Contemplating silence: a review of understandings and clinical handling of patient silence in psychoanalytic psychotherapy

Patient silence may cause the therapist serious anxiety. It is an enigmatic, over determined phenomena that has been variously defined and clinically addressed in psychoanalytic literature. This dissertation is a systematic literature review (with clinical illustrations) of psychoanalytic literature on patient silence. The findings have been classified into three broad categories: first, silence as resistance; second, silence as communication; and third, silence as creativity. Patient silence is illuminated as one of the greatest barriers to, and one of the deepest moments in an analysis