ABSTRACT
This chapter discusses the Iris Ackerman's disclosure of dream to Kate, a 23-year-old patient with bulimia and a clinical material that emerged as a result. Ackerman explores a theme centered on 'bothering', 'being a bother', and 'mutual bothering' that becomes a pervasive part of the fabric and texture of her patient's analytic treatment. In discussing the co-constructed dynamics of this shared dream event new and creative territory become available that allowed them to explore boundaries, need, desire, hope, and the denial of all. To the degree that eating-disordered patients fundamentally struggle with deficient self-regulatory functions, being a bother, apologizing for being a bother, or mutual bothering between patient and analyst may represent the patient's best attempt to communicate the degree to which developmental needs and deprivations may have been denied or dissociated. Evolving viewpoints define boundaries as the "structural characteristics of the therapeutic relationship that allow the therapist to create a climate of safety".
