Apr 9th, 2010 by admin
JOURNAL OF PALLIATIVE MEDICINE
Volume X, Number X, 2009
Anthony L. Back, M.D.,1 Susan M. Bauer-Wu, Ph.D., R.N.,2
Cynda H. Rushton, Ph.D., R.N.,3 and Joan Halifax, Ph.D.4
In trying to improve clinician communication skills, we have often heard clinicians at every level admonished to ‘‘use silence,’’ as if refraining from talking will improve dialogue. Yet we have also noticed that this ‘‘just do it,’’ behavior-focused ‘‘use’’ of silence creates a new, different problem: the clinician looks uncomfortable using silence, and worse, generates a palpable atmosphere of unease that feels burdensome to both the patient and clinician. We think that clinicians are largely responsible for the effect of silence in a clinical encounter, and in this article we discuss what makes silence enriching—enabling a kind of communication between clinician and patient that fosters healing. We describe a typology of silences, and describe a type of compassionate silence, derived from contemplative practice, and the mental qualities that make this type of silence possible.