Can sandplay therapy help with trauma and emotional healing?

Sandplay therapy has accumulated a substantial evidence base suggesting it can — and the reasons why reach into the deepest assumptions of depth psychology about how the psyche stores and releases what it cannot yet say.

The method was founded by Dora Kalff, who trained with Jung and also spent time with Margaret Lowenfeld and Winnicott. Kalff took Lowenfeld's "World Technique" — a tray of sand, water, and miniature figures — and grafted onto it a coherent Jungian understanding of symbol and the unconscious, along with an influence from Eastern contemplative traditions that emphasized holding space for spontaneous creative acts. The result was a therapy built around what Kalff called "a free and protected space": the therapist present without judgment or interpretation, the client free to build whatever world the hands want to build.

That phrase — free and protected — is doing real theoretical work. Roesler (2019) notes that the sandtray's physical boundaries contain the fear of being overwhelmed by emotion, while the therapeutic relationship provides a second container. The regression invited by touching sand and figures is held within a double frame. This is why sandplay reaches material that talk therapy often cannot: the hands move before the ego can censor, and what appears in the tray is already there before the client has decided to show it.

The trauma literature illuminates why this matters. Ogden (2006) argues that traumatic memory is not primarily a narrative problem — it is a body problem. Trauma is stored as implicit, somatic memory: muscle tension, autonomic arousal, sensory intrusions, procedural habits of defense that persist long after the danger has passed. These memories "do not come with a story," as one survivor put it; they occupy a dimension parallel to language, never quite intersecting with it. Verbal therapies that target explicit, narrative memory may reach only the surface of what trauma has laid down.

What is available, no matter how much or how little narrative memory is intact, are the visual images, olfactory and auditory intrusions, intense emotions, sensations, and maladaptive physical actions. It is not the events themselves but these nonverbal fragments from the past and their unresolved maladaptive action tendencies that wreak havoc on the client's experience and ability to function in daily life.

Sandplay meets the trauma where it lives — in the body, in the hands, in the image — rather than asking it to translate itself into language first. Wiersma et al. (2022) report that sandplay "activates multiple brain systems that regulate sensory input and the stress response system," and neuroimaging studies have found improved synchrony in frontotemporal networks, potentially facilitating memory reprocessing with an optimal degree of cognitive control. Symptom improvement in generalized anxiety has been associated with improved functioning in the limbic system and prefrontal cortex — the very regions that trauma dysregulates.

The quantitative evidence is now substantial enough to summarize. A meta-analysis of 40 studies across eight countries, representing 1,284 participants, found an overall effect size of Hedges' g = 1.10 — large by any standard — with large effect sizes maintained for internalizing symptoms, externalizing symptoms, and ADHD. Individual treatment outperformed group format. The range of presenting problems addressed includes anxiety, depression, trauma, addiction, autism, borderline personality disorder, and migration stress (Wiersma et al., 2022).

From the Jungian side, Chodorow (1997) situates sandplay within the broader practice of active imagination — the disciplined engagement with unconscious contents through an expressive medium. Jung himself, she notes, pointed to symbolic enactment with the body as potentially more efficient than "ordinary active imagination," though he could not say why. Sandplay gives the unconscious a physical grammar: the image is not described but built, touched, rearranged. The tray becomes what Kalff called the site of "natural transformation" — movement toward what Jung named individuation, the integration of split-off parts of the psyche.

What the evidence and the theory converge on is this: for people whose suffering has gone below language — whether through early developmental trauma, acute shock, or the slow accumulation of what the body has had to hold — sandplay offers a medium in which the psyche can speak before it is asked to explain itself.

Dora Kalff — portrait of sandplay therapy's founder and her Jungian roots
Active imagination — the broader practice within which sandplay sits
Individuation — Jung's term for the integrative process sandplay is said to support
Implicit memory — the somatic, nonverbal memory system that trauma most deeply affects

Sources Cited

Wiersma, Freedle, McRoberts & Solberg, 2022, A Meta-Analysis of Sandplay Therapy Treatment Outcomes
Roesler, Christian, 2019, Sandplay Therapy: An Overview of Theory, Applications and Evidence Base
Ogden, Pat, 2006, Trauma and the Body: A Sensorimotor Approach to Psychotherapy
Chodorow, Joan, 1997, Jung on Active Imagination