chapter  Thirteen
17 Pages

The dynamics of containment

WithDavid Bell

This chapter shows that containment is a central part of all work with psychiatric patients. Like many psychoanalytic terms, the word "containment" has both an everyday meaning and a more technical psychoanalytic one, the latter providing a deepening of the concept and also locating it within a theoretical structure and a model of the mind. In approaching the concept of containment within a service, it is important to bear in mind the many different levels within the system, which interact with each other in complex ways. Central here is the distinction between the depressive position, a state of mind characterized by its capacity for integration and containment, and the schizoid mode of functioning, where reflective thought is severely compromised by the mind's urgent need to deal with overwhelming anxieties. The extent to which such processes enact the split aspects of the patient's mind is the extent to which the possibility of the system's containment of them has broken down.