Learning from Playing with Children in Psychotherapy (article)

When searching for the dynamics of a case involving a child, I have found that the exploration should include the family constellation and the role of parents. Early on I try to make the parents part of the treatment—the parents as also the patient. Parents may feel guilty that they have to bring their children to treatment. I have learned to work towards relieving the parents’ feelings of guilt through acceptance by listening. I tell them my time with the child is brief compared to the 24 hours they are with their children. This reduces the parents’ feelings that they are inferior. After all, if a parent produces a child with several or many problems, it can be humiliating. Also, parents don’t always know what the reason is for collateral sessions to discuss their child with me, so I coach the parents to talk in the sessions by saying things like, “How do you think the treatment is going?” Parents are encouraged to express their thoughts and feelings because an objective question has been raised away from the sensitive subject of their child. This way they are less defensive about feeling they might be criticized for something that they did or did not do for their child.

I have often found that parents who are unsure of their parenting skills tend to be harshly critical of themselves and their children. For example, a child of such parents may create a drawing and be very pleased with it and show it to the parent, only to have the parent find something wrong with it. Such parents are not aware how destructive this can be. They often make such critical remarks in front of the analyst, which reveals this unconscious message to the analyst: “You see, I am the boss; you know nothing.”

Even when not meeting such parents, what they are like often comes through in the child’s sessions. The child may become bossy and critical of the analyst through play. What comes across is, “I am showing you what my mother/father is like.” For example, I recently went to the waiting room to take seven-year-old “Russell” to my office for his session. Russell was with his mother. He was excited to see me and started to tell me some of the things he wanted to do in his session. His mother said to him in a stern manner, “Save it until you get to the room.” In my office, Russell promptly set up two chairs, one in front of the other, which he said was a “car.” He put himself in the “driver’s seat” and ordered me to sit in the chair behind it, which was the “backseat” of his car. Then he pretended that he was driving in traffic. At one point he jumped from his play car and went to yell at an imaginary driver in another car. “Why don’t you watch where you are going!” he said with the same angry look on his face and voice inflection that his mother had displayed moments before.

Often children come into treatment frightened. They do not know what to expect and they fear the consequences. I was aware of this when meeting with “Patsy,” age five. Her mother, who was recently divorced, brought her to treatment because Patsy was afraid to go to school. She had dropped out of preschool and refused to go back—she only wanted to stay home with her mother. She would sleep only in her mother’s bed and seldom let her mother out of her sight. My job over the summer was to help Patsy get back into school

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in the fall. Patsy told me in her sessions that she did not want to go to school because it was “boring” and that she would sit watching the school clock until her mother returned to take her home. Later I learned the truth about her fear about going to school. She thought she would be required to know more than she knew: how to do math, how to read, and how to speak a foreign language, and that she would be punished at school for not knowing these things.

Soon after her treatment began, Patsy wanted me to play games with her that involved school situations. The games were her idea; she was in charge and I was to follow her directions. She arranged chair cushions on the floor and said that we were going riding on a big yellow school bus. I was to be a “pupil” and she was to be the driver of the school bus. The driver carefully drove her pupil to the imaginary school. Then Patsy set up a classroom with the cushions and became the teacher. All summer long, Patsy played teacher to my being pupil. I became aware that she was expressing her fears about school in play. She babbled words that had no meaning and gave me made-up words that I couldn’t spell. Taking my cue that this was a fear Patsy was attempting to work through, I encouraged her to talk about these fears. Still playing the pupil, I began with a question:

“What should I do when the teacher says words I don’t understand?”

“Ask her what the words mean,” Patsy advised.

“And what if she asked me to do something I can’t do?”

“Ask her how to do it,” answered Patsy, matter-of-factly. “That’s all. Just ask.”

A week before school started, Patsy talked freely about everything that worried her about going to school, such as wondering what the teacher would be like and if the other children would like her. “I’ll just have to wait and see,” she said at last. With that, she said that she was now ready to go back to school. She enjoyed the first day and looked forward to going every day after that.

As Freud discovered, helping children to master their fears through play begins with a game of peek-a-boo, at age one, when the child playfully works through the fear of a vanishing mother, father, or other significant caretaker. Soon afterwards, children discover toys with the same enthusiasm that the Forty-Niners discovered gold in California but they need role models for play. Mothers generally have more tolerance for helping with this and can give their children longer play periods. Some parents need help playing with their children. One father reported to me how he sat awkwardly on the floor of his 18-month-old son’s room, with the two of them surrounded by toys, and wondered where to begin. His son looked at him firmly and said, “Play!” The father said that he had expected the boy to play and that he would observe. “Play!” his son repeated. Then the father realized that his son was demanding to be shown how to play with the toys he was collecting.

Suddenly, the father reached for an assortment of blocks and started to build a house. His son watched intently. Then the father placed some toy figures inside the house. He had the figures play different roles as he mimicked the voices of the characters. His son picked up another of the figures and walked it into the house to join the others. The father and son played together for the first time with a family of figures. A daily play hour continued. The father and son played out many exciting stories with their family of toy figures—everything from Western shoot-’em-ups to space adventures. The toys were given names and each had an individual personality. Father and son bonded through play.

Often I have children write or draw about their fears and conflicts, which serves as another form of play. The writings and drawings help children to release symbolically through their creations the things that trouble them. A six-year-old girl was helped in this way to verbalize her angry feelings about her mother and father’s getting a divorce. She had frequent tantrums at home and school, and broke things. I knew that she liked cats and I invited her to write and illustrate a book about a playful cat that did silly things. She called her book The Mad Cat Who Was Very Bad. We talked about her book as follows:

“Why is the cat ‘mad’ and ‘very bad’?” I asked.

“Because she smashes things and knocks things over and breaks them,” she answered.

“I spilled a jar of paint on the floor this afternoon,” I responded. “Does that make me bad?”

“That was an accident,” she answered.

“But what if it wasn’t an accident?” I persisted. “Suppose I did it on purpose?”

“Then you would be bad. Cats get away with things, don’t you know?”

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The symbolism of her communication revealed to me that she was playing the role of a cat and that she discovered writing and drawing pictures about it was a safe way to smash and break things. I encouraged her to write other stories about her “mad cat.” For several weeks her “mad cat” became the theme of drawings, clay figures, and paintings. Then she went on to other characters including a loveable group of monsters. As she worked, she talked about the things that were worrying her about her parents’ getting a divorce. Through her writing and drawing she was able to talk about her angry feelings. Her tantrums and need to break things stopped. She came to understand that there was nothing she could do to keep her parents together and it was not her fault that they were breaking up. She accepted seeing them separately.

I have learned that parents (and teachers) have an important role in helping children to express and overcome their fears through play, art, dancing, and performing. Playacting is especially beneficial as it gives children the opportunity of being someone else and thus protects their fragile egos while they learn to adjust to life around them and resolve their emotional conflicts.

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