The Play's the Thing How the Essential Processes of Therapy Are Seen Most Clearly in Child Therapy

Analytic child therapy techniques developed as modifications of techniques from adult psychoanalysis. Child therapy continues to be regarded as an adaptation of adult analysis and to give a central place to the methods and conditions of adult analysis, such as interpretation, in its understanding of how therapy heals. I propose that child therapy is not a modified form of therapy and that the essential processes of therapy are fully present in child therapy. In fact, they often may be seen more clearly there than in adult therapy. I suggest two interrelated processes as the essential ones in all analytic therapy. The first is play. I examine several interrelated aspects of play, specifically as they occur in child therapy. These include the emergence and integration of dissociated self-states, symbolization, and recognition. The second process I propose as essential in analytic therapy is the renegotiation of self-other relationships through action. This renegotiation is what can help patients become able to play in therapy when they have difficulty doing so. Since I suggest that action is at the heart of analytic therapy, I go on to consider the role of talking in an action therapy. Finally, I explore the dimensions of mutuality in the relationship between child and therapist,

including mutual influence and regulation, mutual recognition, and mutual regression. The intersubjective nature of psychotherapy, which is increasingly appreciated in adult analytic therapy but not in child therapy, provides a fertile context for the evolution of play and for the productive renegotiation of self-other relationships.