Two Studies in Problems of Containment

While in training we each wrote a clinical paper. We subsequently realised that both papers seemed to show some of the same aspects of the problems of containment. The following introduction is an attempt to elucidate some of these problems.

Both the patients we describe manifest their anxieties first and foremost in physical and in concrete ways. Their behaviour illustrates the link between infantile phantasies about containment in body terms and the structure or lack of it in the mental functioning.

The mother, through physical and emotional caring, serves as a container for the infant's experiences. She gives them shape and space, making them more tolerable so that the infant may take them back into himself.

Insofar as either the infant is unable to tolerate frustration or the mother is unable to be a “good-enough” container, projective and introjective processes may be impaired.

The material to follow will show how the patients’ feelings colour external reality to such an extent that at times little differentiation is possible, hence little thought. The ensuing confusion shows itself in treatment through the transference, permeating all areas of the personality. The transference relationship expresses the confusion between the infant and parents; between inside and outside; between parts of the self; between body and mind; between good and bad. The patients live in a world peopled largely by the products of their own mind, and symbolization cannot develop.

In the therapeutic process, the room, the session times, the boundaries and limits set by the therapists are attacked in various ways. A healthy link with their objects, carrying with it the implication of separateness, is experienced by the patients as extremely threatening. On the one hand, persecution or the inadequacy of a damaged object is feared; on the other hand, in moments of greater confidence, there may be an inability to allow their object a life of its own.

The therapist experiences these co