Snow White: An Archetypal Journey

Here’s a very interesting article submitted by reader Martha Nodar on the subject of archetypes. Ms. Nodar earned a gift certificate to childtherapytoys.com for her submission. Learn how you can do the same!

Snow White: An Archetypal Journey

         Once upon a time, Jung (1953) argued that archetypes are shared universal and implicit patterns of behavior which reside in the collective unconscious. For instance, the Child archetype is innate in every psyche (Myss, 2001) and almost needs no explanation. Fear of rejection is a characteristic associated with this archetype and it is frequently explored in fairy tales such as in Snow White and the Seven Dwarfs—the story of a princess rejected by her family who is thrown into a journey of survival, both literally and metaphorically. Jung emphasizes it is important to understand the meaning of the symbolism behind the archetype. In other words, what does it mean to have the Child archetype and how does the fear of rejection is likely to manifest symbolically in one’s life as the result?

Child-Orphan Archetype

        While Jung (1953) focused on a few major archetypes, Myss (2001), a Jungian analyst, has expanded Jung’s repertoire to cover different dimensions of the major archetypes Jung suggested. She contends that although humans share four major symbolic archetypes in their collective unconscious (Child, Victim, Saboteur, and Prostitute) (Myss, 2001), there is usually one archetype that seems to be more prominent in an individual’s psyche. For instance, in the case of Snow White, Myss (2001) proposes, the princess embodies the Child-Orphan archetype (a dimension of the Child archetype), which includes those who feel “they are not part of their family. . . [and yet, oftentimes]. . . succeed at finding a path of survival [after] having won a battle with a dark force” (p. 372). Snow White’s dark force is her wicked stepmother who wants to see her dead. Consistent with Myss’ arguments, one of the characteristics associated with the Child-Orphan archetype is the ability to build a network of friends—illustrated in the story through the princess’ relationship with the dwarfs and Prince Charming. One of the aspects of the shadow side of this archetype is the extent to which one may be vulnerable to be indiscriminately trusting of others who may have a hidden agenda. This dynamic is symbolized in the fairy tale when the princess trusts the disguised wicked stepmother and eats the poisoned apple.

Check out the full article here: Snow White

Contribute to our blog and get free stuff!

We recently received some great articles from fellow practitioners which you can read below. I’d like to remind our readers that contributing to our blog isn’t just an opportunity to share your hard work with others, it’s also a way to get free stuff at ChildTherapyToys.com! In fact, the authors of the below articles each earned a $25 gift certificate!

This blog was created as a place for practitioners, or anyone interested in play therapy, to come for news and information relevant to this unique therapeutic method. I also envisioned it as providing a forum for play therapists to share their knowledge, ideas, and experiences.

Send us an idea or intervention that you have developed or used in the play room, and if we publish it to the blog, we’ll send you a $25 gift certificate for ChildTherapyToys.com.

All entries are only accepted by email. Send to gary@childtherapytoys.com.

Unexpected Blessings: Integrating School Counselors and Senior Citizen Volunteers Using CPRT/CSRT

Here’s an excellent article submitted by reader Angela Yoder, PhD. Ms. Yoder earned a gift certificate to childtherapytoys.com for her submission. Learn how you can do the same!

As a young child, I watched my grandmother tirelessly volunteer to help others. She had a profound influence on me as a counselor and human being. I remember the way she communicated that she cared and understood and even as a child, I could see that she had time for me. Her pace of life was different and so were her priorities. She didn’t just glance at me in a rush on her way somewhere else like many adults did. She really saw me. Years later, as I worked with at-risk children, I noticed how many, if not most of them, had no access to the kind of guidance and wisdom I received from my grandmother.

Mary Piper (1994), in her book Reviving Ophelia, notes how society separates its generations: little ones go to preschool, teens go to high school, and elderly folks reside in separate homes and communities. This separation robs each of us of the wisdom, insight, and support of different generations with different perspectives. Today’s retired senior citizens are active, gifted, talented, ready to give back, and many now have the time to pursue the volunteer work they couldn’t manage with a full-time job. Meanwhile, school counselors are overburdened with higher counselor to student ratios, with Illinois’ ratio being 1:672. In 2010, I set out to see if senior citizen volunteers might be able to stand in the gap with school counselors and fill a crucial role by offering volunteer play sessions in the schools.

Given the strong empirical support for adaptations of filial models, including Child-Parent Relationship Therapy (CPRT) (Landreth & Bratton, 2006) for use with teachers, teacher’s aides, and even high school students, I decided to adapt Landreth & Bratton’s CPRT 10 session model for use with senior citizen volunteers. The pilot study started out small, with only 4 volunteers and 4 children, growing to serve 20 children this past year. My research team and I were amazed at how well the volunteers caught on and the skill level they maintained throughout the project. In addition, we were delighted to notice downward trends in the children’s internalizing and externalizing behavioral problems. The children loved working with the seniors and characterized their experiences best with pictures. The picture featured is from a biracial boy who was referred for noncompliance and aggressive behavior. Racial tension was prevalent in both the home and in his classroom and the student’s self-esteem was really suffering. As he progressed in his sessions and changes were made in his classroom environment, he began to improve. This is the picture the boy made for his volunteer at the goodbye party following completion of the study. You will notice that he chose to color them both green and included an “A+” on his work. Previously the boy had reported that he was bad. As encouraging as this type of data were for us, perhaps what surprised us the most was how much the senior volunteers were positively impacted by working with the children.

Camelia, who grew up in the Philippines, reluctantly joined the Child-Senior Relationship Therapy (CSRT) group that was modeled after the CPRT program. She worried that she would not be able to connect with American children and believed she had experienced this problem in the past. Initially, she was concerned that we were going to ask her to falsely praise the children in session so she was delighted to hear about encouraging the effort vs. praising the product. She also later reported that she agreed to participate because I told her she could withdraw her participation at any time. Camelia reported challenges connecting with and understanding her own daughter, having adopted her late in life. Camelia was an eager student of CPRT and each week came back with success stories of how she had utilized these skills with her daughter. Like many retirees, she had a part-time job and worked as an adjunct faculty member at a nearby university. From time to time, she commented on her struggles working with the students.

Camelia was paired with Abby, a child referred for clinginess, loneliness, social problems/isolation, and anxiety. Prior to the referral, Abby’s symptoms had worsened when she found out her mother was planning to remarry and have a baby. She was the only child, but seemed to have a need for attention and care that was like a black hole. Much to Camelia’s surprise, Abby connected easily with her. In many sessions, they could both be heard giggling and genuinely enjoying the company of each other. Camelia began to look for Abby’s feelings and reflect them, communicating Landreth’s “Be with” attitudes of “I hear you. I’m here. I care. I understand.” And Abby ate it up. Her symptoms began improving in the classroom with her teacher reporting less clinginess and whining and improved social skills. Abby learned to find her own voice and cope with her anxieties about the world. In fact, during one session, the lights in the school went out. Camelia skillfully attended to Abby’s fears and they both worked to creatively problem solve by turning on the light in the dollhouse for comfort. On another day, Abby made Camelia a card and taped it on the wall. Camelia remembered to hang the card up each session just for Abby and Abby absolutely delighted in the fact that it was there each and every week. Abby finally felt seen and heard.

Our revelation about the many benefits of the CRST program occurred when Camelia made a surprising disclosure at the end of CSRT group. She had grown up in the Philippines and at age 5 was responsible for watching out for her toddler brother. As many children do at that age, Camelia had become distracted and the boy had her brother wandered off. Living near the water, her parents feared the worst, and having looked unsuccessfully for him for hours, Camelia was severely punished. She tearfully noted that although her brother was later found, it was at that time she began to believe she wasn’t good with children. Her voice quivered as she continued and proudly exclaimed “Now I KNOW I am good with children!” She reported that she utilized the CPRT training beyond the study resulting not only in an improved relationship with her 12 year old daughter, but in improved communication with her students. Camelia noted that using the “be with” attitudes, along with skills of reflection and paraphrase had transformed her teaching and that her teaching evaluations were the best they had ever been. As you might expect, there wasn’t a dry eye in the group.

These unexpected blessings have continued to emerge from our senior volunteers with reports of improved communication skills with friends/family, the excitement of learning something new, a renewed purpose in life, satisfaction of helping others, increase in personal confidence, and the joy and healing which accompanies the unconditional positive regard the children gave to them. One woman put it best by stating “I’m old, white-haired, overweight, and creaky in the knees. But, to her it doesn’t matter. To her, I’m just her friend.”

 

Helping Military Children: Ignorance is no longer an excuse

Here’s an excellent article submitted by reader Brandon Menikheim on a very unique subject: intervention with children of Military families. Mr. Menikheim earned a gift certificate to childtherapytoys.com for her submission. Learn how you can do the same!

There is a growing problem contained within the walls of each and every school around the nation, and around the world. In the aftermath of September 11, 2001, a new population of students has added to the diversity of the student body. Children with military affiliations continue to increase in number, even amongst schools that are not centered around a military base. What is the problem that is becoming so pervasive? Most educators are at a disadvantage when it comes to understanding this unique, yet more common, group of students. The issues which these students face are life altering, yet very often unnoticed by an outsider trying to look in.

Due to the lack of understanding, “military children see themselves as set apart (Horton 2005, p 259).” They feel different from everyone else, which leads to development of feelings associated with a lack of belonging. Their isolation stems from the inability of their peers, and others in their environment, to be able to understand their reality; It is one that you must experience in order to fully understand. They give themselves labels, such as “military brats“, and feel stigmatized by them. Unique challenges and issues confront military dependent students that educators and counselors generally are not aware of, but need to become aware of in order to effectively develop appropriate interventions (Harrison & Vannest, 2008). While it may be common knowledge that deployment negatively impacts children, what may not be openly realized is the exact ramifications it has emotionally, academically, and behaviorally.

According to Harrison & Vannest, deployment can lead to a decrease in children’s academic performance, an increase in feelings of anxiety and depression, and the development of aggressive and defiant behavior. While these functional problems were typically found to only exist during the time of deployment, it was also noted that the inability of educators and counselors to address these needs, could develop into a learning gap. Changes in a student’s functionality may be deemed as temporary due to the circumstances. By creating this false perception of the student’s abilities, the educator or counselor does not provide the services that the student is in need of, which in turn intensifies the issues the student is privately dealing with.

A common misperception is that the problem a student exhibits is in direct correlation to his or her inability to cope with the absence of the deployed. The truth is however, negative emotional and behavioral issues are typically associated with the inability of the parent left behind to cope with the separation, and therefore provide effective and supportive parenting to the child. In the absence of a loved one, those remaining become the only available support system. It is only logical that a lack of this support system would create problems of maladjustment, given that the child has no foundation to work from. Factors that can contribute to this lack of familial cohesiveness are the length of the deployment, and whether the deployment is noncombatant, or wartime. Stress levels are significantly more elevated the longer someone is deployed, and the degree of danger they are in while deployed. As can be expected, there is a correlation that exists. As deployment time, and/or risk of combat increases, family cohesiveness decreases. Knowing that, it is important for educators to realize the need to develop a supportive educational, and social, environment for these students while in school.

Lincoln, Swift, & Shorteno-Fraser (2008) validated these findings and stressed the difference in today’s military children from decades past. Today’s children are dealing with unpredictability. Lengths of deployment were at one time relatively Military Children predictable. Currently, however, deployment extensions, and multiple deployments in a relatively short period of time, are more frequent. The frequency of deployment has developed a sad statistic for military children, “the average military family moves every 2 to 3 years (U.S. Department of Defense, 1998).” Even though the statistic today is outdated, the only difference in the statistic would be a lower stability rate in terms of consistency of movement. In other words, today, reserves are activated more frequently than they were being activated 12 years ago. It can only mean that military children are being moved around even more in the recent years compared to a decade ago.

With constant movement from one place to another, children have difficulty developing new friendships, establishing themselves academically, and adequately adjusting to their environment. It is hard for these children to develop the support system that they need, because they feel that as soon as they do, it will only be ripped out from underneath them once again. It becomes a double edged sword; a defense mechanism that they utilize to keep themselves from being hurt anymore, but at the same time, it isolates them from those around them.

What is even more disturbing for the military children of the 21st popularity the current war situation has in the media. Due to the extent to which the war is being covered by local media, there is an increased awareness of the risks associated with war, leading to increased risks of emotional and behavioral difficulties. Knowing what the situation overseas is, seeing it constantly unfold before their eyes on the television, children find it hard to keep their minds off the potential impact that war can have on a loved one’s safety. The distractive nature of these thoughts manifest itself in the form of sleep difficulties, poor attention spans which lead to difficulties in school, anger, and/or loss of interest in usual activities. It becomes vital at this point for school personnel to have the second order of mind ability to realize that these impediments are more than just instances of acting out, but are products of the student’s mental health.

What can educators and counselors do to help these children who are falling under the radar until it is too late? The simple answer to the previous question is simple, yet tends to bewilder many educators still today. What they need to do, what we need to do, is to take initiative. Too often the excuse of ignorance is used to explain the lack of action that is taken. People rationalize their immobilization by pleading that they had no idea a given issue was actually a problem, or that they simply did not know how to approach the problem because of lack of training in that area. There is a way to combat ignorance however, it is called research. Continuing education is at the forefront of every occupation. Trends and issues are drastically changing, so it becomes the responsibility of the professional to keep up with the times in his or her field. In the school system, research can be done simply by walking the hallways of the school. Observe the students, listen to them, empathize with them, just try to understand their world. It is that simple. To find out what students need, ask questions. It is also a good idea to take the time to review the current literature on the topic. While the availability of various literature resources is scarce, what is available is helpful in determining what it is these students need.

Current literature is drawing the most attention to assisting students with maintaining communication with the deployed family member (Harrison & Vannest, 2008). Students need to be encouraged to write e-mails, letters, arrange for phone conversations if available, and/or use current technology like instant messaging to their advantage. These are activities that can be incorporated into school groups, or into individual classes (such as language arts or English classes). It is a way to help the students develop that connection which is lacking during times of deployment. Keeping communication lines open gives the student the outlet he or she needs to express his or her feelings, and to have validation about the current physical state or his or her loved one.

Individual and group counseling is also emphasized as a therapeutic intervention for military affiliated students. Counseling sessions gives the students the opportunity they need to share their feelings, needs, and fears about the process of deployment. It offers students a supportive, safe environment where they are not judged, only listened to and validated. Groups also offer the educators and counselors the opportunity to teach students some vital coping strategies such as anger management skills, relaxation techniques, and social skills training via role-play and modeling.

Horton (2005) is a strong advocate for the group counseling aspect of helping military children. She held to the belief that stress management classes not only for children, but for parents as well, can aid them in understanding the burden of stress that they are under, but also to help them realize they are not alone. As has been stressed already, the support system is vital during times of deployment. The hard thing is actually the development of a trusting relationship, because these are the people who fear getting too close, because they believe it will only be ripped away. Horton felt that a way to combat this blockade is through nontraditional counseling techniques. Art and art therapy can enhance trust, build rapport, and help children to process their internal struggles. She also felt that using poetry and story writing is helpful in giving voice to the children’s feelings and emotions.

Another important lesson to teach military students, according to Horton, is how to interpret the media. Children may need help in sorting out the messages they receive from the mass media, and learn for themselves how to understand the reports; they may need help determining when reports are incomplete and therefore cannot be taken too seriously. Sometimes the only means of communication these children have with the deployed individual is the media. It is the only source of information they are given when the military member is on assignment and unable to make phone calls or write for weeks, if not months. Any information the student receives through the media is going to be taken to heart, because he or she has nothing else to go by. It is important to help the student sift through the information that is reported because of this reason.

Regardless of what form of research is used, whether it be actually questioning of students, or reading up on literature, one conclusion is obvious, deployment affects children. Some military affiliated students are more resilient than others, but all have a lot to deal with emotionally. The unfortunate side effects of emotional exhaustion are deficits in academic and personal/social functioning. The recommended supports that the research offered have been shown to create stable, supportive environments in which children can experience a safe learning environment, which will hopefully carry over to other areas of their life as well.

Resources
Harrison, J., & Vannest, K. (2008). Educators Supporting Families in Times of Crisis: Military Reserve Deployments. Preventing School Failure, 52(4). 17-23.

Horton, D. (2005). Consultation with military children and schools: A proposed model. Consulting Psychology Journal: Practice and Research, 57(4), 259-265.

Lincoln, A., Swift, E., & Shorteno-Fraser, M. (2008). Psychological Adjustment and Treatment of Children and Families With Parents Deployed in Military Combat. Journal Of Clinical Psychology, 64(8), 984-992.

U.S Department of Defense (1998). Selected manpower statistics, MO1 (The Directorate for Information, Operations, and Reports). Washington, DC: U.S. Government Printing Office.

Mr. Menikheim has also included this great example of a therapeutic group for a Military Support Guidance Program.

Play Therapy: The Universal Language of Very Young Children

Here’s another great article from Alessandra Longo, LMSW, MA. For this submission, a $100 gift certificate to childtherapytoys.com will be given to a public agency or program of Alessandra’s choice.

Kevin was an energetic toddler; he entered the classroom not really knowing where he was in space. I remember him flinging himself hard onto the floor, into objects, running laps around the classroom and not responding to his name. Toddlers are normally in their own egocentric space but we all agreed something was different about this child. He had an otherworldly quality that made it seem as though he was not interested in establishing any relationships with teachers or peers. I was faced with the challenge of developing a therapeutic relationship with a child within a preschool setting.

The agency where I work assists toddlers through the separation process from parents and caretakers. This child did not have an exceptionally hard time leaving his mother. Few children at this age play with peers but most seek out interaction with adults in the classroom. My client was not really noticing anyone. He had a very difficult time focusing on anything and a lot of the day was spent trying to get him to stop running in circles or keeping him out of the closet. It was evident that Kevin needed extra attention and I became invested in responding to his specific needs. As the year went on we developed a very strong bond fraught with highs and lows.

Kevin is 3 years old. He is bilingual and in the beginning of the year favored Japanese over English. Early in our relationship he would emphatically tell me things in a stream of Japanese, especially when he was angry. He showed clear frustration when I did not understand. There came a point when he became extremely agitated with the difficulty of communicating through language and he began to hit. This would mainly happen when he would get hurt or drop something. These were all situations where he did not feel a sense of control. I was his safest object in the classroom and therefore also experienced the rage. If someone else reprimanded him he would be sure to find me somewhere in the classroom and hit me. I tried to stay calm and consistent in my response to physical aggression and as his English developed further his hitting disappeared. All of these issues of control and attachment naturally pushed my thinking into the realm of psychodynamics with this child.

My client began potty training midyear. During this time his desire for control really became magnified. In the playroom next to the classroom we had a basket of plastic balls that the children liked to throw around. One day my client suddenly decided he hated the playroom and would become hysterical each time we entered. He would desperately grab his shoes and try to put them on so he could leave. When I asked him what was wrong he initially wouldn’t say but finally identified the problem as the balls getting stuck under the play structure. He wanted them in the basket and put away in an orderly fashion. The mess was unmanageable. During this time he also had an obsession with making sure the closet door was closed, the cabinets were all shut with locks fastened and no puzzle pieces were missing.

This desperate seeking of order at school seemed like a direct reflection of his inner conflicts. He was experiencing incomplete control of his bowels and this anxiety appeared to be manifesting itself in daily activities. Blum and Blum (1990) discuss the turmoil of the toddler during this phase of establishing autonomy and separateness in the world. I felt this article applied to Kevin because he had a dawning awareness of being his own person but also realized that person still needed a lot of help from adults tofunction in the world. The realization of not having complete control over one’s self can be highly frustrating and it did not surprise me that this manifested in the classroom. His mother told me he came home and said, “I went pee-pee on the potty with Alessandra.” This did not actually happen. It was a fantasy where he seemed to be working through his bowel control issues. It also informed me that he considered me a safe person to help him through this anxiety, even if it was just in fantasy. He also loved looking at the toilets, especially if another child was using it. Whenever I would attempt to actually take him to the bathroom he would insist that he didn’t have to go.

Clearly, Kevin and I did not sit down and talk about goals in such blunt language. In essence he was a “mandated” client and was going to stay in the classroom all year even if he didn’t want to. A goal that was beneficial to us both was to establish a secure attachment. His mother would not be in the room so I hoped for him to come to trust me. A hopeful side effect of this would be his ability to explore the classroom freely. Another big goal was to help him through his anxiety in the playroom. The agency and I were largely responsible for setting these goals. Kevin made his opinion clear in the way only a toddler can. De Cooke and Brownell (1995) discuss young children’s tendency to seek out help when they desire to “master” a challenge. The cues I got from Kevin were not always verbal. When he was at the pinnacle of anxiety and unable to verbalize what he wanted he was able to take me by the hand and point out the troubling situation. This is how I discovered the plastic balls getting stuck to be the cause of his distress. He also had a strong opinion about me being his attachment object, which I will discuss further.

His anxiety lessened considerably in the playroom as he progressed in potty training. Even though his joy was rekindled and the balls no longer frustrated him he would still tell me he was “very sick” and that he “hated the playground” before we entered the playroom. He would then either crawl into my lap or motion for me to pick him up. I don’t think it was coincidental that he would seek physical contact whenever this topic was broached. The stress of the incident was clearly imprinted in his mind. I think it may have been a comfort to verbally work through the residual feelings in close proximity to me. I would usually say to him, “You feel sick? What hurts? What part of you is sick?” or some variation on the theme. At first he would only say, “I don’t know” or “I am not sure.” One day his answered changed. He shook his head adamantly and insisted, “I am very very sick…Alessandra, when I am sleeping I miss you!” A few weeks later it hit me that this was not just a very sweet thing to say. I was working with a child desperately seeking order in his newly, somewhat, independent life. In his statement I heard echoes of the original themes that caused such angst. Where does the poop go? Where do the balls go? Where does Alessandra go? Why does she belong at school but not at my house? Later on the answer evolved into, “I miss you. I do not like sleeping.” Sleep is another common power struggle for toddlers. It felt like a logical addition to the equation. He seemed to be saying, “I do not get to control when I see you. I do not get to control when I sleep or what I think about when I am sleeping.” It appeared as though verbalization and exploration of categorizing helped him resolve some inner conflict and therefore meet our shared goals.

Play therapy was a wonderful aid in establishing a secure attachment and client directed relationship. I was also able to explore his positive transference towards me. I found his anxiety was lessened through working on ego functions, specifically reality testing and affect regulation. If I were working with adults in the context of psychodynamics then the method would be talk therapy. Through talk, adults establish rapport with therapists. Children do the same thing but in their language, which is, play. When Kevin became highly anxious it was a struggle not to absorb that anxiety. I would find myself getting lost in his feelings and wanting to “make it better”. This did not work and I eventually figured out that giving him space to experience his feelings (whatever they were) and then exploring his ego functioning afterwards was far more effective.

As mentioned before, this child was challenging to connect with in the beginning. He seemed to be functioning on another plane. Axline (1974) is adamant about letting the child lead the therapist into his world and not the other way around. If the therapist is too directive and makes various demands on the child, the relationship may be compromised. In the beginning of our relationship I would make too many demands on him. I insisted he sit for art projects or participate in circle time. It was not working and didn’t feel right. At this point rapport was nonexistent. I had him pegged as the stubborn, resistant one but in reality I was the one not listening. He didn’t like art but he loved trains. His favorite activity was building train tracks on the floor and running the wooden cars along the tops of the bookshelves so they were at eye level. Once I truly accepted that this was where my client was and he was doing exactly what he needed to be doing our relationship blossomed. Instead of resisting him I joined him and began to build train tracks alongside him, even if everyone else was at art. If he wanted to dance at circle time I complimented his dance moves and didn’t pull him onto the carpet. Slowly, he began to notice me.

Attachment is an extremely important part of a toddler’s life. From what I observed Kevin’s mother was extremely attentive to his needs and was able to share experiences with him. Holmes (1993) wrote a comprehensive article illustrating how a healthy therapeutic relationship shares many of the same elements of attachment theory. When I played with Kevin I tried to be mindful of his needs, as I had seen his mother doing. She set clear boundaries with him and allowed him to explore the world while remaining a comforting presence to return to. Through play my relationship with Kevin began to mirror the one he had with his mother. Over time I was able to recognize when he needed independence (getting puzzles from the shelf, climbing the play structure, and self soothing when he got physically hurt). Then there were other times when he needed my support (holding my hand in the hall, working through his quest for order and identifying unknown objects in the classroom). Once the boundaries of our relationship were clear and my behavior became predictable he was able to use me as a tool to explore the classroom more fully.

Bowlby (1988) noticed that children have an internal sense of who to go to for comfort. When the main attachment figure leaves the room a child will seek out another person who they believe will offer comfort. Bowlby’s theory is in keeping with the previous paragraph. I received much of Kevin’s mother transference since I was his second choice and replacement in the classroom. Children at this age are appropriately egocentric. It is very difficult for toddlers to understand that people do not all have the same needs and wants at the same time. Lyons-Ruth (1999) mentions the phrase “decoding another’s subjective reality” (p. 583). This refers to parent’s initial attempts to figuring out what their infant is trying to tell them through nonverbal communications. When an infant cries there is no definite way to know exactly what they are saying. Parents are constantly trying out solutions that will fit. Lyons-Ruth (1999) believes this trial and error and acknowledgement of not being able to read the child’s mind is an integral part of “coherent communication” (p. 583). Kevin exhibited a behavior that I assumed stemmed from these types of early developmental interactions with his mother that went hand in hand with the fact that he was not fully individuated from her. On multiple occasions Kevin would say things such as, “Alessandra, you don’t like this book at all” or “Alessandria doesn’t like John” (another child in the class). These types of statements embody a toddler’s egocentrism or inability to see others as independent thinkers. It also reminded me of what Lyons-Ruth discussed because before a child is verbal parents are constantly trying to guess at the child’s needs. The chance of guessing right is probably much higher if the parent is more attuned to the child. This may appear as a sort of omniscience to the toddler. If parents seem to know what is going on in a child’s head it may appear to offer support of all thoughts being the same. Also, children this young are just realizing the fact that they do not share the same body or mind as mother. Since he had mother transference feelings towards me it makes sense that it would be extremely difficult to tell where his thoughts ended and mine began. Whenever he made these statements I would acknowledge the fact that he was thinking about me but would also inform him of my true opinion. I would also tell him things like “people like different things” or “you may not like the book but I do.” Through our attachment bond I was able to test and expand his reality in small ways as well.

When Kevin first got upset about the balls all over the playroom I would try to soothe him by giving him a hug or other physical contact. This made him more agitated and he would lash out. I was at a loss of what to do. This incident repeated itself a few times. Eventually I remembered a case illustrated by Lenore Terr (2008). A child went into a hysterical tantrum in Terr’s office and nothing Terr could say or do would ease the child. Eventually, she stopped trying to talk the child down and went about her office tasks. Terr’s calm tolerance of her client’s emotions sent a message of unconditional acceptance. The next time Kevin melted into hysterics I sat a moderate distance away and told him I would be there if he needed my help and said nothing else. Ultimately, he tired himself out. He walked over to me and asked to go look at cars out the window in the classroom next door. I agreed. While we looked out the window he said, “Mommy is in an airplane, Mommy is in a car, Mommy is at the store.” Since he couldn’t see Mommy anymore it was a mysterious to where she had gone (Piaget 1954). In addition to unstable object permanence this statement came juxtaposed to the ball upset. It felt like just one more thing Kevin could not control. Since he had calmed down I figured it would be a safe time to question his reality a little further. I asked, “Do airplanes fly in the sky?” He nodded. “Is Mommy in the sky?” He thought for a minute and then said, “No! Mommy is not in the sky.” I reassured him that mommies always come back and didn’t his mommy always pick him up from school? He visibly relaxed after processing the familiar fact that Mommy did indeed pick him up everyday. It’s possible he had troublesome memories of his mother going on an airplane trip in his very brief past but I didn’t think it was the time to probe that deeply. I got the sense that the residual feelings from his intense upset caused his reality to become very chaotic and unmanageable for a brief amount of time. I wanted to help him see what was really happening in the outside world and not let the stress of his internal world make him doubt that.

Kevin displayed a desire for order and knowing things were in their proper place. In the classroom he would check the latches on the cupboards and close the closet doors before entering the playroom. These ceremonies paid homage to the order he so desperately sought. The world is a big place and small children cannot control all aspects so they construct rituals that are meaningful (and controllable) in order to become centered amidst the chaos (Feygin, Swain & Leckman 2006). Sometimes these rituals are not enough to ease the stress loss of control brings on. When the stress becomes too much children have an incredibly hard time regulating their affect. Their emotions get away from them. An incident that followed was similar to the previous scenario where Kevin struggled with object permanence and distorted reality. After we had looked at cars together I went over to drink from my water bottle. Kevin noticed and asked, “What are you eating, Alessandra?” We both noticed the mistake and laughed. Before this he was pretty calm, definitely not happy but managing. I was delighted to see him laugh and seized the moment to engage in some verbal world play. Johnson and Mervis (1997) explored humor development in children under 3 and would identify this type of verbal humor as “incongruent label jokes” (p. 190). Here children call things the wrong name but know what it is really called. I am unsure if Kevin labeled my drinking as eating on purpose or not but it then developed into a game that allowed for a lot of shared joy. I answered with, “Kevin! I am not eating! I am drinking…Why are you sleeping??” He laughed wholeheartedly and then said, “Alessandra! I am not sleeping! I am standing!” We went back and forth for a bit and when I assumed he was truly happy I took a risk and said, “Kevin, why are you crying?” I was afraid this would set him off since he had been in hysterics not too long ago. It happily had the opposite effect. He laughed again and said, “Alessandra! I am not crying. I am laughing!” Through play and humor his affect became regulated. The fact that he picked up the game so quickly and enthusiastically made me hopeful that he could carry the memory with him next time he was upset. This is clearly not something that happens overnight but if I could provide tools to help regulate his emotions, even after a huge upset, perhaps the lows would not be so overwhelming and scary. There is something comforting about knowing a way out of emotional turmoil.

The language barrier was an obstacle in the beginning of the year when Kevin would express himself only in Japanese. This was the time he began to hit out of frustration. As the year went on he began to master both languages. At times he will say things in Japanese to me. This has turned into a running joke as well. When he does this I will say jokingly, “Kevin, I still don’t speak Japanese!” Then I will throw my hands up in mock desperation, which he finds funny. This enables us to share a laugh. But I believe that it might also be a way of Kevin working through his original stress of not being able to communicate with me. Only now that he has the mastery of two languages can he make a joke out of it. It reminds me of children who master potty training and then enjoy potty humor. A previously stressful situation suddenly turns hilarious once conquered.

Working with this child gifted me many takeaways for future work. We were capable of establishing a strong therapeutic bond within the classroom setting. Once I was able to put aside my own anxieties and expectations, Kevin was free to truly ask for what he needed to flourish. Play became our shared language and allowed me to join in on the inner workings of his developmental challenges. It was gratifying to see how much progress Kevin was able to make once he began directing the play and I began following his lead. Arriving at this place of acceptance permitted me to wholeheartedly experience shared joy with my client.

References:

Axline, V. M. (1974). Play therapy. New York, NY: Ballantine Books .

Blum, H. & Blum, E. (1990). The development of autonomy and superego precursors.

International Journal of Psychoanalysis. 71, 585-595.

Bowlby, J . (1988). A secure base: parent-child development and healthy human development. Great Britain : Routledge.

De Cooke, P.A., & Brownell, C.A. (1995). Young children’s help-seeking in mastery-oriented contexts. Merrill-Palmer Quarterly: Journal of Developmental Psychology. 41(2), 229-246.

Feygin, D.L., Swain, J.E., & Leckman, J.F. (2006). The normalcy of neurosis: Evolutionary origins of obsessive- compulsive disorder and related behaviors. Progress in Neuro-Psychopharmacology and Biological Psychiatry. 30, 854–864.

Holmes, J. (1993). Attachment theory: A biological basis for psychotherapy? British Journal of Psychiatry, 163, 430-438.

Johnson, K. E., & Mervis, C. B. (1997). First steps in the emergence of verbal humor: A case study. Infant Behavior and Development. 20(2), 187-196.

Lyons-Ruth, K. (1999). The two-person unconscious: Intersubjective dialogue, enactive relational representation, and the emergence of new forms of relational organization. International Journal of Psychoanalysis. 19, 576-61.

Piaget, J . (1954). The construction of reality in the child. Great Britain: Basic Books Inc.

Terr, L. (2008). Magical moments of change: How psychotherapy turns kids around. New York, NY: W.W Norton and Company, Inc.

Family Environment and Children’s Behavioral Disorders

This contribution is from Martha Nodar, who earned a $100 gift certificate to childtherapytoys.com. Learn how you can do the same!

Family Environment and Children’s Behavioral Disorders

Confounding influences such as family environment may have a significant role in children’s disruptive behaviors at home and at school, which may continue and worsen by the time they reach adolescence (Green & Gibbs, 2010). Green and Gibbs (2010) are referring to parental discord, divorce, neglect, verbal abuse, corporal punishment, parental substance abuse, and poor or inconsistent parenting skills as examples of family environments conducive to children’s disruptive behaviors. Poor or inconsistent parenting skills may include subscribing to an unreliable disciplinary paradigm, such as disciplining the child according to the parents’ mood at the time. Green and Gibbs (2010) also include “harsh punitive discipline,” such as “scolding, spanking, restraining, grabbing” (p. 227) as triggers of disruptive behaviors in children. However, they cite “humiliation or contempt” (pp. 227-228) as the types of abuse responsible for inflicting the most psychological damage in children and the antecedent of most disruptive behaviors. This paper advances the current literature by offering a perspective on different forms of intervention and the implications for school counselors and therapists.

Social impairment is the hallmark of behavioral disorders, which may encompass shouting at teachers or parents, kicking siblings or classmates, and the inability to play with peers. Green and Gibbs (2010) argue that “repressed hostilities and rage” (p. 226) as the result of perceived deficits in nurturing may be the underpinning driving the children’s disruptive behaviors. These scholars suggest that most of the time disruptive behaviors emerge during the preschool years when the children come in contact with their peers. Drawing from their experience, Green and Gibbs believe there is a relationship between how children may behave with others and the type of attachment they may have formed with their primary caregiver, who in many instances may be the mother (Bowlby, 1988). Insecure attachment (avoidant or withdrawn), elicited by perceived inconsistent care, tends to trigger children’s reliance on “primitive structures” such as kicking and screaming, rather than using social skills (Green & Gibbs, 2010, p. 228).

Based on a 2012 study that Duncombe, Havighurst, Holland and Frankling conducted with 373 children between the ages of 5 and 9 years-old, they found that parents’ mental health; a habit of dismissing their children’ s emotions such as sadness, “inconsistent parental discipline and corporal punishment are associated with the development of serious problem behavior” (p. 728). In particular, inconsistent parental discipline is the one especially correlated to disruptive behavior disorders. When these disruptive behaviors continue to escalate as preschoolers start grade school, some children may be diagnosed with Attention Deficit/Hyperactivity Disorder (ADHD). Attention Deficit Disorder (ADD) is usually the diagnosis given to children with mild ADHD. Leisman et al. (2010) cite ADHD as “the most common neurobehavioral disorder in childhood” (p. 283). Inattentiveness, being easily distracted, unable to sit down for any period of time, social impairment, and physical impulsivity are some of the characteristics found in both ADHD and ADD. These characteristics range from mild to severe in both ADD and ADHD depending on where they may fall in the spectrum.

Pfiffner,McBurnett, Rathouz, and Judice (2005) argue that disruptive behaviors in children with ADD/ADHD are likely to be not only triggered but also exacerbated by family dynamics. In order to find support for their theory, Pfiffner et al. (2005) assessed 149 children between the ages of 5 and 11 years-old who had been diagnosed with ADHD, and their parents. Grounded on their findings and in agreement with some of Green and Gibbs’ (2010) arguments, Pfiffner et al. cite paternal antisocial behavior; punitive or inconsistent parenting style, and lack of parental warmth in their interactions with their children, as examples of a family environment that may precipitate behavior disorders in their offspring with or without ADD/ADHD.

Although disruptive behaviors are a symptom of ADD/ADHD, not all children with disruptive behaviors have ADD/ADHD. Recent research points to the notion of a behavioral continuum range where normative behaviors of young children are found at one end of the behavioral landscape, and those behaviors that fall outside the normative range are clustered toward the opposite end of the spectrum. In a pioneer study, Wakschlag et al. (2007) examined the quality of behavior of preschoolers (the pervasiveness, intensity and frequency of the behavior) to determine what they refer to as “clinical discrimination” (p. 976). This means, for clinicians to have the ability to discern what falls inside or outside the normative range of behaviors observed in young children.

Download the entire article here.

Examining Separation Anxiety Disorder in Children

This great research paper on separation anxiety comes from Martha Nodar. Martha received a gift certificate to childtherapytoys.com for her submission. (And so can you!)

Some young children show signs of anxiety when separated from their parents for any period of time.  Mohacsy (1976) argues that children go through a process of slowly separating from their mother or primary caregiver, and begin to form their own individual self beginning approximately around “five months” and completing the process by “the third year of life” (p. 501).  Perez-Olivas, Stevenson, and Hadwin (2008) argue that separation anxiety disorder is one of the most common childhood disorders, particularly in children who are younger than 12 years old.  As described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR, 2000), Separation Anxiety Disorder (SAD) (309.21) refers to pervasive and intense feelings of anxiety experienced as the result of being away from a familiar and primary caregiver especially after the third birthday.  

In most cases, the attached caregiver is the mother (Allen, Blatter-Meunier, Ursprung, & Schneider, 2010).  In order for the level of anxiety—as the result of the separation from the mother—to be categorized as a disorder, the manifested symptoms must meet certain criteria: feelings of anxiety must be above and beyond what is expected for the child’s developmental age, and must result in significant academic, social, and occupational impairment (DSM-IV-TR, 2000). Children who suffer from SAD are often diagnosed by health care practitioners when their behaviors start hindering their cognitive, social and academic skills.  It is worth mentioning that typically, children who are diagnosed with SAD as their primary disorder fall within the range of normative cognitive abilities.  Some children with special needs may have symptoms in similarity with SAD as the result of the comorbidity with their primary diagnosis, but SAD is not their primary diagnosis.  Multiple empirical studies have found a high correlation between a child’s development of SAD and maternal anxiety.  

How SAD Manifests

Manifestations of SAD in children younger than 16 years old may include an excessive insistence in knowing where the caregiver might be; constantly making telephone calls trying to get in touch with the attached important figure, and preoccupations with thoughts of death, accidents or illness of the caregiver and the idea that they may never see that person again (Dallaire & Weinraub, 2005).  Children who suffer from SAD may also worry about what possible harm may come to them in the absence of their mothers. Depending on their age and development, symptoms of SAD may manifest through the children’s inability to play in a room by themselves, avoiding visiting friends, struggling to focus on anything else, having nightmares, difficulty either falling or staying asleep, stomach problems such as nausea and vomiting, and having palpitations at the thought of being away from their mothers (Allen et al., 2010).  Although for many children these feelings of intense anxiety may start subsiding after they turn three years-old, for others, the intensity of the separation may continue or even worsen through the years (Dallaire & Weinraub, 2005).  These feelings may manifest in different ways depending on age, personality and circumstances bringing the scholars to research what may be the etiology of SAD.

Etiology of SAD

Recent research points to the notion that SAD may be triggered by a sequence of events that may begin during fetal development. Development refers to those changes occurring in collaboration with both heredity (nature) and the environment (nurture) (Santrock, 2011).  Fetal development involves changes that may happen to the fetus in the womb—which is considered part of the environment. Maternal stress during pregnancy, such as worrying about caring for a child, or having second thoughts about becoming a parent,  experiencing feelings of inadequacy about raising children, or apprehension about the relationship mothers may have with the father of their babies, are all environmental factors that may play a role in fetal development (Santrock, 2011).  In agreement with Santrock (2011), Lavallee et al. (2011) emphasizes that “maternal stress seems to influence . . . hormonal reactions and blood flow to the uterus influencing the development of the hypothalamic-pituitary adrenal axis in the fetus” (p. 355). 

Considered a major part of the neuroendocrine system, the hypothalamic-pituitary adrenal (HPA) axis is responsible for producing hormones, which are carried into the blood stream (Carlson, 2004).  The HPA axis facilitates a flow of communication and feedback between the hypothalamus (a structure in the brain responsible for stimulating hormones) and the pituitary gland (responsible for releasing hormones). The hypothalamus produces corticotrophin-releasing hormone (CRH) and delivers it to the adrenal glands where it is metabolized and secreted into the blood stream as cortisol, which helps the body adapt to stress (Carlson, 2004). These actions occur in consonance as the brain’s prevailing function is to balance itself.  

An over production of cortisol (by the adrenal glands) due to stress would inhibit both the hypothalamus and the pituitary gland from producing hormones. This means, the body’s natural resources (homeostasis) would be highly compromised. In other words, the extensive exposure to stress may render an individual’s nervous system inadequately prepared to cope with stress long term (Lavalle et al., 2011). A fetus consistently exposed to the over secretion of stress hormones as described above is more likely to be born with a susceptible nervous system. This is what it is called genetic predisposition, which begins in the womb and is impacted by the mother’s own level of anxiety during pregnancy (D’Amato et al., 2011; Lavallee et al., 2011).  Based on this data, D’ Amato et al. (2011) claim that the mother’s own anxiety is likely to play a major role in her children developing symptoms of separation anxiety. 

Arising from a similar paradigm, Perez-Olivas et al. (2008) claim that neuroticism (a personality trait), may be the mediating variable underpinning the mothers’ unconscious (out of conscious awareness) motivation to enhance their children’s propensity toward separation anxiety. Neuroticism shows up as emotional instability in interpersonal relations (Perez-Olivas et al., 2008). Feelings of shame, anxiety, guilt, low self-esteem typically accompany neuroticism.   In a move to seek evidence for their theories, Perez-Olivas et al. conducted an empirical, quantitative study in Britain with 129 children between six and 14 years of age and their mothers. Whereas the Revised Child Anxiety and Depression Scales-Child Version (2000) was the tool these researchers used with the children to assess symptoms of depression consistent with the DSM-IV-TR, the Five Minute Speech Sample was the tool applied to mothers to assess maternal over involvement and “self-sacrificing/over-protective behaviors” (Perez-Olivas, et al., 2008, p. 512).  Drawing from their findings, Perez-Olivas concluded that mothers with a propensity toward neuroticism also have a tendency toward anxiety—a major component of neuroticism.  Motivated to seek relief for their anxiety, mothers with this propensity tend to be overprotective of their children.  Overprotection “has been associated with enhanced levels of childhood separation anxiety” (Perez-Olivas et al., 2008, p. 510). 

Augmenting Perez-Olivas et al.’s (2008) arguments, Mills et al. (2007) propose that parental overprotection is not a sign of nurturing, but rather shows a tendency toward exerting psychological control over the children, which seems to be triggered by the parents’ own psychological instability.  It is important to distinguish between parental concern that falls within the normative range, and compensatory dysfunctional behavior, which is focused on the parents and attempts to mitigate the parent’s anxiety.  Parental overprotection is about protecting the parents from feelings of inadequacy, not about protecting the children (Mills et al., 2007).  By excessively worrying about their children’s safety (outside the normative range) the parents may be trying to cope with their own feelings of shame by shifting focus to their children (Mills et al., 2007).

Bradshaw (1988) defines this type of shame as “toxic shame” and suggests that toxic shame may be the cardinal feature of pathological behavior (p. 10).  Parents functioning within a toxic-shame framework are likely to view their children’s imperfections as a reflection on themselves and may unconsciously resent them as the result (Mills et al., 2007). Although some fathers may also overprotect their children, mothers are the most likely parents with that tendency.  Freud (1965), the founder of child psychoanalysis, emphasizes that “some mothers assign to the child a role in their own pathology and relate to the child on this basis, not on the basis of the child’s real needs” (p. 47).

Maternal Overprotection

In agreement with Freud (1965) and Mills et al. (2007), Levy (1943) argues that parental overprotection is most likely a futile attempt at protecting the parent from feelings of shame and guilt.  Levy’s operational definition of maternal overprotection includes the mother’s excessive interaction with her child to the point of preventing the child from developing as an independent person while trying to keep the child in an infantile state for as long as possible.  Levy categorizes a mother’s tendency toward overprotection of her child as falling under the realm of obsessional neurosis. Obsessional neurosis was a term first used by Freud (1926) early in his career.  Admitting being somewhat mystified by it, Freud suggests that the goal of obsessional neurosis is to ultimately prevent conscious awareness of unacceptable thoughts related to the past in a futile attempt to avoid or mitigate feelings of anxiety.    

In concert with Freud (1926) and while studying the mothers’ own histories and family of origin, Levy (1943) detected negligence, lack of emotional support and nurturing deficits in the way these mothers were raised themselves. These findings led Levy to suggest the probability of a multigenerational impact of insecure attachment in the family system of overprotective mothers. In other words, the mother’s tendency toward overprotection of her child may have begun long before the mother became pregnant with her child. Some researchers such as Dallaire and Weinraub (2005) argue that “Bowlby’s theory of attachment provides a theoretical framework to understand the etiology of separation anxiety” (p. 394).  

Bowlby’s (1969) attachment theory may shed light on the multigenerational effect of compromised attachment suggested by Levy (1943), and Dallaire and Weinraub (2005).  Dallaire and Weinraub assert that the type of attachment (secure vs. insecure) within the parent-child dyad is a good indicator of whether or not there is a presence of SAD observed in the children’s behavior. Attachment refers to the emotional bond infants tend to develop with their primary caregivers, which may have a tendency toward secure or insecure with both dynamics existing on a continuum (Bowlby, 1969).  Insecure attachment may include anxious, avoidant, and ambivalent bonding for the most part.  Insecure attachment manifests itself as either absent or inconsistent emotional availability to significant others in one’s life most of the time (Bowlby, 1969).  

Driven to investigate the probability that a child may develop SAD as the result of an insecurely-attached parent-child dyad, Dallaire and Weinraub (2005) led a longitudinal, quantitative, empirical study in an effort to isolate the predictors of SAD by the time the child is six years old and ready to start school. Dellaire and Weinraub recruited 95 participants of diverse ethnic and educational backgrounds including Caucasian, African-Americans, Hispanic-Americans and Asian-Americans mothers who had just given birth.  Their study began when the children were one month old followed by a regular schedule until the children were six years old.  As a corollary, in addition to observations in the children’s and mothers’ natural environment, the researchers used the Strange Situation procedure (Ainsworth & Bell, 1970) with the mothers.  Mothers of infants completed the Infant Temperatment Questionnaire.  The Child Puppet Interview was used with the children when they reached the age of six years old.   

Based on the results, Dallaire and Weinraub (2005) concluded that “infant-mother attachment insecurity during infancy predicted elevated levels of separation anxiety at age 6 years” (p. 403).  Furthermore, these researchers contend that their findings are “consistent with the literature linking” SAD in children with unresponsive childcare from the primary caregiver (Dallaire & Weinraub, 2005, p. 404).  Unresponsive childcare means the caregivers fail to appropriately and consistently meet the children’s needs most of the time (Bowlby, 1969). This data is significant because most children start attending school when they are six years old.  Refusing to go to school may become problematic and thus, may prompt parents to bring the child to a healthcare practitioner for assessment unaware of their own role in their child’s separation anxiety disorder.

Assessing/Diagnosing SAD

There are a number of instruments used to assess SAD, such as the Multidimensional Anxiety Scale for Children; the Screen for Child-Related Anxiety Disorders, the National Institute of Mental Health Diagnostic Interview for Children and Youth, and the Revised Child Anxiety and Depression Scales-child version. These tools are self-reports given to children in an attempt to assess the presence, degree, and intensity of the minors’ anxiety level as the result of being separated from their primarily attached caregivers. When children are too young to answer the questionnaire, the parents are then given the Revised Child Anxiety and Depression Scales-parent version to answer questions on behalf of their children.  

Striving to gain a better understanding of the children’s phenomenological response to the separation from their mothers, Allen et al. (2010) designed an anxiety daily diary for children over eight years old called Separation Anxiety Daily Diary-children version which assesses whether the children’s SAD may be triggered by the parent-child separation.  To test the efficacy of this instrument, Allen et al. (2010) conducted an empirical, quantitative study using descriptive data with 58 European children ages ranging from seven to 14 years old.  Allen et al. were eager to implement this tool to compensate for what they believe to be a low agreement rate between the older children’s self-reports on separation and anxiety and their mothers’ self-reports on their perception of their children’s separation anxiety.  Freud (1965) emphasizes on the importance of assessing both the mother and her child to discern the mother’s “pathogenic influence on the child” (p. 46).  Allen et al. concluded based on their findings, that for the most part, the children’s compliance with their daily diaries was high enough for the data to be useful to their hypothesis, which shows a correlation between the mothers’ anxiety and their children’s propensity toward SAD.  Once an assessment has been completed, the next step is usually intervention.

Treatment

For the treatment of SAD to have an opportunity to be successful it must encompass treating both the primary caregiver who tends to be the mother, and her children.  Freud (1926) argues that the first line of treatment for modifying adult personality traits, such as neuroticism must involve a psychoanalysis-based intervention.  Psychoanalysis is a type of insight-oriented therapy grounded in intellectual understanding and emotional acceptance.  Furthermore, the prevailing agenda of psychoanalysis is to bring the unconscious material to conscious awareness, which is expected to produce resistance in clients. Resistance is particularly expected from those who engage in toxic-shame.

Freud (1926) argues that “resistance presupposes. . . anticathexis” (p. 83).  This means that resistance is rooted in the individual’s investment of psychic energy in self-serving biases, such as self-deceptions.  Self-deceptions are the basis of a client’s defense system, which may be activated to preclude early experiences from reaching consciousness (Freud, 1926).  Parents may be motivated to keep themselves from learning the role they may be playing in their children’s SAD.  Treating the child’s SAD and the parent’s propensity toward anxiety and self-deception may also include sandplay therapy as a complement to psychoanalytic-based treatment.

Sandplay Therapy

Compelled to find a way to address the human tendency toward self-deception, Jung (1954) introduced the creative arts into his practice in an effort to by-pass the propensity of clients to self-edit their stories. A form of creative arts that is gaining momentum both with children as well as with adults is sandplay.  Coined by Jungian analyst Kalff (1980), sandplay is a form of play therapy using a tray with sand and analyzing the play under Jung’s (1954) theories.  Sandplay may be used with adults and children six years old and older.  Sandplay is nondirective, intuitive, metaphorical, and focuses on the sandplayer’s internal processes which are believed to be enacted in the sand (Bradway & McCoard, 1997).  

Sandplay therapy involves the sandplayer creating a scene in the sand and having the opportunity to express feelings about the scene. Depending on the miniatures used, the location of the figurines, and the sandplayer’s nonverbal communication, the counselor may begin to form conjectures in regard to what may be happening in the sandplayer’s internal world.  Bradway and McCoard (1997) argue that the entire tray represents the sandplayer’s unconscious. The sand itself represents a safe haven and facilitates the process (Bradway & McCoard, 1997).  Bradway and McCoard (1997) submit that children, especially boys who are between six and eight years old tend to use animals, especially prehistoric animals, such as dinosaurs, in their trays.  Riveting with metaphors, a crocodile, for example, when placed in close proximity to another, more gentle miniature representing the child, may symbolize a child’s perception of a devouring mother (Chevalier & Gheerbrant, 1969).  Any depicted towers in the sand may represent anger (Bradway & McCoard, 1997).  It is worth noting that while Sandplay and Sandtray may be used interchangeably, there are important differences. Sandplay was developed by Kalff (1971), and Sandtray was developed by Lowenfeld (1939). Sandplay is based on Jungian’s theories. Sandtray may be used applying  Jung’s approach, and also the humanistic, and the cognitive –behavioral approaches, or an eclectic integration.     

Discussion

Empirical data presented herewith points to the notion that mothers who engage in overprotection may feel inadequate for reasons of their own that date back to their own childhood in their family of origin.  Intervention offers parents an opportunity to consciously acknowledge and begin to heal their early wounds. Findings presented in this paper have implications for marriage and family counselors. It is incumbent upon these counselors to dig deep into the parent-child dyad and not simply accept what they may find at the surface—the presenting problem may be a disguise of the real problem in the family.  

References:

Ainsworth, M., & Bell, S.  (1970).  Attachment, exploration, and separation: Illustrated by the behavior of one-year-olds in a strange situation.  Child development, 41, 49-67.

Allen, J., Blatter-Meunier, J., Ursprung, A., Schneider, S. (2010).  The separation anxiety daily diary: Child version: Feasibility and psychometric properties.  Child  Psychiatry and Human Development, 41(6), 649-662.

American Psychiatric Association (2000).  Diagnostic and statistical manual of mental disorders, 4th edition, text revision. Washington, D.C.: American Psychiatric Press, 121-124.

Bowlby, J.  (1969).  Attachment and loss.  Vol. 1: Attachment (2nd ed.). New York, NY: Basic Books.

Bradshaw, J.  (1988).  Healing the shame that binds you.  Deerfield Beach, FL: Health Communications.

Bradway, K., & McCoard, B.  (1997).  Sandplay – silent workshop of the psyche.  New York, NY: Rutledge.

Carlson, N.  (2004).  Physiology of behavior (8th ed.).  Boston, MA: Pearson Education.

Chevalier, J., & Gheerbrant, A.  (1969).  Dictionary of symbols.  Buchanan-Brown, J. (trans.) (1994).   New York, NY:  Penguin Books.

D’ Amato, F., Zenettini, C., Lampis, V., Coccurello, R., Pascussi, T., Ventura, R., Puglisi-Allegra, S., Spatola, C., Pesenti-Gritti, P., Oddi, D., Moles, A., & Battaglia, M. (2011). Unstable maternal environment, separation anxiety, and heightened CO2 sensitivity Induced by gene-by-environment interplay.  PLoS One, 6 (4), 1-11.

Dallaire, D. H., & Weinraub, M.  (2005).  Predicting children’s separation anxiety at age 6: The contributions of infant-mother attachment security, maternal sensitivity, and maternal    separation anxiety.  Attachment & Human Development, 7 (4), 393-408.

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Homeyer, L., & Sweeney, D.  (2011). Sandtray therapy: A practical manual (2nd ed.).  New    York, NY: Rutledge

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Quantifying the Success of Play Therapy Intervention

Play Therapy UK recently released the results of a ten-year research program aimed at an estimate of the effectiveness of play therapy intervention. The report is called ‘An Effective Way of Alleviating Children’s Emotional, Behaviour and Mental Health Problems – the Latest Research’ and it’s comprehensive approach and important results make it well-worth mentioning in a blog post. With useful charts and uncomplicated language, the report sheds light on the impact play therapy intervention is having on the lives of individuals receiving the therapy, as well as society as a whole.  As you will read, the results are encouraging, showing a 74-83% positive change in children referred for the therapy. It also considers such factors as age, gender, length of treatment, type of treatment (group, sand tray, puppets, etc.), and nationality. It even does a cost-benefit analysis of play therapy, analyzing the money put into play therapy programs and the return received by society. This is a must-read for any practitioner. What do you think of the results? Share your opinions in the comments section.

Small Objects that Affect Big Change: How Art Materials Can Shift Family Dynamics

This submission comes from Alessandra Longo, LMSW, MA. It’s a beautifully-written account of one of those moments that makes the job of a child therapist so fulfilling. Alessandra received a childtherapytoys.com gift certificate to childtherapytoys.com for her submission. (And so can you!)

My five-year-old patient picked a scrap of ribbon off my desk. She wound the bright pink fabric tightly between her petite fingers. “I want this in my hair,” she told me. Longing clung to the delicate features of her face.

I was thrown. This child had never made a direct demand on me before. Expressing desires openly appeared to be treacherous territory. Normally she slid comfortably into the role of cautious explorer. Her eyes would stay glued to my face as she picked up a paintbrush or caressed a baby doll. I sensed her apprehension was linked to the anticipation of a punitive response from me.

My office served as a direct contrast to her home life. For 45 minutes a week she was spared the squabble and noise that accompanied multiple siblings crammed into a small apartment. Attention was focused solely on her and my patient was ambivalent. I naturally began to take on a mother-like transference throughout the treatment. Unlike my patient’s mother, I did not respond to her actions with anger or indifference. The young girl met my encouragement with scrutiny. A celebratory approach towards her endeavors in the therapeutic relationship clashed dramatically with what she had known in the past. This dissimilarity of attitudes towards attachment made trusting me in the room extremely difficult.

Excited to show my patient that I was happy to fulfill her request I grabbed a baby doll from the shelf to demonstrate how I would tie the ribbon in my patient’s hair. Her face immediately fell and she said with resignation, “Just give it to the baby.” Sadness overwhelmed me as I realized I had disappointed her by acting just like everyone else. Inevitably, I too would realize her desires were too much and she would end up empty handed.

I prodded the emotional chasm between us with a few words. “Does this happen at home? Do you feel like the babies get everything?” She nodded lethargically. I fully took in the tiny child standing in front of me. She wore a pair of her sister’s hand-me-down pants that were falling off her narrow hips. Her face looked like her mother’s and she told me she was the same color as her father. I realized I had many shards of a personality in front of me but which parts belonged only to my patient?

“I don’t want to give this ribbon to the baby. I want to give it to you. You are the only person I am playing with right now.” My words did not reach her immediately but after a few moments she came and sat close to me. “Can you tie it like a bow?” she asked softly. “Of course I can,” I replied. We sat together on the floor. I hoped this moment would stand out as vividly to my patient as the neon ribbon tenderly secured to her dark tresses.

Latino Childhood Sexual Abuse: A Multicultural Approach to Treatment

Our thanks to Rebecca A. Lund, Saint Mary’s University of Minnesota, Schools of Graduate & Professional Programs for this paper.

Abstract:

This paper is a summary of the author’s clinical experience relevant to the literature on cultural complexities in belief and value systems in the Latino community regarding CSA. In the literature review, she provides a definition of CSA and discusses the prevalence, symptoms, and risk factors associated with this occurrence in the Latino population. Interventions are presented that contain elements of traditional therapeutic techniques that demonstrate how to use them in a culturally sensitive manner. The benefit of approaching therapy from an ecological perspective to coincide with the Latino culture’s centric family-focused structure is discussed.

Click here to read the remainder of this paper.