English French Psychoanalytic Psychotherapy Borromean Knot


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To Talk or Not to Talk: a Qualitative Research

English French Psychoanalytic Psychotherapy Research

The few clients who at times were finding it difficult to articulate their feelings gave the researcher the idea of conducting a research about the therapists’ clinical experience concerning those situations in particular. As the primary expression of its manifestation, it was found that the common experience of ‘silence’ had not been explored extensively in the context of therapy and from the practitioner’s perspective. Silence in therapy is a rather enigmatic phenomenon which most often leaves therapists in a dilemma about it. Notions of resistance or ‘impasse’, where the client is ‘working at not getting better’, seems to demonstrate the existence of a clear and intense dynamic unfolding between the therapist and his or her client. Seven participants cooperated in this research. Their accounts were recorded and analysed using Giorgi’s Method of qualitative research (Giorgi, 1985).

The findings suggest that mainly two types of silence occur in therapy. Positive silences were exhaustively examined by Levitt (2002) whose study illuminates the former category. It was found however that harmful silences were more frequent and could potentially have a significant and lasting impact on therapists. Some of those resulting feelings were found to be for example being cut-off, rejected, used and blamed. It is assumed that a situation where the client finds it difficult to talk is an essential subject for therapists to explore with the view of allowing themselves to reach for more possibilities. The following chapter called ‘discussion’ will be the stage of a critical debate concerning the validity of the research. The researcher argues that a post-modernist view of scientific research, in general, is based on a constantly fluctuating language which cannot allow for some truly representative data. Also, and as was demonstrated by Freud (Freud in Gay, 1995), it was found that factors like ‘unconscious communication’ eventually render the present research as ‘only’ a piece of knowledge, a snapshot in time which can only be ‘bracketed off’ or ignored next time a situation of the type explored emerge. This debate was also looked at from Foucault’s (1991) perspectives where the dangers of using scientific research, in general, were examined. Finally, future forms of studies were also looked at with a view to encode the body language to produce more efficient results.

Chapter 1: Introduction

The researcher was in his third year of an MSc in Psychotherapy and Counselling and practicing as a trainee therapist when it became increasingly clear that one client was at times finding it difficult to talk during sessions. Especially when invited to explore feelings this particular client would become silent, as if lost for words and apparently unable to cooperate any further.

This situation was new to the researcher who at first became somewhat anxious while wondering what to do. Thankfully, supervision helped contain his concerns and explore the therapeutic relationship with this client. With time and appropriate support the researcher eventually learned to relax and started noticing that, as the sessions progressed, the client seemed increasingly more comfortable and talkative especially when, rather than focusing exclusively on some specific issues, a more imaginative exchange of ideas would be taking place. At the same time the researcher had also begun to explore the notion of ‘play’ by D. Winnicott (1982, 51-70) who saw it to be an “essential aspect of the psychotherapeutic process”. Indeed, the clinical work by Winnicott on the subject of playfulness seemed to have verified what the researcher was finding out by himself in his practice. An atmosphere of play in the session seemed to have effectively helped the client be more creative and talk more easily. This experience left the researcher curious both about this aspect of playing in therapy as well as what was actually happening in therapy when the client would not be able to talk.

As the researcher began to inspect the relevant literature it was discovered that other psychotherapists had been working very closely with clients whose ability to talk was problematic. The psychoanalyst psychotherapist Melanie Klein (1946) used to work with very young and autistic children would could not use language efficiently. In order to help interpret her patients’ latent thoughts Klein came to resort to using some form of play which eventually enabled her to gain important insights into the infant’s primary forms of communication and phantasies (Mitchell, 1986).

According to Klein, the infant who is still too young to use language refers to his internal and external world by splitting it into two categories: ‘good’, or gratifying, loved and loving, and ‘bad’, or frustrating, hated and persecutory. Klein argued that this pre-verbal way of relating, which she named the ‘schizoid-paranoid position’ (Mitchell, 1986: 21-22), could frequently be revisited in adult life during periods of profound anxiety. When the subject felt threatened he or she would ‘regress’ to this primary form of relating and ‘project’ the good or the bad parts of himself or herself into others. According to the psychoanalyst very intense feelings would be at play during the early periods of life in the infant not yet able to speak. Could there be anything like this happening with the researcher’s client? Finding himself increasingly interested in this subject the researcher decided he would conduct a study on what was happening in therapy when the client would not talk.

Hanna (2002: 24) quotes Ottens & Hanna as saying that a baby acquires pre-verbal judgements or beliefs referred to as ‘ontological core schema’ that can be thought as fundamental notions encompassing awareness, love, people, self, problems, and the world in general. In turn Dowd & Courchaine (1996: 164) argue that certain beliefs would be formed at an age so early that they cannot easily be spoken about and therefore very difficult to address in conventional therapy which relies on talking. According to Hanna (2002) if those primary and fundamental assumptions could not be changed then neither would the client

In the same vein the concept of ‘resistance’ became widely used by most therapists to describe the clients’ attitude of blocking any painful acknowledgement of their feelings in the therapeutic process. Hanna (2002: 18) quotes Freud as saying “The patient who comes seeking desperately for help soon bends every effort to defeat help being given”; the client would “repress” into his unconscious any painful and distressing materials evoked during the session (Freud in Gay, 1995: 32).

If Hanna (2002) claims that the notion of resistance has changed since its inception by Freud in the invention of psychoanalysis, in most cases it still remains that the client is mainly perceived by the clinician as “defiant, unruly, stubborn, undermining, ambivalent, apathetic, or deceptive in their attempts to avoid change” (p 19).

For Lacan (2006: 595) however, the reverse is true as he writes“There is no other resistance to analysis than that of the analyst himself”. According to the French psychoanalyst the treatment becomes difficult ‘because’ the analyst does not want to face what is genuinely happening during session. In fact Fink (2007: 132) refers to Freud as having had previously recognised this attitude of avoidance from the therapist which he referred to as “the ostrich policy”.

In line with Lacan’s idea of resistance Hanna (2002) claims that more recently this concept has turned around and with this is shedding more light on the responsibility of the therapist. For the author the therapists’ miss-perceptions and inappropriate approaches are in part responsible for the clients’ perceived resistance and that most difficulties in therapies should be seen as a form of self-protection from the client against an ‘untrustworthy and threatening therapist’. She writes: “When a client is not changing, it is often for an excellent reason, and it could be that a therapist is indirectly bringing about the problem” Hanna (2002: 21).

In chapter two the researcher will be exploring the existing literature in relation with the therapist’s experience of a client who finds it difficult to talk where the action of talking, although seemingly obvious in its definition, would be taken from Freud’s idea of the ‘talking cure’ where progress in therapy depends on a therapeutically relevant form of talking (Freud in Gay, 1995).

Wittgenstein (2001) wrote in the preface of his book “What we cannot talk about we must pass over in silence”. As a commonplace phenomena occurring when the client is not talking the researcher will also conduct a literature review using the keyword ‘silence’ and explore its findings from an existential-phenomenological, person-centred and psychoanalytical perspective.

Conducting a research requires that the researcher develops an awareness of the existing methods and the epistemological stance upon which they rest (McLeod, 2000). In chapter 3 the researcher will be examining both quantitative and qualitative approaches in the light of their epistemological inclinations. It will be argued that a qualitative enquiry is in line with the present research since it is the most appropriate method of research in the domain of psychotherapy and counselling (Alasuutari, 2010). The precepts behind some other qualitative research methods will also be explored and eventually rejected in favour of Giorgi’s empirical phenomenological approach of qualitative enquiry (Giorgi, 1985).

In chapter 4 the researcher will introduce the chosen research method in Giorgi’s method along with the rational behind its choice of sampling, selection of participants, data collection and ethical considerations with regard to doing a qualitative research on the subject under investigation.

In chapter 5 the research findings will be unveiled as analysed using the method by Giorgi (1985). Finally in chapter 6 the researcher will first discuss the findings in the light of the reviewed literature, then present his own thoughts on the research, and offer his ideas on possible future research.


Chapter 2: Literature Review

A literature review consists in locating, assessing and exploring the existing professional and research literature so as to sensitize the researcher to the phenomenon under investigation (Moustakas, 1994; Polit & Hungler, 1995). In order to conduct the literature research the researcher used the following sources: The British Journal and Guidance and Counselling; The British Journal of Psychotherapy; Changes; Counselling; Counselling and Psychotherapy Research; European Journal of Psychotherapy; Education; European Journal of Psychoanalysis; Free Associations Journal and Journal of the Society for Existential Analysis. Also both the British Library as well as the university library catalogue OPAC were used at great length.

As it stands at this point in the research the research question is:

Kadirli “What is the therapist’s experience of a client for whom the act of talking is problematic?”

It was found that a search using the words ‘psychotherapist’; ‘reluctance’ and ‘talk’ individually and in combination was either too wide or didn’t produce any meaningful results. However, “the study of human phenomena, starting with the way that they are first given in commonplace experience, is always the beginning point of a phenomenological study” (Giorgi, 1983: 83). On the basis that the commonplace experience of a client who does not talk may be regarded as a form of ‘silence’ the researcher proceeded to review the existing literature in relation to this phenomena in the context of therapy.

Given that psychotherapeutic progress is completely tied to the client’s ability to use language (Freud in Gay, 1995; Zeligs, 1961, Balint, 1992), it is perhaps not surprising to find that relatively little materials seem to have been written in the domain of silence as a non-verbal form of communication in the therapeutic process.

For Zeligs (1961) however, silent moments in therapy can reflect various but arguably distinct and contrasting psychic states and qualities of feeling. He writes

                   “[silences] might evidence agreement, disagreement, pleasure, displeasure, fear, anger, or tranquillity. The silence could be a sign of contentment, mutual understanding, and compassion. Or it might indicate emptiness and a complete lack of affect. Human silence can radiate warmth or cast a chill. At one moment it may be laudatory and accepting; in the next it can be cutting and contemptuous. Silence may be the sign of defeat or the mark of mastery” (Zeligs, 1961: 10).

Along with processes such as verbalization, thinking, remembering and postural expression silences are, he writes, an integral part of the therapeutic encounter.

Again with Balint (1992) one can recognise in his description of silences two different aspects of the phenomena. His own experience shows that they can effectively be experienced as

                  “an arid and frightening emptiness, inimical to life and growth, in which case the patient ought to be got out of it as soon as possible; or it may be a friendly exciting expanse, inviting the patient to undertake adventurous journeys into the uncharted lands of his fantasy life; silence may also mean an attempt at re-establishing the harmonious mix-up of primary love that existed between the individual and his environment before the emergence of objects” (Balint, 1992: 176).

Located somewhere in between those two very distinct states and quality of feelings it is perhaps not surprising to find that the most difficult task for the therapist in the situation where the client is silent is to know whether he has to intervene or not (Coltart, 1993). As Ihde (2007: 177) reminds us “face-to-face meeting without words results in awkward silence, because in the meeting there is issued a call to speak”.

In her research study Levitt (2002: 333-350) explores what she refers to as ‘productive silences’. According to the author there would exist three ‘Productive Pauses’ which she claimed “are experienced as highly productive moments in therapy” (Levitt, 2002: 333-350). For Levitt the first of those pauses, ’emotional pauses’, describe the lived experience of the client who comes into contact with an intense feeling or profound and powerful emotional state. Those particular moments of silence, she posits, are important experiential state in which the client needs time to make sense of his emotions.

As a second type of productive silence, ‘expressive pauses’ describe psychic states where the clients is involved in an active inner search so as to find the most adequate symbolic description of their current feeling state. At this stage a certain struggle may be a sign that the client is engaged in an intensive process where he is moving back and forth from the feeling to its symbolic representation.

Finally, ‘reflective pauses’ are those moments of understanding and insights, where the client questions or makes a connection between his experience, feelings and awareness. All three of those productive pauses, Levitt claims, may happen in succession and contribute significantly to the therapeutic process. In the same vein Winnicott (1982) recognised the need at times to leave the client ‘alone’ in his silence, which he saw as a necessary ‘uninterpretive’ act in order to help the client organise his private and internal mental development.

The more ‘negative’ silences from the client, on the other hand, seem to have attracted more attention in the literature and appears to be presenting the therapist with an “ironic dilemma” (Bollas, 1987: 174), a “puzzling problem” (Balint, 1992: 26) or as Coltart (1993: 80) puts it

                    “a strange, unwelcome and disconcerting shock, one which taxes the analyst’s skills to the utmost where much or all that one has faithfully taken in during one’s training, and with cases under supervision, goes out of the window”.

Clients who have made it a feature of their therapeutic process to have many and long silences have been identified by the psychoanalytic literature under the name of ‘silent patients’, or sometimes referred to as ‘difficult’ or even ‘deeply disturbed’ patients (Balint, 1992: 14). In their extensive study on crises occurring in therapy Leiper and Kent (2001) use the term of ‘impasse’ in order to refer to the situation whereby the therapeutic relationship breaks down.

From a phenomenological-existential perspective we learn that the self is regarded as a ‘sedimented self-construct’ built from the product of both relational experience and foundational building beliefs, like for example fixed values (Worrell, 1997). The realisation for an individual that he can change his self may mean that it is not built on any concrete and solid grounds. Worrell (1997) claims that the resulting feelings of terror of ‘non-being’ (May, 1994; Bugental & Bugental,1984) may be struggled against and expressed in what he refers to as an ‘ontological resistance’ (p 10).

For Merleau-Ponty ([1945] 1962) the function of speech is, of all bodily functions, the most intimately associated with the existence in community. A loss of speech does not just mean a refusal to speak “it is an escape, a denial of Others, co-existence and the future”. What collapses is the whole field of possibilities. In those moments, the philosopher writes

                     “nothing further happens; everything looses its meaning, shapes and forms. Time becomes a recurrent flow of identical ‘now’ and the patient has withdrawn into his own body which has become ‘the place where life hides away’” (p 187-188).

For Mearns and Cooper (2005) the event of a deep trauma leading to some loss of the ability to speak  in those clients are not just verbal; those client are “communicatively silent. Their whole expressive and communicative system has closed down – they have separated themselves from the interactive world. They have separated themselves from living” (p 99). In silence the body is left by and with itself, dissociated and extinct like a dead and empty shell. In those circumstances Balint (1992: 19) reports having experienced a feeling of deadness, being lost, futility, emptiness coupled with “an apparently lifeless acceptance of everything that has been offered”.

The notion of escape and withdrawal from the Others and the world into oneself is also taken up by Zeligs (1961) as for him the most intense emotional experiences in life are spent in reflective silence rather than speech. He writes

                    “Silences isolates and tends to create a closed circle. It serves to shut one’s inner thoughts and feelings and isolate so as to be safe from others and oneself. This may be a voluntary act, as in preparation for falling asleep, or it may be an unconscious protective process against any kind of threat, real or fantasied” (Zeligs, 1961: 25).

From a psychoanalytical perspective it was found that most authors regard a reluctance to talk as a form of ‘resistance’ the client deploys against the therapeutic process (Giorgi et al, 1983: 88; Coltart, 1993; Bollas, 1987; Greenson, 1961) and whose aim is to control the analyst (Coltart, 1993). In the context of what they refer to as an ‘impasse’ Leiper and Kent (2001: 140) suggest that a prolonged silence may be a sign of “defiance, passivity, a fear of fantasy/feeling or a fear of lack of interest”.

At this stage in the literature it seemed important to clarify the concept of resistance in the context of this research.

According to Zeligs (1961) soon as a contract is established between a patient and a therapist, the former is implicitly handed the position of ‘patient-as-talker’ while the latter is positioned as the ‘one-who-listens’. This specific structure is central to the therapeutic alliance and until its termination is implicitly taken for granted by both participants. Any longer than expected duration outside of this arrangement, Zeligs suggests, may indicate a form of ‘resistance’ from the client .

From an existential perspective Loewenthal and Snell (2003: 17) suggests that the therapeutic encounter can be thought of in terms of Kierkegaard’s view of the patient’s “Shut-upness unfreely revealed… for the shut-up is precisely the mute, and if it has to express itself, this must come about against its will when the freedom lying prone in unfreedom revolts upon coming into communication with freedom outside, and now betrays unfreedom in such a way that it is the individual who betrays himself against his will in dread”. Kierkegaard seems to imply that the client cannot but be anxious of revealing himself in words since the therapists very presence illuminates the client’s inauthentic attitude.

In turn Fink (2007: 132) quotes Lacan as saying that “There is no other resistance to analysis than that of the analyst himself” which, in line with Leiper and Kent (2001) implies that if a client resists talking then the therapist is implicated in some ways. For Leiper and Kent (2001) it could be that this situation is provoked by the therapist not being able to bear her client’s pain and therefore adopting a very rigid approach based on an ‘individualistic view of causation’ (p70).

In the same vein Stern (2003) suggests that in similar situations therapists might be blinded by certain aspects in the relationship and therefore limited in their faculties to create the necessary space for relating to their clients’ experience. Balint opens this notion up by suggesting that if the client is running away from something he is also running towards ‘an area of creation‘ (Balint, 1992: 26) – a relatively safer place in which he can work on the things that are distressing him.

Zeligs (1961: 23) claims thatspeaking is an ability which, if acted upon, forces the speaker to identify with his own thoughts whereas, while referring to Lacan, Bailly (2009) writes that language necessarily creates a relationship “between organism and its reality” Bailly (2009: 31-32): through a process of verbal symbolization the self becomes conscious of itself as an object and comes into being by the act of subjecting itself to something external to itself: an Other with its own rules to follow, or not, at one’s own risk. Implied in this idea is the sense that feelings of anxiety may well be evoked since the speaker is inescapably dependent on the Other as language for what to say and how to say it (Fink, 1996).

In view of the above and in the context of therapy it is argued that the client may be seen to be recoiling from verbalizing  his ideas and subsequently fall into silence in order to avoid the dread attached to having to commit to one’s own thoughts and therefore invite judgement. For some, Kierkegaard claims, having to face the fear of being neither understood nor approved is too menacing, and so notto venture and remain silent is to be safe. This attitude however, he warns, invariably leads to the worst kind of loss: “the loss of oneself” (Kierkegaard, 1849/1983: 34).

In turn Fink (1996: xii) refers to Lacan as suggesting that the subject can be conceptualized as a “stance adopted with respect to the Other’s desire”. At first the infant defines himself in relation to the desires of the Other as parents, and then as an adult defines himself in relation to the desire of the Other as the society at large. Indeed in the context of her work Coltart (1993) remarked that at times some of her patients felt a very strong wish to please her and so fell silent as part of a deep fear to get it wrong.

In the same vein Rigas (2008) recalls working with a client who did talk, but the words she used didn’t seem able to convey the real distress of her feelings. In a desperate attempt to communicate Rigas thinks that the client resorted to a primal form of communication called ‘projective identification’ (Rigas, 2008: 37 – 41) in which he subsequently became “infected with the sickness of the setting”. Bollas (1999: 83) refers to a similar phenomenon in terms of “an occasional madness of the psychoanalyst” as he recalls having changed for the worse, regressed and gradually lost his identity as a therapist as well as his empathy towards the patient to eventually be assailed by feelings of guilt.

For Rigas his interventions had become formal and false, his comments superficial as he recounts feeling a growing dislikes for the patient; sessions felt like a ‘void’ where he was unable to have thoughts or reveries but instead “an experience of contact with something as dangerous as death itself” (Rigas, 2008: 42); the patient’s internal space felt like a place he could not reach as his words would not have any effects.

In turn Rycroft (1958: 3) speaks of clients who “equates being understood with being devoured or penetrated” and therefore make it practically impossible for the therapist to understand them. Those clients, he writes, may doubt the sincerity of the therapist on the basis that their relationship only exists in order to allow him to earn a living and so proceed to undermine him by insisting he lacks the essential qualities to be a good therapist. Along the same lines Coltart (1993: 81) writes that a client “can drive himself into silence because of his own alienating feelings of fears and greed, or his sadistic wishes to bite, devour and hurt”. For Ferenczi (1953: 38-40; 258-259) a silence can be an expression whereby the patient “equates strength with retention of all feelings” orat other time the patient may be filling up the analytical space with unimportant matters as a “loquacious form of silence”.

The client who remains deeply silent may provide the therapist with an impression that some emotional damage have occurred very early in his life, at a ‘pre-verbal’ level which Balint refers to as ‘the basic fault’ (Balint, 1992). At this level, Balint claims, the contrast in intensity between the experience of satisfaction and frustration can be enormous and sees the client suddenly cease to cooperate and adopt an attitude which could be reflected in a refusal to move and change as well as a complete refusal to bear any difficult tensions or anxiety in therapy. The author adds that any kind of interpretations offered to those clients may be experienced as either something “highly pleasing, gratifying, exciting or soothing”, or instead as “an attack, a demand, a base insinuation, an uncalled-for rudeness or an insult, unfair treatment or injustice” (Balint, 1992: 18-19).

In a similar fashion Coltart (1993) experienced her clients as being trapped by feelings of shame, persecution, or sorrow and so finds that theoretical ideas around the affects of meanness, spite and grudgingness can be of significant help.

In those particular circumstances it is recognised that therapists may generally find it difficult to remain sympathetic, objective and passive but instead becomes emotionally involved (Balint, 1992; Rigas, 2008). Therapists may allow themselves to be affected by the client and change their therapeutic approach accordingly or get drawn in and deliberately choose to carry on with the approach they have always been using while reassuring themselves that their technique has survived the test of time and that their interpretations can deal with any types of situations.

Leiper and Kent (2001: 140) suggest that in those instances the therapist may show feelings of defiance passivity, fear of fantasy/feeling or fear of lack of interest. Potential feelings of failure in the therapist may ensue and become difficult to untangle from the client’s, eventually risking to resulti in disastrous consequences for the therapeutic relationship. In this instance the authors argues that the therapist’s feelings of knowing while not being able to escape the situation may result in powerful feelings of shame and incompetence which undermine his self-esteem. At worse, those authors write, “the therapy can seem like a charade” (Leiper and Kent, 2001: 89) as the therapist finds himself in complete denial of the situation as he carries on believing that his work is still helping the client.

It is vital that the therapist wake up from this state of mind” writes Leiper and Kent (2001: 70). According to them the therapist should take his responsibility of the situation and identify what has become stuck in the therapeutic process. At the end however, Rigas (2008: 43) claims that “what is of the utmost importance is the analyst’s survival!”.

Mishandling a silence can perpetuate violence and ultimately leaves the client feeling violated, controlled, rejected and persecuted(Zeligs, 1961; Coltart, 1993; Mearns and Cooper, 2005).

In the eventuality that a client becomes reluctant to talk the therapist needs to be patient, intuitive, capable of tolerating not knowing while being creative (Coltart, 1993, Leiper and Kent, 2001). For Mearns (Means and Cooper, 2005: 105) “there is a very narrow boundary between encountering and invading”, while Giorgi (Giorgi et al, 1983: 88-89) cites Maes as claiming that it is ‘attentiveness’ which is at the heart of the therapist’s listening and observing activity. For him

              “The therapist must listen and observe his own reactions as well, inasmuch as his disciplined self-awareness either promotes or detracts from the emotional climate necessary for the analysis as such”.

For Mearns (Mearns and Cooper, 2005) who works from a person-centred position, the work of psychotherapy for traumatised silent patients cannot be approached from a ‘normal’ position defined by reality as one usually apprehends it. In those situations, he claims, only phenomenology and a form of ethics appropriate to the actual situation may provide a functional basis from which to work from. Perhaps this idea is reflected in Ihde’s words “If there is an ethics of listening, then respect for silence must play a part in that ethics” (Ihde, 2007: 180.

From Mearns’ account one learns that when working with a mute patient it is important not to expect them to speak back or reciprocate in any way (Mearns and Cooper, 2005). Instead, the author emphasizes the importance of being authentic in one’s own approach. For him in those situations “I have to present myself exactly as I see myself, warts and all, with all my doubts, fears and, particularly, including how I feel here and now” (Mearns and Cooper, 2005: 101). Finally, he warns, if a person is protecting himself then the therapist should be making it his first priority not to invade him.

In an effort to connect with traumatically silent clients Mearns refers to what he calls an attitude of ‘situational and contact reflections’ which sees his communication being kept very broad and mundane (Mearns and Cooper, 2005: 103). Therapists make contact not just on a deep and emotional level, but also and most naturally through a range of different kinds of more ‘down-to-earth’ subjects which connect with the client. Mearns also stresses the importance of the softness in the voice and the genuine caring for the client in an effort “to earn the right to engage” with him (p 112).

For Coltart the transference, and more specifically the counter-transference or internal feelings evoked in the therapist during sessions, “become the instruments par excellence of the work” (Coltart, 1993: 86). In the same vein Balint speaks of the therapist needing to be absolutely indestructible and ‘in tune’ with his client whilst allowing him to experience what the psychoanalyst refers to as a “harmonious inter-penetrating mix-up” (Balint, 1992: 53) whereby the most accepting, understanding and nurturing therapeutic environment should be fostered for the client: the therapist must be ‘there’ and accepting the client to the highest degree possible while not offering much resistance.

Almost all literature points to how sensitive the therapist should be towards the client during periods of silence. Mearns (Mearns and Cooper, 2005: 106) talks about the client ‘being a barometer of his own presence to his own presence’ which enables him to gauge the quality of his own presence with him. The client, the author recalls, was able to sense the level of his focus or his drifting. In turn Kreitemeyer (Kreitemeyer & Prouty, 2003: 155) use the terms ‘contact rhythm’ in order to describe the unspoken experience of resonance between them and their clients. Finally, for Coltart (1993: 89) the observation by the participants in therapy is a two-way process: “the patient is studying the analyst’s silence with just as much keenness as the analyst is studying his”,  while Zeligs (1961: 17) writes “if the analyst’s silence in one way or another denotes impatience, boredom, indifference or hostility, this will surely be sensed by the patient and thought of as a disapproval, rejection or condemnation”.

For Leiper and Kent (2001: 90) the best therapeutic approach for resolving silent impasses is one characterized by “imaginative but disciplined flexibility”, whereas Mearns talks of using his imagination as a powerful way to “freshen up his empathy” (Mearns and Cooper, 2005: 106). He would imagine what might be going on for the patient during sessions in order to stay ‘connected’ with him between sessions. Also in his account Mearns mentions the importance of supervision where he explores the boundary between full involvement and over involvement. For him learning about who we are in terms of our boundaries is a fundamental part of freeing ourselves so as to offer clients the possibility of a relationally deep encounter (Mearns and Cooper, 2005: 107). Finally Mearns argues that engaging at relational depth is also to let the moments ‘be’ and not attempting to dissect them endlessly so as to render them superficial (Mearns and Cooper, 2005: 109).

While Merleau-Ponty ([1945] 1962: 190) argues that it is only confidence and friendship within an authentic relationship that can allow for a change in existence, for Clarkson (2005) the key factor during those moments is a continuing, stable and dependable therapeutic relationship. In turn Coltart (1993) speaks of ‘faith’ of the therapist in his training, the psychotherapeutic process and in himself while ‘avoiding memory and desire’.

At the end however, Coltart (1993: 86) finds that working with silent clients is intensely gratifying as both participants truly listen while the bodily senses become “unbelievably sharpened”. She writes

             “Above all, we have the gratifying, if at times alarming, sense that we are truly heard in what we say. One thing we can be sure of with a silent patient is that both participants listen”.

Silences are privileged opportunities to reflect deeply on what the therapist does, develop patient endurance and ultimately witness some deep and lasting changes in the patients (Coltart, 1993; Leiper and Kent, 2001).

The researcher is now going to examine and explore the currently existing approach in research.


Chapter 3: Methodology

The present research has as its aim the exploration of the therapist’s experience of working with a client whom talking is problematic. At this stage of the project two distinct methodologies present themselves for the researcher to choose from in order to carry out the present study: a quantitative or a qualitative approach. The researcher will first demonstrate why a qualitative approach is best suited to the context in which this research is taking place. Then the researcher will proceed by looking at the various existing methods within the qualitative approach and explore why the qualitative method of Empirical Phenomenological Analysis (EPA) developed by Giorgi (1985) appears to be the most appropriate methodological application for carrying out a research on the subject being studied.

Chapter 3.1: Qualitative versus quantitative approaches

Quantitative methods subscribe to the positivistic paradigm based on the belief that there is one objective reality which is knowable through the use of scientific methods (von Wright, 1993). Quantitative methods aim at measuring and quantifying phenomena using mathematical models, theories and/or hypotheses so as to describe and ultimately predict their inherent dynamics of cause and effect (Oakley, 2003; Seal, 2003). In this approach the researcher is expected to gather data whilst adopting a detached and independent attitude (Elliott & Williams, 2001). In the context of the present research this type of approach would translate in a method using statistical models in an effort to measure, objectify and quantify insights, intuitions and perceptions so as to control the variables which make up the experience of a therapist in response to a client who is reluctant to talk. The researcher questions the validity of such proposition given that the aim of this research is not to define a verifiable theory that would accurately predict the causes and effects in relation to the therapist’s experience of a client is reluctant to talk, but for the researcher to contribute towards an exhaustive and rigorous description of the phenomena in order to open up new possibilities for therapists who happen to find themselves in a similar situation.

Qualitative methods are built around the epistemological belief that consciousness is the basis of all experience and that reality isn’t represented by one single truth but instead that there is a multitude of possible interpretations of it (McLeod, 2000). As Walsh (1996: 1) once put it “Rather than forcing a phenomenon into pre-established classes or reducing it to numbers, qualitative research explores experience in its unconstrained complexity”.

In this sense qualitative approaches are specifically designed to examine the construction of meanings in the experience while recognising that the primary researcher is an integral part of the data set and therefore part of the process (Grafanaki, 1996). For Polkinghorne (1989) the investigator does not simply use tools; he or she is the tool. Since the present research is concerned with investigating the therapist’s subjective experience in relation to a certain situation the researcher chose to conduct the research using a qualitative approach.

For Marshall and Rossman (1995) the use of a qualitative approach has to be justified as well as the results, and so the researcher will now be examining and critic the existing methods.

Chapter 3.2: Phenomenology

Qualitative methods use phenomenology as their basic analytical tool (Osborne, 1990; McLeod, 2000: 3-50) in order to ‘deconstruct’ and lay bare the diverse meanings at play within a phenomena. Phenomenology is the science of describing that which is perceived, sensed and made known to one’s immediate awareness and experience or as Merleau-Ponty ([1945] 1962: vi-xii) puts it “it is the study of essences”. First encountered in the writings of Kant and then developed by Hegel (Moustakas, 1994: 26) it was Edmund Husserl (1859 – 1938) who, responding to the increasingly dogmatic scientific views of the Enlightenment, developed a phenomenological method the purpose of which was to unveil beyond ‘doubt’ the self-evidently true in a phenomena (McLeod, 2000: 39).

For Husserl consciousness always ‘reaches out’ towards something. It is ‘intentional’ in that the mind inescapably reaches towards something (Moustakas, 1994: 26). Also, every intentional experience is comprised of two correlates: the noema and the noesis. The noematic correlate is not the object that consciousness is ‘looking at’ but the features and meaning(s) that make it appear as it is. The noetic correlate describes the intentional process itself, or how it is that we are experiencing what we are experiencing (Moustakas, 1994: 28-31). In the context of this research it is argued that, although inter-changeably, the noema regroups the meanings attached to the experience of a client who is reluctant to talk while the noesis would represent the accompanying feelings and sensations. In turn the noesis would point to some other noematic meanings accompanied by their noetic correspondents, ad infinitum.

Embracing Descartes’ idea that some ultimate truth can emerge from adopting an attitude of doubt (Moustakas, 1994: 43), Husserl saw to it that the enquirer should first of all approach the experience under investigation in what he called the ‘epoché’. In it the researcher dwells meditatively and in contemplation of the phenomena, free of any analytical reflection and scientific explanations or as Sass (1988: 234) puts it: “one dispenses with all metaphysical, ontological, and epistemological assumptions and returns to ‘the things themselves’”. The enquirer first puts ‘on hold’ his everyday and unexamined way of experiencing the world, also called ‘the natural attitude’ (Merleau-Ponty, ([1945] 1962: vii) in order to let freedom invite the phenomena to patiently show itself from itself, free from the enquirer’s projections and desires.

The second phase in Husserl’s method is called the Transcendental-Phenomenological Reduction (Moustakas, 1994 34). At this stage the researcher is invited to describe the experience repeatedly and in as much details as possible both in terms of its noematic and noetic characteristics, while keeping an attitude of ‘horizonalisation’, or “never asserting that the meanings are what they present themselves to be” (Giorgi, 1985: 43). In the context of this research Husserl invites the enquirer to constantly leave ‘open’ the flow of his perception of meanings and feelings in connection with the experience of a client who is reluctant to talk, while never asserting that a particular view is more appropriate than another. The combined aim of epoché and reduction is to keep uncovering the various layers of meanings which constitute the experience, without ordering them into a hierarchy and until it has ceased to be what it is.

The last and final stage in Husserl’s phenomenological method is called the Imaginative Variation (Moustakas, 1994: 33). This procedure has as its aim to arrive at “a structural differentiation among the infinite multiplicities of actual and possible cognitiones, that relate to the object in question and thus can somehow go together to make up the unity of an identifying synthesis”(Husserl cited in Moustakas, 1994 where to buy Ivermectin : 35).

This phase, also called the ‘eidetic intuition’, describes the enquirer’s attitude of imagining the phenomenon from different perspectives in order to retain its invariant properties, universal structure(s) or essence (Moustakas, 1994: 34). In the context of this research an eidetic reduction is meant to unveil the universal and irreducible components of what constitutes the therapist’s experience of a client who finds it difficult to talk.

Here stops the purely transcendental-phenomenological method as originally conceived by Husserl. In an effort to appreciate more fully the research tools available to conduct this study the researcher is now going to be looking at the evolution of phenomenology.

Chapter 3.3: Existentialism

Following on Husserl, Heidegger (1889 – 1976) claims that the noetic ‘I’ of intentionality cannot but bear an indissoluble relation with the world around it (Langdridge, 2007). For the philosopher there exists a clear distinction between the ontic and the ontological. The latter can only be revealed through a philosophical study of Being or existence, whereas the former refers to the particular facts of existence of Dasein, meaning ‘Being-there’ whose characteristics can effectively be uncovered through an empirical investigation (Langdridge, 2007: 29). Qualitative research has as its aim to uncover the ontic qualities of Dasein.

Encapsulated in the concept of Dasein is Heidegger’s claim that all human experiences are inescapably lived from the point of view of a temporal, practical, pre-reflective, ideological, existential, social and ideological perspective (Langdridge, 2007). According to him the philosopher’s task is therefore to ‘interpret’ the phenomena in terms of those characteristics (Giorgi et al, 1983).

Throughout his work Heidegger particularly emphasised the ideological, or discursive aspect of Dasein (Heidegger, 1971). According to him meanings form into clusters or discourses which, the philosopher argues, is a fundamental aspect which allows Dasein to relate to the world it lives in. Uncovering Being therefore necessary implies an examination of its discourses. This brings us finally to a notion central to qualitative research: hermeneutic.

Chapter 3.4: Hermeneutic

Originally developed within the field of Biblical scholarship in order to help theologians interpret the meanings of scriptural texts, Heidegger combined hermeneutic with phenomenology in an effort to examine and ‘interpret’ the structure of the narrative through which the lifeworld is experienced (Moran, 2000; Langdridge, 2007). Starting from Heidegger’s position that “an interpretation is never a pre-suppositionless apprehending of something presented to us” (Heidegger, [1927] 1962: 191-192) it was Hans-Georg Gadamer (1900 – 2002) who then set out to explore the substance and essence of a phenomena in terms of its prevailing place and space, history and culture (Gadamer [1960] 1990). Since “one cannot step outside history” McLeod (1994: 23) hermeneutic claims that interpretations are the basic structure of experience. Gadamer sees the act of ‘understanding’ (Verstehen) as “less a subjective act than as participating in an event of a tradition” (Gadamer, 1984: 290) and ultimately the key to human existence through language and conversation (Langdridge, 2007: 42).

Gadamer also claims that an authentic interaction with a text or a person, as the case may be, invites for an exchange of ideas, or ‘fusion of horizons’ (Lawn, 2006), the underlying dynamic of which would lead to ‘a true knowledge of the experience‘ (Moustakas, 1994: 9). Gadamer ([1960] 1990: 267) writes:

“It is necessary to keep one’s gaze fixed on the things throughout all the constant distractions that originate in the interpreter himself. A person who is trying to understand a text is always projecting. He projects a meaning for the text as a whole as soon as some initial meaning emerges in the text […] Working out this fore-projection which is constantly revised in terms of what emerges as he penetrates in the meaning, is understanding what is there”.

The name of ‘hermeneutic circle’ was chosen to describe the dialectical relationship that exists between the whole and its parts, the reader and the text. Understanding arises in a dialectic between one’s knowledge and what already exists ‘out there’. The result is a change or fusion of perspectives which ultimately creates further knowledge in turn ready to be compared and subsequently transformed (McLeod, 2000: 143). For Gadamer meanings are time, context and tradition specific and therefore constantly changing as McLeod (1994: 245) quotes Gadamer as saying “The focus of subjectivity is a distorting mirror. The self-reflection is only a flicker in the closed circuit of historical life”.

Chapter 3.5: Selection of a qualitative method for the research

Several qualitative methods were examined in view of conducting the present research. In the context of this project it is understood that a hermeneutic approach would see the researcher’s own horizon ‘fuse’ with the participant’s in an effort to ‘construct’ the meanings inherent in the experience being studied.

However, Fink (1996: 9) quotes Lacan as saying “Other people’s views and desires flow into us via discourse […] Desire is the desire of the Other”. According to Lacan individuals respond in function of what the other wants or desires to hear. Based on this implication the researcher questioned to what extent any accounts of a participant engaged in a dialogue would tell what he wished to hear. It seemed that adopting a hermeneutic approach would unavoidably invite various and perhaps irrelevant discourses to alter the validity of the enquiry. In the same vein McLeod (2000: 153) quotes Haraway as saying that at its worse hermeneutic can be seen as a means to reinforce the power inherent in some social discourse. On the basis that according to Lacan some ulterior motives would automatically be generated as part of the interaction with the participant ,the hermeneutic approach was rejected.

Since the method of Interpretative Phenomenological Analysis (IPA) places hermeneutic at the centre of its approach (Smith et al, 2009), it was rejected on the basis of the arguments advanced above.

The method of grounded theory was initially considered by the researcher on the basis that it offers a clear set of explicit guidelines to follow. Grounded theory is best suited for producing theories from research questions requiring processes and actions (McLeod, 2000). It requires the researcher to organise the participants’ understandings of their phenomenal world into themes and categories in order to produce a theory (Glaser & Strauss, 1999). However, the method of grounded theory was rejected on several basis. On the one hand and as stated earlier, it is not the aim of the researcher to produce a theory which invites for actions but to expand the therapist’s awareness of a certain experience in order to open up possibilities in the context of the situation being studied. On the other hand the mechanism of interpretation inherent to a grounded theory reflects a fundamentally hermeneutic approach (McLeod, 2000) whose validity had previously been rejected.

A heuristics approach requires the researcher to use his own self in order to explore the nature and meaning of human experience (Moustakas,1994). This research method was also rejected on the basis that, according to the researcher, its design would presumably yields findings which might reflect too closely the primary researcher’s own views and biases and therefore prevent new knowledge to emerge.

Finally discourse analysis is an approach to the study of meaning influenced by semiotics and at times psychoanalysis (McLeod, 2000). Its method reflects the assumption that language constructs reality in the performative sense that ‘we do things with words’ (McLeod, 2000: 90). The researcher reads and re-reads the transcript until he founds the passages he thinks are relevant for another closer analysis. Once those extracts have been identified the researcher then inspects the text for other form of categorizations, articulations, and discourses or other passages which will confirm or disconfirm the ‘candidate hypothesis’ (McLeod, 2000: 92).

It seemed that this approach would not allow any positions for the enquirer to adopt in order to derive any new knowledge and therefore on this basis discourse analysis was rejected.

Chapter 3.6: Merleau-Ponty and Giorgi’s method of qualitative research

While agreeing with Heidegger that it is not possible to adopt a “God’s eye view” of phenomena which presumes that the enquirer can adopt a detached view of even its own intentionality, the researcher contends that Merleau-Ponty’s approach remains ‘phenomenologically closer’ to Husserl’s method of enquiry by choosing instead to examine our connection with the world via our embodied consciousness rather than discourses. After all “we find in texts only what we put in them” (Merleau-Ponty [1945] 1962: ix) . He writes:

“I am the absolute source, my existence does not stem from my antecedents, from my physical and social environment; instead it moves forward and sustain them, for I alone bring onto being for myself the tradition which I elect to carry on, or the horizon whose distance from me would be abolished – since that distance is not one of its properties – if I were not there to scan it with my gaze” (Merleau-Ponty, [1945] 1962: x-xi)

It is the researcher’s own view that Merleau-Ponty’s epistemological beliefs lend themselves to qualitative research with an added validity over the other qualitative research methods in that the philosopher recognises that experience is not limited to that which is only languaged. A client or participant who winces or rattles his throat at an interpretation or intervention may indeed be regarded as a form of body communication whose dimension hermeneutic does not, to the researcher’s awareness, acknowledge.

If this research is concerned with the therapist’s experience of a client who finds is problematic to talk the philosophy of Merleau-Ponty should naturally come as a more appropriate epistemological choice given that it makes it a central element of its phenomenological approach to enquiry the bodily senses where words might not be there.

Also, Giorgi (1985: 43) quotes Merleau-Ponty as saying that “the achievement of the essence is not the end of phenomenological analysis, but only a means of bringing to light all of the actual ‘living relationship of experience’” whichmakes the philosopher belong to a post-modernist tradition promoting creativity, openness, incertitude and ambiguity.

Giorgi’s method of enquiry was chosen on the basis that it was designed to ‘articulate’ scientifically Merleau-Ponty’s approach to phenomenology in that it is descriptive, reductive, searches for essences and is concerned with ‘intentionality’ (Giorgi, 1985: 43).

Having described the epistemological orientations in relation to the existing qualitative methods of enquiry the researcher is now going to explore in details the practical steps which constitutes the method devised by Giorgi.


Chapter 4: Research Method

As seen in the previous chapter the research chose to use the method of empirical phenomenological analysis devised by Giorgi (1985) as a tool of enquiry in order to explore the therapist’s experience of a client who is reluctant to talk. In this chapter the researcher operationalises the research question by establishing the practical steps in Giorgi’s method. Sampling will also be defined and the ethical issues inherent to conducting a qualitative research considered.

Chapter 4.1: Sampling

The term ‘participant’ expresses the idea that the interviewee works cooperatively with the primary researcher (Osborne, 1990) whereas for other authors the term ‘co-researchers’ is more appropriate and encouraging of the human approach behind qualitative interviewing (Tripp-Reimer et al., 1994). Not one particular way of naming the participant seemed to have been needed in order to help conduct the interview, and so the term of ‘participant’ remained the term used by the researcher throughout the research process.

As seen earlier Giorgi’s method of enquiry requires a sample of participants in order to operationalise its process of imaginative variation (Giorgi et al, 1983). Qualitative samples are typically small – but information rich (Patton, 1990). Also, descriptive phenomenology generally uses ‘maximum variation sampling’ as its primary method of sampling (Langdridge, 2007: 57) which implies that the sample should demonstrate as wide a variety of demographic characteristics as possible whilst still related to the experience of working with a client who was reluctant to talk (Mason, 1997; Polkinghorne, 1989).

Organisational constrains and risks of being overwhelmed with too much data were carefully taken into consideration and on this basis it was decided that a sample size of seven participants would be a reasonable figure for providing the necessary depth in variations that a qualitative approach requires.

A briefing document was sent to each participants where it was made explicitly clear that the interviews were going to be tape-recorded and the data eventually published in a dissertation.

Chapter 4.2: Selection of Participants

To qualify for this research project it was initially asked that the participants should be trainee or practicing psychotherapist or counsellor accredited with a regulating body (i.e. BACP/UKCP) as well as willing to join the researcher in a mutual effort to investigate in details their experience of a client who appeared to be reluctant to talk.

Several candidates expressed their interest and responded positively by kindly offering to share their experience as part of this research project. At the end six females and one male therapists were selected and then invited to attend one informal semi-structured interview in a mutually convenient location where he or she could reflect upon their personal experience in relation to the research topic.

It was made clear that the interview would be tape-recorded and the data eventually published in a dissertation.

Chapter 4.3: Ethical Considerations

Qualitative research requires sensitivity to the ethical and political dimensions of the research (Mariano, 1990).

An ethics application (Appendix I – IV) was therefore reviewed and subsequently approved in January 2010 by the School of Ethics Committee at Roehampton University Ethics board.

Participants were then sent a briefing document (Appendix I) stipulating that the researcher would like to invite him or her to take part in an MSc research study which aimed at exploring in details the therapist’s experience of being confronted with a client who was reluctant to talk. It was made explicitly clear in this document that the aim of this research paper was to compile a detailed description of this phenomenon so as to heighten therapists’ awareness about this situation and help create more possibilities for interventions.

Participants were told they could withdraw at any point before a specific date (see Appendix I) when data would be collated for submission. They were also told that the interviews would be transcribed and stored in a secure location ensuring all identities remained anonymous. It was specified that the data would be destroyed after 6 years as per university guidelines and that the results of the study would not be used for any other purpose. Finally, the participants were told that the final dissertation and transcripts would be made available to them on request.

Langdridge (2007: 62) writes“Consent is perhaps the most fundamental of all ethical principles” and so, once selected, a consent form was sent for all seven participants to sign and return (Appendix II). Once the participants’ consent were secured the researcher offered an arrangement with regard to the place and time for the interview to take place. According to Grafanaki (1996: 5) “Choosing the right place for conducting the research can be as important as recruiting appropriate participants” and therefore it was decided on a common accord with the participants that the interviews would take place at the clinics where they worked respectively. The researcher made sure that the participants’ privacy was always going to be respected by people who could have access to the room.

If the aim was to encourage the participants to talk about his or her experience in an as a “complete, honest, rich and authentic” (McLeod, 2000: 197) manner as possible it remained nonetheless of the utmost priority for the researcher to never intrude, violate or infringe on the the participant’s right to privacy. As Levinas (1985: 86) wrote

“The face is exposed, menaced, as if inviting us to an act of violence. At the same time, the face is what forbids us to kill”

It was in a spirit of creating, sustaining and nurturing an ethical relationship of responsibility towards all participants that the researcher approached the interviews in the context of this research project. At the end of the interviews a thank-you letter was sent to each participants for their valuable contribution. In the next chapter the researcher is going to examine the findings.

Chapter 4.4: Data Collection

In order to acquire the necessary naive descriptions for the method the researcher opted for conducting a semi-structured interview. For Langdridge (2007: 65) “this approach to interviewing represents a trade-off between consistency and flexibility that best meets the needs of many qualitative researchers”.

In line with the principles underlying semi-structured interviews it was important to first create a relax atmosphere and develop a rapport which helped the participant explore his or her experience in relation with the subject being studied.

Once set up the researcher went through the Participant Briefing Form and Participant Consent Form (Appendix I & II) with the participant and asked whether there were any questions the participants wished to ask before starting the interview.

The researcher then asked the research question buy prednisone tablets online “Please can you explore with us your experience of working with a client who was reluctant to talk?”

In line with Giorgi’s method the researcher would not engage in any kind of conversations or dialogues, except in re-iterating the question when the participant seemed in need of support (Giorgi, 1985).

Interviews were recorded safely using a digital recorder and declared complete once the participant agreed that he had no more to add to his description of the experience being studied.

Finally the recorded data were subsequently transcribed onto word format so as to be ready for analysis. The participant is regarded as a ‘subject’ and therefore denominated by the letter S (Giorgi, 1985).

Chapter 4.5: Data Analysis

Giorgi’s method has for aim to conduct a direct analysis of the psychological meaning of naive descriptions (Giorgi, 1985: 1) in relation to a therapist’s experience of working with a client who is reluctant to talk.

The analysis was conducted following the four essential steps as defined by Giorgi (1985: 10-19).

1. The researcher read the entire description several times in order to get a sense of the whole. At this stage the researcher also engaged in bracketing off his preconceptions in relation with the experience being studied (Langdridge, 2007: 88). It was important to read the text with a sense of discovery without trying to impose meanings or describing what was going through the researcher’s mind.

2. Discrimination of Meaning Units Within a Psychological Perspective and Focused on the Phenomenon Being Researched. Once the researcher had grasped the sense of the whole the transcript was read again with the specific aim of discriminating ‘meaning units’ “from within a psychological perspective” (Giorgi, 1985: 11) and in relation to the therapist’s experience of working with a client who is reluctant to talk.

As advocated by Giorgi (1985) the meaning units were identified spontaneously by detecting a change within the narrative. Pauses in talk were important in this respect (Langdridge, 2007: 89). The meaning units were selected as ‘constituents’ on the basis that they had an indisputable relation with the experience under investigation. The researcher preserved the original language of the participant in order to conserve in full the meaning as it was being expressed in the transcript. Finally, the discriminated meaning units were placed on the left-hand side of a table representing the analysis

3. Transformation of Subject’s Everyday Expressions into Psychological Language with Emphasis on the Phenomenon Being Investigated.

In this phase the researcher assessed the meaning units for their psychological significance. The meaning units which had no particular relevance to the experience under investigation were removed and the psychological insight expressed in the remaining meaning units brought to the fore (Giorgi, 1985: 17).

Also in this procedure, the meaning units or constituents were distilled through a process called ‘imaginative variation’ (Giorgi, 1895: 18) whereby the researcher imagined alternatives in order to delimit the set of experience that defines the phenomena under investigation. At this level of analysis the researcher provided a description which was neither universal because context related nor particular but general and enlightened by phenomenological common sense (Giorgi, 1985: 50).

4. “Synthesis of Transformed Meaning Units into a Consistent Statement of the Structure of the Experience.

In this process all the insights contained in the meaning units transformed in 3. were synthesised into a consistent description of the structure of the experience (Giorgi, 1985: 19).

One individual structural description was then produced for each participants before generating a general structural description. All the psychological meaning units were synthesised through an identification of the key elements or invariant properties in the experience being described (Langdridge, 2007: 90).

Finally the researcher presented the final general structural description representative of the essence of the therapist’s experience of working with a client who is reluctant to talk. Verbatim from the participants’ transcripts were used in order to illustrate the structure (Wertz, 1984)

In the following chapter the researcher will be looking at the findings.


Chapter 5: Findings

This chapter presents the findings in relation with the qualitative data as collected from the participants’ accounts of their experience of a client who is reluctant to talk.

In order to remain within the allocated word-count the researcher will only show the first twenty five meaning units as discriminated from S1’s original transcript. The rest of S1’s table of analysis, along with the full analysis in terms of discrimination of meaning units from the other participants can be found in appendix V.

Section two will then offer the specific description structure of S1’s experience. The specific descriptive structure for the remaining participants can be found in appendix VI.

Finally, in the last section the researcher will present the findings as a General Descriptive structure of the experience of working with a client who is reluctant to talk

Chapter 5.1: Meaning Units

All Constituents Present in S1’s Description

Constituents of Description Expressed More Directly in Terms Revelatory to a Client Being Reluctant to Talk

1. S1 provides therapy sessions within an eating disorder unit where patients are sent for treatment and so S1 feels it is a slightly unusual situation in that they don’t have a choice when it comes to therapy, and some of them are quite reluctant to talk.

priligy buy online canada 1. S1 feels that perhaps there is a correlation between those patients who are reluctant to talk and the fact that they haven’t got the choice in coming to therapy.

2. Some of them don’t know how to use the space so the silence in the session are actually quite a common feature and S1 thinks it can be interpreted in lost of different ways really.

2. S1 thinks some of the patients don’t know how to use the therapeutic space which often creates silences whose interpretations can vary.

3. S1 once had this very difficult patient in a sense to be with really because she clearly didn’t want to be; she did want to be in the hospital, she did want treatment and S1 always got that feeling, that impression that nothing she did was going to be right.

3. Even though S1 knew the patient wanted to be in therapy S1 always felt that nothing she did was going to be right.

4. The patient had a real animosity towards her father and it was never really clear why and there was a sense that she was withholding information about her relationship with him. S1 and her team weren’t really sure if there was some abuse, or what. The patient wouldn’t tell them.

4. S1 learns that the patient has a very hateful relationship towards her father, whose details she would purposefully keep secret from S1 and her team.

5. The first time that the patient was silent in the session was about 3 or 4 sessions in and S1 was asking about her relationship with her father. The patient was saying that she hated him. And it wasn’t quite clear why it was, that perhaps she could tell S1 more. And she suddenly became very withdrawn. S1 was left thinking “have I stumbled into something that is very painful… or.. or what really”

5. S1 felt that her attempting to explore something seemingly very painful resulted in the patient withdrawing into a prolonged silence.

6. As the therapy went on S1 got the sense that there was always something that the patient wasn’t telling her and her team. She almost needed to tantalize S1 and her team. It was almost a way of keeping her in their minds really. No matter what they said she wasn’t going to tell them. And it seems over the months, it seemed to sort of figure that it was her way of keeping in people’s mind. It was somehow “I am not going to let you in and therefore you will be wondering why” and that’s how she seemed to kind of keep people engaged.

6. The patient tantalizes S1 and her team by withholding the information they want so as to keep them thinking about her.

7. Other time the patient would be silent in the session because she seemed to be very angry because something had happened in the unit. She hadn’t been allowed to go out at the week end for example because she hadn’t put enough weigh so she would treat S1 as if it was all her fault that she couldn’t get to go out and so she wouldn’t really talk to S

7. When the patient’s needs were not met she would be blaming S1 and then sulk.

8. If S1 tried to find out what was going on the patient would say things like “the team hates me, what’s the point of talking? There is nothing that can be done about this. Noting is going to change.”

8. S1’s efforts to reach out to the patient are met with hopelessness and dismissal.

9. In another situation the patient just closed down practically for the whole session and S1 decided not to say anything to her. Later the patient told S1 that she really didn’t know what she was thinking or feeling at all. S1 got the sense that the patient was almost floating in a kind of pre-verbal world; the patient just couldn’t locate herself anywhere.

9. An unperturbed silence allowed S1 to sense that the patient was almost floating in a kind of pre-verbal world where thoughts and feelings were impossible to pin down.

10. S1 tried to get the patient to start labelling some of the things that were coming up for her. The patient got very angry and said “why didn’t you tell me to do that before? We are coming to the end of the admission; you could have told me this before…”

10. S1’s offers to help the patient formulate her thoughts and feelings turned into an opportunity for the patient to put her down and criticize her work.

11. The patient was once able to tell S1 that if she started eating, and started recovering, then there would be nothing, that nobody would understand what her pain was. So therefore there would be nothing to keep her in people’s mind.

11. If the client talked then there would be nothing for other to hold her in their mind.

12. Sometime S1 got this sense that the patient was like a kind of massive rock, stuck there, that whatever one did one couldn’t bulge this rock. The patient wanted to want, wanted to be like other people who want more from life but somehow she couldn’t want anything.

12. S1 feels impotent with her patient for whom it seems impossible to ‘want’.

13. For S1 it was almost as if the patient couldn’t initiate anything in her life and so was leaving the other to take responsibility for keeping her alive. The patient often said that she didn’t want to be alive, but she didn’t want to kill herself either. She didn’t want to take the initiative to kill herself but she actually saw little point in living. So the patient was leaving it to every body else to keep her alive. It was a handing in of one’s life.

13. S1 has the impression that her patient is completely passive and unwilling to take any kind of responsibility in her life.

14. In one particular session S1 realised part of herself was almost retaliating. She thought “ok… if you don’t want to talk, I wont talk either”. S1 had actually come to a complete dead end, and just didn’t know how else to get her to talk. S1 tried all sort of little things: observations, little prompts, but the patient wasn’t going to do or say anything. And so S1 was left at a complete loss.

14. S1 repeatedly sees all her efforts reduced to nothing. Feeling frustrated and at a complete loss S1 respond by also being silent.

15. For S1 it was actually very calm. She felt quite relaxed as she just let her mind wander and just see what came into her mind.

15. The silence is comfortable for S1 and it allows her to be open to what comes to her mind.

16. At the end of this session S1 asked the patient how was it for her. The patient replied that it had not been comfortable at all. S1 realized she was much more comfortable than her patient was in silence. The patient said “it’s not comfortable at all, but I don’t know what to say, and I don’t know what I am thinking or feeling”

16. S1 learns that in silence the patient was anxious, uncomfortable and unable to symbolise her feelings.

17. In the following session the patient did actually start talking quite a lot. S1 thinks the patient found it uncomfortable enough to actually decide to take some initiative in the session but that didn’t last.

17. The previous experience seemed to have invited the patient to react positively, only to return later to her previous mood.

18. The patient was communicating a great deal, but not with words. She was actually very articulate, a well spoken person and educated, so she had the words but somehow not for her emotional experience. She couldn’t really talk about that.

18. Even though the patient was articulated she could not use language in order to explore her feelings.

19. S1 feels as though her and her patient did have a relationship but it was a very difficult one. The patient did want therapy, even though she wanted to attack it. She wanted to attack it but she wanted S1 there so that she could attack her. So S1’s purpose was to be attacked and to survive the attack.

19. S1 felt her only role in this relationship was to be there and survive the repeated attacks from the patient.

20. The patient said to S1 right at the end that one of the reasons she found it so difficult to explore was because she was so afraid, she didn’t have any idea how long the admission was going to last, and it seemed to S1 as though she had a major kind of attachment problem. Because the patient thought it was going to end at any moments, she didn’t feel secure enough to be able to really work with it, to explore and she had to keep constantly sort of establish, sort of keep S1 there in a way.

20. S1 learns the patient did not wish to resolve her feelings as this would have meant becoming attached to S1 and therefore suffering her loss when the treatment ends.

21. S1 thinks that those patients want you to be able to use the space for them in a way and by actually not using the space it feels very withholding. S1 feels as though the therapist is withholding something, or attacking in some way.

21. S1 feels the patient wants her to use the therapeutic space and therefore it would be persecutory to leave the patient fend for herself in it.

22. When S1 is in the room it’s a case of trying to gage what is going on in terms of what’s happened before in the therapy, what you know about that patient really, to sort of gage whether you can let the silence be, or whether you need to intervene.

22. S1 is mindful of the context in which a silence takes place. Its ‘tone’ is an indication if she needs to intervene or not.

23. S1 thinks the anxiety of those patients is so great that they just can’t put it into words. S1 supposes that with most of these patients there is something very early about their experience and it’s almost as though it is a preverbal experience of not being held. And so it creates enormous anxiety, they feel uncontained in that silence so usually S1 feels like she has to start and create a sort of verbal structure for it in a way.

23. S1 thinks she needs to create some sort of verbal structure that can hold and contain an otherwise unboundaried and anxiety-provoking space for the patient.

24. With those particular patientsthey had a real problem with the symbolic language and so it’s really a case of talking about something much more concrete. For those patients who got very stuck in silence S1 has tried to introduce something outside of the room, so perhaps trying to get them to be talking a little bit about home life, or something then start using that in more symbolic ways. With no material there is very little to work with.

24. Those patients who find it difficult to talk about themselves seem hardly able to use language creatively. So S1 invites them to talk about more mundane topics which she then attempt to link symbolically.

25. Sometimes the silence can feel quite persecutory to S1 as well. One particular patient was very contemptuous and angry and seemed to expect that S1 had all the answers. S1 ended up being sort pulled into behaving into quite a clumsy way with her, saying or doing the wrong things and she made it very clear that S1 wasn’t much good to her.

25. S1 is put into the position of the expert and expected to have all the answers, which pushes S1 to show her limitations in clumsy ways. The patient then uses this as an opportunity to put S1 down.

Chapter 5.2: S1’s Specific Descriptive Structure

In order to remain within the word limit only the specific descriptive structure of S1 will be presented in this section.

S1 feels that perhaps there is a correlation between those patients who are reluctant to talk and the fact that they haven’t been given the choice of coming to therapy. For her, some patients don’t seem to know how to use the therapeutic space which often creates silences whose interpretations can vary. One patient did express a wish to be in therapy, but seemed to have needed to use it so as to regularly make S1 feel as if nothing she did would ever going to be right. Once, an attempt at exploring a particularly painful issue saw the patient withdraw abruptly into what until the end of her admission became a mysterious retreat. This episode left everyone in the hospital forever wondering about her and what had happened. It was almost as if the patient could only relate to others by keeping them forever guessing and wondering. If she ever talked, the client once admitted, then there would either be nothing for others to hold her into their minds or she would become attached and later suffer a great loss when her treatment ends.

If her needs and wants could not be met the client would blame S1 and verbally cut herself off from her. S1’s repeated attempts to reach out to the patient would invariably be met with hopelessness and dismissal, further attacks and critics of her work. Sometimes and for no particular reasons S1 would just be left in silence and feeling attacked, anxious, powerless, clueless and deskilled. For S1 it was as if in this silent withdrawal the patient was floating in a kind of pre-verbal world where thoughts and feelings would be impossible to grasp. At other times the patient would put S1 in the position of an expert and expect to receive all the answers, which ultimately pushed S1 to show her limitations in clumsy ways and provided the patient with yet another opportunity to put her down.

Eventually S1 would end up feeling very frustrated and at a complete loss. She once decided to share her feelings about the relationship with her client, and things somehow improved slightly, if only for a little while before they got back to before. In retrospect, S1 believes the only role she had in this relationship was to take in and survive the repeated attacks from her patient.

Exasperated, S1 once decided to stay in silence which she actually found comfortable and creative. For the patient however, this experience had made her anxious, uncomfortable and confused. If this difficult experience seemed to have pushed the patient to talk more in the next session, S1 admits that it didn’t seem to have changed her at all.

Disempowered, S1 felt there was nothing that she could do to influence her patient for whom somehow it seemed impossible to ‘want’. Even though this patient was articulate she could not seem able to use language creatively in order to explore her feelings; the patient would remain passive and unwilling to take any kind of responsibility for her life. In those circumstances, S1 admits that she feels disappointed with herself that she cannot give anything back to the patients. If S1 learned that she could rely on her thoughts and feelings in her work, she also found out that she could not necessarily make use of interpretations. So at times she invites the patient to talk about more mundane topics which she then attempts to link symbolically. However, it seems that talking about concrete things has no real therapeutic value and simply amounts to filling up an empty space.

S1 is mindful of the context in which a silence takes place. Its ‘tone’ is an indication if she needs to intervene or not. She claims her role is to help patients use the therapeutic space by creating some sort of verbal structure that can hold and contain an otherwise un-boundaried and anxiety-provoking therapeutic experience. For S1 it would be persecutory to leave the patient fend for herself in the therapeutic space.

On the contrary, with another patient, S1 felt comfortable in the silence. She would let her mind free and communicate her passing thoughts to the patient who in turn seemed somehow able to accept her in her world and respond creatively. This patient seemed more able to use language symbolically and let S1 sense and provide the motherly presence and permission to feel which, it seemed, she had never really been given before. In retrospect, S1 thinks their relationship was secure enough to let the patient come closer and use the therapeutic space creatively while sharing feelings and ideas openly.

With those patients who feels lost in particular, S1 finds herself completely at a loss and empty. For some patients the silence reminds her of death. In those moments there aren’t even feelings or thoughts, but only a void. With another patient, S1 had this really uncomfortable feeling that she couldn’t help but be pulled into rescuing her from some anxiety of separation evoked in the silence. S1 felt as if she was literally glued to her.

Even though sometimes it is really difficult to keep, hope is for S1 a crucial element in her work. She believes that if the patient can see the therapist survive what goes on in their silences then this can be powerfully therapeutic.

Chapter 5.3: General Descriptive Structure

Four main themes were identified by the researcher in the general descriptive structure:

  1. Positive feelings evoked in the participant

  2. Negative feelings evoked in the participant

  3. Feelings evoked in the therapist for their clients

  4. Participants’ learning experience

As advocated by Wertz (1984) the invariant meanings will be illustrated whenever necessary by what the researcher thought were the most representative extracts from all the transcripts produced during the research interviews.

Chapter 5.3.1: Positive Feeling Evoked in Participant

The impression that the therapeutic space was being used creatively in the silence was verified by the participants experiencing the following feeling:

– Taking time

The client was felt to be reflecting on what had just been talked about and seemed to be processing some insight. In this silence there is a sense that a form of learning is happening for the client who is considering what has just been brought to light in the session. This moment is almost representative of some change in action and transports a clear and definite impact and therefore time is necessary for the client who turns himself internally in a need for privacy. As S3 noted “I think silence is very useful. I think it’s very valuable. I think sometimes when awareness comes out it needs some stillness to realise what’s just come to our mind, what we are feeling in our body. We have to come to terms with what has just revealed”.


The participant somehow feels confident that he can make use of the on-going silence as a therapeutic tool of exploration for the client’s experience. This moment is felt as an opportunity to help the client at this point in time specifically; it is used as a space for the client to make his first steps into a new phase of understanding about himself. In a silent union with the client the participant feels they are together while facing the unknown. As S7 puts it “But above all of that I always had a sense that it was the client’s choice not to say anything for a moment”.

An empowering trans-personal space

This type of silence is felt as a shared experience whose positive energy leaves both client and participant changed positively. The moment is almost felt as if something inexplicable and almost religious is unfolding in the room. As S3 reports “I don’t know if it is a spiritual thing or may be some sort of trans-personal thing; but it can be very empowering”.

An opportunity for the client to ‘exist’

The client feels he only needs to ‘be’ in a reassuring and non-demanding but secure and respectful presence of an Other. In this silence the participant feels he is perceived by the client as being-there but detached, observing but not controlling. As S1 noted: “With this patient the experience was more of needing to be next to a young child. It was an experience of being with a sick child who just wanted a presence, who didn’t necessarily wanted me to give her anything but just a presence, just a sort of containing presence […] I think she was actually quite pleased to be given permission; to start feeling and thinking about feelings as well.”

Chapter 5.3.2: Negative Feelings Evoked in Participant

When the client is reluctant to talk the following negative feelings may be evoked in the therapist:

– Stuck and at a loss

The participant is confronted with a silence whose tone leaves him not knowing how to engage with the client anymore. At this point nothing seems to really work in order to reach the client and the participant has the feeling of having ran out of ideas. This situation may baffle the participant may to the point of him wondering what the client is effectively getting out of therapy.

If not literally empty of words, the client’s discourse comes across as peculiarly abstract, controlled or disembodied, without life or meanings – its only purpose being to fill up some space. As S5 puts it:“The feeling of frustration doesn’t quite capture it but it think it is more like feeling incredibly stuck”.

– Cut off, rejected and not allowed to create a rapport

The participant feels as if being kept at a distance, if not completely dismissed from the therapeutic relationship altogether as the client is not even offering an opportunity for exploration. The client simply doesn’t want to be involved in the relation, or have anything to do with the therapist at that moment. As S1 recalls: “Sometimes the patient would just sit there with an angry expression on her face, very very drawn and I was just left feeling ‘what have I done?’”

– Deskilled and made impotent

Either left in silence, bluntly or more subtly, the participant is reminded of his obvious failures to be a competent therapist as the client is antagonizing and sabotaging the participant’s efforts. For example S1 would be left thinking to herself “I am a hopeless therapist; I haven’t got a clue what to do with this person” or, as S6 would recall “she would tell that basically you are shit but in the nicest possible way during the course of the session”.

– Controlled and tantalized

The client behaves in such a way that the participant is forced to think about her in between sessions. For the most part this device seemed to be implemented by for example withholding information, or getting in touch with the therapist outside

sessions. As S2 said “The client once sent me an email right before my four week’s holiday saying that it was our last session because I would probably not want to carry on working with her. I replied it was certainly not going to be our last session”.

– Denied as an individual

Here the therapist is left feeling he is being used as an object, a container for sanitary needs, or even as an ‘extension’ of the client. As S2 would recall: “It feel like the client can’t wait to get out of the room. She seems kind of guilty, almost like she’s kind of chat in the room and quickly got off before I could say ‘hang on minute; look at this mess you left in this room’” or as S5 said “I feel there was no space, the client wasn’t giving me the space to be in that relationship with her as a person”.

– Assigned the position of the responsible expert

The therapists is cast into the role of an expert and handled the responsibility for the client’s therapy or even life. As S6 saw it “the client was constantly expecting me to answer her questions. I recall that every single session for the first two years would end with the client getting up and saying “what should I do? Tell me what to do.” For S1 “it was almost as if the patient couldn’t initiate anything in her life and so was leaving the other to take responsibility for keeping her alive”.

Attacked and punished

The findings show that most participants felt at some point or another attacked and punished by a client who came across as particularly persecutory in the relationship. As S1 puts it “I feel as though I and my patient did have a relationship but it was a very difficult one. The patient did want therapy, even though she wanted to attack it. She wanted to attack it but she wanted me there so that she could attack me. So my purpose was to be attacked and to survive the attack”.

Chapter 5.3.3: Feelings Evoked in the Therapist for their Clients

The analysis of the experience under investigation also uncovered feelings in the therapists about their clients. The present findings seem to suggest that in most cases the clients who were reluctant to talk appeared to their therapists as if they were:


Most participants felt their clients’ attitude was reflecting a huge amount of anger and rage. As S2 would put it “I realise that I have to know how to survive over a long period of time when faced with someone who is very angry”.

A dead and an empty ‘object’

The client is in the room but somehow life seems to have escaped from him. In its place is left a gap, an empty void reminiscing of death itself. As S7 puts it “When the client was quiet he would almost become an object rather than a subject… I could make whatever I wanted of him rather than to ask him to relate”. For S2 “When things are bad I can feel a kind of sleepiness, just like a closing-down. It’s almost like if the energy has been sucked out of the room and I find myself struggling with that emptiness. It is a very odd feeling to be in the room but not be there”.

Unable to symbolize

The participants feel that their clients seem to find it particularly problematic to use language in an effort to transform feelings into words. As if the client hadn’t had the time yet to learn how to inject their words with feelings, there is an impression that something in their clients is somehow very ‘early’ about their experience. As S1 puts it her client seemed somehow like “floating in a kind of preverbal world where feelings were impossible to grasp and symbolise”.

Anxious to lose

In this instance the therapist felt that their clients were concerned with being abandoned and left behind. As S1 would recall The patient said to me right at the end that one of the reasons she found it so difficult to explore was because she was so afraid, she didn’t have any idea how long the admission was going to last, and it seemed to me as though she had a major kind of attachment problem”.

The client seems uncannily aware of the situation with them and between them and their therapists, yet any kind of therapeutic change seemed hopeless and unattainable. As S5 puts it “When I point things out to her or make a reflection, or an interpretation, it is not that it just doesn’t sink in; the client is reluctant to take it in. I have this image of her spitting it out and when I remark this out to her there is a pause where the client gives this impression of examining it, and chucks it away”.

Finding it enormously difficult to change

The client seems uncannily aware of the situation with them and between them and their therapists, yet any kind of therapeutic change seemed hopeless and unattainable. As S5 puts it “When I point things out to her or make a reflection, or an interpretation, it is not that it just doesn’t sink in; the client is reluctant to take it in. I have this image of her spitting it out and when I remark this out to her there is a pause where the client gives this impression of examining it, and chucks it away”.

Chapter 5.3.4: Participants’ learning experience

Participants have benefited from the experience and felt themselves to have developed in the following area:

– Reflexivity

Participants found themselves reflecting more on their potential contribution in their clients being reluctant to talk. As S2 would put it “I reflected on myself being so formulaic and realised it was very difficult for me to feel empathy and compassion towards someone who would sit there for 6 months not really reciprocating my efforts”.


Following on a certain amount of self-reflection about their own attitudes and sometimes negative reactions most participants felt to have subsequently become more accepting of their client’s reluctance to talk, and of their individualities as a person. As S2 says “it made me start to connect with his client again and not see her as this really “oh my God what’s happening” but thinking that this is who she is and on this basis try to connect with her more humanly.”

Use of internal feelings to guide themselves in the unknown

In those instances the participants attuned themselves with added sensitivity to their own feelings in order to ‘sense’ the silence and decide to let the client ‘be’ or intervene and explore what it was that was being expressed in the room. As S1 puts it “I am picking up my own feelings, my own counter-transference of what the silence might be about.”

Remaining true and resist colluding

Silence triggers an anxiety-provoking state of not knowing in which it is easy to ‘act out’, especially after being relentlessly attacked and persecuted. As S4 showed “In the past I tried the ‘scaring each other out’ approach which is that if the client is quiet then I will be quiet in return. I wonder if at the time I wasn’t somehow engaged in some fight, some kind of challenge between me and my client”.

Some participants, especially the less experienced ones, admitted being drawn, willingly or unwillingly, into trying to ‘incarnate’ what they had learned from school resulting in a contrived and inauthentic approach. As S2 said “I think I need to learn to show more of my vulnerability as I am not that kind of “all knowing person” the client has for fantasy. I need to learn how to live with this kind of unknowing. My vulnerability around that has been a key message”.

Awareness of a need to survive and keeping faith

The findings suggest that in those intense situations a key element in therapy is the ability to survive the client while holding on to a sense of hope. As S1 admitted rather poignantly at the end of her interview “I suppose I have to carry a lot of hope. For some of those patients they have given up life and sometimes it is very difficult for me not to give up as well. I have to try to keep that hope alive”.

The following chapter will examine those findings in the light of the reviewed literature.


Chapter 6: Discussion

In the first section the researcher will be exploring the findings in the light of the literature in an effort to further illuminate the insights contained in them. Surprisingly enough, it was found that very few research papers have been written explicitly about clients who are reluctant to talk in therapy therefore the researcher has at times resorted to comparing the findings with more classic points of reference.

In the following section the researcher will demonstrate that this study has been conducted in a conscious and reflective manner by engaging in a disciplinary reflexivity (Wilkinson, 1988) through a critical debate in the context of theory and method.

Gough (2003) identified the dangers inherent to an epistemological reality of research which may invite the researcher to claim some objective truth. The researcher will therefore also engage in an epistemic reflexivity (White, 1997) which will see the researcher adopts a critical stance towards the discourse of scientific research itself.

Finally This chapter will conclude with the researcher offering recommendations with regard to future research.

Chapter 6.1: Findings in the Light of Literature

The findings suggest that clients who are being reluctant to talk may be indicating to their therapists that the therapeutic space is being used in two quite different manners. Participants felt that the silences from their clients were either taking place in the context of a harmonious and cooperating alliance, or on the contrary seemed to part of an attitude which at times put tremendous pressure on the therapeutic relationship and the therapist himself. Still, the findings suggest that most of the time the silence left the participants in a place of not-knowing which felt particularly sensitive.

One may look at those findings in the light of Zeligs (1961) who claimed that silences are over-determined phenomena in terms of the contrast in emotional states that the client finds himself in at the time. If silences may be representatives of a wide range of emotions, according to him, they are ‘guarantee’ of a profound emotional state happening in the client. One wonders if this intense emotional state is not perhaps reflected in a therapist who can only witness without knowing how it is for the client at this particular time.

The findings also suggest that in those silent moments it was difficult for the participants to know whether to intervene or let the moment unfold by itself and see what was coming next. The participants reported that those instants could be quite anxiety provoking and forcing them to look hard into themselves in case they could misread the situation. In a similar vein Coltart (1993) noted that comparable situations had presented her with “special challenges” (p 79) as to whether the client needed the therapist to accompany him in the silence or intervene. Indeed it seems that those moments are quite crucial and consequential for the client and in their study on impasses Leiper and Kent (2001) stress that a better education in `not knowing’ would help therapists deal with such experiences more constructively.

Even though the participants didn’t know what was being enacted in some silences, at the time those were somehow sensed to be more secure, positive or on the verge of heralding something meaningful for the client. In this particular context the participants reported a general feeling that their clients were cooperating and being creative in the therapeutic process. Thus, sensing that something important was being addressed in the silence the participants decided not to interrupt but let their clients ‘be’.

If in this instance the findings suggest that those silences felt more ‘productive’ it doesn’t necessarily mean that there were no feelings of anxiety around for the participants – they chose to take a ‘risk’ and waited in faith of their own senses that something positive for the client was being formulated.

The researcher suggests that this finding may be seen in the light of the research written by Levitt (2002) who found that some silences could be regarded as insight-facilitating pauses and therefore crucial therapeutic moments for the client. In this particular context the author claims that the client might be in the process of deriving some significant meanings from his experience and associated feelings. In the same vein Winnicott (1982) and Bollas (1987) argue that in those specific moments the therapist should not intervene but offer the necessary mental space for the client to re-organise his private and internal development.

Positive feelings evoked in the silence were also reported by participants to be sometimes related with something seemingly very ‘early’ in the relationship. The findings suggest that in this instance the client appeared in some way very young whilst conveying at the same time that there was no need for the therapist to intervene, especially not for telling him what to do. The experience is one where all that is required by the client is a simple, empathic understanding and non-demanding presence from the therapist. Those findings seem indeed to illuminate Balint’s idea of ‘primary love’ (Balint, 1968: 65) whereby “the aim of all human striving is to establish – or, probably, to re-establish – an all embracing harmony with one’s environment, to be able to love in peace”.

One participant reported having experienced the silence of her client as an “empowering trans-personal space” whereby both participants in therapy were joined ‘together’ in an almost spiritual place while sharing something which significantly transformed their experience of each other and in a positive manner. With regard to this feeling, the researcher is not entirely sure what was exactly meant by this. No comparisons in relation to any existing research could effectively be made a this point in time. Any elaboration on this particular piece of data from the participant would require an exercise of interpretation and invites the researcher to go beyond the chosen methodology for this research.

At its most ‘virulent’ expression the findings showed that the therapists felt, amongst other things, cut off, rejected, deskilled and controlled. In those instances the therapeutic relationship would evoke in the participants feelings ranging from being ‘stuck’ to hostility from the client. When this was the case the participants described their jobs as ‘particularly difficult’ or ‘hard work’.

Under such intensity of feelings most participants reported having found themselves colluding with their clients or responding in some forms of retaliation. The range of response would vary from being silent in return, to wishing their clients would not come back. This perhaps links in with Leiper and Kent (2001: 81) who in their work on impases refer it as ‘malignant alienation’ the situation whereby the therapist becomes cold and avoid contact with the client while venting their frustration in latent ways. The danger, they claim, is that in those instances the therapist might be colluding with the client’s hopelessness and ultimately contribute to a breakdown in the therapeutic relationship when in fact, as Lacan had also suggested earlier (Fink, 2007), the problem implies that the therapist is also involved.

Along with perceived feelings of deadness or emptiness, as if dissociated from the living world and others, therapists also reported feelings that some clients were somehow unable to symbolise and verbalise their feelings and experience. It may feel as if the client is ‘floating’ in a kind of pre-verbal world and unable to anchor himself into words. This experience rings true of a vivid description offered by Rigas where in a similar situation he felt as if the client’s self “could not be affected by the therapist’s words” Rigas (2008: 42).

Perhaps it is useful to consider those findings in the light of Balint (1993) whose observations of similar situations seemed to have showed that human development is characterised by a clear separation between the ‘pre-verbal period’, where the infant is not yet able to use words in order to objectify his environment, and the following phase where the infant is finally able to use language (p 32). Indeed, in line with this theory all participants sensed that effectively something seemed ‘very early’ about their clients in those situations, especially when they acted out. Finally, depending on where the client is situated in relation to those phases in life, Balint notes, the therapist might be required to become quite flexible in his approach (Balint, 1992).

It is also suggested that when finding themselves in a situation where a client is reluctant to talk the participants use their feelings extensively as a guide to sense whether to intervene or not. This approach seems particularly well reflected by Coltart who speaks of the internal feelings of the therapist, which he refers to as ‘counter-transference’, as being “the instruments par excellence of the work” (Coltart, 2003: 86) – the therapist listens and observes not only the reactions of his client; he is also attentive to his own reactions as well. This finding seems also in line with the work by Mearns and Cooper (2005) which stipulates that the client’s internal space may be approached phenomenologically in that the therapist should sense where the client is while presenting oneself in an authentic manner. Finally, the notion of ‘contact rhythm’ by Kreitemeyer & Prouty (2003) may help capture the idea suggested in the findings whereby in those moments the therapist is ‘tuning in’ or ‘calibrating’ himself in order to achieve a deep relational contact with the client.

Chapter 6.2: Disciplinary and Epistemic Reflections on the Research

As seen in chapter 3 the researcher decided to remain ‘in line’ with the Husserlian approach to phenomenology by adopting the qualitative method devised by Giorgi (1985) which agrees with Merleau-Ponty’s philosophical views of the human body as the first medium of contact with the world and therefore a primary source of knowledge.

As demonstrated in the same chapter it was argued that Merleau-Ponty’s epistemological inclination was the most appropriate in that it didn’t just take into consideration the philosophical concerns which had been raised in relation with Husserl’s early convictions that the phenomenologist could adopt a ‘God’s eye view’ and step outside intentionality to claim some indisputable truth about a phenomena, it also claimed that individuals are above all immersed into the social world before reflecting on it through language (Langdridge, 2007). Since Merleau-Ponty’s phenomenological approach is ‘sensitive’ to what remains outside language it seemed particularly adapted for an investigation of the therapist’s experience of a client who was reluctant to talk.

All along this study the researcher kept a journal where he wrote down any relevant insights.

As seen in the chapter on methodology the empirical phenomenological approach is based on the condition that the enquirer avoids adopting the natural attitude of trying to explain and interfere rationally with what emerges in the experience under examination. Following on this principle the researcher approached the interviewing process with the specific intention of only asking the participants to describe their experience of working with a client who was reluctant to talk.

It is claimed that the interviewing process conducted in this research has been an opportunity for the researcher to appreciate the extent to which the results it generates depend on the rapport between him and the participant.

For a start the researcher did effectively catch himself wanting to hear only certain aspects of the experience under investigation whilst wishing that the emerging data would safely fit within his own idea of how the findings should look like, as opposed to let the participant shape them. As those feelings were recognised and bracketed off the researcher subsequently became aware of a desire to engage the participant and discuss his experience in the light of his own. Even though the researcher did not intervene in any way except in paraphrasing or repeating the question when the participant seemed in need of support, this experience left him wondering how much the participants were responding to the researcher’s wishes to somehow receive his own answers.

Lacan (2006) claims that the Subject is developed in the discourse of the Other. According to him one is the product of desire (or no-desire) whose alluring content is conveyed through language and starting with the mother assigning meanings to the infant’s early survival needs. Lacan also writes that ‘desire is the desire of the Other’ (p 312). In other words man desires what the Other desires, and in a similar manner (Fink, 1996: 54). In the context of the interviews conducted in this research Lacan implies that on some level the participants were responding to the researcher’s needs and desires.

In the same vein and in the light of the implications of Freud’s discovery on the unconscious (Freud, 1915) many questions followed such as: how representative were the data in relation to the actual experience? How and what has the researcher helped construct as part of the account being offered? From a phenomenological perspective Spinelli (1989) argues that past experiences are reviewed in the light of the present.

To what extent then has the interviewer influenced the memory of the actual experience as lived from the participant? Freud (1915: 194) once wrote that “It is a very remarkable thing that the Ucs. of one human being can react upon that of another, without passing through the Cs”. If this is so then what was the unconscious dialogue being held during the interview between the researcher and the participant? Would another interview with the same participant at the same place yield the same set of data? Would the participant report the same experience if he had a different rapport with the interviewer? All those questions do not even take into consideration what the participant and interviewer brought of his own life into the interviews.

For those reasons the researcher’s realises that the idea of collecting ‘unbiased’ data in an interview as part of qualitative research is unattainable.

When eventually something seemingly new appeared to have emerged from the findings, as for example when S4 referred to her experience of silence as “an empowering trans-personal space”, the researcher found himself unsure as to what the participant exactly meant by this remark. Since the literature had not identified this particular aspect of the phenomena, the researcher’s first reaction was to consider this information as somehow redundant – it felt ‘risky’ to legitimise this new aspect of the phenomena in case its meaning would be questioned and discredit the validity of the research findings. As Heidegger ([1927] 1962: 43) once wrote

“Dasein simultaneously falls prey to the tradition of which it has more or less explicitly taken hold. This tradition keeps it from providing its own guidance, whether in inquiring or in choosing […] When tradition thus becomes master, it does so in such a way that what it ‘transmits’ is made so inaccessible, proximally and for the most part, that it rather becomes concealed”.

In the light of the fact that this particular meaning might not correspond to a description but to an interpretation led the researcher to wonder if the method being employed wasn’t limited in some significant respects. It seemed that restricting oneself to a pure ‘descriptive’ approach of a phenomena was limiting the depth of investigation that could potentially be reached should the experience be grasped in the light of, or from a particular context. In order to better understand the participant’s reference of an ’empowering trans-personal space’ the researcher would have needed to be allowed to relate and interpret from a similar experience. Indeed a major critique of the empirical phenomenological approach is reflected in the idea that it can be restrictively too descriptive (Langdridge, 2007: 158).

This experience has made the researcher aware of the extent to which the existing knowledge may be suffocating new knowledge while ‘forcing’ the inexperienced researcher to disregard the unconventional and different in order to have his study safely conformed, accepted and legitimised by, in this particular context, the academic authorities. Conversely, the researcher was made aware on how the scientifically legitimised findings in this research may in turn be ‘asphyxiating’ any potential knowledge not yet identified outside of it.

In the same vein it is also the researcher’s view that, paradoxically, qualitative researching may be regarded as a positivistic approach based on modernist assumptions. To begin with, qualitative interviewing expects participants to be approached and systematically asked to recall and describe their experience in relation to a precise phenomena. Recorded and then analysed, the data changes from being fluid and contextual to dissected into distinct units whose subjective weight will decide on their eligibility for further reduction in the light of the general. A subjective ‘average’ is then applied to all similarly processed entities in order to produce a result in the shape of some unambiguous findings ready for publication.

Viewed in this light the researcher contends that an element of control and power can be detected in methodology in general. It is argued that this phenomena was effectively identified by Foucault (1991) who in his work isolated and analysed the structures of the human sciences as discursive systems in the service of ideological power (Burr, 2003).

The language that this small-scale research unavoidably needs in order to convey its message is unstable, persistently slippery and ambiguous (Sarup, 1993). As Scheurich (1995: 240) quotes Berman as saying

“Language wherever used is composed of structured signifiers, systematized among themselves by differences or oppositions and linked to signifieds in a way more tenuous than even Saussure realized”.

Meanings constantly move and slip along a chain of signifiers, never to be fixed permanently – inherent to language is a fundamental indeterminateness of meaning and communication (Sarup, 1993). When a word takes on a certain sense it happens within a specific sentence whose meaning is attached to a particular context and history. In the same vein the contents in the data collected as part of this research interview are taken to be a unique function of a number of un-verifiable factors since they were dependent on a certain point in time.

In the light of the above it is therefore claimed that the primary aim of this study is to provide only a perspective on a particular phenomena, a reference to be bracketed off when being confronted with what appears to be a similar circumstance in therapy.

In the same vein the researcher wonders about any systematic thinking that this research project might be inviting for. In the context of this research a study on the therapist’s experience of a client who is reluctant to talk has yielded some findings and so in the process intrinsically created a link between a phenomena and its meaning(s). Even though it was made explicitly clear in the findings that the therapist is to some extent responsible for their clients’ reluctance to talk the researcher is also aware that some derivative associations might incite potential readers, or psychotherapists as the case may be, to use this research in order to justify any distressing feelings emerging in a similar situation and conclude conveniently that those are evoked clearly ‘because’ the client is reluctant to talk. Following on the ideas in relation to power as developed by Foucault (Sarup, 1993) it is possible that one may look at this piece of research and use it as a tool to manipulate and define others. In this instance, the philosopher claims, there is a danger that knowledge ceases to be liberating and becomes instead “a mode of surveillance, regulation and discipline” (Foucault cited in Sarup, 1993: 59).

However, it is equally true that as the researcher actually experienced it himself in his own practice, this research may also help therapists create possibilities. It has been the researcher’s experience that conducting a phenomenological investigation on therapists’ experience of a client who is reluctant to talk has provided him with an added ability to contain and understand his own anxiety in relation to this situation. As described at the beginning of this project the research question was originally inspired by one of the researcher’s clients who used to regularly come, sit and remain silent. Our work together has run in parallel with this research, and in accordance with it the researcher noticed a meaningful change in the therapeutic relationship.

In his role as a therapist the researcher can easily identify some important implications from aspects visited in this research. For example the concepts of the ‘hermeneutic circle’ and ‘fusion of horizons’ have been significant to better understand and in a way better empathise with the experience of the client as conveyed though the meanings in her narrative. This has allowed the therapist-researcher to develop an added trust in his own senses when facing the unknown which is, as explored earlier, a situation most especially met when a client is reluctant to talk. Instead of deliberately bracketing off any thoughts and feelings which may occur at one moment in therapy the researcher is now more inclined to examine them in the light of the context offered by the client.

In any event the various ways with whith this piece of research can be used suggests that it can open as many possibilities as it can close.

Chapter 6.3: Future Research

First of all this research was conducted using seven participants and the researcher. The findings suggested here are only representative of the experience as lived by those individuals only and therefore an improvement on the research could include a greater sample.

In the course of this research it was realised that for all intents and purposes Giorgi’s method is limited in that it cannot preserve the participants’ silent and unconscious communication. As Finlay (2006) also saw it, there seems to be a definite absence of the body in much phenomenological research.

While recounting their experience some participants effectively became quite emotional and seemed to convey a lot of information through their facial expressions and body postures. Perhaps as an improvement inspired from the method of discourse analysis which records the breaks in the participant’s speech, the empirical phenomenological approach could be adapted to somehow record and code the interviewee’s body language. This added dimension, it is suggested, would serve a greater depth in the research and further illuminate the phenomena being studied.

Finally the researcher is well aware of his biases towards choosing exclusively a purely qualitative approach, and therefore wonders to what extent qualitative research could benefit from ideas and concept coming from a quantitative approach. As Onwuegbuzie and Leech (2005) demonstrated, a polarization on one research methods promotes purists and researchers who restrict themselves in their approach. A form of indoctrination which states that qualitative methods are incompatible with quantitative research (Howe, 1988) indeed reminds the researcher of the dynamics of power discovered by Foucault (1991) in order to control its subjects.

Could there be a means to incorporate what quantitative methods has best to offer into a phenomenological approach? Onwuegbuzie and Leech (2005: 380) quotes Ryan and Bernard as stating that

“the value of turning qualitative data into quantitative data is ‘abundantly clear’: Doing so can produce information that engenders deeper interpretations of the meanings in the original corpus of qualitative data.”

In turn Sarup (1993: 136) refers to the post-modernist writer and philosopher Lyotard as claiming that “Both science and non-scientific (narrative knowledge) are equally necessary”. Without entering into unnecessary methodological details in the context of this section it seems that a regard for such a possibility would be in line, if not expected, with the kind of openness as the one underlying the very philosophical basis of this research.

Chapter 6.4: Conclusion

First of all this research was conducted using seven participants and the researcher. The findings suggested here are only representative of the experience as lived by those individuals only and therefore an improvement on the research could include a greater sample.

In the course of this research it was realised that for all intents and purposes Giorgi’s method is limited in that it cannot preserve the participants’ silent and unconscious communication. As Finlay (2006) also saw it, there seems to be a definite absence of the body in much phenomenological research.

While recounting their experience some participants effectively became quite emotional and seemed to convey a lot of information through their facial expressions and body postures. Perhaps as an improvement inspired from the method of discourse analysis which records the breaks in the participant’s speech, the empirical phenomenological approach could be adapted to somehow record and code the interviewee’s body language. This added dimension, it is suggested, would serve a greater depth in the research and further illuminate the phenomena being studied.

Finally the researcher is well aware of his biases towards choosing exclusively a purely qualitative approach, and therefore wonders to what extent qualitative research could benefit from ideas and concept coming from a quantitative approach. As Onwuegbuzie and Leech (2005) demonstrated, a polarization on one research methods promotes purists and researchers who restrict themselves in their approach. A form of indoctrination which states that qualitative methods are incompatible with quantitative research (Howe, 1988) indeed reminds the researcher of the dynamics of power discovered by Foucault (1991) in order to control its subjects.

Could there be a means to incorporate what quantitative methods has best to offer into a phenomenological approach? Onwuegbuzie and Leech (2005: 380) quotes Ryan and Bernard as stating that

“the value of turning qualitative data into quantitative data is ‘abundantly clear’: Doing so can produce information that engenders deeper interpretations of the meanings in the original corpus of qualitative data.”

In turn Sarup (1993: 136) refers to the post-modernist writer and philosopher Lyotard as claiming that “Both science and non-scientific (narrative knowledge) are equally necessary”. Without entering into unnecessary methodological details in the context of this section it seems that a regard for such a possibility would be in line, if not expected, with the kind of openness as the one underlying the very philosophical basis of this research.

Psychoanalytic Psychotherapy English French



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