Shirah Vollmer MD

The Musings of Dr. Vollmer

Archive for the ‘Play’ Category

Hide and Seek: A Game That Endures

Posted by Dr. Vollmer on January 23, 2010

This blog is part of my series on play.

Why do children throughout the ages love hide and seek? I propose that there are a number of reasons that both hiding and seeking are thrilling for children. First, children hide because they want to know that they can go out and explore. They want to know that they can be fine on their own. They want a sense of autonomy. However, soon after the child feels the joys of exploring, he gets lonely and so he wants to be  reassured that his friend wants to find him. This is life affirming. To be pursued is to be loved. The joy of being found is the joy of being alive and feeling cared for. This is the second reason why this game is so popular.

Third, the game of hide and seek brings together children and adults into the sandbox of play. There is a shared mission to alternate exploring and being discovered. The moments of suspense, when one person looks for another adds to the tension which then leads to the excitement of coming together. Fourth, hide and seek reassures children that people in relationships can separate and they can come back together. This dance between separation and reunification is endlessly reassuring because it reminds the child that separations can be temporary and therefore sustainable. Further, it reinforces the tremendous joy in the reunion since there is always fear that coming together will not happen.

The game Peek-a-boo is a an infant version of hide and seek. In the game, the older player hides his face, pops back into the baby’s view and says-to the baby’s amusement-Peekaboo! I see you! Since the infant does not have object permanence, meaning that in a literal way, the infant’s brain processes information such that out of sight means out of mind, when the older player covers his face, then the baby believes the player has gone away. The joy in seeing the face return comes from the relief that the separation ended. Turning the anxiety of separation into a game of joy is a form of mastery. In other words, instead of the baby crying when the adult leaves the room, the baby is now laughing because despite his fears, the adult has reappeared. Peek-a-boo is played over and over again. The repetition is comforting.

We have to cope with separations throughout life. Hide and seek gives the child practice at independence and it gives the child joy in reunification. This game helps a child conquer his fear of autonomy and separation. It is fun to master fear. A game which gives a child a platform to feel powerful endures through time.

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Play in Videogames

Posted by Dr. Vollmer on January 23, 2010

This next blog will continue my series on play.

John C. Beck and Mitchell Wade, authors of Got Game: How the Gamer Generation is Reshaping Business looked at 2500 US business professionals looking at differences between those who grew up playing videogames and those who did not. Professionals who grew up playing video games actually made better business people. They were more serious about achievement; more attached to the company they work for and the people they work with; more flexible, persistent problem-solvers; more willing to take only the risks that make sense.

The ages 5-15 when kids play video games corresponds to the same ages that neural pathways of the brain are being formed. This is known as the plasticity of the brain. This window of opportunity allows children to learn different languages and still sound like native speakers. Those who learn languages when this window closes will always sound like a foreigner. The reason for this is that after 15 the new language layers over the old language and so it is not part of the neural design. Based on this theory, it is possible that children who play video games are wiring their brains in a way in which we do not understand.

The gamer generation sees life as a game. In fact, one series of games called The Sims is a strategic life-simulation computer game. It is a simulation of the daily activities of one or more virtual persons (“Sims”) in a suburban household near SimCity. Will Wright, the game’s designer calls it a “digital dollhouse”. The only real objective of the game is to organize the Sims’ time to help them reach personal goals. In 2002 The Sims became the top-selling PC game in history.

The gamer generation knows that learning and winning involves trial and error. The stakes are high. The emotional rewards are grand. The child persists. Tenacity may be teachable. Technology might be able to help us here.

As a child psychiatrist, parents often ask me if they should limit their child’s “screen time”. At first, I approached this question as I would approach any pleasurable activity. I inquire about the child’s eating and sleeping habits, their academic performance, their relationship with their peers, their outdoor activities and their relationships at home. If the child’s life seems to be in a good balance and the child is thriving, I suggested that if it is not broken, why fix it. However, as I learn more about video games, I have changed my approach. Now, I ask these parents to give me more information about the “screen time”. I want to know what they are playing and I want to know how their mood is after they are done. I want to know if they are playing adventure games, sport games or first person shooter games. I want to know if they are using their imaginations. I think about why this particular child is attracted to this particular game. I see the choice of video games as a window into the type of play the child is drawn to. I become curious about the game, the game designer, and the child-game interaction. I wonder how to weigh in on the question of limiting screen time. I think that maybe the question should be reframed. Perhaps I should help the parent ask me what games are good for my child. Perhaps I should be prepared to know the answer to that question.

As Beck and Wade say, the changes in our world will be a result of the minds who have grown up with technology. That is, the minds that have been exposed to a new medium for play. This game-mind interaction is unchartered territory. As with most things, I imagine it to be a good news, bad news situation. The problem is that I do not know the good news or the bad news. I only know that children need to play to expand their minds and a tool which facilitates this play may be useful for development. The fact that they grow up to be better business people is interesting, but not useful for my purposes. I want to know if they grow up to be happy, satisfied  and constructive people. For that, I need more data.

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The Play in Gangs

Posted by Dr. Vollmer on January 23, 2010

This blog is part of my series on play.

A gang is a group of people whose members recognize themselves and are recognized as such by their community. Characteristics of gangs include a recognized leader; formal membership with initiation requirements and rules for its members; its own territory or turf; standard clothing or tattoos; private slang; and a group name. A study conducted at the University of Southern California, which itself is surrounded by gangs, found gang activity in 94% of the country’s major cities and over 1000 cities altogether. The number of gang members in Los Angeles County alone was estimated at 130,000 in 1991.

Social problems associated with gang activity include poverty, racism and the disintegration of the nuclear family. Adolescents whose families are not meeting their emotional needs turn to gangs as substitute families where they can find acceptance, intimacy and approval. Gangs also provide a sense of identity that young people crave as they confront the dislocations of adolescence. Others feel physically unsafe in their neighborhoods if they do not join a gang. For some people, the connection to a gang is through family members who belong-sometimes even several generations of a single family. Another incentive for joining is money from the gangs’ lucrative drug trade.

The basic unit in gangs is a clique of members who are about the same age. The Crips and Bloods consist of many sets, with names such as the Playboy Gangster Crips, the Bounty Hunters and the Piru Bloods. These neighborhood groups have leaders who may command as many as 200 followers.

My interest in gangs grew out of my private practice of psychiatry and psychoanalysis. I see boys who are deeply attracted to gangs and I wonder what that is about. I think it is about play. The gang provides a structure, like a game,  in which the rules are clear. They feel part of something larger than themselves. The obvious question is how do they feel about hurting other people. My speculation here is that the outcome of the activity is not relevant. What is relevant is that it is a game that they enjoy. There are playmates. There is suspense. There is tension. There is relief. The process is more important than the outcome.

One question that follows from my thesis that joining gangs is a way of playing, then the next question is why does not every teenager join a gang. The answer is that some adolescence fear the disapproval of their parents, while others are not stimulated by this kind of play. Gangs do not appeal to all young people, but the huge numbers in gangs speaks to its’ powerful draw.

Understanding gangs as play enables us to take the value judgment out of gang activity. We can look at the back story and see how gang activity fits a need, a human need, for play. As such, we can try to find a substitute activity for these adolescence which involves the same critical ingredients.

Mental health professionals have a lot to contribute to help law enforcement work to diminish gang activity. Looking at gangs from a standpoint of human motivation is one small step towards helping these young people have more constructive lives, and in so doing poorer neighborhoods will feel less tension. The mandate to intervene is strong. There are too many lives which are scarred and destroyed.

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LA Times Letter

Posted by Dr. Vollmer on January 23, 2010

South L.A. tours

Giving Tourists A Look At Gang Culture, Scott Gold, LA Times, December 5, 2009

I fully support the Los Angeles Gang Tours. As a psychiatrist, I know that the more people can relate to how the gang members feel, the more likely it is that there will be financial and thoughtful intervention. Learning the history that the policy of housing covenants caused ethnic ghettos which led to the formation of gangs is very important. Knowing that the past influences the present, a psychoanalytic tenet, helps us move forward. Go Alfred Lomas! Expose the problems. Inspire change.,0,6167426.story

Now, take a look at the published letter.,0,1928270.story?page=3


Dec 12, 2009

The more people can relate to how the gang members feel, the more likely it is that there will be financial and thoughtful intervention. Learning that the policy of housing covenants led to the formation of gangs is very important. Knowing that the past influences the present helps us move forward.

Shirah Vollmer
Los Angeles

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Tea Time

Posted by Dr. Vollmer on January 23, 2010

Steeped in History: The Art of Tea is an exhibit at the UCLA Fowler Museum, on display until November 29, 2009. The exhibit reminds us of our centuries-old fascination with tea. I am reminded how tea, as an item of luxury, created an opportunity for play. There is the Japanese tea ceremony which is a choreographed presentation of tea which includes porcelain hanaire vases for flower arrangements. The rules (as in a game) were seen as too rigid, so by the 19th century, the loose-leaf grean tea sencha began to replace matcha as the preferred Japanese tea. To prepare sencha, a style of tea the Chinese had introduced centuries earlier, the leaves are briefly steamed before roasting to lend a more vegetal flavor to the brew. Because the leaves are whole rather than ground, matcha tea caddies and brewing pots were no longer necessary.

Miniature children’s tea sets became fashionable in the 19th century, making an obvious association between tea and play. There were tea-time dresses, meant to be worn only from 3 pm to 6 pm, again associating dress-up with the play of tea. The ritual of tea meant that people took the time to drink tea and interact in a similar way that children take time to play on the recess yard.

In the final exhibition galleries, there is a British portrait of a family leisurely enjoying afternoon tea. The symbol of wealth is obvious. The wealthy are able to be imaginative. Tea was the medium that they used to sit around a table and exercise their brains. Meanwhile, the workers on the tea plantations in the 1920s were enduring slave like conditions. In this gallery, we see so clearly that in addition to economic disparity, the difference between the elite and the slave-like worker is the opportunity to play.

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Posted by Dr. Vollmer on January 23, 2010

Recently, I saw the provocative documentary “William Kunstler: Disturbing the Universe,” a portrait of a man reviled by some and admired by others. During the 1960s and 70s, Kunstler became closely associated with dramatic battles involving the government and involving activists. In 1969, he defended the Chicago Eight against the charge of inciting riots during the previous year’s Democratic National Convention. Four years later, he represented American Indian Movement Co-founders Russell Means and Dennis Banks in their trial for the occupation of Wounded Knee. In his later years he was a defender of less-sympathetic clients: a drug dealer charged with killing six cops in the Bronx; the assassin of Rabbi Meir Khahane; one of the accused rapists of the Central Park jogger. His daughters, who directed the film, wondered how he could go from being a liberal defender to defending unpopular causes. To me, the common thread is clear. Mr. Kunstler was a man who loved to play, and he loved it when he had an audience who could watch him at his game. Bill, as he was known to his friends, was a master orator. He played with his words to persuade the judge or the jury to see the world in the way that he wanted them to see it. When the cause made people have strong feelings, then he knew he could draw a crowd. The crowd put him center stage, exactly where he needed to be to put on his play. The drive to play in this way stayed with him throughout his life.

I have just finished a fiction book entitled The Post-Office Girl by Stefan Zweig. This is a story of how two poor people, Christine and Ferdinand, in post-World War I Austria were struggling through life. Their lives were so focused on survival that the world of desire seemed unobtainable. Christine and Ferdinand could not play. The oppression of capitalism had robbed them of their ability to be fanciful,  and hence they searched for a solution. They looked for a sandbox. The human need for play pushed them beyond the constraints of the government.

Albert Solnit in his 1987 paper entitled “A Psychoanalytic View of Play” says that play involves four elements. First, there is the suspension of reality. Second, there is a practicing quality to the activity. Third, there is repetition and fourth there is the understanding that the behavior is metaphoric or pretend. Although both the real life character of William Kunstler and the fictional characters in The Post Office Girl were engaged with adult responsibilities, they were also playing at the same time. They were looking for an escape into their minds. They were looking for opportunities to play with ideas. In the case of William Kunstler, he found a forum for his play, but unfortunately, he brought anxiety and fear to his family in the process. In the case of Christine and Ferdinand, they did not have an opportunity to play, so they sought it out.

Play is critical to our survival since it gives us a sense of how we can shape our worlds, so that we do not feel helpless. Shai Bar-Yaacov sums it up best. “…the urge to do theatre is a very natural thing. It stems from the urge to play that exists in all of us. As we grow we have to funnel this urge into other forms.”

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Blogging: A New Form of Play

Posted by Dr. Vollmer on January 23, 2010

This blog is part of my series on play.

“Play becomes a source for initially trying on, practicing, and imaginatively elaborating the capacity for wit, humor, pathos and a whole host of affective experiences (tolerating the feelings) and their expressive communication to others.” Albert Solnit, Yale Child Study Center

In his 1908 paper on “Creative Writers and Day-Dreaming,” Freud stated “Might we not say that every child at play behaves like a creative writer in that he creates a world of his own, or rather re-arranges the things of his world in a new way which pleases him?”

Blogging is my sandbox. I am playing with the written word to express ideas. I am using the flexibility of the internet to edit and re-edit my material. In so doing,  I feel the inner expansion of my mental processes.  When I sit down to blog, I feel like I am starting to play. If I can engage someone in what I am thinking, I feel as though I have found a playmate.

In software development, a sandbox is a testing environment that isolates untested code changes from the production environment. In essence, it is an arena in which to test collections of code. The sandbox is both safe and temporary.

My blogging allows me to enter into an area filled with words and then take those words to create ideas. I can then explain my ideas to my readers. When I am done, I feel refreshed. I have played.

As such, I have a greater appreciation of play in both my adult and child patients. Getting people involved in play, getting them into the sandbox, is often a goal of psychotherapy.Helping people discover that their mind is a fertile ground for creating ideas is a wonderful endeavor. Like with software, the lessons learned from the sandbox can be applied to “live” servers, but they don’t have to be. The choice is theirs.

We all know that the internet has expanded our access to the external world. If a person has access to the world wide web, then he can search deeply for knowledge. What I find so interesting is that the internet has also allowed us to search deeply inward. The opportunity for blogging invites us to first look into our minds to compile our thoughts, and then we can find playmates who can join our sandbox to enhance our play.

Anyone want to play with me?

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The Nature of Excitement

Posted by Dr. Vollmer on January 23, 2010

Fear is excitement without breath.
Robert Heller

Yesterday, I saw an old friend and she asked me what’s new? With great enthusiasm I told her “I started a blog”. Immediately, she asked “can your patients read it?” I said, “absolutely and you should watch what you say since your words may show up tomorrow”. She laughed. I liked that she thought I was funny.

The fear and excitement of this blog feels like the beginning of a new relationship. I am excited about entering into new territory. I am scared that I could be too vulnerable. I am also scared that I could hurt someone.  This convergence of hopes and fears yields a palpable excitement within me. It makes me wonder how excitement happens.

Is excitement the mastery of fear? In the case of this blog, that would make sense. I have wanted to express myself in writing, but I have stopped myself because I was scared that I would sound stupid, and because I was scared that I would say something which might upset someone. Eventually, I decided that I have ideas which I wanted to share so I needed to take the leap. I needed to see what would happen. I needed to try.

Excitation is related to the firing of neurons in my brain. When my brain feels positively activated three things are happening. My amygdala is being triggered, dopamine is being released and frontal lobe activity is being stimulated. The neurobiology of excitement does not help me convey the feelings to others. It does not help me unravel the complexity of the feelings which I experience.

Today, at a psychiatry lecture, I learned that stress is the inability to maintain homeostasis. My excitement about my blog challenges my homeostasis. I am in a state of hyper-arousal. I suppose the neurobiologists are not distinguishing the different valences of stress. I have trouble with that.

Freud would say that all excitement is sexual. I disagree with Freud. Although there are similarities to sexual excitement, my experience of blogging touches upon the thrill of novelty, the movement from paralysis to productivity and from isolation to exposure. Freud does not describe these sensations.

So, once again I feel caught between looking to neurobiology to explain my feeling state and finding that the anatomy and physiology do  not help me to describe this sense of excitement. By the same token the Freudian point of view leaves me feeling that this theory does not capture the complexity of my feeling state.

I am left with an opportunity. The door is open for me to describe the nature of excitement. I see the potential for a paper. I see an avenue where I could contribute to the literature. I feel excited about thinking about excitement.

I want to tell my friend that not only will my patients read it, they may even gain from it in ways that add to their experience of psychotherapy. I fear that if I say that, then my grandiosity will appear to have hypertrophied. At the same time, I hope that that this grandiosity will propel me forward. Today, the hope wins over the fear and my excitement continues.

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