doctor-patient communication. Scientific American, 227(2), 66–74. https://doi.org/10.1038/scientificamerican0872-66
LaFrance, M. (1979). Nonverbal synchrony and rapport: Analysis by the cross-lag panel technique. Social Psychology Quarterly, 42(1), 66-70. https://doi.org/10.2307/3033875
Lee, S. H., & Tanaka, H. (2016). Affiliation and alignment in responding actions. Journal of Pragmatics, 100, 1-7. https://doi.org/10.1016/j.pragma.2016.05.008
Lewis, D. K. (1969). Convention: A philosophical study, 20(80). Wiley-Blackwell.
Liu, S. S., & Liu, L. H. (2012). The appraisal approach and discourse analysis. Journal of Tsinghua University (Philosophy and Social Sciences), 27(02), 134-141+160. https://doi.org/10.13613/j.cnki.qhdz.002062
Liu, Z. X. (2005). Features and inspiration of farmers’ health seeking behaviors. Health Economics Research, (03), 36. https://link.cnki.net/doi/10.14055/j.cnki.33-1056/f.2005.03.020
Li, L., Zhu, L., Zhou, X., Zeng, G., Huang, H., Gan, Y., Lu, Z., Wang, X., Chen, Z., Sun, K., Yang, Di., Zhang, Qi., & Wu, C. (2022). Patients’ trust and associated factors among primary care institutions in China: a cross-sectional study. BMC Primary Care, 23, 109. https://doi.org/10.1186/s12875-022-01709-8
Martin, J. R., & Rose, D. (2003). Working with discourse: Meaning beyond the clause. Continuum.
Mey, J. L. (1987). Poet and peasant: A pragmatic comedy in five acts. Journal of Pragmatics, 11(3), 281-297. https://doi.org/10.1016/0378-2166(87)90134-2
Nimegeer, A., & Farmer, J. (2016). Prioritising rural authenticity: Community members’ use of discourse in rural healthcare participation and why it matters. Journal of Rural Studies, 43, 94-103. https://doi.org/10.1016/j.jrurstud.2015.11.006
Nouralian, R. (2024). A constructivist Grounded Theory strategy in applied linguistics research. Wiener Linguistische Gazette, 95, 31-55.
Pickering, M., & Garrod, S. (2021). Understanding dialogue: Language use and social interaction. Cambridge University Press. https://doi.org/10.1017/9781108610728
Schmid, H. B. (2014). Social capital and self-alienation: An Augustinian look at the dark heart of community. In D. Thomä, C. Henning & H. Schmid (Eds.), Social capital, social identities: From ownership to belonging (pp. 105–122). De Gruyter. https://doi.org/10.1515/9783110292930.105
Stivers, T. (2008). Stance, alignment, and affiliation during storytelling: When nodding is a token of affiliation. Research on Language and Social Interaction, 41(1), 31–57. https://doi.org/10.1080/08351810701691123
Stivers, T. (2011). Morality and question design: “of course” as contesting a presupposition of askability. In T. Stivers, L. Mondada, & J. Steensig (Eds.), The morality of knowledge in conversation (pp. 82–106). Cambridge University Press.
Stivers, T., Mondada, L., & Steensig, J. (2011). Knowledge, morality and affiliation in social interaction. In T. Stivers, L. Mondada, & J. Steensig (Eds.), The morality of knowledge in conversation (pp. 3–24). Cambridge University Press.
Tantucci, V. (2023). Resonance and recombinant creativity: Why they are important for research in Cognitive Linguistics and Pragmatics. Intercultural Pragmatics, 20(4), 347-376. https://doi.org/10.1515/ip-2023-4001
Tantucci, V., & Lepadat, C. (2024). Verbal engagement in doctor–patient interaction: Resonance in Western and Traditional Chinese Medicine. Journal of Pragmatics, 230, 126-141. https://doi.org/10.1016/j.pragma.2024.07.002
Tantucci, V., & Wang, A. (2021). Resonance and engagement through (dis-)agreement: Evidence of persistent constructional priming from Mandarin naturalistic interaction. Journal of Pragmatics, 175, 94-111. https://doi.org/10.1016/j.pragma.2021.01.002
Tantucci, V., & Wang, A. (2022). Dynamic resonance and explicit dialogic engagement in Mandarin first language acquisition. Discourse Processes, 59(7), 553–574. https://doi.org/10.1080/0163853X.2022.2065175
Tantucci, V., & Wang, A. (2023). Dialogic priming and dynamic resonance in autism: creativity competing with engagement in Chinese children with ASD. Journal of Autism and Developmental Disorders, 53, 2458-2474. https://doi.org/10.1007/s10803-022-05505-2
Waitzkin, H. (1985). Information giving in medical care. Journal of Health and Social Behavior, 26(2), 81–101. https://doi.org/10.2307/2136599
Wilce, J. M. (2009). Medical discourse. Annual Review of Anthropology, 38, 199-215. https://doi.org/10.1146/annurev-anthro-091908-164450
Zhao, X. (2024). A politeness-theoretic approach to mitigated disagreements in online radio medical consultations. Pragmatics and Society, 15(5), 732-754. https://doi.org/10.1075/ps.20069.zha
Zhu, Q. R. (2022). Trust between doctors and patients from the perspective of social transformation. Journal of Guizhou Minzu University (Philosophy and Social Sciences), (01), 77-94.
Arbib, M. (2012). How the brain got language: The mirror system hypothesis. Oxford University Press.
Beisecker, A. E., & Beisecker, T. D. (1993). Using metaphors to characterize doctor patient relationships: Paternalism versus consumerism. Health Communication, 5(1), 41–58. https://doi.org/10.1207/s15327027hc0501_3
Bernstein, B (1996). Pedagogy, symbolic control and identity. Taylor & Francis.
Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research & Practice, 16(3), 252-260. https://doi.org/10.1037/h0085885
Cai, J., Wu, D., Sun, K. S., Yang, S., Lam, K. F., Li, L., Lam, P. T., & Zhou, X. (2021). Primary care physicians’ views on the factors for enhancing patients’ trust in rural areas of Zhejiang province, China: a cross-sectional study. BMJ Open, 11(7), e049114. https://doi.org/10.1136/bmjopen-2021-049114
Charmaz, K. (2000). Grounded theory methodology: Objectivist and constructivist qualitative methods. In N. K. Denzin, & Y. Lincoln (Eds.), Handbook of qualitative research (pp. 509–535). Sage.
Charmaz, K. (2008). Grounded theory as an emergent method. In S. N. Hesse-Biber, & P. Leavy (Eds.), Handbook of emergent methods, (pp. 155–172). The Guilford Press.
Chen, G., & Xu, Q. (2025). The evolution of “Acquaintance Society” in urban China. International Review of Economics & Finance, 98, 103914. https://doi.org/10.1016/j.iref.2025.103914
Cook, R., Bird, G., Lünser, G., Huck, S., & Heyes, C. (2012). Automatic imitation in a strategic context: players of rock–paper–scissors imitate opponents’ gestures. Proceedings of the Royal Society B: Biological Sciences, 279(1729), 780-786. https://doi.org/10.1098/rspb.2011.1024
Council for International Organizations of Medical Sciences (CIOMS). (2016). International ethical guidelines for health-related research involving humans. https://doi.org/10.56759/rgxl7405
Dingwall, R., & Pilnick, A. (2020). Shared decision making: doctors have expertise that patients want or need. British Medical Journal, 368, m128. https://doi.org/10.1136/bmj.m128
Du Bois, J. (2014). Towards a dialogic syntax. Cognitive Linguistics, 25(3), 359-410. https://doi.org/10.1515/cog-2014-0024
Fusaroli, R., Bahrami, B., Olsen, K., Roepstorff, A., Rees, G., Frith, C., & Tylén, K. (2012). Coming to terms: Quantifying the benefits of linguistic coordination. Psychological Science, 23(8), 931-939. https://doi.org/10.1177/0956797612436816
Gallotti, M., Fairhurst, M. T., & Frith, C. D. (2016). Alignment in social interactions. Consciousness and Cognition, 48, 253-261. https://doi.org/10.1016/j.concog.2016.12.002
Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. Adline de Gruyter.
He, X. (2000). Progress in the prevention of typhoid fever in China. Chinese Journal of Epidemiology, 21(1), 61-63.
Hobson, R. P., Hobson, J. A., Garcia-Perez, R., & Du Bois, J. (2012). Dialogic linkage and resonance in autism. Journal of Autism and Developmental Disorders, 42, 2718-2728. https://doi.org/10.1007/s10803-012-1528-6
Keller, F., Ludwig, U., & Huber-Lang, M. (2023). Enemy or friend: the personal and the factual patient-physician relationship. Frontiers in Medicine, 10, 1098305. https://doi.org/10.3389/fmed.2023.1098305
Kendrick, K. H. (2018). Adjusting epistemic gradients: The final particle ba in Mandarin Chinese conversation. East Asian Pragmatics, 3(1), 5-26. https://doi.org/10.1558/10.1558/eap.36120
Korsch, B. M., & Negrete, V. F. (1972). Doctor-patient communication. Scientific American, 227(2), 66–74. https://doi.org/10.1038/scientificamerican0872-66
LaFrance, M. (1979). Nonverbal synchrony and rapport: Analysis by the cross-lag panel technique. Social Psychology Quarterly, 42(1), 66-70. https://doi.org/10.2307/3033875
Lee, S. H., & Tanaka, H. (2016). Affiliation and alignment in responding actions. Journal of Pragmatics, 100, 1-7. https://doi.org/10.1016/j.pragma.2016.05.008
Lewis, D. K. (1969). Convention: A philosophical study, 20(80). Wiley-Blackwell.
Liu, S. S., & Liu, L. H. (2012). The appraisal approach and discourse analysis. Journal of Tsinghua University (Philosophy and Social Sciences), 27(02), 134-141+160. https://doi.org/10.13613/j.cnki.qhdz.002062
Liu, Z. X. (2005). Features and inspiration of farmers’ health seeking behaviors. Health Economics Research, (03), 36. https://link.cnki.net/doi/10.14055/j.cnki.33-1056/f.2005.03.020
Li, L., Zhu, L., Zhou, X., Zeng, G., Huang, H., Gan, Y., Lu, Z., Wang, X., Chen, Z., Sun, K., Yang, Di., Zhang, Qi., & Wu, C. (2022). Patients’ trust and associated factors among primary care institutions in China: a cross-sectional study. BMC Primary Care, 23, 109. https://doi.org/10.1186/s12875-022-01709-8
Martin, J. R., & Rose, D. (2003). Working with discourse: Meaning beyond the clause. Continuum.
Mey, J. L. (1987). Poet and peasant: A pragmatic comedy in five acts. Journal of Pragmatics, 11(3), 281-297. https://doi.org/10.1016/0378-2166(87)90134-2
Nimegeer, A., & Farmer, J. (2016). Prioritising rural authenticity: Community members’ use of discourse in rural healthcare participation and why it matters. Journal of Rural Studies, 43, 94-103. https://doi.org/10.1016/j.jrurstud.2015.11.006
Nouralian, R. (2024). A constructivist Grounded Theory strategy in applied linguistics research. Wiener Linguistische Gazette, 95, 31-55.
Pickering, M., & Garrod, S. (2021). Understanding dialogue: Language use and social interaction. Cambridge University Press. https://doi.org/10.1017/9781108610728
Schmid, H. B. (2014). Social capital and self-alienation: An Augustinian look at the dark heart of community. In D. Thomä, C. Henning & H. Schmid (Eds.), Social capital, social identities: From ownership to belonging (pp. 105–122). De Gruyter. https://doi.org/10.1515/9783110292930.105
Stivers, T. (2008). Stance, alignment, and affiliation during storytelling: When nodding is a token of affiliation. Research on Language and Social Interaction, 41(1), 31–57. https://doi.org/10.1080/08351810701691123
Stivers, T. (2011). Morality and question design: “of course” as contesting a presupposition of askability. In T. Stivers, L. Mondada, & J. Steensig (Eds.), The morality of knowledge in conversation (pp. 82–106). Cambridge University Press.
Stivers, T., Mondada, L., & Steensig, J. (2011). Knowledge, morality and affiliation in social interaction. In T. Stivers, L. Mondada, & J. Steensig (Eds.), The morality of knowledge in conversation (pp. 3–24). Cambridge University Press.
Tantucci, V. (2023). Resonance and recombinant creativity: Why they are important for research in Cognitive Linguistics and Pragmatics. Intercultural Pragmatics, 20(4), 347-376. https://doi.org/10.1515/ip-2023-4001
Tantucci, V., & Lepadat, C. (2024). Verbal engagement in doctor–patient interaction: Resonance in Western and Traditional Chinese Medicine. Journal of Pragmatics, 230, 126-141. https://doi.org/10.1016/j.pragma.2024.07.002
Tantucci, V., & Wang, A. (2021). Resonance and engagement through (dis-)agreement: Evidence of persistent constructional priming from Mandarin naturalistic interaction. Journal of Pragmatics, 175, 94-111. https://doi.org/10.1016/j.pragma.2021.01.002
Tantucci, V., & Wang, A. (2022). Dynamic resonance and explicit dialogic engagement in Mandarin first language acquisition. Discourse Processes, 59(7), 553–574. https://doi.org/10.1080/0163853X.2022.2065175
Tantucci, V., & Wang, A. (2023). Dialogic priming and dynamic resonance in autism: creativity competing with engagement in Chinese children with ASD. Journal of Autism and Developmental Disorders, 53, 2458-2474. https://doi.org/10.1007/s10803-022-05505-2
Waitzkin, H. (1985). Information giving in medical care. Journal of Health and Social Behavior, 26(2), 81–101. https://doi.org/10.2307/2136599
Wilce, J. M. (2009). Medical discourse. Annual Review of Anthropology, 38, 199-215. https://doi.org/10.1146/annurev-anthro-091908-164450
Zhao, X. (2024). A politeness-theoretic approach to mitigated disagreements in online radio medical consultations. Pragmatics and Society, 15(5), 732-754. https://doi.org/10.1075/ps.20069.zha
Zhu, Q. R. (2022). Trust between doctors and patients from the perspective of social transformation. Journal of Guizhou Minzu University (Philosophy and Social Sciences), (01), 77-94.
Copyright (c) 2026 Yi Zhong, Xin Zhao
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