Sunday, February 14, 2010

The Work of Psychoanalysts in the Public Health Sector - Intro (The concept of “containment”)

Been reading this book (title above, edited by Mary Brownescombe Heller and Sheena Pollet) that according to the back cover “provides a comprehensive insight into the ways in which psychoanalysts think and work.”

Here are some thoughts on the concept of “containment,” as illustrated through the lens of parent-infant relationship.

"CONTAINMENT"

 

THE THEORY (described by Bion, 1962, paraphrased here):

-Baby depends on mother to manage said baby’s “unbearable experience” which baby can convey to her w/o words (through gestures, etc).

-Baby disposes this unbearable or unmanageable experience (labeled a beta element) to mother by projecting it on her

-Mother takes in this unmanageable experience, reflects on it (reverie), then returns this to the child in the form of a modified, more bearable experience (alpha element). Returning the reflected-on beta element, for the mother, is performing her alpha function.

-Alpha elements can be used for thinking, so the baby can then think a rudimentary thought.

-The whole process is containment. Bion considered it a “crucial factor in the infant’s developing the capacity to manage his own experience and to think.”

 

COMMON SENSE TRANSLATION (in case you didnt get it the first time around)

-Baby conveys difficult emotions through gestures, aura, crude baby-like sounds, etc.

(Poor) tennis analogy: On the ad-side, baby hits a mean kick serve to mother’s backhand.

-Mother processes the baby’s harsh emotions with her motherly wisdom, and returns a gentler more manageable response to the baby, again via gestures, aura, subtle facial expressions, etc.

With Agassi-like prowess, mother steps inside the baseline, takes the kick serve early with a compact backhand, almost no backswing, and remarkable reaction time. Unlike Agassi, she feathers this return to baby’s forehand, right in his comfort zone.

-Baby thinks, and therefore learns to deal with life, from mother’s returned (modified) response.

Baby drills a forehand winner down the line. He wins – at tennis, and at life, which tennis is supposedly a great representation of. He learns to think, on the court and off.

 

REAL-WORLD IMPLICATIONS

I believe we should be able to use this process of “containment” to develop the depressed person’s capacity to manage his own experience differently.

Sure, a college-student’s mind may not have the same level of plasticity as an infant’s, but I’d say we’re at an even more influenceable stage of life – perhaps even the most influenceable age. At least in terms of higher-level decision-making and cognitive choices (combined with the opportunity to explore), there’s no time like now for change.

And make no mistake, it’s entirely possible for someone, even with the severest depression and the most stubborn/unwilling personality, to change the way he manages his experiences.

Two people might experience the same or a similar experience. Due to personal factors/worldview/innate character traits, one might react positively (manage the experience well), and the other might react negatively (manage the experience poorly).

Is the second person doomed to forever poorly manage his experiences? Hell no. It’s never late to change, even (and perhaps especially) for someone of college age. I know because I did it. It's hard work, but it’s entirely possible.

 

THE QUESTION IS, HOW?

To what extent is talking useful? How about taking action (for instance, by embracing one's passions in the effort to develop a sense of self-worth)? Does action really have to be premeditated for a specific consequence in order for beneficial changes to take place? Etc.

I'll definitely have these kinds of questions in mind as we look to start the pilot program for our social venture.

Keep reading as I keep reading, and as I retrospect and extrapolate from my own life to try to figure out how to codify the process as much as possible.

The important thing is to turn all this theory into something:

1 Actionable

2 Scalable

Our venture will have limited impact unless we can find a way to do this.

Anyone have any ideas?

-David

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