Play Therapy: The Art of The Relationship: Ch2 The Meaning of Play

• Play is intrinsically complete, does not depend on external reward, and assimilates the world to match the child's concepts…"play is the way children learn what no one can teach them it is the way they explore and orient themselves to the actual world of space and time, of things, animals, structures, and people. By engaging in the process of play, children learn to live in our symbolic world of meanings and values, at the same time exploring and experimenting and learning in their own individual ways." - Frank (1982)
• Analyzing play is a way for us to see how the child sees the world and their place in the world.
• Play can help bridge the gap between concrete experience and abstract thought.
• A major function of play is the changing of what may be unmanageable in reality to manageable situations through symbolic representation, which provides children with opportunities for learning to cope by engaging in self-directed exploration.
• This can be seen by observing the effects of 911 on children and adults. Adults would talk about their experience and feelings on the subject at length, while children would not verbalize their emotions, thoughts, or concerns. Rather they would build towers and crash airplanes into them, or at walls, then scolded the toy aircraft.
• For children to "play out" their experiences and feelings is the most natural dynamic and self-healing process in which they can engage.
• It is the therapists responsibility to go to a child's level and communicate with children through the medium which they are comfortable.
• "the toys implement the process because they are definitely the child's medium of expression… his free play is an expression of what he wants to do… when he plays freely and without direction, he is expressing a period of independent thought and action… he is releasing the feelings and attitudes that have been pushing to get out into the open". (Axline, 1969)
• Children's feelings are often inaccessible at a verbal level.
• The child's world is a world of concretes and must be approached as such if contact is to be made with the child.
• "the most normal and competent child encounters what seem like insurmountable problems in living. But by playing them out, in the way he chooses, he may become able to cope with them in a step-by-step process. He often does so in symbolic ways that are hard for even him to understand, as he is reacting to inner processes whose origin may be buried deep in his unconscious. This may result in play that makes little sense to us are the moment or may even seem ill advised, since we do not know the purposes it serves or how it will end. When there is no immediate danger, it is usually best to approve of the child's play without interfering, just because he is so engrossed in it. Efforts to assist him in his struggles, while well intentioned, may divert him from seeking, and eventually finding, the solution that will serve him best." - bettelheim (1987)
• Play is a voluntary, intrinsically motivated activity involving flexibility of choice in determining how an item is used. No extrinsic goal exists. The processes of play is enjoyed, and the end product is less important. Play involves the child's physical, mental, and emotional self in creative expression and can involve social interaction.
• Thus when the child plays, one can say that the total child is present.
• "play therapy is defined as a dynamic interpersonal relationship between a child and a therapist trained in play therapy procedures who provides selective play materials and facilitates the development of a safe relationship for the child to fully express and explore self through play, the child's natural medium of communication, for optimal growth and development."
• The dynamics of expression and vehicle for communication are different for children, but the expression (fear, satisfaction, anger, happiness, frustration, contentment) are similar to those of adults.
• Even though many children may have the vocabulary, they do not have the rich background of experience and associations which would render these words meaningful condensates of emotional experiences in terms of their potential usefulness in therapy.
• Children's play is meaningful and significant to them, for through their play they extend themselves into areas they have difficulty entering verbally
• Play is the child's symbolic language of self-expression and can reveal
• What the child has experienced
• Reactions to what was experienced
• Feelings about what was experienced
• What the child wishes, wants, or needs
• The child's perception of self.
• Play is the child's way of working out balance and control in their lives for, as children play, they are in control of the happenings in play, although it may not be possible to actually be in control of the life experience represented in the play. It is the sense or feeling of control, rather than actual control, that is essential to children's emotional development and positive mental health.
• The therapist is allowed to experience and participate in the emotional lives of children rather than reliving situational happenings. Because children thrust their total beings into their play, expressions and feelings are experienced by children as being specific, concrete, and current, thus allowing the therapist to respond to their present activities, statements, feelings, and emotions rather than to past circumstances.

Stages in the play therapy process.

• Stages in the play therapy process are the result of shared interactions between the therapist and the child, experienced in the non-evaluative, freeing environment of the playroom, facilitated by the genuine caring for and prizing of the child as communicated by the total person of the therapist. In this unique living relationships, in which the unique nature and individuality of the child are accepted and appreciated, the child experiences permission to expand the horizons of themselves in keeping with the degree of acceptance inwardly felt and communicated by the therapist.
• Moustakas' (1955)
1. Defuse negative feelings, expressed everywhere in the child's play.
2. Ambivalent feelings, generally anxious or hostile.
3. Direct negative feelings, expressed towards parents, siblings, and others, or in a specific forms of regression
4. Ambivalent feelings, positive and negative, toward parents, siblings, and others.
5. Clear, distinct, separate, usually realistic positive and negative attitudes, with positive attitudes predominating in the child's play.
• The disturbed child's attitudes-whether anger, anxiety, or other negative attitudes- all follow this process and play therapy progresses. … the interpersonal relationship allows the child to express and explore the various levels of the emotional process and thus to achieve emotional maturity and growth.
• Hendricks (1971)
• 1-4 sessions: at thi8s stage, children expressed curiosity; engaged in exploratory, noncommittal, and creative play; made simple descriptive and informative comments; and exhibited both happiness and anxiety
• 5-8 sessions: here the children continued exploratory, noncommittal, and creative play. Generalized aggressive play increased, expressions of happiness and anxiety continued, and spontaneous reactions were evident.
• 9-12 sessions: exploratory, noncommittal, and aggressive play decreased; relationship play increased; creative play and happiness were predominant; nonverbal checking with the therapist increased; and more information about family and self was given.
• 13-16 sessions: creative and relationship play predominated; specific aggressive play increased; and expressions of happiness, bewilderment, disgust, and disbelief increased.
• 17-20 sessions: dramatic and role play predominated, specific aggressive statements continued, and increased relationship building with the therapist occurred. Expression of happiness was the predominate emotion, and children continued to offer information about self and family.
• 21-24 sessions: relationship play and dramatic and role play predominated, and incidental play increased.

Play of adjusted and maladjusted children.

• The initial reactions of maladjusted children are cautious and deliberate. Adjusted children are free and spontaneous in their play.
• Adjusted children will examine the whole play setting and use a large variety of play materials, in contrast to maladjusted children, who use a few toys and play in a small area. Maladjusted children often want to be told what to do and what not to do. Adjusted children use various strategies to discover their responsibilities and limitations in the therapeutic relationship.
• When bothered or annoyed, adjusted children use a concrete way to bring out their problem. Maladjusted children are more likely to express their feelings symbolically with paints, clay, sand, or water. Maladjusted children often are aggressive and want to destroy the play materials and some times the therapist. Aggression also is seen in the adjusted children, but it is clearly expressed  without massive destruction, and responsibility is accepted for the expression. Adjusted children are not so serious and intense in their feelings about themselves, the therapist, or their play as are maladjusted children.
• The difference between well-adjusted and maladjusted children lies not primarily in the type of negative attitudes they demonstrate, but rather in the quantity and intensity of such attitudes.
• Maladjusted- less focus and direction.
• Aggressive children presented frequent play disruptions, conflicted play, self-disclosing statements, high levels of fantasy play, and aggressive behavior towards the therapist and toys.
• Withdrawn boys- identified by their regression in response to anxiety, bizarre play, rejection of the therapist's intervention, and dysphoric content in play.
• Well- adjusted children- less emotional discomforts, less social inadequacy, and less fantasy play.
• Withdrawn girls- could not be differentiated from well adjusted girls.
• " maladjusted children expressed significantly more disphoric feelings, conflictual themes, play disruptions, and negative self-disclosing statements than did adjusted children. Maladjusted children also spent a larger portion of their playtime feeling angry, sad, fearful, unhappy, and anxious than did the adjusted children. Maladjusted children talked and played out their problems and conflicts during more of the play session than did adjusted children. No significant differences existed between adjusted and maladjusted children in the area of social inadequacy play of the use of fantasy play.
•  the therapist is cautioned about unrestrained inferences as to the meaning of child's play. Neither the toys the child uses nor the manner in which the child plays with the toys is an absolute indication of an emotional problem area. Environmental factors, recent happenings, and economic depravation may be structuring factors.