Gestalt therapy

Question 1

person centered conceptualization

Answer 1

look at how person has not received empathy, unconditional positive regard and congruence. Therapist has to provide them with these things.

Question 2

overview of Gestalt

Answer 2

Therapy founded by Fritz Pearls, comes from word for “whole” or “form”, looking at individual/person in a holistic manner, you are trying to understand pathology in how the person has been fragmented, what have they experienced in where they do not feel like a whole individual, phenomenological (focusing on experiences of client and what client feels), if you are experiencing sadness you really need to feel it and you need to feel it in the moment, inability to find what one needs/what one needs to be complete, Pearls treated soldiers with brain injuries, not about expectations (What we are expected to do or what society expects us to do) about who we are right now, expectations lead to fragmented/un-whole life, important to talk about feelings and experience those feelings (might ask patients to redo things and ask them how they are feeling, also through their body language)

Question 3

existential and phenomenological

Answer 3

looking at clients experience, it is grounded in the client’s “here and now”

Question 4

initial goal

Answer 4

Initial goal is for clients to gain awareness of what they are experiencing and doing now

• Promotes direct experiencing rather than the abstractness of talking about situations
• Rather than talk about a childhood trauma the client is encouraged to become the hurt child
• Power of therapy comes from experiencing things in moment
• “Talk to the chair”, talk to the person as if they were there, that is how you get all the material about how a person is feeling, much more powerful than abstractly talking about it, think back and feel

Question 5

EDMR

Answer 5

asking client to re-experience trauma, giving them coping mechanisms to manage those experiences as they are re-experiencing it (eye movement desensitization and rapid processing, when we are upset about something our eyes more rapidly), trying to get client to go back to traumatic event and be in that space (Where are you, who is there) while the therapist is trying to insert different ways to respond to the trauma, principle of this comes from Gestalt (cannot make progress unless you go back and experience)

Question 6

principles

Answer 6

holism, field theory, figure formation process, organismic self-regulation

Question 7

explain holism

Answer 7

• The full range of human functioning includes thoughts, feelings, behaviors, body, language and dreams
• Does dream work, analyzes dreams by asking about everything in the dream (Nothing is unimportant, everything means something)
• Nothing has superior value, everything is an equal important part of the client

Question 8

explain field theory

Answer 8

• The field is the client’s environment which consists of therapist and client and all that goes on between them
• Client is a participant in a constantly changing field
• We have to constantly adjust to them, have to take this into consideration, what are the roles that are changing for individual

Question 9

explain figure formation process

Answer 9

How an individual organizes experiences from moment to moment (from one aspect of their life to another)

• Foreground (what has focus of attention ex. Being doctoral student, covid, election): figure
• Background (undifferentiated fields that we have not addressed or they are closed or completed ex. Something happened in past): ground

Question 10

explain organismic self-regulation

Answer 10

• Emergence of need sensations and interest disturb an individual’s equilibrium
• What may be in the background, we ask the client to think about / bring it to the foreground

Question 11

explain gestalt photos

Answer 11

old woman and young woman (there is more than what you originally see, what you see first is what is in the foreground, are you able to see what is in the background); two faces and candle stick/vase; two people about to kiss or a woman in the dress

• What does person see and what do they see in the moment
• Are they able to look at multiple perspectives, you want them to integrate multiple aspects

Question 12

explain our power is in the present

Answer 12

• Nothing exists except the “now”
• The past is gone and the future has not yet arrived
• Pathology occurs because they lost the power of the present, what is going on right now,, people end up focusing on past mistakes and not what they can do right now

Question 13

explain the power being lost for many people

Answer 13

• They may focus on their past mistakes or engage in endless resolutions and plans for the future
• Focuses on non-verbals, body posture, gestures
• Instead of questions like “why”, “what” and “how” (what are you feeling right now, where do you feel that)

Question 14

explain unfinished business

Answer 14

Feelings about the past are unexpressed

• These feelings are associated with distinct memories and fantasies
• Feelings not fully experienced linger in the background and interfere with effective contact
• Have to fully experience these feelings and experiences or else it can lead to pathology
• Blockages in body (physical symptoms), if you do not deal with something in past it will manifest itself physically, we are at an impasse where we feel stuck if we do not deal with something

Question 15

result of unfinished business/power of present lost

Answer 15

Preoccupation, compulsive behavior, wariness oppressive energy and self-defeating behavior

Question 16

explain contact

Answer 16

Interacting with nature and with other people without losing one’s individuality

Question 17

explain boundary disturbances/resistance to contact

Answer 17

The defenses we develop to prevent us from experiencing the present fully
-Five major channels of resistance:

Question 18

what are the five major channels of resistance

Answer 18

1) Introjection: turning experiences of others to self
- Ex. Parents want me to be a doctor, not engaging in autonomous way, also can be negative if they hear negative things about self from others

2) Projection: feelings person is experiencing that they put onto someone else
- Ex. I want my child to be a doctor, so I tell them “you want to be a doctor, you want to go into medicine)

3) Retroflection: take out what we feel towards others onto ourselves
- Manifests in self harm
- Ex. Angry with partner and instead of expressing it to them, we punch wall instead

4) Deflection: distraction, we are talking about something personal (emotions or feelings) and we deflect to not be able to talk about what is meaningful

5)Confluence: when there is a blurriness between the outside world and what someone is expected to do, you internalize it and take it as own
Ex. Outside world expects you to be professional and reserved, and you end up saying that is your personality

Question 19

six components of gestalt therapy methodology

Answer 19

1) The continuum of experience: in therapy will focus on the whole experience of person and presenting problem, not just one aspect
2) The here and now: not focusing on what was in the past

3) The paradoxical theory of change: focusing on what is vs. what is not, we are constantly worried about what we do not have
- Ex. If the client is saying “I am sad”, you say “can you focus on not being sad?” what does that look like
- If you love a person so much, look at what you do not like

4) The experiment: in-the-moment exercises, you might do the empty chair, pretend I am the mom and you talk to me like I am your mom
- Spontaneous exercises client engages with, with therapist

5) The authentic encounter: genuineness you share with client
- Call people out for being fake/phony, be honest about feedback and what you are experiencing

6)Process-oriented diagnosis: therapist does not diagnose or test, but they process; conceptualize person through the process and what is happening in the moment, help client establish awareness autonomy & self-awareness

Question 20

therapeutic techniques

Answer 20

-The experiment in Gestalt Therapy: exercises/spontaneous experience to engage in with client

Internal dialogue exercise
-We have something called a top dog and underdog, top dog is demand expectations of what we should do, underdog is what we end up doing the silenced part more victimized we do things we do not really want to do

Rehearsal exercise
-Client practices or rehearses experiences

Reversal technique
-Client talking to another part of self, see themselves as really sweet so you have them express aggressive part; if they see themselves as lazy tap into the hardworking part

Exaggeration exercise
-Gestalt therapist exaggerates movement, asks someone to do something over and over again, used to access feelings/frustrations so she can find the words and process what she was feeling

Staying with the feeling
-Reflect on feelings

Making the rounds

• Done in group therapy, you speak to each member of the group and talk about what you need from each member in group
• All people in group are part of experience and you need something from each of them

Dream work
-Reliving every part of dream, no part is insignificant

Question 21

stages of change/levels of neuroses

Answer 21

1) Phony layer: clients come into treatment because they are trying to be what they are not
a. Come into therapy because don’t care about others

2) Phobic layer: aware of fears that force them into phony game
a. Realize they do care, but fear of rejection

3) Impasse layer: shed environmental supports to keep phoniness, but do not know better way to cope
a. Constantly worried about rejection and do not know how to engage with people in other ways, stuck

4) Implosive layer: aware of how they limit themselves by engaging in phoniness and experiment with new behaviors
a. Figure out other ways of being with people, try to connect with people, find people who they feel safe with

5) Explosive layer: discover unused energy tied into this phony existence, and find a more authentic way of living
a. Start to realize they are engaging with people in a better way, start to feel better about selves and no longer feel they do not care about people, feels authentic

Question 22

limitations

Answer 22

• The approach has the potential for the therapist to abuse power by using powerful techniques without proper training
• This approach may not be useful for clients who have difficulty abstracting and imagining
• The emphasis on therapist authenticity and self-disclosure may be overpowering for some clients
• The high focus on emotion may pose limitations for clients that come from cultures where it is valued to be emotionally reserved

Question 23

what we learned from video

Answer 23

• Think about environment and roles in Gestalt and how they intersect
• Unfinished business people experience and how it contributes to presenting problem, and what ways it contributes to contact / resistance to contact