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Setting Limits

Gene M. Abroms, MD
Arch Gen Psychiatry. 1968;19(1):113-119. doi:10.1001/archpsyc.1968.01740070115017.
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IN THE course of psychotherapy, a patient tells of many concerns and evidences a broad repertoire of behaviors. One of the therapist's main tasks is to link the various details into a meaningful pattern so that his responses to the patient can have a rational basis. A coherent conceptual framework, whether derived from psychoanalysis or some other personality theory, is of immense help because it attunes one to the play of key dynamic forces, such as hostile dependency or competitive guilt. These serve to clarify and connect events which otherwise might seem obscure and unrelated.

The therapist must also appropriately time his responses. He must have some sense of which clue to respond to now and which to revisit later. For example, the experienced therapist, rather than immediately interpret hostility, might first call attention to his patient's exaggerated politeness and only later approach the underlying affect.

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