Containing States of Mind

Exploring Bion's 'Container Model' in Psychoanalytic Psychotherapy

Duncan Cartwright

• Publisher: Routledge
• Year: 2014
• eBook ISBN: 9781317762911
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

Wilfred Bion's insights into the analytic process have had a profound influence on how psychoanalysts and psychotherapists understand emotional change and pathological mental states. One of his most influential ideas concerns the notion that we need the minds of others to develop our own emotional and cognitive capacities.

In Containing States of Mind Duncan Cartwright explores and develops some of the implications that Bion's container model has on clinical practice. He argues that the analyst or therapist best fulfils a containing function by negotiating irreconcilable internal tensions between his role as 'dream object' and 'proper object'. The container model is also used to illustrate different 'modes of interaction' in the analytic field, the nature of particular pathological states and some of the key dilemmas faced in attempting to make unbearable mental states more bearable.

As well as addressing key theoretical problems, Containing States of Mind is a clinical text that renders complex ideas accessible and useful for psychotherapeutic and analytic practice and as such will be essential reading for all those involved in the fields of psychoanalysis and psychotherapy.

Chapter 1

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Encountering unbearable states of mind

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Wilfred Bion’s ideas about psychoanalysis and psychotherapy continue to enrich our thinking about how we should approach analytic encounters. In this book I explore and develop his model of the container and related ideas. Bion’s ideas about the container stand out as a major contribution to understanding the invariants of analytic experience and the transformatory conditions for generating psychic meaning and change. Grotstein (1979) goes so far as to say that the container-contained configuration uncovers ‘a new natural law’ (p. 110), a new way of organizing material that exposes new ways of seeing the order of things. However, despite the usefulness and popularity of the idea of ‘containing’ in various forms of psychoanalytic practice, understanding and application of ‘the container model’ varies greatly and still remains relatively under-theorized. The focus of this volume is twofold: first, I explore various theoretical aspects of the container model putting forward ideas about how I apply it in the therapeutic setting; second, I explore and develop some implications that the model has for understanding the development of pathological states or ways of thinking.

Developing Melanie Klein’s (1946) ideas about projective identification, Bion thought that projective identifications, split-off parts of the self that are located in other objects, required containment in another mind if they were to be modified in some way. His thinking introduces a particular dynamic that he based on the prototype of a sexual union denoted by ♀♂ (container-contained).

Bion’s container model can be applied in various ways at different levels of abstraction. In the clinical setting it translates into a model whereby the analytic pair (predominantly the analyst) attempt to make unbearable mental states more bearable, in turn, enriching the scope of the experiential field. Because unbearable mental states remain separated, split off, from the patient’s core self, the therapist’s containing function relies on attending to thoughts and feelings at the periphery of his awareness. For this reason the therapist’s reverie, his dream thoughts, become a gateway to accessing unprocessed experience that requires further psychic work. In this way the therapist’s container function becomes part of broader psychic processing system, picking up on and attending to parts of the patient’s internal world that for various reasons cannot be tolerated or given meaning. There are many questions here:

• How does one apply Bion’s container-contained configuration to the clinical setting?

• What is the difference between the ‘container’ function and the container-contained configuration?

• How does the analyst make use of his reverie in this process?

• What implications does the container have for understanding pathological processes?

It could be said that Freud chartered a metapsychology that had as its driving force the energetics of the unconscious pitted against reality. Klein, on the other hand, sought to understand the concrete nature of internal objects, phantasy, and their management through projective and introjective processes. Bion’s point of entry is quite different. It lies at the interface between objects and thinking, between individuals' minds, in search of transformative links that make change possible. In this way, Bion brought to psychoanalysis a unique perspective on what might be called the psychoanalysis of encounter. Although his work underwent a number of transformations it is the encounter between minds, and how this generates change, that remains a constant fascination to Bion. He emphasizes, particularly in his later work, the idea that the mind is always in transit and is constantly in a state of ‘becoming’ something else. External reality is not thought of as being a stable, consistent, objective entity, suitable for Cartesian apprehension. Rather, it is always mediated through the mind of an other. From this perspective we are left with a difficult set of parameters to work with: a mind is dependent on another mind for meaning but this necessarily remains ineffable, opaque, and always in flux.

Perhaps along with Winnicott, Bion was a true innovator of the in between. Rather than getting mired in theoretical dilemmas about the role of affect, sexuality, the drives and so forth, much of his thinking focused on understanding how the encounter between subjectivities is able to transform psychic occurrences (bearing influences from internal and external experience) into meaningful experience, in turn, leading to growth of the personality. In many ways Bion’s thinking can be seen to pre-empt some of the current debates on intersubjectivity¹ in psychoanalysis (e.g. Beebe et al., 2005; Benjamin, 1990; 1998; Gentile, 2007; Mitchell, 2000; Stolorow et al., 2002).

Unlike much of the thinking about intersubjectivity, however, which tends to emphasize a ‘harmonious mutuality’ between patient and client, Bion’s ideas attempt to articulate the struggle we are engaged in when we are truly engaged with an other. For Bion, a real human mental connection is like an emotional storm caused by the coming together of minds that crave and resist each other. Although we are equipped with some kind of primary awareness of sensory objects and emotions, the ability to think and generate meaning demands that the encounter be subjected to a series of transformations that Bion made central to his work. The task becomes finding ways of tolerating this emotional storm for long enough so that it can be thought about and given particular personal meaning. As put by Bion, it involves working out how ‘to make the best of a bad job’ (1987, p.247). It is here that he locates the model of the container.

Despite Bion’s often abstruse use of abstract terms and complex theoretical notions, it seems to me that the essence of his contribution lies in his struggle to articulate the transformatory qualities of lived experience always unfolding at the cusp of our awareness. He is interested in the minutiae of experience, how we come to know our experience and learn from it, use it, and be transformed by it. I read him as constantly puzzling over dilemmas about how to engage or encounter the ‘nearness’ of analytical experience. In his words:

I am not very interested in the theories of psychoanalysis or psychiatry or any other theories; the important point is what I call ‘the real thing’, the practice of analysis, the practice of treatment, the practice of communication.

(Bion, 2005b, p.16)

Unfortunately, this ‘radical experiential view’ (Godbout, 2004, p.1125) is often obscured by Bion’s marshalling of ‘empty’ nomenclature in an attempt to avoid the ‘penumbra of associations’ linked to the concepts he is discussing.² Despite this, however, a number of his theoretical contributions have markedly changed the way one might think about psychoanalytic experience, bringing the ‘nearness’ of the clinical encounter into full focus. To this end he replaces ‘invisible’ instincts with the emotional links between objects (Loving, Hating and Knowing), the formation of thoughts cannot be considered apart from affective experience and its inherent link to ‘other minds’, the analyst’s ‘free floating attention’ is given ‘subjective depth’ in his use of the term reverie. Further, Bion’s focus on dream-work-alpha and the ‘waking-dream’ draws the analyst’s attention to the real-time processing of analytic experience and the creative aspects involved in transforming raw experience into mentation. Similarly, in the heat of the analytic encounter, the concept of the container becomes a means of tolerating and transforming unassimilated experience through building meaningful commentaries about the self in interaction, the self in the encounter. Put simply, the container makes unbearable mental states more tolerable through making them meaningful as they emerge.

The container function

In order to locate the container function I start with a very brief sketch of mental functioning as conceptualized by Bion. He used the terms ‘dream-work-α’ (Bion, 1992)³ and later ‘alpha-function’ (Bion, 1962b) to isolate a function in the psyche that transforms sense impressions into elemental psychic impressions (alpha-elements) or proto-thoughts and proto-emotion. Alpha-function is responsible for animating the psyche, imbuing it with a sense of subjectivity (Symington and Symington, 1986). To use an example, let us say I observe a couple kiss. It impacts my senses, creating sensory impressions on the mind (beta-elements). To this I have an unconscious response which involves transforming the experience into pictograms (Rocha Barros, 2000) using alpha-function. This, in turn, leads to the emergence of images and psychic impressions, largely unconscious or preconscious. For example, we may imagine that this experience simultaneously elicits arousing physical sensations and ‘pleasant undefined feelings’, undefined ‘bad’ feelings associated with the image of an evil figure, images of a child alone, a vague sense of feeling alone, images of babies, images of my mother, a sense of deadness or hate, and so forth. These alpha-elements are best thought of as being the ‘components of thought’ (Ferro, 2005a, p.1) that can then be stored in memory and used to create dream-thoughts and later, reflective conscious thought. These components of thought may appear in consciousness in the form of momentary ‘flash’ images (similar to those experienced by trauma victims) but lack any particular narrative or developed meaning.

With the capacity to create basic proto-thoughts or pictograms set in motion, further psychic operations are required to develop these pictograms into dream-thoughts which eventually form coherent narratives. For this Bion deduced Ps↔D⁴ and the container function as the mechanisms that make psychic change possible, processes used to work on the relationships between psychic objects in order to generate psychic growth. ‘Ps’ represents a process of fragmentation or disintegration that allows psychic elements to be reintegrated (D) in different ways, creating a changed relationship between disparate elements. Through the process of disintegration (Ps) and integration (D), psychic impressions or pictograms integrate and recombine into constellations that await meaning. In terms of the above example, this might include: ‘I love my father and my mother is evil and I feel left out’ or, ‘I feel evil witnessing such intimacy,’ or, ‘I feel hate towards my parents but I also feel pleasant loving feelings’, and so forth.

The containing function, on the other hand, works to hold these thoughts in mind so that they can be ‘detoxified’ and permitted to gather new meaning. Ps↔D and the container essentially work in a dialectical way. In Bion’s words: ‘On the Ps↔D operation depends the delineation of the whole object: on the successful operation of ♀♂ depends the meaning of the whole object’ (1963, p.90).

In sum, the container comprises a mental function that allows such thoughts to be held in mind long enough so that these dream-thoughts, in the processes of integration and disintegration, can be thought about. To continue with the example, perhaps with the aid of my therapist’s ‘containing’ capacities I begin to think about the idea that I have feelings of hate towards my mother and I feel rejected by how my father seems to prefer her. From this, a meaningful narrative begins to form that can then be recycled through the same process in search of other ‘selected facts’ (Bion, 1962b) or sources of meaning that allow these narratives to reconfigure. Put simply, the containing function represents an area of mind or a mental connection that attempts to find ways of tolerating undeveloped psychic content and emotions so they can be held in mind and understood. But how is this to be applied to the therapeutic situation? What does the analyst actually do when he says he is using his containing function in working with the patient?

Bott Spillius (1988) argues that the container model along with Bion’s alpha-function is the most widely accepted and best understood idea in Bion’s work. In my experience it certainly seems to be tacitly accepted by most (across a number psychoanalytic orientations), but I would not concur that it is well understood. Although the idea of the therapist’s ‘container function’ has taken hold as a key psychoanalytic concept, it has undergone relatively little development in theory and practice. Caper (1999) has similar concerns about the theory of ‘the container’:

Considering the impact that this theory has had on psychoanalytic thinking, it is surprisingly sketchy, and it is remarkable how little it tells us about how containment is actually supposed to work.

(p.141)

Caper (1999) wonders if this was deliberate on Bion’s part; another of his concepts that require the analyst to fill in the details using his or her own experience. As mentioned earlier, Bion deliberately uses the signs ♀♂ for container-contained in an attempt to prevent the meaning of the concept being saturated by fixed ideas that prevent ongoing thought. In my view, however, there seem to be other important factors at play here that relate to its intuitive appeal.

Bion’s ‘containing analyst’ often seems to be used as a saturated term where assumptions about it as a theoretical and technical idea are simply assumed. In my experience, it is often said that ‘we need to contain emotions and thoughts’ or ‘contain the patient’ and there are many nods of acknowledgment but little unpacking of what this might actually mean. There may be a number of reasons for this. First, Bion’s often schematic descriptions of the containing process have an almost seductive ring to them where objects can be transformed through allowing the mother to metabolize them. To quote Bion:

The infant projects a part of its psyche, namely its bad feelings, into a good breast. Thence in due course they are removed and re-introjected. During their sojourn in the good breast they are felt to have been modified in such a way that the object that is re-introjected has become tolerable to the infant psyche.

(Bion, 1962b, p.90)

How this actually occurs is often not apparent in Bion’s writings. It appears that this sometimes leads to the idea that containment, along with projective identification, is quite a magical and mysterious process. How projections are ‘detoxified’ is simply taken for granted. One possible reason for the tacit acceptance of the analyst’s container function might be that it parallels deep unconscious phantasies, inherent preconceptions, about the maternal object and about the need to be ‘contained’. In Chapter 8, I explore how such phantasies contribute to countertransference states that I call ‘idealizing the container’, a psychic state often employed defensively to avoid thinking about intolerable affects. The second reason why the container appears to be taken for granted is related to the idea it represents a three-dimensional object, a near-physical repository. This conception has technical implications for the therapist. For instance, from this point of view, ‘containing’ is often viewed as being synonymous with the therapist being ‘silently and passively receptive’ to the patient’s emotions and projections. Alternatively ‘containing’ often takes on a ‘protective function’ or a sense of empathizing and needing to ‘be there’ for the patient. All these are associated with the idea that the container is a near-physical, ‘concrete’ object with an interpersonal emphasis. The above may be important therapeutic factors in some cases, but Bion had in mind a much more active, transformative psychical process. To this end he makes clear that ‘containing’ demands much more than the dutiful presence of the therapist or mother (Bion, 1959). Here Bion is developing the idea that the containing function represents a mental connection that goes beyond reified or interpersonal conceptions of the container. From this perspective it is the mother’s ability to retain ‘a balanced outlook’ (1959, p.313) that seems to be important. But what might a ‘balanced outlook’ mean? In this book I make this idea central to informing what might be considered to be ‘containing’ aspects of the analyst’s mind when applied to the clinical setting.

Following Bion, there appears to be broad agreement that the process of containing involves an interchange between patient and analyst whereby the analyst, receptive to the patient’s projections, introjects them, somehow ‘detoxifying’ them making them available to the patient via interpretation so they can be taken back in a more manageable form. This model, as it stands, seems to make intuitive sense, especially when it is seen as analogous to the process that occurs between mother and infant. But what does this actually all mean? What do I mean when I say I needed to contain my patient’s hate? How is it possible that projections are ‘exchanged’, modified, and ‘given back’? How does...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• Preface
• Acknowledgements
• 1 Encountering unbearable states of mind
• 2 Projective identification, countertransference and the containing function
• 3 The analyst's containing mind
• 4 Polarities of the containing connection
• 5 Notes on interpretation
• 6 Speculations about proto-containing experiences
• 7 Modes of interaction
• 8 Idealizing the container
• 9 Some aspects of beta-mentality: on mimicry and thinking in a technological age
• 10 Beta-mentality in violent men
• 11 The autistic mode in agoraphobic syndrome
• 12 The dead alive self in borderline states
• References
• Index