Holding on; being held; letting go: the relevance of Bion's thinking for psychoanalytic work with parents, infants and children under five

Abstract

This paper attempts to convey how the ideas of Klein, Bion and Bick underpin psychoanalytically based interventions with parents, babies and young children in the Camden Under Fives' Service, Tavistock Clinic. As the title suggests, my focus is on ways in which anxiety relating to separation and loss, can be contained through the transformative function of ‘reverie’. I describe two clinical examples, of a bereaved couple who lost their baby at six weeks and of a three-year-old child suffering from severe constipation, to explore the role of therapeutic work in facilitating a shift away from a defensive ‘holding onto’ a concrete object as a means of evading separation, towards a more symbolic level of functioning, feeling ‘held in mind’. Steiner's description of the mourning process moving along a continuum from ‘fear of the loss of the object’ towards ‘experience of loss of the object’ as the patient shifts away from the ‘paranoid–schizoid’ towards a more ‘depressive position’ and the successful completion of mourning, is linked to Bion's concept of container-contained. The role of the clinician as ‘container’ of unprocessed states in young children, is discussed and linked to the recognition of ‘turning points’ in brief and longer-term work with under fives.