Session Nine: Therapeutic Storytelling and Play Therapy with an 11-YearOld Female
Therapeutic Storytelling and Play Therapy with an 11-Year-Old Female This case example exemplifies the use of therapeutic storytelling along with play therapy, to assist a child to cope with traumatic experiences such as abandonment, school phobia, dealing with a mood disorder, and low self-esteem. It can also exemplify the use of storytelling with children experiencing a wide variety of problems that traditionally might be treated with play therapy. The sessions were divided into two 30-minute sections. The first half-hour constituted the therapeutic storytelling process and the second 30 minutes was allotted for the play therapy experience. The first three sessions were weekly and the last two sessions were biweekly. Parent Interview I conducted an information gathering session with Denise’s mother where I learned that 11-year-old Denise had been diagnosed with bipolar disorder and was being treated with medication. She had recently experienced the separation of her biological mother and her stepfather, Thomas. Her biological parents had separated shortly after her birth and she did not have any contact with her biological father until age 8. Consequently, she had bonded with Thomas and viewed him as her father. Denise had an older sister, Marianne who also lived with her and who shared the same biological parents. Denise also had a half brother, Larry that was a
product of her mother and her stepfather’s union. She was referred by her mother because of a situation that resulted after the separation in which Thomas announced that he was intending to exercise his access rights with his biological son only and was refusing to take Denise for weekend visits. This resulted in a great deal of sibling rivalry between Denise and her half brother Larry. Denise also had a strong reaction to the rejection by her stepfather; she became very aggressive at home and at school. The school problems escalated to the point where she refused to do any schoolwork and at times refused to attend school; when she did attend, she was in a constant power struggle with her teacher. I also learned that Denise had been having regular visits with her biological father every other weekend for the past two years. When I interviewed Denise’s mother, she was mostly concerned with the rejection by Denise’s stepfather and asked if I could help Denise deal with this. I learned that Denise’s psychological problems surfaced when she was 6-years-old and were characterized by incessant crying, mood swings, rages, and extreme depressive moods. Between the ages of 6 and 9, Denise saw three psychiatrists before she was diagnosed. She had been on several different medications before her diagnosis, and it took another nine months before the proper medication and dosage was determined. As a result she missed a great deal of school that year but was promoted to her age-appropriate grade. She had been receiving remedial help at her present school, but this was discontinued due to her resistance. Denise was experiencing
sibling rivalry with Marianne as well, had very few friends at school or in the neighbourhood, and the relationship between her and her mother was becoming strained.
Initial Interview with Denise I met with Denise for a preliminary session and learned that she felt very angry towards her stepfather, felt loved by her biological father, and felt loved by her mother, her sister, and her brother. Denise stated that she hated school because the work was too hard and too boring, she hated taking her pills because they were too hard to swallow, and she hated going to the doctor because he made her cry. She reported that she liked to draw, play computer games, and go shopping. Denise also said that she felt that she was not a “good girl� and that she caused her mother a lot of problems. She mentioned that she often felt sad and would spend a lot of time in her room crying or sleeping.
SESSION ONE Storytelling Session I chose to begin with the story “Handless Maiden” (Burns, 2012) because I felt that it addressed the main issues in Denise’s situation. The story begins with the girl’s father selling her to the devil, which in a very real way happened to Denise. Her biological father had abandoned her to her stepfather who was now one source of her “living hell” (mood disorder, social problems, and being denied access to stepfather). Denise’s victimization is further paralleled by the fate of the girl in the story. The maiden’s innocence causes her to become the victim of her father’s cruelty. She is forced away from her parents and home and sent out to cope without hands. This is a good example of the impossible task that Denise is challenged with, and for her she has several. She not only has to deal with a major psychological illness for the rest of her life, but she also has to cope in a learning situation that seems impossible. She has to deal with her extreme jealousy of her brother’s relationship with her stepfather while trying to understand why the man who she believed was her “daddy” does not love her. The deception by the father in the story and the further deception by the husband also parallel Denise’s experience. The lack of hands often symbolizes an inability to connect socially. This was a problem for Denise in her peer group.
The messages contained within the story, I felt, were appropriate to Denise’s situation. The girl in the story, with the help of the spirit and the old queen, both feminine characters, is able to heal, regaining her hands. In the course of the story she gives birth to a baby. A baby or infant, in a therapeutic story, is often symbolic of something precious and in this case could represent Denise’s self-esteem, which was indeed fragile. The story is also well grounded in the feminine and also includes a union between the positive masculine and feminine energies. If she is to cope with a major psychological illness her whole life, she will need to combine and unite her psychological energy sources. When the story was completed Denise decided to draw the picture of the girl having her hands chopped off. It was a very graphic drawing of the blood dripping into a pool and the child’s tears forming a pool next to the blood. I felt the drawing was an excellent depiction of Denise’s grief, anger and fear. She made no comments about her drawing other than describing it as “the part where the girl gets her hands chopped off.” This choice may have been prompted by Denise’s feelings of helplessness regarding her bipolar disorder. Play Session Denise’s play during the play therapy part of the session, which followed the story, was very aggressive. She wanted to play-fight me with the encounter bats (foam bats) and later to hit a foam ball with a tennis racket as I pitched it to her. After about 10 minutes she decided to play with the action figures (plastic adult male and female figures), and this play was also quite aggressive with figures being swallowed by dinosaurs, run over by vehicles, and brawling with one another.
SESSION TWO Storytelling Session The second story I selected was “Hunter and Son� (Burns, 2012) because of its obvious violent theme and the element of rejection by a male father figure. This story, although masculine in nature, I felt would be useful to Denise because it reflected the rage she was presently in and also because it symbolized her rejection by both male father figures in her life. The boy in the story is struck down with an axe for not obeying his father. Hurt and rejected, he is forced to seek out a new father. There are two incidents in the story (the slaying of the horse and the maidservant) that illustrate the ruthlessness Denise must possess in order for her to move past her victimization. If she stays stuck with her anger, resentment, and guilt, she will be trapped, but if she can slay the negative thoughts and emotions that disturb her, she will be able to function again. The boy in the story leaves and finds a new father, one who cares for him, and he is able to pass the tests of the tribe and become the chief’s son (prince). Denise needed to move from her present state of negative self-worth to one that clearly reflected her value as a person, and in the end, needed to remain true to her self. When the story was completed she drew the scene of the boy walking up to the village where he met the chief. She showed me her drawing when it was completed and
commented that the boy in the picture was sad. I asked her if she could identify with the boy’s feelings, and she felt she could. She was not willing to elaborate or give an example of when she had felt like that. Instead she wanted to play with the toys. Play Session In the play therapy session, Denise played with the action figures exclusively. Her play was aggressive, cruel, ruthless, and extremely violent. Characters had their heads rammed into buildings and run over by trucks, and I was expected to make the sounds for the tortured figures. One particular character was constantly drunk and extremely violent but portrayed as a comical and at times heroic character. The most aggressive and dominant figure was a redheaded male figure (Denise has red hair).
Follow-Up While Denise was drawing her picture after the story telling I went out into the waiting room to speak with her mom. She said that the teacher had reported a significant change in Denise’s attitude and behaviour over the past week. Mother said that Denise had gone to school every day in the previous week and that she had come home only once upset with her performance. I informed her that if this behaviour change was maintained through to the next week, I would lengthen the time between her fourth and fifth sessions to two weeks. If change occurs quickly in these severe cases, I like to give the child, and the learning and integration process, time to develop.
SESSION THREE Storytelling Session I chose the story “Two Sisters” (Burns, 2012) for the third session so that I could reinforce some of the messages that had already been sent. I also wished to address her relationship with her sister and mother as well as her integration and appreciation of her self. This story is also a female initiatory tale that complements the major elements of the feminine nature, which in turn complement Denise and her stage of feminine development. The two sisters in the story were very close but both had different temperaments and abilities and this was reflected in Denise’s relationship with her sister. The mother figure in the story is a consistent and stable character as was Denise’s mother. She also symbolized Mother Nature through her affiliation with the rose bushes and the bear. I wanted Denise to connect with this constant, stable, and earthy part in her internal world. The two sisters become friends with a male bear who later on in the story is transformed into a handsome prince. This transformation in the story mirrored and therefore recognized Denise’s improvement in her selfesteem. She was changing from a “bear” to a princess.
It also underscored and reinforced the concept and possibility of change introduced in the two earlier stories. The sisters attempt to help a dwarf (the immature or underdeveloped masculine), who symbolizes the ways in which Denise had expressed anger and resentment to this point in her life (temper tantrums, physical and verbal outbursts). The dwarf abuses and ridicules the two sisters for their help and is later destroyed by the bear. The bear symbolizes the healthy masculine nature that Denise will have to establish in order to defeat her dwarflike behaviour. The story ends with a complete integration of all the healthy characters in the story. The two sisters marry princes and bring their mother to live with them in their castle. When the story was completed, Denise chose to draw the scene where the dwarf got his beard stuck in the tree trunk. This is a comical part in the story in which the dwarf is trapped, symbolizing the capture of the petty cruelty and harshness of the masculine. Perhaps Denise would like to see her stepfather in this predicament or perhaps she was identifying with her dwarflike nature. She showed the completed picture to me and said that she drew it because it made her laugh. I found it humorous because I could see her dwarf nature from the last two play sessions reflected in her drawing.
Play Session The third play session continued much in the same way as the last two sessions. There were lots of violent scenes however the forces of good (police, rescue workers, nurses) were not being beaten as badly by the forces of evil (a redheaded male doll and an android) as in previous play sessions. Once, during the middle part of her play, the forces of good apprehended the male doll (red) and held him confined for a while, but later the android helped him to escape. Follow-Up In a telephone conversation with Denise’s mom she reported that Denise was still defiant at home but her progress at school, according to the teacher, continued. I decided to set the time between this session and the fourth session to two weeks.
SESSION FOUR Storytelling Session I chose the story of the “Frog Prince” (Burns, 2012 for the fourth session. I was encouraged by Denise’s success at school, which had continued, according to a telephone message left by her mother. I felt the messages in this story would be useful to her at this stage of the therapeutic process. The story opens with a girl who has been singled out by her father as his favourite daughter. Time passes and she loses her treasured golden ball. Objects that are golden are used in therapeutic stories to represent things of great value such as dignity or self-esteem. She loses her sense of self and everything in her life changes. Denise went through a lengthy battle with the fields of medicine and psychiatry before she got her diagnosis and proper medication. Just as she was stabilized, her parents separated. This child has lost her golden ball many times in her life. The girl in the story is controlled by her father and forced to do things against her will, just as Denise was being controlled by both her father’s and stepfather’s rejection. This story also contains messages of transformation from the lowly station of a frog to that of a handsome prince. Denise was in the middle of this process of transformation as was signified by her behavioural and attitudinal change and I believed that this would be recognized and affirmed for her in this story. The transformation occurs when the girl defies her
father and kills the frog. Denise needed to defy and kill the feelings of worthlessness and shame accompanied by her rejections. She was rejected by both of her fathers and she was also metaphorically and socially rejected by her mood disorder. The story ends with the transformed prince marrying the girl, and the uncle, who represents the good father, escorts them off to their New Kingdom. Denise drew the scene of the frog retrieving the ball for the princess. The scene perhaps represents the recent retrieval of her gold as reflected in her changes at school. Play Session The play therapy session continued much along the same lines as the other three preceding sessions focusing on the action figures. A pattern was emerging--the forces of good were becoming more powerful and more successful at containing the forces of evil. The red-haired male character was sober for most of this session and was much more secretive and cunning in his behaviour. The violence was less severe and blatant. Follow-Up I spoke with Denise’s mother while she was doing her artwork, and she reported that Denise had had another good week at school. She also noted that Denise had not reacted after her brother left on his weekend visit with her stepfather. Denise was clearly making some changes in her behaviour. I decided to continue with her sessions being every other week to see if she could sustain the changes at school and at home.
SESSION FIVE Storytelling Session I chose the story of “Vasalisa” (Burns, 2012) for the fifth session, partially to honour Denise’s successes at home and at school and also to suggest strategies that would be helpful to her in the future. “Vasalisa” is also a female initiatory story. The girl in this story overcomes the negative feminine energies in her life (stepmother and stepsisters), accomplishes the tasks set out by the wise old crone (Yaga), and rekindles the fire that has been extinguished. Denise will have a number of impossible tasks to accomplish throughout her lifetime. Individuals suffering from mood disorders have a tendency toward other disorders particularly anxiety, have a high rate of suicide, and their offspring have a high possibility of developing a mood disorder (Wilson, Nathan, O’Leary, & Clark, 1996). I felt that the story of Vasalisa and her experience with the Baba Yaga was a good choice for Denise. Her dying mother gives the girl in the story a very valuable and powerful source of wisdom. The little cloth doll, which represents the child’s inner wisdom, is the deciding factor in her ability to do the impossible. Denise’s inner wisdom will be challenged throughout her life, and therefore she needs to be in close contact with it. The story also indicates that sometimes wisdom and strength are manifest out of the impossible task and suggests to Denise that she need not shy away from or be frightened by them.
When the story was completed Denise drew the scene where the Yaga gives the girl the fire. Denise drew the witch spitting into the skull, and in the background there were the three dwarfs, the three riders, and the yoga’s hut. She spent a long time on her drawing, and when it was completed, she commented that this was her best drawing yet. This scene or series of scenes that she drew represent the climax of the story. Vasalisa asks the witch about her three riders, who are dear to the yoga’s heart, and thus endears herself. She does not ask about the three dwarfs, which would possibly have angered the witch. The witch spits into the skull and creates fire for Vasalisa to carry home to her family. Denise’s therapy is reaching the climax. Her next step, as is Vasalisa’s in the story, is to return home. Play Session The play therapy session took on a different focus for this session. Denise decided to build an elaborate city out of blocks. She populated the city with animals of all different types. She used the farm animals, the wild animals, the dinosaur figures, and made robotanimals out of plastic blocks. The animals all lived in fenced-off areas and were tame and friendly with one another. I reminded Denise that the next session would be her last and wondered if she wanted to have it in two weeks or if she wanted to save it for when she felt she needed to talk. Denise decided to save her session. This is a technique that I often use with children who are in therapy for a specific number of sessions. I feel that it provides them with a safety net or back up if they fear that the change is only temporary. A saved session gives the
child more control over the future, and she can decide if and when she needs further assistance. It also can be a measure of the child’s confidence and sense of self-security. If she feels that she needs to have another session, perhaps she is not ready for discharge. Follow-Up After two years Denise was doing very well. She continued to make gains academically and socially. Her previous symptoms had not returned and her medication appears to have stabilized her depressive symptoms with no detectable side effects.
Epilogue Therapeutic storytelling and play therapy seem to be a natural combination for this 11-year-old female. I usually conduct the play therapy session after the storytelling session for two main reasons. I want to use the relaxation and centering aspects of the storytelling technique to focus children and to establish them in the milieu. I also want to save the more active and expressive form of therapy to the last so children can leave the session more balanced. The storytelling often stirs up emotions in children which when expressed are less of a problem between sessions. Denise took the opportunity to express the excess anger that she was feeling in her play sessions as evident from the tone of her play. This emotional outlet I believe allowed her to vent her emotions and as a result they became less troublesome for her between sessions. Without this outlet perhaps Denise’s progress would have been stifled. The story themes and the themes of Denise’s play complemented one another and showed a clear progression especially her play themes, which seemed to reflect her recovery. Denise progressed from a violent redheaded character to one of compassion and finally one of universal acceptance (animals of all types).
Bibliography Burns, M. (2012). Into the dark forest: Therapeutic storytelling. Kingston, ON: Child Care Press. Wilson, G., Nathan, P., O’Leary, & Clark, L. (1996). Abnormal psychology: Integrating perspectives. Boston: Allyn and Bacon.