There you are, sitting across from your therapist. You’ve just been talking for a few minutes. And then… silence. Your therapist looks at you, nods, or goes “mm mm” and says nothing more. One minute. Two minutes. Five, even!

So in your head, the thoughts start racing: “Did they understand? Am I boring them? Are they judging me without saying anything?”

Silence during a session is one of the most disconcerting experiences in therapy. Understanding what’s really going on on the other side can change everything.

What Silence Means from the Patient’s Perspective

In a session, silence can be scary. Sometimes it creates discomfort, sometimes stress, and sometimes even guilt. This is especially noticeable at the beginning of therapy! But in reality, it’s universal! Almost all patients feel this way. Yet very few dare to talk about it directly with their therapist.

This unease stems mainly from common beliefs about silence. Our brains hate a void. When information is missing, they naturally seek to make sense of it. And when faced with silence from someone important to us, they almost automatically begin to imagine what’s going on in that person’s mind. We fear that they’re hiding a disagreement, a conflict, a judgment, or even rejection. This is mainly because we’re social beings. We use speech to build connections and reassure ourselves. So, naturally, its absence can cause uncertainty and discomfort.

You might tell yourself that if your therapist isn’t speaking, it’s because they’re bored. Or because they don’t know what to say. Or worse, because they’re thinking something negative about you, judging you, but holding back.

In reality, if you’re asking yourself these questions, it’s often because you’re paying close attention to your therapist’s reactions. And that’s often exactly what your therapist is doing in return: they’re carefully observing yours. It’s a deeply human reaction: when the other person remains silent, our brain tries to guess what they think of us.

So this isn’t “paranoia.” It’s simply your brain trying to make sense of something for which there aren’t yet any words.

Sometimes, putting what’s happening into words right away is simply too difficult.

But more importantly, here’s what that silence isn’t.

What silence is not, from a psychologist’s perspective

Silence is never indifference.

Did you know that sometimes your therapist can be deeply present, attentive, and moved—even while remaining silent?

It’s never a disguised judgment. But it’s not a lack of competence either.

Most often, the therapist remains silent to maintain a stance that is both neutral and compassionate. This stance allows them to fully receive everything you say. In other words, your therapist says nothing precisely because they are careful not to guide, influence, or judge you.

Silence and compassion are therefore not contradictory.

Contrary to what people sometimes imagine, your psychologist’s silence is rarely a moment when they’re “doing nothing.”

But then the question is: What might your therapist be thinking during these moments of silence?

That’s where it gets interesting!

While you’re wondering what they think of you, your psychologist is often observing something else entirely: how you navigate that silence. Are you searching for the right words? Is an emotion welling up? Does your gaze change? Your breathing? Do you suddenly change the subject? All these elements can help your therapist understand what’s going on for you—sometimes even more than the words themselves.

In reality, silence is part of the therapeutic process. For the psychologist, it is also a source of clinical information. In other words, your psychologist doesn’t simply endure the silence: they observe it, take an interest in it, and try to understand what it reveals about your experience. Your psychologist therefore works with silence, not in spite of it.

Ultimately, one of a psychologist’s essential skills is to wait and seize the right moment for you to speak. Intervening too quickly risks cutting short something that is in the process of developing within you. Your therapist therefore often prefers to let whatever may emerge come to the surface, rather than filling the space at all costs with a question that might steer your thoughts. It is, therefore, a form of active patience, not passivity.

Behind this silence, there is often much more attention than meets the eye.

And depending on their therapeutic approach, silence will take on a different “tone”:

In the psychodynamic approach, silence opens the door to free associations and unconscious processes.
In mindfulness-based therapies, it allows you to step back from the usual stream of thoughts to be more in touch with your inner experience.
In Gestalt therapy, it fosters the emergence of sensations, emotions, and what is being experienced in the present moment.

All these approaches converge on the same idea: silence is not a void. It is a workspace.

For the patient: how to become comfortable with silence during a session

You don’t have to endure the discomfort in silence (so to speak). Here are some practical tips.

Name it. If the silence weighs on you, you can simply say so: “I don’t know what to say, and that makes me uncomfortable,” or “I feel like I’m hesitating.” This isn’t an admission of failure. Quite the contrary—it means taking an active role in your therapy, because that’s often where something important begins.
Observe what’s happening inside you. Rather than trying to find something to say to fill the silence, try to notice what you’re feeling during that silence. Tension in your body? An image that comes to mind? An emotion you weren’t expecting? It’s often during these silences that these sensations or emotions become easier to perceive. And that’s how therapy moves forward!
Don’t measure the value of a session by the number of words exchanged. A single session where little was said may have been more meaningful than several sessions where you talked a lot. Sometimes, even a very talkative session can be a way of avoiding what really matters.

For the therapist: managing silences without “breaking” them

From the therapist’s perspective, the question isn’t “How can I avoid silences?” but “How can I be present in the silence without breaking it too soon or too late?”

The therapist knows that a patient’s silence is never an interruption of communication, but rather a shift to a different form of communication. And as such, silence calls for a presence rather than a response. Not necessarily words, but a presence. Simply.

Here are two guidelines for working with silence:

Of course, there are the universal techniques of acknowledgment. These might include a nod, maintaining eye contact, or even the famous “mm mm.” These techniques help reassure the patient and ensure the continuity of the interaction. In reality, it is sometimes these small gestures that allow the patient to feel secure enough to continue exploring what they are experiencing.
There’s also this question to ask: Is this silence productive or stifling? A productive silence has a “texture.” The therapist senses that something is taking shape, preparing to emerge. A stifling silence, on the other hand, feels like avoidance. The therapist senses a sense of paralysis or unchecked anxiety. In this case, the therapist can use a gentle intervention, such as rephrasing or simply asking an open-ended question. This may be enough to get the therapeutic work moving again without interrupting what was in the process of emerging.

And indeed, sometimes the most appropriate thing to do is to say nothing at all.

Finally, what if silence were a form of care?

Your therapist’s silence isn’t an oversight. It isn’t a blunder. It’s often the most appropriate thing they can offer at that moment, in their own way—based on what they know about you and your resources.

So, the next time silence settles in during a session, perhaps resist the urge to fill it immediately. Observe what’s happening inside you. That silence may already be helping you hear something that words couldn’t yet express.

Sometimes, words allow us to speak. Silence allows us to hear ourselves.