23: Inner Value, Hopelessness, Helplessness, and Self-Sufficiency Themes
Note: Play Therapy Across the Lifespan is created to be heard. If you are able, we strongly encourage you to listen to the audio so that you are able to appreciate the emotion and emphasis that cannot be captured by text alone. Transcripts may contain errors and differ slightly from the audio. Please check the corresponding audio before quoting it in print.
Resources and Links
The Healing Power of Play on Amazon: https://www.amazon.com/Healing-Power-Play
Prologue
This is episode 23. I hope you are enjoying learning about these play themes as much as I am enjoying sharing them with you. For our fourth season, I have grouped play themes into four categories that I call core needs. They are safety and security, empowerment and control, inner value and relationship needs. Everyone has all four, but if you ever experience that need being threatened, then it activates the need, and you do what you can to meet that need. Sometimes, the ways we meet those needs are unhealthy or become problematic later, but unhealthy coping is always preferable to not having the need met at all, and that’s often what we see with our clients.
This gives us a positive and logical way to understand clients better, which makes it easier to empathize with them. Once we understand our clients’ deep needs, it’s easier to see how unhealthy relationships and maladaptive behaviors really serve a purpose, whether it’s a two-year-old tantrum or a 52-year-old tirade. Play therapy is, after all, effective across the lifespan. This knowledge also guides you in how to facilitate the work.
In the last three episodes, I covered the safety and security and empowerment and control core needs and some play themes that you might see in those categories. Today, I want to look at inner value.
Inner value is our need to have worth, be loved, and matter. It is the essence of who we are, and if others (or ourselves) don’t value who we are, then this need will be activated. Some examples might be being called degrading names, experiencing prejudice or hatred, or trying to measure up to another who is older, more accomplished, or saintly deceased.
Just a quick caveat here. You want to understand the need from the perspective of the client, not try to classify behaviors and diagnoses as pointing to those needs. While there are some general things that usually point to certain core needs, that’s not always true. Listen for word choice and watch what your clients are showing you through their play. You may have a client who has experienced abuse from a caretaker who hissed to the child, “You are never going to amount to anything.” If that child internalized that message, then it is an inner value need, but, you may also see some safety and security if the child felt unsafe. Emotional safety would certainly be threatened in that example. When you hear more than one core need, follow the client’s lead to discern which one (or if both) are being expressed in the current play.
Hopelessness is a play theme you might see when a client is struggling with inner value. Things like… Why try to do well in school when you’ll never be good enough? No matter what you do, people won’t love you. Why continue to struggle and feel such pain when you don’t matter anyway? This is a bleak apathy that happens when you don’t believe things will change. Regardless of what you say, do or think, it seems impossible that a person will really love and cherish you, that you can bask in finally being good enough or that who you truly are will be acceptable. This theme can be a short step away from dangerous (possibly suicidal), so when I hear this theme, I like to reflect it right back – you knew I’d say that, right? – and then follow that with, “But what if you were?” For example, if a child says, “She’s a bad girl. She did something really bad.” Then I might reflect, “She’s a bad girl, something really bad happened to her, but what if she could be good, too?” This isn’t a question I am listening to hear answered, but more of a verbal pondering. What if? With an adolescent, it might go something like this: “No one will ever want to be with me now. I practically slept with the whole team, so they just see me as trash now.” And I might say, “After what happened, they see you as worthless trash. But what if you aren’t?”
Helplessness is the next play theme. It may be combined with hopelessness, but this one is a freezing of any sort of agency over the situation because giving up voluntarily on becoming valuable or loved is better than trying and having it clearly confirmed. The child feels like he can’t scream his rage at the parent who moved out because it would risk a fragile relationship. Not being loved would be much worse than just pretending like things are okay. It doesn’t solve the rage, but it protects inner value, so instead the rage comes out with those who can see it and still love the child, even when they aren't the target. Children living through court cases often feel helpless because others are making decisions about them, but sometimes it seems like the decision-makers don’t care about the child. They may not even ask what the child wants. The message that is internalized is, “They don’t care about me.”
The last inner value theme I want to talk about is self-sufficiency. Now, you may see a healthy version of this in mastery play that looks something like, “I can do that myself now.” We’ll talk more about that in a couple of episodes, but here I want to talk about an unhealthy reliance on taking care of self (and maybe other loved ones) because no one else can be trusted to do it. This version is a thorny façade that shuts others out to prevent more hurt and disappointment. “If you won’t love me, I don’t need you anyway!” “If you don’t think I’m good enough, then F you…” and this is usually followed by hurtful words intended to tear the other person down. The idea behind this is that if I shut you out, I can protect myself. If I don’t expect you to honor and value me, then it doesn’t hurt as much when you don’t. If I make it hard to love me, then I at least chose it when you can’t love me.
If these themes feel especially heavy, it’s because they are. This is the core of who you are, and any message that who you are isn’t good enough or valuable really, really hurts. I think it is part of the reason why many therapist truly grieve over social injustices. These carry a lying message that one group of people is less valuable than another. But what if, that isn’t true at all?
Rachel’s Book Review
Dr. Eliana Gil may be a name that you’ve heard before, as she is a true powerhouse in the field of play therapy. She is a former APT president, creator of Trauma-Focused, Integrative Play Therapy and founder of the Gil Institute for Trauma Recovery and Education. She is a therapist, teacher, speaker, and clinical supervisor.
One of the first books I ever read on the topic of trauma and play therapy is one that she wrote. It’s called, The Healing Power of Play: Working with Abused Children. This book describes how therapists can facilitate play therapy and intervene during a client’s post-traumatic play. She reviews several traditional play therapy modalities, like child-centered play therapy as well as more directive theories. The book offers six detailed clinical vignettes that offer step-by-step guidelines for assessment and intervention based on different situations of abuse or neglect.
For each vignette, she presents referral information, social and family history, clinical impressions, treatment plans, and snapshots of various therapy sessions where she presents the dialogue between her, the therapist, and the client. Similarly to the way that Axline writes in Dibs in Search of Self, Gil gives us a front-row seat into some of her sessions and how she intervenes and guides them.
One of the subjects she speaks to in the book is this concept of “post-traumatic play.” This kind of play happens when a child or adolescent reenacts his trauma in the playroom. Because the child is in control of the reenactment and how it plays out, this kind of play can enable mastery and empowerment in a safe environment.
She also speaks to how post-traumatic play can become fixed or repetitive. She suggests that allowing fixed or “stuck” play to continue to happen over and over again may actually be anxiety-provoking and might even reinforce feelings of powerlessness. She offers several ways of interrupting the child’s play. Here are a few of her suggestions:
Making verbal statements about the child’s play to help suspend the self-absorption and rigidity of the play
Manipulating the dolls/toys, moving them around, and asking the child something like, “what would happen if…”
Encouraging the child to differentiate between the traumatic event and current reality in terms of safety
There are practical suggestions and useful tips just like these all throughout this book. If you work with traumatized or abused children, I believe this book is a must have for your bookshelf.
Conclusion
We’ve been talking about inner value core needs, and the play themes of hopelessness, helplessness and self-sufficiency. The great news about these difficult play themes is that you already know the way to help your clients navigate through them. Unconditional positive regard. Your unconditional positive regard for your clients shows them that you believe they have inherent worth and value simply because they are. Not because of their ability to do better and achieve. Not because they may one day catch up that perfect sibling. Not because they overcome this. They already have it. You do, too. You have worth and value already, even if you never help another client or graduate or get married, or anything else you think will give it to you. Even if you don’t believe it yet, I’m willing to believe it for you until you can.
I’ve promised to give you some practical helps, too, and I want to lighten things up with some humor. I really don’t like social media much, but my graduate assistant has drug me into the 21st century with an Instagram account that she convinced me we needed to accompany this podcast. One of the benefits is that get to follow some of our alumni, like Scoville Counseling. Elizabeth Scoville has a talent for humor that has been known to make me laugh out loud. One of her posts says this:
Session:
Plays the floor is lava with client
Documentation:
Clinician coached client through utilizing problem-solving skills in stressful situation
I love this on many levels. Sometimes as clinicians, we think all we do is play a silly game with a client. Yeah, we know that it is more than that. We know it has a purpose. That is why we do it after all, but we tend to sell ourselves short. This isn’t just playing. This is therapeutic work, with an emphasis on work.
Another thing I love about this post is that it is a reminder that how we describe what we do is important. If you describe your work as “just play” then that is what others will believe. But if you describe your play as helping the client learn problem-solving in vivo while experiencing a stressful situation, that is what others will believe. Don’t discount your profession.
Learning these themes gives you language to describe the therapeutic work that happens through play. Learn to identify them and write your progress notes to include them. You may work at a site that requires specific progress notes, but if you can adapt them to add a checklist of possible themes, you can quickly learn to identify them and become better at noticing how the play related to those themes is changing. You don’t need to interpret their work, just notice it and trust your client.
If you appreciate therapy humor, you might want to check out Scoville Counseling on Instagram for yourself.
