Many people in the realm of caring for children, especially teachers and pediatricians, are quick to refer children to behavioralists or to suggest cognitive behavioral therapy. These approaches miss the mark of how children actually communicate and learn. These assumptions regarding children and their needs can be harmful and provide a great disservice to children. Let’s look closer at what these approaches mean.
 
Behavioralists: This approach is rooted in the study of Pavlov’s dog. Essentially, when feeding a dog, they paired the feeding with a bell tone. This they proved led the dog to associate the bell with food, thus when the bell would ring the dog would salivate. Once the food was removed from the equation, leaving just the bell, the dog continued to salivate. Essentially this is about creating new associations. I see this as a more antiquated approach to behavior, and here we see it is actually rooted in working with animals with less complex brains than humans.
 
Cognitive Behavioral Treatment: Here we are working on the idea that if we change how we think, we can change how we feel, and thus behave.  In this approach, we are also fully engaged in the analytical areas of the brain and the frontal cortex. Here is the problem, this part of a child’s brain is still developing. In fact, we now know the human brain continues to grow until the age of 25. Frankly, this higher-level thinking is the exact approach adults are using before a child arrives at my office. Everyone has already tried similar approaches through various forms of reasoning, and there has been no resolution. I also feel this kind of approach is fairly accessible through a Pinterest or Google search.   
 
When it comes to children, I believe both approaches are overly simplistic. Their common go to by professionals who work with children, both inside and outside of the mental health field, is rooted in essentially a lack of more complex thinking and education about children, their development, and it is an underestimation of children.
 
I agree with the idea of forming new associations that are positive. I also agree with the idea of teaching new ways of thinking to children, and new ways of coping.
 
But, I believe SO. MUCH. MORE. First of all, I know that by the time children arrive at my office, these two approaches have been tried and exhausted. This is how the world already approaches children, whether by parents, teachers, coaches, or whoever. And it is EXACTLY what has NOT been working. So, I ask you, why would I repeat that cycle? Parents, teachers and the like often expect me to. It might even be how they evaluate me, by how I can prove I am teaching them.
 
Instead, play therapists know how to reach the child where they are. In play therapy, the child goes to exactly what they need to work on in the play therapy room, without me directing them and telling them what they need to do - or should do. And frankly, kids are directed in their lives more than 80% of the time. In fact, I believe with all of my experience, training, and witnessing of children in play that if I did take the lead and direct it, I would only delay their healing process by getting in the way of that process, because…
 
Children know exactly what is causing them disruption in their lives, and somehow they know (when given the right conditions and support that we provide as play therapists) that it is safe to go there, and that is where they go. They may not consciously be aware of it, but at a deeper level they know it exactly. By not relying solely on words and abstract thinking (which fits for adults, and is how adult brains function), this frees up the child’s psyche to go where it needs to go, deeper and more fully than words permit.
 
This can take repetition. After all, our brains learn best by repetition. Through these processes there can be alleviation, processing, assimilation, and learning new ways of being in the world.
 
An Example:
I knew an adult who kept sending her daughter to a behavioralist at age 3, then again at 4, and then again at 5. As they focused on changing her behaviors, no one worked to address the real problems she was struggling with, that a therapist acting in the role of teacher, focusing on how to shift her behaviors could never get to:
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• The child witnessed significant domestic violence in the early stages of life.
• The child had spent the last two years watching her primary caregiver slowly and steadily getting sicker and sicker, going in and out of hospitals and care facilities. Her mother was essentially dying.
• Daily life was focused on surviving day to day, and the home environment was fairly chaotic.

 
Nothing was being done to help her process her trauma. Nothing was being done to explore how the grief of watching the most important person in her life dying was affecting her. Instead, the system of adults involved in the child’s life were trying to change her behavior.
 
But I ask you, who wouldn’t be in a high state of turmoil given these realities? We as adults would be as well, yet somehow we perceive her, a small child living in a daily environment of stress, turmoil, and grief, as the problem. Here is the larger systemic break down that was occurring among the professionals involved with this family:

• Everyone felt really good about what they were teaching her, they could write this down and say, wow, look what we did. We did good. We gave her SO much.
• Insurance was happy with the service as it was concrete and measurable in tangible steps. The school was happy as it was very educational. The parent was happy as they advocated for their child and did what they could to support her and meet her needs. Everyone could feel “good” about their efforts and how they tried.
• Their treatment sounded great on paper. Everyone could say they tried and contributed.
• Except, nothing really did change, or it was very short lived.

 
But here is the biggest disservice of all: the failure that is then placed on the child for not changing.

• Can you imagine what short- and long-term consequences this may place on this small child? What might the diagnosis be? Might there be a decision toward long-term medication? Yet, what the child really needed was to have their early childhood trauma addressed. What the child really needed was to express what life was like with their mother slowly deteriorating, every day of their life.
• How would this impact you, an adult? Now imagine how it would impact you as a small child with a limited vocabulary to express these very complex realities. It’s difficult for adults to put into words. How can we expect a small child to?
  
  

I look forward to a future where all child therapists are play therapists, because play allows children to express their inner reality in a manner that isn’t limited by words. We really need to move beyond our adult limitations and see children as unique and complex people with a language of their own. And if we hope to reach them, we need to learn how to bridge the language gap. Play is the vehicle to do this.

“Play therapy is to children what counseling is to adults. Play therapy utilizes play, children’s natural medium of expression, to help them express their feelings more easily through toys instead of words[1].”
 
Children use play, as it is their primary and most natural form of communication, just as adults use language. Here are some examples to illustrate the power and importance of play for a child’s complete ability to communicate in therapy.

• A ten-year-old boy has a parent in prison but is silent in front of his mother. When she leaves the room he walks to the dollhouse, takes the father figure and walks him to the art cabinet, puts him in, closes the door, and says, “He’s in jail.”
• A four-year-old child, burned as an infant, plays with the dollhouse and engages in repetitive trauma play by placing the baby figure on the stove.
• A first-grade child living in a shelter takes a baby doll and slams it to the ground.
• A three-year-old child in in-patient care suddenly tells his play-therapist, “The police are coming, we need to hide.” He then explains that the toys he was previously playing with from a medical kit, are items we also need to hide. After all, the police are on their way.

 
I think of each of these children and how different therapy would have been had I approached them with words and my own agenda of what the child needs, or worse, worksheets. Imagine approaching a ten-year-old boy and asking him how he feels that his father is in jail? We could clearly expect a shrug of his shoulders and an immediate, “I don’t know.” Cognitively, he probably doesn’t really “know”. A young child burned in infancy surely has a scar that remains but would likely not have sufficient words to talk about it. After all, this is a pre-verbal trauma, thus there is no formal and conscious memory to pull from. She simply doesn’t remember; but, her body does. We know this from modern day neuroscience, and her play shows this. What if I had taken the liberty to start with the last child example on how to manage our anger, as that was what brought the child into counseling? I would be working on my agenda, and I would be asking the child to enter into my adult world of full brain development and understanding. I would also miss the larger problems at work and operating in his life. The problem is, we are dishonoring the child by these common day and frequent approaches of asking children to participate in talk therapy.  
 
Through Child-Centered Play Therapy, I instead enter into the child’s world, rather than expecting a child to enter into my adult world. Child therapy must be more than an adult approach to therapy, simplified. In my treatment room, I get out of the way while providing all of the tools/toys that children need for expression, so they can go where they need to go for healing. In this space, my presence as a very well-trained clinician fills the room with understanding, and the carefully thought through responses then enable the child’s world to come alive, in the context of the play therapy room. Why? Because the child does know what the problem is and given the right environment with a well-trained play therapist, they will go there. And they will process it. 
 
I firmly believe that every therapist who works with children should be a play therapist[2]. And I think you should see it this way, too. 
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[1] What Is Play Therapy? UNT, College of Education, Center for Play Therapy. https://cpt.unt.edu/what-is-play-therapy#:~:text=Play%20therapy%20is%20to%20children,through%20toys%20instead%20of%20words.    
 
[2] I also want to recognize other expressive therapies which are similar and important, as they work differently from talk therapy. Such credentials to look for are Art Therapists (ATR, ATR-BC, and ATCS) as well other credentials (RSP/CST/CST-T, REAT, RDT), all of which are earned and maintained through either national or international organizations.

Abuse.

When it comes to abuse, people are quick to think of child abuse or domestic violence. When people think of domestic violence, they often think of physical abuse that involves bleeding and hospitalization. I am here to tell you the truth.

Abuse is so much more.

​And abuse is all I could hear as I listened to the scandalous accusations from Sunday night’s interview.  
 
Many of my clients with a history of abuse report a more insidious form of abuse, that is abuse of a more verbal or emotional nature. This is the type of abuse that gets minimized. I would argue it is as damaging, or even more so, as it hits in a way that can be hard to put your finger on; hard to define. But it wreaks havoc on the psyche and soul; it does so in such a way that it is hard to lay out and explain to others who are not living it.  
 
I will venture to lay out eight parallels, labeled in the interview as a lack of “support”, and explain how they actually fit clearly in the paradigm of abuse. Don’t let the fact that this doesn’t involve a parent to a child, or a spouse to a partner confuse the situation. This is an institution acting as all of the above, after all, the institution is made up of individuals acting in accord. 
 
Power and Control: Abuse is all about power and control, this is the tool used to maintain power. The extent of the control is laid out at every corner of the interview. Here, I will go into more detail. 
 
Medical Neglect: This is quite simply the refusal of providing medical care to an individual. Ms. Markle identified many efforts to go to an “institution” due to experiencing suicidal thoughts so intense and dire she had to say it out loud or she feared she would act on them. “The Firm” as they referenced it, or at times “The Institution”, would simply not allow her. This places this larger bureaucracy in a parentified role. Both the Duchess and Prince Harry spoke of many attempts to get mental health care, yet their attempts were denied. Normally we don’t think of neglect in relation to able bodied adults, but this type of institutionalized system creates a unique dynamic. 
 
Removal Of Personal Effects: Ms. Markle reported when she entered the marriage her passport, license, and keys were taken from her. This is an example of abuse, cutting an individual off from their identity and ability to freely leave their home. Essentially, the interview seemed to suggest a sense of being imprisoned in their own estate, as Meghan referenced not leaving in four months. 
 
Isolation: To the prior point, clearly removing personal effects isolates a person, but Ms. Markle further went on to state she wasn’t approved by the staff to go dine with a friend. This type of permission requirement again brings us back to a highly parentified system, and one that marks how she didn’t even have control over her own whereabouts.   
 
Punishment: I want to make this very clear, when abusers do not get their way, they resort to punishment. Punishment was such an ongoing theme in the interview that it seemed at the slightest push from the couple, punishment ensued. Some examples include: Prince Charles not taking Harry’s phone calls, removing titles for their children (with far reaching effects that extend beyond mere words), and not allowing them the privilege to work part time as their cousins and other family members are naturally afforded. Furthermore, more punishment and intimidation appeared to be present a few days before the airing of the interview, when negative staff reports were released accusing Meghan of being terrible to work for. Here’s another fact of abusers, they often accuse their victims of abuse, I suspect this could be in operation here: Abusers Often Accuse Their Victims Of Abuse.  
 
Placing Them In a Dangerous Situation, Intentionally: Perhaps the most devastating of all the admissions in my opinion, was the outright punishment and intimidation by “The Firm” in their reported decision to remove the family’s security. This is a shocking move, and possibly the cruelest of those reported. Prince Harry said so himself, he was born into the risk that goes with being a royal. Removing security detail from a royal, whose own mother was killed due to a paparazzi car crash, could result in so many dangerous possibilities, even death, like his mother. Punishment like this goes hand in hand with another abuser tactic: Intimidation. Oxford dictionary defines this verb as: (To) "Frighten or overawe (someone), especially in order to make them do what one wants."
 
These are simply a few common examples of how abusers manipulate and abuse, but to me they were the heavy hitters presented in Sunday evening’s interview. There are likely so many more.    
 
The reported racism of the royal couple, and clearly demonstrated in the print media is another topic entirely. But these acts are also abusive: commenting on the potential skin color of a future child in a degrading manner, comparing their precious son to an animal that has been historically used as a racist euphemism, providing the Duchess and Prince with a different set of rules to follow…the list goes on and on. I would even argue that not providing the Duchess with professional support, such as in learning the National Anthem are more examples of neglect, in that it left me wondering if the monarchy was quite possibly hoping to watch them fail, but utilizing a passive aggressive approach to avoid the appearance of any direct responsibility.

Last but not least, I applaud Prince Harry and Duchess Markle for having the courage and strength to stand up to such an overwhelming system, and their move to shifting what has likely been centuries worth of generational patterns of abuse for their family, which direly needs to be addressed. Prince Harry is a courageous and brave husband, Duchess Markle is a bold and strong woman, and their son is very fortunate to have them as parents. 
 
What did I leave out? What would you like to add? Please feel free to comment. 

As I mentioned in my previous blog, The Art Of Processing Unresolved Grief, I attended a wonderful Summit (or Zoomit if you will), on expressive therapies. The second of three workshops I attended focused on “Painting From the Source”. Like the previous workshop, the focus was essentially on laying color on paper, without any preconceived thoughts of where to begin, and to begin in the moment, just like a child does. A child’s inspiration comes from within, without much pre-thought, and it flows through them in a stream of consciousness so to speak.
 
In preparation for the course, I had spent a good amount of time reading the text by the presenter Aviva Gold, MFA, CSW, ATR. The day before taking the course, I watched as my five-year-old took a stubby piece of pink chalk, and while singing proceeded to walk around the front yard drawing on a large rock. She then waltzed to the sidewalk where she continued her masterpiece. It was pure and free expression; I watched in awe as she illustrated my textbook before my eyes. At five she possessed what I had lost a long time ago; something I now had to glean from a book. This is another example of how children have so much to teach us “adults”.
 
For my summit canvas, I had collected some packaging cardboard that I had held onto, in hopes of  finding a creative use. I took one and brought it to the training session. As I began using oil and chalk pastels, I found myself irritated by the honeycomb pattern that emerged from the board, made more obvious by the oil pastels. Had it been paint this wouldn’t have been so noticeable. I thought I should switch canvasses, but something felt like I should continue, as the topic seemed to call for me to continue in my discomfort, as this too is part of the process. The colors came on in a beautiful way, I played around with them and again I ventured into the soft pastels. Some spirals also found their way in as well, and the honeycomb seemed like an extension of this for whatever reason. The colors were so beautiful that I thought I should probably be venturing into something deeper and darker, but here is where the painting remained. So that is where I remained.
 
Eventually curves found their way in and I found myself drawing the profile of a pregnant body. I worked somewhat on proportion but knew to stay away to some degree, as I was “painting from the source” and it required me not to worry about anatomy. Given my skill level this was just fine with me. But I did focus on the breast, and some scrutiny required my inner self to make it heavier and more real. Then I drew in the milk, as if making the milk glands. Then I focused on the curve within the body. I did finish a few minutes ahead of the cut off time, unusual for me, but it felt done.
 
I wondered about what I had to birth, figuratively. Then I wondered if the womb was empty, or if it was full. If full, what was it full of? Upon further reflection, it seemed to be more developing versus empty or full. I wondered why I had drawn this, but I really liked it. I really liked the colors, and in the end the honeycomb shape seemed to fit her. She was obviously out of proportion, and that did pull at me. The soft colors helped make up for that. I wondered about what may still need to be nurtured. Or was it symbolic of my maternal self as a mother, but also as a nurturer to my clients. I feel my clients are these wonderful people who just don’t yet see it, and I feel I am able to hold their light, as I work to bring them to it.
 
In essence, art has the power to bring things to awareness that are waiting to be seen; and are waiting to be heard. This project elicited a lot of questions for me to explore; and brought my awareness to the many possibilities available to me, as well as to the awareness that something was taking form. I looked forward to seeing what that may be. 

​I recently attended an Expressive Therapies Summit, which was to be held in New York. Like all things pandemic, there was a change of plans. ​​Fortunately, it was far enough into the pandemic to allow for and adequately plan a successful transfer to Zoom, verses a Summit, a Zoomit if you will. In all seriousness, I was drawn to a class that used a divination deck to explore and process what may be emotionally affecting us. A divination deck, sometimes called oracle cards, simply put are a variation of the tarot deck.
 
I’m not a tarot card reader, but I do find them interesting for their history and immense symbolism. They certainly have a place in the psyche from a historical and symbolic perspective, as they go back hundreds of years. In this training by Abbe Miller, MS, ATR-BC, LPC, we explored her deck, the Soror Mystica deck. We ventured into taking two cards, personally selected, and using these to begin artwork that was free flowing. We were to begin just by putting color down on paper. As we did this, from an open place, we were to see what emerged and go with that.
 
I thought as I began writing this blog, how on earth do I put my experience of art into words? But this is a fair question as we really do feel this way about our inner pain, and our inner struggle. How on earth do you put that into words? This is where the struggle resides, and therefore a perfect illustration of the limitation of talk therapy. How do you, when language is such a limited resource? This is the power of expressive therapy; it goes deeper than words.
 
As directed, I began with a symbol. I chose the spiral. As I added to the colors my intuition carried me to the next piece, the next color. I used oil pastels and the blending looked very pretty. In the midst of this free stream of color blending and feeling positive about the soft nature of my work, it suddenly shifted, and I didn’t really want to go there, but this is what the work required. I knew this in my bones.
 
And so the black emerged. The blackness of the womb, of the son who had passed shortly after leaving my body. I certainly did not come to this training to go there. But this is where it went.
 
He emerged, there in my spiral. He emerged surrounded by gray matter. It obstructed the balance of my artwork, as the loss obstructed the balance of our lives. On the other side, more black was needing to be expressed, the darkness and curve emerged of the open arms which were only able to hold him for a brief part of his short ten days. The empty womb, the empty arms. The mother suffering a fatal loss. It was here that it dropped me, in all its truth it dropped me. I thought, well this is quite resolved, I did years of therapy on this.
 
Didn’t I?
 
I did.
 
I did meaningful work and meaningful therapy. I have been able to survive and thrive. But as every mother knows, and is told, the loss of a child stays with you for a lifetime. It definitely waxes and wanes, and unlike the cycle of the moon, the cycles do get longer and longer apart, even duller and duller. But they last, and when they emerge, they truly hurt. And it emerged. Sometimes clients can be fearful of “going there”. I want to say that I was able to go there without destruction, instead of wrecking me it helped lead me through another of those cycles. This is the power of using art in therapy.

​These initial entries were completely relevant and necessary, it was an easy start. Since then, I have been stuck on what to write. Partly because it seems that there are a million and one blogs in the world and I wasn’t too sure what I could possibly add to an already well covered conversation. Today, my starting point finally emerged with an idea that felt authentic and not contrived; something that feels new, versus old and used.
 
Yesterday, I had a fun time speaking to a group of future counselors who will be graduating soon, my job was to answer questions they had about the field. They were a smart group from my alma matter and the idea really began with the nature of questions I was asked. There was a lot of curiosity regarding what the type of therapy I do actually looks like, as it’s so different from what is taught in school, and most continuing education trainings. I realized that if it’s tough for fellow counselors to envision, then surely it will definitely seem foreign to non-therapists. Hence my idea was born. How do I explain what I do in a way that lays it out more clearly and makes it more tangible, while attempting to convey the power of expressive approaches.
 
Thus, this is my starting point for the next five blogs. The first three will be regarding my experience in trainings that I recently participated in, which focused on incorporating art into my work with clients. I will use my own art to demonstrate, and I will explain the powerfulness of this for myself, and thus for clients that would like to work with me. In my fourth blog I will connect these three different pieces of art, explain the personal meaning, but more importantly how this fits within the larger cultural context of what is happening in America. Although my blog will not be political, it will relate to the larger themes at work playing out in the political arena. This may turn into two separate blogs, a personal and cultural collective.
 
Lastly, I will explore a scene from Maleficent, which connects to blog three, a training on using monsters and folklore in therapy. Since I work with many survivors of rape and sexual assault, I will use this to further explore trauma using this form of art: cinema. This will provide more insight to rape and trauma. I am excited that I have finally figured out a worthy start that brings something new to the world of blogs. I look forward to sharing my insights with you, and I’m hopeful this will better define the immensity of the healing power of therapy, particularly as we delve into deeper realms using less verbal and cerebral methods.
 
Thank you for your interest, and let’s get started!