The Power Of Silence

In 1932, my paternal Grandmother-Of-Blessed-Memory bought the house where my father and aunt – and eventually my brother and I — grew up.  Until her passing while I was in medical school, she was the undisputed queen of the castle.

As a stereo-typical Jewish Mother, she was in constant competition with my mother in the kitchen.  My mother always tried to act pleasantly, but between her father driving in from two hours to the west and arriving at 6 am on Sundays to tell her she was too fat, and my father’s mother besting her in the kitchen, she was generally miserable and had little ability to hide her misery from me.

My father did not show my mother any affection where I could see.

My mother never fought with my father; indeed, she prided herself on that.  But sometimes he would say things that did not seem kind or loving.

Like the first time I can remember, when I was three or four, he basically told her not to bother trying to cook, and that he would take my grandmother’s food, and she could restrict herself to cooking for and taking care of my boisterous little baby brother.

My mother was devastated, clearly fighting tears.

I hardly expected her to be comforted by anything my grandmother could say, but she was, and mightily.

After my father left the room, my grandmother said “Af alle narishkeit daft’men nisht anferen.”

This means, quite simply, that it is not necessary to answer all foolish utterances.

Father’s big sister, Sadie — my Aunt-Of-Blessed-Memory — told me shortly before she passed that we were all living off the wisdom of my grandmother.

My grandmother — my Bobie-Of-Blessed-Memory — never told me enough about her childhood in the Ukraine for me to understand where her wisdom came from.

She grew up in the village of Linke near Kiev, in the days when nobody would dream of educating a woman.  But she often came up with brilliant aphorisms that would make me she was the Jewish channeller of George Bernard Shaw.

But that single Yiddish sentence I first heard over the kitchen stove has reverberated in my brain in a variety of levels of relationships, and has served me like a priceless tool.

My Father-Of-Blessed-Memory, on the other hand, used silence in a very different way.  I remember distinctly how he would stop talking for two or three days, for no reason I could determine.  Daddy was acknowledged by the household as brilliant and hard-working, a stable and stellar provider, who magically wrote musical notes on very special music paper (his only expense) and played the big pipe organ at Synagogue.  This was very important because it brought in checks and when he went into public school teaching there were bigger ones.  Yet I was imbued with a fear of spending too much money and running out. That a fear remains imprinted on my consciousness to this day.

When he had a “silent spell,” he would take to his bed and read quietly.  I cannot have been more than four or five when I sidled up to him lying on the bed and I told him it was selfish and immature to stop talking when we wanted to ask him things and talk about family things.  He nodded and told me later he just needed a rest from talking sometimes and there was nothing else going on.

Oy!

As I look back, he could be pretty socially inept back then and my mother often bailed him out.  In more mature age his manic-depressive illness did give him his share of discomforts, so all is forgiven.

But now I must refocus on my very first day of psychiatry residency training.  Not the strange military psychiatry experience, but the first time, in Kansas, a few other residents and myself sat invisibly behind a panel in the wall that the patient thought was a mirror.  The patient was a fifty-ish mother of many who had attempted suicide by drinking something both poisonous and foul because of the excessive “rottenness” of her husband and kids.  The interviewer was seasoned (male) psychiatry faculty, more than a little obsessive with a really bad comb-over.

Virtually all of Dr. C’s statements to this obese writhing human ball of (female) pain were empathetic, nodding, and trying to get more information out of her.

It worked, of course.  She told him about how her husband (allegedly) beat her up.  This had apparently been the real reason for the suicide attempt.

Toward the end of the (previously projected) hour for the interview, he gently told her that a report would be made and she would be kept safe in an outside shelter.  She could only nod and accept this, and he called someone to escort her back to her hospital room.

I gave him the compliments his fragile male ego needed.  They had been warranted.

He had gotten the job done — gotten the woman to tell him embarrassing parts of her history and miraculously gotten her to seemingly remain his ally as he went on to report her physical assaults to the police, something I knew even then that women rarely do, generally because of some variant of the “He loves me — he really does not mean to do it” argument.

Dr. C. went on to explain to us that silence was not as easy to do as it sounded.

He mimed a gesture I have often repeated for trainees and patients alike.  Both hands in fists, palms down, punching at each other.  Each hand, as it returns from a punch, moving higher and higher.

Once someone takes a position (in the military as in human conversation, I thought then) they tend to maintain it, even if this means escalating their strength.  To not engage is to bring in a different kind of strength, and to maintain the ability to control the interchange.

The he mimed a fist tiptoeing on two fingers round in a circle, then punching the other fist.  This is what he did when he finally told the woman that this matter was bigger than us both, and the police report had to be made. It was just like he said.  He avoided the confrontation until he had the power, her disclosures, to come in for the confrontation and win, which he clearly did.

I came to understand that the psychiatrist’s interviewing art owed a lot to science.  The minute your anger won and you confronted too early, you lost.  This is why the caricatures of silent and nodding psychiatrists came to be.  And this is how they worked.  It took suppressing one’s own emotions long enough to draw out those of the patient.

I decided that the psychiatrist, and perhaps more exactly every doctor, who “lost it” and yelled at a patient lost something, if not everything, in their ability to treat that patient.

So little psychology is formally taught to psychiatric trainees that it is no surprise that psychiatrists have retreated to a purely medical model, and are seen as “pill pushers.”

I often tell patients I am a humble “pill-pushing mama,” even with a little jive song-and-dance, and usually right after I have hit them with an insight they did not expect.

Still, I certainly had enough training to see how powerful silence could be.

For instance, my highly experienced and highly intuitive preceptor in child psychiatry told me that the crux of the art was getting kids to understand the consequences of their actions, which often meant to substitute observation of direct consequences of actions instead of yelling about them.

Like the kid who refuses to clean up his or her room and suddenly realizes he or she cannot find anything.

But the power of silence was far greater when actually trying to shape a child’s behavior.

Yelling at a child who did something wrong was little help, as a child was often defensive and would yell back.  Ignoring such behavior (if it did not put someone in immediate physical danger) could actually extinguish it over time.

“Catch a child doing something right,” was one of his favorite expressions.  Praise and hugs and “positive reinforcement” did a lot more to increase the frequency of a desired behavior that anger could ever do to extinguish an undesired one.

This meant silencing an angry parent (or significant other); is a precious skill, but not easy to teach.

This is not exactly the kind of concept modern researchers attack with enthusiasm.

A search of “silence” in the National Library of Medicine reveals almost entirely papers on how to silence the expression (eliminate the reproduction) of certain genes, and nothing at all relevant to what I am trying to say here.

One fairly typical article on the subject is rather interpersonal and existential, but hard to extrapolate into real life situations, but I’ll add a link in case you are interested.

A more practical article here might make more sense.

Of course angry people must be permitted to speak their piece.

That makes sense.

My grandmother of blessed memory knew, and used, these rules.

I can see now she was a “therapeutic personality.”  Some people intuitively say and do things that promote development of well being in others.

If they don’t get into mental health professions, they often become matriarchs, hairdressers, or something with a lot of public contact.

As someone who has trained both males and females in psychotherapy, I can attest that women seem to find empathy easier, while men seem to find objectivity easier.

I certainly have found it easier to teach objectivity to (some) women than I have to teach empathy to (some) men.

My grandmother of blessed memory was a therapeutic personality.  My father of blessed memory was not.
I seem, by all reports, to be one.

“Af alle narishkeit daft’men nisht anferen.”

You really don’t have to answer everything everyone says, and may be performing a far greater service if you do not.

My husband has withstood enormous amounts of stress in dealing with our complicated life together and I give him control of such situations.

I have, far and away, the happiest and highest-functioning marital relationship known to me.

Sometimes he says things in anger and I let them go without response and the anger takes wings, flying away like a little bird and we are just fine.

Sometimes I hear myself saying something I have derived from my grandmother’s wisdom to my patients, who feel hurt by something a loved one has said to them.

“People will always say what they need to say.  They will almost never say what you need to hear.”

This is often the reason not to answer a “foolishness” which someone else has spoken.  You do not reinforce it with a response, and the anger can fly away like a little bird.