Playing with Silence

Throughout graduate school, knowing professors in courses designed to teach clinical skills will often extol the benefits of silence in the therapeutic encounter.  To be sure, silence can be a powerful tool, however, I think its virtues are often overstated and not as subtly appreciated as they ought to be.  The way it is often positioned to novices seems to be that holding a silence in session is an effective way to produce anxiety in the client which prompts them to fill that space with additional dialogue so as to alleviate the discomfort brought on by the silence.  Presumably the assumption is that the quality of speech this elicits from the client is of equal quality to something that could have been pulled with a well-crafted question or an honest reflection of one’s own countertransference.  To this point I am not so sure.

There is certainly some beauty to be observed in the kinds of silences that can emerge in the therapeutic encounter.  Salman Akhtar in his book on psychoanalytic listening has a whole section on the kinds of silence that arise in a session and ways in which we ought to be primed to listen for the differences in those silences.  Things like silence as a lack of symbolization, silence as conflict, silence as reenactment, and contemplative silence (to name a few) each stir up a different kind of presence to be negotiated, revealing in their respective covering over some different quality of what may be blossoming between therapist and client in the ongoing interaction.  Of course, this kind of discernment requires not only a kind of targeted listening to the other, but a listening to ourselves as well, a feature that is true of most kinds of effective listening but especially in the context of therapeutic listening.  The sensibilities evoked in us by these various silences are often the clearest signal towards differentiating exactly what kind of communication is being manifested through the silence. 

Of course, as anyone who has ever sat down to write without a prompt can tell you, liberating, listening to, and organizing one’s inner thoughts is not always an easy task in which to take part.  Words, concepts, syntax, metaphor, and other flourishes of the literary arts are not always as at the tips of our fingers—or our tongues—as we would like.  Even if they were, the surety that one would have something interesting to say or know quite how to access what one thinks they ought to be sharing is not always guaranteed.  This is primarily why silence as a response to silence is one of the first things that gets taught to graduates in clinical skill courses.  Being in front of a client who seems willing to share little or is looking upon you as the therapist in an expectant and solicitous manner drags out many of the anxious and uncertain responses similar to what one might experience in front of said blank page.  And anyone who has spent any time in the presence of well-meaning graduate students taking their first stabs at clinical writing knows that this is often not when our deftest and most sensitive skills as a clinician emerge.  It is often a clumsy and uncertain process.  As it should be.  Freud took 27 volumes of written material to make his points.  So, students are taught that, rather than trying to reach for something (anything!) to say, use your own silence to volley the responsibility back to the client.  After some several minutes if one wants to offer an “It doesn’t seem like you have much you want to share today” that might be acceptable, but otherwise conventional clinical acumen would suggest the less said the better.  Thus, the best response becomes no response, and the second-best response becomes something like blaming the client for not having a response of their own.

To be sure, knowing how to refrain from saying something for the sake of saying something is an important quality for a therapist to possess.  But silence for silence’s sake, or worse as an attempt to pull the client into a binary that is meant to claim that someone ought to have the responsibility for speaking and driving the discourse, misses the point of the relational properties at play in the therapeutic encounter.  It could be, at best, naïve and, at worst, destructive to the therapy to objectify silence and narrow the possible scope of responses based on that objectification.  To do so is indicative of the powerful countertransferential pull of silence and reveals more about what is going on for the therapist in navigating their own insecurities and expectations for the therapy than the clients.

So, what kind of responses might be on offer in these instances.  To be sure, the possibility of commenting on the client’s silence can be a fruitful one.  However, it is important to be sensitive to the potential impact of the words we choose to frame the silence on their behalf.  As mentioned previously, the offering above, characterized by its implicit power differential of the therapist telling the client something about what the client is or is not doing, carries a shaming and blaming quality to it that might only further exacerbate a lingering silence, or if it does initiate some verbal responses, they will likely be contaminated with some of the shame elicited in how the silence was presented and leave the client feeling guarded and defensive.  “It seems like it is hard to find the words today” or “It feels hard to know what to share” are a bit more thoughtful than merely pointing out that the client is not talking, as it signals the possibility of attempting to point to and articulate what the experience of the silence might be like for the client and invites them to refine or outright dismiss our interpretation in favor of another.  Plus, the use of the word “it” as opposed to “you don’t seem to have much to say” is a bit more phenomenologically descriptive and guards a little better around the possibility of the client having a defensive response to that kind of suggestion.  You are not telling them their experience for them, but are instead signaling something about what might be happening for them with a fair degree of neutrality. 

Rather than center on the client’s experience, one might also feel compelled to bring it back upon themselves, particularly if we know our client to be susceptible to strong negative reactions if we offer interpretations that intrude too much on their experience and give them the sense of being consumed or overtaken.  “I find myself wondering what this silence might be intending to communicate” or some variation of that is one example of what could be offered in that context.  Even something like “It’s good, isn’t it, to be able to share these silences from time to time?” offers some sense that the silence is not only permissible, but welcome.  I find myself reflecting on one client in particular, a younger client who, like many of their peers, has never lived in a world where some kind of immediate stimulation wasn’t always available at the swipe of a finger.  For this client, the possibility of being able to sit in silence comfortably was, in fact, something we had set as a potential outcome to be striving for in therapy.  Commenting on the importance of the connection I felt when we could enjoy silence together, as much as when we were engaged in more vocal communication, became an important part of the work in helping the client to connect with a part of themself that could tolerate the experience of being in silence rather than merely suffering silence.

As is often the case when discussing the uses of the therapeutic relationship in working through some of the structures our clients bring into therapy, the last possibility involves bringing in the relationship itself.  Doing this would require the therapist to have some sense of the specific relational dynamics between the client and the therapist.  Using the relationship in this way demands some specificity about what the relationship is up to that point.  For a client who is quick to fade away in the therapeutic encounter and lose themself in the context of the work, responding with something like “There you go again.  When you go away like that in session, I find myself missing you, wanting to find a way to bring you back in.”  Or for the client who is using silence as a defensive reaction or to “punish” the therapist, to be able to say “Here we are again. This is important.  Help me see where I made my misstep” brings with it the possibility of repairing the moment, while also giving the client the possibility of a richer and more engaged relational experience than those to which they have likely previously had access.

These are just some basic thoughts on silence.  Having recently skimmed through Akhtar’s book, which has some great clinical vignettes and seems like it would be a great teaching companion for one of those aforementioned clinical skills courses, the idea of silence and how we might “use” it had been on my mind.  Indeed my forays back into some of the folks involved in the interpersonal psychoanalytic to contemporary relational theories (ie Levenson, Ghent, Bromberg, etc) as well as my ongoing interest with Leston Haven’s work, seem to be signaling the possibility of a longer piece about the relationship between listening and responding that happens in therapy,  Hopefully some interesting things to come.