Gestalt Therapy

Understand the application of Gestalt therapy to group counseling.

A main goal of the Gestalt group is to heighten aware- ness and self-regulation through interactions with one another and the group itself. Gestalt therapy encourages direct experience and actions as opposed to merely talking about conflicts, problems, and feelings. If members have anxieties pertaining to some future event, they can enact these future concerns in the present. This here-and-now focus enlivens the group and assists members in vividly exploring their concerns. Moving from talking about to action is often done by the use of experiments in a group. Although Gestalt group leaders encourage members to heighten their aware- ness and attend to their interpersonal style of relating, leaders tend to take an active role in creating experiments to help members tap their resources. Gestalt leaders are actively engaged with the members, and leaders frequently engage in self-disclosure as a way to enhance relationships and create a sense of mutuality within the group. Gestalt leaders are especially concerned with awareness, contact, and experimenta- tion. If members experience the group as being a safe place, they will be inclined to move into the unknown and challenge themselves. To increase the chances that members will benefit from Gestalt methods, group leaders need to communicate the general purpose of these interventions and create an experimental climate. Lead- ers are not trying to push an agenda; rather, members are free to try something new and determine for themselves the outcomes of an experiment. ex)In training workshops in group counseling that Marianne Schneider Corey and I conducted in Korea, the Gestalt approach was well accepted. Group members were very open and willing to share themselves emotionally once a climate of safety was created. With these attitudes we found that we were able to use many Gestalt interventions with Korean people in a group training context. In some ways this is not surprising because in Korea there is an emphasis on collectiv- istic values, and group work fits well into the Korean culture.

Understand the evolution of this approach from the pioneering work of Fritz Perls to contemporary relational approaches.

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. Awareness, choice, and responsi- bility are cornerstones of practice. The initial goal is for clients to expand their aware- ness of what they are experiencing in the present moment.The approach is phenomenological because it focuses on the client's perceptions of reality and existential because it is grounded in the notion that people are always in the process of becoming, remaking, and rediscovering them- selves. As an existential approach, Gestalt therapy gives special attention to existence as individuals experience it and affirms the human capacity for growth and healing through interpersonal contact and insight (Yontef, 1995). 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 Fritz Perls was the main originator and developer of Gestalt therapy. The Gestalt approach focuses much more on process than on con- tent.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. Therapists devise experiments designed to increase clients' awareness of what they are doing and how they are doing it moment to moment. Perls asserted that how individuals behave in the present moment is far more crucial to self-understanding than why they behave as they do. Awareness usually involves insight and sometimes introspec- tion, but Gestalt therapists consider it to be much more than either. A defining char- acteristic 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.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 are important awareness processes and goals, all of which arebased on a here-and-now experiencing that is always changing. Clients are expected to do their own seeing, feeling, sensing, and interpreting, as opposed to waiting pas- sively for the therapist to provide them with insights and answers. contemporary relational gestalt therapy stresses dialogue and the I/Thou relationship between client and therapist. Therapists emphasize the therapeutic relationship and work collaboratively with clients in a search for understanding (Wheeler & Axelsson, 2015; Yontef & Schulz, 2013).The majority of today's Gestalt ther- apists emphasizes support, acceptance, empathy, respect, and dialogue as well as confrontation. Gestalt therapy is lively and promotes direct experiencing rather than the abstractness of talking about situations. Gestalt therapy is an experiential approach in that clients come to grips with what and how they are thinking, feeling, and doing as they interact with the therapist. Gestalt practitioners value being fully present during the therapeutic encounter with the belief that growth occurs out of genuine contact between client and therapist.

Describe how the I/Thou relationship is central to the use of experiments in the therapy process.

If clients are to cooperate, counselors must avoid directing them in a com- manding fashion to carry out an experiment. Typically, I ask clients if they are willing to try out an experiment to see what they might learn from it. I also tell clients that they can stop when they choose to, so the power is with them. C Gestalt therapists expect and respect the emergence of reluctance and meet clients wherever they are. Gestalt experiments work best when the therapist is respectful of the client's cultural background and has a solid working alliance with the person. Clients with a long history of containing their feelings may be reluctant to participate in experiments that are likely to bring their emotions to the surface. Contemporary Gestalt therapy places much less emphasis on resistance than the early version of Gestalt therapy. Although it is possible to look at "resistance to awareness" and "resistance to contact," the idea of resistance is viewed as unneces- sary by some Gestalt therapists. Frew (2013) argues that the notion of resistance is completely foreign to the theory and practice of Gestalt therapy and suggests that resistance is a term frequently used for clients who are not doing what the therapist wants them to do. Polster and Polster (1976) suggest that it is best for therapists to observe what is actually and presently happening rather than trying to make some- thing happen It is well to remember that Gestalt experiments are designed to expand cli- ents' awareness and to help them try out new modes of behavior. Within the safety of the therapeutic situation, clients are given opportunities and encour- aged to "try on" a new behavior. An experimental attitude in the therapeutic process involves the client's input and allows what emerges between client and therapist to guide the direction of the therapy (Yontef & Schulz, 2013). This heightens the awareness of a particular aspect of functioning, which leads to increased self-understanding (Breshgold, 1989; Yontef, 1995). Experiments are only means to the end of helping people become more aware and making changes they most desire.

Understand the role of confrontation in contemporary relational Gestalt therapy.

In the workshops that Fritz Perls gave, people often found him harshly confrontational and saw him as meeting his own needs through showmanship. Yontef (1993) refers to the traditional Perlsian style as a "boom-boom-boom therapy" characterized by theatrics, abrasive confrontation, and intense catharsis. Yontef (1993, 1999) is critical of the anti-intellectual, individ- ualistic, dramatic, and confrontational flavor that characterized traditional Gestalt therapy in the "anything goes environment" of the 1960s and 1970s. In contemporary Gestalt therapy, confrontation is set up in a way that invites clients to examine their behaviors, attitudes, and thoughts. Therapists can encour- age clients to look at certain incongruities, especially gaps between their verbal and nonverbal expression. Further, confrontation does not have to be aimed at weak- nesses or negative traits; clients can be challenged to recognize how they are block- ing their strengths. Therapists who care enough to make demands on their clients are telling them, in effect, that they could be in fuller contact with themselves and others. Ultimately, however, clients must decide for themselves if they want to accept this invitation to learn more about themselves. T

Evaluate the contributions, strengths, and limitations of the Gestalt approach.

One contribution of Gestalt therapy is the exciting way in which the past is dealt with in a lively manner by bringing relevant aspects into the present. Gestalt methods bring conflicts and human struggles to life. Gestalt therapy is a creative approach that uses experiments to move clients from talk to action and experience. The creative and spontaneous use of active experiments is a pathway to experiential learning. The Gestalt approach to working with dreams is a unique pathway for people to increase their awareness of key themes in their lives. By seeing each aspect of a dream as a projection of themselves, clients are able to bring the dream to life, to interpret its personal meaning, and to assume responsibility for it. Gestalt therapy is a holistic approach that values each aspect of the individual's experience equally. Therapists allow the figure-formation process to guide them. They do not approach clients with a preconceived set of biases or a set agenda. Instead, they place emphasis on what occurs at the boundary between the individual and the environment. A key strength of Gestalt therapy is the attempt to integrate theory, practice, and research. Strumpfel and Goldman (2002) note that both process and outcome studies have advanced the theory and practice of Gestalt therapy, and they summarize a number of significant findings based on outcome research: Outcome studies have demonstrated Gestalt therapy to be equal to or greater than other therapies for various disorders. More recent studies have shown that Gestalt therapy has a beneficial impact with personality disturbances, psychosomatic problems, and substance addictions. The effects of Gestalt therapy tend to be stable in follow-up studies one to three years after termination of treatment. Gestalt therapy has demonstrated effectiveness in treating a variety of psychological disorders. Limitations and Criticisms of Gestalt Therapy Most of my criticisms of Gestalt therapy pertain to the traditional version, or the style of Fritz Perls, which emphasized confrontation and de-emphasized the cogni- tive factors of personality. Contemporary Gestalt practice places a high value on the contact and dialogue between therapist and client. For Gestalt therapy to be effective, the therapist must have a high level of personal development. Being aware of one's own needs and see- ing 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 thera- pist. There is a danger that therapists who are inadequately trained will be primarily concerned with impressing clients. Typically, Gestalt therapists are highly active and exhibit sensitivity, timing, inventiveness, empathy, and respect for the client Typically, Gestalt therapists are highly active and exhibit sensitivity, timing, inventiveness, empathy, and respect for the client How can they be effective Effective practitioners of Gestalt therapy require a strong general clinical background and training, not only in the theory and practice of Gestalt therapy but also in personality theory, psychopathology, and knowledge of psychodynam- ics (Yontef & Jacobs, 2014). Competent practitioners need to have engaged in their own personal therapy and to have had advanced clinical training and super- vised experience. Such therapists have learned to blend a phenomenological and dialogic approach, which is inherently respectful to the client, with well-timed experiments.

Identify these key concepts of the approach: here and now, awareness, dealing with unfinished business, contact and resistance to contact, body language, and the role of experiments in therapy.

Several basic principles underlying the theory of Gestalt therapy are briefly described in this section: holism, field theory, the figure-formation process, and organismic self-regulation. holism a German word meaning a whole or completion, or a form that cannot be separated into parts without losing its essence.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. 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. Gestalt therapists pay attention to and explore what is occurring at the boundary between the person and the environment. Emphasis may be on 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. The Figure-Formation Process igure-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. Organismic Self-Regulation 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.

Explain these standard Gestalt therapy interventions: role playing, future projection, making the rounds, staying with the feeling, working with dreams, and creating experiments based on here-and- now awareness.

The techniques described here neither define Gestalt therapy nor are they a nec- essary part of Gestalt practice. When used at their best, these interventions fit the therapeutic situation and highlight whatever the client is experiencing. The Internal Dialogue Exercise One goal of Gestalt therapy is to bring about integrated functioning and acceptance of aspects of one's personality that have been disowned and denied. Gestalt therapists pay close attention to splits in personality function. A main division is between the "top dog" and the "underdog," and therapy often focuses on the war between the two The conflict between the two opposing poles in the personality is rooted in the mechanism of introjection, which involves incorporating aspects of others, usu- ally parents, into one's personality. It is essential that clients become aware of their introjects, especially the toxic introjects that poison the person and prevent person- ality integration. The Empty-Chair Technique 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.The aim is not to rid oneself of certain traits but to learn to accept and live with the polarities. Future Projection Technique n future projection, an anticipated event is brought into the present moment and acted out. This technique, often associatedwith psychodrama, is designed to help clients express and clarify concerns they have about the future. These concerns may include wishes and hopes, dreaded fears of tomorrow, or goals that provide some direction to life. A client creates a future time and place with selected people, brings this event into the present, and gets a new perspective on a problem.Once clients clarify their hopes for a particular outcome, they are in a better position to take specific steps that will enable them to achieve the future they desire Making the Rounds Making the rounds is a Gestalt exercise that involves asking a person in a group to go up to others in the group and either speak to or do something with each person. The purpose is to confront, to risk, to disclose the self, to experiment with new behavior, and to grow and change. The Reversal Exercise Certain symptoms and behaviors often represent reversals of underlying or latent impulses. Thus, the therapist could ask a person who claims to suffer from severe inhibitions and excessive timidity to play the role of an exhibitionist. The theory underlying the reversal technique is that clients take the plunge into the very thing that is fraught with anxiety and make contact with those parts of themselves that have been submerged and denied. This technique can help clients begin to accept certain personal attributes that they have tried to deny. When clients share their rehearsals out loud with a therapist, they become more aware of the many preparatory means they use in bolstering their social roles. They also become increasingly aware of how they try to meet the expectations of others, of the degree to which they want to be approved, accepted, and liked, and of the extent to which they go to attain acceptance. ex)I remember a client in one of our therapy groups who had difficulty being anything but sugary sweet. I asked her to reverse her typical style and be as negative as she could be. The reversal worked well; soon she was playing her part with real gusto, and later she was able to recognize and accept her "negative side" as well as her "positive side." The Exaggeration Exercise In this exercise the person is asked to exaggerate the movement or gesture repeatedly, which usually intensifies the feeling attached to the behavior and makes the inner meaning clearer. Some examples of behaviors that lend themselves to the exaggeration technique are trembling (shaking hands, legs), slouched posture and bent shoulders, clenched fists, tight frowning, facial grimacing, crossed arms, and so forth. If a client reports that his or her legs are shaking, the therapist may ask the client to stand up and exaggerate the shaking. Then the therapist may ask the client to put words to the shaking limbs. Staying With the Feeling Most people want to escape from fearful stimuli and avoid unpleasant feelings. At key moments when clients refer to a feeling or a mood that is unpleasant and from which they have a great desire to flee, the therapist may urge clients to stay with their feeling and encourage them to go deeper into the feeling or behavior they wish to avoid. Facing and experiencing feelings not only takes courage but also is a mark of a willingness to endure the pain necessary for unblocking and making way for newer levels of growth. The Gestalt Approach to Dream Work The Gestalt approach does not interpret and analyze dreams. Instead, the intent is to bring dreams back to life and relive them as though they were happening now. The dream is acted out in the present, and the dreamer becomes a part of his or her dream. The suggested format for working with dreams includes making a list of all the details of the dream, remembering each person, event, and mood in it, and then becoming each of these parts by transforming oneself, acting as fully as possible and inventing dialogue. Each part of the dream is assumed to be a projection of the self, and the client creates scripts for encounters between the various characters or parts. All of the different parts of a dream are expressions of the client's own contradictory and inconsistent sides. By engaging in a dialogue between these opposing sides, the client gradually becomes more aware of the range of his or her own feelings.

Define the philosophy and basic assumptions underlying Gestalt theory and therapy.

Therapy aims at awareness and contact with the environment, which consists of both the external and internal worlds. The quality of contact with aspects of the external world (for example, other people) and the internal world (for example, parts of the self that are disowned) are monitored. The process of "reowning" parts of oneself that have been disowned and the unification process proceed step by step until clients can carry on with their own personal growth. By becoming aware, clients become able to make informed choices and thus to live a more meaningful existence. Due to this view of human nature, Fritz Perls (1969a) practiced Gestalt therapy paternalistically. Clients have to grow up, stand on their own two feet, and "deal with their life problems themselves" (p. 225). 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. His conception of human nature and these two agendas set the stage for a variety of techniques and for his confrontational style of conducting therapy. He was a master at intentionally frus- trating clients to enhance their awareness. 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. Arnie Beisser (1970) suggested that authentic change occurs more from being who we are than from trying to be who we are not. Beisser called this simple tenet the paradoxical theory of change. We are constantly moving between who we "should be" and who we "are." Gestalt therapists ask clients to invest themselves fully in their current condition rather than striving to become who they should be. Gestalt therapists believe people change and grow when they experience who they really are in the world (Yontef & Schulz, 2013).

Describe the practice of Gestalt therapy from a multicultural perspective.

There are opportunities to creatively use Gestalt methods with culturally diverse populations if interventions are timed appropriately and used flexibly. Frew (2013) notes that contemporary Gestalt therapy can be a useful and effective approach with clients from diverse backgrounds because it takes the clients' context into account. One of the advantages of drawing on Gestalt experiments is that they can be tailored to fit the unique way in which an individual perceives and interprets his or her culture. Shortcomings From a Diversity Perspective 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 ex)Other individuals have strong cultural injunctions prohibit- ing them from directly expressing their emotions to their parents Gestalt therapists who have truly integrated their approach are sensitive enough to practice in a flexible way. They consider the client's cultural framework and are able to adapt methods that are likely to be well received. They strive to help clients experience themselves as fully as possible in the present, yet they are not rigidly bound by dictates, nor do they routinely intervene whenever clients stray from the present. Sensitively staying in contact with a client's flow of experiencing entails the ability to focus on the person and not on the mechanical use of techniques for a certain effect.