Child Therapy

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What is Child Therapy?

The method of child therapy I use, psychoanalytic play psychotherapy, was first discovered in the early 20^th century by Anna Freud , Melanie Klein  and Hermine Hug-Hellmuth.

They discovered that young children usually cannot speak in adult language about their problems. Children could not say why they were hyperactive, or why they were being so rude to their parents, usually because they did not know.

It was believed that children’s play could enable children to reveal their worries in a way that was equivalent to adult language. Play was thought to be like dreams, in that the meaning of the content of the play was usually related to some kind of conflict in the child’s life (often the conflict), this meaning was often hidden in symbols in the play, and it required someone to interpret the play (or the dream) into clear language that made sense.

 A common example is the child who is afraid to go to school and wants to stay home with mom. In play therapy, you would likely see this child playing a lot with the school bus  and dolls representing the child and mom. In the story of the play, the child will often show

(without knowing that he is doing so) why he is afraid to go to school.

Perhaps a new sibling was recently born and the child acts out a play where a person takes his mother's attention away from another character in the play that represents the child. We would then wonder if the patient’s reluctance to go to school was related to the child’s wish to be with mom, too, and, when the time was right, this could be stated by the therapist to the child in clear language.

Or maybe the mom in the play is not feeling well or is sick, and the child wishes to nurse  the mother instead of going to school. We would then wonder if the child doesn’t want to  go to school because the child fears what could happen to the mother if he leaves her.

What Klein, Freud and Hug-Hellmuth found was that if you carefully share this information contained in the child’s play with the child, and are able to have some kind of conversation about the child’s “real” fears (about mom, or brother, or father, etc.) with the child, than the original fear of going to school eventually disappeared.

This happens to everyone at times, when we are feeling depressed or anxious and we don’t know exactly why. Then we have a dream, or a memory, or a thought, and the real reason why we not feeling well is suddenly triggered, and then we often feel better.

The pioneers of child therapy were discovering that knowing the ‘why’ of our behaviour often led to its improvement, but that it was a tricky business finding out exactly why children behaved or felt as they did, and this was why child therapists were needed. Therapists could act as translaters or interpreters who could convert the child’s confusing behaviour into something that made sense to the child and to the child’s parent(s).

It was discovered that playing was therapeutic and growth-enhancing, and that children’s psychological development, including brain development, was facilitated through play from the beginning of life. Play was considered the natural medium for therapy, as play is

basically a method of communication for the child, and is something the child enjoys and will do voluntarily, often showing initiative and creativity in this process.

Some play therapists just play with the child and do not translate the play into adult language for the child, and sometimes “just playing” works by itself and the child improves. Other therapists do a lot of translation and there is more talking than playing.

I have found that each child is different and that each treatment approach must be custom-made for the child, often depending on their capacities and personal preferences.

I do think that talking to the child and encouraging the child to use language to express themselves, in addition to using play, is usually the approach that ultimately facilitates the most emotional growth in the child. But it does really depend on the child, as each child varies in its capacity to use language to express it thoughts and feelings.

It is not uncommon for children to improve enormously without having talked about anything explicit about the problem that brought the child into therapy, but I have found that if the child can ultimately reach a place developmentally where they can reflect on their own minds, then the result is often more rewarding for the child and for the parents.

© Andrew Guthrie 2006