Patient Silence Might Mean:įear: The client may be afraid of your judgment afraid of your rejection afraid that you wont honor confidentiality. So if being silent it isnt resistance nor a lack of engagement, what is it? Lets take a look at some of the most common reasons that patients who come to us for help dont offer enough verbal information for us to be helpful.

We should instead be working to understand the meaning of the clients nonverbal engagement. Our efforts should not be directed at the narrow idea of engagement as verbal dialogue. As soon as there is someone else in the room with any individual, a conversation is going on, though it may be nonverbal. Not to engage is to engage in a particular way. Instead it is the persistence of a behavior clients use when they dont feel safe or dont have the skills to verbally share what is going on for them in session.įailure to engage in treatment: I also reject the idea that clients who fall silent are refusing to engage.

By that standard, not talking isnt resistance. Hoffman and her colleagues instead talked about the persistence of patterns of patient behavior that are part and parcel of what brings them to therapy in the first place. One of the most valuable things I learned from theorist Lynn Hoffman is that the whole notion of resistance blames the patient for when treatment gets stuck as if we are so brilliant and comforting that we are irresistible. (Feb.Resistance: Lets get the idea that silence is resistance out of the way. Agent: Sam Copeland, Rogers, Coleridge & White (U.K.). This edgy, intricately plotted psychological thriller establishes Michaelides as a major player in the field. The boundary between doctor and patient blurs as Theo, who admits he became a therapist “because I was fucked-up,” seeks to cure his own emotional problems in the course of treating Alicia. Her current therapists reluctantly agree to let Theo treat the heavily drugged Alicia to get her to speak. Before the murder, Alicia painted a provocative self-portrait entitled Alcestis, based on a Greek myth that seemed to echo her life. Since the day of her arrest, Alicia has never said a word. The evidence against Alicia was clear-Gabriel was tied to a chair and shot several times in the face with a gun that had only her fingerprints.

Psychotherapist Theo Faber, the emotionally fragile narrator of Michaelides’s superb first novel, finagles his way to a job at the Grove, a “secure forensic unit” in North London, where artist Alicia Berenson has been housed for six years since she was convicted of murdering her prominent fashion photographer husband, Gabriel.

What is the silent patient about