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Book review: Creative psychotherapy: Applying the principles of neurobiology to play and expressive arts-based practice

Published by Routledge, 2017
ISBN: 978-1-138-90092-9 (pbk)

Reviewed by Eve O’Kelly

This recently published book is a collection of articles by experts in the fields of play therapy and creative arts-based therapies for children, adolescents and adults. Edited by two leading professionals in this area, Eileen Prendiville, MIAHIP, Course Director for the MA in Creative Psychotherapy at Ireland’s Children’s Therapy Centre, and Dr Justine Howard, Associate Professor at the College of Human and Health Science at Swansea University, it brings together a very readable selection of material on brain development and how play and creative approaches can help in working with the impact of trauma.

While this may seem like a specialised area of interest, this book is relevant to any therapist or creatively minded practitioner for its insights into how, by knowing more about how the brain works, we can design a wider range of appropriate interventions in working with clients. It has long been known that how the brain’s wiring is laid down in the early years of childhood is crucial to the life that individual will later lead. But what has not been so well understood is the amazing neuroplasticity which enables the brain to fire up new neurons right until the moment of death. This is where recent research in brain development has shed much light on how the brain can reprogramme its neural networks and how different therapeutic approaches can support that.

When we meet clients – whether as children, adolescents or adults – it can greatly inform how we work with them, to understand what stage of neurobiological development they had reached when the life circumstance or impact they are presenting with occurred. Here Eileen Prendiville’s introductory chapter on ‘Neurobiology for psychotherapists’ is an excellent overview of the hierarchical development of the brain and the nervous system, from the lower, more primitive brainstem and midbrain, through to the higher limbic system and cortical regions, as well as the different roles of the left and right hemispheres. She points out that talk therapy focussing on cognition — a left brain activity — will not connect with the brain’s creative, sensory right hemisphere which is dominant in the early years of life and where unresolved childhood trauma and disturbing memories are therefore lodged. An understanding of stress responses, emotional systems and memory storage gives important insights in planning effective therapeutic interventions with clients of all ages.

The next chapter on ‘Neurobiologically informed psychotherapy’ delves further into the relevant research in a very accessible way. It leads into subsequent chapters by a range of Irish and international practitioners addressing a range of approaches to play and expressive arts therapy with children, adolescents and adults. As well as discussing theory and approaches, each chapter gives practical case studies showing how music, movement and touch, sensory play, art psychotherapy, sandtray therapy, storytelling and drama can be used in a therapeutic setting across the life-span. Comprehensive references for each chapter provide useful suggestions for further reading. A final summary chapter by Joan Wilson brings it all together, emphasising the need for awareness of the client’s sensory and emotional world and how – regardless of the biological age of the client – non-verbal interventions can allow processing of intense experiences that cannot be put into words, hence leading to repair of neural networks. In this way, as she notes, “Integration between brain and body functions is developed, which supports flexible and adaptive responses to stress, relationships and overall well-being” (2017: 207).

As a psychotherapist with an arts background, since reading this book I have begun to introduce creative elements with some adult clients. The results have been intriguing. With one long term client, for instance, using a basic sandtray setup in some sessions opened up a new layer in the therapy and provided fresh insights for the client and for myself. I encouraged another highly cognitive client to fiddle with some play-doh as he talked. Over the course of the session, it was fascinating to observe him ‘coming down out of the head’ and going progressively deeper into difficult emotions which he had not made contact with before. It seemed as if the tactile sensory activity, as simple as it was, had somehow knocked out the defences of the left brain and opened up the emotional processing of the right brain.

This very accessible book is highly recommended to all therapists, as is the same editors’ earlier volume, Play Therapy Today: Contemporary practice with individuals, groups and carers (Routledge 2014).

Eve O’Kelly is a psychotherapist in private practice in Mind and Body Works, Dublin. eveokelly@gmail.com and www.mindandbodyworks.com

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