Images of Death in the Sandplay of Children Suffering from Life Threatening Diseases

Ahuva Yavin Arnon, MA, CST-T, JA, Licensed Educational & Medical Psychologist

Abstract

Confronting death and dying is a profound challenge for both the sick and their caregivers, family members, and professionals. This challenge is especially complex when it involves children, who symbolize beginnings, hope, and the future, and whom we seek to protect. Understanding the inner world of children coping with life-threatening illnesses is therefore essential for effective treatment. For these children, death exists on multiple levels of awareness and meaning. The therapist becomes a witnessing participant to the child’s confrontation with death, separation, and loss, while holding the intense fear and suffering. Although open communication is important (Kübler-Ross, 1983), when verbal expression is not possible, sandplay therapy, provides a protected and safe symbolic space. Sandplay offers a temenos that can contain overwhelming feelings and restore a sense of agency. Clinical examples and sandplay images illustrate children’s encounters with death and the therapist’s task of maintaining a containing therapeutic relationship while bearing the emotional weight of these images.

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