Gestalt Therapy challenges and confronts you

Gestalt therapy seeks to understand how the client sees the world, without the pre-conceived ideas of others getting in the way. Gestalt techniques focus on heightening the individual’s awareness of their responsibility for their own behaviour, feelings, and thoughts, including those they may not be aware of (Gilliland & James, p. 137). It deals with immediate, direct feelings: instead of talking about the client’s childhood trauma, the client is encouraged to become the hurt child, to feel the pain, right now.

Gestalt: The whole is greater than the sum of its parts: everything a client does and does not do is an expression of the self. Understanding of the self is based on the totality of experience (gestures, voice, posture, breathing, unspoken words), the Gestalt.

Therapeutic Relationship

Gestalt therapy sessions are different from other therapies. Psychoanalysts try to not interact with their patients at all, so as not influence their thinking. Rogerian therapists aim to accept without judging, giving unconditional positive regard. Gestalt therapists will challenge, confront and discomfort their clients.

Gestalt therapists believe that the client needs direct, minute by minute interaction and feedback. Reflecting back what they are doing is the only way that the client will come to realize how they are creating their own problems. The therapist asks questions, as opposed to offering opinions. Gestalt therapists do not interpret for the client what they think what the client might be saying or doing. The therapist only observes and reflects.

Gestalt therapists will notice and point out when say, a client is automatically stopping acknowledgement of of their own experiences. For example when a client might smile apologetically and change the topic after reporting the death of a beloved grandmother, without noticing that doing that means she has distanced herself from the feeling.

The Gestalt therapist does not try to fit the client into any theoretical framework. Instead, the therapist simply observes, reflects back and makes the client aware of what they are doing. For each individual, the organization of their external world is defined by their subjective reality. To change the world, you have to change yourself. To change yourself you need to change your perceptions.

Gestalt Therapy Concepts

Awareness

Awareness is the key to positive growth and integration. Awareness comes from attending to and observing what is happening in your body in the present moment, what you are doing, feeling and thinking right now.

Gestalt theory focuses on recognising and analysing the elements of Contact, Boundaries and Support. Contact involves being aware of the connection with others, with the world outside oneself, while actively managing, monitoring and maintaining that connection. Boundaries join and separate us. With weak boundaries we confuse the needs of others with our own. With rigid boundaries we feel alone and alienated. Support comes from inner resources. Anxiety occurs when we do not believe we have or will have the support we need. “Awareness is curative.”

Boundary Disturbances

Clients are taught to recognize boundaries between them and others, between what they do and what they think they should do. A form of neurotic self-regulation occurs when you live according to unconscious rules you’ve learned so well that they seem natural. For example, in automatically being polite and agreeable all the time, we are disregarding our own interests, concerns and opinions.

When there are disturbances in the contact boundaries, several difficulties result. Awareness of these disturbances is one focus of Gestalt therapy.

Introjection: You believe your thinking and emotions really belong to or are shared by someone else. Individuals accept information or values from others without evaluating them.

Projection: When we ascribe aspects of ourselves to others, such as when we project some of our own unacceptable thoughts, feelings, or behaviors on to friends.

Retroflection: feeling toward other turned on self. When we do to ourselves what we want to do to someone else.

Deflection: When individuals avoid meaningful contact by being indirect or vague rather that being direct, deflection occurs, avoiding contact with self or other

Confluence: When the separation between one's self and others becomes muted or unclear, we experience confluence. Thus, it can be difficult to distinguish what is one's own perception or values from those of another person. Merging with another through agreement of opinion or feeling (we are one)

Lack of Awareness: Peeling the onion

Gestalt therapist see change as going through five stages.

1) The Phony Layer: Behaving inauthentically in social settings. Reacting to others in unauthentic or patterned ways.

2) The Phobic Layer: Energy is spent covering feelings of fear and helplessness. An avoidance of psychological pain. “I’m fine, I’m fine.” (Similar to Denial)

3) The Impasse Layer: Is the point at which we are afraid to change or move. An impasse is a situation in which external support is not forthcoming and the person believes he cannot support himself.

4) The Implosive Layer: the client may experience their feelings, start to become aware of the real self, but may do little about the feelings. Contact with the implosive level is authentic and without pretence.

5) The Explosive Layer: Letting go of old self, thus energy is freed up to form new self.

Techniques of Gestalt Therapy

Body Awareness

The primary technique to get the client in touch with their feelings by noticing how their own body is expressing them. Questions are aimed at becoming aware of what they are doing in the moment, to encourage client to “stay with” emotion in session. Most clients are not good at staying with emotions, most of their energy is spent trying to move past or avoid the emotion.

“Where do you feel your anger?” A feeling that one’s head is about to blow up is different from an ache in the stomach. An unconsciously clenched jaw may be a sign of an impulse to speak being repressed: “If your clenched jaw could speak, what would it say?” “Really exaggerate your clenched jaw to increase intensity” while talking about how you feel.

“Think of a strong emotion you recently felt. Can you locate it in your body? Does its location clarify the emotion to you in any way? Now feel the emotion and conduct a body scan to determine how you physically express this emotion”.

Role Playing

Client acts out different perspectives, people, polarities, conflicts, etc. during the session. Uses their imagination to actively fantasize and make experiences vivid.

Empty Chair Technique: Use an empty chair for a discussion. Client sits in one chair to defend “I should” and then moves to another chair to discuss “I want”. Use to act out character, emotion, inner conflict for conflict resolution.

Dream Work

Each part of a dream represents a projection or aspects of the dreamer, fragments of a personality that need to be integrated.

Get the client to present the dream in detail and in the present tense. Client plays roles of persons and objects in dream, client gives a voice to each part and has them converse. Helps to integrate parts, make sense of and utilize dreams.

Fantasy Games

For creating awareness:

Client fantasizes being an animal and tries to understand what it feels like

Wise person: client asks and answers one question to/from a wise person

Psychodrama

Uses a group of people to act out past experience of client, with client acting as the director. This is used to bring past into present. The client can act as self and experiment with alternative ways of interacting. Doing it is always preferable to talking about it.

Writing

Integrate thoughts and feelings

For three closest people write
- “I resent _____”
- “I demand _____” and
- “I appreciate _____”

Write a paragraph on my greatest weakness and why it is a strength

Language Modification

Close attention to the client’s language reveals their world view and typical methods of avoidance.

Therapist insists on using present tense and the use of the word “I”.

“I Can’t” must be turned into “I choose not to”. “I have to” changes to “I want to”. “I won’t” replaces “I can’t”. “I’m not able to” becomes “I decide not to”.

Turn statements about others into statements about self (to explore projection). Change questions to statements “I should” not “do you think I should”

Take responsibility: Right now I feel _______and I take _______ % of the responsibility

Sentence completion (a favorite of Gil Boyne) “I help/hurt myself when I ___________

Adding on “… and I take responsibility for it”

Influence

Gestalt is often criticized as being unscientific because it does not have a theoretical basis. It was developed in the 1950s and soon split into competing variants but the techniques had a wide impact. The influence of Gestalt can be seen today in many different modalities: Parts Therapy; Symbolic Modelling; Metaphor therapy; PsychoDrama; Transactional Analysis; Mindfulness; all use ideas drawn from Gestalt. Many therapists are unaware that they are using techniques that originated from Gestalt.

References

Gilliland, B. & James, R. (1997) Theory and Practice of Counseling and Psychotherapy. Ch 8. NY: Allyn & Bacon, Inc ISBN 978-0205268320

Zinker, J. (1978) Creative Process in Gestalt Therapy. NY: Random House. ISBN 978-0876301401