In this paper the interplay between silence and the spoken words used by analyst and patient will be explored within the context of clinical practice. Both analyst and patient, it is argued, are engaged in a personal struggle to try to discover an integrative connection between silence, often experienced as nothingness, and speech, often experienced as suffocating or mendacious. The uses of silence in aiding speech to attain integrity will be described with reference to two clinical vignettes. Selections from psychoanalytic theory and practice will be discussed, throwing some light on silence and analytic spoken dialogue, and it will be argued that a Jungian perspective contributes a further, unique, insight through the concept of transcendent function. This is a way of seeing silence and speech as opposites, out of which new levels of meaning arise as a result of union and unconscious cooperation in the relationship between them. This union is known as coniunctio.