Child Treatment and the Therapy of Play
- Author:
Lydia
Jackson, B.bc.(Oxon) and Kathleen M. lodd, M.B., D.P.M., with an introduction by Emanuel Miller, M.R.C.P., D.P.M. Methuen and Co. Ltd., London. 1946. Price 8s. 6d.
When a child is taken on for treatment in a psychological clinic, what happens ? He comes once a week. If he is of an age to enjoy play rather than conversation, he goes with the therapist into a playroom at each visit and there he ” has his treatment “. And what happens behind the closed door of the playroom ? Often this remains somewhat of a mystery not only to the child’s parents but even to many who are working in the clinic. For an account of what happens is extremely difficult to give.
In Child Treatment and the Therapy of Play the authors attempt such an account, and with so great a measure of success that this book must be welcomed by all serious students of child psychology, as well as by those who are engaged in the treatment of children’s mental disorders. From the point of view of those treating children, of very great value are the careful and detailed accounts of children’s actual play during treatment and the authors’ interpretation of its meaning. One is grateful that they confine their accounts to play which is really significant of the child’s character and conflicts, and avoid the trivial or merely witty ; grateful, too, that they avoid the suggestion of quick relief and spectacular recovery which often makes play-treatment appear to be something much snappier than it really is. Their evaluations of the children’s play show great freedom from bias: they relate to the individuality of the patients rather than to schools of psychology, which from the therapist’s point , of view is essentially important.
Equally valuable is the attempt to describe the play of different types of children, obsessional play, hyper-active play and so on. Here, necessarily, only a small part of the ground is covered. But one is glad of beginnings, for it is a subject which has been little studied and where knowledge is very much wanted, for purposes of diagnosis as well as of treatment.
The accounts of obsessional play are the most detailed and interesting, and the work on obsessional children is perhaps the most illuminating in the book. It forms a real contribution to our knowledge of this disorder. So we are taken behind the playroom door and we certainly see the child at play. But that leaves us with only a very inadequate knowledge as to what happens during treatment. For the therapist does a large part of the work. And here we are very much more in the dark. We do not know how much of the interpretation of play given to the reader is ever made to the child. Clearly some is made; but as to how it is made and at what stage, whether as a regular means of promoting further play or only as an explanation at crucial moments, all of this is left vague. Nor are we any wiser about methods other than interpretation. ” The therapist is there with his knowledge and understanding, his sympathy and tolerance; he controls and guides the play in directions which he knows will promote recovery.” The notion of controlling and guiding play is foreign to many forms of play-therapy and it is certainly one about which we should like to know more. But not even an illustration is given.
Thus while we have an admirable and quite invaluable record of children’s play, we have singularly little information as to the technique of treatment. This is the more to be regretted since some study of this is so badly needed. There is a vast literature on the technique of the psychoanalysis of children. But there are many forms of treatment other than analysis. Clearly they involve technique and do not depend solely on the wisdom and personality of the therapist. It is a pity that this book, so good in other ways, should contribute so little to our knowledge of the methods of treatment, to an understanding of the therapist’s part in the work.
But it is not only those engaged in treating children who will find this book interesting. It will almost certainly appeal to parents with an interest in psychology and it should add a great deal to their understanding of psychotherapy and their confidence in it. Whether it will help so much in other ways is more doubtful. The parents, in the cases recorded, do not on the whole appear in too favourable a light and it is possible that this may add to the sense of guilt, the belief that ” it is all my fault ” in any anxious parent who may read the book. Moreover, in dealing with the parent-child relationship there is considerable stress on the ill-effects of parental mistakes. To take one example: ” Just as food fads in children and adults are frequently the consequence of unwise feeding and weaning in infancy, the common complaint of constipation and a variety of ‘ stomach ‘ troubles are often the result of the clumsy handling of the child’s bodily functions.” Anxious, and especially rather obsessional parents always tend to be over-concerned about doing the right thing or the wrong thing, and will perhaps here tend to find authority for their anxious and obsessional attitude. Possibly greater stress on matters that are more fundamental for the child’s good development, such as the parents’ own happiness in marriage, in work and friendship, might have been useful. But these are small points. To the very large number concerned with the mental health of children this book should prove quite invaluable. It will introduce the beginner and prove a boon to the experienced worker. It derives from long experience and wide knowledge. It is free from pedantry and written with a directness and clarity which make it a pleasure to read. E.N.
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