Janyce, was my very first client  -- from December '94 to June '95.  Janyce is a nine year old, Afro-American female, living at home with her mother and six siblings, the middle child with four sisters and one brother. I was an intern at Learning Services and my placement was at an elementary school in San Francisco. The fourth grade teacher referred Janyce to the Care Team, a group of teachers, mental health consultants and interns, who then assigned Janyce to me.

Until about a year and a half ago, the family had been homeless and most of Janyce’s life had been spent in shelters. Her family is now in low income housing, supported by Aid For Dependent Children. Her mother had recently been released from prison due to drug involvement. Her father is not present in the home although Janyce has frequent outside visitations with him.

According to her mother, Janyce was an unplanned but wanted pregnancy. Janyce’s mother was using crack and alcohol at the time of her birth. The birth was vaginal and Janyce had no early health problems. Janyce was breast fed until six months. Toilet trained at two, Janyce started to wet and soil herself when she started kindergarten.

Janyce was treated for "probable" sexual molestation which happened around four or five years of age. Janyce’s mother made the connection between this abuse and Janyce’s onset of enuresis and encopresis. The abuser was one of Janyce’s mother’s husbands but not Janyce’s father. (There are seven children and five different fathers.) The perpetrator was jailed for also molesting the other girls in the family. Janyce had told her mother that, "the man would check between her legs after she pee-peed." Janyce was treated at Family Services on Gough Street twice after sexual activity was suspected. The counselor felt treatment was minimally helpful because of "the relatively small impact it could have on the enormous social, economic, and psychosocial problems facing the family."

Janyce’s present teacher felt there was no further abuse in the home. However when Janyce’s mother is phoned or receives a letter about Janyce’s behavior in school, she disciplines her, sometimes severely. Janyce becomes frightened when her teacher tells her that her mother is going to be called. Janyce is also subject to some physical discipline from her older sisters.

In 1993, Janyce was evaluated at Langley Porter Institute and it was concluded that her academic skills were in the average to below average range. Janyce’s reading skills were quite adequate while her math skills were weak. In terms of behavior, Langley-Porter Institute found Janyce to show signs of anxiety when she did not have a ready response during the testing. Janyce appeared scattered at times and showed signs of impulsivity and of distractibility.

Janyce required some structure to help her focus. However, her concentration and memory on structured rote tasks was quite adequate to well above average, in spite of intermittent distractibility. Overall, Langley-Porter expected Janyce to continue to function better in more structured situations.

On the basis of the above history, the Langley-Porter Psychiatric Institute’s educational evaluation and my own observations, I diagnosed Janyce as having a Reactive Attachment Disorder (DSM 313.89) and Oppositional-Defiant Behavior (DSM 313.81). Her underlying ego strength was strong, but there was need to have her strengths reflected back to her.

Janyce was seen by me for twenty-seven sessions beginning 12/1/94 and ending on 6/8/95. My work with Janyce was non-directive. I used a playroom which included a sandtray, various toys, dolls and puppets, art materials and a small piano. My goal was to follow the course of her play, providing an atmosphere in which trust in the relationship could develop, one in which she could experience her strengths as well as to share her fears and concerns. I hoped that in this atmosphere enough strengths would develop so that she could begin to manage her own anxiety in a way that was more appropriate for her at home and at school.

In the following detailed account of the sessions, the specific nature of my work and Janyce’s participation with me will be described.

I entered the classroom to pick Janyce up for our first session when an Afro-American child (I couldn’t tell at first if the child was a boy or a girl) said to me, "Who are you?" and, as it turned out, it was Janyce. She had just gotten her hair cut very short and her teacher told me in front of Janyce that, "Janyce was feeling very self-conscious."  Her teacher told me that Janyce’s recess was at 11:35 AM and I should just take her out to the school yard when we were finished. I asked Janyce if she wanted to come downstairs to the playroom with me and she nodded in agreement. As we were leaving the room, the teacher called after us saying, "Just make sure she goes to the bathroom." I was surprised to find out that Janyce knew exactly which of the rooms downstairs was the "playroom".

Session One: (12/1/94)

When Janyce entered the playroom for the first time, I could see her eyes open wide as she looked at the room with all the toys displayed. We sat down at the table and I explained to Janyce who I was. I told her that I work with children and try to help them with some of the difficulties they may be having. I explained that this work happens through play and that the time we spend together was just for her and whatever we would talk about would remain between us.  She did not say a word while I spoke to her. I continued, telling her that we would meet for three times (sessions) and then we would decide together if we would continue to meet. I asked her if that sounded OK and she nodded yes. Janyce waited for a few moments and then told me how much she liked the pictures on the wall (the one with the rainbow dress, the one with the baby carriage, the one which said "I feel happy") - on and on until she described and told me she liked all the pictures. Janyce knew some of the children who drew the pictures and there were some photo’s also posted on the wall in which Janyce identified her sister.

"You can tell by her face", she said as she ran her finger over her sister’s picture. We then read all the pages in the pad that Janyce had brought down to show me, a kind of journal. The first page of her book held an image of a baby with a rattle that she drew next to the image of a T-shirt which had her Mom’s face on it.

We came to a page where Janyce wrote about getting dressed up: "I get dressed up for Thanksgiving and I get dressed up for funerals." She told me that there were some people in her family that had died but she didn’t attend their funerals; she knew their names. Her grandmother died when she was 98 years old, her brother was 27 and her uncle was 32.

I asked Janyce if she had ever seen a sandtray before to which she responded, "No." I explained to her that some children take different figures and place them in the sand. She didn’t respond.

Janyce asked me if I ever watched the Rugrats on Nickelodeon. When I told Janyce that I had not seen the Rugrats on TV, she asked, "You got any children?" I told her I didn’t. She said that  the Rugrats was one of her favorite shows. We  then talked about the Addams Family movie because the seashells on the table reminded Janyce of what Morticia used when she danced in the movie. (The scene in the movie lasted no more that two seconds! Morticia and Gomez were on a dance floor when Morticia walked over to a table and picked up some shells to makes castanets to use as she danced.) Janyce spoke about Morticia’s daughter, Wednesday, from that movie and the things she did. (In one scene, Wednesday is at a very prestigious, snobby all-girls summer camp. Each girl had a partner and were lined up on a dock. One girl was to jump in the water and feign drowning. Her partner was to jump in and rescue her. It turns out that Wednesday’s partner really couldn't swim and Wednesday just stood on the dock, watching her partner panic and calling for help. Wednesday never jumped in to help her - she just stood on the dock with her arms folded over her chest.) Janyce had seen this movie over six months ago at her Dad’s house.

Janyce asked me if I had read Charlotte’s Web because the pig I had (a sandtray figure) "looks just like the pig in the book."

Janyce told me that she was going to be a "Power Ranger" when she grew up and for Christmas she hoped to get one of their powerful gloves. I told her that I would like to see the glove and I invited her to bring it in to the playroom. She said, "I don’t know for sure if I’ll actually get one for Christmas but if I do, I’ll show you."

Janyce started to play and touch the figures that were sitting on the table next to us. She started to squeeze a cupie doll until it squeaked. Janyce picked up the miniature bride figure and brought it closer to her. She asked me what that was on top of her head and I told her it was a veil. Janyce didn’t know what a veil was and so I explained it to her. (I explained that a long time ago women had to wear something on their heads if they were to enter a church - a sign of respect.) She ignored this statement the same way she did when I explained to her about the sandtray and who I was.

There was a noise (someone in the room next door) which frightened her and she asked with alarm, "Did you hear that?" I explained to Janyce what the noise was and Janyce calmed down. She moved the figure closer saying, "Those guns scare me, they scare me a lot." I asked her to show me the gun and she pointed to what I thought was a wrench however, it was a gun.

Janyce announced that she wanted to play with the toys in the sand and asked if that would be OK. I said "of course." She got up, looked all around the room and walked over to the desk where most of the other toys were placed. She picked up a small ambulance and asked if the ambulance doors opened up and if the lights on the top worked.

She found the small wind-up toys, one of which was a skeleton head whose mouth chattered. Janyce liked this but said, "He is talking too fast for me to understand him." She then found her most favorite thing, an orange-stone ring with rhinestones seated on velvet in a plastic container. Janyce was very interested to know if I remembered where I had gotten the ring. She immediately brought the ring over to the sandtray and placed it inside. She took two large trays of play food and just dumped them into the sandtray as well.

Janyce looked around the room and asked if she could play with the other toys and chose the "doctor’s kit". She took her blood pressure and then spent a lot of time with the stethoscope, rapping on it saying, "Who’s there? It's me." over and over. In the doctor’s kit were two "clamp-ons", one a cast and one a band-aid both of which Janyce put on her arm. She asked me if I was bleeding and I asked her if she thought I was bleeding. She said, "No" and then buried the band-aids in the sand saying, "Where are my band-aids?" "I’ve lost them." (At 11:35AM, as instructed by her teacher, I asked Janyce if she had to go to the bathroom. She said she didn’t. I told her that when she did, she should let me know.  That was that.)

Janyce started to identify all the different plastic foods that she had dumped in the tray and when she came to the carrots she told me that, "they are my favorites." Janyce saw the plastic turkey and said, "Oh, now we can have Thanksgiving!" She started to prepare a complete meal asking me to tell her which were my favorite foods.

I told Janyce that we had to finish up and her response was to act as though she didn’t hear me, that she was deep in her story. I repeated what I had said and Janyce responded that, "she had to put things away first." I allowed her to continue for a minute or two but reminded her that we really must go. Up she stood saying, "I want to come back tomorrow!" I explained that it wouldn’t be until next week that we would see each other again in the playroom. As we walked down the hall to the door, Janyce put her little arm around my waist and said, "I like you, you’re nice." I told her that I liked her too because I did.

As we walked back to the classroom, I asked Janyce if she needed to go to the bathroom. Again, she said she didn’t. I reminded her to tell the teacher if she needed to go after she got back to her seat. I told her to have a good rest of the day and she said she wanted to come with me. I told her that wasn’t possible and she entered her classroom, waved to me and became immersed in what her teacher was doing at the blackboard.

Session Two: (12/8/94)

When I picked Janyce up for our session, she told me we had to find her reading teacher first because she had promised Janyce a pin for good behavior, for "not getting her name on the board." The teacher gave Janyce the pin and asked me to help her put it on, however, Janyce pinned it on her shirt herself.

When we arrived at the playroom we sat down at the table and Janyce asked me if the plastic witch was new. She became very involved with the seashells and quartz rocks and would count each of them several times to see which of them could fit into a small woven basket; Janyce thought this would indicate "which of them won", the rocks or the shells. This went on for at least 20 minutes. (During this time, Janyce spoke again about the Addams Family Values movie. She said she saw it when she was at her Dad’s house last June. She said she liked the part where the little baby wound up falling on a huge electric switch which "sent that current back to that evil woman.") She spoke about liking the smallest shell the best, she commented "it was the most delicate and easiest to be broken" as she tapped it with her fingernail. Janyce said that she would be in trouble if she dropped the shell and it broke.  Janyce asked if she could throw a metal airplane in the air  because "if it fell, it wouldn't break".

Janyce put one of the wind-up toys in front of the airplane on the floor and said, "Try and get me, try and get me." Suddenly, she walked over to the table and started to put some of the babies in bed. She said in a stern voice, "Get in bed!Get your butt in bed!" Janyce put an infant on the adult male doll’s crotch and immediately went to the window and asked to "put up the shades". (All the shades in the room were pulled down because our room looked outside onto the school yard where other classes played during recess.) Now, during recess, Janyce could identified a child outside our window by the other girl's voice saying, "She always hits the younger kids." Again there was a noise in the next room which scared Janyce and she concernedly asked, "Did you hear that?"

Janyce didn’t wait for my response or my answer. She immediately went to the blackboard and told me that she was going to instruct me about a game she had learned. She said, "Now, you tell me the word when I write it." She asked me to spell four words for her: "none", "hey", "shin", "gimall". I tried to follow her, letting her know that I was unsure as to what she was showing me. Next to the four words she began to make odd shaped drawings. Janyce then drew a square and divided it into four parts putting a word and a letter into each division. She explained to me that in this game you could either win all the money or lose all the money.

It was important to Janyce that she completely erase the blackboard and put things away before ending this session.

On our way back to Janyce’s classroom, I told her that I wanted to know more about what she had shown me on the black-board in the playroom. Janyce said that when we got to her classroom she would show me the book that she had read a while ago which explained all this. The book was entitled, Herschal and the Hanukkah Goblins and what Janyce drew for me on the blackboard was the four sides of a dradel with the four characters of the Hebrew alphabet and their associated names: Nun, Hay, Shin, and Gimel. When looking at the illustrations in the book, I realized that Janyce had quite adequately represented the Hebrew letters on the blackboard as well as their names.

Session Three: (12/15/94)

Janyce came into the playroom and immediately went over to the sandtray. She started to play with the sand for some time, hiding her hands in the sand. She decided to add some animals and chose the animals which had families saying, "You can tell the Daddy, he’s the biggest!" She would just toss the animals in the tray with no sense of placement. Janyce insisted that I tell her which animal family I wanted to play with so she could give them to me.

We read a story together and Janyce referred to the character in the story as "fat and stinky." As she read, her behavior seemed to change and she started to make strange sounds along with burping noises for which she apologized.

Then there was aggressive play with puppets. Janyce screamed on the top of her lungs and roared like a bear. Her puppet would attempt to devour the witch and it seemed representative of her fighting for food. We finished the session talking on the play phones.

Session Four: (1/5/95)

When Janyce entered the playroom, she looked over all the things to see of any of them had been missing or if anything new was added. She immediately noticed a new set of small, plastic utensils. She placed these into the sandtray along with a large "babydoll." Janyce looked at the box of blocks and asked me if she had ever played with those before. ("No") She seemed excited as she emptied the blocks onto the table and announced that she wanted to "make something really big." She built for about 20 minutes and I noticed that her breathing got very heavy, almost asthmatic. Eventually she built a place for the doll, which earlier she had sat in the sandtray. For the rest of the session, Janyce cooked an extensive lunch for "all three of us." The sandtray became the stove/oven and again she dumped all the plastic food into the tray.

I suggested that she use the small, white plate but either she didn’t seem to know what I was talking about or she didn’t hear me. Again Janyce heard a noise which startled her.

Session Five: (1/9/95)

Janyce came in and started to play in the sandtray with her hands. As she let the sand flow through her fingers, she told me about a bus trip with her other two sisters. Her older sister would try and separate Janyce and her younger sister because they would laugh too much on the bus. She said she visited her "Auntie" at Potrero Hill over the holiday.

Janyce moved to one side of the sandtray and started to read to me a list called "People Skills" which was posted on the far wall. Some of the vocabulary was beyond her level but she would sound the words out until she could identify them. She then said to me that she couldn’t see out of her right eye and continued to tell me, "You know Marie, I can’t see you unless you get really close up". I had her cover her eye and try to read the letters I pointed to but she wasn’t able to do this using her right eye.

We played a game of checkers and then Janyce wanted to draw a picture and write a note to me. As she drew the picture, she said to me, "You don’t like all black people, especially those that do bad things."

Janyce asked me if I wore glasses when I was 5 years old and told me that her doctor made her sister wear glasses. There was a long pause and then she asked me if I would take her to the eye doctor.

Session Six: (1/19/95)

In this session, Janyce placed the largest dinosaur in the sandtray on its side. She buried it saying that it would now "stay dead" and not bite her or "hurt me ever again". Janyce wanted to know if I had ever changed a baby’s diaper and decided that she would put new diapers on the two dolls which she considered twins. A fire drill necessitated us going outside into the school yard. On our return, Janyce changed the diaper on the second doll. As she did, she would tell me how bad they smelled and she would smell each one before deciding if they needed to be changed. She would reprimand the doll for smelling so much and threaten to "slap it upside its head."

She attempted to remove the tape which held the old diaper in place but hurt her lip and we went to the office for an ice pack. When we returned to the playroom, Janyce said she had to take care of the two dolls because they were both ill and she used the "doctor’s kit" to make them better.

Janyce asked me to point to some letters and see if she could identify them with her weak eye; she was unable to read them. (I submitted a referral to the school’s heath nurse which started the process for obtaining some glasses for Janyce.) During my supervision, it was now decided that Janyce would be seen twice weekly.

Session Seven: (1/26/95)

Janyce wanted to open the door to the playroom herself with the key. Janyce told me that she and her sister, Tiffany, were going to their father’s house until Tuesday. (She and Tiffany have the same Dad.) We started to play checkers and this time it was important for Janyce to win. I made a move which caused a tie but Janyce didn’t stop playing.  Instead she  rearranged the pieces so we had to go on. During the play, she would start to make inappropriate noises and then look at me and say, "I’m crazy aren’t I?" She wouldn’t give me a chance to answer and said, "Its your move."

Janyce said that she had to blow her nose but was too embarrassed because "it would sound too gross." I assured her that everyone had to blow their nose and I promised I wouldn’t look and went into the other room which made it much easier for her.

We shared a croissant and Janyce liked its name. She got the play phones and ordered three dozen, screaming the word croissant over and over into the phone!

Janyce wanted me to be her and she would be her Mom.  She asked to call her Mom and when I did, she asked me if I was behaving at school.  Janyce, acting as her mother, said, " She fusses at home with the younger kids". Janyce told me that I was now to hang up and call her friend Renee. Renee’s mother was lying on the floor "bleeding from her face". I asked her how this happened and she said that she was trying to jump out a window and cut her face and was bleeding on the floor. We called for an ambulance to come and care for her. At this point I made sure that Janyce knew her own address, phone number and the number to call - 911. She asked if I ever met her Mom and if so, when? Janyce asked me if I liked her Mom and said, "She’s a chubby Mom."

Session Eight: (2/2/95)

When I picked Janyce up from her classroom, she was excited to tell me that she was getting a game and some books to bring down to our playroom. She told me of her time at her Dad’s house and how happy everyone was that the 49'ers won. Janyce asked if I saw the O.J. Simpson movie on Monday (I told her I didn’t.). She said that, "the movie showed that O.J. didn’t do the murder but instead, his white friend did it."

Janyce asked if we could play marbles and then changed her mind to cooking with pots, pans and plates. Sand became breakfast foods and said that, "her eggs would be the best I would ever taste." We spent the last part of the session with Janyce fixing me breakfast. She told me that this was going to be the best breakfast I ever had. She gave me the stack of play $$$ and told me I had to pay for the different dishes.

I called Janyce "Miss" (addressing her as a waitress) and she said, "I ain’t your Miss." I asked her what I should call her and she said, "call me friend." When I let Janyce know that we had five minutes left, she fell on the floor saying that she needed an ambulance and was very ill. Then, on her way back to the classroom, Janyce crawled up two flights of stairs on her hands and knees.

Session Nine: (2/6/95)

Janyce brought her different log books down to the playroom to show me. She showed me her assignment from reading class and read all the different entries to me. As we did this, Janyce said that I was one of her best friends and wanted me to help her draw a mouse for one of her assignments. I asked her to try but she became quite frustrated and then just drew a large O instead. Her behavior regressed and she began making inappropriate noises. She stood up and got the cans of Playdoh. Janyce wanted me to "make something" and whatever I would attempt, she would copy. She asked me to make the ears for her creation but again I encouraged her to make them on her own. It was becoming more difficult for Janyce to leave our sessions and her behavior started to regress a great deal.

Session Ten: (2/9/95)

As the session started, Janyce told me that on Friday she was going to meet her friend who had just bought a car, a small car but big enough for her to fit in. Minutes after being in the room, Janyce asked me if she could go to the bathroom and we did. On our return to the room, she brought all the baby dolls to the table to change their diapers. She said they smelled and asked me if I "ever dirtied in my diaper." Janyce focused on the microphone/tape which was situated on the top of the piano and went over to explore it. She began to sing into the microphone while playing the piano (i.e. banging on the piano) while telling me about different TV shows. We planned to listen to the tape for five minutes before ending our session. However, the fire alarm bell rang and we spent our last ten minutes out in the yard. I explained to Janyce that because of the drill she needed to return to the classroom with her teacher for it was now 11:00 AM. At first she thought I was kidding but when she realized that I was serious, her behavior became regressive. She sat on the stairs and refused to come upstairs with me . Janyce said that she was going to cut her head off and then stick it in a pile of dirty clothes. As she said this, she stuck her head inside the shirt she was wearing. (Later, I learned from the teacher that some of the other children had said that Janyce smelled and she lashed out at them.) Slowly I was able to return her to her reading class as she pleaded with me the whole way for "just five more minutes."

Session Eleven: (2/13/95)

Again we started the session off with Janyce needing to use the bathroom when we first entered the playroom. When we returned to the playroom I tried to explain to Janyce how much time we would be spending together each session and since our separation was so difficult, I was going to let her know when we had only ten minutes left so we could finish things up. I asked her if that would be OK and she said "yes."

The rest of our session was spent with Janyce drawing a picture of me and asking me what colors and what kind of bows to put in my hair. She gave me a crown because I was a "princess." After she finished drawing the picture, she cut it out and then taped it onto a larger sheet. When I told her of the time, she pleaded, "Wait Marie, I need to do something." I told her that we needed to finish up and as I said this to her, she lifted up, off the page, the image of me that she had taped there.

I asked her if I was to keep it and she said, "No, I’m going to take it with me and show everyone my friend Marie." Suddenly, there was a shift, she placed the drawing of me on the table and asked me for a favor. She asked if she could borrow a "babydoll" until Thursday. Before I could answer, she promised that she would take really good care of it, that she wouldn’t take it home because her brothers and sisters would "mess" with it; she would even ask Ken, the principal, if he had a big envelope to keep the babydoll safe in. It seemed as though this transition object was quite important and so I said "yes", she could take the doll until Thursday. We did go to the principal’s office for the large envelope and there, all three of us, named the doll "George."

Session Twelve: (2/16/95)

It is now Thursday and when I picked Janyce up from class there was no "babydoll" or a mention of one. We proceeded down to the playroom and when we entered, her eyes widened when she looked at the other "babydolls" sitting on the table - but still, no mention of "George." For the first half of our session, Janyce spent the time hiding the ring in different boxes having me guess where she had put it. We played the piano for some time and I taught Janyce how to play "Mary Had A Little Lamb" which she practiced until she mastered the tune. About 10 minutes before we were to leave, I knew I had to ask Janyce about the "babydoll". I said, "Janyce, come and sit down over here, I have something I need to talk to you about." "I’ll be there in a minute, I have to finish reading this." was her response. I waited a few more minutes and finally said, "I need you to come and sit down here so I can talk to you about something." Finally, she came over and sat down.

Then Janyce told me that we needed something to put the babydoll in because he was "necked" (naked). I looked all over the playroom and the only thing I could find was a small silver lamé shopping bag just about big enough to fit the doll in. We went all the way upstairs to her classroom but the room was locked and so we had to go downstairs again and out onto the yard where half the school was in recess to find her teacher and get the key to the classroom. However just as we enter the yard, Janyce decides to put this silver lamé bag on her head, drawing all the children’s attention to her as she holds my hand. I asked her if she needed to "wear" the bag and with that she pulled it down even further over her head to the point where she couldn’t see and had me lead her as though she were blind. We found her teacher, got the key and went all the way back up to the classroom, got the "necked" baby doll put him in the bag and were on our way down to the playroom.

There were a few moments of pleading to play some more but at this point I had had it and told Janyce "its time to go, now." On our way up to the classroom, we met two of her friends and they all started to play tag running up the stairs. Her friends entered their first floor classrooms and Janyce and I continued upstairs. Janyce was still not together and was running up and down the hallway. Finally she sat down on the floor outside her classroom door. I saw that the school counselor was inside her classroom and I didn’t want Janyce to re-enter in such a hyper state.

Before I knew it, the words just came out of my mouth: "Janyce, come on, stand up and pull yourself together." "Niki is in there. You can’t go in there like this." Well, all of sudden Janyce stood up, brushed herself off, straighten her clothes, KNOCKED on the door and entered the classroom.

Session Thirteen: (2/23/95)

Earlier in the day, Niki the school counselor told me of Janyce hitting another child and when she was reprimanded, she hid under the desk. When I met with Janyce sometime later that day it was the first time she brought the "soldier stuff" near the sandtray.

Janyce then brought over the fences and trees/shrubbery. She walked over to the piano and played from memory the tune, "Mary Had A Little Lamb" perfectly and had to repeat it at least 10 times. As she walked back to the table she said, "I’m really smart aren’t I?" She sat down and put all the "scary" bugs and animals on my arm. I said to her that it seems like she wants to scare me and she said, "I just want to see what you’ll do." I asked her if she ever felt scared. She said, "Yes, at home when I have to go downstairs in the dark to get something for my Mom." Janyce began to put fences in the sandtray in a very orderly way and also some "pretty" trees. As she did this she told me that Niki said she was her mother. I asked Janyce why Niki would say something like that and she said that Niki was angry with her for hitting another child. She asked me what I would do if someone "got in my face" because "I know that you could defend yourself good". I told her that I would probably go to the teacher or to Niki because I don’t like hitting or hurting another person. We played a game of checkers for the last 10 minutes when Janyce and I put the remaining pieces of the game on the piano to save the game for the next week. We left the room without any difficulty.

Session Fourteen: (2/27/95)

We started to finish the game of checkers from last week, Janyce wanting to win and show me how "smart she really is." Just then Janyce heard a voice out in the schoolyard and asked me if she could put up the shades and look out. This seemed symbolic of the last time this question was asked and so, I said "yes". After doing so, she just stood there as if waiting for something to happen. After a few moments, she asked me if she could keep them up and I said yes. Our checker game became "rule"-less and our play turned to the puppets in the sandtray using the checkerboard as a slide. Near the end of the session, Janyce asked if she could take a toy. This time I did not think it was wise and so I said, "No, all the toys need to stay in the playroom." There was begging and pleading. She said she was angry and upset with me. She said that she was going to kill herself and never wanted to see me again. I told her that I would come and look for her in case she changed her mind because I would really like to see her. It was very difficult returning Janyce to her classroom and I had her reading teacher come out and help to re-orient Janyce as to what was going on in the classroom.

Session Fifteen: (3/13/95)

Janyce missed the next three sessions "due to a cold" and the next time I saw Janyce she had her hair done very differently. It was all braided making her look much older. She told me that she had gone to the eye doctor with her mother and picked out some eyeglasses which she thought were "pretty".

We played the piano and sang songs for most of the session. Janyce found some colored wire and wanted to make a bracelet for me. At the end of the session, Janyce said that we weren't going to be friends any more.

Then she said, "Psych ya, we'll be friends forever." It was much easier for her to separate and return to the classroom.

Session Sixteen: (3/16/95)

I learned that Janyce was to be suspended from school for 5 days for fighting on the bus. She told me how angry she was because it really wasn't her fault. One of the kids from the front of the bus came to the back of the bus and hit her in her head and she just defended herself. She said that she called out to the bus driver but he wouldn't help. As she told me this, she played with some of the doll figurines, hitting them on their heads with a plastic bone. Janyce was concerned about what her Mom would do saying that she was already in trouble but could still go outside. Janyce began to hide things in the sandtray for me to find and then turned to the larger doll "George", placing play glasses on him and checking him out with the doctor's kit. Janyce returned to class without much upset.

Session Seventeen: (3/23/95)

Janyce now had on her glasses! She seemed in very good spirits and as soon as she entered the playroom, she asked if we could go outside and play "store" and before I could answer her, Janyce went to the chalkboard and drew a frog. She came back to the table and asked if we could play the piano. We talked a bit about glasses and their care. Janyce told me that her mother told her that "she was to keep her glasses on her face until it was time for bed." There seemed to be a much deeper sharing between us and Janyce started to talk about being scared when she hears noises, especially at home at night. (Janyce gives me book, If Your Afraid of the Dark.) She just pulls the covers over her head. She talked about scary movies, Candyman and Mask, saying that you can't say the word "Candyman" out loud otherwise he will come and kill you. Janyce would say, "Look out Marie, he's right behind you, he's going to get you! Psych ya".

Session Eighteen: (4/6/95)

Janyce spoke about the Lion King and said that "there were some parts that were really sad and tears came into my eyes but I didn’t cry." She went on to talk about different topics, how her sister "fixed hair" and about a new friend she just met, "a Mexican girl who is wild!"

She played with the "babydoll" in the sandtray and mentioned the diaper several times. At the end of the session, Janyce wrote on the blackboard, "I love you. You love me. We're a happy family. With a great big hug and a kiss from me to you, I want you to say you love me too. Bye Barney."

As we were leaving the room I could tell that Janyce seemed sad. I asked her how she was feeling and she was able to express how hard it was to leave and how much she wanted to stay with me in the room all day. I explained to her that it was hard for me too but just knowing that we would see each other again in a couple of days made it easier. She agreed and we returned to her classroom.

Session Nineteen: (5/1/95)

With spring break and my week’s intensive, I didn't see Janyce for 2 weeks and I wondered how she would be the next time we met. She seemed very excited to see me and said she had missed me. With a kind of pride in her voice she said, "I told everyone that you were at college!" Janyce had her hair intricately braided which made her look very different. For the next 20 minutes we played the piano and sang "This Little Light of Mine" and "Kum Ba Ya."

Calvin, a first grader, started to kick on our door when Janyce got up, opened the door and told him to "knock it off." She sat back down and said, "Marie, that boy is bad, he is really bad." Knowing Calvin, I could not disagree with her. I told her that it hurts my heart about Calvin. She looked at me and asked me if we should say a prayer for Calvin. I was surprised. She asked me if I knew how to pray and I said that there were many different ways to pray - how did she pray? She said, "You know, give us this day our daily bread". We prayed for Calvin and then moved over to the sandtray. Janyce told me that she and I were good friends because "we talk and listen to each other." Again, we talked about how hard it was for her to leave.

Session Twenty: (5/4/95)

Janyce seemed much more open and talked about her many food "likes and dislikes", how much she hated canned milk "even if it was mixed with chocolate!" Janyce told me that she knew everything about me and went on to describe what she thought my house looked like, what size bed I had, the color of my kitchen cabinets, etc. saying, "I bet your house is hecka clean". Out of the blue she asked me, "How much longer will I be seeing you?" I asked her what she meant and she responded, "till the end of the year?" I told her "almost" and she became really sad.

After a few moments, she seemed excited and said, "Maybe we can go on field trips and I can ask the principal if that would be O.K." She said she wanted to come and see my house. "Do you think that’s possible, Marie?" I told her I didn’t think so and she became quiet for some time. I felt it now was time that I could reflect back to Janyce how much easier it was for us to separate knowing that we would see each other again on Monday. She agreed and seemed happy.

Session Twenty-One: (5/8/95)

As soon as Janyce entered the playroom, she asked me if I remembered to look in the store for some "Funions" (onion flavored snack). I told her that I looked in three different stores but couldn’t find any. She seemed pleased that I had remembered in any event. Janyce spent most of the session writing down the names of all her brothers and sisters, including her half-brothers and sisters, on a piece of paper. Along with their names went a little story until at one point she wrote, "Janyce is dead" asking me if she spelled "dead" correctly. I followed her with that and asked, "Janyce is dead?" "Do you feel like your dead?" She just smiled at me, put her head on the table and told me not to wake her up. Next, she told me that she had to go to the bathroom but said "Psych ya!" and told me that she no longer has that problem at school. I told her that was wonderful and asked her how she was doing at home. She responded, "how you know about that?" I told her when we first talked about her problem in school, I also asked her about home. She remembered our conversation and told me that she is doing much better.

As we walked back to her classroom we passed a small boy running down the hall. Janyce told me "he was real bad" and that "boys do that nasty thing". She continued:

Session Twenty-Two: (5/11/95)

Janyce was excited when I picked her up from her classroom because "she had something very important to tell me." She said, "Guess what I did today?!" I tried to think of things (its only 9:30AM) but finally had to give up. With great pride she said that she "broke up a fight on the bus"! I told her that was fabulous and she wanted to tell me all the details of how the fight started. The bus driver asked her to break up all the fights from now on. I asked her how she felt about that and she said "great".

Janyce told me how much candy she had already eaten that morning and said she was feeling very "hyper". She started to play with the people figurines, two women and one man. The man was deciding which woman to marry.

Janyce started to regress in her behavior, singing inaudible words to a song. She asked me, "Marie, which one do you think he should choose?" When I finally had to choose one, Janyce told me that she was too fat. I mentioned that it might just be her dress but she told me, "look at those fat arms" when in fact, the doll’s arms were not fat at all. The male would attempt to kiss the female but as he approached her with his kiss, he would say, "I hate you." Janyce stayed in this state until the end of the session when she showed me how to dance a little saying, "Marie, you know how to dance, don’t you?"

Session Twenty-Three: (5/15/95)

When I picked Janyce up for our session, she had a bandage around her wrist which she quickly took off when she saw me and put it in her pocket. It was only much later in the session that she told me her wrist hurt and it was when she was trying to sneak out of the house that the door closed on her arm. Most of the session was spent cooking food and during her play she sang, "I am you, you are me" over and over again. She asked me at least three or four times during the session if I thought she was crazy, never waiting for my reply and at one point shouted, "Well Marie, am I crazy and if I’m not crazy what am I?" While making a mess with the "food" (sand) she said, "I’m just a big fat pig!" She could not talk to me about that and moved to the play phones. She called me, acting as her mother, wanting to know how Janyce was doing at school and if I knew that she broke up a fight on the bus. At the end of the session, I had to fill out a form on the blackboard as to whether or not I was Janyce’s friend, yes or no.

Session Twenty-Four: (5/18/95)

During this next session, Janyce spent some time describing her field trip yesterday to Davies Symphony Hall. She and Selena were friends "again" and she felt good about it. While looking at the posters on the wall, showing me who looked alike, Janyce moved her hand quickly and got a paper cut. The situation worsened to where we had to go upstairs to the principal’s office and get a Band-Aid. Janyce wanted to know why we weren’t wearing "latex" gloves because the sign recommended them for "blood or other bodily secretions". We decided to spend the rest of the session outside in the schoolyard and talked about the pigeons, her sister Clara and her many adventures.

Session Twenty-Five: (5/22/95)

I picked Janyce up from her classroom and she was excited to show me her new hair braids. Her mom has been learning to do hair and did some extensive braiding to Janyce’s hair. Since she and Selena were now friends again, Janyce asked if she could bring Selena down to our session, "just for one minute." I explained to her why I thought it wouldn’t be such a good idea and she seemed OK with it.

When we arrived at the playroom, Janyce started to play with a large black spider and told me of a scary dream she had, one with "monster bubbles". She said that she was sleeping and heard "real loud breathing in her room and got really scared." Only after she was awake did she realize it was herself breathing. We talked about only having three more sessions left when suddenly Janyce started to make sounds as if she was a big, mad dinosaur. She brought all the large dinosaurs over to the table (she found that one dinosaur had a marble in its mouth and had to remove it before we could continue) where she stung them with this big black spider and they were all killed. Janyce decided to bring over the elephants so they could stomp and kill this bug but they too were stung by the spider. She asked me if she could cut the tentacles off the bug. I thought about it and said, "yes." She asked, "Are you sure you won’t be mad at me, Marie?" and I said, "No." She tried to pull the tentacles off but couldn’t and asked me for a scissor. She carefully cut the tentacles off which she said were poisonous and buried them in the sand. She then buried the spider in the sand and said to me, "It's my fault, huh Marie? I’m bad. It’s my fault, huh?" I tried to stay with her saying, "You feel like it’s your fault Janyce? As I said this, she gently picked up the baby elephant that was killed by the spider and said, "See Marie, its dead." I looked at the elephant and said, "Yes, I see the baby elephant is dead." Silence. Janyce said, "Look Marie, it's sleeping now, it’s a little weak." She held the baby elephant for a while and then gently put it down, laying it in the sandtray. She played quietly with the marbles until the end of the session.

Session Twenty-Six: (5/25/95)

At the beginning of the session, we talked about Janyce’s visiting with a new friend and the party she was hoping to attend this weekend. She spent the rest of the session reading stories to me and showing me their illustrations. Near the end of the session, Janyce asked if she could take a toy with her. I told her that the toys needed to stay in the playroom so they would be there for her use next session. Janyce responded, "I know that other kids play with these things and since I’m the first child you saw, they should all be mine!" Janyce settled for making Xeroxes of a puzzle maze for some of her classmates and returned to her classroom without any regressive behavior.

Session Twenty-Seven: (6/1/95)

I met with Janyce today for the last time. She was in a very elated mood and said she was happy to be in the playroom. Again Janyce’s hair was different although still braided. She said that her sister restyled it and she wanted to show me how long her "real" hair was. Janyce told me that "most people think the extensions (braids) are made out of horsehair but really they are made out of plastic." She spent time talking about an incident on the school bus where she felt she was unjustly accused of hitting another child.

She now saw the word "disappointment" on one of the wall charts and told me that she had that word in reading class. She spent some time writing and spelling the word for me. Under the word she wrote, "If I am not quiet in class, the teacher says I will have detention and that is what disappointment means."

When we spoke about this being out last time together, Janyce asked me if I would go on Monday to the zoo with her class and on Tuesday to Golden Gate Park. At the end of the session, she returned to her classroom without any difficulty. On our way, Janyce asked me questions like "what should I do if someone hits me or my younger sister or my baby brother?" Outside the classroom we gave each other a big hug and Janyce said, "I know that I’ll see you hecka soon."

In retrospect, it seems clear that in the course of these twenty-seven sessions, the dynamics of transference and counter-transference were very active. In the very first session, Janyce comments "I like you, you’re nice" and I responded that "I liked her too." Janyce’s struggle to leave which began almost on the first day indicated her transference onto me, and to the process, which carried the projection both of the healer and the mother. Janyce and I created a figure who could take care of her fears, and be "nice" to her.

Janyce’s capacity, over time, to accept the boundaries of our time limits and to respond to my request to "pull yourself together" indicated to me that she was able to begin to integrate some of the strengths supplied by our relationship.

Janyce’s drawings of the two of us, in which she made my face brown, also showed her desire to assimilate with me, to bring me directly into her life. When she began, in the last few months, to tease me saying "we aren’t friends anymore" and then to say "Psych ya!", there was a play of separation, supported by the reality of a friendship developed beyond the transference. Janyce could be separate but chose to relate.

My countertransference onto Janyce had to do with an attraction to the warm and bright, full-of-life small girl. But I also felt the sense of separateness when the time came for termination, indicating that we had both used the "transference energy" for a dynamic which surrounded the play of therapy. With Janyce’s increased strength, the transference could be to some extent withdrawn when integrated.

I feel that it was a privilege to share this time with Janyce, and in some inner way, we will be "friends forever".