The Shifting Sound of Silence: A Constructivist Grounded Theory

The aim of the research is to answer the question: How do psychotherapists use silence in clinical practice? A literature review concluded that although there is a wealth of data on client silence, there was limited data that pertained specifically to the research question. This supported the employment of field research. Aim/Methodology: The study was underpinned by a constructivist epistemology, the theoretical perspective was interpretivist, and constructivist grounded theory was used as a qualitative methodology. The sample was achieved by purposive sampling, and twenty intensive interviews were conducted with American psychotherapists. The interviews were transcribed and analysed under the constructivist grounded theory approach, using the constant comparison method, memoing and sorting. Findings: A significant number of initial and focused codes were generated, supporting focused coding, and further conceptualisation of four main coding categories: conditions (evolving disparity, rendering alliance, minding the gap), cornerstones (sensitising silence, productive comforting, productive discomforting, temperature gauging), consequences (deepening the treatment), considerations (timing, silently experiencing). A constructivist grounded theory was proposed: intersubjective–silence and the effective use of silence in the clinical setting. The study indicated that silence is powerful and ambiguous and is best used later in treatment when there is strong therapeutic alliance in place. The individual comfort and needs of the client presented as more significant than any modality or theory. Silence was used to create space where the treatment could be deepened by the presence of the therapist and mutual introspection. Participants cited experience as a core variable in their relationship to silence. It is proposed that a contemporary approach to the use of silence should be addressed in training institutes. Further research into the concepts benign witnessing and presencing and the nuances between them has been recommended.