Cultivating Intentionality, Presence, and Composure Through Containment

Sarah Ozol Shore
Jan 12
5 min read

Francesca Woodman, Untitled (Providence Rhode Island) 1978

A Somatic, Depth-Oriented Approach to Psychological Reorganization

Many people who seek psychotherapy are not confused about what is happening in their lives. They are capable, reflective, and often highly intelligent. They have insight into their histories, can articulate their patterns, and may already understand the psychological language of trauma, attachment, and coping.

What brings them to therapy is not ignorance, lack of motivation, or failure to try hard enough. It is a quieter, more persistent recognition: the way they are organized no longer works.

They are functioning — sometimes impressively — but at a cost that has become impossible to ignore. Attention feels fragmented. Decisions feel effortful. Emotional regulation requires constant management. Life is being navigated, but not inhabited.

This work begins from the premise that such experiences are not primarily problems of insight, willpower, or mindset. They are the consequences of how the nervous system and identity have adapted over time.

A Nervous System–Based Understanding of Change

At the foundation of this practice is an understanding that psychological life is inseparable from physiological state. The autonomic nervous system organizes perception, emotion, attention, and behavior long before conscious thought is available.

When the nervous system remains oriented toward threat, vigilance, or collapse — even subtly — higher-order capacities such as sustained attention, emotional flexibility, reflective thinking, and choice become compromised. Not because the person is deficient, but because the system is prioritizing survival.

Many women live for years — even decades — in a state of chronic over-activation or over-control that is socially rewarded and internally costly. They learn to function through vigilance, endurance, and self-monitoring. These adaptations are often intelligent responses to environments that required reliability, caretaking, emotional containment, or self-suppression.

Over time, however, the system begins to strain. What once allowed functioning now produces depletion, anxiety, irritability, brain fog, emotional reactivity, or shutdown. From this perspective, change does not begin with trying harder or thinking differently. It begins with creating the conditions under which the nervous system can reorganize.

Somatic Awareness and Right-Brain Integration

This work is fundamentally somatic — not in the sense of techniques or exercises, but in its orientation to how experience is actually held and processed.

Much of psychological organization occurs outside of conscious awareness, in right-hemisphere, affective, and relational systems. These systems encode experience implicitly — through sensation, emotion, posture, rhythm, and relational expectation — rather than narrative memory or explicit belief.

For this reason, insight alone often fails to produce durable change. A person may understand why they react as they do, yet continue to react in the same way. The underlying organization remains untouched. Therapy here attends to experience as it unfolds in real time:

shifts in activation or collapse
subtle bracing or withdrawal
changes in breath, posture, or tone
moments of disconnection or hyper-focus
the loss and recovery of internal contact

By tracking these processes with precision and restraint, clients develop somatic literacy — the capacity to notice internal states without overriding, intellectualizing, or abandoning themselves.

Over time, this allows previously implicit patterns to become available for integration rather than repetition.

Depth-Oriented Clinical Processing

This practice is also depth-oriented. Symptoms are not treated as isolated problems to be eliminated, but as meaningful expressions of underlying organization.

Anxiety, depression, indecision, exhaustion, or relational difficulty are understood as signals — indicators that adaptations forged under earlier conditions are still organizing present-day functioning. Rather than asking, “How do we get rid of this?” the work asks:

What function has this served?
What conditions made this necessary?
What would have to change for it to no longer be required?

This orientation allows symptoms to be approached with curiosity rather than urgency, reducing internal conflict and self-judgment. As the system reorganizes, many symptoms soften or recede without being directly targeted.

Containment as the Central Mechanism

Containment is the central organizing principle of this work. Containment refers to the presence of clear, reliable, and consistent structure — relationally, temporally, and psychologically — that allows the nervous system to stand down from constant monitoring.

Many women have spent their lives being the container: holding emotional space, maintaining stability, managing complexity, and adapting to others’ needs. What they have often lacked is sustained containment for themselves. In this practice, containment is not metaphorical. It is concrete and deliberate:

sessions are held weekly, at a consistent time
boundaries around time, payment, and communication are explicit
the therapeutic relationship is attuned but not porous
urgency does not override structure

These conditions are not imposed to be rigid or withholding. They are necessary for deep work. Without containment, the nervous system cannot risk change. When containment is present, the system no longer has to fragment, brace, or over-function to maintain stability. This allows higher-order capacities to re-emerge organically.

Intentionality, Presence, and Composure

From this foundation, three capacities begin to return. Intentionality emerges as access to choice rather than compulsion. Decisions become less reactive, less driven by obligation or pressure, and more aligned with internal reference.

Presence becomes possible when the system no longer needs to divide attention between experience and self-protection. Presence is not a mental state; it is a physiological one.

Composure develops as internal organization stabilizes. Emotional experience can be held without collapse or over-control. Complexity becomes tolerable. Authority becomes internal rather than defended. These capacities are not trained directly. They arise as byproducts of containment and integration.

Why This Work Often Succeeds Where Therapy Has Not

Many clients arrive having already “done therapy.” They have insight, language, and awareness. What has been missing is not effort, but the conditions required for reorganization.

When therapy is inconsistent, overly flexible, or organized around reassurance, the nervous system remains in charge. When containment is present and sustained, identity can reorganize at a structural level. This is why the work is deliberate and demanding. It is not crisis-oriented, intermittent, or open-ended by default. It requires commitment — not to the therapist, but to the process itself.

An Orientation Rather Than a Promise

This work does not promise ease, constant calm, or rapid resolution. It offers something quieter and more durable: coherence. Coherence is the capacity to remain present, discerning, and self-directed across changing circumstances — without relying on self-sacrifice, vigilance, or collapse.

For many women, this represents not improvement, but a return — to a way of inhabiting themselves that was never fully available.