What is presented in this article is, first of all, the explanations of S.Freud, D.D. Winnicott and the psychosomaticians of Paris Psychosomatic School, based on the idea that the silent functioning of the organs is not always an indicator of health. The paradox that surprises us as psychosomatists is that patients with serious somatic diseases are quiet in their psychic world and their diseases manifest themselves in a very noisy way. We explain this situation, which Smadja calls the clinic of silence, as the loss of impulsive vitality, and the ego's last resort is the destructiveness of the death drive which is called “the work of somatization”. While words act without words; as psychoanalysts trying to find melody for those who have monophonic inner worlds, that is, those who have monotonous and stereotyped discourses without melody, similar to monophonic musical notes, what we should pay attention to is the handling of the silence of the psychoanalyst and the clarification of the place of the maternal function in psychic vitality.