Therapy

Play Therapy: Far More Than Just Play

Reciprocal and mutual interaction with children can catalyze healing and growth.

Posted Mar 29, 2019

Free-Photos/Pixabay
Source: Free-Photos/Pixabay

Play is critical to emotional learning. If I am able to connect playfully, on a level of mutuality with a child, at the very least a message is conveyed that I mean no harm. A visceral sense of safety is foundational to a learning state of mind and being.

British pediatrician Margaret Lowenfeld was the first to utilize sand tray play as a therapeutic technique. In the book Floor Games, written in 1911, H.G. Wells described the fun-filled games he and his sons played on the floor. Inspired by Wells, Lowenfeld introduced two zinc trays to the children's playroom at the Institute of Child Psychology she founded in London during the early 1930s. The first tray was half-filled with sand, and the second tray contained water and a variety of objects used for shaping sand. A "wonder box” filled with small toys, paper, pieces of metal, and other colorful trinkets was kept in close proximity to the trays. Lowenfeld reported that children created three-dimensional scenes by combining elements from the box with the sand in the tray.

Lowenfield invented non-verbal techniques that enabled children to convey their thoughts and feelings without resorting to words, and through her "world technique," part of the foundation for modern play therapies, children's emotional expressions were met with the responsive, empathic acknowledgment that satisfied their need for nondirective processing.

In the very best of cases, play therapy is a form of nondirective, person-centered therapy. It is also a form that utilizes very old healing methods: confession and catharsis. The therapist offers the warmth of presence, empathic regard, and emotional responsiveness as a safe presence. Carl Rogers (1942), the forefather of person-centered therapy, compared play therapy to ancient forms of cathartic expression, including the Catholic Church's sacrament of confession. Rogers (1942) explained,

The confessional has been used by the Catholic Church throughout many centuries. It has allowed the individual to talk out his problems to an individual who provides a certain defined type of acceptance. Both the Church and individuals outside the Church have found this method helpful... We have learned new ways of using this old approach. The whole technique of play therapy is based on the fundamental principles of catharsis; the use of finger paints and psychodramatics and puppet shows all have a relationship to this old and well-established category of psychotherapy. (p. 21-22)

Play therapy has much in common with psychoanalysis in this regard. A play therapist allows the child freedom to explore the play environment, interact with an inanimate object—figurines as well as more "liquid" media like sand—and project onto them their outlook.

Free-Photos/Pixabay
Source: Free-Photos/Pixabay

Play offers a symbolic language. Figurines and toys representing life and the environments in which life takes place, as well as art materials, opportunities for theatrical improvisation, free association, and more offer a child means to communicate struggles, feelings, thoughts, relationships, interpretations of experiences, and the realities of their particular world.

One excerpt shared by Rogers (1942) from a play therapy session, phonographically recorded as part of his process of providing clinical supervision to therapists through a community counseling center, provides a glimpse into a few moments of therapeutic play. A young boy (Rogers calls him "Jim") plays out with figurines the kinds of interaction, presumably, that happen at his home, inverting his and his father's roles.

Again, to be clear, in the following, both "Father" and "Jim" are the boy (client) speaking on behalf of figurines he is playing with:

(Holding two figurines in the sand tray)

Father: "I want you to stay and help me."

Jim: "I ain't goin' to. I want to make somethin' of it."

Father: "Oh, ya do, do you?"

Jim: "Yeah, I want to make somethin' of it."

Father: "O.K., come on, make somethin' of it!"

Jim: "All right you!" (Striking the figurine of the father and knocking his head off) "He won't get back on in a hurry. Huh, I'll take a piece of you off, that'll fix him. There. I'll make you weak, that'll fix him. Now don't you go to sleep on me again! (very short pause) Oh, say, what did you do, go to sleep? Hah, hah!"

Father: "I didn't go to sleep."

Jim: "Well, you must have done somethin'! I'm getting tired of your impudence. Get up, get up, get up (shouting), come on, dad, get up."

Moments later, the boy pretended someone was holding his father up in the air to torture him:

Fernando Venzano/Unsplash
Source: Fernando Venzano/Unsplash

Jim: "Let's git that guy for making his kid hold him all day. (Short pause.) They got 'im."

Father: "Hey, let me down."

Jim: "Not till you promise to let your boy go for all day."

Father: "No, I won't."

Jim: "All right, then, you're going to have to balance up high, see, and you are going to like it, and you'll do it."

Father: "Help, you guys, I'm fallin'. Help!!" (Short pause as he drops clay and crushes it.)

Jim: "That's all, folks. (Pause.) He ain't there. He fell off a cliff in a car." (p. 37)

The depth of hurt and violence in the feelings of the child are easily observed, as is the opportunity provided by the therapeutic play space in facilitating cathartic expression.

In Rogers's commentary, he indicated that the therapist was emotionally responsive not to the intellectual content of Jim's play but to the feelings underlying it, reflecting that sometimes such feelings are "deep ambivalence, sometimes they are feelings of hostility, sometimes they are feelings of inadequacy." And he emphasized the therapeutic priority "to create an atmosphere in which the client can come to recognize that he has these negative feelings and...accept them as part of himself, instead of projecting them on others or hiding them behind defense mechanisms."

In three consecutive sessions, Jim kept up his aggressive play between representations of himself and his father, but during the latter part of the third session, Rogers described,

Jim ceased playing with the clay, and wandered about the room a bit. He took a newspaper clipping out of his pocket, showing a picture to the psychologist and saying, 'Chamberlain looked like such a nice man, so I cut out his picture and carried it with me.'

Rogers wrote,

This was [Jim's] first statement of positive feeling toward anyone. Following it there was never more than a mild expression of hostility, and the change in the therapeutic situation was roughly paralleled by the change in the home. (p. 39-40)

In the course of play therapy and, in fact, in the course of any form of nondirective, person-centered therapy, there are certain outcomes which are not only not goals for the therapy but that are almost assuredly never achieved: complete insight, resolved problems. It is unlikely that any physiological or temperamental tendencies are significantly changed. It is unlikely that therapy has prevented the need for help again in the future. Yet the client—indeed, whether child or adult—has freely explored problems and their relationship with emotions. The client has developed a working insight of reaction patterns blocking constructive engagement with the surrounding world. The client has learned experientially new, more satisfying and beneficial methods of facing difficulties.

Patricia Prudente/Unsplash
Source: Patricia Prudente/Unsplash

The client—oftentimes a young child, temporarily stalled in the midst of the very serious work of playful exploration—has in many cases become increasingly independent, confident, and mature in navigating existential suffering, behavioral responsibility, or at least interpersonal communication, bonding, and meaning-making. Surely, we must give far greater credence to the therapeutic value of play and play therapy.

LinkedIn Image Credit: Photographee.eu/Shutterstock

References

Rogers, C.R. (1942). Counseling and psychotherapy: Newer concepts in practice. Cambridge, MA: The Riverside Press.

Wells, H.G. (1911/in U.S., 1912). Floor games. Boston: Small, Maynard and Company.