Child’s symbolic play and mentalizing capacity (MC) are essential resources to work through intrapsychic conflicts and relational difficulties in psychotherapy. However, these abilities are commonly underdeveloped in children who have been exposed, repeatedly and from a very young age, to traumatic events that occur within their significant relationships. First, this article presents the concepts that are fundamental for understanding the role of play as a means of communication. Second, the consequences of complex trauma on the child’s ability to use pretend play in psychotherapy are exposed. One of these consequences is related to the presence of traumatic play, which is characterized by the literal repetition of traumatic events. Although the child strives to avoid the outcomes of the trauma, the anxiety linked to it could invade his or her play activities. Finally, the possible impacts of complex traumas on the child’s MC are discussed. The authors suggest that children who have been exposed to complex trauma present prementalizing modes of psychic functioning that of which repercussions can be observed in their play activities.