What Is… Containment in Therapy

Containment in therapy: client brings raw mashed potatoes, therapist transforms them to mashed potatoes

In this series, I dig a little deeper into the meaning of psychology-related terms. This week’s term is containment.

British psychoanalyst Wilfred Bion first proposed containment to describe a pattern of communicating mental experiences. Another researcher later suggested that Bion’s traumatic experience fighting in World War I influenced the development of his theory.

Early life containment

Containment is theorized to begin between a child and its mother. The containment that the mother provides for the child’s inner experiences promotes healthy child development.

Early-life containment happens in this way:

“The normally-empathic mother with intact ego functions is able to gather in and decipher (introject) aspects of the infant’s experience beyond its current cognitive and emotional capabilities. The mother returns to the infant tolerable aspects of her experience of the infant’s (projected) experience.”

Billow, 2000

Essentially, it’s the mental equivalent of mom picking up the potato that a young child isn’t able to do anything with, then taking it into mommy’s kitchen, and finally emerging with a bowl of mashed potatoes. This allows the child to eat the potatoes, but they also start to learn how dirt-covered raw potatoes can be transformed into mashed potatoes in the first place.

Thought loops

While it’s desirable to provide some level of containment for one’s own thoughts and feelings, Bion believed that this could sometimes lead to getting trapped in thought loops. His solution to this was:

“…the assistance of the other, the possibility to temporarily lean on someone else’s ‘rêverie’ and containment capacities, a possibility which was a necessity at the offset of the individual’s existence, and which analysis can resume once more to allow the individual to introject a more ‘solid and durable’ system of response to the ‘emotional complications of life.'”

Godbout, 2004

Containment in therapy

In therapy, containment can happen in more than one way. The psychoanalytic therapist must be able to contain their own reactions to what the client is putting out there, also known as countertransference, in order not to project those reactions out towards the client. Countertransference is viewed as therapeutically useful in psychoanalysis; however, it should stay contained within the therapist rather than spilling out onto the client.

An important form of containment that the therapist provides is along the lines of what happens with mother and child. The therapist is able to receive and hold the client’s raw, distressing inner experiences, make some therapeutic mashed potatoes, and then serve it back to the client in a way that can foster safe growth and understanding.

A paper by Billow describes the process of the therapist containing distressing mental experiences as being more important than dealing with the actual content that the client is putting out there in the early stages of the therapeutic relationship. Essentially, it’s less important whether the client is passing over a potato or a yam, and more important that the therapist can do the mashing and serve it back in a form that can be worked with.

Does containment make sense?

I have mixed feelings about psychoanalytic theory. Some ideas are on point, while others are rather out there. To me, the idea of containment sounds intuitively very reasonable in the context of the therapeutic relationship, regardless of how well it may or may not apply in early life. I’ve never done psychoanalytic or psychodynamic therapy, and I don’t think we would get along, but in general, I’ve never had the kind of therapeutic relationship where there was an element of containment.

Is this something that you’ve experienced, in therapy or otherwise?

References

The post Psychotherapy Alphabet Soup: CBT, DBT, ACT, and More provides an overview of a variety of different therapeutic approaches.

The Psychology Corner: Insights into psychology and psychological tests

The Psychology Corner has an overview of terms covered in the What Is… series, along with a collection of scientifically validated psychological tests.

Ashley L. Peterson headshot

Ashley L. Peterson

BScPharm BSN MPN

Ashley is a former mental health nurse and pharmacist and the author of four books.

15 thoughts on “What Is… Containment in Therapy”

  1. I worked a lot with this concept, both myself as a psychologist and as a client. It is one of thé most important things and a concept that I value very much.

    Your analogy with the potatoes is spot on because that is what mothers do and therapists also. I found it particularly useful when working with psychosis when the inner world is shattered. Psychosis and mother-baby is in my experience, I can’t say anything about other settings.

  2. I like the potato to mashed potato analogy. It reinforces the vital nature of the therapist’s role too with how the mashing and handing back of the potato is perhaps more important in the process. Interesting one to cover, Ashley! We actually didn’t cover this in my Psych degree but I remember doing outside reading (only very brief) around some of the theorists in this area. xx

    1. I think the difference between the two has a lot to do with the different theoretical perspectives they come from. Reframing is very cognitive, and is something that someone can do alone or work on with a therapist.

      Containment involves thoughts and emotions, and like anything else from psychoanalytic theory is a lot more dependent on the therapeutic relationship.

  3. Yes. T-1 would feel our feelings—since we didn’t know how to, process them, and explain them to us. T-1 would include T-1’s reactions sometimes. This seems hard to avoid, but T-2 never includes T-2’s direct reactions, but they are evident in how T-2 processes our experience. We both disdain therapy and feel like we need it to make sense of life. We are really low right now. COVID distancing is ruining therapy. We are struggling to get by

  4. I’d say my therapy in the early and middle stages needed a lot of containment. Love the mashed potato / mashed yam analogy. It’s pretty much like that for me. I can do a lot of processing myself now, but she’s started really… Pushing us to… Go deeper, mash harder?

  5. I’ve obviously mentioned in my blog that I had long-term therapy and I felt that counsellor was able to contain all my gut-wrenching and raw emotions many a time. It’s like she stayed with me throughout my counselling journey and held me together. Like you say sometimes she gave me mashed potato and sometimes potato chips 😉

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