ABSTRACT
When I was in training as a psychiatrist, one of my teachers, Emanuel Miller, used to tell the story that he once saw a patient over a period of about a year. The man came three times a week, took up his place on the analytic couch, and, at every session, plunged straight into 'free association'. At the end of the year, the patient pronounced himself cured and offered his deepest thanks to Dr Miller. The latter asserted that, during the whole of this period, he himself said nothing whatever. Although it is possible that Dr Miller may have slightly underestimated his own verbal participation, this story is not as incredible as it generally appears to the uninitiated. The inexperienced psychotherapist is not only anxious about what he should say to a patient, but also usually talks too much. In ordinary social interchange, we seldom tolerate silence for long and, if we cannot think of anything interesting to say, take refuge in banalities about the weather. Psychotherapists must become accustomed to tolerating periods of silence. These may indicate that there is something which the patient is reluctant to talk about, or that he is finding it difficult to put into words thoughts and feelings which he may never previously have explored. When a patient who has previously been talking freely becomes 'stuck', it is legitimate for the therapist to take up and repeat the end of the patient's last sentence with an interrogatory tone which suggests that he knows that there is more to come and that he is anxious to hear what that more may be.
