Container-contained: Psychoanalytically informed work in a social services unit for disturbed adolescent boys

It is argued that psychoanalytic concepts are particularly relevant to the residential care of severely disturbed adolescents. When working with adolescents who have fragmented, partially projected object relations, Bion's ideas on emotional containment are an essential framework. Within an institution, the gathering up and working with split transferences can be seen as a first step in the process of correcting what Rousillon (1998) termed the defective process of symbolisation. In most cases of severe delinquency there is an initial emotional disturbance where the fundamental disturbance or fault lies in the relationships formed within the paranoid-schizoid and depressive positions. As a result of a faulty container-contained stage of development, there is an enduring tendency to delinquent acting out, reflecting a lack of containment. From a psychoanalytic perspective, the inability to tolerate frustration, the propensity to action and the disturbance of thinking, are important areas for therapeutic work. It is argued that psychoanalytically informed work can help make sense of what is often seen as wanton destructiveness, and help maintain a therapeutic focus using the relationships formed with staff as a primary agent of therapeutic change.