White Noise Machines and Psychotherapy

Flown by Will Smith in Independence Day

Under an end table in my waiting room sits the fourth most important piece of technology in professional psychology: the white noise machine. Why would we bother?

It sounds impressive as the fourth most important technology (behind the clock, the phone and the computer), but I actually can't think of what comes in fifth. The lightbulb? Practical, but natural light or candles would do the job. I suppose audio or video recording devices are pretty important for those in supervision. So far, iPads have no clinical function that I'm aware of. In fact, they appear to have no unique social, occupational, entertainment or otherwise practical function whatsoever, but I digress. Some might say door locks and pens count as technology, which would throw off this whole ranking. Back to the sound machine.

Help me Obi Wan Kenobi, you're my only hope

Each morning I twist in a clumsy, non-ergonomic fashion to switch on my white noise maker. It's a gadget from Bed, Bath and Beyond that people use to help promote sleep for themselves or their infant. I'm reminded of this each day when scrolling through the soothing sounds: waterfall, crashing waves, babbling brook, rainforest birds, the bog (or whatever they call dueling frogs and crickets), slow heartbeat (aka - creepy horror movie tension builder) and finally white noise. For 3x the price I could get a unit that looks like R2-D2 and specializes in white noise alone. That kind of money would ostensibly get a product with whiter noise, or perhaps is white noisier. Mine does the trick. Many therapists opt for the diuretic trickling water fountain or cringe-worthy Muzak as their sound screen of choice; to each his own.

The function is simple: it masks the voices from my office so people in the waiting room can't understand what we're saying. Any therapeutic dialogue will sound like Charlie Brown's teacher to those outside. They can perceive that people are talking, but white noise (for auditory physics reasons I haven't taken the time to learn) makes the specific words unintelligible. This is critical. If I work on a 50 minute hour and ask clients to come at least 10 minutes early to their session to collect their thoughts and prepare for the session, we're bound to have moments where the 3pm client is in the waiting room before the 2pm client leaves. Or sometimes a client will come with someone else (like a parent bringing their teen) who stays in the waiting room through the session. In my 80 year-old building with thin walls, masking the sound is a necessity. Without it, the client would have to whisper in order to maintain the privacy of their session. And in the case of the teen brought to session by a parent, the very parent they want to complain about during this session, that small amount of protection provided by the noise machine is priceless.

In order for clients to establish trust in the therapist and therapy relationship, we work to maintain confidentiality. Therapists make a promise to keep private everything our clients say. Our case notes are under lock and key and if someone calls to ask about a client we cannot confirm or deny that person is even in therapy with us. Only in the most extreme circumstances (or with written consent) would we ever share any knowledge of our clients or their issues. We are secret keepers, bound by law. Even to the point of utilizing an electronic noise shielding device so no one can hear what we're talking about. In many offices (including mine) clients even have a separate exit so they won't be seen by the people in the waiting room.

The white noise spewer also has a comical side-effect: these machines are primarily sold as sleep aids, and they work. My warm, cozy, boring little waiting room with the constant "ssssshhhhhhh" of the machine spells nap time for many client-bringers, making for some awkward "see you guys next week" moments. I've got no problem with waiting room dozing, naps are healthy.

If you are a client in therapy, look for the white noise machine the next time you're in the waiting room and appreciate the sanctity of your session. Unless you're a big horror movie fan, keep it off the heartbeat mode.