Integrating Play Therapy and EMDR With Children

A. USING ART & SAND TO CREATE IMAGES FOR PROCESSING:

The use of drawing images for processing has been discussed so much that this section will focus on the tactile experiences of sand, play dough and water. These mediums are always available to the child in the playroom where most of the processing takes place, be it through play or using EMDR. Children are tactile learners and much is learned and integrated into their belief systems using hands-on methods.

Children naturally gravitate toward sand and water during play sessions. Sand and water are elements that express the unconscious and unformed contents of the mind as perfectly as any medium in nature. The use of sand almost always conveys the feeling content of a child’s psyche.

One of the best experiences of using a tactile medium to concretize feelings occurred with four year old Zack, (fictitious name) water and play-dough. He had been brought into treatment because of the difficulty he was experiencing trying to adjust to his parent’s divorce and the relationships that developed as an outcome of the divorce.

Zack used a lot of sand in his play with and without water. He also used a lot of water, with and without sand.

Zack had made considerable progress in therapy and most of his symptoms had disappeared. But one day as we were moving toward the termination stage of therapy, Zack was a little down in the dumps. He got out the play-dough and dumped several colors onto the table. Little by little he added water to the play-dough as I watched. The water transformed the consistency of the play-dough into "slimey, yukky, icky," stuff. Together, our hands mucked around in these "slimey, gooey, sticky," feelings.... which Zack laid out on the table, so to speak.... This play enabled us to clearly identify some of his most negative emotions concerning recent divorcing family events which were: "slimey, gooey, icky, sticky, and yukky." Ok. Zack, now follow my (sticky) fingers and tell me what you feel now? "Good, glopey good!"

His negative feelings quickly yielded to laughter. We shared a "joke," at a time when therapeutic themes could have been very gloomy indeed. Not only did Zack understand the alchemical nature of water instinctively, he was able to process troubling feelings in a fun and very precise way. This experience was one of my first spontaneous instances of integrating play and EM. The EM in this case helped to validate not only his feelings but his ability to express and change his own feelings, his own way.

Children create sand tray pictures - which are really more like the "movies," or motion pictures - because most of the time children’s sand play is in motion, processing. Dinosaurs fight viciously, threatening to take over the "water hole" of the lions, (survival themes) who try and defend and protect their babies from a large T-Rex who reaches down and grabs a baby cub between its sharp teeth and starts chomping. The big lion growls and bites T-Rex’s tail, but the baby cub is hurt - no matter how, the metaphor will evolve.

Staying physically close to the sand table allows not only a close viewing of the dramatic action but also the child’s expressions. I am almost always on my knees or sitting on a child-size chair. This is not a good time to be towering above the sand table looking down at a child’s play.

I observe the play aloud saying: "The mom can’t find her baby. Sharp-tooth is eating her baby...." I grab a "friend" dinosaur in my hand. "Quick! Watch this one; he wants to help the baby! Make the baby cry when the teeth sink in!" With luck, timing and practice... a short set of EM can be integrated into the sand play drama. "Mom is getting stronger - she’s winning over Sharp-tooth!" (EM to reinforce safety.) When the big tiger attacks T-Rex with renewed strength and determination the dinosaur friend helps. T-Rex drops the baby cub. "Now, the baby is free and safe. " (EM). (It is important to use the word "safe" a lot in both EMDR and Play.) The big tiger picks up the cub and retreats to the corner of the sand tray. They -- safe right now. Then T-Rex falls on his back and is dead.

"The tiger mom and the baby cub are safe for now. They have a safe place too." Use EM with mom tiger and baby to reinforce safety and lower SUDS. "This guy wants to go too, watch him now so he can be safe to." Quick set using the same "friend" dinosaur or the baby and mom.

Here is where the real flexibility and creativity enter the processing. NC’s are symbolically interpreted through the metaphor of the play. When T-Rex grips the baby cub between its sharp teeth it is easy to see the negative beliefs: "I am not safe," "I am in danger," "I am scared." As the conflict and fear are played out: The PC - "I am safe," is installed spontaneously during the play using the toys to carry the feeling. Later, the PC of "I am safe," can be re-enforced in whatever way seems most natural.

Usually, this type of play continues and the repetition of the theme will ensue. Just when we think everything is okay, T-Rex gets up again.... Roaring! This is the child’s way of showing you the repeated nature of the abuse or fear. It appears that the integration of EMDR at these crucial moments may lessen the need for repetitive play in some children. In other words, the use of EMDR can help the child to feel resolution more quickly over repeated, traumatic events.