Holding and containing. The same or different?
The psychoanalytic terms “holding” and “containing” originate, from the writings of two prominent psychoanalysts: ‘Holding’ in the papers of Winnicott (1960); ‘containing’ in the papers of Bion (1962). The current focus in psychoanalysis of emotional nurture and exchange rather than one of hedonic satisfaction, is primarily as result of Winnicott’s writings and observations. Both terms are now part of the core vocabulary of all therapists, and many other helping professions.
Winnicott’s philosophy of normal development highlights the holding milieu offered to the child in the initial phase of life. Object relation theory refers to the idea that the self-ego lives relative to other objects, which may be outside or inside the psyche. Internal objects refer to internalized adaptations of external objects, formed from early exchanges with parents. The theory of holding includes both bodily and emotional features and promotes the infant’s ego-incorporation, his aptitude for object relating, and ultimately his ability for object usage.
Winnicott describes the holding environment as a developmental stage in which the child and mother are one entity, as yet undifferentiated in the infant’s consciousness. His writings on the subject emphasized empathy, imagination and love between the caregiver and infant. The core purpose of “holding” is to allow the child to be completely unconscious of his requirement for a separate individual:
“It is axiomatic in these matters of maternal care of the holding variety that when things go well the infant has no means of knowing what is being properly provided and what is being prevented.” (Winnicott, 1960, p.52)
Winnicott (1953) conceptualized the psychic space between the mother and her infant, describing it as neither wholly psychological nor physical:
“It is in the space between inner and outer world, which is also the space between people–the transitional space–that intimate relationships and creativity occur.”
This he termed the “holding environment”. The holding environment facilitates the child’s transition to autonomy. Failure on the Mother’s part to provide an adequate holding environment results in a “false self disorder”, according to Winnicott. Winnicott’s theory of “false self disorders” is strikingly similar to descriptions of the schizoid personality by Laing in “The Divided Self” (1960), whereby the individual’s personality is characterized by a complete lack of harmony, resulting in a distant attitude, emotional coldness and idiosyncratic autism
Winnicott argues one of the primary purposes of the therapist is to provide a “holding environment” for the client, in order that the client may begin to recognize and meet previously neglected ego needs and facilitate the emergence of the true self.
Containment is similar and yet fundamentally different to holding. Bion’s theory of containing originates from the idea that the infant projects into its mother feelings that are upsetting, fearsome, painful or in some other fashion, intolerable. The mother in turn feels the emotion herself, and is able not to react to it, but instead to contain it and give the child back the feeling in an adapted and contained form to the infant, so the child can repossess it and reintegrate the emotion as its own.
Containment is crucial in a therapeutic context as a way of providing a safe place for the client to look at feelings that otherwise are likely to be experienced as overpowering and bewildering. The importance of this in the healing process cannot be under-estimated. Individuals who have experienced extreme pain, fear, desertion and anger will often find it difficult to think; they may find it particularly difficult to think about their emotions, which can remain completely exempt from consciousness, and hence unavailable for reflection.
When such emotions due enter consciousness they do so with such tremendous power that thought becomes unbearable. Hence, behaviour demonstrated by the individual’s children, or conflict with partners, which is perhaps irritating or creates feelings of discomfort, can provoke uncontrollable fury and distress. In relationships with therapists, clients will project at least some of these difficult feelings, particularly the ones least available to consciousness and most unbearable. Hence the therapist will experience in some way, the feelings their client is most unable to feel, verbalise and comtemplate. If a therapist can be aware of such feelings, and find some way of starting to put them into words, then the process of the client reclaiming these feelings, thinking about them and integrating them into their sense of self, begins.
In Bion’s view, the infant itself is not contained – the Mother manages the difficult emotion projected into her and returns it in a more manageable state to the child. As a result the infant is likely to develop an overall sense of wellbeing, and containment as a consequence of a wealth of similar experiences of having an uncomfortable emotion contained and returned. Bion focused his writings on the method by which the infant copes with fury and frustration. He argued that through the mother’s ability to contain those projected feelings, the infant is able to grow the capacity to think, to contain its own emotions and to use them as a source of reflection. Thus containment does not involve responding to a client’s expressed needs. It does not involve alleviating their anxiety via the provision of help or comfort. Nor does containment involve the provision of medical aid, money, or advice. Containment involves a discourse which looks to find expression for previously unspeakable feelings and experiences as they are projected into the psychotherapist.
Let us consider an example from psychoanalytic practice. A 33-year-old mentally handicapped man attended every day a sheltered workshop where he engaged in menial and demoralizing tasks. He eventually sought treatment from a therapist, who believed that the client had a mental capacity capable of higher-grade work. In the therapy sessions the client would sometimes utter, “ I am 33 years old and is that nothing?” and then a minute later, “ Can’t you give me a picture of who I am?” After consideration, the analyst responded by saying:
“The fact that you feel they have been thirty-three years of emptiness, waste and nothingness is so painful that it is better to have people’s picture of you than to face this ghastly nothingness.”
The client responded:
“Well, if you won’t give me a picture what do I come here for?”
This prompted the therapist to stand, place himself next to the client him and say:
“It is like this. There in front of us is thirty-three years of waste, nothing and emptiness. It is like sitting in a train and opposite sits a man with a wounded and diseased face and it is so horrific that you have to hold pictures up in front of you because it is more than you can bear. But the reason you come to see me is that perhaps there is just a possibility that if you have me beside you then you can look at it.”
Until this point the client had been unable to manage his painful feelings relating to thirty-three years of “waste, nothing and emptiness.” The incident is also reminisant of a mother’s dealing with a distraught child in manner that allows the potential of the distress eventually being held and managed in the infant’s own mind. Here the therapist seeks to demonstrate to the client that these feelings are manageable if they go through the therapist and reflect upon them together.
The concepts of holding and containing the client are a strong theme in psychodynamic counseling, following the revolutionary input of Winnicott, Bion, and Klein. Winnicott wrote extensively about the mother holding her baby, which he interpreted into the client–counselor relationship. Bion, however, considered the issue of containment, and looked at how Mothers keep their baby safe from it’s intolerable thoughts. From there, the concept of the therapist as a container of the client’s most unbearable thoughts became popular.
Containment and holding are inextricably linked as in order to contain difficult emotions and then return them to the client in a manageable fashion, the feelings must be “held” by the therapist – s/he holds the pain, anguish, confusion and demonstrates to the client that these feelings are in fact tolerable after all. Containment may be described as the ability of an individual to “stay with” the suffering of another being, whilst psychologically and emotionally holding the anguish in a way that allows the emotion to be survived by the bearer. Casement (1985) described the key dynamics of containment and uses the terms containment and holding interchangeably:
“… a form of holding, such as a mother gives to her distressed child. There are various ways in which one adult can offer to another this holding (or containment). And it can be crucial for a patient to be thus held in order to recover, or to discover maybe for the first time, a capacity for managing life and life’s difficulties without continued avoidance or suppression.” (pg. 42)
Both containment and holding focus on the emotional development of the infant. The current fashion for cognitive analysis finds little attention here. Bion’s theory emphasises the emotional aspect containment by reference to the mother’s containing of the child’s projections of uncomfortable feelings. She mentally digests them, makes sense of them, and via her understanding, empathetic response she allows the infant to have a meaningful emotional experience and alleviate it’s distress. Winnicott’s idea of holding also focuses on the emotional aspects of this developmental process as he describes the mother’s total attunement to her child is based upon her empathy with the child; this encompasses the holding purpose and allows the infant’s ego to integrate and his instincts to be fulfilled (Winnicott, 1960).
Both terms, containment and holding, place similar emphasis on the experience of bereavement, separation, abandonment as the primary stimulator of learning and cognitive growth. Winnicott ( 1958) does note, not simply the disillusionment and pain side of the equation, but that there needs to be a balance between the two in order for healthy development to occur. Similarly, Klein (1937) placed some emphasis on balance as opposed to just the negative experience. She repeatedly wrote that the introjection of the good breast was a fundamental for future development. Generally however, both theorists consider the experience of uncomfortable emotions to be all-powerful and the need to manage them basic and crucial. Similarly, Bion stresses the effects of harmful experiences in Learning from Experience (1962).
‘The link between intolerance of frustration and the development of thought is central to an understanding of thought and its disturbance’ — what matters is the choice the personality made between procedures designed to evade frustration and those designed to modify it.’ (pg 102)
Bion (1962) also outlined described a function of the mind which that allows thoughts to be thought about – alpha function. He argued that thoughts come before thinking, and suggests that:
‘thinking is something forced on an apparatus, not suited for the purpose, by the demands of reality, and is contemporary with, as Freud said, the reality principle…. The apparatus has to undergo adaptation to the new tasks involved in meeting the demands of reality by developing a capacity for thought.’ (pg. 57)
Bion (1962) did not consider the idea that the alpha function might also work on the basis of contentment, happiness, and other experiences positive, enjoyable experiences. Equally, he did not suggest that the mother’s containment of emotions might also work upon on experiences of pleasure. Winnicott, however, makes reference to the mother holding the baby through episode of exhilaration. But neither writer seemed to consider the mother’s ability to offer inspiring or enjoyable experiences as a facilitator to intellectual and emotional growth.
Melanie Klein held with Freud’s hedonic philosophy, viewing the infant’s incessant explorations as aimed at seeking pleasure. Klein argued the infant’s psychic drama was acted out inside its own subjective space, with figures that were the demonic projections of its own undeveloped sense of reality. According to Klein, the definite environment and its people were of no interest to the infant. Here marks a crucial distinction between holding and containing; in Winnicott’s holding theory, although the child is unaware of its interdependence, the child is wholly dependent on Mother for holding of difficult emotions. The infant does not project difficult emotions into its own subjective space; instead in holding theory, the psychic space is shared by the Mother and infant, as a one unit.
Winnicott absorbed much from Klein, and in many ways their theories are similar. Crucially, however, Winnicott (1975) argued that the infant searches for complex forms of relationship and reciprocity, and not simply its own pleasure, as believed by Klein. Winnicott held that the infant’s development cannot be understood without considering its real environment, the objects, responsive or non-responsiveness the infant experiences, that then either build a “facilitating environment” for emotional growth, or alternatively cause the self to bury itself, its place taken by an inflexible, automatic substitute (the false self). Thus, Winnicott once said, “there is no such thing as a baby” on its own: we are always dealing with a “nursing couple.” Winnicott’s theoretical writings emphasized empathy, imagination, and, in the words of philosopher Nussbaum, who is an advocate of his theories, “the highly particular transactions that constitute love between two imperfect people.”
Some of these differences have been reconciled in the work of John Bowlby (1979). His attachment theory attempts integration of the cognitive and affective, the inner and outward appearance of human social relations. Bowlby and other attachment theorists (such as Mary Ainsworth) showed early patterns of attachment tend to be enduring and add to the representational models, or ‘inner world maps’, of the self in relation to the primary caregiver – they become ingrained or internalized. Bowlby argued that the ‘secure base’ provided by the Mother in attachment experiments, mirrors the way the therapist also provides for the patient in his internal explorations. This is similar to Bion’s “containment” and Winnicott’s “holding”, according to Bowlby (1979) and amalgamates the two concepts.
In answer to the original question, we must consider what is the purpose of such a distinction? Many well-known psychoanalytic theorists and expert psychotherapists advocate working with clients in a fashion devoid from intellectual arguments and fixed theoretical leanings, in order to promote a greater naturalness, aliveness, and sense of reality in therapeutic sessions (Belger). Debatably, this is really only viable once an initial stage of training and practice has been completed whereby theory has been used and internalized to such a degree that the analyst’s own subjectivity as an analyst has evolved. Hence the importance of understanding the theories of containment and holding are central to a budding psychotherapist. However, the two concepts in practice aim to produce the same effect, one of manageable, controlled emotions that do not overwhelm the client. Holding and containing are not things therapists do to clients. Rather, they constitute a collaborative process of development, which occurs only through the contact and conversation therapists have with their clients.
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