Violet Oaklander on Gestalt Therapy with Children

Violet Oaklander on Gestalt Therapy with Children

by Rafal Mietkiewicz

The founder of Gestalt therapy with children and adolescents discusses therapeutic relationship building with kids and teens, the unique rewards of introducing expressive arts therapy techniques, and the challenges of being sufficiently directive in working with children.  
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An Unorthodox Notion

Rafal Mietkiewicz: Violet, what makes me curious is that you are trained as a Gestalt therapist and people connect you with Gestalt therapy, but Gestalt therapy was mainly considered, at least here in Europe, to work primarily with adults. How did you find your way to do Gestalt therapy with the kids?
Violet Oaklander: I was already working with emotionally disturbed children in the schools when I got interested in Gestalt therapy. One of my children became very ill and died. I was very depressed. My friend was going to Esalen Institute to be in a group for a week with Jim Simkin, so I went with him, and I was so impressed with what happened to me. It made such a difference for me that when I came back, I started training in the Los Angeles Gestalt Therapy Institute, and while I was training, I thought, "How could I apply this to children?"

It seemed very organic to me. Fritz Perls talked about the body and senses and all of that. I found that it fit my work with children and child development. And of course, over the years, I started using a lot of creative media, like drawing and clay and puppets and music, because that's the only way it would interest children. But behind that, the basis of my work was Gestalt therapy theory and philosophy. And I developed it more and more as time went by. That's how it got started.

... Continue Reading Interview >>
RM: That's what you wrote in your book—that children already know, but they are wearing special glasses, so you just take the glasses off?
VO: Yeah. I have many stories working with kids. I'm trying to think of when I first started. When I first began, I was working in the schools with maybe a group of 12 children. And they were older—maybe 12 and 13 years old, all boys. These were kids that didn't make good contact; they didn't connect very well with other children.

I started doing things that were sort of different. I would have them finger paint. I'd line up the desks so it was like a table, and they'd stand around the table finger painting. At first, they didn't want to do it. "It's for babies." But while they were finger painting, they would talk to each other, make really good contact. And of course it was important to establish boundaries—what they could not do and what they could do. So that was very clear.

Another thing I started doing was bringing in wood, and they would build things. These were children who weren't allowed to hold a hammer or a saw because they were very disturbed children—it was dangerous. But I saw other classes had wood and got to build things, so I got that. And they had rules: they couldn't swing the saw or the hammer, or else they had to sit down that day.

I wouldn't let them build guns, but they could build boxes and birdhouses, and they would work together because they had to share the tools. You would not believe they were emotionally disturbed children. They were making such good contact and really enjoying this. I did many things like that.
RM: You look like you really enjoy your work.
VO: Oh, yeah. I even had the old empty chair. I had two chairs in the front of the room, and when a kid would get really upset and angry, I would have him sit in the chair and talk to the empty chair.

And the child that he was angry at might be in the room there, but he would be talking to the empty chair. And then I'd have him switch and say, "Well, what do you think he would say back to you?" and it was so amazing because he would realize that he was projecting. They didn't know that word—they didn't have that insight. But they could see that they were projecting their own stuff on the other boy.

It would be so amazing. They would come into the room and say, "I need the chairs." They would talk to a teacher who had yelled at them outside. They would talk to that teacher, and then they would begin to see that the reason the teacher yelled at them is because they did something they weren't supposed to do. They knew this, but when they sat in the empty chair, they'd say, "Well, I yelled at you because you hit this other boy!" And then I'd say, "Now, what do you say to that?" They'd say, "Yeah, I guess I did. I did do that, yeah." It was just little things like that that I began to do, to experiment with some of the techniques.

After I left teaching and I was in private practice, I thought a lot about what I was doing, and I started developing a therapeutic process that was based on Gestalt therapy, beginning with the "I-thou" relationship, and looking at how the child made contact, and then building his sense of self and helping him to express his emotion.
RM: It seems like you combine a bunch of techniques and approaches in your work—like expressive art therapy or child group therapy.
VO: Yeah. We do a lot of sensory work. I mentioned finger painting—anything they can touch. Clay is incredibly sensory and evocative. If it seems like they need to do some movement, we do that. Sometimes we play creative dramatics—charades—because to show something, you have to really be in touch with your body. We might start with fingers: "What am I doing? Now, you do something." And they think of something and they have to use fingers to act it out.

And then maybe we do a sport—they have to show with their body what sport they're playing, and I have to guess. It might be obvious, but they enjoy doing that anyway—maybe catching a ball or hitting with a bat or tennis racquet. They have to get in touch with their body to do that.

The projective work with drawings and the clay is also very important, because this is how they can project what's inside of them and then own it. One example is a boy who had a lot of anger but he kept it inside. He presented himself as just very nice and sweet, and nothing was wrong with his life. It was only after I asked him to make something, anything—I usually say, "Close your eyes and just make something, and then you can finish it with your eyes open"—he made a whale, and told a whole story about how the whale had a family—a mother and a father and sister.

What I always do after they tell the story is try to bring it back, so I said, "Well, does that fit for you? Do you have a family like that?" He said, "No, my father lives far away because he and my mother don't live together. I never see him." "Well, how do you feel about that?" And then we started talking about his father, which he would never have mentioned, and all this feeling came up. It's very powerful.
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The First Session

RM: How do you approach the first session with a child?
VO: I always meet, if possible, with the parents and the child the first session, because I want the child to hear whatever the parents tell me. I don't want the parents to tell me things and have the child not know what they told me.
Even if the parents are saying bad things about the child, the child needs to hear what I hear from the parents.
Even if the parents are saying bad things about the child, the child needs to hear what I hear from the parents.

Usually in the first session, I have a checklist, and very often I would put it on a clipboard. First I would say, “Why are you here?” and all that. Then I would ask the child these questions. “Do you have a good appetite? Do you have bad dreams?” A whole list of questions.

Sometimes the parent would chime in, but mostly it’s to the child. It was a way of really making a connection with the child. Of course, if they were very, very young, four years old, maybe I’d still ask these questions, but not everything—and use language they could understand.

That's always pretty much the first session. But if there are no parents involved—because I saw many kids who were in foster homes or group homes—the first session is an important one to establish some kind of connection or relationship. Sometimes I’d ask the child to draw a picture on that first session. I’d ask them to draw a house-tree-person. But I wouldn’t interpret it. It’s not for interpretation. It was to say to them when they were done, “Well, this picture tells me that you keep a lot of things to yourself. Does that fit for you?”—because maybe they wouldn’t draw many windows. And they usually would say “yes.” Or, “This picture tells me that you have a lot of anger inside of you. Does that fit for you?” If they’d say, “No, I’m not angry,” I’d say, “Oh, okay. I just need to check out what I think it tells me,” and we would have that kind of a session.

I did that once with a very resistant 16-year-old girl who at first said she wouldn’t speak to me. And when we finished, she wanted her sister and her mother to come in and do that drawing. So it’s a way of connecting.

But we don’t always do that. If it’s a child who is very frightened—I had a girl, for instance, who was very severely sexually abused for many years, and it finally came out when she was about 11, and she was removed from the home. So she was in a foster home, but the foster mother was very devoted to her and came in, too.

But she was very, very frightened and didn’t want to talk to me. So in the beginning we would take a coloring book, and we’d both color in the book. And we wouldn’t really talk about anything. I’d say to her, “Should I use red for this bird? What do you think?” and just begin to connect with her that way. Pretty soon I was asking her, “Well, what do you think the bird would say if it could talk?”—that kind of thing.
 
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Pay Attention

RM: It's my guess that you don't really diagnose kids in clinical terms.
VO: No. I mean, sometimes I would have to for an insurance company. But it's a matter of seeing where they're at, where they're blocked. I had one boy who walked very stiffly all the time. He was 11 years old. And I thought, "Maybe we need to do something to help him loosen up before we even talk about his feelings"—that kind of diagnosis.
RM: So, you don't find clinical diagnosis useful in therapy?
VO: Not very much, no.
RM: You trust in what you see and what you feel about the kid.
VO: What I see, yeah.
If, for example, the child has a lot of difficulty making a relationship with me, that's what we have to focus on, because I can't do anything unless we have that relationship.
If, for example, the child has a lot of difficulty making a relationship with me, that's what we have to focus on, because I can't do anything unless we have that relationship. Sometimes children have been very hurt and damaged so early, they have trouble making a relationship. So we have to figure out how we could do that.

I used to see a lot of adolescents who were arrested by the police because they had committed a crime. I was involved in a program where they would send these children to counseling. It was a special program they were trying. So this one girl came in. She had to come—she had no choice. She was 14. She wouldn't look at me, she wouldn't talk to me. She just sat there. Naturally when a child does that, it makes you have to come forward more. Well, it didn't work. So I thought, "Maybe I cannot see this girl. Maybe I have to refer her to another person."

I went out into the waiting room the next time she came, and she was reading a magazine. I sat down next to her and I said, "What are you reading?" She flashed the cover at me. I said, "I didn't see it," so she held it up.
RM: And that was the beginning of contact.
VO: Yeah. Already we were making contact. And it was a music magazine about different groups. I said, "I don't know anything about that. Could we look at it together?" So we went into my office and looked at the magazine, and she was telling me about the different groups. It was mostly heavy metal. And she was all excited, telling me about the groups and which ones she liked.

We tried to find the music on the radio because I said, "I don't know what it sounds like." We couldn't find it, so she said she would bring in a tape. The next week, she brought it in and we listened together. Some of the songs were so amazing—all these feelings and anger. So we just started working with that. And we had a relationship.

But we need to do that—start with where they are. Pay attention. I wasn't paying attention in the beginning. It was only when I thought, "What am I going to do?"
RM: So apparently the child therapist must be very in touch with his own senses. I guess it's more important than clinical knowledge.
VO: I think you're right. You have to know things, but that's most important—to be in touch with yourself. It's not easy to be a child therapist. An adult comes in and says, "This is what I want to work on," or, "This is what's happening." When a child comes in, she doesn't have a sense of what she needs to do. And you have to talk to parents, and you have to talk to teachers, and that kind of thing, too. So it's different.
RM: Do you do something particular to help bring each session to an end—to help bring the child back to "regular life?"
VO: I think the job of the therapist is to help the child express what's going on inside. But I notice that most children will only express what they have the strength to, and then they get resistant or they close down. They take care of themselves better than adults that way.
Most children will only express what they have the strength to, and then they get resistant or they close down. They take care of themselves better than adults that way.
But if they do open up a lot, we have to pay attention to what I call "grounding" them. I have a policy that children have to help me clean up whatever we've used. So we start cleaning up and then I'll say, "Well, that was hard. Maybe we'll talk some more about it next time, but where are you going now?" or "What are you having for dinner?" or "What did you have for dinner?" We talk about regular things to help them come back to ground.
RM: I know that Gestalt therapists hate "shoulds," but using a paradox, are there any "shoulds" that a good child therapist should obey?
VO: Nothing comes immediately to mind, other than things I've already said. But speaking of "shoulds," it's worth noting that children have a lot of "shoulds." People don't realize that, but children are very hard on themselves. They're split—there's a part of them that's very critical of themselves and then a part of them that, of course, rebels against that. Sometimes we help them understand that, especially if they are adolescents.
RM: Do you touch or hug your clients?
VO: Sometimes, but I'll always ask them. I might say, "Can I give you a hug?" I don't just do it. I have to ask them. Or I might put my hand on their shoulder. I can tell if they pull away that that's not a good thing to do. Or sometimes we shake hands. We do a little bit—not a lot.
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Working with Parents

RM: Do you often talk to parents?
VO: Oh, yes. This girl that I just mentioned, she lived in a foster home, and they didn't care about her, so they weren't interested. They just did what they had to do. But yes, parents come in. Every three or four weeks they have to come in with the child. Sometimes we just have a family session and I don't see the child individually. It depends. You have to just decide which is the best way to go.
RM: We have agreed that it's important for therapists to be in touch with their own feelings. What other qualities should one have to be a good child therapist?
VO:
You have to understand child development so you have a sense of if the child is not at the level she needs to be at.
You have to understand child development so you have a sense of if the child is not at the level she needs to be at. You have to understand the process. You have to be in touch with yourself. You need to know when your own buttons are being pressed—in psychoanalytic vocabulary, they call it transference. You have to understand when you have some countertransference, and to deal with that and work with that.
RM: In your Child Therapy Case Consultation video, a therapist is presenting a case of a child who is acting aggressively. You state at one point that kids can't change their behavior with awareness. Is this why you often use art or have kids smash clay or other activities, versus just talk therapy?
VO: Yeah. What I mean is children don't say, "This is what I'm doing to keep me from being happy or satisfied." Even adults have trouble being aware of what they do to keep themselves stuck. So, with children, these drawings and clay are powerful projections. And it's the way they can articulate what's going on with them, without bypassing the intellect, but coming out from a deeper place. And at some point, they will own it. They will say, "Oh, yes, that fits for me."

When children feel stronger about themselves and they express what's blocking, their behaviors change without having to force it or say anything. I mean, what makes children do what they do? All the behaviors that bring them into therapy are really ways of not being able to express what they need to express—of not being heard or not feeling good inside themselves.
RM: How do you measure progress in your work with children?
VO: It's important to help the parents see the small changes, and not to expect complete reversal. And, of course, we have to work with the parents, too. Often the parents have a lot of difficulty with their own anger, and we have to work to help them understand how to express these feelings without hurting people around them. We can often do that in family sessions—help them to express what they're feeling and what they're wanting and what their sadness is about.

One of the things I'll say to parents is that I don't fix kids. But what I do is I help them feel better about themselves.
One of the things I'll say to parents is that I don't fix kids. But what I do is I help them feel better about themselves. I help them express some of their deeper feelings that they're keeping inside, and help them feel a little happier in life. We do many things to make this happen. And that's what you have to look for. So when a parent comes in a month later and I say, "How are things going at home?" and the father says, "I think he's a little happier," then I know that this father has got it, and he's seeing some progress here.

I am thinking of this was a boy of maybe 14 who was stealing, and the father wanted to send him to a military school because he couldn't control him. There was a lot of reason the boy was like that, but that doesn't help to understand the reason. It's good to understand the reason why he's like that, to help him change and be different.

So that's how I look at progress. When they're doing better out in life, they're going to school and have some friends, and doing some of the things they have to do at home, and doing their schoolwork, then you're seeing progress. They may not be altogether different, but they're functioning in life.

The other thing that's important is that it has to be at their level. Children can't work everything out. They have different development levels. So the girl who was very severely sexually abused, we did a lot of work about that. But when she was 13, she had to come back into therapy for more work—things came up. They reach plateaus. They have to go out and be in life, and then maybe more things come up.
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Becoming a Child Therapist

RM: Does it happen often that, when therapists work with a kid, the therapists' trauma from childhood appears?
VO: Absolutely. That's something one has to really know about—be in therapy, have a therapist. I have several people who come to me for supervision who are very experienced therapists, and that's the reason they come. I think it's really good for a child therapist to have somebody to talk to and consult with because it's very difficult sometimes. You can't always see what's going on.
RM: How long does it take to be fully trained as a child therapist?
VO: Oh, gosh. For many years, I did a two-week training. People would come from all over the world. And sometimes they would get it in those two weeks, and other times they didn't, so I don't know. Two weeks is not enough, but it was the most that people could give of their time. Sometimes they'd come back two or three times to the training, but those were people who actually got it the most, because they were so committed to learning more.

I can't define a time. They have to have the experience of working with children first, I suppose, and understand about children. You have to have patience when you work with children. If one thing happens in a session—if they say, "I'm like that lion. I get so angry, just like that lion," or whatever—if they say one thing, sometimes that's it for a session. You have to be patient.
RM: What are the most frequent mistakes that therapists make when they work with kids?
VO: Usually what happens is therapists get stuck. They don't know where to go next or what to do next.
RM: But why do they get stuck?
VO: Maybe they're just not able to stand back and look. Sometimes, in a supervision or consultation, I'll give a suggestion, and they'll say, "Oh, of course, why didn't I think of that? Of course, I know that." They get too close to it and worry about doing the right thing. They're afraid to make mistakes, really. I always tell them, "No matter what you do, you can't really go wrong."
RM: If you were to give the best advice to the young therapists about working with children, what would be this advice be?
VO: I might say if you're working with children, you have to like children!
If you're working with children, you have to like children!
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What Keeps Me Going

RM: My last question is personal. How do you manage to keep so vital?
VO: You know, I'm 84.
RM: You don't look it.
VO: I don't know. I am who I am, I guess. I'm still working some. I have this foundation (The Violet Solomon Oaklander Foundation), and we're having a conference this weekend at a retreat center, and I'm going to do a keynote. So every now and then I still do something like that, or conduct a supervision. That's what keeps me going. I do a little writing. I read a lot.

I lived in Santa Barbara, California, for 21 years. And my son, who lives in Los Angeles, decided I was getting too old to live there by myself. So he tore down his garage and he had a little cottage built, and that's where I live now, in this little cottage behind their house.

I miss Santa Barbara. I had a lot of friends. I'd be more vital if I was back in Santa Barbara. But I am getting older, and I had a little heart attack this year—little. I'm okay. But I was in the hospital a few days. So it's good that I'm near my son and my daughter-in-law.
RM: It is obvious for me that you, at 84, have still have so much to give to the others.
VO: Thank you very much for those nice words. I will, as long as I can.
That's what keeps me vital: just doing as much as I can, as long as I can.
That's what keeps me vital: just doing as much as I can, as long as I can. I just have to learn to take it easy.

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Violet OaklanderViolet Oaklander, PhD is internationally renowned for her unique approach, incorporating Gestalt Therapy and expressive techniques with children and adolescents. She has received several awards, and authored numerous articles, as well as two books: the classic Windows to Our Children: A Gestalt Therapy Approach to Children and Adolescents and the recently released, Hidden Treasure: A Map to the Child's Inner Self.

See all Violet Oaklander videos.
Rafal Mietkiewicz, PhD is a clinical psychologist working in private practice in Gdynia, Poland. He is trained as a Gestalt psychotherapist, and includes an existential approach in his work. Apart from classical psychological knowledge, he takes a lot of inspiration from literature, art and philosophy. If you`d like to contact him, please visit his website www.psychoterapeuci.net.
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