Healing the Wounds of Trauma through Play

• A Story of Abuse
• Creating a Safe Environment
• Taking it Home
• The Playroom
• Cops and Robbers/From Victim to Hero

At the time of the disclosure described below, four-year-old Sam, was living with his maternal grandparents. His mother, who had a lengthy history of alcohol and drug problems, was living elsewhere with her boyfriend, and would come to the grandparent’s home to change her clothes and visit briefly with Sam. When the child made his disclosure to his grandmother, she shared it with the family therapist, who then reported it to the Division of Family and Children Services (DCFS). Upon their investigation, Sam’s grandparents became his foster parents. Sam was seen once by a DCFS-referred clinician who reportedly utilized physical restraint, compelling the grandparents to discontinue services. The family therapist referred Sam to me for play therapy. That therapeutic work is described in the following narrative.

A Story of Abuse

Sam and I were playing with his ocean animal rescue toys in our playroom. I had just prepared some snacks and drinks for us. Sam asked me if I wanted to smell his butt. I said, “no!” He said, “I put my finger in my butt, and I smell the stinky,” and laughed. I jokingly told him he would have to wash his hand because of germs and how they could make him sick. Sam said, “I stuck my head in the potty, Daddy told me to do it.” I asked him to show me, so he went to the potty, lifted the lid and put his head down into it. I asked why he did that, and he said, “Daddy told me to and put his hand in my butt. I asked, “Why did Daddy do that,” to which he responded, “I don’t know why Daddy put a toy in my butt.” I asked what toy it was, and he said it was his Daddy’s toy. I asked Sam what it looked like, and he said, “It was a dinosaur, a brown one.” I told Sam if that was true it wasn’t nice, and Daddy should not do that. Sam quickly responded with, “I’m teasing.”

We sat together in silence while I tried to process the information. Then Sam said, “It’s the truth. Nana and I didn’t like it.” I said, “I bet you didn’t. I wouldn’t like that either and it is not OK. If anyone did that to me, I would tell them no and then tell Papa so he could help keep me safe.” I hugged him and told him I was sorry this had happened to him, and it was not OK. He continued to play, and I joined him. After a while I went into the bathroom to cry and gather my emotions.

After Sam’s Papa (his grandfather) got home from work, I told him what Sam said in private, and suggested we did not overreact and just hear what he had to say. I asked Sam if he wanted to share with Papa what he told me about the potty. Sam told Papa, “Daddy put my head in the potty.” Papa said, “Well that is not nice.” Sam said, “Daddy put a dinosaur in my butt.” Again, Papa said, “That’s not nice either, Daddy should not do that.” Sam said, “I didn’t like it!” and I cried hard.” With outstretched arms, Papa told him to come to him, and Sam ran over. Papa cried with Sam, hugging him, and I joined them for a group hug. We all cried. We told Sam he was safe now and it was good that he told us so we could make sure this never happened again. Papa repeated what I said, and Sam leaned out of the hug looking at our faces, cried and hugged us both.

Creating a Safe Environment

Appointments were mostly held on Saturdays or Sundays when no other children were present to reduce the “clinical” feeling and to differentiate the building and the playroom from the previous treatment facility. Following each appointment, the family transitioned to a more spontaneous, non-therapeutic activity to put closure to the session. Having an awareness of what would happen after an appointment helped Sam know there was an end to playtime.

In my clinical experience children processing trauma must process their story (I call it The Twist) from all three perspectives: victim, aggressor, and hero/rescuer. Sam was no exception, and his therapy began in earnest.

My initial appointments with Sam, who was accompanied by his grandmother, focused on establishing the playroom as a safe and fun place, and letting him experience the personal power of coming and going. I never separated grandmother and grandchild, always including her from day one.  

Sam, his Nana, and I often began in the sand tray room. He would chase us around the room with the smelly ghost in his hand. Over several sessions Scooby-Do and his cast of characters joined the smelly ghost. The smelly ghost (held by Sam) was joined by a witch (held by Nana). The witch would fly around the room and scoop up Little Scooby (Sam) who could not cry for help. (How symbolically perfect to represent a nonverbal child at the time of the trauma.)

Nana and I would model alternative responses for Little Scooby: fight, scream, hit, call for help. She, along with a designated good witch, would take the bad witch to rescue Little Scooby. Sam would laugh hysterically and repeat the story as we continued to model different outcomes. One day, the smelly ghost took Little Scooby and flew out of the playroom down the hall into another playroom. Nana and I took our figures and followed! Sam had made the leap from symbolic to experiential!

Sam entered preschool that Fall, and his Nana was providing added support by driving him to and from school. One evening I received a frantic phone call from Nana stating, “Sam’s going backwards!” She added that she had volunteered to help on the school playground daily and on the first day, when it was time for her to leave and for the kids to go into the classroom, Sam ran to her wanting to leave with her saying, “Don’t leave me here Nana, I want to stay with you.” The teacher came and tried to grab Sam’s hand. Sam hid behind me. She tried again and Sam ran from the playground across the field toward the road. The teacher ran after him, and Nana yelled for her to stop, saying, “You are scaring him!” She stopped and I walked towards Sam telling him, “Come to Nana, I am not leaving.” He stopped running. When Sam finally calmed down, all three entered the classroom together. Nana remained in the back of the class until he was OK with her leaving.

When she finished her story, I said. “What more could you ask for? He did everything we have modeled in the sand tray for the past several weeks. He protected himself. He fought. He ran. He cried for help, and you rescued him!”

Taking it Home

Through his transference to his grandmother at home, Sam worked through incidents where his mother had failed to protect or had injured him. As Sam and Nana were building a snowman in the yard, for example, Nana went to brush the snow from his face. Sam flinched and withdrew.

After he flinched, she asked, “Did that scare you?” He nodded yes. “I’m sorry baby, I was just wiping the snow from your face. I didn’t mean to scare you.” He hugged her. Nana told Sam she loved him; he said, “Love you” and went back to building the snowman.

Sam recalled an incident at the kitchen table where his mother hit him on the mouth and drew blood. Nana was present but unable to intervene. Nana responded, “I’m sorry that happened to you Sam. Nana and Papa will not let anything like that happen to you again.”

After an extended visit with his paternal grandparents, getting Sam to sleep was a continual struggle. One evening, Sam became verbally and physically resistant to going to bed. He lost touch with reality and began physically attacking his grandparents. His grandparents placed themselves in a “safe” room. When Sam attempted to enter and could not, they reinforced the need to be safe. This broke the trance state and Sam began crying. His grandparents were able to provide him with comfort and safety. A powerful healing moment of play that would not have occurred in the playroom.

The Playroom

Sam’s most intensive work was done within the safety of the playroom. In role play with Sam and his grandmother, he worked on resolving the issues with his mother. He and his Nana had captured a bad person (me) and placed them in jail. Sam, sword in hand, was guarding the prisoner. Periodically, he would reach into the cell and poke the prisoner with the sword. Sam wearied and handed the sword to his Nana. While he rested, he would signal her to poke the prisoner. Nana asked him why when the prisoner was not doing anything and he responded, “Because you are my very best friend.”

The emotional level of the play suggested it was time to address the trauma he experienced with his father and have his grandfather join the play.

The play themes evolved from the sand tray to a psychodrama where we changed back and forth between witches, vampires, ghosts, werewolves, and zombies on command. Papa when directed would die and did so many times. Sam would play and replay a scene where the vampire would come out at night to bite him. It was gut wrenching to watch this little boy, eyes shut making mouth movements like an infant with no teeth to protect himself in his fight.  

It was intense and physically exhausting as four-year-olds with imaginative powers can be. Because vampire’s sleep by day, we would use the light switch to symbolize day and night to break the trance and regulate his high arousal level. Sam incorporated the light switch into the play quickly and was soon regulating his arousal level by himself.

In his final reenactment, our little vampire was in a sleeping state via light switch. His grandfather had carried him back to the therapy room and laid him on a cushion of pillows. Sam, pretending to sleep, had been lying peacefully and safely in his grandfather’s arms, a smile on his face. Sam jumped up from this peaceful state, grabbed his bottom with both hands and began to shout “A vampire bit my butt. A vampire bit my butt!” In the play the grandparents slew the vampire, and in the present, they reassured him they would protect him and keep him safe.   

Cops and Robbers/From Victim to Hero

In a later phase of our work, therapy took a new direction when Sam and Papa (the good guys), weapons in hand together went looking for the bad guys, (Nana and I). The bad guys were caught and jailed for lengthy periods of time while the good guys did their thing. We would be released to steal things so the good guys could catch us, return what was lost, and put the bad guys away.

Sam’s psychodrama shifted a final time when he incorporated his Nana, Papa, and I into his force of personal power.

When Sam’s play dropped in intensity to a symbolic level, and the family became busy with other things in the community, appointments decreased in frequency. The grandparents had knowledge and understanding of trauma triggers and how they manifested. They had demonstrated many times over the ability to handle traumatic reactions. The treatment ended by mutual agreement.

***

Since this writing, Sam has been legally adopted by his grandparents. He is secure in his attachments to them and surrounded with love, safety, and understanding when trauma triggers activate him. Sam is loving and caring for people and animals, which are his passion. He occasionally has anxiety but has learned that handwork, artwork, playing with figurines, board games, and card games calm him and bring him joy. He talks about his feelings freely and handles feeling overwhelmed by separating himself from whatever it is or requesting quiet time as needed.

We knew immediately after one session with play therapy this was the right treatment for Sam. We are grateful we found the right kind of therapy with Play therapy!

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