Home PageArticolo rivistaThe unaccettableness of the “limit”: strategies of encouragement in front of the “violation of the setting” in psychotherapy

Levy T.
Pubblicato nel numero: Year XXXVIII January – June 2010 – Number 67 – SUPPLEMENT (contributions to XXI Congr. SIPI “The encouragement strategies...", 2009)
Parole chiave: Encouragement, Setting, Limit, Therapeutic distance

The unaccettableness of the “limit”: strategies of encouragement in front of the “violation of the setting” in psychotherapy

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Summary.  The “violation of the setting”, amply treated by the psychoanalytic literature, includes neither sexual intercourses between therapist and patient, nor it can be simply identified as transgression of formal rules defined in the therapeutic contract: indeed it consists in some behaviours and attitudes, very distinct among them, dealing with the problem of “distance”: it means that the patient cannot accept and respect the boundaries between inner and outer world, the Self and the Other, the therapeutic setting and the real life. In the reported clinical case many “acting-out” behaviours observed during psychotherapy sessions (e.g. missed therapeutic sessions, leave session without paying, calling therapist over weekend, demanding little items for gifts, etc.) represent unconscious tempts of the patient to  destroy therapeutic relation, in order to verify the possibility to be considered and loved, in real life, primarily as “individual”, not as a “patient”. In such situations, which generally belong to personality disorder, the therapist can use either encouragement strategies or interpretations, according to circumstances and to patient’s insight capacity, but he should be perfectly conscious of the risk of favouring a “regressive dependence” through his “counter-transference” and his “counter- violation”
of setting.

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