Oren - The use of board games in child psychotherapy.pdf

(138 KB) Pobierz
RJCP_A_347457 364..383 ++
JOURNAL OF CHILD PSYCHOTHERAPY
VOL. 34 NO. 3 2008 364–383
The use of board games in child psychotherapy
A YALA O REN
Haifa, Israel
Abstract Playing checkers, football or more recently, computer games, is an important part of the latency
child’s culture. The ability to play games demands a level of emotional development similar to that needed
to cope with the emotional/developmental demands characteristic of latency. A game shared by the therapist
and child provides a picture of the child’s development, patterns of interaction and internalised
representations, and is an arena where the therapist can intervene, verbally and non-verbally, in response to
the specific needs of the child. The child’s desire and need to play clash with the difficulties in coping with
the demands of the game. This raises the same issues that children confront during their maturation and
interactions with others. Observation and analysis of game play allow the skilled therapist to evaluate the
emotional development, internal representations, projections and patterns of relations of children and to
intervene to help them with their specific difficulties and conflicts and, importantly, do so in an enjoyable
way. The special challenges for the therapist using board games in psychotherapy come from the need
simultaneously to observe the game, play it ‘well’, plan actions, regulate the child’s anxiety level, maintain a
playing atmosphere and deal with transference and countertransference issues – all in the highly tense
atmosphere of competition. In the paper, I outline how board games can be used in psychotherapy, focusing
on projective and developmental domains. I present a scheme that links emotional development stages and
their expressions in game play, and use a case description to illustrate how it can be used in assessment,
treatment planning and following progress. Some of the dilemmas faced by the therapist using games in
therapy are also discussed.
Keywords Psychodynamic psychotherapy; game play; board games; emotional development.
Introduction
In my work as a child psychotherapist, I have often been faced with a problem: many
children aged 6–12 refuse or avoid imaginary play and ask instead to play games – board
games or sports – during therapy sessions. While psychotherapy with children commonly
uses imaginary play, as well as projective techniques such as drawing or drama, the use of
board games is less common. Generally, when children refuse to play imaginary games or
draw, we talk with them about resistance to therapy and fantasy, or agree to play one
game as a ploy to keep them in the therapeutic relationship. Like many other therapists,
Journal of Child Psychotherapy
ISSN 0075-417X print/ISSN 1469-9370 online ª 2008 Association of Child Psychotherapists
http://www.tandf.co.uk/journals DOI: 10.1080/00754170802472893
590222203.001.png 590222203.002.png 590222203.003.png
THE USE OF BOARD GAMES 365
I, too, often ‘gave in’ to children who refused to use imaginary play and agreed to play
games, hoping that, afterwards, they would agree to talk. I quickly realised, however, like
some before me (Bellinson, 2002), that for many children at this stage of development,
talking is not a natural language for interpersonal and inner discourse. This led me to
consider whether playing games could be used as a tool in psychotherapy.
Games are part of the culture of the 6–12-year age group. Children like playing games
and this seems to reflect their importance in children’s development. Less is written on
the use of structured play in psychotherapy than on imaginary play and opinions about it
are divided. There is general consensus in the literature that games allow examination,
strengthening and improvement of ego functions. They may assist in controlling urges,
checking reality, understanding the relations between action and outcome, regulation of
frustration and anxiety (Bow and Goldberg, 1986; Frey, 1986; Swanson, 1986),
practising coping with situations that resemble realistic ones in cooperation with others,
exercising self-discipline, responding to social norms, self-control, adaptive expression of
aggression and, in general, enhancing socialisation (Redl and Wineman, 1951). Authors
are divided however, whether games encourage or prevent expression of unconscious
fantasies, conflictual issues and other unconscious contents.
Solnit (1993) argues that games with rules serve as a defence against fantasies, prevent
imaginative play and regressive behaviour and are therefore undesirable in therapy. Bary
and Hufford (1990) contend that games serve to prevent dealing with primary pain by
focusing on action and tensions in the ‘here and now’ of the game. Berlin (1986) and
Peller (1954) see games as an expression of competition with siblings or parents, in
which the strong need to win represents the desire for victory in the Oedipal struggle. In
their view, games with structured, clear and rigid rules do not involve emotional and
creative investment except for this expression of competition In contrast, Eiferman
(1993) believes that even the wildest fantasies could be hidden within game play. The
rules of the game, which seem to be a defence, actually serve the purpose of the child’s
free expression. When following the rules of the game, children are free to express
fantasies, wishes and urges that are acceptable only in the framework of the game. The
rules release them from responsibility for their acts (within the game) and therefore
eliminate guilt. Eiferman (1993) disagrees that playing games prevents creativity. She
compares a game to music: the game developer is the composer, and the players are
musicians following the composer’s rules and instructions, but creating their own
interpretations. Bellinson (2002) emphasises the dynamic psychological meaning
expressed in the use of board games. The choice of the game, the way it is played and
the interaction with the therapist, reveal the emotional state, difficulties and interactions
of the children in their social and family frameworks. In her view the erroneous
conclusion that board games do not allow the expression of fantasy and unconscious
material is due to a limited focus on the content and mechanics (e.g. throwing the dice,
advancing on the board) of the game. Observation of how the game is played, the
decisions and reactions of the child allows insights into his/her emotional dynamics.
An issue frequently raised in discussions of board games, is that of cheating –
breaking the rules. Meeks (1970) views cheating in games as a means of maintaining
magical omnipotent thinking. He contends that children whose ability to cope and
adapt is underdeveloped cannot accept a reality that is impervious to their desires and
366 A. OREN
wishes. Those who cheat are those who cannot accept losing a game without severe loss
of self-esteem. In a later article, Meeks (2000) suggests that it is cheating and breaking
rules that reveal the child’s inner world and particular problems. Bellinson (2002) claims
that cheating allows the expression of the child’s creativity, as well as providing a view of
their difficulties. She adds that telling children to stop cheating, as recommended by
Beiser (1970) is not productive. Children know that they are breaking the rules and that
this behaviour is unacceptable – their parents and teachers tell them so. She argues that
playing games according to the rules is not interesting in terms of therapy, whereas
cheating reveals an individual style and manner. The way in which children change the
rules provides important information on their emotional dynamics. Children who abide
strictly to rules lack spontaneity. They repress emotions by sticking to the rules; their
play lacks vitality. Bellinson (2002) argues that cheating at games is part of an inner
struggle with the rules of society. Therefore, the breaking of rules is to be expected in
psychotherapy either because the children are young and lack the ego strengths that
enable them to play within boundaries or because there is a conflict between abiding by
rules and resistance to authority. Observation of cheating in a game makes it possible to
identify the prominent themes and conflicts, and to work on them metaphorically.
Indeed, she considers that a game that does not include breaking rules is not a good tool
for therapy, but a waste of time.
Watching children play, I often asked myself why they want to play and compete
even when the emotional tasks are very difficult for them. What is this need to compete
and why is it easier for some children than others? If games are not real, why do children
respond as though they are experiencing something real?
Winnicott (1971) calls the emotional space in which games occur the ‘playing space’
or ‘potential space’. If we view imaginary play as occurring between two extremes – the
inner world/‘me’ at one pole and reality/‘not me’/other at the other pole – then the
game is positioned closer to the reality pole. Because of this closeness, playing games can
cause more anxiety than imaginary play as it threatens the child’s experience of the
playing space as protected. On the other hand, like imaginary play, games are distinct
from reality and enable expression of emotions, thoughts and attitudes that usually
would not be exposed (Capel, 1968; Schaefer and Reid, 1986).
Interactions during structured play reflect coping patterns and internal representa-
tions of the child (Bellinson, 2002). When used appropriately, playing games brings out
the same issues as imaginary play, but in a different way, and one often more suited to
the latency period.
When participating in game play, the therapist presents the child with a new object
for identification, which, in addition to being an object of transference, interacts in a
real way within the ‘reality’ of the game. Therapists function as ‘subjective’ players
working towards the goal of the game in a reality that has rules. Unlike imaginary play,
where the therapist enables the expression of children’s dreams and refrains from
entering their subject reality, the game allows the child to see the therapist as a real
figure for identification. The therapist, like the child has to deal with situations of
frustration and can thus serve as a model for coping with difficult feelings by expressing
them appropriately and not disregarding them (Frey, 1986). Another feature of game
play, relevant in particular to Oedipal issues, is the need to relate to the game as an
THE USE OF BOARD GAMES 367
independent third element in a triangle (him, me and the game). The game has its own
independent set of rules and practices (its own ‘personality’), which are not dependent
on the players (even if the players agree to change the rules, the rules belong to the game
and not the players) and exists as a separate entity to which each player has to relate.
This relationship between player and game exists in addition to each player’s conscious
and unconscious associations with the game and game playing and to the relations
between the players.
The ability to play games indicates the proper development of latency: it involves
recognition of reality, of the existence of others and the ability to cope with the external
world. It requires an internalised authority, experienced as coming from within and not
dictated from the outside. In many of the children who come to me for therapy, these
developmental achievements are not stable and they regress to earlier stages of
development in situations of stress and anxiety. These regressions occur in different
situations of their life, and are often the reason for their referral to therapy.
When systematically observing children at play I use two main perspectives. The first,
a developmental perspective, focuses on the child’s ability to fulfil the developmental
requirements needed to play a game. The second – a projective perspective – focuses on
the way in which play expresses the child’s internal representations, patterns of relations
and object relations. Information from both perspectives is used to formulate therapeutic
interventions. In the following sections, I will summarise some of the principles which
guide me in the psychotherapeutic understanding of the use of board games.
Emotional development needed to be able to play a game
As discussed above, games constitute an important component in children’s culture and
social activities. Since games come from the adult world (Habas, 2002), game developers
assume that players will have attained the level of emotional development needed to play
the game. This involves not only understanding the rules of games but also adequate
maturation along a number of developmental dimensions. I will now outline the more
important of these.
The wish to compete
Players want to try out their abilities under equal conditions and not win at any price.
To be able to compete fairly in a game the child must not experience losing as
annihilation, destruction or humiliation, but as something that is temporary and limited
and can be reversed in the next round. This ability is usually present in the latency child.
However, if it is not stable, stressful situations that occur in competitive games can cause
threat, anxiety and regression. In such anxiety-provoking situations, children experience
the game as one of survival and not competition.
The ability to regulate drives, particularly aggression, by sublimation
Drives, particularly aggressive ones, can be regulated by means of sublimation in the
game. A player who has achieved the necessary level of emotional maturity can cope
368 A. OREN
with the frustration and anger that arise during and after a game, regulate them and treat
the situation as ‘only a game’.
The ability to delay gratification and action
Every game demands the ability to delay immediate gratification, to wait and act
according to a set of rules. The ability to delay gratification and action is a prerequisite
for development of thinking that is related to emotional experience (Bion, 1967). In
turn, development of this type of thinking requires an ability to deal with frustration
and ‘lack’ without resorting to omnipotent magical thinking, or filling the ‘lack’ with a
bad object. Thus, the ‘lack’ becomes an internal location where the apparatus of
thinking is created (Symington and Symington, 1996). Creation of this internal space in
which deliberation can take place is important for the ability to contain emotions, think,
plan and consider options before acting. During normal development, adults use graded
frustration (optimal frustration) to help children develop the tools necessary for
tolerating delayed gratification. An inability to deal with ‘lack’ or frustration results in
difficulty in delaying gratification – a place for thinking (Bion, 1967) or the ‘potential
space’, the space that makes fantasy and expectation possible (Winnicott, 1971), fails to
develop. These abilities are needed to play games and playing games helps to develop
them. Children who have difficulty delaying action find it difficult to wait for their turn.
They may move the other player’s piece for them, rush them, play with another toy or
fidget. This is related to the child’s neurological and emotional maturity, their level of
anxiety, and their ability to maintain coherence of self.
The ability to regulate anxiety
It is expected that children, like adults, will feel tension but not anxiety when playing a
game. Children who have not gained control and self-regulation may experience the
frustration and anxiety in the game as too strong. They may regress to magical
omnipotent thinking and change the rules of the game (Meeks, 1970) or lose control,
act out or stop playing. The ability to regulate anxiety is central to the ability to play
according to rules. When anxiety is overwhelming, the game may be experienced as a
dangerous reality, and the safe ‘playing space’ is lost.
The need for a flexible enough superego
A flexible superego makes it possible for the player to enjoy the option of expressing
regulated, sublimated aggression. For instance, the child may enjoy taking the
opponent’s checkers, removing them from the board without apologising or feeling
guilty, but will not express aggression by destroying or overturning the game. When the
superego is rigid, the child finds it difficult to express aggression and desires. Such
children are afraid to attack or defeat the opponent – for example, in checkers, they will
avoid taking the opponent’s pieces, and apologise for being forced to make a move that
is perceived as aggressive. They request permission and guidance, and assist the
opponent instead of acting in their own interests. Their game lacks playfulness.

Plik z chomika:

Inne pliki z tego folderu:

Inne foldery tego chomika:

Zgłoś jeśli naruszono regulamin