Containment: from cruelty to kindness

Abstract

Purpose – This paper is about therapeutic containment. It makes links between what the author understands about containment in therapeutic communities and wider perspectives on containment in the context of organisational and social forces within which the author lives and works in modern society. The paper aims to discuss these issues. Design/methodology/approach – The author explores relational dynamics, focusing particularly on the English NHS, using evidence from a cross-section of disciplines including ethology, anthropology and economic philosophy. Findings – The author suggests that the crisis in healthcare culture reflects a wider crisis of containment in the modern world; and that the theoretical legacy from, and lived experience in, therapeutic communities offers a rich perspective on the issues and points to ways forward. Social implications – The paper suggests ways that therapeutic community thinking can be applied more widely to topical problems such as the undermining of healthcare culture. The paper argues that an explicit focus on values is important in order to mitigate the forces that distract from co-operative and therapeutic relationships. To illustrate this, the author describes a simple model for nurturing the conditions for intelligent kindness. Originality/value – The paper draws important parallels between therapeutic community philosophy and practice, and the culture at large.