The Possible Person: Playfulness, Expression, Trust-Building, & Meaning-Making with At-Risk Youth in Psychotherapy

Far too often in therapy with at-risk youth—prompted by clients, caregivers, or even sometimes therapists—terrible weeks are merely re-hashed. The client's unstable mood or erratic behavior steals the show, a caricature of the forgotten person hiding beneath the masks worn day after day, stubbornly affixed as a concealment and a false comfort, and the possible person underneath the monstrous mood or the harrowing history is forgotten again.

In working with at-risk youth in therapy, I have found myself periodically stuck in vicious cycles of re-hashing. Even in clinical staffing of cases, I have become stuck in these vicious cycles. Multidisciplinary consult teams commonly become stuck in what I call "case gossip," a perversion of good, constructive case staffing in which small talk, generalized curiosity, and telling-everything-you-know takes the place of careful case conceptualization.

Therapy with at-risk youth risks devolving into cynicism, marching forward under a cloud of subconscious assumption that the pattern of pathology presented will persist. Such a mindset ever keeps true therapy at bay. Healing happens where growth happens, and growth happens where life flows freely into an open, as-of-yet undefined, and changeable future.

The Pace & Space of Trust-Building & Meaning-Making

I can remember that initially, Bria was not too happy to sit with me during our weekly sessions. Having experienced an early childhood of broken trust and sexual trauma, and after having bounced around between too many foster homes over too many years, she was understandably reticent to relax into my couch and lean into our relationship.

Bria was not the first client I had encountered with such an agonizing history. I had discovered by trial and error a therapeutic path that invited expression, an imaginative leap from dreadful realities. I had devised a simple self-assessment that helped me know whether my clients had any enjoyment of particular expressive activities such as writing stories, writing poetry, writing song lyrics, sketching drawings, sculpting clay, or other art forms. If there seemed to be no interest in these activities, I would gauge interest in more passive but still meaningful activities such as listening to music, short stories, or watching movie clips.

One day, I provided Bria with my assessment, and she indicated an interest in drawing. As I maintained a collection of colored pencils and drawing paper in my office, I offered them to her, and, another common practice of mine, I showed her an array of different colored folders she could choose to keep her drawings in at my office so they would be available to her each week. As a point of clarification, she was welcome to take any of her drawings from my office, but I only asked that she allow me to make a copy of any piece she would be taking away. If she did not wish for me to have a copy, I would honor her decision.

Every time she came to see me thereafter, I had art paper and colored pencils waiting for her. I never provided another invitation for her to use them. I didn't need to. And I never asked her about her drawings. I just sat with her and attempted, oftentimes awkwardly, to get to know her and to work with her to help organize her emotions into reflections and her reflections into meaning. She, all the while, organized her troubles into sketch art. Occasionally, she would hand a piece over to me and expound upon its finer points, its errors, and its meaning. On one occasion, as she did so, she fell apart into tears. At one point in the midst of that, she yelled and cursed so loudly that I could hear the footsteps on creaky hallway floors of a colleague come to discreetly check on things at my door.

Bria entered therapy oscillating between expressive anger, reflective sadness, and emotional distance. These matched her foster parents' reports from home. During the first two months of therapy, I observed difficult interactions between Bria and her parents, especially highly defensive behaviors by Bria. In her first several sessions with me, she had seemed emotionally rigid. As time wore along, I began to experience Bria differently. She seemed, in the context of our conversations over her sketch art, to be appropriately vulnerable, emotionally pliable, and more deeply reflective. However, her parents’ reports to me were nearly unchanged; the Bria living at home remained stuck in an alternate dimension.

The difference, in my view, between the kind of expression and interaction that Bria experienced in therapy (eventually) versus the kind frequently experienced during the rest of her weeks was a difference of control. During the week—during her life for that matter—she felt little of it. There were a number of reasons this could be said to be true. Yet during our sessions, she had a great deal of control. And she liked that. Sketch art did not solve Bria's problems. Nothing solved Bria's problems. Sketch art did not change Bria's past. Nothing changed Bria's past. Sketch art did not teach fantastic new life skills. I must confess that I certainly did not teach her much of anything, if "anything" should be construed as insight or manners or gumption (note: she already had gumption). Yet something happened in the course of our time together, and something of the give-and-take between us forged a new possibility for Bria, a new way of being in the world.

Her father noticed, and in his noticing, he came to me to ask what had changed. I reflected what wonderful care she was being provided in their home. I knew that their consistency and care was the most powerful intervention in Bria's life. He did, however, want to know more about Bria's therapy. I rarely knew, as a young therapist, how to explain to parents my work with their kids, and this encounter was no exception. When he pressed about what kind of strategies I was using to process her past trauma, I sputtered out a nearly undecipherable explanation of how I try not to push her and of how she had not actually opened up to me about her past trauma. Ultimately, her father reflected, "When I pick her up from her session each week, it's like the light in her has been turned brighter, and she's opening up in a new way. She actually has begun talking to me about past abuses, just matter-of-factly, really... and what's more, she's been kidding around with us a lot more lately."

All the World's a Stage

The psychologist David Elkind (1967) wrote of how adolescents are constantly reacting to an imaginary audience. He said that, as a result, they begin to develop a kind of personal fable in which the youth begins to see herself as a unique being in the world all her own and over-differentiates her thoughts from those around her, failing to see the interrelatedness in this ecology of people living life together. The personal fable is a narrative youth are telling themselves that begins to take on mythic life. It is difficult for some youth to differentiate their own mental constructs from reality.

When there has been a history of abuse or neglect, a survivalist mentality and an emotional schema to accompany it necessarily develops and often persists. Yet, when there is no longer a need for such a mindset, it is not easy to shed the once so-helpful rigidity and reactiveness. There is a kind of play that must be learned or relearned to become creative and integrative in life, as life at its best demands. Play, like summer vacation, has mysterious ways of relaxing stress, reprocessing experience, and integrating learning, preparing us for higher levels of growth, which includes healing processes.

Donald Winnicott (1971) referred to psychotherapy as playing together in the creation of symbols, as meaning-making. In his own words—

"Psychotherapy takes place in the overlap of two areas of playing, that of the patient and that of the therapist." (p. 44)

"It is in playing and only in playing that the individual child or adult is able to be creative and to use the whole personality, and it is only in being creative that the individual discovers the self." (p. 63)

It is never merely perspective or skill that holds power to change people’s lives. It is an expanded capacity for creating. It is the integration of character. It is a wellspring of courage fed of a source previously unknown. There is integrity, beauty, and in some cases, even justice, in the fluid, organic, and risky enterprise of care.

Because our clients need this sort of holistic integration, there must, therefore, be a dimension of “play” in psychotherapy, a breaking loose of rigid constructs—beliefs and behaviors—in the process of retrofitting a more constructive and contributory meaning. Play, as a literal or figurative activity, is a relationship-building catalyst, spurring development as therapeutic gains are consolidated. As we lower our guards and heighten our senses, we tend to position ourselves for greater learning and growth. Like breathing, eating, and sleeping, we all have a built-in need to be playful, to be exploratory and creative, to be more fully ourselves, to find the spaces necessary to shed persona and pretense.

If a child isn’t good at playful interaction, they’ll end up feeling more awkward and are more likely to withdraw from social situations. Our capacities for playful expression correlate with our capacities for resilience.

Playfulness involves imaginative consciousness and meaning-making. Everything we do can be permeated with an attitude that is playful. Emotionally responsive playfulness has its own way of signalling that there is safety in the room, and it holds potential for promoting vitality. Our clients often find themselves wandering in emotional deserts, harsh internal environments devoid of the fundamental elements necessary for play. Yet my former colleague Blanche Douglas (2015), asserted—

"There is never a total absence of potential space for the creation of meaning... Where trust and reliability have been internalized, there is a potential space with an infinite capacity for being filled with creative activity. It is there that unbearable contradictions become paradox, and paradox cannot only be tolerated but can be made use of in the experiencing of life."

(p. 25)

I have found myself slipping in and out of different personas myself as I have sat with youth in therapy over the years. Since I'm not great at being playful myself, this has very often taken the form of my best efforts to engage playfully, which is, in many ways, just another way of being vulnerable. There are few better ways for therapists to catalyze therapeutic alliance with emotionally resistant clients than modelling some degree of appropriate, genuine, power-sharing vulnerability.

I think of one older adolescent boy with whom I regularly ended sessions by walking outside to have him show me his latest tricks on skateboard. He would urge me to try, and I would nearly inevitably fall flat on my face. Those few minutes each week opened up a world of trust between me and that angry, rebellious, isolated boy who felt there was no adult in the world who was worth his time of day.

I remember a preteen girl I had seen from the time she transitioned out of juvenile detention. She was quite skilled with hurtful words. When she walked into the room one early session, my greeting was met with a sarcastic precision that punched me in the emotional gut and stripped me of confidence. I doubled-down in modeling goofiness and a bit of strategic self-deprecation, showing her my floundering skill of juggling hacky-sacks, which required me to stand up out of my comfortable armchair, dance around as I tossed them in cascades over my head and between my legs, and concluded in hacky-sacks flying chaotically toward opposing walls, leaving me stumbling off balance, arms and legs twisted.

In such moments, she would laugh not only at me, but with me. Her icy remarks would morph into playful teases that left just enough space to engage in a verbal jousting match of wit and trash talk. In the irony of that space, she—and so many other at-risk youth—have come to lose that respect, borne out of fear, for my position and power, and gain a more pliable, useful respect borne out of trust. In the microcosm of those spaces, seeds of meaningful therapeutic work are reliably planted.

Much of that work involves identifying the personas, or masks, that youth wear, instruments which conceal and protect. Rather than conveying that my clients have some "truer self" underneath their masks, I try and help them see their value and praise them for their adaptive skill in managing anxiety. My goal is not to strip them of their masks but to help them decorate them and practice expanding their repertoires. In As You Like It, William Shakespeare (1564-1616) began the introductory monologue—

"All the world’s a stage,

And all the men and women merely players;

They have their exits and their entrances,

And one man in his time plays many parts."

Carl Rogers (1961) wrote that as a person becomes increasingly comfortable with ways of being and becoming themselves over the course of therapy, they drop "one after another of the defensive masks with which he has faced life…[and] discovers in these experiences the stranger who has been living behind these masks, the stranger who is himself” (p. 123-124). I contend that a key word in Rogers's assertion is "defensive;" in other words, not all masks. Rogers did not intend to place clients in positions of untenable fear without recourse to their own internal, creative coping skills. He intended to have clients gain the power to become flexible in the face of fear.

Additionally, did you notice that in Rogers's metaphor, the person seemed to have had many defensive masks on all at once? This is another critical key. It does no good to wear all the masks all the time. We must know which work well for which particular role or "Act" we happen to find ourselves in. The capacity for shifting personas fluidly and creatively serves us all well in the theater of our lives, and we have responsibility to ensure our clients are equipped to perform well as they play their parts.

The Family Emotional System and Other Second Order Considerations

The field of psychotherapy has by and large engaged individuals in ways that ignore the complex webs in which individuals are entangled. In the course of therapy with at-risk youth, we must both remain focused and centered in our immediate psychotherapeutic work with the particular understandings and responsibilities of individual persons while also acknowledging the multilayered complexity that is the ecological web of their life. This is no small challenge, yet while to focus only on the systemic context would be to risk missing the person, to focus only on the person would be to miss that in which the individual is firmly embedded. Either error risks psychotherapy as an adventure in missing the point.

When the positive end of one magnet is placed against the negative end of another, an invisible force pulls them together. When the magnet’s positive end is placed against the positive end of another, they repel one another. Two pieces of uncharged metal neither attract nor repel. There is magnetism in the emotional systems of families and, to greater or lesser degrees, between every member. The force between two is skewed by a third, and so on. The challenge of therapy is of how to work therapeutically with processes that bind and unbind, generating flexibility and instilling resilience. To grow, at-risk youth must experience freedom within the pushes and pulls of powerful self-perpetuating life forces in which not only their problems—but their families—maintain themselves.

By the time children have become adolescents, they have experienced the formative role of the affections and intolerances, approval and consequences, freedoms and restrictions of their particular family. As an adolescent’s life outside the family expands, so do these dilemmas. Differentiation is a kind of rebellion, becoming unraveled from a family-of-origin and unfurled into a new adventure all our own. And this is all best-case-scenario.

We cannot ignore a youth’s role in their family, their functioning in the family, their support or lack of support from the family, their responsibilities to the family, and the role of the family in their dysfunction. Though it is not our only influence—our lives are so complexly woven into biological, psychological, and social systems—family relationships are ground zero for developmental processes. Thus, regardless who attends therapy sessions, the family is never emotionally far from the scene.

As we grow, we increasingly develop self-consciousness, and by the time we become adolescents, we are self-conscious for good and ill. In angst, an adolescent may avoid play or playfulness within their family out of embarrassment. Nonetheless, playful interaction can be emotionally nourishing and has the power to send the message that you mean no harm, and it has the conduction to ground emotional lightning storms and provides a channel for more genuine engagement. Make no mistake about it—along the way, families are the best possible venue for practicing playfulness, expression, trust-building, and meaning-making. Families sometimes need therapeutic help to become sufficiently relaxed and open for playful interaction and "playing with options" to occur.

Whitaker (1978) described "the battle for initiative" and "the battle for structure," contending for therapists to win the struggle against the continual drift toward entropy, to ensure the opportunity for therapy to occur in family therapy (Napier & Whitaker). I have fought many such battles by offering what Una McCluskey (2002) called "a fork in the road"—letting them know when were tempted to explain again an explanation of their prior explanations, that they could choose between carrying on explaining, remaining in the safe position of knowing what they know already, or exploring with me other paths and perspectives, an opportunity for a different kind of learning. This approach is effective in facilitating a shift between defending, criticizing, or debating facts to a space where new emotional experiencing may reshape the landscape of not only the individual internal process but that of the emotional systems in which the individual is embedded.

Gregory Bateson (1972) suggested that painting, poetry, music, dance, and other metaphoric art forms serve as a bridge between the conscious and the unconscious, a way of communicating outwardly what dwells inwardly in order to explore relationships between the meanings they express. Whitaker (1989) taught us that what is therapeutic is not necessarily the experience itself but the meaning attached to it. If the person is to change, creative and transformative experiencing must occur.

Systemic, person-centered psychotherapists understand that clients are not the sum of their parts or their problems and that the intimately personal, meaning-centered encounter is the instrument of therapy's fundamental utility. We see potential linkages, and power, between the client and every other person, challenge, and opportunity in their world and lean toward them, respectfully and intentionally stirring some of their anxiety-evoking interrelationship within the flux-and-flow of the here-and-now to invite problems into the room in order to engage hope for meaningful, second-order, sustainable changes to occur.

Every time that an at-risk youth becomes defensive or abrasive or despairing, we have responsibility as therapists to normalize and perhaps even validate the emotions that extend from their complex existential situation. Every time colleagues and parents become again entrenched in problem-saturated narratives and anchored to their own fears and anxieties for clients or children, we have responsibility as therapists to point them beyond their fears and anxieties to the possible person, whose courage we playfully, carefully, evoke.

Blake Griffin Edwards is, by training, a systemic psychotherapist, currently the behavioral health director at Columbia Valley Community Health in north central Washington State. Blake wrote the chapter, “The Empathor’s New Clothes: When Person-Centred Practices and Evidence-Based Claims Collide” in the book, Re-visioning Person-Centred Therapy: Theory & Practice of a Radical Paradigm.

The preceding is an adapted excerpt from a longer version of this article (available here) published in the Irish Journal of Counselling and Psychotherapy, 18(4), by the Irish Association for Counselling and Psychotherapy (Dún Laoghaire, Ireland). Reprinted with permission. Clients identities have been altered in protection of privacy.

References

Bateson, G. (1972). Steps to an ecology of mind. Chicago: University of Chicago Press.

Douglas, B. D. (2015, August). Therapeutic space and the creation of meaning. Context Magazine. Warrington, England, United Kingdom: Association for Family Therapy and Systemic Practice. [Edited by B. G. Edwards.]

Elkind, D. (1967). Egocentrism in adolescence. Child Development 38(4), 1025–1034.

McCluskey, U. (2002). The dynamics of attachment and systems-centered group psychotherapy. Group Dynamics: Theory, Research, and Practice, 6(2), 131-142.

Rogers, C. R. (1961). On becoming a person: A therapist’s view of psychotherapy. Boston: Houghton Mifflin Company.

Shakespeare, W. (1623). As you like it. First Folio. London, England: Blount, Jaggard & Jaggard.

Napier, A. Y., & Whitaker, C. A. (1978). The family crucible. New York: Harper & Row.

Whitaker, C., & Ryan, M. (1989). Midnight musings of a family therapist. New York: Norton.

Winnicott, D. W. (1971). Playing and reality. London: Tavistock.