Chapter 8: Gestalt Therapy

Because the Gestalt therapist has no agenda beyond assisting clients to increase their awareness, there is no need to label a client's behavior as ____________.

"resistance."

Change occurs through the heightened awareness of ________ ______.

"what is."

Limitations and Criticisms of Gestalt Therapy

1. For Gestalt therapy to be effective, the therapist must have a high level of personal development. Being aware of one's own needs and seeing that they do not interfere with the client's process, being present in the moment, and being willing to be nondefensive and self-revealing all demand a lot of the therapist. There is a danger that therapists who are inadequately trained will be primarily concerned with impressing clients. 2. Inept therapists may use powerful techniques to stir up feelings and open up problems clients have kept from full awareness only to abandon the clients once they have managed to have a dramatic catharsis. Such a failure to stay with clients and help them work through what they have experienced and bring some closure to the experience can be detrimental and could be considered as unethical practice.

Gestalt Therapy: Shortcomings from a Diversity Perspective

1. Gestalt methods can lead to a high level of intense feelings. This focus on affect has clear limitations with those clients who have been culturally conditioned to be emotion ally reserved and to avoid openly expressing feelings. 2. Therapists who operate on the assumption that catharsis is necessary for any change to occur are likely to find certain clients becoming increasingly reluctant to participate in experiments, and such clients may prematurely terminate counseling.

Gestalt Therapy: Strengths from a Diversity Perspective

1. There are opportunities to creatively use Gestalt methods with culturally diverse populations if interventions are timed appropriately and used flexibly. 2. contemporary Gestalt therapy can be a useful and effective approach with clients from diverse backgrounds because it takes the clients' context into account 3. Gestalt experiments is that they can be tailored to fit the unique way in which an individual perceives and interprets his or her culture 4. In cultures where indirect speech is the norm, non verbal behaviors may emphasize the unspoken content of verbal communication. These clients may express themselves nonverbally more expressively than they do with words.Gestalt therapists typically ask clients to focus on their gestures, facial expressions, and what they are experiencing within their own body. They attempt to fully understand the background of their clients' culture. They are concerned about which aspects of this background become central or figural for their clients and what meaning clients place on these figures.

Miriam Polster (1987) described a three-stage integration sequence that characterizes client growth in therapy:

1. discovery 2. accommodation 3. assimilation

Contributions of Gestalt Therapy

1. the exciting way in which the past is dealt with in a lively manner by bringing relevant aspects into the present. 2. paying attention to the obvious verbal and nonverbal leads provided by clients is a useful way to approach a counseling session 3. Through the skillful and sensitive use of Gestalt interventions, practitioners can assist clients in heightening their present-centered awareness of what they are thinking and feeling as well as what they are doing. 4. Gestalt methods bring conflicts and human struggles to life. 5. Gestalt therapy is a creative approach that uses experiments to move clients from talk to action and experience. 6. Gestalt therapy is a holistic approach that values each aspect of the individual's experience equally. 7. They do not approach clients with a preconceived set of biases or a set agenda. 8. A key strength of Gestalt therapy is the attempt to integrate theory, practice, and research. Although Gestalt therapy was light on empirical research for several years, it has come more into vogue recently.

What are the three cornerstones of practice?

Awareness, choice, and responsibility

discovery

Clients are likely to reach a new realization about themselves or to acquire a novel view of an old situation, or they may take a new look at some significant person in their lives. Such discoveries often come as a surprise to them.

the figure-formation process

Derived from the study of visual perception by a group of Gestalt psychologists, the figure-formation process tracks how the individual organizes experience from moment to moment as some aspect of the environmental field emerges from the background and becomes the focal point of the individual's attention and interest.

An example of the figure-formation process

For example, imagine seeing a woman on a hill in the distance. You do not see her clearly but receive an overall impression of this figure: a Gestalt. As you move closer, you gain more awareness of this figure and she becomes increasingly clear and more detailed: you see her face and the way she buttons her blouse. In the figure-formation process, contemporary Gestalt therapists facilitate the client's movement toward and away from this figure of interest. The dominant needs of the individual at a given moment influence this process

Who was the main originator and developer of Gestalt therapy?

Fritz Perls

What is the paradoxical theory of change?

Fritz's good friend and psychiatrist colleague Arnie Beisser (1970) suggested that authentic change occurs more from being who we are than from trying to be who we are not.

What is immediately evident in the experience of the perceiver?

Genuine knowledge

Holism

Gestalt is a German word meaning a whole or completion, or a form that cannot be separated into parts without losing its essence. All of nature is seen as a unified and coherent whole, and the whole is different from the sum of its parts. Because Gestalt therapists are interested in the whole person, they place no superior value on a particular aspect of the individual. Gestalt practice attends to a client's thoughts, feelings, behaviors, body, memories, and dreams.

The Gestalt approach focuses much more on process than on content. This process involves

Gestalt therapists putting themselves as fully as possible into the experience of the client without judgment, analyzing, or interpreting, while concurrently holding a sense of one's individual, independent presence.

Field theory

Gestalt therapy is based on field theory, which, simply put, asserts that the organism must be seen in its environment, or in its context, as part of the constantly changing field.

What are important awareness processes and goals which are all based on a here-and-now experiencing that is always changing?

Self-acceptance, knowledge of the environment, responsibility for choices, and the ability to make contact with their field (a dynamic system of interrelationships) and the people in it

explain empty chair

The empty chair is a vehicle for the technique of role reversal, which is useful in bringing into consciousness the fantasies of what the "other'' might be thinking or feeling. Essentially, this is a role-playing technique in which all the parts are played by the client. In this way the introjects can surface, and the client can experience the conflict more fully.

Organismic self-regulation

The figure-formation process is intertwined with the principle of organismic self-regulation, a process by which equilibrium is "disturbed" by the emergence of a need, a sensation, or an interest. Organisms will do their best to regulate themselves, given their own capabilities and the resources of their environment (Latner, 1986). Individuals can take actions and make contacts to restore equilibrium or to contribute to growth and change. What emerges in therapeutic work is what is of interest to the client or what the client needs to gain equilibrium or to change. Gestalt therapists direct the client's awareness to the figures that emerge from the background during a therapy session and use the figure-formation process as a guide for the focus of therapeutic work.

Although Perls was influenced by psychoanalytic concepts, he took issue with Freud's theory on a number of grounds. How so?

Whereas Freud's view of human beings is basically mechanistic, Perls stressed a holistic approach to personality. Freud focused on repressed intrapsychic conflicts from early childhood, whereas Perls valued examining the present situation.

Gestalt therapy does not ascribe to a "goal-oriented" methodology per se, but therapists clearly attend to

a basic goal-namely, assisting the client to attain greater awareness, and with it, greater choice.

Field theory may emphasize

a figure (those aspects of the individual's experience that are most salient at any moment) or the ground (those aspects of the client's presentation that are often out of his or her awareness). Cues to this background can be found on the surface through physical gestures, tone of voice, demeanor, and other nonverbal content. This is often referred to by Gestalt therapists as "attending to the obvious," while paying attention to how the parts fit together, how the individual makes contact with the environment, and integration.

A current trend in Gestalt practice is toward greater emphasis on the client-therapist relationship, and therapists who operate from this orientation are able to establish

a present-centered, nonjudgmental dialogue that allows clients to deepen their awareness and to make contact with another person

Perls' conception of human nature and these two agendas set the stage for

a variety of techniques and for his confrontational style of conducting therapy.

Gestalt therapy is lively and promotes direct experiencing rather than the

abstractness of talking about situations.

The therapist's job is to invite clients into an active partnership where they can learn about themselves by

adopting an experimental attitude toward life in which they try out new behaviors and notice what happens

The general orientation of Gestalt therapy is toward dialogue which is

an engagement between people who each bring their unique experiences to that meeting (**Traditional Gestalt therapists assumed that clients must be confronted about how they avoid accepting responsibility, but the dialogic attitude that characterizes contemporary Gestalt therapy creates the ground for a meeting place between client and therapist.)

What is learned from an experiment is a surprise to both the client and the therapist because

an experiment is an intentional entry into novel experience aimed at discovery.

Perls practiced a highly confrontational approach as a way to deal with _________, but this technique-focused style of working has given way to a more __________-___________ methodology today

avoidance; dialogue-centered

The major focus is on assisting the client to become

aware of how behaviors that were once part of creatively adjusting to past environments may be interfering with effective functioning and living in the present.

A basic assumption of Gestalt therapy is that individuals have the capacity to self-regulate when they are

aware of what is happening in and around them.

A main goal of the Gestalt group is to heighten

awareness and self-regulation through interactions with one another and the group itself

Gestalt leaders are especially concerned with

awareness, contact, and experimentation

Define retroflection

consists of turning back onto ourselves what we would like to do to someone else or doing to ourselves what we would like someone else to do to or for us. -usually involves a fair amount of anxiety -Depression and psychosomatic complaints are often created by retroflecting. Typically, these maladaptive styles of functioning are adopted outside of our awareness; part of the process of Gestalt therapy is to help us discover a self-regulatory system so that we can deal realistically with the world.

In Gestalt therapy ________ is necessary if change and growth are to occur.

contact

The therapist has faith that self-regulation is a naturally unfolding process that does not have to be _____________.

controlled

Gestalt therapists also focus on interruptions, disturbances, and resistances to contact, which were developed as

coping processes but often end up preventing us from experiencing the present in a full and real way.

Blocked energy is another form of ____________ ____________.

defensive behavior.

Rather than trying to rid themselves of certain bodily symptoms, clients can be encouraged to

delve fully into tension states and bodily symptoms.

What does contemporary relational Gestalt therapy stress?

dialogue and the I/Thou relationship between client and therapist

The therapist works with the client to identify the figures, or most salient aspects of the individual-environmental field, as they emerge from the background. The Gestalt therapist believes each client is capable of self-regulating if those figures are

engaged and resolved so others can replace them.

In contemporary Gestalt therapy, confrontation is set up in a way that invites clients to

examine their behaviors, attitudes, and thoughts.

The Gestalt view of human nature is rooted in

existential philosophy, phenomenology, and field theory.

It is well to remember that Gestalt experiments are designed to

expand clients' awareness and to help them try out new modes of behavior.

The initial goal is for clients to

expand their awareness of what they are experiencing in the present moment (Through this awareness, change automatically occurs)

Contemporary Gestalt practitioners view clients as the ________ on their own experience and encourage them to attend to their

experts; sensory awareness in the present moment.

The effects of unfinished business often show up in some blockage within the body, and the therapist's task is to assist clients in

exploring these bodily expressions.

Therapy aims at awareness and contact with the environment, which consists of both the

external and internal worlds.

As a therapeutic orientation based on __________ ________, Gestalt therapy is well suited for a group context.

field theory

Clients may not be aware of their energy or where it is located, and they may experience it in a negative way. One of the tasks of the therapist is to help clients

find the focus of interrupted energy, identify the ways in which they are blocking energy, and transform this blocked energy into more adaptive behaviors.

Perls was a master at intentionally _____________ clients to enhance their awareness.

frustrating

The goal of the approach is, first and foremost, to _________ __________

gain awareness.

**The Gestalt approach helps clients note their own awareness process so that they can be responsible and can selectively and discriminatingly make choices. Awareness emerges within the context of a __________ meeting (contact) between client and therapist. The existential view (see Chapter 6) is that we are continually engaged in a process of remaking and discovering ourselves. We do not have a static identity, but discover new facets of our being as we face new challenges. Gestalt therapy is basically an existential encounter out of which clients tend to move in certain directions.

genuine

*In a nutshell, this approach focuses on the

here and now, the what and how of experiencing, the authenticity of the therapist, active dialogic inquiry and exploration, and the I/Thou of relating

Four basic principles underlying the theory of Gestalt therapy:

holism, field theory, the figure-formation process, and organismic self-regulation.

clients explain dreams

in present tense and as they are happening right now

Gestalt therapy is an existential, phenomenological, and process-based approach created on the premise that

individuals must be understood in the context of their ongoing relationship with the environment.

People who rely on retroflection tend to

inhibit themselves from taking action out of fear of embarrassment, guilt, and resentment.

With awareness, they have the capacity to face, accept, and integrate denied parts as well as to fully experience their subjectivity. Through becoming aware of these denied parts and working toward owning their experience, clients can become _________, or __________

integrated, or whole.

to Perls dreams are the "royal road to ____________"

integration

Effective contact means

interacting with nature and with other people without losing one's sense of individuality.

Polster and Polster (1973) describe five different kinds of contact boundary disturbances:

introjection, projection, retroflection, deflection, and confluence.

What is confluence

involves blurring the differentiation between the self and the envi ronment. As we strive to blend in and get along with everyone, there is no clear demarcation between internal experience and outer reality. Confluence in relationships involves the absence of conflicts, slowness to anger, and a belief that all parties experience the same feelings and thoughts we do. This style of contact is character istic of clients who have a high need to be accepted and liked, thus finding enmeshment comfortable. This condition makes genuine contact extremely difficult

assimilation

involves clients' learning how to influence their environment. At this phase clients feel capable of dealing with the surprises they encounter in everyday living and clients have learned what they can do to maximize their chances of getting what is needed from their environment.

accommodation

involves clients' recognizing that they have a choice. Clients begin by trying out new behaviors in the supportive environment of the therapy office, and then they expand their awareness of the world. Making new choices is often done awkwardly, but with therapeutic support, clients can gain skill in coping with difficult situations. Clients are likely to participate in out-of-office experiments, which can be discussed in the next therapy session.

Gestalt experiments work best when the therapist

is respectful of the client's cultural background and has a solid working alliance with the person.

Awareness includes

knowing the environment, knowing oneself, accepting oneself, and being able to make contact. Increased and enriched awareness, by itself, is seen as curative.

Gestalt therapists do not force change on clients through confrontation. Instead, they work within a context of

l/Thou dialogue in a here-and-now framework.

The goal of an experiment is always

learning-slowing down and deepening experience in the service of new understanding and new possibilities for more flexible and effective response

In Gestalt therapy special attention is given to where energy is

located, how it is used, and how it can be blocked.

Perls's style of doing therapy involved two personal agendas:

moving the client from environmental support to self-support and reintegrating the disowned parts of one's personality.

Explain impasse (or stuck point)

occurs when external support is not available or the customary way of being does not work. The therapist's task is to accompany clients in experiencing the impasse without rescuing or frustrating them. The counselor assists clients by providing situations that encourage them to fully experience their condition of being stuck. By completely experiencing the impasse, they are able to get into contact with their frustrations and accept whatever is rather than wishing they were different. **Gestalt therapy is based on the notion that individuals have a striving toward actualization and growth and that if they accept all aspects of themselves without judging these dimensions they can begin to think, feel, and act differently.

If we remain in introjection,

our energy is bound up in taking things as we find them and believing that authorities know what is best for us rather than working for things ourselves.

When we introject, we

passively incorporate what the environment provides rather than clearly identifying what we want or need.

A defining characteristic of awareness is

paying attention to the flow of your experience and being in contact with what you are doing when you are doing it

Phenomenological inquiry involves

paying attention to what is occurring now and suspending any preconceived ideas, assumptions, or interpretations concerning the meaning of a client's experience.

The approach is phenomenological because it focuses on the client's ____________ of reality and existential because it is grounded in the notion that people are always

perceptions; in the process of becoming, remaking, and rediscovering themselves.

Gestalt therapists pay attention to and explore what is occurring at the boundary between the

person and the environment.

Gestalt therapy is an experiential approach that stresses two things:

present awareness and the quality of contact between the individual and the environment.

To promote "now'' awareness, the therapist encourages a dialogue in the _________ _________

present tense

Gestalt therapists use active methods and personal engagement with clients to increase their awareness, freedom, and self-direction rather than directing them toward

preset goals

Perls's concept of ____________ is central in his theory of dream formation; every person and every object in the dream represents a

projection; projected aspect of the dreamer.

What are exercises?

ready-made techniques that are some times used to make something happen in a therapy session or to achieve a goal. They can be catalysts for individual work or for promoting interaction among members of a therapy group.

Contemporary Gestalt therapy places much less emphasis on ___________ than the early version of Gestalt therapy.

resistance

The Gestalt theory of change posits that the more we work at becoming who or what we are not, the more we remain the _______.

same.

Contact is made by

seeing, hearing, smelling, touching, and moving.

Gestalt therapists ask clients to invest themselves fully in their current condition rather than

striving to become who they should be.

Experiments are aimed at facilitating a client's ability to work through the ________ ________ of his or her life.

stuck points

experiments need to offer a balance between

support and risk

Therapy provides the setting and opportunity for that awareness to be ___________ and ______________.

supported and restored.

Unfinished business persists until

the individual faces and deals with the unexpressed feelings.

We attempt to diffuse or defuse contact through

the overuse of humor, abstract generalizations, and questions rather than statements.

Define deflection

the process of distraction or veering off, so that it is difficult to maintain a sustained sense of contact. When we deflect, we speak through and for others, beating around the bush rather than being direct and engaging the environment in an inconsistent and inconsequential basis, which results in emotional depletion.

Define projection

the reverse of introjection. In projection we disown certain aspects of ourselves by assigning them to the environment. Those attributes of our personality that are inconsistent with our self-image are disowned and put onto, assigned to, and seen in other people; thus, blaming others for lots of our problems. By seeing in others the very qualities that we refuse to acknowledge in ourselves, we avoid taking responsibility for our own feelings and the person who we are, and this keeps us powerless to initiate change. People who use projection as a pattern tend to feel that they are victims of circumstances, and they believe that people have hidden mean ings behind what they say.

Define introjection

the tendency to uncritically accept others' beliefs and standards without assimilating them to make them congruent with who we are. These introjects remain alien to us because we have not analyzed and restructured them.

The way in which clients resist doing an experiment reveals a great deal about

their personality and their way of being in the world.

Explain resistances

they are typically adopted out of our awareness and, when they function in a chronic way, can contribute to dysfunctional behavior. Because resistances are developed as a means of coping with life situations, they possess positive qualities as well as problematic ones, and many contemporary Gestalt therapists refer to them as "contact boundary phenomena."

What are experiments?

they grow out of the interaction between client and therapist, and they emerge within this dialogic process (so, a surprise for both the client and therapist). They can be considered the very cornerstone of experiential learning. Spontaneous, one-of-a-kind, and relevant to a particular moment and a particular development of a figure-formation process. They are not designed to achieve a particular goal but occur in the context of a moment-to-moment contact ing process between therapist and client. Frew (2013) defines the experiment "as a method that shifts the focus of counseling from talking about a topic to an activity that will heighten the client's awareness and understanding through experience"; flows directly from psychotherapy theory and is crafted to fit the individual as he or she exists in the here and now; an intervention and active technique that facilitates the collaborative exploration of a client's experience (Brownell, 2016; Yontef & Schulz, 2013). Experiments give people a chance to be systematic in learning by doing and are best thought of as ways of exploring a client's experiential world (experience internal conflicts, resolve inconsistencies and dichotomies, and work through impasses that prevent completion of unfinished business.) Clients explore their awareness process and discover how their thinking, feeling, sensing, and behaving either works for them or does not

Gestalt therapists emphasize paying attention to the bodily experience on the assumption that if feelings are unexpressed

they tend to result in some physical sensations or problems.

Gestalt therapists talk about the two functions of boundaries:

to connect and to separate (*Both contact and withdrawal are necessary and important to healthy functioning.)

It is essential that counselors establish a relationship with their clients, so that the clients will feel ________ enough to participate in the learning that can result from Gestalt experiments.

trusting

Leaders are not trying to push an agenda; rather, members are free to

try something new and determine for themselves the outcomes of an experiment.

When energy is blocked, it may result in ________ ________.

unfinished business (**It can be manifested by tension in some part of the body, by posture, by keeping one's body tight and closed, by not breathing deeply, by looking away from people when speaking to avoid contact, by choking off sensations, by numbing feelings, and by speaking with a restricted voice, to mention only a few.)

When figures emerge from the background but are not completed and resolved, individuals are left with

unfinished business, which can be manifested in unexpressed feelings such as resentment, rage, hatred, pain, anxiety, grief, guilt, and abandonment. (*Because the feelings are not fully experienced in aware ness, they linger in the background and are carried into present life in ways that interfere with effective contact with oneself and others)

Gestalt group therapists attend to matters such as

verbal and nonverbal language, postures, voice, interpersonal interactions, and group processes

It is important to explore what the resistance does for clients:

what it protects them from, and what it keeps them from experiencing.

To help the client make contact with the present moment, Gestalt therapists ask ______ and ________ questions, but rarely ask ______ questions.

what; how; why