ABSTRACT
Differences in capacities for relatedness interest people in planning psychotherapy because no matter what our interventions, they are presented and responded to within the context of a relationship. Relationship impairments at a moderate level of severity are subtler. These impairments can occur in a variety of patients, including those with borderline disorders, certain narcissistic disorders, and certain pervasive developmental disorders. Patients with deficits in their ability to integrate good and bad experiences with others build alliances with an inherent weakness. While boundary difficulties always inform the problems the patient comes with, it is necessary to establish sufficient boundaries within and around the work to allow adequate focus and energy to look at those problems. Langs called this 'setting the frame'. Mild deficits in the capacity for relatedness need attention because although they may escape notice in brief treatment, they emerge as problems in long-term therapy alliances. Patients with mild deficits may form a pseudo alliance.
