A Case Study - The healing power of Play Therapy for children
The following case vignette, of a child I will call, ‘Everett’, aged seven years which illustrates the potential healing power of play therapy in a child’s life.
Everett entered the play room for his first session and planted his hands firmly in the sand tray, remarking ‘That’s cool, look at the shape of my hands in the sand.’ He sat down on the mat and turned toward me saying, ‘Can I throw sand on the ceiling?’ I responded, ’The ceiling is not for the sand.’
Everett: Aw, why not?
Helen (Therapist): Because it is difficult to remove.
E: Can I throw sand at you?
H: I’m not for the sand either.
His next question/response took me by surprise.
E: We could use goggles!
H: Still, I’m not for throwing sand at.
E: Ahhhhh…..can I yell out the window and spit on the people?
H: The people are not for spitting on or yelling at.
At the end of this session, while walking through a quiet corridor, Everett passed the door of my colleague and yelled, ‘Happy Christmas!’. All I could do was remind him that other people also worked in the building and that required his attention to their privacy. This opening session gave me an insight into how Everett felt about himself.
Everett was referred to Play Therapy by his parents. They were going through a painful marital separation and were concerned about him because he was easily distracted in school. They reported that he was unable to concentrate and found it hard to maintain interest in reading and writing. They said he was frightened of the dark, afraid to ride his bike and constantly fighting with his younger brother. Everett spoke in a fast, almost cartoon-like way, and had mannerisms of batting away imaginary flies, blinking and sniffing.
Everett had been tested in a child guidance clinic and his parents told me he was very hurt because he was present during the sessions where the psychologist had asked them personal questions about him.
Meeting the child in the playroom provides the therapist with a full understanding of what the child is grappling with in his life.
Everett arrived for his second session and asked me if I knew his parents were separated. I said that I did. He became very energised, turning toward the sand tray and said, ‘OK, let’s play war.’ Dividing the sand down the middle of the tray, he placed in miniature soldiers on either side and played out a ‘battle’, burying two small treasure chests deep in the centre of the sand. ‘This is what they are fighting for’, he said.
Symbolically, Everett was able to represent his parent’s legal battle and how it was affecting him and his brother without having to verbalise it. As his sessions continued, the atmosphere in the playroom became charged with a feeling of unpredictability. Anything could happen at any time. I felt it was crucial to offer a tolerant attitude; all his feelings were accepted in the the session, but some feelings could not be acted upon.
Everett tested me over and over again, like a small toddler determining his boundaries. During one session, he opened up the doll’s house and threw the miniature furniture on to the floor. I reminded him that some of them might get broken if he continued to throw them that way, but he ignored me.I mentioned it again, saying I did not want to stop his play but if he continued to throw the items around the room, that he could choose something else. Everett slowed down and stopped tossing out the dollhouse furniture. He picked up the miniature sofa, banging himself gently on his forehead. I was aware that his family home had been sold and he was moving to a new house with his mother and brother within a few weeks.
H: I’m wondering if you’re thinking about the move to your new house.
E: My new house is closer to school. I don’t care about my old house. The new owners are welcome to it, including the bills.
He moved the miniature boy from the doll family, through the house, wandering from empty room to empty room. Then Everett closed up the house and placed the boy doll outside, looking in the window. I reflected that the boy was sad to say goodbye to the house he had lived in ….and Everett finished the sentence by saying, ‘since I was four years old.’ Because I focussed on asking Everett to respect the ‘no throwing’ rule, his play became more centred on his feelings of loss and sadness.
After a break for summer holidays, his play continued to show how hard he was trying to understand his parents’ separation. He took a large ball of clay, pulling off small pieces and dropping them on to the floor, walking around in circles. Finally, he overturned a chair and hid behind it, leaving the floor resembling how he might be feeling - in bits!
At the next Parental Review, his father spoke of introducing his new partner to Everett and his brother while they were on holiday. In his next session, Everett asked me if I was married. When I said, yes. He seemed surprised and said, ‘Really married to the same person? I felt Everett was torn in his loyalties to his mother, finding it hard to know where to place this new relationship of his father’s. His play mirrored this feeling over several sessions, with much messy play and furniture overturned which helped me to understand how he was feeling, which was upended!
During this turbulent period, Everett asked me if he could strike a match from the box, I kept on a high shelf in the playroom. His parents told me they were finding it difficult to trust him due to his unpredictable behaviour and yet I felt he needed to be regarded as being capable and trustworthy. I set the boundaries by placing a bowl of water into a dish of sand on the floor and told Everett that is where he could put the match when it had burnt out. I put six matches into the small box and positioned myself close to him, conveying in my attitude, I trusted him and believed him capable of handling matches and containing the flame.
Striking the first match, Everett was surprised at the flash of flame from this ‘little wooden stick’ which was how he referred to the match. He dropped it quickly into the bowl of water and enjoyed the sound it made as it went out. After a few more experimental strikes, he discovered that if he held the match horizontally instead of vertically, the flame did not burn down as fast, giving him some control over it. He grew more relaxed and calmer as he concentrated on these flashes of fire. He asked if he could burn some paper and I suggested small pieces as we needed to stay safe. The sudden flame and heat when the match was struck, provided Everett with an experience of safety in the playroom that no amount of adult words could impart. Taking responsibility for this, he lit a few pieces of paper and then left them in a heap - in ashes.
The hot flame was a metaphor for Everett’s behaviour at school and home, as his angry flare ups were getting him into difficulties. The ashes seemed an appropriate metaphor for what he had lost. In other sessions, he created a circle of stones in the sand and set up a tiny bonfire with a few pieces of paper. His circle of stones created a feeling that he could contain his own inner ‘fires’. Over time he stopped using the matches and appeared much calmer, instead of rattling off words so fast that it was hard to understand him, now he was communicating fluidly and with ease.
His parents spoke of a change in Everett. He began to take an interest in books. His handwriting, according to his teacher was legible and clear and Everett was now riding his bike, playing on the road with other children and forming new friendships. His father was still concerned that Everett was having difficulty with the concept of subtraction, at school. Subtraction means taking something away and Everett had lost much, over which he had no control.
Near the end of Everett’s sessions, he brought books into the playroom and seemed excited about this new found pleasure of being able to read. He offered me a book to read saying he would get it at the next session and then in an adult voice ‘I expect you to have read it all by then!’. He discussed the book, ‘The Boy in the Striped Pyjamas’ by John Boyne, wondering aloud if there were other people in the death camps, beside Jewish people. I said there were groups of handicapped people and people of other persuasions. He seemed thoughtful and said, ‘If I had been alive then, I would be in the camps.’. I asked him why and he said, ‘Because I think I have something wrong with me.’ He asked me in the next session if I liked him. I responded, ‘Yes, I like you, Everett.’
When he asked me, did I like him, I felt beneath that question lay another, ‘Am I alright as I am?’ His realisation that all his feelings were acceptable along with the freedom to express them but not necessarily act on them, provided him with safe boundaries in the playroom. Seeing him as trustworthy and capable brought him through some challenging times where he pushed hard to see if I would reject him. I not only had come to like him but understood his struggle and admired his courage.
During the ending sessions of play therapy, Everett sat on the floor, chatting and making eye contact, telling me about adventures he was having at home and school. He brought in sweets, giving me the last sweet in the package. He had been named, ‘Student of the Week’ at school, telling me proudly that his task was to look out for smaller children at break, ‘in case they got hurt.’
Everett used his sessions well and was able to, through the medium of play, sort out his many feelings, over which he had no control, concerning the change in his family circumstances.