Play as therapy in child care, 1967

I read this paper last summer (1967) to a child care course at the North-western Polytechnic.  This was in itself a rewarding experience, and has been followed by a series of seminars during which I have been able to discuss the paper with members of my audience, in terms of their own experience.

I think that a definition can usefully be made between spontaneous play, therapeutic play groups, and play therapy:  and that therapeutic play groups could make a valuable contribution to residential child care in homes, school and hostels.

I

Lili E Peller (1955), in a paper entitled ‘Libidinal development as reflected in play’, classifies the main features of children’s play characteristic of successive stages of normal emotional development.  She describes:

1. Narcissistic play – the child with himself.
2. Pre-oedipal – the child with his mother.
3. Oedipal – the child with both parents.
4. Post-oedipal – the child with others.

Writing of narcissistic play, she says:

In the earliest months the playing infant appears interested in the parts of his body; in their functions and their products.  Gratifications and their counterparts – deprivations – stay in the immediate neighbourhood of body needs….remember that gratifications as well as frustrations are not yet accompanied by words or symbols.

Peller goes on to consider the child’s play at the stages listed above, and summarises as follows (the examples are my own):

1. Narcissistic play which is purely idiomatic; for example, a baby playing with his toes, or with his mother’s body as part of his own.
2. Pre-oedipal play, which can encompass another as an object; for example, a baby playing peek-a-boo with his mother.
3. Oedipal play which can be shared by several subjects and where theme and contact are communicable; for example, a toddler playing house with his parents.
4. Post-oedipal play, which takes forms that are predicated on step-by-step communication and mutual understanding; for example, a game of hide-and-seek with other children, according to agreed rules.

Peller does not, however, speak of ‘integration’ in her description (the essential process which must have taken place between stages 1 and 2); nor does she describe ‘transitional experience’ (Winnicott, 1958), in the course of which babies start to make use of symbols to bridge the gap between themselves and their mothers, as they separate out from a primary unity with their mothers to become individuals in their own right.  I wish, therefore, to add ‘transitional play’ to Peller’s classification, and to make a clear distinction between pre-integrated and post-integrated play.  It would not, I think, be helpful to try to fit the phases of play to particular age groups.  You are aware that integration as an individual normally takes place towards the end of the first year of life; however, in the course of residential work with deprived children of any age, workers will observe play belonging to all the phases described here.  Peller’s statement, that babies in the first phases are unable to think in words or to make use of symbols, is very important to us because there are many deprived children who are still limited in this way; their needs for play are very different form those of integrated children, who can symbolise.  After all, words are symbols, as are the letters which form them.

We cannot assume integration in deprived and disturbed children, and it is this fact which creates tremendous problems in all aspects of management, including play. The baby at the beginning is contained by his environment; his mother (supplemented by others) is the environment which contains him.  He is not yet in a position to contain experience; he is only able to reach such a position through the primary provision made by his mother’s adaptation to his needs (described by Winnicott) so that he has eventually enough experience with which to build a self.  The self is made of experience, and it is only on a basis of enough experience that he can become a container.  He is then able to contain further secondary experience, because he can realise and symbolise what happens to him.  He is no longer at the mercy of ‘unthinkable anxiety’ (Winnicott) which can only be remembered by feeling: panic is a good example of such memory by feeling.  Symbolic play becomes an important field in which to sort out his experiences – to ‘cope’ with them; verbal communication links him with other people, so that he can describe what he is feeling to himself and others.

Many of the children technically described as ‘deprived’ are nevertheless integrated, having had a good enough start to their lives.  They need plenty of facilities for play, and can make good use of these.  The play of these children comes into the later categories.  You will remember that Peller says ‘their play can be shared by several subjects; theme and content are communicable’ and ‘they may use play forms which are predicted on step-by-step communication and mutual understanding’.  Integrated children can play in groups; they enjoy games with accepted rules, such as ball games, hide-and-seek, or ‘grandmother’s footsteps’.  They play ‘house’ or ‘hospital’, they paint, model, or build, and this play enables them to find relief from conflicts and tensions, which they can express and resolve in symbolic terms.

In residential places, however, one would expect to find other children who are emotionally as well as technically deprived; who have not had sufficient primary experiences to build selves, who are not containers, but need themselves to be contained if they are ever to achieve integration as individuals.  They are unable to make use of play forms which would seem appropriate to their age and intelligence (the later phases of play described by Peller): on the contrary, they are likely to disrupt such play.  Far from using games and toys – a dolls’ house, draughts, or paints, for example – these emotionally deprived children will be more likely to destroy the toys, smear the paints over themselves and other children, break the furniture in the dolls’ house, and generally wreck the situation for everybody, making it impossible for other more integrated children to make use of play provision in a meaningful and valuable way, and causing ‘play disruption’ through impingement.

I suggest, therefore, that in residential places we should think of two main types of play group; one for integrated, and the other for unintegrated children.  Both the play material and the type of adult support provided for these groups should be firmly based on the degree of individual integration: on the capacity to contain (the integrated) and on the need to be contained (the unintegrated).  Of course integrated children can have areas of non-ego functioning, just as unintegrated children may have limited fields of ego functioning.  Nevertheless, there will be an overall picture which can make such assessment feasible, and in any case the grouping can be flexible.

We could say that where there is ego functioning there must be opportunities to function, but where there is no ego functioning there must be provision of containment.  This applies to all fields of management, but here I am thinking especially about play.  The children whom we are containing may well need the first kind of play described by Peller.  She speaks of this, you will remember, as being idiomatic, ie, special to the individual concerned.  She remarks that there are neither words nor symbols involved at this stage.  She talks of narcissism, ie, the play does not relate to others; the mother is included only as part of the child.

We are thinking also of transitional play, because unlike Peller, we need to be especially concerned with a more detailed consideration of phases of play which belong to the era of pre-integration.  Transitional play is part of transitional experience, to which I have already referred; the essential bridging to the increasing space between the mother and the baby, which is a normal and tolerable process, without which there can only be a traumatic break leading to a state of deprivation.

Provision of play for unintegrated children must include idiomatic and transitional opportunities (later we shall be considering what this means in practice).  Provision for integrated children will need to be made in a way that acknowledges the ability of such children ‘to encompass another as an object’, ‘share with several subjects….’ and ‘make use of forms of play based on communication and mutual understanding’.

Bearing these phases in mind, we now have some sort of a framework, within which to consider the use of play in a residential place.   I shall be thinking about children whose ages range from roughly three to twelve years; however, many of the principles involved apply to play with adolescents.

II

I assume that in any group of children in a place there will be representatives of various stages of evolvement, on the journey to more-or-less integration as individuals, and that facilities for such various types of play need to be available at one time or another.  How can such provision best be made?  One grown-up can play with one child with comparative ease, at whatever stage of integration the child may be at that moment; nor will the grown-up have too much difficulty in running a play group of children who are functioning at the same sort of level, whatever that may be: the difficulties appear when there is conflict amongst the needs of a group of children who are functioning at various levels.  Perhaps one could call this play-incompatibility.  I am sure that you have all had to deal with this fundamental problem; it has much to do with integration, with the establishment of identity, and with the recognition of the identity of others.

Let us assume that there are sixteen children in a residential place, and that there are, let us say, two people available to play with these children for an hour after tea.  Sixteen children can also be seen as two groups of eight: the selection of these two groups could be worked out by the people of the place.  In fact, I think there would need to be a sort of assessment discussion, within which the people caring for the children could pool resources of observation and experience in order to decide the point of integration reached by each child.  The two groups could then be planned on a basis of such an assessment; one group would be for the less integrated children – the ones who need to be contained.

Factors which could be used in this assessment:

1. The capacity to play with others without disruption.
2. The ability to communicate, especially in a symbolic way.
3. Respect for others and awareness of other people’s needs.
4. Capacity for tolerating envy in respect of other people’s gifts and achievements.
5. A lack of the need for total attention – the need to be the only one, different from the others (either as protégé or as scapegoat).

I think that on this basis one can make a reliable assessment of suitability for an integrated or an unitegrated group.

So here we are with two groups of selected children, one group of integrated, one group of not integrated children: we have suggested a time (an hour after tea), and we have the leaders of the groups – two people who might be looking after the children anyhow.  But who are these people to be?  I think there must be general agreement about this, whoever may be chosen for this particular kind of work.  Certainly it would be a help if hierarchy could be forgotten, if the two people chosen could be simply those who found it easiest to play with children without feeling guilt (ie, without feeling ‘this is a waste of time’ or ‘children can play on their own’, and so on).  The decision must rest with the person who is running the place, who accepts great responsibility and whose decisions must be justified to supervising and inspecting agencies.  When, therefore, there is a junior and less experienced worker who for one reason or another has developed such an idea – a play group for example – he or she will need to bring it to the head of the place (be it a school or a home) for consideration.  It would be worse than useless – in fact, actually destructive – for a play group to be launched split off from the life of the place.  We have learnt that there is no one person, alone, who can help deprived children; only someone supported by other people can do this kind of work.  It follows from this that there must be a lot of discussion and planning before play groups can be launched as an integral part of the life of the place.

The play groups could take place in a garage, or a workshop, or the living room, or even in the play room.  If the two groups must run in parallel, between five and six o’clock in the evening, perhaps – then there will have to be two places for play at the same time.  Ideally the play group place should not be in use all the time; a living room presents snags.  There could be a cellar.  I suppose there is a great deal of variety, but if the worst came to the worst, perhaps a play hut could be built – a simple prefabricated building with a wall radiator and an electric light.  If there really is only one place available for such special use, this should be reserved for the unintegrated group, for reasons which will become apparent as we proceed.

Now we come to the problem of equipment.

Provision of material for integrated children. The integrated group could make use of glove puppets, which are easy to make from papier maché and scraps of material.  They will need paints (powder paints), sugar paper or newspaper, large brushes, and mugs for water. They may like to use masks, which can be made from papier maché.  There could be a dolls’ house with furniture and a family of dolls.  A sand tray and water could be important; a couple of small screens could be used in all sorts of ways – as a house, a shop, or a hospital.  Then there could be games; draughts, ludo, and cards, for example.  Clay is better than plasticine.  I am sure that the children’s teachers could help with planning and make suggestions, especially in regard to where to buy cheaply and well.

Provision of material for unintegrated children. The second group (made up, as you will remember, of children who need containment and who are functioning at a much earlier stage of development) will need rather more special provision.  They can make use of large boxes, big enough to contain a child.  Other ideas which could be helpful are: blankets, cushions, etc, for nesting material; soft toys (teddy bears, and so on): feeding bottles filled with orange juice; a mirror; materials necessary for finger painting; a large jar of sweets of various colours; glove puppets; story books suitable for reading aloud; sand and water; and equipment for blowing soap bubbles.

You will see that there is some degree of overlap between the two lists.   You may find it advisable to alter these lists; flexibility is essential in all arrangements for play groups.  I only wish to indicate some kind of frame of reference within which to start two play groups in a residential place.

The room, shed or garage in which the unintegrated group will play will need to be as uncluttered as possible.   Children who need to be contained need a reliable environment, geared to their needs (just as they need continued and reliable care), so that the arrangement of equipment, once decided, should be constant.  A large cupboard in which toys, etc can safely be stowed away between play sessions would be better than shelves, especially if both groups will be using the same room.

The integrated children could play in a living room; however, there are difficulties involved.  You will find it hard to alter the room sufficiently for the children to feel that this is a different and special place, and that you in this context become a different and special person.

I am now imagining the possibility of these two play groups making use of a special play room, perhaps on alternate evenings.  These play periods would not be directed: suitable materials and equipment such as I have described would be available and within the reach of hand and eye.  The grown-up would not be concerned with ‘good behaviour’ during these times; ‘good manners’ would not be relevant.  The worker would, in this setting, be a therapist; his or her role in regard to the play group would be different from that at any other time in the twenty-four hours.  The worker and the children would be sharing a very special kind of experience during these brief periods.

People working in residential places sometimes tell me that they have very little time to play with the children in their care.  There are many practical tasks to be fitted into the day: physical care, administration, maintenance, cooking, mending, and so on.  Often they say to me, ‘If only there was just a short time when one could just play with the children.’ Listening to them, I get the impression that ‘playing with the children’ is regarded as a luxury which they cannot afford – an ‘extra’ rather than an essential factor.  I am quite sure that a planned play group, at a given time in a given place, would not only be valuable, but could even be essential.  Furthermore, I think that the feelings released in the playgroup and also in the leader of the play group, whilst sometimes disturbing, could nevertheless relieve tensions in the life of the place.  This can only be the case, however, if the grown-up is prepared to accept the responsibility of being a therapist.  Such a play group is therapeutic; and for this stage of affairs to come about, certain conditions need to be fulfilled.

Alxline (1947) describes total acceptance of the child.  She says:

Complete acceptance of the child is shown by the therapist’s attitude. She maintains a calm, steady, friendly relationship with the child.  She is careful never to show any impatience.  She guards against any criticism and reproof – either direct or implied.  She avoids praise for actions or words.  All this calls for vigilance on her part.  There are innumerable traps into which the unwary therapist might fall.  The child is a very sensitive being and is apt to catch the most veiled rejection of himself on the part of the therapist.

This, for you, working in a residential place, means that although a few minutes earlier you were scolding Michael for making such a mess, or urging Janet to get on with her homework, now in this setting you (the same person) are accepting Michael and Janet as they are at that particular moment in that place; not needing to direct them in any way (except in regard to safety).  You may feel that such a change of role must be disturbing to the children, and that at the end of such a period of undirected play Michael and Janet could tend to be disrespectful, disobedient, and so on.  In fact, such a reaction is likely to turn up at first, but presently the children will sort out the roles for themselves – that is to say, you as a child care worker and you as a therapist.  I work in this way myself with our private patients who live in our house, with an age range of from nine to seventeen years.  Most of the time I am a grown-up managing a group of children: I am often critical of their behaviour – I get cross, I refuse to put up with this or that.  However, for one hour in most days I am a therapist, and they talk with me alone and make use of me in a very special way, which is deeply different from any other time.

In the residential school for maladjusted children where I work as a consultant, the teachers find that at one time they can be critical – authority figures – while at another they can be running non-directive groups, in which their comments are for the most part attempts to reflect what the child is feeling.  It is true that one is not treated with what people term ‘respect’ in this context, but on the other hand one is trusted in a rather special way; one may even be allowed to enter the inner world of the child whom one may have ‘known’ – without knowing – for a long period.  Communication at such times becomes either symbolic or pre-verbal (the child may only communicate through actions).  A small boy in the therapeutic school said recently to his teacher, Liz Greenway, ‘I hate when people are just opining their mouths and noises are coming out but they are not really saying anything.’  Often what we say to children, and they say to us, becomes stereotyped; in a play group communication can come alive.

Axline lays down eight basic principles for non-directive play therapy.  I think that these principles are relevant to the special kind of playing with children which I am discussing here, and later I shall quote them in full.  You will observe that the grown-up attitude which she describes would not be appropriate in some fields of the child’s life.  If a child says suddenly, ‘I don’t want to go to school today’, we cannot help very much by saying, ‘You feel you don’t want to go to school today’, because we and the child usually know that he is going to school this morning, and that he can accept this fact.  In the same way he can say that he doesn’t want to go to bed, or wash his hands before tea; we can understand that he does not want to do these things, but we can usually rightly insist just the same, and he can tolerate our insistence.  However, if in a play group a child says, ‘I want to smash that dragon’ (a puppet), we do not need to say, in this special setting, ‘But that would be naughty’; we can just settle for ‘You feel you want to smash that dragon.’ (Perhaps this boy’s name is George?  This is the sort of thing to keep in mind.)

I am now going to consider Axline’s eight principles, and discuss how they apply to residential therapeutic play.

1. ‘The therapist must develop a warm, friendly relationship with the child, in which good rapport is established as soon as possible.’

Here, the fact that our ‘customers’ are already known to us may make the establishment of such rapport unnecessary because it has long since been achieved.  However, the children will also have assigned us specific and personal roles in their lives, so that initially there may be difficulty in accepting us in this different climate.  Perhaps an important point to bear in mind would be, that in this special context, anything which has happened during that week or day becomes irrelevant.

2. ‘The therapist accepts the child exactly as he is.’

I have already spoken about Axline’s concept of total acceptance of the child.  If we can just accept the child in this place, at this time, as he or she is, we may escape the temptation of relating the way in which the child behaves in the play group to his behaviour in other contexts.  Total acceptance could mean that when Johnny wants everything in the play group we do not say, ‘There you go, Johnny, grabbing everything as usual’, but we might say instead, ‘Johnny feels he must have everything – it must be awful for him to feel like this.’

3. ‘The therapist establishes a feeling of permissiveness in the relationship, so that the child feels free to express his feelings completely.’

Johnny, at breakfast, must say ‘Please’ and ‘Thank you’ and be polite to others.  At school, too, he must be respectful to his teacher, and this is as it should be.  However, in the play group, if Johnny is to feel free to express his feelings and to be totally accepted – for an hour – then he may be rather rude to you, but he may also show you that he loves you.  You will see a better and worse Johnny than you would meet in other contexts.  If he is free to say what he likes he will probably not do anything antisocial; freedom of speech can serve as a valuable safety valve.

4. ‘The therapist is alert to recognise the feelings the child is expressing and     reflects these back to him in such a manner that he gains insight into his behaviour.’

This kind of awareness is difficult to achieve; it depends on how much insight we have gained ourselves and how much we understand our own feelings.  The more of this self-awareness we have gained, the more we can understand the children in our care.

Possibly, just because we are playing with Johnny and the others, just because we are not teaching, training, nursing, or supervising, we may be free to wonder more about the meaning of the play: for example, when a very quiet, good child becomes a savage giant when he is wearing a mask, we may wonder what hate and helpless rage may be seething inside him from behind the calm exterior he presents to the world.  So that when the giant roars and rages you may find yourself saying, ‘This giant is very angry about something – I wonder what made him so angry?’  and perhaps the child talking as the giant may tell you important things about himself, about his inside reality.

5. ‘The therapist maintains a deep respect for the child’s ability to solve his own problems if given an opportunity to do so.  The responsibility to make choices and to institute change is the child’s.’

For example, we can respect the giant’s feelings; we can indicate such respect by the way in which we respond to the giant’s rage.  We can respond to what the child-as-a-giant says, making it clear that we can accept the giant’s decisions within the framework of the play.

6. ‘The therapist does not attempt to direct the child’s actions or conversation in any manner.  The child leads the way; the therapist follows.’

This, I think, confirms what I have said earlier.  We are not teaching or training, we are doing therapeutic work.

7. ‘The therapist does not attempt to hurry the therapy along.  It is a gradual process and recognised as such by the therapist.’

Most of us think in terms of progress as improvement, recovery, and above all, change.  Change there will be, but not if we are trying to bring about change in children rather than support them in evolving – changing – in their own special and individual way and in their own good time.  We cannot hurry this sort of process:  I think that the best plan is not to worry about change, but simply to continue to maintain a supportive reflecting role in relation to the child.

8. ‘The therapist establishes only those limitations that are necessary to anchor the       therapy to the world of reality and to make the child aware of his responsibility in the relationship.’

This principle for play therapy laid down by Axline brings us to the important question of limits.  How permissive should we be?  Where do we establish boundaries?  I think that we must use sense and sensibility to determine limits in a play group. Much of Axline’s work has been done with individual children; she acknowledges the difficulties inherent in group therapy of this kind.  There are various views on the subject of ‘limits and I feel that the wisest plan is to set them as they are reached.  For example, you would not allow children to hurt you or each other, to break windows, or to urinate in the sand tray.  But it would be a mistake to announce a list of limits.  Most groups will establish boundaries and remain within them.

These eight invaluable principles would seem applicable to therapeutic play of the kind under consideration here.  The principles apply to play with both integrated and unintegrated children, with the exception of the ‘limit’ problem.

As I have already said, unintegrated children need to be contained: they may actually need to be held.  They are aggressive and destructive; we often have to supply the missing boundaries.  Anticipation becomes especially important – awareness of impending play disruption and its interruption at a sufficiently early stage, to preserve the coherence of the group.  One comes to recognise the first signs of such disruption and to localise the ‘Storm Centre’ (Redl).

We are now in a position to compare any group of children playing in the presence of an adult with the kind of group we are thinking about here, where the play group has a therapeutic purpose.

I think that it is especially the attitude of the grown-up which determines the nature of the group.  Often someone who is supervising children’s play will only intervene if necessary; in this situation the grown-up is not often involved with children, unless he or she is actually taking part in a game.  The person who is running a therapeutic play group is deeply involved; contributing to the individuals and to the group as a whole; responding, reflecting, and sensitive to every mood and feeling.

The children in a spontaneous play situation may communicate with the supervising grown-up, and are likely to appeal for judgement in regard to ‘fair play’.

Integrated children in a therapeutic play group will make use of the grown-up in a different way.  More integrated children will draw the grown-up into their midst; asking for assistance, talking about their paintings, communicating with him or her from behind a mask, or with a glove puppet.

Unintegrated children will be seeking opportunities for regression: they will need to be fed, to be wrapped up, to be tucked into a nesting box, and to be read to (another way of being fed).  They will indicate their needs, once they know that you will meet them whenever possible.

One must be prepared for surprises.  Quiet children may become noisy and aggressive; noisy, tough children may turn into pathetic and trusting babies.  Even the more-or-less integrated children may need to regress now and then; quite normal children regress in the course of an illness and become deeply dependent on the person who takes care of them.  In an ordinary play group children do not tend to regress.

You may feel that there are many deprived children who do not need any kind of therapy, but only normal recreation.  However, most children who are not living normal lives in their own homes have problems, however well they are coping with them; once in a while they need to find themselves in a situation where they can be absolutely themselves.  The play group can often offer them such an opportunity, in a way which normal recreational activities cannot do.

The ordinary play time can take place in the garden, the living room, or the play room.  The games that children play in the garden are different from those they play indoors.  Children will play during any ‘in between’ time.  A therapeutic play time needs structure; because what happens within the session is fluid and changing, the structure must be reliable.  So a play group needs to happen in the same place, at the same time, and with the same person.  This is true of all therapy.

III   HAPPENINGS

The happenings which follow have to do with various play groups with which I have been involved, at one time or another.

1.  The first happening which I am going to describe took place on a wet winter afternoon, when, for various reasons, I had to play with twenty deeply disturbed children in one large room.  We had no play equipment: there were tables, chairs, and mats on the floor, but little else.  Because the group was so large and play material was lacking I suggested that we could play ‘Desert Island’.  Since the group seemed to accept this idea, I put one mat at the end of the room, and arranged all the furniture against the walls (the children by now were helping me) turning one table upside down on the floor.  I explained that the mat was the desert island, the upturned table a ship, and the rest of the floor the sea.  Before I could say any more, a crew had manned the boat, led by a very determined captain – four children and a captain squeezed themselves aboard and prepared to set sail.  All the other children sat with me on chairs and tables round the walls.  We all waved as the ship set off on its long voyage.  By now, the captain and the crew were eagerly discussing the treasure they hoped to find, and the dangers they would have to face.  Suddenly the captain exclaimed, ‘The wind is rising!’  At once the children round the walls began to make the sound of a threatening storm; one boy banged a biscuit tin so that lightning flashed and thunder rolled all around us; the waves grew higher and higher until eventually the ship was wrecked and the sea was dotted with desperate sailors swimming for their lives.  The captain and three members of his crew succeeded in reaching the desert island, but one sailor was drowned.  (The audience by now was the storm; at the same time they shrieked to the crew to swim to safety on the island.   They accepted the death of the sailor who was drowned as inevitable, saying, ‘He didn’t really want to live.’)

Now the captain and his crew lived on the island for a long time (about five minutes, in reality); they built a hut, lit a fire, killed and cooked and ate wild animals, and caught fish (all this was talked about and mimed).  Suddenly they saw a ship – should they leave the island?  They were undecided, but they audience shouted: ‘You want to go home, in the end.’ So the captain and his crew were rescued by the passing ship and the audience cheered; the drowned sailor was pulled out of the sea and ‘came alive again’.

During this adventure I perched on a table with some of the audience.  I said very little except when someone involved me in the drama.  There were calls for help form the captain, ‘Are you going to let us drown?’  I replied that he must feel that no one was helping them.  The captain replied, ‘We’ve got to do it ourselves!’ One of the crew asked me, ‘Shall I stay for ever on the island?’  I said that it must be difficult to decide whether to go or to stay.  One of the audience shouted: ‘You’ve got to decide.’  Presently, after a lot of discussion, a new crew set sail and there was another voyage, storm, and shipwreck on the island.  Although the main structure was fairly constant, each voyage was highly individual.

The children all made use of the game in valuable ways.  Certainly their lives had been stormy voyages; often there had been family shipwrecks: the island had something in common with the therapeutic school which they would one day leave.  Here, in symbolic terms and without direction, they could safely act out some of their deep problems.

This group was made up of a mixture of integrated and unintegrated children.  The integrated ones set the pace, made use of the symbols I offered them, and communicated at a symbolic level with the other children and myself.  Unintegrated children were ‘carried’ by the group.  The sailor who was drowned was not integrated and was overwhelmed by the force of the storm.  My role was essentially a supporting and reflective one.  I gave no advice, and there was no need for intervention.

The Desert Island game, as played by this mixed group, had elements belonging to most of the phases of play which I have listed earlier.  For example, the drowned sailor was not really aware of the others; his play was idiomatic, in that he did not relate to the rest of the crew or to the audience – he ‘drowned’ for his own private reasons.  The game was shared by several subjects; theme and content were communicable.  All the integrated children made use of symbols (the storm, for example).  At certain points the play suddenly settled between one child and myself (the child encompassing another as an object), for example, when the captain shouted to me: ‘Are you going to let us drown?’  There was not much evidence of form predicted on step-by-step communication and mutual understanding; the game developed spontaneously.  Much of the game had a transitional character; the children were essentially bridging gaps.  My particular choice of game and symbols had been intended to provide such an opportunity.

2.  This happening concerned five very difficult and unmanageable children, in the same school.  The group was indeed made up of those who were too disturbed to work in a lesson group – so they came to play with me.  We met in a small room in which there were a table and several chairs; there was also a high, broad windowsill which turned out to be important.  We had paints, paper, etc, some glove puppets, and some cushions and blankets. The five children were all residential (feeling rejected by their own groups); none of them were integrated, and two were in fact psychotic.

David and Stuart started a slanging match full of obscenities; John charged round the little room making a loud roaring sound; Peter wrapped himself up in a blanket and huddled in a corner; Tom climbed onto the windowsill and curled up on it in a foetal position. I sat and waited.  Presently David and Stuart found the glove puppets; they put them on – one on each hand – so that presently there were four puppets arguing and threatening each other and me.  I collected two puppets myself and tried to communicate with the children’s puppets, but this broke down at once.  David and Stuart threw away their puppets and started to wrangle again, and to prod Peter, who was still wrapped up in a blanket.

Tom (curled on the windowsill) suddenly woke up, and took a flying leap into the room, upsetting the paint water.  All this time John had been charging round, still roaring steadily – the total sum of noise was ear-shattering.  I said, rather loudly, that I wondered what fierce animal was roaring so loudly, and John paused long enough to inform me that he was of course a lion.  Presently he allowed me to make a den out of chairs and a blanket; tucking himself into the den he reached tranquillity through containment: indeed he spent the rest of the session in and out of his den, with only occasional roars.  I put a cushion under Peter’s head and made an arrangement of blankets for Tom on the windowsill, in case he should return.  By the end of the session, things were fairly clam, but there was no real group – just five isolates trying to find holes into which to crawl.  At one point I held Stuart to prevent him from actually attacking David.

This was a group of unintegrated children: these five were far more difficult to manage than the twenty I have described previously.  They made little use of symbols, although the lion became important to John in later sessions.  There was no real contact with me through communication, my role was to reflect; but it was also to establish boundaries, to provide containment, and to hold if necessary.  The play was narcissistic, except for the wrangling between David and Stuart; these children were not in touch with each other or with me, as separate people.

3.   The third happening which I am going to discuss I have also described in another context elsewhere.  It concerns a group of eight children: we were playing in the garden.  The group decided that they wished to make little nests out of twigs and grass.  They asked me if I would provide eggs to put in the nests.  I offered the possibility of small squares of chocolate, which they accepted.  The children all made nests, with varying degrees of skill, and brought these to me to be filled (I should note here that I neither praised nor criticised the nests).  I asked the first child, ‘How many eggs?’ and he replied, ‘Four.’  The second child wanted five eggs.  The third child, Roy, wanted one egg.  I just reflected what he said, giving him the one egg, and murmuring, ‘Roy wants one egg.’  I thought to myself that this child – who was very greedy and loved chocolate above all things – nevertheless needed so much to be the only one that this symbolic experience became more essential than the chance to eat several pieces of chocolate.

Here one can see a child making tremendous use of play, finding opportunities for symbolic experience which could feel real to him.  The other children in the group had their own personal experience; each nest was, in this sense, unique.  In the course of this happening my role was essentially that of acceptance and support.  The group – especially Roy – were having important and creative feelings: children who had reached despair were beginning to hope again.  I asked no questions, because questioning could have been intrusive.

Here, I think the play was mainly transitional; the children were not really playing with each other, but they all included me in their play; the nest and the ‘eggs’ needed contributions from the children and myself, building bridges between us.  Although every child in the group decided to make a nest, their play remained pre- oedipal.  Each child encompassed another as an object (myself).  There was little connection between the children: for example, no one (except for my reflection) commented on the fact that Roy wanted only one egg; neither, for that matter, did they remark on the child who asked for five eggs.  There were lifelines, of a sort, from each child to myself.

These happenings are not as relevant as they should be, for the purpose of this discussion, in that all the children described were deeply disturbed – basically emotionally deprived – at various stages of recovery in a therapeutic school.  However, it so happens that my work had been with such children, and I have drawn on my own experience.  Perhaps the acute nature of this kind of disturbance may highlight the points that I wish to make.  In any case, there must be many group happenings in your own experience which you can subject to the same scrutiny.

What follows now is imaginary, although most of the material has turned up at one time or another.  I am going to try to describe a fictional happening; seen as an educational experience, then as a spontaneous supervised play period, and finally as a therapeutic play group.  I feel that such distinctions are worth teasing out, because they tend to become confused.

I am choosing to describe a group of eight unintegrated children, their age range five to twelve years, playing with a child care worker whom they know fairly well.

1.   The educational play group. The grown-up is in the room when the children arrive.  She has taken a lot of trouble to arrange the play material on the tables and shelves.  She asks each child what he or she would like to do, and provides material accordingly.

Three children say that they will paint – the paints are ready mixed.  The grown-up gives each child a piece of paper and a brush, discussing with them what they will paint.  One child is lying on the floor; the grown-up gently raises him to his feet, saying in friendly tones, ‘Come along, Peter, this is play time, not bedtime!’  The two remaining children wander about in a vague sort of way.  The grown-up manages to collect them and settles them at the table on which stands the dolls’ house.  One of this pair hits the other, and the grown-up intervenes and begins to arrange the furniture in the dolls’ house while the children sit silently watching her.  Presently the grown-up looks at the pictures the children have painted, praising good efforts and making constructive criticisms.

2.   The supervised, spontaneous play group (with the same children, adult, setting, and material).  The grown-up and the children come in together.  The grown-up has some mending with her.  She settles near the window and starts to darn a sock.  One child asks permission to get some water for painting; the grown-up gives permission, asking him at the same time not to make a mess.  Another child comes and talks to the grown-up, perhaps about a television programme.  Two of the children start playing with puppets.  This begins a sort of fairy-tale, but rapidly degenerates into a battle, with the puppets being used as weapons.  The grown-up takes the puppets away, saying that if they cannot use the toys properly they may not have them.  The children sulk in silence.  One child lies in a corner doing nothing; he looks as if he is dreaming.  No one goes near him.

3.    The therapeutic play group. The grown-up comes into the room with the children.  She has already put away the dolls’ house, but she has left blankets and cushions in the corners and under tables, and also a couple of containers (a large tea-chest and a laundry basket).  She sits on the floor in the middle of the room with a puppet on each hand.  A child asks, ‘What shall we do?’ and the puppets on the worker’s hands discuss this, saying how difficult it is to decide what to play with.  Different children argue with the puppets.  Another child lies down on the floor, and the worker puts a cushion under his head and wraps him up in a blanket.   The child says, ‘I don’t want to do anything,’ and the worker replies: ‘You don’t want to do anything, perhaps you just need to be.’

By now there is nest-making in progress; children are fixing up safe places into which to tuck themselves.  The worker helps where she feels needed: for example, a child in a tea-chest asks to be completely covered up and dark, and the worker makes a roof out of a blanket.  Several children specify particular soft toys that they want to hold.  One asks for a baby’s bottle (already filled with orange juice) which the worker gives him.  Suddenly there is a fight over a toy: the grow-up has noticed which child is the aggressor, and she holds him very firmly saying that she knows how angry he must be feeling.   The attacking child is in a rage and screams.  The grown-up goes on holding him, and the other children pay little attention.  The child screams, ‘Leave me alone!’ and the grown-up, understanding what the child may mean, says that he is afraid that she will leave him alone…..he calms down.

I would like now to draw attention to the little boy lying on the floor in the course of each happening.  You will have noticed that in the first case he is gently picked up and told, ‘This is play time, not bedtime’, and he adapts to the demands made of him; in the second happening he passes unnoticed because he is not presenting difficulties, he hibernates; in the third happening, his behaviour is seen as regressive.  He is treated as someone in need of very early babyhood experience, and he responds to the adaptation made to his needs.  He is now aware that not only is he being taken care of, but also that someone is caring about him – as he is at that moment and in that place.

SUMMARY

In this paper I have tried to catch the wind.  Erikson has said (1950):

Modern play therapy is based on the observation that a child made insecure by a secret hate against or fear of the natural protectors of his play in family and neighbourhood seems able to use the protective sanction of an understanding adult to regain some play peace.  Grandmothers and favourite aunts may have played that role in the past; its professional elaboration of today is the play therapist.  The most obvious condition is that the child has the toys and the adult for himself and that sibling rivalry, parental nagging, or any kind of sudden interruption does not disturb the unfolding of his play intentions, whatever they may be.  For to ‘play it out’ is the most natural self-healing measure childhood affords.

I have tried to contrast integrated with unintegrated children and to compare their needs in the province of play.  I have also attempted to clarify the therapist’s role in a therapeutic play group, and to demonstrate the differences between this role, an educational role, and a supervisory role.

What I have been putting forward is the suggestion that child care workers, although no psychotherapists, can nevertheless do valuable therapeutic work of a special kind.  I am suggesting that some of this already existing play could be channelled into non-directive play therapy.

I feel that there is a need for support for workers running such play groups, and that opportunity for discussion could be invaluable and perhaps essential – at first, anyhow.  Perhaps some such opportunity could become available; in any case there could be discussion in the place about the happenings in the play groups: this would be valuable for the people in residential work who are trying to learn more about the children in their care.

Clare Winnicott (1963), talking to social workers, has said:

Of course we shall not always understand what is going on or what they are trying to convey to us, and often this does not matter.  What matters most is that we respond in a way which conveys our willingness to try to understand.  And it must be obvious that we really are trying all the time.  This in itself can provide a therapeutic experience.

The children in a special play group will do and say things that we shall often not understand; but by reflective techniques and total acceptance we can help them to become more truly themselves.  I believe that such work could be both practical and valuable.

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