Peeps Into the Therapy Room

What fun to have peeps into the therapy room – here on paper, so you can imagine what it might be like for your child if you decide some play therapy sessions will help them, in addition to what you're already doing to ease their anxiety at home.

The case of the unbeatable monster

Therapy room peep 1

A nine year old takes more and more handfuls of clay, fixing it roughly to his “monster” until the monster is so big he says, “No one can beat him!” 

I’ll tell you what happened to the monster in a moment. 

But how many of us have clay in the house ready for our kids to play with?

• It’s messy.
• They need a clear space to do it.
• They’ll probably put clay-y hands on our favourite device.
• And we’ll lose our temper.

I know, it’s hard. Much easier to leave it to school! 

And play dough will be OK, won’t it? 

Well, in my book, no. It’s good but it’s different – and once mixed into a brown mess it’s shunned by any self-respecting child. 

Clay is a grey mess to start with, so that’s fine! 

I believe that children can solve many of their own problems if given the opportunity to play them out. Like that boy I worked with.

Let’s watch... 

I’m instructed to outwit the clay monster (always good to follow the child’s instructions if they’re playing something out). But despite all my efforts, I fail. 

(I have to be careful there – the boy has said the monster can’t be beaten, so that’s the “story” I’m following.) 

But guess what? 

The child suddenly reveals the monster has a soft place at the back and can be injured. 

“Oh. What can he do about that?” I ask. (No suggestions, leave it open.)

The boy thinks. “He can stand with his back to the table edge so no one can get round.” 

I presume there's a connection with not allowing himself to be goaded, but he doesn't explain.

He does, however, seem very satisfied with himself, having come up with this solution! He puts the clay aside and goes off to play with the doll house (in the playroom, boys are quite happy to play with dolls and doll houses as no one's going to sneer at them).

The following week, his teachers tell me he doesn’t rise to the bait once when taunted and isn’t sent to the time-out room at all. 

Who sorted out his problem? 

---

The case of the buried treasure chest

Therapy room peep 2

An eight year old makes an island in the sand tray, and chooses a toy boat. She loads up pirates and a little girl into it, and sails them across to the island. They have a rocky landing because she’s already covered the shore with stones. 

“They’ve stolen her,” she explains. 

I’m beginning to understand this play but I say nothing, just nod. I don’t want to interrupt her train of thought. She’s obviously playing something out that she herself wants to solve. 

We’ll see if I’m right in a moment. 

About 12 years ago, it was national news that sandpits had disappeared from children’s playgrounds all over the country. The media realised instinctively that something “was going wrong in life”. Sensationalist, but with an element of truth! 

Children do need sand to play with. Soaking wet “pooh-y” sand (their word, not mine!), damp buildable sand, and dry pouring sand. 

Sand is versatile. Plus it offers different tactile qualities that stimulate the imagination. 

This child was using the damp sand.

Let’s watch... 

She asks me to help her make the pirates come across hidden dangers and run away (explosions of sand – what fun to help with that!). 

“But this magician is casting a bad spell,” I’m told. She waves him around in front of the little girl figure. “She’s trying to reach that skeleton because he’s guarding a buried treasure chest.” She points to one corner. 

“It sounds like the magician’s spell is stopping her,” I comment. “How difficult for her.” (I’m not sure which way this will go, so I play cautious.) 

The child fetches a large chimpanzee figure and together they battle through, sending sand flying all over me, and unearth the treasure. 

She makes the girl figure pick up the treasure chest and stagger across the sand to a cave: “This is her new home,” she tells me. “But she’s okay now because she’s got her treasure.” 

This child had been sent to live with relatives straight after her single mum died and had not been allowed to attend the funeral. 

She’d played her way to some kind of acceptance. Using sand and miniature toys. 

---

The case of the perfectionist painter

Therapy room peep 3

A young boy chooses very fine brushes to paint with. He tries to do the London Eye, which he’s just visited. The outline goes wrong. His face gets red.

He changes colour and mixes something for his name. His name goes wrong. The brush will not hold enough paint to write properly.

He jabs the brush in the black and obliterates the letters, gives up and goes back to the sand pit. 

I accept this change – he’s calming himself down, which is good. 

A few weeks later, after several aborted painting attempts, he takes a medium brush, pours several colours and mixes the brown he wants in a different pot. 

He then paints an intricate criss-cross thing that he says is “an instrument – one of those things you see people play”. I’ve noted he doesn’t totally freeze when an “error” starts to happen but keeps trying for a while. Yes! Although it's still very approximate. 

Children progress at their own pace in their skills and ability to cope with so-called mistakes. 

But me, I’m about to make a mistake of my own! Let’s watch... 

Following this progress with the “instrument” painting, I casually suggest we might use up the other paints together by pouring them on some paper and using huge brushes to spread them around. 

(I want to assess his seemingly lessened need for everything to be his sort of perfect.) 

He delights at first but within minutes says, “Stop!” 

(Well, you can’t win them all!) 

But two weeks later, he takes more paper and his preferred small brush and designs something in spirals, placing blue and yellow bits among the red. No frustration, no giving up. 

I watch as he starts looking suspiciously at some accidentally crooked lines and drips. But he then carefully makes them into part of his design. 

He puts his brush down and says, "I did that well." 

Yay! Mistakes can be dealt with. He's now accepting his own. 

I’m pleased there's paint in the room. He’ll now move on to accepting other people’s ideas and ways of doing things when he’s ready. But not before!

---

The case of the missing dolls cot

Therapy room peep 4

A child visits me in my therapy room and is critical of my poor supplies. “Where’s the Lego,” she asks. “Have you got an X-Box? Or a phone?” 

I do have a phone, a plastic toy one! Most children don’t ask, though. I sometimes think they actually enjoy the basic toys and equipment most therapeutic playrooms have. It’s kind of calming. 

I gently explain to this child that she can play with anything in the room but will have to invent anything she needs that isn’t there. “Well I need a dolls cot,” she says, hands on hips, looking round dejectedly.
I suggest she looks to see what she can use instead.

I keep quiet but watch to see what she will do... 

Eventually she chooses two cushions and a rug, tips the toys out of a tray she needs, and spends 10 minutes making up a special bed for the dolls. 

She then puts them lovingly and carefully to bed with a tea-set spoon as a rattle! 

She’s delighted with herself. We share a smile of pleasure as her whole demeanour changes from challenging to satisfied. 

Stuffing them in a branded cot with a garish mobile would have taken only seconds, and deprived her of the enjoyment of providing a bed. She’s also nurtured someone smaller than herself and found herself capable of being resourceful and effective. 

Her brain got a needed workout and grew. 

After a series of sessions, this child goes on to grow in resilience and be less annoyed at having to share her time between two homes. Her parents are divorced – reasonably amicably, admittedly. But her favourite things never seem to be in the right home at the time she wants them. 

She’s gradually learning to live with this state of affairs. Her brain development is on target again.

---

The case of the puppet family pile

Therapy room peep 5

Jed is a tiny, neat little person and always polite to me when he arrives. Until he starts playing with the puppets! 

Week after week, I watch as he grabs them, stuffs them in various places around the room while listing who they are (members of his family, seemingly), how old they are and what they like doing. 

He treats them pretty badly, granted they represent his family. So I immediately take note: Jed is with a foster family. 

He doesn’t seem interested in putting the puppets on his hands to play out a drama – which is what often happens in puppet play. Nor does he invite me to play, but instead instructs me to remember who they all are! Some task when there are so many. 

After he’s done this, each week, he goes off to a different activity and is as calm as anything. 

I watch to see if there’s any progress in his puppet play from week to week – and worry that I’ll forget the names by the time he needs me to know them! 

One week, he holds out one puppet. “This is me,” he says holding up a frog. 

I swear frog has been someone else at some point. But maybe I’m losing track. And I might have to be honest at some point and simply say I can’t remember who’s who... 

But Jed piles them all into the basket they’re usually stored in and jumps on them heavily several times, shouting, “Die, die, die!” 

I note that frog is in the middle of the pile. 

Is this suicide intention?? Is he feeling smothered by the others in real life? Has he been watching things on TV that are now being acted out? 

Let’s watch and see what happens... 

He retrieves “his” puppet (frog) from the pile, turns to me and says in a shaky voice: “I hate this family. I don’t belong with them. I want to go back to my own mum and dad.” 

And finally there are words he can use. We can now talk and draw and think about his distress, with frog there on the table beside us. 

Jed is outwardly doing fine in his foster home and at school. But obviously, under the surface he’s shut in a lot of anger at being there. 

We talk a little bit about the foster family. Jed feels they all seem to have loads of fun, hobbies and in-jokes – and he simply doesn’t belong. Even though they love him and include him in everything they do. 

It’s many weeks before he can go home again. But his anger has been released safely, like lancing a wound. Frog, rabbit, cat and all the others have done a good job! 

---

The case of the musical storm

Therapy room peep 6

Max is only 5 when he comes to see me. 

He seems to expect me to tell him what to play with, what to talk about. I could. I’m good at suggestions! But in the therapy room I always hold back. His choices will tell me lots. 

Apparently he’s causing trouble at home. It started a couple of months ago with tantrums and refusing to do anything without a row first. 

His parents want someone outside the situation to help see what’s bothering him. Nothing has happened in their lives that they’re aware of. 

He pulls out the tub of percussion instruments. I feel a glimmer of excitement – I like music! 

I tell myself to keep quiet. He might not be going to make music. Maybe he wants to count them or just investigate. 

After a few moments he lays out the finger cymbals, the little xylophone, two small African drums and some wooden blocks. Tentatively he plays a few notes on the xylophone with one hand, and then adds some drum slaps with his other hand. 

“Make it rain,” he instructs me. I pick up the finger cymbals and try to make rain-drop sounds like on a roof. 

“Storm coming!” he yells. “Make it louder.” His right hand is running the xylophone stick hard up and down the instrument and his left hand is slapping the drum fast and mad. 

I add my dramatic bits by swinging the little cymbals and clashing the wooden blocks. 

“Stop,” he says. No slowing the rain down in the aftermath of the storm, Just sudden silence.

“It sure was raining hard,” I say.

He plays for a while and then returns to the instruments again. “Another storm on the way,” he announces. 

After another three storms in the space of half an hour, I’m contemplating the cause of the storms in his life, as well as thinking how nice it would be to have some “sunny weather” in the room too! But I have to go at Max’s pace. 

Let’s see what happens... 

After the fourth storm, I gently say, “There’s a lot of storms happening at the moment.” 

This is just a comment. He can ignore me. But he smiles sadly and says: “They always shout STOP!” 

“A bit annoying to be told to stop,” I say. 

I realise (oops!) that that might come over as me being annoyed at him shouting stop! No one is perfect. 

Max gets up and walks to the other end of the room: “You wanna know what makes a good storm?” 

“Percussion instruments?” I ask, in an attempt at humour but holding my breath for the truth. 

He comes back with something in his hand from the doll house. “This!” 

It’s a miniature baby. I’m surprised. I’m not aware of siblings in the family. 

“Oh. What a loud, frightening storm made by such a tiny baby,” I say. 

“They haven’t told me, but I know. I don’t want a baby.” I see his lip start to quiver. 

I reflect to him how hard it is when grown-ups keep secrets. 

I see his anxiety diminish as I show I understand his feeling. 

I suspect that knowing his parents have kept a secret from him has provoked more anxiety than the baby idea, but I don’t share that. 

While we’re clearing up the room later, I deliberately reminisce about the fun activities we’ve done – and the wonderful percussion storms we made.

“Shall we tell Mum about the wonderful percussion storms we made and the little baby that caused them?”

I’m not offering to share the meaning at this stage, just the fact of what we did together. He’s entitled to have some privacy if it’s not a child protection issue. But I know his parents will get the message either way. 

He nods. With me there, he’s brave enough to tell them what he knows. About how “this tiny baby” made all the storms and he “doesn’t want a baby”. I look at them over his head and raise my eyebrows with a knowing smile. I see them glance at each other. 

Later they ring to let me know they’ve told him officially about the pregnancy, and that his behaviour is improving. If he hadn’t chosen the instruments, I wonder how he’d have shown me? 

---

The case of the missing map

Therapy room peep 7

This intelligent girl in year 6 has agreed to come to see me for a few sessions.

She isn’t interested in looking around the room. She immediately sits on the little low settee.

I grab a cushion and sit cross-legged nearby. I always think informal chats go better if I get down on the floor. It makes it somehow more of a collaboration than an interview between adult and child.

“Mum says it will help,” she says straight away. “But there’s nothing wrong with me. Except me,” she adds, looking sad. “Everyone else is fine.”

“How so?” I ask. “Help me out here. What does fine look like? Just so I know we both mean the same thing.”

She tells me “fine” is getting on with life and not crying and things. “Things” turn out to be: getting into trouble or lying on the bed thinking about Dad. 

I’m aware he died six months earlier. That and the crying and lying around make me consider low mood and depression, but somehow this child doesn’t seem depressed, just confused.

I reach up behind me to the window ledge for a set of SAGA cards I have in the room for just such occasions.

Thing is, I’m not sure which things she might want to talk about most – and it was her mum who suggested she come. What might she herself want? This activity will help me find out.

I invite her to spread the cards on the floor and choose one that tells me what she feels like now; one that tell me what she’d feel like when it’s all much better (I never say “better” or “right again” because that’s very complete, and some things in life don’t ever get completely better); plus one that seems to show what’s stopping her getting there.

While she’s choosing, let’s flag up those SAGA cards. I’ve put lots of ways of using them in the strategies section on the website if you want to look. This is the easiest of the many sets of OH-cards to use – and even 4 and 5 year olds can use them to tell stories that show us something about what they’re thinking when we need to know!

So, let’s see what she’s chosen…

She says she’s like the spider in the web. Trapped. Likely to be killed by someone at any minute if they don’t like spiders. She gives a small smile. “Things die all the time,” she says sadly.

“Yeah,” I say gently, “and it sounds really sad to be that spider trapped and likely to die.”

She explains the flame is alive and bright and moving and warm. “You can do things with fire energy,” she says. 

It sounds like she’s been listening in class! But I also hear the message behind it: she feels she has no life and energy any more.

I agree with her that it would be super to feel as much energy as that flame – all that energy for dancing, videos, music, games, friends and school… 

I then listen carefully to what she feels is stopping her. “I need a map or chart or just something to show me how to get out of this properly.” 

“Sometimes,” I say quietly, “there isn’t just one map and everyone will use that same map. You need your very own map because it’s your way out. Would you like us to make your very own map here while we’re meeting together? Would that help?”

She nods and I watch her struggle with emotion. “No one talks about Dad any more,” she says. “It’s like he’s dead and gone.”

The flood gates open. But we have a start. A plan. Something she’s chosen to do. And I know we can get her out of the mire she’s in and into a better place with her own way out. Not to forget her dad but to start dealing with her grief, a little bit more, and in her own way.

Being able to use image cards is an imaginative way to think about what needs doing. Therapy (and storytelling) is not science, it’s art! And it works like magic. Try them with your children? 

---

The case of the ball thrower

Therapy room peep 8

It’s always lovely when a child comes into the room eager to be there, and wanting help, and knowing what they want help with! Saves me a lot of detective time. We can get to work and do what I love to do: send them on their way quickly to get on with life and feel OK.

It doesn’t always happen that way. For a few weeks, one lovely, lively child entertains me with stories of visits to relatives, to visitor attractions, to school outing venues and shopping centres. Busy-busy, detailed, messy narrations, going off point this way and that way, as if every detail has to be related!

I listen, I respond, I think about what I'm hearing, and in the end decide that this might not be as straightforward as I’ve thought it would be!

But hang on, she’s told me, the minute she walked through the door, that she knows I can help and she knows what she wants from me. Is it all bluster to cover something up?

Gradually, over a few weeks, I notice she's consistently using the blow-up beachball in a game she's invented that goes like this and which we play between narrations:

She throws it to me and names – for instance – animals as the group to use. (It's a beachball so any sort of throwing is fine. Nothing can be broken in the room.) So I have to catch it and name another animal. No animal can be named twice. Back and forth with laughter, quick thinking and, um, animals, or transport, or countries...

You see, if we run out of animals she changes the subject and we continue. Then the ball is discarded, and we go back to the stories she's telling me about her life. She does once mention not feeling that she fits in anywhere she goes. No one understands her. Does that include me??

I'm aware that she gets into trouble at school, not for being deliberately naughty but for being somewhat scattered in her approach to everything. Late in, incomplete work, only half listening to instructions, interrupting games that are going on. Of course I have some ideas running through my mind... 

But let’s see what happens.

Over the weeks, I notice that the stories are becoming less jumbled, more on point, and contain observations about other people in the story that seem more mature and more thoughtful than previously.

We continue to play the ball-throwing game in between these stories, as usual. And I realise that in some way she's feeling that I'm in sync with her, and that this is helping her in some way – maybe to become more organised inside herself.

Was attunement the problem and the answer? She certainly wouldn’t have known the word!

Let’s take a moment to look at attunement. The brief version is: the care, the calming down, the glances, laughter and words that a baby exchanges with their carer(s) all help to socialise them and regulate their emotions – until they can do those things from their own brain because they’ve learnt how to – from us.

I'll never really know how that child is solving her own problem with all the ball throwing week by week, but it’s my bet that something she needs has been missing, and that our eye contact, comments, back-and-forth and general therapeutic relating is filling a little hole.

She has a good home, don’t get me wrong. But children always know what they need subconsciously. That's why play therapy is so effective. 

And her teachers report a great improvement over the few months she's with me. So she’s clearly used me in some way to get the help she needs to feel a bit more like she can fit in at school. 

Therapists – and parents – often have to live with "not-knowing" and just accept the magic of change!

---

The case of the silent boy

Therapy room peep 9

Sometimes a child agrees to come to therapy but simply doesn’t know how to start sharing what’s wrong or even playing with the toys. This happened to a boy who was still grieving for his grandma.

I could say to him: “Your mum’s told me about your gran. That’s really hard for you to cope with, isn’t it?” But I don’t push.

I always prefer to let children speak for themselves in case they think “mum” has told me everything so there’s no point in them saying anything else. That way, information that the child deems important will be lost.

On the other hand, I have a lad sitting here in silence, not comfortable to explore the room, and looking very ill at ease! I know (from his mum!) he loves to draw, so I say, “Let’s play a drawing game while you have a think about what you’d like to do.”

I rarely make suggestions in this way, but sometimes it seems the best option for a situation. I know most children like a challenge and this is within his skill set. Safe choice.

He immediately grabs paper from the stack, plus a wax crayon.

“OK,” I say. “The game is I ask you to draw something. If you can’t, I get a point. If you can, you get the point! OK?” I see the corner of his mouth nearly smile!

“If you were on a desert island, can you draw the one person you would choose to have with you?” He nods and quickly draws an adult with a long coat and boots.

“Bother, you win,” I say, with a grin. “Um, I’ll try again…”

We go through several thing and he gets excited at winning. I can tell – his face relaxes and he quickly adds fun details to his drawings as he waits for me to dream up another poser.

Why this drawing activity? Well, a silent, uncomfortable child is going to feel too awkward to take part in therapy. So I’ve compromised by finding a way to “meet” him – but without using the death of his gran as a way in. I want him to deal with that in his own time.

Let’s see what happens.

Over the next half hour, we also draw what monster his biggest fear would look like; the present he’d most like to be given; the item of clothing he likes to wear best; where he’d most like to visit if he got off his desert island! Plus several more.

I make it fun and non-serious. The lad has still not said a word! But a grin has taken over his face!

Somehow, by meeting him at a place he felt more sure about (drawing), we’ve found a way of relating. We put the paper aside for now. It may get used one day. It may not. He simply gets up and goes to find the box of Lego cars and sets up a race track in the damp sand.

I don’t know if he will play out his grief or talk about it eventually. What I do know is that without the relationship we just set up (relaxed, fun, non-threatening), nothing of use will happen!

---

The case of the unusual chess game

Therapy room peep 10

In the therapy room, there’s a small, primitive chess set – nothing convoluted like the expensive sets you can buy! It’s unobtrusive. It isn’t often chosen. 

One young lady of five makes a beeline towards it and turns with a smile and says: “First, I’ll beat you at chess. I bet you can’t play!” 

My stomach does a tumble. 

I have no worries about games. I highly value games in therapy. They tell you so much about the child. And you can do therapy using just games if that’s what the child chooses to pursue each week.

And I have no qualms about letting a child teach me something. As I said above, it makes for equality and a good relationship in which to do the therapy. 

No, my stomach lurch is about my brain! She’s barely five. Unless she’s a child prodigy at chess and thrashes me (fine) – I feel it might involve a set of "rules" that have never been heard of before! That means me doing a stupendous feat of brain power to remember how her version of chess goes as we play. 

“Not very well,” I say with a grin. “And yes, you’ll probably beat me. Set it out for us and lead the way.” 

She lays out the back row of the white pieces. Then she picks up the black king and puts it in the middle. “The kings’s in charge,” she says. 

In quick moves, she places the black pawns all round the king. “They’re the king’s favourites. The king only looks at those bits.” 

“OK,” I reflect back. “The king can always see these favourites but none of those other pieces. Have I got that right?” 

She looks straight at me. “Yes.” 

I’m beginning to wonder if this is a game or an illustration of what’s happening in her life. School? Family? I remind myself (in case that’s true) to NOT name the king as he or she. I haven’t been told yet. 

She sits back, and after a moment, I say: “So, you’ve set out the game for us. How do we play? (I’m staying in the game metaphor till I’m told something else.) 

Let’s see what happens next. 

In turn, we have to move any of our other pieces. I only have the major black pieces left, so I put one of them on the board whenever it’s my turn and move it somewhere. Anywhere seems fine, not the usual moving rules. 

Whenever it’s her turn, she moves one of her original back row right up towards the king and kicks over a pawn and moves it off the board. 

When my piece gets near to one of the black pawns round the king, I look up and say: “What does my piece have to do?” (We’re playing to her rules, which I’ve never seen before! Best to ask.) 

You have to smash them all because your bits are here, here and here,” she says indicating where my pieces have randomly arrived after a few turns. Like it's been a rule I achieved unconsciously. 

“Smash all the black pawns?” 

“Yes.” 

I smash them away from around the king, and sit back. “Is it your turn now?” 

She nods solemnly. 

I watch as she moves each of her major pieces (not the pawns – they never came on the board) up to the king and makes them form a ring round the king in the centre. 

“You’ve carefully moved them all, right round the king,” I comment with a smile. “Have you done everything you want to do for your turn?” 

“Game over,” she announces suddenly, with a grin. “You don’t get another turn. I win.” She picks up the wooden board, tips everything off in a pile and stands up. 

She then runs across the room looking every bit like a typically playful five year old. 

I’m pretty sure she has indeed won! But in a way, I've won, too – because I now know what kind of thing is bothering her. It’s been a good first half hour.

---

The case of the little hoarder

Therapy room peep 11

A diminutive lad blows into the therapy room, literally – like a whirlwind! He's cheerful, full of life, talkative and absolutely OK with choosing what he wants to play with and talk about.

So far so good. Until he wants to play a game with the cushions and the dolls and soft toys. A game that involves him getting all settled for bed with them and wanting me to tuck both him and them in, and say good night.

He can’t get comfortable! 

I check (in a stage whisper) what it is I have to do – I always check out my role and stay within it. 

I do my best. Nothing works.

I’m already thinking about what all this might mean. What might be causing him not to be able to settle for bed? What does he need that he's unable to ask for?

“I’m not getting it right, am I?” I say tentatively. “You just can’t settle for bed. You want me to do something and I’m just not understanding. Help me out here.”

He sighs and sits up. 

I move away a little to give him space.

It seems as if he's going to say something – and many children do know exactly what they want and need. Often it’s something they haven’t had enough of but are unable to articulate. In these cases, they’ll regress a bit in therapy to make sure they get what they’ve missed. For example, they might want to be given a feeding bottle or a bedtime story, or just be allowed to chat during their “pretend bedtime”.

Let’s see what happens.

The lad empties out his jacket pocket. A few coins, sweet wrappers, a toy from a Christmas cracker, a tissue, a cinema ticket, that sort of thing. Maybe the full pocket is uncomfortable to lie on?

And then he empties the other pocket of his jacket… a similar huge collection of things! I notice a creased photo of a lady.

Before I can keep up and think of a comment, he’s pulled up the edge of his jacket and started on his trouser pocket… more stuff. And then the other one!

“I keep a lot of things,” he explains (somewhat unnecessarily!) “and they get in the way sometimes.”

I think quickly. “Would it help if we put them all on the shelf, safe, so you can play freely while you’re here?”

His face floods with relief. 

Is that (I wonder) because I haven’t said to "throw all the rubbish away"? Or because I’ve used the word “safe”, which proves I understand about his need to keep this stuff? Or some other reason I am yet to discover?

What I do learn later is NOT that he's now living with foster parents – obviously that sort of information came out at the initial interview – BUT that he had been picked up from school one day by social services when they needed to remove him to safety, and that he'd never had a chance to say goodbye to his mother who then went to prison.

He's now anxiously holding on to whatever he can in order to find some stability. Which, as I said, he was doing fine on the face of it, and surviving. But not probably thriving underneath.

So over the next few months, we work on what's happened to him until he understands better and can let some of the stashing go as his anxiety and confusion diminish.  

I think of him today as a little red squirrel whose habitat was decimated in an instant in a storm. No wonder he started another stash he could keep with him for "if in case".

---

The case of the little scapegoat

Therapy room peep 12

A child comes to their session one day and angrily announces: “They always blame me for everything!”

I can identify with the feeling! Some days, life seems like you’re the scapegoat for everyone else and you’re nothing but “the one to blame”. But I don’t put my own view, simply acknowledge they feel they're always to blame.

It's clearly just happened because emotions are still running high. But the thing is, you can’t really discuss things calmly with a child when they’re on fire with the injustice of it all. 

So, even while acknowledging the child’s feelings, I sit myself slowly down near the sand tray and the child follows suit – as I hoped they would. 

We dig our hands into the dry sand and drizzle it across each other’s arms for several minutes until I notice their breathing has calmed down.

I say: “Feel like telling me what happened now? Or do you want to forget about it?” I always give choices.

The story comes out something like this. 

The little brother had knocked something off the coffee table. The child was immediately blamed, and this made them feel the brother was the favourite and the parents always expected the child to take care of the brother, make him happy, let him have most of the fun when something new happened in the family, and sort him out when he was crying!

That’s quite some complaint to carry around! 

“It’s hard to feel you’re nothing but a childminder, isn’t it?” I say. “Especially if it’s always you they seem to blame. I think I’d feel the same. But you know what?”

The child stops with a handful of sand at the ready and looks up at me. “What?”

“Try putting your fist in front of your eyes,” I suggest. “Can you see the room?”

“Of course not” they say with a grin.

“OK, so put your fist out in front of you like this,” I say, demonstrating. “Can you see the room now?”

“Of course!” 

Sometimes, a child can’t see anything but the one thing that’s bugging them right then. Right in front of their noses. None of us can. My job is to help them gain some perspective so they can restore their emotional wellbeing and cope better.

I reach up to the shelf and grab a paper plate and a bundle of cards. “Fancy having a go at my magic hat game?” Which child  ever refuses a game?!

The game works like this. I put the eight pieces of card face down on the plate around the edges and invite the child to turn a random one over, one at a time, with discussion in between, sometimes acting it out. We then try to decide which time the child can remember being one of the eight “people” – in other words, when have they worn each hat?

Let’s see what happens.

The child happily turns over a card, wondering what to expect. It reads “mascot”. I explain a mascot is something you take with you that makes you feel better. 

This child is 10, so they're immediately able to say: “That’s when they always boast about my good marks in Maths to the neighbours! It makes them look like good parents. But I'm proud of myself really!” 

We share a laugh.

Why does this help? The child now remembers they’re good for something else too. They’re not just a scapegoat and nothing more.

The child turns over another card. Hero? They say they recently grabbed the brother before he put his fingers in an electric socket. Sick one? They sheepishly admit sometimes pretending to have a stomach ache to get a day off school!  Little one? Acting babyishly when it suits them to not have to do a job. It works, apparently!

And so we carry on through caretaker, peacekeeper, quiet one – and scapegoat of course. And the child realises they’re not just the scapegoat but have lots of other sides to their character, all of them useful at one time or another.

“What do you reckon? Do you like being 'you' in all these ways?” I ask. 

I wouldn’t have asked this if I hadn’t been working with this child for several weeks and know what’s okay to ask.

“Yeah, it’s okay, and I do love my little bro, actually. He’s just a pest sometimes!”

The visual, tactile experience and conversation we've just had in the playroom is now inside their heads  and can be recalled next time they feel they’re “just the scapegoat” in the family and nothing more. Hopefully it helps stabilise an upset reaction at some point.

---

The case of the important agenda

Therapy room peep 13

A young client bounces in with his usual agenda on a slip of paper in readiness. He announces he’s had a better week at school and then copies his agenda onto the little chalkboard and props it against the wall.

"This is important," he tells me.

He says that every time! The whole session is always punctuated by repetitive phrases. I think this must give his sessions a kind of structure that makes him feel safe.

We also always follow his agenda for activities, partly because that’s how therapy works, and partly because therapy can be usefully done via any activity, any play, any conversation.

The first item on the agenda is to show me his violin and play me a tune.

“You concentrated really hard there to get the notes right,” I tell him as he finishes and clips the bow carefully back into the case. “I could see it on your face.”

His smile broadens. “I did,” he replies. 

“Suddenly his face goes solemn. "But we didn’t get the baby right.”

This is the reason he’s here. He’s distraught most nights at bedtime about the loss of baby Z (as he calls him) – at a very, very early stage of pregnancy. He’s old enough to know how babies start their life, but I do wonder sometimes how early is wise to share the possibility with younger children.

Still, this has become a weekly report – part of his agenda – to tell me how he's feeling. I didn’t suggest this. Remember, we follow his agenda. He obviously needs to report in on the reason he's here.

Despite reminding himself and me that it had all gone wrong with baby Z, he tells me he's feeling “this much” better, demonstrating a smallish amount with his hands!

He kneels by the sand tray and tries to pick up one grain. “It’s only this big now,” he says. (Presumably the bad feeling?) “Next... it's time to slap our legs,” he says.

This is not as rum as it sounds! He decided in the first session that we'd march around, so I simply did the alternate-thigh slapping myself and he happened to copy! (I'm always aware a child may copy – so huge thought is needed beforehand as to whether something is in the child's best interests or my own!) However, bilateral tapping carried out in all sorts of ways regulates the nervous system from the scary fight-or-flight mode back to balance and rest. It often settles trauma.

So we march together up and down the room, slapping our own thighs alternately and reciting: “Bother, bother, it would have been grand, but now it’s just a grain of sand.”

I assume "would have been grand" refers to baby Z. He invented this routine and words in a previous session, so I guess he said what he meant. In effect, he’s doing his own therapy and monitoring his own results! 

“Picture time,” he announces as we stop marching.

This is an ongoing image he’s making with paints, crayons and drawings he sticks on that describe all his sad things – like Dad leaving to live elsewhere after the baby was lost, fall-outs at school, and a change of teacher that upset him.

As he fills in as much as he wants to this week, he describes in great detail his second home, his second bedroom and the second heating system and how it works differently to the one in his first home.

Detail matters to him and I don’t take over. I probably nod and say "um" quite a bit, though! And I clarify every so often.

I wonder to myself if he's possibly always relied on a mental list of the order in which things should happen when a mum gets pregnant, and therefore I wonder whether the fact that the list went wrong is more bother to him than the loss of the unborn foetus. I may be wrong, but he’s sorting himself out in his own way, given time and space here to do so.

Amazingly, he suddenly ditches the next item on the agenda and announces: “I’m going to paint Dad’s new house.”

I indicate the clock and simply remind him that he has another 15 minutes if he wants to finish his agenda. But that it’s always his choice.

“It’s all right,” he assures me, sounding like a mini adult. “I can change the agenda if I want. It’s mine!”

“It sure is,” I agree. “Paint it is, then.”

The rest of the session has no relevance at all to the agenda he set. This is a first! No agenda, no structure. No needing to feel specially safe.

And because of that, I know that very soon he'll be fine and go on his way. Therapy doesn’t have to go on and on.

In the end, he was with me for only six sessions. 

---

The case of the secret hiding place

Therapy room peep 14

My therapy room is only about 19 feet by 7 feet but it must sometimes feel a little too large for a small anxious child. This child was one of those, and the floor figured a lot during his sessions!

I often sit on the floor to do what we’re doing – make that “usually”! – as it gives me a child’s eye view of anything higher than the pair of us. Sometimes the whole session involves me being on the floor. Quite exhausting at times!

Alex is a sensitive child. Although things are always peaceful in my room (when he arrives), he still enacts the overwhelm he always feels in the outside world. 

That’s fine by me. If he brings it in with him, I can start to understand his world better.

Let’s see what happens.

Alex always comes in, nods at me, and immediately takes refuge under the table.

It’s become his special spot, and he gradually takes in blankets and cuddly toys until he feels calm enough to speak.

So, here I am again today – down on Alex’s level, joining him  – at his invitation –in making the safe place how he wants it.

Today it’s a fort. Blankets and cushions. Inside the fort, we have a mini world of imagination and adventure going. We play it out together, following his directions. 

I always trust a child to make sense of things in their own way and time. And I also see that the pretend games are growing Alex’s confidence week by week.

So today we’re searching for treasures just outside the fort. We swap roles – one minute the explorer unearthing potential treasures, then an angry animal coming to steal them.

When we’re safely back inside the fort, he says: “What can we do now till morning?”

"Morning" is part of the play scenario, of course!

We have half an hour of time left in his session. He’s been here a few weeks and I feel I can make a suggestion that may help.

“How about we search in the forest for any crayons left by the kids who play there? Maybe there’s some paper left that we can use here in our fort? But who’s brave enough to go search? It’s getting dark out there!”

This throws it open for Alex to refuse the idea or take things further. I don’t want to lead but equally I don’t want to stall the process when he’s asked a specific question.

“I’ll go,” he says. 

I hear a ring of new-found confidence in his voice – that he can deal with the world just a little bit better. Maybe no angry animals will overwhelm him this time?

I wait a few moments, not completely able to see what he’s doing through the one slit in the blanket-curtain, though my ears are alert. I am, after all, responsible for his safety!

“Got it,” he beams crawling back into the fort. “Let’s make a book of our adventures.”

This is gold dust!

He’s going to draw and colour, and he can tell me what it’s about if he wants – or I can “read” what’s going on if he doesn’t.

After this week, Alex gradually spends longer outside his hidey hole than in it. The play gets more boisterous, without him needing to escape from it. In a few weeks he’s ready to return to the world to see how he copes with noise and people all round him.

Me, I love being on the floor in the therapy room, but it’s nice to stretch my legs sometimes and make sure I can still walk!

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ALWAYS:

Trust your instincts,
use your judgement, protect the spirit
of your child