Psychotherapist/Creative Art Therapist Private Practice/Pratt Institute New York, NY, United States
“It is in playing and only in playing that the individual child or adult is able to be creative and to use the whole personality, and it is only in being creative that the individual discovers the self.” (Winnicott, D.W. 1971,p. 54) This case presentation follows the treatment of a severely dissociated young boy who survived repeatedorganized abuse outside his home. Symptoms included the presence of compartmentalized, dissociated self-states. Session vignettes from treatment, beginning when Andrew was 5 years old and ending just before his 9th birthday, will illustrate how the treatment room became the reliable play space, holding the potential for discovery, expression and healing for the young boy and his parents. Children express themselves through action…Thru play they explore conflicting feelings and gain a sense of control in their lives. (Landreth, G.L. 2001). Trauma disrupts a child’s natural use of play, resulting in difficulty identifying and communicating feelings and needs. Children like Andrew create relationships and engage in play that can be described as disorganized and chaotic. The sensitive therapist will invite all the ways of being into the play space, while also allowing the child to set the pace. Beginning in his first session, the therapist provided a variety of mediums to facilitate collaborative self-expression. Art materials became a bridge for communication, promoting meaningful discoveries about the dynamics underlying the young child’s dissociative system.
The role of the therapist, as an “organizing, enhancing and engaged play partner” (Slade, 1994. pp.81) will be emphasized. General treatment principles recommended by the ISSTD (2004) and currently in revision will be discussed, highlighting the significance of the therapist’s authentic presence and playfulness, regardless of technique or clinical orientation.
Through the hard work of play, the child’s capacity to recognize and move seamlessly between affect-states increased as he developed the capacity to sustain a sense of cohesion within himself and in relationships. In a treatment room that promoted self-expression, respect and hope, Andrew and his parents created meaningful connections, leading to the development of alternate coping strategies and an increased capacity to regulate and be in charge of his emotions while utilizing age-appropriate resources in his world.“We play with kids to help solve mysteries-mysteries of betrayal, mysteries of experience, mysteries of meaning, and mysteries of life itself…The chance to enter the (child’s world) of fear and pain exists in our ability to join in. We play right along... We think “sideways”. And the wonder of all this: we have fun” (Webb, N.B. 2015, pp.xi)
Learning Objectives:
At the conclusion of this session participants will be able to:
Apply general treatment principles recommended in the ISSTD Guidelines for the Evaluation and Treatment of Dissociative Symptoms in Children and Adolescents
Describe three playful interventions that can be adapted and used in treatment sessions with children with dissociative disorders
Identify and describe the significance of parent and child interactions in therapy sessions for healing from complex trauma and the development of a cohesive sense of self