Play and Power

Liselotte Grunbaum, Karen Vibeke Mortensen, Liselotte Grunbaum, Karen Vibeke Mortensen

• Publisher: Routledge
• Year: 2018
• eBook ISBN: 9780429917325
• Topic: Psicología
• Subtopic: Historia y teoría en psicología

The power of play, so central to psychoanalytic theory and practice, is conjoined to the social psychological or socio-politically coloured concept of power, giving rise to many fruitful discussions of how these concepts manifest themselves in clinical work with children, groups and adults. The inspiration for this book was the 3-section EFPP conference in Copenhagen in May 2007 with the main theme "Play and Power". At the conference and in the book, this theme is presented both inside and outside the therapeutic space. It is amply illustrated in clinical cases from individual psychotherapies with children and adults and from group analysis. Most of the examples are with hateful or resigned children and adults who have been exposed to extremely damaging or unhelpful environments, and who demonstrate convincingly some of the devastating consequences that abuse of power in the real world may have. Play and power are also explored in the broader context of the community, however.

Chapter One

Transformation through play: Living with the traumas of the past

Monica Lanyado

Play has the power to transform. It can be liberating, aggressive, sad, satisfying, illuminating, angry, anarchic, funny and beautiful. The full range of human emotions and experiences are there. Playing can be the bridge to pleasure, joy and internal freedom. It can also be the bridge to unexplored depths of pain, sadness and violence. The capacity to play is the vehicle which holds these often powerful emotions, within a space where they are not acted out in what might otherwise be destructive ways. When the capacity to play breaks down because the symbolic functioning of the player is overwhelmed due to a weakness in the ability to play which has not fully developed, or an overload of what it is trying to carry, powerful uncontained feelings are set loose.

For example, young children need the watchful eye of an adult to help them when playing otherwise, reality steps in before too long because the “as if” quality has been overstretched, and a battle between soldiers becomes a real fight between two angry, rivalrous toddlers (Segal, 1975). Adults also need boundaries which keep play safe. The game of football, which often has the sense of being the present day version of a gladiatorial sport, can readily break down into real fights on and off the pitch, where the idea of playing a game has been lost and the reality of the referee and police needs to be brought in to restore some kind of order. Little girls playing mummies and babies come to blows when jealousy and possessiveness as well as bossiness, cannot be held within the imaginative play. Sulks, tantrums and tears reflect their feelings of rejection and fury.

Playing with ideas, whether as a child playing with toys and other children, or as an adult “toying” with thoughts which might lead to new ideas, takes place in what Winnicott has described as an intermediate area of experience, a potential space, often now thought of as a ‘transitional space’ (Winnicott, 1971). Descriptively, this is the third area of our experience, which is neither fully internal nor external, but paradoxically, both. It is the “both-ness” of the paradox which enables intuitive and spontaneous ideas to surface from the depths of the unconscious, when some of the restraints of reality are removed, because it is “only” playing. Like dreaming, playing “speaks” its own language but is still censored and restricted in many ways.

Observing and witnessing the therapeutic process of children who have been severely deprived and traumatised, has taught me that the gradual emergence of the capacity to play is a very important milestone in their long, slow recovery. If the child or young person leaves therapy with a reasonably robust capacity to play, he or she is much better equipped to face the difficulties of their lives, which are still likely to be many and, at times, severe. The same issues are present when working with adults who have been severely traumatised by war, torture or more “everyday” traumatic losses. Here I am thinking about the capacity to play in the adult sense—of finding as creative a way as possible of living with the dreadful traumas of the past and the difficult realities of the present.

The capacity to play

The ordinary development of a capacity to play takes time. For each of us, this will depend on how we manage to grow the third space that we live in, a transitional space between our unique internal and external realities. The growth of this third space continues throughout life. Playing and the growth of transitional space, are vital contributors to our discovery of who we are and what lies in the depths of our beings, driving as well as helping us to navigate the way we live our lives in good times as well as bad.

In childhood, the development of this space will be dependent on the loving care and attention of an adult who is able to be emotionally available to the growing child in the way that Winnicott describes as enabling the child to be alone “in the presence of someone” (Winnicott, 1958). The therapy of children who have been severely neglected, traumatised and abused shows us what happens when this kind of emotional availability has not been present for the child, the often concomitant lack of protection making the child vulnerable to traumatic experiences. Sadly, many of these traumatic experiences have been within the very relationships that are meant to protect the vulnerable child.

Throughout this paper I will be using the words “living” and “playing” in what I believe is a Winnicottian sense (1971). I put it this way because I am often struck by the many different ways in which Winnicott’s writings are interpreted by his readers. It is as if we are all speaking the same language but, at times, with very strong regional accents! So I am going to describe what these terms mean for me, derived from what I have understood from reading Winnicott over the years, from which I learn something new each time.

The question of what we mean by “living” life to the full or being “alive” has been addressed by many psychoanalytic writers probably because so many patients bring the difficulties and pain that they feel because they cannot engage with life and truly “live” it (Bollas, 1987; Casement, 1985; Ogden, 1999; Winnicott, 1971). These patients may often be struggling with the opposite of a sense of living: a sense of internal deadness (Ogden, 1999). The ability to live life to the full is not an easy thing to do. It is a challenge and ultimately an achievement. It is not even clear quite what is meant by this every day phrase.

It has something to do with openness to both the beauties and the hardships of life from which we all have to learn as much as possible. It has something to do with pleasure and happiness and what promotes these at times elusive feelings. It also has something to do with being able to bear the sadness and pain that are inevitable parts of life with fortitude. It is an acceptance that for each one of us, life will dish up a very varied menu of experiences that we all have to learn from, without experiencing each hardship as too much of a narcissistic blow, or each achievement as a confirmation of our omnipotence. It is about reaching for a sense of living a balanced life. It is about finding out who we truly are, our place in, and contribution to, an ever changing world. It is about being able to change as we move through our lives, and not cling to the negativities of the past. It is about letting go of what is no longer relevant in our lives, learning to go with the flow of life, so that we can make space for the new.

Now some thoughts about playing. Playing can be hard work; it can be serious and intense. It is free to go wherever it wants because it lives and breathes in its own space somewhere between the internal and external world, the place Winnicott evocatively describes as the “place where we live”; the intermediate space or transitional space (Winnicott, 1971). Playing is present in ideas, in cultural activity, in relaxation and pleasure. It continues throughout life, in adult games with rules, in sexual games and foreplay, in a sense of humour. It can be both a solitary experience and an interpersonal or group experience. It is an achievement because so many internal and external experiences can disrupt and interfere with its natural course. Playing is an expression of the life force.

Most of our patients, be they child, adolescent or adult, seen individually or in a family or other kind of group, will be more able to play at the end of a reasonably successful therapy than they were at the start. Rather than regarding this as a by-product of the therapeutic process, I now have my therapeutic eyes firmly on my patients’ capacity to play as the best indicator of the level of emotional health and resilience in their internal worlds. I am always on the alert for the emergence of new kinds of playfulness in my patients and pay particular attention to them, like a vigilant gardener watching over seedlings that I hope to see grow into big healthy plants.

This paper presents the idea that play is a very powerful vehicle for therapeutic change. Play of the kind illustrated below is “playwith-a-serious-purpose”. It is a process which, if it can be facilitated through the therapeutic environment and relationship, reconnects or connects for the first time, the individual with their sense of true self. There are many kinds of play, for example, defensive play, boring play and stuck play which are diversions along the way. Part of the therapist’s task is to enable the patient to become more able to recognise these different kinds of play so that when they manage to play creatively, this becomes an experience which can be attended to and become a source of more fulfilled living.

The idea of power in this context relates to the strength of what can be achieved through play. Power, in the sense of power-play within the therapeutic relationship, is likely to obscure the freedom of expression of either patient and/or therapist and to be anti-therapeutic. The essence of the approach described below is of the therapist getting alongside the patient, however young or constrained the patient may be, so that therapy is an exploration of the patient’s internal world, facilitated by the therapist. Whilst power differentials between therapist and patient may play more or less significant parts in the process, depending on what both patient and/or therapist bring to the relationship, too much attention to this dynamic may obscure or inhibit the natural processes of healthy playfulness which are arguably as universal as joy, laughter, tears, anger and sadness. Therapy is thus a joint and, in this respect, equal enterprise.

To illustrate the surprising places to which I believe the capacity to play can take our patients, and us as fellow travellers, I am going to describe my work with Gail. I am grateful to Gail’s parents for allowing me to describe aspects of her therapy as an illustration of the way in which play can become transforming.

Clinical example

I am going to summarise most of Gail’s therapy and then describe in more detail, a session towards the end of her treatment, when she was trying to wean herself from therapy after 5 years of first twice weekly and then once weekly therapy. What I am trying to describe is the ways in which her transitional space grew and transformed during this time. This account shows how she moved from her early, very high levels of erratic and anxiety driven activity, via a very active playful period, to a remarkably meditative and “still” place by the time she felt ready to try to cope with her life without therapy.

Gail started psychoanalytic psychotherapy when she was twelve years old, after a period of art therapy which she had used very positively. She had been adopted when she was seven years old, having been abandoned by her mother when she was five years old. She had been born with a mild syndrome which meant that she had some slight physical abnormalities in addition to the possibility that she would have permanent learning difficulties. The most significant feature of her early life was that both of her birth parents were profoundly deaf, whilst she was able to hear quite normally. Her birth parents had also had very difficult childhoods with her father diagnosed as having a personality disorder. It was because of his violence towards Gail’s mother that she walked out of the marriage when Gail was eighteen months old. Gail had probably witnessed many frightening arguments and was neglected in many ways but it is unlikely that she was physically or sexually abused.

The current social policy in the UK around helping such children makes every effort to place these children in families rather than children’s homes. Consequently, after some brief and unsuccessful attempts before she was five to keep her in her birth family, she was placed with first one and then another foster family, before her adoptive family were found when she was seven years old.

The early days of Gail’s therapy were characterised by her impulsivity and inability to stay with any play theme for more than a few minutes. She was, like many other children who have suffered this kind of early history, unpredictable and quixotic (Cleve, 2004; Edwards, 2000; Hindle, 2000). I always felt very on edge and hyper-alert when with her as I had no idea what she might do next such as rush out of the room, insist on playing in the hallway instead of in the therapy room, shutting me out of the therapy room or re-arranging all the furniture in the room. This kind of difficulty around holding the boundaries of the therapy will be very familiar to those working with severely traumatised and deprived children. Thankfully, she was never physically aggressive towards me although she could often be rude and disdainful, flouncing out of the room or ignoring me as if I was totally worthless. She was extremely difficult for her adoptive parents to live with hence the referral. They had regular therapeutic support throughout her treatment.

Playful interpretation

Gradually, Gail became able to listen a little bit more to the few comments and interpretations that I managed to make. This came about as the result of what I came to think of as “playful interpretations” which, rather like someone trying to spoon-feed a reluctant baby, I managed to persuade her to take in by being “playfully present” for her whilst actually offering her something very serious. This was always a very delicate dance between us as I needed to be alert to when she was playfully available and then find a way of engaging her with what I wanted to say to her. This is the kind of “therapeutic seedling” I am trying to illustrate that I referred to earlier which can carry a great potential for growth.

For example, for a long while when I started to try to talk more seriously to her about our relationship by making a transference interpretation, or when I tried to verbalise something that might have been helpful for her to think about that had become evident from her fragments of play, she would often simply cover her ears, turn her back or walk out of the room. I eventually decided that I might get further if she was able to feel more in control of the alarming things which she felt came out of my mouth, and playfully asked her if I could say something “very small” about what was happening at a particular moment. She agreed but in her typically controlling way said, rather warily, but also slightly playfully, “How small?” I spontaneously put out my parted hands in front of me, indicating a short length of words, at which she smiled faintly and her eyes twinkled slightly as she said, “Okay then but no more than that”. For a considerable time, I prefaced much of what I wanted to say with this question and it provided a communication bridge between us. There were plenty of times when she refused my requests but, just as with my parallel of the feeding of a reluctant baby, I would persevere as far as seemed non-forceful and try again in some other way, later in the session.

This paved the way for us to play lengthy role-playing games which continued from one session to the next. Whilst I followed her lead in these games, my focus was much more often on enabling her to keep playing, rather than interpreting the content of the play. By this point, I had realised that it was the playing itself, as a medium of communication of her deepest concerns that I wanted to facilitate. I rarely linked the content of her play with her past life as this was still too overwhelming for her and likely to disrupt the play which I felt was so healing for her. It was the actual experience of playing, both within therapy and increasingly in her everyday life that I felt was transforming her ability to communicate what she was living with in her inner world.

Whilst I did not interpret the play, I was always paying very close attention to it and “listening” very carefully to what she was trying to communicate while trying to make some sense of it in my own mind. In this respect, I was being the person who she was “alone in the presence of” as she played (see Lanyado, 2004 for a fuller discussion of this idea). The fact that Gail’s birth parents were both deaf whilst she had normal hearing was a constant yet easily overlooked factor in all our communications. It was as if this very difficult reality soaked into everything that took place between us, probably most profoundly in the ways that I felt that I listened to her with my total being. I felt utterly absorbed in trying to understand what she was trying to communicate, even though I often had to accept that I really had not understood at all. This may well have been a vivid re-experiencing in the transference-countertransference relationship because of the communication difficulties that are inevitable in parent-child relationships where the child has normal hearing and the parents are deaf. For these relationships to work one can imagine that other channels of communication need to be intensified and turned to full volume; it was this that must have been so hard for her birth parents to manage.

Play, as a vital form of communication, created the pathway for the transformations that Gail was able to make in her life. Her ability to concentrate started to grow and this became evident in her improved schoolwork which she shyly let me see during what at times, felt like endless varieties of games of schools. Other games involved wafer thin enactments of her birth mother’s abandonment of her, in which she was able to express some of her outrage that a mother could behave like this towards her daughter. However, only rarely was I allowed to relate these games to her own experience and when this did happen, it was mostly at her instigation. This stage of therapy is discussed in more detail elsewhere (Lanyado, 2006).

Starting to live with the trauma of the past

Approximately two and a half years into her therapy, when she was close to fifteen years old, things started to change and we became more able to talk about what had happened to her. She was emotionally much stronger by then and, of her own accord, suddenly decided to bring her Life Story Book to the sessions, eventually leaving it in my safe keeping for us to look at together, over roughly the next two years. This was one of the spontaneous ideas which I believe emerged from her growing transitional space. All children in the UK who have been moved from their birth families have a Life Story Book, compiled by social workers and foster carers, containing the most important information about their birth families and foster families. This book is often the heartbreaking story of their life, sometimes in a sanitised form, at other times in a horribly, matterof-fact form.

We spent a great deal of time pouring over the photos of Gail with her birth family, foster families and the early days with her adoptive family. The information was contained in a loose leaf file and many sessions were spent with her arranging and then re-arranging the pages as she tried to find some way of making sense of all of it. During this period of her therapy, I realise in retrospect that I spent a great deal of time quietly sitting with her as she searched the pages with great...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Contents
• Foreword
• Some Brief Organisational Perspectives
• About the Authors
• Introduction: Liselotte Grünbaum and Karen Vibeke Mortensen
• Chapter One: Transformation through play: Living with the traumas of the past
• Discussion: The power of play—a comment on Monica Lanyado’s article: ‘Transformation through play: Living with the traumas of the past’
• Chapter Two: Has play the power to change group and patients in group analysis?
• Discussion: A commentary on Peter Ramsing’s article ‘Has play the power to change group and patients in group analysis?’
• Chapter Three: The power of hate in therapy
• Chapter Four: Survival and helplessness in empty space
• Chapter Five: The power to play with movement, vibrations and rhythms when language emerges
• Chapter Six: The return of the absent father
• Chapter Seven: Power and play: A tale of denigration and idealisation
• Chapter Eight: Research in psychoanalytic psychotherapy with children—an enterprise in need of power?
• References
• Index