Silence as an Integrative Factor

Psycho-analytic treatment depends, as we know, on certain exchanges which develop between the patient and his physician, exchanges which are at the same time evoked and limited by what we call the analytic situation.

But is not all exchange between human beings, no matter on what level, based on speech? And is speech not a kind of bridge between two human beings, a bridge by which they can communicate? Furthermore, does not psycho-analytic technique specifically depend on these verbal exchanges? The patient speaks, the doctor comments or interprets, and the insights, centre of therapeutic action, result from the interpretations.

This constant exchange between the patient and the physician, these reactions and inter-reactions which form the very woof of psycho-analytic treatment, are possible only through words, spoken words, which bring to the surface the affects which are stirring below: no one has ever thought of carrying on genuine psycho-analytic treatment by mail; the idea itself is absurd.

But why do we think it absurd? Why are we certain that it would not be possible for us to give sufficiently effective explanations and interpretations to someone who outlines in writing his difficulties and conflicts, or relates his dreams even in the greatest detail? The answer will immediately be that the keystone of psycho-analytic treatment is free association of ideas, possible only through speech which almost without conscious effort brings to the surface the buried affects, to which I referred earlier.

To this reason, sufficient by itself, I will add another: that the psycho-analytic relationship is based on living speech and cannot do without it, unlike other relationships—friendly, intellectual, even perhaps loving relationships—which can sometimes content themselves for many years with contact through the written word.

Here then are the physician and his patient settled in the analytic situation, and allowing a relationship to develop on the basis of a dialogue.