Modality and metaphors of constraint in healthcare discourse of gestational diabetes

Nao, M. ORCID: https://orcid.org/0000-0001-6300-4867 and Tang, C. 2025. Modality and metaphors of constraint in healthcare discourse of gestational diabetes. Presented at: 50th International Systemic Functional Congress and Institute (ISFC 50), Glasgow, UK, 7-11 July 2025.

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Abstract

Gestational diabetes (GDM) is a pregnancy condition with risk of adverse outcomes such as birth complications. Its treatment includes patient self-management through diet control and blood sugar monitoring. High stakes can thus combine with an expectation of behavioural constraints to create an extended healthcare domain of prohibition, paradoxically both implicating and inhibiting patient volition. Adopting a discourse dynamic approach (DDA) to metaphor (Cameron et al. 2009), we examine the use of metaphors of constraint from more than 7 focus group discussions on the experience of gestational diabetes, including patients, partners, and healthcare providers. Compatibly with Systemic Functional Linguistics, DDA methodologically presupposes meaning as interpersonally emergent. The analysis of the metaphors’ surrounding co-text and wider discourse is thus core to the dynamic framework, to which end DDA flexibly accommodates a diversity of potential yet commensurate approaches. Here, we incorporate into this discourse analytic focus Halliday’s congruent (non-metaphorical) modality, such as can’t and should (Halliday & Matthiessen 2014). While such instances of use differ through their directness from his ‘grammatical metaphor’, we propose that for this very reason they may serve as framing devices intensifying the metaphors coded as mappings in DDA. Responding to the opening up of the conference call to non-SFL studies, we present in an exploratory way this hybridized framework of analysis in light of emergent findings from a GDM study.

Item Type:	Conference or Workshop Item - unpublished
Date Type:	Completion
Status:	Unpublished
Schools:	Schools > Architecture
Last Modified:	17 Sep 2026 09:30
URI:	https://orca.cardiff.ac.uk/id/eprint/189629

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