ADHD, an account of a successful play therapy (psychoanalytical psychotherapy)

1. ADHD, an account of a successful play therapy (psychoanalytical
psychotherapy)

2. Case Report
ADHD, an account of a successful play therapy
(psychoanalytical psychotherapy)
Puja Pushkarna*
Psychoanalyst and Psychotherapist, Chief Psychologist, Department of Psychology, Apollo Hospital, Bhat,
Ahmedabad, Gujarat 382428, India
a r t i c l e i n f o
Article history:
Received 14 January 2014
Accepted 30 January 2014
Available online 17 March 2014
Keywords:
Attention Deficit
Hyperactivity Disorder
Castration anxiety
Oedipus Complex
Oedipal love
Play therapy
a b s t r a c t
In this case of a successful play therapy Attention Deficit Hyperactivity Disorder was cured
without medication at Apollo Hospitals, Ahmedabad, psychology dept. A strong positive
Oedipus Complex is revealed in the play, and its successful resolution through play therapy
helped in the cure.
Copyright ª 2014, Indraprastha Medical Corporation Ltd. All rights reserved.
1. Case
P, a 6-year-old child studying in a premier school of Ahme-
dabad was brought to the hospital with the complaints of
hyperactivity and talking to himself for 1.5 years, and lack of
concentration in studies, crying at school and shyness in
approaching others for 6 months. The precipitating factor
was a scolding by his class teacher for talking in the class.
P was taken to the Tata Memorial Hospital, where after
conducting the necessary investigations he was diagnosed to
be suffering from Attention Deficit Hyperactivity Disorder. He
was referred to Apollo Hospitals, Ahmedabad, psychology
dept, for treatment.
P’s therapy lasted for 8 months; he was seen for an hour
twice a week, in his initial sessions his hyperactivity could be
seen in his play. He would only play with small Maruti car and
make it run all around in the room. He did not like to indulge
in any other activity. As therapy progressed he started playing
with more toy cars, toy trains, a Maruti van, jeep, etc. He
would have a motor car race and the train would always win.
When asked if the Maruti car (small in size) could win, he
would say “It is not possible. If the car tried to win then it
would meet with an accident and die.” or would sometimes
say that the train would crush the car if the car tried to
overtake it and demonstrated it in the session. If asked what
happened to the driver, he would say, He is alright, nothing
has happened to him.” (castration anxiety).
* Tel.: þ91 9426009607.
E-mail address: pushkarna_pooja@hotmail.com.
Available online at www.sciencedirect.com
ScienceDirect
journal homepage: www.elsevier.com/locate/apme
a p o l l o m e d i c i n e 1 1 ( 2 0 1 4 ) 3 5 e3 6
0976-0016/$ e see front matter Copyright ª 2014, Indraprastha Medical Corporation Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.apme.2014.01.010

3. After a few sessions he stopped playing with cars and
started playing with blocks, he would make a house and an
eagle with the blocks which according to him, would attack
his mother and sister who were staying in that house and he
would say it was his duty to protect them and the house from
the eagle, as his father had gone out of town. He would run
with a block piece, which he called a knife to kill the eagle,
would kill the eagle and say that he had protected his family
from the danger like his father (identification with the
aggressor).
One day in the therapy his mother left him at the hospital
and went to purchase something. He came to the therapy
room and started looking out of the window after playing for a
few minutes, when he saw what he thought was his car
(which was not) in which a lady was sitting; after a few sec-
onds a man came and drove away the car. He became
extremely violent and started saying that someone had taken
his mother and gone away. He did not listen to the therapist
and stopped playing. He ran out of the room and when he did
not find his mother outside he was shocked and started to cry,
and became unmanageable. Only after his mother came did
he become quite. But after that he did not want to play and
wanted to leave with her immediately. When the therapist
made an interpretation in that session that he wanted to be
with his mother and take her and go away, and that he was
violent because someone else had taken her away instead, he
said yes. That day he did not continue his 55 minutes session
and left in 20 minutes (oedipal love for mother).
As the therapy progressed he again started playing with
cars but now a change was noticed in his game. He would
line up the cars saying the silver car belonged to his father,
the blue to his driver, the green to the therapist, the yellow
to him and the white to his mother, he would arrange his
car, his mother’s car and the therapist’s car next to one
another and have a race. But now his car would win the race
and his father’s would be last. When asked what would
happen to him if he overtook his father’s car, he said
nothing would happen to him or his car. The other inter-
esting fact seen during these sessions was that the cars he
now used to play with were of the same shape and size. He
would keep changing the colors of the cars and the persons
to which they were assigned. Whatever be the color of the
car he assigned to himself, his car would win and his fa-
ther’s would come last or second last.
During the course of the therapy he had started per-
forming well in his academics, related to people, played
with other children and started feeling less scared of big
boys who used to bully him. In one of the sessions he
narrated to the therapist how he had beaten up a boy who
was older and was bullying him in his school. During the
termination of his therapy his hyperactive symptoms did
return but they subside quickly and the termination was
uneventful. A follow up call was made after 6 months and it
was found out that he was doing well at school and his
performance was good in his annual exams. He was well but
the only symptom that appeared at times was that he would
lose is concentration.
Conflicts of interest
The author has none to declare.
f u r t h e r r e a d i n g
1. Sigmund Freud (translated from the German under the
General Editorship of James Stracey), In collaboration with
Anna Freud, assisted by Alix Stracey and Alan Tyson.
a p o l l o m e d i c i n e 1 1 ( 2 0 1 4 ) 3 5 e3 636

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