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Liegner, E. (1974). The Silent Patient. Psychoanal. Rev., 61(2):229-245.

(1974). Psychoanalytic Review, 61(2):229-245

The Silent Patient

Evelyn Liegner, M.S.W.

Silence as a phenomenon in classical psychoanalytic practice has long been understood theoretically, but its management has been limited in the past to interpretive techniques which have rarely led to its resolution as a major resistance. This paper will deal with the understanding and management of silence and present alternate methods to the handling of silence therapeutically.

Silence serves multiple purposes. In a positive sense, silence may indicate pleasure, joy, harmony, acceptance, approval, understanding, interest, anticipation, peace; in a negative sense annoyance, anger, fear, despair, depression, aggression, contempt, disinterest, withdrawal, or absence of emotion.

Concepts of silence have crept into our language. We say, “Still waters run deep.” We give someone “the silent treatment.” We refer to “the strong and silent type.” In the Old Testament (Proverbs) we learn that “even a fool, when he holdeth his peace, is counted wise.” Carlyle, in Sartor Resartus, pointed out that “Silence is the element in which great things fashion themselves.” And it was Oscar Wilde who, in The Picture of Dorian Gray, observed, “He knew the precise psychological moment when to say nothing.”

Silence unites and separates. As M. A. Zeligs wrote,27 it can

reflect many psychic states and qualities of feeling. … Human silence can radiate warmth or cast a chill. At one moment it may be laudatory and accepting; in the next it can be cutting and contemptuous.

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