Playing In the Sand – How Therapy Works

Dr. Brett HowardMental Health, Performance

Sometimes during a meeting with a client I bring out a big box of sand and ask my clients to use little miniature-sized objects (like little plastic people, cars, rocks trees, etc.) to construct a physical representation of what is on their mind. Why would I have grown professionals spend valuable therapy time playing in the sand? Here’s why…

Your “problem-solving mind” (as opposed to your “observer mind”) is in charge of organizing, planning, evaluating, judging, making sense of things and holding on to parts of your identity. Not only is this part of your mind responsible for all of that good stuff, but it’s also the main contributor to the reason why you are alive and reading this article today.

hmmm…I am noticing that after I ate that cookie, I am having difficulty breathing and my throat is beginning to swell shut. Also, I am deathly allergic to peanuts. Rather than seeing if this feeling will pass, I choose to use my Epi-pen and ask my colleague for assistance in activating the local emergency medical service. Thanks problem-solving mind!

With our possession of such a sophisticated analytical tool, how could anybody find themselves in need of a psychotherapist? Or asked another way, if our brains are such magnificent problem solvers, how can they not come up with a solution to get us out of depression, help us focus or lessen our anxiety? The answer lies in understanding how our analytical minds have evolved and how we process information.


It all started with us learning how to name things. Like when aunt Cheryl stood in front of our 14-month-old selves saying “SHER-URL…SHER-URL.” When we decided to mimic these sounds we may have produced something similar to the sound “SHER-URL,” and it was particularly fun to do so in front of the pretty woman who smells nice (aka, aunt Cheryl) because she sure gave us a lot of attention when we said her name correctly.

It may have also been pretty fun to make the sounds “DOG-GIE” whenever that cute 4-legged animal came around (again, from the praise we got when we named the “dog” correctly). It was also fun when that “DOG-GIE” licked our face and made us laugh, but that seems to only happen when I am at that place where I also see that “SHER-URL” person. I liked laughing and the feeling I got when I pet the “DOG-GIE” so if I am at my own house and I want to see that “DOG-GIE” again, I should make requests to see that “SHER-URL” person.

Whoa, that is quite a lot of words to highlight the background processing of liking aunt Cheryl’s puppy. But the main point here is that a whole lot of connections were being made in our 14-month-old brains, automatically and without much effort:

cognitive network of aunt cheryl's new puppy


Our brains love getting praise & attention, and we quickly discover that we get lots of it when we start connecting certain sounds to certain things. In other words, we have learned that we get praise from the process of “naming things”.

This process becomes so rewarding that our brains have internalized this mechanism and put it on auto-pilot. We begin to “name” things (and later to categorize, classify and judge things) on an often subconscious level. Our brains become expert matchmakers by automatically making connections between sounds, words and things very often without us consciously trying to do so.

And so it goes, day after day, our brains making connections…automatically and without effort. Our analytical mind is constantly laying down lines and arrows between things, ideas, people, images, animals and anything else it can get its brain-hands on. It even starts laying down these connections between intangible things like emotions and imagined future states.

The automatic creation of these underlying connections also happens while we are trying to make other specific connections consciously, like when we engage in active learning or studying. Do you remember the time in math class when you were first exposed to fractions? The conscious/formal education you received allows you to know that 1/2 + 1/2 = 1, AND the memory of that class (where you were sitting, the image of your teacher, the feelings of frustration) is the result of the automatic learning process that was happening at the same time.

The automatic and consciously learned material blend together to form a network, and most of the time these networks are tremendously helpful to us. But problems seem to arise when we try to consciously turn off portions of the network that we don’t like or want.


As we learn more and more, our networks become bigger and bigger with different networks becoming housed within other networks. If you have ever had the experience of coming up with a brilliant metaphor to better explain a complicated concept, that was one network of ideas being linked to another network of ideas.

Learning continues as we gain access to more complicated words and concepts. We also begin to expand the “types” of automatic connections that can be made resulting in enormous & complicated networks of interrelated concepts that are linked in many many different ways.

The types of connections within a network come in many flavors. One of the most basic types comes in the form of something being the “same” as something else (like the sounds “sher-url” are the same as the person “aunt Cheryl”). Other types of connections show something being “less than” something else or “stronger than” or “came before” something else. The length of the list of types of connections is about as long as the length of the list of individual concepts that can be connected.

As an example, here is a small portion of an imaginary network related to public speaking:

cognitive network of performance anxiety and public speaking


In this network, we find our hero having made connections between the act of public speaking and several other concepts, memories and emotions. On the one hand, our hero knows that public speaking is good for his career and that a speech well-delivered will make him feel accomplished and prideful. On the other hand, he holds the memory of having tried to bust out his karaoke version of Hey Jude at a friend’s birthday party only to end up with him choofing up several slices of olive pizza due to a sudden case of stage fright.

Since the future experience of “appearing on a stage to give a career-boosting presentation” has been linked in his mind with the thought of “appearing on stage results in puking” then the associated emotions of fear and anxiety have also been activated. When this network gets triggered, we have a guy with a small case of performance anxiety.

There Are No Erasers

At this point, one’s problem-solving mind quickly comes up with the easiest & most logical solution to performance anxiety: just stop thinking about running off stage to puke when its time to give your work presentation. The problem-solving mind then retreats to collect high-fives for a job well done, after all, avoiding something that makes you feel bad or is painful has worked pretty well up to now. BUT, our mind does not work that way. We cannot erase connections or delete associations that are made in our networks…we can only ADD to them.

What’s worse is that when we try to avoid a painful or unhelpful part of our network, the effort itself becomes connected to the very thing we were trying to avoid in the first place. So if our public speaking guy tries to deal with his performance anxiety by “not thinking of the karaoke vomit situation,” then the actual instruction to himself to avoid thinking of this event becomes connected to the painful puking memory itself.

This is why the image of an elderly jolly bearded dude comes to mind the minute I ask you to NOT think of Santa Claus.

It’s like a glass of salt water

Yes, it’s like a glass of salt water. If the water is too salty you can’t just reach in and take out the salt, you have to dilute it with more water. And THAT’s what therapy is all about. We can’t remove the things in your networks that are painful, stressful or anxiety-provoking. We can only ADD things to your networks to try to make their overall effect on your life easier to hold.

Therapy is most often about looking at the networks that are interfering with your ability to live the life that you want, and then strategically & carefully adding concepts, experiences and emotions to that network to dilute their net negative effect. When I ask my clients to use minis and a sandbox to construct a representation of what is going on in their mind, I am giving them an opportunity to add to a painful network a metaphorical representation of the same painful content but in an alternate form that might be easier to relate to in the long-run.

Therapy Explained

Whether the therapy you receive comes in the form of talking, music, art or sand, much of its power is in its ability to add important concepts & experiences to an existing cognitive network that your problem-solving mind hasn’t been able to handle on its own. This means that the experience of therapy may not always feel good to the problem-solving side of your mind. That side of your mind wants the solution to your depression or anxiety and is eagerly waiting to hear the answer to the question, “But what do I do to get rid of this feeling?”

Therapy can’t get rid of pain and it doesn’t have the answer to how you can get rid of it on your own. Getting rid of horrible feelings is the same as asking your brain to NOT think of Santa Claus. Your brain cannot be told to NOT have any experience. All we CAN do is add to the content that’s already there to dilute its effects and make it easier to handle…so we ask you to do things you may not be used to doing…like playing in the sand.