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Mirandize Your Supervisees

Therapists have the right to remain silent.

Beginning therapists think they should say something, anything, to disguise the fact that they don’t know what to say. It’s not a bad approach, since the therapist has to get used to the role of therapist, learn enough psychology so as to eventually actually have something useful to say, become someone who approaches rather than avoids interpersonal conflict, and acquire some early successes so as not to become too disheartened, even if success is defined as getting the client to come back. While acquiring all these skills and sensibilities, therapists are well-advised to access other skill sets they already have, such as treating the client as they would the person sitting next to them at social event: act interested, get their story, and let them know you are following it.

The problem is that therapists learn to do therapy conversationally and then never switch. The problem with conversation is that it evokes social responding in the client, and social exchanges require people to polish their masks, while therapy involves taking them off. Social responding also creates a situation in which interpretation and pointed curiosity are rude, as they would be at a dinner table, instead of intimacy-enhancing, as they should be in therapy.

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So I mirandize my students: You have the right to remain silent. Anything you say can and will be used against you. You have the right to talk to a supervisor.

Ideally, the patient learns that the therapist’s silence is the exact equivalent of the therapist saying, “Let’s see where your thoughts go from here,” which is the basic method of using the patient’s verbal behavior as a guide to what’s going on. Freud called this the free associative method, although I prefer the behavioral terminology, namely, that like all behavior, verbal behavior’s meaning can be understood only in functional relation to its occasioning environment, whether the primary stimulus in that environment is something the therapist did or the subject at hand. In order to create a relationship in which the patient’s speech can be understood as a response to the patient’s topic or to the therapy itself, the therapist has to keep from tossing in even more stimuli to respond to.

Thus, silence is essential to creating a therapeutic as opposed to a social relationship and to allowing the patient to respond to what’s important without also having to respond to what’s not. If the silence itself stands out, then the therapist can try to understand the patient’s reaction in functional relation to the silence, usually by investigating how the therapist’s prior activity level has created a social encounter, how the patient experiences himself without steady confirmation of something else, or how the patient avoids getting deeper into a topic.

Silence is also essential if therapists want feedback on their efforts. Sure, you can get a sort of feedback by asking patients how they experienced something, but that is always colored by the power dynamics in the relationship, not to mention the patient’s cognitive dissonance and confirmation bias in wanting to believe that the therapist’s comments are useful. The best feedback is the patient’s metaphorical speech, which can provide an unbiased picture of what the therapist’s most recent comment or behavior reminded the patient of. But you can’t get that feedback unless you are silent after making whatever comment you want feedback on.

What’s the most important skill in learning to be a bowler, the one skill that with enough time could make you a better bowler all on its own? Letting go of the ball. If you roll the ball and look at the pins, eventually the feedback from the pins could make you a pretty effective bowler. (For expertise, you’d also need to experiment and get some advice from experts.) When a therapist makes a comment or does something overt, the equivalent of letting go of the ball is to stop talking and start seeking feedback.

Michael Karson, Ph.D., is a professor of psychology at the University of Denver.

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