What We’ve Said

What we’ve said about Containment

16 points from 6 episodes, newest first

Also searched as technical containment

In short

Technical containment means perceiving a patient's inner experience, digesting it and handing it back in words, without giving information or changing anything. It is how thinking and emotion regulation develop, it is the core of empathy and of motivational interviewing, and it comes before any analysis, interpretation or confrontation.

What it is

  1. Technical containment is perceiving the inner emotional experience of another person, receiving it, digesting it yourself and communicating back that you have perceived them. That is all: you are not giving information or changing anything. You use your mind to clarify the patient's disorganized thoughts and feelings so that over time they can organize their understanding of themselves.

    “What is technical containment? It is when you perceive the inner emotional experience of another person, you receive it, digest it yourself, and you communicate back to them in some fashion that you have done so, that you've perceived them. That's all. You're not giving information. You're not changing anything”
    33:43Tips to Avoid Burnout in Psychiatry (Outpatient, mostly)Mar 2026
    Also said in 1 more episode
    “technical containment would be that you're there to receive the disorganized thoughts and feelings of the patient. And you're going to use your mind to clarify them towards the patient so that they can organize their understanding of themselves in the long term”
    47:49Probably The Most Important Topic in Psychiatry: Therapeutic Alliance and FrameJan 2025
  2. It comes from Bion's theory of thinking: humans cannot inherently form thinkable thoughts. Before experience becomes words, it is undifferentiated, and the caretaker, physician or therapist perceives that internal process happening in the other person.

    “he had a theory about thinking, in that it wasn't inherently possible for human beings to form thinkable thoughts, that before you could form thoughts into basically words, language that you communicate to other people and yourself, that you would just have sort of undifferentiated internal experiences”
    30:33Psychodynamic Technique and Therapeutic Intervention: ContainmentApr 2026
    Also said in 1 more episode
    “the child or the patient has an internal experience OK, that internal experience is not put into words. It's not turning into symbols or language. But the caretaker, physician or therapist can perceive that process happening in the other part”
    39:41Psychodynamic Technique and Therapeutic Intervention: ContainmentApr 2026
  3. If you are not doing some containment, you are not really having a conversation; you are both just talking at the same time.

    “If you're not doing some amount of containment, technically, you're not really having a conversation so much as you're both talking at the same time”
    45:11Psychodynamic Technique and Therapeutic Intervention: ContainmentApr 2026
  4. Containment is processing thoughts and metabolizing them so the person can hear them back. Mirroring is showing the person they have an individual self that is seen, important and recognized.

    “containment as more of processing and putting thoughts into a container and metabolizing thoughts in a way that they can kind of hear back and mirroring as a way to show that this person has an individual self that can be seen and is important and recognized”
    4:37Psychodynamic Technique and Therapeutic Intervention: Mirroring, Clarification, Confrontation, InterpretationJun 2026

Why it matters

  1. Ask how often someone has carefully listened to your internal experience and communicated it back in a way you could accept. If you cannot understand what is going on inside yourself, there is no way you will understand what is going on inside somebody else.

    “how often in your life has someone carefully listened to and paid attention to your internal experiences and then communicated their findings back to you in a way that you can accept”
    38:07The Treatment Frame in Action: Lessons from ‘I Fell in Love with My Psychiatrist’Sep 2025
    Also said in 1 more episode
    “if you can't understand what's going on inside yourself, there is no way that you're going to be able to understand what's going on potentially inside of somebody else”
    40:27The Treatment Frame in Action: Lessons from ‘I Fell in Love with My Psychiatrist’Sep 2025
  2. Some people cannot name emotions or put experience into words because of a lack of development: they were never given the tools or the chance to self-reflect.

    “I want people to think that maybe people can't name emotions or put their internal experiences into words because of a lack of development. They weren't given the tools or the opportunity to be able to self-reflect”
    32:48Psychodynamic Technique and Therapeutic Intervention: ContainmentApr 2026

How we use it

  1. Before any analysis, interpretation or confrontation: contain, contain, contain. Show the patient you have actually heard and experienced something like what they went through.

    “before you do any analysis, okay, before you do any interpretation, before you do any confrontation, contain, contain, contain. Demonstrate to the patient that you have actually heard and experienced something like what they have gone through within themselves emotionally, psychologically”
    36:25Tips to Avoid Burnout in Psychiatry (Outpatient, mostly)Mar 2026
  2. Step one is to observe and hear what the patient is saying and doing in front of you, what they are not saying and doing, and what ordinary people might experience in their place.

    “So step one is you observe and hear what the patient is saying and doing in front of you, and also maybe what they're not saying and doing, or even what ordinary people might be experiencing if they're talking about or thinking about that”
    42:26Psychodynamic Technique and Therapeutic Intervention: ContainmentApr 2026
  3. Used judiciously in a diagnostic interview, containment bolsters the patient's ability to elaborate, builds rapport and gets you more information.

    “If you do technical containment within a interview for diagnosis, for example, judiciously, you will, in my opinion, jaw bolster, even in that moment, the patient's ability to elaborate on experiences and it builds rapport to and it really helps you get the more information”
    52:26Psychodynamic Technique and Therapeutic Intervention: ContainmentApr 2026
  4. A diagnosis can be a container. For a patient frightened by OCD obsessions, the concept of intrusive thoughts explains what is going on so the thoughts no longer feel wild and unexplainable, and they feel much better.

    “the concept of intrusive thoughts provides a container for their experience to help understand what's going on so it doesn't feel like all these wild, called unexplainable thoughts, and in a sense, contains them and makes them feel much better”
    35:08Psychodynamic Technique and Therapeutic Intervention: ContainmentApr 2026
  5. Almost the same session can feel like being used and dumped on with one patient and be necessary and therapeutic with another. The relationship decides which it is.

    “there are a ton of patients that I feel used by and I feel dumped on by. And then there are patients that will have almost the exact same session, but in the context of my relationship with the patient, I find it's something that is necessary for them and helpful for them and therapeutic for them”
    48:27Probably The Most Important Topic in Psychiatry: Therapeutic Alliance and FrameJan 2025

Pearls

  1. Do not be afraid to simply reflect back. It may underlie the whole development of thinking and emotion regulation, especially in traumatized people, and at minimum it proves you are listening.

    “don't be afraid to simply reflect back. And why is that important? Not only does it possibly underlie the whole development of thinking and emotional regulation, especially in traumatized individuals, but at the minimum, you're proving that you're actually listening”
    49:34Psychodynamic Technique and Therapeutic Intervention: ContainmentApr 2026
  2. The actual core of motivational interviewing is technical containment, Rogerian mirroring, which lets patients notice discrepancies in themselves they would not otherwise notice.

    “The actual core of motivational interviewing is the ability to do this technical containment, the Rogerian-type mirroring, and in it, allowing patients to actually notice areas of discrepancy within themselves that would not otherwise be noticed without these kinds of reflections”
    55:26Psychodynamic Technique and Therapeutic Intervention: ContainmentApr 2026
  3. To learn it, watch Carl Rogers work on YouTube. His client-centered technique was essentially only containment: only reflective statements.

    “go on YouTube and watch Carl Rogers work. OK, Carl Rogers, follow. of client-centered therapy, which spawned motivational interviewing, his therapy technique and theory was only containment in my eyes. It was only reflective statements”
    45:37Psychodynamic Technique and Therapeutic Intervention: ContainmentApr 2026

Pitfalls and myths

  1. Venting by itself is not helpful, and it should not be documented as a psychotherapy intervention. What helps is the reflections you do.

    “venting itself is not actually helpful. It really bothers me when I see venting being documented as a psychotherapy intervention. The venting is not the operating procedure that actually helps people. It's the reflections you do”
    33:01Psychiatric Technique for Diagnostic Interviewing and Therapy: 6 Mantras Every Clinician Should KnowApr 2026
  2. Many therapies offer unconditional support for whatever the person is experiencing instead of curiosity and a wish to expand and understand it.

    “I fear that that's what occurs in a lot of therapies is just unconditional support for the primary process of what the person's experiencing rather than a curiosity and a desire to expand and understand it”
    51:17Psychodynamic Technique and Therapeutic Intervention: ContainmentApr 2026

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From these episodes

Every point above is something said on the Psychofarm podcast, with the words as spoken and a link to the moment in the episode. It is education, not medical advice, and an episode reflects what we thought when we recorded it.

Educational content only. Everything here is what was said on the Psychofarm podcast, for clinicians. It is not medical advice and not a substitute for clinical judgment, current labeling or guidelines. An episode reflects what we thought when we recorded it, so check anything before you rely on it.