Silence often makes people uncomfortable. In U.S. culture, particularly, we are prone to filling up silences in conversations as quickly as possible. One reason for this is that prolonged silence may be interpreted as a sign of discomfort or disapproval. For the same reason, new psychotherapy students often feel a need to jump in and ask questions when things become quiet. At times, this can be a supportive thing to do. But, there are other times when this may signal discomfort, and when a period of silence may be just what a client needs in order to process feelings or to reflect on what has just been said.

When a client who is usually verbal begins to fall silent while talking about something difficult, corresponding silence by the therapist is often helpful and supportive. It may convey attention and interest, as well as the therapist’s commitment to not interfere with the client’s need to process what is going on.

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If the silence continues for a substantial period of time, the pressure to help the client by saying something becomes greater. Therapists differ in how they handle this situation, depending on their orientation to treatment and their own individual style. I, personally, rarely let a silence last more than a minute or two without saying something—even if it’s just “Would you like to say anything about what’s going on?” On the other hand, some therapists have had breakthrough sessions when they gave a client a significant period of attentive silence that no one else had ever offered them.

While many clients can use periods of silence productively, there are others for whom silence is not a good strategy. In my experience, older children and younger adolescents generally fall into this latter category. This can present a double-bind because these young clients often do not want to talk but also hate to be questioned. I have worked with many adolescents who have had previous unsuccessful therapies. Their two most common complaints about previous therapists are “He asked too many questions!” and “He never said anything!” Over the years, I have come to the conclusion that while questioning may be painful to many adolescents, silence is often downright excruciating.

So, what do you do with an early adolescent who finds questions painful, who can barely handle talking at all, but who also hates silence? Many therapists try to engage such clients by talking with them about things they like to do. This can be a good way to start therapy with an adolescent, but it is not always easy to do, and some adolescents also find it irritating and patronizing. This is especially true for adolescents who know that they are in therapy for serious problems and who may legitimately experience small talk as disingenuous or “fiddling while Rome burns.” I have found that it is often preferable to go a different route with these nonverbal youngsters, taking over most or all of the talking at first by gently describing what you know about the client and then gradually introducing some speculation as to why they may be acting as they do.

My first experience with this was in working with a 13-year-old girl who had been hospitalized with borderline features and possible early-onset schizophrenia. She had been acting increasingly depressed, erratic, and withdrawn, and had begun engaging in drug use and self-mutilation. She was barely verbal, responding to questions with one-word answers minimizing her problems, or with silence or shrugging. With my supervisor’s help, I began relying less on questions and spending more time talking sympathetically to her about what her parents and the hospital staff had reported about her behavior, and making some guesses about how she must have been feeling at the time. Before long, she began to acknowledge some of these feelings, and eventually she started talking about other significant issues, including having frightening hallucinations and feeling stress about her father’s alcoholic behavior, which her parents had not revealed to us.

Interestingly, very young children often tolerate silences quite well in the context of play therapy. They are used to playing on their own and may feel comfortable with an adult in the room quietly accepting what they do and making only the occasional comment. When they get older, however, children cross a certain threshold—typically around 8 years of age—when they start to become self-conscious about playing but are not yet accustomed to talking with adults, especially about personal issues. A few years after this—at, say, 14 or 15 years of age—they start to become sufficiently verbal to express themselves more easily and to tolerate some appropriate silence from therapists.

It should also be noted that not all adults feel comfortable with therapists who are silent, especially adults who come from backgrounds in which it is not culturally normal to share personal information with an unknown professional. With these clients—and indeed with all clients—some preliminary assessment is usually advisable to determine how comfortable they are with a more exploratory approach in which some silences may occur, as opposed to a more problem-solving approach in which they probably will not.

Looking back over the silences I have shared with my clients, I am struck by how full and how varied they have been—each with its own special meaning: anxiety, sadness, recalcitrance, closeness, and speechless perplexity, to name a few. Each one is different, and each can lead, potentially, to a greater understanding of the client.  

File under: The Art of Psychotherapy, Child & Adolescent Therapy