The mother’s immediate concerns were twofold: her daughter’s virginity and the fact that she could not find a way to tell her husband what had happened to their child. She came to see me after we had spent at least 2 hours on the phone together. I spent quite a bit of our first session in my office discussing her hesitancy to tell her husband whom she described as “a good and sensitive man.” Hypothesizing that she could receive needed support from her husband, I explored her concerns. She de-scribed being terrified that her husband would have a violent response and attempt to kill her father. Interestingly, Rosa’s father had no history of any violence whatso-ever, making me speculate that it was the mother’s own constrained rage that she feared. In addition, she was worried that her husband would view their female child as “damaged,” being traditional in his view that women should be virgins when they marry.
The mother and I discussed her fears and she was receptive to my suggestions, particularly my offer to meet with her husband immediately so he could be informed about Rosa’s sexual abuse. I noted that Rosa was young and there was no reason to believe that Rosa would automatically have long-term physical or emotional prob-lems, particularly if responses were swift, sensitive, and appropriate. The mother called her husband from my office and he agreed to join her, sensing something was terribly wrong. My next appointment had been canceled, and I was able to accom-modate a joint parental session straightaway.
I assisted the mother in the process of telling her husband what had happened and predictably Father was shocked and concerned. He held his wife as she cried, and reproached her for not telling him earlier and then turned to me for informa-tion. “Is she injured?” “Is she going to be okay?” “How will this affect her future?
She’s so little, so young, so tender, how does she understand this?” I told him that the worst was over now and that at this point we would concentrate on helping Rosa recover. I also told him that children’s resiliency is remarkable and it was reasonable to expect Rosa to survive these experiences. Finally, the question arose:
“Is she still a virgin?” I told him that I was not a medical doctor but that I had been assured by the nurses that her injuries would heal quickly. “She’s so young,”
I told him, “by the time she marries it is likely that this will be a very remote memory and her body will be completely healed.” After this initial session I sched-uled an appointment to meet with Rosa. The mother and father left hand in hand and brought Rosa to each of her subsequent appointments. I encouraged them to take their daughter in their arms and tell her that they were very sorry that grand-father had hurt her and they were very proud of her for telling them so they could put an end to the abuse.
tures and placed two large spiders and a dinosaur in the sand as well as an insect hiding behind a “wall” (see Figure 12.1).* In addition, she buried a well, rendering it “dry,”
and a casket was buried next to a tombstone. She commented that the dead person was her “good grandfather” who had died and was buried in her country. She commented that she cried whenever she thought of him dying. I was impressed with her ability to express her emotions and commented, “It sounds like you miss your grandfather who died and that he was a good grandfather to you.” She nodded her head affirmatively. I did not ask more but was struck by her choice of multiarmed insects and how the tray seemed somewhat barren and threatening as well as sad.
The next session Rosa asked if she could paint and stated, “I’ll make a picture of me!” I set up the easel, paints, and brushes and offered Rosa a choice of paper (she picked 11″ ×14″rather than standard 812″ ×11″or the larger 18″ ×24″). She made a small figure on the bottom right-hand side of the page (Figure 12.2). The rather large oblong arms seemed disconnected from the body and she encapsulated her self-portrait with a bright red square shape which she then colored in with purple and rectangular green and black shapes. The black rectangle sits directly on top of her figure, giving the picture an interesting look. When she finished her picture she said,
“This is me and I’m inside my house. There’s a black cloud inside my house.” “Oh,”
I responded, “there’s a black cloud inside your house.” She sat back in her chair and said in a quiet voice, “I don’t like my room because my abuelito [grandfather] would do bad things to me in my bed.” “I’m sorry to hear that,” I said. “It sounds like you had one grandfather who was very good to you and one grandfather who did bad things.” “Yeah,” she said, “and I’m scared he’s going to come and get me.” Rosa and I then discussed her fear that her grandfather was going to kill her because she told.
The more she talked the more I realized that her grandfather had made many serious threats that had rendered this child helpless and terrified. Rosa seemed to have opened the floodgates and talked about her grandfather with great disdain. “He made me touch his palomita and he told me I should lick it and kiss it and I did.”
“That’s okay Rosa,” I told her, “when grandfathers tell their granddaughters to do something, they obey them because they’re little and the grandfathers are the adults.
He was wrong to ask you to touch his palomita and you didn’t do anything wrong.”
She looked at me through tears and said, “Abuelito told me that God knew I was a bad girl and that he was mad at me.” She then added, “He told me that my mommy and daddy will be mad at me when they find out what I did and that I was bad.”
I was internally enraged to hear the type and level of manipulation that this man had used to ensure this child’s silence. Rosa looked sad and confused and I held her hand and told her that her grandfather had done bad things to her (her language) and that she was a good little girl and God and her parents loved her very much. I contin-ued to reassure her that her parents held her grandfather responsible because he knew that it was wrong for him to touch her. “What’s more,” I added, “your parents 158 CLINICAL APPLICATIONS WITH CHILDREN AND ADOLESCENTS
*As an art therapist I find sand therapy an easy transition. In fact, I view the creation of sand scenarios as parallel to creating an art product. Interestingly, some children who cannot or will not draw are able and willing to use miniatures to create pictures in the sand. These pictures have the added dimension of being three-dimensional and vibrant. The scenario has a “life” similar to that found in artwork.
want to take good care of you and make sure this doesn’t happen to you again.”
Later we agreed that her mother should join us and I encouraged Rosa to tell her some of what we had discussed. She prefaced her comments with “Mami, please don’t cry, okay?” Rosa was well on her way to healing, letting months and months of preoccupation and fear come forward, eliciting clarity of response, reassurance, sup-port, and nurturing from those around her. As they left, I commented that perhaps the cloud in her room would not feel so heavy and dark anymore. She smiled.
Art and Play Therapy with Sexually Abused Children 159
FIGURE 12.1.Sandtray with two large spiders, an insect hiding behind a “wall,” and a dino-saur.
FIGURE 12.2.Painting with a small figure.
During the next two sessions I invited Rosa to work on a project developed by Sobol and Schneider (1996) which consists of children building a “safe environment”
for an animal miniature. I chose to recommend this project based on the picture she had made in which she appeared confined in her room. The encapsulation in Rosa’s self-portrait can be interpreted in two ways: She might feel the need to feel safe with reinforced boundaries or she might feel imprisoned and constricted. I wanted to give her an opportunity to transform the image by asking her to make a safe environment which I assumed might have a quality of freedom rather than containment. Rosa chose a dog, commenting that she always wanted to have a dog but the landlord would not let her family keep one. She picked the dog, placed it on a small cardboard plate (see Figure 12.3), and proceeded to build it a safe world in which the dog’s needs were met (she included food, water, a soft bed, and toys to play with). She also made a toy phone (included later) so that the dog could talk to friends and parents as well as call for help when needed. She was pleased with her product and rushed out of the office to show her parents what she had created—our difficult previous session had been followed with a session full of mastery and satisfaction.
In the following two sessions Rosa returned to the sand and miniatures making wedding scenarios. The first week she poured some water to make the sand wet and malleable. She liked the sensation of wet sand and talked about the beaches in her country and how much she enjoyed going to the beach with her “good grandfather.”
She was obviously enjoying these memories and suddenly constructed a wedding (Figure 12.4) with a bride and groom, bridesmaid, best man, and a small pet dragon who was there to take care of everyone. A fairy godmother took center stage to take care of the bride and groom. Finally, Rosa selected a two-headed dragon and re-flected, “That dragon is kind of scary and he can scare people but nobody knows he’s there so they’re okay.” I guessed that Rosa was struggling with how reliable her sense of safety was. Rosa’s grandfather had fled the country after the abuse surfaced and 160 CLINICAL APPLICATIONS WITH CHILDREN AND ADOLESCENTS
FIGURE 12.3.Safe world in which the dog’s needs were met.
although she was happy that he was not a present threat, she had recently told her mother that maybe he would “sneak back” when no one was looking. Rosa and I talked a little about the wedding and what it was like to know that the bride and groom might be in danger. She said she did not know what would happen but came to the next session ready to create another sand world. Figure 12.5 shows an ex-panded version of the wedding scene with a great many more animals lined up paral-lel to the two-headed dragon. “Now,” she said, “he can’t do bad things because the elephants will stop him . . . they are very, very strong.” This appeared to be Rosa’s way of stating the obvious: Her parents would be there no matter what dangers the future would bring. She was also careful to place some baby birds and mothers in birds’ nests and said that the parents were taking care of their babies, helping them grow, and finding good food to eat. She laughed and we took a picture of her sand scenario for her to take home.
Rosa was making progress and seemed comfortable with me. She had told her mother that she wondered why God had let this happen to her and her mother and I discussed how to respond. I realized that it would be important to let Rosa know that sexual abuse happens to lots of children and that they often feel they have done something wrong. I selected a book titled No, No, and the Secret Touch (Patterson &
Feldman, 1993) and read the book to Rosa. I also played an audiotape that accom-panies the book and I played it to Rosa’s delight. She absolutely loved the book and often stated, “I felt that way,” identifying with the little seal (who is sexually abused by her uncle), or “I know she’s scared but she should tell her mom and dad . . . they’ll help her.” Rosa had made such a positive identification with the little seal in the story that the next week I surprised her with a project which she thoroughly loved: I had purchased a set of seal parents and a baby seal and invited her to make another safe Art and Play Therapy with Sexually Abused Children 161
FIGURE 12.4.Sandtray depicting a wedding with a bride and groom, bridesmaid, best man, a small pet dragon who was there to take care of everyone, a two-headed dragon, and a fairy god-mother.
environment. Her parents tell me that to this day she says “good night” to the seal family.
Following this work which directly addressed the sexual abuse, I invited Rosa to make another self-portrait and she did so willingly. This second self-portrait (Figure 12.6) was made on larger paper and the color scheme changed. Rosa placed herself on a grassy field with patches of flowers growing underfoot. She made a “very warm sky” with orange saying that the sun was so hot it made a
“cloud” of heat. I noticed that the cloud overhead in her original picture which she described as “heavy and dark” was now replaced by a warm cloud which was
“helping the flowers to grow.” I also noted that Rosa’s arms were now connected to her body and she had her feet firmly planted on the ground. She said her arms were outstretched because she was welcoming the warm sun. I felt this picture showed progress in Rosa’s emotional state and reflected her new view of the environment as nurturing and safe.
At this point, Rosa’s parents felt that she was now “more herself” and they wanted to resume their lives and put the abuse behind them. We had a family meet-ing in which we openly discussed what had occurred, everyone’s reactions to the abuse, current feelings about grandfather, and what each person thought would hap-pen in the future. I’ll never forget Rosa’s last statement in this meeting: “Even though abuelito is not here and the police can’t punish him, God will punish him when he gets to heaven.” Parents asserted that God would indeed punish grandfather for hurt-ing her and the session ended.
At our termination session Rosa brought a cake she had baked for me and we each had a piece on small plates with small eating utensils. After our meal she rushed to make a final tray. The wedding scene appeared again, this time a double wedding complete with flower girls, fairies, wizards, and an array of guests, mostly four-162 CLINICAL APPLICATIONS WITH CHILDREN AND ADOLESCENTS
FIGURE 12.5.Sandtray with an expanded version of the wedding scene with more animals lined up parallel to the two-headed dragon.
legged (Figure 12.7). Rosa stood back and said, “This is my wedding and this is my mom and dad. There are lots of nice people at the wedding and lots of love to go around.” She smiled and said, “This is my good abuelito’s place because he will be with me when I get married.”
I reviewed with Rosa the work she had done in treatment, chronicling her initial disclosure, medical exam, and visits with me. I showed her pictures of all her work Art and Play Therapy with Sexually Abused Children 163
FIGURE 12.6.Painting of self on large paper.
FIGURE 12.7.Sandtray of a double wedding with flower girls, fairies, wizards, and an array of guests, mostly four-legged.
and she smiled as she recognized them, copies of which she had taken home. She of-fered many insights about her work and about the lessons she had learned.