ABSTRACT
The therapist's delineation of the ground rules offers a great deal to the patient, but it also generates certain basic anxieties. These same tenets, and the manner in which the patient adheres to or deviates from them, offer much to the therapist, while also generating sectors of danger and anxiety. In secure-frame psychotherapy, the therapist has established the ideal set of ground rules for the patient and is working within that context. In deviant-frame psychotherapy, one or more of the basic tenets of treatment is fundamentally modified. Both secure- and deviant-frame psychotherapy offer the patient some measure of protection while generating an additional measure of danger and anxiety. In addition to the many sources of anxiety and danger, the deviant frame provides the patient with basic manic and counterphobic defences. Manic defences occur when there is a fusion quality to the deviation, pathologically joining patient and therapist.
