Will Bad Mothering Become the Newest Disorder?
Some Drugs Boost Oxytocin

How Child Therapy Heals

Megan runs her fingers along the collection of dolls and figurines that line the wall of Sally Clark's office. (The child's name and some details have been changed to preserve her privacy.) The five-year-old's parents are separated and divorcing. She worked with Clark,  a therapist in Albany, Calif. who specializes in helping children and adults to heal prenatal, birth and attachment trauma, for eight months when she was two; now she's back with her mom to help her handle this major shake-up.

Megan is a charmer who seems to know she can rely on her mother, casually climbing into her lap or throwing a leg over her as she talks to Clark about her dress. Soon, she goes to the sand tray, a shallow, three-foot-square box, and begins to pick out objects from the hundreds arrayed on five shallow shelves. She places a tiny ceramic aquarium bridge in the center of the sand. "It's land under the bridge, not water," she says. She arranges two pavilions toward the center, and places a paper teepee in the right front corner. Into each houses goes a little dog.

Soon, the tray is full of objects. A Marilyn Monroe figure, leaning over to give a sexy kiss, faces an androgynous doll with boots and a sword. In the back left corner, two black mummy cases represent the mother and grandmother, who died. Behind them, a lighthouse pokes up.

Megan points to a tiny toy. "This dog is lost," she says. "He needs his mommy."

"Can you find someone to take care of him?" asks Clark, providing some direction for the first time.

Megan picks out the figure of a woman holding a swaddled baby, and places it near the dog. It keeps falling over, so Clark moves another piece to hold it up.

Megan doesn’t want to tell a story about the scene she's created. "I'm not good at stories," she says. But she spends a few minutes drawing a picture of a sun, a woman's face with huge grinning teeth, and a little dog in one corner. Finally, she and her mom snuggle in a cushioned, curtained alcove.

There's plenty to interpret in Megan's mise-en-scene. The mummy caskets could represent the death of the marriage; the bridge might stand for this family transition; the teepee seems to represent a safe home, or perhaps the womb itself. In addition to the problem at hand, her parents' impending divorce may also trigger memories of earlier attachment trauma hidden in Megan's right hemisphere. Clark will discuss all this with Megan's mother, and provide some suggestions about how to support the girl through this difficult period. 

But the interpretation is secondary, Clark says. What will help Megan cope is not Clark's insights, but the opportunity she had to communicate in a safe environment. Says Clark, "It's not the interpretation. It's that she expressed herself and was heard."

Clark's work illustrates the way healing takes place below the conscious level.

Babies and children this age generally have the cognitive and verbal skills to understand and talk about the fright and distress of their earliest experiences, which are lodged in the emotional memory of the right hemisphere. But they can express it, and play is a direct channel to that hemisphere.

Clark and Megan are communicating limbic system to limbic system, as Allan Schore, author of "Affect Regulation and the Repair of the Self," says. It's the state of limbic resonance, where they're attuned, on the same wavelength. When this happens, Clark's mature nervous system can take charge and let Megan's experience the journey from arousal to fear to calm again.

As Schore explains it, the pairing of traumatic feelings with the context of safety and support gives Clark's patients not just a re-enactment, but an actual new experience, the experience of feeling frightened or angry and being comforted and loved.

To read about a therapy that helps mothers and children bond, read Inside a Circle of Security.