Relational Levels of the “Container-Contained” in Group Therapy

The cornerstone of W. R. Bion's theory of individual and group development is that thinking is a primary emotional need, and it matures in the context of social communication. Bion (1970) formulated the essential relationship between thinking and communicating in terms of the container-contained relationship. Bion (1970) described three types of communication, occurring on different levels of development: commensal, symbiotic, and parasitic. These patterns involve normal and pathological variations of the container-contained and call for different expressions of the therapist's subjectivity. In this paper, I describe each of these alterations as they apply to group therapy and to therapeutic activity. I include case examples of how I utilize the conceptual framework in my work.     

Rebellion in group

Rebellion is a strategy of social action: to overthrow the group's status quo or to adamantly oppose its revision. Rebellion occurs when other avenues of influence seem futile or unattractive-a judgment that depends on the group's genuine receptivity to discussion and change, and equally, on the state of mind of the rebel. There are different pathways of rebellion: defiance, secession/exile, anarchy, or revolution. Although rebellion represents an individual's mental attitude toward a group, it is useful to think of group process and rebellion as an attempt to move the group in a different direction. Similar to other group members, the therapist has rebellious feelings and thoughts, and may take on the multiple roles of defiant instigator, exiled outcast, anarchist, and revolutionary.     

An intersubjective approach to entitlement.

Entitlement is an emotionally based but not necessarily pathological mode of experiencing psychic reality, one which belongs to both analyst and patient participating in the inter-subjective matrix. I use myself as an example of an analyst who initially believed he was constructively analyzing treatment-resistant entitlements. The course of the work involved identifying expressions of entitlement in myself, as well as in the patient or supervisee. I came to understand that distinctions such as normal or pathological, entitled or counterentitled, often become irrelevant. The focus of the work shifts toward uncovering the bidirectionality of entitlement experiences, revealing the varying elements of entitlement and discovering how they function in the therapeutic relationship.     

McEwen-Induced Modulation of Endocrine History: A Partial Review

In endless facets of physiology, there are points of homeostatic balance, such that too much or too litttle of something can both be deleterious (i.e., an "inverse U" pattern). This is particularly true when considering glucocorticoids (GCs), the adrenals steroid secreted during stress. In the first part of this paper, I review a number of realms in which a paucity and an excess of GCs are both damaging. Some findings are classical (for example, concerning GC effects upon body weight), while some are quite recent and have considerable implications for both physiology and pathophysiology (for example, inverse U's of GC actions in the realm of immunity and neuronal survival). The second part of the review considers the far thornier issue of how such inverse U's of GC actions are generated on a cellular and molecular level. One solution that has evolved, primarily in the hippocampus within the nervous system, involves the presence of two different types of receptors for GCs within the same cells; so long as the two receptors have very different affinities and mediate opposing effects on some cellular endpoint, an inverse U will emerge. The second solution, found in a number of peripheral tissues, involves GCs having opposing effects on the amount of some signal being generated (e.g., an immune cytokine) and the sensitivity of target tissues to that signal; under conditions that appear to be physiologically relevant, inverse U's emerge from this pattern as well. The final section of this review considers the enormous role played by Bruce McEwen in the emergence of this literature. I suggest that while much of this obviously has to do with the facts that have come from his group, another substantial contribution is from his steadying and supportive personality, the veritable embodiment of homeostatic balance.     

Bonding in group: the therapist's contribution

Bonding is an ongoing aspect of intersubjective experience, a type of mental relationship to oneself and others. As a behavioral mode, bonding utilizes verbal and nonverbal communication primarily to establish a basic feeling of connection between individuals. Bonding is the floor, a cognitive-affective state that precedes and prepares the way for the complex processes underlying identification. The concept relates to Bion's early theory of basic assumptions, and takes on new and different meanings according to his later ideas regarding social communication. Bonding is also a therapeutic posture or technique, an element in the establishment of group cohesion, the positive transference, and therapeutic and group alliance. Case examples illustrate how the therapist and other group members bring a complex of bonding needs and anxieties that must be negotiated to establish and maintain bonding, which is a necessary condition for successful therapeutic work.     

I am I:A/M—The Therapist as Personification of Hopper's Fourth Basic Assumption

The group therapist often and perhaps necessarily personifies Incohesion and displays its predominant defenses of contact-shunning Aggregation, and merger-hungry Massification. Hence, I am I:A/M. In Hopper's group example, and in each of three of this author's groups, the therapist displayed aggregative and massified defenses, countertansferential duals of basic assumptive transferences. In any therapeutic interaction, it is possible to find elements of incohesion, dependency, pairing, and fight/flight. The incohesion concept has significant clinical utility. A theoretical question remains, whether Hopper's proposed axis of experience and defense merits the special status, basic assumption, or whether incohesion may be collapsed into the existing triad of basic assumptions.     

Developmental and sex-related differences in preschoolers' affective decision making

This study investigated developmental and sex-related differences in affective decision making, using a two-deck version of Children's Gambling Task administered to 3- and 4-year-old children. The main findings were that 4-year-old children displayed better decision-making performance than 3-year-olds. This effect was independent of developmental changes in inductive reasoning, language, and working memory. There were also sex differences in decision-making performance, which were apparent only in 3-year-old children and favored girls. Moreover, age predicted awareness of task and the correlation between the latter and decision-making performance was significant, but only in 4-year-old children. This study thus indicates that there is a remarkable developmental leap in affective decision making, whose effects are apparent around the age of 4, which according to our results, also marks the age when the correlation of declarative knowledge and decision-making performance becomes significant.