The consideration of the setting is paramount in any context in which analytic psychotherapy is practiced. When working with patients seen as traumatised and borderline personalities, however, the setting is often the site of contention. One might consider the setting to be constituted by a variety of conditions: the building in which the treatment takes place, the actual therapeutic room and its furniture, the temporal arrangements, even the demeanour of the analyst, but it also includes the type of work that the therapist does and the boundaries around the work that restrict contact with the patient to the analytic time and maintain the confidentiality of the patient’s material.

For all patients, and in particular traumatised patients, the setting can become a facsimile of their internal world. The therapeutic setting they encounter can be filled by the patient with unconscious projections from their wounded past. When the patient perceives the object – that is, encounters the therapist – within the setting, the latter can quickly be imbued with terrifying imagoes. As J. Baldwin (1940), in ‘Many Thousand Gone’, writes, ‘It is not a question of memory. Oedipus did not remember the thongs that bound his feet; nevertheless, the marks they left testified to that doom toward which his feet were leading him. The man does not remember the hand that struck him, the darkness that frightened him, as a child; nevertheless, the hand and the darkness remain with him, indivisible from himself forever, part of the passion that drives him wherever he thinks to take flight.’