The shifting sound of silence: A constructivist grounded theory

Data on the use of silence from a therapist's perspective remain limited. This study aimed to develop an understanding of psychotherapists' use of silence in clinical settings. Practising psychotherapists were interviewed about their experiences of silence, and a constructivist grounded theory approach was adopted to arrive at a substantive theoretical understanding of psychotherapists' silence. A grounded theory analysis supported the construction of a theory conceptualised into four main categories: conditions (evolving disparity, rendering relationships and minding the gap), cornerstones (sensitising silence, productive comforting, productive discomforting and temperature gauging), consequences (deepening the treatment) and considerations (timing and silently experiencing). Silence is intersubjective and effective in clinical settings, and the results of the current study indicate that silence is powerful and ambiguous and is best used later in treatment when a strong therapeutic alliance is in place. Individual comfort and the needs of the client were found to be more significant than any single modality or theory. Silence is used to create a space in which treatment can be deepened through the presence of a therapist and mutual introspection. This study recommends a greater focus on a contemporary use of silence during the training and education of psychotherapists, and the importance of free association should be addressed earlier in clinician training. This theory requires further exploration of patients' experiences to establish their correspondence.