The Boundaries are Shifting: Renegotiating the Therapeutic Frame

Shapiro, Edward R. M.D.

Psychodynamic treatment is under siege. Shifting societal values and increasing economic pressures are shaking the structures of our work. The Author examines this crisis by looking at the phenomenology and current treatment of personality disorders. Using this illness as a lens, he notes the impact of current pressures on therapists' ability to establish a reliable framework for dynamic treatment. Such a framework has always included the interplay of interpretation and management (Milner, 1957; Baranger, 1966; Langs, 1976). The increasing intrusion of third parties into the treatment setting, requires us to reconsider the relationship between these two methods of intervention.

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