The science of dolls investigates the impact of doll play on empathy and emotional development.

What is Doll Play?

Doll play is a form of pretend play in which people use objects, such as dolls or figures, to simulate social situations, relationships and inner worlds. It is widely studied in psychology as a key way humans develop empathy, imagination and social understanding. By giving life to objects, we rehearse social situations, explore emotions, and practice understanding others. In this sense, dolls are not just toys, but tools for thinking.

Every known culture has provided its children with miniature versions of human beings. Dolls, as playthings and symbolic objects, have been found in ancient Egyptian tombs and the local shopping centre near you. Playing with dolls has historically been associated with role-playing caregiving and nurturing behaviours (Hall, 1897). Yet, dolls enable far more than parental roles. Children can use dolls to act out scenarios such as travelling the world, caring for the sick, and throwing a tea party; while playing with dolls, children practice different behaviours and emotions in various situations.

Doll play and the theory of mind

Playing with dolls prompts children to engage in internal state language (ISL), verbal expressions and representations of thoughts, emotions, and mental states. This verbalisation develops children's ability to imagine others' thoughts, feelings, and intentions. Studies have shown that doll play can help with emotional processing, regulation, and social understanding (Hashmi et al., 2021, 2022; Gerson et al., 2024).

A 2022 study found that doll play may be particularly effective in social development by encouraging real and imagined social interactions. Frequent ISL about others was associated with greater activation of the posterior superior temporal sulcus (pSTS), a brain region implicated in social cognition and understanding. Doll play can mentally simulate interactions, reinforcing children's capacity for empathy and perspective-taking.

The research further revealed that while both digital games and doll play encouraged storytelling, only doll play consistently elicited high levels of ISL. Functional near-infrared spectroscopy (fNIRS) scans confirmed that doll play uniquely activated the pSTS region, reinforcing its role in social cognition and understanding. Interestingly, while children's talkativeness increased with age, the use of ISL, and its associated brain activation, remained consistent across the 4–8 age range. Notably, girls used significantly more ISL about others during doll play than tablet play, while boys showed no such difference. The study concluded that social brain activity is connected to engagement with others' internal states (Hashmi et al., 2022).

How Pretend Play Shapes Thinking?

Neuroscientist Dr Sarah Gerson argued that "when children create imaginary worlds, and role plays with dolls, they communicate at first out loud and then internalise the message about others' thoughts, emotions and feelings" (Tucker, 2022). Playing with dolls encourages children to talk more about others' thoughts and emotions and to use language related to others' feelings and thoughts. In a recent study, Gerson et al. suggest that children who engaged in doll play showed significant improvements in the theory of mind, the ability to understand others' thoughts and feelings as distinct from one's own, compared to those who played digital games (2024).

Figure 1 shows the difference in children's performance on false belief and memory tasks after engaging in doll or tablet play. Figure 2 examines how children's peer problem scores (social difficulties defined by parents) influenced their improvement in false belief understanding. The study found that doll play may be particularly beneficial for children who struggle with social interactions, providing opportunities to practice understanding others' perspectives. Lastly, Figure 3 is a visual example of a false-belief and memory trial from the Sandbox task, which was the key measure used for false belief and memory. The first image shows the object's initial location (A), the second shows its new location (B) after movement, and the third shows the child's response.

Doll Therapy 

The therapeutic power of dolls is rooted in psychological theories of attachment and comfort objects. John Bowlby's attachment theory (1969) remarks that humans seek comfort through attachment bonds, which remain relevant even in old age and cognitive decline. Similarly, Donald Winnicott's transitional object theory (1953) highlights how tangible objects, such as dolls, provide emotional stability during periods of stress. Building on these foundations, Bère Miesen (1993) applied attachment theory to dementia care, recognising that many behavioural symptoms in dementia stem from unmet emotional needs. Fulfilling a person's innate attachment needs, even through inanimate objects, can improve emotional well-being, especially for those with cognitive impairments.

A 2018 study found that doll therapy (DT) significantly improved agitation, irritability, and depression compared to gesture-verbal therapy (GVT) and control groups. When comparing the two interventions, DT was more effective in reducing agitation, whereas GVT was more effective in alleviating apathy. GVT and DT can effectively reduce specific Neuropsychiatric Symptoms (NPS) in dementia patients, with each therapy showing strengths in different symptom areas (Balzotti, 2018).

Similarly, a 2023 meta-analysis confirmed that DT reduced neuropsychiatric symptoms such as depression and anxiety (Peng et al., 2023). The psychological benefits of doll therapy extend beyond behaviour regulation: empathy dolls strengthen caregiving responses, while lifelike dolls provide emotional comfort without fostering strong attachments. However, cognitive improvements remain limited, suggesting that DT primarily influences emotional well-being rather than memory or executive function.

Doll Therapy at Vida Healthcare, a specialist dementia care home in Harrogate (image source).

Dolls have a role in social cognition and social understanding, improving emotional processing and providing a unique medium for practising empathy and compassion. Whether enabling a child to navigate challenging social interactions or offering solace to a person with dementia, dolls act as more than just objects; they are catalysts for connection, understanding, and healing. As neuroscience and psychology continue to uncover the potential of dolls, it is clear that they are not only instruments of play but also an essential tool for shaping the human experience. Dolls are unique tools for exploring human emotion and interactions, deeply woven into human history and psychology. Studies underscore their role in social cognition, improving emotional processing, and providing a unique medium for practising empathy and compassion.

Tiz Creel of Living Things Studio ©2025

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