Last Thursday, I spoke with another art therapist on therapeutic toys. This time, the focus was on design. Below are selected interview notes.
What does a traumatized child need to get (developmentally) back on track?
BF: The first step is establishing a sense of safety and equilibrium. Trauma causes the brain to shut down or function in a state of hyper-vigilance. You need to down-regulate the autonomous nervous system. Bruce Perry and Bessel Van Terkolk talk about pattern sensory repetitive involvement as a therapeutic technique in these cases. The technique uses repetition when the child needs to down regulate. Lullabies, heartbeats, familiar sounds, familiar smells, and soft objects can all have a soothing influence.
The second step is processing. You help the child understand what happened and come to a different conclusion. Children will play out traumatic events given the toys or props to do so, but that doesn’t mean they will learn anything from it. You must help a child understand why something happened and what can be done about it.
What are some techniques that you’ve found useful in your practice?
BF: It’s important to break the mental state of hyper-vigilance by shifting the brain’s focus. When patients come in, I give them lavender hand lotion. The tactile sensation of rubbing one’s hands together, combined with a strong scent sets the stage for a productive session. Some therapists make drums out of coffee cans and duct tape at the beginning of their sessions. You’re providing a predictable pattern at the start of a session that creates an entry point into an oasis from the rest of that person’s day.
You mentioned sensory repetition as a therapeutic technique. Can you talk about some appropriate things that a sensory kit for children might include?
BF: Sound-making devices, perhaps mimicking heartbeat. Crayons, or whatever art supplies are culturally appropriate. Stencils, because if you’re giving kids a way to draw, the idea of containment is important. They are comforted by the edge. Yarn. Puppets. Stuffed animals. I knew a therapist that would put a satchel of peppermint in a stuffed animal and use it to focus the child’s mind. You could put a box inside to symbolize private space. The child could decorate it as she saw fit and put it into the larger container for the kit.
Lessons: There are two stages that need to be addressed in trauma recovery. Cognitive processing fails if a child’s brain function remains in the primitive “fight or flight” state. In the first six months, focus on establishing safety and equilibrium. Six months to a year out, give children the tools to play out their trauma.