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Sounds of Silence

September 1, 2006
by Jeffrey D. Roth, MD
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Perhaps the most common nightmare of the beginning group therapist is being confronted by the group's silence. This terror is based on the foundation of a myth that the therapist's job entails getting the group to talk. Ironically, since most addicts are well trained in spotting our Achilles' heels, the group therapist who is most terrified of silence is likely to be the first to have to deal with it.


Jeffrey D. Roth, MD

Silence triggers one of our most primitive fears—the fear of abandonment. Those of us who grew up in dysfunctional families might have experienced silence that meant a serious emotional storm was arriving, or silence that conveyed being locked out of the heart of a parent and left in the icy tundra. In these families, silence was hardly an indication of serenity.

Under such circumstances, need we be surprised that our response to silence is accompanied by anxiety and the message that we must do or say something to fix the problem? Alternatively, we may become frozen in the silence, immobilized by the shaming message that we must have committed some grievous therapeutic error for the group to have become silent.

Resist the urge to speak

Participants in workshops that I offer on group psychotherapy with addicts frequently find my style of beginning a group session remarkable. I very seldom make the first comment in a group (if I had an actual rule about that, I would suspect myself of rigidity). Most of the time I am content to wait for the group to start the conversation. Therefore, I have many opportunities to experience the silence that precedes this first comment by a member of the group.

Since most of my group members have experience with my willingness to be silent, they usually start working as soon as they hit the group room (sometimes they actually attempt to engage in work when I open the door that leads from the waiting room to the group room). Other times we might have a minute or two of silence, which seems like an eternity to many group members.

Allowing group members to take responsibility for their own participation, and therefore not rescuing them from their own anxiety about the silence, can be quite productive. Not jumping in to fix the silence also allows the group therapist to make use of the silences that have the most obvious meaning: those that occur immediately before or after highly charged issues that are the most productive for emotional work.

The silences that provoke the most intense anxiety for the group are those that cover the group's relationship with the therapist. These silences are actually busy moments for the group, in which members covertly go about the task of finding a member who will speak to the group's most conflicted feelings about being in a relationship with its therapist. Therefore, if we pay close attention to which member breaks the silence, and what this member's sharing brings to the group's consciousness, we learn exactly what we need to know about how to work with the group. Sometimes the conflict will be about how to express anger; sometimes it will be about how to express longings for the therapist's love.

Whenever I am tempted to jump in to rescue the group from its silence, I like to remember that I have the option of feeling grateful for the silence. Many addicts can identify with the idea that when practicing the addiction one is reduced from a human “being” to a human “doing.” Adopting an attitude of “don't do something; just stand there” seems particularly apropos at such moments. These concepts help me to appreciate that when the group is silent, its members may be doing some of their finest work.

Dealing with compulsive talking

On a related note, how frequently have we witnessed group members in the midst of intense emotion attempting to talk away their feelings? Sometimes the most effective intervention is to ask the group member who is talking to breathe. If the person surrenders to attending to breathing, he/she also may surrender to the feelings that are bubbling up with the group's support. The wordless expression of these feelings may be an echo of the silence that filled the room only moments before the compulsive talking began.

In our role as therapists, we may be more compassionate to the group's difficulty in being direct and open with its feelings when we can take ownership of our own ambivalence about the silences that may precede the emotional flood.

I would like to take this opportunity to remind my readers of some opportunities coming up soon to engage in the experiential learning at group relations conferences, which were the subject of the column in the September 2005 issue. I will be directing three conferences: an online conference from mid-September to mid-November; a conference December 15-17 in Chicago; and a conference January 26-28 in Fredericksburg, Virginia. For more information about these conferences (or to direct questions to me that I might address in this column), please contact me at jrothmd@juno.com or visit the group relations conference Web site: http://www.grouprelationsconference.com.

Jeffrey D. Roth, MD, is an addictions psychiatrist and group psychotherapist. He is a Fellow of the American Group Psychotherapy Association and the American Society of Addiction Medicine (ASAM), and is a member of ASAM's Family and Generational Issues Work Group. He is the author of

Group Psychotherapy and Recovery from Addiction: Carrying the Message (published by The Haworth Press and reviewed in the September 2004 issue of

Addiction Professional).

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