Body, Language, Affect: Modes of Containment
In the process of doing therapy, we invite our clients into an impossible situation. Were it to exist outside of a historically agreed upon set of practices and norms, the act itself would seem a form of the exact kind of madness therapeutic intervention is intended to resolve. The activity demands that they cross some threshold of well-established social decorum to bare the unbareable (and unbearable) to a relative stranger—a stranger who remains as such once the pleasantries have passed and a reasonable amount of trust has been established. Usually there is a good faith agreement that the party doing the receiving of said unmentionable parts of the client’s psyche has been vetted and accredited by some governing body responsible for making sure the folks engaging in this kind of work meet some kind of minimal qualifications. Some further debate may even be welcome in revisiting what “minimal qualifications” does and ought to mean. And yes, that trust is vested over much more than placards and certifications. A good therapist must prove themselves and—if conversations with past clients about others they have worked with in the field are any indication—there is anywhere from some to many therapists practicing out there do not manage to do so.
Even once the usual guards of social decorum have been breached and the client has resigned themselves to entrusting some matter of personal sentiment to the entrusted, the therapist still needs to have the mettle to prove something. And this is likely where the therapist invites themselves into a reciprocally impossible task, which is of course born out of a complementarity with the first. As it goes, the reason the first impossible task, that is expecting a client to feel comfortable baring some portion of their soul to another human being, is so impossible, is because in any sensible manner, the idea that there are persons out there capable of employing themselves to the use of others, in order to serve as a sufficient container for some of the most trying, depleting, and harrowing experiences of what it means to be a human being is an incomprehensible ask. There is a reason Freud sat outside of the vision of his clients. From the earliest days of psychoanalysis, it was immediately understood that the therapizer was instantly as vulnerable as the therapized, in ways that were somewhat orthogonal to one another. The idea that this practice took off and has survived for well over a century now is something of a miracle of human persistence. It would seem no one in this arrangement stands in any relation to the possibility of winning.
So why do we do it and how does it work? The best I can offer are things I have observed in my practice and heard shared in the practice of others whom I have come to trust. The therapeutic factor we are talking about, that of containment, is (pleasantly so to those who quiver at every mention in psychology of “evidence-based”, “reproducibility”, and “operationalization”) fundamentally unmeasurable. It is a quality of being one brings into the relationship. We might be able to factorialize the things that make up the therapeutic alliance and qualitatively analyze one’s efficacy in forging a working therapeutic relationship. But the presence and attunement one must manifest to properly hold a client through that process calls to mind the distinction between those articles of a bygone era where novices could put silhouetted pictures of feet on the ground to guide them in the newly acquired steps of a particular dance technique, as compared to the fluidity and grace one can witness by those who simply embody the stylistic flourishes of something like the tango, the waltz, or even (with the right client-therapist combo) the frenzied micropops and implosive recoils of capable swing dancers.
By my estimation, the art of containment happens primarily at three sites: that of the body, affect, and language. Of course, it is first helpful to acknowledge what we mean by containment. Originally, the idea comes from the world of object-relations and is most often associated with the work of Bion—and loosely with that of Winnicott, though he doesn’t use quite the same language in his discussion of holding. For Bion, the maternal responsibility functions along a dimension of container and contained. In this model, the infant’s unbearable thoughts are reconstituted and given structure by the mother, allowing the infant to repossess these experiences as thinkable, while also learning how to metabolize these thoughts in the process.
Phenomenologically, containment seems to have two principles at play which are related but slightly separate. On the one hand, the process of containing is a process of setting a limit. It involves drawing a line around something that might otherwise seem hazy, ill-defined, and all-consuming, in a manner that says, “I know this all may seem like a lot, but what if we consider it within this possible set of conditions.” Containing defines, without arbitrarily limiting. It creates a sense of scope around something that, to those in need of containment, seemed scopeless. It also involves containment as a kind of holding, which is where the association to Winnicott comes in. Limits and definitions are not just set; they are set with purpose, relationally, and in way that is meant to soothe and bring ease. It is the act of bouncing around the room with a crying infant, lulling them to the point of a gentle rocking motion. It’s the “there, there” that comes with the gentle patting on the back, a there which means “I can see the shape of your suffering: it is there, and so are you. And this there is here now, and we can both be here with it.”
Thinking about psychotherapy and the site of the body, this might look like the various ways we maintain and contort ourselves physically while in the process of sitting with a client. It is in knowing when to lean in and meet something head-on, or to allow oneself to recline and take something in. To arrive, open and hungry for what the client is trying to share with you, or to bring gentle presence to something that needs to be received gently and with care. The idea of knowing what it is like to understand the space of the body, both its physical form and where the liminal space between beings extends to, and how to hold that space, is difficult to teach. It is a kind of knowing that must be cultivated over time in those who are not particularly inclined to want to be in their body. It would not be right to say I remember the shift itself in my own work, but I can say for certain I used to be far more cerebral than I am now. I try to take in a lot more of what my body is doing and feeling, both in my work and in my day-to-day life, than I was naturally taught growing up as a bright and intellectually precocious youngster. I’m glad to have encountered in this work folks who refused to let me forget my body and the importance of the role it plays in both gathering and communicating some sense of the world.
Containment via affect may involve a lot of separate but related processes. Sometimes it is in helping a client begin to sort out and name the various things they are feeling. The relationship between their body, what it is sensing, and what we then call that thing. The tense narrowing of experience and the sudden sense of something always imperceptibly behind you, inching up on the possibility of taking you over, become something like terror. The devastating hole that opens inside and swallows us back into ourselves when we notice ourselves failing or flailing becomes shame. Or that thing skittering beneath my indignation at the impossibility of the conditions I am being asked to navigate, this world I have been thrown into and can’t possibly manage, becomes something like sadness, or more precisely grief. In naming these, we may even be tasked with opening the possibility of the descriptive position of these experiences, overcome as difficult emotions usually are by a kind of generalist and existential form of anxiety or angst. A confrontation with some set of internal conditions which will not and cannot be named. That before we can characterize, the permission structure for feeling must be announced and shared.
This may also arrive in therapists’ needing to demonstrate and hold for themselves some kind of affective expression. Projective identification is of course one version of this, but it might be fair to simply call it the emotional demand of truly being with another. What we are tasked with feeling might not always be what is being disavowed by the client and may in fact be some sense of something they cannot even quite equate with the situation they are describing. Or they can and are but need the supportive structure of having those emotions mirrored and perhaps even amplified by another. If containment is about showing the shape of something, this may mean sometimes not merely constricting and bringing something in but inviting the possibility that the terrain of the emotions and affects entering the field is even more expansive than is being sensed. That there are shady realms of what it means to feel that the client has the capacity for and into which they simply need some sort of guide.
And then there is language, the discourse we bring to bear on the above experiences in order to make them communicable and bring them into full relational expression. Of course, the language dimension is not just the words we say, but the tone and tenor of how we choose to say what we choose to say. I hope in this you can see why I started with the body and how these all really build upon one another and intermingle in their responsibility within this dimension of the work of psychotherapy. When we decide to help a client name an emotion—or dare to name before them one we are feeling in the moment that is arising in relation to them—we are arriving at the intersection of these loci, naming through language the felt sense of what arises in our body within the specific set of affective conditions the moment demands.
This came up as a teaching moment in class recently. A student was recalling a passage from a text in which the therapist was offering the remark “This must be how your girlfriend feels…” when the client was doing such-and-such a thing. The student recalled it dryly and maybe even in a manner that was somewhat pointed. However, we were also able to mine that phrase for different cadences; pauses; shifts in volume and tone; and underlying affective delivery that could make that statement feel like a myriad of different things.
There is an old actor’s exercise, in which the actor is given a line and, with or without direction, is asked to come up with as many ways of delivering the line as possible, changing their reading either dramatically or slightly with each iteration. The purpose of the repetition is to push the training actor to find the various nuances in a single line of dialogue and various ways it could be played, some grounded and sensible, others exaggerated and needing to be grounded in the sensibilities and expression of the actor.
Therapists, one might propose, need to develop a similar technical repertoire but carried out to a different end. Our task is not to bring a range of emotional readings to a text to potentially satisfy the needs of a director’s vision regarding how a scene is meant to be played out. But we do need to have access to a broad emotional range so that we might be able to bring some amount of authenticity to bear on the experiential conditions of the therapeutic encounter. The intersection of body, affect, and language must be the therapist’s play space so that we might be able to provide the containing function Bion names of helping the client to configure and reshape theirs. Winnicott noted that in doing therapy, we are often being tasked with teaching the client how to play. The kind of care we can bring to the creative process of the containing function of therapy, and the development of our own capacities to enter fully into these three registers, will mold the kind of processes we are capable of providing in our work, and the depth of encounter we might be able to present to those who dare to do with us the impossible.
