On Becoming a Play Therapist

United States · CPD courses & CPD points · Health Professionals

Becoming a play therapist, or a child psychotherapist, is an ongoing journey of learning to create a safe space for a child which invites play and free association, and grasping how to link the play to emotional experiences in a meaningful way. There are a number of interlinked strands to convey: a sense of warmth and openness; a containing presence; the capacity to bear difficult experiences; genuine interest in the child's internal world; and a capacity for play are among them. I believe that the therapist's contact with his or her inner child is facilitative of the capacity for play, humour and sponteneity, characteristics which facilitate meaningful relating in child psychotherapy.

An idea which I have kept in mind when working with children is that the technique of the psychoanalytic play therapist largely involves following the play "like a river". This is an open stance where the therapist approaches the child's play with curiosity. This is not just about the caricatured repeating of what the child is doing; "you're building a tower", or "you're banging two cars together", but a genuine interest in the twists and turns and developments in the child's play; in the unfolding narrative which psychoanalytic practitioners believe is infused with unconscious phantasy.

Melanie Klein's major contribution to psychoanalysis is represented by the idea that the child's unconscious dynamics are reflected in play, with play being the medium through which unconscious fantasies and conflicts are expressed. For Klein, play is symbolic and requires interpretation, much like the dreams and free associations of adult patients. In her paper about Klein's play therapy technique, Patricia Daniel writes about Klein's fidelity to the psychoanalytic method: she would limit her enquiry to the child's play and associations to this, rather than asking about external events in the realm of conscious experience.

I am becoming increasingly aware that this deceptively simple point is in fact crucial. We are so used to interacting with children by asking them about their external lives; "how is school"; "how is soccer going?"; "who do you play with at break time"? At times there is a sense of pressure to get to talking about the issues bringing the child to therapy, and we face the challenge of trusting in the psychoanalytic method with a sustained focus on the child's play. I have the figure of Melanie Klein in mind as I remind myself not to dismiss what the child is doing in the room because I'm concerned about getting to the "real stuff", but rather to actively enquire about the unfolding narrative, to seek associations to the child's drawings or to the family scene being played out in the dolls' house, for example. I am increasingly able to let go of the pressure I feel to address the presenting concerns, and to allow the events in the room to wash over me in the state of reverie which Bion recognises as so important.

I have realised that staying with the child's play is the optimal route to exploring his or her concerns, far more helpful than trying to force the issues into the room, an approach which is often met with resistance. A child troubled by parents' divorce, for example, is likely to express these worries through play. The child might play out family dynamics with dolls in a dolls' house, revealing concerns around togetherness and separateness. The child might also express these concerns more symbolically, for example, repeatedly sticking items together with Sticky tape or Prestick, revealing a concern with how things (or relationships?) stick together and how they come apart.

One of the most powerful ways of accessing a child's internal experience is through the medium of projective identification. This is Melanie Klein's idea that a child tends to project parts of the self into a significant other. Wilfred Bion elaborated this idea, describing projective identification as a primitive form of communication, where a young child would elicit strong experiences in his or her caregiver. This process, for Bion, is driven by the unconscious need for the caregiver to know something of the child's experience, and to make sense of this experience and feed it back to the child in a processed and more manageable way. In play therapy, this is often enacted very vividly. For example, a child may ignore the therapist, shutting him or her out and giving the therapist a taste of his or her own experience, or the child may create a chaotic mess and leave it for the therapist to clean up, giving the therapist an experience of helplessness and anger which the child struggles to bear on his or her own. Over time, the therapist can slowly begin to use his or her countertransference experiences to reflect back to the child what he or she might be struggling with.

What I find compelling is the magic of play therapy. The child senses the therapist’s open stance, and the therapy room becomes a co-created, playful, and dream-like space, which nourishes the child’s psychological development. Over time, themes are repeated and games are revisited and revised, their layers of meaning slowly uncovered. Children become more able to articulate their emotional experiences in the outside world, and new friendships begin to form as the child’s capacity to relate takes shape. I like to think that the experience of the therapy lodges in the child’s mind, as a safe and contained space which the child can draw on in more difficult times, and which can continue to sustain and nourish the child’s ongoing emotional development.