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“I’d rather not speak” on the psychoanalytic work with a silent patient.

Psychoanalytic Psychology, Vol 43(2), Apr 2026, 124-129; doi:10.1037/pap0000567

The presented article examines the psychoanalytic treatment of a young woman whose excessive silence significantly hindered the therapeutic process. The patient, Linda, traumatized by loss and abuse, was chronically suicidal and often communicated during sessions through prolonged periods of silence. This very silence triggered feelings of powerlessness, frustration, and helplessness in the analyst, who was only gradually able to address them. Initially, the analyst sought to understand the silence as an expression of Linda’s fears, her need for control, and as a defensive mechanism. The silent phases were interpreted as responses to internal conflicts, particularly following progress in therapy. Theoretical frameworks such as John Steiner’s concept of psychic retreats and Freud’s notion of the negative therapeutic reaction provided preliminary explanatory approaches. These perspectives highlighted that Linda’s silence was both a defense against emotional overwhelm and separation anxiety and an expression of guilt and control. However, in pivotal sessions, it became clear that Linda partly used the silence to recover from emotional and even physically felt overwhelm. The analyst came to realize that it was important to tolerate Linda’s silence and understand it as an opportunity for self-awareness, rather than viewing it solely as an obstacle. This shift enabled new possibilities for therapeutic work. (PsycInfo Database Record (c) 2026 APA, all rights reserved)

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Posted in: Journal Article Abstracts on 03/31/2026 | Link to this post on IFP |
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