155 | Overcoming Separation Challenges: A Child-Centered Approach

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You're listening to the Play Therapy Podcast with Dr. Brenna Hicks.

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Your source for centered and focused play therapy coaching.

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Hi, I'm Dr. Brenna Hicks, The Kid Counselor.

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This is the Play Therapy Podcast where you get a master class in child-centered,

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play therapy and practical support and application for

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your work with children and their families.

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In today's episode. I am answering a question from Jemima in England

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and Jemima wrote in asking about a nine year

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old boy who she has just begun working with

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and actually when she wrote in it was a couple of months ago.

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So at this point, I'm sure she's

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a little further into the process, but at the time, she had had two sessions

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and the little boy is struggling pretty intensely with separation anxiety.

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So her question was about that, how to handle that

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and what it looks like when a child really

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will not be comfortable leaving a mom or a dad

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or whomever you know, they have their separation anxiety, attachment issues to,

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to come back to the playroom.

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So I'll read you parts of the email that she sent and

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then we'll be able to talk through that a little bit.

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So she said, hi Brenna,

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I've started working with a nine

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year old boy who's experiencing separation anxiety

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and isn't able to be away from his mom without feeling sick.

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This started after the family spent some time living in Tanzania.

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He got a bit of an upset tummy when living there,

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which then turned into feeling ill whenever he was away from his mom

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and he has been off school for an entire term since returning back.

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We've had two sessions so far and his mom has come back with him for both of them.

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She left for the last five minutes of each session.

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She tried to leave the session earlier and go wait in the reception a few times,

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but he didn't want her to. So she stayed.

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How would you approach this?

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I'm not trained in having the parent in the room,

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although I feel I am able to work with him while she's present,

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but I'm not sure how this will work going forward.

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I feel it's important that I don't rush him as

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I want him to feel comfortable and safe with me,

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which may take a while,

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but I am aware that there is an expectation from mom

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that he will come on his own.

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Any advice would be much appreciated. Thanks so much for your podcast.

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All right, Jemima. Thank you so much for emailing and for sharing this question.

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It's interesting because

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we've talked a lot about lobby sessions and parking lot sessions and

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when a parent calls and says I can't even get them to get in the car.

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I don't know that we're gonna make it.

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So we have all kinds of resistance for all kinds of reasons, right?

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And in this scenario, I think it's helpful to start with,

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this is really not so much about

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separation anxiety as it is the root cause and the anchored things that are going on.

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So let's tease that apart first and then I'll

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actually be able to dive into more specifics about

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practically addressing this in the playroom.

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But let's kind of track this backwards. Ok.

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So they went to live in Tanzania

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and he got an upset stomach.

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Ok.

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So I suspect that was probably from the water he was drinking

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or it was from certain foods that he was eating, that he was not used to

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or he might have just gotten the stomach bug for a

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few days or there was some kind of somatic nature,

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maybe he was really overwhelmed being in a foreign country.

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And so he actually started feeling a little bit nauseous, but it truly was somatic.

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So at this point, we're not really sure what caused the upset stomach,

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but we know that it was present.

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All right.

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So once a child experiences

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a feeling that is physically present in their body,

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they will naturally anchor that

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to certain circumstances

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and therefore they will anchor the resolution of that

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to other circumstances. So let's make sense of this.

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Let's say he was feeling really bad, his stomach was really bothering him.

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And

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when mom came and gave him some juice or mom hugged him and rubbed his back,

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or mom put a wet washcloth on his forehead

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or told him that he was fine and there was nothing

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wrong and she reassured him and soothed him with her words.

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All of a sudden

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his physical symptoms abated

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which now I have an anchored sensation of being scared when I feel bad

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and feeling not scared when mom is with me? Mom made it better?

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Ok. So are you tracking with how that unfolds in this child scenario?

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So understanding that that is probably the path

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that the child has been on,

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it makes sense now that mom has become the security blanket

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when mom is not around

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the stomach issues immediately reemerge

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and at this point, they truly are somatic.

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So whereas there might have been an actual cause when they were in Tanzania.

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Now it is an anxiety, fear, worry based,

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upset, stomach or nausea,

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which therefore,

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somatically

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is going to make him feel the same thing that he felt

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when they were living abroad.

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And therefore, when I'm with mom, I feel relief.

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So yes,

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we can see this as a separation anxiety issue because he doesn't want to leave mom.

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But usually separation anxiety

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is

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not usually I shouldn't say that often. Separation anxiety is

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attachment related.

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It's relational.

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In this case,

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it's very, very likely tied to huge levels of anxiety

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and the somatic symptoms that go along with that.

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So once we understand that

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that actually helps us kind of formulate

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some thoughts on what we do.

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Now,

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the child-centered model doesn't change based on whatever information

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or insight we can gather from a child.

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So I'm not saying that now that we know that it's

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probably somatic and it's rooted in high levels of anxiety,

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et et cetera.

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We don't do anything differently,

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but it's helpful to at least be aware of what's likely

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causing it because that helps us discuss with mom and dad

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that helps us give them some awareness and perspective,

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that helps us give them tools they can use,

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that helps influence what we might reflect to the child

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because

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we could say

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you really want mom to come back to the playroom with you.

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But is that really what the child's need or desire is?

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I would argue it would be more appropriate to say

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you feel really safe when mom's with you

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notice how that changes the whole dynamic of how we're

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going to reflect once we have insight and awareness.

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So that's why we kind of dive into how did we get here, right.

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All right. So

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Jemima

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to specifically address your questions about how do we navigate this? Ok.

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So at this point, when you emailed it was two sessions in, I'm sure you might be,

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you know, closer to 10 or so.

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Now,

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but, and I have no idea whether the child has actually started to go back on his own.

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But all of us deal with kids that

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don't feel comfortable leaving mom, don't feel comfortable going back.

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Don't want to go back to the playroom for a variety of reasons.

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So this is really important.

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I've said it again. I mean, I've said it before. I'll say it again.

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We never ever, ever force a child to go back to a playroom.

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Under no circumstance. Will we ever insist that a child go back?

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So sometimes that means we have lobby sessions

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and they're just as therapeutically important and

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valuable as when we're in the playroom.

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But in this case, Jemima, he was able to go back if mom went with him,

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our

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policy at the center is that parents do not go back with the child.

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Sometimes the child chooses for the parent to walk them to the playroom door,

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but they do not go into the playroom with the child. That's our center policy.

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But in your case,

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child and mom were both in the playroom.

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So I will work with that scenario even though we would typically encourage

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you to make sure that the mom can sit outside the door.

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If the child really does not feel comfortable without a parent present,

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or they can walk them back to the door,

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but they don't actually enter into the playroom.

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But that said,

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once we realize the child is not willing or able to go back on their own.

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We will not force them,

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we constantly remind them of expectations,

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but we don't necessarily set limits.

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So here's what that might look like.

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You aren't quite ready to go back to the playroom without mom

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or you're choosing to spend some time with mom before we go back to the playroom.

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Or you're unsure if you want to go back and play and have mom wait out here for you.

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So we're just going to continue to validate.

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And if and when the child is at a calm place.

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In other words, they're not emotionally upheaved, they're not crying,

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they're not in panic mode, they're not overwhelmed.

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We might say,

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I wonder if you're ready to go check out the playroom yet

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because by

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checking in

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and

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letting them know that the expectation is that they will go back to the playroom.

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It's making it known

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that that is where the goal is to end up.

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There's no force, there's no push,

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but I wonder if you're ready to go back to the playroom yet.

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Now, in this scenario,

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you can offer choices

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for how the child chooses to

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have mom involved or not involved.

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So, Jemima,

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I'm going to go with your scenario where a parent

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was actually already in the room at one point.

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So I'm going to give different choices than we would give at our

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center where the parent is never allowed in the room but I'm,

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I'm working with your scenario.

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So what you might do after you've had several sessions

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where mom was in there for all but five minutes,

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then you would give choices for a

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longer amount of time that mom won't be in there.

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So let's say the little guy's name is Jack. So

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Jack, it's time for our play time

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and you know that our playtime is just for kids.

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And I know you like to have mom back there.

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So you can choose to have mom stay in there for 30 minutes today

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or you can choose for mom to stay in there for 35 minutes today.

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Which do you choose?

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Now? Of course, the child's going to pick 35 minutes, right? So that's a given.

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But here's what we've done.

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Mom is now out of the room for 15 of the 50 minutes.

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The child had control over it. The child doesn't feel like you tricked him.

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He made the choice I choose for mom to stay for 35 minutes.

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So then 15 minutes

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are without mom,

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then you do that for a couple weeks and then you move to

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ok, you know that our play sessions are just for kids.

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So I wonder if you're ready to come back without mom today? If he says no,

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then it's ok.

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So I wonder if you choose for mom to stay in there for 20

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minutes or if you choose for mom to stay in there for 25 minutes.

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I'm sure he's going to pick 25 and then he's in the room with mom for

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half of his play time and in the room without mom for half of his playtime.

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And all that's happening is the child has a measure of power and control.

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The child has ownership over the outcome.

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And he is learning over time as a slow desensitization

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that he is ok without mom

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and the time keeps increasing.

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So

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that is a really effective way

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to help a child learn that he is capable

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of handling a scenario that otherwise is very,

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very fear invoking and very overwhelming for a highly anxious child.

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Now, here's the caveat

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allowing a parent to be in the room. And Jemima, you mentioned,

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I'm trying to see where you said it.

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I feel I am able to work with him while she's present. OK. That's huge

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because

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the whole

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child-centered model falls apart

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if your relationship with the child is not at

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the heart of everything that's happening in that playroom.

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So if there's intervention, if there's interference, if there's dialogue,

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if there's directive, if mom keeps undermining what you're trying to do,

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if there's anything going on from the parent in there,

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it is detrimental to the process.

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So with this, you can choose to have mom in here for X amount of time or X amount of time

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on the side of this. You also have to coach mom

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on what to do, what not to do, what to say, what not to say.

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Mom needs to be made aware of your expectations of

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her if he's choosing to have her in there.

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So that's a phone call or that's an email exchange or that's, you know,

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an independent

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interaction where the child is not present

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where you're able to say

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the child-centered model is that the child gets to be in charge.

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So please don't say anything. Please sit in the corner and remain quiet.

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If he engages you,

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you can do what he asks, but please do not ask questions. Please do.

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You're going to have to give her some coaching

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on what that looks like

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so that she can support and co-operate

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the work that you're doing

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rather than have it be detrimental.

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And as

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the time goes by and as you have more and more sessions, I mean, you know,

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two sessions in, of course, the child is scared to death, right?

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You're a stranger. It's a strange place. It's a strange thing.

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You know, what is this play room about? Why am I going to play with this person?

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I don't even know

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all of that is very overwhelming over time. Kids get used to it.

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There's predictability, there's consistency

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and they fall into their rhythm and their groove.

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But in a scenario like this, it's helpful to always remind a child,

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you know, that playrooms are only for kids. You really want mom to be back there.

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But you know that that's just a place for kids to play.

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And over time

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with that expectation set, kids are able to operate within that boundary.

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And the choice giving is the antidote to the fear.

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Because when you have highly anxious kids,

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they're grasping at a measure of control.

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So we give them control in the process of giving them choices

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and then they don't feel so powerless

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and then they don't feel that they have to fight so hard to stay with mom because

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they know that they've already chosen to have mom

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in there for a certain amount of time.

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So I hope that you'll find that helpful if you have any questions.

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If you have follow up, I'd love to hear from you brenna@thekidcounselor.com.

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And I would also love to hear from you if you have questions.

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So if you are in the States,

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you can call 813-812-5525 and leave me a message and

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then I can answer your question from the voicemail.

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You can also go to CCPT Collective

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and that's dot com, by the way, that's a website CCPTcollective.com.

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My husband's like,

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sometimes you don't say.com or sometimes you don't say CCPT

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and I don't think people know what you mean.

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And I'm like, OK, I'll be better about that. So

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that was for my husband

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CCPTcollective.com. Is where you can find out about our online group.

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We're just shy of 100 members now. So exciting.

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And it's a community. It's a discussion. It's live Q and A twice weekly with me.

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I would love to have you there. Please come check it out.

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We have people literally all over the world that have joined and what a fun,

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inspiring, exciting place to be.

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So, if you would like to check that out, we'd love to have you.

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I'm really grateful that you send me questions.

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I'm grateful that you send me emails. I'm grateful that you call in and

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you all are the most engaged, passionate

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invested, excited group that I have ever had.

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The privilege of interacting with working with spending time with. I

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really cannot. Thank you enough for how much this matters to you.

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You know how much this matters to me.

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I wouldn't be doing this if I wasn't passionate about child center play therapy,

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but my passion is bigger because of your passion.

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So thank you so much for pouring into this

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and caring about this so deeply and working to

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work on your skills and grow your ability and

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be the practitioners that you really want to be.

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It makes me so so happy every day to have you as a part of my life.

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So super grateful for each and every one of you. You know how much I love you.

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We'll talk again soon. Bye.

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Thank you. For listening to the Play Therapy Podcast with Dr

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Brenna Hicks.

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For more episodes and resources,

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please go to www.playtherapypodcast.com.