The Silence of the Mother, or: Twenty Years Later. Pearl Lombard, pp.  197-223.

Lombard addresses the issue of silence in the analytic hour, discussing dual functions of silence: defense and enactment (of an unconscious experience that the patient has not been able to put into words). The author's reflections are based on her work with twenty patients, twelve women and eight men, whom she saw over a period of twenty years. The shortest of these analyses lasted eighteen months. In all of them, the patients' silences were a major issue. They were all patients who were functioning reasonably well, but suffered from a feeling of not being able to move forward because they felt themselves limited by profoundly depressive feelings. Some had attempted suicide; others had fantasized about suicide as a way out of a hopeless psychological situation. The author remarked that some patients expressed their wish for help openly in the beginning sessions, but more often they did not use words, communicating instead with an intensely painful gaze that deeply touched the analyst. The majority of these patients usually avoided direct eye contact because of their inner painful experiences.

Lombard's first case example is a 27-year-old married, intelligent, attractive man who looked more like a 20-year-old, and who