All My Children

How important such play is in establishing selfhood was demonstrated to me by an eight-year-old autistic girl. As often happens, the severe pathology of her case permitted observing a phenomenon also seen in normal behavior but as if it were under microscopic enlargement, or thrown into bold relief by a bright light. This girl had been virtually mute all her life. She completely rejected all efforts to reach her physically or verbally, and was unresponsive to all aspects of her environment. She resented all efforts to make contact with her; if one reached out to her actively, she responded with angry, terrified withdrawal.

It took more than a year during which we carefully respected her wish to be left alone, while still trying to take tender, loving care of her, before she moderated her total isolation and permitted occasional approaches, although she did not respond to these in any discernible way. Of all the many and various ways in which we tried to reach her she finally responded only to one: a simple game which combined features of Peek-a-Boo and Where’s the Baby, in which I eagerly “looked” for her and expressed my delight when I found her. Although she was right there all the time, I pretended for a time not to see her, so that I could rejoice when I “discovered” her. Eventually she actually hid behind a curtain, even peeked out from behind it, mimicking what I had done innumerable times in my play of finding her. As we were once more playing this game for quite some time, she permitted me to hug her. At this, I proclaimed louder my joy at finding her—and my pleasure was indeed great and genuine, especially because she had allowed such close bodily contact without immediately shrinking from it. We continued the game, and she continued to permit herself to be hugged; as I thus held her gently, she suddenly uttered a complete sentence, her first ever, telling me what she wanted from me.

This American girl, who had been brought to Vienna for psychoanalytic treatment, had by then been living with us for a year and a half. Since she was mute, there had seemed no point in talking with her—and in front of her—in English; so since the time she had come to Vienna she had been spoken to in and had heard only German. Nevertheless when she uttered this, her first sentence, she said in perfect English, “Give me the skeleton of George Washington.” The tragedy of her life had originated in the fact that her father was completely unknown, not just to her but also to her mother, because of the strangest of circumstances. The mother, who became aware of her pregnancy only after she was in her fourth month, had tried to get rid of the fetus. After the child was born, she wished that the girl had never been born, so that her own life would not have been destroyed—as she saw it—by this child. Only after the girl was five years old and clearly autistic did the mother become guilt-ridden and try to do the best she could for her daughter. Her desperate efforts to secure treatment for her by the best experts in the United States proved futile, since the girl was universally declared hopeless, so she finally came to Vienna and Anna Freud, who told her that only living in a psychoanalytically organized environment might offer hope for her girl, the environment which we created for her. It is completely unclear how she got sufficient knowledge of her history to know that her problem was due to the fact that she had no known father. Still, in her sentence she told that what she needed was a father, and as an American girl with no known father she could think only of the father of her country as a solution to her problem. Since the unknown father was “the skeleton in the closet” of her life, she asked for his skeleton.

It is important to note that in telling me what she wanted to give to her, she not only spoke for the first time in her life, but spoke in a complete sentence, referred to herself by means of the personal pronoun “me,” and addressed me by my name. These details are remarkable in view of the fact that autistic children, even after they begin to talk, do not use personal pronouns. Thereafter she never stopped talking altogether, although for quite some time she used language only sparingly.

This girl—who until then had refused any contact with the world— achieved the rudiments of a self first through Peek-a-Boo and through playing it recognized the other, to whom she communicated something of greatest importance to her. It was by means of Peek-a-Boo and the other game in which I “searched” for her that she realized that she was the one who was hiding, that it was she who was being searched for, and found. Playing these games enabled her to find herself and at the same moment to find the world of other people—through play she had joined the world. Also through play, she became able to hope that what she desperately needed could be given to her.

A feeling of selfhood and the experience of being able to communicate and to receive communication are acquired through playing such simple games, but they also serve other important purposes. They teach a child that even when he and his mother are temporarily out of sight of each other, the interruption of visual contact does not mean that their emotional contact is also broken. His mother’s frantic quest in Where’s the Baby and her delight in finding him clearly demonstrate to him that out of sight does not for a moment mean out of mind—on the contrary, losing sight of the baby only increases the desire for his presence. It provides him with the much-needed assurance that contact will not be lost, whatever may happen. On the strength of this knowledge he learns that he need not cling to his mother at all times; he can safely let her out of sight for a while. And his mother’s pleasure when she finds him, and his in being found, adds a positive dimension to his daring in leaving her or permitting her to be invisible for a moment.

As Peek-a-Boo reassures the child that he won’t be lost or forgotten, so are other anxieties assuaged by games which demonstrate the integrity and importance of all the parts of his body; for example, This Little Pig Went to Market, which involves touching and naming the toes or fingers. This game conveys to the child the information that his body is in good shape; nothing is missing or liable to be overlooked. Even more important, it assures him that the various parts of his body are emotionally significant to his parent.

In addition to quieting anxiety about disappearance, games in which the child can take a more active role, such as Hide and Seek, also serve to enhance his mastery of himself and the world. Hide and Seek is one of the most ancient and pervasive games known to mankind. All efforts are bent on searching for the player who is “it.” This convinces him that even if he is not visible, he has not been forgotten; and that it is important to one and all that he be found, because the activity—and, in the transferred sense, life—cannot go on without him. Such is the dignity and reassurance that “simple” play can confer on participants.

In the more primitive hiding game Where’s the Baby, the child waits to be found, although he may help out by shouting, “Here I am!” In Hide and Seek and its related variants, his success depends on his getting to safety (called home, home base, or house) through his own efforts. What he learns through this more advanced play is that he can afford to venture out on his own into the world, risking exposure to its dangers (as represented by the pursuer and the strange hiding places), and return again safely to the permanent security of home base. He can test his skill, luck, and daring out there, confident that somehow he will again be able to reach safety. The game even provides a built-in consolation prize: should he be caught, he does not lose out or have to leave the game, but becomes instead the powerful and active pursuer in the next round.

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