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Reflections From President Blau: The Therapeutic Frame

January 28, 2016

Our monthly blog feature from MiSPP President, Dr. Diane Blau, discussing what’s on her mind and in her heart regarding MiSPP and the field of professional psychology.

Imagine a favorite painting, the lines, colors, and textures within, and how it all comes together in an impressive gestalt. Everything within the frame of the painting is essential to its impact; clinical psychology school Diane Blaunothing need be added or removed.  The frame defines boundaries such that focus remains on the image alone.

I often think of therapy using the analogy of a framed painting.  Psychotherapy is the painting that emerges from the borders of the frame: a “therapeutic frame”, if you will.  Considering how to respond, when to be silent, when to comment, or how to intervene, I think of the process that is unfolding between the client and myself as brush strokes within the painting.  One marking interacts with the other, like an improvisational dance.

During the interaction, I strive to stay within the frame of therapy and remain present to the client.  I hope to facilitate articulation and descriptions of experience in expressions suitable for this particular person at this particular moment. One client may communicate best by talking, a second with role-play, a third by writing and yet another may decide to draw. All the while, I am careful not to interfere through irrelevant or distracting statements or questions.

Concentrating on the client’s expressions and desiring to further the exchange and engagement between us (enhance the painting process), I ask myself whether or not my words or actions belong within the frame or should better remain outside of it.  Will my words or actions promote client awareness, generate deeper understanding or enable a potential shift?

It is not my intent to imply that differentiating between what belongs in the therapeutic frame and what must stay out is simple. Boundaries, along the entire continuum, can be challenging to maintain and become problematic for even the most seasoned practitioner. Missteps and mistakes occur throughout therapy.  Fortunately we find out rather rapidly, from our client’s reaction, when we veer off course, and are able to regroup and steady our approach.

Using the painting and frame analogy, that is, imagining the therapeutic process unfolding as an emerging painting within a distinctive frame, might be a helpful cognitive and visual resource as we reflect on clinical work. The imagery calls us to hold and preserve the space within the frame solely for the unfolding therapeutic process while carefully recognizing the boundaries that the frame defines.