Play Therapy for Children's 2015 Update

Heart Centered Play Therapy™: Daniel’s Healing

By: Susan Garofolo

Over the years, I’ve worked with many children who have experienced early trauma. Recent research on attachment treatment has taught us a great deal about how the human spirit is willing and able to heal. In my practice, I regularly watch children unfold their inner process. However, nothing is more moving than to witness a child who has experienced a primal loss surrender to his or her own self-discovery.

An adopted 6 year old boy has been in just such a process with me over the last few months. A few weeks ago, he came into his session and shared an incredible story which inspired me to write this article.
At the beginning of his 14th session, sitting on the floor playing with action figures, he looked up at me with wide, clear eyes and shared the following;
D: Susan, guess what?
Thx: What, Daniel?
D: I decided to start my life all over again!
Thx: You decided to start your life all over again!
D: I woke up one day and I was a baby! Then I kept growing older. I had my first word, it was Mama! Then I kept growing and I was a toddler. I looked in the corner of my room and found all kinds of new toys!
Thx: You found new toys!
D: They weren’t really new, but they were new to the toddler.
D: Then I kept growing for the rest of the day till I was 6 again.

Daniel had begun a new phase of his healing process. Up to this time Daniel had experienced both child-focused, non-directive play therapy combined with directive Theraplay activities.



Daniel’s story:
Daniel’s adoptive parents were referred by their family physician because they had many concerns over their son's behaviour. Daniel presented as a tireless child who bounced off of furniture and ran around his house constantly. From the time he was brought home at the age of two, he could not allow himself to be nurtured (cuddled or fed) or be comforted when hurt. Generally, he behaved as an impulsive child, younger than his years. This created challenges to building friendships and attending to tasks at school.

Adopted at the age of two, Daniel’s biological mother had originally planned to give him up to private adoption, but changed her mind. However, before the birth, children’s aid services intervened due to reports of domestic and drug abuse. Daniel was declared a ward of the court at birth where he went directly into foster care.

Heart Centered Play Therapy™:
Blending Non-directive, child-focused play therapy with Theraplay
Daniel first entered the playroom wide-eyed, carefully examining the play room toys, art materials and me. I had explained to his mother, in advance, that Daniel would be in non-directive play for the first thirty minutes, followed by a Theraplay session (parent, child and therapist) for the remaining thirty minutes.

This time in non-directive play allowed Daniel to build trust in me and acclimate to an environment of self-discovery and transformation. Daniel expressed his deepest emotions nonverbally. Reflection and validation of Daniel’s expressions empowered him to process and reconcile tensions within his mind and body.
Daniel progressively presented as a younger and younger child as he began his process. For example, after the fourth session, he began making baby-like sounds, playfully making shapes with his mouth. I responded by mirroring his expressions, much as a mother would do with her infant. From this time forward, Daniel began each session by flopping himself on the sofa, eyes fixed on me, waiting to be “seen” This showed me that Daniel was preparing to be open to his younger self. I trust the child to communicate their needs and in turn they trust me to receive them and keep them safe in the “therapeutic bubble”.

Theraplay activities were introduced early in this process. I discussed what the activities would look like with child and parent separately, so that everyone was prepared to play them. Daniel enjoyed knowing ahead of time what we would be “teaching” his mom and dad that day in the Theraplay part of his session. This gave him a sense of control which allowed him to feel sufficiently safe to engage in these new activities. Preparation of the activities with the parents is, however, most important. Some parents may  feel uncomfortable engaging in play with their child as a result of their own childhood experiences.Therefore, it is critical to examine these issues before the Theraplay sessions.
In this case, the preparation helped the parents understand their responses during the play and how important it was to meet their son’s younger needs. Regarding the latter, Daniel’s mother described the process as, “When the magic happened!”



We began with structured and active Theraplay activities, responding to Daniel’s physical presentation at the time. The structured activities helped regulate his impulsivity, gradually ceasing the “bouncy” behaviour, in the play room and at home.
Nurturing Theraplay activities were later introduced, such as ‘hot dog roll up’, 'stiff and floppy’ (to help him relax before bed) and ‘back messages’. Sensory focused games were gradually introduced, which allowed Daniel’s parents to have more physical contact through play. For example, mixing many colours of playdoh and squishing them together with mom’s hands over Daniel’s and finger painting where she would playfully paint “hand over hand” with him. Daniel also enjoyed playing food games like “snack hide-n-seek” where mom would find hidden gummy snacks and feed them to Daniel.
Within just a couple of months, Daniel’s parents reported that power struggles had lessened and he was overall “less intense and easier to be with.”
Now, after 4 months of sessions, Daniel’s mother happily reports that there is much more laughter in their home. Daniel’s impulsive activity has quieted considerably and before where he would run away screaming when hurt, he now easily seeks comfort from his parents.

Heart Centered Play Therapy™ allows a child to heal early wounds as well as provide a “here and now” connection for the parent and child. This is a bottom up approach which can eventually include cognitive or narrative modalities to help the family continue to grow.

Every child we work with teaches us something unique. I am awed by this family’s courage to stand with Daniel in his pain and joy. Daniel’s courage to ‘let go’ to his parents safe arms reminds me to continue to always trust a child’s own intrinsic ability to heal.




Biography:
Susan Garofolo, B.A., CPT, CTT is a play therapist and owner of Play Therapy for Children in Burlington, Ontario, Canada.
With 20 years of work experience in the child mental health community, Susan serves a wide range of clients, from children with attachment issues to children experiencing divorce and other forms of loss.
Heart Centered Play Therapy™ was developed through her many years of training and experience in both directive and non-directive play therapy modalities.
For additional information please visit Susan at: www.playtherapyforchildren.com