Obstructive silence in work with adolescents: a phenomenological study of psychotherapists’ experiences

Abstract

Previously, three broad categories of silences in therapy contexts were identified: productive, neutral, and obstructive. Empirical studies have shown that obstructive silence is the most common type of silence in adolescent psychotherapy. The present study focused on obstructive silence, aiming to understand psychotherapists’ subjective experiences of such stoppages in the therapeutic process specifically in work with adolescents. Interviews with eight psychodynamically oriented psychotherapists were analyzed using Interpretive Phenomenological Analysis. Six core facets of the phenomenon of obstructive silence emerged. Coming in touch with unconnectedness described the therapists’ understanding of the emergence of obstructive silence, how it was experienced in themselves and in relation to the adolescent patient. Obstructive silence was not experienced as static but as fluctuating between and within therapy sessions. Therapists’ emotional reactions and inner dilemmas in the form of unwanted negative emotions, losing oneself as a therapist, and trying to make sense of what was occurring could be experienced separately, simultaneously or after each other. How the therapists experienced the situation could influence their attempts to reestablish a connection with the adolescent. This process could work in direct association with the understanding of the situation or in interaction with other facets. Attempts to reclaim connectedness could enable paths where the therapeutic process could be resumed or lead back to unconnectedness. The most painful facet of obstructive silence was when the therapists experienced the emotional duality of oscillating between being connected and being unconnected, both with the patients and themselves. In conclusion, obstructive silence was experienced as a multifaceted phenomenon with different origins, functions, and challenges that affected the therapist, the adolescent, and the therapeutic process.