Floortime is powerful play therapy. You can use it to recreate an emotionally charged event in your child’s life, and allow him to play out different roles and endings as he desires and imagines. But can you do this with a child with severe challenges in symbolic thinking and language? Yes you can! You can even go down to the sensory level if necessary to reach your child and access the event. In fact, that’s what’s often necessary to help kids with PTSD recover from their trauma.
At the recent DIR Profectum conference earlier this month, I watched a videotape of a grandmother working with her granddaughter on a the sensory level to help her recover from PTSD night terrors and agarophobia a year after a traumatic car collision. The child was swinging in a net swing and instructing her grandmother on how to push her. Her grandma was working on stopping the swing as a surprise, to try to recreate some of the sense of sudden stopping that the child had experienced, but change the associations from unpleasant to pleasant. So the key was making it fun and loving, and also to hand control over to the child. So the granddaughter got to tell grandma to swing just forward and back, not side to side, and only stop her when facing forward and not while going too fast. She gradually got grandma to increase the force of her push and stop more abruptly to make it more exciting. They worked on these “self-titration” exercises over a year, till finally, the PTSD symptoms melted away.
So I tried it with Peter. He had a hard time getting out of the car the other day to attend his brother’s track meet, as he gets anxious in crowded and noisy places. So I gave Peter a race track/ramp and car, and watched him self- titrate the how far up he’d release the car on the ramp to control the excitement. He ended up laughing in excitement when he was able to release the car from the top of the ramp. Then I had Charmander (a big stuffed animal) drive up in a toy car, and watch Peter release the car down the ramp intently. Charmander grew very interested and leaned as far as it could reaching for the car, but was too scared to come out of the car. Finally, I asked Peter, “What should Charmander do next? Sit in the car or come out?” Peter looked at me and emphatically stated, “Sit in car!” Then he gently nudged the entire track/ramp next to Charmander’s car, and handed Charmander the racecar. Charmander didn’t know how to make the car go, so Peter repeated his titration procedure of releasing the car at increasing distances up the ramp. When he let it go from the top, Charmander cheered, and said, “I see! You can go slow, and then fast. Good idea!” Peter looked at me with a huge smile, as if he really appreciated my acknowledgement of the coping strategy he’d worked out.
So when your child has either a strong emotionally positive or negative experience, think of the theme- as Dr. Greenspan puts it, competition, aggression, fear, excitement, nurturing, or whatever it is- and set up play dramas with dolls, puppets, or stuffed animals around it. Or set up a sensory experience analogous to the one that affected your child. Then let your child explore different outcomes, on his own initiative, at his own pace, with your support (such as choices- “Should Charmander sit in the car or come out?”). You’ll be surprised at what you learn, and what your child will tell you about his feelings and desires through play.