[humanser] Handling Silence in Therapy

Tue Sep 30 10:49:49 UTC 2014

Thank you for sharing those great examples, Susan.

Mary Ann Robinson
----- Original Message ----- 
From: "Susan Tabor via humanser" <humanser at nfbnet.org>
To: "'JD Townsend'" <43210 at Bellsouth.net>; "'Human Services Division Mailing 
List'" <humanser at nfbnet.org>
Sent: Monday, September 29, 2014 10:35 PM
Subject: Re: [humanser] Handling Silence in Therapy

> Great thoughts, JD!  This question makes me think of three people I saw in 
> which silence was key.
>
> The first one happened after I'd been a therapist for less than a year. 
> My client was a recently divorced man in his very early thirties with a 
> drinking problem and anger issues.  You haven't lived until you've sat in 
> a session with someone who's switching his switchblade for the whole hour 
> and talking through gritted teeth!  That was a tough one for me, as I knew 
> I needed to be very careful.  He didn't talk much that hour but the anger 
> was very palpable.  We got it named that hour and that's about all we did 
> but hopefully it was enough; he lived and I lived.
>
> The 2nd one was a teen who did not want to be in therapy.  She had been 
> hospitalized after being steadily non-compliant with her diabetes 
> medication.  She was a Type I diabetic and HATED it!
>
> She did not say one word to me for the entire hour.  I offered her pencils 
> and paper to draw on and she refused.  I talked with her about how it was 
> important for me to get audible cues from her; nothing.  Not only was she 
> silent, but she was still.
>
> I put my hand on her shoulder before she left to ask her if she'd come 
> back.  I thought if I touched her shoulder I could detect movement.  She 
> shrugged her shoulders. I asked her to bring me a picture of what her life 
> was like when she came back, and maybe we could talk about it.   I didn't 
> expect to see her again and she did not come back.  That was a tough one, 
> too.
>
> The third one was a 13-year-old girl who had just lost her leg.  She had a 
> new prosthetic leg, which she hated.  Her mother was trying to encourage 
> her to stay in athletics, especially track and field, which she loved, but 
> the girl was not interested.
>
> She wouldn't talk to me when I asked questions.  So I operated on a hunch 
> and started talking with her about her anger, and my own identification 
> with it.  As a blind teenager, I hated the white cane which was introduced 
> to me in 8th grade.  And so I told her it was OK to have her anger.  I 
> asked her to use the passion behind that anger to motivate her while 
> working out to run again.  That anger could be the fire underneath which 
> she would train.
>
> I didn't see her again either, but I ran into a relative of hers socially, 
> who told me that she was running and was competing in school sports and 
> doing well.  She didn't talk much with anyone about our conversation, but 
> the family saw an almost immediate change in her demeanor.  I know the 
> family really was afraid of her getting stuck in anger, so I imagine that 
> she had not been encouraged to own it.
>
> Anyway, so much for my thoughts and experiences.  I hope this is in some 
> ways helpful.
>
> Thank you, Allysa, for having the courage to bring up this topic.  All the 
> best to you!
> Susan
>
>
> -----Original Message-----
> From: humanser [mailto:humanser-bounces at nfbnet.org] On Behalf Of JD 
> Townsend via humanser
> Sent: Monday, September 29, 2014 6:54 PM
> To: Alyssa Munsell; humanser at nfbnet.org
> Subject: Re: [humanser] Handling Silence in Therapy
>
>
> Alyssa, what a great question.  I’m looking forward to how others answer 
> this one.
>
>
> First, your uncomfort with silence is absolutely normal for blind as well 
> as
> for light dependent psychotherapists.  The answer, for me is answered by 
> the
> individual patient and their place in treatment.  For an anxious patient 
> who
> may panic due to the pressure of silence, for the depressed patient who 
> may
> be crushed by silence I would avoid it like the plague.
>
> For the fully engaged patient faced with a difficult decision I’ll let the
> process go on as long as the session takes.
>
> I like the book and the movie ANTWAN FISHER;  in the story the young man 
> is
> forced to see a psychotherapist due to anger issues.  He sits in sessions
> for a long time until he decides to talk, then it all comes out.  We don’t
> have the luxury of weeks of psychotherapy with nothing said, but the 
> process
> would work.
>
> Personally I listen to clues like shuffling feet, finger play and 
> breathing
> to determine when patients are rolling their eyes or playing on their 
> video
> games during treatment.
>
> I often have patients who have little knowledge that their words have any
> power, so I actively work to engage them in talk, talk about almost 
> anything
> at the start of treatment to engage them in the process.  I’ll talk
> football, alien invasion, or food if it will get them to talk.  Treatment 
> is
> in the relationship and without that engagement little progress can be
> realized.
>
> Your discomfort with silence may be a reflection of the patient’s 
> uncomfort
> and it may be being reflected back and forth between you.  I would engage
> your supervisor in discussing this transference/counter-transference
> relationship.
>
> Thank you for bringing up this great topic.
>
>
>
>
>
> -----Original Message----- 
> From: Alyssa Munsell via humanser
> Sent: Monday, September 29, 2014 7:27 PM
> To: humanser at nfbnet.org
> Subject: [humanser] Handling Silence in Therapy
>
> Hi everyone!
>
>
>
> I hope this message finds you all well. I have a question for those of you
> who practice mental health therapy. I've been doing therapy for my final
> year internship, and I am noticing that I'm not comfortable when there is 
> a
> long period of silence between my clients and I. This is because I'm not
> able to see their body language well, and therefore, am having a hard time
> assessing whether or not the silence is productive. As you probably 
> already
> know, silence can be powerful and necessary in therapy, so I don't want to
> diminish it. However, without being able to see non-verbal cues about 
> what's
> going on with the person (e.g. they're just thinking or looking at me to 
> say
> something), it is hard for me to know what to do. I was wondering what you
> all do in those types of situations.
>
>
>
> Any feedback would be immensely appreciated.
>
>
>
> Thanks so much,
>
>
>
> Alyssa
>
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> JD Townsend LCSW
> Helping the light dependent to see.
> Daytona Beach, Earth, Sol System
>
>
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