A Flexible Frame: Holding the Patient in Mind

The author questions the classical psychoanalytic frame as the basis for the analytic container. The history of the concept of the frame and its purpose are reviewed. Five clinical vignettes where the therapy takes place outside the boundaries of the traditional frame (through email, text, or phone) are offered. In each vignette, the patient felt held in mind and valued in a way not accessible during the session, even after many years of treatment. The author questions whether therapy that takes place only within the analytic frame can help the patient who has never felt held in mind by a parental figure. The author acknowledges that the current culture of psychotherapy is changing. She promotes a hermeneutics of trust over one of suspicion and encourages the modern therapist’s use of ancient cardinal virtues over a rule-bound psychotherapy.