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Mar 9

Choosing to make use of a patient-initiated frame bend: The discovery of ritual within spontaneity: Dr. Hilary Offman

March 9, 2022 @ 7:30 pm - 9:00 pm

Making valid use of a frame bend in a relational framework: The discovery of ritual within spontaneity

Presented by: Hilary Offman, M.D. FRCPC

Wednesday, March 9, 2022
7:30 p.m. – 9:00 p.m. EST
Event Held Online via Videoconference; Zoom link will be sent upon registration



How can we make use of relational freedom without contributing to a caricature of relational theory as a set of undisciplined interventions that some have labelled insufficiently psychoanalytic? This presentation explores how discovering relational ritual within a spontaneous frame bend can support making use of it as a valid psychoanalytic choice.

We often think of psychoanalytic rituals as already established ways of being with patients. But ritual can also be defined by its function—distinguishing psychoanalytic actions as special relative to regular, everyday actions (Bell, 1992). In that case, we can also include individualized and co-constructed psychoanalytic interventions that we end up adopting as ritual.

I will present a case of a therapeutic impasse in which I spontaneously respond to my feelings of “countertransference urgency” (Schwartz-Cooney, 2018) by offering a patient the opportunity to join me in a knitting group outside of our customary analytic frame. While I remained mindful of the pitfalls associated with choosing to engage with my patient outside the analytic hour, I also believed there were significant therapeutic potentials inherent in working within this newly expanded frame. But I did not want to be accused of undervaluing psychoanalytic ritual when I agree with Hoffman’s (1998) assertion that the presence of asymmetrical psychoanalytic ritual is vital for the psychoanalyst’s power to transform.

It turned out that working with the frame bend was transformative in a way that neither my patient nor I could have foreseen. I believe that the discovery of ritual within the frame bend supported the maintenance of the ritual-spontaneity dialect underlying a relational framework, rendering it a psychoanalytically valid intervention.


Hilary Offman, MD FRCPC is a psychiatrist and psychoanalyst with a private practice in Toronto. She is a lecturer and supervisor in the Department of Psychiatry at the University of Toronto, with hospital appointments at the University Health Network and St. Michael’s Hospital. She is also a supervising analyst and Board member for the Toronto Institute for Contemporary Psychoanalysis (TICP). She is the former co-chair of the Candidates Committee for the International Association of Relational Psychotherapy and Psychoanalysis (IARPP) and a current member of the IARRP Board of Directors, where she chairs the International Membership Outreach Committee. She is a member of the Editorial Board for the journal Psychoanalytic Perspectives. Hilary has presented her work at several international IARPP conferences, Division 39 of the American Psychological Association, the International Health Humanities Consortium, and the International Federation of Psychoanalytic Educators (IFPE). Upcoming presentations include the Examined Life Conference sponsored by the University of Iowa’s Creative Writing Center and the Austin Psychoanalytic Institute. Hilary’s articles are published in Psychoanalytic DialoguesTransgender Quarterly, and her most recent paper, “The Otherness of Fat- An Intersectional Enactment of Epic Proportions”, in Psychoanalytic Perspectives. Her papers, “The Princess and the Penis” and “The Queering of a Cisgender Psychoanalyst,” are used to teach about working psychoanalytically with patients who identify as non-binary. She knits simple projects with yarn that is too expensive. Her husband is a paediatrician and neonatologist in the Department of Paediatrics, University of Toronto. Her golden doodle Steve supervises her in her office, and her son comes home from university periodically for elaborate meals.

Free to all TSCP members. To check your membership status, please contact the administration office. Non-TSCP members may attend for a fee of $25; contact info@ticp.on.ca for registration.

Pre-registration is required


March 9, 2022
7:30 pm - 9:00 pm
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online via Zoom


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