EMOTIONALLY ABUSED CHILDREN DOES PLAY THERAPY WORK?

Contents
...................................................................................................................................2 1 Introduction................................................................................................................5 2 Language....................................................................................................................5 3 History of Childhood..................................................................................................6 4 Prevention of child abuse fact sheet...........................................................................8 5 What is an emotional experience................................................................................9 6 Concept of Emotional Abuse...................................................................................10 7 Types of Parenting. ..................................................................................................12 8 Importance of Childrens emotions. ........................................................................15 9 The Childs Emotional self........................................................................................15 10 Attachment.............................................................................................................15 11 Forms of Emotional Abuse according to prevention of child abuse there are 5...16 12 What the effects of Emotional Abuse are...............................................................17 13 Implications of Abuse............................................................................................19 14 Interventions...........................................................................................................20 15 Family or parental indicators .................................................................................22 16 Prevention...............................................................................................................23 17 Presenting problems in the counselling room. .....................................................24 18 Play Therapy Defined.............................................................................................24 19 History of Play Therapy.........................................................................................24 20 Research in Play Therapy ......................................................................................25 21 Child Development Theorists ..............................................................................26 22 Conclusion .............................................................................................................29

1 Introduction

Emotion Strong mental or instinctive feeling such as love or fear. Abuse - Use to bad effect or for a bad purpose; insult verbally, Insulting language use, (Oxford Dictionary) Abusive language and behaviours in the home directed at young children can have a detrimental effect on their lifespan. In this thesis I will explore the concept of emotional abuse its effects and consequences on young children, presenting some history of how society has viewed children and how this has changed through the centuries. Parenting styles will be discussed and their effects on child development and how hard it is to detect emotional abuse and what interventions are available to detect and protect the child. Play Therapy is a non-intrusive type of psychotherapy primarily used with children, the theories and theorists behind this will be discussed and how the process of play therapy is used using an analysis of a case study.

2 Language Sticks and stones may break my bones but words (names) will never hurt me (Northall, 1894). This is the
advice parents and guardians give children when another child has been name-calling or insulting them. Despite this advice, words can be sensitised by children and cause upset and have emotional consequences.

3 History of Childhood
As there is little information of what childhood was really like in the past, it is incredibly difficult for historians to reconstruct the life of a child, much more the experiences of a child. In so many ways the history of childhood is a history that slips through our fingers. Few parents have left written records of how they reared their children (De Mauses, 1998)

Date Medieval Times

Note Young person of 7 seen as adult. In Roman Catholic theology 7 is the age of sin awareness. (Corbett, 1985)

13th Century

Swaddling babies reduced from 1 year to a few months. Birth and Paediatrics and educational philosophy. Gentry begin to stop wet nursing babies with peasants. Mothers nurse their own babies, babies respond to mothers by stroking her breasts, face and cooing (De Mauses, 1998).

17th Century

Swaddling removed soon after birth. Enemas not given to babies on a regular basis. Move from corporal punishment substituting with psychological punishments. E.g. locking into dark closets/rooms (De Mauses, 1998) Children worked as young as 5 in factories.

18th Century 19th Century

Childhood begins to solidify itself. Anti-Child labour laws introduced forcing millions out of work. Idle youth called delinquents. Introduction of mandatory schooling, From age 5- 12 (Corbett, 2995) More attention given to raising the child. Helping children to progress as children and to prepare for adulthood (Victoria Nurseries, 2001). Free school meals introduced. Introduction of minimum pay-levels, removing children from workforce. Boot fund charity provides boots for all poor children. 1970s end of corporal punishment. Abolished in private schools in 1999(Lambert.

20 Century

th

Bowlby (1969) suggests the roots of attachment are to be found in newborns first phase. The baby is building up expectancies and schemas and fine-tuning her ability to discriminate Mom and Dad from others (Boyd & Bee, 2006). Babies sent out to be wet-nursed during the 17th Century were missing out on attachment with the mother. The historian Alan Vaenline studied 600 letters written in the 18th century from fathers to sons, none of which show evidence of warmth or empathy (De Mauses, 1998).

In 1963, Philippe Aries wrote a landmark book on the study of young people, Aires book was translated into English as Centuries Of Childhood; he argued that childhood is a very new concept and that cultures lacked the concept of childhood. Aries proposed that childhood did not exist in medieval period and it grew into existence in the upper classes in the 16th and 17th centuries... Aries points out that paintings in the past have no children, but there are babies and little adults, what we call children did not exist. The musculature, dress, expressions and mannerisms are all adult. It has been suggested by art historians that this embarrassing fact was because artists lacked the skill to paint children. Aries suggests another explanation they could not paint young children because they were not children (Corbett, 1985). The most alarming thing of all is that child abuse still exists today in the 20th century. 4 Prevention of child abuse fact sheet

One third of all births in the world go unrecorded, and 40 million babies every year join those who will spend the rest of their lives without an official identity or citizenship. (Fact sheet 2001) 2001 28,000 to 30,000 children under the age of 18 approximately half of them 10 14 years old are used in prostitution in South Africa ( C.P.I.S, 2006) In 2004 there were 218 million children engaged in child labour, excluding child domestic labour. Some 126 million children aged 5 7 are believed to be engaged in hazardous work In 2005 children less than 15 years old living with HIV was estimated at 2.3 million. More than half a million children (570,000) died of Aids during the same period (C.P.I.S, 2006).

5 What is an emotional experience Emotional experience originates with autonomic nervous system arousal. Sometimes emotion precedes cognition; sometimes it is preceded by cognition. These two important systems work in

concert. First there is arousal; the autonomic nervous system is aroused by notable change in the persons world. This can be caused by an environmental event, by the actions of the individual, by the action of others or by memories. Sometime this arousal is limited to lower, more primitive brain systems. Individuals experience these lower level emotions across the lifespan. From toddler hood onward, motivation and cognition often work together strongly to influence emotional experience, because individuals create an increasingly complicated network of desired outcomes or goals. Hence the need for cortical brain involvement in much of emotional experiences is clear (Denham, 1998). 6 Concept of Emotional Abuse Emotional abuse is not as obvious as sexual or physical abuse. If a child has a broken leg, attention will be drawn to the child and questions asked as to how it happened. Emotional abuse is suffered in silence it cannot be seen. Emotional abuse includes all acts of omission or commission, which results in the absence of a nurturing environment for the child. It occurs when the

caregiver continually treats the child in a negative way that the childs concept of self is seriously impaired. Emotionally abusive behaviour by the parent or caregiver can include constant yelling, demeaning remarks, rejecting, ignoring, isolating or terrorizing the child. This form of abuse can be the most difficult to identify and prove. (GovPublication, 2001). Emotional abuse (or the concept of emotional abuse) is an area of interest and research in the fields of psychoanalysis and development psychology. Literature from the early part of the 20th Century on insecure attachment was clearly related to hostile, rejective and cruel parenting which forms the basis of contemporary understanding of emotional abuse (Iwaniec, 2006). Iwaniec describes emotional abuse in children as a persistent, chronic pattern of parental behaviour, often towards a particularly vulnerable child, which over the years becomes internalised and gives rise to the feeling that the child alone is to blame (Iwaniec, 2006). Emotional child abuse is also sometimes termed psychological child abuse,

verbal child abuse, or mental injury of a child (MD, 2005).

Garbarino (1993) defined emotional abuse as a constant attack of a child by an adult that negatively affects the childs self worth. Every newborn child is unique in the world. Telling a child from birth through their child hood into adolescence that there special, one of a kind in a genuine and loving way is a powerful way of boosting a childs sense of themselves (Humphrey, 1998). Criticising a child constantly will have a negative effect and the child will have low self-esteem. The term abuse can invoke images of cruelty, violence or maybe images of sexual abuse, Klosinski (1993 pg5) makes reference to this when talking about emotional abuse of children by parents, Wolfe further defined parental Emotional Abuse as the behaviour which signify the extremes to which a given parent may go in attempting to discipline his or her child, and the parents lack of sensitivity to the childs limitations and needs. Wolfe goes on to identify two significant strands in parental attitude towards parenting: Parental demanding. Parental sensitivity. Abuse occurs when these two approaches are missing or mismatched. For example, a very demanding, strict but insensitive parent is more likely to be abusing their child than a parent who is both demanding and sensitive. (Alfandary, 1993)

7 Types of Parenting.

According to (Wolfe 1991 pg 6) there are 3 types

Child Centred Parent Will provide a variety of sensory stimulation and positive emotional expression. They engage in highly competent, child-centred interaction but can also scold, criticise, interrupt child activity using a harsh tone.

Borderline Parent - Will show rigid emotional expression and inflexibility in responding to the child and use verbal and nonverbal pressure to achieve unrealistic pressures. They will be insensitive to the childs needs, make unfair comparisons and take advantage of the childs dependency.

Inappropriate and Abusive Parent - Will denigrate and insult the child, express conditional love and ambivalent feelings towards the child as well as emotionally or physically reject childs attention. They will show no sensitivity to the childs needs and intentionally seek out ways to frighten, threaten or provoke the child. They will respond unpredictably with emotional discharge.

Patterns of crying among individual babies often reflect the babys own temperament and their emotional reaction to a new situation. Spock has found in his research that many parents learn to respond to their baby with greater comfort when they know about different cries. . Parents not responding to their babys cries or knowing

different cries can be seen as the start of emotional abuse (Spock, 2001 pg 2). If children have not been thought or cannot model their behaviour in a positive way like the people who raised them then these children are categorised as emotionally abused or neglected, these children are unaware that they have been Emotional abused or neglected. We make assumptions that all children know when someone is violating them but often they do not have good self-protection skills (Spock, 2001) By comparing the development of babies who have been raised by responsive and loving parents with babies raised by unreliable unfeeling parents Spock discovered babies learn to trust and appreciate faithfulness. He goes on to say ... the deepest strongest and most durable of emotions in children is love. Children are born equipped to learn to love. This is developed in response to their parents love. Love can be expressed in various ways by parents and children at different ages. When parents have no love to give, their children never become loving and this is a form of Emotional abuse (Spock, 2001 pg 1).

8 Importance of Childrens emotions.

Emotions are at the centre of childrens relationships, ell-being, and sense of self and moral sensitivity and centrally linked to their increasing understanding of the world in which they grow up. Parental modelling, coaching, and contingent reactions to childrens emotions contribute to the childrens own patterns of expressiveness, understanding of emotion, and coping with their own emotions and those of others (Denham 1998)

9 The Childs Emotional self

Development of the emotional self begins when babies learn to identify changes in emotion expressed in others faces, at 2 to 3 months of age. Initially, they discriminate emotions best when they receive information on man y channels simultaneously such as when they see a particular facial expression and hear the same emotion expressed in the adults voice (walker-Andrews 1997 pg 157). By 5 to 7 months they also respond to a much wider variety of emotions than younger infants do and can distinguish among happy, surprised, angry, fearful, interested and sad faces (Soken & Pick 1999 pg 157). Near the end of the first year, infants perceptions of others emotions help them anticipate others actions and guide their own behaviour (Phillips, Wellman, & Spelke 2002 pg 157).

10 Attachment
An attachment is a type of an affectional bond in which a persons sense of security is bound up in the relationship. When you are attached you

feel a special sense of security and comfort in the presence of the other and you can use the other as a safe base from which to explore the rest of the world( Ainsworth, Blehar, Waters & Wall 1978 9g 140). Studies of parent child interactions suggest that one crucial ingredient for secure attachment is emotional availability on the part of the primary caregiver (Biringen 2000 pg 145). Ainsworths classification system has proven to be extremely helpful in predicting a remarkably wide range of other behaviours in infants, children, adolescents and adults. Dozens of studies show that children rated as securely attached to their mothers in infancy are later more sociable, more positive in their behaviour toward friends and siblings, less clinging and dependent on teachers, less aggressive and disruptive, more empathic and more emotionally mature in their interactions in school and other settings outside the home (Carlson, Sampson, & Sroufe 2003 pg 148). A major influence on a childs selfesteem is the overall support the child feels they are receiving from the important people around them particularly parents and peers (Franco & Levitt 1998 pg 278)

11 Forms of Emotional Abuse according to prevention of child abuse there are 5

Rejecting Parents who lack the ability to bond will often display rejecting behaviour towards a child. They tell a child in a variety of ways that he or she is unwanted. They may also tell a child to leave, call him or her names and tell the child he or she is worthless. They may not talk to or hold the young child as he or she grows. The child may become the family scapegoat, being blamed for all the family problems.

Ignoring Adults who have had few of their emotional needs met are often unable to respond to the needs of their children. They may not show attachment to the child or provide nurturance. They may show no interest in the child, express affection or even recognize the childs presence. Many times the parent is physically there but emotionally unavailable. Terrorizing Parents may single out one child to criticize and punish. They may ridicule him or her for display normal emotions and have expectations far beyond his or her abilities. The child may be threatened with death, mutilation or abandonment.

Isolating A parent who abuses a child through isolation may not allow the child to engage in appropriate activities with his or her peers; may keep at bay in his or her room, not exposed to stimulation; or may prevent teenagers from participating in extracurricular activities. Parents may require the child to stay in his or her room from the school lets out until the next morning, or restrict eating to isolation or seclusion.

Corrupting Parents permit children to use drugs and alcohol; to watch cruel behaviour towards animals, to watch pornographic materials and adult sex acts; or to witness or participate in criminal activities such as stealing, assault and prostitution.

12 What the effects of Emotional Abuse are Detecting child abuse is not easy. Some children learn to wear a mask. They may seem bubbly,

happy, outgoing, chatty, and interact with other children normally. In some instances an emotionally abused child will show no signs of abuse. For this reason emotional abuse is the most difficult form of child maltreatment to identify and stop. This type of abuse leaves hidden scars that manifest themselves in numerous ways. Insecurity, poor self esteem, destructive behaviour, angry acts (such as fire setting or cruelty to animals), withdrawal, poor development of basic skills, alcohol or drug abuse, suicide and difficulty forming relationships can all be possible results of emotional abuse. (Fact sheet 2001) A childs ability to swallow emotional abuse and to carry on, seemingly undamaged, can be seen by some as strength. The cycle of abuse gets established and can become generational and socially acceptable. When a child is coerced to accept that the abusive attitude they experience from the parents / carers is good for them and the emotional abuse is minimised, the lack of symptoms is likely to be used as a justification of the abuser so the impact of the abusers behaviour is minimised.

Research projects have highlighted the potential functioning. negative It is short and for long a term childs consequences of emotional maltreatment for later destructive competence in a number of areas including verbal and non-verbal communication skills, patience, goal setting, ego development in terms of basic confidence and security. Effects have been found to include withdrawal academic underachievement and emotional instability, social adjustment and interpersonal problems and difficulties in forming secure attachment, stunted physical growth and self-harming behaviour. Further research suggests emotional maltreatment is particularly damaging to a childs self esteem. Belittling a child it directly targets a childs worth through internalisation of sustained negative criticism. Low self-esteem has in turn been seen of a as wide a key factor of in the development range difficulties.

(Iwaniec, 2006)

13 Implications of Abuse
Emotions are a vital part of our being; emotions and emotional reactions are messages from our being to our consciousness. Burney (as sited in joy

2meu.com pg 1) proposes emotional abuse is underneath all other types of abuse the most damaging aspect of physical, sexual, mental, abuse is the trauma to our hearts and souls from being betrayed by the people that we love and trust. Emotional abuse is the heart and soul of mutilation Because emotional abuse attacks the childs psyche and selfconcept, the victim comes to see him or herself as unworthy of love and affection. Children who are constantly shamed, humiliated, terrorized or rejected suffer at least as much, if not more, than if they had been physically assaulted. An infant who is deprived of basic emotional nurturing, even though physically well cared for, can fail to thrive and can eventually die. Less severe forms of early emotional deprivation may produce babies who grow into anxious and insecure children who are slow to develop or who might have low self-esteem (National Exchange Club Foundation 2000).

14 Interventions The national childrens strategy talks about giving children a voice! Article 19; Protection from abuse and neglect recommends that The state has an obligation to protect children from all forms of maltreatment perpetrated by parents or others responsible for their care, and to undertake preventative and treatment programmes in this regard (D.O.H.S. 2000). How do these children get a voice if the In chapter one reference was parents / carer givers are emotionally abusing these children?

made to children not knowing they are being emotionally abused especially at a young age. The Following professionals may be in contact with children who are or have been emotionally abused. Health care providers and facilities of all types Mental health care providers of all types Teachers and other school personnel Social workers Day care providers Law enforcement personnel
The following is an example name some ref

Behavioural Indicators in the Child who is being emotionally abused

A child missing a lot of school Negative statements about themselves Shy Passive Compliant Lags in physical Mental and emotional development Self destructive behaviour High aggressive Cruel to others

A child with emotional behavioural disorders often needs what the people around them find difficult to give: support and understanding. What the child is communicating when they act out or withdraw is that something is wrong in their world and that they want or need help to sort the problem out. Children with such difficulties may also engage in attention-seeking behaviours, which an involve activities that attract the positive or negative attention of others. To the attention-seeing child however, negative attention is a desirable alternative to no attention at all (Cooper, 2005). 15 Family or parental indicators Blames or puts down child Is cold and rejected Indifferent to childs problems or welfare Withholds affection Shows preferential treatment when there is more than one child in the family (Child Emotional Abuse 2005)

Quoting Emily Logan (Ombudsman for children) in (Evening Herald Wed 4th Nov 2006) Isabel Hurley wrote As a state Ireland has little to be proud of when it comes to how its children have been treated in the past. The things that we as a society did and tolerated others doing to children are shocking. We allowed the Magdalene laundries to steal the youth of so many girls. We failed to act when unspeakable acts were perpetrated on children in the care of the state. She went on to say that children were not respected and listened to as individuals instead they were viewed and treated as possessions. In response An Taoiseach said a referendum would most likely be held March 2007 in it We should make provisions in our Constitution for children to be protected from maltreatment, neglect or abuse (Hurley, 2006). Perhaps the word Abuse needs to be defined! 16 Prevention
Preventing emotional abuse begins with education. Informing parents about the potential consequences of emotional abuse. Parenting classes, perhaps as a required part of high school curricula, can help inform parents or future parents about principles of child development and appropriate methods of communicating with their children. Previously in

the essay reference was made to interventions and the different professionals identifying parents who seem to have problems attaching to their children. These opportunities may present themselves for example when health nurse do home visits or surgery visits.

17 Presenting problems in the counselling room.

As discussed earlier in the essay children may not have to language to say what is wrong or know they have been emotionally abused. Counselling young children like adults therefore is not an option. A child coming for counselling may be extremely withdrawn or aggressive when first meeting the counsellor. This is why may be play therapy might help break down the barriers of communication.

18 Play Therapy Defined

Play therapy is a form of psychotherapy used chiefly with children to help them to express or act out there experiences, feelings and problems by playing with dolls, toys and other play materials under the guidance or observations of a therapist (American Heritage dictionary, 2000). Its an expressive therapy that uses play to diagnose and treat psychological problems. Play therapy is often used as a diagnosis tool. A play therapist observes a client play with toys to determine the cause of disturbed behaviour. The objects and patterns of play, as well as the willingness to interact with the therapist can be used to understand the underlying reasons for behaviour both inside and outside the sessions.

19 History of Play Therapy

The pioneers of child psychotherapy Anna Freud (1928, 1964, 1965), Margaret Lowenfield (1935, 1970), Melanie Klein (1961, 1987) first elucidated the uses of play therapy and posted the theoretical premise for the use of play. For instance Klein stipulated that a childs spontaneous play was a substitute for the free association used with adults within adult psychoanalysis. Theories and practice surrounding play differ within each child psychotherapy tradition. However each tradition is connected by the central proposition that play transmits and communicates the childs unconscious experiences, desire, thoughts and emotions. With in the migration of the early child psychotherapists to Britain in the 1930s, Child Psychotherapy has grown and developed as a strongly European tradition. Whilst play therapy has emerged from elements of child psychotherapy, the specific theoretical foundations emerged from the humanistic psychology tradition, (B.A.P.T.2006)

20 Research in Play Therapy

In 1995 Kot conducted an investigation on the effectiveness nondirectional play therapy. The subjects of the investigation were children aged from 3 to 10, all of who were witnesses to Domestic Violence. The results showed that the treatment group had significantly reduced externalising behaviour problems and significant reduction in their total behaviour problems. A further meta-analysis (Ray et al, 2001) of 94 research studies investigating the clinical effectiveness of Play therapy measured the effects of Play therapy conducted by mental health professionals in America and contained 3263 subjects. The authors concluded that play therapy is an effective intervention for a broad range of childrens difficulties (B.A.P.T. 2006).

21 Child Development Theorists

Jung as sited in Jennings (2004 pg 44) theories have only been applied to work with children in recent years, in particular through the pioneering work of Michael Fordham. Melanie Klein introduced the technique of play therapy through which interpolations could be made about a childs unconscious world; it was Winnicott who recognised the importance of the playful and creative relationship between mother and child. Both however fit into the objective relations theoretical framework in relation to child development. Piaget repeatedly investigated how children adjust intellectually to the world in which they live and he identified four stages in the development of cognition: 1. Sensorimotor; 0-years 2. Pre-operational 7 years 3. Concrete operations: 7 11 years 4. Formal operations: 11 years onwards Eriksons epigenetic places his eight own developmental stages alongside those of Freud: Stage 1-2 Years 1-3 Years 3-5 Years 6 yrs/Puberty Puberty/Adolescence Young/Adulthood Middle Age/Stage 6 Freud Oral Sensory Muscular - Anal Locomotor Genital (Phallic-Oedipal) Latency Puberty and Adolescence Young Adulthood/ Erikson Basic trust vs. Mistrust Autonomy vs. Shame/Doubt Initiative vs. Guilt Industry vs. Inferiority Identity vs. Isolation Generativity vs.

Adulthood/Stage 7 Stage 8

Genitality Adulthood Maturity

Stagnation Ego Integrity vs. Despair (Old Age)

Freud as sited in Jennings (2004 pg 47) suggests the id; the ego and the super ego mediate the relationship between primary and secondary processes and the inner and outer life. He says a child cannot separate the healthy life regulating ego from the pleasure seeking instinctual id until he or she has moved through the oral, anal and phallic stages.

Bowlby (as sited in lifespan development 2006 pg 144.) Suggested three phases in the development of infant attachment. 1. Non-focused orienting and signalling new born 2. Focus on one or more figures 3 months 3. Secure base behaviour 6 months. Stranger anxiety and separation anxiety 6 to 8 months, these rise in frequency until 12 to 16 months and then decline. Studies of parent-child interactions suggest that one crucial ingredient for secure attachment is emotional availability on the part of the primary caregiver. An emotionally available caregiver is one who is able and willing to form an emotional attachment to the infant. For example, economically or emotionally distressed parents may be so distracted by their own problems that they cant invest in the parent-infant relationship. Such parents may be able to meet the babys needs but unable to respond emotionally. Infants of parents who display contingent responsiveness in the early months are more likely to be securely attached at the age of 12 months (Boyd & Bee, 2006).

22 Conclusion
Young Children do not have the ability to articulate there emotions the way most adults can, as evidenced by the case study a childs behaviour can present itself as some form of disruptive attention seeking or behaviours that can be similar to metal retardation. Through the use of play therapy the childs interactions and enactments in play can be observed and assessed by the therapist. Play therapy facilitates a childs expression of feelings and helps process promote helped its him self-confidence enhance his and sense of and competence. In the analysis of Dibs the psychotherapy creativity playfulness; this helped develop a sense of trust in himself and others, which defined healthy boundaries.

Dibs created healthy bonding in relationships, which his therapist was to find out through a mutual friend when he was 15. Through play therapy a child can learn more adaptive behaviours when there are emotional or social skills deficits. The relationship with the child and therapist must be positive during play sessions; this provides the corrective emotional experience necessary for healing, as many of the childs problems are emotional trust. Children First National guidelines for the Protection and Welfare of Children and Duty of Care 2002

helps individuals increase their awareness around children. A copy should be given to every new mother and father in the hospitals along with the other free introduction packs they get. This should also be available for teachers in schools.