Containment
It is a word we use a lot in the therapy world. As a word person- I wanted the actual definition.
Containment- the act, process, or means of keeping something within limits OR the policy, process, or result of preventing the expansion of a hostile power or ideology.
How does this term “containment” relate to therapy, mental health and why is it so important? I first understood the importance of containment during my internship when I worked on the inpatient unit- technically the 5th floor of the Maimonides Medical Center. At that stage of my career, I didn’t fully understand why hospitalization worked. I assumed that the reason people got better in the hospital was because they took their medication regularly and were monitored and had therapy every day. But, once I worked on the unit, I began to see that what it was really about was the slowing down of life.
The second you walk onto a psychiatric unit you hand over everything in your possession, including your phone and the literal clothes off your back. From that moment forward everything is taken care of. There is a schedule in place that does not waiver: meals, groups, bed-time and wake up. Medication is administered, and there is total consistency from day to day. There are visiting hours, but they are brief and often monitored. Initially patients fight tooth and nail to stay out of the hospital: “I have things to do, I need my phone, I cannot be out of touch”. But then a few days roll by. They are long those first few days, filled with restlessness and anxiety around missing the outside world. But then slowly, the limbic system begins to slow down.
The Sympathetic Nervous System (SNS) known for protecting us from danger and harm, the piece inside of our brains that tells us to fight or flee, the system that is in overdrive due to anxiety begins to slow down and cool off. The reactions and over reactions and agitation begin to subside.
Without danger to react to (be it real or perceived), the body has time to heal.
As the SNS cools, this provides space for the Parasympathetic Nervous System (PNS) to step up and occupy space. The PNS is the side of the nervous system that allows rest and healing to occur. The difficult part is that the body only allows for the PNS to activate when the SNS has calmed down. Meaning simply- we cannot rest and heal unless there is no danger. We cannot sleep unless we are sure there is no need to fight or take flight.
We live in a world that over stimulates us. We have work that occupies more hours in the day then we have available, our children and days and minds are over scheduled. It is no wonder that Valium and Klonopin are familiar to so many of us. How else do we activate our safety and healing sensors without some help in this chaotic world we live in? I think we all have moments when the idea of someone taking our phone, feeding us our meals and telling us that our only job is to follow the schedule we are given, sounds like heaven. How lovely would it be to have a tiny little world that is managed for us, and our only job is to not react?
That my friends- is the real reason an inpatient unit works. It contains us and makes us feel safe and secure so we can rest and heal.
Containment- the act of keeping something within limits. Now I am not suggesting that the Inpatient Unit is idyllic, but what I am saying is that the strategy of containment is something we can all do better. I am also saying that it is an incredibly effective way of lowering our stress and decreasing our reactivity. How can we do this in our own worlds?
Choose one thing.
For me? I have chosen not to rush. I hate rushing. I hate running from thing to thing. Squeezing in my time, having to exit conversations that I enjoy because something is scheduled too tightly.
Choose one thing. Something that allows you to keep your ideas and dreams big but makes your world slightly more contained. The containment will allow so much more time for the things you truly want to do.
