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Exploring sandplay with children who stutter Addison, Sharon J. 1999

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E X P L O R I N G S A N D P L A Y W I T H C H I L D R E N W H O S T U T T E R by S H A R O N J. A D D I S O N B.Ed . , M c G i l l University, 1991 A T H E S I S S U B M I T T E D I N P A R T I A L F U L F I L L M E N T OF T H E R E Q U I R E M E N T S F O R T H E D E G R E E O F M A S T E R O F A R T S in T H E F A C U L T Y O F G R A D U A T E S T U D I E S (Department o f Counselling Psychology) We accept this thesis as conforming to the required standard T H E U N I V E R S T I Y O F B R I T I S H C O L U M B I A March, 1999 © Sharon J. Addison, 1999 In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of British Columbia, I agree that the Library shall make it freely available for reference and study. I further agree that permission for extensive copying of this thesis for scholarly purposes may be granted by the head of my department or by his or her representatives. It is understood that copying or publication of this thesis for financial gain shall not be allowed without my written permission. The University of British Columbia Vancouver, Canada Department DE-6 (2/88) 11 A B S T R A C T This study examined the use of sandplay, with three school-aged boys who stuttered. Each child was offered one-hour of sandplay therapy per week, over a four-month period. The number of sessions per child ranged from twelve to sixteen. Participant-observation was used for data collection. All sessions were videotaped and photographs were taken of each child's sand pictures. A detailed description of each session is presented. This is followed by a detailed analysis of the themes and symbols that occurred in each sandplay picture, based on Carl G. Jung's theory of Analytical Psychology and Dora Kalff s theory of Sandplay. Researcher served as the sandplay therapist in all sessions. The researcher/counsellor's clinical impressions and reflections are also presented. Quantitative pre- and post-tests measured each child's level of anxiety, self-esteem and attitudes towards his speech. The stuttering level of each child was also tested before the sandplay therapy began and once it was completed. The quantitative tests produced a wide range of results which seemed to be most useful for gathering further information relation to each child. The stuttering levels of each child increased slightly over time which was attributed to the possibility of the stressful time of year (end of the school year) during which the study was completed and the physiological demands that could have been occurring due to emotional catharsis. The sandplay process of each child appeared to indicate that each child was experiencing some psychological distress. However, during the four months of sandplay each child seemed to show some signs of some inner emotional healing. According to Kalff s (1980) theory iii of sandplay, each of the three boys depicted images representing the beginning and middle stages of ego-development. Symbols associated with wholeness, order and sense of Self were also portrayed. From a Jungian perspective, after four months of sandplay, each child experienced some inner healing and gained some inner strength, thus enabling each child to feel stronger when facing external conflict. Sandplay as a therapeutic intervention and as an adjunct to speech therapy appeared to be a beneficial form of therapy for release of unconscious and conscious psychological issues, and a valuable means for gaining further insight into the emotional world of each child. iv T A B L E OF C O N T E N T S Abstract i i Table o f Contents iv List o f Graphs v i List o f Tables v i i List o f Sandplay Pictures v i i i Acknowledgements ix C H A P T E R O N E : I N T R O D U C T I O N 1 Rationale 4 Research Approach 7 Purpose 9 Definition of Terms 10 Delimitations 12 C H A P T E R T W O : L I T E R A T U R E R E V I E W 13 A n Overview of the History and Theory o f Sandplay 13 A Historical Overview o f Stuttering 31 C H A P T E R T H R E E : M E T H O D O L O G Y 42 Personal Background Information in Relation to the Presented Research 42 Research Approach 43 The Site and Selection of Subjects 44 The Role of the Researcher 46 Procedure 48 Instruments 48 Observation methods and Data Collection 53 Analysis 54 C H A P T E R F O U R : P E T E R 56 C H A P T E R F I V E : B R E T T 123 C H A P T E R SIX: C U R T I S 159 C H A P T E R S E V E N : T E S T R E S U L T S A N D D I S C U S S I O N 207 Manifest Anxiety 207 Self-Esteem 211 Speech Associated Attitudes 213 Levels of Stuttering 213 C H A P T E R E I G H T : D I S C U S S I O N 217 Delimitations 218 Implications for Theory 219 Implications for Practice 222 Implications for Future Research 225 Summary 227 R E F E R E N C E S 229 A P P E N D I C E S 236 Appendix A : Ethical Review Committee's Approval Certificates 237 Appendix B : Letter to Parents 240 Appendix C: Letter of Permission 243 Appendix D : Pictures of Sandtrays and Toys 247 Appendix E : Letter of Professional Endorsement 249 Appendix F: Raw Scores from the Revised Children's Manifest Anxiety Scale 251 Appendix G : Raw Scores from the Culture-Free Self-Esteem Inventory Form A 253 LIST OF GRAPHS Results of Revised Children's Manifest Anxiety Scale Graph 1. Peter Graph 2. Brett Graph 3. Curtis Results of Culture-Free Self-Esteem Inventory Graph 4. Peter Graph 5. Brett Graph 6. Curtis vii LIST OF TABLES Table 1. Results from the Communication Attitude Test-Revised 213a Table 2. Percentage of Syllables Stuttered 214 viii LIST OF SANDPLAY PICTURES Sandplay pictures for Peter, sessions one to sixteen 122a Sandplay pictures for Brett, sessions one to twelve 158a Sandplay pictures for Curtis, sessions one to twelve 206a ix ACKNOWLEDGEMENTS I would particularly like to express my appreciation and gratitude to Dr. Ishu Ishiyama, Dr. D o n Sawatzky and Ms . L i s a A v e r y for their valuable support and guidance in this study. Their expertise and encouragement gave me the strength and motivation to pursue this area o f research. I would also like to thank Dr. John A l l a n for introducing me to Jungian Sandplay and Ms . Sy lv ia S imony i -E lmer for her consultation on each o f the subjects' sandplay processes. M a n y people have contributed to this research project and I am thankful for their contributions. Without the support o f Mr . C a m R e i d and Ms. D e b Crossan, at the N e w Westminster Counsel l ing Centre, this project would not have been possible. M a n y k ind colleagues and friends administered the standardized tests, proof read chapters, created graphs, assisted with videotaping, helped with the clean up after a sandplay session and bought me sandplay literature and miniature toys for birthday and Christmas presents - thank-you to all o f you! Particular acknowledgement and gratitude are in order for my fami ly and closest friends. They have always had faith in me and g iven me support. T h e homemade dinners, proofreading o f chapters and listening ears are greatly appreciated. If it wasn't for Laura, m y speech-language pathologist friend, and a chat over tea in Gastown one afternoon, the idea for this thesis wou ld have never come to fruition - thank you Laura for all o f your encouragement. Final ly, a special thank you goes to Nigel , who f rom the first day o f data collection and construction o f toy cabinets, to the completion o f this study provided me with constant support, laughter and joy, even during the peaks o f stress! 1 CHAPTER ONE: INTRODUCTION The mysteries behind the causes and treatment of stuttering continue to elude researchers all over the world. The exact cause of stuttering is unknown and a consistently successful treatment has not been found. Stuttering affects 1% of the population and the male-to-female ratio is approximately 3:1 (American Psychiatric Association, 1994). Some individuals who stutter have been fortunate to have a spontaneous recovery with no relapses and without intervention, but others have spent years trying to overcome this speech impediment without success. Thankfully, people who stutter are no longer sent to special schools to sit in silence, or receive electric massage to their faces and throats (Van Riper, 1973). Even as late as the 1850s, people who stuttered underwent surgery to cut a wedge out of the root o f their tongue in the hope that this would eliminate their impediment (Kernan, 1981). Today, stuttering and its potential concomitant psychological issues remain a puzzling phenomenon that raises many unanswered questions. In the Diagnostic and Statistical Manual o f Mental Disorders I V (American Psychiatric Association, 1994), it is stated that stress and anxiety are associated features that seem to increase the severity of the stuttering. Moreover, physical movements such as eye blinks, tremors o f the lips or face, head jerks, breathing movements and fist clenching are also noted as accompanying features. There is much controversy as to whether anxiety is a primary or secondary condition of stuttering (Perkins, 1996), or whether individuals who stutter have greater anxiety than those who speak fluently (Craig 1990). I f anxiety is an 2 associated reaction to stuttering, could psychological therapy for the individual's emotional/behavioral issues lead to improved communication, as suggested by Prizant et al. (1990), as well as improved emotional well-being? Blood & Seider (1981) conducted a survey to gain information on the accompanying problems of individuals who stutter. Their research revealed that 68% o f young children who stuttered had some other type of concomitant problem including an emotional disturbance. Mooney & Smith (1995) have also reported on the emotional side effects of "stammering" [a term that is now used synonymously with "stuttering" in the United States (Perkins, 1996)]. They state that "dysfluent children are often shy and lacking in confidence and may face a constant stream of difficulties, especially in school" (p.24). Their studies indicate that, "children who stammer may experience a high degree o f bullying and that the detrimental effects (which may continue into adulthood) require intervention" (p.24). Furthermore, they found that children who stutter are often less assertive and less capable o f verbally defending themselves, thus their home, social and school lives are affected. I f children who stutter are more likely to have a lower sense of self-esteem, it seems paramount that these emotional side effects be addressed in their overall treatment plan. Sandplay therapy is a psychological, projective method of intervention that has proven to be an effective treatment modality for many children with diagnostic problems (Mitchell & Friedman, 1994). Sandplay is primarily a non-verbal therapy that can be used to help children cope with psychological problems (Berry, 1988). It provides an objective means for children to express their 3 stresses without depending on verbal skills to articulate them. Through this therapeutic method, children can go on an inner journey to the emotional core o f their complexes and view their unconscious material in a concrete, visual form (Stewart, 1995). It is an activity that permits them to freely express their emotions and feelings within the container o f a sandtray. Using miniature toys, representing many everyday objects and images from our inner world, the individual is able to create a picture in the sand and act out a fantasy from his/her psyche. It may be in the form of a drama and may represent an unconscious problem. Because there is no need for verbal dialogue, this therapeutic method seems to readily activate one's inner process. Thus, the child is less likely to be concerned with ego based censorship and be more comfortable following his/her fantasies and allowing the language of symbols to flow through the natural activity o f play (Kalff, 1980). Since sandplay is primarily a non-verbal form of therapy, it appears as though using sandplay therapy with children who stutter could be very beneficial. What themes would emerge in the sandtrays of children who stutter? How would these themes transform over sandplay sessions? H o w would these themes compare and contrast from child to child? Identified themes could enable professionals to gain a greater understanding, both at unconscious and conscious levels, of the underlying issues that may be affecting the child who stutters. Using sandplay and a primarily Jungian based interpretation, these are the principal issues that wi l l be addressed in the present study. 4 A s an ancillary component of this study, standardized tests were administered to increase contextual understanding of each child. The standardized tests measured the children's levels of anxiety, self-esteem, attitudes toward speech and levels o f stuttering before commencing the sandplay sessions. Approximately four months later, at the completion of the sandplay therapy, the standardized tests were re-administered to observe any changes that may have occurred during the four months. Rationale Upon reviewing the literature on therapeutic interventions with children who stutter, one becomes aware that there is a paucity of research describing children's experiences when they receive speech therapy in conjunction with psychotherapy. Prizant et al. (1990) state that their "clinical experience suggests a direct positive correlation between improvement in communication and improvement in emotional and behavioral problems" (p. 187). They recommend a treatment approach that would emphasize the whole child, psychologically, biologically and socially during the assessment and intervention stages. Such an approach would link the speech-language pathologists and the mental-health professionals, ultimately benefiting the individual who stutters by focussing on his/her overall needs. At the present time, it is not common for speech-language pathologists and mental-health therapists to collaborate. Sandplay could be a beneficial mode of therapy for the child who stutters because such intervention could identify themes related to previously repressed or suppressed emotional disturbances. Furthermore, in the sandtray the child has the 5 opportunity to regress, explore and metaphorically address his/her personal stresses. With the support of a non-judgmental therapist who accepts the child unconditionally, she/he can engage in open conversation that may create a new level o f personal awareness. She/he is free to work at his/her own pace, coming to a resolution when the sense of Self has been constellated and the strengthening of ego consciousness has occurred (Kalff, 1980). According to Analytical psychology, the major theoretical framework for sandplay therapy, it is believed that each individual has the ability to heal psychological wounds at an unconscious level (Allan, 1988). Ka l f f (1980) states that through sandplay, the child is able to play and fantasize in a safe and protected place, thus enabling the ego (consciousness) to tap into the powerful healing energies of the unconscious and manifest the sense of Self. According to Kal f f (1980), the manifestation of the Self is the most critical point of personality development and this can ccur only i f the child feels secure. Symbolization of the Self is the crucial factor to a healthy developed ego and the consolidation o f the personality. Through the sandplay process, a child who is experiencing psychological difficulties can integrate the conscious and unconscious energies. A s the ego consciousness strengthens and the sense o f Self becomes symbolized, patterns for wholeness w i l l appear in the sandtray signifying a balance. A s these symbols are expressed, they strengthen the ego and provide the child with an inner sense of security as they release unconscious energies that transcend consciousness. Thus, for the child who stutters, sandplay 6 could be a very powerful means to express and work through possible psychological disequilibrium. Recently, it appears that the field of speech and language pathology is implementing a more integrated approach in the treatment of school-aged children. The value of emotional support is being recognized as an integral component in the overall treatment o f the child with a communication disorder. Healey & Scott (1995) state: "Enhancing the fluency skills o f upper elementary-grade children may prove unproductive unless time is spent in exploring and modifying the child's feelings, beliefs, and attitudes about stuttering.. providing a place where children can confront their stuttering and communicate freely is beneficial in the long term" (p. 152). In the model proposed by Healey & Scott (1995), the initial goals o f speech therapy are to develop a good relationship and rapport with the individual who stutters, and to gain an understanding of the nature of the problem. The second phase of the treatment concentrates on specific techniques for enhancing fluency and modifying stuttering. This model recognizes the importance of emotions and perceptions and the integral role they play in the individual's overall speech. Since research concurs that there are many social and emotional factors associated with stuttering (Berkowitz et al. 1994; Blood & Seider 1981; Conture & Kel ly 1991, Craig 1993; Mooney & Smith 1995; De N i l & Brutten 1991; Prizant et al. 1990; Ramig & Bennett 1995) it seems essential that a mode of psychotherapy such as sandplay be utilized as a concurrent method of intervention with speech therapy. The child's communication and sense of Self may be 7 strengthened, and a greater awareness o f the child's emotional needs may also be revealed. This study explores sandplay as an effective mode of therapeutic intervention for exploring these psychological issues. Although some recent speech and language literature is now recognizing and advocating the implementation of a more holistic theory that encompasses the emotional well-being of the individual who stutters, this integrated treatment plan is still not always the chosen approach. Therefore, the strong moral imperative contained in this research focuses on emotionally supporting individuals who stutter. Research Approach The present study was qualitative in nature, utilizing an exploratory and descriptive case study approach. Qualitative methodology provides an opportunity to understand and examine an experience in-depth from the perspective of the individual experiencing the investigated phenomenon (Strauss & Corbin, 1990). Furthermore, it enables description to be thick and rich, and reports the active process being studied over time. In this study, the sandtray and miniature toys were the media provided for projection, as each child constructed scenes that showed how social objects were made meaningful in his/her inner and outer experiential world. According to Carl Jung, the founder of Analytical psychology, all human beings possess a collective unconscious that contains universal archetypes we all share. Furthermore, all individuals also possess a personal unconscious that expresses itself through complexes (Corsini & Wedding, 1995). Dora Kalff, who 8 was encouraged by Jung to apply his theory of Analytical psychology to children, discovered that sandplay provides an opportunity to observe these archetypes in both an individual's collective unconscious and in the complexes of his/her personal unconscious. The investigator, as participant-observer, was therefore concerned with identifying symbols and archetypes in the child's sandplay process and final sand pictures from a Jungian perspective. Thus, through sandplay, each child was able to express some aspect of his/her psyche by constructing scenes that represented his/her view of reality in relation to his/her universal inner patterns. This study is a multiple-case study of three school-aged boys who stutter. In order to gain a broader understanding of each child and possible changes that may have occurred throughout the study, the children were given three standardized tests. They were tested by an external counselor, using standardized measures to determine their present levels o f anxiety, self-esteem, attitudes toward speech, before, and then approximately four months after the start o f sandplay therapy. A n outside tester increases the external validity of these testing measures as there is no opportunity for the child to build rapport with the tester during the study which could influence the post-test measure. In addition, a speech-language pathologist assessed the children's level of stuttering before and after sandplay therapy. The children were engaged in twelve to sixteen weekly sandplay sessions with the investigator as the therapist. Each child was invited to create a three 9 dimensional picture in the sandtray with the option o f working in silence or making words or sounds. Each session was video-taped and the investigator recorded her impressions and observations at the end of each session. This provided an overall summary of the main points of each session (Miles & Huberman, 1984). Photographs were taken of each sand picture and detailed notes were written from the video-tapes. The sandplay processes and photographs were analyzed from a Jungian theoretical perspective. These methods o f gathering information created a formal, presentable database that would be accessible to other investigators who may want to review the evidence directly thus increasing the reliability of the case study (Yin , 1994). To increase the overall validity of the data analysis, a certified IS ST (International Society of Sandplay Therapists) Sandplay Therapist was consulted regarding the three individual case studies. Sandplay analysis was conducted from a Jungian perspective according to the sandplay theory originated by Dora K a l f f - the founder o f sandplay as a Jungian therapeutic intervention. Through the utilization of thick and rich description, hypotheses could be generated thus making a valuable contribution to further research in the field of Sandplay Therapy and Speech and Language Therapy. Purpose The main purpose of this study is to present its descriptive, exploratory component, in order to increase understanding about the tacit processes and hidden emotional issues o f the three research participants who stuttered. It could 10 also become a catalyst for further research into counseling interventions with children who stutter or continued exploration of the prominent themes that emerged. This research aims to emphasize the paramount importance of treating an individual who stutters holistically by implementing sandplay as a complement to speech therapy in supporting the child who experiences psychological demands. A n ancillary objective was to observe any measurable changes in the children's levels of anxiety, self-esteem, attitudes toward speech or level o f stuttering during the four months of sandplay therapy. This qualitative and quantitative information was used to create possible hypotheses that could lead to future research in the fields of counselling psychology and speech and language pathology. Definition of Terms Archetypes Instinctual behavior and images that are universal (Pascal, 1992). Complexes Highly sensitive unconscious forces that are emotionally charged and contain personal meaning. A simple word or action could trigger a complex which could cause one to react very strongly (Pascal, 1992). Ego The centre of one's consciousness that absorbs information from one's unconsciousness as well as from the outer world. A healthy Ego is essential for balancing these two realms without being overpowered by either side (Corsini & 11 Wedding, 1995). Psyche "The inner realm o f personality that balances the outer reality of material objects.. this inner world influences biochemical processes in the body, affects the instincts, and determines one's perception o f outer reality" (Corsini & Wedding, 1995, p.95). Psychotherapy " A formal process of interaction between two parties.. for the purpose of the amelioration of distress in one of the two parties relative to any or all o f the following areas of disability or malfunction: cognitive functions (disorders of thinking), affective functions (suffering or emotional discomforts), or behavioral functions (inadequacy o f behavior), with the therapist having some theory of personality's origins, development, maintenance and change along with some method of treatment logically related to the theory and professional and legal approval to act as a therapist" (Corsini & Wedding, 1995, p . l ) . Sand Picture The three-dimensional scene created within the container of a sandtray using a variety of miniature figures representing inner archetypal images and objects found in our outer world. This creation is understood to represent some aspect of the creator's psychic condition (Kalff, 1980). 12 Sandplay Process The sandplay process is the overall transformation observed within the sandtray of each child throughout the study. It is completely child-directed, taking its own direction and time and creating its own goals (Mitchell & Friedman, 1994). Self The centre of one's totality - the conscious and unconscious. "The Self directs the psychic developmental process from the time of birth" (Kalff, 1980, p.23). "This inner order, this pattern for wholeness, is the most important moment in the development of the personality" (Kalff, 1980, p.29). "When the Self is constellated, it is accompanied by a feeling o f inner harmony and a transformation of energies that evokes a numinous quality" (Mitchell & Friedman, 1994, p.75). It is this manifestation of the Self that is the essential precursor for a healthy, developed ego (Mitchell & Friedman, 1994). Delimitations The following delimitations outline the parameters that were set at the beginning o f the study: 1. that the investigator was also the therapist in all sessions; 2. the number of subjects was limited to three; and 3. the time period for the sandplay therapy was four months. 13 CHAPTER TWO: LITERATURE REVIEW An Overview of the History and Theory of Sandplay It seems magical that children of all cultures and from all eras have discovered the joy o f playing in the sand, using whatever sticks or rocks they could find to express their imagination. During Carl Jung's self-analysis, he suddenly remembered childhood incidents that involved ritualistic play and a pattern that brought personal meaning without conscious interpretation. For him, the image and the meaning were identical; as the image occurred, the meaning would follow. A s he and Freud were parting ways, he listened to his unconscious which seemed to be suggesting that he should recover the creative life that he experienced as a child. He recalled the pleasure that he had experienced by a lake building little houses and castles and playing with stones and mud. A s he began to play again, he discovered that play led directly to unresolved issues from childhood and released a plethora of fantasies with which he became actively engaged. It appeared that for children, symbolic play was a similar process to adult active imagination and dreams where a flow of fantasies would be released from the unconscious (Stewart, 1982). It was Jung who encouraged the originator of sandplay, Dora Maria Kalff, to pursue child psychology and to study in England with child therapist, Margaret Lowenfeld. Lowenfeld was the first person to introduce the concept of using a sand tray with toys as a projective medium with children, in 1929. Although K a l f f had the greatest impact on the development of sandplay as a means o f child psychotherapy, Lowenfeld was the first person to introduce toys and a sandtray as a counseling technique. Lowenfeld placed great emphasis on 14 the non-verbal 'thinking' of children. She stressed that children fuse their personalized similar experiences together into a single whole, forming a clustered group that cannot be separated verbally. This leads to a personal form of mental functioning that is unique to each child and is incommunicable in words to others. Moreover, children have another type o f mental functioning that is rational and can, to some degree, be expressed verbally. Many people are not aware of the first non-verbal kind of thinking that is based in the unconscious and Lowenfeld believed that only through projective methods such as The World Technique could children express their multi-dimensional and unconscious thoughts. Lowenfeld identified four conditions that would most probably appear i f children were not able to bring their non-verbal 'thinking' into the outside world. If children were not able to test their internal concept with external reality, their energy might become locked within a group of clusters and they may become spiritless. Secondly, i f children developed a great amount of energy that had no outlet, then their bodies would become tense and overloaded with stress. These children seemed to develop conditions that had no organic cause such as asthma, convulsions, disturbed sleep, digestion patterns and so forth. Thirdly, i f children believed that these internal clusters were "real" in the outside world, then the repercussion may be a phobia, an obsession or a ritual. Finally, for children who could not differentiate between their outside and inside worlds, they might become disengaged and may develop an early psychosis. Therefore, it was imperative that children had a medium through which they could express their internal conflicts (Lowenfeld, 1948). 15 Lowenfeld's inspiration for a projective medium through which children could express themselves came from a book called "Floor Games" by H . G . Wells, published in 1911. Wells wrote this book about the games that he and his sons used to play. They would play on the floor, within a confined area, using empty boxes that they transformed into buildings, boats, trains and so forth. Wells believed that play lay the foundation for creativity in adulthood (Mitchell & Friedman, 1994). Lowenfeld remembered Wel ls ' book and envisioned a therapeutic technique that involved an assortment of materials for creating anything a child imagined. This box of materials was known as her "Wonder Box" . In 1929, Lowenfeld's clinic moved to another location where she added two zinc trays to the playroom, one contained water and one contained sand. The Wonder B o x evolved into a small cabinet that contained many small toys. The children spontaneously mixed the water and sand and then added the toys. This is how "The World Technique" was born. The scenes that the children created in the sand trays were called "world pictures" and thus the intervention was named "The World Technique". Lowenfeld observed that play is a natural function o f childhood; it is not something that one has to learn. She felt that the way to a child's mind was through toys. Children's concepts were not necessarily related to what adults term "real" and thus the child's consciousness was completely absorbed in an emotion as he/she was experiencing it. Therefore, an apparatus such as the sand tray enabled the child to spontaneously express ideas and feelings without needing to 16 feel skillful or knowledgeable. The World Technique allowed movement, touch, sensation, sight and fantasy in a contained area making a complete image (Lowenfeld, 1939). This technique provided Lowenfeld with an instrument for objectively analyzing and recording the emotional and mental states of the children with whom she was working (Mitchell & Friedman, 1994). In 1944, Ka l f f moved to a small village in Switzerland where her son often played with Jung's grandchildren. The children's mother Gret Jung-Baumann noticed that her children came home relaxed and happy when they had been playing at K a l f f s house, and thus the two mothers met and became friends. Baumann encouraged Ka l f f to pursue child psychology and introduced Kal f f to her father, C . G . Jung, who also encouraged her to pursue this career path. In 1954, while studying at the Jung Institute, K a l f f attended and was greatly impressed by a lecture presented by Margaret Lowenfeld describing her "Wor ld Technique". Jung had also observed Lowenfeld at a conference in France and he encouraged Ka l f f to contact Lowenfeld. B y 1956, K a l f f had completed the required courses for becoming a Jungian analyst and had completed personal analysis with Jung's wife, Emma. K a l f f went to London to study with Lowenfeld for one year. While in London, she also studied with Dr. Donald W . Winnicott, a distinctive contributor to the psychological understanding of human development, and Michael Fordham, the first Jungian child therapist in England, who also became her mentor. Upon returning to Switzerland, Ka l f f integrated her Jungian training with components of the World Technique and created her own approach and personal 17 theory which she called "Sandplay". The development of Sandplay was also greatly influenced by K a l f f s connection to Tibetan Buddhism. For eight years, a Tibetan Lama refugee lived with her and her family. This led to many contacts with other Tibetan monks. Ka l f f also met the Dalai Lama several times and had visits from the heads of all four branches of Tibetan Buddhism. Another significant Eastern influence was the Zen Buddhist scholar, D . Suzuki. He confirmed K a l f f s philosophy of honoring a profound universal truth when he compared it to the Zen philosophy in which a student does not receive direct answers when seeking wisdom; she/he has to rely on his/her imagination and inner wisdom. Ka l f f went on to teach Sandplay in Japan as wel l as the United States and various European countries. K a l f f died in 1990 but the International Society for Sandplay Therapy, which she founded in 1985, continues to grow and provide training and certification for therapists all over the world (Mitchell & Friedman, 1994). According to Ka l f f (1980), through sandplay an individual can represent some aspect of his/her psyche. She stated that the Self directs the development of the psyche from the moment a child is born. Jung defined the Self as archetypal energy that orders and integrates the personality, an encompassing wholeness out of which personality evolves. The Self is the goal of personal development. The infant starts in a state o f initial wholeness, as a unitary Self that soon fragments into subsystems (Corsini & Wedding, 1995, p. 103). During the first year of the child's life, the child has basic needs such as 18 warmth, shelter, and food; she/he needs to experience unconditional security and love in order that she/he can separate from the caregiver one year later. A t this point, it is hoped that a trusting relationship w i l l have formed between the child and the caregiver and the Self o f the child w i l l have separated from the caregiver. If the child feels secure in the world, then his/her Self w i l l be grounded within the unconscious. In creative forms o f play, this sense of wholeness w i l l be portrayed through symbols such as circles or squares. "The manifestation o f the Self, this inner order, this pattern for wholeness, is the most important moment in the development of the personality" (Kalff, 1980, p.29). Ka l f f (1980) emphasized the significance of the circle representing the totality of the psyche and the square representing earthbound matter of the body and reality. These symbols have appeared frequently, throughout history and across all cultures. They arise in dreams, myths, religion, and in mandalas drawn by Tibetan monks. In astronomy, art and circles were engraved in rocks before the wheel was invented. It appears that the psyche has an unconscious desire to bring these symbols and the basic factors that they symbolize into our conscious world (Jaffe, 1964). In disturbed children, who appear to have weak ego development, the symbols o f Self have not appeared (Kalff, 1980). The ego is the most important component of the Self and first appears in a young child when he/she is beginning to develop a sense o f autonomy. The ego is the center of consciousness and therefore absorbs information from both the unconscious and the outer world. For healthy psychological development to occur, the ego needs to be strong and 19 resilient in order that it doesn't become overwhelmed or over identify with either of these two realms (Corsini & Wedding, 1995). Disturbed children may not have experienced the attachment bonding that is imperative in the first few years of life for encouraging independence and identity, thus their inner feeling of wholeness may have been damaged (Allan & Berry, 1987). The function o f the ego can be impaired by environmental influences such as war, illness, or lack of care and awareness by the primary caregiver. The intent o f sandplay is to provide a safe place where one feels complete unconditional acceptance, thus providing the Self with an opportunity to stabilize itself and establish a relationship with the ego. I f children feel protected when they are happy or distressed, a therapeutic relationship can develop that may restore the attachment bonding that did not occur in the first year of their life. The psyche has the potential to find inner peace enabling the personality to fully develop (Kalff, 1980). Through sandplay, children can act out traumas by means of fantasy, thus gaining control over inner impulses (Allan & Berry, 1987). Through the powerful language of symbols, children in therapy have been able to recover their sense of Self (Kalff, 1980). Jung described the symbols as being: the remedy with whose help neurotic dissociations can be repaired, by restoring to the conscious mind a spirit and an attitude which from time to time immemorial have been felt as solving and healing in their effects. They are representations of collectives which facilitate the much-needed union of conscious and unconscious. This union cannot be accomplished either intellectually or in a purely practical sense, because in the former case the instincts rebel, and in the latter case, reason and morality. Every dissociation that falls within the category of the psychogenic neurosis is due to a conflict of this kind, and the conflict can only be resolved through the symbol (Jung, 1963, p. 191). Many of the images or symbols that are used in sandplay are described as archetypes. An archetype is an organizing principle, a system of readiness, and a dynamic nucleus of energy... Jung believed that humans have an inherited predisposition to form their personalities and to view reality according to universal inner patterns... Jung wrote that there were as many archetypal images in the collective unconscious as there were typical situations in life, and that they have appeared in individual experience from time immemorial and will reappear whenever analogous situations arise (Corsini & Wedding, 1995, p.96). These archetypes are located in the collective unconscious and travel to the personal unconscious before rising to consciousness. The collective unconscious is the universal psychic energy that Jung believed was common to all human beings. Archetypal images shared by all individuals travel from the collective unconscious to the personal unconscious where they are modified according to each individual's life experiences, the personal unconscious being the container for images rising from the collective unconscious. It also contains material that is repressed because it has not been 21 accepted by one's ego and superego, as well as material that is no longer important to the psyche and has therefore been temporarily or permanently discarded from consciousness. The archetypal image flows from the collective unconscious to the personal unconscious by means of a complex. A complex is a highly sensitive charge of emotional energy with individual meaning. Complexes are connected to emotional associations that are related to one's personal history; for example a self-worth complex or a negative mother/father image complex. Jung believed that these complexes were of paramount importance because they enabled confrontation of one's issues thus promoting an individual's development and growth (Corsini & Wedding, 1995). Depending on the theoretical orientation of the therapist, interpretation of the symbols that appear in the sandtray wi l l be manifested differently. For the Jungian therapist, the sand tray depicts many archetypal images that do not need to be interpreted to the individual. More importantly, the therapist needs to convey to the child that she/he is respectfully witnessing the process of play that has produced significant images and symbols, and is actively present in thought and feeling. Sandplay is now recognized as an invaluable medium that produces an image using a wide variety of symbols within a specific area. It is recommended that the dimensions of the container measure 20 x 30 x 3 inches in order that children can view their whole sand picture in one glance. Also, the inside o f the tray should be painted blue to represent water. The therapist's collection of 22 miniature toys and objects should include many objects that represent items and images in our inner and outer world. In addition to a dry sand tray, it is also recommended that a wet sand tray should be available where individuals can mould and play with sand of various consistencies and access different levels o f consciousness. A t the completion of each session, many therapists take a photograph or slide of the sand picture to record and create a reference of the various stages of sandplay. In Jungian sandplay therapy, the therapist's role is to provide a therapeutic container for the individual participating in sandplay. B y providing a "temenos", a free and protected space, the individual feels comfortable exploring and expressing him/herself within the container of the sandtray and the containing atmosphere provided by the therapist. Usually in silence, the therapist sits a short distance away from the sandtray, providing support by participating as a silent but active witness. A s the individual takes part in the ritual o f sandplay, the therapist observes and aims to gain a deep understanding of the presenting sandplay process (Bradway & McCoard , 1997). Ka l f f (1980) describes the initial sandplay session as a significant indicator regarding the direction in which the client appears to be heading. The client's goal of Self realization seems to be represented within the sand scene. B y expressing this goal in the sand, the individual releases new energies which w i l l begin the development of a healthy ego. Ka l f f (1980) has found that the first stages of ego-development are often represented by pictures with many animals and vegetation. However, before 23 showing signs of ego development, the child may need to express disorganization and chaos where the toys do not appear to be specifically chosen and there could be an absence o f animal, plant or human life. The scenery may be bare and dry or the child might pour hundreds of miniatures into the sand tray. This state of chaos would be representative of the child's distress and emotional state. These types of scenes might be created for two to three counselling sessions (Allan & Berry, 1987). The next phase of sandplay is identified by Ka l f f (1980) and Al lan & Berry (1987) as the fighting stage where many battles occur. These pictures depict intense conflict often involving monsters, armies, and robots. The battles reoccur and every object is destroyed. In the beginning, everyone and everything is blown up and there is no victory, but over the weeks, the struggles become more organized and not everyone is killed. The enemy is often taken captive and a hero may appear, after having beaten the opposing forces. A s children begin to feel stronger, they are able to face the destructive forces and come to terms with them. Aggression is often a sign of overwhelming fear, many children may have resorted to aggression as a coping mechanism and may be used to expending all their energy in this hostile manner. Therefore, it is common for such children to have little energy for anything else and to be easily frightened by any demands (Kalff, 1980). Sandplay provides them with a non-threatening medium where aggression is acceptable and a place where alternative methods of interacting can be explored. 24 Finally, in the resolution phase, the stage of adaptation to the collective, the sand tray pictures show more order and balance between the environment and the people, and the activities of daily life. Animals are in their appropriate habitats and fences are used to protect the sheep and cows in the fields. The therapist can sense that the conflict has been resolved and that the child has found a place in this outer world. Throughout the sand tray sessions, one particular miniature may have appeared, disappeared and reappeared representing a specific symbol for the child. In the resolution phase, this key symbol may completely vanish or may become integrated with the other miniatures in the scene. Furthermore, as children begin to feel stronger, they w i l l often state that they don't need to come anymore; this feeling of wholeness and completeness w i l l be demonstrated by symbolic circles and squares in the sand (Allan & Berry, 1987). The order shown in the sand picture represents the transformation o f the aggressive forces that were blocking the healthy development o f the ego. At this point it would seem that the child would have experienced internal growth, which would have enabled him/her to cope with external struggles and finally reach a stage where he/she could adapt to the collective. In this stage, peace would have been created thus leading to a greater sense of security and strength to cope with the outer world (Kalff, 1980). Bradway & McCoard (1997) have outlined the following key themes that often appear during the sandplay process: 25 Place of incubation Sometimes there is an enclosure within a scene which may be indicative of the shelter that an individual needs in order for growth and transformation to take place. Providing energy for the journey Energy may be represented by mechanical energy (vehicles, gas stations); primitive animals (suggesting aggressive energy) and domestic animals (suggesting more controlled energy); non-mechanical forms of transportation (a sailboat suggesting natural wind energy). Blocking of energy Trapped vehicles; blocked water. After expressing this blocked feeling, the individual may be ready to continue forward again. On the journey There could be many ways to portray this such as a vehicle about to take off, or a path, or a row of animals heading somewhere. Being controlled by vs. confronting authority A domineering authoritarian figure versus a smaller figure such as a baby animal. Handling anger Fenced in animals may represent anger that needs to be contained. Development of the masculine and feminine A n individual may need to become more aware of his/her gender identity or his/her contra-sexual side. A tray may be made with predominantly feminine symbols such as a scene with all shells versus a predominantly male scene such as 26 a male gorilla standing on top of a mountain. For differentiating between masculine and feminine, masculine items may be placed on one side o f the tray while feminine items are grouped on the other side. Union of opposites Through sandplay, there could be many opportunities to portray opposites which may become united further on in one's process. This could invite the transcendent function to become a part of the process. The transcendent function mediates between these warring opposites and unites them with a reconciling symbol. This is experienced consciously as a new attitude which transcends the original divided state of the self. After this change in attitude it is then possible to effectively change our behavior in a natural and stable way (Bradway & McCoard , 1997, p.83). Attaining the treasure Treasure for some individuals may be related to one's sense of spirituality or treasure could be related to treasures in one's unconscious. For example, after having experienced anger within the sandtray, a treasure chest may appear. Besides being a therapeutic tool, the use of small toys within a contained space has also been used for diagnosis and research. In 1951, Charlotte Buhler brought "The World Test" to the United States. She reported that the topic o f the world picture, the story during the creation and the pattern of the completed image, revealed characteristics of specific personality disturbances. She categorized world pictures into the following six classifications: a) Aggressive - accident scenes that were not mentioned in the story; 27 b) Distorted - display of confusion; c) Closed - large areas closed off that do not relate to enclosures in reality; d) Disarranged - chaos and contradictions, for example, cars pointing in opposite directions while moving on the same side of the street; e) Rig id - artificial and excessive portrayals of order; and f) Symbolic World Signs - qualitative scenes where the child states a metaphorical message. Buhler reported that two or more of these signs would be indicative of an emotional disturbance (Mitchell & Friedman, 1994). However, Buhler's test is not considered valid nor transferable to sandplay due to several variables. According to Stone (1959), none of Buhler's studies discuss the reliability o f the scoring or the training required in order to identify the presence of "Signs". Since the presence o f two symptoms can be indicative of an emotional disturbance, it seems essential that a more precise scoring method be utilized. Furthermore, Buhler's miniature toys were a standard size representing defined categories whereas contemporary sandplay therapists have miniatures of many sizes that encompass a wide variety o f categories. Moreover, Buhler omitted the use of sand and water. For contemporary sandplay therapists, her test and research may be useful as a general guide, but not as a quantitative instrument with sandplay. Currently, sandplay is used with a wide variety of populations. Carey (1991) has incorporated sandplay therapy into family therapy. The sandtray has been beneficial as a container for families where boundaries have been a problem. 28 Sandplay encourages family members to explore alternative ways o f interacting and communicating and provides the therapist with an opportunity to observe alliances within a family. Children may feel more comfortable working with older members of the family since sand and toys are familiar media to them. For the adults, it can be healing for them to express their "inner child". Sandplay appears to be a unique tool in family therapy because it provides a safe place where unconscious material can be projected in a form that can be readily observed by the family therapist and the other family members (Carey, 1991). The use of sandplay has also been successful with hospitalized children who have experienced psychic trauma, and with school children in remedial reading programs. At a hospital in San Francisco, the nursing staff were able to identify the children's unconscious language and develop empathic responses toward them after observing their sandplay. The sandtray provided a metaphor for the children to bridge their inner and outer worlds, and enabled staff to gain insight into the initial trauma from a safe distance (Miller & Boe, 1990). In a special education classroom in Stanford, Noyes (1981) found that sandplay with her sixth grade remedial readers produced positive results. It fostered a more immediate and deeper rapport between herself and the students, and provided the students with a modality for expressing their fantasies, thus clearing their minds for reading. Noyes found that "working in sand particularly trains and uses the creative right brain in the visual skills needed to connect the graphic information on the page with the child's total experience" (Noyes, 1981, 29 p.232). A l l the children's reading scores increased from a range of 2.0 to 5.5 years, their self-esteem improved, and inner conflicts were resolved. Using sandplay as a therapeutic tool seems to be a versatile medium suitable for diverse populations. In particular, it appears to be beneficial for those who experience restricted verbal expression due to emotional, physical or cultural circumstances. Sandplay is a unique modality because it provides a multi-dimensional means for representing one's perception of the world. Nonverbally or with dialogue, one can convey how one creates meaning and perceives life, and through exploration, metacognitive processes can be observed. Sandplay is a powerful mode of internal expression with young children, because they can express themselves in a less direct and symbolic manner. The use of metaphors in sandplay seems to complement other creative art therapies where, according to Jung, the individual can express his/her unconscious in symbolic form which then "taps into the 'healing potential' o f the psyche" (Allan, 1988, p.224). Using sandplay with young children could benefit them as they enter the Initiative versus Guilt psychosocial stage as defined by Erikson in Corey (1991): Basic task is to achieve a sense o f competence and initiative. I f children are given freedom to select personally meaningful activities, they tend to develop a positive view o f self and follow through with their projects. I f they are not allowed to make their own decisions, they tend to develop guilt over taking initiative. They then refrain from taking an active stance and allow others to choose for them (p. 103). 30 Erikson's psychosocial description relates to Carey's research (1990) which found that sandplay enables the child to be in complete control of the action and thus gain a sense of his/her own power. In addition, the tactile sand provides a complete sensory experience that leads to a peaceful space where the protected Self can develop. The numerous applications and successful results from the therapeutic use o f sandplay clearly indicate that it is a valuable intervention for encouraging development of the Self and developing a positive relationship with one's ego. Recent research shows that many children who stutter experience concomitant psychological issues, however, there is a dearth of current research exploring the use of psychotherapy in conjunction with speech therapy for children with speech impediments. According to the sandplay literature, it appears as though sandplay could be an ideal form o f psychotherapy, in conjunction with speech therapy. If these children were experiencing psychological distress, sandplay could be a non-threatening, non-verbal medium that would encourage unconscious expression o f psychological disequilibrium. This would enable the children to experience psychological healing and provide their families and speech-language pathologists with greater insight into the overall coping levels o f the children. In psychotherapy, children who stutter may be able to develop their sense of Self and strengthen their egos, thus increasing their resiliency to external influences that for children who stutter could be particularly challenging. 31 A Historical Overview of Stuttering There is much ambiguity in regards to the relationship between stuttering, organic causes, environmental influences and psychological factors. In the early 1900's, Lee Edward Travis proposed that stuttering was caused by a defective relationship between the two cerebral hemispheres. "These abherrancies could include the creation of a mistiming of nerve impulses to the bilateral speech musculature" (Travis, 1978, p.278). This theory, based on cerebral dominance, was tested in research conducted by Travis and his students. A subject's nondominant forearm and hand were placed in a cast in order that the competition for control of the speech mechanism would be resolved, in favor of the dominant hemisphere ( Perkins, 1996). This theory was tested for an academic year with no positive results (Travis, 1978). In the 1940s, Travis began to view stuttering as a psychoneurosis. Through therapy clients were encouraged to openly express their repressed needs and emotions (Perkins, 1996). Around this time, many psychoanlaysts were also considering stuttering as a symptom of an inner psychodynamic conflict as well as "a sign o f a defective or insufficiently developed ego. It is an integral part of a specific syndrome, and not only the stutterer, but the parents as well can be described in terms o f their characteristic dynamics" (Fried, 1994, p. 3 54). Van Riper, the father of stuttering modification therapy, believed that stuttering was a learned behaviour that stemmed from inadequate interpersonal relationships. The goal of the psychoanalytically based stuttering therapy entailed 32 modifying or reducing the demands of the overwhelming conscience (Van Riper, 1973). In 1942, Wendell Johnson introduced the diagnosogenic theory as an explanation for the onset of stuttering. He believed that it was the parents' negative reaction to their young children's normal disfluency that perpetuated the problem into clinical stuttering. Although after almost fifty years this theory was also undermined, there continues to be much debate today concerning the role of the parents in the speech development of their children (Perkins, 1996). Oliver Bloodstein (1987), a student of Johnson's, continued exploring the diagnosogenic theory. He abandoned the theory of parental judgment, and hypothesized that stuttering was a result of daily pressures in communication that resulted in tension and fragmentations. Since it is a natural reaction for us to become tense when we feel fear, he predicted that young children who are just learning to speak may be apprehensive. Thus, it seemed plausible that under these circumstances, they would stop their flow of speech, become tense, and in anticipation of a difficult word, exhibit stuttering behavior. These environmental factors continue to play a significant role in current research. The prediction that stuttering was a mechanism for eleviating built up apprehensive fear then became popularized by the operant behavior theorists (Perkins, 1996). Operant conditioning describes the process of an action on the environment producing a specific response. For example, if an individual felt that stuttering was producing a positive response, such as increased positive attention, this would reinforce the behavior of stuttering and encourage this action to 33 reoccur. Therefore, behaviorists concentrated on the development of fluency, not the stuttering. People who stuttered were encouraged to slow down their rate of speech and to prolong their sounds. More recently, Raymond Kent, Richard Curlee and William Perkins have devised the neuropsycholinguistic theory to explain stuttering (Perkins, 1996). They believe that the disorder is based on rhythm and "a dissynchrony somewhere in the speech production process" (Perkins, p.43, 1996). Speech would not be fluent if the processing of syllables was occurring at a different time to the articulatory processing. Their theory states that when this mistiming happens, the result is stuttering (Perkins, 1996). Some researchers believe that a combination of genetic and environmental factors interact in the onset of stuttering (Peters & Guitar, 1991). The Demands and Capacities Model (Starkweather, 1987) is an approach that has attempted to organize and structure the information that is well known about stuttering. This theory recognizes that i) long words and complex sentences are linguistically challenging and thus more likely to produce stuttering, ii) the majority of children who stutter also have language development delays and iii) some children who are linguistically advanced also stutter. Although these two groups of children are very different, they both share the common fact that their environment requires them to perform linguistically. If they can't meet the expected level, stress on the child's motor capacity occurs. Since language and motor performance occur simultaneously while speaking, the central nervous system that processes language and motor output may reduce motor performance to compensate for 34 language production. Secondly, longer words and sentences need a higher level of motor performance which could then create a linguistic challenge. Thus in both scenarios there is a similar conflict between the demand and the capacity for producing fluent speech. In addition to specific language skills, it was realized that this theory seemed to apply to other areas as well. For example, if children live in environments where people appear rushed or excited, they may feel a demand on their speech motor performance. Similarly, in a heightened emotional or social situation, a child may speak dysfluently. Moreover, as children grow older, more demands are placed on all areas of their lives, but often the children who stutter do not appear to have the capacity to meet these expectations. In these cases, the demands need to be lessened to match a child's capacity for fluent speech. According to the Demands and Capacities Model, emotional demands can greatly affect the child's fluency by increasing the child's arousal level, which in turn can create difficulty in fine motor coordination. Negative emotional tension such as illness and marital discord can disrupt speech production, and positive emotional arousal can also affect a child's fluency. Events where there is excitement such as a birthday party, a visiting relative or a trip away can negatively affect speech probably more than fear or anxiety (Starkweather & Gottwald, 1990). Because children have underdeveloped nervous systems, they have less resources and therefore less processing capacity to share their resources. "The child is a system with a finite amount of resources which must be parceled out to tasks he is engaged in" (Peters & Guitar, 1991, p. 51). 35 It appears that some children could be predisposed to stuttering and may begin to stutter due to developmental pressures and/or environmental pressures. Attitudes and pressures by parents, or any stressors in the environment that create uncertainty or insecurity may create demands beyond the child's capacity to cope, which in turn could create too much pressure and a breakdown in fluency for a child who is predisposed to stuttering (Peters & Guitar, 1991). The most recent article that discusses stuttering as a "symptom of far-reaching emotional disturbances" (Kernan, 1981, p. 109) interviews Philip Glasner, who was 71 years old at the time of the interview and who once stuttered severely. While pursuing a degree in psychology, he was discovered by the Dean of the Department of Child Psychiatry at John Hopkins University, Baltimore, and invited to join their staff. He claims that every child that he has treated in his 36 years at John Hopkins University, has stopped stuttering. He strongly believes in treating the child as early as possible. Children usually begin stuttering between the ages of two and five but many are only treated once they start school. Many researchers criticize Glasner for his psychological theory, but he firmly believes that the causes of stuttering are "rooted in the child's feelings of tension, unrest and insecurity...Glasner estimates that boys stutter five times as much as girls. For him, the reason is that boys are put under more social pressure sooner in our culture" (p. 114). Although these results are impressive, they are based on anecdotal information which has not been clinically tested. Therefore these statistics need to be interpreted with caution. 36 Due to the many theories of stuttering, there are numerous ways of approaching intervention. In the 1950s, the psychoanalytic theory was very influential and from this perspective stuttering was attributed to inner psychological conflict. Thus, the role of psychotherapy seemed to address these psychological issues. For children who stuttered, play therapy was implemented. Through therapeutic play, Van Riper believed that children were able to take on roles and partake in activities that would enable them to overcome their anxieties. He noted that children would often engage in hostile play as a means of expressing their frustration over their dysfluency, and perhaps as an outlet for expressing some possible resentment against the parents, who would often react adversely to their children when they would stutter too frequently. The therapist was able to provide a warm, permissive environment based on unconditional acceptance, thus providing an alternate outlet for children to express their "unacceptable feelings" besides through stuttering. "In his play he not only recreates many of the stresses that formerly disrupted his life and his speech but he also masters them" (Van Riper, p.398, 1973). Through play therapy, an emotionally supportive relationship develops for the child with the therapist, into which more specific speech therapy activities can then be introduced (Guitar, 1984). Travis & Sutherland (1957) suggested the use of psychotherapy in conjunction with speech therapy to address the emotional problems underlying the speech symptoms aggravating them. Children were encouraged to verbalize their feelings through techniques such as finger painting, clay smashing, art, story 37 telling, drama, sucking and blowing on a modified spirometer, and sometimes with the aid of puppets, plastic figures, and Travis Story Pictures. During this time period, these techniques of art and play therapy were also used in speech therapy in the public schools. They enabled the therapist to set limits on physical actions but not on speech. "They provide safe disguises under which the child may more honestly express his disabling fears, hostilities, and loves in the 'unlearning' process" (Travis & Sutherland, 1957, p.911). Open and free communication could be fostered between the child and therapist, and the children who stuttered were able to improve their communication with themselves and others. The children were able to portray their feelings and display them in this sheltered environment. Over time, the children would model the therapist's behavior and speech patterns, learn to feel well and speak fluently again (Travis & Sutherland, 1957). In general the etiology of stuttering is no longer explained by the psychoanalytic theory of repressed feelings and defective ego. It is most commonly attributed to factors in the environment and within the child. Therefore, treatment tends to be focussed on a combination of these elements. The theoretical orientation of the speech-language pathologist influences the amount of therapy directed toward speech mechanics and discussion of attitudes and feelings about the individual's experience in his/her environment (Peters & Guitar, 1991). In a school model proposed by Ramig & Bennett (1995), the importance of including the parents and teachers in the therapeutic process is highlighted. 38 Other topics are also addressed including the attitudes and feelings o f the children who stutter and their concomitant problems. They feel that by educating parents about the problems that negatively affect the chi ld and the family, the chi ld wou ld be able to cope better. Furthermore, parents are taught specific speech skills that may facilitate their child's fluency. F r o m a holistic perspective, Ram i g & Bennett's model (1995) seems positive because it encourages parents to talk to their children about their speech and to address the feelings and emotions that result f rom stuttering. In addition, the teacher is educated in topics such as oral participation, teasing, disfluency and so forth. The aim o f the program is to incorporate a multidimensional approach to the stuttering child's intervention. In a study by Berkowitz et al. (1994), a model that focuses on changing the attitudes o f students and parents is introduced. Parents were given the opportunity to express their fears and concerns about their chi ld 's stuttering in a parent support group and with professionals. In addition, providing a support group for children who stuttered enabled the youngsters to share their fears and created a safe environment that facilitated change in their attitudes about their own stuttering. The experience o f the group decreased the chi ldren's sense o f isolation, offered a mutually supportive environment, and thus led to an increased self-confidence. The current literature seems to be emphasizing the treatment o f communicat ion disorders f rom a holistic approach. Accord ing to Prizant et al. (1990), speech-language pathologists are frequently facing challenges in regard to 39 the behavioral and emotional states that some of their clients are experiencing. Research has also reported a relationship between communication disorders and behavioral and emotional disorders in children and adolescents (Baker & Cantwell, 1987a; Gualtieri et al., 1983). Therefore, there appears to be a need for speech-language pathologists to gain a greater understanding of these psychological factors and to coordinate with mental health professionals regarding communication disorders and emotional/behavioral disorders. Recently research has reported a high prevalence of speech, language and communication disorders in children who are seeking help for emotional and behavioral problems, and vice versa with children referred to speech and language clinics (Prizant et al., 1990). However, the studies are not in agreement as to the specific characteristics of the emotional and behavioral disorders in children who stutter. In 1951, a study using the Toy World Test with different groups of children, including a group of children who stuttered, was conducted to evaluate the psychological state of different populations of children. One hundred children (age 6-9 years) were evenly divided into the following four categories: "normal, stuttering, withdrawing, and retarded behavior" (Lumry, 1951, p.26). The children were provided with a box containing 150 miniature items and cardboard for making fields and rivers. Each child was asked to make whatever he/she desired and the final products were analyzed according to the criteria for "symptoms" from Charlotte Buhler's World Test. In total, the "normal" children were found to have a frequency of 8 symptoms and a mean of .32. Both the 40 "withdrawing" and "retarded" categories had a frequency of 63 symptoms and a mean of 2.52 and the "stutterers" had a frequency of 58 symptoms and a mean of 2.32. It was concluded that "the frequency of appearance of symptoms is of clinical importance in differentiating the well-adjusted child from the one who has certain psychological difficulties" (Lumry, 1951, p.27). Thus the child who stuttered had more psychological difficulties than the child who was "normal". This research appears to concur with Prizant et al. (1990) that children who stutter may experience more psychological issues. Upon reviewing the literature on therapeutic interventions with children who stutter, one becomes aware that there is a paucity of research describing the effects on children who have received speech therapy in combination with psychotherapy. Although psychotherapy as a mode of speech intervention was frequently used in the 1950s, the article on Philip Glasner (Kernan, 1981) seems to be the only relatively recent report on the effect of psychotherapy with individuals who stutter. In addition, there doesn't appear to be recent research on the utilization of psychotherapy as an adjunct to current speech therapy programs. However, it would seem to be an integral component in a holistic approach to stuttering, as some of the recent speech therapy literature is now advocating. Although expressive art therapies are presently popular in many areas of psychotherapy, there are few current, direct references to art and play therapy with individuals who have speech impediments. Dora Kalff (1980) made reference to the use of sandplay with a child who had multiple problems including a speech block. She stated that through the course of sandplay therapy the child 41 did begin to speak without inhibitions, although she did not write a detailed account. Lois Carey (1990) refers to the use of sandplay with a child who had a history of speech and language disorders. Through sandplay, this nine year old boy's self-esteem increased and his ego boundaries became stronger, but no further reference was made to his speech impediment. It would seem plausible that a primarily non-verbal therapeutic intervention such as sandplay would be a beneficial mode of psychotherapy as a complement to speech therapy for some children who might be experiencing psychological demands. 42 C H A P T E R T H R E E : M E T H O D O L O G Y Personal Background Information in Relation to the Presented Research According to Sandelowski (1986), it is important to assess the trustworthiness o f the researcher in order for readers to evaluate the trustworthiness o f the study. For each case study, I have included my clinical impressions and reflections after each session with each child. This provides the reader with the opportunity to hear my personal experience of each child's sandplay therapy. Another method o f developing trustworthiness is for the researcher to explain how she/he became interested in the subject matter being studied; therefore, I have included my personal story. M y interest in speech-language pathology began when I was thirteen years old. I was in grade 8, already feeling insecure about entering high-school, when an insensitive classmate thought it would be amusing to tease me by calling me "Tharon Addithon" (Sharon Addison) and imitate me in other unkind ways. I was devastated and immediately asked friends and family i f I really did have a lisp. I was told that I had a "little" lisp. I was shocked and very self-conscious. With my parents help, I immediately began looking for a solution. I underwent surgery to have the piece o f skin that tied my tongue to the bottom of my mouth surgically cut back but I continued to lisp. Then we waited for my orthodontic braces to be removed but I still had a lisp. A t school I was scared to speak out in class and terrified of oral reports. Every time I spoke I thought people were noticing my lisp. Finally, I went to speech therapy and learned how to position my tongue in order that I could say the "s" sound more clearly. After six months of speech 43 therapy, I felt more confident that I could say the "s" sound but I still remained anxious about oral reports in front of the class. As I remember these self-conscious experiences during adolescence I think back to how counselling, through an intervention such as sandplay, may have supported me and helped me face some of my fears. Over time I regained my confidence in public speaking and didn't discuss this experience again until a close friend began the Speech and Language Pathology program at U B C . As we talked about my personal experience, we also discussed how counselling as well as the speech training was also a large component of speech therapy . My friend stated that she wished she had more training in counselling and we began to realize that this was an area where there appeared to be research potential for a counsellor with an interest in speech, such as myself. This was the beginning of my quest to research a counselling intervention that could be beneficial therapeutically and diagnostically for individuals with speech impediments. Research Approach Underlying this research was the guiding assumption that sandplay therapy would give each of the three children in this study the opportunity to symbolically express themselves unconsciously and consciously. This was the primary purpose of this research. The sandtray served as the "therapeutic tool of self-expression and healing" (Mitchell & Friedman, 1994, p. xviii). After each child participated in sandplay, a photograph was taken of the completed sand picture. Sometimes a child would request a photograph during his session, and then these additional photographs were also taken. Field notes were taken and 44 each sandplay session was videotaped to record the process and an audiotape was used as a back up. If the child told a story to accompany the sand picture, it was included in the session summary. Furthermore, the investigator as participant-observer, using qualitative methods, recorded the verbal and non-verbal aspects of the process in the form of memos. In the memos, the investigator recorded analytical insights, raised questions and made comments. In addition, the sandplay process was described, such as the child's manner of selecting and placing the miniatures, salient comments, as well as the use of the sand, water and so forth . The theoretical foundation of the sandplay sessions was based on Carl Jung's theory of Analytical psychology and Dora K a l f f s Jungian theory of Sandplay. A s an auxiliary component to this research, standardized tests measuring levels o f anxiety, self-esteem, attitudes toward speech, and levels o f stuttering were administered to each child before commencing the sandplay therapy. Upon completion of the sandplay sessions, these tests were re-administered to each child to identify i f there were any quantitative changes over the four month period. It was thought that these findings could be useful for gaining a greater understanding of each child and formulating hypotheses for future research. The Site and Selection of Subjects The site of this study was the U B C . N e w Westminster Counselling Centre. The two sandtrays remained in the same position each session and the miniature objects were returned to the same place on the shelves at the completion 45 of each sandplay session. This provided continuity for each child from session to session. According to some researchers (De N i l & Brutten 1991; Ramig & Bennett 1995) children as young as seven years old who stutter may exhibit significantly more negative attitudes toward speech than those who do not. Consequently, the investigator aimed to recruit three school-aged children to participate in this study since the research shows that children of this age would be more aware of their speech impediments. The sampling style was purposeful in order that the subjects possessed certain specific attributes that would be explored in this study. Therefore, the subjects were school-aged children who stuttered with the possibility of accompanying psychological issues. The investigator recruited subjects by contacting speech-language pathologists throughout the Lower Mainland of Vancouver and asking them to give a letter describing the study to potentially interested families. Furthermore, the School of Audiology and Speech Sciences at the University o f British Columbia was contacted for potential recruitment of subjects. Interested parents of potential research participants contacted the investigator and were invited to meet with her for an overview of sandplay and an explanation of the procedures of the study. Complete confidentiality was guaranteed. Pseudonyms replaced children's names throughout all field notes, memos and throughout the writing of the research. Letters of parental permission were obtained. A summary o f the sandplay study and a comprehensive written report of the child's speech patterns was provided to the parents at the completion of the study. This written report 46 included an assessment o f the child's stuttering, recommendations for future treatment and information about the nature o f the child's speech. This report was compiled by a speech-language pathologist. Parental permission was obtained for qualified external testers to: (a) measure the level of the child's stuttering before beginning the sandplay therapy and at its conclusion; (b) measure the child's level o f anxiety and self-esteem at the beginning and end o f the study; and (c) measure each child's attitude toward his speech pre- and post-sandplay therapy. The Role of the Researcher The researcher was the investigator and therapist. Ka l f f (1980) emphasized the importance of creating a temenos - "a free and protected space" which serves as a psychological and physical container. The child then feels free to let his/her imagination flow while feeling protected by knowing that the therapist is also a limit-setter. The therapist needs to be caring and unconditionally accepting on an inner level in order to allow an atmosphere of trust and complete acceptance to evolve. The therapist needs to remain open and non-judgmental to the play since it is not initially known whether something would produce a positive or negative outcome. Each child should feel accepted for being just as she/he is. It is not necessary for the therapist to verbally communicate in order to be actively engaged in the sandplay process. K a l f f (1980) recommended that the 47 therapist sit a short distance from the child in order that she/he does not feel intruded upon yet close enough that the child knows that the therapist is available. There would still be a therapeutic effect even when no words are spoken, as it is the actual process of creating the sand picture that contains the healing (Mitchell & Friedman, 1994). Upon completion of a sand picture, the child may have offered to tell a story. Symbols "hold a universal power through time and touch a deep level of the unconscious" (Mitchell & Friedman, 1994, p.55). It is essential for the therapist to have a deep understanding of archetypal images and symbols, and be familiar with the theory o f Analytical psychology and the fundamental tenets of sandplay. This investigator has been studying the basic foundation of sandplay, including the theoretical framework and the language of symbols, for the last two years. In Apr i l 1997, she attended the fourth International Sandplay Conference held in California. She has also attended other Sandplay conferences acquiring 38 hours o f sandplay training. In addition, she has been involved in her own sandplay process with a certified sandplay therapist in Seattle since M a y 1998 to the present. She continues to read current books and articles published by various members of the International Society of Sandplay Therapy. The investigator has used sandplay in her work as an elementary school counselor for the past one and a half years, and during her supervised clinical placement - a requirement for the University of British Columbia's Master of Arts Counselling Psychology program. 48 Procedure v. Over a period of sixteen weeks each child was offered the opportunity to take part in a weekly one-hour sandplay session. Sessions were usually held at the same time and on the same day each week. "This regularity sets the rhythm and the psychological protective boundaries for the child within which change can occur" (Thompson & Allan , 1985, p.65). In the initial session, the sandplay process was explained to the child. The child was encouraged to touch the sand in either or both the dry and wet sandtrays. The painted blue bases of the sandtrays were explained as possibly representing images of water. The child was invited to explore the hundreds of miniatures on shelves around the room. The therapist offered the child the opportunity to make a picture in the sand using the miniatures and by adding water to the sand i f he so desired (Mitchell & Friedman, 1994, p.54). The child could create freely, according to his natural instinct. He could choose to play in silence, use accompanying sounds, or speak to the therapist during his sandplay. Each child was told that this was his hour to use as he wished. Structural information was given regarding the time remaining in the session. Toward the end of the therapy, preparation for closure was addressed in order that the last phase of the sandplay therapy could prepare the child for termination. Instruments Sandplay The two sandtrays and the hundreds of miniatures were the primary instruments of research. The sandtrays measured approximately 20-x-30-x-3 49 inches (Allan, 1988). These dimensions enabled the child to observe the sandtray in one glance without having to turn his head to view the entire creation. One sandtray contained damp sand, to which water could be added, and the other contained dry sand. It was important to offer both options as one child may have preferred to mould with the damp sand whereas another child may have preferred the texture of the dry sand. The hundreds o f miniatures represented the following categories as recommended by Hegeman (1992, pp. 105-106): Nature Earth (rocks, stones, volcanoes, mountains, semi-precious stones and crystals). Ocean (coral, shells, seaglass, driftwood) Plants (trees of natural materials as well as plastic. Shrubs, sticks, flowers) Animal (ideally in different poses and family groupings) W i l d (birds, snakes, mammals, fish, insects etc.) Domestic (horses, cows, bulls, sheep, chickens, dogs, cats) Prehistoric (meat eaters and vegetarians) Fantasy (unicorns, dragons, and monsters) Human beings Ordinary People (walking, sitting, working, different ages, similar proportions) Occupations (farmers, doctors, firefighters, clergy, athletes,) Fantasy (wizards, dwarfs, futuristic. Figures that are scary and eerie) Different Cultures (people throughout the ages and of different races) Other entertainers (soldiers, royalty - enough figures to make a scene) 50 Transportation Land, sea, air vehicles. Mili tary and work equipment. Buildings Churches, schools, stores, lighthouse, institutions, different kinds of houses. Old and new buildings, castles, structures and dwellings for foreign cultures. Structures Bridges, fences, and wells. Equipment Work, farm, household, musical instruments. Furniture D o l l house bath, kitchen, bed and living room. Miscellaneous Mirrors, flags, umbrellas, feathers, candles with matches, bonfires, string, plasticine, pipecleaners and other building and construction materials. Sandplay as a therapeutic tool has been tested for its reliability by several researchers. Denkers (1985, in Mitchel l & Friedman, 1994) state that sandplay is effective in diagnosing psychological disorders and reliable in indicating developmental stages. Volcani, Stollak, Ferguson and Benedict (1982, in Mitchel l & Friedman, 1994) state that this technique is highly effective in eliciting fantasy play in children. Sandu (1978, in Mitchell & Friedman, 1994) found that sandplay "is a viable, projective tool through which to view the archetypal nature of the human psyche" (p.98). Bradway (1987, in Mitchell & 51 Friedman, 1994) analyzed the effectiveness and components of sandplay that make it so effective and powerful as a therapeutic process. The following standardized tests were also used to gain a greater understanding of each child by knowing their levels of anxiety, self-esteem, attitudes toward speech and levels of stuttering: Culture-Free Self-Esteem Inventory There is some research that indicates that children who stutter have lower self-esteem than children who speak fluently. Levels of self-esteem were assessed to gather additional information for exploratory purposes (Mooney & Smith, 1995). The Culture-Free Self-Esteem Inventory was administered to each child by an external counselor pre- and post-treatment. Reviews of the test in the describe it as a reliable and valid measure that is easy to administer and score (Adams, 1985; Morgan Riggs 1985). It is a simple test and requires the child to answer yes or no to a series of questions regarding his/her behavior and feelings. Revised Children's Manifest Anxiety Scale According to the Diagnostic and Statistical Manual o f Mental Disorders I V (American Psychiatric Association, 1994), stress and anxiety are associated features that seem to affect the severity o f stuttering; therefore, the children's level of trait anxiety was assessed to further contextualize each child. A n external counselor also administered this test before beginning sandplay therapy and upon completion of the sandplay sessions. Gresham (1989) reviewed this test and found it to be a "well-standardized self-report measure of anxiety" (p.697). He found internal consistency reliability o f the Total Anxiety score but found that the 52 reliabilities of the sub-scales were too low to be interpreted separately. Thus the investigator viewed the sub-scale scores with caution. Stewart (1989) also found internal consistency reliability and construct validity except for black females under age 12. Overall, Stewart states that the test has the "psychometric properties that support its usefulness as a measure o f the trait o f anxiety with children o f school age" (p.699). Childrens' Attitudes About Talking - Revised D e N i l & Brutten (1991) used the Children's Attitudes About Talking -Revised Test to assess the speech-associated attitudes o f stuttering and non-stuttering elementary and middle school age children. They found that children as young as seven years o f age who stuttered exhibited significantly more negative attitudes toward speech than their fluent speaking peers. In addition, the speech related attitudes o f children who stuttered became more negative with increasing age. The Children's Attitudes About Talking-Revised Test was administered to each child by an external counsellor pre- and post-treatment. Levels of Stuttering A speech-language pathologist assessed each child's level o f stuttering in reading and conversation pre- and at the completion of the sandplay therapy. The two oldest boys read a 159 syllable passage from the Stuttering Severity Instrument while the youngest boy described the pictures he saw in a storybook. She had a conversation with each boy to gather a 300 syllable sample of conversation. The speech-language pathologist then measured her intrajudge reliability by making calculations on 100% of speaking tasks. The reliability 53 measure was calculated on a point-by-point basis using the following formula, number of agreements/ (number of agreements + disagreements) x 100. Reliability measures ranged from 91% to 100% with a mean of 96%. Observation Methods and Data Collection The investigator/therapist wrote field notes immediately following each session to record, in memo form, analytical statements, comments, questions and impressions of the therapy session. These were personal, and subjective notes. K a l f f recommended asking oneself "What impression does the picture give me, what strikes me first about the tray? H o w does this make me feel?" (Mitchell & Friedman, 1994). For example, i f the therapist felt feelings o f incongruence upon observing the child and the tray, it was important to record these feelings (Mitchell & Friedman, 1994). Each session was videotaped and audiotaped. When a story was told or salient comments were made, these were included in the session summaries. R ich and descriptive notes recording the sandplay process, and the specific content o f the sandtray were written while watching the videotape. The investigator focused on the specific categories and characteristics of each session. For example, which categories of miniatures were used? Were there aggressive themes? Were there signs of chaos? Were there signs o f order? And so forth. While the investigator did not limit herself solely to these categories, they provided guidance and a basic summary of each sandplay session. Through immersion in the sessions and in the data, many individual themes to each child also emerged. Sometimes during, and always at the end of each session, a photograph was taken 54 of the sand picture and, when necessary, a sketch was drawn to identify miniatures that may have been difficult to recognize in a photograph. Analysis The analysis was primarily inductive which involved the investigator thoroughly immersing herself in the setting to identify themes that seemed to be meaningful to the creator of the sand pictures and themes that could be identified through Jungian analysis. The investigator analyzed the sand pictures according to the following components as outlined by Mitchel l & Friedman (1994, pp.84-85): The content of the trav (a) The symbolic meaning of the objects based on Jungian theory. (b) Use and placement of miniatures. (c) Shapes that emerged out of the use of sand and miniatures. (d) Developmental stage indicated in the tray: for example, K a l f f s vegetative, fighting, and collective stages. (e) Overall organization of tray. A n external rater was not used as "the process of inductive, qualitative inquiry frequently depends on insight and on the process o f linking data (both among categories and with established theory), expecting another investigator to have the same insight from a limited data base is unrealistic" (Denzin & Lincoln, 1994, p.231). Internal validity was conducted by reaching an agreement of theme classifications with the researcher's supervisor. In addition, the investigator 55 consulted with M s . Sylvia Simonyi-Elmer on each of the three case studies. M s . Simonyi-Elmer has twelve years experience as a child therapist, is a member of the International Board of Examiners of Certified Chi ld and Play Therapists ( IBECPT) and is a certified member o f the International Society o f Sandplay Therapists. In the appendix is a letter from her endorsing this study. The objective o f the case studies was to discover the salient themes in each child's sandplay sessions thus increasing one's overall understanding of each child. The discovered findings were then generalized to theoretical propositions as opposed to populations (Yin , 1994). The final analysis shows both similarities and differences in the themes of the sandplay processes Of the three boys in this study. Moreover, the individual stages of psychological development for each child were outlined and the importance o f counselling through sandplay for each child was emphasized. Finally, the results o f the standardized tests were discussed in relation to each child. 56 C H A P T E R F O U R : P E T E R Chapters four to six wi l l give some background information on each child and provide summaries o f each child's sandplay process. If the child gave a title or titles to his sand picture(s), they are noted in quotation marks at the beginning of each session summary. The summaries include a description o f each session, followed by the counsellor/researcher's clinical reflections and impressions of the sandplay process from a Jungian perspective. The sandplay pictures for each child are located at the end of each case study. The summary descriptions are drawn from videotape records and photographs, and clinical impressions and reflections from field notes o f each session, the counsellor/researcher's Jungian sandplay training, and Jungian sandplay literature. Peter began the sandplay sessions when he was eleven years old and celebrated his twelfth birthday during his ninth session. His parents are Polish and he speaks Polish at home and English at school. Peter stutters in both languages which greatly concerns his mother, although Peter stated that it did not bother him too much. His mother also stated that she was worried that Peter did not seem to have many friends, was frequently teased by classmates and did not enjoy school. However, Peter seemed to receive much pleasure from music and was a member of a choir as well as a talented pianist. Peter's stuttering began when he was four years old and seemed to increase in frequency during his kindergarten year. He began receiving speech therapy from the school speech-language pathologist when he was approximately 57 seven years old. At the time of the study, he was receiving speech therapy from the school speech-language pathologist for thirty minutes per week. Peter attended sixteen sandplay sessions from February to June, 1998. He seemed to thoroughly enjoy the majority of the sessions and stated that he was going to miss the sandplay when it was over. A description of Peter's sandplay process now follows: Session One: "The Year of 1438, Eruption, Land Dead" and "1987, Lots of Things Appeared" (dry sandtray) Session Summary Peter began the first session by creating a scene about the "early people", "old people", "new people" and "the improvement". Peter started his sandplay by using popsicle sticks as a measuring device to find the exact midway point for "the divider" (the long wooden fence) which he utilized for separating the two halves of the sandtray. He appeared to be dismayed that the fence did not stretch across the width of the sandtray. However, using a popsicle stick to measure, he found some candles that were the exact same height as the fence to fill the gap. Peter then continued to create two symmetrical scenes for the "Old Wor ld" and the "New World". For example, he placed a volcano in the "Old Wor ld" and a hil l in the "New World". He placed two deciduous trees in the old world and measured where he had placed them with a popsicle stick. He then stated that a volcano hit the tree in the old world and thus it became a pine tree when it grew in the new world. Initially, he stated that the new world was sixty 58 years later, and the old world was 1781. He then changed the year to 1871 for the old world and 1932 for the new world; however, he still wanted it to be sixty years later. Next, Peter poured some sand into the volcano and made some water in the old world by exposing the blue base. He then made some water in the same place in the new world, but this water covered a smaller surface area. He stated, "That takes care o f the water, now for taking care of the land". He was insistent that no other part of the blue base could be showing. Eventually, he took the pine tree out because, he explained, it was frustrating because it kept catching on his sweater. He then decided that the old world was 1000 years ago. In the new world, he proceeded by making a road out of clay bricks, but because, from his perspective, he was one brick short, he decided that a solution would be the addition of the bridge. As he retrieved the bridge, he stated "I aint as dumb as I look". Then he made a small church using a small, brass shrine and a white pipe cleaner (in a T-shaped formation) for a cross. He joined the gray fencing together and stated "That's smart? Finally something smart". He followed this by making a river in the new world, using a small canoe as a shovel to transport the sand from the new world to the old world. He then placed the bridge over the river and created an "uphill parking lot" using the red car and the black car. Next, Peter used the little bricks to make paths to the church, to the graveyard, and to the lake. As he held up the headstone he stated " I 'm sorry you died". He then added the two white crosses to indicate how to get to the church, 59 which he named the church of St. Peter. A sheriff car was placed on the centre o f the bridge and some small bricks were added around the lake for people to walk around, as well as a Canadian flag. A s he held up the canoe he stated, "These people are still dumb so they didn't make these" and thus he made a "canoe" (out of popsicle sticks), which seemed to resemble a raft, for the old world. One of the popsicle sticks was warped and he stated that he could not use it because "These people were careful". Back in the new world, Peter created a funeral scene with a nun and a box for a coffin. He stated "Just pretend he died two weeks ago.. .his name is Robert Ice whatever". He added a small figurine of an old man with a cane looking at the coffin. He then returned to the old world and added an Indian chief whom he described as an "olden day guy" saying "Look over there, it's a volcano, it's erupting". He then changed his mind and said that the olden day guy was saying, "This is the year, the day and the month of the eruption" and "He's showing them the eruption". Peter then returned to the new world, placed a police motorbike behind the police sheriff car and a red car behind it. Peter stated " Y o u know this guy had lots of friends". He then added the king because "it was not too long ago", and after exploring the selection o f buildings, he added the school and library "near the graveyard". He then looked at the old world and said "Something's missing -1 guess they didn't have anything right?" A s he looked at the new world, he said, "Huh, I 60 knew something was missing... o f course the guy who died". He added a small Playmobile figure and poured sand over him while stating "Since he's dying, they're burying him up. His head is there sticking out.. .there just his legs are sticking out". He then returned to the old world and added a small pink abstract figure (behind the tree) and stated that this was the olden day guy's "men". He said "They're crossing the land". Back in the new world, the sheriff exclaimed that someone was attacking. The king then made the order "Keep out the Germans" which resulted in a German soldier being placed in the corner and a cowboy aiming at him. Peter then placed more barriers and grass between the brick road and the funeral scene for "privacy". He also added a rake and an axe to the right hand side of the tray because "It's fall, and they're getting ready to cut wood for the winter". This was followed by him placing a silver flower on top o f the " h i l l " but he stated that that was a "bad place" and then placed it in front of the hi l l while stating, "I wonder what this could be? It's sort of like a sign you know." Lastly, he buried some marbles under the sand and hid some under the hil l . He described the hi l l as a gold mine which had evolved from the volcano millions of thousands o f years ago. The gold was "Just waiting to be picked". Before I took a photograph of this picture, Peter wrote the following titles for his scenes: "The Year of 1438 - Eruption - the land dead" and "1987 - lots of things" He placed each sign in its respective world and then just as I was about to take a photograph he stopped me and said " I f you had taken the picture I would have been doomed. Lots of things appeared". 61 As Peter was leaving the room, he repeatedly stressed the importance of people knowing about "the divider" and that "This is some years ago and some years after". A t first he explained that this was Canada, and then he stated that it was very small island from Hawaii - "Canada's Land". Out loud he asked himself what the flower could mean and then stated that "about eleven years ago, the gold mine's still there". Finally, as Peter left, he asked i f he could take the titles with him to remind him of what he had done. A s he walked away from the tray, his final words were "Land dead - it was a hilarious crash". Counsellor's Clinical Impressions and Reflections Many sandplay therapists have stated that the initial sandplay session may reveal the various issues that the individual needs to address. "Frequently, the initial picture gives information about the situation and contains, hidden in the symbols, the goal to be aimed at: the realization of the Self. In this process, new energies which lead to the formation of a healthy ego development are freed" (Kalff, 1980, p.32). Through Peter's story and the sandplay creation, Peter seemed to share a lot o f personal information. Peter's last statement as he walked away from the sandtrays, "Land dead -it was a hilarious crash", appeared to be an extremely incongruent statement as did his overall persona throughout the session. I was intrigued and jolted by the incongruence that seemed to be evident throughout the session. I quickly sensed that Peter had a strong desire to please, as indicated by the way that he would look up at me after he had just said something or created something in the sandtray. In 62 addition, his attempts to be perfect with the measuring and so forth also seemed to be a tactic for making a positive impression. However, he would then contradict his perfectionism by acting dramatically clumsy or saying something negative about himself. He frequently used humor and dramatization to cover up for a mistake or possibly as another method o f seeking approval. I wondered i f these behaviors were related to his stuttering, perhaps at an unconscious level he felt that his speech was unacceptable and therefore he may have felt compelled to overcompensate by trying to be a perfectionist and a comedian. Perfectionism can be a defense mechanism, Peter may have needed to block off unconscious impulses in order to maintain a sense o f balance. Initially, Peter stated that the wet sand gave him "the creeps" and therefore he would only be using the dry sand. In Jungian sandplay, the use of the wet sand and/or the showing of the blue base to represent water in either sandtray may signify that one is accessing energies from the unconscious (Bradway & McCoard , 1997). Peter's adverse reaction to the wet sand may have suggested that he was not yet ready for such depth. Peter's use of the fence as the emphatic "divider" and the creation of "the old world" versus "the new world" seemed to indicate opposing forces within him which could have represented a split within his psyche. The apparent importance of the divider to Peter continued to draw my attention to this split, as did the original names of the two scenes "The O ld Wor ld" and "The New World". In a case presentation by Dr. Kaspar Kiepenheuer at the International Sandplay J 63 Conference, California 1997, he discussed a child who had created an old world and a new world divided by a stream. He had felt as though this had been an indication that the opposing forces had not connected. I was also concerned that Peter seemed to have such a need for precise measurement, symmetry and rigidity. In drawings, rule (rigidity) may be "symptomatic o f a weak ego. Yet without some of it, the child lacks steadiness, constructiveness, and some degree of conformity. However, an over-abundance of Rule indicates an ego defence that is too rigid, usually having been established too early in childhood along with the possibility o f dominant repression and harsh social conscience" (Thompson & Allan , 1987, p.25). It seemed plausible that Peter's ego defence may have been too rigid. The pouring of sand into the volcano may have been a sign of pent-up anger or emotions (Bradway & McCoard , 1997), which may have indicated that Peter was preparing to bring some emotions to the surface. The opposing image for the volcano in the new world was the hi l l which remained solid and did not erupt. It could have been that Peter was hoping to achieve this sense o f stability. In addition, the exposure of some of the blue base may have suggested that he was connecting with some unconscious energy (Bradway & McCoard , 1997). The transformation of the deciduous tree to the coniferous pine tree may have symbolized the movement from death and renewal, represented by the deciduous tree that loses its leaves and grows new buds, to everlasting life, represented by the coniferous tree that keeps it leaves all year round. However, the coniferous tree was later removed and the deciduous tree was left standing. It may have been that a part of Peter was not yet at the stage of the healing process which would allow the coniferous tree to remain. The addition of the bridge appeared to be a positive sign that Peter was seeking connection (Bradway & McCoard , 1997). Although, the bridge was connecting the bumpy road to an uphill parking lot which may have indicated how Peter was feeling. The helping forces of the police vehicles on the bridge may have signified that help was available. The comment that he was not dumb as he looked seemed to indicate that Peter's self-esteem was low; however, he did seem proud of the fencing that he had joined together. His comment that "these people are still dumb" and "these people were careful", in reference to the olden day people, may have been a reference to himself. Previously he had mentioned looking dumb, and throughout the sandplay he had taken extreme care to be meticulous when he was not acting clumsily. The funeral scene appeared to be honoring somebody's death. Peter mentioned that this person had died two weeks ago. Coincidentally, my first meeting with Peter was two weeks ago. At this time we had talked about sandplay, and the upcoming months that we would be meeting together. I wondered i f unconsciously he had been psychologically preparing for sandplay and getting ready to allow a part of himself to die, in order that he could experience a rebirth during sandplay. It seemed significant that Peter looked for the "missing something" in the old world and then remembered that the dead person was missing in the new world. I wondered i f the old world was possibly symbolizing his current emotional state and i f the new world was foreshadowing 65 the issues that he was going to be facing. The importance Peter placed on adding the word "appeared" to the title of the new world also seemed to indicate that this was very significant and could have represented that the new world was related to new growth. There were three crosses associated with the funeral which is often viewed as a powerful quantity. The number three may represent the masculine (Weinrib, 1983) and might also be indicative of how power is going to be accessed. This power is often associated with the holy trinity, which seems to be connected to spiritual development (Kalff, 1980). The school and the library are both academic institutions that may have been related to negative forces for Peter as he is constantly teased at school. The extra barriers and grass by the funeral scene seemed to be adding extra protection around this ceremony. The flag may have represented identity (Matthews, 1993) and the old man with the cane may have been a witness or his meaning may become more clear in upcoming sessions. The king may have symbolized "God, the sun, the sky, the center of the cosmos, or the mediator between heaven, human beings, and Earth.. and often symbolizes the hoped for goal o f ego development" (Matthews, 1993, pp. 110-111). Furthermore, the king and the Native Indian Chief are both authority figures that seem to be ruling over their respective worlds - and they may be connected to Peter's rigidity and perfectionism. The order to "Keep out the Germans", the German soldier and the cowboy seemed to represent negative, aggressive energy from which Peter might have been trying to defend himself. I wondered i f the reference to the German soldier 66 might have been related to his Polish culture and the historical animosity between these two nationalities. The hidden treasures under the hill may have represented the unconscious treasures within him, waiting to be discovered (Dundas, 1990). Moreover, the silver flower seemed to be a sign that could have been alerting other people to these hidden treasures. It seemed significant that he stated that these treasures had been there for eleven years and he was presently eleven years old, soon to be turning twelve. In the old world, the "men crossing the land" and the erupting volcano seemed to be indications of dynamic energy. The boat in the water could have symbolized "the crossing from the realm of the living to the realm of the dead or vice versa" (Matthews, 1993. p. 26). This seemed to be related to the title o f the old world that described the land as being dead. Peter's desire to keep the titles may have been akin to a transitional object, symbolizing the therapeutic relationship and his sandplay experience. This concept of a transitional object was introduced by Winnicott. He stated that " I f the infant has had the experience of a good enough mother, it learns to cope with her absence by finding a comforting object that it can hold onto when needed whether the mother herself is actually present or not" (Bradway & McCoard , 1997, p.81). Sandplay is a powerful experience because it touches an individual at a pre-verbal level; therefore, it may have been comforting for Peter to take a part of his creation with him. 67 Session Two: "Titanic Found" and "Titanic Sunk"(part I) "Titanic Sunk" (part II) (dry sandtray) Peter began the session by stating many facts about the sinking of the Titanic. He began placing some glass cones into the dry sand and asked i f I knew what he was going to make. I guessed "The Titanic" and he said "Got me again, got me again, just like that". To create a Titanic scene, he once again used the fence as a "divider", only this time he placed this fence, and other ones, horizontally, after carefully measuring the length that he needed with a popsicle stick. Again, he smoothed out the sand and made sure that the base was completely covered. A s he created the scene, he provided a very detailed explanation of how the Titanic had hit an iceberg. After completing this scene, he stated "That's one scene of the crime" and then on the other side o f the divider he placed a boat and said " A ship searching the Titanic". However, after Peter described what the Titanic should have done to avoid hitting the iceberg, I summarized the role of the search boat and he stated that this is where I had "gone wrong" and that this other boat was not a search boat, but the Titanic before it hit the iceberg. He then asked for paper and said " Y o u can't take chances" which seemed to imply that he didn't trust me to understand his story unless he wrote it down. He proceeded to make titles for each of the scenes in the sandtray. I took a photograph of this creation and then he created a second picture. 68 While he was making his next picture, he continued to tell me more facts about the Titanic and then reenacted the sinking of it. When he described the people falling off the boat he stated that this was "The most hilarious thing o f al l" . A s he tried to bury the Titanic with sand, he became frustrated because the sand would not completely cover the boat. He threw some sand at the boat, which uncovered it further, and then he acted more dramatically. For the final picture o f this second scene, he took the other boats off, half buried the Titanic and used a sign from the previous creation for his title. After I had taken the picture he said "Good", and as he was leaving the room, with his signs, he reiterated the importance of the "Divider". Counsellor's Clinical Impressions and Reflections After this session, it appeared that Peter had been overcompensating by giving me large quantities of factual information. He seemed to have read a lot on this topic and appeared to be eager to impress me with as many details as possible. I wondered i f acquiring such knowledge gave him a feeling of self-worth. On the other hand, the Titanic has become a very popular topic due to the recent release of the movie, thus Peter may have been reciting facts that he may have learned with the other students at school. The use of the popsicle stick for precise measuring, the use of the divider (although a different directional split), and the writing of signs to take home were all repeated themes from the previous session. In addition, I was once again struck with incongruent feelings. Not only had Peter made another seemingly incongruent statement about people falling from the boat and this was hilarious, 69 but his entire sandplay creation seemed incongruent too. The happy face on the sign also seemed to be another indication of incongruent feelings. Within the sandtray, he had created an ocean scene, but had purposefully covered up any evidence of the blue base which is usually used to represent water. This may have been an indication o f his need to continue to interact on a surface level and as a way o f protecting himself from connecting with his unconscious energies (Bradway & McCoard , 1997). His story also appeared to be incongruent. Initially he stated that the blue tug boat was searching for the Titanic and when I reviewed the story with him and when he wrote the title, he stated that this was the Titanic before it sank. His unconscious may have provided this helping force but when I summarized this part of the story Peter had not been able to recognize and accept this help. The three glass cones representing icebergs seemed to represent phallic symbols. Furthermore, as mentioned in the impressions from last session, the number three may be strongly associated with the masculine and is often viewed as a powerful number. The story and the final scene of the sunken Titanic all alone in the centre of the sand seemed to represent a feeling of helplessness. The search boat that had become the Titanic was no longer present, nor were the icebergs. Helping resources did not appear to be available. I wondered i f this image represented Peter's feelings of helplessness. Lastly, a theme that was at this point not yet evident to me in my field notes, but an issue that seemed to subtly evolve throughout our sixteen sessions 70 was one of testing and the empowerment that appeared to accompany this action. In this session, Peter asked me to guess what he was going to make even though he had given me clues such as talking about the Titanic as soon as the session began, and placing the glass cones in the sand. When I guessed the right answer, he made a joke about how I "got him", although it appeared that he had set it up this way. Furthermore, during the session when I summarized the role of the search boat, he stated that I was wrong, changed the story, and wrote the story on paper because " Y o u can't take chances". At the end of the session when I took the photographs, he stood back and said "Good, good" in a seemingly approving voice. This role seemed to be empowering for him. Session Three: "1996 Traffic Problem. Road to people's homes is on a detour. They are trapped for two days." "1996 Farm invaded with poisonous animals. 100 people died on farms." "1678 Castle is set up and king just died." (dry sandtray) In this session, Peter created three aspects within one scene, separated by "dividers", within the dry sandtray. The first aspect included a castle, walls, a king figurine and a draw bridge. He talked about hating Mondays and that "They bring him bad luck". He found it difficult to reach the miniatures on the bottom shelf and stated "Every time I lean on something I fall down" and then whispered "I 'm too heavy". He stated that he played school at home with his mother because he did not have any brothers or sisters. "So I 'm alone and I don't have anyone to play with.. that's why I took this opportunity to enjoy m y s e l f (referring to the sandplay). 71 The second aspect was a farm, which frustrated him because he could not find the exact fences that he was looking for. He seemed to show a sense of agency when he stated " I ' l l keep looking ' t i l I find something that I 'm happy with" and then found a fence that suited him. He then dropped two farm signs on the floor and seemed to blame them by saying "Thank you very very much". Next, he wanted to make a road out of popsicle sticks, but I had accidentally left the basket that contained the arts and crafts supplies such as the popsicle sticks at home. His facial expression and statement, "Forget about the road then" seemed to indicate discontentment. He then added a farmer, horse and cart, bails of hay, straw, chickens, brown horse, sow lying down feeding piglets, two standing calves, one cow lying down, and three "Farm Land" signs. During the third aspect, he talked about playing a "detour guy" at home which involved him telling his parents which directions they could and could not go. He then restated that he had really wanted to make a road out of popsicle sticks. Using the various road signs, he made detours and an airport and then accidentally knocked my cassette tape over and said " I 'm a bad luck charm today". He looked at the two way mirror and said "I know I 'm a pain in the neck today". A s he picked up the bridge he said to himself "Don' t drop i t" and stated that he thought his picture from the previous session o f The Titanic was boring. After completing his traffic aspect, he wanted paper and scissors but they were also in my basket at home. However, I found some paper and he asked me not to look while he wrote the titles. He seemed to be proud of his titles as he stated "I wrote everything up". 72 A s he wrote the title for the airport aspect, he explained that the people took a vacation three weeks ago and they came back and were trapped because the road was closed. A s he wrote the title for the farm aspect, he showed me the poison on the animals, by pointing to the black markings on the cows. A s he wrote the title for the castle aspect, he stated that "The castle was built but because the king wanted it, the king missed being in the castle.. .didn't even put a foot in . . the queen died three weeks ago and it's possible that they may have been poisoned." Peter directed where I should take the photographs from and took his titles home with him. Counsellor's Clinical Impressions and Reflections After this session it appeared as though Peter had interacted on a more authentic level. He seemed to be less dramatic and more genuine as he made several statements which seemed to indicate a low sense o f self-esteem. I was also experiencing my own feelings o f guilt for forgetting the arts and crafts basket and Peter reminded me of this several times. The playing "school" with his mother and "detour guy" with both of his parents gave me an indication of the loneliness he probably felt and his lack of close friendships with classmates. It also seemed as though the play games that he played with his parents were a source of power and control. With the castle, it seemed significant that Peter used two bridges (including the "drawbridge"). Bridges are often thought to be a sign of connection, reaching out and a desire to unite opposing forces (Bradway & McCoard , 1997). The fact that there were two bridges in this scene seemed to 73 doubly emphasize the use of the bridges. It seemed significant that the bridges were not connected and that one of the bridges was a drawbridge which needed to be manually operated. This may have indicated a desire to control when the bridge was up or down. It appeared as though Peter was beginning to show signs of reaching out, but was still withdrawn, like the drawbridge, and very protective. The three clay walls seemed to indicate a strong need for protection, and once again the quantity of three appeared. The castle is often seen as a strong and safe place where treasures might be hidden (Dundas, 1990). In Peter's story, it appeared as i f the king had been dreaming of a goal (living in a grand castle) for a long time, but then he died before his dream came true. Peter may have found it difficult to believe that dreams could come true. The next aspect, the farm, showed a farmer with a cart of hay and straw, who appeared to be going in an opposite direction to the animals. The piglets seemed to be well as they fed from their mother, but the chickens were lying on their side. In addition both the cow and the pig were lying down. The cow, being the giver of milk, may have symbolized "maternal earth, plenty, and containing protectiveness" (Matthews, 1993, p.47). The horse could have been symbolizing both life and death (Cooper, 1995) and representing the masculine and instinctual (Matthews, 1993). The sow is sometimes associated with the Great Mother (Cooper, 1995) and chickens are thought to be guides o f the soul in initiation rituals and the sacred animal in some religious celebrations (Matthew, 1993). However, according to Peter's story, all o f these animals were poisoned which would seem to have contaminated their life giving characteristics, thus people 74 died. Peter might have been expressing that although he appeared to be well nourished and loved on the outside, on the inside it may have felt as though he was poisoned. The third aspect was about blocked roadways and people who were trapped. The numerous road signs seemed to prevent the locomotive energy from flowing. This seemed to indicate that Peter could have been feeling trapped, helpless and that his energy was blocked. I wondered i f the blocked energy could have been related to the blocks in his speech that he sometimes experiences when he stutters. In addition, he may feel trapped when he is being teased and is not able to assert himself without stuttering. The overall feeling of the entire scene seemed to be one of defeat and pain. Session Four: "Building House. These are some walls." Peter seemed to begin this session feeling quite dejected. He said he had had a "strange day". At first he couldn't think of anything to do and then he decided to build a house where he could place a piano inside. He looked at the house furniture on the shelf and told me that I was missing a fourth chair (although there were only three). He asked me how he could build a house and I encouraged him to think of his own idea. He made puffing and panting noises and said "Oh w e l l " and then there was silence. I broke the silence by suggesting that he use some craft sticks. He thanked me for this idea and decided to try. He became frustrated and made several "Arrrrghh" noises and then asked me to wish 75 him luck as he attempted to put two pieces together. I wished him luck and he tried but he was not successful. He then told me that I needed more sand in the dry sand tray, and that it was "too puny". With a popsicle stick he measured the depth, repeated how little sand there was, and requested more sand for next time. Next, Peter selected the regular popsicle sticks and started to build a wall by stacking them side by side and taping them together. He fumbled as he got the scissors and then dropped them to seemingly dramatize the situation and then stated " I 'm clumsy, do you know that?" After he put a few sticks together, his mood seemed to change and he started to sing a song from his choir. While he used another popsicle stick to accurately measure an opening for a door, he continued singing and stated "You' re enjoying my concert I see". He then brought out the fences, which up until now he had always used as "Dividers" and placed them in the sandtray in a square shape. He asked me i f I had a third fence like the others and although I stated that I didn't, he said he was sure that I had had a third fence the last time. He became frustrated with the fences and the beginning o f his house, said he was "tired of this," and threw the fences in the basket while stating "These drive me nuts." Then he said that I had to save his work. I took a picture of the beginning of his house and he wrote a sign saying, "Building house, March 13, 1998, these are some walls". He asked for the photograph to be of the furniture too and as he left, he asked me not to forget his popsicle sticks and paper with the title because "They are very important". 76 Counsellor's Clinical Impressions and Reflections This was a difficult session for me because Peter seemed to be dejected when he arrived and then he experienced frustration throughout the session. He seemed to find many things that were inadequate, such as the quantity of sand, the number of miniature chairs, and the number of fences. It appeared as though he could have been projecting his own feelings of inadequacy. It also seemed as i f he was using frustration and silence as methods of drawing me into helping him, and he was successful. I realized after the session that he would have been capable of finding appropriate materials for building the house without my suggestion. Furthermore, his directive sentences were apparent again as he told me that I had to save his work and for me not to forget the popsicle sticks and titles. The "dividers" appeared again, but were less of a focus than in previous sessions. His rigidity seemed to be prominent as he meticulously measured and taped the popsicle sticks together. The accompanying singing and dancing were new to our session and, although it appeared to be a new method o f seeking approval, it also seemed as though Peter was very happy when he was singing. This was a completely opposite affect compared to his seemingly somber mood at the beginning of the session. Music seemed to be an important component in Peter's life and music is often symbolically associated with happiness (Cooper, 1995). The theme o f this sandplay was based on the construction o f a house. This was the first time that the theme had not involved some form of disaster. The symbolism o f building a house seemed to be positive. The house may be 77 associated with several symbols. Ka l f f (1980) stated " A house is a symbol for man's inner being" (p.53). It could also represent " A world centre; the sheltering aspect of the Great Mother; an enclosing symbol; protection.. .descent into the darkness before rebirth and regeneration" (Cooper, 1995, p.86). It may also symbolize "the cosmos or cosmic order" (Matthews, 1993, p. 102). The title of this session was "Building house, these are some walls." This session seemed to signify that Peter could have been preparing for the building o f his inner being, and was beginning with the walls which would appear to offer protection and security for this sacred process. The request for the furniture to be displayed in the photograph may have been an indication that Peter was also preparing for the inside o f the house, which could have also symbolized his soul. Andreina Navone (1998), a Jungian analyst and sandplay therapist, has noticed that children with severe emotional abandonment issues tend to build a house outside of the sandtray before they can participate in sandplay. She stated "This choice seems to be connected to the need to find a concrete container, one that is more controllable than the sandbox, before undertaking such a deep contact with the psyche in the sand.. .the house could also represent that 'secure base' that the child needs in order to experiment with the regressions experienced in the course of the therapy with a function that is analogous to the one assumed by the mother during the exploratory movements of the child" (Navone, 1998, pp.29-30). This may explain Peter's desire to build a house outside of the sandtray. 78 Session Five: "Progress" A s I walked into the room, Peter was sitting on the table. He asked for his wall and I told him that it was in the basket. He went over to the dry sand tray and asked i f I had added more sand. I stated that I had added a little and he approved. He sat down with his popsicle sticks and his wall and asked me what he was going to make. I said that I wondered and he stated that he was going to make a house. Peter then showed me how he had turned the end of the tape over in order that he could find the end which was " A smart thing". He stated that his mother was going to buy him some sand for home because he found the sandplay helpful, but believed that this would be even better i f he was playing in the sand more than once a week. He said that after leaving the sandplay sessions he felt relaxed. He then started singing and dancing a little as he worked on his house. A s in the previous session, he precisely measured the height of the walls relative to the furniture and so forth. From out of his pocket, he brought a pen to assist him with his measuring. He joked that a person was waiting to move into the house. As he worked on the door, he asked me for a suggestion as to how he could open it, but then thought of an idea himself. Toward the end of the session, he made two walls and he asked me to help him hold them together while he taped them. I commented that he had made a lot of progress and he asked "How?" I stated that he had made a door, a window and 79 walls. He stated that he'd need my help to hold more walls next time. He also added the following pieces o f furniture: a piano; a toilet; a wash basin; a table and three chairs. I took a photograph of his house, so far, and he called it "Progress." For the photograph, he asked for two photographs, one with the door closed and the other with the door open. Counsellor's Clinical Impressions and Reflections Peter seemed to be in better spirits in this session. He validated himself for a couple of accomplishments but still asked me for some suggestions before he found solutions himself. He checked the sandtray to see i f more sand had been added. After much deliberating, I decided that the sand level had been a little low and his request for more sand may have been his way o f testing the therapeutic container to see i f I was going to be there for him. Peter continued to sing throughout the session. Once again my impression was that he could sense that I enjoyed hearing him sing, but on the other hand it appeared that he was really enjoying singing too. His comments about the positive effects o f sandplay may have been another tactic for trying to please me, or they could have reflected his genuine feelings about the sandplay. His comment about someone waiting to move into the house made me wonder i f "the someone" could have been Peter waiting to move into his inner-being represented by the house. M y comment about the progress that he had made also appeared to have had a positive impact on him as he used this word for his title. Requesting a photograph with the door open and another with the door closed may have been related to the pride which Peter seemed to be experiencing 80 for making a functional door. In addition, it could have symbolized Peter's experimenting with opening up a little part o f himself. The symbolism for a door could be associated with "Hope; opportunity; opening; passage from one state or world to another; entrance to new life: initiation; the sheltering aspect of the Great Mother. The open door is both opportunity and liberation" (Cooper, 1995, p.54). This may have indicated that Peter was wil l ing to open up to some hope. The placement of the piano by the window seemed to be significant. A piano is a form of music which is often associated with happiness. This image seemed to represent "a window of happiness" in Peter's life, since Peter is a talented pianist. Furthermore, the window may sometimes represent "receptivity and openness to outside influences" (Matthews, 1993, p.215). The placement of the piano by the window may have represented a willingness to expose this part of himself. The washbasin and toilet seemed to symbolize cleansing and clearing o f waste. The table with the three chairs could have been an indication that nurturance was awaited. In addition, the quantity of three was apparent again. The placement of the walls o f the house in the sand may have been an indication that Peter was feeling more secure and wil l ing to come closer to the energy of his psyche within the container of the sandtray. Session Six: "Progress" Peter entered the room, walked over to the table where his popsicle stick house was standing, and said "Where were you keeping this"? He seemed very 81 disappointed that the tape was no longer holding some of the sticks together and stated that he could not do anything else unless he started over. I looked at it with him and tried to fix it. He placed it in the sandtray and stated that he was in a "shady" mood and wouldn't be singing. A s he became frustrated with the tape, he said he had a headache and then said that this was really beginning to bug him. He stated "I 'm wasting all my time repairing" and continued to say that this was a waste o f time and that it was going to take longer for him to complete his house now. He continued to make several complaints and I moved next to him to try to fix the corner that was not holding together. Peter then began his precise measuring and stated that "It's better to work in twos than in ones". He talked about an incident at school where nobody had wanted to be his partner but now he had a temporary partner while one student was away. He began to sing and stated " Y o u know that's funny. I 'm feeling down but I sing". He appeared to become happier and began his dramatic acting when asking for the scissors. He asked for ten extra minutes to make up for the time that he had spent repairing. I said that he could have five minutes added on to this session and to the next session. Suddenly, he realized that he had forgotten the door and said " I 'm not that dumb, I 'm not that dumb" and then figured out a solution. Meanwhile, he sang the theme song from the movie "Miss ion Impossible." For the remainder of the session Peter seemed to be performing in his comedian role. When I stated that we had five minutes left, he acted as though he 82 was in a frenzy and starting picking things up and dropping them. After I had taken the photographs of the house with the door closed and door open (as requested by Peter), he asked about the "divider" (folding partition) in our sandplay room and then he proceeded to tell me about the "divider" in his classroom and how it worked. Counsellor's Clinical Impressions and Reflections During and after this session, I felt guilty that the house had not stayed taped together and was concerned that it had been moved around a lot during transportation between sessions. I wondered i f Peter had viewed this as my lack o f concern about his house which could have also been a metaphor for me not caring about his inner-being. On the other hand, I was aware that Peter could have been using this opportunity to be very critical and to then ask for extra time. His complaints about external inadequacies may have been projections of his internal feelings o f inferiority. His comments about school confirmed that he experiences a difficult time interacting with peers and that he does not have any friends in his class. B y helping him with his house, it seemed to give him support and he seemed to open up and share more personal information. The theme song from "Miss ion Impossible" seemed to be an unconsciously appropriate choice of song since building the house seemed to have become a greater challenge than he had originally anticipated. It also appeared as though there may have been several areas in his life which were challenging and could have seemed impossible to conquer. It was interesting that Peter discussed the sliding partition in detail and 83 that he called it a "divider". Although he did not use the fences in session, he still discussed the concept of a divider. This may have suggested that the opposing forces within him were rising to the surface. Peter continued to title his work, "Progress" and requested a picture with the door closed and another with the door open. Developing a ritual and knowing what he was going to work on each week may have provided him with a sense o f security and stability. Meanwhile, the walls of the house were coming together which may have been a metaphor for his own feelings of strength and self-protection. Session Seven : "Land Before Struck Asteroid" "Land After Struck Asteroid" (wet sandtray) and "Progress" Peter entered the room cleaning his glasses with a special piece of material and then he ate some Tic Tac candies from his pocket. He walked over to his popsicle stick house and inspected it very carefully. I sat down a short distance from him and he immediately stated "I am going to need you again". I moved over and held the wall again. He cut the tape and asked me to watch and learn as he did this the "old fashioned way". He made sound effects and then discovered a few popsicle sticks that were not sticking together properly and stated " Y o u tried, I know you did." He continued working on a lock for the door of his house and said " W e l l I did something today". He ate more Tic Tacs, continued measuring and taping and 84 said that he had been planning on installing the wall for two weeks but the previous week he had spent his time fixing and measuring. He described his house as being a cheap house and continued to act dramatically as he worked on it. He used the big rock to bang the scissors and then dropped it in the dry sand where it made a "blob". He threw it in the wet sandtray and liked the impression that it made. He used the dustpan to smooth out the wet sand and then threw the rock in and said "Asteroid!". He asked me to take two photographs, one of the land before the asteroid had hit and one of the land after it had hit. He stated that the exposed blue base could be water. He added some vegetation to the land and touched the wet sand a little with his fingers. He then told me many facts about asteroids. I took a photograph of the land before the asteroid hit and then he threw the rock into the sand and was not pleased with the result. He asked i f he could try again even though he stated that he hated having to re-do things. This time he blew up approximately 70% of the land and used the dustpan to enclose the area a little. He placed fire in the centre and tried to make some "cracks" in the land. In a seemingly proud voice he exclaimed "Isn't that a wreck? It's a big wreck right?". I took a picture of the house and he reminded me that I needed to be very careful with the pieces, that they were very important, and that I needed to keep the house in the same place as the previous week. Again, he requested a picture of the house with the door open and closed. 85 Counsellor's Clinical Impressions and Reflections In this session, I felt that many similar themes arose: the critiquing o f the house; giving me directives, which seemed to indicate that he was feeling superior; the dramatic acting; precise measuring, and the approval-seeking behaviours. However, the joint effort in building the house appeared to be therapeutic as Peter seemed to need to experience a positive relationship where he could work together with another person. The use o f the wet sandtray was a new shift in his sandplay process and it seemed significant that he had returned to the sand for a short period. Although the theme of the sandplay was once again a natural disaster, it seemed that the use o f the wet sand, the visible blue base representing water, the vegetation and the fire were all sources of natural energy and signs o f growth. In addition, Peter was able to lightly touch the wet sand which he had stated would not happen in the first session. It seemed significant that the plant life in the "Land before struck asteroid" appeared to be growing out of the wet sand with no other forms of life or objects around. I wondered i f this image represented growth within Peter that could have been emerging from the original prima materia state which the barren wet sand seemed to represent. The second picture showed that the plant life had spread out. Perhaps natural growth within Paul was also reaching new parts of him. In addition, a fire was left in the centre of the sandtray. Fire may represent "burning emotion and inner heat, suffering and pain. But it also signifies cleansing and transformation" 86 (Ammann, 1991, p.72). It might also be associated with strength, power and renewal ofl ife (Cooper, 1995). Peter may have been cleansing himself from negative forces such as feelings of despair and hopelessness, in preparation for the formation of a stronger ego. After I had taken the two pictures of the asteroid scene, I took a picture of the popsicle stick house. Peter was insistent that the toilet and the washbasin were also in the picture. It occurred to me that the cleansing that may have been symbolized by the fire, seemed to be appearing in the second image represented by the toilet and the washbasin. Peter may have built the bathroom as the first room to his house because he needed to experience the cleansing and clearing process, before he could begin to rebuild his inner-being. The lock for the house may have provided him with a stronger feeling o f security. Session Eight : "Progress" Peter began the session with the following dramatizations: dropping things, banging his fist, yawning in an exaggerated manner and then talking about sleeping in and how that morning he had "slept out". He seemed to be very proud of this new term that he had just created. He seemed dejected, despite his acting, and he stated that he had had a "horrible week". He said that his home would probably be finished the following week and then he sang a song that he called " I 'm coming home" because, he said, he was finishing his home. Then he sang a song with the title " I ' l l be home for Christmas" and pointed to his house whenever he sang the word "home". Once he started singing his mood seemed to completely change. He continued to sing and move his body to the tune for the whole session. He asked me to help hold the walls and told me that he thought his house was very ugly and that no-one would want to live in it. Since the house is often a symbol for the Self, (Kalff, 1980) this statement seemed to reiterate his low self-esteem. He also told me another new word that he had created, " A mini half a quard" which was his term for the number three not being able to be divided by the number two. This was related to some calculating that he was doing with the popsicle sticks for his house. He then talked about the television show "Fawlty Towers" and about an episode where they created a "Good-bye committee" which he decided to add to his other new terms from this session. I took one photograph of the house which he continued to title "Progress" and then, as he walked out of the door, he sang "I 'm heading for home my friends, I 'm heading for home." Counsellor's Clinical Impressions and Reflections M y strongest impression from this session was all the references to the word "home" and his final words about "heading for home". Home is often thought of as a safe place, a sanctuary, and I wondered i f unconsciously he was feeling more grounded and secure. Since a house often represents oneself, his words may have suggested that he was accessing some energies within himself and thus he may have been feeling more connected. In addition, the home that he was building now had three walls and was able to stand up by itself. It was still a little wobbly, but nonetheless it was able to support itself. 88 I was intrigued by the effects of Peter's singing. Although he may have been trying to be funny and make an impression, it also appeared as though singing provided a significant release for him. He had entered the session appearing quite dejected yet, as the hour progressed, his spirits seemed to rise and he appeared to be most joyful as he left the room singing. Lastly, his comment about watching the English comedy show Fawlty Towers gave me some insight as to the source of his comedy act. In this television show, the actors are often clumsy, exaggerate their actions and experience strange mishaps. Session Nine: "Finished" Today was Peter's birthday and while he was in the waiting room I gave him a piece o f chocolate birthday cake as a small gift. Peter began the session in silence. He was very quiet and seemed to be serious and focussed on his house. He broke the silence to ask about a wall that he had made last time. He then tried to find a popsicle stick in the bag and pretended to get his hand stuck in the bag. He asked how I had remembered that it was his birthday and asked how I knew he liked chocolate cake. He added that he liked vanilla cake better. He told me that last year he had invited friends to his house for his birthday, but this year he had not told anyone at school because he always brought candies to school and his classmates might have asked him for his candy. He also said that he was afraid his friends would ruin his belongings i f they came to his house. 89 Peter went back to working in his home and stated "I've been waiting for this day for a long time". He said that he had not used the sand for a long time and " N o wonder I stutter more because I don't use the sand". He then said he was going to give me a quiz while he continued working. While laughing, he said that he wanted me to remember the three words that he invented last time. He gave me some clues, continued laughing and said " I 'm having a good laugh so hard on my birthday today". He then invented some more new words related to his popsicle sticks and continued to laugh. This was followed by Peter assembling all four walls o f his house. "The walls are up... do you hear me?" he said in a very loud voice. "Je suis large" he said, in reference to the house, but the actual translation of this would be "I am wide". He then laughed even more as he realized that the wall was upside down and the bedroom door was on the roof. He cut and fixed it and asked for my help. He stated, " Y o u are a life saver" and after more singing " I 'm feeling much better now. I was feeling so down today. I had diarrhea in the afternoon and diarrhea in the morning, not a good day, I think it's some kind o f allergy connected to the ' f lu . " He then took his house, with my help, to the dry sand tray and I announced that there were five minutes left. This seemed to instigate a comedy act which involved him grabbing toy furniture in a frenzy with much banging and crashing. He slowed down a little and placed the furniture in the house and then gave me a tour o f all the rooms. He asked for a photograph from a top view as well as a side view and titled the picture "Finished". For the first time, he asked 90 his mother to come into the sandplay room and look at his creation. He told her that it had taken him a month to build this home. Then, as usual, he took his title with him. Counsellor's Clinical Impressions and Reflections During this session, I sensed that Peter was continuing to feel superior as he talked about other classmates wanting his candy (that he was not wil l ing to share), tested me on the words that he invented, and laughed while I struggled to remember these new terms. When he asked me for the new words, I felt really guilty that I couldn't remember them and when I did remember a couple of the terms I felt very relieved. During the session, I was thinking that i f I didn't remember the words it would seem as though I hadn't been listening during our last session. Peter made some interesting comments during this session. Although he was trying to say that the house was big, he actually stated that he was wide which may have been a metaphor for him being overweight. He also described me as a "life saver" because I had helped him with his house, but in the context of my role as his therapist, this could have referred to some healing that had taken place during our sessions. In addition, his diarrhea may have been a medical problem, but it may also have been a sign of internal stress. The comment in reference to his stuttering may have been his genuine perception or he may have said it to please me. To me, the most striking incident of this session and of Peter's sandplay was the fact that he completed his house on his actual birthday. A s well as this 91 being the anniversary of the day on which he was born, it seemed as though it also had been a B I R T H day; as though his inner-being had been reborn. A l l the different parts o f the house had been joined which could have been symbolic o f a fragmented Self being constellated (Kalff, 1980). It also seemed significant that once the house was finished Peter was wanting to show this product to his mother. It appeared as though Peter's ego was now strong enough to share his Self accomplishment with his mother. In psycho-analytic dream interpretations, the kitchen sometimes represents a psychological transformation (Matthews, 1993). Interestingly, the bathroom and the bedroom were the only two rooms that were sectioned off. The bathroom could have been placed in its own area to contain the possible clearing and cleansing of psychological waste. A bedroom is often associated with sleeping and dreaming. The bedroom may have been sectioned off to contain the psychological healing that can take place through dreams. The living room and eating area seemed to suggest that nurturance was still being awaited. However, the presence o f the lamp seemed to be a positive sign, as light may represent "life and happiness" (Matthews, 1993, p. 119). The study area, next to the bedroom, seemed to indicate that there was still work to be done. The overall shape o f the house was a square which is another significant symbol. Dora Ka l f f (1980) stated, "The square, my experience has shown, appears when wholeness is developing" (p.24). 92 Session Ten: "Accident is about to happen" and "Accident just happened" (dry sandtray) Immediately, Peter asked "Last time I finished my house right? So what did you do with the house?" I asked him i f he would like me to bring it out and he stated "No it's okay". He then tested me on the first three new words which I remembered, but I didn't remember the new words that he invented last session. He stated that his memory file had opened but mine was stuck. He went over to the sandtray and decided to create a scene about an accident. He searched for a miniature police officer and said "I have a problem, no, you have a problem". As he tried to stand up he said "I can't stand up now. I think I've been eating too much for the last two years or I could be getting older you know". He asked me about the artificial plant life that was in a basket and he stated that it wasn't plant life, it was "plant dead". He seemed pleased with this new term which he added to his collection o f new expressions. Peter began his sandplay using the "divider" and creating "old days" and "new days". This was a very similar theme to his first sandplay, with the old world and the new world. A t first, he placed a regular car in the old world and a bigger car in the new world, a helicopter with propeller problems in the old world and a newer helicopter and a rescue helicopter in the new world. In the old world, he placed a fire truck without a fire ladder, a sheriff car, an old car and a gas station. In the new world, he added a service vehicle, police vehicle, security vehicle and a tow truck. He removed a lot of the vehicles and left two red, regular 93 cars in the old world, with one of them in front of the gas station. He added a concrete mixer. In the new world there was one black regular car, one motorcycle, one white and blue bus and one red, regular car. He announced that an accident was about to happen and asked me to take a picture before he created the next scene. The next scene was titled "Accident Just Happened". In this scene Peter was very methodical as he calculated the specific angles that the cars needed to be at in order for them to collide, and as he did this he said "I've got such a good mind". In the old world, on the left hand side from the back of the tray to the front, he placed a yellow tow truck with a sheriff's car in front. B y the gas station, in the bottom left hand corner, he placed a red service vehicle, a white first aid vehicle and a blue police helicopter hovering on the edge of the tray. He added a concrete mixer that was head first in the sand and two other red vehicles, one representing the fire department and one a regular car. In the new world, he added a red firefighting helicopter, a white first aid vehicle, a white and blue bus, a red motorcycle on its side, a regular red car half buried in the sand and a police vehicle, head first in the sand. On the far right side of the tray he added a red jeep that was half buried, a white police helicopter hovering on the side, a regular, black car and a fire truck. Peter explained that there was a crash in the old world and the fire department was called to the scene. One car was completely "hurt" and the other two were safe. The sheriff then arrived. He moved to the new world and stated that the police thought that the rescue helicopter was about to land on them so 94 they turned and landed in the ditch. The service car and the motorcycle landed in the ditch and the motorcycle was sinking because the ditch was big. Peter explained that some of the vehicles in the new world were sinking, as well as the gas station and highway, thus they were taken away from the new world. He stated that one of the guys in the old world was going to have trouble getting out. Peter repeated the story to me and asked i f I remembered what happened in the old world. I stated that this was for him to decide, which resulted in him repeating each event to me and then saying "right?" at the end of each sentence. At the end of the session, Peter gave me a study sheet with the new words that he had introduced. He took his titles with him and asked his mother to look at his creation. Counsellor's Clinical Impressions and Reflections M y strongest impression of this session was that Peter's role seemed to give him a feeling of superiority. His entire sandplay was precisely calculated and then I was tested to see i f I could remember all the details that he had told me. In addition, he continued to test me on more newly invented words. I thought about Adler 's theory o f superiority and inferiority and hypothesized that Peter's need to be competent, perfect and knowledgeable may have been his way o f compensating for inferiority and coping with feelings of helplessness (Corey, 1991). Furthermore, Peter seemed to indicate that he was aware of being overweight, but did not appear to take responsibility for his weight issue. It seemed significant that Peter created a scene with some similarities to his very first sandplay session. Once again he created a scene with one aspect 95 taking place in the past and the other aspect representing modern times. This may have been an indication that he was feeling safe enough to explore some of the issues that arose back then. The "divider" down the middle of the tray suggested that opposing were forces were still repelling within him. Although many helping forces seemed to be represented by the rescue helicopters, police, fire, first aid, and gas station, several of these helping forces appeared to be sinking, but at least they were still present. It seemed as though Peter was able to acknowledge their presence but still felt a sense of helplessness within himself. He seemed to be in conflict with receiving help versus crashing and sinking. Session Eleven: (no titles given for part I & II) 'Catastrophe at Great Lake Park" (part HI) (wet sandtray) "Earthquake at Great Lake Park" (part TV) (wet sandtray) As soon as the session started, Peter announced that I would be getting a quiz. He asked for my study sheet and clicked his fingers on the paper every time he read a new word. He stated "Two weeks away and I remembered them, I've got a file case up there". He then began his dramatic acting and sat down to write the test, telling me how long it would be, how many marks and so forth as he wrote it. He then gave me the test and sang very happily as he began his sandplay. He used the train and the railroad tracks and asked me to try and guess what was going to happen. I described what I could see and he said 96 "Correct... correct". He continued to test me by asking what action I thought would happen. Next, he asked for a photograph and then decided to mark my test and told me that I could watch if I wanted to. While he marked he exclaimed, "Ahh ha, got you" and in his chair he did a little dance and clicked his fingers. He also tapped his fingers on the desk, while he was marking, and then added up my marks aloud, added them again to double check and handed my test back to me saying "Not bad". He then said "Next week, new words", laughed loudly and said "Just kidding". He said that he wanted to scare me. He also said that he was giving me this test because he wanted to be a teacher when he is older. Peter returned to the sandplay and stated "Suddenly the brakes blew off and the train went gazooming like that, got it?" He also used the wet sand tray but used the dustpan to move the sand. He decided to build a path with popsicle sticks and instead of using the ones that were loose in the bag, he asked if he could use the ones that had been taped together by someone else. He told me that an accident was about to kill some people and he started singing "Mission Impossible" and told me that this was what he was singing. After he had made the popsicle stick steps, he said "Nice eh?" He then asked for a picture of the whole scene and said that the train was heading for a big catastrophe. He requested another photograph by stating, "Get ready for the action, get out your camera, this is going to be a hot one". He explained that three families had been walking along a path, but one person was killed. He stated that the wet sand was all rock. He showed me a crack in the "rock". He explained that the rock had been permanently damaged by the train, but that the path could 97 be fixed. The damaged rock would now be something for the people in Great Lake Park to look at. He took the train out and asked for another photograph. He called the accident "Catastrophe at Great Lake Park". According to Peter, some of the passengers in the train were killed due to the faulty construction of the railroads. After the catastrophe, Peter removed the train and requested another photograph of the wet sandtray. He told me that his father believed that beautiful views were wrecked by nature and now, in his sandplay, the water was dirty because of the rock. This scene was followed by another incident. Peter created an earthquake by stirring the wet sand. He requested that I notice all the walkways and stated "Remember the story. It might help you". Then the testing began. He asked me "Where is the first one? (He was referring to the popsicle stick representing the path.) That is your problem, can you find it?" He also stated that he did not know where it was, that I could take a photograph and then we could look for it. He further explained that "the earthquake was on the same day, time, hour as the train accident". I took another photograph and then he started digging with a popsicle stick to find the pathway. Meanwhile, I had warned him that there were five minutes left, but he did not seem to want to leave and pushed this time limit. Finally, he said "What a good story eh?" and took his titles with him. Counsellor's Clinical Impressions and Reflections After this session, it appeared as though I had become Peter's student. He seemed to receive great joy from giving me a test and marking it and then he 98 continued to test me with his sandplay. Several times he asked me to guess what was going to happen or to find something such as the pathway from the earthquake scene. In addition, he asked me to take several photographs during the session which seemed to be another method of giving directives. By asking questions or giving directives, he could have unconsciously been keeping the session at a more surface level to prevent himself from going further in his process. The initial scene began with the train moving from the dry sandtray towards the wet sand. It seemed as though energy was flowing through Peter, as represented by the locomotive energy of the train moving towards the possibly unconscious energies of the wet sandtray. In addition, the large amount of blue base that was exposed in the wet sandtray seemed to indicate that Peter had accessed unconscious energies (Bradway & McCoard, 1997). In the third scene, the train had an accident and was not able to continue functioning. At an unconscious level, it appeared as though Peter had also put the brakes on and was able to go no further. In the fourth scene, the train disappeared and its imprint was left behind which seemed to imply that it had not completely disappeared. In the fifth picture, Peter had toiled the sand and stated that there had been an earthquake that had killed one person. The shaking of the earth may have been associated with shaking the Great Mother, since the earth is often represented as a symbol of the Great Mother (Cooper, 1995). The person who died may have symbolized a part of Peter that had also died. Lastly, in the final picture of this series, the earth had been toiled some more and the path lay strewn. 99 It appeared as though Peter was connecting with his unconscious energies, but did not know his direction. The "d i v ider " had reappeared in session ten but was not mentioned in this session. It could have been that the opposing forces within Peter were beginning to f low and come into contact with one another. Session Twelve: "A King of Thieves" (dry sandtray) Peter walked into the room, directly to the "d iv ider " (room partition) and said that he was just checking. H e asked where his comfy chair was and then asked me about my test from last week. H e told me that he was going to be g iv ing his mother a science test soon. H e started his sandplay with several horses. It seemed as though he was trying to keep me in suspense about what he was creating as he made " a h a " and " a h m m " comments and made facial expression that seemed to indicate that he was up to something. H e discovered the small dinosaurs and decided to create names for them which he could then use for my next test. H e made me a study sheet and seemed to be very pleased with the names that he had invented. Several times he pretended that he had forgotten one o f the dinosaur's names and asked me what he had said, to which I reflected the question back to him. The first half o f the session he discussed the test and seemed to be using it as a control mechanism. Fo r example, he stated " W h e n I come again next Tuesday I'm going to give you the test and you 're going to write it whi le I do 100 something here" and "Okay so the test is next week unless I feel joyous and I ' l l re-do the test for next next week." He placed seven horses in the sand and found figures to ride the horses. Although the four figures in the left back hand corner were pirates, Peter said that he wanted to pretend that they were not pirates and that he had had to use them because he could not find anything else. He stated that the two buildings in the upper right hand corner were a village including police headquarters and the man next to his horse was the king's messenger. He also stated that the king's messenger lived there too and that he was dishonest. Zorro, a television character, was represented by the navy blue figure riding the black horse and was chasing the figure with the yellow hat because he had stolen some land. Meanwhile, the other four pirate figures were chasing Zorro. Peter's sandplay involved him conveying a lot of factual information. H e discussed the movie "The L i o n K i n g " and then moved into the story of his sandplay which was a scene about a television character called Zorro. He was very insistent that I guess what his picture was about and when I would not guess, he seemed to be very frustrated. He stated " A h come on, with the cowboy hat, can you guess or can you not guess? There we go. Okay. (Clapped hands). N o w can you guess. I 'm worn out. Can you guess?" Finally, Peter did tell me about his picture with elaborate detail. Counsellor's Clinical Impressions and Reflections I felt worn out after this session. I found it difficult to understand Peter's detailed story and many times I had to ask for clarification, which also provided 101 an opportunity for Peter to take on the role of a teacher. It seemed as though his complicated story could have been another method of gaining control and extending the teacher role that he had established at the beginning of the session when he had been talking about tests and preparation for the following week's test. Peter's sandplay seemed to indicate a shift, as this was the first time that he had used animals since session three and the first time that he had used people since session one. Horses are often a sign of instinctual energy (Bradway & McCoard, 1997) and a horse rider may suggest dynamic energy as well a relationship between man and his instincts (Ammann, 1972). In addition, there were seven horses in this picture which is often viewed as a significant number. Historically, the number seven has been a mystical number as in "there were seven known planets which were understood as the divine and visible expression of cosmic order.. .In the Bible the number seven occurs many times, in both a positive and a negative sense but always as an expression of totality... Seven is an important totality number in fairy tales and folk customs; seven brothers, seven ravens, seven kids, seven different foods on special days" (Matthews, 1993, p. 171). "Seven is the sum of three and four... number three as masculine and active... [four] is a containing image and therefore feminine. On that basis the number seven would then also be a union of the masculine and feminine" (Weinrib, 1983, pp. 141-142). For Peter, the use of seven items may have symbolized a sense of wholeness that may have been forming at an unconscious level. 102 Once again Peter did not use a "divider" and although the theme of the sandplay was still negative, it was not about a natural disaster. The horse riders seemed to be riding away from the dishonest messenger, and Zorro, the "good" character appeared to be caught in the middle of the negative characters. Apparently, the television character Zorro, has two identities and nobody knows who Zorro is, similar to the disguised, heroic character of Superman. I wondered i f Peter was identifying with Zorro. He may have thought that he was trying to do the right thing, but people didn't see this side o f him and were always chasing him or picking on him as represented by the pirates on horses in this scene. The title of the sandplay was " K i n g o f Thieves". The title o f the story may have implied that the people who worked for the K i n g were all thieves and therefore they could not be trusted. Peter may have identified with this television show because he has some feelings of distrust about some people who he interacts with, such as his classmates. Session Thirteen: "Catholic Church and Cemetery of St. Paul" (dry sandtray) A s I walked toward the room, I could hear Peter laughing and singing. Immediately, he asked me i f I wanted the test. I joked that I did not, which seemed to shock him and he told me how this was helping him practice for his future career. He then showed me the two pages that he had typed on his typewriter and stated that I would need an eraser. He showed me his eraser where 103 he had written "am I smart-yes" on one side and "am I dumb-yes" on the other side. For the first section of the test, he showed me various dinosaurs and I had to write the names of them. He told me that I was not to forget capital letters for the names and then he clicked his tongue. I was told that I could do Section B and C on my own and then he told me that he would "Give me a hand" with Section D , and therefore I should only complete up to Section C. He joked that there would be another test the following week and then stated "I don't exactly like tests but I love giving them". This was followed by him saying, " I 'm feeling joyful today". I started the test and Peter began his sandplay by placing a nativity scene and statue of Mary in the upper left-hand corner, and then added two crosses and two headstones. Suddenly, he noticed that I was writing section D and he stated "I think I told you not to do D " . I had forgotten and I apologized. He continued with his sandplay, creating a cemetery for rich people with four angels, a soap stone carving, a white heart, a totem pole, a Kachina and two clay bricks. He then created a cemetery for poor people with the remaining eleven, large clay bricks and four small clay bricks as their headstones. He added fencing around the wealthier headstones. He wanted to find some doors and asked i f I had any. I replied "Whatever you can find" and he stated "Whatever I can find? I can't find anything here." He added some more fences and a gate for the main entrance and explained that the rich people wanted their own land and their own 104 space, meanwhile the poor people suffered. He explained that this was a Catholic church. After the sandplay he decided to mark my test and asked me i f I wanted to take a look. He began to act dramatically and told me that he had had a bad day yesterday because he had fallen on his back and had forgotten to do his homework for speech therapy and therefore had to complete it at lunch. He had also misplaced his wallet and could not find his pens and pencils but was now having a better day. He began the marking in a dramatic manner and seemed very pleased when he discovered a mistake "There I tricked you, I tricked you, I tricked you. I love tricking you, you know, I especially put in those tricky questions you know". A s he marked the test, he explained that I could only use a dinosaur's name once throughout the whole test, even though this hadn't been in the instructions. He then stated "Mamameeya, you better study next time". Section D was very subjective and for one answer I had made a joke. As he read it, he said in a loud voice " B E S E R I O U S , be serious, I 'm serious here (he then laughed and banged his fist on the table).. that's a little you know, you know, you know". He then found another answer that he disagreed with and stated in a loud voice " T H A T ' S W R O N G " and banged his fist on the table. He added up the marks and told me what I would have needed to earn each letter grade. He awarded me with a B , then changed it to a C+, and then asked for last week's test which I gave to him. He told me that he would bring a report card for our next session. 105 Counsellor's Clinical Impressions and Reflections After this session, I strongly sensed that I needed to redirect my role in our sessions and discontinue participating in the student role. M y philosophy was that the sessions needed to be child-centered but I was also aware that by writing the tests I was adding my own input to the session and therefore this was not conducive to child-centered therapy. I had felt the control and power in this session more strongly than any of our previous sessions and I was puzzled by Peter's need for this control and desire to test others. I hypothesized that perhaps he felt as though his life was a test. Every time he spoke, it could have seemed like a test as he had no control as to whether or not he was going to stutter and whether or not the person to whom he was talking was going to tease him, walk away from him, or finish his words for him. It seemed as though it would be a very out of control and scary feeling to have these experiences whenever one spoke. I realized that, for our few remaining sessions, I wanted to reassure Peter that this was not a place where he needed to be concerned about testing and that we could interact in other ways. The symbols o f death and spirituality seemed to show a shift in Peter's sandplay process. Dora Ka l f f (1980) explained that the appearance of spiritual figures may represent the development o f the wholeness of the psyche. "These symbols o f a numinous or religious content tell o f an inner drive for spiritual order which allow the relationship to the deity" (p. 29). The theme of the cemetery and the numerous headstones could have marked many o f Peter's difficulties that he was wi l l ing to have come to an end and be buried. 106 It seemed significant that Peter did not use the one fence as a "divider" separating the two halves of the sandtray. Instead, he used smaller fences to give the rich people their own land because they "want their own space to have a statue or a heart". Once again, the split o f opposites was evident between the rich and the poor and the rich side had fences to separate it from the poor side. However, it appeared as though the openings and gateways that Peter carefully planned might have indicated a possible interaction between the opposing energies. The comments on the eraser "am I smart-yes" versus "am I dumb-yes" also seemed to be symbolic of a split that Peter was experiencing on a more conscious level. Session Fourteen (no title given) Peter entered the room singing and stated " I ' l l just finish this okay, it's your report card. N o w what were your notes [grades]". I told him that I didn't remember. He then asked me how to spell "3 r d " and I told him that in our session he could spell it however he liked. He decided to try and spell it using the chalkboard because it gave him the feeling o f being a teacher. He then asked me to sit next to him as he wrote down 1st test, 2 n d test and then asked me what I saw next... 3 r d test. He said this was going to be a surprise test and that it could be next week. He tapped his fingers, made some small howling noises, put his hands behind his head, sang, looked over at me and then said "Ding, ding, ding, you know on the other hand I might just make the test today". He smiled, tapped his feet, put his hands back behind his head and asked me to repeat the words from the first test. I explained that I needed him to say them for me and that he could 107 write the test for me. He said that he could not remember the words and that his mind was blank . He talked more about the third test and I stated that I would like to see how he would write it. He replied that he was presently in "a dumb position", like me, because we did not know the answers. I explained that it did not matter i f he knew the answers in our session. He continued to talk about the plans for the next session and stated that the following week he might say " N o test, here are new words, or new words and test, or reminder test, or third test, or you know what, no more tests". Peter then began his sandplay and chose the long green snake and beige, coiled up snake, while stating that he didn't like snakes. He then found the bag of small dinosaurs which he had used on a previous test and said "Ding ding ding". It seemed as though he was pretending to have suddenly remembered all o f their names as he brought them out of the bag and named them one by one. He then took the coiled up snake and bounced it up and down and sang as he wound it up. Next, he made a "Ssssss..." noise as he held it up and got the green snake and made an "Arrghhh" noise while looking at me. He talked about ripping the tongue out of the green snake and then changed the topic to tell me some more factual information about a meteor heading toward Los Angeles. This was followed by the big green snake chasing the coiled up snake and the coiled up snake chasing the small blue snake. The green snake attacked the coiled up snake and he said "Just kidding". He then said that this was his picture and " N o mind", which seemed to mean that he couldn't think of anything else to create, and then he stated 'Tast hey?" It seemed as though he thought he was 108 punishing me by not devoting a lot of time to his sandplay. He said that he was finished and I stood up to leave. He stayed sitting down with a seemingly nonchalant look and I asked him i f he was ready to leave. He worked out our remaining time and in a seemingly casual manner stated that he'd like to stay and that this time could be used for learning new words for the next test. He then thought about changing his sandplay picture because he thought it was boring and asked me i f I liked it. I would not give him a "yes" or "no" answer and he said "Oh come on with that nonsense". Peter discontinued the sandplay, whistled and got ready to create the next test using the ruler, pencil, pen etc. that he was carrying with him in his pocket. He stated "Now i f you take a look at this, this is not my language, what this is, is new words that I've come up with in a new language. Right? Right, right. This is your study sheet and this is going to be your test, right?" I replied with "So when you write this test for me next week.. ." and he dismissed my comment. He then talked about his original words and tried to get me to say "sleep out" by asking me "What is the opposite o f sleep-in in my language?" and then he raised his voice and asked i f I knew the meaning for "sleep out?" He also banged his fist and asked what was the opposite of long? I said it could be various words and he yelled the word "short" and said "Tough crowd.. just kidding". This was followed by him giving me different words that he had created and asking me to pronounce them but I would only say them i f he said them for me first. When I did repeat these words, he told me that I spoke a magic language. He asked me how to spell giraffe and I stated that in our session it could be spelt in any way and he told me to forget about that and stated "Tough crowd in here". He told me that he hated this and that he just wanted to know the correct spelling. He then said that he knew how to spell " l ion" but wanted me to spell it for him anyway and I stated that he could spell it anyway he liked and he said "Arrrghhh I thought I had you in my palm". He then said that I would need to be able to pronounce these new words for next week and I repeated that he would be writing the test for me. He stated "oh come on" and asked why he would have to write the test. I said that the purpose of the sessions was that they were for him and that I didn't want to be adding my own ideas to the session. He stated "Here is my answer. I 'm N O T going to write any tests." I stated that I wouldn't be either. I further explained my rationale and he asked i f it was wrong that I wrote the other two tests. I explained that it wasn't wrong, but that I had learned from this experience and would be participating differently now. He seemed very dejected and repeated "Tough crowd - yes tough crowd today. I guess I 'm just having one of those bad days.. wel l anyway I had a bad day at school. Not like always. Today there's a change of moon." I said "School didn't go so well today?" and he replied "and guess what so did here". We continued to discuss what had happened and he expressed that he wasn't really disappointed, but was very surprised. It seemed as though we had a very genuine discussion and he did laugh a little at the end. A s he left the room he said "So I guess that's the end of our test session in here.. . i f you feel like writing a test there you go" and he handed me the new words. 110 Counsellor's Clinical Impressions and Reflections I experienced very mixed feelings after this session. Prior to the session, I had consulted with a play therapist about the role confusion that I was experiencing in my sessions with Peter. The therapist had encouraged me to discontinue writing Peter's tests and to return to child-centered therapy with Peter contributing the content. After the session, I felt badly because it appeared as though I had burst Peter's bubble, but on the other hand I felt relieved that I had been truthful with Peter. I had no longer been feeling comfortable writing his tests and this was affecting the authenticity of our relationship. During our discussion, I felt as though we were both being genuine and were able to exchange honest thoughts and feelings. When he made the comment" I thought I had you in my palm", I realized how far the control had gone and I was thankful that I had taken steps to change my role. When Peter was referring to words that he had invented, he described them as being his language. I was struck by this comment because it occurred to me that by inventing new words and new pronunciations it was a method of having control over language which Peter didn't have when he stuttered. Later in the session, he also described his new words and pronunciations as a "Magic language" which also seemed to imply that there was something special about his invented language. The theme of Peter's sandplay seemed to show a further shift in his therapeutic process. For the first time, he did not mechanically place the objects to create a static scene, but instead his play was dynamic and seemed more I l l spontaneous. Ka l f f (1980) stated that the snake may appear during puberty representing the connection with deeper layers as the transformation to an adult occurs. Moreover, a snake's ability to shed its skin is representative of death and rebirth which may indicate a transition (Andrews, 1997) or symbolize a renewal beginning in the unconscious (Kalff, 1980). In the Native American culture, the snake also signifies transformation and healing (Andrews, 1997). It appears significant that as I changed my approach to our sessions, Peter created a scene that was very different from his previous sand pictures. It appeared as though my shift in my approach toward therapy could have created a shift within Peter. There were three snakes in this picture and three could represent masculinity (Weinrib,T983). Dora K a l f f (1980) stated that "the number three holds a clue as to how this power is to be reached" (p.64). The use o f the snakes and the number three seemed to indicate that Peter was experiencing some form of transformation. In addition, when Peter was holding the snakes toward me and making aggressive sound effects, it seemed as though this could have been a way o f expressing his anger and frustration toward me as he seemed to have sensed that I was not going to play the student role any longer. As he began to talk about ripping one of the tongues out, he quickly changed the topic to something much safer; factual information about an asteroid. He then returned to the snakes, but suddenly ended the sandplay while one of the snakes was attacking another one. In this session, it appeared as though Peter had some anger to release and was able to begin this process through the sandplay, but was not yet able to 112 verbally express his feelings or completely express them through the use of the snakes. Session Fifteen (no sandplay) Peter entered this session looking forlorn, and his body language seemed to indicate that he was distressed. He looked at the shelves with the toys, tapped his fingers on the table, sat on the table and crossed his arms while continuing to look away from me. He then shrugged his shoulders and I verbally reflected this body movement. He spoke and said that this meant that he had " N o idea" and "Looks like F m not going to do anything today". It seemed to me that the anger from last time was surfacing and his frustration with me for not writing his tests was increasing. He asked me i f I wanted him to tell me about the most recent episode o f "Zorro" the television show and I stated that he could i f he wanted to and he replied " A h come on, none of that stuff like last time". He then pretended to sleep and followed this by asking for some ideas for the sandplay. I did not give him a suggestion and thus he replied, "I guess there's nothing then." He told me about a retirement party there had been at school for one of his teachers and stated "One person comes, another person goes". Peter then found the pipe cleaners and tied one into a knot and attempted to hand me the pipe cleaner while stating in a direct tone "So can you untangle this". I sensed that this was another form of testing and I stated that he could show me how. He seemed frustrated with my answer and stated "Arrgh. . . never mind" and then " W e l l I 'm not going to untangle it for you so I ' l l just leave it here 113 for you to untangle." He placed it on the comer of the table in front of me. He asked for an explanation as to why I did not want to try to untangle it and I gave him the same explanation as in our previous session about the session being a time for him. He asked how much time was left and crossed his arms and looked away from me again and stated "I guess I'm wasting time today huh? Nothing else is going to pop into my head... so I guess there's nothing today and be aware of nothing next week, maybe, I don't know, probably". He asked for a suggestion and I commented that it seemed to make him a little angry that I wouldn't give him an idea. He replied that it didn't really make him angry, so I asked if it made him a little mad and he said "No, it doesn't really matter, it's you who's writing it right?.. It's a waste of time I guess right? Like a waste of time for my speech pathology at school. I don't get people this month -everyone's gone mad or something." I asked if I was one of the people who had gone mad and that it was okay to tell me if he was having this thought. He said "no" but when I asked if things seemed a bit different he did say "a little". It appeared as though this was the small opening that we needed to discuss last week's session. Peter stated that it was hard to tell how he felt but "Not exactly happy and not exactly mad, just medium." He then said a little sad and a little upset and explained that he had these feelings because of a boy at school who had made him really mad. I tried to bring our conversation back to last week's sandplay and I told him that I had sensed that he might have been feeling a little sad and upset. 114 Peter walked away to sit behind the tables that were in the middle of us and said " Y o u could tell eh?... I 'm over it though - you can tell right?" I said that it felt as though he was still upset in this session and he stated that 50% of his feelings were related to the boy from last week, 48% were from the speech pathologist and 2% were from me not writing the test and then he quickly added "But that's nothing really". He stated "This month my friends have gone mad, my teacher's gone mad, my speech pathologist has gone mad, the kids have gone mad". I asked i f he had talked to any of these people, such as his speech pathologist, and he stated that he preferred to forget about the problem. He said that he goes his way and that they go their way. I asked him i f it would be scary for him to talk to the people with whom he was having and he stated 10-15%, although it wasn't scary for him to talk to his M o m and Dad. I suggested that we talked about the 2% that was related to me and he said that there wasn't much to talk about and that it was all gone but did finally admit that he was a "tiny bit sad". He said that when everyone's gone mad he feels alone except for his M o m and Dad. We talked a little more about his speech-language pathologist and he said that he had tried to talk to her, but felt that it was best to "Just sweep it aside - pretending it never happened right?" He then said that talking had helped to release some of his feelings and that it was different when he talked to his parents. He also wanted confirmation that "This is a normal problem that everyone has right? Not physical right?" I explained that people can have different problems and that some people are affected physically. He thought about the butterflies in his stomach when he sings 115 in a concert and stated that he sometimes gets diarrhea which at first he blamed on bacteria and then stated that it could be due to the fact that his body was stressed. I said that stress might also affect his speech and he said "When I'm mad I stutter more - you can tell I'm mad now, not at you, but I stutter more and you can tell right?" I took this opportunity, as our session was drawing to a close, to mention future counselling as a means for helping him with his stress. Peter stated that he would be worried about meeting a new counsellor and that he wasn't sure if he would have time to go to sessions. Just as we were leaving the room, he asked me again to untangle the pipe cleaner and we both laughed as I said he knew that I wouldn't. Counsellor's Clinical Impressions and Reflections After this session, it appeared as though Peter and I had genuinely connected. At the beginning of the session, it seemed as though he was determined to not participate in sandplay as revenge for me having not written his test in our previous session and because it seemed as though he could no longer control me. When he decided to engage me in conversation, he asked me to untie the pipe cleaner which seemed to be another form of control and way of testing. Although the first half of our session seemed to feel thick with tension, I was hoping that Peter would initiate a conversation that would lead us to talking about the present dynamics and the impact of our last session. Once he started to talk about his feelings, while continuing to use his technical and precise language of percentages, I felt as though we were genuinely connecting. Although it appeared to be very difficult for him to express his negative feelings, he was able 116 to admit that 2% of his anger was related to me and this seemed to be very significant that he could state this. I felt that this was probably scary for him and that he must have felt safety and strength within our therapeutic container. I also felt sad that this was our second to last session as we seemed to have reached a stage where he was able to recognize his feelings and was beginning to express them. Session Sixteen: (no titles given for part I, III, IV, V) "Town of Destruction" (part II) (dry sandtray) Peter began our last session by asking if I had spoken to his speech-language pathologist and if I had untangled the pipe cleaner. I stated that I had not telephoned his speech-language pathologist, nor had I untangled the pipe cleaner. He seemed frustrated that I had not untangled the pipe cleaner and said, "Well you're going to need it - maybe someone else will untangle it for you.. just kidding". He then said "So last time we talked about my problems right?.. yep today I feel 20% bad but that's good you know I mean that's 80% happy or maybe 15% bad and 85% happy". He went on to explain that his classmates had been teasing him but that it seemed it was partly his own fault. As Peter began his sandplay, he shared the last two years of his school play experiences with me. He explained that he would create games to play at recess and lunch that involved role playing and exclusive groups, such as creating a Police Academy. He was the head of the police and therefore the boss of any of 117 his friends that joined, or he would create a company where he was the president; He stated that he may have given his friends too many orders and that he had had approximately ten friends, "then two or one or maybe none." He stated that he had now been alone for two years, admitted that it was lonely and wasn't exactly sure why he now had no one to play with. He was aware that "Daniel", the boy who was presently bullying him verbally, had been a commander in his Police Academy, until Peter had fired him because he had been a "traitor". However, once Peter fired Daniel, then everybody else quit. After this incident, Peter created a company and re-hired Daniel. He explained that this was "The mistake of my life". Peter stated that Daniel convinced him to fire the girl that was in their company, and, even though Peter thought she was a good worker, he fired her but had re-hired her secretly. Daniel discovered that the girl had been re-hired, called Peter a traitor and he and the others in the company resigned. Peter said that last year, after this episode, he made another situation where he was the boss who created schemes against the other children and thus became the "Madman on Daniel and really cheated him up". He explained that he had wanted revenge. He said that he had forgotten about all of this, until recently when Daniel reminded him. Peter said he was not mad, but did admit to being sad that he was teased by the children at school, in particular Daniel. He then talked about the last club that he had run last year where he made "the biggest mistake of his life" again. He hired Daniel and another boy and paid them two candies per lunch hour. Peter wrote a contract stating how many 118 candies they would receive for certain tasks but the two other boys changed the number by pretending to erase commas on the contract when they were really erasing the numbers. Peter said that he noticed this immediately and said "I'm not so dumb after all". He threatened that if they did not change the numbers back to the original quantities that they would never receive another candy from him. They changed the numbers, but not back to the original quantities. Peter stated "You know you can't trust anybody in this world you know". He said that it had now been exactly a year since he fired them. He was distracted by the sound of a fly in the room, and he changed his style of interacting from a serious conversation, where he had been expressing his feelings, to a dramatic act in which he was trying to kill the fly. In between attempts to swat the fly, he explained his sandplay scene of a town. He had placed seven coniferous trees and two deciduous trees in the dry sand tray. He added eleven buildings, one old red car and one white and blue bus. He began to expose some of the blue base for water, but he changed his mind and covered it up. He asked for a photograph of this scene. His attention was once again diverted by the fly and as he tried to hit it, he said "Revenge." After I had taken the first photograph, he said "Prepare for the damage" as he poured sand over the houses and apartment buildings and knocked over the trees. He said "I don't know how they are going to get out of here right?" as he covered the buildings with more sand. He called it the "Town of Destruction" and decided that an avalanche had hit the town. He stated, "These people have a 119 back door - no back door now. If they want to come, the best way to come out is through the chimneys." He requested a photograph of this scene too. Peter then pretended that the town had been "dug out." He said that "This is after many years - the people who were trapped in their homes are dead, it's about six years, four years, after right?... a passenger bus, tourist bus didn't survive - no one survived.. it's a sad thing huh?" He uncovered the "back doors first" and explained "They [the searchers] are going in the back door first to see what's in there." He commented that the school was buried, and admitted that he was kind of happy that the school had been buried. He also pointed out a rich house and a poor house. He stated that "they look inside one of the buildings and find a skeleton". He asked for a photograph of this excavation and stated that this would not be his final picture. Next, he retrieved the shovel and, once more, poured sand over the buildings, which he described as an avalanche. According to Peter, this time not all o f the backdoors were buried and therefore some people were able to escape, "so all the people didn't exactly die, the first time all o f them died." The school was buried again. He then used his hand to move the sand as he pretended that he was a bulldozer. He stated, "I've damaged the buildings now.. the buildings are old now. . I ' m taking all the sand - what am I talking about - all the snow." His final words about the scene were, "When I took the sand away from here, the building collapsed because for many years it had been on snow." A s he left the room, he ran his fingers through the sand as i f to say "good-bye." 120 Counsellor's Clinical Impressions and Reflections After this session, I felt great empathy for Peter. It seemed as though it had been therapeutic for him to talk about his loneliness and the social problems that he had experienced with various classmates, but I was sad that we did not have more sessions to continue this issue. As he talked about the fantasy play that he enjoyed creating, I recognized his pattern of being the director. It had seemed to work for him for a few years, but no longer seemed to serve its purpose, and even Peter appeared to be aware that his role playing may have turned some people away from him. When he talked about the candies as a method of payment, I realized that he may still carry candies (Tic Tacs) in his pocket, as a way of enticing other children to interact with him, in order that he could decide if he would give them a candy or not, or give them orders to fulfill, in return for candies. He also seemed to be aware of his loneliness and his anger as he described himself as acting as though he were a "Madman". The encounter with the fly in our session seemed to give him the opportunity to act out this madman. As he called out "revenge" to the Ay, it seemed as though the fly could have been a metaphor for Daniel. Lastly, Peter's sandplay seemed to show that he was still struggling with opposing forces. Initially, he made a scene of a town with some buildings, and trees which could have represented growth and an energy source. The only other sessions in which he had used vegetation, were session one and session seven's asteroid scene. The two vehicles, in part one of this series, seemed static and 121 would not have been able to drive forward. Although there were no people or animals, this scene seemed to show some signs of growth and there did not appear to be any signs of a disaster, as had been Peter's reoccurring theme. However, after I had taken this photograph, a disaster did occur as an avalanche hit the town and all the trees disappeared. The buildings and vehicles were covered with sand. Some of the blue base was exposed and some tops of buildings were left uncovered. The people that were buried in this avalanche may have been representative of feelings of suffocation and helplessness in Peter. Peter asked me to take a photograph of this scene and then he began to uncover the town, and explained that all the people had died. In the next scene (part IV), an earthquake caused another avalanche, but this time some of the buildings were only partially covered and some people were able to escape. Also some of the blue base was showing. It seemed as though this was a positive picture, compared to the first scene, as Peter had left some doorways and windows uncovered, in order that some people did not suffocate. The exposed blue base may have indicated water as a source of energy and a symbol of deeper contact with his unconscious (Bradway & McCoard, 1997). In the final scene, there was a lot of damage to "old buildings," for which Peter took responsibility. This may have indicated that a part of Peter was now ready to let go of, a part that was old, that he wanted to destroy. His final statement may have also been a metaphor for using his power to destroy something, perhaps a part of him, that had been standing for many years. Although this last scene appeared to be destructive, I was aware that this was 122 what his psyche had needed to bring to the surface in order to contribute to his inner healing. I hoped that another opportunity would arise for Peter to continue on his path toward individuation. Conclud ing Impressions During our sixteen sessions, it appeared as though Peter was continuously working through conflict, which usually revolved around the theme of struggling for existence. In building a house, over six sessions, it appeared as though this created the ego strength that Peter needed to begin to express the inner conflict between opposing forces that seemed to be apparent in his first four sandplay sessions. After the completion of the house, the following five sessions seemed to delve further into conflict. In Peter's final sandplay session, he appeared to be expressing that there was a way out, through chimneys, doors and windows. The covering and uncovering with sand seemed to be an attempt to reconcile two sets o f incompatible feelings, helplessness versus hope. The final product was left with the buildings uncovered from the sand. A s Peter ran his fingers through the sand and walked away from the sandtray, it appeared as though he had released a lot o f negative energy, gained some inner strength and was now more able to face the struggles in his external world. 122a P E T E R ' S S A N D P L A Y P I C T U R E S Session One Session Two (part I) Session Four Session Five 122b Session Seven (part II) Session Seven (part H I ) Session Eight Session Nine 122c Session Ten (part EE) Session Eleven (part I) 122d Session Eleven (part II) Session Eleven (part III) Session Eleven (part IV) Session Eleven (part V) Session Eleven (part VI) 122e Session Twelve Session Sixteen (part I) 122f 123 CHAPTER FIVE: BRETT At the onset of sandplay therapy, Brett was twelve years old. He had been diagnosed with Asperger's Syndrome at Children's Hospital, although a recent report by a different child pediatrician identified language delays but did not support a diagnosis of Asperger's Syndrome. Asperger's Syndrome is considered to be a form of high-functioning Autism. According to the Diagnostic and Statistical Manual o f Mental Disorders I V (American Psychiatric Association, 1994), "The essential features of Asperger's Disorder are severe and sustained impairment in social interaction and the development of restricted, repetitive patterns of behavior, interests, and activities" (p. 75). Brett stutters frequently and has been dysfluent since he was approximately five years old. He has received speech therapy, intermittently, since he was four years old. At the time of the study, he was no longer receiving speech therapy at the school as the speech-language pathologist felt that she was not able to expand upon the skills that had already been taught to him. Brett was experiencing many social difficulties at school and peers frequently teased him. However, he was thoroughly enjoying sports and played on an ice-hockey team and roller hockey team. Brett's sandplay process consisted of twelve sessions from March to June, 1998. The twelve sessions are summarized as follows, accompanied by my clinical impressions and reflections as the counsellor. 124 Session One: "The Animal Kingdom" (wet sandtray) Session Summary Brett experimented with many o f the sandplay toys during this first session. Approximately nineteen times, he placed objects in the sandtray and took them out, or built a structure with the wet sand and then demolished it. Many times it appeared as though he was not satisfied with the sandplay toy collection, and, in particular, i f some toys were out of proportion to other figurines, he would comment on their size and then remove them from the sandtray. However, through this careful selection process, he also had the opportunity to explore the shelves and view the variety o f different toys. Although Brett had many scene changes, he finally decided to use the following items that he had first chosen at the beginning of the session: the volcano, castle and cave. A s he placed the walls around the castle, he called it "The Dark Kingdom". He seemed to show some pride in his creation. He stated that he had some good ideas when he attempted to make a bridge by threading some wool through the fence and then tried to tape this bridge from the volcano to the cave. However, this did not work and he abandoned the idea of a homemade bridge, and continued to create different scenes within the sandtray. Towards the end of the session, he stated that he was not sure what to do, but then quickly thought o f an idea. He stated that he was having fun and decided to make a forest, which he described as being "cool ." 125 Finally, his scene included four coniferous trees, a cave, a castle surrounded by hand built walls, wi ld animals, their young and a volcano. With the exception of the panda bears and the giraffe, the wi ld animals were in groupings of three and the animals appeared to represent an adult with children. He titled his scene "The Animal Kingdom" and explained that "poachers live in the castle and the animals just found out so they are all leaving.. .the volcano -sometimes it erupts and sometimes it is quiet." A s I took the photograph, Brett poured water into the volcano. Counsellor's Clinical Impressions and Reflections After this initial session, I was left with a feeling of curiosity as I wondered where this journey might be going and i f the following indicators might have been a sign that Brett was connecting with his unconscious energies: The picture had been created in the wet sand which is often a sign of accessing the unconscious and the animals were travelling toward the left of the sandtray which may also be a sign of connecting with the unconscious (Bradway & McCoard , 1997). The presence of trees in his sandplay may also have suggested some natural growth (Bradway, 1994). Although Brett stated that the animals were leaving because o f the poachers, it seemed significant that what Brett said actually contradicted the movement of the animals. The animals, with the exception o f the pandas, seemed to be moving diagonally from left to right, towards the seemingly aggressive energy which could have been represented by the poachers inside the castle. The panda bears appeared to be observing the other animals. A t an unconscious level, 126 Brett may have been preparing to face some aggressive energy which could have been represented by the poachers. The volcano may have also suggested some aggressive energy in the form of "pent-up, possibly explosive feelings" (Bradway & McCoard , 1997, p i l l ) and thus, his overflowing volcano may have indicated that he was preparing to release some inner emotions. Brett's desire to create a bridge seemed to be very significant as "a bridge is a readily observed expression of the connection. The placing of the bridge is the actual attempt to connect what is symbolized or represented on the two sides of the bridge" (Bradway, 1985, p.9). It could have been that Brett's attempt to make a bridge represented his unconscious preparing to create a connection or begin a confrontation with the conscious. His attempt to unite the volcano and the cave could have symbolically represented the bridging of opposing forces. Volcanoes are "terrifying examples of the earth's destructive energy" (Fontana, 1993, p. 114) and according to Cooper (1995) the cave often represents a feminine symbol of positive energy "the heart, the place of union of the Self and the ego; the meeting place of the divine and the human.. .the womb of Mother Earth and her sheltering aspect" (p.31). It appeared as though Brett could have been attempting to bridge destructive feminine energy with feminine positive energy. The four green trees could have also been another symbol of femininity as this number is often associated with the feminine (Weinrib, 1983). The animal theme also gave the impression that Brett was accessing his instinctual energy as suggested by the use of the wi ld animals. A l l o f the baby 127 animals were with a parent except the baby giraffe. The pairing of parent animals with their young may represent mother-child unity which is described by Winnicott (1971) as an essential stage in the healthy development of a child. In this picture the baby giraffe was not with a parent. It could have been that the giraffe was a symbol representing Brett. The giraffe is an animal that is soundless and grows to be a tall animal that can see great distances which may be connected with foreseeing future events (Andrews, 1997) It could be that this baby giraffe could grow, step forward from behind and become united with his/her parent on the upcoming journey. The castle itself was surrounded by hand built walls which seemed to reflect a need for protection. The castle could have been representative o f Brett's ego that may have wished to keep him protected. The walls seemed to be keeping him safe from aggressive and instinctual energies. Overall, Brett's initial scene seemed to be very expressive. The first sandplay scene often depicts the individual's inner conflict or dilemma (Bradway & McCoard , 1997) and in this picture, the main theme appeared to be the wi ld animals in conflict with the poachers inside the castle behind the walls. While Brett was creating his sandplay, he frequently seemed to express dissatisfaction about my sandplay collection which was difficult for me not to take personally. For example, he requested doors which I did not have, thought the shelves looked too crowded and other objects were out o f proportion. A s he made these comments regarding the sandplay collection, I wished that I had all the toys that he wanted. Then I remembered hearing a presentation by Sylvia 128 Simonyi-Elmer at the International Play Therapy Conference, Vancouver, 1998. She stated that many clients wish for miniatures that the therapist does not have and that many therapist naturally want to provide their clients with all the miniatures needed to create their desired image. However, it would not be therapeutic to have an overwhelming amount of materials, as this would be comparable to the all-consuming Great Mother image with no sense of limits. Session Two: " A Town" (dry sandtray) Brett began this session by stating that he wanted to make a scene using First Nations people, but he could not find the kind of figurines that he was hoping to use and therefore he completely changed his idea. He then began to create a scene using the railroad tracks, but did not complete this image. Instead, he decided to use the houses to make a town. He added trees and placed them equidistantly from each other. He then asked me to buy miniature hockey players in order that he could make a hockey scene with an ice rink, since he is on a hockey team and his favorite sport is hockey. He asked i f I had any roads and I suggested that he could make some using the craft materials. He said that would take too long. Lastly, he placed a wedding couple in the sandtray in front of the church, but then removed them because they were too big in proportion to the buildings. Counsellor's Clinical Impressions and Reflections In this session, Brett seemed to think that the miniature collection was inadequate. Although it would be impossible for me to have every toy that any 129 child wished for, I decided to order some miniature soccer players since I could not find any hockey players. Brett had also indicated that he enjoyed soccer. B y requesting some hockey player figurines, Brett may have also been testing me to see i f I was going to come through for him. Brett also seemed to express a desire for perfection through his precise placement of the trees. It appeared to be very important that the trees were equidistant and that the objects were all in proportion. Brett titled this sandplay, " A Town". The buildings and the trees seemed representative of a town scene but I wondered where the people, animals and vehicles were. The use of the coniferous and deciduous trees appeared to symbolize opposites. The coniferous trees are able to keep their needles even through the coldness of winter whereas the deciduous trees lose all their leaves and remain bare in the winter until the conditions are conducive for creating new buds. The overall scene appeared to be deserted and static, with a feeling of emptiness and absence of instinctual or dynamic energy. After such a seemingly dynamic, expressive and instinctual first scene, Brett may have needed to pull back to prevent himself from going too deeply into his unconscious too quickly. The fact that he moved from using the wet sandtray in the first session to the dry sandtray in the second session also seemed to indicate this. Session Three: "Lost in the Forest" (dry sandtray) Brett completed this sandplay session quickly. He seemed to be rushing, perhaps because it was a beautiful day during Spring Break and his father had 130 stopped him midway through his roller-hockey game to bring him to sandplay. On the other hand, at an unconscious level, Brett may have known what he needed to create and express, and may only have needed twenty minutes. Brett placed the house, church and two headstones in the dry sandtray and then stated, twice, that he did not know what to add. He finally decided to add the miniature farm people (a man carrying a sack on his shoulder, a man holding an axe, and a woman carrying a bucket), all o f the coniferous trees in my collection, the castle and three strong clay walls. He stated: "People got lost in the forest and had to build a house to survive. They're trying to find food. Rich people moved into the castle." Counsellor's Clinical Impressions and Reflections I knew that Brett had experienced the aforementioned external distractions in regards to attending this particular sandplay session, but I was also hoping that he was still enjoying and benefiting from the sandplay despite the haste that he displayed in this session. Even with the large selection o f miniatures, it seemed to be difficult for him to think o f ideas, but on the other hand I felt positive that the sandplay therapy could provide him with an opportunity to access his imagination. Brett titled this scene "Lost in the Forest" and I wondered i f this scene could have emerged from the journey that had begun in the previous session. In this scene he appeared to have more depth as indicated by the additions of the castle and walls, people and church and headstones. These may have been indications that he was moving into the conflict further and ready to take more 131 ownership. It seemed to be a positive sign that there were people in this scene who were actively attending to various tasks to be self-sufficient. In addition, Brett had stated that these people were working hard to survive. They had built a house and were looking for food. If one considers that a house often symbolizes "the human body and is often thought to offer the soul a habitation for only a short time" (Matthews, 1993, p. 102), it could have been that in building a house Brett might have been symbolically providing a sanctuary for his body and soul. Furthermore, the image of the farmers looking for food may have suggested that Brett was also finding a way to nurture himself. The fact that the people had built a house could have represented Brett's acknowledgement of how challenging life can be and how important it is to have warmth and shelter, which he may have been providing for himself through the image of the people building a home. Finally, it seemed significant that the castle reemerged and was placed in the same position as in the first session, but this time was surrounded by thick, clay walls. The people inside were once again inside the castle, but this time they were "rich people". The rich people moving into the castle seemed to be a completely opposite scene to the people building their own home and finding their own food. The rich people were unable to join the other people as they Were separated by the clay wall barriers. I f the ego was being represented by the castle, it appeared as though it was still separating itself from the other parts of the Self portrayed in this scene of survival. It appeared as though the Self knew that it needed to work in order to survive. 132 The presence of the quantity of three was vivid in this scene as it was in the first session. There were three human figures in this scene. The number three is often representative o f the masculine (Weinrib, 1983), thus these images could have been related to some aspect of Brett's masculinity . The headstones might have been symbolizing a part of Brett that needed to die before it could be reborn. Session Four (no titles given - wet sandtray) Brett began the session by explaining that he and his father had had a long talk about him rushing his previous session and he stated that his father had been upset with him. He asked again about the miniature hockey players, and I told him that I had ordered some soccer players. Knowing that the soccer players were ordered, and that I had heard his request, may have provided Brett with a sense of security and safety for returning to the wet sand. Brett started his sandplay in the wet sandtray with the castle, walls, cave and volcano- the same items that he used in his first session. He added trees which were once again equidistant from each other and then he decided to take all the items out of the tray. Next, he tried the dinosaurs and placed them equidistantly in the wet sandtray, but was still dissatisfied and removed them. He then placed the trees equidistantly from each other and once more added the dinosaurs. This time he was satisfied and asked me to take a photograph. Brett stated that he would like to make two sandplay scenes and continued in the dry sandtray to create the following recurring image: He placed the castle in 133 the tray and surrounded it by clay bricks, only to discover that there were not enough bricks and he replaced them with the big clay walls. He then removed all o f the objects. Brett continued to struggle to think o f an image and stated, three times, "What can I do?" or "I don't know what to do." He asked me for a suggestion and I stated the various categories o f toys. Suddenly, he said "Oohh" and it seemed as though he had an idea. He used the dust brush to sweep the wet sand to make it "more even," patted the sand down and then fit the railroad tracks together. He covered the tracks in order that only the edges were showing and then he placed vehicles such as a bus, jeep, service vehicle, police car and ambulances on the tracks while asking i f I had a roadblock. He proceeded to invent his own roadblock by placing some railroad tracks and a train perpendicular to the road that he had already created. He added trees and commented that the toy collection had only two trains. He asked i f I had railroad lights or anything to indicate stopping. I pointed out the stop signs and he decided that he was finished. Counsellor's Clinical Impressions and Reflections In this fourth sandplay session, it seemed to be a recurring theme that Brett found it challenging to access his imagination. I sensed that he seemed to be struggling and part of me wanted to give him ideas. On the other hand, I felt that the product needed to be his own work for his self-confidence to develop and his psyche to experience the struggle. Once again, it appeared as though the collection of toys was not going to completely fulfill his needs, but I recognized 134 that this weekly critique was part of his process; it may have been that he needed to externalize his own inadequacies. I was also curious as to why the castle and walls were the objects that Brett seemed to turn to when he appeared to be having difficulty imagining. It appeared as though this could have been the ego's way of protecting Brett and keeping him from connecting with other parts o f himself. In addition, a castle is often a mystical place where treasures are kept and the walls are built for protection. Many children also think of a castle as a secret and safe place (Dundas, 1990). I wondered i f Brett's use of the castle was symbolizing the treasures that he had not yet accessed in his unconscious and i f the walls might have represented defense mechanisms. The repeated use of the castle, walls and volcano may have also been an indication that Brett was preparing to access the same depth of process that he appeared to access in the first scene when he used these items. In the first sandplay picture of this session, many of the dinosaurs were eating the trees which could have indicated that Brett was finding sources of nurturance for himself or that the people around Brett were providing nurturance. In addition, the presence o f the baby dinosaur inside the egg seemed to suggest that the baby was safe and being cared for, but still appeared to be on its own and in a vulnerable position. In the second sandplay scene, it appeared as i f primitive energy, which could have been represented by the dinosaurs, was transformed to modern locomotive energy. I was particularly struck by the theme of this roadblock; the 135 train was blocking the way and there was no movement. When I saw this image I thought of Dora K a l f f s (1980) description of a traffic jam representing blocked energies in the unconscious. In Brett's sandplay, there were a series of vehicles, including helping forces such as the tow truck, police and ambulance, moving in the direction of left to right which could have represented potential movement of these helping forces from the unconscious to the conscious, i f they were not blocked. I wondered i f this blocked energy might have also been related to the blocks in Brett's speech when he stutters. In a case presentation by Dr. Kaspar Keipenheuer at the International Sandplay Conference, California, 1997, he showed the sandplay pictures o f a client who stuttered. This individual had created a dam with the wet sand which Dr. Keipenheur felt was a sign of a blockage which might have been related to this individual's stutter. Session Five: "Funeral at Forest Lawns" (dry sandtray) Brett began this session by adding water to the wet sandtray and mixing it with sand. He asked i f I had bought the soccer men yet and then selected the nest with the birds, but decided that it was too big. A s in previous sessions, he seemed to have difficulty creating an image and throughout the session he asked seven times what he could do or what he could add. Although it appeared to be a creative challenge, he seemed proud of his final image. Initially, he placed his own shoes in the wet sandtray with a plastic male figure having a leg in each shoe. However, he decided not to continue with this 136 scene and started again with two headstones. He added a church, a nun and some crosses. He used a small wooden box as a coffin and four Playmobile figures as the pole bearers who lifted the coffin. He noted that the coffin was much larger than the church but decided to still use it for this scene. He added trees which, once again, he placed equidistantly. To complete his scene he created a sign saying "Funeral at Forest Lawns" which he insisted on holding while I took the photograph. When his mother looked at the creation, she asked who had died and after some thought, Brett stated that his teacher had died. Counsellor's Clinical Impressions and Reflections After this session, I felt joy for Brett. The fact that he began by placing his own shoes in the sand seemed to indicate ownership to the process. He seemed to have used his imagination to produce a scene, which had involved some problem solving skills. The seemingly blocked energy from session four appeared to emerge as death in this session. His answer to his mother, regarding the teacher who died, probably reflected his thoughts on a conscious level regarding his teacher whom he greatly disliked. However, on an unconscious level it appeared as though a part of him might have died and was honored with a spiritual ceremony. He added a large quantity of water to the sand which could have signified a deeper connection with the unconscious (Bradway & McCoard , 1997). In the third session, the headstones has been used but no significant attention had been drawn to them, whereas the theme o f this whole scene was a funeral ceremony. The church and the crosses are often seen as patriarchal 137 symbols. Christian churches are often "laid out in the shape of the human body with arms outstretched" (Fontana, 1993, p. 76) to replicate the belief that M a n was created in the image of God. Furthermore, the cross may be viewed as. a symbol o f universal, archetypal man, capable o f infinite and harmonious expansion on both the horizontal and vertical planes; the vertical line is the celestial, spiritual and intellectual, positive, active and male, while the horizontal is the earthly, rational, passive, and negative and female, the whole cross forming the primordial androgyne. It is dualism in nature and the union of opposites and represents spiritual union and the integration of man's soul in the horizontal-vertical aspects necessary to full life; it is the Supreme Identity (Cooper, 1995, p.45). It appeared as though the funeral could have been honoring the death of a part of Brett before he could experience rebirth. Session Six: "Animals Leaving the Kingdom" (wet sandtray) Brett began by stating that he did not know what he was going to do. He placed some wi ld animals in the wet sandtray and added the volcano and the cave. Next, he decided to make a bridge, which seemed to be his focus for the duration of the session. First, he used wool which he threaded through the wooden fencing, and then tried to suspend this "bridge" from the cave to the volcano. He stated that below the bridge there was a big fire and the animals would only survive i f they crossed using the bridge. He became frustrated as he tried to tape 138 the bridge to the cave and the volcano but without success. He tried different ways, but then he put his head in his arm as he realized that his bridge wasn't going to work. His sandplay continued with the addition of more animals, trees and a small ceramic bridge placed between the wet and dry sandtrays, which he then removed. He returned to experimenting with the wooden fence and tried to lay it across the length of the sandtray, but discovered that it was not long enough. He asked me how the animals could cross over and then he thought of a solution using the popsicle sticks and string. In a leadership program at school, he remembered taping popsicle sticks together, thus he used this tactic to attempt to build a bridge. At first he thought that it was going to work as he said "This might work .yes . . time to perform my magic." This statement seemed to indicate that Brett was feeling empowered, but then he said that the popsicle stick bridge was too short and was making him perspire. He stated that it was too hard and that he might try again another time and asked i f I could bring masking tape for our next session. Counsellor's Clinical Impressions and Reflections Brett's persistent desire to build a bridge may have been an indication that he was once again feeling the urge to connect opposites as he re-attempted, without success, to connect the volcano and the cave. Throughout this session, I was also feeling Brett's frustration. It was difficult for me to observe him as he became excited about his bridge and then deflated as his attempts failed. His ideas appeared to be practical, but it seemed as i f he stopped trying just before he 139 achieved success. Knowing the potential significance of the bridge, I felt that his unconscious might have been holding him back from making the connection and that the challenge could have been an important step in his personal development. Brett titled this sandplay, "Animals Leaving the Kingdom." He stated that the animals were leaving the forest and going to the town. This story line seemed to continue from his first session, when he created "The Animal Kingdom," to the second and third sessions which involved towns. The wi ld animal kingdom was a contrasting habitat to the town but the story line seemed to link the two scenes. This scene may have recurred after the funeral scene, because he could have now been ready for a re-birth of a part of himself. The theme o f this picture was similar to his initial sandplay session which seemed significant because the first picture of a sandplay process often identifies the individual's inner conflict (Bradway & McCoard , 1997). Therefore, it appeared as though Brett was now ready to address this conflict as he recreated a similar scene to his initial picture. The number three is often referred to as a powerful number and is believed to be representative o f the masculine and the active (Weinrib, 1983). Groupings o f three were vivid in this picture. The animals were in families o f three and three species were represented. Dora Ka l f f (1980) emphasized the potential significance of number three. She stated "The number three holds a clue as to how power is to be reached. Since ancient times, not only is the number three regarded as a dynamic force, but it is also defined as holy.. . the three seems to be connected with a super human power" (Kalff, 1980, p.64). She also quoted Jung who stated 140 "The Trinity is an archetype whose dominating energies not only foster spiritual development, but may on occasion, actually enforce it" (Kalff, 1980, p.64). In addition to the powerful representation of the number three in this scene, parent-child unity seemed to be represented in each of the animal groupings. It is also interesting to note that Brett had the opportunity to choose a medium sized animal, which is often representative o f the mother animal, but he chose the largest polar bear, tiger and elephant which is often associated with being the father animal. This seemed to be another indication that he was connecting with the father archetype at an unconscious level which may have also been related to his return to the wet sand. The selection of animals appeared to be significant since the elephant, tiger and bear are all considered to be powerful animals. The bear may have represented the awakening o f the unconscious and the polar bear is known to have no fear; it holds the highest position on the food chain (Andrews, 1997). In Asia , the elephant is thought to be "the steed of the ruler and a symbol o f power, wisdom, peace, and happiness.. . in Africa the elephant has been revered as a symbol of strength, happiness, and long life" (Matthews, 1993, pp. 68-69). In Buddhism, the tiger is believed to be the animal "which finds its path through the jungle, represents spiritual exertion. Since it can orient itself even in darkness and at the time of the new moon, the tiger also represents the inner light, the increase o f light, or the life after dark and difficult times" (Matthews, 1993, p. 199). As the animals appeared to be moving toward the unconscious, which is suggested by the 141 movement from right to left within the sandtray, it seemed as though Brett could have been accessing some deep and powerful unconscious energies. The placing o f the deciduous and coniferous trees may have represented a presence of the opposites. The tree is often thought to symbolize the Self as well as be a symbol o f the union of opposites as stated by Ka l f f (1980), "It embodies not only maternal femininity, but its straight trunk also has a phallic meaning" (P.46). Session Seven: "Journey to Mars" (dry sandtray) Upon entering the room, Brett asked me for the masking tape and told me that he had not wanted to come to sandplay because he was missing the N H L hockey playoffs. He then sat down to work on constructing a popsicle bridge which he stated "takes a long time". Once again he became frustrated and stated that there was "no point". Twice, he asked what he could do but then thought of an idea; he wanted to turn something into Mars. He placed the astronauts equidistantly in the dry sandtray and seemed very excited to find an alien on the shelves. He added a rocket ship to the scene and asked i f I had a red light that he could shine on the picture "to make it spooky". He added a cartoon figure of Y o g i bear with a camera and stated that Y o g i was taking a picture. Lastly, he added a flag and stated "There I 'm done" and that the alien was saying, "Join Us . " He stated that the astronauts had just planted the flag and were now going back in the spaceship since the creature wanted to k i l l them. 142 Counsellor's Clinical Impressions and Reflections I wondered i f it was synchronicity that Brett created this picture about aliens and Mars and was also wearing a tee shirt that said "Property of Extra-Terrestrial" with a picture of an alien on the front. According to Matthews (1993), Mars is described as "masculine, as the planet of battle and strife, as hot and dry, and as causing lightning, storms, wilderness, and mercilessness" (p. 106). Brett's "Journey to Mars" may have symbolized his journey and connection to his masculine energies. The rocket also appears to be a phallic symbol, thus it may have been significant that the alien, with its outstretched arms, and the rocket were placed opposite one another with the astronauts exploring this new territory in between. The astronauts coming from the rocket, moving towards the alien, may have represented the coming together with parts of himself that might have previously felt alienated. The Y o g i bear photographer could have been a witness o f this moment, as was I. In addition, the placement of a flag is often a sign o f honoring identity as well as sovereignty (Matthews, 1993). The statement "Join U s " by the alien with the outreached arms seemed to be in conflict with the creature who then wanted to k i l l the astronauts. It could have been that there needed to be a struggle with a part of his inner self, which may have felt alien to him, before a resolution could occur. After this session, I felt disappointed for Brett that he had still not succeeded in building his bridge. However, he appeared to work through his frustration and seemed to be proud of his space scene which gave me a pleasurable feeling. Once again the objects, in this case astronauts, were placed equidistant from each other. The need to be precise and structured seemed to still be necessary for Brett. It seemed as though the placement of objects in an equidistant manner could have given Brett a sense of order and control. Session Eight (no title given - wet sandtray) Brett started by brushing the wet sand with the dust brush to level out the sand. He then stated that he did not know what to do but quickly thought of an idea as he selected the two ceramic bridges and placed them in the wet sandtray. He proceeded to move some sand out of the tray into a container. Very carefully, he made a strip of land across the center and stated " I 'm trying to make this perfect". While he meticulously cleared the sand away, he stated " I 'm taking such a long time" in a seemingly proud voice. He then placed a person on a bridge, as well as two boats into the water. He added a large quantity of water to complete his scene. After I had taken a photograph, he showed his mother and made a handprint in the sand while he was talking to her. Counsellor's Clinical Impressions and Reflections In this session, there appeared to be a shift in Brett's sandplay process which may have been an indication of some psychic movement within himself. After having struggled for so long to make a bridge in previous sessions, it seemed significant that Brett was now ready to use the two ceramic bridges that had been available to him since the first session. His use o f these bridges in this scene may have symbolized a form o f connection. According to Bradway (1985), 144 " .. the bridge provides for the phenomenon of the transcendent function" (p.9). The transcendent function meaning the "process through which opposites are united.. .the transcendent function begins with a confrontation between the opposites in the conscious and unconscious, leading to a collaboration of conscious and unconscious data which effects a transition from the old attitude to a new, more comprehensive one" (Bradway, 1985, p.2). In this scene, the two bridges joined together three patches of sand which may have symbolized a connection to the masculine as suggested by the quantity of three that reappeared in this scene. In addition, not only did Brett remove most of the sand to expose the blue base, but he also added a large quantity of water. This may have indicated that Brett was gaining greater access to his unconscious energies (Bradway & McCoard , 1997). The boat often symbolizes "a safe passage across to the other shore" (Fontana, 1993, p. 112). It may have been that the bridges were connecting Brett's unconscious to his conscious, which could have been represented in this scene by the blonde boy looking down at the water. The water is often a symbol for the depths of the unconscious (Cooper, 1995) and the use of the young male figurine looking down at the water appeared to be a more concrete and conscious act. Brett is also blonde and the use o f a blonde boy may have been an indication that he was taking greater ownership of the process. The placement of a young blonde boy in the scene seemed to be a move towards an adaptation to the collective, meaning that "he is admitted to the environment as a person and becomes a member of the collective" (Kalff, 1980, p.33). This blonde male 145 figure seemed to indicate that Brett was recognizing and feeling his masculinity. Furthermore, the hand print may have signified that he had "given shape to something that is found within h im" as interpreted by Andreina Navone, a sandplay therapist who also had a client who created an imprint of his hand in the sand (Navone, 1998, p.52). The lighthouse seemed to be an important symbol. It could be viewed as a phallic symbol representing the masculine (Matthews, 1993), as well as a tower that provides safety and light for guidance. In ancient times, the lighthouse was sometimes viewed as "a symbol o f the eternal goal toward which the ship of life steered across the waves of this existence" (Matthews, 1993, p.201). Brett appeared to be showing several signs of emotional growth. The use of the bridges, the large amount of water and the blue base seemed to indicate that a process of transformation could have been occurring at a deep unconscious level. In addition, Brett stated "I don't know what to do" only once at the very beginning o f the session and then he became immersed in his sandplay world filled with water. This seemed to suggest that he was completely focused and had connected with the powerful energies o f the unconscious. He no longer seemed afraid and appeared to have been able to bridge and make connections. Session Nine (no title given - dry sandtray) Brett's father brought him to this sandplay session, which may have influenced the overall content. Although Brett and his father seemed to be very 146 close, the last time Brett's father brought him to sandplay his father criticized him and told him that he had to stay in the session for a longer amount o f time. Brett began the session talking about the N H L playoffs and placing the castle and three surrounding walls in the dry sand tray. He asked i f the soccer player figurines had arrived yet and then asked, "What can I do?". He placed a gargoyle on top of the castle and continued to ask what he could do seven more times. He stated that he wanted something smooth and of a specific width to make roads, but the two objects that he tried were not the correct size. He decided that he would try to make a bridge one more time and he asked me to help him hold the tape. He seemed to be easily frustrated, discontinued his bridge and took the castle and walls out of the sandtray. Following this frustration, he asked how he could make hills and I suggested that he could use some playdough that was in my car. I retrieved the play dough, but it was not suitable for Brett's idea. However, he decided to play with the playdough and made a mask using his face as the mold. He held it to his face and it fell apart. He then stated "Made a bridge, tried to make that face.. what can I do?" He appeared to be disheartened and decided to clean up. I suggested that I could take a picture of what he had done in the sandtray and although he seemed surprised, he also appeared pleased. He then left the room without a word and went to the waiting room to tell his Dad that he had not made anything. 147 Counsellor's Clinical Impressions and Reflections This was a particularly difficult session for me because there were several times when I had the urge to attempt to rescue Brett. In hindsight, I realized that Brett would probably have thought of some way to create hills and it was not necessary for me to retrieve my playdough. In addition, when he did seem frustrated I was being quiet to honor his feelings, but on the other hand I think I could have been more supportive i f I would have reflected his feelings of frustration and given him some encouragement. Usually after our sandplay sessions, Brett would leave the room and I would dismantle the sandplay picture, but in this session he returned the objects to the shelves before he left the room. It seemed as though he did not want his father to see anything that he had done. I walked to the waiting room with Brett where he told his father that he had not made anything. A s they left the counselling centre, his father told me that he thought Brett was feeling pressured because of him being there. This did seem plausible. Although Brett seemed to struggle, it was interesting that he attempted to make a bridge again but did not succeed. It appeared as though he was preoccupied with worry about pleasing his father and thus, the conditions may not have been conducive to the creation o f an object that may symbolize reaching out and connection. In addition, his repeated use of the castle, and the walls, and the addition of a gargoyle at the beginning of the session seemed significant. According to Fontana (1993), the castle often represents "the stronghold of either good or evil, or a place in which treasure is guarded" (p.76) and "a castle is an 148 androgynous symbol. A s a place to live, it is a feminine image; as a fortress, it is a masculine image" (Bradway & McCoard , 1997, p. 169). A s mentioned earlier, the castle may have represented Brett's ego, protecting him, and as an androgynous symbol it may have related to a lack of identity. The thick walls surrounding the castle and the gargoyle protecting the castle may have suggested that Brett was guarding treasures within himself. Dundas (1990) has found that to most children a castle represents "at least a secret place where they can be safe. They also think of it as being very old and durable" (p. 39). I f Brett was worried about pleasing his father, he may have used the castle as a means for protecting himself and his treasures. Session Ten: "Journey to Mars" (dry sandtray) In this session, the "Journey to Mars" reappeared. Once again there was an alien, a flag, a rocket ship and astronauts placed equidistant from one another. The "first dog in Mars" was added, as well as a totem pole, two headstones, two crosses and a skeleton. Brett explained that these were new astronauts and that they had discovered the skeleton of one of the previous astronauts. Counsellor's Clinical Impressions and Reflections After this session, I was pleased for Brett that he seemed proud of his creation. I was surprised that Brett placed the dog in this scene because in previous sessions he had removed an animal i f it was not in proportion. The dog in this scene did not seem congruent with the rest of the picture. Although, after I had gained a greater understanding o f the symbolism o f a dog, I was amazed at 149 how significant the dog seemed to be in this particular scene. In many cultures it appears as i f "the dog is associated with death; it guards the realm o f the dead and is the psychopomp (spirit guide) or mediator between the worlds o f the dead and the l iv ing" (Matthews, 1993, p. 5 8). In the Celtic tradition the dog is associated with healing (Fontana, 1993). In this sandplay scene, the dog was placed between the dead astronaut and the small cemetery and living astronauts. It appeared as though the dog may have been the mediator between the world of the dead and the world of the living. This could have been significant for Brett i f the dog was helping him to heal from his masculinity that had seemed "dead" and now appeared to be coming into the world of the living. The totem pole may have represented "protective divinities, spirits or powers in Nature, or the protector of a particular tribe" (Cooper, 1995, p. 175) and " in the religions o f some Northwestern Native Americans, the totem pole connects the tribe with their animal ancestors" (Bradway & McCoard , 1997, p.204). The totem pole may also signify "tribal membership, of feelings o f belonging to a group" (Weinrib, 1983, p. 153). In Brett's sandplay, the totem pole seemed to be overlooking the scene in a protective, spiritual way, perhaps in connection with the dog. It may have also been an indication that Brett was adapting to the collective, and feeling a sense of belonging. The totem pole was placed diagonally to the dead astronaut which may have further symbolized Brett's need to connect with his animal instinct after having possibly faced the death of a part of himself. 150 Session Eleven (no titles given - wet sandtray) Brett began this session by talking about food. He stated he was hungry and told me that he had not eaten since lunch time. He also asked i f he could bring a surprise snack for the following week, as it would be our last session. Brett then asked me i f the soccer players had arrived and I stated that I would have them for our last session. Throughout his sandplay he stated that he did not know what to do five times, but he did become quite immersed in his play once he began. First, he created an oval shaped racetrack. He made "jumps" that the cars had to go over; although none o f the cars made it over the jumps successfully. Two cars were stuck and the third car landed in the water. After this scene, Brett took the cars out of the tray and began to form a mountain in the centre of the tray. He added trees to the mountain and a male figure who fell off a cl iff on the side o f the mountain. However, this figure did not fall to the base, but became stuck in the side of the mountain. His head was inside the mound and his feet were hanging out. He asked for a photograph o f this scene and then started to add more sand to the side o f the mountain while stating "Okay I want to put this guy in there, now I 'm going to close him up and then he's going to die". But suddenly, he changed his mind and decided to make a cave with Aladdin searching for the gold. He stated that he had wanted to make an image of the tiger as in the cave scene from the movie "Aladdin" but this was too difficult for him to make. The scene was left with Aladdin about to enter the cave where he hoped to retrieve the gold. 151 Counsellor's Clinical Impressions and Reflections At the beginning of the session, Brett brought up the topic o f food several times. I wondered i f this topic might have been related to a need for nurturance as we drew closer to termination I also noticed that Brett's previous sessions had been mostly static scenes, but in this session I had felt a lot of movement within the tray. The racetrack seemed to indicate dynamic energy and I wondered i f this might have signified that Brett's inner energies were also in motion. The circular, oval shape may have been the beginning sign o f wholeness. Dora Ka l f f (1980) stated " . . the center of the Self is stabilized in the unconscious of the child and begins to manifest itself in symbols o f wholeness... The circle, particularly as a symbol o f perfection and of the perfect being" (p.24). It appeared that there was still some blocked energy as the three cars were not able to drive around the racetrack without hitting an obstacle. The number three appeared again, and as a possible symbol of masculinity, the car race may have symbolized that all o f Brett's masculine energies were not yet flowing smoothly. The formation in the wet sand resembled the shape of a turtle. Martin K a l f f (the son o f the Dora Kalff, the originator of Jungian sandplay) states that it is important to look at the shapes in the sand when interpreting sandplay scenes (Kalff, 1993). In Kay Bradway's (Bradway & McCoard , 1997) study of turtles in sandplay, she discovered that turtles were often used in times o f transition. She believed that "the turtle was an androgynous symbol, a symbol o f the union of opposites... The turtle combines the sky - the dome-shaped top shell - with the 152 earth - the square base; it combines the masculine - the projecting head - with the feminine - the round container. And I recalled that Jung had written about turtles as an image of the Self in dreams" (pp. 76-77). She also learned that mother turtles abandon their babies before they are born. Many of her clients were using turtles upon hearing that she was going to be retiring. Kay Bradway felt that her clients who were using turtles in the sand were "contacting an image that linked their experience of abandonment with a source of inner support that was related to the creation of new life.. (they) were calling on an image that is a source of strength. It is the solid base within us that can support any burden, no matter how heavy, and it is the inner guiding spirit that goes with us (Bradway & McCoard, 1997, pp. 81-82). As Brett was preparing for the transition of the termination of sandplay, it seemed to be a very positive sign that the image of the turtle had appeared in this session. In the second sandplay scene, the creation of the central mound of sand seemed to indicate the beginning of a centering scene which preceded the following theme of disaster. The figure fell off the cliff, but was fortunately saved by the side of the mountain and then he almost suffocated but suddenly transformed into Aladdin seeking gold. This appeared to be a pivotal and crucial moment which may have represented a transformation within Brett. The cave may have represented "the world centre; the heart; the place of union of the Self and the ego; the meeting place of the divine and the human, hence all dying gods and saviours are born in caves, inner esoteric knowledge; that which is hidden; a place of initiation and the second birth" (Cooper, 1995, p. 31). Gold "has been 153 universally identified with the sun or with fire; consequently it is also a symbol of insight and knowledge.. The alchemists' attempts to make gold from base metals, which related to the Philosophers' stone, were originally associated with the quest for purification of the soul (which is symbolized by gold)" (Bradway & McCoard, 1997, p.87). These ancient beliefs may suggest that the cave was symbolic of Brett's union of the Self and ego, and the hidden gold may have represented the esoteric wisdom and spiritual treasures in his unconscious. The final picture of the wet sand formed into a central mound strongly suggested a centering process (Bradway & McCoard, 1997). As Brett made the scene with the figure falling off the cliff, I wondered what this potential for disaster could have been indicating. Four trees were lying beside the cliff and the number four may have represented the feminine. "Four, the number of wholeness, is the goal and therefore would be a structural whole. It is a containing image and therefore feminine" (Weinrib, 1983, p. 142). Three identical trees were placed on top of the cliff which seemed to represent the masculine It appeared as though the feminine energies were lying on one side while the masculine energy was standing tall, but in a precarious position, on top of a cliff. It is possible that this scene was representative of Brett's last struggle to come to terms with his masculinity. The male figure almost fell off the side of the cliff but succeeded in saving himself and went on to become Aladdin ready to find the gold. The final scene seemed to show that Brett had worked through his struggle to connect with his masculinity and was now ready to enter the cave, which is 154 often thought of as a feminine symbol. He was ready to find the gold which may have been symbolic of the treasures within himself. This last scene seemed to be full of positive energy and hope. Session Twelve (no title given - dry sandtray) As Brett entered the room, he immediately noticed that the soccer players had arrived and stated "Good, I was running out of things to do." However, upon close inspection, Brett critiqued the soccer players and decided not to use them. Throughout the session, he stated eight times that he did not know what to do or add to the scene. Brett started his final sandplay by placing the trees equidistant in the dry sandtray and then he added wolves but he seemed to be frustrated by them because they were bigger than the trees and thus out of proportion. I pointed out the smaller bags of animals and he placed the smaller horses equidistant in the forest that he had made. He then placed two snakes in the forest but took them out and added a tree with a bird and eggs in a nest. He stated "Where's the Indians? These people are chasing the horses but they killed one, they killed a horse.. .no they didn't kill the horse but they tried to.. .the horses are getting away.. the bird is watching up there." He added as many horses as he could find, seven American Indians and lastly, he tied a bird to a pipe cleaner and held the bird over his sandplay picture using the pipe cleaner. 155 Counsellor's Clinical Impressions and Reflections Dur ing this session, I was surprised that Brett had chosen not to use the soccer players after having requested them so frequently. Initially, I had thought that it was probably not wise to have had these soccer players available for our last session in case it affected his choice o f miniatures for the final sandplay scene. However, once Brett critiqued them and decided not to use them, I realized that the powerful unconscious brings images to the surface in order for healing to occur and thus the purchase o f new miniatures wou ld not influence the psyche. After thinking about Brett's persistency about the soccer players, I wondered i f they may have been a metaphor for our relationship. B y ordering them and providing them, it may have showed h im that I was hearing h im and was indeed there for him. A l though Brett stated eight times that he did not know what to do, it appeared as though he was immersed in the sandplay once he started creating. A s in previous sessions, proportion and equidistant objects seemed to be very important in this final scene. The fir trees were the first objects that Brett placed in the sandtray. Th i s had been a recurring theme throughout his sandplay process. The fir tree is often thought to have its own unique symbolism: " T h e Tree o f L i f e is the fir o f Woden, or, later, the lime, or linden. The fir later became the Christmas T r e e " (Cooper, 1995, p. 179). Across cultures, trees are often thought o f as very significant symbols. " [The tree] is the embodiment o f life, the point o f union o f the three realms (heaven, earth and water)" (Fontana, 1993, p. 100)." In psychology, the tree is often " a symbol ic reference to the mother, to spiritual and 156 intellectual development, or to death and rebirth" (Matthews, 1993, p.202). The deciduous tree together with the coniferous trees may have represented the presence of the opposites. The deciduous tree might have also represented death, re-birth and renewal and the coniferous trees could have been representing everlasting life (Matthews, 1993). These symbols may have related to Brett in regards to his personal difficulties and the feeling that a part of him may have died, as well as what also appeared to be his ability to find inner strength, renewal and a sense of life. At the end o f the sandplay, Brett placed a Bluebird at the top of the larger, deciduous tree. He stated that the bird was watching from up above which seemed to give it a numinous quality. It is often believed that "Birds that live in the crown of the world tree represent higher levels o f spiritual being and development" (Matthews, 1993, p.202). The colour blue is often viewed as "the hue o f intellect, peace and contemplation" (Fontana, 1993, p.66). Moreover, the bird that Brett placed in the tree was a mother bird sitting on her eggs in a small nest, which may have suggested that Brett was able to recognize the existence of a home which can provide nourishment, protection, warmth and shelter. Brett's previous scene at the end of session eleven seemed to show that he was centering himself and in this final session, it appeared as though he was now ready to release this new energy. The horses in this sandplay seemed to signify the instinctual energy that Brett appeared to have accessed. Although they were being chased, they were not hurt and as they moved in the same direction, they seemed to be going somewhere. They were heading toward the right of the tray 157 which is sometimes depicted as the conscious side in sandplay (Bradway & McCoard, 1997). Horses may represent movement and travel. The "horse brings with it new journeys. It will teach you how to ride into new directions to awaken and discover your own freedom and power" (Andrews, 1997, p.282). In many cultures, the horse is viewed as a psychopomp, and in this scene it appeared as i f these horses might have been Brett's spirit guides. Horses may also be viewed as a symbol of masculinity (Matthews, 1993). However, these horses were also being chased by "the Indians", as Brett stated, who were portrayed in a negative role as they aimed their weapons towards the horses. In this role, they seemed to symbolize the negative masculine aggressive energy that Brett was getting away from as suggested by Brett's statement: "The horses are getting away." However, it seemed as though this image showed that Brett was not completely free of this negative, aggressive energy, but was safely moving away from it. The dynamic energy of the horses seemed to indicate that Brett was ready to go forward, possibly with the positive, masculine, flowing energy that the horses could have symbolized, and continue on his path of individuation. Lastly, Brett held a green and yellow bird above the picture which appeared to be a very powerful moment. The bird is often thought of as a spiritual symbol. Birds may represent "Transformation; the soul; a spirit; divine manifestation, spirits of the air; spirits of the dead; ascent to heaven; ability to communicate with gods or to enter into a higher state of consciousness; thought; imagination" (Cooper, 1995, p.20). Adding a second bird to this picture appeared 158 to doubly emphasize this significant symbol. Through the use of the pipecleaner, it seemed as i f Brett was directly connected to its spiritual energies. Concluding Impressions Overall, Brett's final sandplay picture seemed to show many signs of transformation and spirituality. It appeared as though Brett was ready for his next journey. Although there was still negative aggressive energy close by, Brett seemed to be leaving it behind as the horses, his possible spirit guides and symbols o f masculinity, seemed to be leading him to his next destination. Finally, the two birds seemed to suggest that Brett was well protected in a spiritual sense and that a transformation could have been occurring. Particularly for Brett, being diagnosed by one doctor with Asperger's Syndrome and language delay by another, it appeared as though there was much confusion concerning his identity from a medical point of view. Brett was probably sensitive to the fact that he was constantly being assessed and this may have been related to a lack of identity which appeared to be the conflict that he presented and worked through in this deep and powerful sandplay process. BRETT'S SANDPLAY PICTURES 158a Session Six 158b Session Seven Session Eleven (part I) 158c Session Eleven (part II) 159 C H A P T E R S IX : C U R T I S At the onset of sandplay therapy, Curtis was seven years old. At birth he had health problems and remained in hospital for tube feeding for sixteen days. His mother described him as currently having some social interaction problems with boys in particular. He had also been teased by other children when he stuttered but was now able to ignore this. In addition, Curtis was described as being impulsive, talkative, energetic and easily distractable. Curtis began stuttering when he was three years old and his parents have noticed an improvement in his speech pattern since then. He started to receive speech therapy when he was five years old, and at the time of the study he was receiving thirty minutes of speech therapy per week from the school speech-language pathologist. Curtis attended twelve sandplay sessions from February to June, 1998. Curtis created many sandplay pictures during his twelve sessions. Frequently there was not one particular theme for each scene; therefore, an account of the salient actions, statements and images will be described, followed by the Counsellor's clinical impressions and reflections, including interpretations of significant symbols and images from a Jungian perspective. 160 Session One: "Looptey Loop" (wet sandtray) "The Greatest Desert in the Wor ld" (dry sandtray) Session Summary Curtis immediately began the session by molding the wet sand into a sandcastle with a moat. It appeared as though he was fully immersed in the sandplay as he added numerous miniatures, and built various scenes for the full hour. Inside the sandcastle, a king and marbles were buried and Curtis stated "People didn't believe the treasures were there but really they were". In the dry sandtray, Curtis buried a house (top left corner) and poured beach glass over the buried house while stating " It rained rubies, diamonds, emeralds, over there". He then threw the marbles into the wet sand tray and stated " A wizard was casting a spell over there and it was raining and it was hurting the little kids.. there were dozens of them and then the big ones came too". This was followed by soldiers in the wet and dry sand trays who were attempting to dig up the treasures and break up the castle. When the greenery started to "sprout up", Curtis stated " N o one wanted to go near the trees because it might grow on top of them". He then uncovered the gorilla, which he had buried earlier, and used it to "crash around" in the wet and dry sand. The well was added and Curtis poured water into the bucket of the well. A s Curtis added the R I P headstone, he stated that "This guy was not peace." 161 In the dry sandtray, a protective gargoyle seemed to be guarding the buried house and an army tank attempted to climb to the top, but according to Curtis this was "The guy that could never make it to the top." Once our session was over, Curtis stated that he would like to help with the clean up "to help terrorize it a little bit." He stayed for a few minutes to help with the clean up, but used this time to have the elephant and the gorilla "crash around." Counsellor's Clinical Impressions and Reflections After this session, I felt amazed. It seemed as though Curtis' unconscious energies had been overflowing as represented by the numerous objects that were placed in both trays (Kalff, 1993). It appeared as if this must have been a tremendous release and I wondered how much more tumultuous energy was stored inside of Curtis. I was not surprised that he had been described as impulsive, energetic, and easily distracted and I wondered if this distressed emotional state might have also been affecting his speech pattern. The title of the wet sandtray, "Looptey Loop", seemed to refer to the pipe cleaners formed into loops and could have related to the loops and obstacles of his life such as his stutter, and/or the difficulties he had socially interacting. The title of the dry sandtray "The Greatest Desert in the World" may have also been related to Curtis' present life situation. A desert may be associated with images of emptiness, dryness, lack of water and life. According to Cooper (1995), a desert might symbolize "Desolation; abandonment; but also a place of contemplation, quiet and divine revelation" (p.50). Curtis may have been 162 presenting an image that currently reflected his feelings of being deserted such as his lack of social connection with peers. However, the reference to a desert may have also been an indication that he was preparing to reveal and experience a revelation as sometimes happens to people who travel across a desert. Initially, the creation of the sandcastle seemed to indicate a centering process and could have been Curtis' way of accessing his unconscious energies (Bradway & McCoard , 1997). Although these pictures give the impression of confusion, they also seemed to represent a powerful image of Curtis ' unconscious state. Many significant symbols were used and several statements were made that led to a greater understanding of these creations. According to Jung, the image of the king symbolizes the wisdom of the collective unconscious and treasures may symbolize esoteric knowledge and individual development (Matthews, 1993). From Curtis' statement, it appeared as though he was aware o f his inner knowledge, but preferred to keep it buried since no-one would believe him. B y leaving the king upside down, he seemed to be amplifying this belief. The buried house (top left corner) may have suggested that Curtis was not ready to bring his inner being (possibly represented by the house) to the surface. He seemed content to throw treasures at the house which may have been a method for releasing some aggressive energy or an expression o f the hurt that he might have been experiencing. His statement about the wizard's spell and the rain that was hurting the small children seemed to be an expression of hurt that he could have been projecting. The spear like stone pointing at the elephant's 163 ear adjacent to the grey soldier seemed to represent aggression as did the army tank that was trying to climb to the top. Other items such as the railroad tracks that were not connected to each other, or to the railway station (the red and green building in the upper right hand corner) appeared to be a further representation o f Curtis' lack o f connection. The marble in the old piece of wood was described by Curtis as looking like an eye and did not appear to be connected to other items in the picture. The large shell seemed to have no connection to any particular item but could have represented "The feminine, watery principle; the universal matrix; birth; regeneration; l ife" (Cooper, 1995, p. 151). The wheat grinder adjacent to the shell may have been a symbol for a machine that is able to make food and thus provide nurturance i f it contains wheat and is hooked up to the necessary outlets. Trees are often thought of as a symbol o f natural growth and another symbol o f the Self (Kalff, 1980). When Curtis stated that people would not want to be in close proximity to the trees because they might grow on top o f them, he seemed to be implying that i f people came close to him, they might also find him overwhelming. However, his use of another natural force, water, suggested that he might be wi l l ing to access and expose his unconscious energies as symbolized by the well , the water he added to the bucket, the use of the wet sandtray, and the addition of the small shrine which was filled with water (Bradway & McCoard, 1997). The uncovered gorilla which "crashed around" with the elephant could have represented an unleashing of instinctual energy. The word "terrorize" used to describe the actions of the gorilla and elephant seemed to be an advanced word for a seven year old and I wondered i f he had previously been described as a "terror" or as someone who "terrorized". The fencing, walls and umbrellas could imply a need for protection, and the fencing in the wet sandtray seemed to be protecting "the jewels" (crystal and pieces of translucent, colourful plastic)which might have symbolized "treasures to be found in the unconscious" (Bradway & McCoard , 1997, p. 154). These jewels were then exposed by the elephant and the gorilla during clean-up, which might have been an indication that Curtis wanted to show that they were there. The use of the wi ld animals during clean-up might have further indicated that he was connecting to his instinctual energy. The gargoyle seemed to be another protective force that was successfully guarding the house. The thick walls surrounding the volcano and fire appeared to be giving containment to the intense feelings associated with the volcano and the fire. The volcano often symbolizes emotions and anger that have not yet risen to the surface (Bradway & McCoard , 1997). The fire can indicate "burning emotion and inner heat, suffering and pain. But it also signifies cleansing and transformation" (Ammann, 1991, p. 72). The statement about the man who "was not peace" might have been an externalization o f Curtis ' feelings of distress that also seemed to be objectified through the following images: the three crashed airplanes which might have indicated blocked energy (Bradway & McCoard , 1997); the rocket which could have signified a desire to take off; the white heart which has no blood; the fallen horse which is sometimes depicted as a symbol o f instinctual energy; and the random placement of furniture which gives the impression of a dismembered 165 home. The mention of the person that died and the placement of the cross and headstone may have also been an indication that a part of Curtis needed to die before it could be reborn. The isolated axe in the upper left hand corner of the wet sandtray seemed to imply that something needed to be chopped. The quantity o f three appeared several times. In the dry sandtray, three different flags were used. In the wet sandtray, there were three black marbles, three crashed airplanes and three glass cones which may have also been phallic symbols. The rocket in this scene appeared to be a phallic symbol. The number three is often viewed as a powerful number and as representing the masculine and the active (Weinrib, 1983). Dora Ka l f f (1980) emphasized that the number three may indicate how power is going to be accessed. In relation to the number three and spirituality, it often represents the Trinity and thus may be connected to spiritual development (Kalff, 1980). There seemed to be some signs of hope as indicated by the bridges which often imply a desire for connection and a reaching out to life (Dundas, 1990). The different flags might have represented Curtis' confusion regarding his identity (Matthews, 1993) and the totem pole may have symbolized his desire to belong to a group (Weinrib, 1983). The use of the crystals could have represented the sense of Self(Ammann, 1991). The final pictures depicted disjointed themes. The scenes were not cohesive and the wide assortment o f objects were randomly placed. John Al lan (1988) describes this stage as chaos and as a reflection and obj edification of the emotional distress in the child's life and the overwhelmed condition of the child's ego. This is amplified by the use of both the sandtrays. Session Two: "The Crazy Land" (wet sandtray) "The Sand War" (dry sandtray) The use of the two trays, numerous objects and disjointed themes continued. Many objects and scenes were repeated from the previous session such as the crashed airplanes, the gargoyle, the totem pole, the shrine filled with water, the R I P headstone, the beach glass, marbles, the bridges and the rocket ship ready for take off. Many new objects and images also appeared. Curtis began this session with another centering ritual. In silence, he placed the small, plastic bird eggs deep into the center of the wet sand and added four birds. The dinosaurs were then placed in the sand. Many "jewels" were added to this central area as well as several forms of mechanical energy such as helicopters, motorcycles, jeeps, a rocket and crashed airplane. A s Curtis placed a figure on the stretcher (bottom left), he said he was going to make someone die and then he shook the person on the stretcher and said "I 'm injured. I 'm injured". Close by, he placed a cross, headstone, body parts, a red jeep overflowing with sand, and a white jeep that was trapped. He described the jeep as being stuck and having to go through walls. Other salient images in the wet sandtray were the placement of the following forms of homes: the cave, houses, nest, and shrine. In addition, the 167 bridge appeared to have a small amount of water running under it as represented by the blue base. In the dry sandtray, some of the same themes appeared such as the dismembered body parts, cross and headstone, marbles, a bridge and various homes. The centre o f the dry sandtray appeared to be an extremely powerful image. Inside the four walls, amongst the clay bricks were two pieces of crystal and a few marbles. Curtis stated that the surrounding knights were fighting for the crystal but they would get "zapped by the wool" i f they tried to cross it. He placed cannons on the wall and umbrellas to further protect the crystals. Nearby, he added a nativity scene, sleeping angels and praying angels. Counsellor's Clinical Impressions and Reflections Once again, I felt tremendous awe for the power of sandplay and the images that Curtis brought to the surface. The beginning ritual with the eggs felt ceremonial. It appeared to be very important for Curtis who had been described as "impulsive" to center and ground himself through the sandplay. In addition, there is significant symbolism associated with the egg. Dunn-Fierstein (1993) states that to see the egg in the sandtray, one knows that something new and hopeful is within reach. "Initially there may be great chaos just as within the egg all is undifferentiated in its early formation" (p. 64). The addition of the four birds could have represented transcendence and often appear when the child is experiencing some form of transformation (Allan, 1988). The number four is often associated with wholeness, containment and femininity (Weinrib, 1983) and may have related to the close relationship that he seemed to share with his mother. The placement of dinosaurs also seemed significant as a possible representation of primitive energy. The rocket ship and helicopters seemed ready to take off. They may have symbolized a way out from the chaos. The rocket ship might have also signified the desire to explore an unknown world (Navone, 1998). The mechanical energy from the motor bikes, crashed airplanes and jeeps appeared to be blocked. In particular, Curtis stated that the white jeep was trying to break through a wall. Curtis moved the jeep back and forth several times but did not succeed in breaking through the wall . This blocked energy may have indicated blocked energy within Curtis. Curtis' enactment of the dying person on the stretcher seemed to be a form of externalizing his call for help for his injured self. In addition, the scattered body parts may have indicated a feeling of body dismemberment. The nearby cross and headstones might have symbolized a part o f Curtis that was dying. The placement o f several homes suggested the appearance of the Self and the soul (Kalff, 1980) which is an opposite image from the buried house in the first session. This may have been an indication that Curtis was feeling safer to expose himself. The presence of the cave could have been an indication that Curtis was accessing some feminine energy since the cave is sometimes representative of the womb o f Mother Earth and her sheltering qualities (Cooper, 1995). In the dry sandtray, the four walls, red wool, umbrellas, cannons and bricks appeared to be protecting the crystals and marbles in the centre of this 169 image. This seemed to be of extreme significance. The crystal might "correspond to the Tapis' o f the alchemical process, the 'treasure hard to attain', the Self. The alchemists said the lapis consisted of body, psyche, and spirit and was a living being.. crystal is a symbol o f wholeness of the inner, higher personality" (Ammann, 1991, p.64) This would suggest that it was crucial to Curtis that his sense of Self was protected by building a safe container for himself where he felt secure and guarded. The knights and horses seemed to be coming toward this protected area from many different angles. It appeared as though they were full o f aggressive energy, but had not crossed over the red wool and been "zapped". It seemed as though Curtis was still protected but that the aggressive forces around him were attacking. The spiritual figures on the right appeared to be protecting Curtis and these guarded treasures, as they prayed and watched over this central image. In addition, a church was placed within the boundary o f the red wall and seemed to be helping to ward off the negative forces. The many symbols of spirituality may have also indicated that Curtis was accessing his spiritual energies. While I was cleaning up, I discovered a figurine of a praying figure that had been buried face down in the wet sand. I was really struck by this image and wondered i f it represented hope to Curtis at a very deep, unconscious level. Session Three: "The Sign Wor ld" (wet sandtray) "The Crazy Desert Land" (dry sandtray) Curtis began this session by adding water to the wet sand. This was followed by another centering ritual of piling the sand into a central mound which he stated was a volcano. He attempted to make a bridge out of the wet sand and then dumped all the marbles into the crater and threw the beach glass and clay bricks onto the side of the volcano. A s the three airplanes, three helicopters and three glass cones crashed into the side of the volcano, Curtis stated "Everything's landing into the volcano and it's going to blow up." In addition to the volcano made out of sand, Curtis also placed the paper mache volcano along side. He filled this volcano to the brim with sand. The recurring theme of blocked mechanical energy was depicted in this picture by the crashed airplanes and helicopters, and jeeps that were obstructed by road blocks. Curtis attempted to move the jeep back and forth but it was trapped. In addition, a motorbike was stuck in the sand and many road signs and cones were placed all around the volcanoes and the variety o f vehicles. In this scene, Curtis used more forms o f vegetation and added a small house surrounded by water. He added another form o f nature: a large rock; and he dumped a pile of wooden popsicle sticks next to it, with a square shaped formation made out o f popsicle sticks on top. Lastly, the small shrine, cross, 171 headstone, and gargoyle were added and had been used in his two previous sessions. In the dry sandtray, a spiritual place evolved consisting o f a nativity scene that was buried in the top right corner and a cross and headstone which were placed on top. To the left, a glass "crystal" (as Curtis described it) and some purple flowers were placed. The praying angels and dream catcher were placed at the bottom of the hi l l and the totem pole, egg and helping forces such as the police and paramedics were close by. A variety o f homes reappeared. Many houses were scattered close to the centre and the big old house in the top left screen that had been completely buried in the first session was positioned in the identical place but this time it was only covered partly by shells. The shells and the surrounding marbles were thrown at the big house. The clay walls were recurring objects from the previous two sessions. A s Curtis was carrying the thinnest wall to the sandtray, he accidentally dropped it and it cracked. He immediately looked at me for my reaction, and I reassured him that accidents sometimes occur. He then stated that it looked "cool" and "no wonder" it broke, it was "the skinniest one". It appeared as though Curtis did not want to accept responsibility for this accident and preferred to dismiss any negativity related to this incident. The final salient image that appeared to be a separate scene and consisted of the snake biting the man's foot. The man was standing next to a red car that was not able to make it up the ramp. 172 Counsellor's Clinical Impressions and Reflections After this session, I felt as though Curtis was comparable to a volcano. His desire to fill the two trays without much order and his impulsive urge to throw objects such as the shells, clay bricks and marbles reminded me of an overflowing volcano. I was thankful that he had a safe container where he could release these energies and I also wondered how much more overflowing the volcanoes needed to do. The double image of the volcanoes and Curtis' need to throw objects at and into the volcano seemed to be the most striking image. Harriet Friedman, a Sandplay Therapist at the International Sandplay conference, 1997, referred to double items as "The Power of the Pair". She stated that it is as i f the image is being underlined. Thus this image strongly suggested that pent-up emotions were about to burst through the surface. Three airplanes, three helicopters and three glass cones all crashed into the side of the volcano. Ka l f f (1980) described the number three as being a very dynamic number that contained a clue as to how some power was going to be accessed. The quantity o f three is often representative of the masculine energy (Weinrib, 1983). Curtis' sense of masculinity may have been portrayed through the crashing of these three groups of three items. In addition, all the blocked locomotive energy in the forms of jeeps, airplanes, helicopters and road obstacles seemed to indicate that Curtis had accumulated a lot o f blocked energy that needed to be released. 173 The water added to the wet sand as well as the exposure o f the blue base representing water seemed to indicate that Curtis was accessing his unconscious energies (Bradway & McCoard , 1997). The house which may symbolize the Self (Kalff, 1980) was surrounded by water and a large amount of vegetation was present which could have also been indicating some natural growth (Bradway & McCoard , 1997). Other possible symbols o f the Self were close by, such as the large rock (Dundas, 1990) and the square structure made out of the popsicle sticks. The square may indicate a symbol o f wholeness (Kalff, 1980) and this square popsicle stick formation could have been giving the impression that some order was starting to develop out of the chaos represented by the heap of popsicle sticks below. The ambulances and police motorbike are vehicles that are operated by adults who help those in need and thus may represent helping forces. They were also close to the angels which may be considered guardians or guides. The nearby "crystal" (piece of glass) was left exposed but seemed to be safe on top of two thick walls with the ambulances and police in close proximity. This could have been an indication that Curtis, possibly represented by this crystal, was sensing that there were helping forces nearby, but he still needed to be protected and in a sheltered place above the confusion, away from the negative forces and close by to the purple flowers. Flowers are often seen as a feminine symbol that may also represent "the fragile quality o f childhood or the evanescence o f life" (Cooper, 1995, p. 70). Curtis was a fragile child at birth when he needed to be 174 tube fed, and seemed to still be fragile as he experienced difficulty in social interactions and appeared to need external limits. The totem pole may once again have been signifying identity and the desire to belong to a group. The totem pole is also similar to a cross which is a sign of the trinity and the integration of mind, body and spirit. Nearby, the image o f an egg reappeared and could have been an indication o f re-birth. It could have also been another sign of emerging wholeness because "within the egg all is undifferentiated in its early formation" yet "it contains everything necessary to create a completely new entity" (Dunn-Fierstein,1993, pp.64-65). The appearance of the cross was another significant symbol that could represent order. Weinrib (1996) quotes Jung's belief about the cross, "Its meaning is that of a central point defined by the crossing of two straight lines...The cross signifies order as opposed to... disorderly chaos...In the psychological processes it functions as an organizing center and in states of psychic disorder caused by an invasion of unconscious contents, it appears as a mandala divided into four" (p.24). In Curtis' sandplay, the cross may have been another indication that some order was beginning to emerge out of the chaos. The theme of homes, in particular the big old home that was previously buried in a former session, could represent the presence of the Self (Kalff, 1980). There were many shells on and around the house which Curtis threw. These may have symbolized the feminine (Cooper, 1995) and possibly some anger as suggested by the aggressive throwing. The marbles that were referred to earlier as "treasures", perhaps the treasures o f Curtis' unconscious, were also left exposed. Finally, the snake could have been a sign of transformation and healing (Ammann, 1991), as well as death and rebirth symbolized by the shedding of its skin (Andrews, 1997). The snake in this scene appeared to be eating the person's foot. Snakes often use their venom and bite to protect themselves, (Andrews, 1997) thus this could have indicated that Curtis may have been feeling threatened by a person or humans in general. The snake appeared to look threatening in this scene, and this was the first time that Curtis used a human figure who was not in armor. This may also have signified that he was feeling safer to expose himself and portray his feelings. Session Four: "Wet Water Wor ld" (wet sandtray) "Crazy Sand Pictures" (dry sandtray) Curtis began this session with another centering ritual. He used the cave as a shovel and made a circle in the wet sand. He then buried and unburied the blue egg several times before leaving it unburied in the dry sand. The last part of this centering ritual involved building a sandcastle in the center of the wet sandtray which he then punched and flattened. Once he appeared to have finished this initial ritual, he went to the bathroom. Once again, the small pieces of beach glass were thrown into the wet sand and then patted down. This was followed by several acts of dumping throughout the session. The houses were dumped into the tray; some were buried and others were left unburied. A s Curtis uncovered one o f the houses, he stated "Yay , I 'm free". The popsicle sticks were also dumped into a corner of the dry sandtray with 176 some being carefully placed to make "a little round circle" in the corner of the wet sandtray. The clay bricks, rocks, pom poms and candles were also dumped into the trays. Curtis threw the marbles into the trays again, but this time he made targets using spiritual items such as the Mary statue, the headstones and crosses, the totem pole, the Kachina, and a soapstone carving. As he aimed for the totem pole, he knocked a wing off and stated "Oopsies, I knocked it off... oh well , it looks kind of neat and then all you have to do is break off the other one and it wi l l look like a normal statue." It appeared as though Curtis seemed to be covering up any negativity associated with this incident. In addition, when he noticed that I had glued the wall back together he told me that it looked "gross" which seemed to indicate that he was feeling uncomfortable that I had had to fix something that he had broken accidentally. After breaking the totem pole, Curtis continued to throw marbles at the targets which meant that I had to set limits, especially when he expressed interest in throwing the very large black marble. After this final limit, he discontinued throwing. The rocket, big rock, glass cones, small shrine, four clay walls and two crosses were recurring themes from his previous sessions, although the rocket was now placed upside down and Curtis stated that the rock and the rocket were both going to blow up. The crosses were placed side by side which seemed to give them extra emphasis. <y 177 The other distinctive image in the wet sandtray was the presence of many animals. There was a mixture of an eagle with wi ld , prehistoric, and marine animals. Birds also made a strong presence in the dry sandtray. There were no birds in the nest but there were several birds on the two bridges which were placed over two empty plastic containers. Another spiritual scene was created in the dry sand. Curtis grouped sleeping and awake angels and the nativity scene together. He placed the blue egg close b y , which was another repeated item from the previous week's session. To complete his sandplay, Curtis used a washable marker to draw some lines on one piece of paper and a smiley face on another. He then dipped them in water to smear them a little and placed them across from each other diagonally in the wet sandtray. Counsellor's Clinical Impressions and Reflections During this session, I felt uncomfortable when I had to limit Curtis from throwing the marbles. I did not want to restrain his unconscious energies but I also realized that he needed to know that there were still boundaries with the sandplay. I sensed that Curtis was testing the limits. Thus this may have been his way of asking for limits to give him a greater sense o f security and control. Once again there was much chaos in his play, but there were also many signs that he was experiencing some healing and moving toward another stage. The beginning ritual involving the formation of a circle could have been an indication of some wholeness that could have been developing (Kalff, 1980). However, he did not leave the circle intact as he began to flatten the sand with the beach glass. Flattening could be "indicative o f the desire to control emotions, or ... o f fear from unconscious material which produces an obsessive defense" (Kalff, 1993, p. 22). His need to go to the bathroom may have been indicative of a psychological as well as physical clearing of waste (Macnofsky,1996). The dumping o f various categories of toys seemed to be a part of his state o f chaos (Allan, 1988) as well as a release of energy which seemed to be apparent in many forms throughout the session. For example, Curtis' comment that he was free as he turned over some houses seemed to indicate that a part of his Self, which could have been represented by the houses, was now present. In addition, the throwing of the beach glass and the marbles seemed to be a release of aggressive energy toward the spirits. He stated that the rock and the rocket were going to blow up. Some o f this energy may have been the product of built up emotions that Curtis had seemed to contain in the two volcanoes in the previous session. Although he was firing at some spiritual symbols, there also seemed to be a positive connection with his spiritual energies through the use of the crosses, the Virg in Mary and the nativity and angel scene. These symbols may have provided him with some solitude amongst the chaos that he seemed to be experiencing. The group of rocks could have represented more symbols o f the Self and could also be a symbol for hidden beauty since they are often dull on the outside but shiny and beautiful i f they are split open, polished or wet (Dundas, 1990). The use of the four clay walls was different in this session. Although it appeared as i f Curtis still needed them, they were separated and could have still been offering protection but now there was more space between them. This could have symbolized that Curtis' walls were also opening up. The strong animal presence seemed to indicate that Curtis was connecting to his instinctual energy as well as releasing more aggressive energy. Kal f f (1980) also states that the presence o f animals and vegetation are a sign that the child is experiencing the initial stage of ego-development known as the animal-vegetative stage. Thus, this first use o f animals appeared to be extremely significant as a beginning stage of Curtis' ego-development. The many birds could signify that Curtis is experiencing a transformation. Birds may be a spiritual symbol for one's soul and can indicate movement toward a more mature stage (Allan, 1988). Bradway (1990) states that during a period of transition, "the ego needs an additional supply o f energy in order to cope with the struggle between inner and outer forces. Another object used during this period, although not solely in this period, is the bridge, which indicates an attempt to make connections between opposing parts of ones' s e l f (p.97). This may be the intention of Curtis' use of two bridges. On the left side o f the bridges there were walls which could represent obstacles and fallen over houses while on the other side of the bridges there were upright houses, angels and an egg. In addition, perhaps the bridges were raised in order to access higher energy or to be further away from the chaos below. Bradway states that it is important to pay attention to objects that are on a diagonal as they may signify a struggle or an issue that is being worked on 180 (Bradway & McCoard , 1997). The pieces of paper may have represented the presence of opposing forces between the smiley, orderly side of Curtis versus his chaotic side. Session Five: "The Wet Land" (wet sandtray) "The Dry Land" (dry sandtray) Once again Curtis began with a centering ritual as he took the beach glass and marbles and buried them in the bottom left hand corner of the wet sandtray, and dumped the glass cones and plastic crystals into the right hand corner. He then made a big sandcastle in the middle of the tray using all o f the sand. Next, he threw marbles which he called "junk" at the mound of sand. He pushed some marbles into the sand and pushed a glass cone all the way through thereby creating a tunnel. A s in the last session, he then went to the bathroom. Upon returning to the sandplay, he was focussed on shooting marbles through a tunnel in this central mound of sand. Sometimes, the mound would fall apart and then he would rebuild it and continue to shoot the marbles through to the other side and sometimes completely out of the sandtray. It appeared as though Curtis was unblocking the marbles. Once after rebuilding the central mound, Curtis stated that that was "The B i g Bridge." A s the end of the session approached, I stated that there were ten minutes left and Curtis seemed to be very surprised. He walked over to the miniatures and noticed that I had glued the wing back on to the totem pole. He said "Glued, 181 shmooed, I don't care i f it 's glued or not." This was the second time that he had tried to dismiss the repairing that had taken place on an item that he had broken. He then added animals to the central mound of sand and lots of water. He discovered that as he dug deeper and deeper he could reach the "mud." He said that the elephants were falling down into the dead and then covered the baboon and elephants with mud saying " Y o u can't breathe in this stuff.. help I 'm sinking I 'm sinking." Knowing that our session time was over, Curtis quickly made a scene in the dry sand using green vegetation with a little of the blue base showing. It seemed as though he wanted to continue even though I re-stated that our session was finished. Counsellor's Clinical Impressions and Reflections The previous session had suggested that a transformation could have been occurring and indeed, this sandplay session seemed to show a shift in Curtis ' process. After this session, I felt amazed by the apparent shift that had taken place in Curtis' sandplay. It appeared as though the throwing o f marbles and building of tunnels at the beginning o f the session had made way for his unconscious energies to flow and express themselves in this seemingly regressive state which could have been represented by the mud. Curtis appeared to be accessing the alchemical prima materia, the primal origin o f all being (Matthews, 1993). The unconscious depth may have been too much for him as indicated by his comments that he was sinking and, consequently, he may have finished in the 182 wet sandtray and moved to the dry sandtray to create a more positive image and feel grounded before leaving. The wi ld animals, shrine, marbles, glass cones and plastic thumb seemed to have all been mixed in with the mud. It appeared as though Curtis may have needed to contain the instinctual energies, which might have been represented by the wild animals, by covering them with the wet sand. The combination of the dry sand and wet sand pictures seemed to be representative of K a l f f s (1980) animal-vegetative stage which could have been another indication that the ego was in its first stage of development. These two trays seemed to represent a presence o f opposing forces which was further exemplified in their titles. The desire to stay beyond our appointed session time may have been a sign of Curits ' emotional neediness (Navone, 1998). Session Six: "The Wet Wet Lands" (wet sandtray) (no title given for the dry sandtray) Curtis began the session with his familiar centering ritual, creating a mound of sand in the middle o f the wet sandtray. He then converted it into a wall, a similar structure to last session. A s in the previous two sessions, he then went to the bathroom. Upon returning, he squeezed some marbles through a tunnel, until the structure resembling a bridge collapsed. At this point he decided to make a " M u d Land." He added a lot of water to the sand, and placed a hippo in the mud, stating "Help! Help!" He then added a big giraffe and completely covered it with sand. 183 He placed some balloons on top of the covered giraffe. He went to the bathroom again. After he returned, he grouped the beach glass together and left it exposed and adjacent to the castle. Next, Curtis stated that he needed a bandaid and could not play in the wet sand anymore because it was irritating a cut in his finger. I gave him a bandaid and he stated that he was "probably going to stay five to ten minutes extra" because he had had to go to the bathroom and get a bandaid. I stated that our session would still be finishing at the original finish time. He responded by saying that soon he was going to be getting really tired because he would be starting baseball twice a week and therefore he might not be able to come to sandplay. It appeared as though this was a manipulative tactic to spite me because I had stated that our session would not be extended. Curtis moved over to the dry sand and as he placed the old house in the top left corner he stated "I don't really want to be making any mud things anymore." Meanwhile he buried the big old house with sand and placed it in the same top left corner that he had in previous sessions. In addition, he placed protective walls by the house. He threw some marbles at the house and noticed that they sank into the sand and disappeared. This was followed by him playing with some cars on the floor and another bathroom visit. After returning from the bathroom, Curtis finished his sandplay by placing many vehicles together in a group. Upon leaving the session, he destroyed his pictures by knocking over the castle, the balloons and the buried giraffe in the wet 184 sandtray as well as knocking over the vehicles and pulling the old house out of the dry sandtray. Counsellor's Clinical Impressions and Reflections Curtis seemed to create a similar scene to last week which could have indicated that he was prepared to re-access potentially deep and regressive energies. The fact that he went to the bathroom three times may have been indicative of psychological and physical waste that he was clearing or he could have been testing the limits to see i f there would be consequences. The presence of the wi ld animals could suggest that Curtis was connecting with his primal instinctual energies. The call for "help" by the hippopotamus may have been Curtis' call for help. As a symbol, the giraffe sometimes represents far-sightedness, the ability to see what is ahead (Andrews, 1997). It could have been that at some level Curtis was not ready to see what was ahead for him and therefore he covered the giraffe. However, the addition of the balloons could suggest rising energy (Lauren Cunningham, International Sandplay Conference, 1997). Curtis may have been preparing to bring the giraffe's energy and far-sightedness to the surface. Furthermore, the "jewels" were exposed which could have represented Curtis' willingness to share his treasures. They might have been placed by the castle in order that they would still be protected. In the dry sandtray, the buried house and marbles seemed to indicate that Curtis was needing to cover up and feel less exposed. The numerous blocked vehicles seemed to signify that the unconscious energies had stopped flowing and were blocked. It appeared as though the dry sandtray was providing some 185 containment for the connection with the unconscious energies which Curtis may have experienced in the wet sandtray. Curtis' desire to destroy his creation as he left could have reflected some anger toward me for not allowing him to extend the session. At an unconscious level, it may have been Curtis ' way o f destroying his original ego (Dundas, 1990). Also, he may not have been ready to have witnessed what he had just created. Dundas (1990) states that it is very important to note what the child creates following the destruction of a sand picture as it w i l l signify "what is to be renewed after the old ego is destroyed" (p.20). During this session, I felt uneasy regarding Curtis ' comment that he might not attend next week's session due to predicted tiredness. I realized that at some level he may have sensed that it was important to me that he attend our sandplay sessions for completion of my study. Also he may have sensed that some very deep healing was occurring and I wanted him to continue to benefit from the therapy he had started. I was aware that he seemed to use this same behaviour with his mother. When she tried to set limits, he seemed to react and think of a manipulative solution to get his own way or upset her. The following week Curtis did not attend his sandplay session. His mother telephoned and explained that he had had a very upsetting week at school and that he was "falling apart." She seemed to be very distressed and told me that his teacher at school had become so frustrated with him that she had dumped all his belongings from his desk on the floor. When his mother arrived at school to pick him up, she found him crying under his desk, surrounded by his belongings. 186 Curtis' mother wondered i f it would be better for Curtis to discontinue his after school activities to give him some quiet time, but I encouraged her to continue to bring him to sandplay since he seemed to be experiencing healing at a very deep level. I also stated that he may have needed to release his feelings from the humiliating incident he had experienced at school. His mother agreed and brought him to the next session. Session Seven (no titles given) Curtis began by throwing marbles into the sand with a lot of force. He then built a mound o f sand in the centre of the tray and threw the beach glass at the mound. Next, he buried the "Rest in Peace" headstone and crosses while saying "Rest in Peace, Rest in Peace." This was followed by him creating a "digging tool" out of popsicle sticks and masking tape, for digging, scooping, flattening, smoothing, and reaching in the corners. He seemed proud of his tool. As he walked over to the shelves, he noticed some new items and then knocked over the toys on the shelves while making sounds like a monkey. Curtis stated " Y o w I 'm making a mess!" and seemed to be thoroughly enjoying himself. He added the new tin soldiers to the mound of sand and poured water on top of them while saying "Aaah, it's raining, oooh oooh, ouch." He then went to the bathroom. When he returned, he added a lot more water to the wet sandtray and stated that he was "Back in the mudlands." He then began to dump some toys into the tray and stated "Dump dump everything. N o w you're going to have to do 187 some sorting." He continued to dump toys and add water and stated that this was "The Busy Land." He also stated that this would make his mother mad because he had made "messes" like this in his house and they were five times bigger than the pile that was forming in the sandtrays. Curtis continued by sweeping the shelves with the dustpan and brush. After he had dumped every single item into the two trays, there were still ten minutes left and he decided to move the furniture around and upside down. He took the shelves out of the cabinets and put the tables on their sides. He then decided to hide himself inside the cabinets in order that his parents would have to look for him. Counsellor's Clinical Impressions and Reflections Although I had predicted that Curtis may have needed to express his upset feelings from last week's incident through the sandplay, I was still taken back by the content of this session. I was thankful that Curtis' mother and I had communicated in such detail before the session and that she and Curtis' father were somewhat mentally prepared as they entered the room at the end of the session. I was also able to quickly warn them that Curtis had turned the room upside down before they entered. They continued with their usual routine of asking Curtis about his creation and did not make any judgmental comments. Later, Curtis' mother and I spoke and she stated that she realized that this had been a therapeutic experience for Curtis and was particularly amazed that he had almost reenacted what had happened to him at school. 188 It was a profound experience for me to witness Curtis ' release of seemingly aggressive energy and emotional turmoil. As he began his dumping, he looked at me and seemed to be watching for a negative response. I reflected his actions and continued to provide a safe container for him as he continued to dump. It seemed as though the volcanoes, the blocked locomotive energy, and the aggressive animals from previous sessions had now expressed themselves in full force in this session. June Singer states " . . . what would there be to put in order i f there were nothing but emptiness? Chaos is the potency that exists in the V o i d . . . The V o i d of the Chaos is the starting point for nearly all creation mythology" (Singer, 1989, p.34). It appeared as though the previous sessions had been the preparation for this expression o f chaos and I wondered i f some order may begin to evolve from this climacteric. Throughout this process there seemed to be some significant symbolism occurring. As Curtis buried the head stones, he had chanted "Rest in Peace" which could have been an indication that he had the desire to bury any symbols associated with peace. Furthermore, the dumping of all the objects, followed by the cleaning of the shelves could have been representative o f a cleansing of himself. Lastly, Curtis ' wish to hide inside the cupboards while he waited for his parents may have been his way of protecting himself since he had already stated that this would make his mother angry and he was probably concerned about how both o f his parents would react. 189 Session Eight: "The Cat Head" (first image in the dry sandtray) "The Sun" (first image in the wet sandtray) (no titles given for the second images in the dry and wet sandtrays) Curtis began this session with a different ritual. He flattened the dry sand and the wet sand using the big rock. He discussed the last session when he dumped all the toys into the sandtrays and stated "I was a little hard on you last time." He also commented that it had probably taken a long time for me to clean up and I told him that it was okay in the sandplay room and that this could be part of sandplay. In the dry sandtray, he proceeded to make "The Cat Head" from the opposite side of where he usually stands. In the wet sandtray he returned to his usual standing position and created "The Sun." Curtis then added dry sand to the wet sand to make the sun image and added the marbles which in previous sandplays he had referred to as jewels and had frequently chosen to bury. After I had taken the photographs, Curtis "wiped out" the pictures and added more water to the wet sand to make a "wetland." He then threw several animals into the tray but was discerning about which items were not appropriate for sitting in the water. This was the first time that I had observed Curtis taking responsibility for some of the toys. He threw the gorilla into the water and moved him around in the sand while stating "Bury it, bury it, move it buster, move it right now, ouch, ouch" (as he threw marbles at the gorilla). As he threw the marbles in, he stated that the big 190 black one was an incoming bomb. He added the heart and eyeballs. A s he picked up the frog, he squeaked it and said "Shut up you dumb frog or I ' l l kick you in the head. .1 said be quiet." He described the airplanes, helicopter, and skeleton as crashing as he threw them in. As Curtis continued to throw objects into the tray, I had to set limits about the amount of splashing. He then went to the dry sandtray and used the fences to make some shapes such as a square and a triangle which he buried under the sand. Meanwhile, in the wet sandtray the fences were added and Curtis stated that "no-one, nothing is allowed in this territory." As he added the popsicle sticks, their colour started to wash away and Curtis stated "So what i f they're white, it doesn't matter right?" He tried to add dry sand to the wet sandtray and twice I had to state that the dry sand needed to stay in the dry sandtray. He then placed the bridges in the water and said "bury the bridge, bury the bridge." The egg reappeared in this session and was placed in the center of the wet sandtray. For the first time, at the end of the session Curtis decided he was finished and proceeded to walk into the waiting room and draw a picture of circles while waiting for his mother. Counsellor's Clinical Impressions and Reflections Once again I felt uncomfortable about setting limits because I wanted Curtis to be able to express himself freely. On the other hand, I was aware that I needed to set limits to maintain my comfort level and the strength of the therapeutic container as well as my ability to provide unconditional acceptance. It also seemed as though Curtis could have been testing the limits to show that he 191 needed these kind of boundaries in his daily life. After this session, I spoke to Curtis' mother about his limit testing and she stated that this was a regular behavior at home. I then talked to her about the importance o f consistency and boundaries and gave her some psycho-educational resources to read. A week later she stated that she was trying to implement some of the suggested techniques. This was the first session where Curtis had begun by flattening the sand with the big rock. After such a seemingly emotional release in the previous session, it seemed as though Curtis could have been trying to control his emotions and unconscious energies by flattening the sand down (Kalff, 1993). His comment that he was a "little hard" on me seemed to be an indication that he was feeling badly about dumping the toys. The cat and sun images that were produced at the beginning o f this session felt very sacred. It appeared as though they were showing the order which had emerged from the previous chaos. It also seemed significant that the images in their separate trays were facing opposite directions. This appeared to indicate that opposites were present but not yet ready to be united. The cat may have many different symbolic meanings, but as a domestic animal can represent the instinctual and feeling sides o f oneself (Bradway & McCoard, 1997). In some cultures, the cat represents bad luck but in others such as the Japanese culture the cat is seen as having powers of transformation (Cooper, 1995). 192 The sun is considered to be a very important symbol in most traditions. The sun is often seen as an image of God (Matthews, 1993). The sun could also be "the supreme cosmic power; the all-seeing divinity and its power... enlightenment" (Cooper, 1995, p. 162). Ruth Ammann (1991) states "The sun is our source of light and warmth and represents our life energy.. the sun symbolizes simultaneously the power and the effect which emanate from one's true being" (pp.58-59). Furthermore, the dry sand, which Curtis added to the wet sand to make the sun image, could have been a sign of a presence of opposites. The marbles, could have been "the jewels" that he had referred to in earlier sessions and he may have felt safe exposing them within the light and energy of the sun. The "wiping out" of these pictures, followed by the addition of water and several animals, seemed to signify that Curtis could have been accessing his unconscious and instinctual energies. The throwing of the "bomb" and "crashing" of various objects also seemed to be a sign o f a continued release of aggressive energies. Furthermore, the throwing of objects and comments to the frog appeared to be representing aggressive forces. The shift to the creation of shapes in the dry sandtray seemed to be another representation of order. KalfF (1980) stated that shapes such as the square and the circle occur when the psyche is expressing wholeness. The circle, triangle and square are original forms of the universe according to the Zen tradition (Kalff, 1980) Curtis created a triangle and square with the fences, and a circle in the sand 193 pictures of the sun and the cat, and the picture of different coloured circles that he drew on paper at the very end o f the session. The theme o f protection seemed to arise again as Curtis fenced off diagonally opposite corners and stated that this territory was out of bounds for everyone and everything. B y burying the bridge, it appeared as though Curtis was not ready to make any connections at this time. Although the final picture once more depicted chaos, I felt hopeful that the image o f the egg in the center of the tray could have indicated that "something new and hopeful is on the horizon. The egg carries the new life or new attitude towards something (Dunn-Fierstein, 1993, p. 64). In addition, the sandplay of the cat, the sun, and the geometrically shaped fences seemed to indicate that out of the chaos some semblance o f order was emerging. It also appeared to be a positive sign that Curtis was able to end the session when he was ready, as opposed to other sessions where he had tried to add as many toys as possible, up until the last minute of the session. It could have been that his mother's attempt to set consistent limits at home was having an effect. Curtis' picture of circles seemed to be another sign that order was slowly emerging. Session Nine: "The Great Flood" (wet sandtray) Once again, Curtis began this session using the big rock to flatten the wet sand and then he placed a group of trees in the bottom left corner, carefully 194 covering their roots with sand. Next, he made a small moat around the trees. After making this scene, Curtis went to the bathroom for quite a long time. When he returned, he built " A Wal l o f Fear" in the upper right corner. He said that people think there is a dragon there and that no-one had ever entered this area. As he poured a lot of water into the tray, he stated that he was going to break the wall down. He used marbles and beach glass as objects to throw at the wall and then announced that there was an earthquake. He proceeded to knock over all the trees in the forest, but suddenly stopped because he said the sand was getting in to his bandaid. After this sudden shift, Curtis moved to the dry sandtray where he buried some small pink abstract figures. He then used one as a spinning top and asked me to take a picture of it spinning. He enjoyed spinning this object and it seemed to give him a break from the intense play that he had just experienced. The rest of the session was spent at the tables where Curtis made a ramp for the cars to shoot off and onto the chair. He threw other items off the table too. He thought about using the shells but I stated that these could not be thrown as they would break. He returned to the dry sandtray and placed the fences in the tray, dumped the popsicle sticks in, and used the dustpan to play with the sand where the pink figures were buried. This appeared to be disorderly play that had followed the throwing of the objects off the table. Once it was time to leave, Curtis wanted to stay and throw more toys off the table and I had to set limits about our session time being over. 195 Counsellor's Clinical Impressions and Reflections During this session, I felt uneasy about the toys being thrown around the room. Although the room was also a container, it was a larger container than the sandtrays and it seemed that Curtis was testing the size of the container. It felt as though he was continuing to let me know that he needed limits to be set and appeared to be acting out the relationship that he has with his mother. During the week, I spoke to his mother again and supported her in her limit setting and decided that in our future sessions I would not allow Curtis to throw the toys around the room as he seemed to need a smaller container. A s Curtis planted the trees, he took great care to cover the roots which seemed to signify that the trees were secure in the ground. Trees are often seen as a symbol o f the Self and of natural growth, thus these well planted trees may have been an indication that Curtis was feeling more grounded (Kalff, 1980). In addition, the creation of the moat around the trees could have signified that Curtis was accessing his unconscious energies (Bradway & McCoard , 1997). Curtis' unexpected halt in his sandplay seemed to indicate that a sudden shift had taken place in his psyche. Breaking down the Wal l o f Fear and knocking over the trees amongst the wet sand and water may have been the most that Curtis could process at an unconscious level for this session. In particular, the Wal l o f Fear sounded as though it was a scary place that he needed to confront. It appeared to be territory that neither he nor anyone else had faced before. It also seemed as though it had been wel l protected by the dragon, but as 196 though the time had now come to conquer the protective dragon and find out what was behind the wall . The sudden shift to the dry sandtray seemed to be Curtis' way o f grounding himself. He moved the sand to one side to expose a lot of the blue which could have represented a connection with the unconscious energies. The spinning of this miniature spinning top could have his method for regaining balance and feeling centered. This scene was followed by a move away from the sandtrays, which may have been a further indication that Curtis was needing to be in a more conscious realm. A s he played with the cars off the table, I was feeling uncomfortable. However, I did not set a limit since the cars were not breaking and it seemed as though this was a safe method for Curtis to release energy. The last play that occurred in the dry sandtray seemed to symbolize chaos but not to the same extent as previous scenes. The protective fencing and popsicle sticks seemed to be in disarray with the exception o f one fence that appeared to be protecting the left side of the tray. The pink abstract figures remained buried as though they were not ready to come to the surface. Session Ten (no titles given) For the third continuous session, Curtis began by flattening the wet sand. He poured water into the centre of the tray. He moved the wet sand with his hands and moved it all around. He buried some of the tin soldiers in the upper left corner and then dumped the vehicles into the most watery area o f the sandtray. 197 He then began to shoot some cars toward a ramp that he had made from the wet sand and I stated that the toys needed to stay inside the sandtray. He seemed to accept this limit without testing it. He showed responsibility toward care for the cars when he asked i f they would rust i f they went in the water. He added the boats and then went to the bathroom. After returning, he placed the police car, sheriff car and health unit on top of the big red rock to keep them dry and safe from the big jellyfish that was close by. Some other vehicles that were helping forces too were left in the water. Curtis added many rocks, and showed me how they were all shiny when they were wet. Into the dry sandtray, Curtis threw some marbles and two plastic eyeballs and with those that fell on the floor, he picked them up and threw them again. He also tested the clay bricks in the water to see i f they would dissolve. Once he discovered that they would, he used them in the dry sandtray. Once again, he seemed to be less impulsive and more considerate of the materials. In the bottom right hand corner of the dry sandtray, Curtis placed headstones, crosses, and a white heart. These items were buried with sand until only their tips were showing and then they were surrounded by a wall o f bricks. He used the dustpan as another ramp for various vehicles and then pretended that the jeep was flying through the air, but he continued to hold it while it was flying. Lastly, he placed several people figures inside the cave and trapped them there. The people were all on top of each other and Curtis left them this way. 198 Counsellor's Clinical Impressions and Reflections During this session, I felt that Curtis was respecting the limits that I had set. The throwing of marbles seemed to producea therapeutic effect and appeared to facilitate a release of energy. Although the final scenes still depicted some chaos, there seemed to more order represented in the graveyard scene and the grouping of vehicles, and rocks in the wet sand tray. In addition, it seemed to be a positive sign that Curtis was keeping these helping forces dry and safe from the stinging jellyfish. The use of the rocks could have been a symbol for the Self (Dundas, 1990). Curtis may have been showing the hidden beauty o f himself as he showed me how polished and shiny the rocks could be (Dundas, 1990). The theme of blocked locomotive energy reappeared in this tray and seemed to indicate a possible block of energy within Curtis. The buried tin soldiers in the upper left hand corner could have been there for protection, but since they were buried it appeared as though they were not needed at the present time. In the dry sandtray, the crashed vehicles seemed to be another representation o f blocked locomotive energy. A l l the cars that were going down the ramp (dustpan) into the blue base may have been an indication that a part of Curtis was accessing his unconscious energies. The area with the gravestones in the bottom left hand corner could have been an indication that a part of Curtis was dying. The clay wal l could have been built for protection of this process and the white heart, which would probably have no blood and thus no feeling, could have symbolized that this part o f Curtis was no longer alive. 199 The people who were pushed inside of the cave appeared trapped. They seemed to be in a state of confusion as they lay in a pile and I wondered if Curtis felt as though the prominent figures in his life were also topsy-turvy. Session Eleven: "Same Team War" (wet sandtray) Curtis began with his familiar ritual of flattening the sand with the big rock. He then began throwing the marbles into the tray from a far distance and I set limits as I was worried that he was going to hit the two way mirror. He stated that he had pretty good aim and I restated my limit. He then used the big rock to smash the marbles into the wet sand. Next, he buried the skeleton and placed the "Rest in Peace" headstone and the cross in the tray inside a circle that he had made with his finger. He continued to use the big rock to smash the tin soldiers into the sand. This aggressive act was followed by Curtis knocking over the toys in the cabinet while making "aahh, aahh, woo, woo" noises. Curtis then began to play on the floor with some vehicles and I reminded him that the toys were for using inside the sandtrays. Suddenly, a dramatic shift seemed to occur as he retrieved the bag of pink abstract figures and began lining them up in the wet sandtray. He added some vehicles, knights and horses, cowboys, American Native Indians and army figures. As he placed the knights in the sand he stated "they want to take over the world but they can't." He also, very carefully, added small weapons (that had come with the kit) to as many knights as possible After a period of silence and deep concentration figures as he added all the figures, he stated that it was a war and that they were all on the same team. 200 He wrote this information on some paper, made an "arrghhh" noise as he placed an army figure in the sand and looked over at me. He then went to the bathroom. He quickly returned and continued to add army figures. He took some trucks and the big rock out. He put the stretcher in and stated that "one guy got hit" as he placed him in the sandtray. He then placed two soldiers holding the stretcher, buried the skeleton, but stated that he was going to keep the RIP sign. Next, he added the horse carriage and wagon, and army vehicles with cannons which filled up the sandtray. He then added the three glass cones and stated that they were an emblem that meant "Good Luck." The blue egg was added to the upper right hand corner. Next, Curtis poured water into the back compartments of the army vehicles. He poured the last of the water into the sand, specifically on the right side of the tray by the egg and the army officers with the stretcher. As he did this, several figures fell down and he chanted "wet, wet, wet." To complete the scene, he poured water through a plastic basket to make rain that he spread all over the scene. Curtis then moved to the dry sandtray and played with the dry sand in his hands. Lastly, he placed an empty basket in the centre of the dry sandtray and scooped sand into it. He then held it up and watched the sand pour through the holes. Counsellor's Clinical Impressions and Reflections During and after this session, I was in a state of wonder at the seemingly therapeutic effect of sandplay. The shift in Curtis' process suggested that he was 201 coming out of the chaos stage and moving into the struggle stage, the middle stage that often involves many battle scenes before the final stage of resolution (Allan, 1988) or adaptation to the collective (Kalff, 1980). According to KalfTs sandplay theory, (1980) after the animal, vegetative stage, the child will have gained strength and be able to enter the fighting stage symbolizing that the child is ready to "battle with external influences and he can come to grips with them" (p.33). Curtis' scene seemed to suggest that he had entered the fighting stage, although he appeared to be fighting with forces within himself as indicated by the title "Same Team War." In this session, it appeared as though Curtis was honoring a death that could have been a part of himself that had died. Toward the beginning of the session, Curtis covered up the skeleton and then performed a seemingly sacred ritual as he placed the RIP headstone in the sand with a cross and made a circle with his finger that connected at the headstone and cross. He seemed to express his anger as he dug up the skeleton, hit it with his fingers and then buried it back in the sand using the big rock to smash it. Immediately after this, he knocked the toys over in the cabinet. It appeared as though this was a painful process for him. He seemed to become grounded by playing with the toys on the floor and when he returned to the sand, he seemed ready for the next stage. It was at this time that he began setting up the team of figures. While setting up the figures, he shifted back to the table and played with the small pink spinning top which seemed to center him again as he returned to the sand and continued to place the small, pink, abstract figures. 202 His apparent anger and hurt seemed to rise to the surface again as he made preparations for the war by adding the weapons to the knights and indicated that the scene was a war and that the figures were on the same team, followed by the sound effect "arrghh." The fact that he needed to go the bathroom again at this point seemed to signify that he needed to release and needed a break from the intensity that he appeared to be experiencing in the sandplay. After he returned, he seemed to be willing to show his injured self as he put the wounded soldier on the stretcher. It seemed positive that the injured soldier was receiving help and that there were three good luck charms. In addition, another possible symbol of hope appeared, the large blue egg reappeared. It seemed out of context with the war, but appeared to bring deep symbolic meaning. The appearance of the egg seemed to suggest that something very significant and connected to growth, life and wholeness was happening (Dunn-Fierstein, 1993). The addition of the water, often seen as the "source of all potentialities in existence.. .symbolic of the Great Mother and associated with birth, the feminine principle, the universal womb, the prima materia, the waters of fertility and refreshment and the fountain of life" (Cooper, 1995, p. 188) seemed to be another positive sign. Rain is a very ancient symbol that may symbolize "divine blessing; revelation; the descent of the heavenly influences; beatitude; purification" (Cooper, 1995, p. 136) and it is rain that fertilizes the earth. This seemed to be an indication that the rain was acting as a rejuvenating force for Curtis' personal development. 203 The theme of war appeared to have significant symbolism. According to Cooper (1995), war is "the process of disintegration and reintegration; abolishing disorder and establishing order out of chaos; the conflict between good and evil; the spiritual battle between good and evil in man's own nature; achieving unity" (p. 188). It could have been possible that these were all opposing forces with which Curtis was internally battling. I felt sad that this was our second to last session. Curtis and his mother had decided to finish the sandplay after his twelfth session as school was winding down and he had school projects to work on as well as end of the school year festivities. However, the sandplay seemed to have helped him significantly and his mother stated that he was coping better at home and at school. Session Twelve: "The War (wet sandtray)" In this final session, the fighting scene continued. Curtis began with his recurring ritual of flattening the sand with the big rock. He flattened the sand closest to the outside of the sandtray first and then placed the army vehicles and some figures in the sand too. He returned to patting down the sand with the big rock. This was followed by him calling one of the pink figures "Oil Man" and saying "Oil man kill everyone." Next, he stated that he was not going to be using the dry sand and put the lid on the dry sandtray and used the surface for the baskets of toys. He continued to place more figures into the sandtray, starting at the front of it. He added the first aid army figures with the stretcher and injured soldier. 204 This soldier was covered in sand except for his face. In silence, he placed all of the soldiers in the sandtray. He added the knights and horses and made "ooh ooh" sound effects. He dumped the cowboys and Native American Indians into the back of the tray and proceeded to stand them up. After adding all the war figures and vehicles, he made a big sigh and went over to the white cabinet and knocked over all the toys. He commented that I had bought new things and made "Arrrgh, arrrgh, arrgh" noises. Next, he tried to close the cabinet doors and lock them. As he placed more figures in the sand he stated "I'm dying." As he poured water all over the figures he stated, "Die, die, you're all dirty, die, die, ha ha you fell down, die, die, die." He continued to add water, which created a flooding effect and some of the figures started to fall down. He picked them up and explained that it was a tidal wave. He tried to stand up the fallen figures and sang a song about getting them to stand up. He narrated for some of the figures that were falling in the water. He made some screaming noises and said "I'm dying" and sang "I want to stand up again, stand up again." Suddenly he stopped, told me that the picture was called "The War", asked me to take a photograph and took some paper to the waiting room to draw. As he waited to be picked up, he drew a picture of a bomb. Counsellor's Clinical Impressions and Reflections Curtis appeared to be experiencing a large amount of pain in this session as suggested by his sound effects and by the words of the soldiers about death. He seemed to be angry and beneath the anger there appeared to be much hurt. Although he did not state that this was "The Same Team War", there was not 205 another visible force in the scene. It appeared as though he could have been battling internal as well as external forces. Knowing that this was his last session, he may have taken the opportunity to release a lot of negative, aggressive energy through different mediums such as the war scene in the sandplay, the knocked over toys on the shelves and the drawing of the bomb. In addition, he covered an injured soldier with sand but left his face uncovered and had two other first aid soldiers carrying this man on a stretcher. This seemed to indicate that he was still feeling wounded but was able to breathe and helping forces were assisting him. As Curtis narrated the scene, it appeared as though he was struggling to reconcile opposing forces. Initially, it appeared as though he was trying to kill the figures but then once they were dying, they wanted to stand up. In the final scene, the majority of the figures were left standing which may suggest some inner strength and order that Curtis could have been experiencing . The possible symbolism of a flood seemed significant to this scene that had resulted in a flood. According to Cooper, (1995), a flood could represent "The lunar power of the waters; the end of a cycle and the beginning of a new; causes death but also regeneration" (p,70). It appeared as though Curtis could have been ending an old cycle in preparation for renewal and the beginning of a new cycle. Concluding Impressions My final impressions were mixed. I felt sad that Curtis' sandplay had terminated during what seemed to be the fighting stage, but on the other hand he 206 appeared to have worked through the chaos that seemed to have overwhelmed him at times. I also hypothesized that Curtis may have felt upset about the sandplay finishing and perhaps some of the anger that seemed evident in the final session was related to our termination. Overall, it appeared as though Curtis had gained some inner strength and order. The many standing war figures seemed to show that Curtis was now ready to face upcoming battles in his external world. C U R T I S ' S A N D P L A Y P I C T U R E S 206a Session One (dry sandtray) Session One (wet sandtray) Session Two (dry sandtray) Session Two (wet sandtray) Session Three (dry sandtray) Session Three (wet sandtray) 206b Session Four (dry sandtray) Session Four (wet sandtray) Session Six (dry sandtray) Session Six (wet sandtray) 206c Session Seven (dry sandtray) Session Seven (wet sandtray) Session Eight (dry sandtray) (part I) Session Eight (wet sandtray) (part II) Session Eight (dry sandtray) (part II) Session Eight (wet sandtray) (part II) Session Eight (drawing) 206d Session Nine (dry sandtray) (part I) Session Ten (on the table) 206e Session Ten (wet sandtray) Session Twelve (wet sandtray) 207 C H A P T E R S E V E N : TEST R E S U L T S A N D DISCUSSION This chapter will focus on the results of the quantitative testing that was administered. The pre- and post-treatment results of the tests measuring self-esteem, anxiety, attitudes toward speech and stuttering levels will be presented and discussed. The T-score is a scaled score that provides normalization of a distribution of scores. A T-score is a standard score with a mean of 50 and standard deviation of 10. "Since a majority of the scores fall within one standard deviation above or below the mean, greater significance is attached to those scores that fall outside this range of scores. Scores falling two or more standard deviations from the mean must be given strong consideration" (Reynolds & Richmond, 1985, p.9). For the sub-scales, the scaled scores have a mean of 10 and a standard deviation of3. Manifest Anxiety The Revised Manifest Anxiety Scale measures the child's trait anxiety as opposed to state anxiety. In state anxiety, anxiety, as a transitory condition, is observed based on particular conditions or states. Whereas, in trait anxiety, anxiety is observed as a personality trait in individuals who frequently experience anxiety. Each of the three children answered a set of thirty-seven questions in the form of a self-report. The total anxiety score is considered to be the most reliable score and thus should be viewed with the most significance. Due to the fact that the sub-scales are limited in length, they may not be as reliable. However, the Results from the Revised Children's Manifest Anxiety Scale. Note: In Peter's Pre-test years and in his Post-test he was 12 years old which accounts for the difference in percentages for the same raw scores. Percentile " 5 II i.-ff .2 • o « 3 G r a p h 3 Percentile Curtis 100 -90 -80 -70 -60 -SO -Note: The actual raw scores and T-scores are summarized in the appendix. 208 sub-scale scores have been included as an aid for developing a hypotheses about each child (Reynolds & Richmond, 1985). Peter Insert Graph 1 About Here In Peter's pre- and post-treatment results, his total anxiety score is within two standard deviations below the mean. However, in both tests he scored high on the lie scale. According to the authors Reynolds & Richmond (1985), a standard score greater than thirteen strongly suggests an inaccurate self-report. They state that the child may be trying to present an idealized view of him/herself. The child may not necessarily be aware that he/she does not reach this level of perfection. In addition a high lie score may also indicate "exceedingly high need for social desirability or acceptance, unrealistically high standards by parents or self may be present, feelings of social isolation or rejection on the part of the child, emotional problems, inadequate peer relationships, academic problems in school and stressful situations at home" (Reynolds & Richmond, 1985, p. 10). During Peter's sixteen sessions, it appeared as though he was often trying to make an impression. Therefore, it was not surprising that he scored high on the lie scale. Furthermore, many of the aforementioned social/emotional reasons for lying on a test seemed to relate to Peter with the exceptions of poor academic performance and stressful situations at home. Peter appeared to be performing well academically and seemed to have a supportive family, particularly in 209 reference to his close relationship with his mother. Due to Peter's high lie score, his test results did not seem to reflect an accurate measure o f his overall anxiety. Bret t Insert Graph 2 About Here Brett 's pre- and post-test results for total anxiety indicate elevated levels o f anxiety. H i s total raw score for anxiety was 20 on both the pre- and post-test wh ich falls more than one standard deviation above the mean, but less than two. O n the pre-test he scored fairly high on the lie scale and on the post-test he scored extremely low. In addition, the items that he answered " y e s " or " n o " to in each test varied greatly. In the post-test he answered " y e s " and " n o " to three questions and skipped another question, wh ich thus eliminated these items. It appeared as though there was a large amount o f variability in the manner in wh ich these tests were completed. Throughout the twelve sandplay sessions and conversations with Brett 's mother, it became apparent that Brett frequently experienced diff iculty with language and meaning. In addition, a characteristic o f Asperger ' s Syndrome is difficulty in language comprehension and although Brett may no longer be diagnosed with Asperger 's Syndrome, it is still believed that he has language difficulties. K n o w i n g these factors, it appears that this test may not reflect an accurate measurement o f Brett 's anxiety level. A l though he may have answered some o f the questions accurately, it seems possible that he may not have understood some o f the sentences and that he may also have become frustrated 210 and answered many of the questions sporadically. However, through conversations with Brett and his mother, it appears as though Brett encounters many difficulties in his daily life, thus he may indeed experience high levels of anxiety. Curtis Insert Graph 3 About Here Curtis' pre-test results show low levels of anxiety. His total score falls just below one standard deviation below the mean which is just below the majority, but in his post-test results, he scores extremely low. He falls two standard deviations below the mean for total anxiety and has a raw score of zero. Reynolds & Richmond (1985) state that "clinical experience tentatively suggests that those children scoring extremely low on the RCMAS may actually experience anxiety but have difficulty experiencing it" (p.9). In this light, Curtis may be experiencing higher levels of anxiety than the test results indicate. During Curtis twelve sandplay sessions, there were times when it appeared as though he may not have consciously been aware of or willing to acknowledge the emotional distress that he appeared to be experiencing. Tangible moments where he seemed to be consciously distressed for a few seconds involved situations when he broke a toy accidentally. He would look at me with a seemingly worried face and then dismiss the problem by blaming the item or stating that it looked better broken. Therefore, to ask him questions related to anxiety may have produced a similar response as he may have wished to present 211 himself as an individual who did not experience anxiety. The difference between the pre- and post-test scores may indicate that after having had twelve sandplay sessions in which emotional distress had been displayed, he had a stronger desire to present as though he had absolutely no signs of anxiety. Self-Esteem The purpose of the Culture-Free Self-Esteem Inventory was to assess each child's total level of self-esteem before the sandplay sessions and upon completion of the sandplay therapy. The raw score for the total self-esteem has the highest reliability and the sub-scale scores are included as additional information that may be useful when developing a hypothesis for each child. Each of the children answered sixty questions in the form of a self-report. Peter Insert Graph 4 About Here According to these test results, Peter's pre- and post-test total scores for self-esteem fell within one standard deviation of the mean suggesting that he was in the average range for boys of his age. Both times his academic and parental self-esteem scores were high, thus raising his total self-esteem score and the social self-esteem score was the lowest. These scores seemed to confirm the personal information that Peter had shared during his sixteen sessions concerning his positive relationship with his parents, his good academic marks and his tremendous difficulties in socializing with peers. Results from the Culture-free Sel f -Esteem Inventory Form A. 211a Graph 4 Percentile Peter 1 0o -90 -80 -70 -60 -50 -40 -30 -20 -10 -I f f « UJ c -7 « n O U J 5 i f 1^ M o o - Pre-test • • » Post-test u E E S TJ N a U J * ± " B E -SS O U J Q . i Total teem nerol teem Jocial teem U I V 01 O U J « ' 01 U J Self-i / i Self-(/I £ « O U J IE *3 Percentile 100 -90 -80 -70 -60 -50 -40 -30 -20 -10 -2 E S E is .2 E smic eem If-E ¥ Aca If-E C O _L o E h C O Note 1: Percentile for lie items not given with this test. Note 2: The actual raw scores and T—scores are summarized in the appendix. 212 Brett Insert Graph 5 About Here For the raw score measuring total self-esteem, Brett scored 23 on both the pre- and post-test. This score falls one and a half standard deviations below the mean suggesting that overall he has a low sense of self-esteem. Once again, it appears as though this score ought to be interpreted with caution knowing that Brett has language difficulties and may not have comprehended the questions or read them carefully. On the other hand, Brett and his mother expressed that he experiences difficulties in his daily life, particularly in academics, interacting with peers and keeping up with children his own age in social interactions and academics. Therefore, these results may reflect the low feelings that he might have been experiencing. Curtis Insert Graph 6 About Here According to the pre- and post-test results, Curtis has a very high sense of self-esteem. However, due to the extremely high scores, the validity of these scores is questionable. Furthermore, in the post-test the lie score is also high. It appears that as might have been the case in the R C M A S test for anxiety, Curtis may once again have been presenting himself as a boy with no problems. 213 Although Curtis may truly feel confident and positive about himself in many areas of his life, it appears more realistic that he may have a self-perception problem. Speech Associated Attitudes Each child was administered the Communication Attitude Test-Revised to gain insight into each child's feelings about his speech. This test required each child to answer thirty-two true or false questions pertaining to attitudes regarding his speech. Each raw point scored represented a negative attitude toward one's speech. Insert Table 1 About Here Although this test does not include a lie scale, from these results it appears as though both Peter and Brett have many concerns about their speech dysfluency. Conversely, Curtis appears to have few concerns about his speech pattern. He scored a few points below the mean for children of his age who do not stutter. These results seem to support the hypothesis that Curtis has a self-perception problem. In this test he appears to be consistent with his other test results in presenting as a child with minimal concerns. By scoring lower than the average child who does not stutter, it appears as though he is attempting to present an idealized picture of himself. Levels of Stuttering Peter and Brett, the two older children, were asked by the speech language-pathologist to read a 159 syllable passage from the Stuttering Severity Instrument. Due to the fact that Curtis was younger (seven years old), he was asked to describe the pictures that he saw in a picture-storybook. To assess the 213a Table 1. Results of the Communication Attitude Test-Revised Peter fAee eleven years for pre-test. Age twelve years for post-test.) Pre-Test Raw Score/Maximum Score: 23/32 Post-Test Raw Score/Maximum Score: 26/32 Mean Score for child who stutters (11 years+): 17.57 Mean Score for child who does not stutter (11 years+): 6.34 Brett (Age twelve years) Pre-Test Raw Score/Maximum Score: 20/32 Post-Test Raw Score/Maximum Score. 20/32 Mean Score for child who stutters (1 lyears+): 17.57 Mean Score for child who doesn't stutter (1 lyears+): 6.34 Curtis (Age seven years) Pre-Test Raw Score/Maximum Score: 5/32 Post-Test Raw Score/Maximum Score: 5/32 Mean Score for seven year old child who stutters: 14.79 Mean Score for seven year old child who doesn't stutter: 9.98 Note 1. Mean Scores from De Nil & Brutten's research, Speech-Associated Attitudes of Stuttering and Nonstuttering Children, 1991 214 percentage of syllables stuttered in a 300 syllable conversation, the speech-language pathologist privately met with each child and engaged him in a general conversation. Table 2. Percentage of Syllables Stuttered Peter Brett Curtis Pre-Test Reading: 3.8% 6.9% *1.0% Post-Test Reading: 5.7% 10.3% *2.7% Pre-Test Conversation: 10.3% 14.3% 5.3% Post-Test Conversation: 11.7% 19.7% 7.7% *Note 1. Picture-storybook description task From the results of these tests, it is evident that each boys level of stuttering increased slightly from February to June, 1998. According to the Demands and Capacities Model (Adams, 1990), the time of year could be the reason for the increase in dysfluency. Each child completed sandplay therapy in June and was then re-assessed for levels of stuttering. The month of June may have required different demands on the child compared to the demands required in February. For example, in June, children are excited as they anticipate the upcoming summer holiday. In addition, they may feel tired and mentally exhausted from the academic school year and the final projects and tests that they are required to complete. In conversation with the mothers of the children, they each stated that their child was excited for the summer holidays and tired from the pressures of school. If the children were experiencing greater pressures in June, this may have reduced their physiological capacity for motor output (Adams, 1990). 215 Furthermore, psychotherapy can be an intense, cathartic experience. Often, a process of de-integration needs to take place before psychological growth through re-integration can occur (Fordham, 1969). The stuttering levels of the children in this study may have increased due to emotional demands that they may have affected them during a de-integration - re-integration experience. There may have been no significant changes in the standardized test results due to the short term of therapy. Although images of inner healing appeared in the sand pictures of each child, it is plausible that these positive effects occurring at an unconscious level may not have transferred to the external world at the time of the standardized testing. Overall, the results of the standardized tests provided some additional insight into the psychological profile of each child. However, with each child in this study, it has been important to interpret the relevancy of these scores with caution. The external factors that were present in a child's life at the beginning of the study may not have been the same external factors that were present in the child's life at the end of the four month period. In addition, the psychological make-up of each child appears to influence the accuracy of the standardized results. For example, Peter appeared to be willing to share some information about himself, but seemed to be reluctant to truthfully answer all of the questions related to anxiety. Furthermore, Brett, may have understood some of the questions and answered them truthfully, but he may have also rushed through some of the other questions. Finally, Curtis appeared to present an idealized view of himself on each of the questionnaires which seemed to suggest that he had a self-perceptual problem. Overall, the results of the tests have been useful gaining a greater qualitative and quantitative understanding of each child. 217 C H A P T E R E I G H T : D I S C U S S I O N This study examined the use of sandplay therapy with children who stutter. It was hypothesized that in this study, the three boys who stuttered would benefit from the use o f sandplay as a form of psychotherapy and as an adjunct to speech therapy. Sandplay would provide a medium for expression of both unconscious and conscious psychological issues. Detailed analysis, based on Jungian interpretation, of the many symbols and themes that appeared in the sand pictures revealed that each boy appeared to be experiencing some psychological distress. Over time, it was observed that each boy seemed to experience some psychological healing as indicated by particular symbols and themes that were portrayed. Some of the results of the standardized tests did not appear to be constantly valid as a means to accurately assessing the boys' anxiety, self-esteem and speech attitudes. However, they were able to give further qualitative insight into each child. Some of the tests seemed to give accurate measurements, where other scores appeared to indicate an idealized view o f self, a desire to delude, and possible language comprehension difficulties. The children's level of stuttering was also tested pre- and post sandplay therapy. However, through discussions with the parents and the speech-language pathologist, it became apparent that the time o f the year can significantly affect a child's level o f stuttering. External circumstances such as holiday excitement and academic pressure routinely affect a child's stuttering. The theory of Demands and Capacities states that the greater the demands, the more likely they many 218 influence the capacity to produce in all areas of one's physiology; thus, for a child who stutters he/she may stutter more when experiencing greater demands (Adams, 1990). The timing of this study was from February to June, therefore, when the post testing was administered, the children seemed to be experiencing excitement about the upcoming summer holiday as well as exhaustion from the year-end academic demands. The cathartic experience of therapy may have created emotional demands upon each child which may have also affected their fluency levels. Consequently, it was not possible to determine if the sandplay had an effect on each child's level of stuttering. Delimitations The following delimitations outline the parameters that were set at the beginning of the study: The number of participants in this study was delimited as the case study approach was utilized. The small number of subjects thus enabled detailed analysis of each boy's unique experience as a child who stutters. The individual experience of each child in this study could also draw attention to the emotional issues that other children who stutter may experience. This study was also delimited by having the researcher as therapist. This double role enabled the researcher to share her clinical impressions and reflections as participant observer, thus allowing the reader to have a greater understanding of the therapeutic experience of each child from the subjective experience of the therapist. Counter-transference issues were shared and possible transference issues were also explored. Analysis from a Jungian perspective was 219 utilized with subjective impressions and interpretations from the researcher/therapist's point of view, thus enabling the reader to become immersed in the researcher/therapist's personal experience. This study was delimited by providing four months of sandplay therapy, as the counselling centre was going to be closed for the summer holiday. During the four months, each child appeared to move through the exploratory stage and be well into the working stage when therapy was terminated. Each child was prepared, in advance, for termination. Alternative counselling resources were offered to the parents of each child. Implications for Theory Each of the three boys showed signs that corresponded with Dora Kalff s theory of sandplay. This theory has been further developed by other Jungian sandplay therapists, who are members of the International Society for Sandplay Therapists (IS ST) - the organization that Dora Kalff founded. The following information is a summary of the process, according to Dora Kalff s theory of sandplay, that each child experienced: Peter Initially, Peter's sandplay presented different scenes within one sandtray which seemed to indicate some splits within himself. This was followed by him spending six sessions constructing a house out of popsicle sticks which seemed to be very significant from a Jungian perspective. In Jungian psychology, the image of a house is often associated with one's inner-being (Kalff, 1980), thus it appeared as if Peter was unconsciously rebuilding some parts of his Self. As the 220 Self strives toward constellation, new energies are released which lead to the formation of a healthy ego development (Kalff, 1980). The construction of the house appeared to provide Peter with the foundations and security to continue on his journey and face upcoming psychic struggles. For the duration of Peter's sandplay sessions, his ego seemed to be expressing itself through scenes of struggle. It appeared as though Peter was now stronger and thus able to bring internal problems to the surface. During my interactions with Peter, it seemed that he experienced a strong desire to control the people around him. He discussed situations at school where this had been the situation and he also talked about games he would play with his parents in which he was the authority figure. Towards the end of our sessions, I discontinued my role as the test participant who had been receiving directives from Peter. This seemed to create a shift towards greater authenticity in our relationship, while at the same time producing increased conscious conflict. Peter's last few sandplay pictures also seemed to show a shift at an unconscious level. Animals, which may represent instinctual energy, were used for the first time. Small fences were used to create small enclosures, but this time they were accessible by use of a gate. This seemed to indicate that the energy had a way in and a way out. Although Peter, did not appear to reach KalfFs final stage of Adaptation to the Collective, he seemed to have gained some new insight into himself. Unconscious energies appeared to have been released within him and he seemed to have a stronger ego that would enable him to have greater strength when facing external influences. 221 Brett In the second case study, Brett appeared as if he was on a journey. He created several sand pictures of animal-vegetative content which seemed to indicate that he was experiencing the first stage of ego-development according to Dora Kalff s theory of sandplay. He also created many images that seemed to represent masculine energy. Developing one's gender identity is a key theme in Jungian psychology and sandplay (Bradway & McCoard, 1997). Towards the end of Brett's sessions, he created a scene which seemed to depict conflict with a resolution. A man fell off the top of a cliff but landed on the cliff side and survived. The cliff was then transformed into Aladdin's cave and Aladdin stood at the entrance ready to retrieve the gold. It appeared as if Brett's inner strength had increased as represented by the transformation that occurred in these scenes. Brett's final picture seemed to indicate that there were still external influences to battle, but his ego appeared stronger and more able to protect him from the negative aggressive energy close by. He seemed to be preparing for another journey which may have been bringing him closer to the final stage of Adaptation to the Collective. Curtis In the third case study, Curtis appeared to experience an outpouring of energy from the unconscious as suggested by the numerous items that were placed in both sandtrays for the first four sessions. In sessions four to six, wild animals were used and in the fifth session a vegetative scene was created. These images seemed to represent the animal-vegetative stage, thus indicating the first signs of 222 ego development. In the seventh session, chaos was revealed which may occur in the first stage according to Allan & Berry (1987). The addition of large amounts of water to the wet sand tray suggested that Curtis was accessing his unconscious energies (Bradway & McCoard, 1997) and the creation of the "mud" seemed to indicate regression as Curtis created a material similar to prima materia, which is often thought of as the original substance (Matthews, 1993). Signs of wholeness also began to appear, such as circular and square images (Kalff, 1980). During Curtis' last two sessions, a sense of order seemed to rise to the surface. Many figures were carefully arranged ready to do battle. It appeared as though Curtis had reached the second stage of KalfFs stages of ego-development, the fighting stage. Overall, it appeared as though each boy showed signs of first stage ego-development, represented by the animal-vegetative content, through to the second stage known as the fighting stage. Kalff (1980) explains that at this stage "the child is so strengthened that he can take upon himself the battle with external influences and he can come to grips with them" (p.33). The results of this study seem to confirm the appearance of the first two stages of ego-development together with signs of growth and healing that are the fundamental tenets of Jungian sandplay therapy. Implications for Practice This research has highlighted several points that have relevant implications for practice. First, the results of the current study emphasize the importance of assessing, from a holistic perspective, a child who stutters. Each of 223 the participants in this study appeared to be experiencing psychological distress and seemed to need the support of a counselling intervention such as sandplay in conjunction with speech therapy. In addition, current literature shows that many children who stutter have concomitant psychological issues. Therefore, it would seem imperative that counsellors and speech-language pathologists work together to assess a child who stutters and provide speech therapy in conjunction with psychotherapy for a child who appears to need psychological support. This may also be extended to children with speech impediments other than dysfluency. A child with a speech impediment such as a lisp, could also have many psycho-social difficulties and may also benefit from psychotherapy in conjunction with speech therapy. Second, for the speech-language pathologist and parents of the child who stutters, it would appear to be extremely beneficial to have a greater understanding of how the child is coping. The findings of this study exemplify how each child's life experience is highly individualized. Therefore, it appears as if the speech therapy treatment plan for each child would benefit greatly if it could be tailored according to each child's specific psychological needs. For example, if, through counselling, it became apparent that a child had a problem with self-perception and seemed to be creating an idealized view of him/herself, this would give the parents and the speech-language pathologist important insight into their interactions with the child and may affect how one would conduct treatment in speech therapy. 224 Third, the value of sandplay as a non-verbal therapy that raises unconscious issues has been highlighted in this study. Regardless of whether a child speaks fluently or with a speech impediment, play is the most natural form of communication for all children (Landreth, 1991). For many children, they are not able to cognitively discuss their problems and may not be consciously aware of their unconscious issues. Through sandplay, children have a non-threatening medium through which they can express their authentic selves. In this study, unconscious internal conflict was expressed through sandplay by each of the three boys. Only Peter, towards the very end of his sandplay therapy, was able to express conscious conflict as he initiated a conversation about his psycho-social problems. Furthermore, some of the results from the standardized tests showed the limitations of raising psychological issues at a cognitive level. A child may not be consciously aware of his/her psychological distress or he/she may attempt to delude the therapist into believing that he/she is very well-adjusted. Fourth, the findings of this study draw attention to the importance of detailed analysis of each child's session. A session may appear "unproductive" but upon careful observation, with the knowledge of themes, symbols, archetypes, stages of ego-development, and signs of healing and constellation toward Self, a sandplay therapist may note small changes indicating growth and change. Furthermore, in sandplay, the therapist's silent understanding and support of the child's process is one of the most powerful elements for providing a therapeutic environment that promotes self-healing (Bradway & McCoard, 1997). 225 Fifth, the descriptions of the therapist/investigator's personal experience of each sandplay session could be valuable information for other therapists interested in play therapy or sandplay. Particular topics such as limit setting, re-directing therapy, and acceptance of a child's struggles are some of the areas that were addressed in this study. Finally, if a child was to receive psychotherapy such as sandplay therapy in conjunction with speech therapy, it would appear that this psychological support would enhance the effectiveness of speech therapy. Research has shown that children's academic performance increases if their emotional issues have been resolved (Landreth, 1991), thus it would seem that children would be more motivated to put effort into their speech therapy if they felt more self-assured and emotionally supported. It would also appear to be a mutually beneficial treatment plan. Ffypothetically, the child receiving counselling would start to feel better about him/herself and would, as a result, be able to devote more energy to improving his/her speech pattern. Through improvement in speech, this same child would experience less external stressors (such as teasing or fear of talking with a stranger) and would therefore feel better about him/herself psychologically. According to the Demands and Capacities Model (Adams, 1990) by reducing emotional distress there would be fewer physiological demands which, in turn, would create more energy for other capacities, such as speech. Implications for Future Research There is a dearth of current research exploring the use of psychotherapy in conjunction with speech therapy. Therefore, more research is needed to examine 226 the effects of concurrent speech therapy and psychotherapy with children who have speech impediments. It is suggested that an extended version of this study involving a longer course of sandplay therapy with each participant would increase understanding regarding the relationship between speech therapy and sandplay. Would long-term sandplay be beneficial in increasing the effectiveness of speech therapy by reducing the emotional demands on the child, thus increasing the child's capacity for motor output? Over time would the participants complete all stages of ego-development thus reaching KalfFs (1980) final stage of adaptation to the collective (Kalff, 1980) ? A further direction for exploration would be the theme of blocked energy. In this study, each boy seemed to produce an image that involved blocked mechanical energy which may have represented blocked energy within themselves. In the case of Peter, session three strongly suggested that he appeared to be experiencing a feeling of being trapped. This was portrayed by a closed road, people stuck in an airplane and many road signs and obstacles. Brett also produced a sand picture which seemed to indicate blocked mechanical energy. In session four, he created a scene where many vehicles were stationary as they appeared to be stopped by a train. In Curtis' session six, a scene involving many vehicles close together was created. Many of the vehicles in this picture, and in other sessions, seemed to be blocked or trapped. Kalff (1980) described a case where a child would consistently place obstacles in the road, and on the first occasion where he allowed the cars to move 227 freely, she stated that "the damned-up libido was beginning to flow" (p.47). For the children in this study, their blocked energy may have also been related to the blocks in speech fluency that occur in stuttering. To test this hypothesis, further research exploring sandplay with children who stutter is needed. Summary This study examined the therapeutic process of sandplay with three school-aged boys (age 7-12 years) who stuttered. Each child was offered weekly sandplay sessions over a four month period. The number of sessions per child ranged from twelve to sixteen. Each session was videotaped, with the investigator as therapist. Running notations were made on each child's session from the videotape. Field notes after each session were also recorded. Jungian based interpretation was conducted of each sandplay picture, and the investigator's clinical impressions and reflections as therapist were presented. Stuttering levels pre- and post-sandplay therapy were assessed and standardized tests measuring anxiety, self-esteem and attitudes towards one's speech were administered pre-and post-sandplay therapy. This exploratory study revealed rich descriptions and detailed analysis of each child's individual experience. Each child seemed to show signs of psychological distress which were able to be explored through the opportunity of expressing this unconscious inner conflict within the safe container provided by the therapist and the sandtray. Throughout the sessions, signs of healing and growth emerged as signs of ego-development and order appeared. All three of the participants appeared to reach the second stage of ego-development known as the 228 fighting stage (Kalff, 1980). At this stage, Kalff (1980) states that the individual has experienced inner healing which strengthens the child in order that he/she can now face the struggle with external influences. Clinical observations of each child's sandplay process gave new insight into the psychological profile of each child. The inner world of each child was revealed and it was evident that there was a need for each child to experience inner healing by expressing himself at both a conscious and unconscious level. Therefore, it is highly recommended that Sandplay therapy be used in conjunction with speech therapy to treat children holistically. Through Sandplay, a child has the opportunity to address psychosocial issues and experience inner healing through a non-verbal medium that accesses one's unconscious energies. Within each child, there is potential for self-healing, ego-development, and constellation of Self. Through the medium of sandplay and the creation of a free and protected space in which the child feels completely accepted and protected in all forms of expressions, the ability to tap into the self-healing potential of the psyche is actualized. 229 REFERENCES Adams, G. (1985). 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London: Sage Publications 236 T A B L E O F A P P E N D I C E S Appendix A : Ethical Review Committee's Approval Certificates Appendix B : Letter to Parents Appendix C: Letter of Permission Appendix D: Pictures o f Sandtrays and Toys Appendix E: Letter of Professional Endorsement Appendix F: Raw Scores from the Revised Children's Manifest Anxiety Scale Appendix G: Raw Scores from the Culture-Free Self-Esteem Inventory Form A Appendix A : Ethical Review Committee's Approval Certificates Appendix B : Letter to Parents T H E U N I V E R S I T Y OF B R I T I S H C O L U M B I A Department of Counselling Psychology Faculty of Education 2125 Main Mall Vancouver, B.C. Canada V6T 1Z4 Tel: (604) 822-5259 Fax: (604) 822-2328 January 16, 1998 Dear Parent(s), He l lo , my name is Sharon Addison. I am an Elementary School Counsellor in the N e w Westminster school district and am completing the graduate program i n Counsell ing Psychology at U B C . For my graduate thesis research, I am interested in exploring the social and psychological issues that may affect children who stutter and therefore addressing children's overall needs. M y project is titled "Explor ing Sandplay wi th Chi ldren who Stutter". Sandplay is a well-established form o f professional therapy that has been used to assist children over the last twenty years. The process involves a chi ld creating a scene i n a small and shallow sandbox with a variety o f miniature toys that represent objects found i n our world . Sandplay is a primarily non-verbal form o f therapy, thus it enables a chi ld to express him/herself through projection and wi th the option o f tell ing an accompanying story. It enables unconscious stresses to become objectified through the use o f the sandtray and the miniatures which may symbolize the chi ld ' s personal development. In the past, Sandplay has not been used with children who stutter and I am interested i n observing the themes that would emerge i n the children's Sandplay. The themes could provide information about the chi ld ' s personal development and issues, thus leading to a greater understanding o f the chi ld 's overall needs. Through Sandplay, many children have experienced personal growth and development, enhanced self-esteem and lower anxiety. Thus, there is also the possibility that Sandplay could positively contribute to a chi ld ' s speech pattern. M y research is under the professional supervision o f Dr . Ishu Ishiyama and Dr. D o n Sawatzki o f the U B C Department o f Counsell ing Psychology and L i s a Avery , Speech-Language Pathologist and Cl in ica l Coordinator o f Speech and Language Pathology at U B C . The Sandplay sessions wou ld begin as soon as possible and would be he ld once a week for approximately 45 minutes, over a period o f approximately four months. The sessions would take place after school hours at the page 1 of2 Appendix C: Letter of Permission T H E U N I V E R S I T Y O F B R I T I S H C O L U M B I A February 18 t h , 1998 Department of Counselling Psychology Faculty of Education 2125 Main Mall Vancouver, B.C. Canada V6T 1Z4 Tel: (604) 822-5259 Fax: (604) 822-2328 Dear Parent or Guardian, I am currently involved in research for a graduate thesis for the Master of Arts in Counselling Psychology at the University of British Columbia. I am particularly interested in the social and psychological issues that may affect children who stutter and am therefore conducting a study to look at the play themes and stories o f children who stutter. M y project is titled "Exploring Sandplay with Children who Stutter". Sandplay is a form o f play that involves an individual creating a scene in a sandbox using a wide variety o f miniature toys. After the child has played and made a picture, she/he wi l l then be invited to tell a story about the picture. Through Sandplay, children's play themes evolve and children often experience personal growth and development. They often feel proud o f their pictures, thus promoting self-esteem, and enjoy using the sandbox and toys as materials for self-expression. Y o u wi l l be invited to bring your child to a Sandplay session once/week, for approximately 45 minutes, over a period of approximately four months. The Sandplay sessions w i l l take place at the U B C New Westminster Counselling Centre located behind N e w Westminster Secondary School. With your permission, the Sandplay sessions w i l l be video-taped for two reasons. The tapes wi l l enable me to generate transcripts and detailed descriptions o f the play sessions and they wi l l also facilitate professional supervision of my study by Dr. Ishu Ishiyama of the U B C Department o f Counselling Psychology. This study wi l l be solely descriptive and non-intrusive for your child. I wi l l be focusing on each child's play themes. In the write-up o f the sessions, your child's name wi l l be replaced by a pseudonym. N o actual names or background information that could identify your child wi l l be included, thus ensuring complete confidentiality. In addition, all notes and video-tapes wi l l be kept in a locked filing cabinet. If you wish a copy of the thesis, upon completion of the project, this w i l l be made readily available to you. To gain a greater understanding of your child before the study and at the end of the study, I w i l l also invite your child to participate in three tests that w i l l measure his/her levels o f self-esteem, anxiety, and stuttering before beginning the Sandplay study and upon completion o f the study. These tests wi l l be very simple and w i l l ask the child to read some sentences and answer yes or no to a series of questions regarding his/her behavior and feelings. The results o f these tests wi l l also be made available to you. page 1 of3 1 2 4 6 I understand that my child's participation in this study is entirely voluntary and that I, on my child's behalf, or my child may refuse to participate or withdraw from the study at any time without jeopardy to any other services that my child may be receiving in the community. I have kept this letter as a copy of consent for my own records. I consent / 1 do not consent (please circle one) for my child's participation in this study. I understand that my child's confidentiality and anonymity are ensured in all phases of the study and in the final write-up of the study. (Parent or Guardian Signature) (Date) (Signature o f a Witness) (Date) page 3 of3 Appendix D: Pictures of Sandtrays and Toys Sandtrays and Sandplay Toys 248 Appendix E : Letter o f Professional Endorsement 251 Appendix F: Raw Scores from the Revised Children's Manifest Anxiety Scale 2 5 2 Results from the Revised Children's Manifest Anxiety Scale Peter: Pre-Test Results Raw Score/Maximum Score Percentile T-Score Total Anxiety: 7/28 35% 46 Physiological Anxiety: 3/10 42% 9 Worry/Oversensitivity: 3/11 45% 9 Social Concerns/Concentration: 1/7 26% 8 Lie Items: 5/9 88% 13 Peter: Post-Test Results Raw Score/Maximum Score Percentile T-Score Total Anxiety: 4/28 14% 39 Physiological Anxiety: 0/10 4% 4 Worry/Oversensitivity: 2/11 27% 8 Social Concerns/Concentration: 2/7 41% 9 Lie Items: 5/9 87% 13 Note 1. In Peter's Pre-Test he was llyears old and in his Post-Test he was 12 years old which accounts for the difference in percentages for the same raw scores. Brett: Pre-Test Results Raw Score/Maximum Score Percentile T-Score Total Anxiety: 20/28 94% 66 Physiological Anxiety: 6/10 85% 13 Worry/Oversensitivity: 7/11 86% 13 Social Concerns/Concentration: 7/7 98% 16 Lie Items: 4/9 82% 12 Brett: Post-Test Results Raw Score/Maximum Score Percentile T-Score Total Anxiety: 20/28 94% 66 Physiological Anxiety: 8/10 95% 14 Worry/Oversensitivity: 7/11 86% 13 Social Concerns/Concentration: 5/7 85% 13 Lie Items: 0/9 17% 7 Curtis: Pre-Test Results Raw Score/Maximum Score Percentile T-Score Total Anxiety: 7/28 14% 39 Physiological Anxiety: 5/10 43% 9 Worry/Oversensitivity: 2/11 19% 7 Social Concerns/Concentration: 0/7 6% 5 Lie Items: 2/9 10% 6 Curtis: Post-Test Results Raw Score/Maximum Score Percentile T-Score Total Anxiety: 0/28 1% 20 Physiological Anxiety: 0/10 1% 2 Worry/Oversensitivity: 0/11 4% 4 Social Concerns/Concentration: 0/7 6% 5 Lie Items: 4/9 21% 7 253 Appendix G: Raw Scores from the Culture-Free Self-Esteem Inventory Form A 254 Results from the Culture-Free Self-Esteem Inventory Form A Peter: Pre-Test Results Raw Score/Maximum Score Percentile T-Score Total Self-Esteem: 39/50 64% 55 General Self-Esteem: 17/20 81% 59 Social Self-Esteem. 3/10 14% 38 Academic Self-Esteem: 9/10 91% 63 Parental Self-Esteem: 10/10 87% 61 Lie Items: 3/10 *(not given) *(not given) Peter: Post-Test Results Raw Score/Maximum Score Percentile T-Score Total Self-Esteem: 37/50 53% 52 General Self-Esteem: 15/20 60% 54 Social Self-Esteem: 4/10 21% 42 Academic Self-Esteem: 8/10 77% 5 Parental Self-Esteem: 10/10 87% 61 Lie Items: 2/10 * * Brett: Pre-Test Results Raw Score/Maximum Score Percentile T-Score Total Self-Esteem: 23/50 7% 35 General Self-Esteem: 7/20 6% 33 Social Self-Esteem: 1/10 3% 29 Academic Self-Esteem: 7/10 61% 54 Parental Self-Esteem: 8/10 66% 56 Lie Items: 2/10 . * . * Brett: Post-Test Results Raw Score/Maximum Score Percentile T-Score Total Self-Esteem. 23/50 7% 35 General Self-Esteem: 8/20 10% 36 Social Self-Esteem: 4/10 21% 42 Academic Self-Esteem: 5/10 29% 45 Parental Self-Esteem: 6/10 30% 30 Lie Items: 3/10 * * Curtis: Pre-Test Results Raw Score/Maximum Score Percentile T-Score Total Self-Esteem: 46/50 95% 64 General Self-Esteem: 18/20 89% 62 Social Self-Esteem: 8/10 84% 60 Academic Self-Esteem: 10/10 91% 63 Parental Self-Esteem: 10/10 87% 61 Lie Items: 3/10 * * Curtis: Post-Test Results Raw Score/Maximum Score Percentile T-Score Total Self-Esteem: 49/50 99% 67 General Self-Esteem: 20/20 96% 65 Social Self-Esteem: 10/10 95% 64 Academic Self-Esteem: 9/10 91% 63 Parental Self-Esteem: 10/10 87% 61 Lie Items: 7/10 * * 


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