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Scharff, D. (2008). Frame and Frame of Mind as Fractals: Commentary on Anthony Bass's “When the Frame Doesn't Fit the Picture,” Ilana Laor's “The Therapist, the Patient, and the Therapeutic Setting,” and Discussion by Susanna Federici-Nebbiosi. Psychoanal. Dial., 18(2):230-238.

(2008). Psychoanalytic Dialogues, 18(2):230-238

Continuation of the Symposium on “The Psychoanalytic Frame”

Frame and Frame of Mind as Fractals: Commentary on Anthony Bass's “When the Frame Doesn't Fit the Picture,” Ilana Laor's “The Therapist, the Patient, and the Therapeutic Setting,” and Discussion by Susanna Federici-Nebbiosi

David Scharff, M.D.

Anthony Bass's evocative paper on the frame details the need for a personally flexible response when patients question the rigidity of an analyst's policies, and for practical alterations in the frame that may follow careful work and may facilitate treatment. However, Bass and the following authors neglect to discuss the need for a foundation provided by a firm, well-reasoned frame in all treatments. Such a frame that creates opportunities for work on core issues should be one focus of all training, and is especially needed in the kinds of roller-coaster treatments that traumatized and borderline patients require. This discussion outlines the reasons a firm frame is required in the first place and uses a clinical example from the discussant's practice to illustrate the hardfought vicissitudes of the frame under trying circumstances, even when there may be eventual modification of the frame.

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