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  • Chapter 5 - Framing a Psychodynamic Space

  • from Part 2: - The Model of Psychodynamic Psychotherapy into Practice
  • Adam Polnay, The State Hospital, Carstairs and Royal Edinburgh Hospital, Edinburgh, Rhiannon Pugh, Victoria Barker, East London NHS Foundation Trust, London, David Bell, British Psychoanalytic Society, Allan Beveridge, Royal College of Psychiatrists, London, Adam Burley, Rivers Centre, Edinburgh, Allyson Lumsden, NHS Greater Glasgow and Clyde, C. Susan Mizen, Devon and Exeter NHS Foundation Trust, Exeter, Lauren Wilson, Royal Edinburgh Hospital, Edinburgh
  • Foreword by Nancy McWilliams
  • Book:
    Cambridge Guide to Psychodynamic Psychotherapy
    Published online:
    25 August 2023
    Print publication:
    10 August 2023, pp 79-88

  • Summary

    This chapter focuses on the concept of a framing a psychodynamic space. People come to therapists in various states of mind. Some people have histories of neglect and may carry expectations of something similar happening to them in the clinic. Some may be looking for help with long-term difficulties. Others may be acutely distressed and not know why. How we as clinicians present ourselves and organise the caring environment is crucial for a space to be created – or framed – where something therapeutic can happen in relation to these initial anxieties. The boundaries of therapy are not created with an expectation that the patient will always hold them, but rather that if they are not set out it is impossible to explore what might be behind them being shifted. We examine various considerations that go into framing a psychodynamic space. We also discuss the realistic limits of what therapy can offer, and an impulse that may arise in the therapist to extend themselves beyond what is possible. Finally, we consider the important topic of boundary violations by the therapist.