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Play into Therapy

» Mental Health Library » Treatment Approaches » Play Therapy » Featured Article

By Jan Nakao, LCSW

Jan Nakao, LCSW

Play has been recognized since the time of Plato who said "you can discover more about a person in an hour of play than in a year of conversation." If we go forward to the 1900’s in England, play therapy began to flourish beginning with the work of Anna Freud, daughter of Sigmund Freud, Melanie Klein and Margaret Lowenfeld.

They posited the theoretical foundations for the therapeutic use of play. Each tradition is connected by the central proposition that play transmits and communicates the child’s unconscious experiences, desires, thoughts and emotions.

The first documented case using play as a therapeutic tool was Sigmund Freud who in 1909 published his work with “Little Hans.” Freud saw the boy briefly for a simple phobia and recommended that his father take note of Hans’ play to provide insights that might help the child. During the 1920’s and 30’s play therapy soared; 1960’s the field was influenced by Virginia Axline, an American who created humanistic psychology: 1970’s other forms came into vogue, but by the 1980’s play therapy came on life support until Charles Schaefer organized an association for play therapy which re-established its prominence.

My interest in play therapy began many years ago after working with adults. I found the need for people to explore their childhoods in order to learn about the impact the past was having upon their wellbeing. It was then I became interested in learning about child development. I was influenced by Michael Fordham, a contemporary of Jung, Melanie Klein and especially Donald Winnicott. What I learned about children was how much fun they are to work with because of their openness, truthfulness and eagerness to engage in a process which is healing in its own rights as play is the natural language of children.

During my training to become a psychoanalyst at the C.G. Institute of Chicago, I learned about the method of sand tray therapy which goes back to the 1900’s when Jung introduced it through the work of Dora Kalff. The story of sand tray therapy goes back to Jung in the 1900’s when he and his family vacationed in the Alps where Dora Kalff, a Swiss Jungian vacationed with her children. She had read a book written by Margaret Lowenfeld a pediatrician who had noticed children playing with miniature toys in her waiting room. Influenced by what she saw and observed she created the World Technique. Influenced by Lowenfeld, Dora Kalff, created what is known as sand tray therapy. Sand tray therapy includes the use of a sand tray (19.5" x 28.5" x 3") and small miniature figures and objects. A child is asked to use the sand tray and to recreate their experiences using the available objects.

One of the striking memories I have is when one of my young clients took these miniature figures from me and spontaneously began to create a dialogue between she and her mother. Her behavior only emphasized the need to help children express and articulate the situations they face in their young lives.

Play therapy can be used with children as young as 3 years old to age 12. When I first meet children I establish a rapport by providing the child with paper and markers as a way of introducing their family to me. This activity is usually the steppingstone for introducing the play therapy toys which I carry in a suitcase. Most children will open the suitcase and go right to work doing what children know best. That is to play! Playing is based upon fantasy and enables the child to use symbols, an acceptance that comes early.

Donald Winnicott was a British analyst who began his work as a pediatrician and then turned to child psychiatry and analysis. The theme of play was central theme running through most of Winnicott’s work. By playing he meant not only the play that children do but the work that adults due through play making art, sports, carrying on a conversation etc. He saw play as the critical ingredient to selfhood as it came by way of creative, genuine discovery. One of the noteable ways he played with children was the squiggle game in which he exchanged scribbles with a child. The child would make a shape on the paper and Winnicott would in turn make something out of it. This process would continue allowing Winnicott to understand the unconscious conflict within the child.

Another idea noted by Winnicott was the transitional object or the child’s first not-me object. Please think back to your own childhood. Do you have memories of a toy or object you owned that you were attached to? When a child chooses an object for cuddling it stands for both them and the mother or caretaker. Donald Winnicott called this the transitional object and also defined the space created between the child and therapist the transitional space.

It is well known that infants as soon as they are born tend to use fist, fingers, thumbs in stimulation of the oral erotogenic zone, in satisfaction of the instincts at that zone, and also in quiet union. It is also well known that after a few months infants of either sex become fond of playing with dolls, and that most mothers allow their infants some special object and expect them to become, as it were, addicted to such objects.

A child’s attachment to these objects later becomes the foundation for play therapy which includes the use of toys. It is here that child and therapist begin the work of healing through play.


D.W. Winnicott (1953). International Journal of Psycho-Analysis, 34:89-97 Transitional Objects and Transitional Phenomena-A Study of the First Not-Me Possession.

About the Author...

Janice Nakao, LCSW is a clinical social worker in Evanston, Illinois serving children and adults.

Last Update: 3/23/2015



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