The traumatic roots of containment: the evolution of Bion's metapsychology

W. R. Bion wrote repeatedly about his World War I experiences as a tank officer, thus engaging in historicizing a traumatic emotional experience. A close reading of the many layers in these writings suggests that the war experiences influenced the metapsychology he created. The author argues that haunting questions regarding the ability of the mind to survive trauma led Bion to elaborate on the process of containing emotional experience, and hence to address the lack of an intricate theory of thinking in psychoanalytic metapsychology and to offer a vision of a mind struggling to survive, culminating in the growth of a postmodern consciousness.     

Quality of care and cost containment in the U.S. and U.K.

Many activities of doctors in the acute hospital sector do not improve patient outcome because they are inappropriate. Curtailing interventions that are unnecessary (because the patient is not bad enough) or are unsuccessful (because the condition is too advanced) could both save resources and improve care. Rational rationing depends on knowledge about the expected benefits of various technologies when used in different clinical circumstances.     

Stray thoughts – seeking home: Henrik Ibsen's Peer Gynt read in light of Wilfred Bion's ideas

Peer Gynt, the main character in Ibsen's dramatic poem from 1867, has fascinated scholars since its publication. After a lifetime of escapades, Peer finds himself lonely, detached and with feelings of deadness. Gradually, the underlying structure of his personality confronts him. With the help of Wilfred Bion's ideas, it is possible to trace a distinct pattern, where unprocessed thoughts seem to play a decisive role in hindering Peer's self‐realization. The main female character, Solveig, spends her life waiting for Peer. Eventually she develops into a container, ready to welcome Peer's stray thoughts. This paper demonstrates how she evolves Bionian capacities like reverie, and eschewing of memory and desire. The interpretation that follows thus challenges a tradition where Solveig is seen as a romantic figure who, like Goethe's Gretchen, is designed to save the male protagonist by unconditional love. This paper argues that Solveig plays a more active role towards Peer in offering significant tools for personal development. The paper concludes that Ibsen and Bion have uncovered elements of basic human conditions that in some significant ways seem to coincide.     

Shared ancestry, evolving stories: similar and contrasting life experiences described by foreign born and U.S. born Latino parents

As the Latino population in the United States continues to increase, so does the necessity for in-depth knowledge about their life experiences. This qualitative study sought to privilege the voices of Latino parents by utilizing focus group discussions. Specifically, participants described the life experiences that have the greatest influence on their parenting efforts. Similar and contrasting themes were identified based on participant country of origin (i.e., foreign born vs. U.S. born). Findings described the participants' commitment to being good parents, as well as the ways in which their parenting efforts are influenced by experiences of adversity and discrimination, Latino cultural values, gender roles, and resilience. The results of this investigation can inform researchers and mental health professionals working with Latino families.     

Clinical,Studies in Psychiatry by H. S. Sullivan

A structured group therapy approach for psychiatric inpatients is presented. After reviewing the literature indicating that insight-oriented approaches are not effective with severely disturbed patients, the data supporting an interpersonal, cognitive, problem-solving approach with such patients is reviewed. A rationale for combining this cognitive problem-solving approach and Yalom's interpersonal approach with psychiatric inpatients is then presented. This structured group therapy approach, called the problem-solving support group (PSSG) is discussed, defining the nature and composition, screening procedures, methods, and techniques of the PSSG. Its use with psychiatric patients is illustrated by therapy protocols depicting the nature of the therapeutic interactions during the group, while also demonstrating what the group appears to be accomplishing for its members.     

Orientation,containment and the emergence of symbolic thinking

Orientation is viewed in this paper as an important dimension of containment for the development of thinking. Orientation refers to the particular positioning in space and time of mother and infant so they can find one another and then containment can take place. Bion's container–contained model for the development of thinking is based on the capacity of the mother's mind to function as a ‘home’ for the infant's primitive projections. Containment and orientation are explored in relation to an ancient Greek object called ‘σ?μβολον’ [symbolon], which I use here as a metaphor for the early negotiation between mother and infant to achieve a correct matching to each other's orientation. This is then mobilized and re‐enacted between analyst and patient in the psychoanalytic process. Orientation as part of the container–contained model enables us to view the development of thinking from a new perspective with greater integration of cognitive and emotional aspects. The clinical implication of the concept of orientation is explored in relation to the process of engagement/disengagement between analyst and patient and is illustrated by clinical material.     

Elucidating the role of recovery experiences in the job demands-resources model

Based on the Job Demands-Resources (JD-R) model, the current study examined the moderating role of recovery experiences (i.e., psychological detachment from work, relaxation, mastery experiences, and control over leisure time) on the relationship between one job demand (i.e., role conflict) and work- and health-related outcomes. Results from our sample of 990 employees from Spain showed that psychological detachment from work and relaxation buffered the negative impact of role conflict on some of the proposed outcomes. Contrary to our expectations, we did not find significant results for mastery and control regarding moderating effects. Overall, findings suggest a differential pattern of the recovery experiences in the health impairment process proposed by the JD-R model.     

Social Pressures in Informal Groups by L. S. Festinger,S. Schacter and K. Back

The rising cost of health care within the private and public sectors has created an increased demand for the management of benefit dollars. This trend has significant implications for group psychotherapists, as group modalities offer cost-effective ways of delivering services to traditional outpatient and inpatient populations. Continued cosl-containment pressures and increasing attention to outcome studies will fitel trends toward briefer, manualized group treatments and intensive group outpatient programs as alternatives to hospitalization. Quality-based demands will challenge payors to (a) address biases against group psychotherapy among providers and patients and (b) integrate recent process-and-outcome research in determining the appropriateness of group versus individual modalities for particular patients and presenting problems.