Bion Container And Winnicott Holding

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

Winnicott holding

Donald Winnicott described, with all his extraordinary subtlety of perception and sharpness of observation, the delicate plot of early interactions between mother and child, which forms the basic structure of mental life.

Holding is the "ensemble" of attention that the child is surrounded by from birth. It consists of the sum of the mental and affective, conscious and unconscious in the mother herself, as well as in her external manifestations of maternal care.

Parents not only try to protect the child from traumatic aspects of physical reality (noise, temperature, inadequate food, etc.), but they also try to protect his mental world from premature encounters with excessively strong feelings of helplessness, which can provoke in the child the anxiety of complete disappearance …

If the constantly increasing and intensifying needs of the child (hunger, thirst, the need to touch, to be picked up, in understanding) remain unmet, then an internal defect (disease) develops, which consists in the child's inability to trust himself (in Freud “Hilflosichkeit "). Consequently, the smaller the child, the greater the maternal concern for the early identification of these needs and the readiness to satisfy them. She perceives (one might say, "in countertransference") the threatening feeling of pain that looms in front of the unsatisfied infant, and she strives to help him avoid this pain. In this regard, at the end of pregnancy, the mother develops a partial regression called primary maternal preoccupation, which is a kind of natural physiological psychosis in which she becomes able to tune in to the very primitive feelings of the infant.

An infant, that is, a young child who does not even speak yet, has a vague tension caused by unmet needs such as nutrition. Repeated and regular breastfeeding, at the very moment when the child feels the need for it, encourages the child to feel the correspondence between his inner desire and the perception of the breast offered to him. This kind of correspondence allows the child to achieve the feeling that he himself creates the breast - his first subjective object,. This primary experience maintains in the infant the illusion of omnipotent unity with the mother. This allows him to "begin to trust reality as something from which any illusion stems" (Winnicott). The duration of maternal care, attention and alignment with the child's rhythms, the fact that a good enough mother does not spur the child's development, initially allowing him to dominate, creates reliability and the type of basic trust that determines the possibility of a good relationship with reality.

The infant lives, at least in part, in the protective mantle of the illusion of omnipotent unity with the mother. This protects him from the premature realization of the separate object by reality, which can cause fears of disappearance, and have a disintegrating effect on the early elements of his Self.

As Freud said, if the need absolutely coincides with the response (immediately satisfied), there is no room for thought, and there can only be a sensory sense of satisfaction, the experience of all-consuming omnipotency. Consequently, at some point, as Winnicott says, it is the mother's duty to wean, and this leads to the abolition of the child's illusion.

Moderate frustration (for example, slightly delayed satisfaction of a need) forms what we call optimal frustration. There are some mismatches between mother and child, they are the source of the first, obvious feelings of separation. The maternal object, which is usually satisfying, is felt as being at some, but not too great, distance from the subject, the child.

In an atmosphere of reliability that the mother has already proven, the child can use the memory paths of previous satisfaction that she provided to fill the temporarily gaping space that separates the child from her - someone who will satisfy him a little earlier or a little later. In this way, potential space is established. In this space, it is possible to form a representation of a mother's object - a symbol that can replace a real mother for a certain time, since it is a bridge of representations that associate a child with her. This makes the distance and delay of gratification bearable. We can say, very schematically, that this is the path along which the development of symbolic thinking begins.

During the absence of the mother, all this helps the child to avoid losing any connection with the mother's object, and to fall into the abyss of fear. For a child, the possibility of recreating in this space the image of an "object - breast - mother" enhances his illusion of omnopotency, reduces his feeling of painful helplessness and makes separateness more bearable. Thus, an image of a good object is created, which is present in the inner world of the child and is a support in order to endure (at least partially) the first experience of existence as a separate being. Thus, we observe the process of creating an internal object through introjection.

In order to function, potential space needs two basic conditions, namely, a well-established, sufficient reliability of the mother object, and that there is an optimal degree of frustration - not too much, but nevertheless enough. Consequently, a good enough mother is successful in giving the child appropriate satisfaction, and moderately frustrating him, at the appropriate time. She also needs to be well tuned to the rhythm of the child.

The potential space is created by a secret agreement between the child and the mother, who instinctively cares about his safety and development. The ability to fill this space with more and more complex illusion symbols allows the human being to maintain an ever greater distance from satisfying objects, This is due to the development of transitional phenomena in which illusion and reality meet and coexist. A teddy bear - a transitional object - represents for a child, at the same time, both a toy and a mother. This paradox will never be fully clarified, as Winnicott said, it is unnecessary to even try to explain to the child that his teddy bear is just a toy and nothing else, or that it really is his mother.

There is always a strong temptation to replace potential space with a direct and concrete relationship with an object, nullifying the distance with it in space and time. Therefore, basic prohibitions are needed: the prohibition against touch (Anzieu, 1985) and the oedipal prohibition, in order to support the development of thinking and avoid the collapse of potential space. These prohibitions are naturally valid for adults and for their relationships with children (and for analysts in their relationships with patients), since it is well known how potential space disappears in cases of incest and sexual abuse.

According to Winnicott, the basis of mental health is the process of how the child gradually leaves the illusion of omniopotent unity with the mother, and how the mother relinquishes her role as an intermediary between the infant and reality.

Containing Bion

Wilfred Bion started out as an analyst based on the theories of Melanie Klein, but over time, he took a rather original way of thinking. According to Money-Curl, there is the same difference between Melanie Klein and Bion as there is between Freud and the Klein Medal. Bion's texts and thoughts are quite difficult to understand, so some authors such as Donald Melzer and Leon Greenberg, together with Elizabeth Tabac de Banshedi (1991), have written books that clarify Bion's thoughts. I'm not very deeply familiar with Bion's thoughts, but I find his views on the origin of the thinking function and the basic mechanisms of human thinking quite interesting, I think that they will help us better understand what is happening, both between the mother and the child, and between the analyst and the patient. My sketch of the concept of containment will certainly be a little oversimplified, but I hope you find it useful in your work.

In 1959, Bion wrote: “When the patient tried to get rid of annihilation anxieties, which felt overly destructive in order to keep them in himself, he separated them from himself, and put them in me, connecting them, with the hope that if they will stay inside my personality long enough, they are so modified that he will be able to re-introject them without any danger. Further, we can read: “… if a mother wants to understand what her baby needs, then she should not limit herself to understanding his cry, only as a requirement of simple presence. From the point of view of the child, she is called to take him in her arms and accept the fear that he has inside, namely, the fear of dying. Since this is something that a baby cannot keep inside … The mother of my patient was unable to bear this fear, reacted to it, trying to prevent its penetration into her. If it didn’t succeed, I felt flooded after such an introjection”.

A few years later, Bion developed several new theoretical concepts. He describes two basic elements that are present in the process of human thinking.

Elements in are simply sensory impressions, raw, insufficiently differentiated primitive emotional experiences, not adapted to be thought, dreamed, or remembered. In them there is no difference between animate and inanimate, between subject and object, between inner and outer world. They can only be directly reproduced, they form concrete thinking and can neither be symbolized nor represented in the abstract. Elements, in, are experienced as “thoughts in themselves”, and are often manifested at the bodily level, somatized. They usually evacuate through projective identification. They are prevalent in the psychotic level of functioning.

Elements a are elements of c transformed into visual images or equivalent images from tactile or auditory patterns. They are adapted to be reproduced in the form of dreams, unconscious fantasies during wakefulness and memories. They are essential to mature, healthy mental functioning.

The container-content schema is the foundation of any human relationship. The content-child is freed, through projective identification, from elements in that are not comprehensible. The container - the mother, in turn, contains - develops them. Thanks to her ability to dream, she gives them meaning, transforming them into elements of a, and returns them back to the child, who in this new form (a) will be able to think with them. This is the main scheme of psychological containment, in which the mother provides her apparatus for thinking thoughts to the child, who gradually interiorizes him, becoming more and more capable of independently performing the function of containment.

By the way, in the understanding of Bion, projective identification is more a rational, communicative function than an obsessive mechanism, as was first described by Melanie Klein.

Let me now explain the theoretical mechanisms we just mentioned in a different way.

The baby is crying because he is hungry and mom is not around. He perceives her absence in himself, as a concrete, raw impression of a bad / missing breast - an element. c The anxiety caused by the increasing presence of such persecuting elements in him is increasing, and, therefore, he needs to evacuate them. When the mother arrives, she accepts what he evacuates through projective identification (mainly through crying), and she transforms the child's painful feelings (talking calmly to him and feeding him) into comfort. It transforms the fear of death into calmness, into a light and tolerable fear. Thus, he can now re-introject his emotional experiences, modified and mitigated. Inside him, now, there is a transferable, conceivable representation of an absent breast - element a - a thought that helps him to endure, for some time, the absence of a real breast. (Winnicott would add that this representation is not yet stable enough, and the child may need a transitional object - a teddy bear - to reinforce, with concrete support, the existence of this still unstable symbolic representation). This is how the thinking function is formed. Step by step, the child introjects the idea of a well-established relationship between himself and his mother and, at the same time, he introjects the very function of containment, the way of transforming elements into elements a, into thinking. Through relations with his mother, the child receives the structure of his own mental apparatus, which will allow him to be more and more independent, so that, over time, he will acquire the ability to carry out the function of containment on his own.

But development can also go the wrong way. If the mother reacts anxiously, she says, "I don't understand what happened to this child!" - thus, she sets too much emotional distance between herself and the crying child. In this way, the mother rejects the projective identification of the child, which returns, "bounces" back to him, not modified.

The situation is even worse if the mother, who is overly anxious by herself, returns back to the child, not only his unmodified anxiety, but also evacuates her anxiety into him. She uses him as a repository for her intolerable soul contents, or she may try to switch roles with him, striving to be the most contained child instead of containing him.

Something is wrong, maybe with the child himself. He, initially, may have a weak tolerance for frustration. Therefore, it may seek to evacuate too many, too strong emotions of pain. Containing such an intense emission of elements in can be too difficult for the mother. If she does not cope with this, the child is forced to build a hypertrophied apparatus for projective identification. In severe cases, instead of a mental apparatus, a psychotic personality develops, based on permanent evacuation, when the brain functions, rather, like a muscle that is constantly discharged by elements of c.

We can summarize that, according to Bion, human mental activity, and we can say that mental health, is mainly based on a complementary meeting between the infant's internal tolerance for frustration and the mother's ability to contain.

It must be emphasized that containment does not mean only "detoxification" of intolerable feelings. There is another basic aspect as well. The containing mother also gives the child a gift - the ability to mean, comprehend. She helps him form mental representations, understand his emotions and thus decode what is happening. This allows the child to be tolerant of the absence of someone significant and consistently strengthens his ability to endure frustration. This understanding is close to Winnicott's concept of "holding", through which he shows that the mother's face is a mirror of emotions, which serves as a means for the child to recognize his own internal state. But there is something more in the concept of Bion - the maternal containment function also presupposes maternal intuition about the child's basic need to be thought, thus, to be present in the mother's head. From this point of view, the child's dependence on the mother stems, rather, not from his physical helplessness, but due to his primary need to think. The crying child is trying, first of all, not so much to establish a relationship with another human being, in order to evacuate into him the elements that cause too much pain in him, but also in order to help him develop the ability to think.

A crying child needs a mother who can discern whether he is hungry, scared, angry, freezing, thirsty, in pain, or something else. If she provides him with the right care, gives the right answer, she not only satisfies his needs, but also helps him differentiate his feelings, better represent them in his head. However, it is not uncommon to meet mothers who do not distinguish between this and always respond to the various needs of the child with only feeding.

If the mental contents are of such a form that they can be represented in the mental space, then we are able to recognize them, we can better understand what we want and what we do not want. We can more clearly imagine the elements of our conflicts, their possible solutions, or form more mature defenses. If there is not enough, representative content in the head, we are forced to react, feel only bodily (somatization) or evacuate our emotions and our pain in others (through projective identification). But these mechanisms are the most ineffective, they support compulsive repetition and often produce symptoms. A well-functioning thinking apparatus is therefore a prerequisite for the successful resolution of mental conflicts.

I will present a brief clinical vignette. During the session of an adult patient, I drew her attention to the fact that there is some kind of anger in her that is difficult for her to think about, and which is difficult for her to express. She replied, as usual, that perhaps this is so, but that in order to express it, she needs to move, walk around the office, do something. Her anger seemed to have more to do with bodily sensations than thoughts and could not be well represented in her head and expressed in words. This difficulty often manifests itself in sessions, usually interrupting the flow of her reflections and preventing her from understanding or doing so well enough. to understand her.

A few days later, she said, “I did not sleep tonight because my daughter is sick and wakes up all the time. In the morning I was awake, tired and annoyed when my mother came and said: “What can I do? Let me wash the dishes? " I lost my temper and screamed; “Leave your mania to do something! Sit down and listen to me! Let me complain a little! " This is typical of my mother: I feel bad, and she picks up a vacuum cleaner."

I said with mild irony: "Oh, now it's clear where you learned this when you say you can't talk about what you feel if you don't move or don't act."

Oma continued; “In the past, it happened that I was angry, but often did not know why. Sometimes I knew what I didn’t want, but I never understood what I wanted, I couldn’t think about it. Today, with my mother, I realized what I want - to talk about how I feel! I insisted on saying this, she listened to me, and the tension eased!"

There are certainly many elements in this vignette: transference, the patient's difficulties with her daughter, with her own childish part, etc. But what I would like to point out is that the patient made a request to be contained by her mother. To a certain extent, the patient has already partially contained herself (when she was able to transform her internal anxiety on her own into a clearly presented need and a verbal demand for subsequent containment). We can also say that it is unclear to what extent the mother actually contained her, and how simply she listened to her daughter, which might support her daughter's subsequent self-containment.

A few notes of my own

In my opinion, it is possible to form a hypothetical picture of what happens in the early relationship between mother and baby by linking Winnicott's holding and Bion's containment in a certain way. Both proceed, it is true, from different positions, but they are unanimous in recognizing the basic importance of the quality of the mother-child relationship.

We can roughly say that while a holding rather describes a macroscopic context of a relationship, containment is a microscopic mechanism for such a context. We can imagine that the child needs the mother to allow him to use his thinking apparatus in a contained relationship until he forms his own. She can and must “wrestle” from the illusory omniopotent unity, in which both have partially merged, her apparatus, step by step, while the child “creates a duplicate” in himself. Each premature "extraction" will leave a "black hole" in the Self, where elements of c and concrete thinking dominate, where development cannot take place, where conflicts that arise cannot be resolved.

We may also think that thinking, poisoned by too much anxiety or intense excitement (in both cases, we can speak of too many elements 0), cannot support the function a, that is, the function of thinking and containment. Thinking, in this case, needs further containment. avoiding overreacting, somatization or projective identification, and in resetting the thinking function.

The containment process is carried out if the container and the contents (mother and infant, analyst and patient) are close enough that the message can be fully received, But at the same time, sufficient distance is necessary to allow the mother (or the analyst), and then himself the child to think, to distinguish between what belongs to one and what belongs to the other member of the couple. When a child is frightened, the mother must feel the fear he feels, and in order to understand it, she must put herself in his place. But at the same time, she shouldn't feel like just a frightened child. It is important for her to also feel like a separate person, an adult mother who observes what is happening from some distance, and is able to think and respond appropriately. This usually does not happen in pathological symbiotic relationships.

Bulb scheme

Winnicott sometimes said the following: “I don’t know what is a baby, there is only a mother-infant relationship,” emphasizing the infant's absolute need for someone to take care of him. This proposal could be expanded by saying that no mother-infant pair can exist in isolation from the community and cultural environment. Culture provides the schemes of upbringing, survival, behavioral codes, language, etc. As Freud wrote (1921): "Each individual is a constituent element of large masses and - through identification - a subject of many-sided connections …"

From this point of view, we can view the child's environment as a system consisting of a large number of concentric circles, like the leaves of a bulb. In this scheme, the child is in the center, around him there is the first leaf - his mother, then the father leaf, and then a large family with all relatives follows, and then friends, neighbors, the village and the local community, ethnic, linguistic group, finally, humanity as a whole.

Each leaf has many functions in relation to the inner leaves: to preserve and give part of the cultural codes, to work as a protective shield, and also to function as a container, in Bion's terminology. Winnicott said, "A baby cannot be introduced to the community too early without parental mediation." But also, the family cannot be presented to the wider community on its own, without the protection and containment of its nearest leaves. Glancing at this "onion", we can imagine how some kind of anxiety can overwhelm, overflow one or more leaves in both directions - to the center, or to the outer edge.

In such a “onion” there is a sophisticated system of filters and containment zones for processing between the inner and outer leaves. We can imagine the harm they can do

social catastrophes such as wars, mass migrations, traumatic social changes, etc., violating this “onion”. We can fully experience this by looking into the eyes of children in refugee camps and listening to their disoriented, exiled parents.

I want to emphasize that a suffering child can produce so much pain and anxiety that it can exceed the mother's containment ability, as well as that of the father. We see how often this overwhelms teachers, social workers, and other people involved in childcare. This has to do with a complex question that researchers have answered so differently and therefore vaguely: how to harmonize the child's individual analytic therapy and the influence of his environment. How to build a relationship with a child therapist with parents, and with the wider environment so as not to violate the therapeutic setting.

But what interests us even more is the situation when the child analyst himself is overwhelmed with the anxieties of his patient.. As a rule, the analyst applies for a supervision when with a certain patient at some point he does not feel free, because the patient raises in him too much anxiety or too much impairment of his ability to think freely enough. Analysts working with psychotic patients especially need a group of colleagues with whom they can discuss their work and also be contained by them. We find another type of containment when we read psychoanalytic literature: it can clarify our vague feelings, explain feelings associated with a certain pain that we carry in ourselves, for which we cannot find words, etc. Thus, we can also imagine a parallel bulb in which the leaves are arranged from the center to the outer edge in the following order: the analyst, his or her supervisor, the analytic working group, the analytic community, and the IPA.

But this does not always work well as some supervisors, groups or communities cannot function as good containers as they throw away the anxiety they receive. Or, even worse, they may function so poorly and create such discomfort that all of their inner content is filled with anxiety and anxiety.