Making interpretations and securing the frame: sources of danger for psychotherapists

The basic sources of anxiety and danger experienced by psychotherapists and psychoanalysts in their work with patients are examined. Psychotherapy and psychoanalysis, since they are on a continuum, will be used interchangeably in this paper. Among the sources of such danger are the therapist's use of the two most basic interventions as required by the therapeutic needs of the patient: interpretations and securing the ground rules or framework of the ideal treatment situation and relationship. It is proposed that the present standards of interpretation and ground rules, as they characterize current psychotherapeutic practice, have been fashioned in significant measure by needs within psychotherapists to defend against their own anxieties related to the emergence and realization of their own madness within the course of a therapeutic interaction with a patient.