Arriving at Therapy - and Self
Children arriving in a new space need to orient to feel safe in the environment. Children literally need to connect to themselves, then their relationship with others and then the environment (Elbrecht, 2012).
Young children are not in charge of their lives and they do not often get a choice when they are presented to therapy. They enter a strange space and are then asked to follow instructions with someone they have not met before. This can be very overwhelming as children take in the whole situation as one stimuli: that is you, your energy, your room and all the other activities that you offer (Elbrecht, 2012, p.272; Winnicott, 1964).
“From the Gestalt play therapy perspective, the symptoms that bring a child to therapy are the indications of the client’s unfulfilled attempts for self-regulation and in being supported in his worlds of family, school and community“ (Violet Oaklander, 1978; Carroll & Orozco, 2019). The energy that the child could use for functional life activities is blocked, so the child then makes adaptions, this leaves the natural process towards growth and development as blocked or interrupted. (Carroll & Orozco, 2019).
To overcome these adaptions requires an engaging and impactful relationship that both the therapist and the child build. The foundational need is building safety and security in that relationship. The therapist tunes into her felt sense of what the child is expressing through body tone and behaviour (Carroll & Orozco, 2019; Elbrecht, 2012).
The therapists role as healer is not a new concept, the use of attunement as a vehicle for healing is figural in Gestalt Literature (Bloom, 2009, Spagnuolo-Lobb, 2012, Yontef, 2009) and attention to dialogue in Relational Gestalt (Yontef, 2009) emphasise the quality of the relationship and the impact on individuals as co-created at the contact boundary.
I rely heavily on my Gestalt training as my overarching framework in my work. The phenomenological enquiry, the relational tone, the neuroscience embedded in the theory, the organismic regulation, field theory, and the process of working at the boundary where everything is relational. The Gestalt emphasis is on how to observe and experience what is going on in the present moment. Offering a way to observe how children organise themselves and their world on a moment by moment basis (Carroll & Orozco, 2019).
In private practice we do not always get a detailed referral so you have to be attentive and tuned in when children arrive for their appointments. In order to break down this overwhelm I will frequently meet at the swings in the park across the lane from my space. The swings are my secret weapon for reducing anxiety and down-regulating little nervous systems as well as increasing attunement in relationships.
One example is when Lisa aged 3 was brought for a Clay Field Therapy session. Her parents are going through an acrimonious separation and Lisa is affected by this separation. On the first day I can hear Lisa howling and screaming as the car pulls up outside my space. Lisa has just been collected from an access visit with her father and the mother assures me that Lisa is always very distressed after these visits. I went out and suggested we go to the park and let Lisa have a swing while I talk with the mother and glean as much information as I can about how I can help Lisa feel safe. Mum is pushing her and I am in front of the swings slightly off to the side. I can see that Lisa settles with the rhythmic repetition of the swing. So, Lisa is now arriving in to herself.
I notice she is reaching out her foot to kick me as she swings forward. I am still talking to her mother but I start playing a game. I gently lean in closer to her and she tries to kick me. I pull out when she gets close. Lisa is interested in relating with me but she is still clearly a little activated. I jump in front of her and quickly away again, she misses again but after a few rounds she manages to nick my arm with her foot, she smiles. I make a big fuss about being wounded and Lisa giggles and thinks this is hilarious. We repeat this rhythmic dance. Lisa is transformed back from being highly activated, through aggression to social engagement and play. Lisa feels empowered having been able to complete her fight, flight activation through play (Kline & Levine, 2007). At the end of this action Lisa signals to her mother to stop the swings. Lisa dismounts and takes my hand to cross the lane into my space. Lisa has arrived in relationship with me.
As we enter my space there is a table with a paper plate, a ball of clay and a small rubber duck as well as a smorgasbord of collage material, foliage, treasures, glitter pens, and paints. I position myself beside Lisa and attend to her, giving her my full presence while checking in about how I can help, what does she want to create, enquiring about what the duck needs to feel warm, comfortable and safe. We co-create a nest for the duck. Lisa is able to manipulate the clay and apply her own materials but she outsources to me to make the protective features of doors and fences to secure her boundary. The finishing touches were crystals and fairy dust and a friend stuck on the side of the nest. Lisa has arrived in a safe place. I took photos of the safe place to keep in my space for next time. The creation was taken home with great delight.
I did not know this child’s full story but I was very aware that she craved to feel safe. This session achieved stabilisation and safety through symptom reduction and building social, emotional and psychological resources which is the first phase of trauma therapy and translates to Situation 1 in Clay Field Therapy (Elbrecht & Antcliff, 2014).
Clare Jerdan
MA, Bac.Soc.Sci, AThR,
Clinical memberships: PACFA, ANZACATA, GANZ
References
Bloom, D. (2009). One good turn deserves another… and another…and another: Personal reflections. Gestalt Review, 15 (3), 296-311, 2011.
Carroll, F; & Orozco, V. (2019) Play Therapy,14(3), 36-38./ September 2019/ www.a4pt.org
Deuser,H. (2010), Master Class in Apollo Bay, Victoria, November.
Elbrecht, C. (2012). Trauma healing at the clay field: A sensorimotor approach to art therapy. London: Jessica Kingsley.
Cornelia Elbrecht & Liz R. Antcliff (2014). Being touched through touch. Trauma treatment through haptic perception at the Clay Field: A sensorimotor art therapy. International Journal of Art Therapy, 19:1, 19-30, DOI:10.1080/17454832.2014.880932
Levine, P.A. and Kline, M. (2007). Trauma through a child’s eyes. Berkeley, CA: North Atlantic Books.
Spagnuolao Lobb. M (2012 September). Towards a developmental perspective in gestalt therapy theory and practice: The polyphonic development of domains. Gestalt Review, 16(3), 222-224.
Oakland, V. (1978). Windows to our children: A Gestalt therapy approach to children and adolescents. New York, NY: The Gestalt Journal Press.
Winnicott. (1964). The Child, the family, and the outside world. (Reprinted 1987) Cambridge, MA: Perseus Publishing.)
Yontef, G. (2009) The relational attitude in Gestalt theory and practice. In L. Jacobs & R. Hycner (Eds.), The relational approach in Gestalt therapy (pp. 37-59). New York: Gestalt Press/ Routledge, Taylor & Francis Group.
MA, Bac.Soc.Sci, AThR
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