Partings and impartings: Toward a nonmedical approach to interruptions and terminations

It is the thesis of this paper that therapy offers a sequence of opportunities for the patient to experience a comfortable oscillation between togetherness and parting: thepetit partings within each hour, those moments of silence or withdrawal, partings at the end of hours, vacations, spontaneous interruptions (when allowed), and, ultimately, termination. A nonauthoritarian method particularly respecting and fostering the patient's self-determination is proposed.     

Weaving Ropes with the Desert Fathers: (Re)Inventing Rhetorical Theory as Silence and Listening

Not until the past decade have communication scholars begun to depict silence as rhetoric (Bennett, 2006; Clair, 1998; Glenn, 2004; Kalamaris, 1994). Building upon recent theoretical development and definition of silence as rhetoric within a theoretical and didactic framework, this paper illustrates silence and listening as rhetoric in its origination with the monastic community of the Desert Fathers, while acknowledging it as a basic contemplative and ascetic practice in many ancient religions. Development of this concept was expressed by the following questions: How does the Desert Fathers’s concept of silence and listening contribute to a modern understanding of rhetorical communication theory? How does their concept of silence and listening conflict with modern presentations of contemporary evangelical worship? The work’s contributions include insight into the ancient Desert community’s use of silence and listening as rhetoric since it takes a theoretical approach to silence and symbols as rhetoric, theology, and protest (Glenn, 2004). It follows the desert community’s way and purpose of rhetorical memory and listening, while proposing practical and theoretical implications for higher learning, spirituality, and critical studies.     

A culture of silence: modes of objectification and the silencing of disabled bodies

Throughout history different practices have attempted to silence the experiences of disabled people. In this paper we explore some of these practices including the medical, familial, and self-subjugating practices English-speaking Canadian polio survivors experienced throughout their lives. We analyze participant’s experiences of silence and silencing through a Foucauldian lens, drawing on the three modes of objectification to explain the institutional and cultural discourses around polio subjects that acted upon and through the polio body to silence it. Participants’ oral history accounts demonstrate how sociocultural and medical practices effectively silenced survivors from speaking about their polio experiences. However, the trope of silence is also uprooted within oral history traditions. We will demonstrate how participants broke their silence and shifted their perspectives on polio and disability, and how this process contributed to their resistance of hegemonic conceptualizations of disability as defective.     

Stating culture: colonial matrices

Delineating the complex relationship between state, nation and culture in India, the paper examines the discourses that are produced to define what culture is in the life of the nation. Shared epistemic assumptions in colonial and postcolonial writings tend to constitute a veritable silence on structural social inequalities and marginalized identities. Articulated in a deceptively self‐evident and “neutral” framework, this silence disavows real divisions in the body politic and then, in a contradictory reversal, celebrates them as natural and inevitable. It is the discursive regularities in the movement from the colonial to the national that the paper mainly takes issue with and shows how notions of the “people” and “nation” are installed.     

Sex makes a difference—How gender affects the therapeutic relationship

Because gender issues create obstacles or advance progress, this paper discusses how gender differences affect therapy. The psychoanalytic approach in the four treatment dyads of female therapist-male patient, male therapist-female patient, female therapist-female patient, and male therapist-male patient is presented to suggest propensities. A developmental focus on gender's effect on the therapeutic relationship is indicated by the theoretical rationale from psychoanalytic literature, and by clinical practice discoveries. Because therapists' perceptions about gender identity, gender roles and sexual partner orientation affect responses to patients, countertransference is considered. Acknowledgement of gender components within the transference is recommended if therapists are to provide the best treatment possible.     

Looking for a ‘cure’: negotiating ‘walking’ in a Turkish rehabilitation hospital

This article explores discourses surrounding ‘walking’ in a Turkish rehabilitation hospital and their impact on in-hospital relationships, patients’ attitudes towards disability, and constructions of ‘bodily normality’. Interviews were conducted with 29 patients, 11 medical personnel, and two non-medical personnel. Three categories of discourses emerged. First, hope for walking is kept alive in doctor–patient relationships, either through a state of silence on the matter or an emphasis on time, determination, and faith in God. Second, patients are virtually assured of the retrieval of walking, mostly through interactions with fellow patients and their accompanying family members (refakatçis). Third, a possible non-walking future is highlighted, either within a framework closer to a disability rights perspective or through an emphasis on gratitude. Diverse discourses on walking emerge due to the informality of in-hospital practices. Still, the ‘normal body’ is predominantly reproduced as the ‘walking body’. Thus, patients refuse discharge before regaining the ability to walk.     

Asylum Discourse in New Zealand: Moral Panic and a Culture of Indifference

Recent law changes in New Zealand allowing for the detention of a “mass arrival” of asylum seekers reflect a concerning international rhetoric and associated policy trend in Australia and the United Kingdom towards those seeking asylum. This paper argues that, although the New Zealand public has not (yet) reached a “moral panic” that is prevalent within international contexts, there are concerns about a “culture of indifference” in relation to asylum seekers. By providing a policy analysis about asylum seekers and an examination on the associated discourses utilised in international contexts, this discussion presents the New Zealand context through the process of risk signification. The paper discusses how the social work profession can respond to this culture of indifference through addressing collusion (often through silence) with oppressive asylum policies, the need for stronger advocacy and action, and the associated role of social work education.     

Silence Therapy with Holocaust Survivors and their Families*

Stories of family therapy with Holocaust Survivors and their families are presented. They came with symptoms or complaints that seemed unusual and at times bizarre. Although they had seen other members of the helping professions, the Holocaust had never been mentioned. Only when it was explored did their problems become comprehensible and meaningful, providing the context for alleviating or resolving their complaints. The positive aspects of survivors' silence are explored. Silence is often experienced as strength, courage, and a testimonial to those who perished. The amazing resilience of the survivors, the strength and vitality that made it possible for them to overcome their pasts and build new lives in a new country, are highlighted.     

Bringing our bodies and ourselves back in: reflections on a past, present, and future "medical sociology"

This paper is a revision of an address given upon receipt of the Leo G. Reeder Award for Distinguished Scholarship in Medical Sociology. It was presented on August 14, 1990 to The Medical Sociology Section of the American Sociological Association during its annual meetings, held in Washington, DC. Herein I reflect on the structured silence of personal bodily experience and on the unfinished paradigmatic challenge of feminism as a way of leading to a new praxis in medical sociology.     

THE MYSTERIOUS DISAPPEARANCE OF BATTERED WOMEN IN FAMILY THERAPISTS' OFFICES: MALE PRIVILEGE COLLUDING WITH MALE VIOLENCE

Family therapy has not served battered women well. Men use battering to silence women; a woman, once abused, is unlikely to speak honestly in a situation where doing so invites re-abuse. Therefore we rarely perceive, label or deal effectively with male violence toward women, a major source of marital disruption. To stand with the oppressed, we must learn to detect the possibility of abuse, separate the couple, and refuse to collude with criminal acts.     

Sounding the Holocaust,silencing the city: memorial soundscapes in today’s Berlin

Silence appears frequently in discourses of the Holocaust – as a metaphorical absence, a warning against forgetting, or simply the only appropriate response. But powerful though these meanings are, they often underplay the ambiguity of silence’s signifying power. This article addresses the liminality of silence through an analysis of its richly textured role in the memorial soundscapes of Berlin. Beyond an aural version of erasure, unspeakability, or the space for reflection upon it, I argue that these silent spaces must always be heard as part of their surrounding urban environment, refracting wider spatial practices and dis/order. When conventions are reversed – when the present is silent – the past can resound in surprising and provocative ways, collapsing spatial and temporal borders and escaping the ritualized boundaries of formal commemoration. This is explored through four different memorial situations: the disturbing resonances within the Holocaust Memorial; the transgressive processes of a collective silent walk; Gleis 17 railway memorial’s opening up of heterotopic ‘gaps’ in time; and sounded/silent history in the work of singer Tania Alon. Each of these examples, in different ways, frames a slippage between urban sound and memorial silence, creating a parallel symbolic space that the past and the present can inhabit simultaneously. In its unpredictable fluidity, silence becomes a mobile and subversive force, producing an imaginative space that is ambiguous, affective and deeply meaningful. A closer attention to these different practices of listening disrupts a top-down, strategic discourse of silence as conventionally emblematic of reflection and distance. The contemporary urban soundscape that slips through the silent cracks problematizes the narrative hegemony of memorial itself.     

Disorganized Attachment: A Compass for Navigating the Confusing Behavior of the “Difficult-to-Treat” Patient

The concept of disorganized attachment gives a framework with which to understand patients who present a confusing pattern of relatedness. The therapist may experience feeling connected with the patient only to see a sudden retreat, expressed by silence, argumentativeness, or missed sessions. After presenting a theoretical summary of disorganized attachment, I give two clinical examples. The first illustrates the theoretical material that is presented and gives the reader an idea of what a disorganized attachment pattern looks like in the clinical setting, while the second briefly shows how use of this framework increased my comfort level.     

Factory “Homers”: Understanding a Highly Elusive,Marginal, and Illegal Practice

A “homer” is an artifact that a worker produces using company tools and materials outside normal production plans but at the workplace and during workhours. Despite legal, artistic and ethnographic evidence of their existence, silence surrounds homers. Along with this evidence, interviews conducted mostly with retirees from a French aeronautics plant are used to show that this silence is not linked just to the marginal and illegal quality of these artifacts. Homers shed light on a high degree of “complicity” between employees regardless of their position in the hierarchy. Since the factory's institutional framework has little room for this complicity, the silence surrounding homers is a sign probably of an inability to talk about them rather than of their marginality or illegality.     

La « perruque » en usine : approche d’une pratique marginale, illégale et fuyante

A “homer” is an artifact that a worker produces using company tools and materials outside normal production plans but at the workplace and during workhours. Despite legal, artistic and ethnographic evidence of their existence, silence surrounds homers. Along with this evidence, interviews conducted mostly with retirees from a French aeronautics plant are used to show that this silence is not linked just to the marginal and illegal quality of these artifacts. Homers shed light on a high degree of “complicity” between employees regardless of their position in the hierarchy. Since the factory’s institutional framework has little room for this complicity, the silence surrounding homers is a sign probably of an inability to talk about them rather than of their marginality or illegality.     

„Speaking Up“ statt tödlichem Schweigen im Krankenhaus

We describe the importance of silence versus speaking up for patient care. Silence is defined as intentionally withholding work-related ideas, information, and opinions. Speaking up or voice is defined as intentionally expressing work-related ideas, information, and opinions. Speaking up is not only important for error prevention and correction in healthcare. It also allows for working together in highly diverse teams in complex clinical settings in hospitals and is a core element of organizational learning. However, speaking up is rare in hospitals. Based on recent literature we describe that the scarcity of speaking up is due to organizational climates and group interaction processes rather than to lack of individual skill or motivation to speak up. In addition to provide speaking up-enabling ideas, using the concept of organizational paradoxes we provide paradoxical recommendations as humorous and unserious tips for increasing undesired silence.     

A model for short-term group therapy on a children's inpatient unit

The paper describes the group therapy model which has evolved over the past two years on the Child Psychiatry Inpatient Unit of North Carolina Memorial Hospital. It begins with a brief review of the literature concerning group therapy with latency-aged children. The setting and patient population are described. Vignettes from group sessions are used to illustrate techniques which have evolved to deal with this particular setting and population. These include a leadership style characterized by much clarification, modeling, and limit setting; extensive focus on beginning and terminating; clearly defined behavioral limits; the use of time out; and use of play materials requiring little skill or attention as anxiety binders as well as projective media; and observation and supervisory discussions open to all members of the treatment team. The paper concludes with a discussion of the potentials and limitations of group therapy in such a setting. The thesis is that this model is effective in diagnosing developmental levels, in developing interpersonal skills, in substituting verbalization for action, and in mastering separation anxieties, though the setting limits the extent to which controlled regression, transference, and group pressures can develop and be used to produce change.     

The Possibility of Conversation

In the present article I am concerned with conversation as a way of participation. Hearing, speaking, and silence will cross and create the possibilities of the conversational space I explore. The question of participation opens the essay and leads to the notion of incision both between and within speakers. Speaking is depicted as basically cut by an unheard, repressed silence. The unsilencing of silence evokes a conversation conscious of itself in sadness and in laughter and a reopening of the door for creative speech. The shift of conversation toward its creative possibilities will be likened to a leap to a public square of speaking voices or a piazza of conversation. The article will traverse a certain critical path, mainly through Erving Goffman's idea of staged talk and Jacques Lacan's notion of split within the speaking subject.     

Breaking the Silence: Lesbian Fans, the Internet, and the Sexual Politics of Women's Sport

Women who play sports are often conflated as lesbian. Thus, athletes, coaches, and administrators in women's sport are constrained to never speak of the lesbians who play and work in sport. The injunction against speech keeps lesbians in the closet and controls all women in sport who must constantly monitor their appearance, behavior, and speech to ensure that they project an appropriately heterosexual image. The code of silence is, typically, justified by the assertion that fans and sponsors would abandon women's sport if lesbian participants were vocal and/or visible. Traditional media support the injunction to silence. They rarely speak of lesbians, and when they do, they typically marginalize and sensationalize lesbian participants. The authors analyze two threads of discussion on an Internet newsgroup devoted to women's basketball. The results indicate that the Internet offers fans a chance to challenge the code of silence and that contributors to this newsgroup are supportive of lesbians in sport.     

A Girl Is a Girl,Is a Girl,Is a Girl

ABSTRACT

Before I did not know I was the other in my country, before I did not know it was not safe to be the other in this, before I did not know my existence was a series of ellipses, owing to mispronunciations and a smothering absence of words, before I did not know that the past will, unfailingly, be subsumed by its past and fantasies of a future will become present torments, before I did not know all of that, I did not know I was to be a woman. … Thirty-odd years in, having married a man and birthed children, I was made to look at myself and pronounce the most foreign of words. The sound was deafening. The sound left me speechless. These writings are an attempt at puncturing the silence enveloping the most dangerous of (my) words.     

Integrating a Trauma Lens into a Family Therapy Framework: Ten Principles for Family Therapists

This paper aims to show how a trauma lens can be incorporated into existing family therapy practices, changing how therapists perceive presenting problems and therefore the issues and sites of intervention. After reviewing the family therapy literature concerning trauma and defining different types of trauma, the paper discusses how traumatic memories differ from ordinary memories. Ten principles for practice are described to guide therapists in integrating the trauma lens into their family therapy practice. Three case studies are used to illustrate these principles.