SANDTRAY THERAPY: PSYCHOLOGICAL HEALTH AND WELLBEING

Sandtray therapy is a psychotherapeutic approach to healing based on the research and work of Dr Margaret Lowenfeld (1929), child psychiatrist. This method allows the sandtray therapist to provide the individual a safe and expressive space for exploration of their intrinsic world of emotional and mental states using an indoor sandtray and the vast array of miniature objects that children, adolescents and adults use in different ways to access the implicit image activity of the right brain hemisphere. Sandtray therapy is supported by theoretical frameworks and has been evidenced to adapt cross-theoretical methods into this framework including trauma-informed principles. The aim is for clients, across the life span, to experience good psychological health using this psychotherapeutic approach, where changes to neural plasticity will be of a lifelong benefit, leading towards awareness, new perspectives, a new trauma narrative and self-growth. Sandtray therapy is a non-intrusive trauma-informed approach that is often non-verbal and accessible to ages from three years throughout the life span. This paper will explore these various stages to understand the influence of unmet needs and how these can be met in the exploration of sand worlds.

We often project onto others what we need to see for our own learning. The lessons we learn, sometimes successfully, sometimes not so, are played out in our private playgrounds in which we learn and grow – this could be called the playground of life – which carries all the changes through the life stages that can have a dramatic and profound effect on our lives. The loss of a loved one can take our emotions to places we never knew existed, then at later stages in life we may experience financial difficulties, social issues or changing family dynamics. These can all be triggers that can be experienced as a trauma. It is not the intention of this paper to differentiate the different types of traumas into categories, but simply for the reader to acknowledge the ability of sandtray therapy as a method of exploration of trauma throughout the life span.

Towards the end of the life span, we look for a sense of connection. Erikson’s psychosocial stages express this as generativity vs. stagnation (McLeod, 2019). Some choose to ground their sense of belonging in faith or religion, others go deep into their psyche and explore their soul equation in search for answers or, perhaps, the meaning of life (through Socratic questioning of the self ), asking that profoundest of questions: who am I? Sandtray therapy is a means to guide clients through these psychological processes, unlock thought-provoking and deep aspects of yet uncovered virtues to achieve unmet stages of development, self-growth and good psychological health and wellness.

Lowenfeld (1969) – the original developer of sandtray therapy, known as ‘The World Technique’ – entered her own psychotherapeutic work through medicine, and she made explicit links between emotional and physical processes as they emerge in the psychosomatic disorders of childhood (Lowenfeld, 1930). Influenced by her own experience of World War I and the association with shellshock (post-traumatic stress disorder), she came to understand the importance of psychoanalysis through a different route and in a different way. Lowenfeld’s interest in psychotherapy and the personality of the child was precipitated by wartime experiences.

Take a moment to think about your own childhood’s implicit images, memories and hurtful words. Now come back to be an adult. Do you hear yourself echoing things you heard, repeating your parent’s words: ‘You can’t do that, you’re too short/tall/thin/fat/dumb’ or ‘That’s a boys’ job, girls can’t do that’ … and on it goes. All these words we took in to our core, our very being, they formed part of our belief system and those words were stored in our unconscious mind and our body (Maté, 2011; Ogden, 2015; Lipton, 2008) in the form of images and a felt sense. Lipton (2008) in his work on epigenetics and Maté (2011) in his research into the body–stress connection both analyse trauma and how words, actions and emotional felt senses are warehoused in the very cells of our bodies. Individuals carry trauma in different parts of their bodies – this concept forms a part of the theory of psychosomatics, which is a very real area of health and wellness in which unhappy people will undoubtedly create or manifest pain within the body. We see a clear example in children who are unable to express their distress in words, instead they may say “I have a sore tummy”. It is important to note that Chinese medicine, with its thousands of years of use, shares this philosophy. The body–mind connection: it is how our systems communicate to us that there is a disease building up. This could be an issue from childhood that was left unchecked, pushed away.

Pat Ogden (2015), an advocate for the body–mind connection, has been able to provide the research that Lowenfeld was not when she talked about the ‘whole self ’ and having the instrument as a healing medium to tap into the different energy zones or modes. Maté (2011) takes this research to another level by suggesting there are certain personality types who are prone to disease. If this is indeed a fact, then it is of utmost importance that children are given this medium of sandtray therapy to express emotional stress before any physical symptoms are manifested. As adults we can say that the following apply:

This is your body reacting, saying, ‘No I can’t do it, I won’t do it, you told me I couldn’t, shouldn’t.’ You get the picture; our resistance is entirely stored within our whole self. This is the mind–body connection. This is the depth at which the child ego pushed down the hurts and pains for self-protection. It served us then, but as adults, it no longer serves to hold the pains of yesteryear. Left unchecked, this stagnation can erupt into disease, illness or even death in extreme cases, because it was easier to manifest cancer (Maté, 2011) or heartache than to look at the issue that has caused you so much discomfort. Trauma held is a very real and dangerous foe.

As adults we are capable of change, growth, wisdom and knowledge, yet trauma in the form of complexes hinders growth. We can be left with our deep-seated beliefs (think the iceberg effect) where the traumas are lying just below the surface, pushed down into the unseen realm; this is your unconscious mind, it lies just beneath the psyche, the non-thinking place. We see the psyche as the bridge between or integrator of our left and right brain (Badendoch, 2008). In sandtray therapy, this is the realm of great interest, and the area of the brain that is activated by this method is the intrinsic right brain realm. We are often driven by these unseen forces to behaviour fuelled by our complexes; if we have little awareness of these drives, our attitudes are reflected in this behaviour, thinking and way of being in the world – from tantrums in children to aggressive bouts of behaviour in adolescents and adults.

An example of a complex could be not feeling good enough. But how was that seed planted and how can this lead to trauma? This is the nagging voice in your head, rumination, the monkey mind, the wounded ego, the one that confirms to you as an adult that ‘no you can’t do that, remember!’, ‘you aren’t smart enough, good enough, pretty enough’ – and so we fulfil that complex by not acting because we believe the voice. This voice was a harsh parent, a word said in anger or an angry parent or carer who themselves were treated unfairly. Here we could go on to discuss intergenerational trauma, attachment and abuse; however, as I have stated, this paper will remain focused on the exploration of trauma through the life span. The continuing line of intergeneration trauma has its roots in passing on negative and abnormal behaviours. Sandtray therapy can stop trauma from its energetic flow and profound significance in thinking and behaviour. Through the exploration of the conscious and unconscious mind, this is where deep psychology is found, and this is where we work using sandtray therapy, working through childhood traumas, attachment issues and inner child events that may be affecting adult behaviour and psychosocial development through the life span.

The sandtray miniatures as objects represent memories as implicit images from the ages of two to seven years, according to Piaget’s preoperational stage of symbolic thought (Peterson, 2010). To build resilience against a trauma is to relive that moment where you were vulnerable and unable to defend yourself against harm, either physically or verbally (culturally). To cope, you pushed your felt emotions down to a safe place in order to cope in dealing with a situation or a person’s behaviour towards you. This is the job of the ego; however, what we need is a healthy balance and that is why presenting issues to the sandtray can open that deep part of our inner self and gently allow an exploration into our implicit self-equation. Sandtray is a gentle, non-retraumatising way of exploration.

Sandtray miniatures are also known as archetypes and are used in the process of creating a visual sand world, forming the internalised world of the creator as an external sand world. These miniatures are given meaning by the client or creator and become the symbol in the tray that may guide the new trauma narrative. An example could be a dinosaur used by a child – not as a dinosaur, but as the hero that rescues the mother and child from the enemy. Now, the dinosaur as an image has taken on the character strengths and virtue of ‘courage’. The antagonist, the abuser, is no match for the brave dinosaur, who helps to change the story by giving the child the courage and strength to speak up. A new trauma narrative is created by expressing and verbalising of old beliefs (cognitive behaviour therapy) and the felt sense released through the sensorimotor manner that is sandtray therapy. This body– mind connection is grounded in neuroscience (Badendoch, 2008; Ogden, 2015).

A skilled professional sandtray therapist offers clients a safe and trusted space where children, adolescents or adults affected by trauma can play out their distress. Often with children this is a nonverbal manner of therapeutic healing. Therapists often observe that children group clusters of miniatures according to their subjective sensory experience of objects and events, and these objects are classified into proto systems. This is a system of grouping and linking between experiences, giving rise to primitive thought structures that Lowenfeld called clusters (Urwin, 1991).

Proto systems become the way in which a trained professional can distinguish a trauma sandtray from others, as the sand player – whether child, adolescent or adult – gives meaning to objects in relation with other objects. As a therapist follows a client’s sand world series, the objects can reorganise to show a healthy development and more developed cognitive ability. This reorganisation of sand worlds according to Barbara Turner (2005 pg. 285) is the “elemental reorganisation of experience in sensory, feeling laden clusters whereby the client is affecting differentiation in various aspects of their inner and outer experience into coherent meaning systems”. In other words, building resilience, creating a new trauma narrative, implanting new images to mind and releasing felt senses.

An awareness as an adult means you can steer your own ship, and yes there will always be a strong wind blowing you off course, dangerous undercurrents and rips and shark-infested waters. But isn’t this a wonderful metaphor for life because, on the other hand, you will also experience perfect sun-filled days, calm waters, gentle breeze, dolphins playing and sails billowing in the gentle breeze. These form the Polarity of Balance: we need to experience the extremes in order to find our best place or balance. Here in nature, and life in general, you find opposites, duality and a shadow side where neither can exist without the other. The more you experience adversity with an open mind, the more you can explore the many sides of you. The more you relax into the joy of profound synchronicity, the more you attract good health and wellness. The key is self-awareness and the courage to climb from the depths of selfindifference to the heights of selfawareness – whether the courage is contained in a dinosaur or another image, this is key: find your central figure, your hero or heroine. Let them be your courage, let them walk beside you to explore your trauma in your hero’s journey.

Lowenfeld would have loved our modern-day Star Wars characters as images, the fusion between fantasy, reality, the present and the past, and the person we perceive ourselves to be, our persona and our shadow self behind the mask! I mean, who doesn’t want to be the hero or heroine in their own story? The rest is how we got to be the characters in our life’s story. Just like our dream state, we are connected to each and every character or miniature in the sand world through our unconscious mind playing out our unresolved issues and childhood traumas, leading us to the experiential centre of ‘who am I?’ and ‘what is my purpose?’ And importantly, ‘how do I heal?’.

Fundamentally, we heal by allowing the space for our psyche to place the symbols within the boundaries of the sandtray to tell our story. This method allows a glimpse at intergeneration where we get to see the patterns of our parents, grandparents and ancestors. Here we can see if a significant other was a threat to us in our childhood, affecting our attachment bonds, such as it is now the case with many victims of childhood sexual abuse – their memory has been triggered by another’s story or seeing the abusers on TV. We use images, memory and story to get to the heart of the real issue, and allow the pain stored in the cells of the body to release. The event will never go away, nor will the memory; however, the pain can be eased.

Sandtray therapy allows adult clients to step back and look at dysfunctional behaviour and set patterns and beliefs expressed in sand worlds. For example, are you one of those people who just never finishes anything? Could it be that you were told by your father that you would never amount to anything in life? So you proved him right, that’s how you showed your love. Or are you a high achiever, yet your mother thinks you can still do better? If you attract the wrong type of partner into your life (you know the sort I mean, they’re just not the right person for you), you may develop low self-esteem – why? This was a pattern you set up as a child to get attention from your parent. These are also perfect examples of a father or mother complex. If you had as your mantra, ‘oh I can’t do it’ and now you believe you can’t do anything, even attract a partner you desire or who desires you, in effect you have intrinsically ingested this belief and the complex has become an intrinsic part of your character. Sandtray therapy can help to see this belief expressed as externalised in sand worlds. Once seen, felt and expressed, a reversal is possible – basically, believing you can do it!

A client may have sexual trauma or issues, perhaps they were brought up to be a good Catholic girl and told feelings of sexual desire were bad, so they buried their sexual urges deep within. Consequently, they may have experienced psychosomatic issues such as invisible pregnancies, cancer of the ovaries or miscarriages. So be careful of what you are reading here, what I am saying we have already covered in this section around our cells holding memory and psychosomatics. Tapping into what or who set that idea into the mind of the child can set you free as an adult. Sex is good, good sex is great. No church, religion or state can tell an adult what to do with their body or their natural urges. As you listen to your mind, listen to your body also, it’s speaking to you. Here we may enter into mindfulness or yogic states. A child who experienced sexual abuse grows into an adult who experienced sexual abuse. Sandtray cannot undo the traumatic event, but it can help you distinguish those parts of you that hold onto the hurt, pain and anger, and explore the sexual complex.

As a sandtray practitioner, I watch a client’s body language and listen to their verbal language; with adults I listen for any incongruences, such as saying, ‘I’m so sad’ with a smile on your face. What’s going on there? Once we narrow down a current issue, then I invite you to start processing in the sandtray – that’s where things start getting interesting. With children in sandtray therapy, it’s a little different; they will choose their miniatures and create sand worlds as an extension of play. They do this by moving the miniatures around, burying miniatures in the sand and placing miniatures together in clusters. Boys may create fighting battle scenes, girls (in general) tend to like fairytale archetypal miniatures. The idea is that they are working through issues from the unconscious (where complexes reside), for example, dealing with how their parents argue, the birth of a new sibling, or more traumatic issues. Children use the sandtray as a preventative place of therapy, of sorting through the self-equation and thereby releasing pent-up stress held in their body. Current issues and early traumas are also explored and given a new trauma narrative.

Carl Jung in The red book talks a lot about our “other selves” – he shows us how we can be many personalities in one. And I don’t mean schizophrenia, I am talking about our different personas, characters we have as traits – such as the rescuer, the martyr, the leader, the enabler etc. – that are found within our whole self, they make up our personality and make us all unique. However, some traits have been adopted from our parents or role models and, because of this, some children or adults may lose their own sense of identity. Erikson represented this as industry vs. inferiority (competency) in ages five to 12 years and identity vs. role confusion (fidelity) in ages 12 to 18 years. The key is to be aware of your personality traits, recognise as many as possible and find the balance. It’s important that if you are a rescuer, you allow yourself to be rescued, or if you are a martyr, you recognise that you can’t always save the world. These are the very things that the sandtray will highlight through the choice of miniatures and exploration.

Sandtray worlds will reveal, through the chosen miniatures and patterns in the sand, a side to your own true self that you may be unaware of. Remember we spoke of the dinosaur representing a child’s courage? Courage is a virtue; it lies dormant if not ignited by the energy of the sand player who instinctively knows to tap into the ‘object’. This is your story and as the therapist follows this story of your inner child, they may be curious and ask questions only you know the answers to. Through advanced empathy and by tuning in, the therapist experiences a limbic resonance that serves to bring in the safety and trust – basic elements, but necessary ingredients. If these were unmet needs as a child, then now as an adolescent or adult these needs can be met through the therapeutic alliance. Buried very deep beneath the ocean lies the true you, ready to be revealed and swim to the surface to finally begin to live a true authentic life, just as Mother Nature intended.

Sandtray therapy is crosstheoretical and works well alongside many different models of therapeutic techniques, including cognitive behavioural therapy (CBT), rational emotive behavioural therapy (REBT), narrative, personcentred, mindfulness, positive psychology, sensorimotor and neuroscience. Sandtray therapy is a therapy that can be used as a standalone method or combined to work collaboratively with other psychological methods. It cannot currently be quantified to satisfy the scientific rigour of today’s psychological assessment. However, there is descriptive and correlational approaches to quantitative research to support the proof of the success of this method, documented by Dr Lowenfeld since its inception in 1928 and some of her predecessors. Its success is also echoed by the thousands who have been brave enough to enter its realm, they echo the evidence in their voices and in their advocacy. It is the purpose of this author to continue to explore quantitative research designs, that support this method as a trauma-informed practice used extensively in Asia, the UK, the US, South Africa, Canada, New Zealand and Australia.

In sandtray therapy, the ease at which the miniatures in the sandtray become the language of the unconscious mind, how it awakens a part of the client’s cognition and nudges them on to discover more, to go deeper, to reawaken a knowing and awareness that resides within them – this is resilience unfolding. Sandtray therapy holds no barriers; it cares not about your faith, beliefs, language nor culture, nor you age – you can be three or 103 – it does not matter. What matters is that this method enables expression and choice, and choice is a key to healing trauma. It helps to build resilience, awareness, new perspectives, and it opens your mind to other ways of thinking, doing and being. This paper has highlighted the non-verbal and intrinsic nature of sandtray therapy and its ability to embrace the cross-theoretical approaches, yet as a standalone method it holds firm. It is a method used currently throughout the world. Children benefit by simply being able to play out their childhood issues in the sandtray, adolescents and adults benefit by tapping into an expressive non-intrusive method to explore issues or trauma across the life span.