The Therapist’s Silence: What It Really Means
TL;DR: Behind the room: Psychodynamic therapist Rick Cox explains silence in therapy: it is not an awkward absence, but a courageous container for emotional avoidance. Learn how this focused attention facilitates containment and breakthroughs in depth work.
Behind the room: Part 2 of the 3-part series.
Explore more in: What Your Therapist Really Thinks About You and What Therapist’s Feel, But Rarely Say
Silence: the presence that allows truth to surface.
When Nothing Happens, Everything Does
If you have spent time in depth therapy, you know the silence. It can feel heavy, awkward, and sometimes accusatory. In that quiet space, the internal critic, not you, but that punishing internal voice, can get loud, filling the room with the anxious question: Am I doing this wrong?
The silence in the therapeutic room is perhaps the most misunderstood element of our work. I want to pull back the curtain on this moment and show you what the silence actually means behind the room: It is not a sign of absence or detachment; it is often the most active intervention we make.
Silence is attention. It is a container built to hold the enormous pressure of the feelings you have spent a lifetime avoiding.
The Container for What Cannot Be Avoided
In psychodynamic work, we deal with the emotional avoidance that keeps you feeling stuck. Your system has been wired to keep certain feelings locked away because experiencing them felt too dangerous in the past. These are the fears, shame, and unconscious emotional patterns that fuel your current anxiety.
Silence functions as a specialised containment vessel.
• It halts the escape. When conversation stops, it cuts off the mental flight response, the attempt to intellectualise, distract, or run away from the immediate emotional pressure.
• It increases emotional pressure. When the surface noise drops away, you are inevitably brought into contact with what is present: the knot in your chest, the impulse to apologise, or the rush of anxiety.
• It demands courage. The silence challenges you to turn toward that anxiety, rather than away from it.
In these moments, my silence signals that I am confident your system can hold this feeling, even if you do not yet feel it yourself.
Silence as the Scalpel: Applying Depth and ISTDP Principles
From a technical standpoint, informed by ISTDP, silence is a targeted intervention designed to facilitate movement within The Therapy FAD Framework (Feelings, Anxiety, Defences).
If you are accustomed to having therapists chase you into conversation, my silence is experienced differently. It is a calculated and deliberate choice to hold steady, waiting patiently for the moment your defence mechanism loosens its grip. The diversifying, intellectualising, and denial.
• When you deflect, I might stay silent. This forces you to notice the deflection itself, bringing the unconscious pattern into awareness.
• When deep pain is just beginning to emerge, I might stay silent. This provides the space needed for the pain to fully register in your body and mind. This is when the emotional truth is fully experienced and named in real time, which is ultimately what cures in therapy.
The silence is the necessary pause that allows the unsaid to become speakable, paving the way for relational healing.
The Human Truth Behind the Silence
The clinical silence does not equate to a lack of humanity or a lack of care. I want you to know what is actually happening during those quiet moments:
1. I am calibrating. I am intensely focused on reading your body language, observing the smallest shift in your breath, and listening to the emotional subtext beneath the stillness.
2. I am containing. I am taking on the difficult feelings, processing them internally, and maintaining a steady presence so you feel safe enough to explore.
3. I am waiting with respect. I am holding space for your innate strength. I am not rushing to fill the void because I believe in your capacity to engage and emerge. The silence is a vote of confidence in your courage.
The profound work happens not despite the silence, but within it. It is where you learn that the anxiety you feared would overwhelm you can be tolerated, and that you do not have to keep emotionally surviving. You just need a safe space to pause and listen to the truth you already carry.
Therapy is so much more than conversation.
It’s an attunement between language and pause, between what’s said and what’s sensed. In the quiet silence in therapy, something happens that no interpretation can replicate: the self begins to hear itself.
Continue reading the Behind the Room series: What Therapists Feel, But Rarely Say and What Your Therapist Really Thinks About You
If this reflection resonates, you might explore:
When Growth Feels Like Collapse
Why We Repeat What Hurts Us: The Pull of Familiar Pain
Netflix’s Monster: The Ed Gein Story: When the “Monster” Speaks
Silence is always the moment a feeling gets the space to reveal itself.
Explore more in reflections
What will you find in your silence?
If this topic connects with your experience, discover how I help clients work through it…
FAQ: The Therapists Silence
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Silence can create space for you to notice what arises inside: feelings, thoughts, memories. It’s not disinterest; it’s a form of deep listening that allows unconscious material to surface without interruption.
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That discomfort is part of the process. Therapy often reactivates early experiences of absence or disconnection. The key is to name how the silence feels so it can become a shared exploration rather than a private replay.
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Yes, therapists are observing, sensing, and considering what’s happening emotionally and relationally. Silence is rarely empty; it’s the therapist’s way of staying present without steering you away from what’s emerging.
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There’s no right rule. If you feel drawn to speak, follow that impulse. If you feel the pull to stay quiet, notice what that stillness brings up. Either way, your response becomes valuable material for understanding your patterns.
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By treating silence as a mirror rather than a void. Notice sensations, emotions, and images that arise. Over time, what once felt threatening begins to feel containing, a place where the self can unfold safely.
