CLINICAL EDITOR’S COMMENTS:
their own vicarious trauma reactions.
A
s play therapists, we know the healing and transformative powers of play. Yet how often do we directly engage the tools for ourselves that we use routinely in our
professional practice? The inherent nature of working with distressed people, particularly children and trauma victims, exposes therapists to vicarious traumatization or compassion fatigue, risking potential burnout. Miller
(1998) stated, “Special stresses are attendant to
working with traumatized children” (p. 250). The neurobiology of human connection indicates that “our nervous systems are constructed to be captured by the nervous systems of others, so that we can experience others as if from within their skin, as well as from within our own” (Stern, (2003) asserted this mirrored connection functions therapeutically as a psychobiological
regulator, because therapeutic communication
from the right hemisphere of the brain “nonverbally communicates its unconscious states to other right brains that are tuned to receiving these communications” (p. 49, italics in original). Even when therapists believe that they are consciously addressing countertransference issues, unconscious material continues to be transmitted.
In the formation of this deep-rooted empathetic life-to-life bond, both the intensively use their own lives in this manner, providing a safe container for clients, they face a fundamental risk to their ability to contain their own experiences. Symptoms of vicarious trauma may include “sleep disturbance,… depression, confusion,
fear, anxiety, irritability, anger,
places clients in jeopardy. Accordingly, self-care is an ethical issue that requires vigilance and action on our part.
I encourage therapists’ use of the sandtray method for self-care based on Margaret Lowenfeld’s pioneering play research. Lowenfeld’s (2012) research with children formed her belief that the sand tray functioned as a “cipher language” (p. 7) in which the therapist’s understanding of the client’s meaning of the objects arranged becomes essential to the therapist’s understanding of the core of the client’s life. Sandtray is multisensory and evokes the vague, inchoate, and indescribable elements of life as well as those that are accessible. Sandtray offers
a way to bypass a judging intellect to uncover authentic experience. This method provides three brain-changing factors that enhance neuroplasticity:
focused attention, novelty, and emotional arousal
(Siegel, 2010, p. 84). Sandtray affords a way to identify, negotiate, and resolve intense reactions therapists may have in response to highly distressed clients. Therapists can use sandtray to metabolize counter- transference reactions and to learn to recognize and enhance personal resources. Sandtray also offers the opportunity to explore and heal issues that arise from therapists’ own past experiences when they are evoked by clinical work.
Sandtray affords a way
to identify, negotiate, and resolve intense reactions therapists
may have in response to highly distressed clients
can gain from such modalities. For humans, the consensually agreed upon system of symbols that is language tends to be removed from our profound idiosyncratic experiences. By its very nature, language tends to be inaccurate and falls short when we want to share a deeply individual viewpoint. The sand tray also communicates to the person who formed it, not just to the witness. Sandtray spans the gaps between an individual’s “unconscious,” or less actively accessible aspect of mind, and their more readily available “conscious” aspect of mind. Siegel’s interpersonal neurobiology research supports Lowenfeld’s 90-year-old view, and has particular relevance for therapists: We must keep in mind that only a part of memory can be translated into the language-based packets of information people use to tell their life stories to others. Learning to be open to many layers of communication is a fundamental part of getting to know another person’s life. (Siegel, 1999, p. 43)
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