The “Because Question”: A Variation in Responding to Patients' Queries

One of the principal ways that patients and analysts have of communicating with each other is by means of questions. It is also a basic way that people have of learning about each other and becoming comfortable with one another. Especially in the beginning phases of treatment, questions are critical to laying the ground work for a productive and smooth-flowing therapeutic relationship. In the initial interview the analyst tends to direct many questions to the patient in order to understand the presenting problem, gain some diagnostic perspective, and get some personal background. In most instances patients are cooperative in yielding abundant information about themselves and their situations. Things often begin to get more difficult after the initial introduction has been accomplished and the roles get reversed: the analyst settles down to listen rather than ask questions, and the patients are expected to spontaneously produce verbal communications about themselves. Although most people proceed to do this, quite a few find it difficult or are unable to adhere to the preferred analytic task of expressing their thoughts and feelings. These people often compulsively either ask many questions about the analyst or the treatment or continually seek advice in the form of questions. The method or process the analyst uses in responding to these questions can in itself constitute a body of technique. In this paper I will not discuss this entire area, but will address one limited aspect, that of how one might react to a particular type