Volume VI - 2001
The Emotions: A Vocabulary before Language
by John E. Lennon and Paul F. Barbato
James E. Lennon, Ph.D. is an Associate Professor of Psychology and Coordinator of the School Psychology Program at New Jersey City University (NJCU), Jersey City, NJ. He has been a school psychologist, school district administrator and also a Regional Coordinator for the Primary Mental Health Project, an intervention program for young children. His research focuses on early academic and social interventions with young children.
Paul F. Barbato is a Master's Degree candidate in Counseling and is currently enrolled in the School Psychology at NJCU. Barbato's research interests include therapeutic interventions with young children in applied settings.
Note: The thrust of the collection of essays Affect in Language Learning
edited by Jane Arnold (Cambridge University Press) is that a direct link exists
between the emotions and learning in general, and language learning in particular.
This is close to our basic thesis in this Journal that "Attempts to acquire
a language are significantly enhanced by the presence of an activated imagination."
It seems that the word "imagination" refers to a cognitive faculty that is
concerned mainly with integrating affect and analysis. In keeping with this
metaphor, we might suggest that analysis provides the fragments of deconstructed
concepts that the imagination can re-integrate into new entities. This process
would be ongoing: the new entities would give rise-through analysis and in
time-to more new entities. At least that schematic would account for the endless
articulation of new theories that are found not only in language acquisition
but every corner of human existence, including the sciences which are all
rooted in the perception and logic of men and women. It was Einstein who said
that the faculty of imagination is central to scientific research.
If we are to follow this line of thought, it is essential that we explore both affect-the emotions-and analysis. In the following article, Lennon and Barbato comment on ways in which play therapy is used to supplement the communication that the use of language can accomplish in older children and adults. The imagination and the emotions are central to the "play" these authors refer to. For example, they say that play therapy "may be particularly valuable in mapping feelings onto words…" In doing so, Lennon and Barbato bring attention to the mystery of what is in a word, and what is behind the enormous power of language.
This article, then, pushes us to think more about what the imagination is and what is its place in the development of children and of language. You may have to read it more than once, but it's well worth it. It is research like this that might alter the popular misconception that science is serious while the imagination is frivolous, and that therefore programs like art and music should be cut so that children can focus on math and biology. Einstein knew better.
Play therapist have used puppets, role-play, and a variety of other play materials to help children express their feelings and modify their behaviors. A non-directive approach limits questioning and adult directives and is said to allow an understanding of children from their own frame of reference. However, this traditional form of play therapy may have relied too heavily on case study methodology and may have failed to systematically evaluate psychotherapeutic outcomes. Cognitive-behavioral therapists attempt to incorporate play therapy into a systematic research-based approach called cognitive-behavioral play therapy (CBPT). This approach is contrasted with the non-directive, psychodynamic approach of traditional play therapists.
Expressions through Play
Entering into a child's world sometimes requires a willingness to allow a child's thoughts and ideas to unfold in fanciful stories and meandering play, rather than through the more direct means of asking questions. Using puppets and sandcastles, bits of wood and pieces of cloth, child psychologists have helped children become actively engaged in funny, sad and sometimes deeply emotional monologues and dialogues that provide a window on their ongoing thought processes. Child psychologists interpret the symbolic meaning in a child's play in order to shed light on the feelings and events that children may be unable to talk about in a direct manner. Play is a natural outlet for the expression of thoughts and feelings for children (Piaget & Inhelder, 1969). We may recall play-acting the imaginary roles of classic children's tales and childhood conflicts played with friends from our own childhood. However, play can also serve important functions within the context of a therapeutic session.
Play therapy is often used with children under nine years of age in order to encourage the expression of their thoughts and feelings (Garbarino et. al., 1992). Young children's stories often wander from topic to topic and rarely go from "Point A" to "Point B" in a logical manner. Further, it is often difficult for a child therapist to approach problem areas directly because young children lack the reflective understanding necessary to analyze and resolve problems in interpersonal relationships (Piaget & Inhelder, 1969). In play therapy children are encouraged to "act out" these relationships by doing such things as using puppets to play various roles (Van Ornum & Mordock, 1991). "Acting out" is a psychodynamic concept that refers to the expression of internal energy in the form of observable behavior. Play in the context of a therapeutic session allows the therapist to better understand children's feelings by encouraging and observing their actions in imaginary relationships and other play situations.
Therapists and Children's Play
Interacting with children through play is a practice widely used by experienced classroom teachers. In our own experience, we have seen a child-size replica of an Iroquois "long house" help second grade students imagine the lives of native Americans. We have also seen physics teachers encourage high school students to construct and play with robots in order to teach basic concepts. The excitement of play stimulates imagination and thinking and helps to generate enthusiasm and learning. Therapists also enter into the natural world of children's play in order to meet the child on their own terms and in order to share ideas and feelings .
The following paragraphs will describe the use of play therapy in understanding the thoughts and language of young children and also provide a sampling of the techniques and procedures used to facilitate communication in play therapy. The internal and external validity of the use of play therapy will be examined through a brief review of the child psychotherapy literature. Finally, the theoretical rationale for the cognitive-behavioral approach to play therapy (CBPT) will be examined and contrasted with the non-directive, psychodynamic approach.
Thoughts More Magical Than Logical
Direct question may not produce direct responses from children. Children may not be able to answer questions directly because of the limits imposed by their stage of cognitive development and the relative paucity of words in their personal lexicon to describe feelings and events. Children in the four to six-year-old range are in the pre-operational stage of cognitive functioning (Piaget & Inhelder, 1969). Their thoughts are said to be more magical than logical. They may believe that the moon is "following" them and may have difficulty distinguishing dreams from reality. So it may be difficult to engage in inquiry with young children using direct questions. The language of children, particularly young children, may not be adequate to express what they really know and feel. An adult's lack of understanding about how a young child thinks may cause confusion in an adult-child conversation.
Additionally, children may not be able to express themselves because of certain emotional constraints. Parents are often shocked to see a child playing, seemingly blissfully, at times of severe emotional distress, such as the loss of a close family member. However, it is natural for the child who is overwhelmed by emotion to dissociate him or herself from a distressful event. Play allows an emotional respite. Children put off, or repress, what they cannot handle and this process serves as a protective mechanism. However, within the context of play therapy, children can also explore distressing feelings in the safety and security of the play therapy room. With the benign collaboration of the play therapist, children explore their feelings and anxieties by telling fanciful stories using puppets or by acting out family dramas with the dollhouse. Play, then, can be used as an important tool for assessing a child's cognitive and social development. When talking with children, the non-directive child psychologist does so from the child's frame of reference in order to better understand their underlying feelings and emotions (Van Ornum & Mordock, 1991). This approach allows the child the time and space to express themselves through active play.
Metaphors Provide a Safe Distance
Through symbolic play, children can express ideas and feelings that would ordinarily be taboo. Distancing from the moment affords a feeling of safety and allows the child to "play out" problematic material more easily (Garbarino et. Al., 1992). For example, a sexually abused child might begin to explore power and control issues in a relationship by being a "sheriff who locks up the bad guys." Some therapists may actively participate in play acting, perhaps by taking the submissive role. As the session progresses, the therapist might possibly verbalize reflected feelings of powerlessness in the role, e.g., "It's scary to sit in the cell with no way of getting out!" These words, if accurate in reflecting the child's feelings, give voice to the sensation of powerlessness, thus taking tentative steps toward deepening the understanding of the child's own feelings. In their play, children use metaphors to distance themselves from the content and the characters being enacted. For example, a child can tell a fanciful story about a lost kitten to express his/her own fears of abandonment. Play therapy, then, can be used to gain access to material that is too stressful to deal with directly and allows children to express themselves at their own pace and in their own time (Garbarino et. Al., 1992).
Virginia Axline's seminal work, Dibs: In Search of Self (1964) documented the use of play therapy with an emotionally disturbed child. Axline took a reflective approach based on the "here and now" experiences, but also used the psychodynamic context to develop an understanding of symbolic play. The reflective approach was more similar to the then innovative style of Carl Rogers, encouraging active listening, rather than a more passive stance of psychoanalysis. However, Axline drew upon the more traditional concepts of psychoanalysis to interpret children's play. Current play therapists' interpretation of symbolic play may come from such sources as a reflective understanding of his and her own experiences, familiarity with children's literature and fairy tales, and a familiarity with psychodynamic theories. This non-directive psychodynamic approach takes the direction of the therapy from the child. (Later in this paper, CBPT-a more directive approach-will be described in which the therapist has a clear goal in mind and actively directs the child's play.)
By taking a non-directive point of view, the therapist tries to ensure that the play will be child-centered; i.e., will flow from their own experiences, rather than be directed by the therapist (Schaefer & Cangelosi, 1993). This is markedly different from typical adult-child communications. Youniss (1980) found that most adult-child communications are unilateral exchanges. Children listen to and seek help from adults, while adults direct children's actions. In fact, children come to expect these unilateral communications. For example, when asked how they are "kind" to adults, children say they are kind by "listening to and obeying adults" and adults are kind to children by "giving them things" (Youniss, 1980). However, parents, teachers and therapists have also long recognized the value of encouraging to discover new ideas "on their own," i.e., with minimal direction from the adult. For example, experienced teachers might typically direct the learning activities of students, but also, at times, chose to serve as benign collaborators in order to encourage discovery learning through active, independent exploration. Discovery learning is a key component of educational theories influenced by Piaget, such as the Montessori method.
Non-directive therapists also strive to overcome typical adult-child communication patterns by not directing the activity of the child, but by following the child's lead in the playroom. The intent is to encourage the child to not simply wait for direction from the adult, but to begin to recognize that the playroom is a place of discovery and independent exploration. The therapist then is also serving as a benign collaborator, providing a safe and secure place and a warm, positive interest in the child's activities. Additionally, the opportunities available in the one-to-one interaction with the child allows the child therapist to spend the time required to allow a gradual unfolding of the child's inner thoughts and feelings. Rather than seeking self-disclosure, per se, the therapist seeks to provide a trusted presence, resolution of feelings and template for future experiences, as noted below.
Play: A Symbolic Language with a Vocabulary of Emotions
Play can serve as a symbolic language for self-expression. The "child's play is his talk, and the toys are his words" (Ginott, 1961, p.29). In this view, play activity is thought to be the natural way for children to show how they feel about themselves and the important people and events in their lives. Inhelder and Piaget (1954) note that the projection of one's thoughts, feelings, and conflicts onto play characters provides an immediate tension release. This emotional release is thought to resolve emotional conflicts.
For example, some children have a fear of relationships that effectively sabotages their opportunities for productive interactions with others. These children learn to protect themselves from this fear by pushing people away through aggressive behavior. When such children enter play therapy, the therapist attempts to offer choices and encourages independent activity, while providing warmth, positive regard and understanding. If rapport is established within an individual relationship, the child becomes involved in a very complex and personal learning experience that may serve as a template for future relationships (Jennings, 1999). Children use the medium of play to produce a symbolic neutralization of fears, liquidation of conflicts, and corrections of reality (Schaefer & O'Connor, 1983). They begin to learn a vocabulary of emotions that aids in self-expression.
For example, a child may invent, and then obsess about, a super-hero figure as an emotional replacement for an absent father, a linkage of which the child is unaware. The therapist might hypothesize about the existence of a link between father absence and this powerful fantasy figure, but also recognizes the substitution may be an important part of the child's coping mechanisms. So the therapist carefully and tentatively explores the ongoing flow of the child's day-to-day experiences and the fantasy images, perhaps drawing the child's attention to the times when the super-hero figure becomes particularly important in the child's life. While a direct understanding of this link is unlikely, the child may come to understand that fantasizing about the super-hero figure helps him or her to feel better, thus providing the child with greater understanding of the coping mechanism.
Building the Child's Personal Lexicon
Children may not be able to attach verbal labels to the unhappiness they feel. Helping them to separate feelings of frustration from feelings of anger, and feelings of disappointment from loneliness aids in the process of getting a handle on being vulnerable and out of control. Together, the child and the therapist begin to build the child's personal lexicon of names for emotions. Many therapists draw on a popular poster, which matches assorted facial expressions and a range of emotions. Eventually the child may be able to talk directly with the play therapist about the "ups and downs" of their day-to-day existence and work toward resolution and ego integration. In this way, troubled children begin to establish appropriate boundaries in their life.
Child psychologists often use puppets as a medium of communication with children. Elementary school counselors assist children in expressing feelings, re-enacting events, and modifying behavior by using puppets. Classroom guidance programs for primary level school children have included puppets as part of their presentations to interpersonal skills (Campbell, 1993). Kemple (1994) also notes the wide use of puppets in preschool settings. Puppets are thought to provide an outlet for fears and anxieties and are widely used in a variety of clinical settings. Non-directive, psychodynamic play therapists use puppets to help children transfer their feelings onto an inanimate object in order to deal with uncomfortable feelings.
The most frequently used puppets in play therapy are glove and finger puppets (Jennings, 1999). Finger puppets are easy for small fingers to handle. A child can support a whole family on the fingers of one hand and share with a therapist their perceptions of familial relationships.
A New Sense of Self
Additionally, dramatic play materials are used to stimulate imagination, allowing the play therapist the opportunity to observe the child's verbal and nonverbal behavior and thinking and decision-making processes (Irwin & Rubin, 1976). Tape recorders, play telephones, costumes, and drawing materials enhance and promote communication with a child. These therapeutic props encourage the child to begin to use their imagination and enter into role-play. While in a role, the child can enact a personal vignette or replay a universal theme, such as the fear of abandonment or sibling rivalry. Children sometimes draw on the themes of children literature and fairy tales. In the play room, they can become the "wicked queen who rules the forest." Imaginary roles help children to overcome their anxieties and experience a sense of power and control in their lives. These vicarious experiences can serve as the basis of a new sense of self.
Storytelling and reflection are often used within the context of non-directive play therapy (Jennings, 1999). The therapist and child may engage in mutual storytelling, in which one starts the story and the other enhances and embellishes the story line. While story-telling is often an important and typical component of a literate classroom, the play therapist has the advantage of extended, regularly scheduled one-to-one interaction, unique and special time for the child. The reciprocal interaction of the storytelling is based on a reflective understanding of the child's current emotional state, gained through empathic responding. This reflective understanding is "co-constructed", i.e., based on a mutual understanding and collaboration between the child and therapist. The therapist tries to help the child construct a story that builds on feelings and thoughts of which the child may be only vaguely aware. Here the therapist treads carefully to avoid constructing "false memories" or overtly influencing the child. However, just as an adult might gradually deepen their understanding of a relationship by "talking about it," the child may improve their understanding by "playing about it."
Materials in the play therapy room may include clay, sand and water tables, toy furniture, doll houses, doctor kits, dart guns, and over-sized clothing. Toys are matched to the levels of developmental functioning of the child (Schaefer & Cangelosi, 1993). Specific materials may be selected to encourage the exploration of conflicts and relationships, such as the use of finger puppets to explore the child's concern about divorcing parents. However, the use of toys as a medium of communication with children also has certain limitations. The child may see the therapist's attempts at engaging the child through play as "silly". Some children are reticent about engaging in dramatic play as a therapeutic intervention because of their natural inclination toward shyness. The interpretation of the play is subject to the biases and preconceptions of the therapist. Recent examinations in the field of child therapy raise issues of validity regarding the technique.
Validity Issues in Play Therapy
Durlak et. Al. (1995) reviewed extant studies (376 published reports and approximately 670 unpublished dissertations) in order to evaluate the validity issues in child psychotherapy. Validity is a broad construct in psychology that refers to whether an assessment actually measures what it purports to measure or whether an intervention has the effect or outcome that it was intended to have. As Cicchetti & Toth (1992) have observed, many child psychotherapies are not theory-based, nor firmly rooted in developmental principles. Psychotherapies that are downward extensions of adult-oriented approaches neglect the importance of constraints imposed by a child's level of language development and cognitive understanding.
The difficulties of conducting validity studies in this area were found to be significant. Indeed, Durlak et. Al (1995) noted outcome studies regarding the effectiveness of child psychotherapy generally use quasi-experimental designs (non-random assignment) rather than true experimental designs. Random assignment helps to protect against sources of error variance such as selection bias or placebo effects. The few studies that focused on play therapy in particular were found to be no exception to the general trend in this area. Thus, while play therapy attempts to deal with validity issues by incorporating developmental considerations in the delivery of the interventions, more extensive experimental data on the effectiveness of this approach is needed.
Finally, because many children in research studies were recruited from the general population, they may not be representative of actual clinical inpatient or outpatient populations. Durlak et. Al., (1995) suggests that child psychotherapy research would be strengthened by greater use of normative outcome measures, by assessing the general as well as the specific impact of treatment, by using attention-placebo controls, and by collecting follow-up data.
Recently cognitive-behavioral therapists have attempted to incorporate play therapy into a systematic research-based approach. In this approach, "cognitions" (thoughts) and the child's behavior are the subject of assessment and analysis. Rather than "following the child's lead" as non-directive therapists do, cognitive behavioral therapists take an active, directive role. "Positive self-statements," such as "I'm able and willing to try," are encouraged and concomitant "negative self-statements," such as "I don't have the capability," are discouraged. Cognitive behavioral theory is a goal-oriented and attempts to correct unproductive behaviors and thoughts. Cognitive-behavioral therapists typically use direct inquiry, behavioral observations and data collection to determine the parameters of the problem areas. Cognitive-behavioral therapy relies on the empirical findings of clinical studies, rather than the case study approach of traditional play therapists. Thus, in an attempt to match therapeutic interventions to a child's developmental level, cognitive-behavioral therapists have adopted and modified play therapy in order to gain access the thoughts and behaviors of young children (Knell, 1998). While a young child may not be able to respond to a direct inquiry, such as "What is bothering you today?", this same child may be able to answer the therapist's direct inquiry when given play materials. The therapist may also use play materials to demonstrate a new social skill and encourage the child to practice this social skill in the context of a role play situation using puppets. Thus, while maintaining an active and directive role, the CBPT therapist incorporate a recognition the child's developmental level and uses the materials of play therapy to foster communication and understanding.
The additions of cognitive-behavioral techniques to play intervention (CBPT) offer a new direction for both cognitive-behavioral and play therapies. For inquiry and intervention to be effective, both must be presented to the child in a developmentally appropriate manner. In CBPT, puppets and stuffed animals can be used to model new ways of thinking and talking. Cognitive strategies may include "countering maladaptive beliefs", such as the belief that you should hit and intimidate other children in order to protect yourself from harm. The therapist might work through several role play situations using figurines and modeling in order to encourage appropriate social interactions. Additionally, the therapist might model statements, such as, "When I'm scared, I can look for my friends!" or "When I feel alone, it is better to smile than to frown!", in order to encourage the development of positive coping skills. CBPT differs from traditional play therapy approaches by relying on a therapist-directed interventions, rather than using the traditional non-directive approach. CBPT attempts to graft the developmentally appropriate aspects of play therapy onto a goal-oriented, structured approach.
For example, Knell (1998) analyzed the interactions between a therapist and a girl (4 years, 9 months) who was experiencing separation anxiety. The therapist, through the voice of the puppet, modeled adaptive coping skills for the child, and as therapy progressed, the child began to incorporate these skills into her stories, her puppet play, and eventually her own coping behavior at school. So the puppets can be used to say such things as "When I have a hard time in school, I can ask the teacher for help." Or "I wish the other kids would stop teasing me, but I can talk about it with my mom." After listening to the therapist make such statements through the puppet, the child is encouraged to practice problem-solving through the puppets, first. This is followed by efforts to generalize the problem solving approach and help the child apply these skills to day-to-day experiences.
Puppets have also been used to help new entrants to a school adjust to their new environment (Dempsie, 1997). Children who fear entering a new school participate in puppet shows conducted by teachers with the intention of helping them to understand that their fears are shared by others. The children and teachers then work on developing successful adjustment strategies. One advantage of the CBPT approach is the specification of goals and objectives by the therapist, which readily leads to program evaluation. By contrast, the Rogerian and psychodynamic approaches do not lead to outcome evaluation as easily, because such goals as "improved self-esteem" and "increased understanding" are difficult to quantify and measure. On the other hand, as noted in the previous example, using puppets to improve the child's adjustment to school is a more specific goal and, as such, is more easily measured. Such clear and focused goals lends themselves to descriptions of "how to" use the intervention and "how to" replicate the program with different populations. Because CBPT programs with clear, focused goals lend themselves to outcome evaluation, such programs are likely to demonstrate their efficacy over non-directive methods.
Comparison of CBPT and Non-Directive Play Therapy
With an increased emphasis on outcome evaluations, CBPT methods are likely to continue to gain ascendance over more traditional approaches. However, one would not want to overlook the benefits of traditional methods, just because this approach is not easily quantified. CBPT employs play therapy techniques to directly resolve behavioral, emotional and adjustment problems. In contrast to non-directive models of play therapy, the therapist uses modeling techniques and offers suggestions to help resolve the problem the child is experiencing. CBPT lends itself more readily to evaluation because of its clear focus and identifiable objectives.
Non-directive, psychodynamic approaches attempt to explore the child's world without offering directives or engage in direct questioning. The goal is to establish sufficient rapport to allow the expression of emotions and conflicts that were previously hidden. This release and insight is seen as an end in itself, and at the core of psychotherapeutic change. However, the non-directive and psychodynamic approaches have been criticized for failing to examine outcomes in a systematic manner. As an alternative to the non-directive approach, CBPT, then, provides a therapist-directed approach that lends itself more readily to outcome evaluations by emphasizing on structured sessions and therapeutic goal setting.
However, as noted above, one should not overlook the advantage of traditional methods at the expense of emphasis on quantitative methods. As presented through "case study" or qualitative methods, Axline (1964) and others suggest that a child-centered model allows the free expression of inner feelings and conflicts that would not be available in the typical adult-child interactions. As noted above, Youniss (1980) characterized typical adult-child interactions as unilateral and unidirectional. Children see themselves as listening to and taking orders from adults, rather than sharing their thoughts and feelings. Non-directive therapists attempt to overcome the unidirectional nature of typical adult-child relations by encouraging the child to take the lead in their interaction.
Therefore, in adopting play therapy, but by maintaining a directive (or unilateral) focus, CBPT risks losing the chief advantage of the child-centered approach-reciprocal interactions between adult and child. The traditional model allows the child to lead and set the direction for the content of the sessions, but this does not lend itself to program evaluation as well as short-term, solution-focused therapy does. The directive approach of CBPT, relying on modeling and problem solving, may lose the bi-directional, reciprocal interactions, generated by the children's stories and conversations. The dilemma, then, is balancing the value of reciprocal interactions with solution-focused interventions.
A fine-grained analysis of children's language within the context of therapy sessions may provide a clearer understanding of the relative benefit of unilateral, or directive communication, and bilateral, or reciprocal communication, with children. It is likely that both approaches may have beneficial effects. The non-directive approach may be particularly valuable in mapping feelings onto words and in helping children understand the meaning in their actions in play, while CBPT is likely to be particularly helpful in modeling appropriate problem-solving thinking in order to improve interpersonal relations.
In clinical practice, play therapists may actually use a mixed model. Non-directive approaches would seem particularly appropriate at the beginning of the therapy to encourage the expression of feelings. However, as the therapy progresses or comes to a close, the therapist might become more directive in order to build skills. Practitioners are notably eclectic in their use of psychotherapeutic theories. Thus, research evaluation of a mixed model may be particularly helpful to practitioners' understanding of the process of change and growth in children's thinking.
Finally, this paper has forwarded the notion that play is part of the natural language of childhood and has attempted to describe how child therapists enter into the world of child's play to help children talk about feelings. However, while intuitively appealing, research concerning this approach is often methodologically flawed and quite limited. Practitioners should be encouraged to build evaluation components into their work with children. Recently available meta-analysis techniques for data reduction may help to answer questions about the effectiveness of various methods of psychotherapy.
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