text:
Gestalt Theory
- Overview
- Basic Concepts
- Other Systems
- History
- Gestalt Personality Theory
- Gestalt Psychotherapy
- Mechanisms of Psychotherapy
- Applications
- Treatment
- Summary
Frederick Perls and Laura Perls were the founders of Gestalt therapy as a phenomenological-existential therapy in the 40-s of the last century. Both therapists and patients can learn the phenomenological awareness method. According to this method one should see the difference between perceptions, feelings, actions and interpretation and reshuffling attitudes existed before. Explanations alongside with interpretations are regarded not so trustworthy than perceptions and feelings. Patients and therapists dialogue in Gestalt therapy. It means that they communicate their phenomenological perspectives. Differences in perspectives are in the center of experimentation and continuous dialogue. The clients should understand what actions they are performing, in what way they are performing it, and how it is possible for them to alter themselves and to discover at that how to accept and appreciate themselves.
Gestalt therapy highlights more the process (what is taking place) and not the content (what is said about it). The stress is on what is happening, considered and felt right now rather than on what took place, might, could or should happen.
Basic Concepts
The Phenomenological Perspective
Phenomenology is a subject which assists people to keep away from the ordinary way thinking, therefore it is possible to distinguish between the actual perception, feelings and the previous experience residue (Idhe, 1977). A Gestalt examination values, employs and makes clear instant and "naive" perception and this perception is "undebauched by learning". (Wertheimer, 1945, p.331.) Gestalt therapy regards what is felt "subjectively" at the moment and objective observation too as actual and essential data. This is different from the approaches considering what the person experiences as "mere appearances" and interpretation is used by them to discover "real meaning."
Gestalt phenomenological exploration is aimed at awareness, or insight. Insight is a creation of patterns of perceptual field in this way that the important realities are apparent; it is a creation of a gestalt when the essential factors begin to make sense with reference to the whole" (Heidbreder, 1933, p. 355). As for the Gestalt therapy, insight here is complete understanding of the structure of the situation under observation.
Awareness should go with systematic exploration otherwise it is not usually sufficient to reach insight. This is the reason why Gestalt therapy makes use of focused awareness in addition to experimentation to reach the goal and develop insight. The way the patient becomes aware is decisive to every phenomenological investigation. It is not just personal awareness the phenomenologist studies but the process of awareness itself as well. The patient should understand how to be aware of awareness. The way the therapist and the client experience their relationship is of particular importance (Yontef, 1976, 1982, 1983).
The Field Theory Perspective
The scientists think that Gestalt phenomenological perspective is based on field theory. Field theory is an exploration method describing the entire field and the event being its piece rather than evaluating the event expressing the concept of a class, one belongs to by nature (Aristotelian classification can be an example of it) or a historical and cause-effect sequence (for instance, Newtonian mechanics).
Being a whole, the field consists of such parts as immediate relationship and they influence each other with all parts involved. The field becomes a substitute for separate constituents' notions. The person in somebody's life space is a part of a field.
There is no act in field theory, which is at a distance; this means that everything having effect must involve things affected in space and time. Gestalt therapists make effort in "the here and now" and are perceptive to the way "the here and now" comprise things left from the past, like behavior, principles, lifestyle and body posture.
The phenomenological field is characterized by the one observing it and it is significant just when the person is aware of the observer's frame of reference. The observer is needed since what is seen by him is a function to some extent of how and when the person looks.
Field approaches more describe than speculate, interpret, or classify. The stress is on looking, describing, and clarifying the accurate structure of the thing being studied. If there is no access to facts by means of therapist's direct observation in Gestalt therapy, then they are studied by means of phenomenological focusing, experiments, participants' reporting and dialogue (Yontef, 1982, 1983).
The Existential Perspective
Existentialism has the phenomenological method in its basis. Existential phenomenologists bring into focus existence of people, their relations with other people, happiness and pain, and so on, as experienced directly.
The majority operates in the context of conventional thought which distorts or keeps away from acknowledging how the world is. This is particularly true of person's relations in the world and choices made. Self-delusion is the reason for inauthenticity: living not based on the real facts about oneself in the world brings to feelings of fear, guilt and concern. Gestalt therapy gives the patient authenticity and meaningful responsibility. Becoming aware, the person can choose and arrange his existence with a meaningful approach (Jacobs, 1978; Yontef, 1982, 1983).
The existential view is that every person continually discovering and remaking themselves. Human nature is not discovered once and forever. All the time new horizons, new challenges and new possibilities appear.
The relationship of the therapist and the patient is one of the most significant matters of psychotherapy. Existential dialogue is an important part of methodology in Gestalt therapy. It demonstrates the existential perspective on relationship.
Relationship develops out of contact. Every person grows and forms identity through contact. During contact the boundary is defined between "me" and "not-me." Contact appears when one deals with the "not-me" (in this case "the other person") while keeping a self-identity apart from the "not-me". Martin Buber affirms that one ("I") has meaning barely with regard to others, in the dialogue "I-Thou" or in contact of manipulative kind "I-It". Gestalt therapists like the dialogue scheme better experiencing the client than "I-It" scheme - therapeutic manipulation.
Gestalt therapy assists patients to build up their support for preferred contact or withdrawal (L. Perls, 1976, 1978). Support means anything making contact or withdrawal achievable, such as energy, support of body, breathing, data, interest in others, language, and et cetera. Support activates means for either contact or withdrawal. For instance, to support the enthusiasm coming with contact, one should have sufficient oxygen.
The Gestalt therapist is occupied with involving the client into dialogue rather than by means of manipulation aimed to reach certain therapeutic goal. The signs of this contact are simple caring, warm attitude, approval and self-responsibility. As therapists lead patients to certain aim, the clients cannot be responsible for their development and self-support. Dialogue is founded on experiencing the individual to make him reveal the real self and share this way phenomenological awareness. The Gestalt therapist explains what the person means and persuades the client to act the same way. Gestalt dialogue is based on genuineness and responsibility.
In Gestalt therapy the therapeutic relationship accentuates 4 attributes of dialogue:
1. Inclusion. This is immersion into the experience of the person without judgment, analysis or interpretation while maintaining a sense of one's detached, independent presence at the same time. The phenomenological trust in direct experience is revealed here through interpersonal and existential application. Inclusion grants an environment of protection for the client's phenomenological work and, in the course of communication the understanding of the client's experience, contributes to sharpening of the client's the self-awareness.
2. Presence. The Gestalt therapist opens herself to the patient. Remarks, fondness, feelings, private experience and opinions are expressed on a regular basis, sensibly, and with discrimination. The therapist shares with the client her perspective. This way the therapist forms phenomenological reporting, which contributes to client's learning of trust and application of immediate experience to increase awareness. If the therapist counts on interpretation which is derived from theory more than relying on personal presence, she makes the patient trust the phenomena not thanks to his own direct experience as the instrument for increasing awareness. The therapist does not utilize presence in Gestalt therapy to influence the patient by means of manipulation to comply with the goals set before, but rather induces clients to control themselves on their own.
3. Commitment to dialogue. Contact means something deeper than just something two persons do to each other. Contact is a process, which takes place between people. Contact arises from the communication between them. The Gestalt therapist is involved in this interpersonal procedure. This is closer to letting contact occur than making contact, manipulating, and calculating the effect.
4. Dialogue is lived. Dialogue is closer to action rather than words. "Lived" stresses the enthusiasm and closeness of doing. The dialogue can have various modes, such as dancing, words, songs, or any method expressing and moving the energy between the parties. A significant input of Gestalt theory to phenomenological experimentation is expanding the parameters in order to embrace explanation of experience in nonverbal way. On the other hand, the interaction is restricted by such aspects as ethics, correctness, therapeutic assignment, and et cetera.
Other Systems
Yontef remarks that:
The theoretical difference between behavior modification, Gestalt therapy and psychoanalysis is obvious. In psychoanalytic theory, actions are caused by unconscious incentive which is disclosed in the transference relationship. Scrutinizing the transference the repression appears and the unconscious turns into conscious. In Gestalt therapy the patient studies to use his internal and external senses completely. This is necessary to be self-responsible and self-supportive. In behavior modification, the behavior of the client is altered by the therapist's manipulation of external environmental stimuli. Gestalt therapy assists the person to find the key to the state and to be aware of the process of awareness. Behavior modification requires usage of stimulus control, psychoanalysis can help the client by speaking about and discovering the reason for mental problem. As for the Gestalt therapy, here-and-now experience in directed awareness leads self-realization. (1969, pp. 33-34)
Behavior modification as well as other therapies that first and foremost attempt to take control over symptoms (for instance, chemotherapy, electroconvulsive therapy, hypnosis, and so forth.) differs radically from psychodynamic therapies and Gestalt therapy and in that the systems promote change mostly by learning of the client to understand himself in the world by means of insight.
The methods of Gestalt therapy and psychodynamic therapy employ an accepting relationship and a technology to assist the client to have changes through both emotional and cognitive understanding of oneself. In psychoanalysis free association behavior of the person is considered to be the basic; the main instrument of the psychoanalyst is interpretation. To support transference, the analyst keeps away from direct expression of being an individual (no "I" assertions) and follows the "Rule of Abstinence"; that means, the therapist does not please any wishes of the patient. The same approach works in psychodynamic schools: object relations, classical, ego psychological, Jungian, Kohutian. The psychodynamic therapist separates the person to build a relationship plainly on transference.
Gestalt therapy develops understanding using the energetic, curing therapist's presence and presence of the patient. The relationship is founded on true contact at that. The methods of transference, examined and worked through as soon as it arises, are not supported in Gestalt therapy (Polster, 1968). In Gestalt therapy characterological matters are plainly dealt with through the dialogue as well as phenomenological method.
Gestalt therapists use actively the direct experience of the person. Differing from free associate who is passive and waits for the interpretation of the therapist and later change, the patient is regarded as an active participant who should learn the way to self-heal. The client "works", which differs from behavior of free associates. "What should I do to influence this?" is a usual question in Gestalt therapy and there is a solution. For instance, a couple which has some sexual problems might be offered to apply sensate focusing.
Unlike any other therapy, Gestalt therapy stresses that experience is more trustworthy than interpretation. The patient learns the discrepancy between talking about what happened 5 minutes ago (or previous night or 20 years before that) and experiencing what is taking place at the moment.
A psychoanalyst Applebaum notices that
In Gestalt therapy the client learns fast to see the difference between ideas and ideation, between everyday paths and fresh thoughts, between a statement of a statement and a statement of experience. The Gestalt aim of pursuing experience and insight which comes into view is more effective than insight provided by the therapist. This helps the client and the therapist to determine and keep these essential distinctions. (1976, p. 757)
Therapies, similar to reality therapy, behavior modification and rational emotive therapy dealing with the client's experience are not able to do this. In Rogerian therapy the imposed upon the therapist obedience sternly limit the therapy power to instruct upon these distinctions.
Applying different therapy systems contributes to intellectualizing: speaking about the absurdity of client beliefs, speaking about the behavior alterations, the therapist considers what the client should do, and so on. The methodology of Gestalt therapy uses energetic techniques that explain experience. Gestalt therapists will frequently experiment trying new things during the therapy hour. More than any other therapy, the procedure of detection by means of experimentation in Gestalt therapy is the final point rather than the sensation, content or idea.
The psychoanalyst is able to utilize interpretation. The Rogerian can merely reflect and make clear. Gestalt therapists can make use of any methods and techniques when (a) their goal is increased awareness, (b) they come out of phenomenologic work and dialogue, (c) ethical practice parameters are taken into consideration.
The patient has power and is also responsible for the present. The patient interacted with the surrounding psychologically before and this interaction was mutual. He was not just a passive psychological trauma recipient. Let us suppose that we find out the following during family therapy: the client may have obtained humiliating messages from parents, put up with it and tried to cope with self-blame on his own, but continued to blame himself. This viewpoint is in conflict with psychodynamic attitudes, though in accordance with Adler's and Ellis's opinions.
This point of view gives clients opportunity to be in charge of their existence, and their therapy too. When the therapist considers that the earlier period influences the present time and that clients are under control of unconscious motivation not accessible to them, they are urged to count more on the therapist's interpretations and not on the autonomy.
In therapies when the therapist tries to modify the behavior of the client, the client's immediate experience and the experience of the therapist are not respected. This makes Gestalt therapy different from all other therapies. An offended client may contribute to awareness expressing anger. If the therapist offers this as a means of catharsis, it cannot be called the phenomenological focusing of Gestalt therapy.
Gestalt therapists do not use "shoulds." As a substitute for pointing out what should be, they emphasize awareness of something that is. What is, is. This keeps Gestalt therapists aloof from all therapists who "know" how the client "should" behave. For instance, modification of cognitive behavior, reality therapy and rational-emotive therapy - all try to transform patient attitudes the therapist considers to be absurd, immature or weird.
In spite of the fact that Gestalt therapy does not support the organismic assimilating process as it is aimed at cognitive explanatory intellectualizations, therapists working on the basis of Gestalt theory, do deal with belief systems. Gestalt therapy consists of explanatory thinking, explaining beliefs, and decisions of both parties what suits the client. Gestalt therapy points out thinking avoiding experience (obsessing) and urges thinking that sustains experience. Gestalt therapy keeps out from narcissistic attitude, teaching the client being out of contact and accelerating the self-discovery.
Many people assert that they practice transactional analysis (TA) and Gestalt therapy. More often they apply the TA theory and techniques of Gestalt therapy. Techniques are not so essential in Gestalt therapy. If they are applied used in an analytic way, these techniques have nothing to do with Gestalt therapy! This combination frequently terminates, puts off or neutralizes the awareness effort of the phenomenological-existential method. When notions of transactional analysis are integrated into a Gestalt structure, this combination is much better. So the client's life can be transferred and interpreted on Gestalt language and then experimental and dialogical work with the client continues.
To understand Gestalt definition correctly one should know its distinction from other therapies. Another distinction of Gestalt therapy from others is its authentic care about holism and multidimensionality. People demonstrate their sorrow in the way they act, reflect and sense. "Gestalt therapy looks upon the whole biopsychosocial field, considering organism/environment, as important. Gestalt therapy enthusiastically makes use of physiological, cognitive, sociological, motivational variables. The basic Gestalt theory does not exclude relevant dimension " (Yontef, 1969, pp. 33-34).
One of the co-founders of Gestalt therapy was Fritz Perls and it reflects partially the spirit of times when he lived. Having received the M.D. degree in 1926, Perls left for Frankfurt-am-Main to become an assistant of Kurt Goldstein. They worked at the Institute for Brain Damaged Soldiers and Professors Goldstein and Adhemar Gelb influenced him much there. He also got acquainted with Laura who became his wife later. At that point in time Frankfurt-am-Main can be called a center of intellectual life and Perls was subjected to influence of psychologists, psychoanalysts and existential philosophers, who had a leading role in Gestalt therapy in direct and indirect manner.
Fritz Perls started career of a psychoanalyst. He was under the direct influence of Karen Horney and Wilhelm Reich, Otto Rank and other specialists, who influenced his work indirectly. But Wilhelm Reich influenced Perls more than others. Wilhelm Reich was Perls' analyst in the beginning of the 1930s. Perls said that he was the first who drew his attention to the essential aspect of psychosomatic medicine - to the motoric system function of being an armor. (F. Perls, 1947, p. 3).
It is worthwhile mentioning three major influences on Perls' academic development. One of them was Sigmund Friedlander, a philosopher. Fritz Perls took up the notions of differential thinking from his philosophy as well as of creative indifference, which Perls mentions in his 1st book, Ego, Hunger and Aggression, written in 1947. The prime minister of South Africa, Jan Smuts, also exerted influence upon Perls when he moved to Africa together with his from Nazi Germany and then Holland was occupied by Nazi. Prior to career of politician, Smuts had written a book about holism and evolution which actually scrutinized the wider ecological "whole" from a Gestalt perspective. Smuts devised the word holism. And the third person, the semanticist, Alfred Korzybski, also affected Perls' thinking and development.
Laura Posner Perls cofounded Gestalt therapy together with her husband. Laura's influence upon husband was widely known. She also contributed to the book Ego, Hunger and Aggression. One chapter in it was written by her. When she met Fritz Perls, she was a student and studied phychology. In 1932 she received the D.Sc. degree in the Frankfurt University. She was also influenced by Martin Buber and Paul Tillich, who were existential theologians. Her contribution to Gestalt therapy is great, though there is little she wrote about the subject under her name (Rosenfeld, 1978).
In spite of the fact, that Fritz Perls became a training psychoanalyst, he was irritated by dogmas coming from established Freudian psychoanalysis. The 20s, 30s, and the 40s of the last century were times of protest against Newtonian positivism. It was so for all spheres of life and not only science (Einstein's field theory, for instance), was permeated by a phenomenological-existential influence, but art too in addition to theater and dance, architecture and so forth. Afterwards, phenomenological-existential influence on Gestalt therapy was also big. (Kogan, 1976). Here we can mention, for instance, acknowledgment of responsibility and alternative to create personal existence, the dominance of existence over essence, in addition to the existential dialogue.
Gestalt psychology gives Fritz Perls integrating framework principle for Gestalt therapy. Gestalt belongs to the pattern or model of a set of elements and Gestalt psychologists consider that organisms unconsciously perceive whole models or patterns and not some pieces of it. Full patterns have different characteristics and they are not noticed when you analyze parts. Perception is not a passive process. It is not an outcome of sense organs stimulation received in a passive way. Integral organization of everything about the person should be considered. Organisms have the capability for correct perception when native ability of immediate experience in point of here and now is used. The assignment of phenomenological research and therapy is to use this capability to achieve insight into the studied structure. People logically perceive the whole patterns when they happen, real awareness can be believed more than dogma and interpretation.
Fritz Perls wrote Ego, Hunger and Aggression in 1941-1942. When he published it first in South Africa in 1946, it had different title then: A Revision of Freud's Theory and Method. Later in 1966 its subtitle was altered to The Beginning of Gestalt Therapy. "Gestalt therapy" term was initially used as the book title, the co-authors of which were Frederick Perls, Ralph Hefferline and Paul Goodman (1951). Some time later the New York Institute for Gestalt therapy appeared and its headquarter was in the Perls' family apartment. Fritz and Laura Perls lived in New York City. There were seminars and workshops right in the apartment. Such people as Paul Weisz, Buck Eastman, Lotte Weidenfeld, Paul Goodman, Elliot Shapiro, Isadore From, Leo Chalfen, James Simkin, Iris Sanguilano and Kenneth A. Fisher studied then together with the Pearls.
In the 1950s, serious workshops were organized everywhere alongside with study groups. Prior to American Psychological Association Convention in New York in 1954, an intensive workshop with 15 experienced psychologists was given, which lasted for three days. Workshops of this kind took place in Cleveland, Los Angeles and Miami. The Cleveland study group was organized in the Gestalt Institute of Cleveland in 1955.
Fritz Perls went to live to the West Coast, when Simkin organized Gestalt therapy workshop for him in 1960. Perls, James Simkin and Walter Kempler arranged the first training workshops on Gestalt therapy in summer of 1964 at the Esalen Institute. They worked under the guidance of Perls and Simkin to 1968. When Fritz Perls moved to another country - to Canada, Simkin stayed at Esalen and went on training up to 1970, together with Robert W. Resnick, Irma Shepherd, Jack Downing, Robert L. Martin, and John Enright,.
In the beginning Gestalt theory introduced many ideas accepted later in the practice of eclectic psychotherapy. The enthusiasm of immediate contact between therapist and client, the emphasis on immediate experience, the application of active experimentation, the stress on the "here and now", the accountability of the patient, the awareness, the belief in organismic self-regulation, the mutual dependence between person and environment, the assimilation principle, and similar concepts were innovative, thrilling and scandalous for conservative-minded establishment. At that time the practice of psychotherapy was divided between the traditional approaches of psychoanalytic theory and the innovative Gestalt theory ideas. Gestalt definition was only forming then. This was a phase of development, when principles were integrated and the explanation and enucleation of the principles were left for the subsequent period. In this way Gestalt therapy also came into view and actively proclaimed about itself through contact with the therapist, but did not regard thoroughly what comprised a healing dialogic presence.
Current Status
There are no less than 62 Gestalt therapy institutes all over the globe, and their number is growing. Practically every big city in USA has one Gestalt institute as a minimum.
There is no national organization, no standards for institutes were established, for trainers and trainees. Consequently, every institute follows different criteria for training and membership selection. Many efforts were spent on arranging the conference in the past but they did not succeed. There are no standards for what represents good Gestalt therapy and a good Gestalt therapist. As a result, it is necessary for Gestalt therapy consumers to assess cautiously the educational, scientific, and training background of experts calling themselves Gestalt therapists or training on Gestalt therapy (see Yontef, 1981a, 1981b).
The Gestalt Journal is dedicated first and foremost to Gestalt therapy articles. Gestalt psychology articles are published in Gestalt Theory, as well as Gestalt therapy articles. Bibliographic details can be received from Kogan (1980), Rosenfeld (1981), and Wysong (1986).
With development of Gestalt training therapeutic practices which were common before have changed. For instance, former practice on Gestalt therapy frequently stressed the medical use of frustration, a misuse in notions of self-sufficiency, self-support, and an abrasive attitude of the client was understood by the therapist as manipulative. Due to this approach there was a tendency to develop the shame of shame-oriented patients. Gestalt psychology soft approach has changed a lot. Among the new things introduced were more self-expression by the therapist, accent on dialogues, reduced number of application of stereotypic techniques, more emphasis on explanation of character structure (with use of psychoanalytic notions), and bigger use of group practice.
So a client will discover a
stress on self-acceptance, a softer therapist's manner, more reliance
on the phenomenology of the client, and more unequivocal work with psychodynamic
subjects. The group process is highlighted more, in addition to relation
within a group between its members, and a decline in formal, tete-a-tete
work in group. Much more attention is drawn to theoretical exposition,
theoretical instruction and work with cognition upon the whole.
Gestalt Personality Theory
Theory of Personality
Ecological Interdependence: The Organism/Environment Field
The existence of the person is accompanied with differentiating self from other or with connecting self and other. The boundary has the two functions. To establish good contact with the world of the other person, it is required to try to reach out and discover own boundaries. Successful self-regulation embraces contact in which the person understands the novelty of the environment that is possibly nourishing or on the contrary toxic. It can be assimilated or refused. This type of differentiated contact undoubtedly brings growth (Polster and Polster, 1973, p. 101).
Mental Metabolism
The term "metabolism" is referred to in Gestalt therapy when it is employed as a metaphor for psychological functioning. People develop through biting off pieces of proper size (this can be applied not only to food but relationships and ideas too), then the phase of chewing comes (the same as consideration), and determining if it is nourishing or vice versa toxic. When it is nourishing, it is assimilated by the organism and it becomes the part of it. In case of toxic variant, it is rejected by the organism. This makes people rely on their taste and decision. Discrimination needs actively sensing without the stimuli and exteroceptive stimuli processing together with interoceptive data.
Regulation of the Boundary
The boundary set between person and environment should be penetrable to let exchanges, yet rather strong to be autonomous. One should be able to exclude toxins in the environment. But nourishing also should be discriminated in accordance with dominant needs. Metabolic processes are managed by the laws of homeostasis. The most vital need activates the organism until it is satisfied or is replaced by a more crucial need. Living is a succession of needs, either met or unmet, reaching homeostatic balance and moving to the new moment and next need.
Disturbances of the Contact Boundary
In case the boundary is unclear, gone or impassable, this leads to a disorder of the distinction between self and other, and then contact and awareness are disturbed too (see Perls, 1973; Polster and Polster, 1973). When boundary functions well, people change connecting and separating, and alternate between withdrawal from the environment and being in contact with it. The boundary of contact is gone in absolutely contradictory ways in joining together and separation. In fusion the isolation and distinction between self and other becomes uncertain then the boundary disappears. In isolation, the boundary turns solid that coherence is lost, that means that significance of others for the self is replaced from awareness.
Retroflection is a division within the self, a preventing the aspects of the self with the self. This replaces self for environment, like in doing to self what is desired to do to the other one or doing for self what is desired to do by the other one for self. This scheme brings to separation. The illusion of self-sufficiency is a sample of retroflection as it substitutes self for environment. Though one can breathe and chew for oneself, the air and food is provided by environment. Introspection is a type of retroflection which is either pathological or healthy. For instance, refusing to accept the impulse to convey anger can help to manage hazardous environment. Under the circumstances, biting one's lip can be more practical than biting words.
Via introjection foreign material is taken in without discriminating or assimilating. Swallowing whole contributes to creation of an "as if" personality and inflexible character. Introjected principles and actions are acquired in an imposing manner. Like in all disturbances of this kind (contact boundary), swallowing whole is at times normal or pathological, in accordance with the situation and level of awareness. For instance, students studying something on lectures, with complete awareness what they are doing, make a copy, remember and repeat the material without complete "digestion" or understanding.
Projection is a process when self and other are confused that is caused by ascribing to the outside something which is actually self. Art can be a model of healthy projection. But when the person does not have awareness and admits responsibility for something projected then pathological projection appears.
Deflection is the evasion of awareness and contact turning aside. It is similar to the situation when somebody is well-mannered instead of being direct. Deviation can be achieved by not telling directly or by refuse to receive. The person frequently feels either "untouched" or ineffective and puzzled as he does not obtain what is desired by him. Deflection can be of use where, with awareness, it answers the requirements in the current situation (for example, when cooling down is needed). Different samples of deflection involve methods of not looking at a person, wordiness, elusiveness, understating and speaking about more than to (Polster and Polster, 1973, pp. 89-92).
Organismic Self-Regulation
Individual regulation can be (a) organismic - founded on a comparatively complete and accurate acknowledgment of what is, or (b) "shouldistic," founded on the accidental imposition of what one considers should be or not. This refers to intrapsychic regulation, to the regulation of social groups and interpersonal relations.
Fritz Perls wrote that there was just one thing that needed control: the situation. The main thing is to understand the situation and allow it to control the behavior. If one is able to do it, then he can learn to manage life." (F. Perls, 1976, p. 33). Perls explained it with the help of "driving car" example. As a substitute for a program planned ahead, "The person wants to drive at a speed - 65 miles per hour," a person aware of the current situation will do it in a different way: at lower speed at night and when there is much traffic. He will act in a different way when he is tired. Perls explains that "allow it to control" denotes regulating via awareness of the present-day background, together with one's wishes rather than something that "should" occur.
When self-regulation is organismic, choosing and learning occur holistically, with a normal integration of body and mind, consideration and feeling, impulsiveness and deliberateness. In shouldistic regulation, cognition rules and there is no holistic felt sense.
Apparently, everything applicable to boundary regulation cannot be accompanied with complete awareness. The majority of business transactions are conducted in an automatic, habitual way and minimal awareness is employed at that. Organismic self-regulation calls makes it necessary for the habitual to become completely aware as required. In case awareness does not come forward as necessary and does not display the needed motor activity, psychotherapy can be of help here and contribute to increasing awareness and making important choice and taking responsibility.
Awareness and dialogue are among the most important therapeutic instruments of Gestalt therapy. Such form of understanding as awareness can be freely characterized as being connected with the existence of the person, with something that answers what is - question.
Laura Perls affirms:
The goal of Gestalt therapy - awareness continuum, the freely continuing Gestalt formation where what is of furthermost concern and importance to the organism, the connection, the grouping or society gets Gestalt, comes to the forefront to be experienced freely and managed (accepted, worked through, selected, altered, solved, and so on) so in this way it can be dissolved on the background (disregarded, assimilated and integrated) and free foreground from the following significant Gestalt. (1973, p. 2)
Full awareness can be considered as the procedure of being vigilant contact with the important things in the environment field with full cognitive, sensorimotor, emotional and energetic sustain. Insight as a form of awareness is an instant understanding of evident union of different parts in the field. When the contacts are aware, then new significant wholes appear and this way the problem is integrated.
Effective awareness is explained and activated by the prevailing necessity of the organism at the present moment. This way not just self-knowledge is involved, but knowing directly the situation at the moment and the way the self is under the circumstances. Any rejection of the state of affairs and its requests or of one's wants and chosen response is a disturbance of awareness. Meaningful awareness is of a self in the world, in dialogue with the world, and with awareness of other -- it is not an inwardly focused introspection. Awareness is accompanied by owning, that is, the process of knowing one's control over, choice of, and responsibility for one's own behavior and feelings. Without this, the person may be vigilant to experience and life space, but not to what power he or she has and does not have. Awareness is cognitive, sensory and affective. The person who verbally acknowledges his situation but does not really see it, know it, react to it and feel in response to it not being fully aware and is not in full contact. The person who is aware knows what he does, how he does it, that he has alternatives and that he chooses to be as he is.
The awareness act is at all times here and now, even though the content of awareness can be distant. The act of memorizing is at this moment; what is memorized is not at this moment. When the state of affairs requires an awareness of the past or expectation of the future, efficient awareness regards this. For instance:
P: [Looking more stressed than normally] I do not know what I should work over.
T: What is that are you aware of at this very moment?
P: I am pleased to meet you, but I'm nervous about my meeting with my director in the evening. I have practiced much to get ready and I've made efforts to support myself while I anticipate it.
T: What is necessary for you just now?
P: It came to my mind to offer the chair for her at first, and then have a talk. However I am so nervous that some physical activity is needed: to breathe, move and create noise.
T: [Looking but keeping silence]
P: Isn't it up to me? [Silence. Then the client rises, begins stretching and yawns. There is more energy in his behavior. Some minutes later the client sits on the chair, looking calmer and more active.] Let us start.
T: Now you seem to be more energetic.
P: I have prepared to study what made me so bothered about meeting in the evening.
Self-rejection excludes full awareness and vice versa. Self-rejection is a deformation of awareness as this is a refuse from who one is. Self-rejection is at the same time bewilderment of who "I am" and a self-cheating, or "bad faith" attitude of being higher than that which is apparently being admitted (Sartre, 1966). When person says "I am" as if he observes different person, or like the "I" were not selected, or not knowing the way one makes and keeps that "I am" is more bad faith than insightful awareness.
People, in accordance with Gestalt therapy, are in charge or "response able" - that means, they can determine the way to behave. Confusing accountability with shoulds and blaming, they force and manipulate; they make efforts and are not impulsive and integrated. At these moments their actual wants, responses and needs of the environment and options in the situation are neglected and they either comply with "shoulds" or reject them.
Gestalt therapists consider that it is essential to make a distinction clearly between one's wants and what is given to the person. People are in charge of their behavior. For instance, people are in charge oftheir behavior and protection of the environment. When you blame something outside yourself, you deceive yourself. You can blame genetics, for instance or parents. Taking responsibility for what one did not choose, a typical shame reaction, is also a deception.
Every person is in charge of the moral choice he makes. Gestalt therapy can help the person to understand what can be considered moral and what not. Gestalt therapy gives person an opportunity to choose and value.
Variety of Concepts
Personality theory of Gestalt therapy has developed initially out of clinical experience. The emphasis has been made on a theory of personality that sustains the task of psychotherapists more than a general theory of personality. The concepts of theory of Gestalt therapy are more field theoretical than genetic and more phenomenological than conceptual ones.
Gestalt psychotherapy, in spite of being phenomenological, has to do with the unconscious - with something that has nothing to do with awareness. In Gestalt therapy, awareness is understood as being in touch and unawareness is understood as being out of touch and can be made clear by various phenomena, together with learning which is better to attend to, by suppression, character, cognitive set and style. Simkin in 1976 made a comparison of personality with the floating ball - just a part of it appears above water any time and the remaining part is underwater. Unawareness is the consequence of the situation when the organism was not in contact with outside environment because of being frequently involved in his own fantasies or the inner environment or on the contrary was fixed upon the outer environment and neglect inner life.
Gestalt Therapy Theory of Change
Children introject ideas as well as behavior. Therefore they are more inclined to enforced morality than an organismically compatible. Consequently, people often feel guilty as they act the way the wish and neglect what they should. Some of them direct much energy in maintaining the division between "should" and "want" -- the choice depends upon the morality of the person contrasting to an introjected one. "Shoulds" interferes with people of this type. More often they try to be what they are not, the bigger the resistance, and changes do not follow.
Beisser developed the theory according to which alterations do not occur via a "forced effort by the person or by different personality to alter him," but it does not take place when the person makes attempts to be "what he is," "to be completely in his present position" (1970, p. 70). Once the therapist refuses from the role of change agent, orderly change is possible as well as meaningful change.
The Gestalt therapy concept is that awareness in addition to owning, choosing, responsibility, and contact leads to expected and unplanned change. Compulsory change is an effort to realize an image more than oneself. With awareness the acceptance of self, and with the right to exist as is, the organism is able to grow. Mandatory intervention holds back the process.
The principle of Pragnanz in Gestalt psychology affirms that the field will structure itself into the finest Gestalt that overall circumstances will let. So Gestalt therapists consider too that people have an instinctive drive to health. This predisposition is natural, and every person is a part of nature. Awareness of the evident, the awareness continuum, is an instrument for the person to use intentionally to direct this natural drive for healthy condition.
Differentiation of the Field: Polarities versus Dichotomies
A dichotomy is a division by which the field is regarded not the whole adapted to fit in diverse and interconnected parts, but more as a range of opposing and forces without connection to each other. Dichotomous thinking is in the way of organismic self-regulation. Dichotomous thinking is inclined to subdue diversity among people and of contradictory things about one personality.
Organismic self-regulation integrates parts into total that includes parts. The field is frequently separated into polarities: opposite parts that add or clarify each other. The opposite poles of an electrical field (positive and negative) present a typical example of a field theoretical differentiation. The notion of polarities interprets opposite parts as elements of the whole, similar to yin and yang.
With this polar view of the field, distinctions are admitted and assimilated. Lack of genuine integration creates splits, such as body-mind, self-external, infantile-mature, biological-cultural, and unconscious-conscious. Through dialogue there can be an integration of parts, into a new whole in which there is a differentiated unity. Dichotomies like the self-ideal and the needy self, reflection and impulse, and public requirements and individual needs can be removed by integrating into a whole which consists of natural polarities (Perls, 1947).
Definition of Health I: The Good Gestalt as Polarity
The good Gestalt gives a description of a perceptual field structured well and clearly. A well-formed figure is noticeable on a not so distinct background. Both elements (the figure against the background) are related to each other with meaning. The meaning is understandable in the good Gestalt. The good Gestalt provides a content-free description of health.
In health, the figure alters is necessary, which means that it is moved to different focus when the requirement is met or surpassed by a more pressing need. It does not transform so quickly as to thwart satisfaction (like in hysteria) or so unhurriedly that latest figures have no opportunity to undertake organismic dominance (like in compulsivity). During the dichotomy of figure and ground, one remains out of context with a figure or with a context without focus (F. Perls et al., 1951). In health, awareness in particular presents the main requirement of the entire field. Requirement is a function of outside factors (such as, a physical formation of the field, political movement, natural phenomena, and so forth) and inner factors (for instance, famine, tiredness, curiosity, experience of the past, and so on).
Definition of Health II: The Polarity of Creative Adjustment
Notion of healthy functioning comprises creative adjustment in the Gestalt therapy. A psychotherapy that just assists patients to adjust contributes to conformity and stereotypy. A psychotherapy that made people impose themselves on the surrounding world without taking into consideration others would provoke pathological narcissism and separated from the world-denying realization of self.
A person showing creative interaction is responsible for the natural balance between self and surrounding world.
Within this theoretical context (F. Perls et al., 1951) some apparently individualistic statements of Gestalt therapy and even anarchistic are considered in the most though way. The individual presents a polarity against environment. The option is made between organismic regulation and arbitrary, but not between the personality and society.
Being a polarity, resistance consists of an impulse and resistant to that impulse. Considered like a dichotomy, resistance is frequently referred to as "bad" and, in this context, regularly grows into just personal dictates of the client and not the therapist's. Taken as a polarity, it is as integral to health as the trait is being resisted.
Gestalt therapists deal with consciousness: its working process of and its resistance process. Various Gestalt keep away from the word resistance on account of its pejorative dichotomized nuance, which makes the process a battle between therapist and client more than the client's self-conflict that requires integration into a self, which is harmoniously differentiated.
An impasse is a state of affairs when external support is not following and the individual considers that he is not able to support himself. This is so because the strength of personality splits between resistance and impulse. The most common method of overcoming this is manipulation.
An organismically self-regulating person is responsible for things made for self, things made by others for self, and things made by self for others. The person makes exchange with the surroundings, but the main support to regulate the existence is performed by self. As the person is not aware of this, external support becomes a substitute of self-support more than a nourishment source for the self.
In psychotherapy generally therapist can get around the impasse with the help of external support, and the patient thinks that self-support is not enough. In Gestalt therapy, clients can cope with the impasse thanks to the accent on loving contact without doing something for the patient, without coming to rescue or support of infantilism.
Gestalt Psychotherapy
Theory of Psychotherapy
Goal of Therapy
There is only one aim in Gestalt - awareness. This comprises more awareness in a certain area and also more ability for the client to take automatic habits into awareness as necessary. In its previous sense awareness is understood as content, in the later sense awareness is a process. Two notions (of awareness as content and as process) develop to more profound levels as the therapy progresses. Awareness embraces knowing the surroundings, responsibility for decisions, knowledge of self, acceptance of self, and the capability to contact.
In the beginning clients are mostly concerned with finding solution to the problems. Gestalt therapist is looking for the answer to the question how clients support themselves when they solve problems. Gestalt therapy makes problem easier getting rid of it by means of improved self-regulation and client's self-support. As therapy continues, both parties pay more attention to common personality problems. By the closing stage of therapy with the desired effect the client does the work in large part and can assimilate problems solving, relationship and characterological issues with the therapist, and ways to control the awareness.
Gestalt therapy is of special value for clients ready to work with self-awareness and those who wish to master the awareness process. In spite of the fact that some people declare they want to modify their behavior, the majority of people on the lookout for psychotherapy just want liberation from feeling of uneasiness. They can complain of widespread sickness, particular discomforts, or unsatisfactory relationships. Clients frequently anticipate that relief will follow after therapist's work more than from their own hard work.
Psychotherapy suits for people who are anxious and depressed because they are rejecting themselves, pushing aspects of themselves away, and misleading themselves. In other words, people not knowing how to stop being unhappy are main candidates on condition that they are ready to work over awareness, for the most part awareness of self-regulation. This kind of therapy is good for those who are aware about themselves but do not grow.
If the person just wants symptom relief not including awareness work, then medication, biofeedback, or behavior modification and some other ways will probably work better. The Gestalt therapy direct methods make it easier for the clients to come to this decision on an early stage of therapy. Nevertheless, if the patients have problems with awareness work or contact, it does not mean that they are unwilling to work. Respect for the total personality gives Gestalt therapist an opportunity to assist to clarify the difference between notions "can't" and "won't" and to learn the way internal obstacles or resistance, for instance, prior learning, nervousness, shame and being subjected to narcissistic injury, hamper awareness work.
No "Shoulds"
Gestalt therapy does not comprise "shoulds". Independence and the determination of self for the patient are more important than different values in Gestalt therapy. This is no such connotation the one "should" has. It is rather a preference. The no-should ethic is a priority over the goals the therapist set for the client and passes to the patient the responsibility approving his behavior (the restrictions and requirements of society are certainly not regarded here only because the person is in Gestalt therapy).
How Is the Therapy Done?
Gestalt therapy is an examination more than modification of behavior directly. The objective is development and self-sufficiency by means of consciousness growth. Rather than establishing distance and interpretation, the therapist in Gestalt meets clients and conducts energetic awareness work. The presence of therapist is active and energized (therefore warm), sincere and direct as clients can see, hear and converse the experience, feelings. They see the personality in therapist. Development is the result of contact between real people. Clients learn the way they are perceived, that their awareness process is incomplete, not mainly by discussing the problems, but by the way the contact with the therapist happen.
Focusing starts from plain inclusions or understanding to exercises, that occur generally from the phenomenology of the therapist while with the client. Everything is less important than direct experience of two sides.
The Gestalt therapy common approach is to make the exploration easier and maximize the development even after the therapy session and when the therapist is not present. It is as if the patient is left with a task. The process in not finished after the session is over. It can be compared with a roast that goes on preparing even when it is taken out of the oven. This explains the way Gestalt therapy can be intensive even with the fewer sessions a week. We collaborate and this brings to growth without us; we start the required process. We only launch something that is needed to encourage patient to improve. We make growth possible rather than finish healing process.
Fritz Perls considers that the final purpose of psychotherapy was the reaching that degree of integration which makes own development attainable (1948). An illustration of this type of facilitation is the likeness to a little hole made in the accumulation of snow. As soon as the draining process starts, it is hard to stop enlargement and it continues by itself.
bringing to positive result reaches integration. Integration
needs identification with all crucial functions - not just
some of the ideas, feelings and actions of the client. Any refusal
from one's own ideas, feelings or actions brings to alienation. Reowning
lets the individuality to be whole. So the assignment in therapy is
to let the patient learn about formerly separated parts and experience
them, think about them and incorporate them in case they are ego-syntonic
or refuse from them if they happen to be ego-alien. Simkin (1968) has
employed the image of a cake to encourage patients to reown their parts
which were considered harmful or improper: though such products as the
oil, flour and baking powder are not tasty by themselves, they are essential
to make the whole cake tasty.
The I-Thou Relation
Gestalt psychotherapy concentrates on the patient, just as any other therapy. Nevertheless, the horizontal relationship became the main difference from what existed in the traditional therapy at that time. The therapist and the client in Gestalt therapy find understanding as the speech is on the same language of current centeredness, stressing experience of direct communication of two sides. Therapists in Gestalt psychotherapy confirm their complete presence just the same way as clients do.
From the very start, Gestalt therapy was focused on the patient's experience in addition to observation of the therapist who determines what is not present in the awareness of the client. This lets the patient be an equal participant of the process with complete access to the information of his experience therefore he is able to experience directly from inside what the therapist observes from outside. Not having theological basis for the interpretation, the client is an amateur and does not have knowledge in an interpretive system. It is supposed that the significant inner data are beyond the consciousness, and this data is not experienced.
The matter of responsibility is an essential aspect of the Gestalt therapy relationship. In Gestalt therapy both parties of the process are self-responsible. There is an emphasis on it. In the situations while therapists consider that they bear responsibility for patients, this brings to the outcome when the client does have self-responsibility and manipulation becomes inevitable because of the client's inability to support himself. Nevertheless, it is not sufficient for the therapist to be in charge of self and for the client to be in charge of self - there is a union of client and therapist that should be always and knowledgeably attended to.
Therapists are in charge of the quality and quantity of their own presence, for information about themselves and the client, for preserving a nondefensive posture, and for maintaining their awareness as well as making contact comprehensible for the client. The patients answer for the outcomes of their behavior and for creation of the therapeutic atmosphere and maintaining it.
The Awareness of What and How
There is always accent in Gestalt therapy on such aspects as what the client does and how. What does the client encounter and how does he choose? Does the client self-support or on the contrary resist? Being an instrument, direct experience is stretched out further than what one experienced in the beginning, so deeper and broader focus is obtained. The techniques of Gestalt therapy consist of experimental assignments. They are the tools of enlarging direct experience. They are not meant to get the client somewhere, to alter the feelings of the client, to recondition, or to promote catharsis.
Here and Now
"Now" begins in a phenomenological therapy with the current awareness of the client. What takes place initially is not childhood period, but the period of current experience or now. Awareness comes right now. Previous happenings may be the items of current awareness, but the process of awareness (for instance, remembering) is right now.
Now I am able to contact the surrounding, or now I have the ability to contact recollections or hopes. Without being aware of the present, not keeping in memory, or not expecting are all troubles. The present is a transition point between the past period and the future. Clients are not always aware about their behavior at the present moment. Sometimes they live the way they do not have past. The majority lives in the future. These things present interruptions of time awareness.
"Now" is applied to the present moment. During the therapy hour the clients think of lives from the position of the current hour, or before in the hour, which is not now. Gestalt therapy is more focused on the now than in some different psychotherapy form. Experiences, received in the last minutes of the past, days, or years and even decades are especially important. We try to progress from speaking about to experiencing directly. For instance, this more resembles the situation which is closer to speaking to an individual who is not present physically activates more direct experience of sensations than speaking about the person.
I and Thou in Gestalt therapy is just like "what and how" notions, "here and now" methodology is often applied to grow characterological and developmental psychodynamics.
For instance, a woman, who is 30 years old, is in the group therapy, on some middle stage. She shares that she is cross with a man from the group. Often and legitimate approach of Gestalt psychology is "Inform him." Instead, the therapist follows another way:
T: You feel more than just angry.
P: [looks with attention]
T: It seems that you are furious - the way you look and sound.
P: This is right, I am ready to kill him.
T: You have a feeling of impotency as it seems.
P: I do.
T: Impotence typically goes together with rage. What causes your impotency?
P: He does not acknowledge me and I can't do anything about it.
T: [the observations of therapist verify this] You can't accept it.
P: No.
T: Your rage is stronger than the situation requires.
P: [the person nods and makes a pause]
T: What do you feel now?
P: There were many people in my life before who caused the same situation.
T: Your dad for instance? [this is the result of previous work with client and not just a guess. The client starts to reexperience the narcissistic injury received from father, who was not receptive to her]
Process of Psychotherapy
Gestalt psychotherapy almost certainly has a lot of styles and modalities, more than in any other structure. It is experienced in personality therapy, workshops, family therapy, group therapy and is also good for couples. Its practice takes place in clinics, hospitals, growth centers and others. Family therapy is practiced as a rule in family service agencies and private practices. The styles can be different in every modality on many characteristics: level and sort of structure; amount and worth of techniques used; regularity of sessions; accent on body, cognition, lack abrasiveness; sensations, interpersonal contact; knowledge of psychodynamic themes and work with them; level of individual encountering, and so on.
Gestalt psychotherapy modalities and styles resemble general principles discussed by us: prominence on direct experience and phenomenology (experimenting), direct contact use and individual presence (the sign of dialogic existentialism), and accent on concepts of field theory, such as "what and how" for example, or "here and now". In the boundaries of these dimentions, intrusions are modeled in accordance with the context and the individualities of the therapist and the client.
The core of the methodology is the accent on the discrepancy between work activity and different activities, "speaking about" in particular. Occupation can mean two things. It can refer to a purposeful, intentional and closely controlled obligation to apply awareness, which is phenomenologically accented in order to be able to see the life clearly. When the process in transferred from speaking about a difficulty or spending time with person in a universal way to thorough studying the activity, particularly knowing of somebody's awareness, the person is working. Secondly, in a group, work denotes being the major focus of the therapist's or the group's attention.
Different approaches in techniques are not of big importance, though the value of therapeutic contact and its type and a connection between the manner and accent of the therapist and the client's needs are essential. Techniques are not as important, they are just techniques: the general method, bond, and outlooks are the fundamental aspects.
However ,a debate about strategy or techniques might explain the methodology on the whole. They just demonstrate what can be achieved.
Techniques of Patient Focusing
The techniques of the client who is concentrated on explanation are around the following questions: "What are you experiencing at the moment?" and the recommendation, "Make this experiment and you will become aware of (experience) or learn." Numerous tactics are as easy as just asking about the awareness of the person, or ask more definite questions: "What are your sensations?" or "What are your thoughts?"
"Remain with it." A common technique is to go after an awareness statement with the following rules: "Go on with with it" or "Sense it out."
"Go on with it" helps the person to carry on with the emotion of the thing reported, which makes the capacity of the client grow deeper and work a sensation through to finishing point. For instance:
P: [looks sad]
T: What do you feel?
P: Sadness.
T: Remain with it.
P: [tears in the eyes. Then the patient calms down looking away in a thoughtful way]
T: I note your tightening. What is that you aware of at the moment?
P: I have no wish to remain with the sadness.
T: Remain with the not wishing it. Put your lack of wish into words. [this can lead to awareness of the client's struggle with melting. The client might reply: "I will not show my tears as I don't believe you," or "I am embarrassed," or "I am irritated and don't wish to confess that I miss him"]
Enactment. The client is asked to turn sensations or thoughts into acts. For instance, the therapist may give the encouragement to the client to do it "tell the person about it" (if this is now) or employ role playing (for example, saying an empty chair if there is no person). "Put it into words" is a different sample. Crying client might be invited to "put it into words." Performance is given as a means of growing awareness, not as a type of catharsis. This remedy is not common.
Exaggeration is a particular form of performance. A person exaggerates certain sensations, actions, thought, etc., by demand to feel the stronger (though simulated) enacted vision or fantasy. Enactment turned into doings, art, sounds, poetry, etc., can boost creativity and have therapeutic effect. For example, a man told about his mother without any emotions therefore the client was asked to give a description of his mother. Once saying it, the realization of the fact came to his mind and this entailed warmer attitude which was forgotten already. As the client accepted her position and progress, powerful feelings returned to his awareness.
Guided fantasy. The client can bring an experience at times into the here and now with bigger effect by imagining than by performing:
P: Yesterday night I happened to be impotent with my girlfriend and do not understand the reason for it. [client explains his story in detail]
T: Shut your eyes. Visualize last night and your girlfriend and explain the way you feel and the way your sensations change.
P: I am thrilled as my girlfriends sits close to me on the sofa, but I go soft after it.
T: Let us look at every stage together in detail. Do not miss any thought or anything in your perception.
P: I am on the sofa. She approaches and sits beside me, strokes my neck. It is soft and pleasant, I go hard as I am excited. She touches my arms, and this is excellent. [then he makes a pause, looks anxious] Then it occurred to me, that there was a stressed day, perhaps I will not cope with it.
This client got awareness what the reason for anxiety and weakness was. The recreation of event let him receive complete understanding why it happened to him. The vision might be of an anticipated event, or a metaphorical one, and et cetera.
In the next case, a patient, trying to cope with shame and self-rejection problem, is asked to visualize his mother saying with words and actions "I love you as you are." As the vision is described in detail, the client follows attentively her experience. This vision helps the person obtain awareness of the opportunity of fine self-mothering and can serve as a conversion to integrate fine self-parenting. The imagination is used to conduct work between sessions. It increases sensations about experiences with leaving, loss and awful parenting.
Loosening and integrating techniques. Frequently the patient is so confined with the bonds of the typical ways of thinking that different possibilities cannot be accepted in his awareness. This comprises long-established mechanisms, for instance, denial or repression, but cultural factors as well as learning influence the way of thinking of every person. One of the ways is to ask only the client to visualize the contrary of what it seems to be right.
Integrating techniques helps to bring processes together the client doesn't put together or vigorously separates them. On inquiry of the therapists he puts negative process into words through crying and being tense. Verbal form explains the feeling, emotion. Or a different sample when patient is asked to communicate positive and negative emotions about the similar person.
Body techniques. These comprises all techniques that lead to awareness of the client to the body functioning or contributes to their understanding how they are able to use their bodies for excitement support, and for awareness and contact. For instance:
P: [in tears and with a tight jaw with tension]
T: Would you like to make an experiment?
P: [client nods]
T: Breathe deeply and with every exhale, try to relax your jaw to move it down loosely.
P: [takes deep breaths and lets jaw go down as he exhales]
T: Remain with it.
P: [tears appear and patient begins to sob]
Therapist Disclosures
The Gestalt therapist is urged to have "I" statements as they make the therapeutic contact easier and the patient's focusing and should be made discerningly and with caution. It is necessary for a therapist to have Gestalt training, to be skilled technically and be wise and have self-awareness to make use of "I" statements to make the work easier. Therapists should share with patients what they see, what they hear or what they smell. They should say how it influenced them. Details, the therapist is aware of, while the patient is not, should be given, particularly if the data is not likely to be suddenly discovered in the process of phenomenological work during the gestalt psychotherapy session, yet it should be believed to be significant to the patient.
Mechanisms of Psychotherapy
Old Deficits, New Strengths
The child wants to have a parental relationship which has a nurturant, ecological, organismic/environmental balance. For instance, a mother is obliged to see that the requirements of the person are answered and that the progress of potentialities became easier. A child calls for this warm, fostering type of mirroring. A child also desires space to resist, to be perturbed, and to feel failure. A child wants as well to be restricted with limits and wishes to know what consequences will follow in case he does not behave in a right way. When needs are not met for various reasons the child can get a distorted understanding of boundaries. This is the reason why many parents refuse to follow wishes of their children. This will bring to the wrong understanding, distorted awareness, low self-esteem.
This is sad, but children are frequently shaped to meet parents' support on any occasion when they want something. Therefore the impulsive personality is replaced by an artificial personality. Other group comprises children whose needs are not met without reflection about the independence of others. This brings to the creation of impulsivity more than spontaneity.
Clients require a therapist who will deal with them in a contactful manner, at the same time not losing self by yielding to the wishes of the patient instead of study and working through or causing too much nervousness, embarrassment and frustration as they are considerate, warm, accessible, direct and straightforward.
Clients entering psychotherapy with diminished awareness of their requirements and strengths, more resisting than encouraging their organismic self, are suffering. They strive to make the therapist do something for them they are not able to as they think. If therapists follow this route, clients cannot reown and integrate potential they lost, which was not developed completely. Consequently they are not able to manage organismic self-regulation, with complete responsibility for themselves. They have no opportunity to learn if they are strong enough to exist independently as the therapist answer their requirements but skips such important things as increasing their awareness alongside with ego boundaries (Resnick, 1970).
In the course of Gestalt therapy clients learn how to get awareness and responsibility and how to be in contact, this way they improve their ego functioning. Thus they get instruments for more profound exploration. The experience of the childhood during the formative years are subjected for further exploration without such factors as the regression, extradependency needed in regressive treatment, without the momentary competence loss brought by transference neurosis. Childhood reminiscences are taken upon the current awareness without the supposition that clients are influenced by the events of the past. Clients project transference material on the therapist practicing Gestalt theory, by this means giving possibilities for bigger exploration.
The next two examples demonstrate clients with various defenses, who need special treatment, but with principal issues of the similar type.
A man named Tom was 45. Being proud of his intellect and independence he did not know of unsatisfied dependency wants and bitterness he had. This influenced his marriage much, his spouse sensed that she was undesired and inferior because she showed her feelings and wants. And his self-sufficiency needed reverence - it answered the requirement, was constructive to some extent and was based on his self-esteem.
P: [with pleasure] My mother was very busy when I was a kid, I had to rely only on myself.
T: I value your strength, when I imagine you an independent kid. I wish to stroke you and show a little parenting.
P: [with some tears] Nobody did that.
T: You look sad.
P: When I was little.... [study brought awareness of a reaction of shame to busy parents and a recompensing self-reliance]
Bob was a 45. He felt shame and separated himself in response to any interaction beside absolutely positive. He was constantly unwilling to experiment with nourishment of self.
P: [in a complaining tone] I have no notion what I should do now.
T: [keeps silence]
P: I could tell about the week which passed. [the look is puzzled]
T: it seems to me that you want me to show you the direction what to do. I feel that.
P: Yes. Is it wrong?
T: No. I would prefer not doing it at the moment.
P: Why?
T: You are able to do it on your own. I consider that you are distracting us now from your internal self. I don't wish to do it. [silence]
P: I am bewildered.
T: [keeps silence]
P: You will not show me the direction, will you?
T: You are right.
P: So, let us work on my thinking that I am not able to care about myself. [Client directs a productive part of work that brings to awareness of abandonment worry and shame which was the consequence of busy parents]
Frustration and Support
Gestalt therapy keeps the balance of frustration and support. The therapist investigates more than indulge the desires of the patient. This is the frustrating point for the client. Supplying contact is encouraging, though truthful contact prevents manipulation. The Gestalt therapist shows his self and stresses the importance of exploring, together with wish of exploration, indulgence and frustration. The therapist answers to manipulations by the client not reinforcing them, not giving judging, not frustrating the client on purpose. It is essential to have right gestalt perception and equal amount of warmth and firmness.
The Paradoxical Theory of Change
This is the paradox but the more one pretends to be the other person, the more he remains the same (Beisser, 1970). Many clients try to be the way they "should be" and simultaneously resisting shoulds.
The Gestalt therapist tries to reach integration asking the patient to identify with each contradictory role. The patient is asked about the feelings at each stage. When the patient is aware of two roles, then integrating techniques are applied to go beyond the dichotomy.
Two axioms of Gestalt therapy as "What is, is," and "One thing entails another" (Polster and Polster, 1973). The means of alteration is a relationship between the client and the therapist who establishes contact on the basis of demonstration of who he really is and who accepts and understands the client.
Awareness of the notion "what is" brings impulsive change. If the client manipulating for support comes across the contactful therapist and tolerant, with the one who does not use manipulation, he can obtain awareness of his actions. This Aha! is a new gestalt perception, a new viewpoint, an experience of new oppotunity: "I am able to be with some person without manipulation on my and his part." When this person comes across"therapeutic" collusion, mind games, derision, game busting and et cetera, awareness of this type will unlikely take place.
Aha! can come to mind at every point. If the therapist knows the possibilities or the client can see them and he desires to learn, Aha!'s are achievable and growth is possible too. Awareness comes when the client is willing, in case the psychotherapist is aware of it and can unite it with the whole. The subsequent process in Gestalt therapy brings to overall changes in the field. The more careful the investigation is, the bigger intensity the reorganization obtains. Some alternations can be valued only several years later.
Gestalt therapy patients are responsible for themselves and the way the live. The task of the therapist is to make the process easier and to draw attention to opening awareness, which is limited and certain area where contact boundaries are limited; the therapist determines limitations in places with unclear boundaries and makes them firmer. Since sensing raises in precision and clarity, since breathing gets fuller with more relaxation in it and since clients establish deeper contact, they transfer therapy skills to their lives and get better gestalt perception. At times closeness and job progress goes after Gestalt effort as an act of grace, with no client's connecting the intensity to the therapy work. But the growth takes place with contact and awareness. One thing brings another.
Gestalt therapy is very efficient with any clients the therapist feels easy with. In case the therapist establishes connection with the client, this is possible to use the dialogue principles as well as direct experiencing. With every client, common principles should be adapted to certain clinical situation. If the treatment of the client is made to obey the rules of "Gestalt therapy," it can be unsuccessful or even damaging. To a sociopath, a schizophrenic, a borderline or to an obsessive-compulsive neurotic various approaches are required. Consequently, in order to be competent in Gestalt therapy and to have a successful practice, one needs background also which is not just in Gestalt training. Personality theory, information about diagnosis and psychodynamic theory is required too.
In Gestalt therapy the personal clinician has much discretion. Alterations are made individually by the therapist in accordance with the therapeutic style, diagnostic considerations, and et cetera. The therapist should be responsible to do it. Therapists should have Gestalt training and have a firm ground in psychopathology, personality theory, psychotherapy theories, and sufficient clinical experience. Those who participate in the therapeutic sessions are allowed to experiment with different behavior and later share their cognitive and emotional experience.
Gestalt therapy has been regarded always most successful with "excessively socialized, reserved, constricted personalities" (nervous, perfectionistic, patients with phobia and depression), whose contradictory or controlled functioning is first and foremost a result of "inner restrictions" (Shepherd, 1970, pp. 234-35). Such persons frequently demonstrate just a little satisfaction of living.
Though Shepherd's statement portrays exactly in what way Gestalt therapy is efficient, modern clinical Gestalt therapy practice comprises treatment of a much wider assortment of problems. Gestalt perception is different nowadays. (The way Gestalt theory is understood, or Gestalt perception, is different nowadays.)
The workshop "Perlsian" style in Gestalt therapy has limited and narrow application than Gestalt therapy upon the whole (Dublin, 1976; Dolliver, 1981). In discussion of Shepherd concerning restrictions and cautions, she mentions limitations that are relevant to any therapist but should specially be noted in the surroundings of the workshop, also by therapists who did not have good Gestalt training or dealt with disturbed clients.
Sessions with disorganized, psychotic, or seriously disturbed people are harder and require "vigilance, sensitivity and tolerance." Shepherd recommends not doing work of this kind where it is not possible to make a "long-standing commitment" to the client. Disturbed clients necessitate support from the therapist and some faith that it is possible to heal them before they start deep exploration and experience strongly the "devastating pain, hurt, fury and depression" that lie behind the mental processes of disturbed clients (Shepherd, 1970, pp. 234-35).
Work with disturbed persons calls for clinical awareness of ways to balance frustration and support, comprehension of character dynamics, need for supplementary support (for instance, day treatment and medicine) and so on. Certain statements which seem to be reasonable in a workshop encounter are evident nonsense as soon as a wider context is used. Regard for instance, "do your own thing" referring to acting out clients! In this context this is nonsense.
An examination of the Gestalt perception is seen in books about Gestalt such as The Growing Edge of Gestalt Therapy (Smith, 1976), Gestalt Therapy Now (Fagan and Shepherd, 1970), and The Gestalt Journal. These sources will illustrate Gestalt therapy use for crisis intrusion, ghetto adults in a program concerning poverty (Barnwell, 1968), psychotics, interaction groups, family therapy and just about any other possible group. Regrettably books supplies with examples (there are not so many of them) with insufficient explanation of necessary alterations under consideration and not discussing negative outcome.
Gestalt psychotherapy has been effectively engaged in the treatment of a broad variety of "psychosomatic" disorders together with ulcerative colitis, migraine, and spastic back and neck. Gestalt therapists have productively conducted family therapy, with persons who have problems managing authority figures, with a broad assortment of intrapsychic confrontations. Gestalt therapy has always been efficient when dealing with psychotics and stern character disorders.
Due to the influence of Gestalt therapy and the simplicity with which it is possible to obtain strong, normally hidden affective reactions, it is essential to set up shelter islands where the therapist and client can easily return. It is necessary as well for the therapist to be with the client up to the moment he is ready to go back to these shelter islands. For instance, following a particularly emotion laden incident, the client may be urged to create visual, tactile or any other contact with the psychotherapist or with somebody from the group to tell about the experience. Another protection technique is to have the patient move backwards and forwards between establishing contact in the now with the clinician or members of the group and with the emotionally loaded incomplete situation that the client felt then up to the moment all the influence has been discharged and situation which was not completed worked through.
The Gestalt therapy stresses the importance of interpersonal contact, personal responsibility, and bigger clearness of awareness of what is most important or could be of big worth when difficulties of the present are solved. One pattern is Gestalt therapy use in schools (Lederman, 1970; Brown, 1970).
Gestalt therapists feel oddly no interest in official psychodiagnostic assessment and methodology of nomothetic research. Statistics will never inform the particular client or therapist what exactly is efficient. What is good for the majority is not at all times effective for individual person. This does not denote that Gestalt therapists do not like research; actually, the Los Angeles Gestalt Therapy Institute has proposed grants to support financially research. Fritz Perls proposed no quantified, statistical verification that Gestalt therapy is efficient. He said, "we offer nothing that you cannot confirm for yourself referring to your own behavior" (F. Perls et al., 1951, p. 7). In Gestalt Therapy publication a range of experiments are given that can be applied to test for yourself the power of Gestalt therapy.
Each encounter is regarded as an experiment, an existential meeting in which both sides: the therapist and the patient are involved in deliberate risk exploring something unknown before or prohibited territories. The client obtains help in use of phenomenological skills and learns to apply dialogic contact to understand what is effective and what not. Consequently, regular idiographic research is conducted. Gestalt phychotherapy has "sacrificed precise confirmation for the worth of ideographic psychotherapy of experimental kind" (Yontef, 1969, p. 27).
Harman (1984) made a review of Gestalt research books and could hardly discover quality research on Gestalt phychotherapy. He has not discovered studies that demonstrated improved self-actualization and stated self-concept which was the outcome of Gestalt therapy groups (Giunan and Foulds, 1970; Foulds and Hannigan, 1976).
A number of studies made by Leslie Greenberg together with associates (Greenberg, 1986) were directed to the lack of interest in context during psychotherapy research and the bad separation of procedure and result studies. The Greenberg explorations referred to definite acts and alteration processes in psychotherapy with definite outcomes. The research of them differentiated three kinds of outcome (such as intermediate, immediate and final) and three stages of procedure (verbal communication act, episode and connection). They explored verbal communication in the context of the kinds of episodes when it appears, and they explored the episodes in the context of the connection with the others or relationships where they appear.
In a particular study Greenberg explored the use of the 2-chair technique to decide upon splits. He made a definition of a split as "of pattern of verbal performance when a patient says about a separation of the self procedure into two fractional parts of the self or tendencies." He makes a conclusion that "two-chair operations fulfilled in accordance with the principles [of his examination] have been discovered to make easier a development in the Depth of Experiencing and index of dynamic psychotherapy...and to direct to resolutions of splits with patients looking for counseling" (1979, p. 323).
A study of L. S. Greenberg and H. M. Higgins' work of the "Effects of 2-Chair Dialogues and Concentrating on Conflict Resolution" discovered that 2-chair dialogue happened to generate a more direct experience of split and urged the patient in a self-confrontation form that assisted to create a resolution to the split or conflict" (1980, p. 224).
Harman (1984) discovered a range of studies that evaluated the Gestalt therapists' behavior and the behavior of other therapists. Brunnink and Schroeder made the comparison of behavior therapists, psychoanalysts, and Gestalt therapists and came to conclusion that the Gestalt therapists "gave more direct control, not so much verbal facilitation, less centering on the patient, more disclosure of self, more initiative and less emotional sustain." They also discovered that the "interview" used by Gestalt therapists showed more experiential approach to therapy and subjective as well " (1979, p. 572).
It is not claimed anywhere in the literature dedicated to the Gestalt therapy that it is the "best." It is never explained theoretically why this kind of therapy should be more efficient than any other therapies which are based on different psychotherapy principles. The research of the results may produce not so practical results than research of procedure studying behavior, manners, mind-set and consequences. A sample of this is Simkin's evaluation of the efficiency of Gestalt therapy in workshops which was called "massed learning" in comparison with the "spaced" psychotherapy sessions every week. He discovered verification of the advantage of massed learning (Simkin, 1976).
Some Gestalt therapy points of view on constituents of good therapy are sustained by common research. The study on experiencing within the frames of the Rogerian tradition showed the efficiency of an accent on direct experience by the therapist. In Gestalt therapy personal relating is also stressed as well as presence and experience. This is sad but some therapists frequently and deliberately break the principles of excellent therapy in accordance with the model of Gestalt therapy, but continue to mane themselves Gestalt specialists (Yalom and Miles, Lieberman, 1973).
Ongoing Individual Gestalt Therapy
Though Gestalt therapy has gained a reputation to be applied first of all in groups, its basis is in fact personal treatment. You can find some examples in Gestalt Therapy Now publication (Fagan and Shepherd, 1970). Cases descriptions from an annotated bibliography in Simkin is also interesting to study (1979, p. 299).
Gestalt therapy starts when the first encounter and contact takes place. As a rule, evaluation and screening are performed as an element of the continuing relationship more than in a separate phase of diagnostic testing in addition to social history regarding. The information for the evaluation is received by the point of the work start, for instance, by the point of therapeutic encounter. This evaluation comprises the patient's desire and sustain for work within framework of the Gestalt therapy, the connection of client and therapist, the typical professional discriminations of diagnostic and characterological character, resolution upon regularity of sessions, the necessity of adjunctive treatment and medical consultation.
A standard sessions' frequency is weekly (one session a week). Applying the Gestalt methodology, this intensity is sufficient and the result can be regularly achieved at this regularity. Frequently personality therapy is united with workshops, group therapy, combined or family therapy, meditation, movement therapy, biofeedback training. At times clients can have sessions with bigger regularity, but frequently they require time to take in material and more regular sessions can bring to overdependence upon the therapist. The regularity of sessions is determined by such factors as how long the client can go from one session to another without breaking continuity, decompensation, minor types of relapse. So the frequency can be absolutely different and fluctuate 5 sessions per week to one session per 2 weeks. Less frequent sessions evidently reduce intensity up to the point when the client attends a group every week , the therapist remains the same. The frequency of over two times a week is normally not specified, with the exception of psychotics, and is beyond doubt contraindicated with BPD (borderline personality disorders).
Throughout the therapy clients are urged and helped to make a decision. Everything is discussed: exercises, period of process, kinds of adjunctive therapies for use, and other things and though the client makes the choice eventually, the competence and the right decision should be supported by the expert.
Group Models
The duration of Gestalt therapy sessions is different. There are one-hour sessions, more than on hour up to the sessions which are three hours long, therefore the average session lasts for two hours. A usual 2-hour group consists of 10 persons. Gestalt therapists generally experience maximum participation in heterogeneous group, in which the quantity of men and women is balanced. Group member should be screened. Gestalt therapy is proper for any age group, but the usual range in continuing private practice group is from 20 up to 65 years old and the average age is from 30 to 50.
There are Gestalt therapists, who are Perls' followers and they do one-on-one therapy in the setting of the group employing the "hot seat" structure. "In accordance with this method, a person expresses his desire to the therapist to overcome a certain problem. The center of attention is the lengthy interaction then between client and leader of the group ("I and Thou") (Simkin and Levitsky, 1972, p. 240). Episodes of one-on-one type last in average 20 minutes, but can continue from 2 to 45 minutes. In the process of the one-on-one work, all the rest members keep silent. After the work is completed, they share the way they were influenced, what they watched, and in what way their own experiences are alike with the experiences of the client. During the last several years the work of this kind has been developed and began to embrace awareness work without certain problem in the center of attention.
In the beginning of 1960s Perls wrote in his paper:
Recently though, I have removed individual sessions on the whole with the exception of emergency cases. Actually, I am of the opinion that individual therapy is outdated and Gestalt therapy workshops should be instead of it. During workshops I organize at the moment individual work is put together with group work. (1967, p. 306)
This view was not accepted then by the majority of Gestalt therapists, and it is not now acknowledged Gestalt theory and practice.
Some witnesses have illustrated the group work style of Gestalt therapist and individual therapy within the group setting. This declaration is valid for experts introducing Gestalt perception making use of the model without emphasis or having to do with group dynamics or struggle for cohesiveness of the group. Nevertheless, a lot of Gestalt therapists pay special attention to group dynamics.
Bigger employ of the group is undoubtedly within the Gestalt methods and is used more and more in Gestalt therapy (Feder and Ronall, 1980; Enright, 1975; Zinker, 1977). This takes in bigger involvement of group participants when a personality is performing one-on-one work, working over personality themes with all members of the group, with accent on contact in the group, and work with group practice. The diverse degree and kind of structure supplied by the leader of the group can contain prearranged group exercises or not, examining the group's development to its own structure, urging one-on-one work, and so forth. Frequently Gestalt groups start with several exercises to assist members to progress sharing experience "here-and-now".
A regularly applied model is the model which supports enlarged awareness via accent on contact between the participants of the group and one-on-one work within the group (between its members which are persuaded to be active at this stage of work). This provides bigger flexibility and variability.
Workshop Style
Gestalt therapy and Gestalt training is carried out in workshops, with the schedule for a fixed period, and some of them last only one day. Workshops during the weekend may continue to 20 and even more hours. The durability of workshops varies from one week to some months. A usual weekend workshop participants are a Gestalt therapist and a group of 12 - 16 people. When periods are longer (one week to one month), more than 20 individuals can be observed by one therapist. Regularly with participation of over 16 people, co-therapists are engaged as well.
As workshops are limited in duration and many hours are offered to the participants, the motivation to "work" is usually high. From time to time regulations are set for every participant to give an opportunity to work in turn. Sometimes the rules are avoided. Therefore much depends upon the desire, boldness and strength, some group members for this reason may obtain intense therapeutic consideration during a workshop.
Even though some workshops are prearranged with established groups, the majority of them gather clients for whom this is a new experience. Like in continuing groups, the perfect practice is to screen clients prior to the workshop. An unscreened workshop needs a knowledgeable clinician who dealt with serious pathology and vigilant security for probably susceptible group participants. Confrontive or fascinating Gestalt styles are for the most part likely to worsen mental illness, which may have some group members (Lieberman et al., 1973).
Other Treatment Modalities
Gestalt family therapy use was elaborated comprehensively by Walter Kempler (1973, pp. 251-86). The fullest description of Kempler's work is published in the publication Principles of Gestalt Family Therapy (1974).
The use of Gestalt therapy takes place in temporary crisis interference (O'Connell, 1970), as an accessory treatment for visual problems (1970, Rosanes-Berret), for awareness education of mental health specialists (Enright, 1970), of kids with behavior difficulties (Lederman, 1970), to educate day-care institutions staff (Ennis and Mitchell, 1970), to instruct teachers and the rest on creativity (Brown, 1970), work with a dying individual (Zinker and Fink, 1966), and in organization progress (Herman, 1972).
The management of the case by a Gestalt therapist is a practical subject and determined by the aim of supporting the interpersonal connection. Appointments are generally made on the phone by the therapist. The interior of the office characterizes the personality of the therapist and his style and is not intentionally neutral. The design of the office and its furnishing is aimed to provide comfort and to keep away from a traditional "desk or table" type separating two sides. In general the physical layout gives space for movement and experiments. The therapist is dressed in informal way as a rule and his manners should be also not official.
Fees arrangement depends upon the individual, here there is no definite Gestalt style, but straightforwardness. The question of fees are discussed straightforwardly with the client and generally gathered by the therapist.
Clearness of boundaries is emphasized, with 2 sides in charge of the current assignment. Therapy work begins from the very first moment. The session is not accompanied with the therapist's notes as it is in the way of establishing the contact. The therapist should do it after the session, if necessary. He is responsible for safeguarding comments, tape and video-recordings and the rest clinical material. The therapist establishes payment conditions, cancellation policy, et cetera. Disobedience and protests are openly discussed. The choice is made with the therapist and both parties keep agreements. The therapist organizes the office to guard it from intrusion, and protects the office every way possible.
The assessment process takes place as part of the psychotherapy and is made by both sides. Some reflections engaged in the process of evaluation consists of coming to a decision upon person or group therapy, assessing the therapist's ability to make a considerate relationship based on credit, and allowing the client choose an adequate example if the therapist suits the patient as well as the chosen therapy.
Problems coming into view in the relationship are openly discussed, in the form of managing the definite problem and examining characterological styles of life or relationship development that would be productive for the client to explore. The requirements, desires and direct experience of two sides lead to the examination always and to salvation of problems.
Case Example
Peg visited at first workshop of Gestalt training. She tried to learn to overcome anger to her husband, who killed himself. After his demise she had to raise their children alone and started a career as she had to support her family financially. She was a bit less than 40 then.
With substantial bravery and activity, Peg managed to arrange a crisis clinic supported by a famous service organization in the big city in Southern California where she lived. Peg was a member of the group of 11 people who took part in a Gestalt therapy training film with Simkin (1969). Here is the excerpt from the Gestalt training film, In the Now:
Peg: I have the same ...returning dream. I'm standing near Camp Pendleton on the ground and an open, countryside, which is rising and falling, just in front of me. I see broad and dirty roads, which are crisscrossing there. Hills come after valleys and valleys after hills....there is an army tank to my right, - marine tanks which have big tracks... there are a lot of them they are closed well and rolling in a line over the valleys and hills, they are closed up. Standing near the road I have a plate with Tollhouse cookies. They are hot and are on the platter -- I see tanks coming one by one. I watch them and they move past me. When I look to my right I notice black shoes, a pair of shoes. They are shiny, and run along among the tank treads as it goes on the hill. When they are just in front of me...the person bends down, the tank moves on, when the person approaches me, I see that this is the best friend of my husband. Every time I wake up at this place. At all times I bring my dream to end...and I started to laugh. But it is no longer fun!
Jim: You are right. What is that you are you doing now?
Peg: I am making an effort to stop chattering.
Jim: What's your protest?
Peg: This feeling of nervousness and horror I have is not something I like.
Jim: What do you visualize?
Peg: I visualize ridicule.
Jim: Ok. Begin ridiculing.
Peg: Peg, you're absurd. You are large and lazy. You are ridiculous like a comic. You pretend as if you are grown up but this is not so. Those who look at you know that there is a child inside, pretending that you are a woman of 39 and...it's a ludicrous mask. You are 39 and do not have your own business. An absurd age like you are. Being employed you don't have any notion how to succeed. You think that your grand plans will be carried out by themselves, you are not smart enough to make it, so you will be laughed at.
Jim: Ok, it is time to look at people who are laughing at you.
Peg: I'm afraid to. [she is obeying and doing it slowly] They seem to be serious.
Jim: Whom are you speaking about then?
Peg: I think...just my vision...my...
Jim: Who devised that?
Peg: I did.
Jim: Who are those people laughing?
Peg: Yes. This is so I...I'm actually laughing at things which are not amusing. This is so incompetent. [makes a pause]
Jim: What good qualities do you have?
Peg: I'm kind to people. I do not judge. I can keep my house well. I'm an excellent needlewoman, I can bake well,:
Jim: Perhaps you'll become an excellent wife.
Peg: And I did.
Jim: Perhaps it will happen again.
Peg: I am unaware of it.
Jim: Say it. "I have doubts that I will become an excellent wife once more."
Peg: I have doubts that I will become an excellent wife once more.
Jim: Inform every man in this room about it.
Peg: I have doubts that I will become an excellent wife once more.... [says it again and again - 5 times]
Jim: What are your feelings?
Peg: I am surprised. It just seemed to me so.
Jim: That's it.
Jim: What are your feelings right at the moment?
Peg: Pleasure and satisfaction. I feel fine.
Though "ticket of admission" Peg had was a vision only, it was in the basis of her nervousness and doubts. It seemed to her that she was ridiculed. This dream worked like a vehicle for beginning and, as is often the case, the work brought to unexpected result.
This was the weekend Gestalt training workshop and film was made at that time, later Peg really got acquainted with a man and began to date. They were attracted to each other and eventually married.
A second example of Gestalt phychotherapy is selected from a book to demonstrate certain techniques (Simkin, 1976, pp. 103-18). It is a reduced record of a workshop, where 6 volunteers were present. The session in the morning comprised a film and a lecture-demonstration.
Jim: I would like to begin with saying to you where I am. I would like you to know what I feel now, about my current experience. This looks rather artificial for me, there are lights with cameras around and the public too. I am breathless and loaded with the technical stuff and equipment, and so on, and I am more inclined to running away from the cameras and lights to be in touch with only you. [asks the names of the group members and says his name]
I am thinking that everybody here saw the film as well as the demonstration, and I would prefer to work with you when you are ready to do it. I'll repeat our agreement or contract. The core of the agreement in Gestalt perception is to share where you are, what you are feeling at definite moment, and, in case you are able to, to remain in the awareness, to say what you are concentrating on, what is your awareness now.
* * * * *
I would like to begin first with letting you declare who you are and what you are expecting.
Tom: At this moment I feel tension, for the most part not because of the equipment around me because I am often in such surrounding. This is strange for me to be in a situation of this kind. This morning I felt uneasy for the reason that I didn't see many things here the way you are, and I feel hostility because of it. At present I admit you more as a person.
Jim: I'm looking at your foot at the moment. This is interesting for me if you are able to make your foot speak.
Tom: To make my foot speak? Do you mean to say about the feelings of my foot? What would it say?
Jim: Just go on that, as if you are your own foot.
Tom: I don't get it.
Jim: When you informed me about hostility feeling in the morning, you kicked your leg energetically and I suppose that some kick is still coming from time to time.
Tom: Uh, yes. I assume perhaps I still make some kick, but that does not seem to me that that's something inappropriate now.
* * * * * *
Lavonne: I feel tension at the moment.
Jim: With whom are you speaking, Lavonne?
Lavonne: I remembered this morning, This was a feeling of hostility. I still have a little of it.
Jim: I know that you try to keep away from meeting my eyes.
Lavonne: This is so, you seem arrogant for me.
Jim: You are right.
Lavonne: It is as if I might fight with you.
Jim: Quite right.
Lavonne: I keep away from the eye contact and it is like keeping away from the fight. I have no notion how to solve the problem.
Jim: Would you be willing to tell me what your objections are to my arrogance?
Lavonne: This does not calm me down. In case I have a trouble and I discuss it with you and you're so proud, so I become arrogant as well.
Jim: You reply in kind is what you're stating. Your experience is you react this way.
Lavonne: Yes. Later at this university it seemed to me that I should have been haughty and self-protective always. As I'm black, the reaction of people can be various... people are different ... and I think that I should be ready to answer always...
* * * * * *
Mary: I would like to work on my feelings for my elder son and our struggle but I suppose that this is in fact my struggle.
Jim: Are you able to tell him about it? Call him his name and just say what you think.
Mary: Okay. He is Paul.
Jim: Place Paul on it [moves an empty chair] and tell him about it.
Mary: Paul, there is much confrontation between us. When you independently go out of the drive, I feel hatred. But...
Jim: Wait a little. Repeat it again to Mary. Mary, when you independently go out to the drive, I feel hatred.
Mary: That fits. Mary, when you independently go out of the drive, I feel hatred, because you are bad mother.
Jim: I don't know about your "because."
Mary: No. That's my explanation. When I do yoga I do the same.
Jim: You seem to identify yourself with Paul.
Mary: I do. I am aware of this. I feel envy for his freedom, since he was little and set off to the woods. I was envious of his capability to do it.
Jim: Say Paul about it.
Mary: Paul, at time when you were little, could go away on the whole Saturday without letting me know, I was envious a lot, and I felt upset as I had no opportunity to do it as well.
Jim: You could not do it, or you would not do it?
Mary: I wouldn't though I wished it.
Jim: Well, I get really angry when the person around can afford doing something I want but I can't.
Mary: And I behave this way. I try to remember what I can do and what I will not do. After it I do not do anything. I'm stopping. Tightly planted.
Jim: I would like you to connect with your malice. Place your malice here and talk to Mary's wrecker.
Mary: You are an idiot. Having time and energy for work...which you scatter. You are occupied with numerous things therefore there is always an apology not to fulfill your work, or switch to something different... [makes a pause] You only waste time becoming unhappy and making your life complicated.
Jim: What's happening here? [looks at Mary's hand and points to it]
Mary: I am tight-fisted...this will not do.
Jim: Are you really tight-fisted?
Mary: I suppose I am.
Jim: Okay. There is another part of you - the generous one. Are you able to contact it?
Mary: I am not aware of generous part of myself well.
Jim: Remain tight-fisted just say at that, "Generous self, I do not want to deal with you, I am not aware of you, etc."
Mary: Generous self, I am not aware of you. I consider you try from time to time when you present gifts to people instead of presenting yourself. You refuse an unpleasant lot you could give.
Jim: What took place right now?
Mary: It was a rehearsal. It was not a talk with my generous self. It was a talk with...you mostly. I was keeping back part.
Jim: I have trouble visualizing you like a withholding type of a person. You seemed to me from the very start very energetic and active...and very giving, so it seemed to me .
Mary: I am not aware if I am actually giving. Every now and then I feel like it but my gift is not accepted. And at times I wish to give but I can't. I feel occasionally there was too much I have given already. I shouldn't have given so much.
Jim: Well, just what I'm starting to feel. Some wound. You look wounded - it was in the past. You were wounded during some period when you were vulnerable.
Mary: I'm hurting to some extent.
Jim: It seems for me that you are hurting now, particularly around your eyes.
Mary: I am aware of that, and I don't wish to do that..I have no desire to demonstrate that.
Jim: Okay. Would you wish to block?
Mary: [shutting her eyes] If I do it, I am not able to see you.
Jim: This is right.
Mary: At time I do that, I am not able to see anyone.
Jim: Exactly. At times I block my hurt, no person exists for me and this is my decision.
Mary: I also made this decision.
Jim: It is nice to look at you. You seem so generous now to me.
Mary: You seem generous to me. I think you are generous. You reply to me, I sense that I'm replying to you...
Jim: I'm interested if you can return to Paul for an instant right now. Meet him and examine what takes place.
Mary: Paul, I wish to be generous and warm with you, and I feel this might hurt you if I do so. You are 6 feet tall right now and at times I wish so much to approach to you and to kiss you goodnight or to hug you but I can't do all this any longer.
Jim: You cannot?
Mary: I will not. I will not, because, uh...I've been pushed away.
Jim: You've been wounded.
Mary: Yes, I've been wounded. Paul, I consider it is your own business whether you want to push me away or not, but this does not prevent me from being hurt.
Jim: I like Nietzsche's phrase as far as I remember, when he applied to the sun, saying, that it is none of its business that it shines at him.
Mary: I continue hoping that at 25, Paul, when you go to the Army or whatever...and that at this moment I will have a chance to kiss you good-bye. [makes a pause] I will try not to forget what Nietzsche said to the sun.
Jim: Okay. It was my pleasure to work with you. Thank you.
Mary: Thank you.
Fritz Perls predicted 3 decades ago the future of Gestalt therapy, that in the 1970s it would become recognized and an important force in psychotherapy. His prediction has come true.
There were maybe no more than a dozen people who were seriously interested in the movement in 1952. And in 1987 there were already many Gestalt training institutes and hundreds of Gestalt psychotherapists, there were also a lot of people who did not have Gestalt training or received poor Gestalt training but they named themselves "Gestaltists." Gestalt perception became known for thousands of people, who have tried Gestalt therapy -- a lot of people had positive results - some received poor or doubtful outcomes.
Thanks to the reluctance of Gestalt therapists to establish firm standards, there is a broad variety of criteria for the choice and teaching of Gestalt therapists. Certain people, having passed through the weekend workshop, think that they are ready to practice Gestalt therapy. Other psychotherapists study for years in preparation as Gestalt therapists and have a huge reverence for the simplicity and endlessly innovative and creative approach Gestalt therapy needs and entails.
In spite of the fact that Gestalt psychotherapy looks attractive for certain people in pursue of shortcuts, it also has become a focus for a considerable number of knowledgeable clinicians with big experience who have discovered that Gestalt therapy is not just a influential psychotherapy but a practical life philosophy as well.
If people are in pursue of the easy solutions and shorter alternative ways, they will go away as they want greener pastures. Gestalt therapy will obtain a considerable influence and will be placed into the list of different independent psychotherapies during the following decades. It should keep on drawing attention of creative psychotherapists who are focused on experimental work which will last for the whole life.
Gestalt therapy has opened up a lot of creative and helpful innovations in the theory and practice of psychotherapy. They have been included into general practice, frequently with no credit. Currently Gestalt therapy is developing further, its principles are being elaborated and refined. Not considering the label, existential dialogue principle, bringing direct phenomenological patient's experience into play and therapist's experience as well, the reliance on organismic self-regulation, the accent on awareness and experimentation, the "no shoulds" therapist's attitude, and the client's responsibility in addition to the therapist's for the choice made - all these elements comprise a model of excellent psychotherapy that will be further used by many people.
To sum it up, a quotation taken from the work of Simkin and Levitsky (1972, pp. 251-252) will be just at its place:
In case we were given the choice of one key idea, which would symbolize the Gestalt approach, the conception of authenticity might be pointed out, the pursuit of authenticity...If we look upon therapy and the therapist in the merciless authenticity light, it gets obvious that the therapist is not able to teach what he is not aware of...An experienced therapist is aware that he is sharing his fears with the client as well as his bravery, sincerity and defensiveness together with his misunderstanding and his clarity. The therapist's knowledge, recognition, and sharing true info can become a highly convincing illustration of the therapist's own authenticity. Evidently this can't be obtained overnight. It should be learned and learned more and more to have profound knowledge which should be accumulated during the whole life.