The Play of Psychotherapy.

Abstract

The author reviews the role of play within psychotherapy. She does not discuss the formal play therapy especially popular for young children, nor play from the Jungian perspective that encourages the use of the sand tray with adults. Instead, she focuses on the informal use of play during psychotherapy as it is orchestrated intuitively. Because play-whether we use it consciously or not-is a major source for implicit learning within the social domain, the author considers it a nonspecific factor in therapeutic effectiveness that cuts across all modalities. She also suggests that play bears an important relationship to creativity, especially as it exists in the intersubjective space between therapist and patient, i.e., the fertile zone between two subjectivities in which shared making of meaning arises. Key words: clinical intuition; hide-and-seek in therapy; imaginative play; neurobiology of play; play in psychotherapy; play's purpose in animalsTHE VERY EXISTENCE of a journal devoted exclusively to the multidisciplinary examination of play suggests that there is a paradigm shiftafoot, away from the thinking of scholars who dismissed play as aimless expenditure, toward the neurobiologists, psychologists, sociologists, anthropologists, and other researchers who now embrace and endorse play for its manifest benefits. These benefits all emerge from the most basic mammalian endowment-the playful curiosity that spurs the cutting edge of development in all mammals, knits together self and society, and provides seeds for the creative spirit in human culture. Given that play is a vital instinct hard wired into the mammalian brain (Panksepp 1998), one especially important for the extended childhood of human beings, no wonder play constitutes a hidden layer of psychotherapy. Within psychotherapy of all sorts, play often operates at nonconscious, implicit levels. This occurs through the play of clinical intuition as it manifests at a moment-to-moment level. How and why we psychotherapists play with patients sets the tone for sessions and determines the feel of the intersubjective process.This article draws on the interpersonal neurobiology of attachment to illustrate how the self grows, unfolds, and builds new structure through play. Freedom to play without inhibition or constriction is a key ingredient for joy, interest, passion, and vitality later in life. Just as children reveal their growing edge during play, so too do therapists. Because play is developmentally crucial to achieving cognitive, emotional, behavioral, and social flexibility and complexity, it remains a central part of the repertoire of clinical intuition.Sometimes we therapists succumb to the instinct to play in order to lighten up the atmosphere. At other times, the intuitive urge to play marks an open, nondefensive attitude towards ourselves and others. Whether initiated by therapist or patient, the instinct to play encourages the experience of fun during experimentation with new possibilities. Whether initiated by therapist or patient, the invitation to play is a bid for connection that allows coordination and taking turns. Always, the capacity to play signals safety in the room, and safety is necessary for novel expression and new coping to emerge.I demonstrate here, including clinical examples, how we therapists employ through play our clinical intuition to feel our way into the unique contours of each patient. Through the play of language, we find special terms reserved for each person alone. Through the play of different expressions across our face, the idiosyncracies of special greetings, and the innovation of unique rituals, we co-create meaning that is carried only within this particular relationship. At implicit levels, we play with our focus to guide the focus of our patients, gently leading them into new directions. At explicit levels, we play with how we frame and assign meaning to our patients' narratives, all in service of new hope, healing, and growth. …