How Puppet Therapy Can Help a Child Recover from Sexual Abuse

Sexual abuse in any form can be a traumatic experience for a child. A form of therapy that has help children recover from child abuse is puppet therapy. To help understand what type of impact child sexual abuse can have on a child and how puppet therapy can help a child recover from sexual abuse, I have interviewed Dr. Puppet Lady, Joanne F. Vizzini, Ph.D., LCPC, NCC.

Tell me a little bit about yourself:

"I am passionate about healing and feel privileged to journey with clients, graduate students and workshop participants. I am a Licensed Clinical Professional Counselor, Nationally Certified Counselor, and an Adjunct Professor and Clinical Supervisor at Loyola University in Maryland in both Pastoral Counseling and Education. My Master's (1997) and Doctorate (2003) are in Pastoral Counseling from Loyola University in Maryland and I have a private practice, Freedom Through Psychotherapy, LLC: Transforming Lives, Healing Hearts, in Mt. Washington and Columbia, MD. I began using my puppet troupe, Sunny-sides Up, 31 years ago to teach children/adults about mainstreaming learning disabled children into the classroom through the use of a Maryland State Research Grant (1980), while attending Towson University. I was a Maryland State Certified Teacher until 2009 and utilized puppets while teaching first and second grades, as an administrator of Religious Education Programs and as a caregiver for emotionally disturbed girls (1982-1994). In 2007, I began the Puppet Therapy Institute to train therapists and educators in the US and abroad in the use of puppets for therapeutic/educational purposes and in therapy."

What type of impact can child sexual abuse have on a child?

"Child sexual abuse can be devastating to a child's sense of safety in the world. We know from developmental theorists that children's sense of self grows out of and is supported by feeling secure, physically, emotionally and mentally, and for some spiritually. An event or multiple events of sexual abuse violates that sense of the world as a safe and trustworthy place. Depending upon the child's strengths and growth edges at the time of the sexual abuse, the type of perpetration, (i.e., how invasive and how violent), coupled with the manner in which the situation is handled by the adults involved, (e.g., Is the child believed? Is the child removed from the potentially harmful setting and taken to safety?), the outcome can vary in the severity of the psychological impact. Some children have managed to weather a one-time violation of sexual abuse with very supportive parents and excellent psychotherapy and these fortunate children appear to go back to a very secure baseline. Others who have experienced one event of sexual abuse, up to multiple events, have ongoing issues of depression, anxiety, and post-traumatic stress symptoms, some of which stay with the child throughout life, causing identity confusion, propensity for substance abuse and eating disorders, and creating a hotbed for disorders or personality."

How can puppet therapy help a child recover from sexual abuse?

"Puppet therapy can be a very effective means of healing from childhood sexual abuse. Childhood play with dolls as transitional objects has been a custom across cultures for centuries. Puppets are similar to dolls that can be manipulated to appear "real," resembling human characters. Play as an activity of children, has long been established as an essential ingredient, if not an underlying foundation, of the human experience. Play represents an experience of transcendence from unknowing to knowing or to deeper knowing and has the potential to make the unconscious conscious. The experience of play through puppet therapy has the potential to help the child resolve conflicts with shame, doubt, and ego confusion through reattribution of appropriate guilt to the perpetrator and strengthens the child's ability to express, tolerate and cope with the myriad of feelings involved with sexual abuse. Puppet therapy is an excellent means of aiding the child in learning and practicing strategies to deal with feelings of anxiety and depression.

During the initial evaluation and assessment, police, social workers, counselors and doctoral level clinicians often use puppets to initiate sharing about what has occurred between the child and the potential perpetrator. Children are frequently hesitant to tell what happened to them, even with the wealth of preventative training currently available through pre-school up to high school programs about healthy boundaries and the need to tell if someone violates these boundaries. The reluctance stems at times from the relationship with the perpetrator (father, mother, uncle, aunt, cousin, neighbor, school teacher/aide) and can be increased if the perpetrator has threatened the child or manipulated them into believing that they, or someone they love, will come to harm if they tell about the event(s). Puppets provide a means of suspending disbelief and regression in service of the ego that allows for the freedom to bypass defenses.

The healing is literally at one's fingertips when using puppets in therapy. In my own work with children who have suffered from sexual abuse, I use characters from my Sunny-sides Up troupe that are already formed (characters with a lifelong voice '" not ventriloquism, a story and a way of being) with whom the child can speak. The Vizzini Puppet Therapy Model (copyright 2001) purports that the puppet becomes the therapist. Those trained in expressive arts therapy may ask a child to create a puppet and invite them to tell their story through the puppet (also effective with dolls). In both cases the transference of thoughts, beliefs and experiences onto the puppet through projection allows the flow of information that may otherwise be blocked or unavailable to the child."

What would a typical session using puppet therapy be like for a child that is recovering from sexual abuse?

"While working with girls in an emergency foster care setting for five and a half years, ninety-nine percent of them, ages 3 to 10, had been sexually abused. At the time, I was a childcare giver and educator. They were attracted to the softness of the puppets, the songs of the puppets, and the messages of hope that the puppets offered. A child might choose to hear the puppet Cool Eugene, a male puppet, sing the "Sunshine Song," perhaps because no other male in her life had sung to her or offered hope that the sun could shine.

When using puppets for therapy, the same type of connection with the puppets as described above occurs, depending on the individual child and that child's needs. A child may be attracted to the deer puppet, Deerheart, because that puppet is soft spoken and may be an animal that the child likes. This particular puppet has helped children be able to engage when they have been stuck in a voiceless state of shame. Deerheart may ask questions of the child and then be handed to the child to be cuddled. She, the puppet, can answer those questions, when repeated by another puppet friend, Lionhearted ( a lion puppet), who encourages the child to have "Courage." The child can manipulate the puppet Deerheart and even with just a shake of the puppet's head, "yes or "no," answer questions about what occurred, when the child cannot find her/his voice.

Puppet therapy can take many forms, such as: the child creating a puppet from materials provided and then creating a story about life as they experience it; the child creating a story with puppets that are available to them, adding parents, therapist, or supportive adults joining in the story; or the therapist using the puppets with a defined voice and character to tell a story and dialogue with the child. All types of puppet therapy and therapeutic use of puppets have evidenced effectiveness (see Linn, S., 1978; Irwin, E., 1993; Steinhardt, L., 1994; Aronoff, M., 1996; Vizzini, 2003; Bernier & O'Hare, 2005). In my clinical practice, I use puppets that are fully formed characters and begin puppet therapy with introducing these characters. The child can choose to have a screen/stage so they cannot see the puppets until they appear. If a child seems to want another character that is not already defined, I have about 60 others available, both people puppets and animal puppets, from which they can choose. Hope is held out through the puppet therapy that the child is resilient, was never at fault, and can reclaim their sense of lost innocence and safety. The soft soul of a puppet can reach through the terror of the child's night to bring forth a voice of strength and reclaim the light of day."

Thanks Dr. Vizzini for doing the interview on how puppet therapy can help a child recover from sexual abuse. For more information on Dr. Vizzini or her work please check out her websites at www.puppettherapy.com or www.freedomthroughtherapy.com.

Recommended Readings:

http://www.associatedcontent.com/article/5796524/how_to_stop_being_a_victim_of_verbal.html?cat=5">How to Stop Being a Victim of Verbal Abuse

http://www.associatedcontent.com/article/5723160/how_to_forgive_an_abusive_parent.html?cat=5">How to Forgive An Abusive Parent

http://www.associatedcontent.com/article/5697982/how_to_overcome_the_memories_of_childhood.html?cat=25">How to Overcome Memories of Childhood Sexual Abuse