What is Play Therapy?

In the child therapy world, including Toronto Play therapy, it has become increasingly popular to envision child therapy as a very different enterprise from psychoanalytic work with adults. This trend rests on an assumption about the relationship between development and communication modality. To do therapy with children (I have a Toronto child therapy practice) is a very different undertaking, the play theorist argues, because the majority of children do not have the mental faculties to actively and intentionally use words to communicate their internal, painful experiences, or receive verbal communications from others regarding these experiences. Instead of using words to communicate, the child plays, and in order to communicate with the child the child therapist must play with the child. Therefore, theorists who emphasize the therapeutic efficacy of playing do not verbally interpret the meaning of the child’s play in order to make the unconscious conflicts of the child conscious, as one would with an older teenager or an adult. These theorist believe it is only the rare child who seeks self-understanding and is capable of using interpretations to understand inner experiences. Furthermore, the playing child therapist, like the relational theorist, does not believe that conscious insight resulting from interpretations is what enables healing to occur. There is something else going on. This “something else” is not necessarily conscious, verbal, direct, or intellectually graspable, but exists primarily in the symbolic realm of play and fantasy that need not be made more real in order for children to change in psychoanalytic treatment. The entire analysis could take place in the shadow of play, without the presentation of illuminating words from the analyst to the child in order to expose what the play means, or to create shared linguistic symbols. Much attention is applied to the toys and the play narrative as things-in-themselves that become endowed with personal meaning by the individual child. While the child therapist may maintain a deep understanding of the symbolism of play, this knowledge is not shared with the child as if the child were an adult, but may or may not be used to respond to the child within the metaphor of play. This kind of “pure” play therapy is a covert process where the positive elements of the relationship between analyst and child are facilitated and nurtured, while negative elements remain unacknowledged and unexplored. This stance has much in common with supportive psychotherapy techniques used with adults discussed in the introduction, and therefore may not be well respected by psychoanalytic purists within the Freudian and Kleinian traditions.