Traumas that have seriously threatened the emotional and/or physical integrity of people, eg. being involved in or witnessing physical or sexual abuse, neglect, emotional abuse, warring parents, family violence, bullying, parental separation, unexpected death of loved ones, natural disasters like floods or fires, homicide, war, falls, surgery or motor vehicle accidents, often lead to distressing symptoms, such as fear, terror and helplessness.
Sometimes clients re-experience the traumatic events and begin to avoid any stimuli associated with the trauma. They may display hypervigilance, anxiety, depression or dissociation. They may be unwilling or unable to speak about what happened. Often client’s come to therapy with symptoms and don’t always realise they are trauma symptoms related to a traumatic event from the past. Whether they remember what happened or not, they may need help to resolve their symptoms.
Trauma does not live in the event, the event has come and gone. Trauma lives in the individual’s body, it lives in their nervous system. This means we do not need accurate recall of the event to resolve it. Instead, we can access what is showing up in the body or in the unconscious (implicit memory) of the client, and allow it to complete so that it does not continue to play out or cause distressing symptoms.
As the client attempts to portray the incident in the tray, the focus on the creation process allows some distance from the traumatic event by projecting the events out in front of them and allows the client to reveal details of the story in the tray with less activation and less personalisation. The story can be slowed down to a pace that is tolerable. The client is in control of the telling of the story. They can even add in resources that they didn’t have but may have needed.
Not only does the client re-experience the trauma as they recreate it, but they also frequently move stuck emotional and physical energy as they use their hands to move the sand and manipulate the symbols in the tray. When the client actually sees what occurred during the traumatic event from this playful perspective and explores the experience verbally, a release of emotion and a change of perception frequently occur. Many clients have only relived their traumatic experiences in their head and have spoken little about them.
Using Sandplay Therapy to Remember and Resolve Emotional Wounding
Trauma is not a verbal experience; it is an implicit (non-verbal) experience that is felt throughout the body and is encoded in one or more of the senses – visual, auditory, tactile, olfactory, taste. It is easier to access trauma-related sensations and emotions through sensory based activities including play.
Ordinary declarative memory fails in people with post-traumatic stress. Therefore, language and talk therapy are limited tools in working with trauma (van der Kolk). Instead, therapists need to tune into the somatosensory level through visual images and physical sensations where trauma memories are stored.
Sandplay Therapy is a sensory experience. It is visual, kinesthetic and tactile in nature. It is in fact, multi-sensory. Therefore, Sandplay Therapy is a developmentally appropriate way to support repair and recovery from traumatic events.
Non-Verbal Communication
Non-verbal communication is our most basic form of communication and it is how caregiver and infant initially connect in those first years of life (Schore, 2008). Children in particular, do not always have the sophisticated ability to articulate perceptions, thoughts and feelings about traumatic events.
Sandplay Therapy is particularly useful in helping individuals communicate aspects of memories and stories that may not be readily available through conversation. Memories can emerge through touch, imagery and body movements. Creating in the sand can be more easily tolerated than verbalization, or ‘telling the story’ of what happened. When trauma memories are particularly complex or overwhelming, children who have been severely traumatised may repeat experiences through engaging symbols or movements in the sand.
For people of any age who’ve experienced traumatic events, the language area of the brain, Broca’s Area (in the left side of the pre-frontal cortex), switches off and makes it impossible to put thoughts and feelings into words.
Right Hemisphere Dominance
Research on the impact of trauma proposes that highly charged emotional experiences are encoded by the limbic system and right brain as sensory memories (van der Kolk, 2006). Expression and processing of these memories on a sensory level is an important part of successful intervention.
When an individual experiences trauma, the left side of the brain goes off-line, ie. the language centre, including logical and linear narrative, and the right brain stores trauma memories in sensory based forms – sounds, sights and other fragments of experiences in non-linear, non-verbal forms.
Sandplay Therapy allows clients of all ages to access these sensory based forms through the use of imagination, play, movement, creation and symbolism.
Working from the Bottom-Up
In Bruce Perry’s Neurosequential Model, he suggests a bottom-up approach when working with developmental trauma.
Brainstem → Midbrain → Limbic → Cortical
Safety → Movement → Emotional Engagement → Learning
In therapy this might look like expression of the body’s sensory and kinesthetic (lower brain) experience as a foundation before the eventual exploration of emotion (limbic system) and personal narrative (higher brain).
When working with a client, one might invite them to:
♥ Notice something pleasant (a movement, an element of nature, a symbol, cool air, soft pillow, outside view, painting, etc)
♥ Invite client to name and track sensations in the body – ‘what do you notice is happening inside your body as you tune into that?’ (lower brain)
♥ Invite client to create an image or shape in the sand, or on paper (right brain)
♥ Invite client to make a movement or sound that the image may make (right brain)
♥ Invite client to express any feeling that’s present as they create (limbic system)
♥ Invite client to make up a story about the image they created or some dialogue from the image (higher brain).
Integration
Reparation and recovery from trauma is entirely possible and is referred to as ‘trauma integration’. This is the ability to talk or think about the trauma experience without reliving it, including psychosocial and somatic reactions to traumatic events.
Sandplay Therapy offers a way to reconnect sensory memory (the right brain’s experiential memory of events) with a linear, explicit memory (the left brain’s chronological narrative of events). This helps our clients to be able to create a coherent narrative about their life, a key feature in trauma recovery.
Play, creativity and imagination, inherent in Sandplay Therapy, can restore a sense of possibility, identity and reconnection with parts of self that were silenced in order to survive.