Interpretation and Play

Some Aspects of the Process

of Child Analysis
ANGELA F. JOYCE

Taking a combination of Anna Freudian and Winnicottian approaches

to play and playing, this paper considers the nonlinear relationship be-
tween interpretation and play in the process of child analysis. Using ex-
tensive clinical material from the analysis of a late latency girl who had
been adopted, the author revisits the technique of using the displacement
in play and the variety of modalities within which a child’s unconscious
concerns can be approached when disruption of the setting threatens be-
cause of the child’s fragile ego.

the debate i want to revisit is as old as child analysis itself

and has taken many twists and turns to its current situation of appar-
ently greater agreement. I say apparently because despite many moves
toward center ground it seems to me that there are still significant
differences and this may be one of them: play and playing and their
relationship to interpretation. This discussion will be largely from a per-
spective that straddles that of the Anna Freudian tradition of working
to promote psychic development and the technique of working in the
displacement of play, with that of D. W. Winnicott whose concern with
playing and the analytic process are renowned. There has been much
written in more recent years about the place of play in child analysis,
much from American literature (e.g. Neubauer 1993, 1994; Cohen and

Training and Supervising Analyst British Psychoanalytical Society; Training lead for
Child Psychotherapy Service, The Anna Freud Centre, London; Consultant Parent In-
fant Psychotherapist, The Anna Freud Centre, London; in private psychoanalytic practice
(adults and children), London UK.
The Psychoanalytic Study of the Child 65, ed. Robert A. King, Samuel Abrams, A. Scott
Dowling, and Paul M. Brinich (Yale University Press, copyright © 2011 by Robert A. King,
Samuel Abrams, A. Scott Dowling, and Paul M. Brinich).

152

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 Interpretation and Play 153

Solnit 1993; Mayes and Cohen 1996) etc., where the debates perhaps
don’t have the same contentious history as is the case in British psycho-
analysis (King and Steiner 1991). To help the discussion I am going to
use some clinical material from the analysis of a girl, whom I treated
for four years from the age of 9, to highlight some of the issues that
pertain to this debate.
Michelle was an only child, adopted from abroad by her single mother
at 5 months old. There had been difficulties between them for a long
time, seemingly from the early days of the adoption, and they were ex-
acerbated by the need for the mother to return to work when Michelle
was a year old and left in the care of a nanny. The mother remained
single although part of a wider extended family with whom Michelle
had much contact. On referral Michelle was intensely anxious around
separations and both hostile and clinging to her mother; they often
had physical fights and this had gone on for many years. Michelle was
not doing well at school and found it very difficult to make and keep
friends as she was demanding and very jealous.
From the outset of the work with me, Michelle was restless and suspi-
cious. She seemed not to feel relieved nor understood by my attempts
to talk to her about herself, and she left the room many times when the
comments I made were too near the rawness of her states. The usual task
of creating the analytic setting felt extraordinarily difficult as my attempts
to make contact with this child were rebuffed and I was catapulted into
the management of provocative, sometimes violent behavior. In calmer
moments Michelle began tentatively to play with the doll figures and the
wild animals that were in her box. Although she gradually seemed pre-
pared to play, there was no doubt that she found any direct links from her
play into her “personal concerns” completely unacceptable. I had to be
extremely cautious in deciding to speak, when and about what. Although
I felt I was bombarded by communication it was often impossible to do
anything with it but bear it. One might say we were in the territory of
Bion’s container-contained (Bion 1962), the communication of incho-
ate anxiety to which words could not yet give meaning. I know that this
is an all too common experience of working analytically with children
especially when there are fundamental problems in the narcissistic equi-
librium of the child and I have written about it elsewhere ( Joyce 2002).
Rose Edgcumbe in her 1995 paper about Anna Freud’s evolving
thinking about developmental disturbances wrote: “I think some of us
at least were aware of an inner tension between the wish to be ‘proper
analysts’—that is, doing ‘proper interpretative work’ with neurotic
patients—and finding ourselves obliged to do all sorts of other things
which we tended, in those early days, to think of as ‘non-analytic.’’’

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 154 Angela F. Joyce

Anne Hurry’s book about developmental aspects of analytic work with

children published in 1998 confirmed the legitimacy of the wide rang-
ing techniques that in the past may indeed have been regarded as “non-
analytic.” They are used extensively as the children we see do not come
with a good mental structure, nor the capacity for internalized conflict
for which analysis was originally intended.
First of all we present some material from a session a few months into
the work with Michelle:

Vignette 1

Michelle used the toys provided to make up stories, sometimes

but not always involving me in the play by asking me to “be” certain
characters. She had been playing with the wild animals for several
sessions, making up stories where there was much confusion about
who belongs to whom, in convoluted family relationships, loyalty
conflicts and especially a theme of children not knowing who their
father was.
In one session Michelle set out the wild animal figures with two
adult tiger and lion fathers playing with their cubs. She incorporated
a model of a sphinx from my bookcase, making her into a “God-
dess,” and “flew” her down to where the animals were playing to-
gether. The Goddess was friendly to the cubs and their fathers and
so they all seemed to be having an enjoyable time. All of a sudden
she made the Goddess snatch the young cubs and “flew” them far
away into the mountains. I talked about how frightened the cubs
must be, stolen from their fathers like that. She told me to take the
part of the fathers and to make them search for their stolen cubs.
I played the father as they went on a long and hazardous journey
across rivers, up valleys until they found the Goddess’ cave. I talked
about their fear for the safety of their children, their anger with the
Goddess for tricking them and about their determination to find the
cubs. When they found their cubs Michelle said they did not recog-
nize their fathers because the Goddess had put a spell on them so
they would forget their previous life and believe that the Goddess
was their mother. I then sympathized with their predicament; the
conflict the cubs might feel, wanting to believe that the goddess was
their mummy, but somehow feeling that it wasn’t true and not know-
ing. Michelle was quiet and watchful as she authored this story, inter-
ested it seemed in my response and what I would make of it.

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 Interpretation and Play 155

This narrative can be thought of as a fairly transparent representation

of Michelle’s view of her adoption, an indication of the sense she had
made of the story she had been told and her inner experience of her
history. From this perspective it suggested a belief that she had been
stolen against the wishes of her father and that she only believed this
person (the Goddess, adopted mother) was her mother because of a
trick. Indeed it possibly also reflected her feeling or fear of being cut
off from her history particularly from her paternal origins and being
lost forever in a maternal realm through this spell. The latency issues
of her gender identifications also are suggested, and in the transfer-
ence, her fear that in coming to see me I would, like the Goddess
somehow trick her and steal her away; additionally, her wish that I
might be the father who would rescue her from the territory of the
maternal.
I could have interpreted any one of these themes, or others, but I
was cautious as I had already experienced many attempts to address the
content of her play interpretatively, and it had just led to rupture and
cessation of the play and the session. So I decided not to “spell” out,
explore, these clear links directly. It seemed that we could with some
safety know and understand more about her understanding of the story
of her self, her life, her adoption and her current predicament and
her relationship with me in the transference without the disruption of
turbulent action, the manifestation of her extreme anxiety, by working
with this play in displacement.
This is a particularly Anna Freudian style of child analysis, recogniz-
ing the potentially communicative nature of play but also the value of
the defense of displacement and its use technically (Neubauer 1994;
Sandler, Kennedy, and Tyson 1980). For children whose ego capacities
are limited in ways such as the poor toleration of strong, potentially
overwhelming affects, the analyst’s commenting largely in the play can
mean that the feelings, phantasies, wishes, defenses, etc., are elaborated
in the “displacement,” probably with greater freedom and response by
the child. In addition the work in displacement can be seen as having
reverberations throughout the child’s experience of herself, uncon-
sciously functioning to make links, contributing to the child’s internal
elaboration of meaning, in the here and now. The child may not be
able or inclined to demonstrate this in an obviously insightful way but
as with the associative process of an adult, the movement of the mate-
rial is indicative of these more unconscious or pre-conscious processes.
Michelle could be helped in this way, in an analytic exploration that
at some future point might be more consciously integrated into her
account of her self.

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 156 Angela F. Joyce

As in this session the analyst will often be invited by the child to

engage in play, take roles in the elaboration of a narrative, the differ-
ent meanings of which may emerge over time but equally may remain
hidden or obscure. Clare Winnicott and Ray Shepherd in their preface
to D. W. Winnicott’s posthumously published account of his analysis
of “The Piggle” (Winnicott 1977) say of his technique: “He perceives
and accepts the transference but he does much more; he brings it to
life by enacting the various roles allotted to him. The dramatisation of
the child’s inner world enables her to experience and play with those
fantasies which most disturb her. This occurs in small doses and in a set-
ting which has become safe enough through the skill of the therapist”
(p. viii). “Interpretation” may take place in this elaboration in quite dif-
ferent ways: following the play in action, focusing on the characters in
the story, the child is creating: the affects between them, the wishes and
impulses evident within a character, or from one to another, or simply
following the child’s lead in extending the dramatic narrative. This sup-
ports the development of mental structure, promoting ego and super-
ego development, etc., and at the same time providing the “opportunity
for the child to have a location in play where feelings, phantasies and
wishes may be apprehended, reflective capacity developed and insight
derived” (Mayes and Cohen 1995, p. 1148). In addition the analyst’s
actions qua actions may convey an interpretation but without words
directly. For example, taking part in a ball game of “catch” conveys to
the child the analyst’s recognition of the child’s wish to connect with
her; it may be elaborated in ways such as following the child’s counting
before the ball is dropped; observing who drops the ball and how it is
retrieved, the force with which it is thrown etc., all redolent with mean-
ing which may or may not be put into words. A verbalized interpreta-
tion, “translating” the play, saturated in primary process, into secondary
process form may risk prematurely cutting through the child’s hard won
defenses and unhelpfully disrupt the child’s creative play activity.
At this point it is helpful to consider the nature of interpretations in
child analysis. One of the arguments given for interpreting from the
content of a child’s play, spelling out verbally the possible unconscious
meaning of that content, is that it helps the child move from the mode
of primary process and action to verbalization and secondary process
functioning. However that is not by any means always the outcome, es-
pecially with a child whose psychopathology is non-neurotic and more
severe, nor is it necessarily a desirable outcome with less disturbed chil-
dren. There is a more general principle here, that of the necessity of the
child analyst to stay as close as possible to the child’s way of expressing
themselves. This is a complex issue especially if we think about the func-

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 Interpretation and Play 157

tion of play for a child: for this I will turn to Donald Winnicott, whose
vast experience with young children through his work as an analyst
and as a pediatrician led him to place playing at the center of a child’s
creative functioning, indicative of its “going on being” and aliveness
(Winnicott 1971).
Winnicott’s views about forms of communication do not differentiate
much between what he calls “the vitally important subtle communicat-
ing of the mother-infant kind” (Winnicott 1958), the child playing and
beginning to speak, and the adult talking. He saw them all as aspects
of the human repertoire of representation and communication. Thus,
verbalized, one might say conventional, interpretation is not privileged
but instead one of several modes that can reach children in an emotion-
ally real way, responding to their primary capacity for communication.
Indeed Winnicott’s views about the analyst’s response to the child’s play
is rather special; he was very clear that analyst’s job was not to disrupt the
play by interpreting its meaning prematurely. He saw playing in itself as
constitutive of the unfolding of the child’s personal pattern, of her pre-
occupations, those things she is ready for and is interested in. It is essen-
tially a transitional activity, full of potential and inconclusive. This quality
of openness is also linked to the function of playing as equivalent to free
association in the analytic setting. To pin it down through interpreta-
tion with particular (closed) meaning rather than to open it up through
playful extension would only risk inviting compliance or resistance: play
stops when one of the participants becomes dogmatic (Phillips 1988).
This then concerns the nature of the connection made with the child
to facilitate further imaginative elaboration of potential meanings whose
purpose is to promote his or her ongoing creative aliveness.
Lanyado (2006) observes that Winnicott’s accounts of his work with
children are “in a manner which seems to say ‘Here is something, an
idea to play with and if you find it interesting, we can play with it to-
gether.’’’ In that he sees play as “work,” his playing always had serious
purpose which made him judicious in his use of interpretation and
attentive to the provision of the appropriate setting. Play and inter-
pretation were part and parcel of the clinical work, but interpretation
should not pre-empt or disrupt the child’s enjoyment. For Winnicott
play is intrinsically worthwhile and “is itself a therapy” (1971, p. 58).
He said, “the important thing is not my talking so much as the fact
that the child has reached to something.” In the case of Bob, aged 6,
(1965, 1971) he observed that it was unlikely that the young child could
have put into words what he conveyed in the game, but through it
(the Squiggle game) he was able to communicate something of his ego
dysfunction. Winnicott assumed the playful, non-verbal communication

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 158 Angela F. Joyce

would reverberate through the child’s being and sponsor the impetus
toward healthy development.
To return to Michelle, as her analysis proceeded I had to restrain her
several times from attacking me when I linked her play too directly to
her feelings and thoughts about herself and her life, either in the trans-
ference or referring to other aspects of her life. She often experienced
me as disruptive of her being in this way rather than helpful. I came to
understand this in several ways but largely as revealing the overwhelm-
ing sense of shame and humiliation she felt about her adoption and
her lack of a father. She let me know many times that she found my
comments intrusive and nosey, but her own curiosity about me and my
life which could not be satisfied, felt too concretely as her banishment
from her birth family, where in fantasy she had a father and a mother,
and sisters and brothers. These happy (and unhappy) family scenarios
were played out again and again, in the narrative scenes where I could
talk to her there about the jealous rivalries, fears, wishes, disasters etc.
in displacement and she could use my contributions without being
overwhelmed.
From time to time I also talked to her about what I saw as her defen-
sive use of displacement, her fears about talking directly to me and her
greater ease in showing me in her play what she was concerned about.
Invariably this got a hostile response and many times led to the play
being interrupted. This invokes such concepts as the treatment alliance,
and analytic tact which refer to the necessity of the analyst even in the
face of acute negative transference, being able to establish and retain
with the patient the basic agreement about why they are meeting in the
way they are. In a more complicated way for work with children it also
points up the issue of consent to treatment, who gives it and how it is
sustained at the most difficult times.

Vignette 2

Approaching the first holiday break in the analysis, Michelle

brought a 3000-piece jigsaw puzzle to the session eager to do it
together but saying it would take 3 – 4 weeks and then leaving the
room almost immediately to go to the toilet. The puzzle was actually
far too hard for her and she gradually began to pile the pieces into
my lap so that it soon overflowed. I said that she wanted me to sort
out all these bits and how complicated that was. As she continued

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 Interpretation and Play 159

doing this, I said that she wanted me to put all the bits of herself
together so she could have a picture of herself and that she knew it
would take quite a long time for us to do that together. She quietly
listened. At the end of this session she wanted to leave the puzzle
with me to which I agreed. The following day she repeated the early
part of the session: wanting to do the puzzle, but soon went to the
toilet. She became despondent when she could not easily match the
pieces and I talked about her sense that this was going to be too
much, that the puzzle was enormous and that it would take a very
long time. She added, “if we ever get started,” and then abandoned
the task pouring the pieces over herself and me. With an edgy, de-
termined feeling we repeatedly had to collect the pieces together in
the box. After a while I said, “I imagine all these pieces of the jigsaw
puzzle are just like little pieces of you, Michelle, and they all belong
together like in the box, inside you; but sometimes you feel that all
the bits of you just pour out and like the jigsaw some might get lost,
so that the big picture can’t be completed.”
The affect in the room calmed but after again going to the toilet
the edgy volatile feeling returned. She initiated a game of “catch,”
and then insisted that I keep guessing what I could take away on a
fantasied holiday to California: I was always wrong and, after a com-
ment from me that she seemed not to want me to go, she erupted.
She approached me provocatively, and sat on top of me and going
for my glasses and T shirt in an insistent and forceful way, seemingly
to see my breasts. When my trying to set limits verbally failed, I had
to restrain her by holding her wrists, saying at the same time that
she was showing me how close she wanted to get to me— even be
my baby and me her mummy/analyst—but that these feelings were
very hard and so she also had “fighty” feelings to push me away. This
only inflamed her and she leapt up saying she was leaving. Although
I acknowledged her being upset at what I had said, Michelle re-
mained agitated and ran out of the room and up the stairs and then
down and back into the consulting room. She pushed me and tried
to kick me. I said to her that I wouldn’t let her do that, I needed to
keep us both safe, restraining her, but that we could try to under-
stand what she was trying to tell me. I continued, as Michelle stayed
close but agitated, and said that I thought she was feeling full of
the fighty feelings that she has when she wants to be close but feels
frightened. Michelle grabbed some pencils and threw them at the
light and ceiling and suddenly stopped as one hit the light. She was
immediately worried about what she had done, and I linked this
with her worry about hurting me when she was in this sort of state.
Michelle became somewhat calmer but was still quite agitated as the
session came to an end.

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 160 Angela F. Joyce

The agitated states in this material were related in the transference to

Michelle’s ambivalent dependency upon her maternal object, clinging
and at the same time fighting to get away. After some time and repeti-
tion of this “play” with the puzzle, I directly addressed it as a symbolic
communication of the threat of fragmentation she felt, and this led to
a calmer period for a while. A game of catch, highlighting again the
tenuous link she had with me that was to be broken, led to a game
about the holiday. Verbalization of her wish that I stay did not calm
the situation but instead inflamed it and led to her intruding on my
physical body space, prompting another direct interpretation about her
regressive wishes to be my baby and me her mummy analyst. Michelle
regressed indeed, to action that was fuelled by her anxiety and agita-
tion that only somewhat abated with her fear that she had damaged
my room and me.
Being a child analyst can be dangerous at times; the risk of the child’s
decompensating and regressing to a body/musculature-based action
mode of functioning can lead to injury and require management as
well as understanding and interpretation. The task for the analyst is
varied: to be an auxiliary ego who can process the powerful feelings
that are aroused and bear the threat of being overwhelmed; to take in
projections of intolerable states and work with them internally, resist-
ing the provocation to retaliate and confirm the child’s worst fears that
they are hateful; to keep some thoughtful, imaginative capacity avail-
able, capable of seeing beyond the immediate fight to its underlying
significance, even if that can’t be spoken at the time but held in mind
for a later opportunity. Sometimes it can feel as if there is a siege tak-
ing place. Perhaps a maxim that would summarize these difficulties for
the child analyst is that one does not gratify desires but responds to the
developmental needs of the child.
Many times in the early months and perhaps the first couple of years
of work with Michelle, my affective response was one of intense hostility,
even hatred when attacked by her (Winnicott 1947). I could feel it in my
own body when forced to restrain her; there was tension in my muscles
as I struggled to prevent physical injury and to hold on to some space
for thought. It felt very much a reflection of the relationship described
by the mother where physical fights were frequent between them. I have
rarely had to bear such intensity of negative feeling in my work with
adults. In this session the meaning of my going away aroused unbear-
able feelings in Michelle. The intensity of the response provoked in
me put under severe pressure the need for me to survive her intrusive
aggressive attacks: Would I be provoked into retaliation? and could I
survive? In the transference could she survive outside the intense am-

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 Interpretation and Play 161

bivalence of her maternal relationship, indicating the archaic imprint

of her original separation from her birth mother; physical separateness
invoked the fear of psychic disintegration. The fragments of jigsaw and
her subsequent behavior conveyed her feeling in danger and the need
for safety. My sense of being literally intruded upon and then in danger
reflected her concretely pushing her unbearable psychic experiences
into me.
Her attacks upon me can also be understood as her attempts to create
separateness that could be survived (Winnicott 1971). They contained
a search for a response from me that might help her discover where she
ended and I began, so to speak. I was sorely tried as my own defensive
aggression was stirred up counter-transferentially and threatened to
confirm her belief that to separate (and indeed to be together) was a
disaster. What she sought was my nonretaliation which would enable
her to put me, and find me, outside her omnipotent control, thus
demarcating the boundary between self and other, a necessary req-
uisite for independent psychic life and psychic survival. With a child
the nature of the “destructive” attack understood in this way is often
likely to be at this level of the body; the regression implied, or indeed
the enactment of a state which developmentally has never been ad-
equately established would be connected to the more infantile use of
the body as a conduit for affects that are not adequately represented
in the mind.

Vignette 3

Toward the end of the first year of treatment, Michelle played out
a story with the wild animals of a family that was breaking up be-
cause the violent father divorced his wife. The baby was to be taken
away because a judge decided that the now single mother could not
look after her. The mother frantically tried to keep the baby, secret-
ing her away but the mother was attacked by the father and other
wild animals. As I talked about this and the mother’s desperate at-
tempts to keep her baby, Michelle made the elephants smash the
mother against the wall. Then the game unravelled as she directed
her attacks toward me, threatening to throw an ornament from the
book case.
Because the work had now moved away from the displacement
probably as a result of Michelle’s agitation disrupting her capacity
to play, I decided to interpret directly what was happening and said

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 162 Angela F. Joyce

that it seemed I was like the mummy and she wanted to attack me
for not providing her with a Daddy who would stay. She immedi-
ately said that she did have a Daddy, that he was a secret Daddy; only
she and her Mum knew about him and he lived somewhere else.
After some more potentially violent behavior she transformed what
was happening into a “show,” singing a song she had sung before,
repeating the words “when it seems all your hopes and dreams are
a million miles away I will be there for you . . . ” I silently listened to
her and after she had ended said that she wanted me to be here for
her no matter what she did. She allowed this without further com-
ment and the affect in the room was calm.

This plea for unconditional love from a joint paternal/maternal fig-

ure was very raw, and close to Michelle’s sense that her adoption by her
single mother had not provided her with this. She was seeking an expe-
rience in the analysis that she felt was lost when her fantasied family of
origin had broken up. Perhaps she was also showing in the play that the
analytic baby so under threat was protected in the analysis. The secret
daddy could be me in the transference, to whom she could appeal in
her song. The transformation of the volatile enactment in the session
into the singing play which gave expression to her longings followed the
verbalized interpretation of the transference and reflects the greater
use Michelle was able to make sometimes of my interventions by this
point in the work. It also reflects her creativity and unselfconsciousness
in drawing upon her different capacities to let me know about herself.
This I think is what can be so special about work with children: what
adult could burst into song in this way to express something that prob-
ably couldn’t so easily be said directly?

Vignette 4 from the End of the

Second Year of Treatment

In the early part of this session Michelle told me urgently about

a pigeon with a broken wing which she had seen on her way to the
session, not knowing if it was dead. She then got me to feel her fore-
head saying “ouch” and suggested also that in a fall she had broken
her leg, or twisted it; she needed hospital. I, not knowing if she was

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 Interpretation and Play 163

telling me a literal truth, talked about her being like the pigeon
in need of care. She laughed at me saying it was a joke. I felt very
confused and in my mind I linked this familiar sense of confusion to
a story from yesterday’s session about a vulnerable child. However,
as I began to speak, Michelle quickly changed the subject talking
loudly over me; in no time we were playing hide and seek. I spoke
about her disappearing and then hiding and her wanting to hide
something from me; she carried on playing, wanting me to be under
the cushions, to erupt like a volcano out of them. But I sat on the
chair beside the window and she jumped on me; she was very close
and took my hand looking at my wedding ring. She said she knew
where I lived and that my husband or son had rung up her house so
she had spoken to them. I said she very much wanted to know about
and maybe have contact with my family but . . . and, almost before I
had got the words out of my mouth she said she was going as she had a
headache. For the next 10 minutes she was in and out of the room
leaving to go to the bathroom; when she eventually returned I said
it was so hard for her to want to be close to me and to be looked
after by me especially when she felt that other people like my fam-
ily got in the way; and that she had to get away from me when I
understood something like this that was so important to her. After
some provocation with the furniture she initiated a game of “pass
the pinecones” which felt quite precarious; it could develop into
something antagonistic. I talked of her keeping us together by this
game, perhaps also letting me know how frightened she felt when I
talked to her about these painful things.
The game did not descend into something hostile, and in fact she
helped to tidy up the room after she had been to the toilet again.

Michelle both wanted and did not want me to know about her need
for care of the very vulnerable girl she was; in the transference her
curiosity about my family was so full of poignant envy and jealousy, so
linked to her sense of not getting what she needed and wanted. Over
time these concerns had become more elaborated in the analytic pro-
cess so that they were now expressed in the imaginative narrative of her
play and here were more directly articulated in her relationship with her
analyst. However it is also clear how difficult it was for her to hold this
in her mind, and how even after nearly two years of treatment, the agita-
tion in her body expressed so eloquently what could not easily be borne
in mind. My interpretation of her needs, anxieties, and wishes were
only partially successful in holding and containing her. Over most of

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 164 Angela F. Joyce

her time in analysis she found that thinking about her feelings directly
was overwhelming. Her capacity for affect regulation was very flimsy
and easily rendered useless when subjected to floods of unmodulated
stimulation. Often my interpretations would push Michelle back into
the action mode of functioning. When as in this vignette she seemed
closer to recognizing the links between her play and her self I could
risk articulating them, but it felt for the most part very risky. I had to
find ways of being with her that did not avoid the painful affects but
allowed their recognition to be bearable.

Vignette 5

As she moved toward an early puberty (aged 11 years) the content

of her play began to change. Her stories now were more focused on
adolescent children and what they were up to: now of romantic or
sexual interest. They revealed thoughts about rivalry and jealousy
between partners and expectations of unfaithfulness and lack of
loyalty. There was also cruelty and sadism in the way these charac-
ters treated each other with little evidence of hope and love.
Toward the end of one session Michelle used the doll and animal
figures to play out a secret and unpredictable scenario where boys
and girls linked up together with characters being “dumped” with-
out warning and teaming up with others. The girl cat, only 15 years
old, had a baby with the turtle boy and they were together as a happy
family for a year. Then suddenly a man took the child away as there
was a rule that under-20 year olds could not be parents. The boy
child named John was sent to live with another family, but his young
parents managed to find him as he was having his fifth birthday. Af-
ter first not recognizing them he then did so, but said that he loved
his step parents because he had been with them longer. The birth
parents were very sad and John wanted to stay with them. I said to
Michelle that she was telling me her thoughts about growing up and
being a young woman who might have a baby, but also about who
she imagined had been her birth parents and why she had been
separated from them. She looked at me directly but said nothing.
When she returned the following day she brought a set of Poké-
mon cards and we spent a long boring time ordering, categorizing,
and sorting them. I said that the day before things were not so safely
ordered, which prompted her to leave the room to go to the toilet.
Later as the card play was repeated I said indeed yesterday was much

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 Interpretation and Play 165

more messy than today, with the 15yr old girl having a baby but later
losing him. I said that I had got the message that she wanted me
to know that she was struggling with these thoughts about where
she had come from and how she came to be with her Mum. She
had been talking loudly over me but at this point she stopped and
looked straight at me and said “I know drrrr!!”

The point to be highlighted from this material is the way the play
moves on under the pressure of the developmental process. This is a
particularly Anna Freudian perspective, which gives great significance to
the power of the drives and their impact upon the mind. In this story
Michelle incorporates her budding adolescent interest in sex into her
fantasies about her origins and her implicit question as to whether this
will also be her fate. Will she be a girl (like her birth mother) who loses
her baby because of some arbitrary rule? She makes the baby a boy, per-
haps a thinly veiled attempt at disguise, but it is interesting also to think
about how this might point to gender conflicts that are now emerging as
she moves into puberty and the arrival of her adult sexual body. It is also
of interest that she is able to represent a parental couple who remain
interested in their lost baby, although they are subject to the arbitrary
intervention of the man who takes their baby. And this time it is a man
who takes the baby away in contrast to the Goddess in the first vignette
above. Her latency obsessional defenses are brought to bear on these
fantasies as she retreats in the subsequent session into ordering and sort-
ing cards. I feel the affect in the room as a straightjacket of boredom to
constrain the potentially explosive nature of these fantasies.
Before concluding it is important to mention something about not
being able to play. I have earlier quoted Winnicott’s view that the capac-
ity for playing is a fundamental indicator of good mental functioning
and his dictum that psychoanalysis is a highly sophisticated form of play-
ing is well known. Also well known is his assertion that “when a patient
cannot play the therapist must attend to this major symptom before
interpreting fragments of behaviour” (Winnicott 1971). Michelle was
not such a child, although in these vignettes we can see how her play-
ing was constantly at risk of disruption by the eruption of her anxiety
manifest in the relationship with her analyst.
Clinical experiences where the absence of the capacity for play and
playing is to the forefront is common for child analysts, and not only

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 166 Angela F. Joyce

with children who might loosely be described on the autistic spectrum

about whom Francis Tustin and others have written so eloquently (Alva-
rez 1992; Tustin 1981; Rhode 1997). Winnicott’s injunction to “attend to
this major symptom” is easier said than done. However in my view and
experience this is best done by accessing and using one’s own capacity
for playfulness in the therapeutic relationship and for that to be made
available to the child to facilitate this development in them.

Conclusions

My purpose in this paper has been to use this material to highlight

specific aspects of analytic work with children especially from an Anna
Freudian and Winnicottian perspective. I have focused on the relation-
ship between play and verbal interpretation and especially the tech-
nique of the use of play in displacement, enabling analytic work to
proceed. Without this technique I think I would not have been able
to hold Michelle in the treatment nor would it have addressed such a
wide range of her concerns. However it was not just the exploitation
of that particular defense (displacement) that is at stake here. The ap-
proach to play and playing and its connection to interpretation is not
linear; rather it is a complex process interweaving and overlapping as I
hope I have shown. Michelle was able to use her imagination to com-
municate in play the issues she was struggling with to herself and her
analyst, but it remained difficult to some degree for her to tolerate more
direct discussion and verbalization. I understand this as being related
to the fragility of her ego development, where her capacity for affect
regulation through the mediation of thought was precarious. There
are different aspects to this uncertain capacity: her narcissistic vulner-
ability; the disruptive presence of a profound and continuing loyalty
conflict through which if she was to give herself over to her analysis too
wholeheartedly, she risked betraying the mother who had adopted her,
reflecting the fundamental problem of her adoption. There was also the
dynamic tension between mental process and content where deficits in
her capacity to manage her affective states were compounded by these
dynamic issues of such conflict in her mind. These processes are part
and parcel of all analytic work but perhaps have a particular significance
in child analysis as the development of mind and psyche is still ongoing
and analytic work potentially has such an impact.
To sum up my views about playing and interpretation I am saying
that they interweave in a nonlinear fashion, sometimes overlapping as
when playing itself can be an interpretation; sometimes they are clearly

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 Interpretation and Play 167

differentiated when the analyst uses words to address something directly

about the patient; sometimes words are used to further the narrative of
the play so that through the process of displacement a theme can be
elaborated and not disrupted; the creativity implicit in playing is always
present in whatever form an interpretation takes. In psychoanalysis both
are essential.

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