The Silent Treatment? Changes in patient emotional expression after silence

Soma, Christina S.; Wampold, Bruce E.; Flemotomos, Nikolaos; Peri, Raghuveer; Narayanan, Shrikanth; Atkins, David C.; Imel, Zac E.

doi:10.1002/capr.12537

Couns and Psychother Res

2022

DOI: 10.1002/capr.12537

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The Silent Treatment? Changes in patient emotional expression after silence

Christina S. Soma

Bruce E. Wampold

Nikolaos Flemotomos

et al.

Abstract: Psychotherapy researchers have investigated the perceived function and outcome of silences during therapy. Qualitative studies

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2023

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Cited by 2 publications

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References 76 publications

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“…Silence is a complex phenomenon stemming from multiple origins and affecting the patient and psychotherapist in different ways (Akhtar, 2013(Akhtar, , 2018Dimitrijevic & Buchholz, 2021;O'Toole, 2015;Soma et al, 2023;Weisman, 1955). Individual silence can be autonomic or unconscious, but it can also be a deliberate effort to avoid discomfort or protect oneself (Modell, 1980).…”

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confidence: 99%

Self-silencing and suicide.

Goldblatt¹,

Ronningstam²

2023

Practice Innovations

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Silence in the therapeutic encounter has multiple meanings and complex determinants and is often associated with early childhood trauma or neglect but may also be found in patients with character pathology, who try to exert a sense of control when they feel overwhelmed. Self-silencing is a form of nonverbal communication, which may be autonomic or culturally syntonic, serving as protection of independence and safety, see for example, where renunciation of self-interest is used interpersonally to preserve a relationship with a significant other. Loneliness and isolation arising from such impaired relatedness then increase vulnerability to suicide. Self-silencing often serves to manage intense affects but may also contribute to increased suicidal preoccupation when life circumstances overwhelm personality functioning and self-regulation becomes inundated by unbearable affective distress. Under such circumstances, patients may feel desperately isolated and alone but are still unable or unwilling to communicate their distress to others, including their therapists. Consequently, self-silencing may be unnoticed in the therapeutic relationship, both by the patient and by the psychotherapist. Suicidal action can serve as the ultimate fulfillment of a silencing of the self. In this article, we discuss the effect of self-silencing on therapeutic process and suicidal vulnerability.

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confidence: 99%

Self-silencing and suicide.

Goldblatt¹,

Ronningstam²

2023

Practice Innovations

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How Silence Contributes to the Performance of Sincerity in Psychotherapy

Berger,

Rae

2023

Psychotherapy and Counselling Journal of Australia

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Most literature concerning silence in psychotherapy has focused on the meaning of silences, particularly from psychoanalytic perspectives, and is based on clinical experience rather than empirical studies. These authors tend to interpret silence as pathology or resistance in the client and/or advise clinicians to be especially tolerant of silence and to avoid filling silences. Although some studies have found that moderate silence is correlated with better outcomes, these studies ignore psychosocial aspects of the interaction. No research has looked at silence in psychotherapy as a linguistic device to manage the local sequential environment. Silence following an initiating action is characteristic of dispreferred responses such as refusals and negatively valenced answers in general conversation. In this study, we used conversation analysis to explore preference and the role of silence in nine spiritually oriented humanistic psychotherapy sessions. We found that in contrast to everyday conversation, in these interactions, there is a preference for gaps and pauses while immediate responses are dispreferred.

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The Silent Treatment? Changes in patient emotional expression after silence

Abstract: Psychotherapy researchers have investigated the perceived function and outcome of silences during therapy. Qualitative studies

Cited by 2 publications

References 76 publications

Self-silencing and suicide.

Self-silencing and suicide.

How Silence Contributes to the Performance of Sincerity in Psychotherapy

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