> Deb Gould is a STARTTS Clinical Psychologist and clinical supervisor.

This question guides developmental drives to separate from attachment figures and to play. Play includes games, conversations with peers, drama and so on. It facilitates the same skills that attachment does, particularly emotional regulation. When the need for regulation is urgent (e.g. anxiety around separation), play can be hijacked and it becomes difficult to play and to use it for healthy development. Responses to dysregulation reflect early attachment dynamics and, using the language of Bowlby and Maine, we see children who are:

• withdrawn and anxious , staying close to an adult or playing in a constricted way;
• disconnected, avoiding relatedness in play;
• aggressive, unable to regulate their hyperarousal; or
• chaotic, with no particular plan for managing anxiety.

When we join a child in play, our aim should be to model positive attachment relationships. Be aware though that people with attachment difficulties will try to ‘draw’ therapists into repeating a particular role (this is the transference / countertransference dynamic).
Consider the following principles:

Responsiveness

• Notice and accurately describe (‘reflecting content’) the play using her language;
• Develop a new story around this, opening up alternative outcomes to trauma or loss saturated stories.

Empowerment

• Wiping the board and moving books facilitate sensory integration and a sense of mastery. They also help to give a focus to the hyperarousal.

Predictability

• Boundaries for the toys and for the stories;
• Structure e.g. he draws up a schedule for sessions.

Consistency

• Be the same no matter how ‘badly’ the toys are behaving.

Soothing and regulation

• Provide a soothing context (e.g. low voice and light);
• Have a bag of techniques for teaching children to manage acute anxiety or hyperarousal;
• Remember, the toys can be soothed especially if they are carrying the child’s anxiety.

> Deb Gould
Deb is a Clinical Psychologist and clinical supervisor at STARTTS. She was trained in South Africa and has over 20 years experience as a clinician and supervisor in the psychotherapy field.

© 2008 STARTTS  Contact: hintsforhealing@startts.org.au