Aggression in Play Therapy

A Neurobiological Approach for Integrating Intensity

by Lisa Dion • 2018 • 240 pages

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Psychology Counselling

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Key Takeaways

1. Aggression in play therapy is a window into a child's inner world

Children project their inner world onto the toys and therapist, setting them up to experience their perception of what it feels like to be them.

The setup reveals trauma. When children engage in aggressive play, they are not simply acting out or misbehaving. Rather, they are communicating their perceptions, experiences, and unresolved traumas through their actions and choices in the playroom. This "setup" allows therapists to gain invaluable insights into the child's emotional landscape.

Understanding the nervous system. Aggressive play often reflects a dysregulated nervous system, specifically:

Sympathetic activation (fight/flight response)
Dorsal parasympathetic activation (freeze/collapse response)

By recognizing these states, therapists can better interpret the child's behavior and tailor their interventions accordingly. The goal is not to suppress aggression, but to help children integrate these intense experiences and emotions in a safe, controlled environment.

2. Therapists must regulate themselves to help children integrate intensity

You have to regulate yourself before you can help a child regulate.

Self-regulation is key. Therapists must develop their own capacity to remain present and regulated in the face of intense play. This involves:

Mindfulness practices
Controlled breathing techniques
Body awareness and movement
Naming and acknowledging one's own experiences

Modeling regulation. By demonstrating self-regulation, therapists:

Activate the child's mirror neuron system, allowing them to learn through observation
Create a "ventral embrace" that expands the child's window of tolerance
Provide a safe container for the child to explore challenging emotions and sensations

Therapists should strive to maintain "one foot in and one foot out" - feeling the intensity of the play while simultaneously remaining grounded in the knowledge that it is just play.

3. Authentic expression and congruence are essential for effective therapy

When therapists are not willing to be authentic in the playroom, their incongruence registers as a potential threat in the child's brain.

Authenticity builds trust. Children are highly attuned to nonverbal cues and can sense when adults are being inauthentic. By expressing genuine reactions to the play (while maintaining professional boundaries), therapists:

Create a sense of safety and trust
Model emotional honesty and vulnerability
Provide language for children to express their own experiences

Congruence promotes integration. When therapists' words, actions, and internal experiences align, it helps children:

Feel truly seen and understood
Integrate their own challenging emotions and experiences
Develop a more cohesive sense of self

Authentic expression does not mean losing control or becoming overwhelmed. Rather, it involves mindfully acknowledging and regulating one's own responses while staying attuned to the child's needs.

4. Setting boundaries is for therapists, not children

Kids don't need boundaries in the playroom—therapists do!

Reframing boundary-setting. Instead of viewing boundaries as a way to control or limit children's behavior, therapists should set boundaries to:

Maintain their own window of tolerance
Stay present and regulated
Continue to serve as an effective external regulator for the child

Flexible and authentic boundaries. Effective boundary-setting in play therapy:

Acknowledges the child's needs and impulses
Redirects energy rather than shutting it down
Uses phrases like "Show me another way" or "I don't need to hurt to understand"
Avoids shaming or controlling language

By setting boundaries in this way, therapists model healthy self-care and respectful communication while still allowing children to explore and express their challenging emotions and experiences.

5. Emotional flooding requires creating a neuroception of safety

Once children have emotionally flooded, there is only one task at hand: to create a neuroception of safety and help the children return into their window of tolerance.

Understanding flooding. Emotional flooding occurs when a child's nervous system becomes overwhelmed, leading to:

Excessive sympathetic activation (fight/flight)
Dorsal parasympathetic activation (freeze/collapse)

In these states, rational thinking and self-regulation become extremely difficult.

Creating safety. To help a flooded child, therapists must:

Remain calm and regulated themselves
Use non-verbal cues to convey safety (e.g., slow breathing, open posture)
Avoid lecturing or trying to reason with the child
Provide a containing presence without forcing interaction

Techniques for creating safety:

Rhythmic, predictable movements or sounds
Offering physical comfort (if appropriate and welcomed)
Using a soft, soothing voice
Providing sensory grounding objects or experiences

Remember that flooding is a normal part of the therapeutic process and can lead to significant breakthroughs when handled skillfully.

6. Death play can be therapeutic for hypo-aroused children

Death can be a symbolic representation of the hypo-aroused state of the nervous system.

Understanding death play. For children experiencing emotional numbing, dissociation, or depression, death play can serve important therapeutic functions:

Exploring feelings of helplessness or abandonment
Processing literal experiences of loss or death
Symbolically representing a deeply hypo-aroused nervous system state

Therapist's role in death play:

Remain present and regulated, even when "playing dead"
Use internal regulation techniques (e.g., controlled breathing, body scans)
Stay attuned to the child's energy and needs
Provide a containing presence that allows for exploration of challenging emotions

It's crucial to remember that death play does not promote actual death or self-harm. Rather, it allows children to safely explore and integrate difficult experiences and emotions within the therapeutic container.

7. Parents need support and guidance during aggressive play therapy sessions

Whenever a parent is in the room, you have two clients, and it is your task to teach them how to play and interact together.

Supporting parents. When parents observe or participate in aggressive play therapy:

Their own nervous systems may become dysregulated
They may struggle to understand or accept their child's play
They need guidance on how to respond effectively

Strategies for working with parents:

Include them actively in the play, rather than having them observe passively
Educate them about the purpose and benefits of aggressive play
Teach them regulation techniques they can use in and out of sessions
Model appropriate responses to the child's play
Process their own reactions and emotions after the session

By supporting parents through aggressive play therapy, therapists:

Strengthen the parent-child relationship
Increase the effectiveness of interventions outside of therapy
Help create a more regulated and attuned home environment

Remember that parents may need their own therapeutic support to process their reactions and develop new skills for responding to their child's needs.

Last updated: May 16, 2025

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FAQ

1. What is "Aggression in Play Therapy: A Neurobiological Approach for Integrating Intensity" by Lisa Dion about?

Focus on Aggression in Play Therapy: The book explores how aggression manifests in children's play therapy sessions and offers a new neurobiological perspective for understanding and working with it.
Integration, Not Suppression: Lisa Dion advocates for integrating, rather than suppressing, aggressive energy in the playroom, using neuroscience and interpersonal neurobiology as a foundation.
Therapist’s Role: The book emphasizes the importance of the therapist’s self-awareness, regulation, and authenticity in facilitating healing for both the child and themselves.
Practical Tools and Stories: It provides practical strategies, real-life case examples, and exercises for therapists to manage intensity, set boundaries, and support both children and parents during aggressive play.

2. Why should therapists and mental health professionals read "Aggression in Play Therapy" by Lisa Dion?

Addresses a Common Challenge: Aggression is a frequent and often intimidating issue in play therapy, and the book provides a much-needed framework for addressing it.
Neurobiological Insights: The book translates cutting-edge neuroscience and Polyvagal Theory into practical guidance for therapists.
Therapist Self-Care: It highlights the risk of burnout and compassion fatigue, offering tools for therapists to regulate their own nervous systems.
Emphasis on Authenticity: Readers learn the value of being authentic and present, which is essential for deep therapeutic work and modeling regulation for children.

3. What are the key takeaways from "Aggression in Play Therapy" by Lisa Dion?

Aggression as Communication: Aggression is a normal biological response and a form of communication, not simply "bad behavior."
Integration Over Catharsis: The goal is to help children mindfully integrate aggressive urges, not just vent or suppress them.
Therapist as External Regulator: Therapists must regulate themselves first, becoming a co-regulator for the child’s nervous system.
Authenticity and Boundaries: Being authentic and setting boundaries based on the therapist’s window of tolerance are crucial for safety and healing.

4. How does Lisa Dion define and approach aggression in play therapy?

Symptom of Nervous System Activation: Aggression is seen as a symptom of sympathetic nervous system activation when a child perceives a threat or challenge.
Not Just Outward Behavior: Aggression can be expressed both outwardly (hitting, yelling) and inwardly (self-harm, withdrawal).
Playroom as Safe Space: The playroom is positioned as the ideal place for children to explore and integrate aggressive impulses safely.
Integration, Not Catharsis: The book distinguishes between cathartic release (venting) and mindful integration, advocating for the latter.

5. What is the role of the therapist as an "external regulator" in Lisa Dion’s Synergetic Play Therapy model?

Co-Regulation is Key: Children borrow the therapist’s regulatory capacity to help manage their own dysregulation during intense play.
Mindful Self-Awareness: Therapists must be attuned to their own bodily sensations and emotions, using mindfulness, breath, and movement.
Modeling Regulation: By authentically expressing and regulating their own responses, therapists model healthy coping strategies for children.
Window of Tolerance: Therapists need to maintain a window of tolerance larger than the child’s, setting boundaries when their own limits are reached.

6. How does "Aggression in Play Therapy" explain the neurobiological basis of aggression and regulation?

Amygdala and Threat Perception: The amygdala scans for threats (physical, unknown, incongruence, "shoulds") and activates the autonomic nervous system.
Sympathetic and Parasympathetic Responses: Aggression is linked to sympathetic (hyper-aroused) states, while collapse or shutdown relates to dorsal parasympathetic (hypo-aroused) states.
Regulation Through Relationship: Integration of traumatic memories and sensations occurs through safe, attuned relationships, as supported by Polyvagal Theory.
All Behavior as Regulation: The book reframes all behavior, including aggression, as attempts at self-regulation.

7. What practical strategies does Lisa Dion recommend for therapists to regulate themselves and facilitate aggressive play?

Mindfulness and Breath: Therapists are encouraged to use mindful awareness and breathwork to stay present and grounded.
Movement and Naming Experience: Movement (even subtle) and naming internal experiences out loud help regulate both therapist and child.
Dual Attention: Therapists practice being aware of both their own and the child’s experiences simultaneously ("one foot in, one foot out").
Repair After Rupture: When emotional flooding or mis-attunement occurs, therapists are guided to repair the relationship openly and authentically.

8. How should therapists set boundaries during aggressive play according to "Aggression in Play Therapy"?

Boundaries for Therapist’s Safety: Boundaries are set to keep the therapist within their window of tolerance, not to control the child’s behavior.
Acknowledge and Redirect: Instead of saying "no," therapists are encouraged to acknowledge the child’s need and redirect the energy (e.g., "Show me another way").
Flexibility and Self-Awareness: The need for boundaries varies depending on the therapist’s state, history, and physical limitations.
Repair When Needed: If a boundary is set out of fear or frustration, therapists are encouraged to repair with the child, modeling responsibility and resilience.

9. What is the significance of therapist authenticity and congruence in Lisa Dion’s approach?

Children Detect Incongruence: Kids are highly sensitive to nonverbal cues and will escalate play if they sense the therapist is not being authentic.
Modeling Real Responses: Authentic expression (naming fear, anxiety, etc.) provides children with a model for self-awareness and regulation.
Safety Through Realness: Authenticity creates a sense of safety and trust, allowing for deeper therapeutic work.
Changing Neural Pathways: Repeated authentic interactions help children rewire their brains for better emotional regulation.

10. How does "Aggression in Play Therapy" address the challenges of observing aggressive or death-themed play?

Observer Role is Active: Even when not participating, therapists are still set up to feel the child’s internal world and must regulate themselves.
Use of Observational Statements: Therapists should make factual, non-interpretive statements about the play, and voice what it feels like to be the observer.
Integration Over Catharsis: The goal remains integration, not just venting or acting out aggression.
Special Considerations for Death Play: Therapists are given practical advice for staying present, safe, and regulated during hypo-aroused (death) play, including how to "die" safely and when to set boundaries.

11. How does Lisa Dion recommend therapists work with parents during aggressive play therapy sessions?

Parents Need Support Too: Parents often become dysregulated when witnessing or participating in aggressive play and need guidance.
Therapist as Coach: When parents are present, the therapist becomes a coach, helping parents regulate themselves and set boundaries without shaming.
Preparation and Containment: Therapists should assess parents’ readiness and provide training or containment as needed before involving them in sessions.
Co-Regulation in the Room: The therapist is responsible for regulating all nervous systems present—child, parent, and their own.

12. What are the most important quotes from "Aggression in Play Therapy" by Lisa Dion, and what do they mean?

"Aggression is an extension of the fear and dysregulation that lives inside of them, driven by their perceptions of themselves and of the world around them." — Aggression is not just bad behavior, but a communication of internal struggle.
"Integrating intensity and making aggressive play therapeutic starts with you, the therapist." — The therapist’s self-regulation and authenticity are foundational for healing.
"We regulate to move toward the intensity, not to get out of it." — The goal is not to suppress or avoid strong emotions, but to help children face and integrate them.
"Children come into the playroom and through their words, actions, and play set the therapist and the toys up to feel how they feel." — The projective process is central; therapists must be attuned to what they are being set up to experience.
"Boundaries are used to help therapists stay within their window of tolerance, so that they can continue to hold and regulate the intensity, supporting the child’s integration." — Boundaries are for the therapist’s self-care, not punishment or control.