Frame vs. Boundaries

Frame vs. Boundaries

If we think of the frame as the room you are in, boundaries are your skin. If you have a good immune system, you don’t need to be in a sterile environment. Similarly, if you have good boundaries, your frame can be somewhat more flexible. However, even if we have good boundaries, our patients, frequently, do not.
Boundaries are how we know where we stop and the other person begins. As therapists, we often have fairly porous boundaries — we absorb information and feeling states from other people without knowing who is doing the feeling. (We may call this being intuitive.) When we are with patients who use projective identification as a defense, for instance, the patient projects onto us feelings that are intolerable, and often acts in ways to evoke those feelings in us. For example, if a patient is feeling inadequate, nothing we say will be right, and by the end of the hour, we may feel like we’ve chosen the wrong profession!
If we have good boundaries (or good consultation, therapy and/or experience), we will be able to identify more readily when the feelings do not originate in us. Sometimes particular feelings are more difficult to sort out than others; these are feelings that the patient holds that resonate with us or our own disowned, “shadow” material.
I may get sleepy when sitting with a patient, when I have felt rested or alert when the session began. This is a signal to me that there is a level of deadness in the room, usually when anger or another painful feeling is being suppressed. Although I cannot control the feeling of sleepiness, I have an understanding that the feeling may not originate in me, but my response shows my own vulnerability to taking that feeling on.
Margaret Atwood wrote a wonderful poem with the following lines, which I consider a metaphor for projective identification (about which I’ll write more when I write about defenses). She wrote:

You fit into me
like a hook into an eye
A fish hook
An open eye

We could even substitute “I” for eye, since it is usually our ego that makes us vulnerable. The idea, however, is that we connect with another, for better or worse, through our vulnerabilities. Sometimes we may make an interpretation that will feel like an attack to the patient – our hook hits their eye. Other times, what our patients say or do penetrates our boundaries.

It’s not always painful. Moments of closeness are also moments when our boundaries are loosened. Jung wrote of “being in the soup” with the patient as a way of describing the dissolving of boundaries that occurs when we do our deepest work. He held, and I concur, that it is necessary for some merging of the psyches between the analyst (or therapist) and the patient for therapy to be truly transformative.
I also believe, however, that the state of “being in the soup”, of merger, needs both to be a temporary experience, and one that is thoroughly explored and analyzed, even if not explicitly discussed.