Ripples of containment

The NHS is under huge pressures from an increasing population and chronic underfunding. Generic CAMHS services are operating under these significant demands. The nature of the work means the additional anxieties that arise from patients must also be managed by the organisation for it to function effectively. A situation can arise where the source of containment and management of these anxieties is offered by staff members situated in the midst of a team. By that I mean not at the top of the organisation, from where one may expect this kind of containment to be offered; instead, these staff members are marked out by virtue of their capacity to offer containment and to model and perpetuate a group state of mind rather than a gang state of mind, which can so easily develop in situations where anxieties are overdetermined. It is these individuals who set the organisational culture and consequent capacity to manage the task, not the managers. But how sustainable can this unofficial and unacknowledged structure really be?