MIL is a salient topic for experienced, existentially oriented psychotherapists; they work with MIL extensively with some clients in psychotherapy. We recommend that therapists receive training to work with MIL in therapy, and that they pay attention to MIL concerns when they conduct psychotherapy. We also recommend additional research on MIL in psychotherapy.

We investigated the process and outcome of the first silence event for each of 86 clients and 26 doctoral student therapists in individual psychodynamic psychotherapy. Antecedent client collaboration and client attachments styles did not predict type of client or therapist behavior during silence events. Client collaboration increased from before to after silence events if therapists were productive (mostly invitational) and if clients were productive (mostly emotional and expressive) during silence events. Furthermore, subsequent client collaboration was higher when productive therapist silence occurred with clients who were lower rather than higher in attachment anxiety. In contrast, subsequent client collaboration was higher when productive client silence occurred with clients who were higher rather than lower in attachment anxiety. These results suggest that type of silence and client attachment styles are important factors in the immediate outcomes of silence events. Clinical Impact StatementSilence occurs in psychotherapy, but little is known about its effectiveness, especially across many clients and therapists. Question: We examined what occurred before, during, and after the first silence event in cases of psychodynamic psychotherapy with doctoral student therapists and adult community clients. Findings: If therapists and clients were engaged productively during the silences, the immediate outcome of the silence was positive. It was most important for therapists' behavior to be productive during silence for clients who were low in attachment anxiety, whereas it was particularly important for clients' behavior to be productive during silence when clients were high in attachment anxiety. Meaning: Silence can be helpful if used appropriately with some clients. Next Steps: We need to use this method to analyze silence events across time in a wider range of cases in different types of psychotherapy.

The researchers examined differential outcomes related to two distinct motivations for withdrawal (preference for solitude and shyness) as well as the possibility that support from important others (mothers, fathers, and best friends) attenuate any such links. Adolescents (159 males, 171 females) reported on their motivations to withdraw, internalizing symptoms, and relationship quality in eighth grade, as well as their anxiety and depression in ninth grade. Using structural equation modeling, the authors found that maternal support weakened the association between shyness and internalizing problems; friend support weakened the association between preference for solitude and depression; and friend support strengthened the association between shyness and depression. Results suggest that shy adolescents may not derive the same benefits from supportive friendships as their typical peers.

No abstract