The Story So Far: Play Therapy Narratives

The Story So Far

of related interest Children’s Stories in Play Therapy Ann Cattanach ISBN 1 85302 362 0

Play Therapy

Where the Sky Meets the Underworld

Ann Cattanach

ISBN 1 85302 211 X

Play Therapy with Abused Children Ann Cattanach ISBN 1 85302 193 8

Communicating with Children and Adolescents Action for Change

Edited by Anne Bannister and Annie Huntington ISBN 1 84310 125 8

The Story So Far Play Therapy Narratives Edited by Ann Cattanach

Jessica Kingsley Publishers London and Philadelphia

All rights reserved. No part of this publication may be reproduced in any material form (including photocopying or storing it in any medium by electronic means and whether or not transiently or incidentally to some other use of this publication) without the written permission of the copyright owner except in accordance with the provisions of the Copyright, Designs and Patents Act 1988 or under the terms of a licence issued by the Copyright Licensing Agency Ltd, 90 Tottenham Court Road, London, England W1P 9HE. Applications for the copyright owner’s written permission to reproduce any part of this publication should be addressed to the publisher. Warning: The doing of an unauthorised act in relation to a copyright work may result in both a civil claim for damages and criminal prosecution. The right of Ann Cattanach to be identified as author of this work has been asserted by her in accordance with the Copyright, Designs and Patents Act 1988 First published in the United Kingdom in 2002 by Jessica Kingsley Publishers Ltd 116 Pentonville Road London N1 9JB, England and 29 West 35th Street, 10th fl. New York, NY 10001-2299, USA www.jkp.com Copyright © 2002 Jessica Kingsley Publishers Library of Congress Cataloging in Publication Data The story so far : play therapy narratives / edited by Ann Cattanach. p. ; cm. Includes bibliographical references. ISBN 1-84310-063-0 (alk. paper) 1. Play terapy--Case studies. 2. Storytelling--Therapeutic use. 3. Play--Psychological aspects. 4. Mental health counseling. I. Cattanach, Ann. [DNLM: 1. Play Therapy--Child--Case Report. WS 350.2 S888 2002] RJ505.P6 S76 2002 618.92’891653--dc21 2002021880 British Library Cataloguing in Publication Data A CIP catalog record for this book is available from the Library of Congress. ISBN 1 84310 063 0 Printed and Bound in Great Britain by Athenaeum Press, Gateshead, Tyne and Wear

Contents Introduction

Ann Cattanach

7

1

When All the World was Slime

13

2

The Self is a Telling: A Child’s Tale of Alien Abduction

35

Jeffrey the Dog: A Search for Shared Meaning

59

Sally Hanson

David Le Vay

3

Sue Allanson

4

All that Glitters is not Gold: The Adoption Process as a Rite of Passage 83 Ruth Watson

5

In the Wake of the Monster: When Trauma Strikes Alison Kelly

6 7

The Wounded Hero Maureen Scott-Nash

Finding the Way Back Home: Children’s Stories of Family Attachment Sheila Hudd

103 123

149

8

The Narrow Road to the Deep North: Tracking a Life

187

The Biography Laboratory: Co-creating in Community

209

Ann Cattanach

9

Christine Novy

Contributors

231

Subject Index

233

Name Index

237

Introduction Ann Cattanach This book describes the work of nine play therapists through the narratives of children and adults who come to play or play therapy to tell their stories. First and foremost they describe therapeutic relationships and within the relationships, the power of narratives and stories as a means of communication for those people whose voices are not often heard. To me, the major message, which shines through all the chapters, is the sensitivity of the relationships between therapists and clients. In the busy world there seems little time to sit and listen to what children, young people and adults have to say about their feelings, emotions and their understanding of the world. It is also the quality of the listening and the importance that the therapist places on what children and young people have to say which creates trust and belief in the relationship. It is about people talking, empathic understanding, sharing creativity – not power and control centred on the therapist. Perhaps the ability to listen and accept other perspectives, other worlds, could change the way we all live with each other. The stories and narratives in this book concern complex life events like change of family, abuse, illness, death so are multilayered with many meanings. The encounters between clients and therapist are co-constructions. The child plays, and tells stories about the play and the therapist listens, perhaps asks questions to clarify meaning, and contextualises the story around the social circumstances which exist for that child in their world. 7

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Some children and young people need explanations from the therapist about their social circumstances and this is often incorporated into the narratives and play. If play therapy is sometimes a rite of passage for a child from one state of being to another, then sometimes the therapist takes the role of an elder who can explain the rules and meanings of what is happening in their society. Perhaps this is especially true of children in the care system. The stories are not often direct narrations of life events but concern imaginary lives. These imaginative stories contain similar life changes to the reality worlds of the children and adults. Complex life events cannot always be understood through talking about what happened in reality talk, because the full impact can only be described and contained through metaphor, imagery, myth and story, or sometimes play without words. For example: children explore their understanding of themselves in vivid ways. So Jenny aged 4 presented me with her self-reflection which she described as her map of life. It was a drawing of her face across which were a series of roads. The first road led from a green blob of slime placed on the picture at the top of her head. This was the earth. The road led to her nose marked with another blob of slime. This was the hot planet. A blob of slime in the left eye was the train. The mouth was the star And the ear the moon And the rest of her body was the earth. This was Jenny’s construction of identity. She saw herself as part of the world and also part of a bigger universe. She wanted me to keep the picture so I could think about her. When I think of Jenny I do think of her world and her part in it, her resilience, the stories she told about adults and, above all, the quality of her imagination. There are many such stories of the bravery of children and young people in this book and how they come to terms with life events. In Chapter 1, Sally Hanson describes the way children use messy play and

INTRODUCTION

9

sensory materials to explore beginnings. As with the infant, the child in therapy uses the sensory world to begin a journey of self-discovery. For some children coping with difficult family lives, play with slime and messy materials is a means of having their state of nothingness acknowledged. Sally Hanson vividly describes those meetings with very little verbal communication when sensory play is the only way the children can express the helplessness they feel. This play is crucial to start children on a search for identity. In Chapter 2, David Le Vay explores two stories from Daniel, a 7-year-old boy whose mother has a background of severe emotional and mental health difficulties. Daniel was referred for play therapy with the aim that it would contribute to a fuller understanding of how he perceived and made sense of the complex and ambivalent relationship with both his mother and the wider social system. David considers that in examining the two stories which Daniel often presented, the text in one sense becomes an analogy for the self, and through a fleeting sequence of symbolic, co-constructed narratives Daniel graphically reveals a terrifying world inhabited by a monstrous alien made up entirely of teeth, eyes, claws and guns. This is Daniel’s narrative identity as revealed through his play therapy – a scary place indeed. In Chapter 3, Sue Allanson describes the narratives of two clients who were able to make some sense of sexual abuse through the safety of imaginative stories. She describes how a character like Jeffrey the dog acts as symbol for the child and keeps the play safe. She notes how quickly children and young people move from story to story. She states that children have much to teach us about the fluidity of life and the mercurial nature of feelings. A story which has vibrancy and importance in one therapy session may be viewed with almost disinterest in the next, with the therapist lagging behind, still excitedly clutching what is now history. For the therapist the paradox of undertaking research into the meaning of stories told by one child while in therapy is to let go of the notion of certainty in order to be able to find a shared meaning together. The journey into the labyrinth is unique to each child. Previous maps made with other children are no help and must be filed away so that they do not lead us down someone else’s path.

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Chapter 4, ‘All that Glitters is not Gold: The Adoption Process as a Rite of Passage’, is an apt title for a child who has to lose a family to gain another. Ruth Watson tells Kate’s story about her move from a foster family to an adoptive family and how she created rites of passage that enabled her to make the transition from one family to another. Kate and Ruth co-created narratives, with specific rites encompassed in play, this being the way that Kate managed to cope with change and maintain her sense of self. Ruth states that sometimes the journey was such fun; sometimes it was very sad. Sometimes Kate got furiously angry with her. Sometimes in the play, Ruth was a frightened child and sometimes Kate was the bad mother. So in this way they made their journey from foster home to adoptive family. The tale continues. In Chapter 5, Alison Kelly describes the stories that she and a group of young children worked on following the traumatic death of the children’s teacher. This was therapeutic work in school with a class of young children. She states that it became important to co-construct these stories with the children in the process of helping them to come to terms with their loss. The trauma was contained through the use of story, drama and play. This chapter also examines adult attitudes and responses to post-trauma interventions with children and shows how little the children themselves are consulted. In Chapter 6, ‘The Wounded Hero’, Maureen Scott-Nash states that for some children exceptional things happen which set them apart from others. Jamie aged 6 is one of those children. His story is one of struggle as he fights the life-threatening illness of leukaemia. Jamie’s world is now a fragmented and unsafe place where he has to negotiate a painful journey, with no escape from the invasive medical intervention vital for his recovery. Maureen describes Jamie as a wounded storyteller and herself as the listener. Together they co-constructed a safe and healing space in which to tell Jamie’s story. Jamie used tactile material, red, runny slime, as a visual narrative to interpret his story of the battle against illness. This was his construction of identity, with its messy battles to win the war for remission. In Chapter 7, Sheila Hudd describes her work helping families where there are attachment issues. She explores narratives of attachment in four families and investigates the links between the parents’ own attachments,

INTRODUCTION

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their parenting styles and their children’s attachment and behaviour. Children were offered two ways to use stories: the beginning of a story to complete and space to make their own stories. The therapist used these stories and questionnaires from the parents to examine the attachment patterns in the families. The chapter shows how assessment of families can be linked to short-term, play-therapy interventions to support families. In ‘The Narrow Road to the Deep North: Tracking A Life’, Chapter 8, I describe Carla’s story. She is 14 and has been long-term fostered since she was 6 years old. I have seen Carla on and off for ten years which gives us a unique relationship. Children in the care system often meet many professionals during their childhood so a long-term relationship with a therapist can be very important. For the therapist, one of the great privileges is to journey with a child travelling through fragments and moments of their childhood. The chapter describes Carla’s struggles to construct, amend and then reconstruct herself and to piece together a life and a life story which she can own. Carla uses me in this construction as a kind of sounding board for her ideas and notions of her life and identity. In Chapter 9, Christine Novy describes the Biography Laboratory project. This is a group of six women of different ages, cultures and backgrounds who are involved in action research together. The goal is to explore story creation. The group are co-researching, co-imagining and co-constructing meaning in community. The chapter shows how narrative work, drama and play can be developed with adults exploring aspects of their lives. The stories explored in the project are those which may have been forgotten or dismissed, stories which tell of preferred ways of living and being in the world. Play therapy is an action therapy using all aspects of play as a way of expressing what it is like to be in the world in a particular place and time. It is a way of telling who you are and what you are feeling at that place and time in your life. In order to be heard, there must be a listener. This book describes moments in the lives of both clients and therapists as they meet together, play together and listen to each other. It is never complete: it is the story so far.

1

When All the World was Slime Sally Hanson No sooner had life begun and it began to ooze. (Zalasiewics and Freedman 2000, p.30)

Slime worlds Science is now revealing how much of this world’s early existence was spent covered in slime (Zalasiewics and Freedman 2000). It is suggested that for 300 times as long as the dinosaurs roamed, a slime world ruled over the earth. This sticky mucus dominated the planet, before more complex life forms began emerging from this bed of oozing, sludgy, slimy mud. In my work as a play therapist I have seen many worlds whose beginnings were a very sticky, slimy affair. I have found Zalasiewics and Freedman’s suggestion a very reassuring thought that amidst the slime, and beneath this all smothering mass, lie the makings of new life and the creation of all things as we know them. So now sometimes in play therapy sessions, when we are grappling within the murky depths of slime worlds, I remind myself that this is the way all worlds begin. These qualities of slime worlds, seen as part of the creative process, are the focus of this chapter on play therapy.

13

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The need to begin at the beginning, to explore what there was before there was anything, to see how nothing becomes something, are common themes when seeking to make sense of our experiences and existence in this world. Science, art, religion and ancient myths, have all endeavoured to describe the process of becoming, of creation itself. An Ainu myth from Japan In the beginning the world was slush for the waters and the mud were all stirred in together. All was silent, there was no sound. It was cold. There were no birds flying in the air. There were no living things. At last the Creator made a little wagtail and sent him down from his far place in the sky. ‘Produce the earth,’ he said. The bird flew down over the black waters and the dismal swamp. He did not know what to do. He did not know how to begin. He fluttered in the water with his wings. He ran up and down in the slush with his feet trying to trample it to firmness. He beat on it with his long tail, beating it down and down. After a long time of treading and trampling, and treading and trampling, a few dry places began to appear in the big ocean. The wagtail had created the earth. The islands of Ainu, he had created the world. It is no different for the child in play therapy, for here too the child is part of a creative process. It is through creating a world in play that they begin the process of defining a sense of themselves. But creating a world is no easy mission, as this myth makes known. This is mirrored in the child’s experience in play therapy. They may spend some time submerged in the slime world. Linda took out the slime, a grunge-green, uniform mass spilled onto her hand. She tried to break it, but its shape and form merely

WHEN ALL THE WORLD WAS SLIME

15

stretched and slipped from her hands. As she pulled, the more it stretched, separation still eluding her, a fine hair of slime holding together the two blobs which remained in her hands. Still one mass, it reached the floor in a gaping loop. The slime on her fingers had begun to follow the flow, thickening the thread which, by now, was trickling and circling around in patterns onto the mat. On retrieving the slime, Linda held it high in her hand, watching it make its way back to the floor. Shaking her hand, she saw the slime quiver in response, a ripple undulating down its length, her movements became marked out, solidified as the slime reached its destination. She skipped around the mat, the slime following, tracing her steps. This became an intricate dance between herself and the slime on the mat, her feet placed carefully to avoid treading on her slimy trail. She is beginning to create her world in play therapy.

Play worlds A child comes to play therapy. We make a world together. It is shared, negotiated, kept safe by the therapist, but belongs to the child. (Cattanach 1994, p.26)

In the Developmental Model of Play Therapy described by Ann Cattanach, she suggests that in play children make fictional worlds as a means to make sense of their experiences in the real world. She believes it is this myth-making capacity that helps the child to heal the real hurts they have experienced. In this method the emphasis of play is on its creative and social qualities; its development is seen as emerging through its social context, in relation to another. The therapist holds the play space safe through structure and boundaries, but the meaning of the play becomes a shared understanding between therapist and child. This is negotiated through playful interaction and exists between them, rather than being hidden in the threads of the unconscious for the therapist to unravel. I have found that messy, sensory materials, such as fingerpaints and slime, are a source of much pleasure and intrigue with many children who come to play therapy. In this chapter, by focusing on how children use

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them, I shall show that it is not only with words that we can give children a voice. These materials can enable children to express themselves, their feelings and the way they experience the world. But to listen to children in this way we have to begin at the beginning of both the playing and the creative process. Joshua makes a beeline for the fingerpaints in his first session. He scoops out dollops of paint from the tub and splats it on to the paper. Carefully he places his hands over the paint. He hovers there for a while, then slowly he lowers his hands onto the paint and begins to press. The paint oozes out from between his fingers. He smiles, increasing the weight on his hands, imitating the squelching noise that accompanies the paint’s response to his movements. He lifts his hands, clenches his fists, looking at how the paint’s texture fills every crevice on his fingers as he curls them up tightly. He returns to the paper, and together we make sounds which narrate the paint’s response beneath his fingers as he continues to spread it around. On Joshua’s face is a look of absorption, contentment and fascination, which flickers to satisfaction as we both look in awe as the shapes and colours of paint unfold, created by his movements. He begins to describe what he is doing as he swirls his finger in the paint. ‘I’m making colours. You do it too.’ In the paint we chase each other’s fingers. We play tag on blobs of colour. Soon the paper is covered in a uniform grungy brown. He screws up his nose, wiggles his fingers in the air, grunting and growling in different directions. He laughs, ‘If mum could see me now!’ He returns to the paint, tracing back the marks he has left, leaving hand and finger prints in random places on the paper. We are coming to the end of our session, time to wash away the thick, slimy, gunk clinging on his hands. When I ask him what he likes about the play, he laughs again, ‘It’s messy!’ Words cannot encapsulate his experience of the paint, nor the shared meaning of our interaction. For adults, slime and fingerpaints may trigger all the worst fears and dread of mess. In Joshua’s family such messy play was definitely deemed

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impossible. They have had to develop a rigid routine to cope with the needs of Joshua’s autistic sister. Her demands limit Joshua’s play: order is paramount to maintaining the family equilibrium. With the knowledge that these sessions were to be his time, it was towards the slime and messy play that Joshua was first drawn. This play seemed to satisfy a need previously denied and provide a means of self-expression unattainable in his home environment. The qualities of the slime and paint opened up a channel of communication in which Joshua felt more able to release anger and frustration, and explore different ways of being. The mess was an important part of the message. In Joshua’s sessions the ability of the play space to accept, hold and contain the mess were an important aspect of the interaction. The fact that we were in this mess together made it all the more appealing. My participation in the play was seen as my willingness to listen and converse in the language of his choosing. This was a means to hear and share experiences in a world of his making. In play therapy, children from complex situations come to express and to make some sense of their experiences. It is through the play that a narrative for these emerge; a medium through which to tell their stories. This is an intricate process in which many levels of meaning may exist at the same time, co-constructed between child and therapist. Some of these meanings live in the moment, in the doing and being – their sense held in the here and now, contained within the play experience itself. As Joshua’s play suggests, here is where communication can be multilayered, with experiences illustrated through movement, sound and shape. This gives the children the wider vocabulary they need to express themselves. These are the first narratives of experience, where the child first gains a sense of self. Joshua’s wish to begin this exploration with the fingerpaints demonstrates a child’s need to begin this process in this sensory world through the sensory experience. In my own experience of children in play therapy, many do begin with the slime, or with making murky pools of paint with their fingers. The elusiveness of form, slime’s resistance to holding shape or structure, seem to attract a child to these gooey substances. Seen as a creative process, it makes sense to begin with the chaos, a sense of ‘nothingness’, in order to acknowledge the possibility of ‘somethingness’. This becomes a means to gaining understanding and experience of the process of

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forming and sculpting different ways of ‘being’. I have often noted that much attention is given to the later stages of the journey, to the symbolic worlds children make and stories they tell. However, for many children, this initial stage entails a long and arduous struggle to which we often return: a developmental process through which we move back and forth. In this chapter, I aim to follow and describe aspects of this play; to give more recognition to the sensory nature of play, the non-verbal qualities of play interactions, and to look at these as the place where meaning and the narratives begin; to explore the process of how children begin to make and create their world through play.

Beginnings: the void The bird flew down over the black waters and the dismal swamp. He did not know what to do. He did not know how to begin.

Where, and how, to begin? In my experience, this question is an important one for a child coming to play therapy for the first time. Many have experienced much chaos and mess in their lives. When first setting out to make worlds in play, to begin the task of ordering, containing and making sense of experiences can seem like taking a leap into the darkness – the unknown a great void in front of them. Entering a new space, another relationship and playing can all be difficult and daunting for numerous reasons and hard for a child to voice. In this context, the slime can seem the ideal substance for beginnings. An unformed mass, no real edges to distinguish the beginning or end. Its nature is a paradox of being and not being, mirroring the place from where many children in play therapy are coming, with a bundle of disordered, chaotic experiences into which their sense of being is inextricably bound. In play, slime can fill the void, hold and describe the emptiness and nothingness the child may be experiencing within it. It seems that, as with creation myths, we must begin at the beginning. In play therapy, this is in the sensory world.

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Sensory worlds Sticky, sludgy, slippy slime, the sloppy ploppy creepy kind. (Cole 1985, pp.1–2)

In early childhood infants first gain a sense of themselves in the physical world, through their senses, in their immediate environment. Much of this happens in a space held and shared with their carers. This space between them is where creative play begins. Early playful interaction is not through the language of words, but eye contact, facial expression, movement and sound. A non-verbal interchange develops in which a shared understanding of the experience is created. Mother and child follow and initiate an interaction with each other, responding in relation to one another, so that the meaning is co-constructed, created between them within the play experience. It is here that infants can discover where their body begins and ends, their relationship to their physical world and the space they take up within it. In this preverbal world, a sense of self is created and held within the act of experiencing it. Many children who come to play therapy have missed out on these early experiences for various reasons. Cattanach (1992) describes how the development of creative play can be seen to begin in the sensory world. In play therapy, these play experiences are called Embodiment Play, the first stage of a developmental continuum, where the mess and slime can recreate the preverbal universe of the infant. As with infants, children in therapy need to explore their environment through their senses; to establish a sense of their physical self in relation to the play space – where they end and the rest of the world begins. For many children coming to play therapy, building a clear picture of their world and a sense of self within it, has been difficult in their previous fragmented, chaotic experiences. Their self-image has become distorted and bound up in their past. The slime, and other sensory materials, are ways in which children in play therapy can enter this world and use their senses to begin a journey of self-discovery. Starting with the physical world, this process enables the child to shape and form a sense of ‘self ’ in relation to the play space provided in the session.

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The child must first become familiar with this world of play, be given a safe space where their creativity can develop. This space must be separate from the real world, so new worlds can be imagined, free from the restraints and responsibilities children have experienced in their lives. I introduce the play space in play therapy by providing a mat similar to that outlined by Ann Cattanach in her first book, Play Therapy for Abused Children (1992). We sit on the mat together. Between us is the space for playing, which defines a clear boundary of where the play can begin and end and also separates it from the rest of the world. In this space between us lie the toys and slime which support the child’s creativity in play (Figure 1.1).

Figure 1.1.Using the mat to provide play space in play therapy

I bring a variety of toys to each session, and have found Slime and Gak a very popular choice, especially with children first coming to play. As their names suggest, the main aim of these gooey substances seems to be to epitomise bad taste or taboo subjects. Each is packaged in garish pots, shaped and coloured to hint at the gruesome nature of its contents. I pride myself in having collected a good selection of the best these – toilets, monsters and vampire heads. When opened, all reveal substances of

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different luminous colours: pinks, purples, oranges and some very suspect hues of green. One of slime’s most impressive qualities is to resemble and mimic all manner of disgusting things, especially the more uncontrollable processes, products and messy substances that come with being creative and human. These bodily functions hold much fascination for children. They are still mastering which are to be restrained and contained, and the ‘whys’ and ‘hows’ of their acceptability in the adult world. These are all part of our sense of self.

Pick-a-nose picks awful poem A tadpole doesn’t have much snot in its nose But a whale has got a lot of snot I suppose. Snot! Snot! Green slimy snot! I like it a lot! You can slip on it in the dark, And spread it on bread for a lark. Snot! Snot! Green slimy snot! I like it a lot! I think you will agree There’s not much snot in a flea. Snot! Snot! Green and hot! I like it a lot! It’s snot a nice thing to write a poem about, But I’m snot going to leave it out. Snot! Snot! Green and hot! I like it a lot! (Patten 1985, p.119) Therefore as the above poem suggests, these are a favourite topic of play and humour in children. In Stacey’s first session she sat on the edge of the mat. Her arms folded, she appeared reticent and unsure about being in the space. I began to explain the rules and purpose of our time. Her stance

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remained rigid and hostile to the whole idea as I showed her an array of toys. Her expression changed on sight of the pots of slime. Interest glimmered in her face. With an air of distaste, she asked for a closer inspection. I opened a pot and the slime slithered out. At first, my offer was resisted. While returning the slime to the pot it slurped, with some more familiar graphic noises following ‘Oops!’ I grinned. The ice was broken. She grabbed another pot. ‘I can do that.’ Soon farting noises were being exchanged, admired and bettered – a dialogue had begun. This first session took place in a women’s refuge where Stacey had been living for three months – her longest resting place for over two years. There was a vast trail of different places where she had stayed in her mother’s attempt to keep one step ahead of her violent partner’s rage. Making, breaking or trusting relationships were issues in the forefront of much of Stacey’s experience in life. The opportunity to feel safe enough to play was limited. It is important in play therapy to begin where the child is and for some the issue is whether they feel able to begin at all. The slimy, sensory materials appeared to provide a medium for interaction in which Stacey felt more able to engage, a means to explore the safety of the space and relationship. Assessing the child’s – and your own – limits when introducing messy play is a vital necessity to ensure the safety of the child, the space and the sanity of the therapist. The slime and mess is a means to test these aspects of the space, play and relationship. For Rosie, the slime appeared to affirm this was her space – a place where farting noises and disgusting things were accepted. After five minutes of reciprocating exclamations, voicing our disgust, but admiration, of the grossness in which the slime could sit and revel, our rapport moved to intermittent resounding slurps and farts (created with the slime!). We each praised the other’s triumphs, which were achieved by wriggling and compressing the slime with our fingers in its pot. Once this form of repertoire was established, it was with the playdoh that she chose to go on to explore the

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physical dimensions of the play space. Maybe the slime seemed a little too risky to let loose from its container. Using the playdoh factory, she produced a never-ending strand of dough, which had to be accommodated within the space, curled, balanced, supported and held as it grew and filled the space. The remainder of the first session was taken up with this activity – needing all hands on deck to ensure the safety and development of the trail of dough. Finally, she looked with pride and achievement. ‘That’s all of it,’ she said, with a satisfied air. The mission had been accomplished; there was no more playdoh left. We retraced our steps from the end, carefully following the trail back round to the beginning, while reflecting on some of the more difficult bits of the operation. In the last few minutes of the session, Rosie insisted in dismantling and returning the playdoh to its containers. It is reassuring to see that things once released, and therefore externalised, can still be contained. This play is a means to test the robustness of the space and relationship, to see what they can hold, accept and contain. Strong foundations are essential in order to begin to build new worlds. Rosie was in foster care, one of many placements since being removed from her own family. Rosie and her brothers were found living in squalor, severely neglected. Rosie’s image of herself and her trust of others was low. Rejection and chaos were the themes of many a story in later sessions. The ability to accept and hold tricky and disgusting things is a basic necessity to the safety of the therapeutic space and for testing and building relationships. In these scenes of children’s play, it can be seen how some of the attributes of messy play may help a child enter into the play space. The material’s sensory qualities make it a perfect medium to test the space and begin to forge a therapeutic alliance. In my experience, children often begin with sensory substances which they can pummel, stretch and poke: playdoh to squeeze rather than mould; paints to converse rather than make pictures. The availability of these sensory materials makes interaction and self-expression more accessible to the child. I find the slime or a

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pile of squidgy things say more adequately than words that this is their time and play space. It is the therapist’s responsibility to provide a space into which the child is able and can choose to enter. In early infancy, mother and child, through subtle synchronicity, negotiate the context and content of their interaction. Similarly, in the first few play therapy sessions, these issues are being explored through the play medium that the child chooses which suits their present situation.

Nothingness Nothing testifies more clearly to its ambiguous character as a ‘structure between two states’ than the slowness with which slime melts into itself. (Sartre 1966, p.607)

Cattanach (1994) sees one of the values of slime as lying in its purposelessness. She suggests that, for a child coming to therapy, this serves as a means of relief from expectations of attainment experienced from adults in other contexts, such as school. It provides a medium in which ‘nothingness’ is okay; a permission for existence in a formless state. Much of my work has been with children who have experienced domestic violence. This raises many issues about how, when and whether one can begin a therapeutic intervention. As with Stacey, many of these children may remain in limbo for a long time. They experience many moves and changes, lengthy stays in refuges or transitory places – a long sequence of temporary homes, lives and relationships. Though Stacey has now remained in one place – the refuge – for more than four months, she has watched many other families come and go; some arriving or disappearing, amidst much fear and confusion, in the middle of the night. This is a constant reminder that the refuge is only a temporary solution. Her play after six sessions continues to be mostly with slime. Much time is spent pouring it from hand to hand, or container to container, watching with wonder and admiration its ability to stretch and fall, merge and separate. A constant movement which seems never ending. This was the world we created in play.

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In these chaotic circumstances, no sense can be made of experiences, past or present, but they can be acknowledged. While children’s lives remain uncertain, with safety a constant issue and contact with the outside world limited, it is hard to sustain a coherent sense of self. For some children, the chaos remains and, at times, can be overwhelming. In these circumstances the play therapy sessions can provide a secure, boundaried space in which they feel safe enough to express these experiences. The slime is a means of narrating this transient state; never still, no clear structure or foundations on which to form or shape an identity. This play can be a way to acknowledge being, feeling, nothing.

Somethingness He fluttered in the water with his wings. He ran up and down in the slush with his feet trying to trample it into firmness. He beat on it with his long tail, beating it down and down.

In the therapeutic play space, where the boundaries are clear and constant, the child can begin to experience a physical sense of being. In this slimy world, the concept of where one begins and ends can start to be explored through the qualities of the material. The sensory nature of the play brings out an awareness of a physical self, a means to experience me and not me, the properties of ‘being’ and ‘not being’. From the movement and formations in this physical world there can emerge a more tangible sense of self. The sensory play acts a constant source with which to experience the physical self in relation to the play space. Linda’s play in therapy revolved around the slime for some time. Every week her ritual was to take out all the pots of slime. With each one she opened their lids, then after poking it with an exploratory finger, she would judge its sticky properties and slimyness. The pots were carefully placed in a row between us, each pot’s position an indication of its quality in relation to its neighbour. She pondered for a while. Which one will we take out today? It’s the pink one, stickier and faster flowing than the others. (Different colours have different consistencies you know!) Many sessions have been spent watching the slime ooze, stretch and spread

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around Linda’s body and the mat, reflecting, marking out Linda’s movements and form. This time, sitting down, she let the pink slime first trickle over her legs. This required her to sit quite still as it followed the contours of her knees. She watched intently as it slowly outlined the shape of her body. Next, she poured slime around the perimeters of the mat, marking out our territory of play. ‘You mustn’t cross this line,’ I was told quite firmly. The slime’s consistency and tactile qualities were a means for Linda to experience a sense of being in the physical world, through her senses. The clear boundaries of the play space allowed Linda to feel a sense of her bodily self in relation to the space. This enabled her to explore through the slime different ways of being held, supported and contained. With this play in slime her focus has been on form and shape, their relationship to the space in the play world. In this world that she has created in slime, a sense of a separate self emerges, an identity not so bound by the chaos and mess that exists in her real life. Linda too has lived with domestic violence all her life. She is now in a ‘safe’ house, but her mother and father’s conflict continues to be a prominent part of her world (‘when does his injunction expire?’). Her brother is in and out of care because of his outbursts (‘just like his dad’). The ability to be contained and invisible has been a necessity for self-survival with Linda. The slime is the perfect malleable, transitory medium with which to begin to explore physical shape and form to a possible self that can emerge in play, experienced in the here and now, in relation to the play space, a world separate from the real world. I can recall many instances of children’s play which seem to demonstrate the ways in which children use these sensory materials, moving them around in relation to their body and creating external maps of their experience. When looking at Linda’s exploration of slime’s ability to bend, twist and fold, its capacity to fit into any number of shapes and spaces, nooks and crannies she could find, it would be easy to interpret and relate the play to her past experiences. However, it would be dangerous and inappropriate for me to place such deeper meaning to these play interactions within the session and a breach of the rules of play worlds. Its safety exists because of its distance from real worlds. More

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importantly, these are not the words Linda used to describe those experiences in play, nor the meaning that was created between us. Such connections do not need to be made for the child as part of the therapeutic process. However, the symmetry between their play and real worlds can give validation and recognition to a child’s perceptions of their worlds: the play a means to express them. It is usually in retrospect that the way children have used the slime can be seen to reflect aspects of their lives and experiences within it. It is all too easy to stifle the child’s own process and creativity through our haste to make sense and meaning of the play. For some children like Linda who are coping with domestic violence, play is a means to acknowledge their abilities and coping skills rather than make sense of past events. Their safety has been reliant on their ability to maintain a fluid, flexible state. In the play space is the opportunity to express these aspects of his or herself, and begin to explore their individuality as a separate entity from the confusion in their real worlds. The sensory play world enables these children to create and look at different ways of being, many of which may not as yet be realised or possible in the outside world.

In slimey worlds In the beginning the world was slush, for the waters and mud were all stirred in together.

Mastery and control In the play space the child becomes the creator of worlds. The play with slime in play therapy gives them the chance to explore and control and gain mastery over actions and events. Linda’s accuracy of directing and controlling the slime improved greatly over the weeks, the slime’s resting place now more carefully executed. It takes time and skill to keep this elusive substance under control, to master its movements within the confines of the space. In these sessions, instead of watching the slime’s own formations, Linda was more active in planning the slime’s motion and

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destiny, pouring it from its pot into different containers, cups, plates, and bowls. In this play, she cut, squeezed and squashed the slime. She even dared to play catch with it, but (fortunately) only briefly. Linda has become very adept in this play. Controlling the slime has given her the opportunity to appreciate her skills; a means to reflect on her own abilities. For some children, the task is not to make sense of past turmoil, but to experience a sense of themselves in the here and now, in a way in which they are enabled to take charge of what happens. The advantage of these messy materials is their instantaneous response to the child’s handling, the immediate gratification in their ability to yield to command. The real world may be too chaotic, with little opportunity to be still enough to see the consequences of their own actions. These experiences can only happen in a space separate from the confusion, made possible through the boundaries and safety of the space held between us. In the slime is the chance to be master of the world they have created.

Containment Ideally, therapeutic work begins when trauma is past. But in reality, as in cases I have described earlier, the situation is often more complicated. Experiences of past and present are hard to disentangle and, at times, equally hard to live with. For these children, an appropriate time to begin play therapy can seem impossible to realise. What is meant by ‘stable’ or ‘safe enough’ – bound by an adult perception of safety and stability perhaps? For many children, uncertainty has become a consistent component of their lives. Stacy entwines the slime around her hands, faster and faster she goes, until her hands are covered in fragments of slime. Blobs and strands cling to her fingers. Carefully, she picks them off, wiping the bits onto the rim of the container. Gradually, as the size increases, it slips down the side to the bottom of the pot. Eventually, she manages to remove and disentangle all the slime from her hands. She ensures it is all returned to where it belongs. The container’s lid is quickly snapped on tight.

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When living with much chaos and confusion, it is hard to contain events and experiences when their existence remains so fragile and fragmented. It is impossible to order or make sense of these experiences when past, present and future may merge and separate on a daily basis. At these times, to hold and maintain a coherent sense of identity can be a constant struggle. But in many circumstances, this is the existence that their world necessitates. This play is a means to acknowledge their containment. It is now common practice for children in foster care to continue contact with their birth family. In some cases this can be difficult, bringing back painful memories of the past and an enigmatic dynamic in the here and now. Messy play can be used to narrate the inability of past experiences to be ordered or fashioned into a more manageable form; to narrate the way they may fade or re-emerge, or be a constant dynamic that encroaches on aspects of their present world. Play with slime, and similar materials, can be an enabling experience to help them cope with difficulties they may be facing in the real world, and to explore different ways to cope and contain feelings. In one session, following a recent home visit, Anthony arrives agitated, unable to settle. He chose to start the session with a selection of sticky creatures and balls, and then with increasing speed and force he throws them onto the mat, commenting on the sound, shape and position they take up in the space. He marks out a spot on the mat and continues to throw the ‘stickys’, laughing and clapping when they successfully hit the target he has outlined. His precision improves, and by the end of the session he celebrates the success of all the ‘stickys’ landing within these limits. In this world, he has experienced a sense of control over events, and explored strategies of containment. This play can be a means to experience control over environments and feelings, and how to contain unruly substances. Rowen had been making good progress in play therapy, beginning to make some sense of past events and experiences: being in foster care, the separation from his mother. After Rowen’s last contact

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visit with his mother, our play in the session returned to the slime world, the place we had first visited some time ago. He squeezed the slime in his hands, harder and harder. The air trapped inside the slime bubbled up, the globule expanded and popped, leaving only a slimey trail on his thumb. His mother’s escalating promises had yet again ended in nothing. Harder and harder he squeezed the slime. We watched its ever-changing form slipping through his fingers. He repeated this process several times. The slime escaped capture, no matter how tight he clasped his fingers. His mother had not kept the contact arrangement. Not a word about the visit was uttered in the session, the real world was much too painful. The slime movements said it all. Rowen moved on to the paints, the fingerpaints. His hand dived into the red pot. Red paint was soon vigorously being moved around the paper. His anger at the failed visit was scooped, expressed and released onto the paper, externalised but contained within the confines of the space. Many children are referred to play therapy because of their behaviour. School or their carers find their frequent angry outbursts a cause of concern. In play, children can gain mastery and control of these feelings and find alternative means of expression. This is what Rowen did when he swirled, splattered and spread the red paint energetically on the paper: the edges were not breached which, for him, was quite an achievement.

Being After a long time of treading and trampling, and treading and trampling, a few dry places began to appear in the big ocean. The wagtail had created the earth. The islands of Ainu, he had created the world.

I feel it is no coincidence that in creating both play and real worlds, slush and slime are the place where we begin. Just as in the real world, where life is believed to have emerged from slime, so, when children are ready, from the play with slime there also emerge more complex life forms. Their worlds can begin to contain a more symbolic narrative of their experiences. The wading in the slush and slime is an important part of

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this creative process. From delving into the chaos and disorder, a sense of being and meaning can develop. The children often then move on to other toys to decorate and illuminate their fantasy worlds. When children have created a play world in therapy and their present circumstances are relatively secure, a sense of themselves can be explored that is not so bound up in past trauma. The paints, clay, playdoh or slime can begin to be a symbol or metaphor, and a means to bring some order or sense to experiences. The emerging narrative is first held together in the act of doing, seeing, being – the immediate world experienced through the senses. Joshua in later sessions began to tear all the playdoh into small pieces, spreading them strategically over the mat, then squashing them back together again. This process would be repeated many times. One week, after ripping up the playdoh, he chose some pieces which he began to squeeze together. He did this until he had three different quantities of dough. He squashed the largest piece flat and rolled out the other two into sausages, which he proceeded to bend and place on each end of the previously flattened lump. ‘That’s you and me on the mat,’ he explained. He tore the boy figure up. ‘He’s broken.’ He then placed the pieces back on the playdoh ‘mat’. He squashed this mixture together and then banged and flattened it down again. He took out the gingerbread boy cutter and pressed it hard into the smoothened dough. He spent some time carefully pulling away the excess pieces from the edge of the shape, then pressed the playdoh boy out onto his hand. ‘See, now he is whole again,’ he said. Not all children are able to narrate so eloquently the way in which they use the materials to gain some sense of themselves or their process within the play. But for many it gives them a means to explore and express themselves, to experience the process of ‘becoming’ and begin to develop a sense of their individuality as a separate identity. Joshua’s family had begun to recognise his needs, making time to play with him away from his sister. In the dictionary, alternative words to messy are careless, untidy or dirty – which probably sums up the average adult view of such play activities. But for a child in play therapy, a very different perception can be constructed. Within our interaction meaning is created, though it exists often only in the moment. ‘Mess’ can be seen as a necessary beginning of

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making sense, the disorder part of the process of creating meaning, giving experience shape and form, even if only a temporary one. Central to messy play is that it is in the doing that the child expresses and explores their world, in the safety of the here and now, in a play space on the edges of the real world. Often, emphasis of meaning is that it can be abstracted in relation to something else – symbolic form or a narrative of words. But this evolves from first externalising and reflecting on experiences which as yet evade or transcend the world of words. Much can be missed in ignoring the expression and meaning held within the moment. Its existence is sustained in the experience itself, not in words. I have tried to draw out from children the words to describe these play experiences as a means to ensure I have grasped their understanding of them. However, I have found that, wrapped and absorbed in the moment, I can only glean an expression, a gesture or sometimes a grunt or giggle. This seems to echo the essence of the slime’s seemingly irresistible nature, which the child in play has become a part of. I tend to agree with them. Most of the meaning exists in the experience itself, within the context of the play space created between therapist and child in the slime world. Some feelings or events may remain an enigma, as life is never that simple. At times, words are too concrete to express or contain them. These experiences can be acknowledged and externalised in a slime world, where they may remain for 300 times as long as the dinosaurs roamed the earth. Their transformation to be grasped at another time, in another world. While writing this chapter, I feel that many experiences which I have gone through in this creative process mirror those of a child in play. I started with a collection of intangible thoughts and intuitive feelings of my past experiences in observing and participating in children’s play. These were the ingredients of my slime world, with my beliefs, perceptions and theoretical background mulched in for good measure. They have all influenced my direction, but constantly pulled me in different ways. At times, framing and structuring them into a manageable form to share with others has been an elusive task. The concepts fall through my fingers in my attempts to capture them in words. I have struggled to isolate different issues, to refine and stretch them. I have pulled them in

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various ways to make yet another possible structure of ideas, only to find them all to easily retracting, merging back into their original state – a formless mass – just like slime. From this stance, I can resonate with the child’s first taste of the creative world in play therapy. Finally, I hope I have given their perception of such experiences some life.

Maori From nothing the begetting From nothing the increase From nothing the abundance The power of increasing The living breath. (Gersie 1997)

References

Cattanach, A. (1992) Play Therapy with Abused Children. London: Jessica Kingsley Publishers. Cattanach, A. (1994) Where The Sky Meets The Underworld. London: Jessica Kingsley Publishers. Cole, B. (1985) The Slimy Book. London: Picture Lions/HarperCollins. Gersie, A. (1997) Reflections on Therapeutic Storytelling. London: Jessica Kingsley Publishers. Patten, B. (1985) Gargling with Jelly. London: Viking, p.119. Sartre, J.P. (1966) Being and Nothingness. Trans. Hazel E. Barnes. London: Methuen. Zalasiewics, J. and Freedman, K. (2000) ‘The dawn of slime.’ New Scientist 2229, 30–33.

2

The Self is a Telling

A Child’s Tale of Alien Abduction David Le Vay Take the tale in your teeth, then, bite till the blood runs, hoping it’s not poison, and we will all come to the end together, and even to the beginning: living, as we do, in the middle. (Le Guin 1980 p.29)

During my time as a play therapist, dramatherapist and social worker I have worked with many children and young people and have long been fascinated by the stories that are told and shared within the safety and security of the therapeutic space. It is a magical place where anything can happen and where most things do, and over the years I have witnessed stories and enactments that have been beautiful, moving, terrifying and sad. We live in a world of stories that run through our personal, social and institutional lives – a narrative stream that at times can be fast flowing and ever changing and at other times slow and meandering, carving out patterns in our understanding of ourselves and the world around us. This chapter tells the story of Daniel, a confused and anxious child who was referred for play therapy because of the complex emotional difficulties he was experiencing within his family, and particularly within the relationship with his mother. It is a metaphoric tale of hope and despair as revealed through a narrative sequence which provides a window into an internal world inhabited by powerful monsters, creatures which threaten to overcome his very self. My reason for writing about Daniel and the process of his play therapy has emerged from my interest 35

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in the notion of narrative identity, by which I mean the internal stories which children carry within them as a way of understanding, describing and making sense of their personal and social relationships. But before I talk specifically about Daniel, I will endeavour to place this work within something of a theoretical context by discussing briefly some of the ideas and thinking around the concept of narrative identity and how these ideas can contribute to an understanding of the play therapy process. My interest in the notion of narrative identity, and its relationship with play therapy, developed partly from my involvement in the practice of family therapy and the ideas which had developed within that profession over the last ten years or so; ideas which explored concepts of social construction, narrative and text analogy, for example, in the work of Anderson (1992), Hoffman (1992) and White and Epston (1990). I became both engaged and inspired by the emerging post-modern, post-structural position that was being adopted through the development of a ‘reflexive’ stance to therapy; a position that consciously distanced itself from the more traditional image of the therapist as ‘expert’ and moved towards an approach based more upon mutual reflection and collaboration, in which meaning is sought within a framework of co-construction between therapist and client. In conjunction with this, my play therapy practice with children who suffered trauma and abuse was leading me to become increasingly drawn to a narrative model of identity in which meaning, both personal and social, is created through the sequencing and ordering of life events. In this sense, the self could be seen to become an ongoing process of storying as new experiences are continually re-evaluated and reintegrated into our understanding of who we are and of our place in the world. I felt this model of narrative identity could provide a helpful framework for understanding the process of play therapy as children struggle to integrate their abusive experiences into an understanding of themselves and their place in a confusing and unpredictable landscape. Whilst I have found within my practice that children are often resistant to the formalising of their stories, I have always been fascinated by the semi-formal narrative sequences which are constructed during the course of their play. This may be a brief sequence of dramatic play, a period of projective play with objects and sand, or perhaps simply a child

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recounting earlier events of the day. Children in this sense act as their own narrators, providing a running commentary on their play. In the context of the play therapy space, these narratives become spontaneous collaborations created through the interaction between child and therapist. In this sense then, one of the fundamental processes of play therapy is the facilitation of the child’s expression of narrative identity, in that they are enabled to explore relationships via the symbolic and metaphoric imagery that is co-created during the course of their play. The natural inclination to story personal experience, which is so much part of the human condition, allows for a richness of symbolism and metaphor to develop within the healing process of play, and the healing narratives themselves become embedded within the relationship between child and therapist. So narrative frameworks are constructed which allow children to begin to sequence, order, predict and make sense of the complex feelings that can exist as a result of trauma and abuse. This capacity for the storying and narratisation of human experience was emphasised well by Barbara Hardy: We dream in narrative, remember, anticipate, hope, despair, believe, doubt, plan, revise, criticise, construct, gossip, learn, hate and love by narrative. In order really to live, we make up stories about ourselves and others, about the personal as well as the social past and future. (Hardy 1968 p.13)

As we know, children who have experienced abuse often have great difficulties in forming and maintaining healthy and positive relationships. Their narrative identity, their way of making sense of their abusive experiences, can involve personal constructs of blame, guilt, depression and anger, resulting in a perception of themselves as bad and worthless. By addressing the stories and narratives which children present in therapy it is possible to reframe these abusive experiences and so reconstruct an ongoing narrative for the child that is less influenced by their internalised feelings of self-blame and responsibility. The transitional space that occupies both the playroom and the relationship between child and therapist provides a rich and fertile ground for growth and change, a space where ghosts from the past can be safely conjured with and con-

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trolled and where new narratives of hope can begin to develop and flourish. In seeking to establish some form of definition for the term narrative identity as I use it within this chapter, the family therapist William Lax (1992) helpfully stated: The narrative view holds that it is the process of developing a story about one’s life that becomes the basis of all identity and thus challenges any underlying concept of a unified or stable self. (Lax 1992 p.71)

Lax suggests that the development of a narrative becomes a process of defining who we are in interaction with other people’s perceived understanding of us. Through narrative we forge and shape the world in which we live, creating our own subjective realities within the context of a social community of others. Lax proposes that narrative identity, or a sense of self, arises not only through discourse with other people but is our discourse with others. Within this narrative model of identity there is no hidden self to be uncovered or interpreted and indeed, as Lax states: ‘We reveal ourselves in every moment of interaction through the ongoing narratives that we maintain with others’ (p.71). Essentially then, narrative exists within a context of interaction between people. In the course of play therapy a child reveals their social text in conjunction with the therapist, in the role of reader and co-author. The stories and narratives which emerge during the course of a play therapy session belong then neither to the child nor the therapist, but are the result of a co-construction between them both. A narrative model of identity maintains the view that the act of telling a story is equally an act of creating one’s self, a construction of life through stories that change depending upon the moment of interaction, the purpose of the telling or perhaps the audience or listeners to the story itself. Ricoeur defined narrative as something that ‘makes identity somewhat unstable, insofar as many stories can be woven from the same material’ (Wood 1991, p.4). It is this dynamic, transient and context-driven essence of narrative that I believe to be so valuable in the provision of a model for describing the play therapy process.

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This concept of identity as a somewhat unstable construct is a theme emphasised by Donald Polkinghorne, who proposed that both personal identity and self-concept are achieved through the use of what he termed ‘narrative configuration’: We are in the middle or our stories and cannot be sure how they will end; we are constantly having to revise the plot as new events are added to our lives. Self, then, is not a static thing or a substance, but a configuring of personal events into an historical unity which includes not only what one has been but also anticipations of what one will be. (Polkinghorne 1988 p.150)

In this sense we ‘realise’ ourselves through the stories and narratives that we tell both ourselves and others. The words we use, the sentences we construct, the events that we choose to include or omit, all contribute to the generation of a narrative identity through which we aim to make sense and order out of experience. Like the saying that one can never step in the same river twice, the self is a fluid, illusory construct that changes as our stories change, through the continual need to reorganise, reassess and reintegrate experience into our daily lives. There is a Tibetan Buddhist saying that the ‘self ’ is somewhat akin to a ‘candle flame in an open doorway, vulnerable to all the winds of circumstance’. Similarly, the stories and narratives that children carry within them are shaped and sculpted by the prevailing ‘winds of circumstance’ that they each experience. Within play therapy, children can safely control and experiment with the interplay between their internal narrative constructs and their creative imagination and so explore new stories about themselves. Internal conflicts are externalised through their play so that they cease to become simply the ‘bad bits’ of themselves and instead become objects and roles which can be seen, played with and made sense of. I feel it is important within any discussion around the concept of narrative and therapy to make brief reference to the work of White and Epston (1990), who proposed that an understanding of narrative structure holds an advantage over other related concepts, for example, the use of metaphor of fixed paradigms. They suggest that because narrative places emphasis upon order and sequence, it can be a much more useful and relevant way of understanding change, life cycles and developmental processes. Through their employment of a ‘text analogy’, White and

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Epston talk of the storying of experience as a means of providing people with a sense of continuity and meaning in their lives: In striving to make sense of life, persons face the task of arranging their experience of events in sequences across time in such a way as to arrive at a coherent account of themselves and the world around them. Specific experiences of events of the past and present, and those that are predicted to occur in the future, must be connected to a lineal sequence to develop this account. This account can be referred to as a story or self-narrative. (White and Epston 1990, p.10)

This concept of text as an analogy for the self is drawn from the notion of hermeneutics, a theory and methodology of textual interpretation which acknowledges the intersubjectivity of the therapeutic relationship and places specific emphasis upon the reflexive ‘loop’ of conversation and dialogue. Children, in the context of play therapy, are not simply passive scripts to be read and interpreted, but living texts which change through the interaction between therapist and child, each bringing their own socially constructed view of the world into the dynamics of their relationship. The text analogy for the self is complex, because no one reading will ever be the same, but therein also lies the value of hermeneutic methodology in that it provides an interpretive approach to information, specifically text, whilst also acknowledging the value and importance of subjectivity within this process. The relationship between text and narrative is aptly summarised by Lax (1992): The interaction itself is where the text exists and where the new narrative of one’s life emerges. The unfolding text is something that occurs between people. Clients unveil the story of their lives in conjunction with a specific reader/therapist, therefore the therapist is always a co-author of the story that is unfolding, with the client as the other co-author. The resulting text is neither the client’s nor the therapist’s story, but a co-construction of the two. (Lax 1992, p.73)

It is through the use of text that I have explored the process of Daniel’s play therapy, in that it provides a window through which the co-constructive process can be viewed. Through audio-taping and transcribing a 15-minute section of a play therapy session, I was interested in

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what the resulting text might reveal about Daniel’s narrative identity and the extent to which his sense of location within his personal, social and physical system was discursively displayed. Rom Harre (1994) proposed that ‘the mind of any human being is constituted by the discourses that they are involved in’ and so it could equally be seen to be revealed through this same process. I was also interested in how this sense of personal narrative related to the overall picture of Daniel’s play therapy, and to this end I have also included in this analysis a story that Daniel told, and in fact dictated, during the course of his therapy. From the inner to the outer, the micro to the macro, two co-existing world views of a child in therapy are explored and I shall discuss the contrasting nature of this process in greater detail later. But first I should say something about Daniel and the story that brought him to play therapy in the first place.

Daniel Daniel was a 7-year-old boy living at home with his mother, father and younger sister. Daniel’s mother had a background of chronic childhood sexual abuse and associated long-term mental health difficulties, marked by periodic admissions to psychiatric hospital departments, triggered by emotional collapse and related ‘hysterical’ physical manifestations, for example, loss of use of legs, stomach pains and unexplained fits. She had attempted suicide on a number of occasions and a diagnosis of Munchausen syndrome by proxy had been slowly, and somewhat hesitantly, established over a number of years due to both Daniel and his sister being presented to health professionals with a number of unexplained injuries and health problems. Consequently, Daniel has spent periods of time throughout his life in local authority care both on a voluntary and involuntary basis. The relationship between Daniel and his mother was characterised by her extreme mood swings, explosions of anger and contradictory messages of love and rejection. Her ability to meet the emotional and physical needs of her children appeared inextricably linked to her own state of mind. Whilst professionals had noted that she could at times present as the ‘perfect’ mother, she has also in the past talked of wanting

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to kill Daniel and threatened to suffocate him with a pillow. This ambiguity in presentation led to social services walking an increasingly precarious tightrope between support and protection, along with the need continually to assess the potential risk to the children. The rationale for play therapy intervention with Daniel followed a referral from the family’s social worker requesting a period of play therapy with the specific aim of assessing the impact upon Daniel of the ongoing difficulties he was experiencing within his family. Daniel’s mother had for many years been receiving intensive psychotherapeutic support and, whilst I had reservations about working with a child in such an emotionally (and potentially physically) precarious position, I was equally concerned about what appeared to be the historical pattern of professional attention focusing on the emotional needs of a parent rather than those of the children. It was my hope that a therapeutic assessment of Daniel’s needs and of the impact upon him of living with a mother who suffered from severe mental health difficulties, and who potentially presented some considerable risk to Daniel, would help to shift the focus of professional attention onto the present and future needs of the children. Over the course of eight sessions, Daniel dictated the story of the ‘Dinosaur and the Super Train’. His control over this process was intense, detailing precisely the wording, spelling and punctuation of his story. Before even beginning this process of dictation, Daniel wrote out the alphabet on a separate piece of paper and gave me strict instructions to write the story in his ‘language’. The writing of this story, or ‘the book’ as it became known, formed the basis of Daniel’s play therapy. The Dinosaur and the Super Train Long long ago when the dinosaurs lived, there was some certain dinosaurs which this story is about. There were Tyrannosaurus Rex’s, one Pterodactyl, four Dinonycous, six Diplodocus, four Triceratops, one Stegasaurus. I really can’t tell you all their names because there are too many of them. Now let’s begin. This story starts when the mother of the T. Rex was having a baby. It was a girl T. Rex who was very kind

THE SELF IS A TELLING: A CHILD’S TALE OF ALIEN ABDUCTION

because her mother was very kind. Of course when she grew up she grew up to be kind. Now the bit of the story when she was born. She was so cute when she was born that she was not called T. Rex, she was called Holly Rex. ‘Oh you are such a lovely baby,’ she said. When Holly Rex grew up, when she was three, she made lots and lots of friends and they were all the ones I told you about at the beginning of this book. She played lots and lots and lots of games with them and a lot of games they played with her. One day there was a strange noise when Holly Rex was playing with her friends, a ‘woo woo’ and then a ‘chuff chuff chuff ’. Holly Rex said, ‘What’s that?’ in a whispering voice, and then there was a strange voice and something appeared on the rails. ‘I am the Super Train. I have come to save every dinosaur from the evil T. Rex,’ and then there was a great big ‘ROAR’. And then the T. Rex came up and said, ‘I will eat you’ and the Super Train ran out on the rails and said, ‘Oh no you won’t, these are my friends. I will turn on my wings and turn into a bomber and drop bombs into your mouth.’ And then suddenly there was a great big BANG. There was a puff of smoke and the T. Rex disappeared. ‘Thank you,’ said Holly Rex. ‘You saved us from the evil T. Rex. We didn’t know about it.’ ‘My pleasure,’ said the Super Train. ‘I would really appreciate to run my rails all over the land,’ said the Super Train. And then there was a puff of smoke and the rails went all over the land, under the volcano, through the forest, over a big bridge over the sea, and then suddenly he vanished out of sight but the rails were still there and they could still hear the ‘chuff chuff ’ and ‘woo wooing’. And then, when Holly Rex got back to the cave she said, ‘Mum, I’ve seen a Super Train.’ ‘A Super Train, what on earth is that?’, and Holly said, ‘A Super Train can turn into anything in the whole world.’ D:

Pretend I’ve written it. Because remember I’m telling the story aren’t I.

T:

You are telling the story. It’s your story.

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D:

So, by Daniel…and saying…by Daniel…just drawn by Daniel and written by Daniel, right?

T:

Where shall I write that?

D:

On the back of there.

T:

Underneath where I’ve written the other bit or on the other side?

D:

No on the back, on the other side.

T:

O.K.

Pause whilst Daniel plays with some lego. T:

You feel like playing with the lego.

D:

Yes, but I’ve got a whole pack of lego at home. I’ve told you that haven’t I?

T:

Yes you have.

D:

And it’s so, so big…go on, have you written it yet?

T:

Yes, I’ve done that now.

D:

Right, now… Dear Peter. I’ll just draw, um, before I start you stop and I’ll draw a…I think we’ll skip that piece of paper. Right, try not to tear this piece alright?

T:

I’ll do my best.

D:

Draw a line on there. Right, now. That is where I’ll do the pictures so all the writing has to be down there.

T:

O.K.

D:

It has to be in a straight line though.

T:

In a straight line.

D:

Now remember, I’ll put the pad…because that’s where I’ll do the picture when you are not writing…I’ll put the pad there, right?

T:

You’ll put the pad there.

D:

O.K.

T:

So. You are going to tell me what to write.

THE SELF IS A TELLING: A CHILD’S TALE OF ALIEN ABDUCTION

D:

Long long ago when the dinosaurs lived (comma), are you writing it in my language?

T:

I am doing my best to write it like yours.

D:

Well, I hope mummy can read it though because I am going to take the writing home. If we don’t get the writing done today, because I’m going to write as much of it… Long long ago when the dinosaurs lived (comma), there was…there was…some certain dinosaurs which this story is about, because we are telling about the story on this page, there was three Tyrannosaurus Rexes.

T:

Alright, three Tyrannosaurus Rexes.

D:

Three…the number three, not like that.

T:

You want me to write it as a number and not a word?

D:

Yes. The next time you do a number do it what it looks like…the number.

T:

Right, O.K., I will do that next time.

D:

One pterodactyl.

T:

O.K.

D:

Four Dinonycous. That is a very long word.

T:

Can you say that one again?

D:

Dinonycous.

T:

Dinonycous.

D:

Because that makes sense because Dinonycouses wouldn’t make sense would it?

T:

No, I guess it wouldn’t. You like to get your words just right don’t you?

D:

Yes.

T:

So, we’ve got three Tyrannosaurus Rexes, one Pterodactyl, four Dinonycous.

D:

Six Diplodocus. The number.

T:

Sorry.

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D:

It’s alright, alright. Do you think this is a cool vehicle [taking transformer car out of box]? Beep beep beep beep beep.

T:

That looks very cool.

D:

It’s a space thing. And do you know what? It lives in space, and this…that goes there, I mean there…pretend that… that’s one of these there and one of these there, and one of them is up, probably there [manipulating components on car] and this bit, the one at the back, goes down the tail and through the front and into there, and one on the top…see, if there is any danger on the top…I have to fold it down into the middle and into there…and they can see in front, behind and on top and, I mean, um, one there, one there and one underneath so that it can go full speed away.

T:

So it can see all around itself to see if there is any danger.

D:

Yes. And do you know what?

T:

What?

D:

It’s got guns. It’s got guns there, there, there, there, there, there and there. You see everywhere it’s got that or that or that or that then it…those are guns. So it’s guns on wheels.

T:

So if it saw any danger it could use its guns?

D:

Yes. They shoot a hundred bullets out of each part where there’s a gun…at the same time.

T:

What sort of danger do you think it might see?

D:

Oh, when they go to Mars there is such a dangerous danger. Do you know what it is?

T:

No I don’t.

D:

You see it’s…um…it’s…an alien. Do you know how big the alien is?

T:

The alien on Mars? No I don’t. How big is it?

D:

As big as this playroom and the big playroom down stairs.

T:

That is huge.

THE SELF IS A TELLING: A CHILD’S TALE OF ALIEN ABDUCTION

D:

And do you know what? Do you know how tall its things are, the ones on top. Probably about as tall as this playroom.

T:

What does it look like, this alien?

D:

It’s got all different coloured spots and it’s white and it’s got long pointed teeth and do you know how big they are?

T:

No I don’t.

D:

As big as me. As big as me. It’s so big it could swallow the smallest planet. What’s the smallest planet?

T:

The smallest planet is one called Pluto. It’s very far way.

D:

Well, if it’s Pluto it could swallow good aliens, but he is the king, so it would get all the aliens of there first and then it would swallow it, so it could come to Mars. And do you know how it…how it…could…this is their friend but the baddies have more guns, they’ve got them all over the place, in fact they are covered in guns, and their guns are in shields.

T:

Is the alien the king of the bad aliens or the good aliens?

D:

Well, he’s king of the good aliens so he is ready for the baddies because…do you know what, he has actually got claws, and do you know where?

T:

No I don’t.

D:

He’s got claws on his eyes!

T:

Claws on his eyes?

D:

Yes. And he’s got claws all over his face and all over his…in fact he’s got claws everywhere.

T:

That is a very funny place to have claws

D:

Yes.

T:

So does that help him to protect himself or are they for fighting with?

D:

It’s for fighting with and whatever…whenever anybody who touches him will get…do you know how many people he can kill?

T:

No I don’t.

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D:

At the same time, two thousand.

T:

Two thousand! so he’s very powerful.

D:

And very big.

T:

What does he eat do you think?

D:

He eats only baddies.

T:

Only baddies?

D:

And aliens. He also eats the baddies vehicles so they can’t get away, and he is such a fast runner. Do you know how big his feet are? As big as this playroom.

T:

What, each foot!

D:

Yes!

T:

I wouldn’t like to meet this alien.

D:

But he’s friendly to you because you are friendly aren’t you?

T:

Yes, I’m friendly.

D:

Now if you rob something… It doesn’t matter if you borrow something. If, um, someone who is a goody explains that he…they told him that he has, um, he’s um, he has actually, he’s um, he has er…it’s a goody and he’s, and he’s borrowed it then he spits him down the watershoot and it cleans him and then right at the bottom of the planet he comes out, because he went right through the middle of the planet.

T:

Right through the middle?

D:

Yes.

T:

Can he talk? Has he got a voice?

D:

Yes, he’s got a very kind voice when there is goodies around, but when there is baddies he says in a really gruff voice…and do you know how loud it is?

T:

No, I don’t.

D:

It is so loud. Do you know what? If he roared or shouted straight at the wall then it would fall to pieces, and do you know how small those pieces would be? [Indicates with thumb and forefinger.]

THE SELF IS A TELLING: A CHILD’S TALE OF ALIEN ABDUCTION

T:

Goodness, that tiny. So he could almost smash the whole planet with his voice.

D:

No he doesn’t, because he never knows…he knows that there are goodies there and baddies so he only kills the baddies when they come up. There’s always baddies because baddies come from different countries, not just from our country.

T:

Right.

D:

Now let’s get on with the story…um…four Diplodocus.

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Perhaps an appropriate starting point for this exploration into story and narrative would be to look at some of the differences and similarities between the two as presented by Daniel, with the aim of defining some of the key elements inherent within both structures so that a distinction between the two forms can be made. A fundamental element that makes a distinction between story and narrative possible is one of intentionality, in the sense that a story is communicated intentionally and is governed by certain formal rules of structure and content. Clearly, Daniel’s story ‘The Dinosaur and the Super Train’ contains the classic elements of protagonist, plot, adversary and outcome and has a well-defined sense of beginning and end. Narrative, on the other hand, can be viewed as being embedded within the conversation or interaction between people and is not formalised in the sense that a story is and not necessarily experienced as a story by the listener. Daniel, in the process of telling his story, shifted into an unintentional and spontaneous narrative sequence facilitated through his play with a ‘transformer’ toy. Whilst his fictional narrative contained some elements of character and plot, for example, the King Alien’s battle with the baddies, it occurred informally within the dialogue between me and Daniel and was neither signalled by him as a story nor communicated with that intent. Indeed, it had no formal beginning or end, but simply existed for a brief moment in time before being swallowed up within the safety and security of structure and form. It is interesting also to note the differences in grammatical structure between the story and narrative. There is a strong sense of self-assurance,

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containment and formality within Daniel’s story, created through his controlled use of words and sentences and general desire for grammatical correctness. This emphasis on structure and careful word selection is in stark contrast to the hesitant, faltering and at times confusing spontaneity of the narrative in which words tumble out of Daniel; their meaning being continuously created at the precise moment of their construction. In looking at both Daniel’s story and the narrative text, it struck me that they each provided a very different representation of how Daniel viewed his world and indeed how he perceived his own place within that world. The story of the Dinosaur and the Super Train could be seen to present an idealised, projective fantasy of how Daniel would like his life to be in that he creates a picture of a loving, nurturing mother and of a child, Holly Rex, who is herself both likeable and lovable and with whom other children want to play. In contrast to this vision, the narrative text provides an alternative description of how Daniel experiences himself, his mother and the immediate world around him, with its dominant themes of fear, danger and protection. It is as if the underlying but pervasive theme of duality that runs through Daniel’s narrative identity has been graphically and symbolically represented within the stark contrast between the story and the narrative: one a desperate fantasy of love and nurture and the other a grim portrayal of fear and confusion. It is particularly poignant then that Daniel says of his story, ‘I hope Mummy can read it because I am going to take the writing home.’ It is the safe, contained version of reality that Daniel wishes to present to his mother, perhaps because of the message he wishes to give her or because it is what he believes she wants to hear, or maybe because it simply feels safe. There is certainly no clear distinction between truth and fiction in Daniel’s world and he has in a sense provided two truths, two world views which in themselves reinforce the polarities and splits that exist as a result of the intensely unpredictable and ambivalent behaviour of his mother. This sense of maternal ambivalence even emerges within the controlled containment of Daniel’s story, wherein there is an inexplicable transformation from the ‘kind’ to the ‘evil’ T. Rex. So a significant theme of duality clearly begins to emerge which could be seen graphically to reflect Daniel’s experience of a mother who demonstrates her emotional

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inconsistence through sudden and extreme changes of temperament, and who could for Daniel be at once both safe and dangerous. So what does a closer examination of the text reveal about Daniel and the forces which have shaped his identity? The beginning of Daniel’s narrative discourse and departure from the dictation of his story came about through his spontaneous play with a ‘transformer’ car. The car becomes a ‘space thing’ which to be alert to any potential danger has the capacity to ‘see in front, behind and on top’, as well having the ability to ‘go full speed away’. Daniel goes on to explain that the spaceship is literally covered in guns as emphasised by his repeated use of the word ‘there’ so that it becomes momentarily transformed from being a spaceship to simply ‘guns on wheels’. If, as discussed earlier, one takes on the concept of text analogy, and view Daniel’s use of narrative as an essentially metaphoric expression of his own identity, we can clearly begin to see the emergent themes of watchfulness, protection and danger revealed within Daniel’s narrative discourse. These are characteristics which may for Daniel form part of some kind of projective continuum in the sense that they may relate at different times (or perhaps simultaneously) to his perception of both himself and his mother, and which within the context of the metaphor of the spaceship pose the question, who’s watching who? If an abused child internalises the social construction of the abuser, so Daniel struggles with the distinction between what is his own and what is his mother’s identity. The themes raised here clearly relate to a child who from one moment to the next is unable to predict the temperament of his mother, and the image of a spaceship with 360-degree vision, a capacity for a hasty retreat and bristling with guns, whether they be used for attack or defence, is powerful indeed. Daniel next presents us with the image of the alien with pointed teeth ‘as big as me’ and which is not only as big as the play therapy room but as big as ‘the big playroom downstairs’. Within the space of 30 seconds Daniel uses the word ‘big’ seven times and reveals a frightening sense of uncontainment which is in stark contrast to the controlled structure of his story of the Super Train. Daniel takes the symbolic space of the play therapy room to its very limits in his bid to portray the size of the monster he has created. It is not bigger than the playrooms but ‘as big’ and

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although it may have taken both playrooms in the family centre to contain it, the monster is nevertheless contained. Daniel goes on to describe the size of the teeth of the alien, and his quick repetition of the phrase ‘as big as me’ along with the rest of this whole sequence on size conveys an urgent and frightening sense of being overwhelmed by feelings that are barely containable. It is this sense of uncontainment, so graphically portrayed within the metaphor of Daniel’s narrative, that lies at the heart of the desperate expression of control which was such a prominent feature of Daniel’s sessions. The restless and tense body language, incessant talk, obsession with detail and flashes of frustration and anger if his instructions were not followed I believe were all part of Daniel’s way of managing the internal chaos that he was experiencing – a quest for internal containment through external control. At no time was Daniel able to be still, for fear perhaps that the alien would overwhelm him. The only way of managing the resulting anxiety was through his intense manipulation of both the play therapy space and his relationship with me. The text then leads us to the concept of good and bad and reveals some confusion on Daniel’s part within this passage of the narrative. The transcript displays a faltering hesitancy as Daniel struggles in his identification with the scene he has created and with the question of who is good and who is bad. In an attempt to seek some clarification over this issue, I ask Daniel directly about the nature of the king alien and he clearly states that it is the ‘king of the good aliens’ and goes on to set the scene for the great battle between good and bad. Similarly to many children I have worked with, Daniel externalises his internal conflict through the imagery of war, and interestingly at this point Daniel returns to the weapons imagery used earlier when he says that the ‘baddies’ are ‘covered in guns and their guns are in their shields’. In relation to the theme of duality discussed earlier, the image of a shield covered in guns is interesting, in the sense that he has turned the symbolism of protection that one might usually associate with a shield into something that could also be used to attack and harm. Daniel then presents us with a graphic and somewhat frightening vision of the king of the good aliens, a creature with ‘claws on his eyes…claws all over his face…claws everywhere’. This is a powerful

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image indeed and it was only after reading through the transcript several times that I was struck by its significance. I recalled that one of the impressions I was left with after meeting Daniel’s mother was the intensity of her gaze, to the extent that she brought to mind the expression ‘staring daggers’. I could imagine that both the use of her eyes and a voice that could spin quickly out of control formed a central strategy in her attempts to manage and control Daniel’s behaviour. His image of an alien monster with clawed eyes presents a vivid picture of how he experienced these interactions with his mother. Daniel goes on to to say of the alien that ‘whenever anybody who touches him will get…’ and the implications contained within these hanging words can only leave one guessing at what might have actually happened had anyone gone as far as to touch the claw-covered creature. Once again, there are possible connections to be made here with a mother who, because of her own experience of childhood sexual abuse, found physical contact and the giving of affection almost unbearable. It seems that Daniel’s struggle to understand and make sense of the complexity of this relationship is central to the symbolism contained within his fictional narrative. Daniel’s depiction of the alien continues, of a monster that can kill 2000 ‘baddies’ at the same time, which eats their vehicles to prevent them escaping and which is ‘such a fast runner’ that each of its feet is the size of the playroom. The alien is even in possession of two voices, one ‘kind’ and one so ‘gruff ’ and loud that it can smash a wall to tiny pieces. In its entirety, Daniel presents us with a vision of an alien creature which is so vast and so powerful that it is essentially omnipotent. Although (after some hesitancy) he establishes its credentials as ‘good’, the alien is introduced at the beginning of the sequence as ‘such a dangerous danger’. This sense of ambiguity over the possible temperament of the alien reveals further the frightening element of unpredictability that Daniel has to negotiate. The alien itself is given by Daniel the capacity of being able to distinguish between good and bad, so removing any sense of control that he might have had over this process, and so further creates an image of an all-powerful, barely containable creature moving through space and making indiscriminate judgements about who should live and who should die. Even if the alien succeeds in eating all the ‘baddies’, Daniel

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moves from the narrative sequence back into the story of the Super Train with the final reminder that ‘there’s always baddies, because baddies come from different countries, not just our country’. This again conveys a stark sense of helplessness and the feeling that the alien creature, with all its power, strength and size, will ultimately be unable to kill off the surrounding badness. In terms of narrative identity, this image of badness raises issues about Daniel’s own personal constructs of blame and guilt and how, through his dependence upon his emotionally and physically abusive mother, he has had to internalise the feelings that have resulted from his abuse. Children often survive these situations by internally reconstruing events, so blaming themselves for being bad and imagining their carers as good. In this sense it could be suggested that Daniel has sacrificed his ‘self’ in order to maintain the image of a good mother and constructed a false ‘bad self’ in order to survive. So Daniel’s narrative identity has been abducted by the metaphorical alien and the creature inhabits an internal psychological landscape into which Daniel has allowed a fleeting glimpse. An integral element within the whole narrative sequence is the relationship between Daniel and me, in the sense of its co-creation within the context of our interaction. Daniel clearly dominates the dialogue in terms of word count, but I was struck by the extent and nature of his checking out as he developed the images within the sequence. Did I know what the danger was? Did I know how big the alien was? Did I know how big its teeth were? Did I know where its claws were? Daniel is continually developing, constructing and re-evaluating his narrative imagery, a process of co-construction through the reflective (reflexive?) backdrop provided through the relationship between us. My interventions, although minimal, created the reflexive loop within which the metaphoric narrative could be developed. In this sense the whole of Daniel’s narrative sequence with its rich and startling imagery could not have existed outside the context of the therapeutic relationship. This brings us back to the notion of hermeneutics and the way in which it can provide a model for understanding the therapeutic process. The art therapist Deborah Linesch (1994) described a model of the ‘hermeneutic spiral’ as a concept that reflects the ‘unending dialectical reverberations of the process of understanding’ and which in the context of

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the relationship between therapist and client facilitates the emergence of a co-construction of meaning, which provides the basis for new meaning and potential for change. So through being able to externalise his fear, to visualise, describe, name and manipulate it both verbally and physically, Daniel can begin to play with the idea of a different relationship with the conflict which had become so enmeshed with his narrative identity, his story of himself. The analysis of Daniel’s text revealed the extent of the internal conflicts and ambiguities that he has been living with over the course of his seven years and an everpresent sense of duality lay at the core of his identity, as revealed through his narrative discourse. The conflicting and contradictory themes of nurture and control, safety and danger, good and bad, were embedded firmly within the text along with the pervasive themes of watchfulness, fear and an almost overwhelming sense of uncontainment. Place this in context of a diagnosis of Munchausen’s syndrome by proxy, in which a mother on one hand physically and intentionally harms her child in the search for attention and on the other can be a loving and caring parent, one can truly begin to understand the fears, splits and confusion which lay at the core of Daniel’s personal identity. Daniel’s text reveals a frozen moment of time within a stream of narrative discourse, and the notion of text as an analogy for the self has provided a helpful insight into the construction of his personal and social identity. Within the context of assessment, which was the primary focus of my intervention, the process of working with narrative and text was valuable in that it was possible both to identify and predict existing and future factors relating to Daniel’s emotional, social and psychological development. These included a significant level of internal anxiety, attachment disorder, difficulty in forming healthy relationships, a splitting in maternal perception, domineering social interaction and to some extent a developing difficulty in the capacity for empathy, as indicated by Daniel’s dominant and controlling behaviour and problematic peer group relationships. In the longer term, there has to be considerable concern as to how these issues will manifest themselves over the course of Daniel’s later years and the internal splitting and dualistic nature of his identity, so manifest throughout the text, could well indicate a potential within Daniel for future abusive and dangerous behaviour.

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Of course there is plenty of scope for debate about the limitation of text itself as an analogy or representation of lived experience. It was the deconstructionist Derrida (1972) who suggested that there is ‘no clear window into the inner life of a person…hence there can never be a clear, unambiguous statement of anything, including an intention or meaning’. To an extent Derrida is right and, as acknowledged earlier, any textual analysis of narrative is always going to be a subjective and multilayered process. As Daniel constructed a narrative that gave form to his world, he is also narrated by those around him. It is their stories as well as his own that he brings into the play therapy space and equally, as play therapist, I carry my own stories into that same space. Essentially then, the projective, metaphoric imagery contained within the narrative allowed Daniel the emotional distance to engage, on an unconscious and symbolic level, with the internal fears and anxieties he was experiencing. Whilst there may indeed be no clear window into the life of a person, Daniel certainly allowed both himself and me a brief and tantalising glimpse into another world which existed for a brief moment in time. A model of identity as something that can be revealed through discourse and ordered through the construction of narrative has enabled Daniel’s story to be heard.

References

Andersen, T. (1992) ‘Reflections on reflecting with families.’ In K.J. Gergen and S. McNamee (eds) Therapy as Social Construction. London: Sage, pp.54– 68. Derrida, J. (1972) ‘Structure, sign and play in the discourse of the human sciences.’ In R. Macksey and E. Donato (eds) The Structuralist Controversy: The Language of Criticism and the Sciences of Man. Baltimore: Johns Hopkins University Press. Hardy, B. (1968) ‘Towards a poetic fiction of life: an approach through narrative.’ In H. Rosen Stories and Meanings. Sheffield: NATE Papers in Education, p.13. Harre, R. (1994) The Discursive Mind. London: Sage. Hoffman, L. (1992) ‘A reflexive stance for family therapy.’ In K.J. Gergen and S. McNamee (eds) Therapy as Social Construction. London: Sage, pp.7–24. Lax, W.D. (1992) ‘Postmodern thinking in a clinical practice.’ In K.J. Gergen and S. McNamee (eds) Therapy as Social Construction. London: Sage, pp.69–85.

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Le Guin, U. (1980) ‘It was a dark and stormy night; or why are we huddling about the campfire?’ In H. Rosen Stories and Meanings. Sheffield: NATE Papers in Education, p.29. Linesch, D. (1994) ‘Interpretation in art therapy research and practice: the hermeneutic circle.’ The Arts in Psychotherapy 3, 185–195. Polkinghorne, D. (1988) ‘Narrative knowing and the human sciences.’ In J. Bruner (1990) Acts of Meaning. Cambridge, MA: Harvard University Press, p.115. White, M. and Epston, D. (1990) Narrative Means to Therapeutic Ends. New York: Norton. Wood, D. (1991) On Paul Ricoeur: Narrative and Interpretation. London: Routledge.

3

Jeffrey the Dog

A Search for Shared Meaning Sue Allanson She sat on the chair, sitting as if she wasn’t there, not looking, not speaking, hoping I would not see her. That is how our story began together. I did not know then that stories would help her find her voice. It began that first session with me reading to her a children’s story and for the first time she looked up in response to the sound of my voice reading about a far-off land. I cannot remember how she came to tell her own first story, just the excitement as the words came flowing out of her mouth, the mouth of a woman who had been labelled as learning disabled throughout her education. She started to illustrate her stories with small pencil drawings and the stories just continued to flow.

Lisa For Lisa, an 18-year-old black young woman, stories provided her with the dramatic distancing that fiction can provide and enabled her to describe tragedy, abandonment, love and sometimes resolution. She interwove elements of her own life story into the stories she told. She was then able to receive my comments of empathy and dismay at the treatment which the child had been given in the story. These expressions of her own worth, if directly conveyed to her at this stage in the therapy, might have been too overwhelming. She was able to absorb them from 59

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me as her audience. She revealed the low self-esteem in which she held herself as a black woman through the telling of a tale of twins where one was fair and beautiful and the other dark and ugly. The ‘dark’ twin ran away at the age of 8 because of the unfair treatment she was receiving compared to the sister. The mother did however care enough about her to search for her in the story, found her and returned home with her. The story ended with the comment that the mother loved her in spite of the fact that she was ugly. The story bore some similarity to the girl’s own life in that she was removed from home at the age of 8 with her sister who was white. She had been sexually abused by her stepfather and rejected and disbelieved by her mother. She was then subjected to sexual and racist abuse by her foster carers. The story was told at the point that she was in a caring foster home which had had a positive effect on her, but her poor self-identity as a black woman was still apparent. This young woman continued to ‘make’ stories in the sessions, sometimes needing no prompts or structure other than the play materials available, using the figures or the puppets to tell the story. Sometimes I would select a story which I thought might resonate with her because of the themes of rejection, brutality and abandonment, but which included some hope and resolution. She never actually told me her story in the first person, but we both knew she had told it in other ways. She ended her therapy by writing a story for other children who came to see me. This story described a girl who had been abused and who told her mother. She believed her, comforted her and informed the relevant agencies, ending in the abuser being imprisoned for a very long time. This story could not have been more different from what had happened to her, but I felt the story she told was the one that she knew should have happened. There was comfort, belief, punishment and adults taking responsibility for ensuring there was justice for a vulnerable child. She had developed a sense of fairness despite what had happened to her. She wanted to make it right for herself. This was the story she wrote:

JEFFREY THE DOG: A SEARCH FOR SHARED MEANING

Something Happened to Moesha Once upon a time there was a young girl called Moesha who felt very lonely and pretty much in the dark. She was feeling hurt and pretty much unloved, hurt and ugly and dirty. She thought that nobody wanted to know her and was very scared and very frightened. She had a secret but didn’t want to tell anybody because of the way she was feeling and didn’t think anybody would believe her anyway. She kept it to herself and just didn’t want to go to school just wanted to stay in her room all the time like she was imprisoned.

Figure 3.1

Her mother was pretty much worried about her and was wondering why she wasn’t her normal self, like cheerful and playful and loving. She kept on asking her all these questions: Why she didn’t want to go to school, why she was always sad and miserable and if

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there was anything she could do to help her, but Moesha didn’t answer and her mother asked her if she wanted to talk. Moesha refused and said everything was all right but really deep down inside it wasn’t all right and she wanted to tell her mother very badly but couldn’t as she was scared. Her mother then called up to her and said everything would be all right. ‘Do you want a drink?’ she asked her. Her mother knew there was something upsetting her as mothers do know when their children are upset. Moesha said, ‘Leave me alone, I don’t want anything.’ But her mother refused to leave her on her own. Her mother was curious to find out what was wrong and would not leave her until she had got to the bottom of it. Moesha still wouldn’t tell her mother what happened that day. Her mother was getting really upset now as she didn’t know what was going on. She shouted at Moesha, ‘Tell me else I can’t help you.’ Moesha realised that her mother was only trying to help her so she started to tell her mum what had happened. She told her mum that her father had touched her where he shouldn’t have. Her mother burst into tears and hugged her and then went and told the police what had happened.

Figure 3.2

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Later the police came round to ask Moesha some questions. Moesha told them what happened when she went to her father’s house, ’cos her parents had split up about two years ago. Her father was later arrested and put into custody and her mother said that she was safe now. Moesha hugged her mother and thanked her. Her mother said if she had a secret like that again she mustn’t keep it to herself and she must tell people. He went to court and admitted it all and said how sorry he was and was sent to prison. Moesha was pleased. The End Lisa had managed to transcend the distortions she had been fed and was able to give voice to her own sense of knowing of fairness, through the vehicle of storytelling. I think that this last story of Lisa’s shows that creating stories can enable children to start to imagine other healthier constructions of reality which they can be in control of, dissimilar to their own lived life so far. Creating and thereby experiencing this reality can have a beneficial effect on children who have experienced some adults as brutal and controlling and received no retribution.

The magic of stories Stories and metaphors are professed to have a more direct impact on emotions and behaviour because the information is processed in the right hemisphere of the brain. Bettleheim (1976) thought that the attraction of fairy tales to children was that they helped them to cope with the psychological problems of growing up and enabled them to resolve their particular psychic struggles. He noticed how different children remembered different elements in stories and attributed this to them highlighting aspects that were resonant with their own existential predicament. Stories are being increasingly used by researchers and therapists as assessment and therapeutic tools. Buchsbaum et al. (1992) used story stems to prompt stories from children. Story stems are the beginnings of a story which are told by researchers or therapists to stimulate the child into

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continuing with a story of their own. They sometimes introduce ethical dilemmas or describe relationship difficulties to provoke a response from the child. There were marked differences between the kind of stories abused children told compared to those who were not. They found that the stories from the abused group of children contained more aggression, punitiveness and abusive language and they frequently perceived the self as bad. Lahad and Cohen (1997) developed the six-part story structure to elicit stories from the child which could then be analysed for the child’s dominant coping styles. This can then assist the therapist in identifying which therapeutic intervention would be most effective, building on their strengths initially rather than focusing on the ‘trauma’. Gardner (1993) felt that the dilemma for psychotherapists has been how to use children’s stories in therapy in order to promote a child’s well-being. He argues against the psychoanalytic model of the need to bring the unconscious into conscious awareness in that he had experienced children being resistant to such an analysis. This led him to develop the mutual storytelling technique in which he would encourage a child spontaneously to tell a story. He would deduce its psychodynamic meaning and respond with a story of his own, introducing healthier resolutions. From the engagement with which the children received the story, he would gauge how accurate his interpretation had been. Children’s stories seem to reflect more accurately their inner world and preoccupations than directly questioning them about their lives reveals.

Negotiating the relationship Is it enough to facilitate a child telling a story and to listen attentively or should the therapist be more active in order to enhance the therapeutic process without directing to such a point that it becomes less the child’s story and more the therapist’s? Linesch’s (1994) research is useful in describing this relationship through the concept of the hermeneutic circle in art therapy. She describes a spiral which the therapist enters in order to explore meaning with the client, so allowing the images to unfold further meaning:

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This spiral…creates a backdrop for therapeutic conversation and then engages with the client and the therapists in a dialectical experience out of which emerges joint constructions of meaning on which can be based new understandings and the possibility for change. (Linesch 1994, p.190)

She describes how the roles can then be child as expert with the therapist as learner, rather than the other way round. This model provides a balanced framework as the story that a child tells may have been distorted by the abuser, so passively listening to the child would not necessarily promote a healthier story in itself. The therapist with their own construction of reality can, through dialogue, explore with the child their meaning and out of that can come something created within the relationship, neither one nor the other, the story the child needs to tell and then to hear the response.

When a stone is not just a stone Children can be resistant to returning to their stories once they have been told or responding to an adult’s desire to know what it means. A story which has vibrancy and importance in one session may be viewed with almost disinterest in the next, with the therapist lagging behind still excitedly clutching at what is now history. Children have lessons to teach us about their ability to let go of the object of their creation, the fluidity of life and the mercurial nature of feelings. Sometimes my own desire to understand the meaning behind the stories I am told can block the very creative process I want to encourage. By wanting to fix a meaning, the story can be prevented from having a life force of its own, to ebb and flow, to explore dark caves and then leave them behind. The paradox is to be able to be open to as many meanings as possible, letting go of certainty in order to find a shared meaning together, so that the child can feel understood and their concerns attended to through the metaphors of the story. The journey into the labyrinth is unique to each child. Previous maps drawn by others may hinder rather than help us explore that particular child’s territory. Therein lies one of the difficulties of research into the creative art therapies: metaphors can be unconvincing witnesses unless you are a child.

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Jeffrey, the dog, however, is one such witness; a witness to Kristen’s progress in therapy, but more than that her talisman, her power animal or the embodiment of her self-care. I had decided to combine my role of therapist with that of researcher in order to examine the stories which children told in therapy to test out whether they reflected the meaning they had made of their lives. Prior to seeing Kristen, I decided that I would transcribe three stories she told in therapy, one at the beginning, one in the middle (as far as this was possible to know) and one near the end, analysing them for themes. Kristen had been sexually abused by her father who was in prison when she started coming to see me. She was white, 8 years of age and lived with her mother and three other siblings. I am intentionally not giving much case history in order to invite the reader to be more able to ‘know’ Kristen through her stories. You may also want to pause before reading my ‘interpretation’ to be open to your own. It was tempting to devise a structure which I could then apply to all the stories but I could see the benefit of applying the concept of the hermeneutic circle in order to enable the story to continue to evolve in a way which did not fix it in time and allowed for new meanings to emerge through the dialogue. This would allow for the potential of alternative stories and meanings to develop through the dialogical relationship. In the second therapy session I asked Kristen to tell a story using any of the small figures I had selected. There were 25 figures in total ranging from different kinds of animals, prehistoric, domestic and wild, people figures and objects, which were more ambiguous, so allowing for more imaginative projections. She took a long time selecting the figures and seemed to have difficulty starting. This idea of projective play seemed unfamiliar to her, but once she started the story it was told with an urgency, where she hardly paused for breath. This is her first story: Once upon a time there was a dog called Jeffrey. She went for a walk and saw Kristen, she tripped her up, trip, and then she went back, and she told me to and fetch her so I went and fetched her and picked her up and brought her back home, then my daddy went to work and then he came back from work he took the dog for a walk, so he went walking through the mud, he took him to the park, then he took him back and then mummy came out, then

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mummy went to buy some sweeties and then mummy came back and grandma went for a walk with the dog again and the dog got covered, so grandma went back and slipped up, so she went back up and went to get daddy. She stayed there and she went to find the doggy, ‘Doggy, where are you?’ And then we went back and then mummy tripped up, so then we had to get mummy back up and then Zara came and she messed, and Kristen messed the room, messing up the room, and then Zara went down and to tell mum and then Kristen got sent to bed and then they went to the fair, my family, and then they saw a dinosaur and when they got there they all fell over. And then there was the keeper and he picked them all up and then he went back home and had a nice drink and they had a very good time and the dog disappeared, and they couldn’t find him and they saw a spider in her bedroom and so she went to her bedroom – aaargh there’s a spider so the dinosaur came and ate it and then he ate it, and then they went on holiday and they started playing in the sand, Zara did, so she got the sand and buried everybody up. They sent her to bed and went back home. It took her half an hour to bury them all up. And when she had buried them, she ran away and when all the sand got away they went to look for her and couldn’t find her and then they went to a policeman. S:

And what did the police have to say?

K:

The police said it was their fault.

S:

Why was it their fault?

K:

For letting their child go with them.

S:

So where has Zara gone?

K:

She went to live with her grandma, ’cos she had another grandma and then she got back home… The End.

But what does it all mean? Kristen’s tentative beginnings were in sharp contrast to the eventual flow of the story. It had an urgency in the telling, linear time ceased to have

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importance, grammar flew out of the window and it felt as if it was vital for her to tell it. It took Kristen a painstakingly long time for her to choose the figures and even though I told her the characters could be imaginary ones she chose to name them after her family, but then swopped the names around so it was all very confusing. Some dramatic distancing did start to evolve though. She started as the storyteller in the first person; ‘and then she went back and she told me to and fetch her, so I went and fetched her’, and then she quickly moved into the third person. This story illustrates well the idea of stories opening up alternative possibilities. She describes two parallel sequences before deciding which path to go down: ‘so she got the sand and buried everybody up…they sent her to bed and went back home…and when she buried them she ran way and then when all the sand got away they went to look for her and couldn’t find her.’ Conducting the story in the sandtray offers the possibility of a different texture and dimension to the story. The concepts of life and death or almost death can be conveyed. The underworld beneath the sand can be used to express feelings of safety when hidden, or helplessness which may be a reminder of the feelings evoked when your body has been colonised by someone who is bigger and stronger than you. The near-death experience can be shown as well as surviving against all odds. This was vividly expressed by another child in one of her stories, where the sand both literally through the therapeutic value of its sensory elements and metaphorically contained the tiny almost imperceptible seed of hope and survival: Once upon a time there were animals, who could not stay in the water for too long or the sand as they would die. When they are older they can choose where they live so they don’t have to keep moving … Then there was a storm and it went on for three days. It stopped. All the animals were nearly drowned, the trees have gone, only the goose is still alive as it’s on the pond. The next night there is a storm again. The animals are now drowned but a couple of years later they are still alive as there is food under the sand…

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The burying in the sand in Kristen’s story could be interpreted as the justifiable anger felt by the protagonist in the story towards the adults. However no logical reason for this is given in the story and although the police, representing justice, agreed she was justified in her actions and blamed the adults, this could not be explained satisfactorily in words: ‘they went to look for her and couldn’t find her and then they went to a policeman’. S:

And what did the police have to say?

K:

The police said it was their fault.

S:

Why was it their fault?

K:

For letting their child go with them.

The meaning I placed on this following the dialogue I had with Kristen whilst she was still immersed in the story’s meaning was that the burying of the adults had some emotional meaning for her. In relation to her own life we could speculate that she felt angry with the adults around her for not protecting her from the abuse, which can be a commonly held feeling by children who have been sexually abused, regardless of the mother’s actions. At this point in Kristen’s life, her relationship with her mother had deteriorated to such a point that her mother was not able to say anything positive about her and described her as aggressive and unhelpful. The terrain of the sand also enabled Kristen to convey the instability and precariousness of life events through the persistent tripping, slipping and messing that went on in the first part of the story. Did the ground no longer feel solid for Kristen after her traumatic experiences? There was no one in this landscape that the main character could rely on, hence the ending of the story with the main character going off to live with her grandmother who just appeared magically at the end of the story. Again through dialogue with Kristen about the ending I got the impression that she felt that the only resolution at the moment was to have this fantasy ending in order for her needs to be met: S:

Could anyone say anything to persuade Zara to live back at home?

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K:

Grandma could have asked her why she wasn’t back with her parents.

S:

Could there be another ending?

K:

No.

I found that trying to enter into a dialogue about the story the following week or even when it had just been completed was usually met with patient but disinterested responses, the authenticity of the answers being somewhat dubious. It was another reminder for me about how the need to know can impede the therapeutic process. Staying with my interest about one of the characters in the story had much more resonance for Kristen. Linesch (1994), in her article on exploring the role which interpretation has within art therapy, states that we should ask the question: ‘Where does the imagery point us? not, What is behind the imagery?’ (p.191). This question reminded me to maintain a focus on exploring shared meaning between Kristen and me rather than deciding on an interpretation and selecting data which confirmed this – the process then defining which meanings are more acceptable and thereby silencing the child’s voice. Linesch encourages her client to expand on her metaphor of a house through image making and conversation and demonstrates how the client was able to reconstruct her personal meaning of self through this process. My overall impression was that the story seemed quite confused and chaotic with no coherent close relationships being described between the adults and children except for grandma and Zara, which is conjured up in the last few sentences of the story. The dog seemed to be an anchor in the beginning of the story, having a relationship with most of the characters, whereas they were all quite separate from each other. The first disappearance of the dog resulted in bringing them altogether to look for it. The final disappearance of the dog was linked with them all having a good time together: ‘and they had a very good time and the dog disappeared’. I wanted to know more about this dog, who he was and what meaning he might have for Kristen, and she was eager to tell me. Again she became immersed in the story and it was obvious that Jeffrey had a meaning for her of emotional significance. I was reminded again of the

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power of stories to convey more accurately the emotional tapestry of children’s lives. Buchsbaum et al. (1992) illustrate this with their comments on their findings: ‘The same child who answered “fine” when queried about his relationship with his maltreating mother during a clinical interview session, elaborated on themes of maternal neglect, rejection and punitiveness throughout the course of the narrative technique’ (p.617). I asked Kristen to tell me more about Jeffrey and she told me this next story: My Dog Jeffrey My dog Jeffrey lived in a pet shop and when I was 19 on my birthday I went to the petshop and bought Jeffrey. I had a list of names and they told you about what they were like. He was fierce to people and he was really a nice dog to me so I bought him. I put him on a lead and then we went home and then he had his food, his supper, I watched TV and then I made myself a cup of tea and Jeffrey had his nice water and when it was time for bed me and Jeffrey went to bed. Jeffrey woke me up in the middle of the night. Jeffrey met another dog and its name was Jenny and they went out and they had some puppies and then Jenny went to live with us and Jeffrey and then he had his own room to his self. But in the middle of the night he’d still wake me and bark and bark and bark. He was barking at people who came up the stairs. But when we were downstairs we didn’t know who it was. We stayed downstairs and Jeffrey stayed awake and in the morning Jenny wondered where Jeffrey was. If Jeffrey hadn’t barked we could have had things stolen. Time had a magical quality to it with whole life events happening as if in an instance: Jeffrey woke me in the middle of the night. Jeffrey met another dog and its name was Jenny and they went out and had some puppies and then Jenny went to live with us.

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There is also no clear ending which I thought may reflect Kristen’s continuing need for his presence in her life at that time. She viewed him as her protector and through the actual telling of the story she begins to show a lessening need for him, an example of how the actual creating of an imagined reality can begin to have an effect in itself. We start off telling how things are and then by the telling it changes in front of our eyes. I think Jeffrey gives a vivid example of how stories not only reflect children’s inner worlds but can then transform them. The dialogue with Kristen later demonstrates this. There is a clear linking between cause and effect in the description of a hero whose purpose is clear and who has intentions behind his actions which result in certain consequences. Bruner (1986) describes these ingredients as important in the narrative mode: ‘If Jeffrey hadn’t barked we could have had things stolen.’ The story overall appears less chaotic than the first story she told. There are fewer characters and their relationships to each other are easier to understand. Kristen continues to tell the story in the first person. She started the story being very clear about what kind of dog she wanted: ‘I had a list of names and they told you about what they were like.’ I speculated that Kristen wanted the dog in her story to externalise the fierceness that she was showing towards other people in her life at this time: ‘He was fierce to people and he was really a nice dog to me so I bought him.’ I wondered if the aggression was a coping strategy to prevent anyone getting near enough to hurt her again. If you did not know who to trust, then barking at everyone seems like a good idea. She needed him to be very close to her when she first got him. He slept in her room: ‘and when it was time for bed me and Jeffrey went to bed’. No one could get into her room without him barking and waking her up. I wondered if the intruders in the night could be representing her not feeling safe. It was even scarier if you did not know who the intruders were. Feelings of generalised anxiety and fears can be common effects for children who have been sexually abused: But in the middle of the night he’d still wake me and bark and bark and bark. He was barking at people who came up the stairs. But when we went downstairs we didn’t know who it was.

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I wondered whether Jeffrey going off and having his own life and separate relationship and family represented a lessening of a need for him to protect her as much as he had done, that she was feeling less scared in her life than she did. She still needed to know however that he was available to her just in case she needed him: ‘and then Jenny went to live with us and Jeffrey and then he had his own room to his self. But in the middle of the night he’d still wake me…’. I explored the meaning of the story for Kristen about two months after she told it. She told me that she had been ‘very, very, very scared before Jeffrey came…and I feel a bit happier now’. She corrected the age she was when he came to 10 rather than 19. She told me the people had been coming up the stairs to steal Jeffrey. I introduced the idea of Jeffrey as a talking dog in order to check out my interpretations of his meaning for her: S:

OK so is there anything else you think Jeffrey would say. What would he say now?

K:

That he was glad I was starting to get happy.

S:

Right. That he was glad that you were getting happy [K saying yeah]. So he’s noticed has he that you’re getting happier? How could he tell that then?

K:

’Cos, every night when I go to bed he comes and gets me to sleep and that, and I started to get really happy.

S:

Oh.

K:

I don’t need him.

Jeffrey had played an important role in Kristen’s healing and as he could talk he had provided me with some helpful insight about the positive changes that had occurred for Kristen. I had also been told by her mother that their relationship was much closer and that she was not showing the aggression she had previously. Jeffrey’s opinions were very valuable in deciding the appropriate time to end therapy for Kristen. Sometimes I am aware that children’s agreement to ending therapy may be more a reflection of their powerlessness and compliance than positive decision making. Whilst considering the ending of Kristen’s therapy, I introduced

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the same structure as I had for the first story, giving her the same figures without suggesting a theme. She then told her last story: K:

Once upon a time there was a mummy called Sue, a daddy called Mark and a little girl called Sinead and they had four horses and three cows and three ducks and they had people used to come and visit them, and one day when they all three went to the park they went to meet a friend, and they went to go to the shop.

S:

And how did they get there, to the park?

K:

They went out the house, go through the back, gone out the gate, go through there and to the shop. And then they went to buy some bread from the shop to feed the ducks and then they went all the way to the pond and they gave them all the stuff and chucked some bread. And the ducks kept eating them until they found out all the bread was gone, and when they got home they had some supper.

S:

Who makes the supper?

K:

Dad makes the supper.

S:

What does mum do whilst dad’s making the supper?

K:

Putting the bath on for the baby – Oh, we haven’t got a bath?

S:

Shall we have this as a bath?

K:

Yeah.

S:

I’ll put baby in the bath shall I?

K:

Yeah.

S:

And mum’s over there bathing baby and dad’s making tea. What is he making for tea?

K:

Cornish pasty, and when they ate their dinner, baby went to bed, and when baby went to bed mummy washed the pots, whilst daddy read a story. And when he read baby a story, and when he finished he came downstairs and then mummy and daddy always watches TV and when they watch TV the

JEFFREY THE DOG: A SEARCH FOR SHARED MEANING

baby creeped downstairs, because mummy and daddy fell asleep, and she creeped downstairs. S:

Did she know they were asleep?

K:

Yep and then they watched TV, and she went back upstairs.

S:

They didn’t know she was there?

K:

No, and then she went upstairs and went back to bed and then after when mummy and daddy woken up they went to bed, but daddy went to bed and then mummy went to check on her and she was OK and they turned the [inaudible] and they all went to sleep, but then there was a burglar and he took their purses and left and they heard a noise and all they could see was a tree. Baby and mummy went downstairs and all they could see was a tree and they couldn’t find their handbags, so they called the police and told them and soon after that they smelled fire and there was fire so they pulled the fire alarm and went to the station. And they saw what handprints were on that tree and then they found the purses, they found him, and after they found him … he went to prison.

S:

So who found the burglar?

K:

The police.

S:

Right, and how did they know it was him?

K:

Because of the handprints.

S:

So let me get this right. When mummy and baby went off to the police station, what was daddy doing?

K:

He was asleep.

S:

So they didn’t bother waking him?

K:

No.

S:

No, so what do you think he felt when he woke up that they weren’t there?

K:

He wondered where they were, and then he went to the station to find out where they were.

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S:

So he went to the police station to find out where they were, and then he found them. Yeah OK. [Pause.] So does anything else happen in this story? Is that it?

K:

Uh, Uh.

S:

OK then.

Kristen locates the beginning of the story in the home followed by a trip to the park to return home where the dramatic high point of the story is developed, similar to the second story. This story follows conventional time and logical sequencing, all of the story taking place within 24 hours. Although she still uses the names of people in her life for the characters in her story, on this occasion she is clearly in the role of storyteller. Although Kristen starts with a lot of potential characters, four horses, three cows, three ducks, a mummy, a daddy, a baby and a friend, the central characters soon become the mummy, daddy and baby. Although the mummy and daddy are shown to have a relationship with each other separate from baby, mummy is clearly paired with baby. This is the first time that this relationship has been to the forefront in Kristen’s stories. Another striking feature for me was that within the story there were activities from the adults in relation to the child which were focused on satisfying the child’s basic needs. The child’s emotional needs were being satisfied through doing something child centred altogether by going to the park to feed the ducks. She was being comforted and stimulated intellectually through being read to by her father. She was physically cared for by her father making supper and her mother bathing her. Her safety was being considered by her mother checking on her in the night whilst she slept. Hodges and Steele (2000), in their research using story stems, have commented on the description of ordinary domestic pleasures being more prominent in stories told by children from non-abusive homes or in adoptive homes compared to the ones told by children who had been abused. In the second part of the story the theme of intruders in the night reappears, but with some important differences. There’s no sign of Jeffrey, so I wondered whether this might reflect Kristen’s increasing ability to be able to trust adults to protect her and keep her safe. This time the child is

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supported by the mother and they get up together to pursue the intruder, seeking help from the police. In dialogue with Kristen about the story she said it was a happy and scared story. She liked the character of the mother best and thought that the baby was the most scared. She thought daddy was happy and brave because he could beat up anyone. I pointed out that he was sleeping whilst mummy and daughter went off in pursuit. She said that they thought it was the girls’ turn not to be scared! In analysing them together the following headings emerged: main characters, themes, sensory experiences, endings, intentions. I have therefore grouped examples from the text under these headings in Table 3.1.

Needs One of the striking changes in the stories was the way that the main character’s needs were met. In the first one they were met outside the family. In the second, they were met through the form of an animal and in the final one all the basic needs of the child were itemised: food, shelter, stimulation, love and health and met by the parents. This progression was also reflected in the mother and daughter’s relationship through the period of therapy, so providing some external evidence that children’s stories do reflect their reality.

Relationships In the first story there were many characters who acted independently of each other with some shared activities. The way that Kristen set them out was in a long line looking outwards, with none of the figures facing each other. In story two there is a combination of shared activities and separate activities. In story three all the characters have relationships with each other and as a whole group. The progression of the stories reflects an increasing appreciation of relationships as varied and nourishing and finally displaying a balance between autonomy and interrelationships which are satisfying.

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Table 3.1 Analysis of stories Story 1

Story 2

Story 3

Characters

10

2 and self

3

Qualities

Good

Fierce

Brave

Horrible

Kind

Scared Happy

Bad Helpful Themes

Sensory experiences

Separate activities

Separate and shared activities

Shared activities in group and pairs

Fear of being punished

Fear of unknown intruders in the night

Needs not being met

Need for protection met by animal

Fear of intruder identified as outside the family unit. All child’s needs met by carers

Dinosaur ate the spider

Watch TV

Buy some bread

Tripping up

bark and bark and bark

Ducks eating all the bread

Being buried

He had his food, his supper

Making tea

Covered

Cup of tea

Cornish pasty

Mess

Nice drink

Ate their dinner

Nice drink

See a tree

Buy some sweeties

Hearing a noise Smell of fire Watch TV Sleep Bathing baby

Ending

Resolution through heroine living outside family

Living at home with dog, no sign of carers

Living at home with carers, resolution of safety issues, intruder in prison.

Intentions

Mum will miss her when she’s gone

Dog needed less now to keep her safe

Girls can be brave too

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Fear Fear in the night is common to stories two and three. In story two the intruder was unknown which could be more scary. The way that the intruders were dealt with seemed to be different: in story two the intruder was unknown and perhaps therefore this is more scary and she had to rely on a dog to scare them away. In the third story the mother and daughter joined forces: the intruder was imprisoned and therefore the object of the fear was known and dealt with, so not leaving residual anxiety of further intrusions.

Sensory experiences Sensory experiences are prominent in all Kristen’s stories but the full range of all the senses is present in the final story: taste, touch, sight, smell and hearing. Fahlberg (1994) states that if a baby’s expression of discomfort is not responded to by a carer that tension continues for the baby and their capacity to perceive the outside world is reduced. That Kristen did have a general appreciation of the sensory experiences in the world coupled with other observations indicated she had a secure attachment to her mother, but the trauma of her experiences had temporarily affected their relationship. When Kristen started coming for therapy she was showing signs of her distress through her behaviour, but her mother did not know how to comfort her. Using this hypothesis we can see that as her ability to describe the sensory experiences in her stories expanded, so her ability to receive comfort increased and her mother’s ability to give it to her. As the tension and fear in her inner world had less of a grip she was able to relax and enjoy ordinary domestic pleasures again.

Endings The endings of the stories also seem to reflect the themes already highlighted. In the first story the main character ends up living outside the home without an idea about how this could change. In story two the resolution is achieved through the introduction of a protective character. In story three the fear is dealt with and removed outside the home.

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New meanings Stories offer a way of organising events when nothing seems predictable any more. They provide a grain of hope where there has been a famine for the last seven years, which when planted flourishes and replenishes itself. The power of being able to scare your audience and for you to decide when and how it will end is good, but is there something more? Perhaps it is to relinquish a little control and give the other a small part in the drama just as long as they do not take over. After all they do seem to be interested in your stories, even the gruesome ones. Gradually that need to be right because the world can be a scary place no longer dominates all the time and it seems much more fun again to have someone join in, even if they get it wrong sometimes. Kristen was able to show me the chaos in her world where the rules about fairness and justice were incomprehensible and you have to invent your own endings and protectors to tackle the demons in your life. The stories reflected the past and the present and she was able to try out possible solutions to see how that felt. She was able to express her feelings through the fierceness of Jeffrey and started to experience a feeling of safety within the story. This in turn seemed to enable her to absorb the care and protection that was there for her in her life and for those who cared for her to be able to respond more warmly when they were not being kept at a distance by her aggression. Of course these are only my interpretations, but they are backed up by Jeffrey in places, so perhaps it is more fitting that we end this chapter with the words of Jeffrey and Kristen: S:

What would he [Jeffrey] say now?

K:

That he was glad I was starting to get really happy …

K:

I don’t need him.

The process of seeking shared meaning is paradoxically both simple and complex. There is a need to let go of certainty in order to allow other meanings to emerge within the therapeutic relationship, let go of being the expert, the one who knows, of introducing happy endings with the eagerness of a rescuer. One thing known is that, despite sometimes clumsy attempts to understand, something happens and the stories

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change. They tell us but in a way that we’re still not quite sure. The child continues to hold the key and that is the magic as this last dialogue with Kristen shows: S:

So do you think I’ve understood this story properly then?

K:

Bits of it.

S:

[Laughs]

K:

I think you did.

References

Bettelheim, B. (1976) The Uses of Enchantment. London: Thames & Hudson. Bruner, J. (1986) Actual Minds, Possible Worlds. Cambridge, MA: Harvard University Press. Buchsbaum, H., Toth, S., Clyman, R., Cicchetti, D. and Emde, R. (1992) The Use of a Narrative Story Stem Technique with Maltreated Children. USA: Cambridge University Press. Fahlberg, V. (1994) The Child’s Journey through Placement. London: BAAF. Gardner, R. (1993) Story Telling in Psychotherapy with Children. Northvale, NJ: Jason Aronson. Hodges, J. and Steele, M. (1999) ‘The Effects of Abuse on Attachment Representations: Narrative Assessments of Abused Children.’ Journal of Child Psychotherapy 26, 3, 433–455. Lahad, M. and Cohen, A. (eds) (1997) Community Stress Prevention. Israel: Community Stress Prevention Centre. Linesch, D. (1994) ‘Interpretation in art therapy research and practice: the hermeneutic circle.’ The Arts in Psychotherapy 14, 1, 77–84.

4

All that Glitters is not Gold The Adoption Process as a Rite of Passage Ruth Watson They found the treasure but they did not live happily ever after.

A little background information In the period following World War II, adoption was seen as a solution to the problem of infertility. This was a time when nurture was supposed to rule over nature. Great effort was put into matching infant and parents in an attempt to create a ‘family’ as much like a biological one as possible. An ‘adoptable’ infant was, generally speaking, white, healthy, of normal development and from an ‘acceptable’ background. For the prospective adopters, there were strict regulations regarding such things as age, religion and length of marriage before they could be considered suitable to adopt. Bowlby’s (1969) theories on maternal deprivation and bonding were very influential. It was thought that children separated from their parents after the age of two would fail to attach themselves to adoptive parents. By the late 1960s older children or those with even a minor disability were not considered for adoption and were likely to be raised in residential accommodation. Adoption was more concerned with the interests of those adopting rather than the children. 83

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By the 1970s there was a drastic drop in the number of young white children available for adoption. This in part was explained by more effective contraception methods, the legalisation of abortion and also in part the result of changing sexual mores. In Britain it was increasingly socially acceptable for a single parent to raise a child. The availability of state welfare benefits now made it financially possible for some single parents. By the 1970s awareness was growing of the thousands of children in either residential care or foster homes who had no realistic possibility of returning home to their own families. These were not the children traditionally seen as adoptable. They were older, some with physical or mental disabilities, some of mixed race, some had siblings and many of the children came from a background of abuse and neglect. These children came to be known as ‘special needs’ or ‘hard to place children’. Happily, both in the UK and USA, projects demonstrated that these children could be found adoptive families, and there was a shift to finding ‘families for children’ as opposed to ‘children for families’. This resulted in broader definitions of suitable family placements. The children now placed for adoption have experienced difficult childhoods and need help to deal with these painful and traumatic memories of the past. The adoption worker needs to explore with the children their ideas about a new family and their wishes, expectations and fantasies about family life. The decision to remove a child from his or her family and to find a new permanent family is one that is not made lightly. It involves a great many systems working to make the best decision where the child’s welfare is paramount. In Figure 4.1 I have tried to give a sense of the many systems involved. The reasons for adoption are many and varied. The common theme is that the child is in care to the local authority, and a decision has been made regarding the future, as to whether the child needs short-term or long-term care. The decision to place a child for adoption will be made, and then a search for a suitable family begins. The move to adoption starts at the point when a suitable family has been identified and the local authority has made the decision that they can meet the child’s needs. Introductions then begin from the foster family to the adoptive family, and it is at this point that play therapists can play a part in

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helping the child in the transition of leaving one family and joining another.

Figure 4.1 The many systems involved in making the decisions about removing the child from the birth family and placing in an adoptive home.

Children in transition: play therapy with Kate This is the story of Kate, a 9-year-old girl who is in care to the local authority and of her journey from foster family to adoptive home. It is also a story of discovery, a new way of structuring transitional work for a child in care going from foster home to adoptive placement.

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Conversations with myself When I was asked to do this work, my first conversation was with myself. Could I find a way of empowering Kate in a co-creative relationship? She had already experienced an imbalance of power between adults and herself through the involvement of courts and local authorities making decisions about her present and future life. Could she trust me enough to tell her story, or was I just another bossy adult who came to tell her what had been decided for her? My personal philosophy of direct work with children is that I follow the children in relation to the story they need to tell. It is my responsibility to provide a safe structure, both emotional and physical, within which their story may be told. This containment and safety is especially crucial in a situation where the child is encouraged to take control. My approach is predominately that of social construction theory through narratives between child and therapist within a framework of creative play. Within this framework I do not have to be neutral or take a dominant power position. We establish a relationship together where both child and therapist have their own special knowledge and skills to bring to the relationship. My aim is to encourage the children to explore and make sense of their world through play. I always try to work in a way which enables the child to lead the way. It is important that the play they create is their own and not mine. I hoped to enable Kate to deal with the major life changes she would experience. I had been interested in the subject of rituals as a way of helping children in transition. I had not been happy with the way they were currently used in direct work with children as a way of leaving the past behind. However, I was aware that a number of writers saw rituals as having a cathartic effect. Eldelman (1971) described this in relation to direct work with children and Jennings (1993) as a response to situations of anxiety and fear. The rituals required for transitions like adoption need to be fluid and Van Gennep’s Rites of Passage (1960) provided the idea of progression through stages: that not only went forward but could also pause or sometimes go backwards. Kate’s transition would not just be a linear progression as she dealt with this difficult period in her life.

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Van Gennep observed that the life of the individual in any society is a series of passages from one age to another and from one occupation to another. He states that there are distinctions between age or occupation groups, with the progression from one group to another marked by special acts, likening them to an old apprenticeship in the trades. Van Gennep’s stages in the development of rituals are as follows: •

Stage 1: Separation and loss

•

Stage 2: Transition or in-between

•

Stage 3: Incorporation or reincorporation.

From my observation of children’s transitions from being fostered to being adopted, there appeared to be a need for a ‘rite of passage’ which would help the child make sense of the major changes taking place in their young lives. As a non-anthropologist I initially wondered if one could create a rite of passage for an individual going through this transition. However, I then thought that people, ordinary people like me, do create their own rituals, particularly in times of crisis. This is supported by the work of Turner (1982) who explores the links between ritual and theatre, explaining the connections between ‘social dramas’ that punctuate our lives both on the large scale and the small scale. Jennings (1993) states that we place a ritualistic frame around certain life events such as birth and death which enables a special form of reworking to take place that is both collective and in the public domain. She describes the concept of the healing ritual, which she maintains is part of the passage through life, providing signposts which mark major changes in status and relationships as well as life crisis or illness. We also ritualise the aspects of our belief system in order to make symbolic statements which affirm our beliefs. All of the arts are part of a ritual: art, music, dance and drama. She makes the point that, no matter how impoverished we are, we have a basic need for the creative experience and artistic expression. Theatre and ritual are essential for survival and allow us to develop not only as individuals but also as communal groups. She sees rituals as assisting us to know who we are and where we are, as well as providing boundaries for the journeys of the dramatic imagination. An important feature of ritualised events is that they are often rehearsed, thus helping us to know what to expect. This then enables us

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to move into other events or try something that is less familiar or unknown. This aspect could be important for children waiting to join a new family who might use play rituals to practise family life. As a play therapist I could connect the concept of rites of passage with aspects of play to create an ideal framework to contain Kate’s journey as she moved from one status to another. In adoption work, some practitioners do involve the use of rituals, often preparing children for adoption by creating life story books. Ryan and Walker (1985) describe this as a way to help children understand what has happened to them from birth to the present. Rituals are sometimes used by the social worker, for example, the candle ritual which was originated by Jewitt (1982). She considers that these rituals provide markers which could be helpful to the child. However, these are rituals that the worker constructs and the child takes part instructed by the adult. Jewitt described one of the rituals: A row of candles is used to represent all the people that the child has loved in his life. In front of this row, a candle is placed to symbolise the child. Lighting the candle it is explained that it represents his birth when he came into the world with an inborn ability to love people. Next, if it is significant, the first candle representing his natural mother is lit and it is explained that this was the first person he loved. Down the line the process continues, a candle being lit for each new situation the child moved into and each new person he loved. He is told that because he was born with the ability to love people, it is not necessary to extinguish the love for a previous caretaker before he can love another. (Jewitt 1982)

However, in my mind neither Ryan and Walker (1985), nor Jewitt (1982) address the complex family issues involved in adoption, particularly the conflict of loyalty that the child may feel about beginning to attach to the new family. One of the most difficult tasks in adoption is helping children move into an adoptive family when the court has made the decision that the child cannot be cared for in their own birth family. The birth family is often opposed to the adoption and is not able to give the child permission to move on. This leaves the child torn by guilt over their family of origin

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and a feeling of disloyalty as they begin to form bonds with their new family. What Van Gennep (1960) illuminated is still valid: that this is a process from one social status to another. He describes rituals which deal with key life changes like coming of age, marriage, birth and death. Whereas he was looking at existing cultures and subgroups, the child moving to adoption and I create our own culture where the transition can happen. There is no formal rite of passage for adoption.

The play therapy I do not work in a formal setting. I work instead with the children where they are living, either in the foster or adoptive home. This means I must take with me all the media that the children can choose to play with, so I have some limitations on the material I can offer. Initially, I take a large selection of toys in separate bags. I have a monster bag, a bag of sea creatures, a collection of family dolls of various ethnic groups, farm animals, doll’s furniture, toy mobile phones, plenty of paper and pens, felt tip pens, glitter glue pens, dressing up clothes, puppets and fingerpaints. The child chooses what media they want to use and how. We either work on the floor or I bring a ‘magic mat’ which represents the ‘playroom’. Before working I explain to the child my role and how we will work and play, and together we create the playroom rules. I also meet with the earlier foster family and the adoptive family and they complete a permission slip. I give them some printed information about play therapy, along with our complaints procedure. If the child tells me a story during the dramatic play, I carefully write it down. I give the child the choice of either having a special book into which I write the stories direct, or else we create a special folder with their photograph on the outside and decorate it, and I bring their story typed on my next visit. Kate was very clear that she wanted a folder with her photo on it, which she then decorated, and I would bring her typed stories to her. At the end of each session Kate and I would discuss what she wanted to share with her adoptive parent. We would then do a presentation together and perhaps read her story and show her drawings or artwork.

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Kate’s family Kate is 9 years old and has been in care to a local authority for a number of years. She is the second youngest of four children, having a brother of 20, who was adopted as a baby, a sister of 18 who was living independently and a younger sister of 6 who was placed with her (Figure 4.2). The children were taken into care following the conviction and imprisonment of an adult family member. As so often happens, the story of the family was difficult to untangle, although there do seem to be instances of abuse, unknown fathers and other incidences of sexual abuse. Kate is a bright, intelligent and articulate child who loves reading and creative play, but she is also watchful and suspicious of adults, in particular social workers. She has a tendency to be secretive. Physically she is a striking looking child, with long black curly hair and green eyes. Her social skills are a concern. She is finding it hard to make friends in her peer group, tending to be overly bossy and controlling. Within her relationship with her brother Peter, she is close to him, overprotective, but also watchful in case Peter gets more than her or something she does not get. Kate relates more easily to men than women and indeed is quite flirtatious with men. She had a strong relationship with her older sister, Gina, but contact was terminated because it was felt that Gina’s influence through manipulation and self-harm was negative.

Figure 4.2 Kate’s birth family

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The aim of the intervention was to help Kate make sense of the transition from foster care to an adoptive family. This meant helping Kate explore the families she has known and answer the question ‘who is my family’ to her satisfaction. There were 14 sessions of play therapy, which took place over a period of eight months. The therapy began in the foster home with four sessions. When Kate moved into the adoptive home I met her there. Kate was free to choose whatever play materials she wished. There was a wide variety of portable media including glitter glue pens, gold and silver pens, puppets, miniature dolls and doll’s furniture, toy mobile phones, toys, dressing-up clothes, dramatic role play, stories and poems. Kate quickly established her favourites and did not use much of the media. Her sessions soon developed a pattern and she enjoyed drawing and dramatic play best. I employed a multidimensional model of play therapy where the centrality of play is acknowledged. It was important for me to assist Kate to make sense of her chaotic world. In the play and storymaking Kate created narratives, with me being part of that narrative, as opposed to me making interpretations and being a reflective presence. Kate’s entire life had been turned upside down. She had been removed from her birth family and was in transition from foster to adoptive family. Her life was in turmoil and everything known and familiar was lost. In these circumstances, my question was whether Kate would be able to create her own rites of passage, if given the opportunity. Do rites of passage help a child feel safe, and would they help Kate deal with her move to an adoptive family? For me, it felt like an act of faith. Could we make rituals to mark the transition from one family to another? If rituals were created and performed, could they become embedded within the individual and continue to work as a positive structure to cope with change? I was interested to explore whether Kate could be helped to find her own healing rituals. For Kate the play therapy process was an exploration via play, narratives and dramatic role play. The form and content was decided by Kate, and I was an active participant in that process, sometimes entering into the play, sometimes expanding it by asking questions or clarifying information, but also keeping the play safe. I was responsible for the

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boundaries of play. The journey we undertook had many twists and turns, the occasional false start and the odd dead end. To use Cattanach’s words (1992), for all children who begin by being ‘lost in the maze of abuse’ there are three stages in the play therapy process. The first stage concerns the establishment of a relationship between child and therapist, so that trust is engendered and the transitional space between therapist and child is a safe place for exploration. The therapist can become aware of the specific problems presented by the child at this stage. In the second stage, child and therapist explore through toys, objects and dramatic play but in a more focused way, to help integrate and make sense of some of the horror of the past. There is much repetitive play at this stage. The goal of the final stage is to develop self-esteem and identity not so bound up in abusive relationships of the past. The child needs to feel that they are not being judged, but rather respected and heard, but at all times it is critical to keep the child ‘safe’. It seemed to me that there were links here with Van Gennep’s (1960) work on rituals, so in my work with Kate I wanted to see if she could be helped to discover Van Gennep’s three stages in the development of rites of passage.

Stage one: separation and loss During the early sessions Kate explored a variety of themes to do with sadness and separation. Initially we spent some time looking at what Kate wanted in a new family. The family must be nice, kind and not be cross in the morning. Kate wanted contact with her older sister but acknowledged that she would not be able to see her mother and father. In Kate’s stories the theme of death reoccurs time and time again. Kate’s first story was about Natalie who is a sad little 9-year-old girl whose mother left her because she did not do as she was told. Natalie lived with her sister Lorna, Lorna’s dad Tom, and her brother Earl: Natalie is a sad 9-year-old little girl whose mother left her because she did not do as she was told. Lorna had to leave school because people kept asking her where her mother was.

Again in session three the theme continued, with the story of two children, Dominic and Sarah, who lived with their grandfather because

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their parents had been killed in a car crash. The children were not with their parents in the car when it happened, but were home alone. They were very frightened being on their own; frightened that someone might come and knock on their door. They were worried that it might be their mother’s boyfriend Robert, who is big and would hit them. The story was accompanied by a gold and glitter drawing of Sarah and Dominic. In the next part of the story, the children are with friends, one of whose mother does not look after them or care. Then Kate told this story: Chris was with the children. Sarah was good with children and she loved looking after them. Sarah wanted to be an adult, so she could look after the little kids. One day it was Sarah’s birthday, people kept knocking at the door in Grandpa’s house. It was her friend Natalie. Sarah was pleased to see Natalie. Dominic said, ‘Why are you here idiot?’ Sarah goes, ‘Why did you call my friend an idiot, you are the idiot, you don’t know how to clean your teeth properly.’ After a few hours, Natalie had to go home because her mother did not know she was there. Her mum was not looking for her, her mother is never cross, she doesn’t care. Everyone else would be worried except her mum. However, for me, the most poignant story was the poem Kate wrote about her mother and sister who live on the bottom of a pond. This was the first session after Kate had moved into her adoptive home. She began the session with a drawing of the windows and doors of her former foster home. There was no structure for the house, just doors and windows. Kate had said she wanted to draw something from her past. She went on to draw the garden and a golden pond with fish and water lilies, which was the garden of the previous foster family. Then she wrote her poem (Figure 4.3):

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The Deep Pond The pond is yellow Yellow like the sun It’s pretty and I love it Gina lives in the pond with mum They live on the bottom of the pond No one lives with them The pond is in Court Lane And they are happy.

Figure 4.3 Kate’s poem to her mother and sister, who live in the bottom of the pond

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Kate then narrated a brief story. She sits under a golden apple tree with golden apples. She is sitting by herself. She has a good book called Spice. Her favourite Spice Girl is Baby Spice. The apples have all gone bad. There is a worm in the apples. At the end of this session, Kate wanted to sit on her adoptive mother’s lap whilst she read a story of Kate’s choice, ‘Tom Thumb’.

Stage two: transition or in-between A recurrent theme for Kate was love hearts. They first appeared in session three when she drew a card with love hearts on it for her prospective adoptive mother. They appeared in session four and briefly in session five, then there was a break then till session seven. This story is from session four (Figure 4.4): The hero was Mickey Mouse; he lives with his wife Minnie. He wants to find the treasure, gold in a chest with a lock on it, in it there are golden necklaces with love hearts on them, his wife is to help him find the treasure. Minnie Mouse spilt blood, ‘No it’s not blood, it’s tomato sauce on her wonderful golden dress that has love hearts on it.’ Eventually Minnie and Mickey find the treasure, but they do not live happily ever after. In session five Kate describes apples which have gone bad because there is a worm inside them, but there is also a love heart. It says ‘I love you’. From session seven onwards love hearts appeared in every session, always making an appearance towards the end of the session when Kate would like to draw and I had to copy her exactly. She always drew love hearts. I asked myself, what do love hearts mean to Kate? Are they part of the safe status passage, a reassuring familiar symbol?

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Figure 4.4 Session four: Minnie Mouse split blood, no it’s tomato sauce on her wonderful golden dress that has love hearts on it

Stage three: incorporation The Spice Girls made their appearance in session five, the first session after Kate moved into her new home. They appeared in a number of her drawings and I had to copy her drawing exactly. Failure to do so resulted in a severe telling off or the threat of some punishment. The Spice Girls then made appearances in most sessions. In session seven, in her story the little girl aged 7 lives with her brother aged 19. Again their parents are dead, but the little girl is having a party and is dressing up as a Spice Girl. In the story I was the child and Kate the punitive adult, who would threaten me with the ultimate sanction, which was being sent to the children’s home for naughty girls. In dramatic play, we did Spice Girl dances. Kate was Baby Spice and I was Ancient Spice. We prepared and practised for our concerts. We dressed up, were very sexy and admired. But as always I had to obey Kate, otherwise I was threatened with being sent home. In a number of sessions that followed we were Spice Girls, Baby and Ancient, and we would dance and perform. I was always under Kate’s watchful eyes and any deviation was liable to the threat of harsh punishments.

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In session eleven we were making a story for television. There were four girls, aged 9, who lived with their mum. Their father does not want their mum. He sees other women and only sees the girls once a month. The theme then changed and we were Spice Girls. Kate was Baby Spice and I was Ancient Spice. We were going to the school disco, but we were also schoolgirls going to the disco and we dressed up. I was her best friend Laura, aged 14. We had to do Spice Girl dances and we practised. We flipped in and out of reality, checking out the boys at the disco. In the final two sessions we were Spice Girls, but we were also mother and daughter, who were invited to sing and dance at the Spice Girl concerts. We performed our hearts out and again I had to obey Kate absolutely or be punished. Finally, we were girls going to Spice Girl concerts, where we too had to perform, and so we had to practise our dancing and dress up. Again I was in trouble for not doing as I was told and was taken home, because as the child I did not do as I was told. But I was later taken back.

Other themes Control issues A major theme was of control, where it would seem that for the first time Kate had some control over her environment or situation. Her exploration of this issue links with mothers. We see at the beginning harsh and punitive mothers, but as the sessions progress we see her exploring a more hopeful situation where mothers can become better. In session six, Kate developed a story which we enacted. I was Claudia and Kate was her mother. The scene started with mother phoning Claudia, telling her off and complaining about her. Then Claudia came home and mother dragged her to her room and hit her for giving cheek. Claudia cried and cried and her mother got angrier and angrier. In session seven the dramatic play involved two children, a girl aged 7 and a boy aged 19. Their mum and dad are dead.

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The girl is having a birthday party. Her mother promised not to hit her anymore and she is dressing up as a Spice Girl for the party. The mother is going to put her in a home for naughty children. The mum had lived in a children’s home because her mum slapped and hit her. The mum told her daughter about the nasty children who lived there. The children there died in a fire. However, as the sessions progressed Kate began exploring a more hopeful situation where mothers can become better and were kind to their children, even if this didn’t happen all the time. It was from these sessions that Kate really got into dramatic play and indeed got quite carried away. I introduced a calming mechanism. The session would begin with mobile phones with Kate giving me a list of phone numbers which I had to write down. We would then have a conversation. Often, I was the social worker and Kate was complaining as mother or foster mother about her children. Kate was a harsh and punitive mother and I was the victim or child. It was from session seven that a new pattern developed. Near to the end of the session we had to sit at the table and she would draw mainly messages to the Spice Girls and I would have to copy her drawings exactly.

Mothers Another theme was mothers – harsh, punitive and unforgiving – who had boyfriends who hit and frightened the children. The harsh mother figured in nine sessions altogether. However, in session seven the mother is trying to deal with a child in a better way, promising not to hit the child any more, but later the mother threatens to put the child in a children’s home for being naughty. In session nine the mother is making efforts to be a good mother, but has difficulty when her son does not do as he was told. In the later sessions the mother is having some success in relating to the child and finally the mother is a good mother who keeps her children clean and had their hair combed, and they have a teddy.

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Love hearts A reoccurring symbol was love hearts that could change and adapt. They were the transition, the vehicle that allowed Kate to move in a non-linear way. With hearts you can go back, they can be love hearts filled with hate, or gone bad, they do not have to be either/or. The love hearts also provide a graphic illustration that can be easily understood – the black heart and the golden heart. They were the engines that allowed Kate to move back and forth in her uncertainty between the stages of transition. They allowed a frightened child in a world where all was changing to feel she had some control via a symbol that was familiar and reassuring. Whilst this meant that Kate did not proceed along the path in a straight way, it allowed her the freedom to return and visit an earlier stage and so played an important part in helping her deal with the conflicts of loyalties to the past, especially her mother and sister.

Gold and glitter pens Finally, the gold and glitter pens were a feature in most of the sessions. Kate chose to use gold pens in 9 out of 15 sessions. Gold represents something costly, precious and rare. However, in her drawings Kate illustrated how gold can also cover up or mask something nasty underneath like worries or anxiety. In session four, Minnie’s golden dress somehow gets blood on it. Kate then denied it and said it was now tomato sauce. Session five saw Kate writing a poem partly in gold. In a later session Kate’s golden love hearts turn black with anger, when the child in the dramatic play does not do as she is told. This was a time of great anxiety for Kate. Everything in her life was changing. Kate tries to make some sense of her life and create some order by coating her drawings with gold. The gold and glitter gives a superficial look of well being, that all is well on the surface – reminding me of the saying ‘All that glitters is not gold’.

Closing reflections For me the experience of working with Kate was an exciting voyage of adventure, as I struggled to bring together the various theories of social construction, narrative identity, adoption and its best practice, play

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Figure 4.5 Kate’s love hearts that turned black with anger – my drawing was not correct

therapy and anthropology with my overriding aim of helping Kate to make the best possible transition into her new home. At times I questioned the advisability of allowing the Spice Girls so strongly into my work, and here the support of my excellent supervisor was invaluable. I was able to explore and look at this issue in depth. I was able to view this area of work in the context of the ‘initiate’ seeing the Spice Girls as important since they enabled Kate to bring forth her idealised young women, the Spice Girls, just as the initiate going into his ceremonial circumcision has a vision of the sort of warrior he wants to be. This view helps the young man deal with the pain and discomfort, the reward being that one day he too will be a brave warrior. For Kate, the Spice Girls provided her with a role model that she aimed for, hence their incorporation and weaving into her story. There was also a sexual element to the Spice Girls, but with ‘safe boundaries and limits’ their dancing was certainly quite sexualised, but here Kate could experiment with being ‘sexy’ in her dancing within safe boundaries. The Spice Girls gave me a ritualised context in which to enact

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idealised roles, create sexualised dancing within safe boundaries as well as testing social skills for the reality of her future world. A closing personal observation is that when Kate and I performed at our concerts we were not only Spice Girls but also mother and daughter contained safely in distanced roles where I was temporarily in role as a mother who would share and support her aspirations. This therapeutic intervention has also been a rite of passage for me, with the reflection that I too was very much the new initiate, testing out my own transitional roles within Kate’s rite of passage. I feel that in the end I survived what at the time was a baptism of fire, but as always Kate was able to put things into perspective: ‘No it’s not blood, it’s tomato sauce.’

References

Bowlby, J. (1969) Attachment and Loss, Vol. 1 Attachment. London: Hogarth Press. Bowlby, J. (1980) Attachment and Loss, Vol.2 Separation, Anxiety and Anger. London: Tavistock, Hogarth Press and Harmondsworth: Penguin. Bowlby, J. (1980) Attachment and Loss, Vol.3 Loss, Sadness and Depression. London: Tavistock, Hogarth Press and Harmondsworth: Penguin. Cattanach, A. (1992) Play Therapy with Abused Children. London: Jessica Kingsley Publishers. Edelman, M. (1971) Politics as Symbolic Action. Chicago: Markham. Jennings, S. (1993) Playtherapy with Children: A Practitioner’s Guide. Oxford: Blackwell. Jewitt, C. (1982) Helping Children Cope with Separation and Loss. London: Batsford. Ryan, T. And Walker, R. (1985) Making Life Story Books. London: BAAF. Turner, V. (1982) From Ritual to Theatre. New York: PAJ. Publications. Van Gennep, A. (1960) Rites of Passage. London: Routledge.

Further Reading

Ainsworth, M.D.S., Blehar, M.C., Waters, E. and Wall, S. (1978) Patterns of Attachment: Assessed in the Strange Situation and at Home. Hillsdale, NJ: Erlbaum. Aldgate, J. and Simmonds, J. (1988) Direct Work with Children. London: Batsford. Burr, V. (1995) An Introduction to Social Construction. London: Routledge.

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Cattanach, A. (1994) Therapy Where the Sky Meets the Underworld. London: Jessica Kingsley Publishers. Cattanach, A. (1996) Drama for People with Special Needs, 2nd edn. London: A. & C. Black. Cattanach, A. (1997) Children’s Stories in Play Therapy. London: Jessica Kingsley Publishers. Fahlberg, V. (1981) Fitting the Pieces Together. London: BAAF. Fahlberg, V. (1991) Journey Through Placement. Indianapolis: Perspective Press. Holmes, J. (1993) John Bowlby & Attachment Theory. London: Routledge. Jennings, S. (1995) Theatre of Ritual and Transformation. London: Routledge. Jennings, S. (1998) Dramatherapy with Families, Groups and Individuals. London: Jessica Kingsley Publishers. Schon, D. (1987) Reflective Practise – Educating the Reflective Practitioner. San Francisco: Jossey-Bass. Triseliotis, J., Shireman, J. and Hundleby, M. (1997) Adoption Theory, Policy and Practice. London: Cassell.

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In the Wake of the Monster When Trauma Strikes Alison Kelly Give sorrow words: the grief that does not speak Whispers o’er-fraught heart, and bids it break. (Shakespeare, Macbeth)

When a teacher is suddenly murdered, how do her class of infants cope with such a tragic event? A class of 6 year olds were all affected when they heard of the sudden and shocking death of the teacher they had known for a considerable portion of their young lives. At such stressful times it can be helpful to use the metaphor of a story to help children make some sense of what seems unbearable. Two years ago I was asked to go and work with a class of such children, and use a group intervention to support and help them to make some sense of a very traumatic event. Mrs X had been murdered one evening on her way home from work. Children heard about it via a variety of means, some from friends and family, some from the media, some in assembly at school the next day. Stories varied and events were distorted and changed according to the source and accuracy of information. Before meeting the children I met with the staff group who were deeply shocked at the loss of their colleague and friend. They were struggling to cope with their own individual reactions to the event and their own personal experiences of loss and trauma. There was great anxiety 103

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and fear about how to talk with the children, what to say and what not to say. There was fear at how they as adults would cope with seeing the children distressed. One member of staff left the room in distress. She said afterwards that she found it too painful talking about death and that it brought up for her painful feelings about personal bereavements she had experienced. Several teachers were concerned that they should not cry or show their emotions in front of the children. For both adults and children alike sudden deaths are more difficult to cope with. They leave no time for preparation on a mental level, and the child’s sense of security in the world may be shattered. Such deaths have a stronger impact on the adult world, with consequences for how children’s needs are handled. In addition, such deaths are often characterised by traumatic aspects that adults want to shield the child from. (Dyregrov 1991, p.47)

Before commencing a therapeutic intervention I needed signed permission from every child’s parent or carer. The headteacher met resistance and anxiety from many families about what was meant by the group work: would it upset the children even more? Everybody eventually agreed. One of the integral aims of the intervention was to assess children’s coping strategies and through processing and exploring their feelings help to prevent the effects of post traumatic stress, which can and does occur when feelings following a traumatic event get buried or are so overwhelming because they have not been acknowledged or explored (Oaklander 1978, p.247). When I met class B they had all been told of their teacher’s death by the head of the school and had also had some time at home experiencing very different responses from families according to beliefs, cultures and anxieties and the need for parents to want to protect their children from such abhorrent reality. I met the 28 children, their substitute teacher and their familiar classroom assistant at the end of the week which was to mark the first weekend after the death of their teacher. A group intervention was appropriate not only because the whole group was affected, but also as a means of assessing how individual children were coping within the group.

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Story as a metaphor Due to the very young age of the children, I felt that a story was an appropriate way to start as they were not ready to take in cognitive information at that early stage. It would also offer a metaphor for their loss. Many stories came to mind that would be fitting after a death, but this death was very specific in that it was a sudden and brutal death of someone who was not old or ill but the victim of a violent crime and someone who was known to them in a very close capacity, and someone who had a huge impact on their lives. I chose a story from India, ‘The People Who Hugged the Trees’, because it tells of a child who experiences a sudden and violent assault on the tree that she loves. Despite attempting to save the tree, she is unsuccessful and thrown aside to witness the brutal destruction of her beloved tree. The People Who Hugged the Trees Long ago in India there lived a girl who loved the trees. Her name was Amrita. She lived in a village on the edge of a great desert. Just outside the village grew a forest. Every morning Amrita would run to the forest, her long braid dancing behind her, and find her favourite tree. She would wrap her arms around it and feel its strong rough bark. Amrita kissed her special tree and whispered, ‘Tree, if ever you are in trouble, I will protect you.’ The tree whispered back with a rustle of its leaves. Her tree shaded her from the hot desert sun and guarded her from the howling desert sandstorms and wherever trees grow there is always precious water. The village depended upon that water for their survival. In the hot sun Amrita would sit and read under her tree, surrounded by its big branches. Sometimes she would climb up into the tree, where she had a wonderful view over the forest. She thought that her tree was the biggest and the most beautiful in the forest. One day just before the monsoon rains, a giant sandstorm whirled in from the desert. In minutes the sky turned dark as night.

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Lightening cracked the sky and wind whipped the tree as Amrita dashed for her house. After the storm ended, there was sand everywhere – in Amrita’s clothes, in her hair and even in her food. But she was safe and so was her village, because the trees had stood guard against the worst of the storm. As Amrita grew so did her love of the trees. One morning by the well, Amrita spotted a troop of men with heavy axes. They were heading towards the forest. ‘Cut down every tree you can find,’ she heard the chief axeman say. ‘The Maharajah needs plenty of wood to build his new fortress.’ The Maharajah was a powerful prince who ruled over many villages. His word was law. Amrita was afraid. ‘The tree cutters will destroy our forest,’ she thought. Amrita ran to the forest and hid. From her hiding place she saw the chief axeman swing his blade towards her special tree. ‘Stop,’ she shouted as she jumped in front of her tree to protect it. She hugged her tree with all her might. The axeman shoved her out of the way and swung his blade. He chopped and chopped until Amrita’s tree crashed to the ground. Amrita knelt down, her eyes filled with tears. Her arms tenderly grasped the tree’s dying branches. When news of Amrita’s tree reached the village, men, women and children came running to the forest. Wherever the tree cutters tried to chop, the villagers stood in their way. ‘The Maharajah will hear of this!’ threatened the chief axeman. But the people would not give in. As soon as the Maharajah heard the news he was furious. He mounted his fastest horse. ‘These tree-huggers will pay for disobeying me!’ Followed by many soldiers, the Maharajah found the villagers gathered by the well. Amrita stepped forward. ‘Oh great Prince, we could not let the axemen destroy our forest,’ she said. ‘These trees shade us from the baking sun, they protect us from the sandstorms and show us where to find precious water.’ ‘Without these trees I cannot build my fortress!’ the Maharajah insisted. ‘Without these trees we cannot survive,’ Amrita replied. The Maharajah glared at her. ‘Cut them down!’ he shouted.

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The villagers raced to the forest as the soldiers flashed their swords. Step by step the soldiers drew closer, as the sand swirled about their feet and the leaves shivered on the trees. Just when the soldiers reached the trees, the wind roared in from the desert, driving sand so hard they could hardly see. The soldiers ran from the storm, shielding themselves behind the trees. Amrita clutched her special tree as it lay on the ground. The villagers hid their faces as thunder shook the forest. Finally when the wind was silent, they came out of the forest. Amrita brushed the sand from her clothes and looked around. She saw that the trees had stopped the desert from destroying the well and the rest of the village. The Maharajah stood staring at the forest. He thought for a long time, then he spoke to Amrita. ‘You have shown great courage and wisdom to protect your trees. From this day on they will not be cut down.’ The villagers rejoiced when they heard this. Where Amrita’s tree had stood they marked a special place. Villagers brought decorations, flowers, ribbons and treasures to decorate Amrita’s tree. It became a place where the villagers would go and sit. One day as Amrita sat there she saw from the roots of the chopped tree, tiny shoots appear.

Attempting to make some sense of the trauma: a group intervention A six-week project Traumatic aspects of the death are often ignored or glossed over. If the traumatic circumstances of a death are not worked through, the child’s grieving process may slow down or even stop. (Dyregrov 1991, p.28) Delayed stress reaction can appear in the aftermath and need special attention. (Ayalon 1992)

The aim of the intervention was to allow the children and staff involved in the group the opportunity of exploring and expressing the thoughts and feelings following the death of their teacher; also to assess how the

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children were coping and to look for any signs of children who may be experiencing emotional difficulties, any signs of post-traumatic stress. Using a story with a class of 6-year-olds was a way of getting their interest and attention in a more indirect way than just talking immediately and directly about the death of their teacher. It also gave them an opportunity not only to listen to the story, but also to choose roles and enact the story, with the experience of embodying different roles and characters. They were able to put what happened into an imaginary context. An important element from the story was the value put on remembering and creating a ritual to celebrate and remember the tree and express their sense of loss and grief. ‘It became a place where the villagers would go and sit,’ it would not be forgotten. Whilst the story ends with a sense that life goes on as the new shoots grow and there can be hope for the future, that was quite far from where the class group work was at the beginning. As with story the place to start was the beginning and the beginning of the trauma for the children was the moment of hearing of the death of their teacher. WEEK 1: THE BEGINNING

There is a very special quality to a relationship based on storytelling. There is the storyteller and the listener, and the story acts in the middle as a way to negotiate a shared meaning between the two. (Cattanach 1997, p.3)

Our initial session was five days after the murder of Mrs X, at the end of the first school week since her death. Although I did not know the class, I was familiar with the school and children would probably have seen me around the building prior to this intervention. Their substitute teacher with whom they were very familiar introduced me to the class. There were also two classroom assistants joining us in the group. It was important that those adults were seen as part of the group, as it was also an opportunity for them to share and explore their feelings and for the children to witness their process equally. As a group of Year One children they were used to sitting as a group to hear stories and talk together. I started by saying that I had heard their

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sad news of Mrs X’s death, and that I was sorry for their loss. I told them that I had a story that I wanted to tell them which was about a little girl and something sad and shocking that happened to her. Everybody told me their name. I told the story of Amrita and her tree. The children listened intently, the power of story holding their attention. Almost every child wanted to choose a role in the subsequent enactment. The carpet area became our stage and the story unrolled with brief bits of narration from me. Six children played the little girl; many chose to be trees; two boys chose to be her special tree; others were villagers or the maharajah and many were guards and horses. Several children and the adults chose to watch from the outside. After the enactment, we discussed the story and the feelings and thoughts the children had. Several children linked her loss to their own. I arranged with the class in negotiation with the teacher and headteacher that I would come back on a weekly basis for a few more weeks, possibly until after the forthcoming half-term break. WEEK 2: SHARING FEELINGS

In our efforts to protect children from pain we may deprive them of their own best means of managing pain and overcoming the effects of loss. (Lendrum and Syme 1992, p.58)

This session began with recapping of the story, what the children had remembered and what they had taken symbolically from the story. We then looked at the links from the story with the death of Mrs X and the feelings that were evoked. I asked them what they thought when they heard about her death. The children were very keen to talk about what they thought and felt on hearing the news. The adult staff also took part and some voiced their feelings too. Every child and adult did a picture or image about their experience. Images and pictures varied enormously, covering a wide spectrum of emotions. It was evident that some children preferred to talk about it in small groups at the tables as they drew while others talked in the large group with no apparent difficulty. The types of images and drawings appeared to be in several categories. Some drew very graphic images of knives and blood, coffins and

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tombstones; some drew pictures or words that they connected with Mrs X. A group of about three boys drew pictures of footballers and football matches and giggled with each other. It was interesting to see the different strategies at work. Many children asked lots of questions about the incident, what it meant, how it impacted on them and their families. The issue of families and their very different approaches was raised a lot: ‘My mum says I can go to the funeral’, in contrast to ‘My mum and dad say that a funeral is not a place for children’ or ‘My gran says I’m too young to go to a funeral’. A sudden loss will often traumatise the parental system. While children are trying to grasp, understand and make some sense of what happened, they often face parents who want to shield, shut out, prevent and hide facts and feelings. Often information is kept hidden from the child or it is manipulated before it reaches him or her. Many family secrets have their origin here. (Black 1993, p.30)

After the children had worked in small groups on their drawings we all came back together as a group and some wanted to share their images. They also clearly needed an opportunity to share, voice and question their thoughts and fantasies about the actual death: ‘How did it happen?’ ‘How did she die?’ ‘Did she feel pain?’ ‘Where did her body go?’ I was struck by the children’s directness and apparent uninhibitedness about asking questions. I felt that it was important to reassure the children that such a death is rare. Most people do not die this way. We talked about the different services that are available in emergencies: that very often the police, ambulance and fire services are able to help and frequently do prevent tragedies. The fact that it was a group activity was helpful as some children would have their questions answered vicariously, others hearing some children ask questions had the confidence to ask a question of their own. Hearing and sharing the shock was clearly beneficial. An acceptance of tears and giggles, questions or silence was reassuring to the group that their own individual feelings were valid and accepted.

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WEEK 3: FINDING WAYS TO REMEMBER

The child who is helped to face grief will not only be better equipped to cope emotionally from day to day but will also not be so vulnerable to future loss. (McMahon 1992, p.140)

For a large majority of the children, their teacher’s death also connected to previous bereavements and losses that they had experienced. Every child that spoke shared another previous experience of personal loss. Within a class of 28 6-year-olds there was already a substantial personal experience of death and loss. In other subsequent interventions with other school projects on the theme of bereavement, I noted that in every class there was a sizeable amount of children who had experienced losses within their immediate family. Many had lost grandparents or family pets and in each case there was more than one child who had lost a parent or sibling. One child talked about the baby that had recently died in her ‘mummy’s tummy’. In small groups the children drew pictures of Mrs X and how they would like to remember her. Inevitably this raised more discussion about her death. We had discussion in general about practical differences between life and death: what things you can do when you are alive and what things you can no longer do when you are dead such as breathe, sleep, eat, talk, etc. Due to post-mortem investigations, the funeral had not yet been held. It was to take place before our next session, which was to include the half-term break. We agreed to have two more sessions after the half-term break. As a class group we talked about who might be going to the funeral and what a funeral was; what sorts of things happen at funerals; who had already been to a funeral. There were also different cultural influences and rituals that some of the children knew about or had experienced. We ended this third session by talking about different ways of remembering Mrs X. Following on from the story about Amrita and her tree, the class decided that they wanted to create a tree of their own. The children wanted to make a tree in the classroom that could remain there for some time; a tree in which they could hang things to remind them of Mrs X; a tree that would become part of the classroom.

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WEEK 4: AFTER THE FUNERAL

Children often tended to be left out of the family grief. They are often not allowed to attend funerals and are sent away to play when they really should be joining in the family rituals. (Black 1993, p.31)

This session came after the funeral and in the large group some children wanted to share with the class that they had been with their parents to the funeral. Others wanted to hear what had happened and what it had been like. About five or six children had gone to the funeral while others had not gone but their parents had. There were lots of questions about what happens to the body and the coffin after the funeral, where does it go. We talked about the difference between cremation and burial. Mrs X had been buried. Some of the children were familiar with or actually went to the church where she was buried. In the second part of the session each child and adult had the opportunity to make their own individual leaf to be hung on the tree. Each leaf was totally unique. Some children wrote poems on the leaf, some wrote words. One of the adults wrote words of remembrance. Others drew pictures, some decorated them. We had a large selection of art materials available: feathers, beads, paint, crayons, felt pens, pencils, fabric, etc. I noticed that one little boy was crying and one of the adults was comforting him. When I spoke with him, he was clear that he did not want to do a leaf. He was upset because he had not got on very well with Mrs X and said that he hadn’t really liked her. He seemed to have a mixture of feelings. He needed to have his feelings validated equally. It gave us the opportunity to talk about a spectrum of feelings that we experience when someone dies. He decided that he wanted to decorate a leaf but said that he did not want to hang it on the tree. Another little girl cried quietly as she did her picture on the leaf. She said that it made her sad to think about Mrs X being dead. In her small group several children talked and shared times that they had cried about Mrs X. WEEK 5: ERECTING THE TREE AND HANGING THE LEAVES

Dealing with death is not necessarily depressing or frightening for children. Ignorance and prohibition are frightening and may lead to

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an arrest of emotional growth. Knowledge and understanding of the mysteries of natural phenomena can relieve the living from crippling anxieties. (Ayalon 1992, p.135)

This session involved making and erecting the three-dimensional tree. We discussed ideas as a large class group and then in small groups. The children made parts of the three-dimensional tree that we had agreed on in small groups. Some made parts of the trunk and others made branches and roots. We located a corner of the room that could accommodate the tree. It had to be central whilst also spacious enough that it was protected and would not become an obstacle in the room. It involved each child or group of children bringing their painted pieces of bark, branch or root. Some were still wet as we constructed, stapled to enable the tree to take shape. There was a great deal of excitement as the tree began to emerge from the classroom wall. Its roots went right from the floor and its branches reached right up and onto the ceiling of the classroom. It was quite a messy operation! Each child chose coloured ribbon with which to attach their leaf and decided where on the tree they wanted to hang it. Every child also had the opportunity to have their photograph taken next to the tree. WEEK 6: ENDING

The journey towards recovery comes once we are able to help the child play again. (Gersie 1987, p.47)

This was the final week of the project. We recapped the previous weeks, going back to the story, remembering the reason for the project to share and explore feelings around the death of Mrs X. The tree was now a part of their classroom, with the leaves gently fluttering in its branches. I gave every child their photograph mounted in a small green card with a little leaf on the front. The children appeared happy to receive their photographs. They had discussion among themselves about where they would keep their pictures at home. One little girl said that she would keep it under her pillow. Two children had chosen a photograph of the tree but not with them in it.

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As a class group we discussed how long to leave the tree up and when and how to dismantle it. It was agreed that the tree would remain up until the final week of the summer term which would have been their final week in that class with Mrs X had she been alive. They decided that the class would do the dismantling themselves and that I would not go back for that ritual. The children said that they would then take home their leaves if they wanted to. Inevitably the theme of this last session was change, memories and the future. The class asked me if I would come back for the memorial service that the school was to hold later that term. I accepted the invitation and acknowledged that I would see them all again then. We talked about the future and obliquely about the importance of hope and a sense that life will go on, as in the story new shoots eventually appear at the roots of the felled tree.

Feedback from the school The feedback from the school was that the children and staff appeared to have found the intervention helpful. Despite initial concerns from some of the parents, after the project parents gave positive feedback to the headteacher. I did return for the memorial service, where I met up with the class again. The school had bought a rose tree and planted it in memory of Mrs X. This was a very appropriate choice and fitting as the class had created their own tree. It felt as if it linked back to our initial session and the story with its tree.

In the aftermath When a death is sudden or happens in a traumatic way, the shock for both adults and children can be enormous. The child in particular can suffer anxiety, fear and stress which can affect their entire emotional and physical well-being. The nature of the death and the manner in which they are informed has a big effect on them. (Furman 1974)

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Due to the traumatic death of their teacher and the fact that there had been media coverage, it was vital that the children were given as much clear information as possible in order for them to feel empowered and to enable them to have the time and space to grieve and find ways of making some sense for themselves of a very shocking event. It was also an opportunity for caring and informed adults to help affirm and validate their spectrum of feelings. This requires that the adults are confident in supporting and validating the children’s emotions, and as a consequence have some awareness of their own feelings and what is evoked for them in seeing children grapple with what they may experience as difficult feelings. It was a significant advantage that there were also adult staff involved in the class group intervention. They were mutually beneficial to each other. One of the teachers involved told me that she had found it very helpful being able to ‘feel real’ with the children and not having to totally suppress her own feelings in front of them. Professor William Yule of the Institute of Psychiatry and a world expert in the field of childhood trauma describes in one of his papers (1992) a 6-year-old boy who survived the sinking of the Herald of Free Enterprise. The child had drawn many pictures of the ‘bad ferry’ and often spoken about it in class with an understanding teacher. The day the headteacher took the class she forbade him to talk about it again. That night he began having nightmares and a few months later he tried to kill himself by sticking a metal rod into an electric socket. He said that he wanted to die to stop the pictures of the bad ferry in his head. This illustration of the little boy demonstrates the devastating effect that can result from a responsible adult’s attempts to silence painful and traumatic images. There appears to be a convenient assumption that if something is not spoken about or ignored, it no longer exists. It has been my experience that after a certain length of time following a traumatic event some adults are of the belief that it is ‘best to put it behind you now’. Very little hard research has been done to provide evidence in this area with very young children and pre-school children. One is dependent on information from adults, carers and parents. If they too have been traumatised, it is difficult to sort out direct effects of the trauma on the

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children from those mediated by effects on the adults and parents. It is not surprising that adults are greatly upset to see children traumatised and distressed. However, it raises the question whether it is to avoid ‘causing’ further grief to the child or whether it is also a blocking mechanism for the adults themselves that they would rather ‘put it behind them’.

Follow-up work: reflection at the time of the anniversary Now (after the event) everything is alright The children are OK now Why should we wake the monster up? (Lahad 1984, p.31–35)

Waking up the monster feels like a very accurate metaphor for many adults who think that it is far wiser to let the monster sleep and not stir it all up again. This was the attitude that I was met with when a year after the group intervention at the school, a year after the teacher’s death, I proposed returning to do some follow-up work with the class after the first anniversary of her death. Although the feedback had been positive from the school, I felt that it would be valuable to see whether the children were in fact still coping one year after the traumatic event. It would also act as a means of assessing the therapeutic value of the intervention and as an assessment tool with the children. I was met with suspicion, anxiety and ‘concern for the children’. ‘They have got over it now and put it behind them. I wouldn’t want to stir it all up again. It would also stir it up for the parents of the children as well. Lots of parents were very upset at the time. I would have to deal with that all again,’ was the response of the headteacher. She was very defensive and appeared to respond to me as if I was incredibly insensitive and wondered why on earth I would want to stir up all those feelings again.

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Stirring up feelings A personal response Evidence shows that many children, aware of how their parents feel, proceed then to conform to their parents’ wishes by excluding from further processing such information as they already have: and that having done so, they cease consciously to be aware that they have ever observed such scenes, formed such impressions or had such experiences. (Bowlby 1979, p.404)

I have had a long-term interest in the affects of bereavement, especially on children. When I was 6 years old I experienced the death of my baby brother. For me his death was clouded in mystery and secrecy. I am aware that his death and its effects have had an enormous influence on me and my perceptions of death and loss. That wound was certainly part of the foundation that influenced my journey to becoming a therapist and I feel that it has also affected my choice of client group as children. I have seen clearly with my own 3-year-old daughter when her grandfather died that she was very aware of her father’s distress and of the great sense of loss. When she saw him crying she said, ‘You are sad because grandad died.’ I was greatly struck by her reaction at just three and a half years old. It affirmed for me that at the age of 6 I must have been only too aware of my parents’ grief. However, as an adult I have no conscious memory of that period of my life. I am sure that my parents went to great lengths to try and protect us from their grief and from what they thought might be too much for me and my sisters to cope with. On the day of my brother’s funeral my sisters and I were apparently taken to the funfair by family friends. I know that my parents were doing their best to shield us from the sadness and loss. Thirty-five years ago it was certainly unusual for children to attend funerals. Even today in our society many people still believe that it is inappropriate for children to be involved in the funeral rituals.

‘Do you want to be buried or burned daddy?’ Last year an aunt of my husband’s died whom both our daughters knew quite well. We all went to her funeral; one daughter was 3 and the other 5

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years old. They were both fascinated and very curious about the entire event. We had prepared them by explaining a bit about what to expect in terms of the coffin, the church, etc. They were full of questions: ‘What is she wearing in the coffin?’ ‘Are her eyes closed?’ ‘Will they lift up the lid?’ ‘Can we see inside?’ During the ceremony they whispered questions: ‘Why are the curtains closing?’ ‘Where is she going now?’ Although they had lots of questions and comments they were also very respectful and had a natural sense of the dignity and seriousness of the occasion. Outside the church as we looked at the flowers we explained that some people are cremated and some are buried. We looked at all the flowers and messages from people and they put their own bunches along with all the others. My elder daughter wanted to read the tombstones and to know who was buried under them and what their names were. In the car on the way to the reception, our elder daughter asked, ‘Do you want to be buried or burned daddy?’ I felt a lump in my throat hearing our daughters discussing their funeral plans, as one said to the other, ‘We want to be buried next to each other.’ ‘Can we all be buried in a row?’ I was also struck by their relaxed and healthy curiosity about the very natural and unavoidable reality of death. Their questions and observations were uncensored and spontaneous, often things that I think we as adults fear or are embarrassed to ask. ‘Do they burn the coffin as well?’ ‘Will she feel anything?’ ‘What do they do with her bones and the bits that are left?’

Why should we wake up the monster? Adults’ denial is the principal difficulty for children who are trying to grapple with death and bereavement. (Lendrum and Syme 1992, p.113 )

The metaphor of the monster seems particularly appropriate. The fear of death and grief can feel like or be perceived as something monstrous and if it is sleeping why should you wake it up? My feeling is that the intervention is not about waking the monster but confronting it, acknowledging and exploring it and perhaps discovering that it is not necessarily the

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monster we fear it to be. Consequently the follow-up work would not be about reawakening it, but about reflecting on it and not denying it. Access to the children was made impossible for follow-up work in the school where Mrs X had been a teacher. I used this experience to inform my practice and adapt future initial contact with headteachers following critical incidents or traumatic events. I then established from the outset that part of the intervention would involve follow-up work on or around the anniversary of the event. Subsequent events included: following the very sudden death of a child from meningitis, the death of a headteacher after a prolonged terminal illness, the unexpected death of a 9-year-old child and the suicide of an adolescent. In each case my initial experience was borne out. Despite the inclusion of stating at the outset that follow-up work would be an integral part of the intervention package, the responses were the same. In each case the fear of stirring up feelings and the insistence that ‘the children have all got over it and are coping well’ was greater than accepting that follow up work could be beneficial. I found myself confronted by the fears and anxieties of responsible adults which impeded the healing process of the children for whom they had responsibility. It was evident that there was a thread throughout my personal and professional experiences connected to adults seeking to protect children from painful and difficult feelings. Shielding children from the morbid aspects of life is thus preferred to helping them acquire coping abilities. (Ayalon 1992, p.134)

Within the education setting I was frequently met with adults’ inability to deal with children’s responses to painful emotions. I attended a training day run by Elizabeth Capewell on ‘Loss, Grief and Trauma in School’. I was interested to discover that my experience was far from unique within the education framework. I found that the intervention I had carried out in Mrs X’s school was affirmed and validated. It had been important to meet the children and staff as soon as possible after the death of their teacher. It is valuable to have access quickly after a critical incident; while people are still in shock they are more open. Once they get through that initial stage and feel that they have coped it is more difficult afterwards for people to accept help. (Capewell 1994)

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Elizabeth Capewell runs the Centre for Crisis Management in Education (address at end of chapter), which acts as a focal point for initiatives which lead to understanding and reduction of post-traumatic and post-bereavement stress. She developed her model of working following the events of Hungerford in 1987 where, after massacring 16 people, Michael Ryan finally killed himself. That event marked the start of her involvement in a field where she is now an internationally renowned expert. She states how important she thinks follow-up work is and how detrimental its lack. She uses the metaphor of not finishing a course of antibiotics to describe not conducting follow-up work: ‘A crisis can provide opportunities for much real life learning at a time when children want and need to find solutions’ (Capewell 1994) The area of trauma and death is so emotive that it elicits strong reactions. The ‘head in the sand’ approach appears to be quite a common strategy for coping amongst adults. The denial of many adults of their own feelings frequently creates barriers to work in schools. Barriers can be personal and institutional, for example, unresolved past distress and hidden grief of adults and staff and beliefs about the role of school and the purpose of education (Capewell 1994). Adults need to feel secure and confident to acknowledge and face their own fears, their own ‘monsters’, so that they are able to support and facilitate the process for the children in their care. Staff may be willing to agree to follow-up work at the time of the crisis, but when the crisis is felt to be over and the status quo seemingly regained, the possible resurgence of feelings is not an inviting prospect. However, if we let the monster sleep and refuse to face the grief or loss, at some time it will reawaken in a manner that might feel uncontrollable and distressing. If the adults perceive the trauma as a ‘monster’, to the children it may seem something quite different. In the story told at the start of the intervention, the maharajah sees and rewards Amrita’s courage and wisdom when she protects the precious trees. To best and most effectively support children through trauma and loss, the adults around them need to find courage and wisdom to trust how they can protect, support and empower the children for whom they are responsible, so that the children will eventually dance in the wake of the monster.

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Ayalon, O. (1992) Rescue! Community Oriented Preventative Education. Haifa: Chevron. Black, D. (1993) ‘Helping young people grieve.’ In B. Ward and associates Good Grief 1: Exploring Feelings, Loss and Death with Under Elevens, 2nd edn. London: Jessica Kingsley Publishers. Bowlby, J. (1979) ‘On knowing what you are not supposed to know and feeling what you are not supposed to feel.’ Canadian Journal of Psychiatry Vol. 24, 404. Capewell, E. (1994) Systems for Managing Critical Incidents in Schools. Report to Churchill Memorial Trust. Centre for Crisis Management and Education, 93 Old Newton Road, Newbury, Berkshire RG14 7DE. Tel: 01635 30644 Cattanach, A. (1997) Children’s Stories in Play Therapy. London: Jessica Kingsley Publishers. Dyregrov, A. (1991) Grief in Children: A Handbook for Adults. London: Jessica Kingsley Publishers. Furman, E. (1974) A Child’s Parent Dies: Studies in Childhood Bereavement. New Haven: Yale University Press. Gersie, A. (1987) ‘Dramatherapy and play.’ In S. Jennings (ed) Dramatherapy Theory and Practice for Teachers and Clinicians. London: Routledge. Lahad, M. (1984) ‘Working with children under threat of shelling.’ Dramatherapy: The British Association of Dramatherapists 7, 2, 31–35. Lendrum, S. and Syme, G. (1992) The Gift of Tears. London: Tavistock/Routledge. McMahon, L. (1992) Play Therapy. London: Routledge. Oaklander, V. (1978) Windows to our Children. USA: Read People Press, p.247. Shakespeare, W. (1967) Macbeth. London: Penguin. Yule, W. (1992) ‘The Management of Trauma following disaster.’ In A. Lowe and A. Millner (eds) Child and Adolescent Therapy. A Handbook. London: OUP.

6

The Wounded Hero Maureen Scott-Nash For some children exceptional things happen which set them apart from others. Jamie, aged 7, is one of those children. His story is one of struggle as he fights the life-threatening illness of leukaemia where he has to negotiate a painful journey with no escape from the invasive medical intervention vital for his recovery. To children diagnosed with leukaemia their world is now a fragmented and unsafe place as they become the main players in the drama of their illness and face a potentially fatal outcome. The emotional impact of leukaemia, with its severe threat over a long period of time, has been referred to as the ‘Damocles syndrome’ as the sword of Damocles has come to represent a persistent and paralysing threat of death (Koocher and O’Malley 1981). While advances in medical technology have heralded enormous optimism, it is vital to recognise the tremendous challenge presented by diagnosis of cancer for both the child and family. The expected safe haven and innocence of childhood has gone as the child with cancer enters the complex world of hospitals – an experience which Spinetta and Spinetta (1981) have compared to being transplanted into an alien culture. Life now revolves around frightening and complex medical procedures, while strange smells, sights and sounds can heighten feelings of fear, insecurity and loss of control. All these fears can be compounded by the anonymous power of the medical professionals.

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Whilst much depends on the age and maturity of the child, and the willingness of adults to divulge information to them about their illness, the child may have very little understanding of the necessity of essential treatments and the likelihood of having to endure periods of fatigue and distressing side effects from the very treatment meant to ‘make you better’. Even with the most sensitive words of reassurance and optimism, children can pick up parental fears and anxieties and hear medical terminology more usually associated with aggressive warfare and military terminology such as kill, attack, wipe out, invade, antibodies, cell counts, resistance and defences. Sontag (1996) points out that the patient’s body is considered ‘under attack’ or ‘invaded’ by the disease, while needles and tubes become probing channels for essential but toxic chemicals. The child’s body is bombarded by chemotherapy, radiotherapy and steroids, enduring blood transfusions, blood tests, bone marrow tests, bone scans and lumbar punctures, to name but a few of the medical procedures which have now become everyday words and experiences in a child’s scary new world. This chapter invites you to follow the unfolding journey that Jamie took in the matrix of play therapy. Frank (1995) found the concept of illness as a journey emerges recursively as the ill person seeks alternative ways of being ill: ‘The journey is taken in order to find out what sort of journey one has been taking.’ This is the story of how Jamie, injured both physically and emotionally, sought to reconstruct and restore the sense of self that had been lost in the midst of his illness. My approach is predominantly based on social construction theory where play therapy is seen as a socially constructed process between therapist and child. Drawing from a pool of creative therapies Jamie and I co-constructed a space and a relationship that formed a safe and healing place where together we explored themes of recovery and resolution. Jamie, who played the passive role in a treatment that can be brutal and traumatic, gained a sense of autonomy and safety in the gentle reflexive medium of non-directive play. Through his play, narratives and stories arose that gave shape and meaning to the ensuing chaos that had threatened to overwhelm him: ‘There is the story teller and the listener, and the story acts in the middle as a way to negotiate and share meaning between the two’ (Cattanach 1997). Whilst I have found that some children are

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resistant to ‘formalising’ stories, a narrative in itself can convey their stories of identity. This child-centred approach, where meanings are explored together, allowed Jamie to belie feelings of helplessness and loss of control and to act as the narrator of his own story. Jamie’s story had began nine months before our first meeting and just days before his seventh birthday. As the play therapist attached to the social work team at a day hospice I received a request for play therapy for Jamie from his paediatric oncology nurse who oversees his treatment in both the hospitals and in the community. Jamie had been diagnosed as having acute lymphoblastic leukaemia within a day of a visit to his GP and an emergency admission to hospital. Jamie’s treatment programme was planned to proceed over a period of two years, later expanded to three, while monitoring continues for up to five years post diagnosis before he can be considered to be ‘disease free’. Given the best currently available treatment, over 75 per cent of children in the standard risk category will remain in permanent remission, but relapse is still all too common, frequently occurring unexpectedly (Lilleyman 2000). Whilst the impact of this illness may not in itself be a reason for therapeutic intervention, in Jamie’s case there were additional factors for referral. The illness and treatment course is not always linear and essential treatment can also become life limiting, with complications occurring. Jamie had experienced frequent emergency admissions to hospital with recurrent medical problems such as infections as his body reacted to and rejected the very drugs and treatment needed to ensure a ‘cure’, causing increased pain, discomfort and trepidation. Jamie’s parents felt that his fears also stemmed from the difficulties of receiving treatment within the ‘shared care’ system between two hospitals. It is common for children with leukaemia to receive maintenance treatment at their local hospital while more intense treatment is obtained from a specialist unit, in Jamie’s case a London hospital. However, only a short time into his treatment the specialist paediatric oncology ward was transferred from one London hospital to another causing a change to a still fragile routine in his programme and leading to anxiety and uncertainty for both Jamie and his parents at a difficult stage in his treatment. Shortly after, they endured a slow response from their local hospital in recognising a seriously painful infection of the pancreas

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which left Jamie extremely vulnerable and overwhelmed by his feelings of helplessness as he struggled to make sense of it all. Consequently, Jamie had become resistant to and fearful of his essential medical intervention, to the extent that his anticipatory fears were causing distressing panic attacks between treatments. The concept of psychic trauma lends itself to understanding the experience of life-threatening illness in childhood. The description of psychic trauma offered by Terr (1990) relates to an overwhelming sense of helplessness for the child in this situation: Psychic trauma occurs when a sudden, unexpected, overwhelming intense emotional blow or series of blows assaults the person from outside. Traumatic events are external, but they quickly become incorporated into the mind. A person probably will not become fully traumatised unless he or she feels utterly helpless during the event or events. (Terr 1990, p.8)

Sourkes (1995) confirms this loss of control and feelings of helplessness experienced by seriously ill children as they are overtaken by the shock of diagnosis, the indelible imprint of the sustained assault on the body and psyche, and the uncertainty of the outcome; while the culprit in life-threatening illness is the inexplicable, impersonal, randomness of fate. Decisions about what to share with a child with a life-threatening illness present complex dilemmas for parents and professionals. There is now much more of an ethos among paediatricians to inform children about the nature of their disease and proposed treatment. The ‘open proponents’ approach suggests that children who are informed are more amenable to treatment, less likely to be difficult patients and better adjusted because of their greater trust in doctors and parents to tell them honestly about what is involved (Eiser and Twamley 1999, p.140). The general trend is to help the child cope through guiding the parents to be open and honest concerning diagnosis, treatment and prognosis, thereby allowing the child to adjust at an early stage. If they are told later they may feel betrayed, shocked and more fearful of the consequences. If the information is inadequate, children develop their own views built on fantasy or what is gleaned from parents’ reactions. But this is no easy task for a family under stress and struggling towards its own adaptation of

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living with the threat of the death of their beloved child. Many families prefer to ‘protect’ their child from complex and threatening information as much as possible. They fear this would cause unnecessary distress and reduce the extent to which the child complied with treatment. Jamie’s parents had faced this dilemma and chosen to deal with it on a ‘need to know’ basis without giving the full picture. Leukaemia is obviously a huge shock for any family to cope with and a family’s response to cancer is influenced by social and cultural factors. Jamie’s parents held a strong religious faith that underpinned their decision. As they told me their story, their distress was apparent; nine months on they were struggling still to believe the unbelievable. Daily they witnessed the difficult path that Jamie’s illness was taking as they coped with the dilemma of having almost to force Jamie to accept the treatment. For him not to have it was more than they could bear as they grappled with anticipatory fears about the future alongside their deep religious beliefs that all would be well in the end. They were also coming to terms with the unexpected death of Jamie’s paternal grandmother just months before Jamie’s diagnosis. The social work team at the hospice offered a systemic approach to all those touched by cancer, ensuring psycho-social support via counselling, medical and financial advice and practical support to Jamie’s parents alongside play therapy and beyond. As I reflect on my first visit to meet Jamie in his home, my abiding image is of devoted parents telling an abridged version of their story with more positive connotations, so making it possible for them to give reassuring smiles for the benefit of their young family. Jamie and his two younger sisters, aged three and five, were all seeking attention and conversation alongside three dogs and four cats in a room filled with toys. I marvelled at his parents’ ability to dispense cuddles, cookies and comfort to all, while managing to create an image of apparent normality in the midst of the uncertainty of this illness in their lives. Jamie was clear about the reason for our work together, but of course there was an air of anxiety and caution at taking the new and uncharted path of play therapy in a venue more associated with medical intervention and illness; daunting for a child who had already been through so much. To help alleviate these fears and aid a sense of control and autonomy I invited Jamie to visit my playroom prior to the beginning of our work

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together. Access is via a pleasant reception area and up a flight of stairs through to the administration part of the hospice, with no sight of medical personnel or treatment areas essential for the patient’s use. I do not benefit from the luxury of my own play space but share a counselling room which is easily adapted by pushing chairs to one end and creating a therapeutic space with a mat, cushions, art and play equipment and a large sandtray. We established a contract for our work together, agreeing 12 sessions after school as he had lost a lot of school time through treatment. In the event we were not able to start for three weeks due to a severe infection in Jamie’s Hickman line which meant a hospital admission. Despite our earlier positive meetings, Jamie arrived for our first session looking anxious, pale and tired. He was still struggling to recover from his recent hospital stay. He sat quietly before slowly exploring the play equipment around him for some time. Deciding to use the paint, he chose a pot of black fingerpaint and slowly and cautiously painted a shape that resembled a black heart on the white paper. He then painted two frames around it – the inner one blue and black, the outer one red (Figure 6.1). His painting conveyed the ever-present threat of his illness, its shape and colour a visual image of the trauma he experienced to his body. The heart looked as if it was squashed and trapped in a box. At the most basic level Jamie was grappling with the concepts that had become salient with the onslaught of the illness and the recent infection in his Hickman line. Jamie appeared to be searching his painting intensely as if seeking some meaning of what was happening inside his body. He then sat back against the cushions and I asked him to tell me about his painting. ‘That’s what my heart looked like when I had the infection,’ he said. I reflected back on this description of his heart looking black inside. Jamie confirmed that that’s how it was, that’s what infections did to it, made it all black. I asked what colour he thought it was now. ‘Red again, but my line’s clean now,’ he said. It was important to acknowledge Jamie’s fears, without denial. He had shown me how he viewed his heart under threat, that he felt the impact of the infection in his Hickman line was as dangerous as the leukaemia. Infections for a child with cancer are of real concern, often heightened by the wearing of gloves, aprons and masks by medical staff during procedures and by visitors.

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Figure 6.1 Jamie’s painting

I was also aware of the fact that Jamie’s grandmother had died of a heart attack and I acknowledged that it must feel scary to have a line right inside his chest. He nodded, adding in an anxious voice that it was right next to his heart, then shrugged his shoulders to indicate his lack of options in this matter. I nodded too at the sadness of it all and in the fullness of silence around us we continued to explore the painting which was now the focus for our joint sorrow. Jamie suddenly lifted up his football shirt. ‘This is my Hickman line,’ he said. My reaction at seeing this device was genuine surprise, but not shock. ‘Wow, that’s amazing,’ I said. This physical manifestation of the illness can impact on the child’s sense of identity: compounded with their own

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difficulty in adjusting to an altered body image is the fear of other’s shock and revulsion at their appearance. Having seen that I was able to cope with this image, Jamie told me all about how it worked. Although Jamie’s tone was slow and matter of fact as he described the purpose of this device, it did not belie the emotional anxiety in his voice. However, Jamie did not touch on the emotional impact of having this device, just on the technical detail. Such a response is common and, indeed, Sourkes (1995) found that intellectualising facts can often be a crucial defence as a means of coping for a child with a life-threatening illness. The central venous catheter, consisting of thin plastic tubes, is pushed under the skin of the chest, tunnelled over the outside of the ribs and inserted into the large vein directly above the heart and stitched into place. The aim of this device is to make the administration of treatments easier for the child. Chemotherapy drugs, antibiotics, blood products and blood sampling can be administered via the capped barrels hanging from the wound in his chest. However, the Hickman line is not without its problems, requiring scrupulous care and needing to be regularly flushed to avoid infection and blood clots (Lilleyman 2000). It was evident that this device was a double bind for Jamie, almost an umbilical cord, a lifeline providing essential healing fluids, yet a direct line to a vein by his heart and possible source of infection allowing access to toxic chemicals that ravaged his body and a visual daily reminder of the physical consequences of his illness and its essential painful treatments. However, once he finished describing the details of this device the subject was closed. This was all he could deal with today and he pulled down his football shirt firmly as if hiding all the evidence of his illness away. In the second session Jamie was recovering from a recent visit to hospital because of a low platelet count. He sat quietly fingering the sand in the tray for a few moments, then slowly moved over to the paints and slime. As soon as he saw the new body-shaped container of runny red slime, he tore it open. It oozed out quickly through his probing fingers and flowed over hands, wrists and up his arms. As the slime advanced, Jamie screeched sounds which conveyed horror, disgust, and anguish. ‘Yuck, it’s nasty, it won’t get off me, yuck, it’s a bloody mess,’ he said while stretching and pulling the slime. He wrung his hands together and the

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slime slithered and snaked its way over fingers and between palms. His hands were quickly buried in its web of bright red wetness. He flexed his fingers and circled his hands over and over each other for a long time, almost lost in the sheer sensory pleasure of the slime, while continuing his exclamations of disgust, though more softly now, almost to himself. He then tried to shake it off, but with little enthusiasm. He sat quietly for a few moments letting the slime drip onto his trainers and over the paint board, then quickly gathered it up and stretched it back over his hands again. He pulled a face of revulsion at having it back on his skin, yet it was almost too scary to let it go. He picked up the body-shaped container and said determinedly, ‘I’ll get rid of this.’ Tugging and yanking the slime off his hands and trying to squeeze it back into the container he shouted, ‘Go away, you’re horrible, it’s horrible’ time and again as it flowed over the edges of the container and back onto his fingers. He gave up then and looked at his slime encased hands with the empty shell of the body-shaped container now trapped between them and sinking in the mess. He turned towards me holding out his hands as far as possible and asked me to help him get it off. Together we struggled to pull and push the slime back into the container where it belonged. This was Jamie’s construction of identity, a visual narrative of his struggle to know his illness with its messy battles to win in the war for remission. The psychological impact of a blood disorder is immense for a child. The aim of chemotherapy is to destroy progressively some of ‘the bad blood’, allowing the good blood to establish itself and become dominant. This is a complex issue for a child to grapple with; that their body can simultaneously contain both good and bad blood (Eiser 1993, p.21). The image of blood gushing, oozing and spilling out of bodies is frequently portrayed as the ‘shock horror’ factor in books, films and plays, whilst in nursery rhymes and fables Jack feared the giant smelling ‘the blood of an Englishman’ and Dracula drinks the very fluid from the body that makes the difference between life and death. Skin is stitched up, sewn together to stop the body losing this vital fluid. In Orbach (1999), D.W. Winnicott described the child’s skin as ‘a limiting membrane’: the child experiences an inside and an outside, a ‘me’ and a ‘not me’. These are all facets that add to a sense of frailty and entrapment. Through the vehicle of play

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therapy Jamie was able to show me his struggle to negotiate a meaning at a stage of his treatment journey that was painful, confusing and very scary. Jamie still appeared pale and fragile when he arrived for the third session and chose to use the clay, taking time to explore its texture and suppleness before giving it shape. The end result showed a lifeless figure lacking facial features (Figure 6.2). The leg fell off as soon as Jamie tried to stand it on the board and the arm quickly followed. He made no attempt to repair it and just nodded when, aiming to convey respect for his experiences, I acknowledged how sad and broken the figure appeared. The clay had offered a bridge between the sense of touch and his inner thoughts and feelings. The broken body, too tired to be repaired or maybe unable to recover at all, was a projection of his feelings about his illness and altered body image. His perception of his body as broken was

Figure 6.2 Jamie’s clay figure

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a fundamental part of this. For children with cancer their developing body image can be especially threatened by illness, pain, drugs, treatments and surgery. Physical changes produced by cancer treatments include loss of hair, changes in weight, loss of strength and energy and scarring to the body. The clay model showed visually his broken and fragmented sense of self. In the fourth session Jamie ran into the room, obviously feeling stronger and anxious to start. He moved straight over to the bag of monsters, soldiers and dinosaurs and found a plastic finger monster. He buried it deeply saying, ‘Go on monster, get buried.’ As he worked, I asked if ‘the monster’ had a name. ‘No, it’s just a little ugly monster,’ Jamie replied. I asked why he thought it was ugly. ‘Because it’s got no hair and it’s scared and ugly,’ he said loudly. A black knight on horseback also came out of the bag and became a constant companion over the next nine sessions, always leading the knights into battle and never getting killed. Jamie always referred to it as ‘the black knight’, no name was ever given. But it was ‘the monster’ who lived in the sandtray for the duration of our sessions together and became a symbol for Jamie’s progress on his journey. It never moved from the sand despite visits from dinosaurs, soldiers, horses, tanks and canons; with each object and character frequently fighting for space and making demarcation lines around their territory. Battles ensued around him and still the monster claimed its place in the tray, a permanent witness to the chaos of war. As I was currently only seeing Jamie in my playroom I was able to leave his play items just for him and this small figure generated a discussion at the end of each session as Jamie chose what position ‘the monster’ was to be left in while all other items were pulled out by him. Sometimes it was buried as deeply as possible. Sometimes it lay half buried, described as ‘injured, but alive’. Towards the last three sessions Jamie built a hill with the sand and placed ‘the monster’ on top, as if surveying the terrain ahead with orders to ‘be on guard this week’. The theme of defences and battles was emotionally important to Jamie as he was living with this battle inside him every day. This was his story in the sand. The monster, with no hair and ugly appearance resembled the clay model Jamie had made the previous week. The sandtray was used during every session from this time onwards, although

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towards the end only fleetingly. The sessions continued and Jamie frequently returned to the embodiment and projectile materials as he grappled to create some order in the chaos of his illness. There were gaps in the visits to the playroom due to colds, admissions to hospital for treatments, tests or potentially worrying infections. During this period of uncertainty, one session was particularly relevant. Jamie entered the room slowly and opened the bag of knights and soldiers. He set the knights up in a fighting position in one half of the sandtray, with the black knight leading the charge as in previous weeks. However, this time there was no movement to set up the opponents. He sat silently, fingers trailing in the empty half of the sandtray. Gently I asked if the soldiers were going to fight a battle today. ‘Yes’ was the reply, but still he sat. After a long silence he altered the knight’s position slightly, moving it closer to the troops, and sat back on his heels. ‘Well, it looks to me like they are fighting an invisible enemy,’ I said eventually. He seemed pleased with this description. Smiling he said softly, ‘Yes, that’s right, they are fighting an invisible enemy.’ He pronounced ‘invisible enemy’ slowly and distinctly. Jamie moved away to other tasks, then came back to look again at the sandtray. Suddenly he swiped his hand over them, knocking them all down in the process. The resulting image was scary, all the figures lay defeated as if the ‘invisible enemy’ had won (Figure 6.3). ‘Have they been defeated?’ I asked. ‘They’re just tired,’ he said. Jamie then buried the monster totally in the sand. This single image seemed to convey the nature of leukaemia – a silent and invisible enemy within. These metaphors construct the experience of illness; recovery or deterioration is now framed as ‘winning or losing’ the fight in relation to the healing process. The treatment aims to ‘kill’ the cancer, so the child is exposed to the message that a deadly war is being waged within his own body. Today, fragile and vulnerable from yet another bout of unexpected infection, he appeared like a wounded soldier, weakened, worn out by the fighting. He seemed to have lost a minor battle, to have had a setback, but the war goes on. ‘I guess they need to retreat for a while,’ I said. ‘That’s what all winning armies did, took time to recover, gathered their strength and planned their next strategy for battle.’

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Figure 6.3 Jamie’s play in the sandtray

‘Did they really? Which army?’ Jamie asked cautiously. I confirmed that they did and racked my memory for an example. I recounted the story of the D-Day landings with its elements of defeat, rescue, recuperation and eventual victory. Jamie listened and asked me to go over the bit about the rescue by hundreds of fisherman with small crafts who dragged wounded soldiers off the beaches (which I have to confess contained much poetic licence). Smiling now, he lay on the cushions and chose a book for me to read him before he went home. He then casually mentioned a hospital appointment due to take place the following week. Jamie was fearful of having invasive procedures, particularly this bone marrow aspiration biopsy, a painful procedure performed under ‘conscious sedation’ when the child is anaesthetised at the site of the

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procedure and sedated to reduce anxiety, but sufficiently alert to respond to the medical team’s directions (Malchiodi 1999). The very nature of this illness makes a child vulnerable to a sense of loss of control. Bodily processes which were taken for granted are suddenly in question as the administration of the treatment can seem to overtake the very being of the child and feelings of helplessness prevail. Anger and frustration are feelings that are frequently hard to express in a safe way. However, in play therapy Jamie found a way to play out his deep sense of anger at the repeated assaults on his body as he recovered from the procedure conducted two days before our next session. Going straight to the sensory box, containing many gruesome items such as eyeballs, squeeze balls, sticky monsters and a variety of slime, he chose the tub of pale green slime with a thicker consistency than the red

Figure 6.4 Jamie spears the slime with the bayonet

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one he had used before. He pulled and stretched it into long strips, then folded it back up again and repeated the pattern for a while. Jamie then asked me to pass him the box containing all the Action Man figures and equipment which he had explored several times before. Jamie found the small dagger and began stabbing the slime time and time again, cutting and slicing into it as it hung limply from his hand. He changed the weapon for a three-inch bayonet, now poking in the blade and twisting it as he grunted with the effort of it all. He swung the slime around on the end of the bayonet like a piece of meat on a hook. The slime hung powerlessly against the penetrating bayonet and the image was of a piece of flesh being pierced, poked and prodded time and again (Figure 6.4). Sourkes (1982) recalled how a child described feeling like a piece of paper that everyone cuts into whenever he was hospitalised. This was certainly the impression that Jamie had presented. He pulled the weapons out then and dropped the slime, but continued the attacking motions as he shadow-boxed around the room with a weapon in each hand. Jamie was able to vent his feelings of anger and helplessness at the invasive treatment, acting the part of aggressor instead of victim and gaining some essence of metaphoric autonomy. These actions are facets of his struggle to maintain a constant sense of self and not lose himself to the illness in his now fragmented world. At the next session Jamie appeared stronger and more agile. He wanted to draw, but could not decide what to do. I cautiously suggested he drew a picture of himself. Jamie appeared keen but simultaneously reluctant to start. He said I should draw him instead. I suggested we both could do some if I were to draw around him for a life-size body shape. It is important to note that by making this suggestion I used a more focused approach with Jamie than I have previously done. This change in my approach was made after careful assessment of his progress so far and in the knowledge that, at this stage in his therapy, Jamie was beginning to show an innate strength and resilience in the face of his illness. I would not have suggested this task at an earlier stage as Jamie may not have been able to cope with the impact of a full body drawing. If Jamie had showed the least bit of resistance, then it would have been essential not to proceed.

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Jamie liked this suggestion and we found large sheets of paper to stick together with tape so I could trace around him. He giggled as I did so and was surprised at his size. He thought that he was fatter because the steroids pills which he had to take for one week each month made him feel bloated and hungry. He moved to the paints and chose red and blue pots and two brushes. I fetched the water and sat beside him as he started to paint the chest and arms with the bright red. He then painted the bottom part with blue. The painting seemed to confuse him as he sat back to examine it. Looking at the blank face, he suddenly said that a mask would look good on the painting. I agreed and found a mask form in the cupboard while Jamie chose the colours to paint it with, slowly lining them up before starting.

Figure 6.5 Jamie’s full body picture

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The final result was a scary red and green face, with large black scars with stitching effects across them. He placed it on the body picture carefully and stood up to see the painted body in full (Figures 6.5 and 6.6).

Figure 6.6 Jamie’s decoration of the mask

This image provided a vivid example of the body under attack, an encapsulated reality, shocking in its starkness. To witness an image of such vulnerability and aloneness was almost too overwhelming. It felt appropriate to capture and hold the moment as we sat silently together looking at Jamie’s body shape on the floor. Jamie sighed and sat back, staring intensely at his painting as if confronting and examining his illness from a whole new position. Through his painting Jamie conveyed the ever-present threat to his body with its tainted blood. In his struggle to know his illness he had created a literal image of its presence in his body, symbolically giving characteristic form and colour to the task. This

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metaphor is his story: what it is like to live with this illness, just under the surface of his skin, but always there, inside his body all day and every day with the aches and pains caused by it and its treatments etched on his face mask. I had my own struggle to clarify what I saw. Jamie had confined the red paint to the inside of the body’s outline, keeping to the boundaries of his skin, unlike the second session when the wet red slime seemed to overwhelm him as it flowed out of control. This blood-redness was contained and Jamie appeared to be confronting and challenging the source of the enemy within as his eyes explored the painting intently. The mask was scary, but the facial cuts were closed and stitched, albeit hanging by a thread with still a way to go before being fully healed. It felt safe to speak now as Jamie smiled as if with a sense of achievement in the very task he had undertaken. ‘Wow, this body looks like it has been through an awful lot,’ I said. ‘Ya,’ he said, as he nodded slowly and wiped his hands together in a gesture of completion. Themes in Jamie’s play so far reflected his fears, experiences and fragile sense of self. His choice of tactile materials such as paint, slime, clay and sand had enabled him to create images held deep inside, when talking about them was still too difficult and painful. This series of images had marked a shift in his struggle to understand his illness and the trauma it causes, achieving insight through his own interpretative efforts. Now Jamie was ready to narrate his experiences and, speaking in a soft, gentle and deeply moving way, he narrated his story of painful treatment, frightening episodes of infection, continuing tests and anxious hospital visits that endlessly weave a thread which casts an unremitting shadow over normal life. He told me about how sick he felt during chemotherapy and how horrible it was losing his hair. The worse bit was having needles pushed into him time and again. Even with the Hickman line in position he had to have injections in his legs. He also feared going to the hospital as he was never sure of what was going to happen to him and he hated waiting for the results of the never-ending tests. ‘It must be so terrible for you,’ I said. Nodding gravely, he agreed. We sat side by side as Jamie told me his story and looked at the body on the floor which still appeared vulnerable and alone. But leukaemia is

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not an illness to fight alone and Jamie had shown strength and courage by confronting the illness through his painting and in his narrative, gaining a quality of resilience not in evidence before. Although still vulnerable, he had found ways of dealing with this vulnerability and thereby reducing its negative impact. As a means of encouraging this resilience I introduced the subject of football, which is a passion of Jamie’s. ‘Who’s on your team here, Jamie, who’s on your side in this battle?’ Jamie caught the spirit of this metaphor. ‘Well, the doctors and nurses,’ he said. Then he went on to name others and I suggested we list the people involved. When we had exhausted the list of those who had been in his world since his diagnosis, we moved on to list the medication and equipment and procedures used, to the three hospitals involved, then the wider community including his school, church and local community centre, currently fund raising in his name to finance research for a cure for leukaemia. We explored his world from the micro to the macro system and the list was extensive. To give this task a more visual impact, I suggested we draw an ‘eco-map’. This technique is used frequently for children in the care system to help clarify, in pictorial form, people, places and moves that they have made (Fahlberg 1981). Jamie’s map provided a full and informative visual image of his new world within the context of his ecological environment. We then drew him in the centre, surrounded by all the resources fighting in his team. Jamie asked me to take a photo of his painted body for his folder and sought reassurance that it would be safe in my cupboard until he took it home. Malchiodi (1999), exploring the role of art with paediatric patients, found that the ‘resulting image’ becomes important, not only for communication of feelings and experiences, but also as a visible and external record of the self. I gave Jamie the camera to take the picture. Then together we gently lifted the body off the floor and reverently folded it in half to fit into my cupboard. We placed the mask on top, as if putting it all to bed then Jamie quietly closed the door. Illness happens in a life that already has a story (Frank 1995). This story goes on, changed by the illness but also affecting how the illness story is told. As mentioned previously, Jamie’s love of football played a major part in his world. Known as ‘the beautiful game’ or ‘the people’s

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game’, it was a passion encouraged and supported by his father and they were both Arsenal supporters. This passion had emerged at our first meeting and early on I confessed my own love for Arsenal and enjoyed listening to Jamie discussing the results, players, manager and league tables at every session. In the next session Jamie arrived excited and eager to show me a pair of football gloves given to him by none other than David Seaman, the Arsenal and England goalkeeper, during a visit to the children’s ward at the local hospital. (It was Bacon who said that ‘adversity is not without comforts and hopes’.) I showed the envy and longing to touch them that Jamie had hoped for as he laughingly put them on and jumped around the room. He also brought an eight-inch plastic model of his team hero, Dennis Bergkamp. We discussed the mid-week match results and I suggested that as he knew so much about football he could write a story about it. Jamie was reluctant because, having missed so much school, he had anxieties about his literacy skills and didn’t like writing or making up stories. Using the ‘story stem’ technique, I suggested that I start off the story and Jamie could continue it while I did the writing. Jamie agreed. I started the story by introducing his football hero who has a back problem and can’t play in a vital cup semi-final. Jamie carried on with the next part, then the next, and in fact completed the story. In Jamie’s story Dennis Bergkamp had to undergo chemotherapy to recover, then went on to score the winning goal in the last moment of a penalty shoot out at the FA cup final at Wembley, becoming the hero of the day (Figure 6.7). It was a story of success and ultimate achievement, of triumph over adversity. Even the battleground was an important factor. The hallowed ground of Wembley, famously described as ‘a field of dreams’ with its ghosts of heroes past and its promise of heroes made, set the scene for this dramatic victory. The story had many parallels with Jamie’s own, but included a magical ending, so far out of reach but one that held an essence of hope and possibility for the future. I read the story back to Jamie and we both got excited as we reached the part when the goal was scored. Jamie decided to complete the story with a drawing of the magic moment the goal went in. I then suggested that we act out the goal-scoring part and Jamie fetched a gruesome red

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Figure 6.7 Jamie’s football story

plastic eyeball containing runny red fluid and placed it ready to kick as I set up a makeshift goal of two cushions. Acting as commentator I set the scene and Jamie charged forward, kicking the ball directly between the goalposts. We cheered and shouted ‘yes!’ as Jamie paraded around the room. I now set the scene for the presentation of the cup. We visualised Jamie leading his team up Wembley’s legendary steps to collect the magnificent cup which proclaimed him the hero of the game and he held up

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his Bergkamp model high above his head with pride. I took a photo for him to take home as he posed with confidence, then kicked the ball into the goal again for good measure. The final session coincided with the anniversary of Jamie’s diagnosis. He arrived with a rolled up piece of paper which he presented to me with pride. It was a computer printout of a calendar onto which a copy of the football hero picture we had taken the previous week had been superimposed. Beside that day’s date had been drawn a small figure (Figure 6.8). The figure looked ugly with sticky-out ears. I asked Jamie to tell me about it and he said it was a drawing of him a year ago when he had lost his hair

Figure 6.8 Jamie’s calendar

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from the chemotherapy and his ears looked big. Again it was important to acknowledge his feelings about that trauma without dismissing them and I did so. Jamie described the importance of the date to him. It represented a whole year of living with this illness. I marvelled at his achievement and congratulated him. Jamie was ready to put the trauma of this time into words and told me the story of going into hospital and being diagnosed – a very dramatic event for him. I suggested that I wrote it down as ‘it is such an important story’. Jamie was able to capture the drama of it all as he spoke and I read it back to him to ensure it was an accurate account of his narrative. I then drew attention to Jamie’s hero picture which was in complete contrast to the sad figure which he’d drawn on the calendar and emphasised the progress Jamie had made this year. An anniversary is a time of reflection and in this last session we reflected on the journey we had made together, looking at his artwork, paintings, photos, stories and discussing the content of his play. Jamie then told me of a meeting with two of his favourite Arsenal footballers he had had this week. Frequently, when surrounded by bad and sad things it is important to find good bits that can be celebrated. As a means of giving this difficult year a different focus and a way of finding some good bits in the midst of his illness, I exaggerated my envy at these meetings and suggested we write a list of the ‘good and bad’ things that had happened this year. Jamie’s top ‘good bits’ were meeting his heroes and his four-day trip to Lapland to see Santa for the ‘Noel Edmonds TV Christmas Special’. I had been aware that this holiday had been a particularly difficult time for Jamie as he had experienced frequent panic attacks and even found it hard to watch himself on the television because of this association. Jamie was now able to talk positively of the holiday and I made much of his ‘TV star status’. As Jamie was about to go, with his body painting and folder held tightly under his arm, he pulled the monster out of the sand and asked if he could take it home. The answer was obviously ‘yes’. It had been a worthy companion on his journey so far and they still had a way to go. In this chapter I have detailed the way that Jamie reconstructed a sense of self in his scary world. Jamie’s panic attacks have stopped and, although still a little anxious, he is now able to accept the essential

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medical treatments. Together Jamie and I had co-constructed a place of safety and healing in which to tell his story, to explore the emotional stresses and fears engendered by his illness with its threat to every aspect of his being. The stories are more than just stories, they are the vehicle through which Jamie made sense of his illness, giving shape and meaning to the ensuing chaos that had threatened to overwhelm him. White and Epston (1990) state: ‘In order to make sense of our lives and to express ourselves, experience must be “storied” and it is this “storying” that determines the meaning ascribed to experience.’ They propose that it is not only the stories people have about their lives that determine the meaning that they ascribe to their experiences, but these stories also determine which aspects of lived experiences are selected for the ascription of meaning. I had accompanied Jamie on part of his journey, had borne witness to his struggle against leukaemia as he slowly opened the scary part of his world. Jamie showed me his emotional and physical battle scars as he continues his fights to win the war for remission, even when feeling fatigued, scared and confused. One of the difficult aspects of our work as therapists is to listen to the narratives of children who have suffered. The self-reflective nature of play therapy has led me to consider the stories and narratives that I have constructed in my own life. As I heard the stories of Jamie’s anxiety and fears it touched on a part of my own story of childhood illness. This experience formed my belief in the need to find ways of ‘hearing’ the child, of giving them a voice to story their experiences, and patterned my choice of career in social work and play therapy. Throughout my work with Jamie I held on to the fact that he was telling a story of living with a life-threatening illness, not a story of dying from it. But the telling didn’t always come easily, and neither did the listening. Sourkes (1995) states: The therapist must be capable of witnessing and tolerating the anguish of threatened separation and loss. To witness is not a passive process. In working with the child facing the possibility of death, the therapist must be able to enter the threat with the child, accompany him through the steps, while knowing that this may be a journey that they cannot complete together. (Sourkes 1995, p.109)

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Jamie’s journey continues, still fraught with uncertainties. His illness had wounded him in both body and voice. Jamie had struggled to know his illness, to state its nature and thereby give it meaning and in so doing he recovered his voice and became the storyteller. Frank (1995) states that it is through their stories that the ill create empathic bonds between themselves and their listeners. These bonds expand as the stories are retold. Those who listen then tell others and the circle of shared experience widens. I hope this chapter goes some small way to widen that circle of shared experience and allows me to acknowledge the bravery and courage of all children fighting leukaemia, but especially of Jamie, my wounded hero.

References

Cattanach, A. (1997) Children’s Stories in Play Therapy. London: Jessica Kingsley Publishers. Council, T. (1999) ‘Art therapy with paediatric cancer patients.’ In C. Malchiodi (ed) Medical Art Therapy with Children. London: Jessica Kingsley Publishers. Eiser, C. and Twamley, S. (1999) ‘Talking to children about health and illness.’ In M. Murray and K. Chamberlain Qualitative Health Psychology. London: Sage. Eiser, C. (1993) Growing Up with a Chronic Disease. London: Jessica Kingsley Publishers. Fahlberg, V. (1981) Fitting the Pieces Together. London: BAAF. Frank, A. (1995) The Wounded Storyteller, Body, Illness, and Ethics. London: University of Chicago Press. Koocher, G.P. and O’Malley, J.E. (1981) The Damocles Syndrome. Psychosocial Consequences of Surviving Childhood Cancer. New York: McGraw-Hill. Lilleyman, J.S. (2000) Childhood Leukaemia: The Facts, 2nd edn. New York: Oxford University. Malchiodi, C. (ed) (1999) Medical Art Therapy with Children. London: Jessica Kingsley Publishers. Sontag, S. (1996) Illness as Metaphor. In D. Judd Give Sorrow Words, 2nd edn. London: Whurr. Sourkes, B.M. (1982) The Deepening Shade: A Psychological Aspect of Life-Threatening Illness. Pittsbough: University of Pittsburgh Press. Sourkes, B.M. (1995) Armfuls of Time: The Psychological Experience of the Child with a Life-threatening Illness. London: Routledge.

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Spinetta, J.J. and Deasy-Spinetta, P. (1981) Living with Childhood Cancer. St. Louis, MO: Mosby. Terr, L. (1990) Too Scared to Cry. New York: Basic Books. White, M. and Epston, D. (1990) Narrative Means to Therapeutic Ends. New York: Norton. Winnicott, D.W. (1999) ‘The Maturational Processes and the Facilitating Environment’. In A. Orbach Life, Psychotherapy and Death, The End of Our Exploring. London: Jessica Kingsley Publishers.

7

Finding the Way Back Home Children’s Stories of Family Attachment Sheila Hudd Introduction This chapter sets out to describe how play therapy was used in assessment to explore the links between four families’ histories of attachment, their style of parenting and their child’s attachment and behaviour. This work took place when I worked in a family centre where the underlying philosophy is to promote children’s welfare within their families. The family centre offers a wide range of assessment and treatment services to include programmes of individual or group work on parenting skills or family therapy. The children may be offered direct work, for example, to help promote social skills or self-esteem and, where appropriate, play therapy. Children and their families are usually referred to the centre when a child is experiencing difficulties and/or when parents are seeking support in managing them. The first approach at the centre is to offer advice on behavioural strategies, but these may not have proved sufficient to resolve the child’s difficulties. It is at this point that it becomes necessary to shift the focus and look at the underlying situation, particularly the factors relating to the parents’ own backgrounds. It is often at this stage that a request for an assessment of the child and family is made.

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At the centre an assessment is undertaken by a qualified social worker who will work closely with all members of the family and any other health and education professionals involved with them. Children are cared for by trained staff and observations of the children and parent–child interactions will be an important part of the overall assessment. Children will have several individual sessions with the social worker, many of whom have additional therapeutic qualifications, for example in play or family therapy. When assessing families it is useful to gain some understanding of both parents’ attachment history in an effort to identify any significant separations or losses. Attachment histories may highlight episodes of separation and/or loss that can range from periods where the main carer has suffered from depression to the loss of a family pet. It will be important to gain some understanding as to how the child in the family has reacted to any kind of loss, as it is possible that the child’s behaviour may reflect anger, confusion, or lack of a grieving process. The space to play with a child is a therapeutic process in itself, but in assessment it is helpful to gain some understanding of a child’s perception of their attachments, both in terms of identifying any future areas of therapy with the child and, similarly, any future work with their parents.

Attachment theory Attachment theory and the research which supports it advocate that an infant’s attachment to its mother (or other primary caregiver) builds an internal working model of expectations and assumptions that will influence subsequent relationships and will not be easily changed (Bowlby 1973). Researchers from this perspective suggest that children’s early attachment experiences have a dramatic effect on their day-to-day behaviour, as well as on their social development in later life (e.g. Bretherton and Waters 1985; Main 1991; Sroufe 1983). A number of research studies have linked a disruption in attachment to a variety of childhood disorders including attentional deficit and hyperactivity disorder (ADHD), conduct disorder, borderline personality disorder and a simple form of post traumatic stress disorder (PTSD) (Fonagy and Steel 1997; Fonagy and Target 1998). There is also growing evidence of the

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link between security of attachment and the social development of cognition (Meins 1997). Research also supports the view that when main carers engage in interactions appropriate to the child’s developmental level and focus of interest, this reduces the child’s cognitive and emotional workload, freeing the child’s cognitive resources for development and learning (McCune et al. 1994, p.163). Children who are rated as securely attached (Type B) have been found to have an internalised representation of a responsive, sensitive caregiver (Ainsworth et al. 1978; Sroufe 1989). Children rated as having an insecure attachment have been found to internalise their experiences in a more negative way. For example, those rated as insecure-avoidant (Type A) appear to expect rejection when in need of comfort and as adults go on to show difficulty with expressing negative feelings (Kobak and Sceery 1988). Insecure-ambivalent children (Type C) tend to have expectations for an unavailable, ineffective parent, resulting in a dependent helpless relationship (Cummings and Cicchetti 1990). Some researchers argue that whilst children rated as insecure-ambivalent are able to express their negative feelings, rather than manage them they tend to be overwhelmed by such feelings and become fearful, sad or angry (Oppenheim, Emde and Warren 1997; Sroufe 1983). Disorganised-disoriented attachment (Type D) has been noted in children who have been frightened by their main carer and/or environment or experienced abuse. Children categorised as Type D are those who demonstrate both approach and avoidance behaviours and other signs of apprehension when in the presence of the main caregiver (Main and Solomon 1990). Main and Hesse (1990) suggest that this pattern of attachment may result when a caregiver alternates between nurturing and threatening behaviours towards the child. Researchers (e.g. Sroufe 1990) argue that early internal working models of the self form alongside the representations of the attachment figure. A securely attached child will have a representation of him- or herself as someone who is acceptable and lovable, whereas the insecurely attached child is likely to form a representation of him- or herself as unlovable, corresponding to her experience of an unavailable main caregiver (Bretherton and Waters 1985).

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Attachment and behaviour In many cases children demonstrate a secure attachment to their main carer towards the end of the first year. Once the child becomes mobile and able to explore, other factors are introduced into the relationship. Observations of parent–child interaction from this stage often reveal the child to be confused and unhappy at the main carer’s anger and frustration with negotiating developmental stages of behaviour or their emotional unavailability. Hyperactive, aggressive or withdrawn children keep adults away. Others may show indiscriminate affection, appearing pseudo-mature or over-competent. Research being carried out in the field of antisocial behaviour suggests a strong link between attachment and behaviour difficulties. Van Ijzendoorn (1997) linked attachment problems with emerging aggression and antisocial behaviour in the child, particularly with regard to the emergence of empathy, morality and social adaptation. Lyons-Ruth (1996) found that aggressive and antisocial behaviour is associated with non-responsive care giving to the infant, social adversity and avoidant/disorganised patterns of attachment in the toddler years. Other researchers have noted that disorganised patterns of attachment in infancy are linked with controlling behaviour in the pre-schooler (Main, Kaplan and Cassidy 1985). Conduct problems can be associated with disturbed attachments and relationship problems, but not necessarily so. However, Greenberg et al. (1991, 1993) found patterns of controlling attachment in boys with oppositional and conduct type behaviour problems. It is evident that children can suffer from a variety of behavioural and psychological reactions to stressful events. Poor parenting and poor attachments can be equally stressful to infants and young children and can contribute to emotional and behavioural disturbances in children which may then go on to be diagnosed as a psychological or psychiatric disorder.

Play therapy in family assessment Play therapy using social construction ideas concerning the development of mentalisation and cognitive and affective processing abilities in

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children are useful to explore and understand more about how children internalise their experiences and expectations. By exploring children’s attachment representations and internal conflicts, early antecedents and risk factors may be better understood. Children who have experienced difficulties may be helped via play therapy to learn to recognise internal cues of affect and to change strong negative feelings into socially adaptive behaviour. Play therapists working within a social construction framework are uniquely placed to offer appropriate preventative intervention to help alleviate a child’s long-term distress. There are three concepts used in play therapy for assessment: •

representations of a child’s external world

•

as a means of reintegrating attachment relationships

•

narrative play and stories.

Play therapy and representations of a child’s external world The social constructionist model of play therapy favours the view that personality continues to develop through childhood during important developmental stages and evolves throughout the life span, which may necessitate change in order to be negotiated (Erikson 1963; Erikson, Korfmacher and Egeland 1992). The social constructionist view of development is threefold and comprises body identity, social and cultural identity and psychological/emotional identity. These are all influenced by social and cultural beliefs and mediated by thought in terms of images, memories and inner language to include the stories we tell about ourselves. How do children represent their external world, especially the world of relationships, internally? Theories such as Bowlby’s developmental psychology (Bowlby 1973) elaborate the concept of an ‘operative internal model’. This includes internal mental representations and memory structures. The way in which external experiences are perceived, the emotions and memories they bring about and the individual responses that they evoke all depend on the internal working model (Zeanah and Barton 1989). One of the ways in which children represent their external worlds and try to gain mastery over their experiences is through the medium of play. The child’s play in turn enables the therapist

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to think about how children may internalise their experiences and to assess modification for change and outcomes.

Play therapy as a means of reintegrating attachment relationships A main function of play is to provide a space between thinking and reality and to try and make sense of experiences. Play therapy enables children with damaging social experiences to rework their feelings into more healthy socialisation patterns (Cattanach, 1997). Crittenden (1992) suggests that troubled children usually need an opportunity for play even more than ‘normal’ children because it is one of the essential interactions with carers that they have usually missed out on. Play therapy can indeed offer the child a chance to recreate a situation where s/he feels safe, secure and accepted. S/he can rely on the therapist to respond promptly, appropriately and predictably. Even a short intervention can help to promote a child’s expectations of security and provide a space to use play to explore emotional problems and renegotiate the organisation of their internal affective responses. By gaining understanding of the child’s attachment relationships in this way, the therapist can use the themes which emerge to plan further areas of work with both the child and main carers.

Narrative play and story stems The underlying approach to narrative is the concept of a story as a form of representation. These representations are stored not as fixed images but as ‘scripts’ that can be understood as active sequences of behaviour. People can and do construct and convey meaning through narrative (see, for example, White and Epston 1990). Current work in narrative therapy regards stories as a means of gaining access to and facilitating change in basic underlying scripts. These ideas are particularly helpful when working with children who may have experienced a range of difficulties in their lives. Play therapy within the safety of narrative can help to challenge scripts and distorted beliefs and to assist with the generation of a number of alternative storylines. Assessment work is usually time limited and story stems are considered to be useful when you may have restricted time with a child or when

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a child may be difficult to engage with. Story stems involve giving a child the beginning of a story and inviting him or her to complete the story by playing and/or dramatisation using a range of dolls or animal figures. Story stems were used initially to explore children’s feelings and fantasies (Moore and Ucko 1961). More recent researchers have found that giving a child the beginning of a story to complete (narrative story stem techniques) is a good way of eliciting themes about their relationships and conflicts (e.g. Buchsbaum and Emde 1990). This technique was built upon and adapted to allow researchers to explore children’s moral development (Buchsbaum et al. 1992). The authors’ research found that children as young as three years were able to produce narrative representations of emotional themes and were able to represent moral themes in the areas of empathy, prosocial behaviour, adherence to rules, reciprocity and aspects of family relationships (Buschaum et al. 1992, p.607). Story stems used in this way have been found to provide an accurate way of exploring internal representations of attachment alongside experiences of being parented (e.g. Hodges 1996; Hodges 1999). For example, disorganised and insecure attachments often create expectations of abandonment and/or rejection alongside low self-esteem and a sense of isolation. However, whilst children’s story stems are viewed as a useful tool in time-limited assessments, children’s own stories are thought to reflect similar themes.

Subjects Four families were selected at random from a sample of ten families attending the centre’s advice and assessment programme. The children were all in mainstream schools, although the schools had expressed concern regarding the child’s behaviour in relation to educational progress and peer relationships. The children’s parents had also identified problems with the child’s behaviour at home. The children’s age, gender and the concerns expressed about them are listed in Table 7.1.

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Table 7.1: Children’s age, gender and behaviour in home/school Child

Age

Gender

Behaviour at home

Behaviour in school

Nicholas

5.2 years

Male

Defiant

Withdrawn

Angela

5.7 years

Female

Sad, miserable

Attention seeking

Paul

8.3 years

Male

Aggressive

Aggressive

Zoë

8.8 years

Female

Aggressive

Aggressive

Parental interviews and observations The parents’ semi-structured interview schedules were adapted from the Adult Assessment Interview (see Holmes 1993) and were analysed by identifying themes from their own history of attachment and relationships. The parental styles were found to fall into six categories: sensitive, insensitive, neglectful, authoritarian, harsh, or a combination of several styles. Direct observations were recorded of the children leaving and rejoining their parents before and after their play sessions. Trained childcare staff supervising the children when their parents attended their own sessions also co-rated observations of parent–child interaction during family play periods. Table 7.2 gives a brief overview of common themes in the parents’ experiences of childhood and their rated style of parenting.

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Table 7.2 Themes of parent(s) history of relationships/parenting Family

Separation/ loss

Abuse

Problem relationships

Parenting style

A

Yes

CSA, DV

Yes

Insensitive

B

Yes

CSA, DV

Yes

Neglectful

C

Yes

Physical, DV

Yes

A/H

D

No

Physical/emotional

Yes

A/H

Key: CSA = child sexual abuse N = neglectful DV = domestic violence

I A H

= insensitive = authoritarian = harsh

Play therapy sessions with the children Each child was offered six sessions of play therapy to complete story stems, create their own stories and enact them if they wished. The children’s story stems and their own stories were written down as agreed with the child. There was a period of free time/play allocated at the end of each session to help ground the child in reality.

Analysis of story stems and stories The method used to analyse the children’s stories is based on the hypotheses that the content of the story completion will be similar to an analysis of direct observation of attachment behaviour in children, and that the structure of the child’s story can be studied to give information about how the child is beginning to process his or her experience in their internal representation of their relationships. The following case examples give brief details of the four family histories, how play therapy was used with the children and samples of the stories and artwork.

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Case study 1

Family A: Nicholas Nicholas’s parents described difficult relationships with their own parents and both left home at the earliest opportunity. Nicholas was not a planned child but the couple decided to marry and set up home together. Mrs A had not given much thought to how she would parent Nicholas as during her pregnancy she suffered mental health problems which included psychotic thoughts about her unborn child and self-harm. After Nicholas’s birth she recalled that professionals were concerned that she was very quiet, tense and showed no motivation. She did not know how to hold Nicholas and constantly needed prompting to take care of him. This changed gradually with considerable help from a range of professionals. Mrs A feels she now shares a close relationship with her son and spends a lot of quality time with him. However, she still suffers from periods of depression and self-harm and been hospitalised on several occasions. Nicolas is now 5 years old. His parents expressed concern that Nicholas refuses to listen to them and generally does as he wants. Teachers advised that Nicholas presented as sad and withdrawn in school and had few social skills. He often made growling noises when he wanted to be left alone. During the first session it was notable that Nicholas did not directly engage with me or make any direct eye contact. As I spoke to him about why he was coming to see me and some of the rules we had agreed for play, he explored the room and stared at some of the artwork, particularly studying the ‘sea world’ section of the room. He gave no indication as to whether he had heard me or taken on board anything I had been saying until I said that I thought he had understood me and if so to nod his head. Nicholas gave a small nod and carried on observing the room. However, if I asked whether he particularly liked something he ignored me and moved on. I wondered whether he was communicating to me his experience of early deprivation and, as he slowly joined me at the table

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where I had laid out some farm animals, I began to talk about wondering whether he would enjoy playing with the animals who sometimes couldn’t hear or understand people. Nicholas at that point smiled shyly and stated that he loved wild animals. I found a large book for him and together we looked at the wild animals. He agreed that he would like to make up some stories about animals and to draw some of them together, which we did.

Nicholas’s first story stem The little pig goes for a walk and gets lost and doesn’t know how to get back. Show me what happens… Well, he ran and ran and ran Until he realised he was all alone No one came to look for him He was all right…he killed animals for food But he felt hungry a lot…and a bit scared… But it was nice and peaceful If anyone came near him he just growled ‘rrrrrrr’ and they went away. Everyone just left him alone He liked it on his own. At night he used to hide in the bushes or climb a tree where he felt safe and could look down on everyone and could see what they were doing. He was OK. Nicholas chose not to extend the story to finding a family or friends and expressed a wish to leave the story. However, despite expressing this wish it was noted that he returned to play with the animals he had left behind, making tentative steps to look for ‘someone’ but then ‘going back to work’. At the end of the session I asked if he wanted to put the little pig with the rest of his family. Nicholas responded that he thought the pig preferred it where he was and would like to stay there. He found a place for him with the ‘wild’ animals and we agreed to see what happened the following week.

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In a later session Nicholas was able to ask for my help to draw an animal and when I too had difficulty we laughed and agreed we would ‘trace’ it from the book together. Nicholas insisted upon calling a large stag a reindeer and this is Nicholas’s own story: The Reindeer Alone on a Mountain Once there was a Reindeer And he lived on a mountain It was good there…quiet…lots of places to climb He never got bored Until one day he slipped down a really really steep bit He fell and hurt his foot ‘Help, help,’ he cried But no one heard him He was actually all alone on the mountain And then he was scared…really really scared He had been quite happy before then But now he needed someone And…no one came He was all alone on the mountain. Nicholas was adamant that the Reindeer did not have a family and that he had always been alone. When asked what happened to the Reindeer in the end, Nicholas replied, ‘Oh, eventually he got up and stumbled around…he was all right because he was used to it.’ Nicholas did not wish to pursue exploring any other ending to this story. However, he did like the idea of acting the story out and we agreed beforehand that if the Reindeer was so hurt that he could not move, I would be allowed to enter into the play just ‘to help him [the reindeer] a bit while he has difficulty walking’. We agreed I would be an old mountain goat who would help him back to his cave and make sure he was warm and to bring him food and water until he got better. As we ended the play I talked generally about people who can help when we need it. Nicholas thought for what seemed a long time. Finally he gave a deep sigh and said it was difficult to ‘trust’ anyone, but maybe he would one day.

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As Nicholas particularly enjoyed stories about monsters, I asked if he would like a story to be read to him about a monster while he played, to which he agreed. I selected ‘The Flying Head’ (from Cattanach 1997, p.199). Children particularly like this story as it illustrates the possibility of someone being able to outwit a monster that everyone is frightened of. Nicholas laughed at this story and asked for it to be read to him again the following week. As we left the playroom, Nicholas suddenly told me he was worried about his mother and whether she would be at home or in hospital. We talked through his worries with his father who reassured Nicholas that his mother was well and waiting at home for him. As discussed and agreed with Nicolas’s parents during our initial meetings, Nicolas’s father was able to reassure Nicholas that he was brave to talk about his worries and that it was good to do so. The themes of Nicholas’s stories appeared to reflect his perceived isolated position within his family. Although Nicholas had remained with his mother at home for the most part, his history was such that there were long periods where she was not emotionally or physically available for him. His father was a busy professional who travelled a great deal and often appeared agitated due to the demands of home and work. It was clear that Nicholas was beginning to work through some of his feelings of loneliness through his stories. He was beginning to ask for help from me during play and to express his fears about his mother’s health and whereabouts. Given Nicholas’s expression of concerns for his mother’s health, I was able to introduce some books relating to children’s fears around parental illness. During the following sessions Nicholas enjoyed drawing as I read to him. Occasionally he asked me to repeat a sentence and/or looked up to see the pictures in the books. He later produced the following story: The Scary Monster in Sea World Once there lived a really really really scary monster who lived under the sea He lived in a dark, dark cave where no one could see him It was very hot in there

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Everyone else in Sea World was frightened to go in BUT…HE WASN’T LONELY! He had two very big eyes that went right around the side of his head So he could see everything… As he got older he grew more eyes One eye could go to the top of the sea and see out His teeth were so sharp and got bigger and bigger He could eat ANYTHING And he had a slimy tongue [rrrrrrrr] That was sharp around the edges One day some men tried to go into the cave But they were weak men…they didn’t even think to bring a sword with them! And the monster ate them all up When they were inside they were sooooo frightened, And they couldn’t get out They were so hot in there…so hot they burned One of the men tried to speak to the monster He wasn’t strong but he WAS clever But the monster would not listen to him So they stayed in there forever The monster really liked it in the cave [Me: what about the others?] I don’t know about the others But it must be really really scary – don’t you think? We talked about how we feel when things get scary, sometimes when mummies and daddies argue or do scary things. Nicholas nodded seriously and said he wanted to draw a picture of a Sea World (Figure 7.1). He appeared to gain a lot of satisfaction from drawing and painting this picture and stated several times how hot it was in the cave and how scary it was, although it was clear he was enjoying talking in this way and did not appear frightened.

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Figure 7.1

Nicholas was once again happy to leave the story and did not want to find an ending for it. As he worked on his drawing I suggested an end to the story whereby the men inside the monster got together and planned their escape. Nicholas did not comment on this ending and concentrated on finishing his painting, adding more glitter and glue to emphasise the heat in the cave. When he was satisfied with the picture I asked if he would like me to read him the monster story that he so enjoyed. Nicholas nodded silently and listened intently whilst playing with the slime. He seemed to gain comfort from this activity and laughed aloud at the point in the story when the flying head went ‘screaming and screaming over the mountains, streams and forests’. We agreed it was ‘good riddance’ to the monster.

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Nicholas added that he would like to ‘wrap his head in slime first’ and proceeded to punch the slime with his fist, laughing as he spread it all through his fingers. The monster theme continued throughout Nicholas’s stories and together we tried to work out plans to avoid or escape them. Subtle changes were noted as follows: The Monsters in Sea World Once upon a time There were some monsters who lived in the sea One day they found an island and decided to live there They were really scary monsters…all big and slimy They could do whatever they wanted…everyone was scared of them The people on the island were all scared and ran and hid Come out! said the blue monster…I’m hungry and want to eat you Go to the woods the people said…there is food there… Off they went to the woods But they fell down a big hole Down…down…‘aaaah’ they cried And all the sand went on top of them [lots of burying] The end [Me: What happened to them do you think?] Well…I expect they…[shrug]…they couldn’t get out. Nicholas’s play terminated abruptly here, as children’s play often does. He later returned to build a sandcastle on top of the mound of sand where he had buried the monsters. In it he placed a ‘king’ and ‘queen’ who were in charge and proceeded to place lots of soldiers around the castle for protection against monsters. Lots of people tried to get past the soldiers into the castle and it all ended in fighting and killing, although no one got to the king and queen. I wondered whether this story and play might be related to Nicholas’s parents being helped to understand a child’s need for parents to be in control of them. Nicholas did not want to talk about his story or sand

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world and instead expressed a wish to pour water on the sand. His play then regressed to becoming quite messy with sand and water. He indicated a wish to continue with messy play and the rest of the session was spent fingerpainting an equally chaotic ‘mess’. His play became quite frenetic when I advised that we had ten minutes left and he had to be stopped from scooping the fingerpaint out with his hands and throwing it onto the paper in ‘true’ artistic form. It felt difficult trying to contain him. At the end of the session Nicholas gave a deep sigh and said he felt tired. It was clear he had worked through quite a lot of anger during this session, but was perhaps there was an element of him saying ‘goodbye’ to the chaotic mess he was used to, as the ‘king and queen’ remained in control, thus allowing him to experience a stage of play he had missed out on. I hoped so. Nicholas’s last story stem involved a leopard from the wild animal selection instead of the farm animals that were also available to him alongside other family type dolls. The Wild Leopard Once there lived a leopard in the jungle. One day he went for a walk and he got lost…what happened next? Once there lived a leopard in the jungle He was all black and furry You could stroke him nicely on a good day He was a special leopard with magic powers He was BIG He was STRONG He had great big magic horns that came out when he was angry He had great long teeth, dripping with blood He had great long sharp CLAWS He had special glitter on his legs and he sparkled But underneath some of the glitter was splinters…they hurt him a bit But he could do anything he wanted to… [Me: What sort of things?]

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He used to KILL animals [Me: Why was that?] Sometimes because he was angry but mostly because he was hungry All the other animals were frightened of him ‘Why do you kill the other animals,’ they said The leopard just growled ‘wrrrrrrr’ so they went away BUT There was one thing he was frightened of…DINOSAURS He was frightened they could come and get him One day they did come after him and he ran and ran and ran But then he fell down, ‘Oh, oh,’ he cried ‘what will happen now?’ A small boy found him and said, ‘I will help you…do you have any magic powers?’ ‘Yes,’ said the special magic leopard And he made himself so small that the little boy carried him into his bedroom He kept him there where he was safe until he got better Then he went back to the woods He felt better and he made some friends He was happy sometimes because he didn’t feel SO angry and he tried not to growl as much. Nicholas later suddenly grabbed the leopard and replaced him with the other animals, shyly looking at me and saying ‘It’s all right now he’s not so angry any more.’ (A drawing of Nicholas’s leopard is shown in Figure 7.2). It was noted that Nicholas enjoyed placing layers of materials for the leopard’s fur. Underneath the red ‘fur’ are layers of yellow, blue and green felt material. Was this perhaps a way of Nicholas communicating his need to cover up his past ‘hurts’ or an attempt at trying to heal them and make them better? The gentle and loving manner in which he tended to his wild leopard suggested that this was a positive experience for him. Our final session included free play when we pretended we were in a ‘special’

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garden where we found safe places to hide from or confront monsters and dangerous animals.

Figure 7.2

During this assessment it was considered that Nicholas had been able to communicate how things were for him in his internal world through the medium of story and play. Overall Nicholas’s stories represented his parents as unavailable and ineffective and these findings relate to children rated as having insecure-ambivalent attachments. Through the safety of story his sense of isolation could be challenged in a secure and distanced way that enabled him to begin to seek and accept help from others – a small beginning to a long journey.

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Alongside this work, Nicholas’s play had helped identify particular areas for his parents to work on. They had been helped to understand the impact of their own attachments on their current relationships and parental style and to understand their child’s emotional and developmental needs within the parenting task. Nicholas was considered to have made good use of his sessions and was offered therapy in his own right.

Case study 2

Family B: Angela Angela’s mother described a difficult early childhood where she witnessed violence between her birth parents and experienced abuse. Angela’s mother later set up home with a younger man who had no previous relationship ties. Her stepfather was described as a kind but ‘difficult’ man in that he was unable to express emotion and liked ‘a quiet life’. She talked about feeling ‘left out’ at home as her mother devoted all her time to her new young husband. Angela’s mother has misused drugs and alcohol from the age of 14 years, Angela’s father was also involved in drugs. Angela was premature and placed in isolation for the first three months of her life. The marriage was volatile and violent. Angela spent time with various family members until she was 2 years old. She returned to her mother full time when her father went to prison where he remains to date. Angela is now 6 years old. The school expressed their concerns that she has few friends and tends to gravitate towards older children who continually ‘reject’ her and make her cry. Her attention span is poor and her behaviour in school is described as attention seeking. Her mother describes a close relationship with Angela but complains that she is often reluctant to do as she is told.

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Angela’s first story stem The little pig goes for a walk and gets lost and doesn’t know how to get back. Show me what happens… Well…the little pig walks along He is very scared as he doesn’t know what way to go Then he meets a cow Hello Mr Cow can you tell me the way back to my farm? No…go away said the cow…I don’t speak to pigs…clear off ! The little pig began to cry Go and ask Mr Lamb said the Cow…he might help you On the little pig went Hello Mr Lamb…can you tell me the way back to my farm? No I can’t said Mr Lamb…find someone else…you get on my nerves… The little pig began to cry again Oh…go away before I hit you…Go and find Mr Dog…he might know Hello Mr Dog…can you tell me the way back to my farm? Yes…come with me little pig They walked along and the dog looked after the pig He saved him from a FOX and a BEAR and a BIG BIRD Who came swooping down GET OFF said Mr Dog GET OFF said the little pig and they fought and fought until he went away When they got back it was dark The little pig tiptoed into the shed…very quietly shhhh He didn’t want to wake anyone because he thought he might get told off He was a BIT happy to be back But he missed Mr Dog and the way he looked after him And he thought he might do it all again some day.

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Angela’s story stem is also suggestive of an insecure attachment relationship. According to attachment theory insecurely attached avoidant children expect rejection or low levels of concern and comforting behaviours (Main et al. 1985). The insecurely attached child is also likely to internalise an unlovable representation of self to correspond with experience of an unavailable caregiver (Bretherton and Waters 1985). For example, if a child is distressed, the expectation is that parents will normally provide comfort. Children who learn that a need for comfort evokes indifference or rejection may go on to ignore painful feelings and to cope with distress in alternative ways. In extreme cases there is concern that this may result in the child experiencing a lack of empathy for others. Angela’s stories often ended mid-way and were bizarre in content. Some stories went back and forward in time and did not offer any resolution as a way of providing the possibility for reducing at least some aspects of the tension created. This was thought to reflect her anxiety suggested by the story or indeed what she might have been visualising as a response. Angela had difficulty in understanding and acknowledging the distress of the main character in her stories. The prominent themes throughout Angela’s stories were of aggression, rejection and a wish to be looked after. Her part stories identified a main carer who was unable to hear her cries and distress and how these feelings impacted on her sense of self. From this family’s assessment it was agreed that whilst Angela’s mother underwent treatment and individual support in her own right, Angela would stay with alternative carers. Angela was able to make good use of further play sessions to work on the emotional issues identified in her play, self-esteem and social skills.

Case study 3

Family C: Paul Paul’s mother described a poor relationship with her own mother and was placed in local authority care from the age of 8. She had her first child when she was 16 years old with whom she continues to have a poor relationship. Paul’s mother has a history of broken

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relationships with family and friends and has experienced harassment from neighbours wherever she has lived. Paul’s mother later had two children from another relationship and all three children witnessed severe domestic violence. Paul’s mother has suffered from bouts of depression in the past and currently receives support from a community psychiatric nurse. Paul’s mother advised that she did not know how to relate to Paul as a young baby and described him as a child who always cried and was ‘weak’, needing to ‘learn’ from an early age that he could not get his own way. She considered her main aim was to ‘toughen’ Paul up in order to help him ‘survive’. It appears that Paul was fed, changed and cared for by whoever visited whilst his mother’s life revolved around her violent relationship with his father. Paul spent two years in care from the age of 1 year when his younger sister was born. Paul’s mother described him as a ‘difficult but loving’ child and she feels that since she ended the relationship with his father she makes some effort to return his affections. Paul is now 8 years old. He is a quiet child who is performing reasonably well at school but has suffered bullying from older boys. He has recently been observed being verbally and physically abusive to some girls in his class. Paul has told teachers that he constantly worries about his mother and her safety and never knows what ‘mood’ she will be in when he gets home from school. His mother complains that he is continually aggressive towards his younger sister.

Paul’s first story stem The little pig goes for a walk and gets lost and doesn’t know how to get back. Show me what happens… Well…the little pig gets lost and does not know what to do He finds a chicken and asks him where he lives But the chicken is also lost They join up and walk to the river And see a frog

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The frog gives the pig a map So the pig goes back to the woods But they get chased by a fox The fox catches the chicken and eats it The pig manages to escape and can only find half the map He looks and looks and when he finds the other half he puts it together And goes back to the farm All the animals had been trying to find him When they all saw him they cheered And threw a party. Common themes in children’s stories of being eaten up are often associated with children who have been hurt or abused (Cattanach 1997). Avoidant patterns of attachment place the child near enough to the parent to feel safe and far enough away to escape rejection and punishment – often meted out by parents who feel they cannot cope with any more demands. Paul’s story stem reflects common themes of finding support but also losing it. People cannot be relied upon. The fact that the little pig manages to find his way home and is welcomed is positive. However, it is suggestive of idealising a home situation and attention that Paul craves, which is far from his reality. Paul’s Elephant in a Bad Mood Once upon a time there were loads of animals living in the jungle The elephant was always in a bad mood He stamped around and All the other animals were scared So they ran out of the jungle Except for the King of the Jungle, the tiger The tiger ordered the elephant to stop But the elephant ignores him and stamps all the trees down

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And the tiger calls his friend and they both try to stop the elephant – but they can’t And the elephant goes on to kill all the wildlife and really really hurts the tiger So all the tiger’s friends go to get help from the humans All the humans come with sleeping darts And shoot the elephant to make him go to sleep It takes the elephant a long time to go to sleep and he goes on killing all the wildlife… Then there is this MASSIVE BANG And the elephant finally goes to sleep All the humans get a truck to put him on to take him to the vets All the animals come and ask the tiger why the elephant was in such a bad mood The tiger said he didn’t know So they all went to try and find out from the humans And when the elephant came back he realised what damage he had done to the jungle He helped all the others to rebuild their homes And says sorry The elephant also helps the humans to plant new trees. Although situations identified in Paul’s story cause hurt and upset, Paul has been able to use his cognitive understanding to try and make sense of and handle his emotional distress. There is also his ability to use constructive behaviours including discussion, compromise and negotiation. Again this is suggestive of having received some good early care. It is probable that consistent care was available to him during his time with foster carers from the age of 1 to 3 years. Paul was too young to understand why he was placed in care and/or to have fully understood why he was rehabilitated home. We know that his mother tries to give him affection and attention but is not always consistent in doing so because of her own distress. For children such as Angela and Paul, who have a history of either witnessing or experiencing abuse, the most prevalent attachment style is

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avoidant-resistant (Howe et al. 1999). With experience some abused and traumatised children will learn that displays of distress and attachment behaviour fail to bring comfort or protection and may also be the cause of fear and danger. The main themes throughout Paul’s stories were confusion and anger and they allowed him to communicate feelings he was unable to express verbally. Paul was later helped to work through some of these early feelings through story making in play and to explore more acceptable ways of managing his anger. By being helped to understand the impact of early relationships, Paul’s mother was able to begin to focus on areas that would help to rebuild relationships with all her children. It was hoped that this work could then lead to Paul’s mother accepting more specialist in-depth work on her past and current adult relationships.

Case study 4

Family D: Zoë Zoë’s mother, described her childhood as ‘normal and happy’. Further exploration revealed that she felt her mother never liked her and considered her elder siblings were jealous of her close relationship with her father. She recalled strict discipline, including physical abuse and rejection from her mother. Zoë’s father was adopted into a large family from an early age. He recalled little of his early life. Zoë’s parents were involved in a physical relationship whilst at school. Zoë was born when they were both 16 years old. Zoë’s mother found it difficult to relate to Zoë and perceived her to be a ‘demanding, spoilt baby’. She acknowledged she was resentful of the attention Zoë’s father gave her as a baby and these feelings persist to date. The couple relationship was soon in difficulty due to Zoë’s father’s alcohol misuse. Zoë lived with her maternal grandparents on and off from the age of 6 months to 5 years but returned to live with her parents two years ago. Zoë’s behaviour was described as ‘spiteful and manipulative’ by her parents and teachers. She was not performing well in school and

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other children refused to play with her. Her brother is 1 year old and has special needs. Ms D expressed concern that Zoë’s behaviour makes her angry and rejecting of her and that she favours her son.

Zoë’s first story stem The little pig goes for a walk and gets lost and doesn’t know how to get back. Show me what happens… Once there was a little pig who went for a walk and got lost He walked and walked and walked until he saw a castle It was a big castle with water all around it He went across the bridge He felt a bit scared…‘who’s there…who’s there’ (it was an echo) Suddenly a big net came down and lifted him up AHA said the monster (a dinosaur) I will put you in my pen and see what you do I like BACON And the pig was dumped in the pen He started to cry and cry – he didn’t like the dark Suddenly he heard a voice ‘Don’t be afraid – I will look after you’ He saw an old pig in the corner Come here I will keep you warm And together we can KILL that dinosaur The next day the dinosaur asked them what they wanted to eat ‘Don’t know,’ said the pig, ‘not until I see what’s in your kitchen’ The dinosaur said ‘all right’ and took him to the kitchen IN the kitchen was an elephant and a giraffe cooking The pig didn’t like what they were cooking and so said he wanted to go back to the pen

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On the way he pushed the dinosaur in the water and he drowned The pig went and got the old pig out of the pen They made friends with the other animals And decided to stay together in the castle. [Me: What happened to the family he left behind?] I don’t know…the pig didn’t want to go back to his old world He was happy in the castle… The End. This story was thought to be a clear reflection of Zoë’s home situation, the conflicts she feels towards her parents and her wish to live with her grandparents. The ‘old pig’ could refer to her maternal grandparents or the therapist. Zoë’s story suggests she feels she has power and control within her world. This is a common theme with abused children who are confused by the power they are able to exert over adults and unhappy when they are unable to use the same power to make friends with other children. Zoë’s choice of an elephant and a giraffe to represent significant others was consistent throughout her stories and was thought to represent Zoë’s parents in terms of their physical appearance. Zoë’s stories suggested her internal working model represented her parents as unreliably available, insensitive and not to be trusted. She therefore approached them with an attitude that presumes they will be denying and unresponsive, but also suggests an approach which is demanding and complaining. This approach is suggestive of a defence mechanism associated with ambivalent patterns of attachment. However, themes of aggression were in the majority of her stories. Some researchers suggest that children may develop an aggressive response to experiences of fear and helplessness, such as when a child is too young or unable to escape, as in most forms of abuse (Pynoos and Eth 1985). Zoë’s behaviour was notably controlling both in her environment and in her stories, a pattern of behaviour that tends to be associated with a disorganised attachment. This type of attachment is often seen in boys with oppositional or conduct type behaviour problems, especially in families in which there is antisocial disorder (White et al. 1990). As we noted in the introduction,

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children with disorganised and insecure attachment often create experiences of abandonment, rejection, low self-esteem and a sense of isolation. For children with this type of attachment, it is particularly distressing for them when other people threaten to withdraw their care and interest. Zoë’s parents had both experienced this style of parenting themselves and acknowledged they used threats of abandonment and rejection in an effort to control Zoë’s behaviour. Zoë’s Story with Puppets One day a boy was walking through the woods and he saw a cave He went inside and saw a ghost And ran home His mum and no one believed him Until one day this little boy said I am going to the cave ‘Be careful,’ said the boy’s mum ‘What of ?’ said the boy ‘That little boy in the cave – he is a menace’ ‘I will,’ said the boy and off he went ‘Aaaaah,’ he screamed and ran home to his mum and said ‘Mum, mum, I saw a ghost.’ ‘Don’t be silly,’ she said, ‘I told you not to go in there.’ So he took her there to see it…but no one was there again But of course there was really BUT it was not a ghost but a sheet with holes in it Because an old man had lived there And that old man WAS ME! THE BOY WHO COULD SEE THE GHOST! When the boy and his mum had run away The ghost said, ‘I wish everyone was dead’ And that wish came true He found everyone WAS dead But he did not say ‘everyone except ME’

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So we are still worrying whether he meant to want to live or not! Cattanach (1997) says that when things are too painful a child will often ‘change sex’ in a story. In this case Zoë was aware that her younger brother was the favoured child who could do no wrong in her mother’s eyes. This is a painful reality for Zoë and it is possible that her stories reflected her wish to be a boy so that her mother would like her more. The themes from Zoë’s stories enabled me to find stories with similar themes and she was helped to understand that she was not alone in her fear of her own powers of wishing people dead and the impact this may have on her own immortality. Zoë’s Story with Slime One day there was this boy and he was bored at home So he went to the shops to buy some goo It was all red And the boy left it on the table and it grew overnight He was worried that the wicked mother might give it to someone else ‘Don’t touch it…please,’ he said. ‘All right, have your own way, but I don’t like it,’ said the wicked mother but the goo grew and grew so big that he built a house out of it but it killed him because he ate it and ate it until one day it was all gone and his mum said ‘MEN…they are so silly sometimes.’ The themes of this story again included Zoë’s conflicts about gender and highlighted fears of her power and needs. Zoë’s parents and grandparents had mentioned that she was tending to crave food, possibly as a form of comfort eating when things were difficult between her and her mother. This may have been compounded by the fact that Zoë’s brother had to have a diet rich in calories due to his health problems. Zoë had difficulty

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on an emotional level understanding why the family allowed her brother dessert when he had not eaten his meal and not her. Zoë’s stories enabled her to communicate her past and current experiences and fears. She had space to express her feelings of anger within the safety of story. Her stories provided areas for future work with her parents in an effort to reduce those anxieties and improve Zoë’s situation within the family home as a first step. Direct work on attachments by way of relationship play therapy with all members of the family also helped the family to deal with their difficulties.

Conclusion Attachment theory is essentially about how people relate to one another and how those relationships are influenced by an overall need for a sense of security. Maternal sensitivity and responsiveness to an infant’s signals of feeding, play and distress during the first few months are predictive of the quality of attachment at the end of the first year (see Nezworski, Tollan and Belsky 1988). These researchers argue that a cycle is set up in the early months, even if parents’ respond better as the child grows. This suggests that babies who have experienced insensitive mothering may refrain from negotiating their psychological needs with others as they grow up because they have developed a negative model of self and do not expect significant others, for example, parents, teachers or peers, to respond and this can become self perpetuating. Common themes in the parenting style of children with behaviour problems include a history of poor prenatal care, limited early parent–child patterns of interaction and a poor understanding of child development. As children grow and become more independent, a lack of understanding of a child’s developmental stages and abilities can contribute to parents developing negative perceptions of their child which may result in communications containing elements of blame, alongside harsh and authoritarian methods of parenting. Many children reared in such environments have been observed to exhibit difficult behaviour and problems in social relationships from as early as 3 years. Children who are raised by unloving, unresponsive or otherwise emotionally neglectful parents appear to be at risk for psychological dis-

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turbance in the short and intermediate term, perhaps especially in terms of disturbed attachments and relationships with others. Such psychological neglect may have severe pervasive effects that, unless treated, may persist across the life cycle. An association between attachment and behaviour may become problematic when the quality of care changes in a manner that is inconsistent with a child’s developmental stages. Therefore the quality of parental input is considered to be a main factor in children’s future adaptation and resilience in general (Cattanach 1997, p.121). Children who have experienced such difficulties need to be parented in a consistent, predictable and non-punitive way. In this study a considerable level of adverse life experiences in each parent’s history was noted, even though this was a random selection of families who were experiencing difficulties and requesting support. A significant factor was that all parents had experienced some form of childhood abuse and/or early separation loss. One parent who suffered severe abuse in childhood experienced several psychiatric breakdowns as an adult, whilst the other continued to receive a level of psychiatric support. The common themes emerging were that all parents interviewed considered adult relationship difficulties to be ongoing and had difficulty in managing their child’s behaviour. The children’s behaviour was noted to be problematic in school to the extent that schools had expressed their concern. During assessment the use of story stems did enable children to communicate patterns of attachment that were associated with difficulties in relationships and behaviour. The themes from the children’s own stories also reflected issues of deprivation, early separation and loss, and some themes of either witnessing or experiencing physical abuse that were considered to be impacting on their overall emotional and behavioural development. The intergenerational linking of disorganised and insecure attachment in parents and their children is interesting and supports findings commonly found in the clinical literature. A consistent finding is that separation is not the only factor that causes harmful effects. However, more detailed studies are needed to look at the child’s early relationship with both parents, given patterns of attachment relationship with fathers are

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found to be relatively independent from those with mothers in infancy (Schaffer 1996). There is a wealth of research that supports the view that early attachments affect self-representations and that negative views of the self are more common among children with insecure, ambivalent or disorganised attachment relationships. However, this study supports the view that as children mature they are able to integrate multiple positive and negative characteristics and dimensions (e.g. Russell and van den Broek 1998). It follows therefore that by the time a child reaches the pre-conceptual stage of cognitive thought (as defined by Piaget) there may be a different pattern of association between attachment, behavioural adjustment and the characterisation of self. These patterns will develop between the child and his/her significant relationships by way of constantly constructing and negotiating meanings. The results of this study support the view that attachment styles are not necessarily fixed across the lifespan, although there may be predisposing factors for later vulnerability in relationships. In accordance with Piaget’s theory of object constancy, internal working models are not ‘pictures’ or passive introjections of past experiences, but active constructions and can therefore be reconstructed. Children develop attachments not just to their main carers but to siblings and those in the wider cultural network and with help can build on existing attachments and go on to incorporate new ones. With appropriate support and intervention, children and their families can work through their difficulties, gain understanding and move on. Play therapy methods using story and metaphor provide a vehicle whereby children may express emotions and ideas that they may find difficult to express in any other way. They may help to alleviate withdrawal from a mental world and to organise memories in a way which is easier to access, retrieve and understand. Play therapy can help reframe a child’s experiences and assist in the development of new internal working models. Play therapy therefore is an invaluable intervention with children who are experiencing difficulties. Story stems are a useful assessment tool to gain some understanding of the child’s attachment history and identify areas of work needed to support the child and his/her main carers. But there is no substitute for

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‘once upon a time’ to enable children to use their imagination creatively to work through attachment issues and related problems in play therapy.

Acknowledgements I would like to thank the children who took part in this study and the parents who worked so hard to achieve change.

References

Ainsworth, M.D.S., Belehar, M.C., Waters, W. and Wall, S. (1978) Patterns of Attachment. Hillsdale, NJ: Lawrence Erlbaum. Bowlby, J. (1973) Attachment and Loss, Vol 2: Separation: Anxiety and Anger. London: Hogarth Press. Bretherton, I. and Waters, E. (eds) (1985) Growing Points of Attachment Theory and Research. Monographs of the Society for Research in Child Development 50 (1–2. Serial no. 209). Buchsbaum, H.K. and Emde, R.N. (1990) ‘Play narratives in 36-month-old children: early moral development and family relationships.’ Psychoanalytic Study of the Child 45, 129–155. Buchsbaum, H.K., Toth, S., Clyman, R.B., Cicchetti, D. and Emde, R. (1992) ‘The use of a narrative story stem technique with maltreated children: implications for theory and practice.’ Development and Psychopathology 4, 603–625. Cattanach, A. (1997) Children’s Stories in Play Therapy. London: Jessica Kingsley Publishers. Crittenden, P.M. (1992) ‘Treatment of anxious attachment in infancy and early childhood.’ Development and Psychopathology 4, 575–602. Cummings, E.M. and Cicchetti, D. (1990) ‘Attachment, depression and the transmission of depression.’ In M.T. Greenberg, D. Cicchetti and E.M. Cummings (eds) Attachment During the Pre School Years. Chicago: University of Chicago Press, pp.339–372. Erikson, H. (1963) Childhood and Society, 2nd edn. New York: Norton. Erikson, M., Korfmacher, J. and Egeland, B. (1992) ‘Attachments past and present: implications for therapeutic intervention with mother–infant dyads.’ Developmental Psychopathology 4, 495–507. Fonagy, P. and Steel, M. (1997) ‘Morality, disruptive behaviour, borderline personality disorder, crime and their relationship to the security of attachment.’ In L. Atkinson and K. Zucker (eds) Attachment and Psychopathology. New York: Guilford Press, pp.223–274.

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Fonagy, P. and Target, M. (1998) ‘How “theory of mind” mediates the attachment problems of individuals with borderline personality disorder: Evidence and implications for treatment.’ Fonargy, P. and Target, M. (2000) ‘Attachment and borderline personality disorder.’ Journal of the American Psychoanalytic Association 48, 4. Greenberg, M.T., Speltz, M.L., De Klyen, M. and Endriga, M. (1991) ‘Attachment security in preschoolers with and without externalizing behaviour problems: a replication.’ Development and Psychopathology 3, 413–430. Greenberg, M.T., Speltz, M.L. And De Klyen, M. (1993) ‘The role of attachment in the early development of disruptive behaviour problems.’ Development and Psychopathology 5. Hodges, J. (1999) ‘Research in child and adolescent psychotherapy. An overview.’ In M. Lanyado and A. Horne (eds) The Handbook of Child and Adolescent Psychotherapy. London: Routledge. Hodges, J. (1996) ‘The use of story stems.’ Fourth Annual Conference Address, British Association of Play Therapy, Warwick University. Holmes, J. (1993) John Bowlby on Attachment Theory. London: Routledge. Howe, D., Brandon, M., Hinings, D. and Schofield, G. (1999) Attachment Theory, Child Maltreatment and Family Support: A Practice and Assessment Model. London: Macmillan Press. Kobak, R.R. and Sceery, A. (1988) ‘Attachment in late adolescence: working models, affect regulation and representations of self and others.’ Child Development 59, 135–146. Lyons-Ruth, K. (1996) ‘Attachment relationships among children with aggressive behaviour problems: the role of disorganized early attachment patterns.’ Journal of Consulting and Clinical Psychology 64, 1, 64–73. McCune, L., DiPane de Fireoved, R. and Fleck, M. (1994) ‘Play: a context for mutual regulation within mother–child interaction.’ In A. Slade and D.P. Wolf (eds) Children at Play: Clinical and Developmental Approaches to Meaning and Representation. Oxford: Oxford University Press. Main, M. (1991) ‘Metacognitive knowledge, metacognitive monitoring, and singular (coherent) vs. multiple (incoherent) model of attachment: findings and directions for future research.’ In C. Murray Parkes, J. Stevenson-Hinde and P. Marris (eds) Attachment Across the Life Cycle. London: Routledge. Main, M. and Hesse, P. (1990) ‘Parents’ unresolved traumatic experiences are related to infant disorganized attachment status: is frightened and/or frightening parent behaviour the linking mechanism?’ In M. Greenberg, D. Cicchetti and E.M. Cummings (eds) Attachment during the pre-school years. Chicago: University of Chicago Press, pp.161–182. Main, M., Kaplan, N. and Cassidy, J. (1985) ‘Security in infancy, childhood and adulthood: a move to the level of representation.’ In I. Bretherton and E.

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Waters (eds) Growing Points of Attachment Theory and Research. Monographs of the Society for Research in Child Development 50 (1–2 Serial no. 209), pp.66–104. Main, M. and Solomon, J. (1990) ‘Procedures for identifying infants as disorganised/disorientated during the Ainsworth Strange Situation.’ In M.T. Greenberg, D. Cicchetti and E.M. Cummings (eds) Attachment in the Preschool Years: Theory, Research and Intervention. Chicago: University of Chicago Press, pp.121–160. Meins, E. (1997) Security of Attachment and the Social Development of Cognition. Brighton: Psychology Press. Moore, T. and Ucko, L.E. (1961) ‘Four to six: constructiveness and conflict in meeting doll play problems.’ Journal of Child Psychology and Psychiatry, 21–47. Nezworski, T., Tollan, W. and Belsky, J. (1988) ‘Intervention in insecure infant attachment.’ In J. Belsky and T. Nezworski (eds) Clinical Implications of Attachment. Hillsdale, NJ: Lawrence Erlbaum, pp.352–386. Oppenheim, D., Emde, R.N. and Warren, S. (1997) ‘Children’s narrative representations of mothers: their development and associations with child and mother adaptation.’ Child Development 68, 1, 127–138. Piaget, J. (1954) The Child’s Construction of Reality. NewYork: Basic Books. Pynoos, R.S. and Eth, S. (1985) ‘Developmental perspectives on psychic trauma in childhood.’ In C.R. Figley (ed) Trauma and its Wake: The Study and Treatment of Post-traumatic Stress Disorder. New York: Brunner/Mazel. Russel, R. and van den Broek, P. (1998) ‘A cognitive developmental account of storytelling in child psychotherapy.’ In S.R. Shirk (ed) Cognitive Development in Child Psychotherapy. New York: Phelan Press. Schaffer, H. (1996) Social Development. Oxford: Blackwell. Sroufe, L.A. (1983) ‘The coherence of individual development: early care attachment and subsequent developmental issues.’ American Psychologist 34, 10, 834–841. Sroufe, L.A. (1989) ‘Relationships, self, and individual adaptation.’ In A.J. Sameroff and R.N. Emde (eds) Relationships and Development. New York: Cambridge University Press, pp.51–71. Sroufe, L.A. (1990) ‘An organizational perspective on the self.’ In D. Cicchetti and M. Beeghly (eds) The Self in Transition: Infancy to Childhood. Chicago: University of Chicago Press, pp.281–307. Van Ijzendoorn, M.H. (1997) ‘Attachment, emergent morality and aggression: towards a developmental socio-emotional model of antisocial behaviour.’ International Journal of Behavioural Development 21, 4, 703–727. White, M. and Epston, D. (1990) Narrative Means to Therapeutic Ends. New York: Norton.

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White, J.L., Moffit, T.E., Earls, E., Robins, L. and Silva, P.A. (1990) ‘How early can we tell? Predictors of childhood conduct disorder and adolescent delinquency.’ Criminology 28, 507–533. Zeanah, C.H. and Barton, M.L. (1989) ‘Introduction: internal representations and parent–infant relationships.’ Journal of Infant Mental Health 10, 3, 135–235.

8

The Narrow Road to the Deep North Tracking a Life Ann Cattanach During his lifetime (1644–94) the great Japanese haiku poet Basho wrote of his travels as he journeyed through Japan. He called his journeys The Narrow Road to the Deep North. He described life as a traveller in this way: Days and months are travellers of eternity. So are the years that pass by. Those who steer a boat across the sea, or drive a horse over the earth till they succumb to the weight of years, spend every minute of their lives travelling.

One of the great privileges for a therapist is to journey with a child travelling through fragments and moments of their childhood. There is much to sort through when childhood has been complex and difficult. Perhaps family have been lost and there are hurts to be resolved, but good times to be remembered and the present and future to consider. The journey we make is a search for identity, a struggle to find meaning for life events. Often the child has made many physical journeys from one carer to another so the idea of a life journey seems a familiar one.

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Carla Carla and I have journeyed together for ten years. Our meetings change in form and frequency as she changes and grows with the years, but always and at all times we have been travelling back and forth between past, present and future. Carla struggles to construct, amend, then reconstruct herself and piece together a life and a life story which she can own. She uses me in this construction as a kind of sounding board for her ideas and notions of her life and her identity. We can co-construct together in this way because I am part of her story. We have weathered storms together and have enjoyed peaceful sunny times. Basho describes one of his travels as The Records of a Weather Exposed Skeleton. He writes this haiku: Determined to fall A weather-exposed skeleton I cannot help the sore wind Blowing through my heart. But all is not trial and tribulation in our journeys. Carla and I juggle with sadness, laughter, anger, ridicule, pleasure and pride in achievements. Although we are exposed to the weather of life, sometimes we put flesh on the bones of our skeletons and laugh at the stories we can tell about each other and the time we have shared. It is within the frameworks of social constructionism that Carla and I have boundaried the therapeutic relationship. Meanings shift as Carla contemplates her past, present and future with someone who has travelled alongside. She explores aspects of identity in the safety of the therapeutic relationship, experimenting with ideas about herself and ways she wants to live in the context of her experiences. In that way she uses therapy as a formal place to tell her story so far.

Play therapy as social construction Burr and Butt (2000) state that postmodern thought proposes that we will never be able to penetrate ‘the real’ with our imperfect perceptions and constructions. But we are naturally sense-making beings who interpret events and confer meanings upon things. They posit an

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objective world that is revealed to us through our senses. There is a split between this objective world and our subjective reality which mirrors the objective world in consciousness. The world we experience is between subject and object. What we experience is both made and found. So we are limited both by events in the world and by our constructions of those events. We might describe this as the ‘lived’ world. The perceived world is not a more or less perfect replica of objective reality: we produce constructions that serve our purposes and help us in our projects. Read the construction of a foolish man. This is a Sufi story. The Foolish Man, the Wise Man and the Jug [A foolish man may be the name given to an ordinary man who constantly misinterprets what happens to him, what he does, or what is brought about by others. He does this so convincingly that for himself and his peers large areas of life and thought seem logical and true.] A foolish man was sent one day with a pitcher to a wise man, to collect some wine. On the way the foolish man, through his own heedlessness, smashed the jar against a rock. When he had arrived at the house of the wise man, he presented him with the handle of the pitcher, and said: ‘So-and-so sent you this pitcher, but a horrible stone stole it from me.’ Amused and wishing to test his coherence, the wise man asked: ‘Since the pitcher is stolen why do you offer me the handle?’ ‘I am not such a fool as people say, and therefore I have brought the handle to prove my story.’ This story describes the way we interpret events for our own purposes. Some of these descriptions are not helpful in the way we present ourselves to others and the way we perceive ourselves. Sometimes distorted narratives can change whole communities – read this Sufi story:

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The Founding of Tradition Once upon a time there was a town composed of two parallel streets. A dervish passed through one street into the other, and as he reached the second one, the people there noticed that his eyes were streaming with tears. ‘Someone has died in the other street,’ one cried and soon all the children in the neighbourhood had taken up the cry. What had really happened was that the dervish had been peeling onions. Within a short space of time the cry had reached the first street; and the adults of both streets were so distressed and fearful (for each community was related to each other) that they dared not make complete enquiries as to the causes of the furore. A wise man tried to reason with the people of both streets, asking why they did not question each other. Too confused to know what they meant some said: ‘For all we know there is a deadly plague in the other street.’ This rumour too spread like wildfire until each street’s populace thought that the other was doomed. When some measure of order was restored it was only enough for the two communities to decide to emigrate to save themselves. Thus it was that from different sides of the town, both streets entirely evacuated their people. Now centuries later the town is still deserted and not so far away are two villages. Each village has its own tradition of how it began as a settlement from a doomed town, through a fortunate flight, in remote times, from a nameless evil. So distorted narratives and lack of communication between people can change the way whole communities live. In therapy with children we can together evaluate the effectiveness of the narratives they bring to us and decide together the impact of their stories on their sense of who they are and how they function in their lived world.

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The concept of personhood A social constructionalist stance describes the self as distributed amongst people and not localised within an individual, it is fluid and constantly changing. The following Arab story exemplifies this construction of the individual: Bring Me Four One day Aklar said to Birbal, ‘Bring me four individuals: one, a modest person, two, a shameless person, three, a coward, four, a heroic person.’ Next day Birbal brought a woman and had her stand before the emperor. Akbar said, ‘I asked for four people, and you have brought only one. Where are the others?’ Birbal said, ‘Refuge of the world, this one woman has the qualities of all four kinds of persons.’ Akbar asked him, ‘How so?’ Birbal answered, ‘When she stays in her in-laws’ house, out of modesty she doesn’t even open her mouth. ‘And when she sings obscene insult songs at a marriage, her father and brothers and husband and in-laws all sit and listen but she is not ashamed. ‘When she sits with her husband at night, she won’t even go alone into the storeroom and she says, “I’m afraid to go.” ‘But then, if she takes a fancy to someone, she goes fearlessly to meet her lover at midnight, in the dark, all alone, with no weapon, and she is not at all afraid of robbers or evil spirits.’ Hearing this Akbar said, ‘You speak truly,’ and gave Birbal a reward. Carla and I use the therapeutic space to co-construct narratives and stories together. Like Birbal in the story ‘Bring Me Four’, Carla stories her life to make sense of a variety of worlds she inhabits. A constructionist stance states that the way we make sense of the ‘lived world’ is to story our experiences. Gergen (1994) states that the terms and forms by which

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we achieve understanding of the world and ourselves are social artefacts, products of historically and culturally situated interchanges among people. Words can only take on meaning within the context of ongoing relationships. In An Invitation to Social Construction (1999) Gergen states that meanings are born of co-ordinations among persons – agreements, negotiations, and affirmations. From this viewpoint relationships stand prior to all that is intelligible. Nothing exists for us – as an intelligible world of objects and persons – until there are relationships. White and Epston (1990) make the assumption that individuals experience problems when the narratives in which they are storying their experience and/or in which they are having their experience storied by others do not sufficiently represent their lived experience and that in these circumstances there will be significant aspects of their lived experience that contradict these dominant narratives. The story of ‘The King’s Favourite’ shows how the meaning of events can be changed and individuals misrepresented: The King’s Favourite Long ago the beautiful woman, Mi Tzu-hsia, was admired by the Lord of Wei. Now according to the Lord of Wei anyone who rode in the king’s carriage without permission would be punished by amputation of the foot. When Mi Tzu-hsia’s mother fell ill someone brought the news to her in the middle of the night. She took the king’s carriage and went out, and the king praised her for it. ‘Such devotion to your mother, for your mother’s sake you risked amputation.’ Another day she was flirting with the Lord of Wei in the fruit garden. She took a peach, which she found so sweet that instead of finishing it she handed it to her Lord to taste. ‘How she loves me,’ said the Lord of Wei, ‘forgetting her own pleasure to share with me.’ But when Mi Tzu’s beauty began to fade, the king’s affection began to cool. And when she offended the king he said, ‘Didn’t she

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once take my carriage without permission? And didn’t she once give me a peach that she had chewed on?’ In an article in The Sunday Times, Gill (2000) evaluates the appeal of ‘The Royle Family’, a TV comedy programme. He describes how the programme has dispensed with plot. He states that plot is not the same as narrative and the programme has a clear narrative, which is a major part of its appeal. He formulates the idea that real life doesn’t have a plot, but it does have a narrative. What we tell of our lives are our own haphazard stories. The following stories belong to Carla and me and we have chosen to share them with you, the reader.

Meeting Carla Carla was born in London in 1984. Her mother is of white Irish and German origin and her father is black, origin unknown. Carla and her mother were involved with social services from Carla’s birth and many attempts were made for five years to help keep Carla with her mother. During those five years Carla experienced much disruption, moving in and out of foster care when her mother couldn’t cope. Several times during this period, Carla disclosed sexual abuse by one of her mother’s boyfriends and by an adolescent who was the son of one of her foster carers, but little heed was paid to her complaints. By the time Carla was 8 years old she had been under the care of ten social workers and a flow chart records 96 changes of life circumstances. When she was 6, Carla was placed for adoption with Eunice Gibson who also had an 11-year-old daughter called Mary. Within days of being placed with Eunice, Carla disclosed the sexual abuse in her birth family and in foster care. Her adoptive mother found these disclosures very difficult to accept and was very angry with social services who had placed Carla with her. Eunice worked with small babies and felt that she could not cope with her work and a sexually abused daughter. She had discussed this at length with social workers prior to the placement. She accepted that a child might disclose sexual abuse once settled in a family, but the social workers had assured her that there was no indication of this in Carla’s history. However, when Eunice later read her file there were

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repeated records of disclosures, which were not investigated appropriately. Eunice felt angry on behalf of Carla whose complaints had not been heard and shocked at the lack of order in the record keeping of social services. She felt daunted by the task of caring for Carla and how it might impact on her ability to do the nursing work which she loved so much. It was at this point that I first met Eunice and Carla. Carla’s story about herself at this time was that until she met Eunice nobody had listened to her and the only way to be heard was to shout loud and be angry. She wanted to tell about the hurt of the abuse and the fears she experienced and to express her desire for vengeance. At the same time she wanted to attach to Eunice and Mary and be part of their family, but found it hard to know how to achieve this in the light of Eunice’s distress. It was a never-ending circle. Therapy for Carla was not enough. The family unit required respect and an apology from social services. Racist attitudes had to be challenged and Carla’s life history, contained in numerous files, needed to be put in some sort of order so she would have a greater understanding of her past. I supported Eunice in her battles with social services to get some acknowledgement of their lack of openness. Eunice does not suffer fools gladly. She is sharp in her attention to detail and can toss off a great letter – and she got results. The director of social services upheld her complaint and an external consultancy were brought in to create order out of Carla’s files and to make recommendations for long-term support. This was financed by social services. It was at this time when Carla’s files were ordered that the chaos of her early years was truly recognised. But the battles took their toll and Eunice felt that she could not trust social services to keep their promises to support the family once she had adopted Carla so the placement remained long-term foster care. Carla has taken Eunice’s surname and is clear that Eunice is her mother and Mary is her sister. She considers Eunice’s former husband to be her father and both girls have an extended family within the Afro-Caribbean community. They belong and feel to be family in that cultural context. However, the fragility of the care system is evident in the years I have known the family. Meetings are often cancelled at the last minute, social workers and managers change and the fragmented nature

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of life in care is very evident. It seems that the family history has to be repeated for the benefit of each new member of staff and it can emphasise the powerlessness of the individual child caught up in the care system. If our identity develops by the stories we tell about ourselves, endlessly to repeat negative stories about abuse and hurt means that this aspect of identity becomes embedded rather than transformed. Some professional workers seem to want constant disclosures and the child in care comes to recognise the negotiable value of ‘horror stories’ and uses those narratives to gain attention or rewards from professionals. So the child remains a victim and the stories become trade. Carla wrote about this:

Change I walk into a room The moment in time has been captured Everything that’s private to me Has been laid bare. There is no cover for me Nothing to hide under Everything I know has been laid before Let no person put asunder. Do you know where I come from? Or where I’ve been? That’s one mystery I have about me Or has the answer already been seen? Everyone is quick to wonder Everyone is quick to stare But why not deflect attention from me And focus on someone who cares? Think about yourself for once In your life make a change There’s things in this life can’t be stopped But once in motion can be changed.

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Carla felt exposed at meetings with professionals as though she was the only one with problems. Children in the care system feel shame and humiliation from all the victimisation they experience and so they build a wall around themselves. They want to be like the rest of their friends and not thought of as ‘odd’ or ‘mad’. Carla hated coming to a clinic to see me because it set her apart from her friends, so I often saw her at her home. When I retired from the clinic, Carla chose to continue to see me now and then and to make the journey to my office at home. Another difficulty of being ‘looked after’ is the constant invasion of professionals into the lives of children. This can make it difficult to attach to the primary carer and the continued experience of loss is repeated as social workers leave and foster carers change.

The interventions: ten years of stories Beginnings – stories of abuse Initially the meetings with Carla and her foster mother were times of stress and anger as Carla’s childhood abuse emerged. It was important to help everybody to think about Carla’s circumstances in a calmer way so that she didn’t feel further abused by telling her story. Carla at 16 says that sometimes she regrets telling this particular story when she was 6 and she wishes she had kept quiet. She is not sure why she feels that way but thinks it might be that it colours her relationship with her foster mother who she feels now worries excessively about her friends and relationships. It is a story which she feels contaminates trust between her mother and her. In play therapy when Carla was 6, she developed imaginative stories which expressed some of the terrors she experienced as a result of her early abuse. The stories shifted as Carla perceived herself as hero as well as victim. I have written about Carla in earlier books, describing how she emerged from the story of contamination in Children’s Stories in Play Therapy (Cattanach 1998, pp.168–177). Her early drawings showed a child with the body of an adult but over time her perceptions changed. She developed a hero who became a persecutor of all monsters. Her story was called ‘The Man-eating Guagwoga Meets the Giant Detector’. She also has a sense of humour, which emerges in her imaginative stories and

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her evaluations of life events. She still perceives herself at times as the Giant Detector, a heroic figure rooting out evil and punishing evildoers.

Later narratives After Carla was satisfied that her stories of hurt had been heard, there came a period of adjustment to her new circumstances with Eunice and Mary. Over the next four years I still saw Carla about once a fortnight to support her placement in her family. There were struggles with school, choosing friends, negotiating with teachers. At times family life became difficult and there were explosions of anger and jealousy – normal family life but often expressed through extremes of feeling. We explored gradations of feeling to consider the subtlety of relationships. We still laugh wryly about the time Carla took £36 from Eunice’s purse to buy tuna sandwiches for herself. She defined it as anger towards her mother, mixed with a puritan streak. She took money to own a part of her mother, but then had to spend it on healthy nourishment because she felt guilty. I feel I would have bought chocolate as my nourishment but Carla thinks healthy eating is better. Carla smiles at my weaknesses. We began to think about the kind of healthy nourishment Carla wanted from her mother. Eunice and Carla talked about this together. Eunice understood Carla’s need but was still angry about the theft. Carla repaid the money. There was constant testing of the relationship, both mother and daughter feeling the pain involved in trusting one another. No narratives are ever finished and Carla returned to themes from her past again and again when she felt helpless and vulnerable.

Stories of vengeance Throughout these years Carla still felt a strong desire for revenge about her childhood abuse and the lack of nurture and support she had received when in care and supposedly safe. She felt she was victim and avenger at the same time. We shared stories and Carla showed me this story.

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When the Dust Falls the Feathers will Settle Tick tock tick tock. The ticking and the tocking of the clock reverberated off of the cheap whitewashed wall in front of her eyes. It had been three months since they had put her in, locked her up, and she had had a lot of time to think about what had happened. How much of it she regretted, she was still unsure, but all she knew, he had deserved every bit of it, every bit of the hell he’d endured – the same hell she’d tolerated at his hands for eighteen years. Five hours was not enough, but she took comfort in the knowledge that he had gone to hell. Her head became awash with the painfully sharp memories of her childhood, the tears of sorrow cried in her pillow every night, as she fantasised about the perfect childhood that was not hers. She cried now for all the lost years, the lost memories and lost feelings that had gone along with her sanity. It was a long road that she had travelled to get where she was, but was sure that she had travelled it well. The memories of the hot heavy breathing, the screams of pain and terror, came flooding back. All of a sudden she was being suffocated, the walls of the room closed in on her, leering at her, laughing a cruel laugh, that she was infinitely not a part of. She was not a part of anything that mattered any more, a transparent shadow on the wall of life, the shadow easily blotted out by anything important. It was going to be like that forever, and the tears of self-loathing and regret would not stop it happening. So she cried again, but she cried tears of blood, as she clawed at her flesh trying to tear away the hatred, to release the feathers of hurt. Eventually she calmed down and began to think. There was that clock again, the same monotonous rhythm that she had to listen to every night for the last three months. It was like she was a friend with the clock, they had a conversation each day, the clock ticking way with her thoughts.

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She could really feel the loneliness now, a suffocating, smothering blanket that muffled her cries for company as the voices of loneliness whispered ‘come’. She curled up in the foetal position but, as she thought bitterly, she had probably never been a foetus. She was too evil for that – foetal positions were for the nice children, not her. She wishes she had a mum, a sister, anyone to be with her, but he took all that away with one fell swoop of his hand. He had been God over life and death; he decided who lived and who died. She wished he had chosen her to die, but as she lay there she doubted if she was even worthy of that. Carla was 15 when she wrote the story. She enjoyed writing extremes in her fiction. It wasn’t her life, her experience, but she had at times felt those extremes, being annihilated as a person, and then wanting vengeance, which would only bring further victimisation. So the circle went round and round. Carla wrote the story as part of her school coursework. Her teacher was impressed and empathic towards Carla. Eunice found it very powerful and it helped her understand how low Carla sometimes felt about herself. Their relationship deepened. I told Carla the story of ‘The Mother of the Sea Beasts’ – a story of the Netsilik people of the Arctic regions. It expresses the harshness which Carla felt about her own life and how cruel acts could create a desire for revenge. In the same way as in Carla’s story, the hurt is endless and goes on forever. But the Mother of the Sea Beasts also created seals out of her pain and hurt. So much is paradox. The Mother of the Sea Beasts Once long ago, the people of Sherman Inlet left to find new hunting places. They made rafts to cross the water. There were a lot of them and they were in a great hurry. At the village there was a little orphan girl called Nuliajuk. She jumped onto the raft with the other boys and girls, but no one cared about her, so they threw her into the water.

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She tried again and again to get hold of the edge of the raft, but they cut her fingers off, and as she sank to the bottom of the sea the stumps of her fingers became alive in the water and bobbed up around the raft like seals. That was the beginning of seals. But Nuliajuk sank to the bottom of the sea. She became a sea spirit and the mother of the sea beasts because she created seals. She became mistress of everything else alive, the land beasts and every creature which mankind had to hunt. She had great power over mankind, who had despised her and thrown her into the sea. She was the most feared of spirits and many taboos were directed towards Nuliajuk in the dark time when the sun is low and it is cold and windy. That is the time when life is most dangerous to live. Nuliajuk lives in a house at the bottom of the sea. She lives like a hermit, and often gets very angry. Then she punishes mankind. She notices every little rule and when it is broken. She knows everything. When people break a taboo she hides all the animals and mankind begins to starve. People then have to call on the elders to help them. One way is for the shamans to shut her in a passage in a special house. They block up the entrance from the passage to the room where the people sit, with a block of ice and Nuliajuk tries to break out through the ice to get to the room and the people. Everybody is scared. It is only when she can’t break the ice that she promises to free the animals. Then the shamans let her go. Nuliajuk’s own house under the sea is very scary. In the passage is the ruler of the passage who keeps the records of the breaches of taboos. He reports everything to Nuliajuk and tries to keep the elders and shamans away. There is also a big black dog. Nuliajuk lives with Isarraraitsoq, ‘The One with no Wings, The One with No Arms’. Nobody knows anything about her. They have the same husband, a little sea scorpion. There is a child called Ungaq, ‘The One who Screams’, who was stolen from her mother. This is all we know of Nuliajuk. She created seals but she’d like to get rid of mankind.

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As Carla grew older she experienced some of Nuliajuk’s desire for strict rules and vengeance for those who broke them. Carla found rejection from friends intolerable as it reminded her of her early times. It became unthinkable. Her vengeance was physical – and she threw a strong punch. But with time Carla has been able to tolerate the ebb and flow of friendship and love without making extreme judgements or taking extreme vengeance as she did in early adolescence. She always wonders what she might do if she met any of the perpetrators. After her disclosures at the age of 8, the police tracked her birth mother’s boyfriend and interviewed him. There was insufficient evidence to prosecute, but Carla had a discussion with the police officer involved, which helped her because her complaint had been heard and acted upon however late in the day. She wrote a poem to her adult perpetrator:

Johnny What’s the difference between me and you? Perhaps it’s that I got on and you didn’t Or maybe that you tried to bring me down to your level, And I rose above it, a little balloon Floating on a vile, rank air of deception and hatred. I’ll hand it to you, I almost didn’t rise above it, There were many things that you did to me, Many things that took away my innocence and robbed me of childhood naivety. But you didn’t take away my mind. The bright, crystal clear stream that runs through my head. You took my dignity but not my integrity. And I did rise above it, I rose above you. And I’ll keep on rising as high as I can, Until I can rise no more.

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Stories about lost and loving mothers and unknown fathers Like many ‘looked after’ children, Carla has had to cope with complex relationships and especially what it means to her to be cared for by a mother. She is angry at her birth mother for not keeping her safe as a child and for rejecting her because she was ashamed that Carla is black. But there are other memories of a softness and vulnerability about her birth mother. Then there is Eunice who is also her mother: black, loving, strong, but critical, demanding and also vulnerable. Eunice fears rejection with some of the same anxiety as Carla, so Carla finds it difficult to express loving feelings about her birth mother for fear of causing distress to Eunice. When Carla was attaching to her foster family she expressed angry feelings about her birth mother. It was a thin narrative about a one-dimensional relationship. But as Carla entered adolescence she began to think about her early life with her birth mother, Jane. Carla wanted to understand what had happened to Jane and the family and why Jane had put her into care. Carla decided that she wanted a meeting with Jane and asked me to go with her. Jane’s social worker prepared Jane for the meeting and explained that Carla had questions she wanted to ask. Carla had prepared a long list of questions about her early years. The meeting was tense. Jane tried to be honest as Carla went through her list of questions. Jane said the meeting was much harder than she thought it would be. It was clear to Carla how vulnerable Jane was so just meeting her helped Carla understand how difficult it was for Jane to care for children and keep them safe. Jane was able to say that when Carla was little she was ashamed of her for being black. This sounded shocking but it was a truth. Jane was not able to say much about Carla’s father and the circumstances of her conception because of this shame. I took Carla home after the meeting and it gave us time for Carla to think about what had been said. She was furious with Jane for admitting her shame about Carla, but at the same time admiring her honesty – a double-edged sword that cut to the heart. The meeting was hard and difficult and for a time Carla became very sad. Eunice had also found the process difficult and worried about how it might affect their relationship. Carla wrote this poem about her birth mother at this time:

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Reciprocated Love Did you love me? I look down at my hands, Inspect them, And wonder if their achievements make you proud. Everything I did, What name I tried to make for myself, Was pushed under a carpet, A carpet that was patterned only of you. Is that love? I tried to look into your eyes, Perhaps see beyond, My veil of hurt and anger, To find love. Do I make you spit the blood, That I have cried for you? Does the hatred leave you upside down? Like the hurt I feel. I curl up like a foetus, Hoping you might love me As I have loved you. At some time in the future Carla would like to meet her mother again, this time to find out about herself as a small child. The questions are less an interrogation, more a desire to reminisce. We look at the questions she wants to ask and deconstruct them. We discover that she can throw them out of the window and perhaps the conversation between mother and daughter will just flow. Carla says this visit will be her last. We think about why that should be. Carla decides to wait and see and not put such boundaries around herself. Woven into the narratives of mothers, with the one who is distant and emotionally unavailable is the one who is there and a bit too emotionally available: Eunice who worries, nags, makes sure you get to school, work

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hard, be a credit, be proud to be black; the one who picks into your brain, fears disaster and most of all fears being abandoned by her child. The love is palpable. I told Carla the story of Mrs Darling organising her children in Peter Pan (Barrie 1928). Mrs Darling heard about Peter Pan when she was tidying up her children’s minds. She did this every night, as is the custom of every good mother after her children are asleep. Mothers rummage in the minds of their children and put things straight for the next morning. They repack and put back in their proper places the many articles that have wandered during the day. When you wake in the morning, the naughtiness and evil passions with which you went to bed have been folded up and put away in the bottom of your mind, and on the top, well aired, are spread out your prettier thoughts, ready for you to put on. We smile at the description. There is recognition. Carla understands Eunice and knows she loves her, but she needs to grow and find her own way. Are mothers really envious or just anxious as their daughters grow to womanhood? The voice of Nuliajuk, the sea spirit in the story, rises to the surface. Carla starts to be strict and critical. Mothers should be pure; they shouldn’t have feelings of anxiety, jealousy, and fear. We consider the question whether mothers are human. Carla finds this hard to believe. I say that Carla and Eunice have a strong and supportive love for each other. Carla reluctantly agrees. Fathers are different. Carla looks in the mirror and visibly sees the blackness and beauty of her father and experiences the loss of his identity. There are many stories of her conception. I say she is mysterious, beautiful, conceived when her mother was happy, having fun at a party. Isn’t that a pleasant way to be conceived? Maybe, but the not knowing and never being able to find out is hard to bear. So Carla feels she wasn’t conceived, never a loved foetus, not worthy, born to a mother who was ashamed. We think about sexual desire, youth, fun and the consequences. I tell her this Hillbilly story.

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Father and Mother Both Fast Oh yes, well a young man stayed with a girl, and by and by he went to his father and he said, ‘Father, I’m going to marry that girl.’ His father says, ‘John, let me tell you – I’se fast when I was young, and that girl’s your sister.’ Well he felt bad and he left her. By and by he picked up another girl and he stayed with her for a while and he went to his father and he said, ‘Father, I’m going to marry that girl.’ Father said, ‘John I was fast when I was young and that girl is so your sister.’ The young man felt very bad and one day as he was sitting by the stove with his head hung down his mother said, ‘What’s the trouble John?’ ‘No nothing.’ She said, ‘There’s something and I want to know what it is. ‘Why did you leave that girl the first one you stayed with and then you left the second one?’ ‘Well,’ he said, ‘father told me he was fast when he was young and they’s both my sisters.’ Says she laughing, ‘Johnny; I want to tell you something. ‘I was fast when I was young and your father ain’t your father at all.’ We laugh wryly. At least there is some universality about Carla’s story, but the pain and loss will always be there and visible in the beauty of her body.

Still walking Life changes for both Carla and myself. I, like Basho, took my narrow road to the deep north and moved to the Highlands of Scotland. Carla found this difficult. She thought of me as an immutable part of her landscape. Ten years is a long journey. Will I like Scotland? It is cold there? She fears the distance between us. I say she is a woman of the new millennium. There is always e-mail, text, phone. She smiles. Soon Carla will go to university. She looks forward to independence but wants the safe home with Eunice to be there for her. These are exciting times. I tell

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Carla a Scottish story. A new landscape for her to imagine and for me to live. Angus Og and the Birds In the north of Scotland the daylight lingers long during the months of summer. Sometimes it seems that sunset will last until the coming of the next dawn, and there will be no night at all. But there must be time for sleep and that comes when a great hush falls upon the earth one hour before daybreak. There is an old story, which tells of the time many hundreds of years ago when there was no end to the day. Time for sleep was hard to find, for always all the time birds would be restless on the moors and in the woodlands, keeping their neighbours awake with their endless singing. Angus Og, the god of Spring, listened to the voices of the birds and they displeased him. He could not banish the light, but he decided he must put such a weariness on the birds that they would be glad to rest. This is what he did. He summoned all the birds from the moors, the mountains and the glens, and when they were gathered around him on the green mound, he asked which of them was the loudest singer. At that there was a fierce argument because none could agree. ‘Very well,’ said Angus Og, ‘from daybreak to-morrow all of you will sing. I will sit on Ben Cruachan mountain and the voice I hear singing above all others will tell me who is master.’ But there were some birds like the wren, the owl and the little brown martin whose nests were hidden in holes. ‘How will we know when the hour to sing is come?’ they asked. ‘The red rooster will tell you that,’ replied Angus Og smiling to himself. Next morning, no sooner had the day begun than the red rooster crowed from his perch as Angus Og had promised. First to wake was the lark and he soared high up in the sky singing his song. He woke the rooks in the trees, the thrushes, robins and linnets, until all the birds had joined the great chorus of song that ran through the forest and far into the mountain glens. Each little

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bird, even the rook and jackdaw, made the best of what voice he had. All through that day Angus Og sat on Ben Cruachan listening. He laughed for it happened as he predicted. All the birds sang to beat their neighbour and not one of them could be heard alone. By sundown all the birds were weary and hoarse from their singing. ‘Go to Angus Og,’ they told the pigeon, ‘and let him tell us who is master.’ But Angus Og shook his head when the pigeon came with his message. ‘It is hard to say. Go back to the birds. Tell them they must sing again to-morrow and every day when the dawn breaks, and I will listen more closely until I have found the master.’ That night, in spite of the long hours of twilight, the birds were glad to rest. But as before the rooster summoned them at daybreak and they tried again. Once more the pigeon went to Angus Og with the message, but Angus Og sent him back with the same reply. Nor did he ever decide who was master, for the singing of the birds made them ready to sleep. Angus Og still listens to the birds when they sing their dawn chorus. If you doubt this, get up in springtime when the rooster crows and you will hear it for yourself. And if you are lucky in the evening you may even see the wood pigeon on his way to Ben Cruachan with the question that Angus Og will never answer. And a spell from the Highlands to keep us all safe. It seems to cover most things:

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The Red Stalk Pluck will I the little red stalk of surety, The lint the lovely Bride drew through her palm, For success of health, for success of friendship, For success of joyousness, For overcoming of evil mind, for overcoming of evil eye, For overcoming of bewitchment, For overcoming of evil deed, for overcoming of evil conduct, For overcoming of malediction, For overcoming of evil news, for overcoming of evil words, For success of blissfulness For success of blissfulness.

References

Barrie, J.M. (1928) Peter Pan. London: Hodder & Stoughton. Basho, M. (1966) Trans. Yuasa N. The Narrow Road to the Deep North. London: Penguin. Burr, V. and Butt, T. (2000) ‘Psychological distress and postmodern thought.’ In D. Fee (ed) Pathology and the Postmodern. London: Sage. Cattanach, A. (1998) Children’s Stories in Play Therapy. London: Jessica Kingsley Publishers. Gergen, K.J. (1994) Realities and Relationships Soundings in Social Construction. London: Harvard University Press. Gergen, K.J. (1999) An Invitation to Social Construction. London: Sage. Gill, A.A. (2000) ‘The Royles, Monarch of Our Time.’ The Sunday Times, 22 October. White, M. and Epston, D. (1990) Narrative Means to Therapeutic Ends. New York: Norton.

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The Biography Laboratory Co-creating in Community Christine Novy What I remember most from my years working as a drama and play therapist with young people is the sheer enjoyment that comes from playfully and artistically authoring stories. The stories themselves were very often sad or angry or even terrifying, but the teller’s delight as they directed the narrative seemed to provide a welcome subplot to their life experiences of helplessness outside our shared play space. In the act of creation, the young person’s perspective shifted from that of victim to agent. Adults, like children, can find themselves stuck in self-stories that are unhelpful and limiting. These stories may accompany a social role or diagnostic label. They may have been assigned by outside experts or reflect popular sociopolitical discourses. The dominant stories do not always sit comfortably with a person’s real life experience or intentions. Yet often these counter-experiences and intentions remain unstoried. The re-authoring process for an adult may well involve remembering and imagining lost, hidden or forgotten stories as they recollect the events of their lives, and to remember what is forgotten or imagine what is lost mostly calls for ‘a playful relationship with reality’ (Jones 1996, p.115). The description that follows will illustrate how a playful narrative approach becomes an invitation for adults, as, in my experience, it was for

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children, to experience their own creativity, thereby reclaiming their authority in the narration and shaping of their lives. When I was 8 or 9 years old, my mother organised a family and friends puppet production of Hansel and Gretel. Everyone was involved in some way. My two brothers played the witch and the hunter. My best friend played Gretel, I played Hansel and my sister accompanied us on the flute. My mother is an artist. She had made the puppets herself with the utmost attention to detail. I remember that the hunter’s moustache was made of fur and Gretel’s hair of raffia. Each fabric for each costume was carefully chosen and sewn, each face was beautifully painted. We had such fun rehearsing, all of us tightly packed behind the puppet stage. I still remember my lines to this day: Gretel: Hansel, are you afraid? Hansel: Afraid Gretel? Why…me? … No, I’m not afraid!

The lights were low. There was the occasional sound of an owl hooting from backstage. My voice, as boylike as I could make it, tremored slightly as I spoke those words. We performed the puppet play at our local village hall to a packed and enthusiastic audience. This is my earliest memory of community. Since then my experiences of community have always centred around art, drama and creativity: shared activities that involve making, building and creating things together. I have always valued the skills that I learned in these settings: skills of friendship, of co-operation and of working together. Sue Jennings writes: Being in a play is one of the greatest social skills of all time because, in the end, there has to be cooperation in order for the production to happen, and there has to be awareness of the skills and necessity of other people and their roles. (Jennings 1998, p.74)

Certainly, as a dramatherapist working with children, I have seen how shared drama activities in a group can invite experiences of validation and friendship. For some children this might be their first-ever experience of feeling valuable. The opportunity to be part of something and integral to its success helps children combat feelings of social isolation and worth-

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lessness. Through their experience of collaborative creation they are able to construct a new identity. When I arrived in Montreal to start a new job – teaching dramatherapy at Concordia University – and a new life, I too was vulnerable to feelings of isolation. I knew that I had to find community in order to survive. The first community I found was the narrative therapy community in Evanston, Illinois. I had already been introduced to social constructionist ideas by Ann Cattanach, who supervised my dramatherapy practice in England. The ideas intrigued me enough to make the trip from Montreal to Chicago every month during my first year in Montreal. What I didn’t anticipate at that time was the principal role that community plays in narrative therapy practices. Their use of reflecting teams as an aid to story co-construction has effected a shift in their work from private to social arenas. As Tom Andersen explains: What was once a very individual process has become increasingly a back-and-forth community process. A model of therapy that upholds the therapist’s sole expertise can often be a very isolating and individual experience. These ways of reflecting have moved us more towards community ways of working. (Andersen 1999, pp.8–9)

Dramatherapy has always been principally a group process. Its roots are in theatre and drama. As Madeleine Anderson-Warren and Roger Grainger explain in their inspirational book, Practical Approaches to Dramatherapy. The Shield of Perseus, even if carried out one-to-one, drama is capable ‘of inventing other members of the cast who are able, although invisible and inaudible, to take on roles as extra members of the group’ (2000, p.20). Both dramatherapy and narrative therapy share an understanding of the integral roles that community and relationship play in the promotion of health and well-being. Both have provided inspiration for the project that I shall describe in this chapter. The Biography Laboratory project was born out of a curiosity to explore and develop further the connections between these two, equally innovative, approaches to therapy. Before I describe the project, I shall first introduce narrative therapy and dramatherapy practices of co-construction and co-creation.

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From narrative co-construction to dramatic co-creation The narrative therapy world view rests on a belief that people are not their problems (White and Epston 1990); that a problem story is just one out of many possible narratives we might choose to represent our lives. Narrative therapists believe instead that people are ‘multi-storied’ and that the stories we choose to tell about our lives profoundly influence how we live. Michael White and David Epston, in Narrative Means to Therapeutic Ends, propose that people seek therapy ‘when the narratives in which they are “storying” their experience, and/or in which they are having their experience “storied” by others, do not sufficiently represent their lived experience’ (1990, p.14). To help people ‘re-story’ their experience in preferred ways, narrative therapists use conversation and written documents. When an individual or family arrives with a problem story, our objective is to construct an alternative story, or counterplot, of that person’s or family’s life. This will be a story that generates new relationships with problems and promotes preferred ways of living and relating (Freedman and Combs 1996). These alternative stories are not necessarily waiting to be told. Very often they need to be constructed from something discovered and frequently involve reclaiming vital aspects of lived experience that lie neglected or forgotten outside the problematic story (White and Epston 1990). To this end, narrative interviews are composed of questions inviting a person to think outside the way they might normally think. The questions and responses together co-construct an alternative story. As such, they ‘are a tool of collaboration’ (Schneider 1998, p.423). Amy, whose story I shall present, described her experience in this way: ‘As you were asking me questions, I was choosing from the images in my imagination. Your questions helped me decide where I needed to go, the next step in my story.’ In the Biography Laboratory we are interested in alternative stories: stories which may have been forgotten or dismissed; stories about which we can feel proud because they tell of preferred ways of living and being in the world; stories that give purpose and meaning to our lives. Our story creation process is inspired by narrative therapy re-authoring practices. Our intention, however, is to take the work in a rather different direction. The Biography Laboratory project’s long-term goal is to provide people

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from marginalised social groups with the opportunity to dramatise preferred stories of self within the framework of theatre art; literally ‘entering into stories, taking them over and making them their own’ (White and Epston 1990, p.13). One notable difference between dramatherapy and narrative therapy is their choice of storytelling media. Whilst narrative therapy uses conversation and written documents to co-construct preferred outcomes, dramatherapy uses drama and theatre processes to bring about change. A dramatherapist’s trust in the creative process to transform experience and open up new possibilities is similar to the narrative therapy belief that people are ‘multi-storied’ (Schneider 1998, pp.426–7). Both reflect a faith in people and their resourcefulness. Both promote a decentering of the therapist’s role. Marina Jenkyns writes about her role as dramatherapist: ‘The journey is not for me to determine – rather I provide the means of transport’(1996, p.60). Before I describe ‘the means’ or media of the Biography Laboratory, I will first briefly explain ‘the journey’ of dramatherapy. In dramatherapy literature the metaphor of a journey is frequently used to describe our work. We leave what is recognisable, our everyday reality, and enter into dramatic reality. It is within dramatic reality that alternatives are explored and new meanings discovered. As such, dramatherapy offers ‘a highly specialised form of structured creativity’ which enables a process of transformation to take place (Jennings 1998, p.75). Transformation lies at the heart of theatre and we borrow extensively from theatre art to facilitate a similar process in our work. The means of transport then are those focused dramatic and theatre processes which foster a creative response to life: the dramatic body, dramatic projection, play, role, symbol, metaphor and ritual (Jones 1996). The Biography Laboratory’s objective is to expand people’s storytelling options beyond words. To this end, we are exploring alternative non-verbal and symbolic languages of gesture, image and prop. Our intention is to experiment with various expressive forms and media, testing for the inherent opportunities within each language to transform our stories. Here members of the Biography Laboratory discuss some of the possibilities of expression, feeling and association that have arisen out of our work with movement and fabric:

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Susan: There are so many possibilities…the fabric allows me to be bigger and to flap my wings, it enhances, it hides, it becomes a shelter, it protects. Amy:

It’s like the imagination is no longer locked away in your head … it flows through your whole body and out through your hands. In your mind you can think ‘I wish I was floating on the wind right now’, but when you have the scarf…you are floating on the wind!

Susan: The imagination just seeps through all your body…into your feet and your toes! And the movement connects everything.

In dramatherapy ‘being creative means setting out to discover meaning in things’ (Anderson-Warren and Grainger 2000, p.141). In the Biography Laboratory project, being co-creative means setting out to discover meaning together. We combine narrative therapy’s practices of co-construction with dramatherapy’s focused application of symbolic and dramatic media. We are playing. We are using imagination and our bodies to create meaning. We are dramatising our stories in community.

From creation to performance As I have already mentioned, community features prominently in narrative therapy re-authoring practices. Narrative therapists, wherever possible, identify and recruit communities of concern to participate as audience to ‘the preferred developments of people’s lives’ (White 1999, p.55). The idea behind ‘spreading the news’ (Freedman and Combs 1996) in this way is to support and strengthen a person’s alternative story by making it more widely available (White and Epston 1990). Freedman and Combs alert us to the susceptibility of new stories being obscured by problem-saturated stories: How persistent problematic stories can be. People have usually been living them for a long time. Often their local culture includes attitudes and practices that support the problem-saturated story. It is not at all unusual for an alternative story to fade between therapy conversations. (Freedman and Combs 1996, p.195)

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Their chapter ‘Spreading the News’ (1996) offers suggestions on how to keep these alternative stories alive: inviting an audience to therapy meetings; teams; reflecting processes; circulating the story through tapes, letters, documents and ceremonies, and leagues. Theatre is not mentioned. Yet Freedman and Combs preface their chapter with a quotation from Victor Turner that caught my attention: ‘The hard-won meanings should be said, painted, danced, dramatised, put into circulation’ (1996, p.37). The rhythmic call of Turner reads almost like an invocation and certainly an invitation to celebrate in community. His words warmly resonate with my perception of the role that theatre might play in ‘spreading the news’. Theatre offers an opportunity not simply to share the news, but to artistically frame and dramatise it: to add colour and image, movement and song; to present the news in three glorious dimensions; to make a spectacle of and truly celebrate our creativity and our lives. The Biography Laboratory project will make available the theatre art skills, media and technical support that are necessary for the creation and dramatic performance of alternative stories in community. One aspect of our work will be to teach applicable skills for people to be able to engage playfully and creatively with their lives. In this way we are also inviting people to become artists reflecting on their lives. The Biography Laboratory project’s title denotes a multi-storied perspective: ‘this is a story about me’, a ‘biography’. It also signals an invitation for the storyteller to step back from their life and view their experience with dramatic distance; to create their preferred story with the vision and licence of a dramatist. Essentially the Biography Laboratory project is an invitation for people who might not readily describe themselves as artists to try ‘the artist’s way’ in life (Cattanach 1992, p.10). My own experience in community theatre projects and my observation of children participating in dramatherapy groups has shown me just how validating it can be to witness our own artistry: the choices we make as we devise, stage and perform our stories. Phil Jones (1996) suggests this is due, in part, to a transformation of identity: ‘the artist in the client is foregrounded within dramatherapy. The creation of dramatic products, the involvement in dramatic process, can bring together a combination of thinking, feeling

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and creativity’ (p.121). This has transformative potential in the way an individual apprehends and responds to themselves and their world. I have always marvelled at the way writers and painters are able to transform their lives into art. It seems to me such an advantage to be able to step back, through narrative or aesthetic distance, and playfully engage with the sense and nonsense of it all, creating meaning, story line, image and form out of chaos. I believe we can all benefit from trying the artist’s way. My motivation in the Biography Laboratory project is to share these skills of co-construction and co-creation with a larger public. Eventually I intend to move the process out of the therapeutic milieu altogether, but for now it is a work in progress.

The Biography Laboratory project: our work in progress Our present goal in the Biography Laboratory is to explore story creation. I am guided by a call from Gene Combs, one of my narrative therapy trainers, to try ‘to create the kind of space within which a person can feel proud not just to tell, but to make a story’. I shall now describe some of the elements that contribute to this kind of space in the Biography Laboratory project. We work in a group: six women of different ages, cultures and backgrounds. We are involved in action research together. Our focus is to explore how dramatherapy and narrative therapy might usefully connect to promote a legitimate space for the creation and performance of preferred stories. The research project is collaborative in its design. Many conversations and shared enactments have contributed to this work in progress. We frequently sit in a circle, discussing our process and how we experience it. We pool our different points of view. As such the project reflects in its methodology some of the values it embraces. We are co-researching, co-imagining, co-creating and co-constructing meaning in community. To further this active dialogue I make regular visits to Evanston Family Therapy Center, Evanston, Illinois. EFTC is run by Jill Freedman and Gene Combs, co-authors of Narrative Therapy. The Social Construction of Preferred Realities (1996). The meetings are designed for a small group of practising narrative therapists to explore and develop new projects and

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practice. In this setting I present the Biography Laboratory project descriptively or through video recordings to further the interdisciplinary exchange. What is so fascinating to me as I sift through the many tape and video recordings of shared conversations in Montreal and Evanston – evidence of our efforts to reflect upon, identify and articulate this common endeavour – is just how multi-voiced this project has become. The Biography Laboratory project is a co-creation that reflects openness, transparency, multiple viewpoints and a decentering of my role (Freedman and Combs 1996, p.284). As I write this chapter I am interweaving their voices with my own, attempting to capture the rich layering of perspective and experience so generously shared in community. We meet fortnightly in the dramatherapy studio at Concordia University in down town Montreal. When our focus is story creation, we work with a number of dramatic and narrative structures adapted to our setting and designed to support the storyteller in the creation of their story. Each week one team member will self-select to work on a story or theme of their choice. The remaining team members become an audience to her story as well as supportive and active participants in its co-creation. We have named this group role the chorus. Certain guidelines are followed by the chorus to ensure that the story is witnessed, acknowledged and enriched as the storyteller moves through the different stages of story creation. These guidelines are inspired, in part, by narrative therapy’s purposeful use of community groups as an aid to story co-construction. Michael White has named this community approach ‘the metaphor of definitional ceremony’ (1995, 1997, 1999). The definitional ceremony opens with a consultation between an individual or family and narrative therapist, witnessed by a reflecting team. Following this conversation, the individual or family and reflecting team switch roles. The individual or family assumes the audience position as the reflecting team engages each other in conversation about what was heard and about their responses to what was heard: ‘In these retellings, the stories of the lives of the people who are at the centre of the definitional ceremony are frequently linked to the

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stories of the lives of others around shared themes, purposes, commitments and values’ (White 1999, p.63). The individual or family then share their responses to this ‘retelling’ in further conversation with the narrative therapist. This ‘back-and-forth community process’ (Anderson 1999, pp.8–9) is designed to achieve multilayered tellings and retellings of the stories of people’s lives. In this way identity moves from being single-voiced to multi-voiced and stories from being ‘thinly’ to ‘thickly’ or ‘richly’ described (White 1997, p.4). Many dramatherapists use a similar structure in their work. Audience and enactment areas are clearly marked within the dramatherapy space and this delineation of space and role enables the process of creation to take place optimally and safely (Anderson-Warren and Grainger 2000; Jennings 1998; Jones 1996). What distinguishes both approaches from the theatre structures they resemble is the influential role played by reflecting team or dramatherapy group members in the storyteller’s unfolding narrative. Like the chorus in ancient Greek theatre, the Biography Laboratory chorus is both inside and outside the developing drama. They witness the story, they mirror the story, they engage with and eventually join and extend the story. They remain decentred yet influential (White 2000, personal communication). The chorus structure and guidelines are designed to promote practices of acknowledgement and validation in our work. Everyone’s role in this shared process is valued and acknowledged. We have been working with fabric and movement as an alternative to verbal conversation in story creation. We begin our meetings with a warm-up that is designed to offer participants an alternative language which may encourage them to create and present their story in a different way. It also serves, quite literally, to warm-up the body, voice and imagination in preparation for the drama. I introduce a number of structured exercises designed to foster a playful and expressive relationship between the participants and the fabric. During the warm-up the Biography Laboratory participants begin to engage with personal stories and memories. We have a rich supply of fabrics and have discovered that the colours, textures, sounds and smells all evoke strong memories. The transformation of thought, image and memory into dramatic reality begins even as the participants survey their choice.

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Following the warm-up a group member will select themselves for the story-creation process. The remaining team members take their seats as audience to her story. The storyteller chooses the fabric she intends to work with and, as facilitator, I join her in the enactment space. Amy shared this story on 13 February 2001. I shall begin with a simple description. I am greatly helped by a video recording of our work that day. Even so, I cannot hope to capture the full, rich impact of her exploration through body, motion, gesture and coloured fabric. As far as possible I am using Amy’s own choice of words as I narrate her story. Amy wraps several layers of fabric around her, one red, one khaki. I invite her to show me rather than tell me where her story begins (Wharam 1992). She places a large piece of floral fabric on the studio floor, kneels at its centre and wraps another, brightly coloured, embroidered square of fabric over her head like a scarf, covering her face. My curiosity prompts me to ask ‘Where is she?’ ‘Who is she?’ Amy tells me that she is in the Appallacian Mountains in North Carolina. It’s really early, the sun is just coming up. She’s in a field surrounded by members of her family: her grandmother’s grandmother, her grandmother’s child, her grandmother’s mother, cousins. She explains that there is movement in the scene. She carefully ties the scarf under her chin, picks up the fabric used to represent the field and pulls it with effort over her shoulder, stretching her body forwards. She identifies this movement as ‘holding on’ and shares that it stirs up feelings of sadness in her. She mentions that the movement belongs to the women in her story. I ask if there is a sound to accompany the movement. Amy begins to sing as she moves: ‘Swing low sweet chariot, mumma’s gonna carry you home, swing low sweet chariot…’ Amy’s story opens with a scene from her imagination. The women she represents go back three generations in time. She knows very little about them. I am reminded of a quotation from Narrative Means to Therapeutic Ends: ‘Stories are full of gaps which persons must fill in order for the story to be performed. These gaps recruit the lived experience and the imagination of persons’ (White and Epston 1990, p.13). Together, Amy and I embark on ‘an imaginative reconstruction of experience’ (Anderson-Warren and Grainger 2000, p.54).

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This is the setting for the story she would like to share. The story is about Camouflage and Conspiracy and about not being seen or heard. I sense the voice of Aloneness as Amy speaks about Camouflage. Yet I wonder about the field of women. I am curious to explore Amy’s connection with these women. As she creates her story, as she purposefully steps from behind the Camouflage to share with us, I ask how the women in the field might respond. Amy kneels on the flowered square of fabric and holds a piece of blue lace to her cheek. She explains that her ancestors would cry, but in a strong way, still holding on to their rage. She identifies this feeling as familiar to her. It reminds her of her work with young people as a practising dramatherapist: ‘I feel like when I sit and listen to a young person I’m working with and they speak about injustices and they share their anger and their pain’. I wonder if in her story Amy’s pain and anger are being witnessed, in a similar way, by the past generations of women in her family. ‘Just now,’ she answers. As I am collaborating with Amy it is helpful for me to focus on the idea of story as progression (Anderson-Warren and Grainger 2000; Gersie 1990). I retell the story back to Amy purposefully arranging the images she presented into a storyline. The story opens with a lineage of women from Amy’s family sitting in a field together; and what they all share is the knowledge of ‘holding on’ in sadness. Amy’s role in this story is to uncover the rage, pain and sorrow that is hidden by so much camouflage. As she does this the women watch her and feel pride. I ask Amy to show me an image of this pride. She stands in the field, holding a bundle of voiles and lace knotted together in one hand, and motions with her other arm. I ask what the movement signifies. She repeats it and adds, ‘You’re not alone.’ She explains that in the bundle the women are carrying their sadness and their hope, their happiness and their rage and that the bundle is now a part of them, it’s no longer a burden. Amy titles her story: ‘Amy’s Throwing the Doors Wide Open. Not Fearing to Feel’. Following the enactment the Biography Laboratory team members move from their audience role to their chorus role to engage in a movement reflecting team process using the fabric. I invite Amy to choose an image from this re-enactment that holds meaning for her and to give it a title. Amy chooses the title ‘Connectedness’.

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I interviewed Amy, as part of the research process, on two different occasions following her enactment. During these interviews Amy spoke about her experience of story co-creation. She described the flood of images that pressed for her attention at the beginning of her enactment: ‘I’m not a visual artist, so I was surprised how visually things were coming to me. I had to decide which images to choose, what perspective I was going to take. It was just too difficult to put into words. I couldn’t find the right words, but I could see it and so physicalise it.’ Amy chose to create and communicate her story through the metaphor of movement. Her story in fact evolved as a succession of movement images: I really like the idea of staying in the metaphor of the movement. I loved when you asked about what I was doing physically. ‘I’m curious about that bundle…’ or ‘As you were moving I noticed you did this…’ Because it felt like you were really seeing me. You were even seeing the things that I wasn’t seeing. These movements held no meaning for me until you brought them to my attention.

During the warm-up, enactment and chorus sequences I will frequently invite participants to choose a movement image or sculpt from their movement with fabric exploration and to name it. Madeleine Anderson-Warren and Roger Grainger identify the first step in this process as a first step towards creating meaning: ‘Sculpts are never used in a static way but always as part of a process, as unspoken words in sentences where final meaning has not yet been fixed’ (2000, p.84). It is as if the movement offers a root metaphor signalling the body’s ‘intentionality as a striving for meaning’ (Srivasta and Barret 1988, p.47). Amy moved her arm as she stood in a field, representing her ancestors and feeling pride. Her gesture moved the story along. The next step towards creating meaning is to ask her to name the movement image or sculpt she has chosen. In this way, the body and mind engage together in discovery (Jones 1996, p.113). In the Biography Laboratory naming serves two purposes. It begins to shape the story, clarifying and concretising something that can seem quite chaotic, and it enables myself and the other participants to follow. This is especially important when the story is non-verbal. Gesture and symbol invite multifold interpretations. Naming guarantees the story-

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teller’s place, centre stage, in their unfolding story and, in this way, ensures that they remain ‘the primary interpreter(s) of their own experience’ (Freedman and Combs 1996, p.45). Amy and I also discussed the direction that her story took and the role that the movement, her imagination and my collaboration played in shifting it from a problem story to an alternative story; how in fact the prepared story that Amy had intended to tell about Camouflage turned about to become a story she was creating about Connectedness: ‘In the beginning of the process I felt I was alone and carrying lots of camouflage, my own and for all these women and I didn’t know how to take the camouflage off and make the connection. I wanted to, but I felt stuck.’ Amy explained that her thinking was shut down to a certain extent and that her kinesthetic and sensory experience assisted her to imagine outside the way she might normally think. As she physically encountered her desire for connection through the enactment, she was able to forge a creative response to her story (Anderson-Warren and Grainger 2000, p.53). Phil Jones describes the dramatic body as ‘a place where imagination and reality meet’ (1996, p.150). This facilitated another meeting between Amy’s ancestors and herself. ‘Questions are informed by particular ways of thinking’ (Morgan 1999, p.203) and my curiosity was prompting me to search with Amy for this alternative story. We didn’t go the route of the Camouflage, the route of the problem. I asked Amy what happened to the camouflage along the route that we chose: ‘It just sort of disintegrated. It became the new story, this story, Amy Throws the Doors Wide Open. Not Fearing to Feel, is the story of the disintegration of the camouflage.’ In other words, the problem story got smaller as the alternative story got bigger. The idea of Aloneness, of not being seen or understood, shrank as it made way for the idea that these women were connected to Amy and witnessing her story. In Amy’s own words: The second story was about my imagination and my connections with these women… In the story I felt they were witnessing me as me, and accepting my story. They were accepting my story of camouflage and pain, and in accepting that story, it changed, became a different story. It was no longer about camouflage it was about them and about my no longer being isolated.

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Remembering The Biography Laboratory project has engaged us in a process of remembering. We’ve remembered how we used to play with fabric as children, making tents and forts out of blankets, sheets and clothes pegs. We’ve remembered our grandmothers: the quilts they made for us and how they taught us to crochet and to sew. We’ve remembered dressing up. We’ve remembered the clothes we wore as children. We’ve remembered jumping on the bed. We’ve remembered playing and laughing with siblings and with neighbours. As one participant explained, the work we share has ‘connected me to memories of things I had forgotten about…and those memories are enriching the relationships I have now as an adult’. It is my impression that a lot of women’s experience lies hidden and unstoried. It is no surprise to me that Amy’s first story was about Camouflage, which disconnects. Remembering, in our experience, reconnects us with our past and with others. The Biography Laboratory is taking a stand against some of the discourses that silence these alternative stories; discourses that ‘powerfully shape a person’s choices about what life events can be storied and how they can be storied’ (Freedman and Combs 1996, p.43). In our second interview I asked Amy about the Camouflage and the various disconnections in her story. In speaking about the Camouflage, Amy told the story of her early adolescence. She described the social pressures on young girls at that time to hide early experiences of sexuality, even if these involved transgressions against them: Well it’s definitely a message about women and womens’ bodies that pervades in our society. The classic ‘if you’re wearing a short skirt you’re asking for it’, ‘if you get into a car with an older boy you’re asking for it’. The girl is being precocious, the girl is being a slut or a whore, as opposed to the boy being manly. It was always the girl’s fault.

Amy explained that she learned early on to cover up what happened to her as a young girl. She did not think she would be believed so she began to hide her past and her history: who she was, where she came from and

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what she had experienced: ‘The camouflage was primarily my perceived inability to show the world “the real me”.’ I also wondered about the women in her story from generations past and how it came about that so few of their stories had been passed on. Amy thought for a bit and suggested that in the USA there was a general feeling of: ‘We’ve arrived here from elsewhere to make a better life and to provide for future generations to come, why look back.’ She explained that as a child she’d made up these women in her head, based on the few images she had. In her story she had connected with ‘their movement and their carrying things and the movement of pulling something over my shoulder… When I was experiencing that it was very representative of the Trail of Tears which is the trail that went from North Carolina to the Indian reservations in south western United States.’ These women were the original pioneers. They were on the field, they were living off the land. Amy was looking for an audience who would be sensitive to her own pioneering qualities and her determination to show who she really was to the world. She was looking for role models to help her understand her own choices in life. She chose to look back and in doing so was able to experience a commonality with these women who had survived displacement and war. She felt a connection with their ability to adjust and survive. I am reminded of a quotation from Dorothy Allison’s Two or Three Things I Know for Sure; Allison grew up in South Carolina: ‘Two or three things I know for sure, and one of them is just this – if we cannot name our own we are cut off at the root, our hold on our lives as fragile as seed in a wind’ (1996, p.12). Amy explained the effect of telling this story on her current life was to feel richer as a person. It also solidified her resolve not to let her mother’s or her grandmother’s stories slide. She told me that her family were working on her family tree. She explained that family trees are traced through the patriarchal line of the family and that her contribution was to attend to the matriarchal side of things: I recently got my grandmother’s old wooden recipe box and pulled out recipes that were so old and crumbling, I don’t even know how they were still bound by the fibers of the paper, and I made photocopies of all of them and have passed them down to family members.

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Those recipes didn’t just come from her, but from her mother or her cousin, from all of these different people.

I asked Amy about her great great grandchildren and wondered how they might remember their great great grandma Amy, what qualities did she think they would identify in her? She answered: ‘An Adventurer; a Stoic Pioneer; Alive.’

The role of community in co-creation I’ve heard it said that if Michael White could rename narrative therapy he would call it Connecting People Therapy. Certainly this has been my experience in the Biography Laboratory project. The progression in Amy’s story towards community mirrors a similar progression in many of the tellings and retellings I have witnessed and been a part of. Stories become multi-voiced as we remember. In fact, the word remembering refers to a special type of recollection. Inspired by the work of Barbara Myerhoff, White uses it to mean ‘Re-membering’ in the sense of reuniting with the members of our lives, our ‘own prior selves, as well as significant others who are part of the story’ (Myerhoff quoted in White 1999, p.66). In narrative therapy and in the Biography Laboratory this ‘re-membering’ takes place in community. Amy’s ancestors became her audience, as we too, the women in the Biography Laboratory, were audience to her enactment, assisting in the ‘telling’ and ‘re-tellings’ of her remembering. Concurrently this ‘re-membering’ fosters community. Over and again we’ve been struck by the similarities in our stories: shared themes of family history, womanhood and the social discourses that affect our lives, ourselves and our bodies. What distinguishes the Biography Laboratory approach to story creation from narrative therapy community practices is the extended nature of our collaboration. In the Biography Laboratory, because we are enacting rather than telling, there is an opportunity for the storyteller not simply to remember, but to remember and relive (Anderson-Warren and Grainger 2000, p.227). When the chorus joined Amy in her story, she was able to re-enact with them the story’s resolution. The team became the women in Amy’s story. They embodied the expressions and gestures

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that Amy had imagined and performed. In this way Amy was able to experience a dramatic ‘re-membering’ of her ancestors in her life, and an embodied acknowledgement by them of the story she had shared. This ability ‘to co-imagine with other people so that we create a shared scenario’ is unique to dramatherapy. As Madelaine Anderson-Warren and Roger Grainger explain, co-creation in dramatherapy ‘introduces us to a way of knowing in which we experience life by participating in it, rather than just thinking about it’ (2000, p.224). In the Biography Laboratory project our participation is twofold. The chorus team has a dual role in the story-creation process. They become the actors in the drama and they are collaborators in its creation. Our search for similar models of co-creation has elicited childhood memories of shared pretend play. The dual participatory role of complementary actors involved in mutual exploration is reminiscent of the way children play together and make meaning through their play. Marie-France shared this story of playing with friends during her childhood: As a child, in the summer, I’d find all my summer friends and there was this wood at the back of the house where no one was allowed to go, and we were so sure that witches lived there, in the trees. It was like this real big story. I remember how we loved to scare ourselves! We’d come back from the beach at six or seven o’clock when the sun is starting to go down a little bit and the shadows start to elongate… Now that is co-creating something!

As child psychologist Judy Dunn (1988) explains, joint pretend play requires an ability to co-operate and co-ordinate towards a common goal. She recognises this ability, even in very young children of 2 and 3 years old, to stem from the equal power relations that are implicit when children interact with other children. As I prepared to write about the Biography Laboratory project, I invited the team to share some of their stories and ideas about shared creativity. We met in our usual space and warmed up with the movement and fabric in our usual way. What followed was a shared conversation during which we gleaned some of the skills and circumstances that promote experiences of co-creation:

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a willingness to share the creation of something

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knowing that your contribution will be valued

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an absence of judgement

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flexibility and compromise

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letting ‘it’ grow, ‘going with it’.

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Leigh spoke about her experience in this way: I found when we were kids that there were bossy kids and kids that wanted to control, and that that’s part of it. Part of co-creating is interaction and I think there were times when things just blended well, and that was a good day! Sometimes we didn’t know how to play … When it didn’t work it was very painful. I remember I’d take my toys, ‘it’s over, today it’s not working!’ and you’d realise how important it was: it wasn’t about playing, it was about playing with that person.

We have found in our work together that a large part of our enjoyment comes from the connectedness we experience as we co-create meaning together. Connecting with each other helps us to connect with ourselves. As memories spark other memories, so playful interaction extends the dramatisation of our stories. In the acting community the golden rule of improvisation is to say ‘yes’ to the ideas of our co-actors. In this way, scenes, stories and entire worlds come into being. One Biography Laboratory member explained it this way: ‘In play the power is playful, it’s not a control thing. Power’s exchanged.’ As adults, the value we place on competition has made it difficult for us to collaborate in joint activities (Wheelan 1994), or be willing to share in the creation of something as equal partners. These skills acquired in community are easily passed over in a culture that prioritises individual achievement, professional expertise and hierarchy. As Susan Wheelan explains: Common sayings such as ‘I am the captain of my own ship,’ and ‘Do your own thing’ attest to our favoring the individual over the group or society. While there are many positive outcomes from such a world view, including the protection of individual rights, this

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emphasis also makes it difficult for us to see our interconnectedness. (Wheelan 1994, p.42)

My involvement with the Biography Laboratory project has reconnected me with values that I hold dear. It has inspired me to remember other occasions when co-creation in community played a part in my life, memories that help connect me to a preferred story and a preferred self; from the time when I was 8 years old and my mother organised a joint family and friends puppet production of Hansel and Gretel, to the various community theatre projects I have been a part of. These have been the happiest and richest times of my life. The Biography Laboratory project is another such venture, contributing to the alternative story line of my life. As we share our stories and reflections in co-research, we are contributing to the ideas that are helping to build the Biography Laboratory project. As we combine our personal and professional lives in this way, we are also contributing to the richness of our lives and relationships outside the Biography Laboratory. We are choosing more and more to become co-creators in our personal and professional lives. Amy and Susan ended our conversation about co-creation in this way: Amy:

I feel camaraderie with the group, and it’s like sharing these stories and remembering these stories with the group really concretises them. It changes from being an alternative story to being my story. It switches in the sharing.

Susan: That’s what I find too. I find it’s so much more real for me. Sharing memories today has been like connecting to everyone and sharing in the richness and it does make my alternative story just the story. It feels like the more important part of the story.

Acknowledgements The co-researchers in the Biography Laboratory project are Leigh Bulmer, Marie-France Gauthier, Csilla Przibislawsky, Amy Thomas and Susan Ward. The project is funded by a Concordia University Faculty Research Development Progam Grant.

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References

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Allison, D. (1996) Two or Three Things I Know for Sure. New York: Plume. Andersen, T. (1999) ‘The reversal of light and sound: from an interview with Tom Andersen.’ Gecko 2, 5–9. Anderson-Warren, M. and Grainger, R. (2000) Practical Approaches to Dramatherapy: The Shield of Perseus. London: Jessica Kingsley Publishers. Cattanach, A. (1992) Drama for People with Special Needs. London: A&C Black. Dunn, J. (1988) The Beginnings of Social Understanding. Oxford: Blackwell. Freedman, J. and Combs, G. (1996) Narrative Therapy: The Social Construction of Preferred Realities. New York: Norton. Gersie, A. and King, N. (1990) Storymaking in Education and Therapy. London: Jessica Kingsley Publishers. Jenkyns, M. (1996) The Play’s the Thing: Exploring Text in Drama and Therapy. London: Routledge. Jennings, S. (1998) Introduction to Dramatherapy: Theatre and Healing – Ariadne’s Ball of Thread. London: Jessica Kingsley Publishers. Jones, P. (1996) Drama As Therapy. Theatre as Living. London: Routledge. Meldrum, B. (1994) ‘Historical background and overview of dramatherapy.’ In S. Jennings, A. Cattanach, S. Mitchell, A. Chesner and B. Meldrum (eds) The Handbook of Dramatherapy. London: Routledge. Morgan, A. (1999) ‘Practice notes: introducing narrative ways of working.’ In Extending Narrative Therapy: A Collection of Practice-based Papers. Adelaide: Dulwich Centre Publications. Schneider, M.F. (1998) ‘A narrative dialogue: an interview with Jill Freedman and Gene Combs.’ Journal of Individual Psychology 54, 4, 416–430. Srivasta, S. and Barret, F. (1988) ‘The transforming nature of metaphors in group development: a study in group theory.’ Human Relations 41, 1, 31–64. Wharam, T. (1992) ‘The building blocks of dramatherapy.’ In S. Jennings (ed) Dramatherapy. Theory and Practice 2. London: Routledge. Wheelan, S.A. (1994) Group Processes: A Developmental Perspective. Massachusetts: Allyn and Bacon. White, M. (1995) Re-authoring Lives: Interviews and Essays. Adelaide: Dulwich Centre Publications. White, M. (1997) Narratives of Therapists’ Lives. Adelaide: Dulwich Centre Publications. White, M. (1999) ‘Reflecting team work as definitional ceremony revisited.’ Gecko 2, 55–82. White, M. and Epston, D. (1990) Narrative Means to Therapeutic Ends. New York: Norton.

Contributors

Sue Allanson has been working therapeutically with abused children for the past ten years both with statutory and voluntary agencies. She set up a therapy centre for children in Leeds under the auspice of FSU and currently works for NSPCC as a play therapist trainer and consultant. Whilst undertaking the MA course in play therapy at Roehampton Institute she became interested in using stories as part of the therapeutic process. She is also a sculptor and enjoys the process of image making for herself. Ann Cattanach is a play therapist and dramatherapist and has an MSc in Developmental Medicine and a PhD for Play Therapy research. She has worked in schools, institutes of higher education and universities in the UK, Singapore, Malaysia, and the Netherlands. Ann has been a childcare consultant therapist for Hammersmith and Fulham Social Services and Harrow Community NHS Trust and developed the first MA programmes in Play Therapy in the UK. She is now a freelance consultant therapist. Sally Hanson is a qualified play therapist and is currently completing an MA at the Roehampton Institute. She has worked with children for over 25 years, where much of her involvement has been with children who have experienced emotional and behavioural difficulties. She now works as a freelance play therapist for voluntary and statutory services and also provides creative workshops and training about play for a small charity she co-founded in North Wales. Sheila Hudd has a BSc (Hons) in Psychology, MSC (Econs), DIPSW, Cert. Couples and Family Therapy and a Post Graduate Diploma and MA in Play Therapy. She has worked as a part-time lecturer in Psychology and as a researcher in the fields of social and medical research and has published and presented her research in these areas. Sheila’s experience with children and families includes working in a Family Assessment and Treatment Centre. She is currently employed as a play therapist in a Child Adolescent and Family Mental Health Clinic in London. She also works on a project supporting the mental health needs of 231

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looked after children. Her area of special interest continues to be early parent–child interaction and all aspects of child development. Alison Kelly has a background in special education, having qualified in 1985 as a drama and movement therapist at The Central School of Speech and Drama in London. She also has an MA in Play Therapy from Roehampton. She currently works as a state-registered dramatherapist for Croydon Educational Psychology Service, working with children and young people who have emotional and behavioural difficulties and also has a private practice as a dramatherapist and registered supervisor. David Le Vay has experience as both social worker and therapist working with children and families within a child protection context. His work as a play therapist has focused on children who have experienced significant loss, trauma and abuse. He is a full member of the British Association of Play Therapy and sits on their executive committee and is also a Visiting Lecturer on the Play Therapy Graduate Diploma at Surrey University, Roehampton. David currently works for ACT, an organisation which specialises in providing assessments and therapeutic support to children and young people who present with problematic and abusive sexual behaviour. Christine Novy began her career as a play and dramatherapist in London where she worked with children, adolescents and their families in a variety of settings. In 1997 she moved to Montreal, Canada to teach in the new Drama Therapy programme at Concordia University. There she is principal investigator for the Biography Laboratory, an action research project combining ideas and practices from dramatherapy and narrative therapy to further a new methodology of story co-creation and performance in therapy. Maureen Scott-Nash is a qualified social worker and play therapist and has spent much of her 20-year career working directly with children. The main area of her work has been in the field of adoption and fostering children with special needs. Since becoming a freelance play therapist Maureen has worked predominantly in the hospice movement where she has particular expertise in working with bereaved children and those living with a life threatening illness. Maureen also acts as an adviser to families and volunteers on all aspects of understanding the effects of these life-changing experiences for such children. Ruth Watson is an Australian who came to the UK in the late 1960s and fell in love with London. She has completed a BA degree in Sociology at LSE and has a CQSW and two Masters degrees – one in Deviance and Social Policy (1977) and the other in Play Therapy (1998). Ruth is both a practice teacher and the deputy director of Independent Adoption Service in Camberwell where, for many years, she has been working to find families for older children who have been damaged and hurt by their experiences. Ruth’s interest in play therapy arose when she was trying to find a better way of working with children and wanted to use something that would enable the children’s imagination and play to be utilised.

Subject Index abused children attachment styles 151, 173–4 common story themes and content 64, 172, 176 disclosure 193–4 narrative identity 36, 37–8, 54 stages in play therapy 92 stories and narratives 9, 42–9, 59–81, 196–205 adoption, and disclosure of abuse 193–4 adoption process, as a rite of passage 10, 83–102 background information 83–5 children in transition 85–9 play therapy 89–92 stage one: separation and loss 92–5 stage two: transition 95–6 stage three: incorporation 96–7 themes of therapy 97–9 Adult Assessment Interview 156 Ainu myth from Japan 14 Angus Og and the Birds (Scottish story) 206–7 antisocial behaviour 152 art, and ritual 87 assessment families 149–50, 152–5 through stories 64, 154–5 work with narrative and text 55 attachment 10–11, 79, 83, 149–85 and behaviour 152 case studies 158–79 family assessment 149–50, 152–5 study subjects 155–7 theory 150–1, 179 attention deficit and hyperactivity disorder 150 behaviour problems attachment and 152, 155, 156, 179–80 play therapy 30 bereavement, children’s experience 111, 117 Bergkamp, Dennis 142 Biography Laboratory 11, 209–29 the ‘artist’s way’ 213–14 co-creation in community 225–8 long-term goal 212–13

possibilities of expression 213–14 remembering/re-membering 223–5 work in progress 216–23 birth families 90 disclosure of abuse in 193 exploring contact problems 29–30 meeting birth mother 202–3 opposition to adoption 88–9 story of separation and loss 93–4 blood disorders 131 bodily functions, fascination for children 21–2 body image, children with cancer 129–30, 132–3 bone marrow aspiration biopsy 135–6 borderline personality disorder 150 brain, right hemisphere 63 Bring Me Four (Arab story) 191 candle ritual 88 care system 8, 11 imbalance of power 86 shortcomings 194–6 Centre for Crisis Management in Education 120 ‘Change’ (Carla) 195 Children’s Stories in Play Therapy (Cattanach) 196 clay 132–3 co-construction mother and infant 19 therapist and client 7–8, 36, 38, 40, 54–5, 64–5, 124, 188, 212 co-creation 214, 217 role of community 225–8 cognitive development, attachment and 151 community earliest memory 210 importance in narrative therapy 211, 214 role in co-creation 225–8 conduct disorder 150, 152 containment 86 in play with slime 28–30 control 52, 97–8 loss in leukaemia 136 through play with slime 27–8 ‘Damocles syndrome’ 123 death life-threatening illness 126–7, 146 as theme of child’s stories 92–3 see also trauma

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‘Deep Pond, The’ (Kate) 94 developmental psychology 153–4 Dinosaur and the Super Train, The (Daniel) 42–3 domestic violence 22, 24, 26, 27 dramatherapy co-creation 226 as group process 211 ‘the journey’ 213 value to children 210 dramatic play 96–7, 97–8 drawings and paintings 95–6, 99, 109–10, 162–3 self-portraits 8, 137–40 duality 50, 52, 55 ‘eco-map’ 141 Embodiment Play 19 enactment 109, 142–4, 219–20 endings, of child’s stories 79–80 Evanston Family Therapy Center, Illinois 216 fabric, use in Biography Laboratory 214, 218, 219, 223 fairy tales 63 families assessment 149–50, 152–5 attachment 10–11, 149–85 attitudes and responses to trauma 104, 110, 117 response to child’s leukaemia 126–7 transition to adoption 90–2 family therapy 36 family trees 224–5 Father and Mother Both Fast (Hillbilly story) 205 father–child relationship 180–1 fathers, unknown 204 fear, in child’s stories 79 fingerpaints 16–17, 30, 128, 165 ‘Flying Head, The’ 161 Foolish Man, Wise Man and the Jug, The (Sufi story) 189 football 141–4 foster care 11, 23, 29, 173, 193–6 abuse in 60, 193 transition to adoption 84–5 Founding of Tradition, The (Sufi story) 190 funerals, children and 110, 111, 112, 117–18 Gak 20 gold and glitter pens 99

group intervention 103, 104, 107–14 Hansel and Gretel (puppet play) 210 healing rituals 87 Herald of Free Enterprise disaster 115 hermeneutic circle/spiral 54–5, 64–5, 66 hermeneutics 40 Hickman line 128–30 Hungerford massacre 120 identity construction through drama 210 construction through messy play 10, 26, 31, 131 effect of repeated disclosure 194 safe exploration 188 threefold development 153 transformation through art 215–16 see also narrative identity; self infancy 19, 24, 152, 179 internal working models 153–4, 181 interpretation and exploring shared meaning 70 play with slime 26–7 Invitation to Social Construction, An (Gergen) 192 ‘Johnny’ (Carla) 201 joint pretend play 226–7 journeys dramatherapy 213 life 187 King’s Favourite, The 192–3 learning disability label 59 leukaemia 10, 123–48 and body image 129–30, 132–3 emotional/psychological impact 123, 126, 131–2 as enemy within 134 informing children 126–7 medical procedures 123–4, 135–6 ‘shared care’ system 125–6 life journeys 187 life story books 88 local authority care 41, 84, 90 see also foster care love hearts 95–6, 99 ‘Maori’ (Gersie) 33 messy play 8–9, 13–33, 165 metaphor 37, 39, 51, 56, 66, 139–40 story as a 105–7 Monsters in Sea World, The (Nicholas) 164

SUBJECT INDEX

Mother of the Sea Beasts, The (Netsilik story) 199–200 mother–child relationships 69, 79, 197, 199 attachment study 158, 168, 171, 174–5 infancy 19, 24 and narrative identity 9, 35, 41–2, 50–1, 53 mothers lost and loving 202–4 theme in child’s stories 98 movement, use in Biography Laboratory 214, 218, 219, 221 Munchausen syndrome by proxy 41, 55 mutual storytelling technique 64 My Dog Jeffrey (Kristen) 71 narrative compared with plot 193 compared with story 49–50 emergence through play 17 relationship with text 40 and stories of identity 125 ‘narrative configuration’ 39 narrative identity 9, 36–41, 51–6 definition 38 Narrative Means to Therapeutic Ends (White and Epston) 212, 219 narrative therapy creating alternative stories 154, 212–13 definitional ceremony 217–18 role of community 211, 214, 217 ‘spreading the news’ 214–15 Narrative Therapy (Freedman and Combs) 216 Narrow Road to the Deep North, The (Basho) 187 needs, in child’s stories 77 ‘Noel Edmonds TV Christmas Special’ 145 parents, attachment study attachment histories 150 case studies 158, 168, 170–1, 174–5 experience of abuse 157, 180 parenting styles 156, 157, 179–80 relationship difficulties 157, 180 Paul’s Elephant in a Bad Mood 172–3 People Who Hugged the Trees, The (story from India) 105–7 personhood, concept of 191–3 Peter Pan (Barrie) 204 ‘Pick-a-nose picks awful poem’ (Patten) 21

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play spaces 20, 89, 128 play therapy in adoption process 89–92 developmental model 15 in family assessment 152–5 reintegrating attachment 154, 181 social construction approach 86, 124–5, 152–3, 188–90 Play Therapy for Abused Children (Cattanach) 20 play worlds 15–18 playdoh 22–3, 31 post-traumatic stress 104, 108, 150 postmodern thought 36, 188 Practical Approaches to Dramatherapy (Anderson-Warren and Grainger) 211 psychic trauma 126 psychoanalytic model 64 racism 60, 194 ‘Reciprocated Love’ (Carla) 203 Records of a Weather Exposed Skeleton, The (Basho) 188 Red Stalk, The (Highlands spell) 208 ‘reflexive’ stance 36 Reindeer Alone on a Mountain, The (Nicholas) 160 relationships and birth of meaning 192 in child’s stories 77–9 parental difficulties 157, 180 see also father–child relationships; mother–child relationships rite of passage adoption process as 83–102 play therapy as 8 Rites of Passage (Van Gennep) 86–7 rituals 86–9, 91, 108 ‘Royle Family, The’ (TV programme) 193 sandtray play 68–9, 133–4 Scary Monster in Sea World, The (Nicholas) 161–2 Seaman, David 142 school behaviour problems 30, 155, 156, 180 trauma intervention 103–21 self attachment and 151, 181 as ongoing process 36, 38–9 physical 19, 25–6 social constructionalist stance 191 text analogy 39–41 see also identity

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THE STORY SO FAR

self-esteem 60, 92 self-perception 64 self-reflection 8 self-representation, attachment and 151, 181 sensory experiences, in child’s stories 79 sensory worlds 9, 19–24 sexual abuse 41, 53, 60, 66, 73, 90 six-part story structure 64 slime 9, 10, 13–33, 130–1, 136–7, 163–4 and beginnings 18 and being 30–3 containment 28–30 mastery and control 27–8 and nothingness 24–5 play worlds 15–18 sensory aspects 20–3 slime worlds 13–15 and somethingness 25–7 Slime 20 social construction approach 86, 124–5, 152–3, 188–90, 191–2, 211 social services 42, 193–4 Something Happened to Moesha (Lisa) 61–3 Spice Girls 96–7, 100–1 sticky toys 29 stories magic of 63–4 search for shared meaning 9, 59–81 ten years of 196–205 story compared with narrative 49–50 as a metaphor 105–7 as progression 220 story-creation process, Biography Laboratory 219–22 story stems 64, 154–5 children’s stories 142, 159, 165–6, 169–70, 171–2, 175–6 ‘storying’ experience 36, 37, 40, 146, 191–2, 212 text analogy 9, 39–41, 51, 55 limitations 56 theatre and ritual 87 ‘spreading the news’ 215 and transformation 213 therapist–client relationship co-construction 7–8, 36, 38, 40, 54–5, 64–5, 124, 188, 212 developmental model 15 sensitivity 7 social construction approach 86, 188

Tibetan Buddhism 39 transitional space 37–8 trauma 103–21 adult attitudes and responses 10, 103–4, 115–16, 117, 118–20 aftermath 114–16 follow-up work 116, 118–20 group intervention 107–14 school feedback 114 story as metaphor 105–7 Two or Three Things I Know for Sure (Allison) 224 uncontainment 51–2, 55 When the Dust Falls the Feathers will Settle (Carla) 198–9 Wild Leopard, The (Nicholas) 165–6 women’s experience 223–4 Zoë’s Story with Puppets 177–8 Zoë’s Story with Slime 178

Name Index Ainsworth, M. D. S., Belehar, M. C., Waters, W. and Wall, S. 151 Allison, D. 224 Andersen, T. 36, 211, 218 Anderson-Warren, M. and Grainger, R. 211, 214, 218, 219, 220, 221, 222, 225, 226 Ayalon, O. 107, 112–13, 119 Barrie, J. M. 204 Basho, M. 187, 188 Bettleheim, B. 63 Black, D. 110, 112 Bowlby, J. 83, 117, 150, 153 Bretherton, I. and Waters, E. 150, 151, 170 Bruner, J. 72 Buchsbaum, H. K. and Emde, R. N. 155 Buchsbaum, H., Toth, S., Clyman, R., Cicchetti, D. and Emde, R. 64, 71, 155 Burr, V. and Butt, T. 188–9 Capewell, E. 119–20 Cattanach, A. 15, 19, 20, 24, 92, 108, 124, 154, 161, 172, 178, 180, 196, 211, 215 Cole, B. 19 Combs, G. 216 Crittenden, P. M. 154 Cummings, E. M. and Cicchetti, D. 151

Furman, E. 114 Gardner, R. 64 Gergen, K. J. 191–2 Gersie, A. 33, 113 Gersie, A. and King, N. 220 Gill, A. A. 193 Greenberg, M. T., Speltz, M. L., De Klyen, M. and Endriga, M. 152 Hardy, B. 37 Harre, R. 41 Hodges, J. 76, 155 Hoffman, L. 36 Holmes, J. 156 Howe, D., Brandon, M., Hinings, D. and Schofield, G. 174 Jenkyns, M. 213 Jennings, S. 86, 87, 210, 213, 218 Jewitt, C. 88 Jones, P. 209, 213, 215–16, 218, 221, 222 Kobak, R. R. and Sceery, A. 151 Koocher, G. P. and O’Malley, J. E. 123 Lahad, M. 116 Lahad, M. and Cohen, A. 64 Lax, W. D. 38, 40 Le Guin, U. 35 Lendrum, S. and Syme, G. 109, 118 Lilleyman, J. S. 125, 130 Linesch, D. 54, 64–5, 70 Lyons-Ruth, K. 152

McCune, L., DiPane de Fireoved, R. and Fleck, M. 151 McMahon, L. 111 Main, M. 150 Main, M. and Hesse, P. 151 Eiser, C. 131 Main, M., Kaplan, N. and Cassidy, J. 152, Eiser, C. and Twamley, S. 126 170 Eldelman, M. 86 Main, M. and Solomon, J. 151 Erikson, H. 153 Malchiodi, C. 136, 141 Erikson, M., Korfmacher, J. and Egeland, B. Meins, E. 151 153 Moore, T. and Ucko, L. E. 155 Morgan, A. 222 Fahlberg, V. 79, 141 Myerhoff, B. 225 Fonagy, P. and Steel, M. 150 Fonagy, P. and Target, M. 150 Nezworski, T., Tollan, W. and Belsky, J. Frank, A. 124, 141, 147 179 Freedman, J. 216 Freedman, J. and Combs, G. 212, 214–15, Oaklander, V. 104 217, 222, 223 Derrida, J. 56 Dunn, J. 226 Dyregrov, A. 104, 107

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Oppenheim, D., Emde, R. N. and Warren, S. 151 Patten, B. 21 Piaget, J. 181 Polkinghorne, D. 39 Pynoos, R. S. and Eth, S. 176 Ricoeur, P. 38 Russell, R. and van den Broek, P. 181 Ryan, T. and Walker, R. 88 Sartre, J. P. 24 Schaffer, H. 181 Schneider, M. F. 212, 213 Shakespeare, W. 103 Sontag, S. 124 Sourkes, B. M. 126, 130, 137, 146 Spinetta, J. J. and Spinetta, D. 123 Srivasta, S. and Barret, F. 221 Sroufe, L. A. 150, 151 Terr, L. 126 Turner, V. 87, 215 Van Gennep, A. 86–7, 89, 92 Van Ijzendoorn, M. H. 152 Wharam, T. 219 Wheelan, S. A. 227–8 White, J. L., Mofit, T. E., Earls, E., Robins, L. and Silva, P. A. 176 White, M. 214, 217–18, 225 White, M. and Epston, D. 36, 39–40, 146, 154, 192, 212, 213, 214, 219 Winnicott, D. W. 131 Wood, D. 38 Yule, W. 115 Zalasiewics, J. and Freedman, K. 13 Zeanah, C. H. and Barton, M. L. 153