You Can't Do That — Or Can You? Historical and Clinical Perspectives on Limit Setting in Child Psychotherapy

摘要

Early child analysts favored a permissive approach in treatment rather than one that valued limit-setting; this paper suggests that a return to this early analytic practice can be productive. Clinical examples are presented of children who were brought to treatment with limit-setting difficulties and were offered treatment where only the time of sessions was limited. These children tested limits, broke rules, acted out, and misbehaved in the early stage of their treatments. They attempted to engage their therapist in the power struggles that were so common and comfortable for them in their experience with authority figures. Gradually, they developed dissatisfaction with their struggling and rule-breaking, an interest in controlling their own behavior, and the ability to do so. For these children, the ability to experience themselves as out of control was an important precursor to their developing internalized controls; as long as authorities demanded that they control their behavior, they experienced the power struggle, but not their own need for control. In the absence of external controls, they were able to decide to limit themselves; this allowed them to become allied with the therapist in facing their dynamics and difficulties in other areas.