In The Beaver, Mel Gibson plays a depressed man who tells his wife that his shrink gave him a "prescription puppet" that is "designed to create a psychological distance between himself and the negative aspects of his personality." (In fact, he found the puppet in a pile of trash.) The toy beaver takes on a life of its own, becoming a sort of Cockney-voiced life coach to Gibson's character. Do therapists ever really prescribe puppets?
Yes. Therapists—especially child psychologists—use puppets to create distance between a patient and his problem. The simplest form of puppet therapy treats the character as a stand-in for the child's body. For example, if a child is about to undergo surgery, a doctor might demonstrate the procedure on a doll first, and then let the child do it, so the procedure seems less frightening. (There's also the classic, "Show me where he touched you.") Psychologists use puppets or dolls in emotional role-playing situations, as well. If a child lives in an abusive household, for example, a therapist might have two teddy bears act out the roles of his father and mother. Another method uses a puppet as a surrogate therapist, when a child is having trouble opening up. In some cases, the child feels more comfortable talking to the doll.
Puppets can even be used to represent particular sides of a patient's personality, as in The Beaver. A 2009 paper in the Journal of Mental Health Counseling describes an 8-year-old boy whose therapist used puppets as a treatment for uncontrollable anger. The boy studied a puppet lineup and chose the one that looked most like his problem—a large bug doll. Then the boy would speak as the puppet—"I like to bug … I like to sting"—and about the puppet. According to the principles of narrative therapy, this would allow him to "externalize" his problem, and thus make it easier to overcome.
Therapists do use puppets when treating adolescents and adults, albeit less often than with children. But it would be rare for a therapist to send a doll home with an adult, let alone urge him to integrate the doll into his everyday interactions, as Gibson's character claims in The Beaver.
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Explainer thanks Matthew Bernier of East Virginia Medical School; Lani Alaine Gerity, author of Creativity and the Dissociative Patient: Puppets, Narrative and Art in the Treatment of Survivors of Childhood Trauma; and Jeffrey T. Guterman and James Rudes of Barry University.