Play as medicine. By Sean Williams

The author Sean Williams is Headteacher at The Forge; a Pupil Referral Unit in Redditch.  We open his article with a few paragraphs written by him about the work of the Forge:

At the Forge we work with adolescents who have been permanently excluded or who are at risk of permanent exclusion from their mainstream school.

We have been on a journey over the last seven years.  We have adopted an increasingly therapeutic approach to our work, healing whilst learning you might say. Using the paradigm of relational trauma and attachment to frame our work,   we  begin our relationship with pupil families and schools by asking a fundamentally different question to the one you might expect.  We’ve moved away from asking ‘What’s the matter with you?’ to  ‘What’s happened to you?’
Using our emerging understanding of the effects of adverse childhood experiences, coupled with an increasing understanding of how trauma shapes our biology, psychology and behaviour, we seek to use ourselves, our environment and our curriculum as an intervention for good, creating a provision where conditions that safeguard growth and development are present in the building and in the relationships within and between people.  We believe that this approach to safeguarding is both  protective and restorative in our pupils lives.


Using play and safety cues to help a pupil relate and regulate, reflect, repair and redeem.

Up until the intervention I am about to describe Claire had verbally revealed very little of her internal landscape to anyone. Meaningful emotional exchange had not been possible and she could not easily take in anything from the team, not even food.   She is clearly very bright, resourceful and courageous but as yet, she seemed unable to stay regulated in a classroom environment or attach to us in a way that could help her explore fully what we, or life, has to offer.

On entry to our school Claire  looked underweight, pale, withdrawn, tired and sad. She presented  with the tell tale signs of a young girl who has been panicked and intensely worried for a long time, a victim of the long term impact of toxic stress, no doubt from a range of Adverse Childhood Experiences (ACES),  very likely exposed to a sustained period of neglect and trauma.

That said, Claire would come alive before our eyes whilst playing football in school in the morning.  With lots of safety cues from staff –  releasing oxytocin and opioids into her mind and body,  she steadily began to join with us  – engaging fully as a respected and effective member of the group in the hall.  A playful rapport was established amongst us all and a sense of connection between Claire and myself emerged over the weeks –  manifest as her choosing me as the man to mark out of the game  – outwitting many of my attempts to get past her to score.   Mutual smiles, celebratory handshakes and gentle teasing ensured that her play and social engagement systems were online and I felt quite sure that the possibility of a safe working alliance was developing.

I noticed as we would transition from the football  activity to the  school welcome meeting  that starts our day, her play system would quickly come offline and she would move rapidly to social defense.  Claire  would find it impossible to sit in the community meeting and welcome –  or be welcomed –  by the wider group.  Following the meeting,   she would often continue to run around school –  dysregulated, apparently panicked,  whirring up feelings of uncertainty and helplessness in our team.

As a direct result of the TIS training, particularly Stephen Porges Polyvagal theory, and a direct application of the PROTECT, RELATE, REGULATE, REFLECT model  I  wondered if  I may be able to support Claire into a deeper relational connection with parts of her experience that she had never shared or thought about.

Here, in this vignette, we bring to light a creative and impactful communication of intense pain that lay underneath Claire’s behaviour in school.  Alongside this courageous communication  we found the inner and relational resources of trust, hope, value, family love and mutual connection.  In this relational connection, Claire, graciously let me into her internal world, which supported her to experience co regulation leading to a co reflection upon the impact of her traumatic experiences which in some way has led to a change in  her internal narrative.      Claire was able to begin to trust and then think about –  in a coherent way –  the catastrophic losses she and her family have suffered over her lifetime  and the emerging sense of self she is  simultaneously  protecting, holding together  and courageously exploring on a daily basis.

Having spent a good while building a relationship with Claire in the Sports hall, I had also been  wondering over the weeks  what  might be going on in her life or may  have happened in her earlier childhood that would mean she existed in such a state of panic/grief in school.


I decided that I would need to do something different and make myself available to Claire for a few mornings following the football.

For the morning I am about to describe, I planned to stay alongside her following the community welcome meeting instead of attending to my usual administrative duties, I would not encourage her to be in lessons but just be alongside as an emotionally available adult.

I stayed with Claire after our football session pre-empting the run around school, and we entered into the room that is set aside for talking and playing.  I had prepared myself to remain open and socially engaged with Claire, ready to let her lead the interaction, remaining alert to my own bodily responses and  any social defence cues that would prevent Claire moving into and remaining  in her social engagement system.  The room is small 3m x 3m  –  it contains couple of desks , chairs, a bean bag and a radiator that is unnecessarily large for such a small room.  It is off a narrow corridor and opposite is an office where two member of our pastoral team work.

I wasn’t fully prepared for the deep impact of her communication or how creatively Claire  would use the material available to her in the room but it brought about a connection and a deeper understanding of how here experiences have shaped her and the power of this work.


Play as medicine  – Balls everywhere.

Silently, she began to open up the bean bag that children sit on in the room –  filled with hundreds of thousands of polystyrene balls.    The zip became stuck but she persisted, at first feeling into the bag with her hand, tentatively.   She then poured out the polystyrene contents over the grey carpet of the room and looked at me  – as if expecting  disapproval for what had just happened.   What felt like a million  balls all over the floor led to my stomach tightening , feeling the possibility of social defence kicking in –  I wondered if I was scared or excited. I maintained my open position and communicated  delight towards  her and her spontaneous, playful expression.  “Those balls have gone everywhere!  I said, watching my prosody and tone.  ‘It looks like snow’ she said –  we can cover the whole room”.  Claire invited  me to join her as she set about on all fours carefully methodically, rhythmically moving the balls, like snow into a pristine white blanket.

We noticed the feel of the polystyrene , how the balls behaved, how rough the carpet was, the temperature in the room.  During the rhythmical activity of sweeping and scraping and gathering and pushing, Claire became regulated and reflective.  She became more  playful and observant as we noticed the unusual effects of the static from the balls, sticking to our clothes, shoes and hands, how when we poured the balls sometime the heat and the static took them upwards or they hovered in thin air.  In excitement, Claire  wanted to show other pupils what was unfolding and three came in  briefly to the play. We threw the ‘snow’ over our heads and everyone whooped with delight.

As our fellow snow throwers left I  asked Claire how she was doing generally –  moving from the experience in the room to the experience in her life –  we chatted back and forth, the topics remained light and superficial.

We ran out of balls to cover the whole floor.  Claire left the room to find another beanbag to open.   Again the bag was opened and he contents released.  With this second emptying in to the room, Claire’s emotional landscape was released too, she gained access to her speech and traumatic experience and  told me about her life –  thoughtfully and sensitively.

I learned of an absent father whom she’d never met but knew was a heroin addict.  I learned of her step father whom she loved and had felt connection to but had been removed from the home for the children’s safety before she was 6.  I learned of her uncle, his cocaine habit and suicidal tendencies and troubled relationships.  I learned of her grandmother whom she loved and protected dearly, yet was incredibly frail,  wheel chair bound and barely able to breathe despite the constant supply of oxygen and tubes attached to her nose.

Claire had more to tell.  “Do you want to know why I feel tired today?”  she asked.

Claire proceeded to tell me about an horrendous experience at home  the night before meaning that she had finally got to bed at 3 am.

She spoke of her Uncles very public recent attempt on his own life and the humiliation she felt at the police involvement –  her inner conflicts: the need she experienced to defend her family from police intrusion and insensitivity, the failed attempts at consoling her grandmother, the  love, hate, fear and sense of helplessness  she felt seeing the adults in her life in such desperation.  She expressed anger at the impact all this had upon her already frail Grandmother, gasping for breath, barely conscious as she tried to repress her panic, unable to find words to bring her son down from the roof of their family home.      I learned of the grief she held for a beloved sister that once provided a vital source of connection and support.  Her sibling is now so shut down she can barely leave the house, chronically addicted to cannabis and now so anxious she has taken to her bed.  She remembered how much love she felt for her step father as the only man she had ever felt loved by and connected to, and pondered on the sense of abandonment that was felt in the home following his traumatic exit from their lives.

Through all of this we continued to push and sweep the balls rhythmically with our hands and feet in to all four corners of the room, sometimes standing, sometimes crawling, sometimes listening sometimes thinking. We wiped the balls off the tables and chairs until there was an immaculate blanket of polystyrene balls covering the entire floor.  The activity soothed and calmed Claire whilst at the same time joined us together  in a moment in time, in the creation of something new. We shared a  moment of pride –  dare I say hope as we looked upon our creation. The obligatory snow angels were made, the room felt lighter and discussion turned to the clean up operation as Claire was to leave school in less than an hour.


The Clean Up

Claire was absolutely clear that she wanted to ensure that every single ball of polystyrene was cleared up and put back in the bags before she left within the next half an hour.

We (mainly Claire) planned what to do and what was needed to clear up –  hoovers, black bags, dust pans brushes and considered the possibility of recruiting more people, staff and pupils to help.

Suffice to say the task was set about with determination and focus.   Two hoovers were involved , three black bags, a sense of purpose, achievement and joint enterprise filled the session  and sticky, static charged balls slowly and weightlessly, often difficult to capture, hard to contain, behaving bizarrely, slowly but surely were poured  into the bags in wide range of creative ways.  The hoovers were inspected, taken apart, emptied and put back together, dustpans, hands, buckets, and team work all used to complete the task that had a sense of urgency.  Is this what trauma is like, I thought?  Is this symbolic of the clean up operation that follows?

After much effort, and periods of seemingly getting nowhere  the mess was almost cleared and Claire spoke.  ‘There’s some left Sir  – in the corners, I can’t get them out, they’re stuck!’ Claire stated, now sweating from the work….but with a sense of calmness about her.     ‘You really want to get it all sorted today, don’t you Claire  I said –  except this time you aren’t all by yourself  are you?

‘No sir, not today – it’s time for me to go, you can pick up the last few bits, see you tomorrow.’  We shook hands and she left, right on time.

What a clever, resourceful girl I thought, as I continued the clear up operation.  In one playful session Claire had wrapped language around her experience and, even  more than that, through her wonderfully creative expression had both communicated and released something much much deeper. I was left thinking and feeling that Claire had powerfully communicated to me some of the impact of  trauma in her life, trauma as something that is difficult to get hold off, get to grips with, put back right ,  something that changes things for ever, and can leave you  both with it and in it.   However, it seemed as if something important  had shifted and been understood.

That night as I got home to the warm welcome of my family  –  I customarily took my shoes off and put my keys on the counter…..  several tiny  polystyrene balls from my shoes and pocket floated  to the floor.

Since this session Claire has attended school better, settled in more lessons and remained more socially engaged with more people more of the time.  I believe that this is because during this session she experienced safety both physically and psychologically.  She was able to use her own resources, her own creativity and our relationship in a way that lead to some kind of healing within, a connection that somehow changed us both.


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