Everyone has trouble with “The Silence.” You lie there week after week babbling away and he says nothing until the dreaded “I’m afraid that’s all we’ve got time for.” You (okay, I) interpret the slightest movement as deeply meaningful and wonder whether this whole getting better project is worthwhile.
In my case a kind of mania used to kick in and I treated sessions as rehearsals for some imaginary stand-up comedy routine, testing out new material, trying to raise a laugh (occassionally succeeding). Every week or so my analyst might say: “It seems very important to you to keep talking.” I would say: “Feel free to chip in.” At some point I must have calmed down and allowed thoughtful silences, sad silences, angry silences—the vulnerability I’d been too terrified to make space for.
But it is a whole different experience the other way round. I dread my silent patient. I start feeling anxious the day before I see him, wondering how I can reach him. I’ve tried to get rid of him by declaring in supervision: “I’m not sure therapy can help.” I feel hated by this patient, rejected, helpless, ridiculous.
And yet he comes, dressed neatly, apparently professional. He has not been late once in six months, he has not rescheduled or missed a session (the glaring signs of, at best, ambivalence towards therapy) and he does not watch the clock. I observe as he glowers at his feet, buries his head in his hands, sighs and closes his eyes to block me out. Frantic, I say things like: “You seem quite angry today.” He replies, angrily: “No. Just tired.” I say: “It seems difficult to sit with me.” He laughs dismissively: “I don’t know what you want.” Once, after 25 minutes of watching him shift around as if trying to free himself from a torturer’s restraints, I asked: “What are you thinking about?” He said: “Nothing.”
Writing this, I feel conscious that qualified therapists will be appalled at my amateurish efforts to engage this man. There is plenty of literature supporting the acceptance of silence as resistance, as communication, even as a creative space. Though some theorists do suggest speaking, more suggest silently understanding the countertransference—how the patient is making you feel. Is he showing me what it felt like being with his rejecting mother? Is he communicating his own sense of helplessness? Freud himself went for interpreting the non-verbal communications: “He that has eyes to see and ears to hear may convince himself that no mortal can keep a secret. If his lips are silent, he chatters with his fingertips; betrayal oozes out of him at every pore.”
That’s true, of course, but if the patient rejects the interpretations and persists with the angry silence then it almost doesn’t help to understand what that patient is doing. I end up grappling for something to say that will help me reach him. Last week I fell back on my old favourite—the stand-up comedy routine. I said the session seemed like a punishment that he had to subject himself to instead of kicking back in his onesie to watch the X-Factor with a tube of Pringles. He laughed and said: “If a cure was that easy you’d be out of a job.” I laughed too, well aware that both punishment and fantasy were mine. This shared laugh was at last a connection. He had engaged with me, shared a thought with me. “Gotcha!” I thought. I’m looking forward to seeing him next week.
