Silence

The silence of the patient and the analyst held a defining place in the history of psychoanalysis and its technique. Once thought simply to indicate abstinence or resistance to free association, silence is an element that often drops out of contemporary case presentations in favor of more dramatic and active tales of therapeutic action. The assimilation of intersubjective and relational perspectives and the widening scope of patients we treat, as well as pressures from economic and time constraints, have shifted our goals towards more fully engaging patients of different stripes within the dyad. What we share tends to emphasize the positive and interactive elements of our work: what we say and what we do.

My interest in silence is partly responsive to the noisy world I inhabit—an urban hub, shared with construction sites and growling garbage trucks, where finding a quiet office can be a challenge, and the retail establishments I enter have been acoustically designed to maximize sales and profits. The volume inside my professional head can grow quite loud in a different way. Thinking more inclusively than was permissible when our field was born, psychoanalysts today seek perspectives from neighboring institutes, multiple journals, and from abroad, and unexpected disciplines influence new clinical models. The abundance to integrate heightens awareness that wherever we are looking in our work, there is much content and texture not attended to. So what has become of silence in the process of our evolution? Are our minds so busy with multiple ways to make meaning that it is too daunting to also track the shifting nature of the quiet spaces in between? Do contemporary psychoanalytic trends press us too readily to bridge silences?

Interiority seems to be at risk at the very same time that psychoanalysts privilege the use of countertransference to guide our work. Crowded sessions at lesser frequency can push contemplative experience outside of psychoanalysis and towards meditation, yoga, and other traditions that promote self-knowledge and healing.

I was a child who naturally loved going to art museums. My experience of looking at paintings deepened when I was later introduced to the discipline of looking at visual art and grasped concepts of formal composition and subjective meaning, as well as the relevance of historical context. Negative space was one concept that helped to build my visual muscle and changed the way I observe. Negative space in art is created when the positive form, or subject matter, is articulated against a background to create figure and ground. The artist's lines and brushstrokes that define the subject at the same time create the shapes, colors, and textures of negative space where the eye can rest from direct confrontation with the foreground. These often overlooked spaces between and around the subject are not just empty, but locations with their own distinct visual form and meaning while supporting the identity of the figure.

Contemporaneous Art

Reflecting on the works of several artists of the modern era, the same in which psychoanalysis developed, illuminates the importance of paying attention to the rich content to be found in what would otherwise be dismissed as negative space. Piet Mondrian was one of the first artists to move into pure abstraction. In distilling painting down to its essence of color, line, and plane, he played with the ambiguity of figure and ground. Is that a narrow band of red painted on to a white background, or is the red background peeking out between larger squares and rectangles? Similar ambiguities concerned Matisse over his lifetime. His early work exploded with color that deliberately blurred the distinction between foreground and background, and between inside and outside. Later in life, the success of his cutout series was based instead upon careful articulation and placement of shapes and colors of both figure and negative space.

Robert Rauschenberg challenged the very existence of empty negative space in his revolutionary White Paintings series. He applied ordinary white house paint to canvas using an ordinary painter's roller, indicating neither subject matter nor even brushstrokes, yet intended that there still be something to see. Perhaps best expressed by his friend and collaborator John Cage, (in his book On Robert Rauschenberg, Artist and His Work) Rauschenberg's white paintings were not meaningless blank canvases but airports for the lights, shadows, and particles and suggested that they be examined in microscopic detail, for the white paintings caught whatever fell on them.

John Cage, musician and composer, made the point even more clearly that silence has meaning and is not just the absence of sound. In his famous composition 4'33“ (Four minutes and 33 seconds), the pianist walks to the piano, sits down, and opens the lid. Then 4'33“ later, he closes the piano and the piece is over. In the absence of piano notes, the audience hears not silence but the presence of unintended sounds. The absence of intentional composition creates space to hear the ambient sounds often overlooked, sounds the composer did not intentionally put there. The piece thus varies depending on context where it is performed, whether an orchestra hall, the outdoor urban garden, or in a silent chamber quiet enough to hear only the sound of one's breath and heartbeat.

The analogy to psychoanalysis is apt. We are not limited by the deliberate notes our patients orchestrate or by the predictions of any singular theory. While we are inclined to track and share changes in the positive form of what is symbolized and verbalized, psychoanalysis is distinguished by its attention to what is not apparently perceptible but there to be found. We mine all that can be projected or enacted around defined foreground. Focus in treatment oscillates between figure and ground, shifting between the known and the unconscious, reality and fantasy, and between multiple ways of organizing experience.

Silence can represent the continuity of space that contains the analytic relationship and from which the symbolized emerges and the time or timelessness through which they move. The line that frames the beginning and end of each session also demarcates the absence of contact in between. Silence as negative space between sessions is not just absence but replete with possibilities for continuity or disconnection, for the ongoing self-reflection we value and hope to engender in our work, or for its failure.

Like Rauschenberg's white paintings or Cage's composition, silence inside the consulting room is neither meaningless background to the process nor emptiness, but the opportunity to collect sounds, thoughts, and feelings yet to be formulated. Silences that punctuate or trump the flow of an analytic hour hold meanings unique to the given treatment dyad at a moment in time. Silence can appear quiet and calm or can be intentional and very busy. Clinical experience tells us that the silent patient may be frightened and avoidant, or profoundly thoughtful. Silence can hold anger, submission, and false compliance or peacefulness and trust. It can reenact profound loneliness or suggest evacuation and retreat from danger and turmoil within. Or silence can indicate a less toxic and more productive pause from the interactive nature of analysis to claim space for self-directed contemplation and consolidation. The analyst's silences range as well, from those reactive to all that might be communicated by the patient to those responsive to the analyst's inner life and preoccupations.

In the Consulting Room

I recognize that I am not quiet just to hear my patient nor in compliance with technique. I ground myself in silence to push away what lingers from the previous session and from intrusive personal concerns. I connect with the interior space that allows access to inner reverie as experience unfolds in the context of the unique relationship created with my next patient. She texts that she is running a bit late, even though she arrives on time. The motivation and sincerity she exhibits about getting to my office contrasts with her characteristic avoidance of silence and reflection once she gets there. Using her phone to create activity she preempts contact with potential associations and deeper anxieties. Her text message diverts our exchange from an exploration of what lateness stirs in her imagination into the realm of social civility. With seemingly eager intentions she continues to control the session by filling it, speaking in full paragraphs. She does not allow me to enter her space until there are few minutes left in the session. She fears the uncertainty of her own mind and the possibility of feeling between us in quiet moments. Speech itself creates subject matter, and negative space is restricted.

The edge of silence sharpens the edge of what is said in sessions. My patient creates noise to avoid this articulation, not yet ready to shape personal meaning or demarcate the unique products of each mind in the room. Refrain from speaking allows a working space for expressed words and feelings to be turned over and viewed from different angles, questioned and elaborated on the way to taking positive form. Laser techniques in art history show us the many changes in the artist's mind and canvas on the way to a completed painting. Silence in the relationship is the living canvas inviting patients to hear their own thoughts, and formulate and revise self experience and understanding in our presence, with clearly delineated sense of ownership of their work.

Contemporary culture threatens to fill patient and analyst alike with the noise of plenty. Technology has offered a class of concrete objects that physically occupy much space and functionally provide constant access to connectedness that can easily dominate the foreground. Communications from multiple devices shrink the negative space of silence that encourages us to hear the contents of our own minds to gather our thoughts and feelings and remember our dreams. The cacophony from our culture and from within our expansive field cannot help but impinge upon the interiority precious to psychoanalysis. As guardians of the process, we need to preserve and respect, regulate along with words, affects, and actions, the meaningful and generative possibilities of quiet negative space.