An Introduction to Gestalt
Therapy
Based
on Yontef, G. & Jacobs, J. (2011). Gestalt
Therapy.
In Corsini, R., and Wedding, D.
(Eds.). Current Psychotherapies, 9th
Edition, Chapter
10. Belmont, CA: Brooks/Cole-Thompson Learning. pp
342-379.
What is
Gestalt Therapy?
Gestalt
therapy is a humanistic, existential, experiential, contextual, and
process-oriented approach to psychotherapy. It was developed by Frederick
“Fritz” Perls, Laura Perls, and Paul Goodman in the 1940’s and 1950’s.
Initially, Gestalt therapy was meant to be a revision of
psychoanalysis and an alternative to behaviourism. Over time, it evolved into a
totally independent and integrated system of
psychotherapy.
Gestalt
therapy is truly holistic since it deals with the cognitive, emotional, sensory,
interpersonal, and behavioural aspects of an individual’s
personality.
Generally, people don’t need psychotherapy because they
are able to learn and grow from their experiences in life. It is when people
are stuck in repetitive, maladaptive ways that psychotherapy is needed.
Psychotherapy is primarily a relationship between a client and
therapist.
The
Gestalt therapist creates a healing experience by being open, alive, honest,
sincere, and warm as he engages with the client. In this relationship, the
Gestalt therapist gives clients a chance to unlearn maladaptive patterns, to
learn how they avoid learning new and creative ways of coping, and to learn how
they can keep on learning.
The
Gestalt therapist is one who gets actively, creatively, and personally engaged
with the client. By using active and creative methods, the Gestalt therapist
facilitates in the client a deeper awareness of oneself and of one’s life. With
deeper awareness comes the greater freedom and power of choice, resulting in
more opportunities for living a self-directed and meaningful
life.
Gestalt
therapy does not focus on “fixing” people or on curing disease. Gestalt therapy
is an exploration rather than a direct attempt to change behavior. The goal of
Gestalt therapy is growth and autonomy through conscious awareness and
self-support.
What
are the foundational bases of the Gestalt
therapy?
Holism emphasizes the positive qualities of human beings:
firstly, that people are growth-oriented and are inclined to develop as fully as
their environmental conditions will allow; and secondly, that people have the
inherent capacity at self-regulation. They have the capacity to prioritize
their needs hierarchically and then meet those needs which are most
urgent.
Field
Theory asserts that an individual can only be understood from
the context (or field) within which that individual is currently situated and
embedded.
An
individual is embedded in his environmental field. Hence, the individual never
has a “solitary self,” but always a “self-in-relation” to his environment. And
since the environmental field is inhabited by other human beings, individuals
are better understood by observing the quality and patterns of how they interact
and relate to each other.
According to Gestalt therapy’s Field Theory, no one can
have a totally objective perspective of reality. An individual’s perception of
reality is never absolute since his perceptions are constantly being affected
and influenced by elements in the environmental
field.
Gestalt
Psychology explains that individuals will interpret their
experiences to makes it sensical, meaningful, or relevant for
themselves.
“Gestalt formation” refers to the emergence of a figure
(i.e., whatever our attention focuses on) contrasted against a ground (i.e.,
everything else that gets set aside into the background). Only one clear figure
can be focused on at any given moment. However, figures and grounds may shift
very rapidly.
What is the Paradoxical Theory of
Change?
This
theory asserts that the more one tries to become someone he is not, the more
fragmented his personality becomes and the more he stays the
same.
What are 3 concepts emphasized in Gestalt
therapy?
Contact is the
maintenance of attention and connection with an experience, whether it be a
mental, emotional, or physical experience. It is “being in touch” or “staying
with” the experience rather than ignoring, belittling, suppressing, or denying
it.
“Contact” is what the Gestalt therapist does by paying
close attention to what the client is experiencing or doing in the session and
to what is happening in the therapist-client
relationship.
Awareness is a process of focusing on and attending to a current
experience.
Unawareness occurs when an individual purposefully,
unintentionally, regularly, or permanently sets aside some aspect of his
experience to the background. Unawareness generally reflects an internal
conflict within the individual. The Gestalt
therapist’s task is
to observe the client’s awareness process, even helping the client become aware of his
“unawareness.”
“Awareness of awareness” is also known as “conscious
awareness.” It is being mindful or observant of one's own awareness processes
and patterns.
Experimentation is the
act of doing something different. In a session, both therapist and client can
creatively experiment with different ways of thinking and doing. In the process
of doing experiments, repressed emotions may surface, suppressed feelings may
find fuller expression, and insights commonly
emerge.
Experimentation is done in accordance with the
Paradoxical Theory of Change: the purpose of experimentation is not to change
the client, but to help the client gain increased self-awareness, deeper
self-understanding, and stable self-support.
What
are some of the other concepts and principles of Gestalt
therapy?
Disturbances at the
Boundary
Healthy
boundaries allow people to maintain individuality despite the contact and
connection with others. Healthy boundaries allow people to acknowledge and
respect each other’s differences. Disturbances at the boundary will result in
any of the following:
@ Isolation is the
failure to allow close contact to occur.
@ Confluence is an
enmeshment resulting in the loss of a separate
identity.
@ Introjection is
acceptance without discrimination or awareness.
@ Assimilation is the
deconstruction of an experience, keeping what is meaningful or useful to oneself
and rejecting what is not.
@ Projection is
falsely attributing to another person something that actually comes from
oneself.
@ Retroflection is turning a shared experience into a solitary
one.
Creative Adjustment
Gestalt
therapists believe that people are growth-oriented and will create solutions to
their problems in the best way they can or know
how.
Creative adjustment is the process of solving a problem
by making full use of one’s resources, by making full use of resources from the
environment, by making modifications in the environment, and by adjusting to
that which cannot be changed in the
environment.
Neurotic
Self-Regulation
Neurotic self-regulation is the result of a creative
adjustment done in the past that has become an outmoded repetitive character
pattern.
The
Gestalt therapist helps the client develop new and flexible creative adjustments
in response to the client’s current field
conditions.
Polarities
The
healthy individual is able to adjust creatively to the polar themes of life:
comfort and hardships, strength and weakness, love and hate, life and death. In
neurotic self-regulation however, the individual is unable to adjust to such
polar themes.
The
Gestalt therapist may use integrating techniques to join positive and negative
poles of a polarity together.
Resistance
Resistance occurs when an individual opposes a thought,
feeling, impulse, or need (stemming from oneself or from another person) in a
context wherein the individual feels
unsafe.
Anxiety
Anxiety
can be created cognitively with irrational beliefs, negative misinterpretations,
or from “futurizing,” that is, making ominous predictions. Anxiety can also be
created physiologically through poor breathing
habits.
Gestalt
therapists are more concerned with the process of anxiety (i.e., how one becomes
anxious) rather than the content of anxiety (i.e., what one is anxious about).
Gestalt therapy is ideal for the treatment of anxiety because it has a
cognitive and body-oriented focus.
Impasse
An
impasse is a paralysis resulting from not wanting to return to a previous state,
yet not being able to move forward to a new one. This paralysis happens because
the individual does not possess enough support (both self support and
environmental support) to move forward.
People
often describe this experience as a darkness, an emptiness, or being caught in a
whirlpool. By “staying with” the impasse rather than setting it aside, people
paradoxically cross over to a more authentic, creative, lively, self-supportive,
and meaningful existence.
Here
and Now; What and How
The
Gestalt therapist has a dual focus during a session. The first focus is on the
patient’s awareness process- what the patient does and how he or she is doing
it. The second focus is on the personal relationship between therapist and
client.
Of all
other types of therapy, it is Gestalt therapy which strongly emphasizes the
“here and now” and “what and how.” This is essential because most people either
live in the past, live as if they had no past, or live in fear of the
future.
The
primary focus of Gestalt therapy is the “here and now” experience. Even in
exploring the past, Gestalt therapy uses creative experiments and techniques to
transform the client’s past into a present
experience.
Inclusion
“Inclusion,” according to Martin Buber, refers to the
process of deeply feeling another person’s experience as if it were his own.
The Gestalt therapist considers the client’s perception of reality as real and
valid as anyone else’s and immerses into the client’s experience as deeply as
possible.
By
responding to the client’s perception of reality with empathy, honesty,
compassion, and respect, the Gestalt therapist creates a venue wherein the
client’s innermost thoughts and emotions can safely surface and be expressed.
Dialogue and
Self-Disclosure
The
Gestalt therapy relationship is based on dialogue- the verbal interaction
between two individuals on a horizontal plane. With the client, the Gestalt
therapist surrenders to the interaction and is open to be changed by what
transpires in the session.
Occasionally and as appropriately called for, the Gestalt
therapist will disclose his personal experiences and reactions, making the
dialogue between therapist and client a mutual phenomenological
exploration.
What
are some techniques used in Gestalt
therapy?
Gestalt
therapy discourages a cookbook style of applying experiments or techniques on
clients. The choice and application of interventions must be tailored to the
client’s unique needs. During the session, the Gestalt therapist creatively
comes up with interventions (also called “experiments”) that aim to deepen
awareness. Some of these Gestalt therapy techniques include the
following:
Focusing
The
Gestalt therapist’s standard question is, “What are you aware of, or
experiencing, at this very moment?” The client is then invited to “stay with”
the thought, feeling, or body sensation experienced during that moment in the
session.
Enactment
Enactment is done by asking the client to put feelings or
thoughts into action. The client may also be asked to exaggerate whatever
action the client does.
Enactment may also come in the form of creative
expression through
art, poetry, dance, or vocalization.
Guided
Visualization
The
Gestalt therapist can invite the client to engage in mental experiments such as
guided imagery exercises or by making the client imagine that a past situation
is happening at the present moment.
Guided
visualizations and fantasy-based interventions have a “loosening” effect on
people with rigid mindsets.
Body
Awareness
Gestalt
therapy has a special interest in the client’s movements, physical sensations,
and breathing patterns. At times, the therapist may ask the client to locate
the area where feelings reside (or are intensely felt) in the
body.
What do
research studies say about Gestalt
therapy?
Uwe
Strumpfel (2006) conducted a meta-analysis of 74 published research studies on
psychotherapy and confirmed the following
findings:
@ Gestalt
therapy was effective in a variety of clinical problems such as psychotic
disorders, mood disorders, anxiety disorders, psychosomatic disorders, substance
dependence, personality disorders.
@ Gestalt
therapy produced stable long-term effects.
@ Clients who underwent Gestalt therapy evaluated it as very
helpful.
@ Clients showed marked improvement in their main symptoms,
personality dysfunction, self-concept, and interpersonal
relationships.
