Episodic Experiences of Child Physical Abuse, Early Relational Trauma and Post-Traumatic Play: Theoretical Considerations and Clinical Illustrations

J Child Adolesc Trauma. 2022 Sep 30;16(2):365-379. doi: 10.1007/s40653-022-00489-8. eCollection 2023 Jun.

Abstract

Through symbolic and make-believe play, children can give meaning to their emotional experiences. For children who have experienced trauma, play provides the means to transform their past and tame the intrusive images and feelings associated with it. The quality of parent-child interactions plays a vital role in the development of mental representational capacity, which is essential for children's ability to engage in symbolic play. However, in child maltreatment situations, the unpredictability and insecurity of the parent-child relationship can have a profound impact on children's ability to play. This article aims to explore how the post-traumatic play of children who have suffered from episodic experiences of physical abuse differs from that of children who have experienced early relational traumas (ERT) resulting from chronic exposure to maltreatment and neglect. A theoretical and clinical analysis of the first play therapy session of a child who lived episodic experiences of physical abuse and that of a child who was exposed to ERT is presented. This analysis is informed by the Children's Play Therapy Instrument and the theories proposed by Chazan and Cohen in Journal of Child Psychotherapy, 36(2), 133-151 (2010), and Romano in Le Journal Des Psychologues, 279, 57-61 (2010). The nature of the relationship between children and their primary caregivers and the child-therapist relationship are also discussed. ERT appear to compromise the development of diverse abilities in children. Among them, access to the world of mental representations, which depends to a large extent on the presence of mindful and attentive parents, and their ability to capture and respond contingently to the playful proposals of children.

Keywords: Early relational traumas; Parent–child relationship; Physical abuse; Play; Post-traumatic play.