Play therapy is just floortime with a specific purpose to work on an emotional issue. In the following example (published here with permission from both the parent and the child), the child is on the withdrawn, compliant side, so it was fortunate that the parent was attuned enough to the child to realize there might have been an issue that needed discussing that had occurred the night before.
This child communicates via typing on his ipad, so the interaction was captured in its entirety.
Sam and his mom had this conversation/play therapy this morning. The previous evening, they didn’t get to Sam’s ILS therapy (listening to altered classical music through headphones to help desensitize a child with sound hypersensitivity; motor exercises are done concurrently to work on sensory integration) until later in the evening. He took a bathroom break, and when they returned to the family room, Dad had turned on the TV. Mom tried to woo Sam into continuing the ILS, but that was not realistic, so she finally said, “I’m not going to waste my time, I’m going to take a shower.” She then set up a bath for Sam, and settled to watch TV. When he finished and came back into the family room, Mom invited him to come watch Frozen with the family, but he said, “Bed!,” pointed to his room, and put himself to bed.
Mom: How come you didn’t watch the new movie with us last night? Frozen was good.
Sam: i was in(side) sad
Mom: Why were you sad?
Sam: because you got mad
Mom: I’m sorry, Sam. I was just frustrated because I didn’t want to fall behind on your ILS schedule, but you got tired and didn’t want to finish the exercises. But I do understand. A person can’t work all the time. So I was hoping you would enjoy the movie with us.
Sam: ok. i hoope you kind(er) next time.
Mom: I deserve that admonishment. I should have gone after you when you went to bed to give you a chance to talk about your point of view about the ILS exercises, and to explain that I really wanted you to enjoy the movie with us.
Mom: Were your feelings hurt when I said I didn’t want to waste my time?
Mom: I’m very sorry. I could see that you really didn’t want to finish those exercises, and knew it was no use to keep trying to persuade you. That’s what I meant about wasting time. I never feel it’s a waste of time to be with you.
Sam: yes i understnd it was a miscommunication, so youdidn’t mean you very mad
Mom: Let’s do a re-do, ok? I’ll be the wolf, and you be Pooh, Ok?
(Mom handed Sam a Winnie-the-Pooh stuffed bear, and she put on a wolf puppet.)
Wolf: Pooh, let’s finish your exercises. Let’s roll the ball 20 times.
Pooh: no i’m tired.
Wolf: What about our ILS today?
Pooh: i had enough. stop hurting me.
Wolf: What hurts?
Pooh: i don’t want to listen anymore. it hurts my ears.
Wolf: I’m so sorry. Is it too loud? or is it this particular piece of music? or are you just tired and would rather do it tomorrow?
Wolf: So what do you want to do?
Pooh: let’s stop for now.
Wolf: It must be hard to have to practice listening to uncomfortable sound, even music.
Pooh: yes. it’s not too much trouble if i feel happy,but i’m too tired nnow.
Wolf: I’m so glad you told me. Please keep letting me know, so we can make this work out for you, ok?
Wolf: Do I push too hard a lot?
Pooh: i don’t think so.
Wolf: That’s a relief. I wouldn’t want to do that. I want you to learn, but at the pace that feels best for you. Will you tell me when I need to slow down or you need a break?
Pooh: yes i will by tyyyping
Wolf: Would you like to watch Frozen with us?
Wolf: That’s great! We really missed you last time. How about tonight?
Pooh: i feel like sausage now
Wolf: Ok, coming right up!
The conversation that preceded the play had already cleared the air in theory, but the symbolic play cleared it in practice. Being able to speak through his stuffed animal freed this gentle and sensitive child to be assertive and actually have the satisfaction of telling “Mom” outright to “stop hurting me,” without having to worry about hurting her feelings. The child got to be in charge of what to do next (“Let’s stop for now”) instead of Mom.
Children often offer more when they feel they are the ones taking the initiative. Sam offered more information about the music “hurting his ears” that Mom had not unearthed in direct conversation. Therefore she was able to express sympathy and understanding about how hard and uncomfortable the ILS was for her son, and probe deeper into the more general issue of how hard she was pushing her son overall. Sam even came up with the seminal plan for how to solve the ILS problem for good by offering the information that it’s only a problem for him when he’s tired, but “it’s not too much trouble if… happy.” Initiative begets more initiative, and Sam ends the conversation by telling Mrs. Wolf that he’s really more interested in breakfast right now than watching a movie with the family.
The mother told me that events later that day confirmed the value of the play therapy. When Sam’s big brother asked him why he didn’t watch the movie with them the previous night, Sam, already emboldened by the earlier encouragement to express his true feelings even negative feelings, went a step further. He replied, “Because I was mad.” (Note now he admits he was mad, as opposed to just sad, and as opposed to Mom being mad.) When asked why, he revealed another as yet undisclosed piece of information, “because I didn’t want ILS and mom said no carride.” He actually said this in front of Mom as she was helping him with his typing. That gave Mom the opportunity to say, “I’m sorry, that was unfair. I should have given you a chance to type before handing down a demand, and you could have told me the ILS was hurting your ears because you were tired.” Shortly afterwards at dinner grace when all the children were giving thanks, Sam’s prayer was to thank God that “I and mom made up.” Later that evening, even though he was getting tired, Sam finished up the last 20 minutes of his ILS session, not in a spirit of anger, but cooperation and perseverance because he also wanted his noise sensitivity to get better.
Don’t feel that play therapy needs to be as direct a re-do as this illustration. Most of the time, therapists set up play scenarios that are much less specific. They observe the child for his favorite toys and stories, and then set up a play scenario using them to introduce a theme of nurturing, aggression, control, or whatever is immediately emotionally relevant to the child. The key element is freedom- to give the child an opportunity to freely express his emotions and act on them in a completely safe environment in which he is encouraged to do so and in which he is handed the control of the action in the play scenario. This gives the child an opportunity to retell his own emotional story obliquely and in as much part as he wishes. Dr. Dan Siegel, author of the outstanding book “The Whole Brain Child,” would probably say that helps the child process his right brain emotional memories with his logical left brain, and bring implicit memories into consciousness so that they don’t have to be acted out later in real life as inexplicably explosive reactions to triggering events that are similar in emotional content.
The recent Profectum conference in Pasadena highlighted the enormous value of symbolic play in both effectively addressing emotional issues and moving development forward. In this illustration, Sam learned how to express his negative feelings in words, came up with the beginnings of a logical solution, and learned how to negotiate and effectively resolve conflict. What a better way to handle anger than allow it to get bottled up inside. As parents of kids with autism, we’ve all seen the self-injury and aggression that can result from anger. We have to give our kids another channel. Make symbolic play a regular part of your interactions with your child, and it will bring you closer, give you a more peaceful home, and most importantly empower your child to not only deal with negative emotions and learn to express it a regulated, organized way, but push his cognitive and emotional development forward.
I wish to thank two outstanding child psychologists, Dr. Mona Delahooke and Dr. Connie Lillas, for their inspiring presentations on play therapy at the Profectum conference. Both of them practice locally in the Pasadena and Los Angeles areas.