The Silent Treatment

From the time of Freud psychoanalysis has trafficked an iconic image of treatment. A patient is lying on a couch, talking to the walls. The analyst is sitting behind him, remaining silent as the patient rattles on about whatever is passing through his mind.

Some called it the silent treatment, and that feels apposite. 

As it happens, and for the edification of those who are not in the psycho analysis business, very few analysts today adopt such a detached posture. 

And yet, they rarely engage with their patients; they rarely converse or exchange pleasantries. In the end, psycho analysts interpret-- they tell you what it all means, and it invariably means that you are refusing to accept your desire to commit incest with your mother.

Of course, psycho analytic treatment never really pretended to cure much of anything. In particular, it has systematically failed to treat or to cure depression. And, to be clear, depression is not an outlier; it is central to the mental distress of most people.

And now we discover the reason. Giving the silent treatment to someone who is depressed is counterproductive. The new research showed that narcissists like to have an audience; they are happy to rattle on without interruption.

And yet, people who are depressed feel rejected and ignored when they are not engaging in conversation. Failure to interact, giving the silent treatment, produces more social anxiety. 

Depressed patients  interpreted disengagement as social rejection.

If you were wondering why psycho analysis, that is the silent treatment, has always been notably ineffective in treating depression, now you know why.