Linking DIR/Floortime with Narrative and Expressive Arts Approaches
The following quote from JENNIFER FREEMAN, DAVID EPSTON, & DEAN LOBOVITS article on Expressive Arts Therapy inspired me to write on my current practice of integrating the Floortime approach with narrative therapy and artistic expression:
“Children caught up in the emotional experience of the problem may have great difficulty expressing themselves in words, yet they may be communicating nonverbally, broadcasting their experience with facial expressions, posture, and movements. To what extent should we keep persevering in the attempt to verbally engage young people who are immersed in such an experience? Information about problems may be lodged at a somatic level even when it is barely within conscious awareness. Approaches are then needed to bring such experience into focus. Elsewhere we have referred to these as “somatic conversations” (Freeman & Lobovits, 1993, p. 198). In the above situations, nonverbal encounters offer alternative means of communication while demonstrating acceptance of the child” (Freeman, Epston & Lobovitz,).
As a therapist who works primarily with children and young adults with ASD and sensory processing differences, I believe that it is important not to limit story-telling to what is expressed verbally. Taking into account the child’s individual differences is essential when it comes to engagement and communication, and some children communicate more readily through song, while jumping, dancing or swinging, or by using toys in symbolic play.
I will say that it is also important for much of our work to model verbal retelling of stories (“Remember that time you thought you had lost Teddy Bear, and you were so sad, but then we looked for him together and found him? How did you feel after?”) These type of stories can bolster a child’s concept of their resilience in scary, novel, or overwhelming situations, especially if we talk about how they solved the problem, how they were able to calm themselves, or how a kind parent was there to soothe them. Particularly when clients are emerging into level 4 (See ICDL.com for more information on developmental levels), where they are beginning to talk about past events (yesterday we went to the zoo!) but are also experiencing big emotions around differentiating, limit-setting, and their own physical limitations, I find myself suggesting that parents engage in verbal storytelling with their children.
However, I want to draw on this concept of storytelling and to expand it into the realm of creative expression through art and play. Verbalizations activate the cortical regions of the brain, and since they are linguistic, they activate the left mode of the brain. This is when naming an experience or emotion has a calming effect. You are integrating left mode with the emotional, right mode activation. It is calming to talk about an emotion, but it is sometimes necessary for a person express it on a somatic level, whether through a dramatic re-enactment, through journaling freely or to a prompt, or through painting or sculpting. Many of my clients connect more freely through nonverbal cues or with physical support such as sitting in my lap, holding hands, or while jumping or swinging together. Children may have heightened sensitivities to auditory or visual input, or they may find that music expresses their experience more accurately than their own words. I find that joining the child in their medium of choice and then structuring within that a space for self reflection and mutuality can help provide the child with insight into themselves or mastery over their current problem or worry.
Freeman, Epston & Lobovitz write:
“The act of expression, in this sense, is often reported as beneficial in itself–it can be a relief for children to literally “express” the externalized problem in a symbolic yet physically experienced way. This allows them to “see” the problem and ponder it more easily. Just as they do when left alone to play, children often like to work and rework stories in oblique forms, such as puppet theater, rather than talking about things directly.”
By allowing a child to manipulate the outcome of her problem or to express a big, overwhelming feeling in physical form, the child can gain a sense of mastery as well as a sense of meaning and identity. The caregiver or therapist provides not only verbal reflection on the child’s process as she explores and expresses, but she also can join with the child in a re-enactment of a scary situation, or a moment when she felt angry.
When I do provide verbal reflection on a non-verbal process, I try to engage with the child in a non-judgemental way (stick to descriptions of what you see unfolding rather than qualifications, opinions or judgements. “The monster is huge! But look, you are smashing him all up!” or “I see that you wrote a lot under the prompt ‘I am jealous when:’ and not so much under the other prompts”). In this way, we can help the child to expand on their theme or idea while also physically co-regulating difficult emotions as they come up.