Silence and the Theory of Technique

In the complex setting of the treatment situation no set of rules may be promulgated to meet each specific occasion when the patient stops talking. Nothing can replace the sensitivity of the therapist nor his empathic response to the unfolding concatenation of influences at any moment in the transference. However, a careful review of the events antecedent to the silence and their proper assessment from the point of view of which functional relationship of the ego is primarily involved may be useful. The therapist's interpretation is an intervention intended to alter the relationship of forces between the discharge tendencies of the id or superego on one hand and the defensive function of the ego on the other. An evaluation of the conflict which led to the interruption of communication must be made in structural terms. On the basis of such an analysis the therapist may decide whether the intervention should emphasize the fending off or the discharge tendencies implicit in the silence. The difference in therapeutic effectiveness between interpretations of the unconscious wish versus interpretations of defense and the importance of appropriate timing of such interventions have been stressed by several authors, notably Loewenstein (8), (9) and Lewin (7). Loewenstein points out, for example, that in the situation in which the ego has instituted a certain defense in order to ward off anxiety associated with an emergent id or superego wish, an interpretation directed at exposing the strength of the wish will lead to a reinforcement of the defensive effort of the ego. Analogously, in our present context, such interpretations would result in an intensification—or, more accurately—a prolongation of the silence. Similarly, Lewin's observations on the relationship between analytic technique, hypnosis, and sleep are apropos at this point. An untimely awareness by the patient of his warded-off wishes may stop the flow of associations in the same manner that the terrifying undisguised dream images may affect the process of dreaming. The dreamer interrupts the process of producing dream images by breaking off both dream and sleep. The patient breaks off the flow of free associations and the permitted regression which it implies by lapsing into

silence. Interpretative efforts directed at the opposing set of forces, namely, the defensive endeavors of the ego in such situations, have an opposite effect, comparable to the effect of an efficiently functioning dream censorship which permits the subject to sleep and dream. Such interpretations provide the necessary assurance that the defensive effort is still working efficiently in order to permit the patient to continue to talk and associate freely.