Play It Out—Here's What Happens In Play Therapy

Photo credit: Rashid Sadykov, Unsplash

Sometimes, the coolest things happen in play therapy! This is because play allows us to express and process experience that is otherwise too overwhelming to approach head‑on.​

The following story is adapted from a real session, with details modified to protect patient privacy. It is just one example of the cool stuff that goes on during a play therapy session.

The Play Session

“Sam” is a six-year-old boy who struggles with a persistent fear that something bad will happen when he is separated from his parents. This leads to huge tantrums around separations.

Part 1 - The Worry Dolls

At the start of this session, we spoke about his fear in a straightforward, logical way. Sam told me, very matter‑of‑factly, that while he knew his parents were safe and would come back, he nonetheless felt like they would disappear. Then Sam’s attention shifted to a basket of tiny “worry dolls” on my shelf.​

I explained that these worry dolls are very good at holding onto our worries so that we don’t have to carry them all on our own. I wondered if Sam wanted to share his worry with them.  

Sweet, sensitive Sam wondered how the dolls cope with holding so many worries. I told him that they have each other, and that they “talk” to one another about all the worries they hold, because talking with others about our worries can make them more manageable.

Sam picked up one of the dolls and, in a small, tentative voice, told it a version of his fear about being away from his parents.​

Sam wanted to know how we could be sure the worry doll was actually listening.

I said,

“Well, they don’t talk out loud and tell us, but we can feel when someone is listening.”

Sam, needing more proof than that, asked me to be the voice of the worry doll.

So, using a playful, squeaky voice that I often use when speaking for the toys in my office, I had the doll respond with something like,

“I hear that you’re scared something might happen when you’re not with your parents, and I’ll hold that worry for you.”

Sam picked up another doll and shared the worry again, using slightly different words, and I echoed it back in the doll’s “voice”.​

We continued like this with a small succession of worry dolls, each one receiving the same core fear in slightly different words, and each one “responding” with a simple, calm reflection.

After several repetitions, Sam announced,

“Okay, that’s enough. They all know my worry now.”

I named what just happened:

“These worry dolls are now carrying your fear, together, in a basket in my office, so you, Sam, don’t have to hold it all alone.”

Sam nodded and, with a visible sense of relief, asked,

“Can we play now?”​

Part 2 - The Aunties

Sam went over to a different part of the room and picked up several bendable dolls, who he called the “Aunties” and a small sofa from the play set. In a high‑pitched, exaggerated voice, Sam made the dolls twist into odd shapes, making dramatic groans and squeals that sounded like a combination of an angry cat and someone moaning in pain.

As Sam contorted the dolls’ bodies, Sam’s own body became wiggly and wild too as he rolled around, limbs bent in strange positions, bursting into giggles. The whole scene was absurd and joyful—we were both laughing at the silliness of it all.

At one point I commented,

“Wow, these Aunties are really out of sorts! What’s going on with them?”

Sam paused, looked directly at me, and said, very clearly,

“I just need to be wild and crazy right now.”​

I reflected,

“Of course you do. You need to get all that wild, crazy feeling out of your body, and the Aunties are helping you do that.”

Then we went right back into the story, letting the Aunties be as over‑the‑top and “too much” as Sam needed them to be.​

Part 3 - The Calm-Down

After a while, I noticed we were getting close to the end of our time, and I wanted to help Sam shift back into a more regulated state before leaving. So, I had the doll I was holding start to settle.

In a calmer voice, I had the doll say something like,

“I think I’m going to sit down and take some slow breaths, because it’s almost time to go back on the shelf.”

I placed the doll on the small sofa and had her take deep breaths—in and out, in and out.

Once my doll felt “calm,” she suggested to the other Aunties (the ones Sam was playing) that they might want to calm their bodies too, since they were also about to go back on the shelf.

She invited them to take deep breaths with her.​

Sam allowed this shift. As he moved the dolls through their deep breathing, Sam’s own breath slowed to match theirs, and I joined in. For a moment, all of us—the real people in the room and the pretend characters—paused together, breathing slowly and settling our nervous systems in sync with one another.

Then Sam arranged the Aunties on the toy sofa and matter‑of‑factly announced that they were going to “hang out and read” until next time. We put the toys away, and Sam walked out of my office, calm and organized.​

Experiences Get Processed Through Play

This play episode so beautifully shows how a child (and really, any of us) can use imagination and play to metabolize overwhelming feelings and experiences.

In the first part of the session, even while we were using “rational” language to talk about the fear, we were also using a playful, symbolic container—the worry dolls. Sam knew it was my voice coming through the toys, and the act of speaking to them and hearing them “speak” back allowed him to feel held, accompanied, and validated by both the worry dolls and me.

The worry dolls weren’t overwhelmed by Sam’s fear because they had each other; they were in it together. And because I was also “inside” the worry dolls, Sam could feel that I was in it with them too—they were not alone (he was not alone).​

The second part of the play allowed space for the raw, non‑verbal, chaotic energy that can take over a child’s mind and body when they are dysregulated (like during Sam’s epic, real-life tantrums). Some of that energy was being acted out through Sam’s body, and some of it was safely relocated into the Aunties.

Instead of feeling ashamed or “bad” for being too much, Sam experienced being understood, accepted, and even delighted in as we played together.

The third part of the play allowed Sam, with my guidance, to practice self-regulation strategies. Doing this from within the role of the expert who was helping the Aunties calm down allowed Sam to feel a sense of mastery over the body-calming process.

Play Is For Everyone!

This is why play therapy is so cool (and why play more generally is so important). It provides children with a creative, embodied way to move overwhelming internal experiences outside of themselves—to look at them, share them, and gradually transform them.

And remember, play isn’t just for children. When was the last time you played?