Navigating Silence in Therapy: When Patients Freeze and Have No Idea What to Say
Therapy is a powerful tool for healing, yet some individuals may find themselves unable to speak during their sessions. This is a common experience, especially for those who have experienced extreme trauma. In these challenging moments, the therapist’s role is crucial in guiding the patient towards healing.
Understanding the Silence
It's important to recognize that silence in therapy isn't always a sign of resistance or lack of will. Many patients, particularly those who have experienced extreme trauma, may find it difficult to express themselves verbally. According to my experience, patients who have undergone significant life events may freeze up during sessions due to the silent but powerful communication from their body.
The Role of Silence in Therapy
Silence in therapy is not just a pause in conversation; it's a language in itself. Patients may find it comforting to remain silent, allowing themselves to collect their thoughts at their own pace. This silence can be a pathway for healing, enabling the patients to reconnect with their body and emotions.
Building a Safe Space
One method I have found effective is to create a safe and supportive environment. For instance, when my patients freeze up, I let them sit in silence for a while. I sit with them patiently, offering a space where they can relax and re-center themselves.
Some patients, like my sister, may even fall asleep during these moments. This is a clear sign that the session is providing a sense of comfort and safety. However, it’s also important to gently guide the patient out of this freeze if it persists. I sometimes ask: 'Are you here with me now?' with a gentle touch, helping them reconnect with their surroundings.
Guiding Through the Freeze
For patients who experience involuntary freezing due to traumatic memories, I employ various techniques to help them regain control. Trauma-focused therapy, such as for Complex PTSD (CPTSD), often involves these strategies. Here’s one such method:
Breaking the Freeze with Body Movements
I start by asking the patient to nod their head if they can hear my voice, which often encourages a positive response. Next, I invite them to communicate through body language, a step necessary for some patients, especially those with CPTSD. I might ask, 'Are you scared?' The nods and tears indicate that they are ready to engage but find the process significant.
Once they feel ready, I guide them through a series of physical movements: turning their head to the right and left, gently moving their fingers, blinking their eyes, and tapping their feet on the ground. This gentle guidance is crucial, as it helps them to reconnect with their present moment and their physical sensations, which have often become disconnected.
The Power of Movement
By getting the patient to move, I help them to return to the present. For individuals who have experienced significant trauma, their bodies can become rigid and frozen. This rigidity is a physiological response to fear, signaling a deep-seated sense of danger.
Encouraging movement can help to break this freeze. Over time, these moments of guided movement can help the patient become more aware of their physical responses and better equipped to manage them. This awareness is a crucial step in the healing process.
It's important to note that while this process takes time, making the transition from frozen to engaged is a significant achievement. The patient's journey is a back-and-forth process where they gradually become more aware of their body’s cues and more capable of navigating their emotions and memories.
Conclusion
Therapy sessions can be challenging, but they are also a potent pathway to healing. By understanding the role of silence, building a safe space, and employing techniques to guide the patient through their freeze, therapists can help those in need to reconnect with themselves and their surroundings. Healing is a journey, and each step forward is a victory.