For the child three to five years old the boundaries between reality and fantasy can be blurred and Imagery may not yet be a stable inner experience. Yet the pre-school child moves very easily from an inner imaginary world to expressing Imagery through play. Translating Imagery into therapeutic play can therefore be highly effective.
For example: Hilary, four years old, was hospitalized for severe excema that covered her entire body. She was referred by her dermatologist because of her distress at having medicated creams applied to her skin. I found Hilary to be a bright, responsive, feisty little girl, and I discussed with her how we "could cool her itchies down." We spoke about the many things that cool us and make us feel good. Hilary declared that creams and baths were definitely no good; she liked clouds. I proposed that we could use a white, soft, fluffy cloud that she could wrap around herself that will cool her itchies. We know that clouds are soft, gentle and cool. She could put the cloud exactly where it needed to go and she could also get mom and me to pack the cloud exactly where she wanted it to be.
Her mother participated and Hilary gave her directions where to put the cloud-coming within one centimeter but not touching her red, angry skin. Scooping up bits of imaginary cloud, her mother and I packed it and checked out every move with Hilary to see if it was working, feeling right, beginning to cool down the itchies. Once the cloud was on thick enough, she wouldn't need to scratch because the cloud protected her skin and allowed it to get better.
Since cream application was a necessary part of her medical treatment, it first had to become more tolerable. Hilary was pleased that first the cloud had to be packed on to protect her skin; then she would blow on her skin as the cream was applied, "like a wind keeping her skin cool and comfortable." Through the Imagery and her cool blowing her relationship with the staff changed; they became participants in helping her to become comfortable during a distressing but simple procedure and she gained some say and power.
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