Multiple Meanings of Primitive Symbolic Play: Whose Poop Is It? Case Presentation of the Four Year Treatment of a Latency Age Girl

Abstract

The case of a four-year treatment of a latency-age girl offers an example of how a therapist can utilize a sequence of vivid symbolic play scenarios to facilitate the expression of primitive relational experiences in order to engender integration of dissociated affective states. The development of reflective functioning and movement from the paranoid schizoid position to the depressive position are delineated as the therapist and patient inhabit many roles in the play and the therapist takes on multiple roles in the treatment itself, as mother's mother, co-parent, and child's mother. The need for the therapist to be aware of and comfortable with her own primitive relationally based emotions is also addressed.