Gestalt therapy is an existential, phenomenological and process-based approach created on the premise that individuals must be understood in the context of their ongoing relationship with the environment. The initial goal for the client to expand their awareness of what they are experiencing in the present moment, Through this awareness change automatically occurs. The approach is phenomenological because it focuses on the clients perceptions of reality and existential because it is grounded in the notion that people are always in the process of becoming, remaking, and rediscovering themselves. Gestalt therapy gives special attention to the existence as individuals experience it and affirms the human capacity for growth and healing through interpersonal contact and insight. Focuses on the here and now, the what and how of experiencing, the authenticity of the therapist, active dialogic inquiry and exploration, a dialogical relationship and the I/Thou of relating.
Fritz Perls was the main originator and developer of Gestalt Therapy. He took issue with Freuds theory on a number of grounds:
- Freuds view of human beings is basically mechanistic, perls stressed a holistic approach to personality.
- Freud focused on repressed intrapsychic conflicts from early childhood, Perls valued examining the present situation
- Focuses much more on the process than on content
- Therapists putting themselves as fully possible into the experience of the client without judgement, analyzing or interpreting while concurrently holding a sense of ones individual, independent presence.
- Perls asserted that how individuals behave in the present moment is far more crucial to self-understanding than why they behave as they do.
Awareness is paying attention to the flow of your experience and being in contact with what you are doing when you are doing it. Self-acceptance, knowledge of the environment, responsibility for choices and the ability to make contact with their field and the people in it are important awareness processes and goals all of which are based on here and now experiencing that is always changing.
Contemporary relational Gestalt therapy stresses dialogue and the I/Thou relationship between client and therapist. Therapists emphasise the therapeutic relationship and work collaboratively with clients in a search for understanding. This model includes more support and increased sensitivity and compassion in therapy than the confrontational and dramatic style of Perls. Gestalt therapy is an experimental approach in that clients come to grips with what and how they are thinking, feeling, and doing as they interact with the therapists.
Key concepts:
The Gestalt view of human nature is rooted in existential philosophy, phenomenology and field theory. Therapy aims at awareness and contact with the environment which consists of both the external and internal worlds. Due to this view of human nature, Perls practiced Gestalt therapy paternalistically. Two personal agendas: moving the client from environmental support to self-support and reintegrating the disowned parts of ones personality. A basic assumption of Gestalt therapy is that individuals have the capacity to self-regulate when they are aware of what is happening in and around them. The therapists is attentive to the clietns present experiences and trusts in the process, thereby assisting the client in moving toward increased awareness, contact and integration. Arnie Beisser 1970 suggested the authentic change occurs more from being who we are than from trying to be who we are not. Beisser called this simple tenet the paradocial theory of change.
Some Principles of Gestalt Therapy Theory:
Holism – Gestalt is a German word meaning a whole or completion or a form that cannot be separated into parts without losing its essence. Gestalt practice attends to a clients thoughts, feelings, behaviours, body, memories and dreams.
Field Theory – which simply put, asserts that the organism must be seen in its environment or in its context as part of the constantly changing field. Emphasis may be on a figure or the ground. This is often referred to by Gestalt therapists as ‘attending to the obvious’ while paying attention to how the parts fit together how the individual makes contact with the environment and integration.
The Figure Formation Process – derived from the study of visual perception by a group of Gestalt psychologists, the figure-formation process tracks how the individual organises experience from moment to moment as some aspect of the environmental field emergers from the background and becomes the focal point of the individuals attention and interest. The dominant needs of the individual at a given moment influence this process.
Organismic Self-Regulation – the figure-formation process is intertwined with the principle of organismic self-regulation a process by which equilibrium is disturbed by the emergence of a need, a sensation or an interest. Gestalt therapists direct the clients awareness to the figures that emerge from the background during a therapy session and use the figure-formation process as a guide for the focus of therapeutic work.
Contact and Resistances to Contact - contact is made by seeing, hearing, smelling, touching and moving. Effective contact means interacting with nature and with other people without losing one sense of individuality. After a contact experience, there is typically a withdrawl to integrate what has been learned. Gestalt therapists talk about the two functions of boundaries; to connect and to separate. Both contact and withdrawal are necessary and important to healthy functioning. Gestalt therapists also focus on interruptions, disturbances, and resistances to contact, which were developed as coping processes but often end up preventing us from experiencing the present in a full and real way. Gestalt therapists refer to them as contact boundary phenomena. Polster and Polster 1973 describe 5 different kinds of contact boundary disturbances: introjection, projection, retroflection, deflection and confluence.
Introjection – is the tendency to uncritically accept others beliefs and standards without ssimilating them to make them congruent with who we are. If we remain in this stage, our energy is boung up taking things as we find them and believing that authorities know what is best for us rather than working for things ourselves.
Projection – is the reverse, we disown certain aspects of ourselves by assigning them to the environment. People who use projection as a pattern tend to feel that they are victims of circumstances and they believe hat people have hidden meanings behind what they say.
Retroflection – consists of turning back onto ourselves what we would like to do to someone else or doing to ourselves what we would like to do to or for us. This process is principally an interruption of the action phase in the cycle of experience and typically involves a fair amount of anxiety. Typically, these maladaptive styles of functioning are adopted outside of our awareness; part of the process of Gestalt therapy is to help us discover a self-regulartory system so that we can deal realistically with the world.
Deflection – the process of distraction or veering off so that it is difficult to maintain a sustained sense of contact. When we deflect, we speak through and for others, beating around the bush rather than being direct and engaging the environment in an inconsistent and inconsequential basis which results in emotional depletion.
Confluence – involves blurring the differentiation between the self and the environment. As we strive to blend in and get along with everyone, there is no clear demarcation between internal experience and outer reality. This conditions makes genuine contact extremely difficult. A therapist might assist clients who use this channel of resistance by asking questions, such as, what are you doing now. Terms such as interruptions in contact or boundary disturbance refer to the characteristic styles people employ in their attempts to control their environment through one of these channels of resistance. It is important to explore what the resistance does for clients: what it protects them from, and what it keeps them from experiencing.
The Now:
Polster 1973 – developed the thesis that power is in the present. As clinets direct their energy toward what was or what might have been or live in fantasy about the future, the power of the present diminishes. Phenomenological inquiry involves paying attention to what is occurring now. Clients often talk about their feelings most as if their feelings were detached from their present experiencing. One of the aims of Gestalt therapy is to help clients become increasingly aware of their present experience. To help a client make contact, therapists ask what and how questions to promote now awareness, they will ask now questions. Phenomenological inquiry also involves suspending any preconceived ideas, assumptions, or interpretations concerning the meaning fo a clients experience. Gestalt therapists recognize that the past will make regular appearances in the present moment, usually because of some lack of completion of that past experience. The therapists directs clients to bring the fantasy here.
Unfinished Business:
When figures emerge from the background but are not completed and resolved, individuals are left with unfinished business, which can be manifested in unexpressed feelings such as resentment, worry, rage, hatred, pain, anxiety, grief, guilt and abandonment. Unfinished business often relates to feelings that have been left over from interpersonal relationships and persists until the individual faces and deals with the unexpressed feelings. The impasse or stuck point occurs when external support is not available or the customary way of being does not work. Gestalt therapy is based on the notion that individuals have a striving toward actualisation and growth and that if they accept all aspects of themselves without judging these dimensions they can begin to think, feel and act differently.
Energy and Blocks to Energy:
When energy is blocked, it may result in unfinished business. In Gestalt therapy special attention is given to where energy is located, how it is used, and how it can be blocked. Blocked energy is another form of defensive behaviour. Clients many not be aware of their energy or where it is located and they many experience it in a negative way. Clients can be encourgaged to recognise how their resistance is being expressed in their body. Rather than trying to rid themselves of certain bodily symptoms, clients can be encouraged to delve fully into tension states and bodily symptoms.
Therapeutic Goals:
Gestalt therapy does not ascribe to a goal-orientated methodology per se, but therapists clearly attend to a basic goal – namely assisting the client to attain greater awareness and with it, greater choice. Without awareness clients do not possess the tools for personality change. With awareness they have a the capacity to face, accept, and integrate denied parts as well as to fully experience their subjectivity. Through a creative involvement in Gestalt process, Zinker 1978 expects clients will do the following:
- Move toward increased awareness of themselves
- Gradually assume ownership of their experience
- Develop skills and acquire values that will allow them to satisfy their needs without violating the rights of others
- Become more aware of all of their senses
- Learn to accept responsibility for what they do
- Be able to ask for and get help from others and be able to give to others
Therapists Function and Role:
The Gestalt therapists job is to invite clients into an active partnership where they can learn about themselves by adopting an experimental attitude toward life. Therapists set aside their biases and suspend assumptions and expectations in order to pay attention to what is emerging in their presence. Contemporary Gestalt practitioners view clients as the experts o their own experience and encourage them to attend to their sensory awareness in the present moment. Yontef 1993 – stresses that although the therapists function as a guide and a catalyst, presents experiments, and share observations, the basic work of therapy is done by the client. Gestalt therapists do not force change on clients through confrontation. Instead they work within a context of Thou/I dialogue in a here and now framework. An important function of Gestalt therapists is paying attention to clietns body language. The therapists need to be alert for gaps in attention and awareness and for incongruities between verbalisations and what clients are doing with their bodies. Therapists can ask clients to become aware of what their laughter might mean. Can mask feelings of pain and anger. Emphasis on the relationship between language patterns and personality. Language can both describe and conceal. ‘It Talk’ ‘you talk’ submitted with I instead. Questions – put questions into statements instead. Language that denies power – maybe, perhaps. Listening to clients metaphors, listening for language that uncovers a story. Polsters challenge to make sure that he not only kep the therpists interested by also presented himself in a way to keep those in the audience interested. Believes that story telling is not always a form of resistance. Instead it can be the heart of the therapeutic process.
Clients Experience in Therapy:
The general orientation of Gestalt therapy is toward dialogue, an engagement between people who each bring their unique experiences to that meeting. Other issues that can become the focal point of therapy include the client-therapist relationship and the similarities in the ways clients relate to the therapist and to others in their environment. Gestalt therapists do not make interpretations that explain the dynamics of an individuals behaviour or tell a client why he or she is acting in a certain way because they are not the experts on the clients experience. Miriam Polster 1987 – described a 3 stage integration sequence that characterises client growth in therapy.
- The first part of this sequence consists of discovery – clients are likely to reach a new realisation
- The second part is accommodation – involves clients recognising that they have a choice, try out new behaviours
- The third stage is assimilation – clients learning how to influence their environment.
Relationship between therapist and client:
Involves a person-to-person relationship between therapist and client. They are also responsible for establishing and maintaining a therapeutic atmosphere that will foster a spirit of work on the clients part. However, therapists need to be thoughtful about what and when they share. Not only allow their clients to be who they are but also remain themselves and do not get lost in a role. Further, they give feedback that allows clients to develop an awareness of what they are actually doing. They warn of the dangers of becoming technique-bound and losing sight of their own being as they engage with the client. The therapists attitudes and behaviour and the relationship that is established are what really count. Many contemporary therapists place increasing emphasis on factors such as presence, authentic dialogue, gentleness, more direct self-expression by the therapist, decreased use of stereotypic exercises, and greater trust in the client experiencing. A current trend in Gestalt practice is toward greater emphasis on the client therapist relationship, and therepists who operate from this orientation are able to establish a present-centered, nonjudgment dialogue that allows clients to deepen their awareness and to make contact with another person. Polster and Polster 1973 – emphasise the importance of therapist knowing themselves and being therapeutic instruments. Therapists are more than mere responders or catalysts. Experiments should be aimed at awareness not at simple solutions to a client problem.
The experiment in Gestalt Therapy
Developing a variety of interventions is simple, but employing these methods in a mechanical fashion allows clients to continue inauthentic living. In clients are to become authentic they need to contact with an authentic therapist. Exercises are ready made techniques that are sometimes used to make something happen in therapy session or to achieve a goal. Experiments in contrasts grow out of the interaction between client and therapists and they emerge within this dialogic process. In Gestalt therapy, an experiment is an intervention and active technique that facilitates the collaborative exploration of a clients experience. Experiments give people a change to be systematic in learning by doing and are best thought of as ways of exploring a clients experiential world. Experiments are a key part of the ongoing dialogue between the client and therapist, not a method to fix the client or to make the therapy process more exciting. These dramatic enactments are designed to increase the clients awareness and learning. Gestalt experiments are a creative adventure and a way in which clients can express themselves behaviourally. Experimentation is an attitude inherent in all Gestalt therapy; it is a collaborative process with full participation of the client. Polster 1987 says that an experiment is a way to bring out some kind of internal conflict by making this struggle an actual process. It is aimed at facilitating a clients ability to work through the struck points of his or her life. Clients may experience the feelings associated with their conflicts as experiments bring struggles to life by inviting clients to enact them in the present. It is crucial that experiments be tailored to each individual and used in a timely and appropriate manner; they also need to be carried out in a context that offers a balance between support and risk. It is important for counsellors to personally experience the power of Gestalt experiments and to feel comfortable suggesting them to clients.
Preparing clients for Gestalt Experiments:
Clients will get more from Gestalt experiments if they are oriented and prepared for them. If clients are to cooperate, counsellors must avoid directing them in a commanding fashion to carry out an experiment. Gestalt therapists expect and respect the emergences of reluctance and meets clients wherever they are. Gestalt experiments work best when the therapist is respectful of the clients cultural background and has a solid working alliance with the person. Contemporary Gestalt therapy places much less emphasis on resistance than the early version of Gestalt therapy. Frew 2013 – argues that the notion of resistance is completely foreign to the theory and practice of Gestalt therapy and suggests that resistance is a term frequently used for clients who are not doing what the therapist wants them to do. Polster 1976 – suggest that it is best for therapists to observe what is actually and presently happening rather than trying to make something happen. Maurer 2005 write about appreciate resistance as a creative adjustment to a situation rather than something to overcome. It is well to remember that Gestalt experiments are designed to expand clients awareness and to help them try out new modes of behaviour. An experimental attitude in the therapeutic process involves the client input and allows what emerges between client and therapist to guide the direction of the therapy. This heightens the awareness of a particular aspect of functioning which leads to increased self-understanding.
The role of Confrontation:
Students are sometimes put off by their perception that a Gestalt couselors style is direct and confrontational. The contemporary practice of Gestalt therapy has progressed beyond the style. According to Yontef 1999 contemporary relational Gestalt therapy has evolved to include more support and increased kindness and compassion in therapy. In contemporary Gestalt therapy, confrontation is set up in a way that invites clients to examine their behaviours, attitudes and thoughts. Further, confrontational does nto have to be aimed at weaknesses or negative traits; clients can be challenged to recognise how they are blocking their strengths. Therapists who care enough to make demands on their clients are telling them in effect that they could be in fuller contact with themselves and others.
Gestalt Therapy Interventions:
Some therapists operate on the erroneous assumptions that the practice of Gestalt therapy consists of a bag of tehcniques that define the therapy, but as Resnick 2015 states, techniques and exercises are the least important part of Gestalt Therapy. There interventions fit the therapeutic sitation and highlight what ever the client is experiencing.
The internal Dialogue Exercise – top dog vs underdog – top dog is authoritarian, demanding, moralistic, boss and manipulative, underdog is playing the role of the victim. Engaged in a constant struggle for control. The civil war between the two sides continues with both sides fighting for their existence. The conflict between the two opposing poles in the personality is rooted in the mechanism of introjection, which involves incorporating aspects of others usually parents, into ones personality.
The empty-chair technique – useful in bringing into consiouness the fantasies of what the other might be thinking or feeling. This is role-playing. There are many applications for this technique. One of the more important uses is to explore what another person in ones social network might be feeling and what that person more realistic predicament might be. Further by helping clients realise that the feeling is very real part of themselves, the intervention discourages clients from disassociating the feeling.
Future-Projection Technique – often associated with psychodrama, is designed to help clients express and clarify concerns they have about the future. These concerns may includes wishes and hopes, dreaded fears of tomorrow or goals that provide some direction to life.
Making the rounds – asking a person in a group to o up to others in the group and either speak to or do something with each person. The purpose is to confront, to risk, to disclose the self, to experiment with new behaviour and to grow and change.
The Reversal Exercise – thus the therapist could ask a person who claims to suffer from severe inhibitors and excessive timidity to play the role of the exhibitionist. This technique can help clients begin to accept certain personal attributes that they have tried to deny.
The rehearsal exercise – When clients share their rehearsals out loud with a therapist, they become more aware of the many preparatory means they use in bolserting their social roles.
The exaggeration exercise – movements, postures, and gestures may communicate significant meanings yet the cues may be incomplete. If a client repost that his or her legs are shaking, the therapist may ask the client to stand up and exaggerate the shaking.
Staying with the feeling – facing and experiencing feelings not only takes courage but also is a mark of a willingness to endure the pain necessary for unblocking and making way for newer levels of growth.
The Gestalt approach to Dream work – does not interpret and analyse dreams, instead the intent is to bring dreams back to life and relive them as though they were happening now. By engaging in a dialogie between these opposing sides, the client gradually becomes more aware of the range of his or her on feelings. Perls concept of projection is central in his theory of dream formation; every person and every object in the dream represents a projected aspect of the dreamer. Suggested that we start with the impossible assumption that whatever we believe we see in another person or in the world is nothing but a projection. The dream is the most spontaneous expression of the existence of the human being. It represents an unfinished situation, but every dream also contains an existential message regarding oneself and ones current struggle.
Application to Group Counselling:
Is to heighten awareness and self-regualtion through interactions with one another and the group itself. Gestalt therapy encourages direct experience and actions as opposed to merely talking about conflicts, problems, and feelings. Moving from talking about to action is often done by the use experiments in a group. When one member is the focus of work, other members can be used to enhance an individuals work. These experiments need to be tailored to each group member and used in a timely manner; they also need to be carried out in a context that offers a balance between support and risk. Gestalt leaders are especially concerned with awareness, contact and experimentation. If members experience the group as being a safe place, they will be inclined to move into the unknown and challenge themselves. We work collaboratively with our clients to discover how to best help them resolve the difficulties they experience internally, interpersonally and in the context of their social environment.
Strengths from a diversity perspective:
Frew 2013 – notes that contemporary Gestalt therapy can be useful and effective approach with clients from diverse backgrounds because it takes the clients context into account. Can be tailored to fit the unique wat in which an individual perceives and interprets his or her culture. Fernbacher and Plummer 2005 stresses the importance of assisting Gestalt therapy trainees in developing their own awareness and contend: to undertake work across cultures from a Gestalt perspective, it is essential that we explore our own cultural selves, to make contact and encourage contact in and with others we need to know about ourselves.’ Effective in helping people integrate the polarities within themselves. There are many opportunities to apply Gestalt experiments in creative ways with diverse clients population.
Shortcomings from a Diversity perspective:
Therapists who operate on the assumption that catharsis is necessary for any change to occur are likely to find certain clients becoming increasingly reluctant to participate in experiments, such clients may prematurely terminate counselling. Methods can lead to a high level of intense feelings. Gestalt therapists who have truly integrated their approach are sensitive enough to practice in a flexible way.
Contributions:
The exciting way in which the past is dealt with in a lively manner by bringing relevant aspects into the present.
Methods bring conflicts and human struggles to life.
Working with dreams is a unique pathway for people to increase their awareness of key themes in their life.
Holistic approach that values each aspect of the individuals experience equally.
The attempt to integrate theory, practice and research
Outcome studies have demonstrated Gestalt therapy to be equal or greater than other therapies
Beneficial impacts with personality disturbances, psychosomatic problems and substance abuse
Tend to be stable in follow up studies on to 3 years after termination of treatment
Demonstrated effectiveness in treating a variety of psychological disorders.
Limitations:
- Emphasises confrontation and de-emphasising the cognitive factors of personality.
- Places high value on the contact and dialogue between therapist and client
- There is a danger that therpists who are inadequately trained will be primarily concerned with impressing clients
- Therapists are highly active, exhibit sensitivity, timing, inventiveness, empathy and respect for the client. If therapists lack these qualities, their experiments can easily boomerange. Competent practitioners need to have engaged in their own personal therapy and to have had advanced clinical training and supervised experience.
