Bion's therapeutic applications

Wilfred Bion is regarded as a psychoanalytic purist and his austere portrayal of the analytic aim and attitude is often considered to make impossible demands on patient and analyst alike. Not surprisingly, the applicability of Bion's theory and recommended practice to once-weekly psychotherapeutic work is often questioned. Bion is thus ambivalently regarded by psychotherapists as the embodiment of an analytic ideal, whose developmental theories are important, but whose practical utility is doubted, especially in the context of the typical therapeutic setting. This paper seeks to challenge these assumptions by presenting the once-weekly therapy of a woman with attenuated mentalizing capacity and a tendency to destructive acting out. The therapy was guided by the application of central concepts, models and 'technical' principles emerging from my understanding of Bion's work. The aim of the paper is to demonstrate that Bion's utility is not confined to formal psychoanalytic settings and that his work may be usefully applied in more modest psychotherapy contexts.