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There are many times in psychoanalytic communication when the analyst hears and reacts to qualities of the human voice that color and transcend the spoken words. The voice may even slip the harness of language and roam more freely, following an older and spontaneous impulse. The analyst then hears a voice without words—a privileged access to sounds which represent affective states without specific associated ideas. Both of these phenomena—voice quality and nonverbal vocalization—were subsumed by the term, paralanguage (Trager, 1958, quoted in Harper, Wiens, and Matarazzo, 1978, pp. 20-21). As one of the chief forms of nonverbal communication, an individual's paralanguage introduces his or her unique experience into the “dialogue” of analytic exchange.
Clinical studies of silences and pauses have not been lacking in the literature (cf., the collection of papers on “The Silent Patient” in The Journal of the American Psychoanalytic Association [Panel, 1961]). Arlow (1961, p. 50) and Gray (Panel, 1990, p. 776) showed that brief silences may indicate disruptions or shifts in the prevailing defense pattern. There are meaningful changes in timbre, pitch, or volume to be heard, following such “pregnant” pauses, but words, whether spoken or unspoken, usually conceal the behaviors of the voice itself.
An exception to this oversight is a slim book by Paul Moses, entitled The Voice of Neurosis , which undertakes to annotate vocal expression in musical terms. There are also scattered comments, such as Edelson's appreciation of the “meanings in the music of language” (pp. 167-181), Alvin Suslick's clinical observations at a panel (, pp. 963-965) on nonverbal communication, and