59 Handouts
59 Handouts
With
Presented
at the
Minnesota Association
of
Childrens Mental Health
Child & Adolescent
Mental Health Conference
May 2, 2006
Duluth MN
By
and
and
Cathlene Ramsdell, MA
Family Therapist in Private Practice
Auburn, WA
2
ABSTRACT
Introduction
Cinema Therapy is linked to the practices of story telling which has been
AAMFT Journal article published in April, 2006; entitled, Changing Emotion: The Use of
One advantage that is afforded by the use of stories is their ability to fit
into multiple theoretical perspectives. As stories are a type of metaphor, this is
not surprising, given that metaphors are so pervasive in everyday language and
interactions. Metaphors can be helpful in therapy because metaphors access
associations, resources, and entertain novel experiences .Particularly in
Western society, stores are a primary way in which we organize our world and
our relationships. With stories so much a part of how individuals organize the
world, the power behind storytelling therapy become apparent. (P. 165).
During the past decade, Cinetherapy or the use of popular films in individual,
couples, and family therapy has emerged as an efficacious intervention for adults and
adolescents. By watching the films and then discussing the stories, character struggles,
and moral dilemmas presented in specific movies, clients and therapists can access
meaningful metaphorical content for clients (Solomon, 2001). Viewing specific films can
resonate with his own. A particular film may also symbolically suggest heretofore-
Cinetherapy as a therapeutic modality has been utilized primarily with adults and
older children. In their manual on how to use popular movies in psychotherapy, Hesley
and Hesley (2001) caution against including younger family members in the process
together (p. 36). In fact, most of the literature reviewed for the present study on the
actually advises against using this approach with younger children (Greenberg, 2000;
However, younger children do watch films and, like his or her older counterparts,
there is the potential that a child can make use of his own film watching as part of the
healing process. Sometimes a child wants to repeatedly watch the same movie, with or
without adults close by. This desire for repetition and current focus of attention on a
particular film can prompt a younger child to come to therapy ready to play out or to
describe the movie she has been watching. Indeed, the clinical experience of the
present investigators have taught us that if we are open, informed (about popular
childrens movies), and responsive, younger child clients will often independently initiate
Recent research also suggests that the learning process is accelerated and the
rates of retention increase when meaningful metaphorical content (i.e. stories) are
employed during the learning process. Gardner (1993) suggests that each person has
multiple intelligences and the more of these intelligences we access the faster we learn.
(p 12)
The effects of the movie viewing experience can be profound. One researcher
postulated that the reason films are a powerful tool which can be utilized quite effectively
There are several concerns that must be attended to when utilizing films in
therapy with small children. Popular films are not inherently therapeutic. Hesley and
opening up discussion in therapy. Films can show ordinary life and let clients (in
conversation with therapists) find guidelines that work for them (p.7). Additionally, films
are occasionally assigned to reinforce an idea introduced in therapy sessions, but they
are more often intended to encourage internal search and insight by the client (p.8).
Films about families and the struggles of children such as Parenthood or Ordinary
People are not appropriate viewing for younger members of a family. Furthermore,
Hesley and Hesleys style of intervention prescribes the films utilized in therapy to be
viewed at home then discussed a week later; they describe such a process as being
The concern that increased media exposure is harmful to children must also be
addressed by any therapist contemplating the use of Cinetherapy with their child clients.
A review of research conducted over the past decade, (Villani, 2001) examined
hundreds of articles and research findings in order to assess the impacts of exposing
children to violent and explicit television and movies, music videos, video games, and
unsupervised internet access. The review concluded that most research demonstrates
that for children the primary effects of media exposure are increased violent and
aggressive behavior, increased high-risk behaviors, including alcohol and tobacco use,
Villani (2001) further concluded: The challenge to adults who deal with children,
either personally as parents or professionally, will be to monitor media use in ways that
foster curiosity and the positive aspects of the ability of media to teach, yet
simultaneously protect children from spending too much time with media at the expense
processed or understood, and from having their value systems shaped in negative ways
Though media exposure can be harmful for children, there exists, nevertheless,
the potential to counteract the passive acquisition of information from movies and
television by engaging children in dialog and/or play. As in other forms of play therapy, a
and active expressions regarding their film experiences. A child may be choosing to
repeatedly watch a film or become focused on a character because she is playing out a
significant developmental task, such as figuring out how to overcome her fear of an
children are hard at work (as in play) on the linked tasks of independence and shame.
C.E. Schaeffer (1980), the author of several manuals for play therapists, notes, one of
development for a child. (p.95). As therapists who work with children often find
themselves explaining to skeptical parents and colleagues who question the purpose of
mucking around in a sand tray; play is a childs work. Hence, for modern childrenwith
or without the guidance afforded by Cinetherapy for childrento paraphrase the Bard
himself, the play, that is, the screen play, really is the thing.
Young clients can play out or retell the stories of movies they have seen as part
of therapy. Sometimes these children are repeating ideas that really excite them.
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Sometimes they are portraying themselves as a character from the film. Sometimes a
child has repeatedly watched a movie not so much to master a fear, but to seek a
stimulation or comfort that he craves. Talking to a child about the movies he loves can
reveal the child's current focus of attention. This process can reveal the internal tasks
capacity for what he defined as focal attention, "man's capacity to center his attention
explained a child's desire to read the same story exactly the same way as a necessary
process for attaining mastery and attention. This work, which takes place through ever
(p.258). Citing the Bible, fairy tales, 1001 Arabian Nights, and the sermons of Buddha,
Schachtel observed that human beings have been listening to the same stories repeated
Schachtel attends in particular to the quality of what a child wants and needs
from repetition: Furthermore, it is of great importance to the child that he can rely on the
story that it does not suddenly disappear, that it is still there (p. 261). Schachtel
focused on stories because he was writing before the invention of the VCR. Now,
technology provides the opportunity for a reliable narration that children can and do
return to repeatedly.
In the interest of exploring and supporting film interventions with younger children, this
paper is accompanied in Appendix A with a plot summary and fictional case assessment of one
of the more popular and therapeutically relevant of recent children's films-- The Lion King
(1994). Suggestions will be made as to how this film may be used to explore with a child
potentially devastating changes in the life of the childparticularly, of course, having to do with
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divorce or loss of a parent. For the purpose of therapeutic utility, the plot summary and case
assessment of the film family is organized accordingly: synopsis, family relationship issues,
recommendations for sub-system viewing (i.e. by whom at home), fictional case assessment, and
case study that demonstrates the actual use of another film with a child client who is presently
Conclusion
themes that are of interest to most child clients. For therapists who work with children
and their families, incorporating the use of films can prove beneficial not only for joining
the client in their life and imagination experience, but also for creating a therapeutic and
fascinating film characters and familiar dramatic vignettes, a child can reveal his own
internal process while having the opportunity to keep an emotional distance from
support ongoing work with child clients who are viewing contemporary films independent
of therapy and/or child clients for whom it may be appropriate to suggest they view a
References
Erikson, E.H. (1968). Identity, youth, and crisis. New York: Norton
Florsheim, P., Henry, W.P., & Benjamin, L.S. (1996). Integrating Individual and
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Dysfunctional Family Patterns. New York: John Wiley & Sons, Inc.
Gill, E. (1991). The Healing Power of Play. New York: The Guildford Press.
Hesley, J.W. & Hesley, J.G. (2001). Rent Two Films and Lets Talk In the
Morning: Using Popular Movies in Psychotherapy. (2nd ed.). New York: Wiley and Sons.
277-303.
Satir V., Banmen J., Gerber, J. & Gomori M. (1991). The Satir Model: Family
Therapy and Beyond. Palo Alto: Science and Behavior Books, Inc.
Solomon, G. (1995). The Motion Picture Prescription: Watching This Movie and
Call Me In The Morning: 200 Movies to Help You Heal Lifes Problems. Fairfield: Aslan.
Solomon, G. (2001). Reel Therapy: How Movies Inspire You to Overcome Lifes
Tanner, L. R., Haddock, S.A., Zimmerman, T.S. & Lund, L.K. (2003). Images of
Couples and Families in Disney Feature Length Animation. American Journal of Family
Review of the Research. Journal of the American Academy of Child and Adolescent
Wolz, (2005).
APPENDIX A
Synopsis:
Simba, a young lion cub, lives with his father Mufasa, king of the lion pride, his
mother Sarabi, and the other members of their extended family (including lions and other
10
creatures) on Pride Rock. Simba learns from his father that he has a distinct place in the
in the "circle of life." Part of his place includes a close bond with his father and the
assumption that Mufasa will always be present to guide Simba towards the adult
responsibilities required from the future king. However, malevolent forces disrupt
Simba's life through the intervention of Scar, Simbas uncle and Mufasa's brother.
Through Scar's deceit, Mufasa dies trying to save Simba's life and Simba runs away
believing that he is responsible for his father's death. While the avaricious Scar takes
over the family, Simba, in his self imposed exile, meets new friends who school him in
the ways of "Hakuna Matata" or "No Worries," a philosophy which encourages Simba to
avoid dealing with his problems and leave his past behind him although, as Simba grows
older, friends from the pridelands come to find him and lead him back to confront his
uncle, reunite with his family, and overcome his own guilt and shame.
*How established family rules in a securely attached family system can translate to
*How a child client's survival stance can shift as a result of experiencing the break up of
his/her family system as the result of the death of a loved one, divorce of parents or
*How a child client's survival style can be manifested in fantasy or acted upon desire to
run away/escape, reflecting the desires/fantasy of all members of the family system.
When we first meet Simba he is part of a structured but flexible family system,
with his father Mufasa as leader of the pride. In their interactions, we see Mufasa
temper his leadership style with affectionate and encouraging expectations of his son.
Simba, is a somewhat precocious though securely attached child. He "is confident that
the parent figure will be responsive, available, comforting, and protective, particularly
William & Benjamin, 1996 p.84). Although Simba has learned that part of his family rule
structure is that he will one day become king and take over, he believes that his father
will always be available to him. Unfortunately for Simba, this sense of security is
extended to his uncle Scar, who has villainous motives for encouraging Simba and his
best friend Nala, a female lion cub, to explore the alluring but dangerous forbidden
elephant graveyard. When Mufasa arrives to save Simba and his playmate from hungry
acting out is enthusiasm for exploring his environment and testing his developing
abilities in preparation for growing up. In contrast, Scar shames Simba for his behavior,
Scar uses Simba's trust to lure him to another dangerous situation, a wildebeest
stampede, and then calls Mufasa to Simba's rescue. Although Scar kills Mufasa himself,
he plays into Simba's sense of guilt and fear, convincing the cub that he is responsible
for his fathers death and Simba's only choice is to run away.
which includes according to Ainsworth et al., "a negative attachment view of self and
others and anticipates betrayal, rejection, and criticism. Such a person is likely to protect
him- or herself from rejection or attack by avoiding involvement with others." (as cited by
Florsheim, William & Benjamin, 1996, p.84) Simba is convinced his remaining family
and pride (extended family) will blame and reject him, so he runs away.
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overwhelming belief that he is responsible for the destruction of his family structure
which according to the family rules, he is supposed to one day govern. Because
Mufasa's parenting (and ruling) style has been so fundamentally hierarchical, Simba
does not have an internal construct to imagine how he or the pride will survive without
Mufasa.
therapist Virginia Satir "Our coping process results from how we feel about ourselves. If
anything raises the question of our survival, we immediately feel defensive. In any
relationship, for example, if something leads us to question whether mutual love and
trust really exist, our survival responses automatically come into play." (1991, p. 35)
As luck would have it, running away actually ensures Simbas survival. While the
rest of the pride and their dependents suffer under the tyranny of Scar and his hyena
minions, Simba is befriended by Pumba, a warthog, and Timon, a meerkat, who allow
him to keep his past a secret while helping him to create a new way of living.
The primary tenant of Simba's new lifestyle is the song "Hakuna Matata" or No
Worries. The song instructs Simba to put his past behind him and live only for the
moment. In the Satir model Simba has adopted the communication/survival stance of
"being irrelevant, which while appearing jolly ,encourages Simba to direct attention
away from any "topics that carry any degree of stress", believing that this is how he will
The film shows Simba growing into early adulthood in his self imposed exile.
why Mufasa is no longer with him. While he outwardly maintains his irrelevant stance,
internally his experience is following the Satir model, as he feels "There is no place for
As Simba struggles with this incongruence, Nala, his childhood friend, and Rafiki,
a mandril shaman, find Simba and tell him of the family's suffering. Initially, Simba
refuses to return to his family. He is ashamed to face his family and is determined to
maintain his stance that his past is irrelevant. Rafiki helps Simba to transform his
survival stance to a more congruent mode of communication. He shows Simba how his
own reflection resembles Mufasa, speaking directly to Simba's yearning for his father's
unconditional love and Simba's fears around his expectations that he is supposed
circumstances, Rafiki then thumps Simba on the head with a walking stick. When Simba
demands to know why, Rafiki replies, " It doesn't matter. It happened in the past." After
this action, Simba's perception of his past is transformed to the immediate and
Once his perception shifts, Simba finds he is ready to return to Pride Rock. His
survival stance begins to shift to a more congruent state. According to the Satir model,
"adding awareness of self, other, and context to the irrelevant stance releases our
flexibility, creativity, and openness to change within an appropriate context, and this
As the rest of the film unfolds, Simba learns that many of the perceptions which
have ruled his behavior, that he was fundamentally responsible for his father's death,
that his family would reject him, were inaccurate. In allowing himself to return to the
context he has avoided, Simba discovers how much he has been missed. This emerging
sense of self and transformation of his survival stance enables Simba to heal himself
Because the Lion King can be viewed and appreciated by very young children, it
is very useful in a conjoint family therapy context that includes a small child coping with
changes in his/her own family. By talking with a child client about Simba's actions, a
family therapist can evoke the client's own fantasy experience around his or her own
circumstances. By talking about Simba's feelings before and after Mufasa's death, a
family therapist can draw a young client into the conversation about how his or her own
family is changing and how he or she experiences that change. By being encouraged to
talk about or play out Simba's experience, a young child may be able articulate fears and
illustrate survival impulses which are presenting as problematic in his or her family's
therapy.
Simba's experience of losing a parent to death will resonate for a child working
through grief in conjoint family therapy. Additionally, Simba's experience can also
family through an impending divorce or through the actions of an outside agency such as
Using this film as an intervention, a family therapist can access the experience of
a child who has been told his or her family's changes are not his or her fault. While the
client may not acknowledge culpability for his or her family's break up, the client presents
with the onset of depressive symptoms which might include (as in Simba's case) low
self-esteem and self imposed social isolation as a result of the disruption of his or her
A small child might experience great relief and comfort in Simba's escape from
the harsh reality of his father's death and his family's assumed rejection, into the
camaraderie of fun new friends and a new way of being. This relief is also reflective of
adult desires of escape. The Satir model recognizes that in coping with highly stressful
circumstances which have evoked survival stances, "magical thinking and escape
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fantasies are other ways we meet our needs" (1991, p. 63). In talking with a family who
is processing loss and change, the therapist would have the opportunity to give all family
members, including the youngest child, the opportunity to reflect upon Simba's escape
and how that experience might fit into her or his own escape fantasy desires and how
The film shows Simba maturing to a size and age where he is more capable of
processing his emotions. However, the therapeutic goal in using this film with a small
child would not be to force an inappropriate level of coping skill on the client. Simba's
growing up is an image that a child can internalize as a hopeful future; a way of growing
up that evolves out of circumstances similar to his or her own. In a conjoint family
therapy session, the film offers an easily understood metaphorical setting for the child to
discuss or play out his or her feelings. A therapist working with the entire family system
can use the film to provide a context for communicating because the youngest client in
References
Florsheim,P., Henry, W.P., & Benjamin, L.S. (1996) Integrating Individual and
Dysfunctional Family Patterns. New York, NY: John Wiley & Sons, Inc
Satir V., Banmen J., Gerber, J., & Gomori M. (1991). The Satir Model: Family
Therapy and Beyond: Palo Alto, CA: Science and Behavior Books, Inc.
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APPENDIX B
socially awkward, often neglecting manners and courteous behaviors that one might
expect an adolescent to have mastered by Jasons age. Jason has poor insight, often
blaming others for his problems and delinquent behavior. He usually appears as having
a flat affect, indifferent and detached, and has difficulty expressing himself openly and
subject shifting. The possible impact of a familial history of mental disorders including
Disorder, and Antisocial Personality Disorder, has been considered in the development
Jason started counseling shortly after his arrest for stealing a car. He was placed
in a foster home where he minimized his theft by saying it was, no big deal, really. He
claims no personal responsibility for the auto theft and blames his friends, because it
was their idea anyway. Jason and his 15-year-old sister, Ashley, have been in at least
four foster homes and one group home since their birth. His two older siblings were
permanently placed by Child Protective Services with their maternal grandfather before
the age of one. Pervasive mental illness coupled with entrenched patterns of drug and
alcohol addiction provided a fertile foundation in which abuse and neglect became the
norm. Compounding the situation, Jasons mother suffers with issues related to her own
neglected and abusive childhood that have intensely impaired her ability to successfully
parent her children. Jason has been diagnosed with ODD and PTSD. He has suffered
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from physical and emotional abuse as well as from abandonment and neglect by his
mother, father, step-father, and his mothers boyfriends. Establishing empathic insight for
himself and others emerged as a primary focus for Jasons ongoing treatment plan
Viewing of a film seemed an ideal way for Jason to experience himself in relation
proved an effective way to bypass the defense mechanisms hindering Jasons growth
process (Hesley, 2001, p. 31). Jason was asked about his favorite movies and the
selection for our first film came from his list. Atop the short list was a movie called,
Secondhand Lions.
The film follows a young boy, Walter, through a difficult adolescence into
adulthood. Walter is abandoned by his mother to live with his great uncles Hub and
Garth whom he has never met. His uncles are reluctant to take in the youth; however,
they slowly begin to bond with their nephew as Garth tells Walter about their past. He is
fascinated and awed by the heroic adventures of his uncles. Walter finds a home with
his uncles who offer him the love, compassion, and guidance he desperately needs. The
three build a strong bond that helps Walter find the courage and strength to let his
mother know how he feels. He is eventually able to exonerate his mother and accept
that she is unable to provide the kind of life he truly needs. Walter accomplishes the
moral reasoning task of forming empathy for the experience of his uncles and then
In one scene, Garth continues telling the story he began earlier in the movie
about their adventures in Africa. Garth elaborates on the special love Hub had found
with Jasmine, a princess. Garth claimed that Hub had heroically fought against the man
Jasmine was expected to marry and won. Walter questioned the authenticity of his
uncles story since Jasmine was obviously no where to be found. However, Garth
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refused to give Walter the end of the story telling him he had to go to Hub and ask.
Walter, still insecure and more than a little intimidated by his uncle, Hub, struggled to
find enough courage to approach him. Finally the young man asked his uncle what had
happened.
After viewing this scene, I asked Jason which character he most related to and
why. To my surprise he related to Hub more than any other character. He admired the
courage and sense of humor Hub displayed. A discussion about how one develops a
trait they wish to acquire commenced. Jason decided he could look for role models and
friends who displayed similar characteristics to those he wants to have (Hesley, 2001, p.
49).
Walters fear was a useful way for Jason to talk about his own fear and anger. By
discussing Walters struggle with strong emotions and feelings of anger, fear, betrayal,
loyalty, love, and insecurity Jason had found a neutral place from which to begin a
dialogue of his own feelings. Fear was a major roadblock for young Walter, and Jason
spoke easily of the ways the characters in the movie dealt with their fears. Jason even
began to speak about his own choices and the consequences of those choices.
Perhaps the most significant idea Jason mentioned while discussing the move
was that of looking for role models who posses the characteristics he wants to acquire.
When clients do not have good role models in real life, film characters can
protgs when they display human limitations. But role models in films
almost always fall from grace and then work their way back. What clients
learn is that true heroes profit from their mistakes, and that they can, too.
(p. 49)
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References
Hesley, J.W. & Hesley, J.G. (2001). Rent Two Films and Lets Talk In the
Morning: Using Popular Movies in Psychotherapy. (2nd ed.). New York: Wiley and Sons.
Secondhand Lions, New Line Cinema, 110 minutes, Rating: PG, Staring: Michael
Wolz, B. (2005) Cinema Therapy: Using the Power of Imagery in Films for the