Does Every Silence Need To Be Filled?

Winnicott teaches us ways to sit with the suffering without using words.

Posted Feb 05, 2018

In addition to my role as a therapist at a community mental health clinic I also have the privilege of being the coordinator of my our intern program. Every week we sit together for one hour to discuss how their work is progressing. It’s fascinating to watch their interest and skill in the work grow and to help them navigate the growing pains of the profession. Last week one of them noted some difficulties they were having with a patient and, somewhat embarrassed, asked, “how long is it okay to stay quiet?” Most every other intern chimed in to offer a variation on the question, noting that they too had struggled to fill in the gaps when a patient seems to have nothing to say.

I was an intern not too long ago myself, and I remember I also was terrified of running out of things to say in a session. I would arm myself with a legal pad filled with questions and notes, and I feared that every second that ticked by without a comment from myself would be an indicator to my patient that I was unqualified or overwhelmed by their problems. This imposter syndrome didn’t disappear overnight, and it can still crop up from time to time unexpectedly, but I learned about what a gift silence can be from Donald Winnicott’s beautiful 1958 paper “The Capacity to be Alone.”

Wellcome Images/Wikimedia Commons
Source: Wellcome Images/Wikimedia Commons

Winnicott begins the paper by saying “In almost all our psycho-analytic treatments there come times when the ability to be alone is important to the patient.” Freud was concerned with what Winnicott terms ‘three body’ relationships, the Oedipal triangle of child, mother, and father; the object relations school of thought focused on the ‘two body’ relationship of mother and child; but little attention had been paid to the ‘one body’ relationship one has with oneself. The capacity to be alone is not something inherited but must be developed; Winnicott notes “a person may be in solitary confinement, and yet not be able to be alone. How greatly he must suffer is beyond imagination.”

The child first learns to be alone in the presence of a parent. Their “ego immaturity” is balanced by the parent’s “ego support.” That is, the child’s developing sense of self is buoyed by the presence of caring parental figures.  If they receive good enough parenting, they are able to internalize their parents to a degree that they are not filled with anxiety when their parents are not immediately present. In Piaget’s terms, they develop object permanence.

Being alone allows the infant, and later the child, to develop their own internal life. They are not reacting to the immediate environment, are not set on a particular goal or task, they just are. If one is not allowed to develop the capacity to be alone, one is left with no solid sense of self and instead is only reactive to the surrounding environment. In a later paper Winnicott calls this the ‘false self.’ Children who do not develop the capacity to be alone grow up to be insecure adults, people pleasers, disconnected from their own wants and desires.

Adults without the capacity to be alone began as children who did not have the opportunity to be alone. Perhaps they had to care for their younger siblings, had parents who were violent or neglectful, or experienced trauma that led them to be particularly attuned to others in order to stay safe. Most of the patients that we see at our clinic have experienced at least one of those realities; many have experienced all three. Despite Winnicott’s extensive focus on the earliest years of one’s life, he did not think that all is lost if one grows up in circumstances and with people that fail to allow the child to thrive. The therapeutic relationship is, in a key sense, a recreation of that earliest parental bond, and the therapist is given the opportunity to fill in for the patient that which was lacking in their earlier experiences.

There is no one type of silence. Silence is textured, layered, ambiguous. Sometimes silence is pregnant with meaning and calls for interpretation. At other times, silence marks the inability of our words to capture lived reality. There is no one approach to silence, just as there is no single approach to much of anything when it comes to therapy.

Cater Yang/Unsplash
Source: Cater Yang/Unsplash

Working effectively with silence starts by acknowledging that our minds are never silent even if our mouths are. Those that have tried to meditate for any length of time will be well aware of this. We can never fully know the thoughts of another, and therapy rests on the premise that we work with the mental material the client feels comfortable sharing with us. The most vital thing for us to do is to create the conditions necessary for the telling of the truth, and that means leaving space for the client to speak or not speak. Often this forces us to confront our own inadequacies as clinicians head-on.

Winnicott offers us a better way of thinking about silence than merely the absence of speech. To be silent in someone else’s presence is a mark of trust. We know this to be true in other relationships; mature romantic relationships are marked by the ability to simply be in the beloved’s presence. To be alone and silent with someone else is to take them seriously as an independent person.

This takes different forms in my work. I recall one client who was painfully shy and obviously not comfortable with the highly verbal way in which therapy is normally conducted. After a few sessions that were torturous for both of us, we began to listen to music together or draw. It did not miraculously pull her out of her shell, but she softened in a way that was not possible when I tried to directly treat her symptoms. Most of my clients don’t embrace silence to this degree, but there inevitably come points in the treatment where words run thin. Instead of rushing to fill them as I used to, I take a step back, breathe, and let the patient continue when they feel ready. Not only does this remind them that they are in the driver’s seat of their treatment, it’s also a way for me to acknowledge that they know far better than me what they need to discuss next. Silence grants agency to those who have been stripped of it in almost every other aspect of their lives, and for that reason it is essential to my work.

References

Winnicott, D. W. (1958). The capacity to be alone. The International Journal of Psychoanalysis, 39, 416-420.

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