Core Concepts in Psychotherapy : Containment

 In this series, registered psychotherapist Alyss Thomas explains some helpful concepts from psychotherapy that you can apply in your everyday life.

When I explain some of my favourite psychotherapeutic ideas to clients, they find them interesting, illuminating and – best of all – directly helpful. These concepts might sound theoretical, but they are incredibly practical. My understanding has developed over my many years in practice. The first article is about the idea of containment.

Containment

Here I discuss the idea that as young children, we experience extremely vivid and strong emotions, and we have to learn to contain them in a healthy way so that we can live alongside others in harmony and cooperation.  Childhood emotions are so strong that sometimes we can even feel as if we are being “attacked” or completely overwhelmed by our feelings, whether these are rage, terror or sadness.   As young children, we need to feel that our emotions are recognised and understood by a safe adult, who is able to contain them for us. The adult may allow us to express our feelings safely, but we will not be allowed to create chaos. Nor will we be left feeling abandoned with out-of-control emotions. An adult needs to be present in an accepting way with a young child when the child is experiencing and expressing emotions.

The issue of lack of containment in childhood

Adult behaviours that make it difficult for children to learn to manage their emotions include yelling back when a child is screaming, rejecting or criticising the child for having the feelings, ignoring, humiliating or sending the child away because they are expressing feelings, or not even realising that the child is experiencing important feelings.   These adult responses get in the way of the child being able to learn about their emotional life, and they do not help the child to develop emotional maturity over time.  In order to support the child’s emotional development, adults need to help the child to learn that it is safe to feel difficult emotions, and to give real-life examples of how they manage their own emotional expression skilfully –  showing that having strong feelings does not have to have a bad impact on the people around us.

When a child is not supported by a present and accepting adult, this can create emotional difficulties in the child’s future – not because of an occasional episode, but if this is frequently repeated. The emotions do not “go away” of their own accord, and the child is left feeling unsafe in relationships later in life.   The child who was ignored, neglected or not noticed while feeling emotional will learn to withdraw, stonewall, become incommunicative, or even become depressed, because he or she feels no one is ever going to be interested in how he or she really feels.   A child who is angry, jealous, rageful or spiteful, and who is shamed and criticised for having these feelings, will not have learned how to master these feelings.  This could for example lead to self-destructive behaviour or self-harm if an adolescent turns the feelings inwards against the self.   A person who is very sensitive and has nowhere to take his deep feelings may learn to suppress, soothe or numb feelings through the use of food, alcohol,  cigarettes or drugs.  An adult who grew up among people who yelled and screamed at her will use this same strategy when trying to stop her own children from dominating family life with their emotional demands.  In fact, when a child experiences being left alone or being rejected for having intolerable emotions, this is experienced within the young being as a form of trauma  This can pre-dispose someone to being more likely to develop the symptoms of post-traumatic stress if further stressful events occur, even many decades later.

When an adult accompanies a child by being attentive, present and accepting when, for example she is raging about something she wants and cannot have, the child is very alert and aware to what response the adult is having. They copy the adult – this is how a child learns. Adults who have not themselves been taught the skills of containment can feel very provoked and activated by their own children asking for containment that they themselves did not receive.  Thus there is a trans-generational aspect to lack of containment that can live on within families.

The stiff upper lip

The British are famous for a stereotype of containment known as “the stiff upper lip” – however I am not suggesting this as a skilful form of containment as the stiff upper lip involves denial. Denial is a form of psychological defence, and says, in effect, that something that happened either did not happen, or is not worthy of our attention.   Ignoring something in the hope that it will go away does not work in the territory of human psychology, because nothing ever goes away that has been experienced emotionally or psychologically.  Another defence that often occurs alongside the “stiff upper lip” is  pretending that things do not hurt, or that you have to pretend that when something hurts it doesn’t matter.  So if a boy falls, hurts his knee and cries, the father says “Why are you crying? This is nothing to blab about, go out and play.”  This is not so much a demonstration of the father’s  manliness, but of his lack of empathy. The father is in effect saying “I will only value you if you act as though your hurt does not matter and you do not bother me with your hurts in life”.   The father feels he is helping his son to grow up, but in fact he is not teaching him emotional competence or emotional intelligence, he is teaching him to act in the same way as he himself was taught.

Containing behaviour towards a child

So what does skilful containment consist of?  In effect, a containing adult communicates to the child:  I know what you are feeling, and I know it feels bad.  They name the emotion, telling the child what they are feeling.  For example, “You feel really angry that I did not let you have the toy.  I understand you feel really angry with me, because you wanted that toy so much. However, I didn’t let you have it because it is not safe for you to play with until you are older, it might hurt you, and I don’t want you to be hurt. I know your older brother plays with it, but he has learned  the rules about how to play with it.  Why don’t you play with this instead.  I know you feel angry and frustrated, but it is ok. This is a bad feeling,  but we can recover from it, and we are not going to allow it to spoil your entire day. “  Now a lot of these words might not be age-appropriate and they may go over the child’s head.  However, the attitude, the tone of voice, and the state of mind of the adult who is speaking them will be carefully observed and internalised. The child will also notice if the adult is consistent with this approach, and will in fact test the adult to see if this will be repeated over and over, or whether they can provoke the adult to act in an uncontained and rageful way. This is because children need to know that they will be safely contained.

The effects of lack of containment in children who are emotionally neglected can sometimes be more difficult to recognise.  Children who are not given much emotional feedback sometimes grow up in a kind of emotional “vacuum” where they experience that their feelings are either not real, or do not matter.  This can sometimes  result in an adult who puts the needs of other people ahead of her own needs, and who needs to placate and please others in order to earn their approval.  She might not even recognise what her own needs are. Because this person can be productive and devoted in her adult roles, she might spend her entire life feeling unnoticed, but she gains her sense of personal  value from the things she does for others.

Learning containment skills as an adult when you did not receive containment as a child is no easy process, as you do not have a built in “template” for what containment is and how it really feels.  It is something you will have to practise. Here are some ways in which you can start. 

Notice how you feel when the people around you, or your children, are expressing their feelings.  Reflect on these feelings, and what they may be telling you about your own experience of containment, or the lack of it, when you were a child in your formative years. 

Think about memories of your own childhood, and how the adults around you responded to you when you expressed your feelings.

When you find yourself having a strong feeling in daily life, consider all the ways you could respond to the feeling.  Look at your habitual choices, and consider if there are some new options you could try, such as positive self talk, where you affirm the importance and value of what you are feeling, and consider ways in which you could express the feeling safely and without harm to anyone. New options to consider could include journalling;  joining a support group for people in the same life situation as you; structured physical exercise where you focus your energies; developing and practising a creative outlet, as many forms of creativity allow you to explore emotions; developing supportive new routines;  or sharing your feelings with a mentor, friend or relative who accepts you as you are.  If you have strong feelings that want expression, such as anger, you will need to learn how to manage these without either suppressing them, or acting them out in ways that are destructive to yourself or those around you. This can take some patience, but in this way you can learn to be your own therapist and trustworthy friend. 

Containment in therapy

So how does a psychotherapist work with containment? Psychotherapy is an unusual situation,  where containment is offered in a very active manner. If you express your feelings while you are with a psychotherapist, they are not going to go unnoticed, and the psychotherapist will respond to them directly.  When clients first start in psychotherapy, they may not have words for how they experience this containment process, except that they feel as though they have been listened to and understood. Sometimes at the beginning, clients do not even recognise that they are being listened to in a new way, as they have never experienced this before.

One of the things a psychotherapist is very much aware of is the need to pick up on, and respond to, your underlying feelings, even if you have learned to mask them with polite and social behaviour.  Psychotherapists value feelings.  Often people who have not paid much attention to their feelings for years may feel afraid that if they start to get in touch with them, they will be overwhelmed and it will be too much.  The psychotherapist is able to reassure them that their feelings are understandable, and that by working in partnership, you can identify them, name them, cope with them better, and eventually make some new choices about how to live with them, so that you feel more balanced and resourced in your emotional life.   A psychotherapist will not be frightened or alarmed by your feelings.  Eventually, you can internalise the psychotherapist’s approach to your feelings and take on the attitude of kindness and acceptance towards yourself.

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