Excerpt from Chapter 11: The Role of Play in Individual Psychotherapy From Childhood to Adolescence

Your image of psychotherapy may be of someone sitting in a chair talking about their feelings and thoughts, a difficult life situation, or a problem relationship. If so, then the idea of bringing your action-oriented seven-year-old son or your tightlipped 14-year-old daughter to psychotherapy may seem odd. But most non-adult patients in psychotherapy do not just sit and talk; they play and talk. The play may take place while sitting at a table, lying on the floor, or standing in front of a basketball hoop. Although play in psychotherapy usually happens inside of an office, it may also take place outside. The play may involve the use of paints or puppets, board games or balls, or just about anything that is used for play. This chapter will help you understand how psychotherapy and play fit together. As you learn more about what goes on in psychotherapy and play therapy, you may feel more at ease taking your child to a stranger for this treatment. ........

Play

Adults know that play has an important role in a child's development—as the expression goes, "All work and no play makes Jack a dull boy." But how important is play, and in what ways is it important?

Think about when your child was a baby, long before she was exposed to the common games or other types of play that are part of our culture. You noticed that she played with such things as your hair, her own toes, or a mobile placed over the crib. Her mood was often pleasant or cheerful, and she could usually set aside the play rather easily for some other activity. Your baby was working at the very earliest phases of the jobs of developing a relationship with another person, getting to know and manage her body, and taking in information about the world around her. This occurred as she was experiencing pleasure and joy, emotions which usually go along with the experience of mastery and being in a setting that feels safe.

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Psychodynamic psychotherapy and play

"But," you may wonder, "what if my child doesn't have such developed language ability, or won't use it, and therefore can't talk directly about such complicated experiences as feelings towards her parents, sibling, or teacher?" Language is not the only way to communicate. Experience is itself symbolically organized in the mind and can be communicated through play (perhaps through drawing, small figure play, or in interactive games) through which your child represents what is troublesome in her life and inside her.

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The extended example below illustrates how interactions during play therapy helped one young boy begin to make sense of his vulnerability and his anger. In parentheses, I describe how the therapy progressed, commenting on how the therapist's actions, and the play itself, helped these positive changes take place.

Roger was a bright seven-year-old little boy who liked to build complex structures with whatever materials were at hand. He did well in school except for the fact that when he encountered frustration, he had major tantrums that included cursing, screaming, hitting, kicking, and biting anyone nearby. As a consequence, he had no friends.

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At one point he grabbed a toy baby bottle and began sucking on it while he built his structures. He seemed to watch the therapist closely for some critical or belittling comment. There was none, and he began to suck on it regularly. (Roger takes a chance and comforts himself in a desirable and self-satisfying manner that appears to be associated with feelings of shame and fear.) One day he filled the bottle with water and began using baby talk with the therapist. (Roger increases his level of trust in himself and the therapist and lets them both see and be more accepting of his vulnerable and dependent sides. He is symbolically playing out how much he feels like a needy baby.)

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