Containment in trauma
The definition of containment according to the English Oxford Dictionary, is ‘the action of keeping something harmful under control or within limits.’ Containment in this instance is a stopping of the spread of contamination and a controlling of infection or epidemic. Containment also suggests a space of some kind that has the capacity to hold and to be filled. Whether it is a fire or a disease, a rage or an anxiety, containment is ultimately concerned with making things safe. Containment also represents that most essential and fundamental of experiences between a mother and child. It is a taking in of what is most primitive and primal to an infant and an offering back of what is manageable and sustaining. It is this capacity to take in what is toxic and poisonous without feeling overwhelmed that is crucial for the child. In this instance, containment represents an experience of resilience, providing the child with the ability to introject or take inside something of the mother’s capacity to tolerate what is terrifying and anxiety provoking. This internalisation of the good enough mother’s capacity to remain with and not become over-burdened forges in the child a capacity to manage and eventually think about its anxieties without fusing with them.
According to Wilfred Bion (1897-1979)(1962a), the good enough mother is perceived as the container for her child and the receptacle for all the good and bad feelings that assault its infancy. The child’s distress is projected onto the mother whose work is then to contain her child’s anxieties. ‘If the mother cannot tolerate these projections the infant is reduced to continued projective identification carried out with increasing force and frequency.’(Bion,1967: 115) A degree of attunement is therefore required for the mother to respond in a containing way to her child. According to Bion (1962a), as well as accepting the child’s experience of wanting and longing the mother also provides meaning to the baby’s earliest and most intense and distressing experiences. Bion (1962a) identified this process as a transformation of elements. Beta elements, or the infant’s projections which are of a sensory-somatic quality, are transformed by the mother into something more mental and therefore more appropriate for thought.
The value and importance of external attachment relationships are vital for the child and it is ‘the distinct presence of ‘other’ who can think about and make sense of the situation and offer this emotional ‘cognition’ to the baby.’ (Levy & Lemma, 2004: 17) In other words, the quality of containment provided by the significant other is crucial in facilitating the bringing together of good and bad experiences. This bringing together of apparent opposites creates an experience of ambivalence and the capacity to hold contradiction and ease splitting. What the mother does for the child the therapist attempts to provide for the patient.
A traumatic event represents a breakdown in containment where both the internal and external containers have been damaged. The capacity to hold what is felt to be dangerous and unpredictable has been lost and the good internal objects that had been fostered are left incapable of preventing an overwhelming assault to the senses. When containment is damaged in this way then contamination occurs resulting in a flooding from the inside and outside. A renewed experience of containment is then crucial in making things safe for the client for ‘without a renewed experience of containment there is no real treatment.’ (Garland, 2002: 29)
In essence, a trauma damages the capacity to think symbolically and a renewed experience of containment is required. The processing of a traumatic experience requires the restoration of an internal good object that can facilitate the bringing together of good and bad experiences. This renewed experience of containment not only provides a vital relationship in which the act of reworking can occur it also provides the patient with the capacity to experience phenomena mentally rather than concretely.
Bion W (1962a) Learning from Experience. London: Karnac Books, 1984.
Bion W (1967) Second Thoughts. London: William Heinemann Medical Books Ltd. Reprinted, A. Wheaton & Co. Ltd, Exeter, 1987.
Garland C (2002) Understanding Trauma: A Psychoanalytic Approach. Second Edition, H. Karnac (Books) Ltd.
Levy S & Leema A (2004) The Perversion of Loss: Psychoanalytic Perspectives on Trauma. Whurr Publishers Ltd.