iPsychology

Gestalt Therapy

Gestalt therapy is a humanistic therapy technique that focuses on gaining an awareness of emotions and behaviors in the present rather than in the past. The therapist does not interpret experiences for the patient. Instead, the therapist and patient work together to help the patient understand him/herself. This type of therapy focuses on experiencing the present situation rather than talking about what occurred in the past. Patients are encouraged to become aware of immediate needs, meet them, and let them recede into the background. The well-adjusted person is seen as someone who has a constant flow of needs and is able to satisfy those needs.

In Gestalt therapy (from the German word meaning form), the major goal is self-awareness. Patients work on uncovering and resolving interpersonal issues during therapy. Unresolved issues are unable to fade into the background of consciousness because the needs they represent are never met. In Gestalt therapy, the goal is to discover people connected with a patient's unresolved issues and try to engage those people (or images of those people) in interactions that can lead to a resolution. Gestalt therapy is most useful for patients open to working on self-awareness.

The choice of a therapist is crucial. Some people who call themselves "therapists" have limited training in Gestalt therapy. It is important that the therapist be a licensed mental health professional. Additionally, some individuals may not be able to tolerate the intensity of this type of therapy.

Gestalt therapy has developed into a form of therapy that emphasizes medium to large groups, although many Gestalt techniques can be used in one-on-one therapy. Gestalt therapy probably has a greater range of formats than any other therapy technique. It is practiced in individual, couples, and family therapies, as well as in therapy with children.

Ideally, the patient identifies current sensations and emotions, particularly ones that are painful or disruptive. Patients are confronted with their unconscious feelings and needs, and are assisted to accept and assert those repressed parts of themselves.

The most powerful techniques involve role-playing. For example, the patient talks to an empty chair as they imagine that a person associated with an unresolved issue is sitting in the chair. As the patient talks to the "person" in the chair, the patient imagines that the person responds to the expressed feelings. Although this technique may sound artificial and might make some people feel self-conscious, it can be a powerful way to approach buried feelings and gain new insight into them.

Sometimes patients use battacca bats, padded sticks that can be used to hit chairs or sofas. Using a battacca bat can help a patient safely express anger. A patient may also experience a Gestalt therapy marathon, where the participants and one or more facilitators have nonstop group therapy over a weekend. The effects of the intense emotion and the lack of sleep can eliminate many psychological defenses and allow significant progress to be made in a short time. This is true only if the patient has adequate psychological strength for a marathon and is carefully monitored by the therapist.

Gestalt therapy begins with the first contact. There is no separate diagnostic or assessment period. Instead, assessment and screening are done as part of the ongoing relationship between patient and therapist. This assessment includes determining the patient's willingness and support for work using Gestalt methods, as well as determining the compatibility between the patient and the therapist. Unfortunately, some "encounter groups" led by poorly trained individuals do not provide adequate pretherapy screening and assessment.

Sessions are usually held once a week. Frequency of sessions held is based on how long the patient can go between sessions without losing the momentum from the previous session. Patients and therapists discuss when to start sessions, when to stop sessions, and what kind of activities to use during a session. However, the patient is encouraged and required to make choices.

Disturbed people with severe mental illness may not be suitable candidates for Gestalt therapy. Facilities that provide Gestalt therapy and train Gestalt therapists vary. Since there are no national standards for these Gestalt facilities, there are no set national standards for Gestalt therapy or Gestalt therapists.

Normal results

Scientific documentation on the effectiveness of Gestalt therapy is limited. Evidence suggests that this type of therapy may not be reliably effective.

Abnormal results

This approach can be anti-intellectual and can discount thoughts, thought patterns, and beliefs. In the hands of an ineffective therapist, Gestalt procedures can become a series of mechanical exercises, allowing the therapist as a person to stay hidden. Moreover, there is a potential for the therapist to manipulate the patient with powerful techniques, especially in therapy marathons where fatigue may make a patient vulnerable

Gestalt therapy is a form of psychotherapy, based on the experiential ideal of "here and now," and relationships with others and the world. Drawing on the ideas of humanistic psychology, the school of Gestalt therapy was co-founded by Fritz Perls, Laura Perls Ralph Hefferline and Paul Goodman in the 1940s-1950s. It is related to but not identical to Gestalt psychology and the Gestalt psychology-based Gestalt Theoretical Psychotherapy of Hans-Juergen Walter.

The school of Gestalt therapy was co-founded by Fritz Perls, Laura Perls- both of whom were originally traditional psychoanalysts , Ralph Hefferline a university psychology professor , and Paul Goodman political writer and anarchist, in the late 1940s to early 1950s. The seminal work was Gestalt Therapy, Excitement and Growth in the Human Personality published in 1951.

They take approaches from a wide variety of psychological and philosophical disciplines, integrating them into a therapeutic approach based on the idea of a complete organism (mind and body as an integrated whole). The objective of this therapy is, to help the person to obtain a greater independence (seen as freedom and responsibility) in their actions, and the ability to face up to the blockages that prevent them developing naturally.

Based initially on the insights of Gestalt psychology and traditional psychoanalysis, Gestalt therapy has developed as a humanistic psycho-therapeutic model, with a well developed theory that combines phenomenological, existential, dialogical, and field approaches to the process of transformation and growth, of human beings.

At the centre of Gestalt therapy lies the promotion of "awareness". The individual is encouraged to become aware of his or her own feelings and behaviours, and their effect upon his environment in the here and now. The way in which a he or she interrupts or seeks to avoid contact with the present environment is considered to be a significant factor when recovering from psychological disturbances. By focusing the individual on their self-awareness as part of present reality, new insights can be made into the their behaviour, and they can engage in self-healing.

Principal influences

• Wilhelm Reich's psychoanalytic developments, especially the concept of character armor and its focus on the body.
• Jacob Moreno's Psychodrama, principally the development of body experimentation techniques for the resolution of psychological conflicts
• Max Wertheimer's Gestalt Psychology , which this therapy derives its name from, influences the application of the concepts about perception to a broader theory about the necessities of humans, and the relation of humans with their surroundings.
• Kurt Goldstein's theory of the organism, based on Gestalt theory.
• Martin Buber's existential philosophy of relationship and dialogue ("I - Thou").
• Carl Gustav Jung's psychology, particularly the polarities concept
• Some elements from existentialism and Zen Buddhism

The practice of Gestalt therapy is based firmly in the personal experience of both the client and the therapist; furthermore, Gestalt therapy is based on an elaborate theory that developed over many years since the 1940s. Consequently, the following points can give no more than a rough impression.

The human being is seen as an indissoluble entity; we cannot work with the mind without also taking account of the body. The two are closely related with, for example, particular emotions being associated with certain postures.

Self-actualization, proceeds by the individual becoming gradually aware of the entirety of themselves and of all that that implies. Generally we are not aware of the greater part of ourselves and we only identify with a lesser part.

For example, in the extreme case of someone over-identified with their job, a person would define themselves through their professionalism, position, authority, responsibility, ability, organization, etc. They will rarely mention other aspects of their identity, such as relationships with a partner or friends. Conversely, they will be strongly influenced by success in their career area, and events like being fired, jobless or retired, could trigger a crisis.

The problem in identifying with a limited number of aspects of ourselves is that the we do not use much of our potential. By assuming we lack of inner resources we look for external support, creating dependencies.

Formation of Gestalt

In the German Gestalt psychology, developed by Max Wertheimer, the mind is considered to function by realizing the distinction between the figure (that which attracts attention or protruding) and the ground (that which dwells in the background/ second plane). Perls uses this distinction of figure-ground to establish a principle of human need. He conceived that needs are part of a continuum. The most pronounced need manifests as a figure until its resolution. This type of Gestalt is called a Gestalt controller since it guides the mental process.

An extreme example of the mental function of this mechanism is the case of a toothache. When we have a toothache, our whole world revolves round the pain. We do not care about other concerns. Until we solve our problem of pain, we can not attend to any other affairs with clarity.

With psychological needs something similar happens; a need is considered in this plane to be like an unresolved situation or an unclosed gestalt. This is manifest as thoughts that seize the mind most of the time in involuntary ways. (For example our conscience may compulsively dialogue with us over an issue). Or it may manifest as a filter that makes us blind to certain information in our environment. (For example, someone who has had a history of abuse in childhood might fail to observe issues of power and abuse in relationships in the present day. These aspects are effectively left in the second plane/background and never come to the fore).

The formation process and Gestalt closing is a natural process that works without human intervention or the control of our will. We go through Gestalt processes everyday that form and close naturally in time. Nevertheless, situations sometimes occur which do not get resolved as they are supposed to, sometimes to a point that we forget the original problem exists or we believe that it has been resolved. This class of perpetuatal problem can cause psychological difficulties.

The Gestalt psychotherapist works with this unfinished mental content or filter forms. They help the individual to recognise them and work towards the closing of the Gestalt using various techniques suggested by the psychotherapist.

Contact boundaries

The human being establishes a relationship with his or her surrounding environment; this relationship defines a boundary. This boundary is what allows a distinction to be made between self and non self, but it is also the area where contact takes place. In Gestalt therapy, it is defined as the ego boundary or the contact boundary. In Gestalt therapy it is considered that the relationships with other people are made at this boundary. When it happens in a healthy manner, then the boundary is flexible, which means that we are capable of distinguishing I from you, but also of forming a we. We are capable of coordinating the appropriate needs with those that surround us and we can see each other as a complete person, and not only as a function of our needs and wishes.

Generally, in a relationship with another person, we are each subject to number of conflicts of interest. In most cases, the individual-societal conflict faces us with a conflict between our needs and the demands of others. Concepts of obligations like must do transform themselves into ideals as to what we must do in a particular situation. We then create rigid formulae for relationships which correspond to these must do obligations. In time these become more and more rigid. In Gestalt therapy, this rigidity is called the character. The structure of a character is an inflexible form of relating which transforms, in the long run, into an obstacle to communications with others.

Another important aspect of the contact boundary is the function of those phenomena known as identification and alienation. Gestalt therapy proposes that we often identify with only small parts of our own true selves. This affects the way we see what is in ourselves and what is in others. We make assumptions that certain characteristics of ourselves belong to others, a process known as identification. We may consider some good qualities as only belonging to others when in reality they are also parts of ourselves. This also produces the phenomenon known as alienation; for example, when we have no capacity to see some defect in ourselves, we tend to criticize it when we see it in others.

Organismic self-regulation

Finally, it is possible to emphasize beforehand that as a basic principle to all the described processes, that Gestalt therapy relies on the naturalness of crux of the psychological processes. Considering organisms as intelligent, any attempt to control or manipulate causes organic imbalance. It is believed that a majority of psychological problems arise from this manipulation or the need of control. The therapeutic principle first kills off control to allow the organism to self regulate naturally. At the base is the belief in that any attempt of directing a change is accostomed to producing the opposite effect, in which the controller part of the person attempts to obtain the objective, but faces another party that refuses that control.

The difference between decisions and preferences, are that decisions are voluntary choices, guided for a form of control (external or internal), and preferences are the choices that in each moment the organism shows as important (through the process of the formation of Gestalt)

Psychotherapeutic bases

The goal of Gestalt therapy is to facilitate the removal of obstacles that lie between a person and the utilization of their full potential. Gestalt therapy's techniques and attitude create a space in which the patient can recover his or her capacity for living. In this way a person can learn to be aware of the self and aware of his or her interactions with others, living in the moment and assuming responsibility for their actions. For Perls, the appropriate experience, further on from the whole explanation or possible interpretation, is therapeutic or corrective in this sense.

It is in this way that Claudio Naranjo systemitizes Gestalt therapy along three basic principles: attitude, attention and responsibility, and constantly brings the patient back to these principles throughout their therapy.

Excessive concentration on the past (memories) or on the future (plans) is a form of escapism with respect to the present. These fantasies with both often occur as a form of escape from the present moment when we can not resolve something or we can not totally experiment. Nevertheless, nothing exists outside the present moment.

By this, Gestalt therapy focuses on the here and now in two ways: on the one hand, it insists on expressing everything that is within the field of the awareness of the client, and working with that; and on the other hand, by means of presentification of the past or future—or of fantasy in general—dramatizing past scenes—even those from dreams—or fantasies of the future. This is made real through gestural, postural, and verbal forms.

Assuming the figure-ground game as a basis for perception, Gestalt therapy attempts to achieve permeability between the two. This permits softening of rigid methods of relating with society (character) with which unknown capacities are recovered to form the grounds of attention.

In this manner, the client is encouraged to be aware of his or her feelings, thoughts, body posture, breathing rhythm, physical sensations, etc., enhancing day-to-day experience. In the next stage, the client is directed to experiment across the dramatization of feelings, thoughts, body posture, etc., of other people (fathers, friends, intimate partners, those who appear in dreams) who are brought as significant material to the session.

The principal idea is to replace the concept of blame (related to shoulds and musts) with responsibility (related to organismic self-regulation). This creates a flexibility with the relationship with the medium, allowing natural equilibrium between needs and the environment, permitting the natural equilibrium between one's own needs and those of the environment.

Gestalt therapy emphasizes the independence of the client, leaving him or her in charge of his or her own development. This contributes to a great measure the role of Gestalt therapy, understood more as a facilitator or guide to the therapeutic process rather than making the Gestalt responsible for the client's well being or pretend to create confidence in the client and his capacity. In this manner it avoids generating a relation of dependency with both and creates a model for a positive relationship for personal growth.

In this light, the therapist does not have the truth about the client, and neither inteprets nor offers solutions. The therapist's role is to generate a space for the client to experiment by himself/herself in a sufficiently protected atmosphere.

Gestalt therapy, along with transactional analysis (TA)—most specifically, Michigan Transactional Analysis—strongly influenced Neuro-linguistic programming (NLP)

Moral injunctions of Gestalt therapy

• Live now, stay in the present.
• Live here, be with the present.
• Stop imagining, experience reality.
• Stop unnecessary thinking.
• Express, rather than manipulating, explaining, justifying, or judging.
• Give in to unpleasantness do not restrict your awareness.
• Accept no "should" or "ought", other than your own.
• Take full responsibility for your own actions, feelings and thoughts.
• Surrender to being who you are right now.