[humanser] Handling Silence in Therapy

[JD Townsend]

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