On Limit and Limit Setting

It was 6:30 on a Friday evening in the midst of a long, cold winter. Snow had been falling all day, and the hospital building in which my office was heated seemed to be deserted. The stillness was broken only by the whine of an occasional car bravely skidding through the snow, the tick of the clock, and the urgent sound of rapidly sucked breaths. Erika, my young patient, sat across the room from me, straining forward on the edge of her chair. Her face was flushed, her eyes bulged, and I could see a vein pulsing on her neck. Out of the corner of my eye, I checked the clock once again and noted to myself that we were now precisely 30 minutes past the scheduled termination of our session. I was already 15 minutes late for a dinner party.

This was our second session of the day. Erika had been apprehensive about the prospect of the upcoming weekend; she had felt panicky and self-destructive, and had requested an extra hour at the end of the day. I was now hungry, tired, and not feeling particularly useful. So for the third time in 30 minutes, I said definitively to her, “We really do have to stop now. “Andfor the third time her breathing became more rapid, her fists clenched, and she barked: “I am not leaving this room until you do something to make me feel better. “After a long, tense silence, I got up from my chair and began to pack my briefcase. With this, Erika sprang up and stood facing me. As her face contorted with rage, she screamed, “If you try to leave, III kill you!” As we stood there looking into each other's eyes, for what seemed an eternity, I began to notice that my legs were shaking.

It will be my purpose in this article to explore the nature of limit and limit setting in psychoanalysis and psychoanalytic psychotherapy. Despite the fact that the clinical material to be considered here is derived from therapeutic work with a deeply disturbed, hospitalized patient with a severe disorder of limit, questions in regard to limit and limit setting are germane in e