When Silence Heals: The Power of Sitting as an Intervention

Authors

Frederick Shack, LMSW^1,4
Mardoche Sidor, MD^1,2,3
Jose Cotto, LCSW^1,5
Karen Dubin, PhD, LCSW^2,4
Lesmore Willis Jr, MPA, MHA¹
Gary Jenkins, MPA¹

Affiliations

¹Urban Pathways, New York, NY
²SWEET Institute, New York, NY
³Columbia University Center for Psychoanalytic Study and Research, New York, NY
⁴Columbia University, Department of Social Work, New York, NY
⁵New York University, Department of Social Work, New York, NY

Correspondence concerning this article should be addressed to Mardoche Sidor, MD, Urban Pathways, at msidor@urbanpathways.org

Abstract

Traditional models of engagement emphasize dialogue, assessment, and intervention. However, for individuals with histories of trauma, homelessness, or serious mental illness, words can sometimes overwhelm or retraumatize. This article highlights sitting, the first stage of the Four-Stage Engagement Model, as an intervention in itself. Drawing from neuroscience, trauma-informed care, attachment theory, and Motivational Interviewing, we show how staff presence without pressure regulates stress responses, builds trust, and creates the preconditions for connection. We present composite case examples from Urban Pathways supportive housing programs and discuss practical training strategies for cultivating presence and tolerating silence.

Keywords

Presence, Silence, Sitting, Engagement, Trauma-Informed Care, Co-Regulation, Polyvagal Theory, Attachment, Motivational Interviewing, Supportive Housing

Introduction

Silence is often misinterpreted as disengagement or resistance. Yet, in relational and clinical science, being-with rather than doing-to is recognized as central to healing (Rogers, 1957; Yalom, 2002). For people experiencing homelessness and trauma, the simple act of sitting nearby, without expectation, signals safety and reliability (Hopper et al., 2010). This stage of the engagement model addresses the most fundamental barrier: the absence of safe presence.

Theoretical Framework

The power of sitting draws on multiple theoretical strands:

1. Polyvagal Theory: Safety cues from calm presence regulate the autonomic nervous system, reducing fight/flight activation (Porges, 2011).
2. Attachment Theory: Reliable presence rebuilds trust and fosters secure attachment patterns (Mikulincer & Shaver, 2016).
3. Trauma-Informed Care: Establishing safety precedes disclosure or treatment (SAMHSA, 2014).
4. Existential Psychology: Presence communicates recognition of the other’s humanity and worth without conditions (Yalom, 2002).

Application/Analysis

At Urban Pathways, staff are learning to operationalize sitting by:

• Spending consistent, calm time in communal areas without pushing conversation
• Practicing “non-anxious presence,” being available without performance or pressure.
• Using environmental awareness (e.g., lighting, body language, proximity) to create a felt sense of safety.

Composite Case Example: A resident with a history of multiple traumas refused to engage verbally for months. Staff members learnt to consistently sit nearby during mealtimes, occasionally offering light greetings but not pressing for conversation. Over time, the resident initiated a conversation about safety in the building, marking the first step toward relational trust.

Implications

• Practice: Presence itself needs to be documented and recognized as a legitimate intervention.
• Training: Staff require skills in regulating their own anxiety about silence and learning to value “being” over “doing.”
• Supervision: Reflective practice needs to address staff discomfort with stillness and nonverbal engagement.
• Policy: Service metrics need to expand to include relational presence, not only active interventions.
• Research: Further studies are needed to measure outcomes of presence-based engagement, including physiological regulation and alliance building.

Conclusion

Silence and presence are not absences of care but the foundation of it. Sitting as an intervention affirms the principle that healing begins not with words, but with safety, consistency, and humanity.

References

• Hopper, E. K., Bassuk, E. L., & Olivet, J. (2010). Shelter from the storm: Trauma-informed care in homelessness services settings. The Open Health Services and Policy Journal, 3(2), 80–100.
• Mikulincer, M., & Shaver, P. R. (2016). Attachment in adulthood: Structure, dynamics, and change (2nd ed.). Guilford Press.
• Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation. Norton.
• Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology, 21(2), 95–103.
• (2014). SAMHSA’s concept of trauma and guidance for a trauma-informed approach. HHS Publication.
• Yalom, I. D. (2002). The gift of therapy: An open letter to a new generation of therapists and their patients. HarperCollins.

Read the full scientific version HERE

This article is part of a collaboration between SWEET Institute and Urban Pathways.