Every organisation produces difficulty. Complaints that cannot be resolved. Decisions that harm somebody whichever way you go. Targets that do not fit the work. Illness, grief, fear, and the ordinary friction of people who have to get along. None of that is evidence of a badly run place. It is what running a place involves.
The question is not whether an organisation generates difficulty. It is where the difficulty ends up.
Containment, and its two halves
Containment is the capacity to receive something difficult, hold it, and hand it back in a form that can be used. The idea comes from Wilfred Bion, who was describing what a mother does with an infant’s distress and what an analyst does with a patient’s. It transfers to organisations more usefully than most psychoanalytic concepts do.
In an organisation it operates at two levels, and it needs both.
Structural containment is design. Whose responsibility is this, actually? What is this role expected to absorb in silence, and should it be? Unclear boundaries, moral ambiguity, conflicting demands and responsibility without limit are not personal weaknesses. They are design faults, and no amount of resilience training corrects them.
Developmental containment is personal capacity. The trained ability to stay present with fear, shame and pressure without collapsing into it and without passing it on.
Neither works alone. Good structure without capacity leaves somebody unable to use the room they have been given. Capacity without structure means a well-regulated person still ends up absorbing what the system was never designed to hold. Pressure turns into personal damage when both are missing at once.
The part that gets missed: difficulty has a direction
Here is what I have come to think matters most, and it is rarely said out loud.
When difficulty is not contained, it does not dissolve. It moves. And the default direction of travel is down.
Down is the path of least resistance, because down is where the least power is. A chief executive can pass discomfort to a director. A director can pass it to a manager. A manager can pass it to somebody on the front line. At every step it is easier to pass the discomfort on than to absorb and settle it, and at every step the person receiving the discomfort has fewer means of refusing it.
So the difficulty does not spread evenly. It concentrates, and it concentrates at the bottom of the organisation.
In a service for vulnerable people, the bottom is the client
I supervise chief executives and directors who carry responsibility for practitioners who in turn carry responsibility for vulnerable people. A child in compulsory education. A child with special needs in a specialist school. A patient on a ward. A resident in a care home. A young person in residential care. A prisoner. Somebody seeking asylum, waiting on a decision they cannot influence.
The very old, the very sick and the very young. People who, by the time the difficulty reaches them, are the least able to defend themselves against it, and the least likely to be believed if they try.
In organisations like these, the direction of travel is not an abstraction. The people at the bottom of the chain are the people the organisation exists to help, and they are there precisely because their capacity to process difficulty is already overwhelmed. That is often the reason they need the service in the first place.
So what arrives at the bottom of the chain is received by the people least equipped to hold that difficulty and most likely to act it out. The acting out is then read as the presenting problem. The organisation responds with more control. More control is more difficulty travelling down.
The organisation defeats its own purpose, and it does so while everybody in it is working hard.
A small example, told flatly
I belonged to a members’ club. Over several months one of the receptionists repeatedly refused me a towel on entry, on the grounds that my level of membership did not warrant one. On one occasion my membership card was taken from me and replaced with a lowest-tier card that locked me out of facilities I was paying for.
When I eventually got to speak to management, it turned out that through an administrative anomaly I was paying more than any other member of that club.
I tell it flatly because the interesting part is not that it was unpleasant. The interesting part is that nobody inside the system could see it. The organisation was extracting the most from the member it treated worst, and it was nobody’s decision that this should happen.
And the receptionist was not the source. They were near the bottom of that chain themselves, receiving whatever had already travelled down and had nowhere further to go. So it went sideways, into the member standing in front of them. I do not know what they were carrying and it would be wrong of me to speculate about someone I never met professionally. But the shape of it is familiar, and I have seen it in settings where the stakes were considerably higher than a towel.
Why holding difficulty is hard
Because containing costs something, and transmitting is free.
To contain is to take the difficulty in, sit with it long enough to be changed by it, and hand back something usable. That is effortful, it is uncomfortable, and nobody sees you do it. To transmit is instant and invisible: a curt email, a deadline moved without explanation, a meeting where somebody is made to feel small, a policy written in irritation. Nothing in most organisations names transmission as a failure, and nothing rewards containment as work.
Containment is also, straightforwardly, a capacity. It can be built. Most senior people have never been trained in it, because leadership development tends to teach strategy, communication and decision-making, and treats the ability to hold difficult feeling as a personality trait you either have or you do not.
Two questions
If you lead an organisation, these are the two I would start with. One is structural and one is developmental, and the answers are usually quite different.
Which decisions genuinely sit with me, and which do not?
What capacity would let me stay present with this pressure, rather than absorb it or pass it on?
If you cannot answer the first, you are carrying things that belong elsewhere and the structure needs work. If you cannot answer the second, the structure can be perfect and the difficulty will still find its way down.
What I am claiming, and what I am not
This is a clinical argument, not a research finding, and I want to be clear about the difference.
The containment concept is well established. Bion set out container and contained in the clinical context, and Isabel Menzies Lyth’s 1960 study of a general hospital nursing service showed how unprocessed anxiety in an institution gets displaced into structure and ritual rather than being metabolised. Both are theory and case study. Neither is an outcome trial.
The directional claim, that difficulty travels down by default and has to be deliberately made to travel up, is my own formulation, drawn from clinical and supervisory work rather than from a dataset. I am not aware of a body of outcome evidence demonstrating that leadership behaviour makes clinical outcomes worse for the people at the end of the chain, and I am not going to attach a number to it.
Treat it as a way of looking, not a finding. Then test it against your own organisation, which is the only place the question can actually be settled.
What this has to do with supervision
A large part of what I do with senior leaders is simply being the place the difficulty can travel up to, so that it stops with them rather than passing through them.
That is not a soft benefit and it is not a wellbeing perk. If the argument above is right, it is the point at which an organisation either serves the people it exists for or quietly works against them.
There is a free worksheet to go with this piece, What You Do With What Lands On You. Seven steps for the moment something difficult has landed on you and you have a choice about what happens next. It is on the worksheets page with the others.
More on how I work with supervisors, senior practitioners and leaders is on the supervision page. There are free worksheets for practitioners, including one on countertransference, on the worksheets page.
References
Bion, W R (1962). Learning from Experience. London: Heinemann.
Menzies, I E P (1960). A case-study in the functioning of social systems as a defence against anxiety: a report on a study of the nursing service of a general hospital. Human Relations, 13(2), 95–121.
