Sandplay therapy is an excellent non-verbal way to help a person with a diagnosis of dementia express themselves. To mark Dementia Action Week, Emilia who is a recently qualified Sandplay Therapist (who trained with Jill) describes working in sandplay and dementia counselling …
Sandplay offers a safe place to support for people living with dementia. It is a therapeutic tool. No instructions are given the client just naturally interacts with the figurines, symbols and objects at hand. They create their own private world (image or scenery) in the sand. This is mostly a non-verbal interaction. However, most of my clients like to talk to their symbols as their sand world unfolds.
I feel that my role in sandplay and dementia counselling is to work as a facilitator. My presence helps to contain the client whilst they engage deeply with the sand. I do not interpret, I just empathically connect with the client with or without words. I mirror their process whilst containing and supporting them in a safe environment. They work at their own speed. Interacting physically with the sand can be deeply soothing as well as very moving. Images and patterns (however vague), senses and feelings can be freely explored and unearthed. This is a non-directive safe environment.
The clients are in what feels like a journey in time, their journey
In the therapeutic hour, the clients are expressing a choice. They are actively sifting and shifting through repetition in what feels like a journey in time, their journey. I feel that working with sand helps people with dementia to feel their sense of well being in the ‘here and now’. Also at times, there seems to be a deeper sense of essence and self-acceptance.
It is a deeply humbling and precious space to help, hold and contain
The people living with types of dementia that I am working with are wonderfully expressive. They actively engage with their metaphorical worlds with expressions of joy, laughter, tears, sighs, shrugs, clapping, pointing, farting, burping, sneezing, coughing and sometimes even dancing. The therapy room is familiar to them as are the symbols that greet them. There is a definite feeling of ritual that takes place in choosing and placing in the tray. You often get a real sense of the person before dementia took hold. As well as stories of rich and complex lives in the past.
J. comes happily sometimes singing into the therapy room. She is very vocal and does not mince her words. J. remembers having visited the room before even though she might refer to it as last year. She chooses the symbols carefully, telling a story before she even touches the tray. Once the symbols make their way into the sand, she will repeatedly bring forth themes of Heaven & Hell, Creation and The Passion, death, rules of life and good and evil. Over the months the trays feel like a preparation towards acceptance. She announces one week, “ I am ready”. It feels sacred and profane.
E.’s worlds make their way anti-clockwise around the tray like a tribe of swirling nomads
She engages vocally with them and slaps the air and sometimes my thigh when she is delighted with what she sees before her. Her laughter and joy are contagious, I usually find myself grinning from ear to ear like a Cheshire cat. The themes she explores vary. Over the last year, she has explored and firmly made clear her feelings on infidelity, abandonment, standing up for yourself, living, dancing, love, beauty and death. She usually finishes the session by ringing the Tibetan bowl with great vigour a specified number of times. This seems to seal the session, containing it as she leaves waving and sometimes singing.
The symbols seem to dance in slow motion over the sand making patterns
S. engages deeply with the symbols. She chooses and actively places in a way that seems to tranche through time. She sucks her breathe and then lets out deep sighs and sometimes tears before engaging with the sand. The symbols seem to dance in slow motion over the sand making patterns, which at times she pinches very gently. She looks at me often, nodding and smiling slowly and then returning her attention to the sand. Quite often she shakes the table and jiggles her leg. It is as though she wants to make the room shake/quake and often it does as the symbols fall or rattle. In the many trays that she has done, there is a sense of bringing the past to surface and then of letting go. This is manifested through bodily sounds, gestures and words spoken.
G. is one of my most recent clients. He is a quiet man although he takes in the therapy room in what feels like a stunned silence. He points to objects and over the first few sessions picks figures up and gazes at them in what feels like wonder and a sense of wistfulness. When he does place symbols in the tray, it is done with such care that I feel deeply moved. His body language is expressive. The sessions are full of his sneezes, hiccups, head rubbing, arms crossing and one-week quiet tears. Each week he reaches for the harmonica and plays: sound seems to soothe.
Essential to sandplay and dementia counselling is clinical supervision
I have a wonderful supervisor who hovers gently and yet firmly above my clients’ and my own therapeutic process. She makes sure I am working ethically and within our Window of Tolerance. She helps me to recognise what senses, feelings and triggers are mine and those that belong to my clients’. Also, she encourages me to honour what feels like a beautiful, deep and unconscious process in the sand.
Sandplay therapy is a great way of counselling people with dementia and their carers. Family members can also express their feelings about dementia in the sand. It is a non-verbal way of exploring your feelings without judgment supported by a kind witness. Emotions that may be difficult to share with loved ones can be safely expressed in a holding environment.
My own father had Alzheimer’s disease and his decline was a long and at times very painful and upsetting as well as frustrating one for him to experience and one to also witness.
One of his many guises was as a sailor, and I can only imagine the worlds he would have created and sailed across the sand tray had he been offered the chance.
You can find more details of our Integrative Sandplay, Working Creatively Trauma, creative supervision and Expressive Arts trainings on our website jillcartertraining.co.uk or by emailing us email@example.com.
We offer courses face-to-face in the UK and online for counsellors and therapists as well as others in the mental health field.
Our courses are offered at introductory, certificate and diploma levels. You can apply online via the website.