Different Kinds of Silence

Why do I keep talking? She's barely muttering…not even looking at me…so why do I try so hard? Guessing my way through the silence, I hardly felt analytic. Laura sat in silence-with no eye contact and a ring of fire around her to keep me away. Yet she came. Why? When I pursued the bulimia she told me about in the first two sessions, she said she now had it under control. She consistently claimed not to know why she was here, or why her friends thought she needed therapy-surely they did not know she was throwing up… While most treatments get to points of impasse, Laura's began with one.

Peter, on the other hand, would not stop talking. If he hadn't planned what to say, he could easily and cleverly riff on any observation, offer up memories, or beat me to the punch by confessing bad behavior about his addictions, complete with explanations. Peter had so much to say, with so little feeling attached. And then there were quiet lapses-often midsentence-when he went very far away. Inquiries about his destination drew humiliation and anger. Peter sought treatment because addictions cultivated to sooth him began to cost more than they avoided. Once he came, I felt he wanted to keep me silent.

Silences may confound us, numb us, distract us, frustrate us, or overwhelm us with hosts of feelings that inform our interventions. Silence in the consulting room has held an essential place in the development of psychoanalysis and its technique. It has filtered into our larger culture as the butt of jokes about how patients and analysts interact-caricatures of either person falling asleep, or wondering if the other is listening. Yet more recently, silence is an element that often drops out of our professional case presentations in favor of more dramatic and active tales of therapeutic action.

As paradigms have shifted to include, along with the verbal, all that is implicit and enacted in the relationship, our job description has shifted from observing and interpreting our patients to parti