Challenges with clients come in all shapes and sizes. Some clients are so chatty you can’t get a word in edgewise—not to mention a helpful therapeutic suggestion. Others are consistently grumpy, or invariably nervous, or such downers you can’t imagine them locating the bright side of a sunrise. But one of the most common issues any type of client might present is when they sit down for a session and announce: “I have nothing to talk about today.”

You may know how to work with depression, anxiety, anger, and grief, but how do you work with “nothing”? What do you do when your insightful questions, expert techniques, and earnest attempts to connect elicit only shrugs? Let’s be honest: sometimes 50 minutes with these clients feels like pulling teeth.

Fortunately, there are ways to make headway with clients who have “nothing to talk about.” There are ways to jumpstart conversation, do deep work, and make your time together less painful. To find out how, we consulted a few seasoned experts who’ve been in this quagmire—and found their way out of it.

Read on to see how DBT expert Britt Rathbone, international trauma expert Janina Fischer, Experiential Dynamic Therapy teacher and a founding member of the AEDP Institute Steve Shapiro, and MFT and ethics professor Kirsten Lind Seal take on this issue.

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Welcoming the Client’s Two Sides

International trauma treatment expert Janina Fisher, author of Transforming the Living Legacy of Trauma, says that when a traumatized client declares, “I have nothing to talk about,” the therapist needs to pay close attention.

She notes, “What they’re really saying is, ‘Don’t make me talk about it. I’m afraid I’ll start to feel overwhelmed.’ I usually laugh when I hear, ‘I have nothing to talk about.’ Then I say, ‘Would you tell me if you did have something to talk about? Or does ‘nothing to talk about’ mean there’s nothing you want to talk about?’ Then I’ll laugh again gently to communicate that there’s no judgment attached to their fear of talking about painful emotions.”

Fisher says she also reassures clients that there’s never any pressure to talk or bring an issue to therapy—it’s fine not to have an agenda. “I’ll ask, ‘What would you not want to talk about?  Let’s start there. That way, I’ll know to what to avoid.’”

She adds that it can be tempting to disengage in these moments—to join clients in their passive resistance. “You might feel like saying, ‘Well, then why did you come?’ But over time I’ve learned that ‘I have nothing to talk about’ implies an internal struggle. Part of the client wanted to come—that’s why she’s here—and part of her didn’t want to come and definitely didn’t want to take down her guard.

“The therapist’s job is to welcome both the reluctant part that has nothing to say and the part that wants my help and connection. I do that by saying, ‘Well, thank you so much for coming anyway, and my thanks to the part of you that let you come. That was very generous!’ Or I might joke, ‘Many people would love to change places with you because they have too much to talk about and not enough time. They’d love to have nothing to talk about!’ Or I’ll ask them, ‘How does nothing to talk about feel? Does it feel liberating? Or numb? Or fuzzy?’”

Fisher says she had a client who, for two years, began every session by sitting down and saying, “I didn’t want to come today, and I have nothing to talk about.” They’d always manage to engage by the end of the session. And when Fisher asked, with some trepidation, “Do you want to make another appointment?” the client would look indignant and say, “Of course I want another appointment. Did I give you reason to doubt that?”

Empowering the Client

Clinical psychologist Steve Shapiro, a certified Experiential Dynamic Therapy teacher and a founding member of the AEDP Institute, says “Engagement is difficult for all human beings, but for those with a trauma history, it can feel like being invited to touch a hot stove.”

In therapy, he explains, not only do clients learn about how they relate, but also about how their longstanding emotional patterns—like avoidance—can be enacted without their awareness. “If we accused a client of being ‘unmotivated,’ she’d most likely say that for reasons unbeknownst to her, she ‘just can’t think of anything to talk about.’ And she might be right. After all, motivation is intentional; resistance is unintentional.

Although it might be tempting to think there’s intent behind the client’s resistance, this could create a polarizing dynamic that keeps her conflict buried and perpetuates her suffering. But if, with our help, she sees the internal conflict, then we empower her to make a choice between that resistance and the healthy alternative.”

Shapiro says that even if clients say they don’t have much to talk about in therapy, it’s important to remember that the simple fact that they showed up reveals motivation in and of itself. He explains, “The therapist could make this explicit by saying something like, “You don’t know what to talk about and you came here to take a more active role in getting your needs met.’ At this point, the therapist can allow her to struggle with that in silence, and have her response guide the next intervention.”

Exploring the Silence

Over nearly four decades of practice, Dialectical Behavior Therapy expert Britt Rathbone has seen his fair share of tight-lipped clients while working with young clients and their families. The coauthor of Parenting a Teen Who Has Intense Emotions, Rathbone says he likes to remember that “behavior always makes sense in the context in which it occurs.”

When a client says they have nothing to talk about, Rathbone says his goal is to “get clear on what’s factoring into their silence or lack of direction. Assessing whether it’s an angry silence, an unmotivated silence, or a hopeless silence is a good starting point.”

To get there, he first asks the client how they felt about coming to the session. “Was there a conflict with someone on the way? Is our time together taking the place of something else they’d rather be doing? Are they upset with me or the therapy itself?”

Whatever comes up, Rathbone says it’s important to validate that feeling. For instance, with a teen who’d rather be anywhere but his office, he suggests saying something like, “It makes sense you don’t want to talk today, given that you’re irritated you’re here instead of hanging out with your friends.”

Rathbone says that when his adolescent clients come in saying they have nothing to talk about, which is often, it’s an opportunity to teach effective ways of communicating and solving problems. “If we can explore their silence or lack of topics with real patience, understanding, and compassion,” he says, “then we’re also modeling valuable communication and problem-solving skills for them, while getting the therapy unstuck.”

For someone whose treatment has been working well enough that they’re questioning whether to continue therapy, or they’ve run out of steam, Rathbone suggests saying something like, “I get it. You resolved the main issue that brought you here, and it isn’t clear what to do next.”

At these junctures, Rathbone says it’s helpful to explore therapy goals. “Maybe we’re off track and need to refocus or reestablish goals that still have relevance. Or maybe we’re done—and that’s okay! Our aim is to put ourselves out of business with clients, and when, with our guidance, they run out of problems to solve, then we’ve succeeded!”

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Rolling with the Punches

Kirsten Lind Seal, a licensed marriage and family therapist with a background in musical theatre, stand-up comedy, and television, says that clients who say they have nothing to talk about often fall into one of four categories.

The first category, she says, consists of those who are simply unsure what therapy entails. Lind Seal says when her clients say, “I don’t know what to talk about,” that’s her cue to do some psychoeducation about the therapy process.

The second category, she says, is clients who tend to be shy or less comfortable with open-ended conversations. Such was the case with her client Allyn, who started therapy by telling her, “You’ll have to ask me specific questions, otherwise I won’t get anywhere.”

“I do my best to roll with the punches,” Lind Seal says, “and always have plenty of questions at the ready. I always try to make a note of the last topic we covered in the last session, and then mention it first thing in the next session.”

With Allyn, she looked at her notes and said, “So shall we keep talking about your relationship with your father?” And they were off to the races.

Lind Seal says she also finds books to be helpful in jumpstarting conversation. Two of her favorites are Viktor Frankl’s Man’s Search For Meaning and Melody Beattie’s Codependent No More. “Going through these books chapter by chapter together and discussing what comes up as we move along can help deepen therapeutic conversation,” she says.

If clients declare they have nothing to talk about during the middle of their work in therapy, Lind Seal believes they may be dealing with something else: they’re holding on to something they’re unwilling or too nervous to divulge.

As for clients who’ve been in therapy for a long time by the time they say they have nothing to talk about, she says it’s usually a sign that therapy is coming to an end. A good way to check is to say something like, “Maybe we’re coming to the end of our work together.  Do you think that might be why it feels like you have nothing to talk about today?”

The client’s response, she says, will tell you a lot. “One of my clients exclaimed, ‘Oh my god, no! Are you dumping me?’ Clearly, we were not done. But other clients I’ve asked have said, ‘Yeah, I think so. Is that bad? I’ll miss you, but I think we might be done.’ Ending therapy usually means that things are going better. I like to tell clients, ‘It’s my job to get you to eventually fire me.’”

“I have nothing to say” can mean a variety of things, Lind Seal concludes. “But in my experience, therapists just need to decide whether to explain, guide, challenge, or close—and the conversation will flow from there.”

 

Photo by MART  PRODUCTION/Pexels

Lauren Dockett

Lauren Dockett, MS, is the senior writer at Psychotherapy Networker. A longtime journalist, journalism lecturer, and book and magazine editor, she’s also a former caseworker taken with the complexity of mental health, who finds the ongoing evolution of the therapy field and its broadening reach an engrossing story. Prior to the Networker, she contributed to many outlets, including The Washington Post, NPR, and Salon. Her books include Facing 30, Sex Talk, and The Deepest Blue. Visit her website at laurendockett.com.

Janina Fisher

Janina Fisher, PhD, is a licensed clinical psychologist and former instructor at The Trauma Center, a research and treatment center founded by Bessel van der Kolk.  Known as an expert on the treatment of trauma, Dr. Fisher has also been treating individuals, couples and families since 1980.

She is past president of the New England Society for the Treatment of Trauma and Dissociation, an EMDR International Association Credit Provider, Assistant Educational Director of the Sensorimotor Psychotherapy Institute, and a former Instructor, Harvard Medical School.  Dr. Fisher lectures and teaches nationally and internationally on topics related to the integration of the neurobiological research and newer trauma treatment paradigms into traditional therapeutic modalities.

She is author of the bestselling Transforming the Living Legacy of Trauma: A Workbook for Survivors and Therapists (2021), Healing the Fragmented Selves of Trauma Survivors: Overcoming Internal Self-Alienation (2017), and co-author with Pat Ogden of Sensorimotor Psychotherapy: Interventions for Attachment and Trauma.(2015).

Britt Rathbone

Britt Rathbone, LCSW-C, ACSW, BCD, CGP, provides mental health services to adolescents and their families in the Washington, DC metropolitan area. He has 30 years of experience working directly with adolescents and families, is a “top therapist” for adolescents, teaches graduate students, trains therapists and leads a highly regarded and successful clinical practice. He lectures often on the value of DBT with young people. He is a dynamic and passionate speaker and his trainings consistently receive the highest ratings. He is the co-author of Dialectical Behavior Therapy for At-Risk Adolescents, What Works With Teens: A Professional’s Guide to Engaging Authentically with Adolescents to Achieve Lasting Change, and Parenting a Teen Who Has Intense Emotions (to be published by New Harbinger in January 2016).

Steve Shapiro

Steve Shapiro, PhD, is a clinical psychologist who maintains a full-time private practice in suburban Philadelphia and has over twenty-five years of clinical and teaching experience.  He has been practicing various forms of Experiential Dynamic Therapy (EDT), since the mid-1990’s, including Intensive Short-Term Dynamic Psychotherapy (ISTDP), and Accelerated Experiential Dynamic psychotherapy (AEDP). He is a founding member and currently an adjunct faculty member of the AEDP Institute in New York City.

Dr. Shapiro conducts training of psychotherapists internationally.  His instruction is often commended for translating complex clinical theory into clear, precise, and practical techniques which are easily understandable and readily applied immediately and deliberately in clinical settings by therapists of all orientations.

For 16 years, Dr. Shapiro was the Director of Psychology and Education at Montgomery County Emergency Service (MCES), an emergency psychiatric hospital, where he worked with a range of severe disorders and those committed involuntarily to treatment. This intensive experience has helped inform his approach to transforming resistance with challenging patients who have a history of trauma, a high degree of resistance, or excessive anxiety and dysregulation.

Kirsten Lind Seal

Kirsten Lind Seal, PhD, is a marriage and family therapist in private practice and an adjunct associate professor of MFT at Saint Mary’s University of Minnesota. Her research has been published in JMFT and Psychology Today, and she is a regular contributor on WCCO (CBS) TV’s Midmorning show.