Residential Treatment as a Holding Environment

Abstract

Winnicott's concept of the holding environment has been applied by Modell to the psychoanalytic treatment situation. Similarly, the concept can be applied to the residential treatment situation, especially when severely emotionally disturbed children are under treatment. These children need a holding environment in order to develop a cohesive sense of self, that they lack, owing to interferences in development during the earliest stages of life. An institutional program is described that details the principles of a residential treatment holding environment and includes: (1) integration with the help of the caretaker as against functional differentiation; (2) permanence in space and time; (3) development of the separation-individuation processes; and (4) empathy of the caretaker without total involvement.