Play and Power

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The power of play, so central to psychoanalytic theory and practice, is conjoined to the social psychological or socio-politically coloured concept of power, giving rise to many fruitful discussions of how these concepts manifest themselves in clinical work with children, groups and adults.The inspiration for this book was the 3-section EFPP conference in Copenhagen in May 2007 with the main theme "Play and Power". At the conference and in the book, this theme is presented both inside and outside the therapeutic space. It is amply illustrated in clinical cases from individual psychotherapies with children and adults and from group analysis. Most of the examples are with hateful or resigned children and adults who have been exposed to extremely damaging or unhelpful environments, and who demonstrate convincingly some of the devastating consequences that abuse of power in the real world may have. Play and power are also explored in the broader context of the community, however. In relation to society at large, psychoanalytic psychotherapy has important contributions to offer society, and we need playful creativity and power to bring forward our knowledge about it.

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Chapter One: Transformation through play: Living with the traumas of the past

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Monica Lanyado

Play has the power to transform. It can be liberating, aggressive, sad, satisfying, illuminating, angry, anarchic, funny and beautiful. The full range of human emotions and experiences are there. Playing can be the bridge to pleasure, joy and internal freedom. It can also be the bridge to unexplored depths of pain, sadness and violence. The capacity to play is the vehicle which holds these often powerful emotions, within a space where they are not acted out in what might otherwise be destructive ways. When the capacity to play breaks down because the symbolic functioning of the player is overwhelmed due to a weakness in the ability to play which has not fully developed, or an overload of what it is trying to carry, powerful uncontained feelings are set loose.

For example, young children need the watchful eye of an adult to help them when playing otherwise, reality steps in before too long because the “as if” quality has been overstretched, and a battle between soldiers becomes a real fight between two angry, rival-rous toddlers (Segal, 1975). Adults also need boundaries which keep play safe. The game of football, which often has the sense of being the present day version of a gladiatorial sport, can readily break down into real fights on and off the pitch, where the idea of playing a game has been lost and the reality of the referee and police needs to be brought in to restore some kind of order. Little girls playing mummies and babies come to blows when jealousy and possessiveness as well as bossiness, cannot be held within the imaginative play. Sulks, tantrums and tears reflect their feelings of rejection and fury.

 

Chapter Two: Has play the power to change group and patients in group analysis?

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Peter Ramsing

In a group of women recovering from anorexia nervosa, one of the participants, Ms M, is evaluating her first year in the group. She eats normally and is of normal weight, but she misses being thin. She says that longing to be thin again is like unrequited love. She continues talking. One of the therapists returns to the association between unrequited love and her anorexia, and it starts a further discussion with lively participation from the rest of the group. Themes such as the following are discussed: If you are going to leave a lover, you have to mourn. It is difficult if he does not want you any longer or has found another (thin?) girl. Unrequited love restricts your life if you are not setting yourself free from the relationship.

Time will tell if Ms M can use this image on her way to a full recovery but in the group, it was obvious that the discussion changed from a matter-of-fact discussion to a playing mode, in pretending that Ms M’s anorexia was a former lover.

It is a commonly held opinion that only children play, but as the example above illustrates, this idea is based on a very limited conception of play and playing. A Dutch cultural historian, Johan Huizinga (1963), sees play as universal and argues in his book Homo Ludens (Man the Player) that play is part of creating culture and not the other way around. A quote from his book seems pertinent:

 

Chapter Three: The power of hate in therapy

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Mette Kjær Barfort

Therapists working with clients who suffer from personality disorders, especially those who are severely narcissistic, are inevitably exposed to intense emotions of hate and hateful fantasies. In my own clinical practice, I find it very challenging at times to deal with the powerful projections from this group of clients whose inner world and relationships are dominated by hate. Hateful clients have very little faith, sometimes no faith at all, in the existence of goodness in themselves and in others, and as a defensive reaction, they tend to attack and destroy their therapists’ empathy and interventions simply because they are experienced as threatening to their psychic existence. When exposed to these hateful attacks, strong countertransference feelings are evoked in the therapist, who may be experiencing the whole spectrum of emotions from anger and hate to guilt, despair and depression.

The strong emotion of hate can be enacted violently and overtly but is frequently transmitted through primitive forms of powerful projective identifications. This hateful non-verbal communication from the client is not always easy to register and understand for the therapist. They may feel overwhelmed and unable to maintain their own sense of analytic space and be unable to function as a container of the client’s hateful emotions. My focus in this paper is to look into what kind of powerful forces are at stake in therapy when the client is full of hate, and the therapist is filled with countertransference feelings while at the same time, struggling to maintain a neutral, playful and exploratory approach.

 

Chapter Four: Survival and helplessness in empty space

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Liselotte Grünbaum

In psychotherapy with recurrently traumatised children, I have often felt that sooner or later, what developed in the therapeutic space was an empty, dead atmosphere in which endless nothingness seemed to build up. What develops is an oppressive silence, only to be broken at certain points by a powerful urge to repeat seemingly meaningless fragments of behaviour. While still struggling to contain the temptation to curtail this deadlock, experience tells me that on the contrary, my task is to keep up reverie while waiting for the child themselves to make a move. Thus, in time, the child eventually will say or do something that links between on the one hand the deadness and compulsion to repeat, and on the other hand, the restitution of symbolic thoughts related to the object relations of the inner world. In the following I will try to elucidate this, partly from a conceptual point of view, and partly from my experience in psychotherapy with a 6-year old girl.

Both in developmental research and psychoanalytic practice, there is unanimous agreement that the repeated experience in childhood of intra- and extra-familial violence, as for instance related to war, organised violence, torture, as well as mental or physical abuse and deprivation, may have severe consequences for the developing personality of the child. It is also agreed that in later childhood or in adulthood, the memory of recurrent traumatic experience is not necessarily present in mental space as conscious, verbal knowledge, but may rather be present as disturbing tendencies, to frozen or dissociated mental states and fragmented patterns of actions (Fonagy et al., 2002; Kaplan, 2006; Pynoos et al., 1995; Terr, 1991a, 1991b). While the children and their families are often painfully aware of how these tendencies strain the child’s relationships and development, the connection between traumatic experience and the compulsion to repeat may have been lost completely.

 

Chapter Five: The power to play with movement, vibrations and rhythms when language emerges

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Chantal Lheureux-Davidse

When we meet an autistic child, retreated in his world, we often ask ourselves whether he will start to talk at some point, or whether he will never have access to language.

The work of Bick (Williams, 1987) on the observation of babies with their mothers, the studies on pre-natal sound in intrauterine life by Maiello (1997), the research at the Centre National de la Recherche Scientifique (CNRS) on imitation by Nadel (Nadel & Decety, 2002), and exploration of the role of very early shared emotions developed by Trevarthen (1997), give us numerous indicators of the necessary conditions for access to verbal language.

Psychoanalytic research into autism makes us sensitive to the importance of cathecting body image in the relationship with the other, for the development of the corporal ego, and to the role of early fixations and regressive movements in relational development within the context of the transference. Once the child feels himself to exist in his body with some continuity, he feels involved with himself and with others, in a shared communication.

 

Chapter Six: The return of the absent father

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Jacob Segal

Last spring, at a discussion group I attended, I heard a metaphor about the relation between play and power, “If you want to hear music on a CD player, you have to press the Power button first, and then the Play button. If you press Play without pressing the Power first, you will get nothing”. There is no play without power first!

I associate this metaphor with the psychodynamic forces in the inner world of a child or a baby suffering from father absence, by which I mean the absence of a sufficiently strong, warm and present father, introjected in the child’s mind as an unconscious source of inner power. A father who is absent, physically or emotionally, creates a hole or wound in the inner world of the child. I am talking here about the inner preconception of the child of a functioning father that meets frustration and creates thinking, or a bad object, if the child is unable to bear the absence (Bion, 1967b). Moreover, I am also talking about the child’s need for a good enough father, an external father who is needed when we deal with ego vulnerability and dependence (Winnicott, 1963).

 

Chapter Seven: Power and play: A tale of denigration and idealisation

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Gerhard Wilke

To begin with, a question: what might the link be between the two apparently opposing and complementary forces of power and play? Power conjures up abusive adults while play invokes thoughts of innocent and playful children. In my musings on this theme it also struck me that we psychotherapists, as a community, have a propensity to idealise play and denigrate power. This tendency gives us an inauthentic sense of authority when we are outside the sacred space of the therapy room. We prefer to be helpless helpers, rather than powerful movers and shakers. Noble and passive victims are our preferred playmates! It has become necessary to reflect on what makes us afraid in the face of external power, attracts us to being at the mercy of fate in the shape of the modernisers of our Health Systems, and prevents us from shaping our own destiny. It is high time that we looked at how we can recover a sense of play as professional therapists. Through this “as if” quality of play, I think we can re-learn to hold power, meet “money givers” as equals and have the patience to survive as an established form of treatment.

 

Chapter Eight: Research in psychoanalytic psychotherapy with children—an enterprise in need of power?

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Karen Vibeke Mortensen

The suggestion that a whole field of research is suffering from a lack of power may sound quite provocative. Is it justified? Although it may be somewhat pushed to the extremes, I think the facts show it to be true. Knowledge about psychoanalytic psychotherapy with children is lagging behind, not only behind what is known about other forms of psychotherapy, but also behind the corresponding knowledge of psychoanalytic psychotherapy with adults.

As I will explain, there may be a number of different reasons for this. Some of these reasons are of an instrumental character, due to the technical complications connected with research in psychoanalytic psychotherapy and with children, but more irrational, emotional and attitudinal factors may also play a part, factors that are characteristic of the whole field of clinical child psychology and not confined only to psychotherapy research.

Research in psychotherapy is traditionally divided into case studies and large-scale quantitative studies, this holding true for research in psychoanalytic psychotherapy with children as well. My concentration on systematic, large-scale, quantitative studies in this chapter is not due to a disregard for case studies or to an understanding of them as irrelevant, less necessary, or less empirically based than the large-scale studies. They are, however, not accepted as the kind of evidence-based research that society wants. Society asks us, justly, if it gets value for money when it pays for psychotherapy, and we cannot escape this demand for quantitative and large-scale research. Public health authorities use such studies as evidence for or against the approval of psychotherapeutic treatment.

 

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