Play Therapy and Curing Child Abnormality

This article throws light upon the top two approaches of play therapy for curing child abnormality. The approaches are: 1. Directive Approach 2. Non-directive Approach.

Play Therapy: Approach # 1.

Directive Approach:

The approach is directive when the therapist decides what material (dolls, or other play material) to use, what plot to adopt, what questions to ask—when to ask and how to ask.

Besides this, the therapist performs the following activities:

i. Systematically observes the play;

ii. Reports what day dreams or dreams the child is having;

iii. He so organises the situation that the child may have a free association with the therapist;

iv. Has a direct discussion with the patient (child) whenever situation permits, and he deems proper.

While observing the child at play, he always remains cautious to be assured that the play is developing on desired lines, and no hindrance is likely to be there. He observes the changes coming over the face of the child, indicative of the dreams passing through his mind.

While the play is going on, he finds out occasions when he should ask questions to the child to know more about the feelings and emotions that are evoked by the different situations in the play—it is through the answers of the child thus elicited that he can have a better understanding of the problem of the child.

Directive play technique, more than other techniques, makes use, at least partially, of the theory and procedures of the psychoanalysis school of psychology. This technique demands controlled and standardised situations.

If the main problem in a family is that of sibling rivalry, and, the patient (the child) is a prey of the same, the therapist encourages the child to play with the plot, and may supply more actors and scenes if for the fulfillment of the objective, it is so needed.

The objective in such a controlled play is always the release of pent up feelings or emotions, as he has always been too afraid to give vent to the same. This is why its leading exponent has called it “release therapy”. While playing with the actors of the play, he would express his grievances which he may have harboured against any of his siblings or any of his parents, or against any of his peers or teachers.

The therapist, thus, provides an occasion for releasing severe anxiety, fear, reactions or night terrors which may have been precipitated by traumatic experiences such as death or divorce of a parent, some surgical operation or so on. David Guy suggests that this technique should not be used in case of a child older than ten years.

I have often seen the newly admitted nursery or kindergarten students playing ‘sir’ or ‘madam’. While thus playing, a child who is greatly fearful of his ‘sir’ or ‘madam’, would give vent to his suppressed feelings regarding him or her.

The “sir” or “madam” may be very rough or harsh, and may have rebuked and even beaten the child; the child because of fear may not be able to express his resentment otherwise. Such feelings of his, the child may express in the free atmosphere of the play.

On the release of his repressed feelings, the child feels much relieved, feels to have got courage to face the situation. Thus, the play therapy helps in the restoration of emotional health. Though in such £in instance if there are no directions from the side of the therapist, and the children are fully free to behave in their own way, the technique would be called as Non-directive.

We are taking another instance of Directive Approach to illustrate how a therapist may provide a situation for the “release” of the suppressed feelings. Suppose there is a child who, generally, remains sad, he hardly ever smiles; he has lost his hunger also. He seems to be growing weak in body.

Such a child would grow neurotic, and if timely therapy is not provided, the case may become chronic when the child grows older as adolescent or adult. The father of the child is responsible for a development of this sort.

He is very strict and non-feeling, he is not sensitive to the feelings of his young child. Whenever the child seeks permission to go out and play with his peers, he gets only a threatening rebuke along with refusal. The poor child may only be: looking at his peers playing their evening games, while himself sitting in his balcony, wearing a long face.

The therapist provides dolls as material. The actors would be a father and his son. Then, there would also be dolls of small size which would be like the peers of the son, with whom he would like to play. But on the Stage there are brought a number of small dolls; there is a ball which each one of them is kicking now and then.

Now, the therapist asks the patient:

T. (Therapist): Who are on the stage?

P. (Patient): There are a number of boys (dolls).

T. What are the boys doing?

P. They are playing.

T. Do you also like to play?

P. Yes, I do.

(Then there is presented a bigger doll on the stage with its face very serious or expressing anger.)

T. Who has come now?

P. A father (expected answer.)

(The bigger doll takes hold of the arm of one of the playing dolls, and pulls the same away).

T. Who is this that has come now?

P. He is also a father.

T. What is he doing?

P. He is looking at the boys play.

T. What kind of father is he?

P. He is good.

T. Why is he good?

P. He allows his son to play.

In this way the therapist may ask more questions to elicit the repressed feelings or emotions of the child whose main cause for problem is the refusal to him for play by his very strict father. If the therapist deems it easy to arrange a set of pictures, and use the same, he may use the same in place of dolls.

Some such sets of pictures may be kept ready in the clinic for the diagnosis and treatment of such a common abnormality as neurosis is. Alternatively, the therapist may orally make the child open his mind in response to the appropriate questions asked by him.

But for it, first, a very close rapport has to be established with the child; the child needs to be made free of fear in exposing his pent up feelings; otherwise, he may choose to keep mum, or, may just evade by making any response which is not a sincere one.

This is why projective method is better where unfinished pictures are displayed by turn, and the child would express his mind when asked to tell what he is seeing in the picture, and what type of person has been represented in the picture, and so on.

Such a therapy may be needed to be applied for either of the parents when one of them is the cause for the trouble of the child. David Guy writes, “… to a child suffering from the results of maternal rejection or overprotection … mother is the exclusive object of therapy.”

Active Play Therapy:

Active play therapy as a controlled method has also been suggested by Solomon. The therapist asks parents to give freedom to the child to express his feelings without fear.

Solomon gives the example:

T. (Pointing to a doll) How does the boy (doll) look like?

C. It is sad (angry, and so on).

(The therapist may ask questions to elicit the child’s reactions to a particular situation).

T. What would you do in such a situation?

In response to such questions, the child would be unfolding himself. This will help him in a better understanding of himself. It will give him self-confidence. His behaviour would improve after going through a series of such a play. The therapist would thus be able to pinpoint the nature of the problem, and would be helping the patient in being cured of the same through his own behaviour.

The patient (child) himself may be now having an understanding of the problem or conflict with more confidence in himself. He begins to be less fearful of his hostility and guilt because he has been allowed to express them in a permissive and unthreatening situation. Direct suggestions as, “you don’t have to feel badly about that” (Solomon) may also be used to help the child.

Play Therapy: Approach # 2.

Non-directive Approach:

Under this approach, the therapist provides altogether a free situation to the patient (child) where he can express his feelings and emotions with no fear of being rebuked, criticised or otherwise punished, nor of being considered guilty by others and by even himself.

The approach is non-directive when the therapist gives no direct suggestion, he allows the child to do or say anything he wants. The behaviour of the therapist remains friendly and interested throughout. Alert, of course, the therapist remains all the time the therapy is being carried out so that his observation may be thorough, and he may indicate his acceptance or understanding of the behaviour of the child.

The therapist is alert to note what the child is expressing in the play or in his conversation. Axline writes, “The child is given the opportunity to play out his accumulated feelings or tension, frustration, insecurity, aggression, fear, bewilderment and confusion”.

When the pent-up feelings have been brought out, the child feels relaxed emotionally. Now, he can see what the trouble is. He can now control them or, can abandon whatever is not desirable. He “begins to realise power within himself to become an individual in his own right”. He can think for himself, he can make his own decisions. Psychologically he is more matured, and is in a position to realise self-hood.

In the play therapy-room the child is the most important person. He feels himself fully secured, is in command of himself, and of his situation. There is no one here to suggest him anything, none to criticize him. He is fully accepted by others.

He feels “here he can unfold his wings; can play in any way he likes, and is accepted completely. He can hate, love or be indifferent as a stone, still he is accepted completely. It is a unique experience for the child to find all adult suggestions, mandates, rebukes, restraints, criticisms, disapprovals, supports, intrusions—gone. They all are replaced by complete acceptance and permissiveness to be himself.”

For the therapist, and for the parents, too; it may be a unique experience to find the same child so active, so progressive, so open and so happy, who otherwise—in the highly restrained situation—behaves so recalcitrantly. The child, who appears so problematic when parents bend upon disciplining him through strictness, and through showering upon him a lot of didacticism, starts behaving pliantly.

Change in the behaviour of the child would not be sudden, only gradual; as the unfolding of the child would continue, he would be improving. Excess of his shyness, fear, anxiety, frustration, jealousy, anger all will be cured as the child would be releasing out all these emotions in the hot, unrestricted pursuits of his game.

The spontaneous play technique is, especially, useful in case of children with longstanding neurotic traits. It is a very effective treatment. Let the child play freely in his own way—he may run, kick at a ball, jump, and cry, push his peer, pull someone or something—no restraint is advisable unless any harm is likely to be caused. This is non-directive play therapy.

The therapist observes and notes which of his repressed feelings or emotions are getting a chance to be expressed: how they are expressed, and what changes come about in the behaviour of the child because of such an emotional relaxation.

The children who are “inhibited, repressed, extremely hostile, excessively timid or overly ridiculous” are most likely to be benefited. The child, under his changed mental state, can adequately deal with previously upsetting situations. He himself starts attempting at new solutions to his problems.

The exponents of the non-directive approach of play therapy forbid the therapist, and all those interested in the treatment of the child, from referring to the events of the past to the child, the child needs to be fully absorbed into his present activities.

Allen, F writes “…Emphasis on present activities, statements, feelings and emotions rather than on past circumstances and events which have influenced his behaviour. Difficulties and problems are discussed in terms of what is happening at the moment. Sessions are treated as growth experiences.”

Thumb sucking, staggering (or stammering) and enuresis are also abnormal behaviours. Likewise, the very serious abnormality aggressiveness which also becomes apparent even in early childhood, and if the cause, giving rise to it, continues, the abnormality would be hardened and more difficult to be cured.

Aggressiveness has also been dealt in detail previously. Play therapy that we have described in great details in above paragraphs, is an effective remedy for it also.

Shyness, fearfulness, anxiety, prejudice all are abnormalities when they are in excess, out of proportion than the cause warrants. One is shy (or withdrawn) because one feels something to be there in his personality which he does not want others to look at as he is afraid of the laughter that others may make him subject to.

One shies the company of others because of his experiences with others have not been good; he may have been neglected, scoffed at or rebuked, or may have been otherwise maltreated. A shy person, whether a child or a grown-up, also harbours some sort of fear in coming in contact with others.

Other people, especially, when their number is big, would make him uneasy, and, he would prefer to avoid them. He shuns the company of others, and likes to remain alone. Such a person is liable to develop a more serious type of abnormality, that is, schizophrenia.

The word schizophrenia is derived from the Greek words schizo + phren; the meaning of the first is “split” and that of the second is “mind”. The schizophrenic is one whose mind becomes split. Split in the sense that his mind is not absorbed in the action that he is doing.

There is no unity of “action” and “thought” or “feeling”. He develops a dual personality. He is not what he seems to be externally; he may be doing something related to his routines yet, internally, he may be lost in his own world of fantasy. Outwardly he likes to remain idle so that he may be able to think about his own problems which generally happen to be the creation of his own fantasy.

i. A schizophrenic tries to avoid the company of others, lest there should be disturbance in his phantasmagoric flights.

ii. Schizophrenia is a mental disorder, its patient has less relationship with realities, and remains absorbed in imaginary problems.

iii. He is always doubtful, anxious, and fearful though no genuine reason for the same is there.

iv. He appears troubled; and sometimes becomes violent, even against one who tries to teach him realities to end his imaginary troubles.

A schizophrenic is rarely seen indulging in a loud conversation with imaginary characters, but if no proper handling is done, the condition may further be precipitated, and the patient may start behaving totally like a lunatic.

Though schizophrenia and some of the other abnormalities develop to the perceptible level only during adulthood yet, we are dealing with them in a book related to child development because the process of development of abnormalities, generally, starts when one is still a child.