Liam Butler: How can the elderly in care benefit from therapeutic space?
René Andre MNZAC:
I first became interested in therapeutic space as a geography student at the University of Waikato in the 1970s. Therapeutic space, a somewhat academic concept, became more palpable for me through personal experience with Sandplay and Gestalt therapies in particular.
Geographical themes are an intrinsic feature of Sandplay and Gestalt therapy, and are also particularly relevant to the needs of the elderly who may struggle with such geographical themes as displacement, homelessness, isolation, the loss of privacy, boundaries – by which we also define ourselves – and therefore identity (Rowles and Chaudhury, 2005). N.B., Many of these themes can be acknowledged without necessarily a word being spoken, as in the case of the “free and protected space” known as Sandplay (Kalff, 2004).
Sandplay is linked with how we learn at a primal level and is therefore well suited to capturing the kind of geographical themes that are of concern to the elderly, in the process. This feature of Sandplay can be acknowledged in terms of Piaget’s theory of learning. Piaget revealed how children learn by exploring the world and a key stage in this development is learning to identify significant places and then learning that pathways exist which connect these places (Kitchin and Blades, 2002). Much of this learning occurs when a child has minimal use of language. It seems reasonable to suggest that elderly people who have difficulties with language, or using language to communicate their concerns, would also benefit from engaging with this modality to explore their world.
An obvious problem with Sandplay is that the majority of elderly people are dismissive of counselling therapy (Patrick, 2006). Despite this aversion, older people can somewhat serendipitously find themselves in a “therapeutic space”.  In other words, art therapies, yoga, gardening, singing and other accessible activities may all have significant therapeutic space aspects associated with them.
All relationships with elderly people have the potential to “open up” a therapeutic space, and in particular those relationships which reflect qualities such as empathy, unconditional positive regard and authenticity. The incidental therapeutic benefits of participation in qualitative research are also well known (Rowles, 1978). Eleanor Patrick in her article on older people’s resistance to counselling  observed therapeutic “side-effects” despite the respondents stating categorically that they were not interested in accessing counselling to work through their issues (Patrick, 2016).
Therapeutic space is a realistic and poignant ideal for aged care and retirement sector providers to aspire to, and therefore merits enquiry. Sandplay, as well as being a good example of therapeutic space, may also serve as a useful resource to guide and inspire care providers in their search for ways to ensure the well-being of the elderly people in their care.
René Andre has a background in human geography, specializing in people’s experience of space and place in relation to well-being. René utilises Sandplay and Gestalt psychotherapy both in his general counselling practice and in his research activities. He has worked as a counsellor throughout the Waikato region for the past 20 years.

References:

  • Kalff, Dora. M Sandplay: 2004 (reprinted) A Psychotherapeutic Approach to the Psyche. See also: https://www.youtube.com/watch?v=aWd40dMH70c
  • Kitchin, Rob and Mark Blades, 2002. The Cognition of Geographical Space. I. B. Tauris, London.
  • Patrick, Eleanor. 2006. Older, wiser and unlikely to present. “Therapy Today – The online magazine for counsellors and psychotherapists. Volume 17, Issue 3.
  • Rowles, Graham.D. (1978). Prisoners of Space? Exploring the Geographical Experience of Older People, Boulder, CO: Westview Press, Reprinted 1980. Paperback Edition, 1980.
  • Rowles, Graham.D., and Habib Chaudhury (Eds.) 2005. Home and Identity in Late Life. International Perspectives. Springer Publishing Company. New York.

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