Home Book Reviews Deep Play: Exploring the Use of Depth Psychotherapy with Children

Deep Play: Exploring the Use of Depth Psychotherapy with Children



I interned with children ages 5 to 18 in a traditional cognitive behavioral-based community mental health clinic. I instinctively brought in boxes of “stuff”. Clients created sock puppets who then told elaborate stories, acted out dramatic scenes. Building blocks, Legos, small plastic figurines, paper, pens, Crayolas, paints, clay and sand brought life to wordless experiences. Perhaps 14 years teaching in elementary school systems influenced my desire to play with clients not sit and talk with them. And when the time felt right, we stopped to watch our sensations, to see what arose in our bodies when stories happened, slowing the process down when appropriate. Mostly, I followed the children’s lead.

Honestly, I love to play, though my definition of play may not exactly match yours. For me, there’s joy in creating new pathways in clay, in sand, in words on a blank page, as well as in snow, or dirt or mud. The material used is not as important as the journey, innately trusting the story that arises as I follow new routes into the unconscious, into the unknown fueling my creation. There’s satisfaction in simply doing and then looking back to witness what I have done.

When I received Dennis McCarthy’s book on Deep Play: Exploring the Use of Depth in Psychotherapy in Children, my mind of course went back to my definition of play, to the deeper resonance I felt within myself as I left the stress of my “real” life and submerged myself in other character’s worlds. Play has always been a part of my life, a way to sink into mystery and imagination, to leave reality behind. Doodles of creatures to converse with, mazes to conquer, and scenes I envisioned myself experiencing fill the pages of notebooks. I have fond memories snuggling with special stuffed animals and sharing adventures with Skipper (Barbie’s younger friend) and as we rode our horses across foreign lands; together she and I faced body image issues, dating fears (my friend across the street had ‘Ken’ who regularly came to visit with his Jeep. He wasn’t into riding horses, which of course Skipper loved). There were Tinker Toys, Lincoln logs and Legos. Erector sets. Hammers, nails, cast off wood scrapes, old rags and bits of this’s and that’s in the garage. I crafted many a vessel to chart the unknown seas after heavy rains flooded our gutters and overran the small stream running through a neighbor’s property. As I grew older I immersed myself in the artistry of chemistry sets, sand sculpting, and ceramics then moved into outdoor pursuits. Trail running along the river, writing in my journal beside the river, laying in the sun telling myself stories based on the cloud formations overhead. Nature became my solace, my connection to self and something greater than me.

I opened McCarthy’s book with a sense of play and freedom. I was unprepared for the level of depth the contributors experienced with their clients, the immense traumas lived through and enacted within sand boxes. The monsters these young children endured and then explored within the safety of sand: deep sand affording deep tunnels, deep holes, floods and fights between good and evil with mass destruction and annihilation initially the typical outcome. I felt mesmerized by the truth of the case histories and anger’s heat as I read about the complete lack of adult compassion and love that many of these children experienced from conception onward, the outright abuse and abandonment, the overwhelm and fear. I read scene after scene enacted in the therapists’ sand boxes with plastic figurines, with clay sculptures and hammers to smash them, with swords and other accoutrements to accent the storyline, the movement from stuck to flowing, from dissociation to connection, from isolation to attunement. I felt the wonder and the magic of the work being shared.

The Book Itself

There are ten chapters in this anthology, including one by the editor, Dennis McCarthy. All provide detailed case studies. All provide extensive citations, grounding the work in peer reviewed literature. There are pictures portraying the creatures clients created, the worlds they constructed to face their foes. One contributor’s initial meeting with a young male client prompted him to meet with his supervisor (McCarthy) for guidance, for direction. Most are written in an embodied style that bring the reader into the moment, into the feelings and sensations explored and exposed during the sessions. Some chapters pulled me deeper into the play than others, the writing more personal, more poignant, perhaps more attuned to some of my professional experiences, perhaps resonating with strains of personal childhood wounds.

Dr. Sue Jennings’ chapter begins the collection with an anthropological offering of play in the form of trance and séance within the Senoi Temiar people. Timothy Rodier writes about the power of tunnels and cave imagery to access the inner imaginative world while Julie Lyon Rose shares stories of revolution and epiphany in deep sand. Michelle Rhodes’s story depicts the changing imagery she witnessed with an 8-year-old male client she called Pete, who was diagnosed with a social anxiety disorder. His behavior interfered with normal family life. She depicts his work with water and sand and the detailed narratives he created to eventually bring “structure into contact with chaos”. In one scene he buries a skeleton then resurrects it only to shove it into a corner and immobilize it again. The young boy moves from sand to clay to drawings, from figurines and representations that continually disintegrate into chaos to three main characters that returned each week in his ‘play’. As Rhode writes, “While it is a human struggle to find balance between the forces of order and chaos, it is a core issue for those such as Pete whose neurological wiring makes them particularly vulnerable to obsessive-compulsive behaviors. . . ” (pg. 72). She also offers a discussion on the use of deep imagery and symbolism, whether it be Jungian archetypes or Freudian drive theory. Taking a phenomenological approach, she writes that we can attempt to see and describe the image itself in detail. . . . we can rely on specific information coming from the client, with no association from the therapist. “Regardless of the approach taken,” she writes, “there is no way of knowing exactly what any image really means inside of Pete’s psyche. I cannot tell him or his parents, or you the reader, what it all means. It was my experience that my own observations and reverie helped me to be attuned to Pete’s process . . .” (pg. 74).

Tim Woodhouse writes about “the most toxic boy in the world’s search for mum”, Therese Bimka shares two case studies about female clients who come from a deeply soul-filled, creative space to invite the essential Self to come out and play yet are disappointed by the real world’s constrictive requirement to conform: “In essence, the energetic power of these big and active imaginations is often in conflict with the need to function in this world” (pg. 105). She depicts her use of Jungian sandplay therapy, Soulcollage, expressive arts, and a variety of mindfulness based practices to work on the body-mind-spirit level via guided visualizations and meditation. Dennis McCarthy, Neal Brodsky, Alan Spivack (who had a stroke in 2013 and continued to write his chapter as he healed), and Rob Greene share case studies detailing the need for long term therapy, for deepening and improving family connections, and body-centered, imaginative play as well as the integration of Core Energetics (pioneered by John Pierrakos, MD, who blended body psychotherapy with spiritual development).
Brodsky’s chapter offered an insightful look into a therapist authentically struggling with how to work with two clients, one young man he called Victor and another named Kenny (all identifying information in this anthology has been changed to protect the clients’ identities). Brodsky writes, “This chapter focuses on two cases where a combination of body-centered Core Energetics including expressive arts and sandplay allowed two boys to find their own channels for concrete achievement and growing independence in the context of complex and often challenging family lives.” (pg. 143).

I was fascinated by the adaptation of Core Energetics (CE) for use with children and adolescents. The use of bodily movements such as standing with the knees unlocked and softening to create a posture known as the bow in CE to increase grounding and presence. Bringing the body in, taking time to connect and sense and feel what is happening during the play. “The goal,” Brodsky writes, “was to complement the ‘big energy work’ he’d just done through an energetic ‘pulsation’ or ‘vibration’ he could feel through his entire body, as the partially exhausted musculature of his legs shook and vibrated gently” (pg. 161).

I appreciated Brodsky’s honesty when he writes about connecting with his supervisor, (Dennis McCarthy) for assistance. It felt gratifying to know that a practiced therapist easily reached out for help, didn’t have to take on the process in isolation, letting community—colleagues—offer insight into the current situation and thoughts about where to go next.
Brodsky also offered his outlet for dealing with the intensity of the deep play. As he writes, “Helping ‘depth work’ to happen with children like Victor was not easy for me at first, especially in the arena of expressive arts that went beyond words. I often felt quiet anxious as they created worlds of sand and clay, paper and ink. Was my role just to watch or could I be more active? To soothe my own restlessness, I had taken on a parallel practice where I wrote my responses in poetry as children expressed themselves through images and structure, reaching for my own inner depth in service of the children who were sharing their worlds with me” (pg.148).

He then shared the poems he wrote as Victor delved into his own process. For instance, when Victor filled a globe with water to dump into a sandtray world, Brodsky wrote (pg. 148):

“Water contained in layers of multi-colored sand.
Deep box smoothing the creative urge, magnifying my own clear growth.
Lights dance in crystal round-ness.
My own hands pressing into the mountain.”

Bringing it together

McCarthy begins the Epilogue with a quote from Nishida, 1990: “Love is the deepest knowledge of things. We can reach reality only through love.”

His writing is eloquent as he captured the essence of experience editing this book:

“ . . . The innate desire to speak our lives through images, and to attempt to connect with ‘the other’ and to ourselves through these connection, is always a revelation. Even when we fail in these efforts, the impulse to do so is moving. . . . If we see, feel, hear, and sense with Nishida’s comment on love kept in in mind, then the way forward is possible.”
“What good is this knowledge in a war torn, violent world?” he asks.

“Love,” he writes, “can in fact show us the way forward through the labyrinth. Then the heartaches we hear about and the wounds we see revealed in the play become intertwined with moments of joy that arise from the creative process. The deeply wounded child sits by the sand box and makes a world in which the forces of evil battle with the forces of good. Beneath it all lies a powerful treasure, named alternately ‘the spark of life’ or ‘the goblet of light that dispels darkness’ or simply ‘the one’. It is this capacity that can make an impasse a portal, a seemingly hopeless situation have potential. In the shadow of an unraveling world. It offers some glimmer of hope for each or us and for all of us.”
For those who work with children, the case studies in conjunction with the reflective analysis offer insight into ways to delve deeper into therapeutic encounters. Ways to integrate materials such as sand, clay, drawing into each session. For those who work with wounded children inside adult bodies, the experiences and the content shed light onto ways early abuse/trauma lingers in the unreachable areas in our brain and offer ways to bring play, the imaginative symbolisms aching to speak, back in to the lexicon of psychotherapeutic interventions.