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Dr. Dabneys Blog

Dr. Dabney’s Blog
Dr. Dabney’s Blog
Posts from May 2014


Why Doesn't My Therapist Talk?

Why Doesn't My Therapist Talk?
 

A silent therapist can make even the toughest among us squirm.  This discomfort occurs when a patient expects a therapy session to follow the social norm.  That is, you talk and then I talk.  In fact, in a typical social setting, it is a faux pas to hog the conversation.  But therapy is NOT a social encounter.  In fact, there is nothing social about it.  It is a patient-doctor relationship. This means one person has a problem and one person has a solution.  The burden is on the patient to say whatever comes to mind about the problem while the doctor/therapist listens for clues on how to solve it.

A conversation going nowhere in a social setting can mean one party is preoccupied, disinterested or simply out of sync with the other person.  In therapy, silence means something else entirely. In short, it provides a wealth of information.

Silence gives a therapist just as much information as words.  When the silence occurs, how the patient breaks the silence, what the patient is thinking about during the silence and how the silence is broken all give the therapist a better understanding of the patient.

As stated earlier, most patients feel awkward when silence ensues. This awkwardness is another word for stress.  Zipping it, therefore, gives the therapist a ringside view as to how a patient handles stress. Does the patient rush to fill the silence, does he get angry with the therapist, does he become silent himself?  An astute therapist will watch this play out then put it together for the patient.  “I noticed you got anxious when there was a silence between us.”  The patient may respond, “Yeah.  Silence always reminds me of when my dad would take off in his car after an argument with my mother.” Now, we have a gem, a new piece of information to focus on that might never have been discovered had we filled the silence with banalities about the weather.

In a similar vein, silence allows a patient to recreate his relationships in the office. This isn’t possible if the therapist is a chatty-cathy.  Her silence allows the patient to make her into whatever character he unconsciously wishes.  The therapist becomes the withholding mother or the distant father or the dead grandparent.   Again, the astute therapist will point it out, pursue it and learn from it.

Further, if the therapist talks it breaks the patient’s train of thought.  Let’s say the patient is talking about a problem with his mother (yes, the stereotypical mother problem).  If the therapist were to chime in and change the course of the conversation, “hey, if you think your mom was bad listen to what my mom did!” The information the patient was trying to parlay would be lost.  Maybe he was going to reveal abuse or another trauma, the opportunity is lost, maybe, regrettably, forever.

So, when your therapist appears “too quiet” understand that she is thinking, watching and listening on your behalf.   He is not making out a grocery list, thinking about his fantasy football team or bored.  Inevitably, there are stories about the rare therapist who has somehow missed this lesson.  They treat the therapy session as a tea party or worse, a therapy session for themselves.  In one spectacularly unbelievable story a patient told me that, while crying about a painful experience, his therapist suddenly asked him where he’d bought his tie!  In a mind-numbing twist of events some therapists act as if they are the patient.  This would be like a surgeon handing a man with acute appendicitis the scalpel and saying “hey buddy, can you stop complaining for a minute and get that little mole off my back there like a good sport?”  What a horrible dilemma! Most patients want to oblige their doctors but they also have an underlying sense of how terribly wrong this is.   There may be a temporary relief that therapy is imitating the social situation but, most patients eventually see this for what it truly is, an abuse of power.

So, remember, silence in session can reveal valuable information.  It’s our equivalent of an xray or blood test.  We can now see what’s going on inside of you.  And, you deserve a therapist who can hold his tongue, is more interested in your problems than theirs and understands that treatment goes in only one direction.   If you want to chit-chat head to a happy hour.  If you want treatment, embrace the therapist who can embrace the awkward silence.

- See more at: http://drldabney.com/why-doesnt-my-therapist-talk-or-embracing-the-silence/#sthash.MRBL4P81.dpuf
A silent therapist can make even the toughest among us squirm.  This discomfort occurs when a patient expects a therapy session to follow the social norm.  That is, you talk and then I talk.  In fact, in a typical social setting, it is a faux pas to hog the conversation.  But therapy is NOT a social encounter.  In fact, there is nothing social about it.  It is a patient-doctor relationship. This means one person has a problem and one person has a solution.  The burden is on the patient to say whatever comes to mind about the problem while the doctor/therapist listens for clues on how to solve it.

A conversation going nowhere in a social setting can mean one party is preoccupied, disinterested or simply out of sync with the other person.  In therapy, silence means something else entirely. In short, it provides a wealth of information.

Silence gives a therapist just as much information as words.  When the silence occurs, how the patient breaks the silence, what the patient is thinking about during the silence and how the silence is broken all give the therapist a better understanding of the patient.

As stated earlier, most patients feel awkward when silence ensues. This awkwardness is another word for stress.  Zipping it, therefore, gives the therapist a ringside view as to how a patient handles stress. Does the patient rush to fill the silence, does he get angry with the therapist, does he become silent himself?  An astute therapist will watch this play out then put it together for the patient.  “I noticed you got anxious when there was a silence between us.”  The patient may respond, “Yeah.  Silence always reminds me of when my dad would take off in his car after an argument with my mother.” Now, we have a gem, a new piece of information to focus on that might never have been discovered had we filled the silence with banalities about the weather.

In a similar vein, silence allows a patient to recreate his relationships in the office. This isn’t possible if the therapist is a chatty-cathy.  Her silence allows the patient to make her into whatever character he unconsciously wishes.  The therapist becomes the withholding mother or the distant father or the dead grandparent.   Again, the astute therapist will point it out, pursue it and learn from it.

Further, if the therapist talks it breaks the patient’s train of thought.  Let’s say the patient is talking about a problem with his mother (yes, the stereotypical mother problem).  If the therapist were to chime in and change the course of the conversation, “hey, if you think your mom was bad listen to what my mom did!” The information the patient was trying to parlay would be lost.  Maybe he was going to reveal abuse or another trauma, the opportunity is lost, maybe, regrettably, forever.

So, when your therapist appears “too quiet” understand that she is thinking, watching and listening on your behalf.   He is not making out a grocery list, thinking about his fantasy football team or bored.  Inevitably, there are stories about the rare therapist who has somehow missed this lesson.  They treat the therapy session as a tea party or worse, a therapy session for themselves.  In one spectacularly unbelievable story a patient told me that, while crying about a painful experience, his therapist suddenly asked him where he’d bought his tie!  In a mind-numbing twist of events some therapists act as if they are the patient.  This would be like a surgeon handing a man with acute appendicitis the scalpel and saying “hey buddy, can you stop complaining for a minute and get that little mole off my back there like a good sport?”  What a horrible dilemma! Most patients want to oblige their doctors but they also have an underlying sense of how terribly wrong this is.   There may be a temporary relief that therapy is imitating the social situation but, most patients eventually see this for what it truly is, an abuse of power.

So, remember, silence in session can reveal valuable information.  It’s our equivalent of an xray or blood test.  We can now see what’s going on inside of you.  And, you deserve a therapist who can hold his tongue, is more interested in your problems than theirs and understands that treatment goes in only one direction.   If you want to chit-chat head to a happy hour.  If you want treatment, embrace the therapist who can embrace the awkward silence.
Why Doesn’t My Therapist Talk? (or Embracing the Silence)
- See more at: http://drldabney.com/why-doesnt-my-therapist-talk-or-embracing-the-silence/#sthash.MRBL4P81.dpuf
Why Doesn’t My Therapist Talk? (or Embracing the Silence)
- See more at: http://drldabney.com/why-doesnt-my-therapist-talk-or-embracing-the-silence/#sthash.MRBL4P81.dpuf
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