**2.5 Wilfred Bion's concept of a container for the contained**

It was the work of Bion that was instrumental in highlighting the need for another to manage anxiety, an idea initially conceptualised by Sigmund Freud. Mawson [2] comments on how Freud pointed towards not only the infant being unable to manage anxiety alone but that anxiety can be made bearable by '… .the timely intervention of the mother, orienting herself not only in the realm of the satisfaction of basic needs but, crucially in the domain of anxiety'. Mawson reminds us that the prototype for all anxiety is one based upon helplessness in the face of destructive forces from within, which the intervention by the mother is essential in helping to manage. It could be said that the infant's continued psychological existence depends heavily upon the mother's intervention in assuaging such primitive anxieties as those discussed above.

Bion [12] was able to recognise that the role of the mother surpassed the necessary provision of basic needs—feeding and physical comfort. Crucially, it also provided a containing function for the infant's anxiety. Bion took this initial idea further and saw that the containing experience of the mother might also be the kernel for the development of thought, thinking and learning. According to Mawson [2], Bion experienced this primary containing function of the mind as a 'dynamic living system'.

Through his clinical work with psychotic and schizophrenic patients in the 1940s–1950s, Bion developed further Klein's idea of projective identification9 extending it beyond the need to get rid of unwanted emotional states or parts of the self. Projective identification in psychoanalytic terms is seen as an important process of maintaining an emotional equilibrium. It could be seen as a mechanism for releasing tension caused by anxiety that builds as a result of destructive feeling states from within. By placing these outside the self, attributing them elsewhere, the external object acts as a repository for them. Bion [12] felt that clinically projective identification by the patient could also be a useful tool for the psychotherapist in terms of it acting as a form of communication. Unthinkable, intolerable, emotional elements and parts of the self projected into the psychotherapist could be a useful tool to gain insight and an understanding of the patient's internal world. It could lend meaning to the patient's emotional experiences which were so intolerable and overwhelming that they needed to be expelled and forcefully put elsewhere.

Bion [13] describes the process of the mother accepting the infant's projective identifications, acting as a willing container that offers flexibility and a transformational process to the infant's anxieties around its own survival. It is the earliest form of communication as the mother receives the baby's distress, mulling it over in her mind to understand what the baby, through its distress and the impact on her, is letting her know. A simple example is the baby whose distress has made an impact on the mother, who in her containing function applies her own thinking as to why the baby might

*Psychopathology - An International and Interdisciplinary Perspective*

presence of her actual mother.

**2.4 Depressive anxiety**

Klein [9] termed the depressive position.

mind through the symbolic representation of her mother. What was evident was how precarious this capacity was and how easily symbolic functioning (her play) could break down when anxiety levels became intolerable. At these moments the substitute for the mother was not enough she needed the reassurance of the physical

For Sarah, as with any 4-year-old, we would not expect her to be able to manage such severe anxieties by herself. However, we would think that in Sarah's case she was still stuck in Klein's paranoid-schizoid position and finding it very difficult to move forwards into the more developmentally mature phase or position which

Halton [10], succinctly, describes Klein's idea of the depressive position and the central anxiety which emerges. He suggests that the anxiety here is as a result of a profound fear that the aggressiveness of the earlier paranoid-schizoid position has irreparably damaged the good object (mother-figure), leading in phantasy to the death of this life-giving source. This phase is flavoured, therefore, with feelings of guilt and remorse and a depressive form of anxiety which galvanises a need to repair the damage done to the object in phantasy. Halton suggests that the depressive position is characterised by a process of ego integration, of bringing different experiences together and of giving up the simplistic state of self-idealisation. It faces the growing self with the complex nature of internal and external reality, for example, that it is the same mother that fulfils that can also frustrate and withhold. The shift,

we could say, is that from concern for the self to concern about the other.

as she recognised she had more 'choices' to deal with the internal pain.

Klein [11] emphasises the importance for the psychological well-being of the individual of reaching this developmental stage of the depressive position and how the anxiety of having damaged something precious stimulates a desire for work and creativity in the process of trying to repair. For Jess, a long and challenging therapeutic process exhibited a growing capacity to tolerate anxiety states. There was a growing ability to find more creative, symbolic ways of managing internal pain, namely, by giving words and language to it. With this articulation came a growing curiosity about how her mother battles with alcohol abuse, her father's early abandonment of the family and an ability to see the impact of past events on her present emotional experience. The need for self-harming behaviour diminished

We see the importance Klein places on tolerating anxiety and the shift to 'depres-

In both Jess and Sarah, we might argue that at the outset of the work, there was a limited capacity for tolerating anxiety. There was a greater need to 'act out', to evacuate and to get rid of the overwhelming levels of anxiety or to find sustenance and relief from the needed actual presence of the mother-figure. This acting out was often apparent in the therapeutic work, Jess at one point even harming herself in the clinic prior to her session with myself. Bearing my shock, my disappointment, my anger and my thinking about such feelings was an instrumental factor in the therapeutic process. Jess, at this stage of our work, could not tolerate and acquire for herself an 'optimum degree' of anxiety—the mind of another was still needed

sive anxiety' in the development of the personality. In terms of the individual's capacity for thinking, for functioning symbolically and creatively, the ego has to develop a true relation to reality and to be able to '… tolerate the pressure of the earliest anxiety-situations. And as usual it is a question of a certain optimum balance of factors concerned. A sufficient quantity of anxiety is the necessary basis for an abundance of symbol formation and of phantasy: an adequate capacity of the ego to tolerate anxiety is essential if anxiety is to be satisfactorily worked over … [8].

**136**

<sup>9</sup> As discussed earlier, projective identification is an unconscious process, whereby unwanted emotions or parts of ourselves are split off, projected and now located in the other. The other is changed by this projection and is now seen as the embodiment of the anger, aggression, envy or other aspects that have been got rid of. It is the other that is angry, aggressive, frightening or envious, not our self. Good qualities/attributes can also be projected and left in others, often as a means of keeping such good aspects safe and away from destructive internal elements of the self.

be distressed. Working this out and meeting the babies need at that moment leads on a proto level to the baby feeling understood. To Bion's mind, it was the origin of the process of thinking and thought as provided by the thinking mind of another.

Bion [13] writes that the infant's projective identifications '… .arouse in the mother feelings which the infant wishes to be rid, if the infant feels it is dying it can arouse fears in the mother that it is dying. A well-balanced mother can accept these and respond therapeutically: that is to say in a manner that makes the infant feel it is receiving its frightened personality back again, but in a form that it can tolerate- the fears are manageable by the infant personality.

Bion is suggesting that it is the capacity of the mother, repeatedly, to bear the infant's unprocessed, unthinkable thoughts and intolerable feelings projected into her (the mother's processing of them and returning them back in a more tolerable form) that will eventually lead to the infant themselves taking in this containing capacity to think about and to reflect upon. Initially therefore, the mother is a 'thinker for the thoughts', until the infant develops the capacity (through repeated experiences of this process being provided by the mother) to think about the thoughts for themselves. This is the process of internalisation of an experience.

If the mother/mother-figure can tolerate the infant's projections and thereby provide such a containing function to the infants intolerable anxieties (without recourse to sending these projections back unprocessed and unmodified), then the infant will later become more able to tolerate, to stay with and to refine states of anxiety. Of course, Bion is saying much more than this. He refers more explicitly to the quality of this containing function of the parent as being essential for emotional, cognitive and psychosocial development. He also pointed to the dire consequences for development as a whole, if the parent is unwilling or unavailable to receive the infant's projections. This would therefore lead to an intolerance of difficult feelings and to increased levels of projection. Behaviour will be motivated by a greater need to expel, to avoid or to evade mental pain than to stay with and modify. Bion [13] turns to Keats when describing the role of the mother/therapist's capacity to tolerate the intolerable. Keats [14] described a concept of 'negative capability' … that is, when a man is capable of being in uncertainties, mysteries, doubts, without any irritable reaching after fact and reason'.

We might wonder if Jess and Sarah had received a consistent enough experience of such a containing transformation of early anxieties. It should be kept in mind that these were parents who themselves struggled with their own very significant mental health difficulties, often in the absence of meaningful support from others. However, unlike their parents, both Jess and Sarah had come into contact with the containing presence and function of ongoing psychotherapy. Over time, Jess's self-harming ceased; she was better able to empathise with her mother's own difficult history as opposed to resorting to attacking and blaming her mother for her shortcomings. Jess found the potential within her to complete her studies and go onto university. Sarah did eventually find it easier to separate from her mother, to engage in creative and imaginative play and to share her play with her peers. The most pleasing for the parents was the broadening of her interests to include swimming and gymnastics, which signalled a shift away from her fixation with food and eating. This psychotherapeutic function corresponds with that of the motherfigure, of providing a mutative, containing function for the patient, a feeding back in a more processed form, through interpretation, those intolerable anxiety-ridden states. This process makes such states more bearable; it is a curative process that can lead to symbol formation, creativity and thinking. I can think about and put words to my worst fears and anxieties rather than acting them out in a ritualised or repetitive way.

**139**

**3. Conclusion**

turely reaching out for 'fact or reason'.

intolerable and the unthinkable.

*Anxiety: The Dizziness of Freedom—The Developmental Factors of Anxiety as Seen…*

help of the therapist which may be helped by an increase in arousal levels.

The emerging theme of this exploration of anxiety is that in order to allow ourselves the experience of Kierkegaard's [1] 'dizziness of freedom'—a freedom to choose, to have options, we must first have in place a capacity to tolerate overwhelming degrees of anxiety that are powerfully present in those earliest moments of life. As we have seen, this capacity is not the one that we can acquire alone. In such moments it is necessary that we are in the presence of a willing and curious mind that can offer reverie to our most primitive fear and anxieties often originating from within.

As we have seen, Klein [9] speaks of the importance for development of being

This chapter has explored those seminal, early experiences between mother and infant that are elemental to the binding and transforming of anxiety and thus creating anxiety of the 'right kind'. The right kind of anxiety is that which has been worked upon, made optimum in its intensity, yet whose presence I have argued is paramount for processes of sublimation, symbolisation and expression (through language, writing, art or music) to take place. We have explored what the consequences for development are for those whose anxiety has been left unbound anxiety which subsequently overwhelms and stultifies development. For those who have not had conferred on them the early experience of a reposeful mind of a parent-figure, we should not feel too despairing as there are interventions that can make a difference. Anxiety states can be optimised; development can become unstuck when there is access to a mind that can contain, tolerate and transform the

able to reach the depression position. With the advent of this phase come the experience of depressive anxiety and an inclination for reparation, which psychoanalysts argue that is essential for the development of our creative capacities. When Kierkegaard wrote of those having learned to be anxious in the 'right way', we might think he is referring to those who can tolerate and be able to modify states of high anxiety without recourse to expulsion through action and doing, without prema-

Widening our focal point slightly, we might wish to turn to experimental psychology and in particular the seminal work of Yerkes and Dodson [11], Yerkes-Dodson law, to further illuminate Sarah and Jess's struggles with anxiety. As

Kierkegaard [1] writes of the 'right kind of anxiety, the Yerkes-Dodson law suggests that there is a need for a 'right'-level of physiological and mental arousal (anxiety) for us to optimally perform certain tasks. The law suggests that challenging or cognitively demanding tasks may require lower levels of arousal in order to optimise concentration levels, whereas tasks that need physical stamina and perseverance may need higher levels of arousal. We might therefore wonder if the capacities of these two young people to develop both cognitively and emotionally were impacted upon by inappropriate levels of arousal given the areas of development under consideration. This is an interesting concept and one that as a psychotherapist it is worth considering in terms of the quality of therapeutic interventions. A therapeutic intervention might inadvertently serve to increase arousal levels in the patient when what is needed for the task is an intervention that offers the opposite. It is consistent with the idea that at times the patient needs the therapist to hear and understand (and not help the patient make sense of their experience) which may lower arousal levels and increase performance levels regarding focus and concentration, whereas there are other times that what is needed by the patient is for themselves to understand their internal/external experiences or states of mind with the

*DOI: http://dx.doi.org/10.5772/intechopen.86765*

*Anxiety: The Dizziness of Freedom—The Developmental Factors of Anxiety as Seen… DOI: http://dx.doi.org/10.5772/intechopen.86765*

Widening our focal point slightly, we might wish to turn to experimental psychology and in particular the seminal work of Yerkes and Dodson [11], Yerkes-Dodson law, to further illuminate Sarah and Jess's struggles with anxiety. As Kierkegaard [1] writes of the 'right kind of anxiety, the Yerkes-Dodson law suggests that there is a need for a 'right'-level of physiological and mental arousal (anxiety) for us to optimally perform certain tasks. The law suggests that challenging or cognitively demanding tasks may require lower levels of arousal in order to optimise concentration levels, whereas tasks that need physical stamina and perseverance may need higher levels of arousal. We might therefore wonder if the capacities of these two young people to develop both cognitively and emotionally were impacted upon by inappropriate levels of arousal given the areas of development under consideration. This is an interesting concept and one that as a psychotherapist it is worth considering in terms of the quality of therapeutic interventions. A therapeutic intervention might inadvertently serve to increase arousal levels in the patient when what is needed for the task is an intervention that offers the opposite. It is consistent with the idea that at times the patient needs the therapist to hear and understand (and not help the patient make sense of their experience) which may lower arousal levels and increase performance levels regarding focus and concentration, whereas there are other times that what is needed by the patient is for themselves to understand their internal/external experiences or states of mind with the help of the therapist which may be helped by an increase in arousal levels.

#### **3. Conclusion**

*Psychopathology - An International and Interdisciplinary Perspective*

fears are manageable by the infant personality.

any irritable reaching after fact and reason'.

an experience.

be distressed. Working this out and meeting the babies need at that moment leads on a proto level to the baby feeling understood. To Bion's mind, it was the origin of the process of thinking and thought as provided by the thinking mind of another. Bion [13] writes that the infant's projective identifications '… .arouse in the mother feelings which the infant wishes to be rid, if the infant feels it is dying it can arouse fears in the mother that it is dying. A well-balanced mother can accept these and respond therapeutically: that is to say in a manner that makes the infant feel it is receiving its frightened personality back again, but in a form that it can tolerate- the

Bion is suggesting that it is the capacity of the mother, repeatedly, to bear the infant's unprocessed, unthinkable thoughts and intolerable feelings projected into her (the mother's processing of them and returning them back in a more tolerable form) that will eventually lead to the infant themselves taking in this containing capacity to think about and to reflect upon. Initially therefore, the mother is a 'thinker for the thoughts', until the infant develops the capacity (through repeated experiences of this process being provided by the mother) to think about the thoughts for themselves. This is the process of internalisation of

If the mother/mother-figure can tolerate the infant's projections and thereby provide such a containing function to the infants intolerable anxieties (without recourse to sending these projections back unprocessed and unmodified), then the infant will later become more able to tolerate, to stay with and to refine states of anxiety. Of course, Bion is saying much more than this. He refers more explicitly to the quality of this containing function of the parent as being essential for emotional, cognitive and psychosocial development. He also pointed to the dire consequences for development as a whole, if the parent is unwilling or unavailable to receive the infant's projections. This would therefore lead to an intolerance of difficult feelings and to increased levels of projection. Behaviour will be motivated by a greater need to expel, to avoid or to evade mental pain than to stay with and modify. Bion [13] turns to Keats when describing the role of the mother/therapist's capacity to tolerate the intolerable. Keats [14] described a concept of 'negative capability' … that is, when a man is capable of being in uncertainties, mysteries, doubts, without

We might wonder if Jess and Sarah had received a consistent enough experience of such a containing transformation of early anxieties. It should be kept in mind that these were parents who themselves struggled with their own very significant mental health difficulties, often in the absence of meaningful support from others. However, unlike their parents, both Jess and Sarah had come into contact with the containing presence and function of ongoing psychotherapy. Over time, Jess's self-harming ceased; she was better able to empathise with her mother's own difficult history as opposed to resorting to attacking and blaming her mother for her shortcomings. Jess found the potential within her to complete her studies and go onto university. Sarah did eventually find it easier to separate from her mother, to engage in creative and imaginative play and to share her play with her peers. The most pleasing for the parents was the broadening of her interests to include swimming and gymnastics, which signalled a shift away from her fixation with food and eating. This psychotherapeutic function corresponds with that of the motherfigure, of providing a mutative, containing function for the patient, a feeding back in a more processed form, through interpretation, those intolerable anxiety-ridden states. This process makes such states more bearable; it is a curative process that can lead to symbol formation, creativity and thinking. I can think about and put words to my worst fears and anxieties rather than acting them out in a ritualised or

**138**

repetitive way.

The emerging theme of this exploration of anxiety is that in order to allow ourselves the experience of Kierkegaard's [1] 'dizziness of freedom'—a freedom to choose, to have options, we must first have in place a capacity to tolerate overwhelming degrees of anxiety that are powerfully present in those earliest moments of life. As we have seen, this capacity is not the one that we can acquire alone. In such moments it is necessary that we are in the presence of a willing and curious mind that can offer reverie to our most primitive fear and anxieties often originating from within.

As we have seen, Klein [9] speaks of the importance for development of being able to reach the depression position. With the advent of this phase come the experience of depressive anxiety and an inclination for reparation, which psychoanalysts argue that is essential for the development of our creative capacities. When Kierkegaard wrote of those having learned to be anxious in the 'right way', we might think he is referring to those who can tolerate and be able to modify states of high anxiety without recourse to expulsion through action and doing, without prematurely reaching out for 'fact or reason'.

This chapter has explored those seminal, early experiences between mother and infant that are elemental to the binding and transforming of anxiety and thus creating anxiety of the 'right kind'. The right kind of anxiety is that which has been worked upon, made optimum in its intensity, yet whose presence I have argued is paramount for processes of sublimation, symbolisation and expression (through language, writing, art or music) to take place. We have explored what the consequences for development are for those whose anxiety has been left unbound anxiety which subsequently overwhelms and stultifies development. For those who have not had conferred on them the early experience of a reposeful mind of a parent-figure, we should not feel too despairing as there are interventions that can make a difference. Anxiety states can be optimised; development can become unstuck when there is access to a mind that can contain, tolerate and transform the intolerable and the unthinkable.

With the current prevalence of patients presenting with anxiety to mental health clinics throughout Europe, we might draw upon Bion's idea of container/contained to understand, or indeed question, Western societies communal approach to the containment of anxiety as it has been explored in this chapter. Bion was keen to emphasise that it is not simply the mother or parent-figure that provides such a process of containment—this is also facilitated by the family, the school, the place of work and indeed the society as a whole. With current epidemic levels of anxiety in our society, we must wonder if institutions, organisations, government and our society as a whole provide enough containing function to its citizens in order to help ameliorate such primitive anxieties as have been explored in this chapter. Or perhaps worse still—do we increasingly live in societies whose values only serve to increase anxiety and arousal levels through its noncontainment?
