You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
Silence is a major problem in the treatment of psychiatric patients, speech being the basis of therapy. Previous authors (e.g. Bergler, 1938), (1947); (Ferenczi, 1916); (Fliess, 1949); (Freud, 1914); (Levy, 1958) have described silence as an isolated symptom, but have not noted the significance of the triad of symptoms: silence, masochism, and depression. Pationts who display this triad act out their silence, masochism, and depression outside the psycho-analytic treatment as well as within it.
This group appears to express the loss of a very close and unique relationship (Kaplan and Rank, 1960) with the mother. Wherever I have observed this triad of symptoms, there has been a loss of status occurring between 18 months and the third year of life in relationship to a change in attitude or illness of the mother, the birth of another child, or some other cause. This syndrome may occur in any ordinal position, although it is frequently seen in the firstborn. It is suggested that an especially close relationship with the mother is lost, but not the mother herself. The point to be emphasized is that the total loss of the mother is not necessary to effect profound changes.
At the age in question, with the establishment of object relationships, neither speech nor the emotional resources for communication are adequate to express the sense of loss of status and the feelings of injured self-esteem. In situations where there are no substitutes or compensation for this loss of the unique status with the mother, a pattern is established of easily injured feelings expressed through silence, masochism as manifested in suffering and withdrawal from emotional contact with others, and depression.
These symptoms prevent further feelings of injured self-esteem and in a passive way serve unconsciously to restore the lost unique relationship to the mother. In addition to controlling and punishing the mother in fantasy, they similarly frustrate her or her surrogates in everyday life.