Interpretation and Containment

Abstract

The author explores two aspects of the analyst's effort to imagine the inner world of his patient and the way that they are manifest in the clinical moment. The first of these is the analyst's recognition and interpretation of his patient's elaborated fantasies. This current of the analyst's imagination is most often evoked by the patient's communication of whole-object transferences, which occurs largely in his verbal associations. The second is the analyst's reception and transformation of his patient's primitive emotional experience, a process that Bion has called containment. This second imaginative current is most often evoked by the patient's communication of part-object transferences, which occurs largely in affect and action. Interpretation and containment both go on at once in clinical work, although one or the other is usually dominant. Attention to the interplay of interpretation and containment in the clinical moment enables us to identify the articulation of whole- and part-object transferences and to integrate ego-psychological and Kleinian frames of reference in clinical work. In addition, the concept of mutual containment opens Kleinian theory to the possibility of a two-person psychology in which the roles of analyst and patient are more symmetrical than they are usually conceived to be within this frame of reference. The author presents two clinical examples to demonstrate the interplay of interpretation and containment. In the first, these processes operate smoothly. In the second, the process of containment is strained but ultimately successful.

Staff Carers' Understanding of End of Life Care

“…Given the ambiguity that exists in many close clinical relationships and situations, this projection of distressing emotions may serve as a defense mechanism. Klein's concepts were further extended by Wilfed Bion's theory having to do with the process of “containment” (Lafarge, 2000). Ill persons may not be able to articulate their needs or feelings, but they may be “contained” by another sensitive person, such as a nurse.…”

How and why unconscious phantasy and transference are the defining features of psychoanalytic practice

“…The analyst's responses to the patient's communications, as she takes them in and imagines what is meant, broaden both the meanings that are available to the patient and the patient's tolerance for painful, or even hitherto unbearable experience (LaFarge, ). The analyst's interpretations of the function of what the patient says and does – in satisfying wishes and managing anxieties as well as responding to the conscious external reality of which the patient is aware – make the patient aware of the multiple meanings that are condensed in contemporary experience and the ways that this experience may be used defensively to ward off other meanings that lie outside awareness; in so doing these interpretations also give the patient access to the experiences and meanings that have been defensively warded off.…”

Interpretation and the case study

“…It happens not when the client is unable to see something, but when that realization is already at the client's 'edge of awareness'. Furthermore, within the post-Kleinian approach, while the centrality of unconscious communication is maintained, interpretation is perhaps no longer central to the psychotherapeutic process but has been replaced by the provision of attunement, containment or a facilitating environment (Casement, 1985;Bollas, 1999;Gordon, 1999;LaFarge, 2000). The central implication for therapy is that interpretation is not enough: it requires the centrality of relationship to break into, for example, a schizoid closed system of self-destructiveness.…”