Playfulness - American Association for Marriage and Family Therapy

 Playfulness:
Enhancing Therapeutic
and Family Connections
Jerry Saltzman, Heidi Stauber, and Sarah Hardin AAMFT 2013 Annual Conference Thursday Institute Workshop Materials If I could have but one wish granted,
It would be to live in a universe like this one,
At the time like the present,
With the friend I have now,
And be myself.
- Harvey Jackins 106: Playful Connections 2 Dear Institute Participants: Welcome and thank you for the confidence you have placed in our presentation. Because it is a largely experiential one, we hope that you will take the opportunity to read through the materials we will be sending in advance. Your doing so will facilitate the maximal use of our time for experiential exercises, reflections and questions that may arise. The perspective, which will be described in more detail in the documents that follow, is more about the tone in which clinical interventions can be delivered than the theoretical orientation upon which the delivery is based. Our choice for the perspective and content of this institute was inspired by the theme of the conference: Raising Vibrant Children. Although many avenues can be taken to accomplish this lofty goal, providing playful environments in which children can develop all facets of their intelligence and skills in a collaborative manner with freedom of self-­‐expression and enthusiasm is a significant one. Yet it is an avenue that seems to be rarely frequented, perhaps due to the increasing pressures placed on parents and the institutions that serve the needs of children and families. Therapists who work with children and families are in an excellent position to help their clients buck this repressive trend. It is our perspective that playful approaches to therapy and assisting parents to incorporate a playful approach into their parenting repertoire can take us further in meeting this challenge. With this in mind, we set one of our primary goals for the institute to be the provision of a space for participants to expand their “playful horizons” through participation in some planned experiential exercises interspersed with opportunities for reflection in small groups and dyads. Therapists’ development of our “playful selves” can be not only useful in expanding our repertoire in delivering interventions and enhancing connections with our clients. It can also serve as an example to them of what is possible in their lives and relationships, perhaps inspiring them to generate some of these possibilities for themselves and their family members. The journey along the path of developing a playful approach to therapy and enhancing family connections is a pioneering one, in that there are no maps indicating direct routes. Thus it is our hope that the experiences we share together will provide some helpful markers. To help prepare you for this process we will be sending several documents. The documents that accompany this letter are: 1) A characterization of a playful attitude toward life and relationships that can be used as a vehicle to examine your attitudes toward playfulness and the present stage of your development of a playful approach to both clinical and personal relationships. This document will provide common ground and material for personal reflection and dyad discussions. 2) A brief discussion of strategies that could be useful in expanding playful approaches to life, relationships, and clinical work. This document was written with the intention of preparing you for the experiential content of the institute. 106: Playful Connections 3 3) A discussion of Special Time, a tool that can be highly effective in helping parents and children enhance emotional connections as well as serving as a building block for solving family interaction issues. The contents of this document include a description of several playful clinical interventions as well illustrations of tools for connection employed by parents. Because of its effectiveness in fostering playful family interactions resulting in stronger emotional bonds, special time will be a focal point in our clinical applications discussion during the afternoon. At this point we are working on a document that describes some playful interventions that we have employed in our clinical work. It will be included in the package for this Institute on the AAMFT 2013 Conference Mobile Site. At the Institute, we hope to include a live clinical demonstration of a playful clinical approach. Please note that the emphasis is on a playful approach to therapy that can be incorporated into various clinical models, not on a specific form of play therapy. We look forward to working with you later this month. If you have any questions or special requests that you would like us to know about in advance, please email Jerry at the following address: [email protected]. Wishing you safe travels, Sarah Hardin Jerry Saltzman Heidi Stauber CHARACTERISTICS OF A PLAYFUL APPROACH TO LIFE AND RELATIONSHIPS Jerry Saltzmani Below is a description of the general characteristics that comprise a playful attitude toward life and relationships. While we cannot offer a precise or all encompassing definition, the specification of these characteristics can provide a general picture that will, hopefully, be useful in thinking about and developing a playful attitude in personal as well as professional relationships. These characteristics can be conceptualized on a continuum, with greater playfulness achieved by a stronger tendency toward their full manifestation rather than away from it. • An embracing, generally hopeful (and sometimes celebratory) attitude toward life, other people, relationships, and tasks. • A tendency toward flexibility and spontaneity in approaching tasks and connections with other people. • A tendency to engage with others in a cooperative manner. Competition can be viewed as a cooperative venture in which participants pit their skills “against each other” in order to increase their mutual skill level or reach a common goal. 106: Playful Connections •
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4 The embodiment of a positive demeanor: Open, welcoming facial expressions, tone of voice, and body language. This demeanor can range form an aura of relaxed confidence to a playful and silly one. A tendency toward authenticity in self-­‐expression A tendency toward lightheartedness and whimsy. A willingness to take risks beyond one’s level of comfort. A baseline level of self-­‐acceptance and trust in one’s acceptance by others that can serve as a reliable platform for experimentation in relationships, tasks and the pursuit of goals. A relaxed, hopeful expectation of the best in ourselves and others, and a tendency to hold onto this attitude when those expectations aren’t fulfilled. This can include holding an attitude toward challenging tasks expressed by the phrase, “Let’s see how far we can get” and a willingness to push through feelings of disappointment, blame, or self-­‐derision that might arise when missteps occur. A tendency toward the use of appropriate laughter and humor in interactions and when addressing challenges and missteps. A tendency to see interactions, tasks and challenges as interesting opportunities to connect in new ways. A tendency toward experimentation with life and relationships. A tendency toward challenging others in a respectful and optimistic manner, without mocking or hurtful teasing. An ability to display love and caring in an open manner. EXPANDING OUR SENSE OF PLAY Jerry Saltzman “I playfully vow to remember to the best of my ability to be incurably myself in personal and professional contexts at all times.” Although we are hardwired for play (Brown, 2009, Siegel, 2012), a number of factors influencing our development have conditioned us to “deactivate” the wires to a large extent in order to function well in the adult, especially the professional, world. In order to reactivate that wiring we need to take steps to expand our playfulness. Taking steps to do so will occupy the morning session of the Institute. The guiding assumptions for engaging in the planned experiential activities are: (1) Playfulness enhances healing and connection. This is illustrated in Cohen (2001), Saltzman (2013) and discussed at length in Schwartz & Braff (2012). (2) By “practicing play” (i.e., having fun and nudging the limits that we have set for ourselves in the area of playfulness) in a supportive environment, we will expand our playful repertoires, perhaps feel a bit more comfortable in expressing our playful selves as well as placing into sharper focus the attitudes and emotions that serve to mitigate the full expression of our 106: Playful Connections 5 playfulness. Thus opportunities for self-­‐reflection will be interspersed with the planned playful activities. (3) The more authentically we therapists can express their playful selves, the greater the chance that our clients can respond in a like manner and incorporate playfulness into their lives. (Rogers, 1980); Schwartz & Braff (2012) If you would like to organize your thinking about expanding your playfulness in advance of the Institute, consider the following: • Take an informal playfulness inventory. The document entitled, “Characteristics of a Playful Approach to Life and Relationships” can serve as a vehicle to “monitor” of your present level of playful commitment. As you read through it, think about the degree to which your attitudes and behaviors fit each characteristic. Celebrate what you have accomplished, and consider what you might need to face to further develop this characteristic. • Think of internal barriers to manifesting those characteristics even more and name them (e.g. embarrassment; feelings that these attitudes and behaviors are useless, inappropriate, silly or unbecoming; competitiveness; need for control, etc. • Consider the source of these feelings, attitudes: How, and in what contexts were these messages delivered? If you feel that you have always had them, consider the dynamics in your family-­‐of-­‐origin or “cultural community” (social/economic class, religious affiliation, ethnic influences, gender conditioning, etc). Does your membership in any socially defined group engender the felt necessity of hiding parts of yourself?ii Consider what the impact of your being an adult (“act your age”) may have on the full expression of your playfulness. • Review experiences in school that either promoted or tended to inhibit your playfulness. (Listening to Harry Chapin’s song, “Flowers are Red” may trigger memories of your playfulness and creativity being stifled.) What might limit the manifestation of playfulness in clinical settings? • As you think about this question, consider your beliefs about appropriate therapeutic boundaries, your theoretical orientation, agency policies, legal and ethical mandates and prohibitions, your professional identity (including your perspective on the place of laughter and “silliness” in clinical settings. • What is your perspective on the compatibility between taking clients’ issues seriously and offering playful interventions (assuming that these interventions are appropriate for that client)? Expanding your playfulness repertoire After taking the inventory mentioned above, think about steps you can take to manifest the characteristics of playfulness that you would like to “show up” even more in your life. Share your ideas with loved ones, friends and colleagues (if that makes sense to you). Invite them to join you in some of the activities you shared. 106: Playful Connections 6 Enjoy! SPECIAL TIME Jerry Saltzman Special time is an opportunity for parents to provide full attention to their children without any distraction or conflicting obligations. Its sole purpose is to offer full, relaxed, positive attention with the goal of developing deeper emotional connections through child-­‐directed play. Ideally, special time should be set up between a parent and one child in order to maximize their connection and permit parents of multiple children to attend to the unique needs of each child. The potential benefits of special time can be summarized as follows: (1) It can offer the child one or more dependable time slots during the week in which she will receive this special form of attention; this dependability can help bolster a sense of importance and being wanted, as well as a sense of safety and consistency. (2) It can offer the child the opportunity to choose how the time is spent (within the limits of safety, financial, and time parameters); this can enhance the child’s sense of having some control over her life in addition to offering an opportunity to experiment with her thinking and creativity. (3) It can offer parents the opportunity to experiment with modes of validating their child’s qualities and skill; this can help bolster the child’s sense of being valued and her self-­‐esteem. For example, direct praise for her efforts or accomplishments when she attempts an activity with which she is struggling or for which she may have been criticized or ridiculed may be most effective. On the other hand, more indirect forms of praise could hit the mark. A child who has a challenging time communicating his thoughts or resists more direct forms of praise might respond to praise in the form of a query into his thinking about the shape or color of an object he drew. Or a child who displays a skill that has been outside of the parent’s capacity might be asked to teach the skill to the parent. This could become a pretext for a good deal of laughter, especially if the parent exaggerates his struggles in developing the skill. (4) It can offer a child the opportunity to work out feelings related to unresolved issues in his relationship with his parents. For example, a child who feels controlled by a parent or somewhat stifled by a parent’s rigidities might choose to engage in an activity that a parent has been reluctant to engage in or endorse. Assuming that matters of safety or impropriety are not of concern, a parent’s enthusiastic engagement in the activity or playful pleading to not engage can serve as a significant step toward alleviating a child’s sense of alienation or powerlessness. Often the parent’s playful protests will result in gales of laugher and repeated 106: Playful Connections 7 insistence on engaging in the “dreaded” activity. Children will often initiate the same scenario repeatedly, with consistent laughter, especially if the parent playfully exaggerates the mock protests, until the issue that prompted the request has been “resolved”. It is likely that a child’s use of special time in this manner serves as a significant step toward the eventual reduction of power struggles. (5) It can offer parents the opportunity to observe and learn about their child from a fresh perspective (Wipfler, 2007b). Because special time is set up for parents to offer full attention to their child without the need to attend to distracting matters, they have the opportunity to observe his behavior in a concentrated and nuanced manner. Children tend to offer a great deal of information about themselves via behavior, facial expressions, styles of communication, their choice of some activities or consistent abstinence from others, and the manner in which they approach various activities. Thus observations of a child during special time can offer fresh clues about his emotional traits, preferences, and problems that may contribute to family tensions. (6) It can promote an environment that offers special opportunities for children and parents alike to heighten an awareness of their connection and their love and appreciation for each other. The unique space and opportunity to give and receive relaxed, focused attention that special time offers provides an excellent opportunity for parents and children to access that deep love and bond that is usually more evident during a child’s infancy when greater importance tends to be placed on relaxed, focused attention. (7) Spontaneous offering of the one-­‐way attention that is characteristic of special time can help ease emotional tension and sibling conflicts. Heidi Stauber offered the following example (personal communication, September 2, 2013): In our most intensely difficult years as a single parent family, when my three kids were infighting a lot, one-­‐on-­‐one time would be offered. At these times, an unspoken decision was made to lay down arms. When I was giving my attention to one of my kids, the other two would get along or ignore each other, but they would not fight. Special time was precious and they knew that my time was limited. Thus, if there was a sixty-­‐minute period with twenty minutes for special time with each child, interrupting that with fighting meant less time for everyone. So they figured out a way to cease fighting during this sixty minutes. For us, in those years, it all took place in our very small apartment, often on my bed. I'd spend 20 minutes with each kid, door closed, and usually it meant listening to them each talk as much as they needed. At times some light play would be included. Even now as teens when a certain type of bickering flares between them I know it's time to get out with each of them individually and reconnect. I request help on an errand or a dog walk. We don't address the bickering; we just spend some dedicated time together with me mostly listening. Often this is the magic solution to what seems like a big conflict. 106: Playful Connections 8 (8) A consistent practice of special time can create the room for a child to show his difficulties and struggles by acting out in an attempt to gain assistance in resolving them. These situations could offer parents a unique opportunity to explore and practice alternative approaches to provide assistance with the specific emotional difficulty or experiment with collaborative problem solving. I could offer many examples of this phenomenon from the special time I spend with my grandson “Aka” (a name by which his twin sister addressed him when they were learning to talk). One striking example came up several times when we spent our designated special time riding bikes together. At some point during the ride he would stop and exclaim that he was going to take off his helmet. My observation of (and sometimes my involvement in) family dynamics offers strong clues about what is behind his insistence. Aka is a voracious and adventurous learner who possesses a keen desire to experiment with all aspects of his life on a consistent basis. At times this results in impulsive behavior that triggers parental concerns for his safety that cannot always be expressed in a relaxed manner by even the most playful and loving parents of twins. The relaxed, playful, loving, highly attuned relationship we have developed gives him the room to act out unresolved issues with me in the hope of resolving the issues occasioned by the non-­‐contingent parental responses. Our conversation about this issue has generally proceeded as follows: Aka: “Opa (the Dutch term for “grandpa”), I am going to take off my helmet now.” Me: “Aka, because you have such a precious brain that works so well in wonderful ways, we want to do everything we can to make sure that nothing bad happens to it.” Aka: “No I don’t…” Me (finishing the sentence): “… Not want to protect your precious brain from harm.” Aka: “Yes I do…” Me (finishing the sentence): “…Want to protect your precious brain from injury.” This verbal sparring would continue with the same words uttered with full engagement and delight in the process on both our parts for up to twenty or thirty minutes. (The attunement of our quirky, impish modes of addressing difficulties has proven to be highly valuable in developing the strength of our attachment and his trust that I can be an effective partner in the resolution of his difficulties.) Sometimes our playful “fight” will end by his deciding to continue riding with his helmet. At other times I will “give in” by allowing him to ride without his helmet at a much slower pace while I hold his bike by the handlebars to provide balance. On a recent occasion, a shift took place in this dynamic. We were planning on riding our bikes on a day when I was wearing sandals. As we were loading our bikes in the car to take them to our favorite riding spot, Aka exclaimed: “Opa, you want to protect your precious toes, but because you are wearing sandals they could get hurt. We are going to your house first so you can put on closed shoes.” (He loves to give orders!) I complied without playfully dramatizing his repetitive stance on the helmet because it seemed to me that he had finally internalized the playfully 106: Playful Connections 9 delivered message about his safety. Since that time, the issue about the helmet has not arisen. In thinking about this series of interactions, I suspect that my providing playful responses that fully engaged his intellect and his experience of successfully asserting his authority by “beating me at my own game” provided an antidote to the disconnection and disempowerment Aka experienced in the worry-­‐laced parental responses to his (at times acted out) tendencies toward impulsive, potentially dangerous behavior. Hopefully this playful aspect of our relationship will serve as a solid plank underpinning his attempt to fully resolve this family issue for himself. Further thoughts about special time: (1) Special time should be thought of as a unique relationship that stands on its own within the overall context of parent-­‐child interactions. Using this designated time to address unresolved issues or to engage in other tasks will tend to diminish its value as a vehicle in developing more secure attachment bonds. (2) It is important that regularly scheduled special times take priority over all other activities, barring unforeseen emergencies. (3) Special time should not be considered to be a reward or an activity to be taken away as a punishment (Howard, 2002). Special time can be thought of as a form of emotional hygiene, just as taking showers and brushing one’s teeth can be regarded as physical hygiene, and are routine parts of one’s day (Heidi Stauber, personal communication, September 2, 2013). (4) Therapists who work with families can use the introduction and support of special time as a vehicle to crystallize therapeutic interventions that address family interaction patterns. For example a therapist who notices an interaction pattern in which a child continually nags a distracted parent to play, leading the parent to respond in a blaming or punitive manner, may coach the parent to provide focused attention for a number of sessions. The effectiveness of this process will depend on accurately assessing the level of a parent’s capability to provide this level of attention and appropriately modifying interventions. (5) Children who have not consistently received relaxed, appreciative parental attention prior to the initiation of special time may try to seek that attention by initiating some behaviors reserved for special time when a parent is otherwise occupied. Parents can be coached to develop tools for addressing this in a collaborative manner. They can, for example, make a promise that the behavior or activity in question can be revisited during the next special time session. Parents may need special support to offer those assurances in a relaxed, supportive manner. (6) Special time can be used as a vehicle to assist children to overcome inappropriate behavior problems. For example, “Lindsey” the 7-­‐year old daughter of a religious mother refused to stop using foul language, and would not be swayed by parental entreaties or punishments. After consultation, her mother and I agreed to 106: Playful Connections 10 use our therapy sessions as special time during which Lindsey could use the foul language to her heart’s content on the condition that she would not engage in that behavior at any other time. During the next four sessions, Lindsey continually used the foul language, laughing heartily at her mother’s (coached) chagrin. The more the mother protested in mock helplessness, the stronger the laughter. During this period, Lindsey kept to her agreement to reserve the foul language for her “special time” sessions. At the end of the fourth session, she announced proudly that she no longer needed to use that “bad” language, and the behavior ceased. (7) Special time can be used as a vehicle to help children overcome isolation and addictive behavior. For example one parent made it a point to pay full attention to his child who shunned connection by compulsively played video games. At first the child would seemingly fail to notice the parental attention and continue with the games as if he were alone. As the parent quietly persisted in offering the attention at pre-­‐determined times, the child increasingly gave signs of recognition of the parental presence and eventually involved the parent in the games, primarily by teaching him how to play. As the special time progressed, the child increasingly involved himself in family activities and communication. (8) Special time can be modified for working parents who do not have the freedom or the level of relaxed attention to engage in special time on a one-­‐to-­‐one basis during regularly scheduled times. For example: • A parent can create a ritual of offering appreciations to each child one or more times during the week. This could occur aloud at bedtime or the dinner table, or a parent could leave a small appreciative note in each child’s lunch. • Transportation to school or childcare could be used for developmentally appropriate activities such as making up collaborative stories, singing, or playing games such as “I spy” or the “What if….” game (e.g. “What if you were a leopard?” or “What if our house were made out of ice cream?”). Therapists can assist parents to initiate special time and support them in developing their competence and confidence by: (1) Directing parents to available resources that address attachment issues. (2) Assisting parents to strategize the initiation of and continued participation in this activity as homework or in family sessions. (3) Assisting parents to process emotional issues that may arise for them as a result of their participation in special time. (4) Assisting parents to work through their resistance to requests by their children to engage in activities that stretch their competence, confidence or tolerance. One playful clinical intervention with a parent who literally shuddered at her daughter’s repeated insistence that they engage in activities that would create a more “messy environment” in their home consisted of my pulling a wad of Kleenex tissues out of 106: Playful Connections 11 the box, tearing up the tissues and throwing them around the office. The mother laughed and cried heavily, at the same time begging me to stop this “absurdly messy and unproductive behavior”. As I persisted, the client continued with the protests until she suddenly stopped and blurted out a realization about the ways she was consistently admonished by a relative/foster parent to “never look back at her alcoholic, no-­‐account parents and their slovenly ways.” Essentially she was “groomed” by this relative to become the diametric opposite of her parents, a persona that she rigidly carried into all aspects of her adult life, including her role as a parent. As she grieved over the loss of her parents and the constriction of her “assigned persona” she began to adopt a more flexible stance in her parenting, resulting in more enjoyable times with her daughter during special time and a closer bond between them. (5) Assisting parents to navigate the boundaries of special time, especially when their child shows resistance to ending the pre-­‐arranged activity. (6) Assisting parents to use approaches consistent with the playful spirit of special time in addressing acting out behaviors and/or emotional issues that may arise during this activity. (Numerous examples can be found in Wipfler, 2007b & d, Cohen, 2001, and Solter, 2013). This skill, although challenging to develop, can be highly effective in deepening family connections and, consequently, promoting cooperative behavior and problem solving. Parent Narratives about the Use of Special Time
(Retrieved from Http://www.handinhandparenting.org)
Special Time by a Working Mom
Susan Darby
Until recently, I worked outside of the home three days per week, and on those days, I
left the house by 7 a.m. Often, at that time, my five-year-old daughter wasn’t awake yet.
When I didn’t get to say goodbye to her on those mornings, I usually left her a “Good
morning” love note. But sometimes, the mornings in which she was awake at departure
time were harder because I was rushing to get out the door and couldn’t give her the full
attention that she was wanting.
A while back, I noticed that the separations after such mornings were causing some
disconnection in our relationship. My evenings with her after my long days at work —
when, needless to say, I was tired — began to feel bumpy. So, I consulted my Parenting
by Connection toolbox and ramped up our Special Time.
Special Time in the evening became more consistent, and I committed to scheduling at
least 15 to 30 minutes into every weeknight. But what seemed to make the most
difference in our connection was the “mini” Special Time sessions that I did for five
106: Playful Connections 12 minutes — just five minutes! — before heading out the door for work, on the mornings
she was awake before 7 a.m. No matter how late I was running, I could make time for
five minutes of Special Time. I would say, “I’m going to set the Special Time timer for
five minutes!” And then, I would follow her lead, pouring all of my enthusiasm and
attention into the activity of her choosing.
My daughter was happy to do this first thing in the morning. Once, she asked for a pillow
fight. Another time, she wanted to do a puzzle together (which she continued on her own
after the timer went off). Another time, she wanted a back massage. With these healthy
little dollops of Special Time in our morning routine, our goodbyes became easier and
sweeter. Not only did my daughter start to seem more connected to me despite the long
separations, I also felt more connected to her, having invested some of the best kind of
quality time with her — and on her terms — while starting out the day.
Solutions for My Son’s Homework Tantrums Natalie Thiel After the start of the second grade, I very quickly noticed some heavy struggles around
homework come up. It was clear I was going to need to help my child with school. At the
start of the year, my son’s second grade teacher gave all the parents special instructions
for doing homework this year: set a timer for 30 minutes for homework time, and when
that timer goes off, put the pencil down and walk away. If any tears or yelling happens
before the timer goes off, put the pencil down and walk away. It was as though he was
perfectly foreshadowing what we were about to see.
For a number of days in a row, when homework time approached in the evening, my son
met it with resistance and frustration. I would see a range of reactions, from announcing
that it was boring and he wasn’t going to do it, to kicking and yelling and crying over his
homework. I noticed in myself how inflexible I was around homework time – I was
frustrated that he wouldn’t just sit down and do the assignments that looked to me like
they were easy enough to do with his eyes closed! It got to the point where I could not
touch homework time – we just had to wait until my husband got home to do it with him,
as he was somehow able to put more play and lightness to it and succeeded in helping our
son get it completed. I could see that this was going to be an emotional project for the
whole family and needed a new strategy fast.
I started on this issue in my own listening partnerships.iii I got listening about how
frustrating homework was, how intolerable my sons behavior was, especially when it was
always topics I know he is good at and have seen him complete with ease! I got listening
around how when I was his age homework was easy for me, so why did it have to be such
a struggle for him? And finally, how I don’t like that homework even exists! It cuts into
our family time in the evenings, and more often than not is as boring as my son says it is.
Next, I made a point to do Special Time with my son before my husband got home to do
homework with him. Honestly I was happy to do Special Time in place of homework
with my son; it was much more enjoyable. We would wrestle, or pillow fight, or play his
106: Playful Connections 13 favorite video game depending on what he would choose. I started to notice that
homework time seemed to go much easier when he would get this extra connection. I saw
these as little victories along the way, but still I found that writing homework of any kind
continued to be a frustrating struggle.
One evening my son pulled out his spelling and writing assignments and asked for my
help. He was already upset about the subject of the homework before he even pulled it
out of his backpack. I asked him to read me the instructions while I was cooking
something in the kitchen. He became more and more distracted and agitated. I told him it
was time to stop playing with what he was playing with and sit down to focus on
homework. “Then come help me!!” He screamed. He screamed this again, and I put
down what I was doing to come in closer to him. He kept yelling “Help me! Help me!”
over and over again, and the closer I got to him while offering my help with my words,
the louder he yelled it. He was kicking and screaming on the floor and I just continued to
say “I am here to help you,” while he continued to scream for help.
This went on for some time and I continued to stay close, holding a gentle arm around his
baby brother to make sure he did not accidentally get kicked.iv I acknowledged that
homework was frustrating, that he works really hard all day at school. He screamed and
kicked, and cried a small amount. After a while his system began to settle down and
relax. He turned to a toy to play with and I let him take his time to play and relax while I
went back to the kitchen to cook dinner.
By the time dinner was done, he had returned to the table and quietly completed his
homework on his own. He was very proud of his work, and showed me each part. In
these last few weeks, I have continued my connection tools all in combination, and it has
meant that I have been able to help him with his homework. He now will often complete
it before my husband gets home and we get extra time to play and connect as a whole
family.
PLAYFUL THERAPEUTIC INTERVENTIONS This document is a reflection of our theoretical perspectives combined with the manner in which we view playfulness in our personal and professional lives. It is designed to serve as examples of clinical stances and interventions that fit our personalities, theoretical approaches, and clinical experience. Please feel free to use this document in any way that might be useful in your professional development and clinical practice. My Assumptions as a Playful Therapist Jerry Saltzman (1) As a therapist, I strive to be generous with who I am (i.e., show many aspects of my personality), while being mindful of appropriate boundaries and monitoring client reactions. My level of openness and willingness to take risks tends to inspire clients to mirror this in our sessions and in their personal relationships. 106: Playful Connections 14 (2) My relationships with clients are open, warm, playful, and collaborative. I conceive of these relationships as special partnerships in which each of us has an equally important role: Clients provide the information (through words, facial expressions, tones of voice, bodily posture and gestures, etc.) that I need to do my job; I read their signals as accurately as I can, and then craft responses. I believe that relationship so conceived assists clients to feel respected and seen, and helps to create safety they need to face deep, challenging issues. (3) Although clients generally seek out therapy as a means to improve one or two specific problems, or address something vague and seemingly overarching such as “depression,” I consistently find ways to assist them in widening the focal lens and to thrive in many aspects of their lives (within the limits of the presenting issues and the level of inner resources available to them, their commitment to therapy, etc). (4) I strive to manifest a hopeful attitude toward clients’ abilities to attain their goals. (5) Emotional release, especially in the form of laughter and tears, tends to accelerate the healing process (Cohen, 2001; Goodheart, 2004; Junkins, 2002; Nelson, 2012). (6) My responses to what clients present in therapy tend to be quite nuanced. v I track the content of their communication (its denotation) and the form it takes, manifested in tones of voice, facial expressions and body language (its connotation). When creating a response I think about what they are trying to tell me (which is often below the surface), the type of response that is called for (e.g., silent, compassionate, informational, directive, playful). When thinking about possible playful interventions, I try to be mindful of the level of playful response that would fit clients’ stated and implied needs, and their level of trust in themselves, our relationship, and the therapeutic process. When offering interventions (especially playful ones), I try to target the central issue(s) with which my clients struggle. A conceptualization of six core clinical issues that underlie their presenting problems is central to my clinical approach. These issues (illustrated by some representative questions) can be conceptualized as follows:) • Goodness: Am I good? Am I loveable? Am I worthy of forgiveness? • Power or Effectiveness: Can I control the course of my life? Can I impact what happens in my family, my circle of friends, my co-­workers? • Trust in one’s thinking: Do I accurately perceive what is occurring in my relationship? Can I trust my reactions? • Connection: Am I seen? Am I wanted? • Safety: How straightforward can I be? How much of an emotional risk can I take? • Level of hope: How much can my life circumstances change?vi 106: Playful Connections 15 (7) Playful responses can assist clients to reduce the felt gravity of their presenting issues and assist them to address those issues from a more differentiated perspective, as illustrated by the following description of a personal counseling experience. Many years ago, after a long search, I was fortunate to find a therapist whose loving, playful demeanor and approach provided the safety I needed to pierce the fog of pretence and denial in which I was living (“despair with a smile”) and openly address the deep terror (which I came by honestly due to a post-­‐birth attachment disruption, years of chronic worry, and the violence to which I was subjected in my family of origin). As the fog began to lift and the terror became more palpable, it dominated my consciousness to a point where I was chronically anxious and urgent, almost to the point of paralysis. I recall a session in which I felt especially urgent and found myself demanding over and over that my therapist DO SOMETHING!!!!!!!!!! As I continued my demands, she brightened up and said, “O.k., I’ll do something!” At the time she was sitting in a chair with her right leg hooked over her left. With a big smile, she put her right foot on the ground, and hooked her left leg over her right, uttering the words, “There! I did something.” Stunned at first, I kept gazing at her smiling face and then spontaneously broke out into uproarious, almost debilitating laughter, which persisted for about forty minutes. This was highly significant step in the long journey to rid myself of the shackling effects of a consistently terrifying childhood. My ongoing decisions to take a playful stance and induce laughter when the “anxiety monster” strikes have yielded significant results in terms of diminishing the power that this deep fear has over my life. (8) From a playful perspective therapy sessions can provide an opportunity for clients to show parts of themselves that they have been reluctant to manifest through role play, art, improvisational games and enactments, as the following examples may illustrate: • Clients whose fear of rejection has kept them from effusively showing their love for their partners or children can be asked to share their image of effusiveness might look like. They could, for example attempt to channel the effusive loving behavior of a favorite fictional character. • In one session a client who was highly fearful of asserting herself stated that she did not want to be a “squeaky wheel”. With some encouragement, she spent the remainder of the session “practicing” making pronouncements and demands, while squeaking, which brought gales of laughter. Sample Interventionsvii Sense of Goodness, Lovability, Self-­Esteem • I tend to display a welcoming, relaxed, open attitude beginning with the first phone contact. If I see the possibility of injecting a sense of lightness into our conversation that induces laughter, I will do so. This tends to convey a sense that I am prepared have positive feelings toward my clients, that their issues are resolvable (Hughes, 2002), and that I will work diligently on their behalf. 106: Playful Connections •
•
•
16 Often, when clients are guilt-­‐ridden or self-­‐deprecating, I may recite or sing songs like the following: “How can anyone ever tell you, you are anything less than beautiful, how can anyone ever tell you, you are less than whole; how can anyone fail to notice that your loving is a miracle; how deeply you ‘re connected to my soul.” (Libby Roderick, 1988) At other times I will ask questions like the following: o Why are your family members, friends, do-­‐workers, etc., fortunate that you are in their lives? (I encourage as many answers as they can drum up.) o Why am I fortunate to be on this healing journey with you? If they cannot think of answers, I will often playfully ask them to invent one. In most cases this allows them to access at least some quality about themselves that they appreciate. If clients cannot think of anything good about themselves, I may ask (again in a very light manner, “Is there a slight possibility that you are not the worst person (parent, partner) who ever lived?” Connection, Feeling Seen • The welcoming demeanor and lighthearted approach does serve to help my clients feel wanted in our relationship. • To the extent that I can offer interventions that target core issues or can accurately attune with my clients’ emotional state, they feel seen. • Assisting clients to be more present in session also assists them to feel seen. When I get a sense that clients are dissociated, which I (playfully) conceptualize as communicating to me from the back of a cave, I will sometimes warmly wave at them, and lightly say “Hi.” Doing so seems to have the air of placing a flashlight into the cave in a way that draws their attention outside of it. This often results in discomfort, laughter, or tears, and may open the way for deep exploration of formerly unacknowledged or addressed issues. Personal Power, Effectiveness • In many cases, clients with low levels of differentiation feel relatively powerless to advocate for themselves or even voice their feelings in their personal and work relationships. On many occasions I will try an intervention that I label Reclaiming One’s Voice. Essentially this consists of the client’s maintaining eye contact, mentioning my name and sharing the first thought that comes to mind (e.g., “Jerry, you are wearing a blue shirt.”) As in this example, the first thoughts expressed are usually about me. I thank them with a warm smile and lightly encourage them to give me another thought. Very soon, clients start giving voice to thoughts about themselves. As the exercise proceeds, the repetition and consistent lighthearted encouragement yield thoughts about deeper issues, sometimes leading to the expression of deep emotions. In all cases, this exercise has yielded greater 106: Playful Connections 17 openness in our therapy sessions. On some occasions it has facilitated exploration of issues that clients have not previously faced. In other cases, this has led to more open communication in intimate relationships. • Sometimes I modify this exercise with clients who felt that they had no right to be expressing their thoughts by requesting to look at me with an expression of pride and utter my name using a relaxed, authoritative tone of voice. This has proven to be highly effective in bring up varying levels of fear and embarrassment, released by gales of laughter. • Sometimes a form of play that looks like “egging someone on” can lead to unexpected assertiveness. Heidi Stauber (personal communication September 2, 2013 shared the following anecdote: “I utilized this form of play with a client whose life is extremely chaotic. She has very unreliable adults in her life, who are at odds with each other and expect her to be loyal to all sides. As far as I witnessed, choices are met with either fear and tears, or outrage and yelling. Boundaries are diffuse. One day in session she managed to assert, “I hate people”. I asked her to repeat this phrase directly toward me. She did. We then began a repetitive “game” in which she asserted this truth and I begged her to like me. I begged and whined and dropped to my knees. She repeated over and over, “I hate people” or “I will not fold”. For those 10 minutes she was completely focused on me; her body remained in place and her eye contact was intense. For a client who is typically in constant motion and won’t look at anyone directly, I felt this was an amazing feat. At the end of the session I stood up, discussed minor details for the next session, and wished her well as she left. I might have been the first adult for a very long time who allowed her to assert herself and establish her boundaries without being met with tears or cursing. Confidence in One’s Thinking “Beth’s” struggle to trust her thinking presented as a paralyzing anxiety over making small and large decisions in her life, an anxiety that was fuelled by overwhelming feelings of guilt for making the “wrong decision”. At a particular point in our clinical relationship, Beth was struggling with the decision over whether to become a parent. Although she was ambivalent about having children, she felt an obligation to do so, because of expectations placed on her by friends and colleagues. During one of our sessions, Beth reported a conversation with an acquaintance who declared with strong conviction that she did not want to have children. Beth’s response to this declaration (expressed with a facial expression and tone of voice reflecting utter dismay) was: “I don’t know how she could say that!” Because of her demonstrated trust in our relationship I know that I could offer the following playful response (as a counterpoint to the seriousness of her presentation): “Very easily: I d-­on’t w-­ant t-­o h-­ave child-­ren!” to which she responded with heavy laughter and deep tears for the remainder of the session. After the following meeting in which Beth continued with the emotional processing, she could address the issue from a more differentiated place. 106: Playful Connections 18 Hopefulness • Taking a light and appropriately playful approach to clients’ deep issues generally yields an increase in their level of hope. Inducing laughter tends to accelerate this process (See Junkins, 1999). • I employ a number of rituals that are designed to keep clients’ attention on what is hopeful. Here are two examples: o At the beginning of sessions I consistently ask clients what has been good in their lives since our last meeting. When doing relationship therapy I ask parties to share something that they have appreciated about each other during the week. When clients report that they cannot think of anything good, we work to find something, even if it is miniscule. o At the end of each session, I will inquire about what clients are looking forward to. In the case of relationship therapy I will also inquire about what each partner appreciated about the other(s) during the session. Positive Pranks and Courtroom Antics Sarah Hardin A Guatemalan family (mother and two sons) engaged in family therapy to address feelings of distress and a high level of distraction in the 12-­‐year-­‐old. His father was arrested for a DUI and eventually sentenced to deportation from the U.S. The family remains unsure of whether a second appeal attempt will be successful, and the mother is having to adjust to parenting on her own – which is made more difficult by the 12-­‐year-­‐old’s increased disruptive behaviors, both in school and at home, toward his 8-­‐year-­‐old brother. The 12-­‐year-­‐old has been pulling pranks on his brother in a variety of creative ways, but mom is worried his behavior is inappropriate. I asked them, then, to work together – mom teaching her son what sorts of behaviors were OK by her, and what she would consider inappropriate, harmful, or mean; and the son teaching mom about his high level of creativity by designing a “positive prank” against me. It was mom’s job to step into a parental role and be the arbiter of her son’s behavior, while allowing her son to explore his innate sense of play (and hopefully loosen up worrisome mom a bit in the process). They came in the following week with a “whoopee” cushion and the client slyly snuck it onto my chair. Playing ignorant, I sat down dramatically and pretended to be highly embarrassed by the results. Mom, both boys, and I were all in stitches. Not 106: Playful Connections 19 only did this strengthen the therapeutic relationship, it allowed mom a chance to parent her sons in a positive, creative, and collaborative manner. Several weeks later, the family reviewed how dad’s original trial had gone, wondering why his appeal was not successful. The 12-­‐year-­‐old had testified; mom had not been present in the courtroom at all. She asked her son several times what questions they asked him, and had been unable to recall everything. I had him serve as director, and turn the therapy room into the courtroom. He put chairs where they needed to go, assigned us all roles, and acted the part of the judge, questioning his mother (who was acting as the boy) in a playfully serious and commanding “judge voice.” The questions came clearly and effortlessly; he even corrected his mother when she gave an answer different from what he’d said in court. Both the powerlessness that he felt while testifying, and the ensuing blame he cast upon himself for the outcome were mitigated by his taking on the powerful role of the judge in a playful way with his family as witnesses and supporters to the act. Artistic Playfulness with LGBTQ Teens Sarah Hardin I facilitate art activities with LGBTQ (lesbian, gay, bisexual, transgender, queer, and questioning) youth in peer support group settings, I’ve found art-­‐making to be a wonderfully playful tool, especially with adolescents, who are naturally inclined toward creative expression (Linesch, 1988; Riley, 1999) and who seem to be resident experts at irony, puns, and wordplay. In one project, participants made buttons about their identities. The buttons were made with collage materials, which allowed the artists to be playful with text and images from mainstream magazines – normally sources of shame, oppression, and invisibility for LGBTQ people. Out of its original context, “where the boys are” takes on a subversive and no longer heterosexual tone. “Real men love unicorns” repurposes and messes with gender stereotypes in a fun way. The transgender girl who covered her button in roosters (you can replace ‘rooster’ with a one-­‐syllable synonym and see where she was going) made a subtle and yet incredibly playful reference to her body in her art. The act of art-­‐making is often in and of itself playful and joyous; sometimes the art pieces, as well, are rich with the power of a playful approach. 106: Playful Connections 20 Playful Interventions Leading to Emotional Processing of an Early Trauma
Marja Vaananen, LMFTA, Seattle, WA
Andy (age 6) has been in his two-father adoptive family for one year with his older
brother (age 7). The brother is diagnosed with FAS; Andy does not present with that
diagnosis, but some drug exposure is suspected. The boys’ biological father, along with
some of his acquaintances, physically and sexually abused both boys. Before the present
placement, the boys had been in three different foster homes. Cognitively, Andy
functions at a high level, and he is physically on target: he is smart, physically agile, and
he has a sense of humor. He came to therapy because the parents were worried about his
explosive violent reactions at school. He is able to regulate his emotions and actions at
home.
Since Andy has experienced a considerable amount of powerlessness and abuse, I chose
to use playful interventions in order to give him the room to test out verbalizing
boundaries. I also wanted to have his father Matt (41) present so that we could combine
attachment work with Andy's individual exploration. Knowing that Andy had attached to
Matt already, I also hoped for Andy to be able tap into Matt's ego strength if we accessed
Andy’s trauma during the session. In particular I wanted the dad to be there to comfort
Andy in the event of emotional release. This would further strengthen the bond between
the boy and his new dad. I chose to have only one dad present so that Andy would have
more momentum in the one-to-one connection.
The Session
First we sat on the floor in a triangle formation and we had a heavy fitness ball we would
push towards each other while we would build up a narrative that did not have to make
sense. I would say one word and push the ball to the dad or the boy; there was no order.
The receiver would continue the story again with one word and push the ball to one of us
others. The narratives sounded like this: PIRATE WAS SINGING AND POOPING ON
A BOAT WHILE HE SAW A WHITE SAIL WITH MONKEYS IN THE TREE.
106: Playful Connections 21 We would then laugh and point out funny details in our stories. The game would be over
if someone said two words or was too slow to come up with one. Andy enjoyed it when
one of the adults said words like “poop”, or didn't come up with words. He also began
to say the 'disgusting words' more and more as the game continued.
After a while, the game changed as follows: Matt would say outrageous things to Andy,
like, “Oh no, you have a third ear on your forehead!” Andy giggled at first and he would
want to hear more. Matt played into this so well, he continued with funny remarks and
soon it became obvious that Andy didn't know what to say. He agreed rather than defend
himself. He comes from a situation where he had been totally powerless and dependent
on his abusers. Now in this warm, fun game, saying no did not enter his mind. I joined
Andy. Each time Matt would say something I would touch Andy by placing my hand on
his arm, or squeezing him, and say with loud voice, “NO, NO he doesn't!!” Soon Andy
joined me and he took over. First he yelled and laughed, “NO NO NO!” Suddenly his
voice turned high-pitched, and the volume went down a notch, as if he had entered a
different emotional space. He screamed an elongated “NOOOOO'” two or three times
and he dropped on the floor and backed off under a chair making wincing,
wounded sounds.
I kneeled next to him and said to Matt, continuing the play but on a serious note, "Quick,
I think he is wounded. The third eye is bleeding, help!" Matt reached out his arms
towards Andy who was under the chair in a fetal position and he said, “come Andy, I will
rescue you, quick!" Andy reached out to Matt and Matt pulled him to his arms and they
embraced each other for a long while. Matt was repeating words “Good, good, I got you,
I got you.'”
Andy then jumped from Matt's arms to the floor and held his bottom. He yelled: “Don't
let the pirates get to my bum, it burns, it burns!” Both Matt and I got close to Andy and
continued the play he initiated. I said, "I will hold the pirates away. Matt! Quick! Blow
the fire out!” Matt would then blow air towards Andy like he was blowing out a hundred
candles. Andy seemed delighted, but also very serious. At this point the play was an act
to hold away pirates and pay attention to Andy's sensation in his bottom. Next to Andy on
the floor there was a big teddy bear; instinctively, Andy began to yell “NO. NO, don't
touch my bum!” to the teddy. Matt picked up the teddy up and I sat behind Andy and
held him while he continued yelling. I felt rage in his small body and after first
containing it for a while, I decided to guide Andy to release it. He seemed determined and
in control. Andy kicked the teddy Matt held for him. He kicked and punched it while
yelling “NO!!!”
Andy was exhausted after some minutes of kicking and punching. At this point he was
panting, and he began to shift his attention to his dad, asking, “Can we do this at home?”
He stepped out of the play. Matt held him and responded that they could play the game in
their next session. Andy seemed content with the answer.
106: Playful Connections 22 I said to Andy that he was very brave boy to yell “NO” to the pirates; Andy snuggled up
to Matt and we ended the session on this note. Subsequent to this session, the incidences
of Andy’s violent behavior at school were reduced.
i I wish to thank Sarah Hardin, Molly Simkins and Heidi for their thoughtful ideas and sharp editing skills that so effectively contributed to the creation of this document. ii Think about privileged as well as marginalized identities. For example, some people feel the need to hide a wealthy background, whereas others may feel the need to hide a an impoverished one, or a marginalized sexual orientation or a racial identity. iii Presenter’s Note: A listening partnership is normally a two-­‐way process in which parents listen to each other for a predetermined amount of time. This can be likened to special time that works two ways. Parents can use the attention they receive in listening partnerships to process emotions that arise for them in the course of their parenting, strategize responses to issues involving their children, their relationship, etc (See Wipfler, 2007a). iv Presenter’s Note: A consistent and successful practice of giving special time can provide sufficient safety for children to “show” their deep emotions, most likely because they have developed sufficient trust in a parent’s commitment, connection, and solidity (Wipfler, 2007b, d). This example of a parent providing solid, focused attention illustrates the possibility of solving problems through creating sufficient safety for a child to release the painful emotions that gave rise to the problem in the first place. v For an elaboration of the points made in this section, see the discussions of the following concepts: Presence, attunement, resonance and contingent communication (Siegel, 2010), the adaptive unconscious (Wilson, 2002; Gladwell, 2005), and thin slices (Gladwell, 2005). vi These issues are not generally presented as discrete. However, I have found that with different clients and with the same client at different times some of these issues take dominance, and that addressing these directly tends to enhance client progress. vii For purposes of brevity, most of the examples in this section refer to work with individual clients. However, the interventions can be easily modified for relationship therapy. 106: Playful Connections 23 BIBLIOGRAPHY Bodiford Mc Neil, C. & Hembree-­‐Kigin, T. (2011). Parent-­child interaction therapy. New York: Springer. Brown, S. (2009). Play. New York: Penguin. Cohen, L. (2001). Playful parenting. New York. Ballantine. Gladwell, M. (2005). Blink. New York: Little-­‐Brown Goodheart, A. (1994). Laughter therapy: How to laugh about everything in your life that isn’t really funny. Santa Barbara, CA: Less Stress Press. Hughes, D. (2002. The communication of emotions and the development of Autonomy and intimacy within family therapy. In D. Fosha, D.J. Siegel, & M. J. Solomon (Eds.) The healing power of Emotion: Affective neuroscience, development and clinical practice. New York: Norton. Howard, B. J. (2002). Guidelines for special time. In Jellinek, M., Patel, B. P., Froehle, M. C. (Eds.). Bright futures in practice: Mental health (V.II) tool kit. Arlington, VA: National Center for Education in Maternal and Child Health. Junkins, E. (1999). The role of laughter in psychotherapy. Retrieved from www.laughtertherapy.com. Junkins, E.(2002). Belly laughter in relationships: Something else positive below the belt. Irving, TX. Dustin Royale Publishers. Junkins, E.(1999). The belly laughter workbook. Irving, TX: Laughter Therapy Enterprises. Linesch, D. G. (1988). Adolescent art therapy. Levittown, PA: Brunner/Mazel. Nelson, J. K. (2012). What made Freud laugh: An attachment perspective on laughter. New York, NY: Routledge. Palmiter, D. (2011). Working parents, thriving children. North Branch, MN: Sunrise River Press. Riley, S. (1999). Brief therapy: An adolescent invention. Art Therapy: Journal of the American Art Therapy Association, 16(2), 83-­‐86. Rogers, C. (1980). A Way of Being. Boston: Houghton Mifflin. 106: Playful Connections 24 Saltzman, J. (2013). Playfulness: Enhancing family and clinical connections. In T. Todd, (Ed.). Family therapy, 12 (3), 16-­‐8. Schwartz, R. & Braff, E. We’re no fun anymore: Helping couples cultivate joyful marriages through the power of play. New York; Routledge Siegel, D.J. (2012). The mindful therapist: A clinician’s guide to mindsight and neural Integration. New York: Norton. Solter, A. J. (2013). Attachment play: How to solve children’s behavior problems with play, laughter and connection. Goleta, CA: Shining Star Press. Wilson, T. D. (2002). Strangers to ourselves: Discovering the adaptive unconscious. Cambridge, MA: Harvard University Press Wipfler, P. (2007a). Listening partnerships for parents. Palo Alto, CA: Hand in Hand. Wipfler, P. (2007b). Reaching for your angry child. Palo Alto, CA: Hand in Hand. Wipfler, P. (2007c). Special time. Palo Alto, CA: Hand in Hand. Wipfler, P. (2007d). Tears and tantrums. Palo Alto, CA: Hand in Hand