Gestalt therapy

                           Gestalt therapy

Individuals must be understood with the context of their ongoing relationship with the environment

Awareness, choice and responsibility are cornerstone of the practice
Contemporary gestalt therapy called as relational gestalt therapy.
Emotion focused therapy developed by Leslie Greenberg is related to gestalt therapy

Views of human nature

 Fritz Pearls practices Gestalt therapy paternalistically. Clients have to grow up ,stand up their feet and deal with their problems by themselves.

This has two agendas:

1. Moving client from environmental support to self support

2. Reintegrating the disowned part of the personality

Therapy aims at  awareness and contact with the environment which consists of contact with both internal and external world.

The process of reowning parts of oneself that has been disowned and the unification process proceeds one by one

The basic assumption is that individuals have the capacity to self regulate when they are aware of what is happening around them .Therapist’s job is to foster assist this awareness

Paradoxical theory of change (Arnie Beisser)- According to this authentic change occurs more from being who we are than from trying to be who we are not.

Principles of theoretical concepts of Gestalt therapy

1. Holism- Gestalt is a German word meaning whole or completion. The whole is different from a sum of its parts

Because Gestalt  therapist are interested in the whole person, no value is placed on a particular aspect of the person.

Emphasis maybe on figure or ground ,cues to background can be found on the surface through non-verbal content ,this is often referred to by as the attending to the obvious


2.Field theory -  Asserts that organism must be seen in its environment as a part of a constantly changing field.

Gestalt therapy rests on a principal that everything is related.

3.Figure formation process -  The field differentiate between foreground (figure) and background (ground). The figure formation process tracks how some aspects of field (environment) from the background becomes the focal part of the attention (figure)

4.Organismic self regulation - A process by which equilibrium is disturbed by the emergence of a need. Individuals can take actions and make contact that will restore equilibrium


Key concepts

1.The now- Gestalt approach emphasizes on learning to appreciate and fully experience the present moment it is a common mistake to invest energies on thinking about past and future which can be used to avoid to come in terms with the present

Phenomenological enquiry involves paying attention to what is occurring now. To promote now awareness therapists help us encourages a dialogue in present tense

One of the aim of Gestalt therapy is to help clients become aware of their present experiences. They also recognises that past will make appearance in the present moment. When the past seems to have a significant bearing of client present it is dealt with by bringing it to the present as much as possible

2.Unfinished business - When figure emergence from background but are not completed and resolved. Individuals are left with unfinished business because these feelings are not resolved they linger in  the background and affect the present living

Impasse or stuck point  Is the time when external support is not available or old copying ways do not work. Therapist’s task is to accompany clients in experiencing the impasse , by experiencing the impasse clients are able to get into contact with their frustration and accept everything as it is.

3.Contact and resistance to contact-Contact is necessary if change and growth are to occur. Effective contact means interacting with nature and which other people without losing our sense of individuality .

After a contact experience there is a withdrawal to integrate what has happened

The function of this boundary is to :

i)to connect and ii)to separate

Both contact and withdrawal are necessary to healthy functioning

Levels of contact have been described by Perls as five layers of neuroses:

To become psychologically mature. Each layer’s removal reveals increasingly impactful contact with the environment.

1. The phony layer refers to reacting to others in unauthentic or patterned ways. Include trying to be nice to someone so they will buy something from

you.

2. The phobic layer is an avoidance of psychological pain. For example, we

may not want to admit to ourselves that an important relationship is over.

3. Impasse is the point at which we are afraid to change or move. We may feel

very little, only a sense of being stuck. Individuals feel little internal or external support. This is a particularly significant level for making therapeutic

change.

4. The implosive level we experience our feelings, start to become aware of the real self, but may do little about the feelings.

5. The explosive layer is authentic and without pretense. For Perls it

was necessary to experience the explosive to become truly alive and authentic.

Polster and Polster describes five types of contact: the interaction with the object or other may follow one of these

five patterns: introjection, projection, retroflection, deflection, and confluence

1.Introjection- Tendency to uncritically accept others beliefs without assimilating them to make congruent with who we are. We passively incorporate what the environment provides rather than identifying what we need

2.Projection - In this we disown certain aspects of ourselves by assigning them to others, blaming others for our problems and avoiding taking responsibility for our own actions.

3.Retroflection- Doing to ourself what we would like to do to someone else or doing to our self what we would like someone else to do for us.
Example :People who self harm ,this often leads to depression and psychosomatic complaints

4.Deflection- It is the process of destruction, so that it is difficult to maintain a sense of contact. We attempt to diffuse by overusing humour ,generalisation and questions rather than statement which result in emotional depletion.

5.Confluence-  It involves blurring in the differentiation between the self and the environment, there is no clear demarcation between Internal experience and outer reality.

This is high and people who are greater need for acceptance and liked by others. This make genuine contact extremely difficult.

Interruptions in  contact or boundary disturbance refers to the characteristic style people employ in their attempt to control the environment through one of these resistance.

Gestalt therapists assume that contact is healthy and necessary for satisfactory

psychological functioning. Introjection, projection, retroflection, deflection, and confluence are ways of diminishing, avoiding, or otherwise resisting contact.

In judging whether these are used in a healthy or unhealthy way

Resistance to contact These are developed as a means of coping with life situations. They are positive as well as problematic ones too. They are now referred to as contact boundary phenomena

Contact Boundaries

Contact boundaries are the process of connecting to or separating from other or objects. More specifically, I-boundaries are those that distinguish between one person and another, a person and an object, or the person and a quality of the person. I-boundaries are formed by an individual’s life experiences.

Polster and Polster distinguish points from which I-boundaries can be described:

body-boundaries, value-boundaries, familiarity-boundaries, and expressive-boundaries.

Body-boundaries are those that may restrict sensations or place them off limits.

Value-boundaries refer to values we hold that we are resistant to changing.

Familiarity-boundaries refer to events that are often repeated but may not be

thought about or challenged

Expressive-boundaries are learned at an early age. We learn not to yell, not to

whine, not to touch, and so forth.

4.Awareness-Awareness of oneself is an important part of gestalt personality theory, referring to contact within individuals themselves, as well as with others and objects

Polster and Polster (1973) identify four types of awareness:

(1) Awareness of sensations and actions pertains to sensing through seeing, hearing, touching, or other senses and then expressing oneself through movement or vocal expression;

(2) awareness of feelings concerns awareness of both emotional

feelings and physical feelings such as sweaty palms or shortness of breath;

(3) awareness of wants refers to awareness of desires for future events to take

place, such as to graduate from college or to win the lottery; and

(4) awareness of values and assessments concerns larger units of experience than those mentioned, including how one values others, social and spiritual issues, and other assessments of events related to these.

Awareness refers to what is happening now rather than what is remembered.

To be fully aware is to be in contact with one’s boundaries.

Cycle of Awareness/Experience Contact

The Cycle of Experience is a core Gestalt conceptual tool for tracking correspondence between awareness, choice, and self-responsible action.

When the cycle has been completed, the individual would return to sensation and wait for a new figure to emerge from the fertile ground of the individual. (Zinker, 1977, 90-91)

Gestalt therapists can use a cyclical approach to assessment (Clarkson, 2004).

five phases: sensation/awareness, mobilization,contact, resolution/closure, and withdrawal.

1.Sensation/awareness- involves taking in experience through the senses.

2.Mobilization -refers to moving from awareness to forming a desire or want.

3.Contact- produces emotional arousal and implies contact with self and others.

4.Resolution/closure- takes place as individuals disengage from an experience.

5.Withdrawal -takes place as the experiencing cycle draws to a close and movesNtoward other contact experiences. In a sense, it is the end of the resolution/closure phase

A break in the cycle of experience would be a break in the movement toward satisfaction

5.Energy and blocks to energy Block energy is another form of defensive behaviour .One task of the therapist is to help client identify the ways in which they are blocking energy and transform these block energy into more adaptive behaviour. Rather than trying to get rid of them self for certain bodily symptoms clients can be encouraged to delve fully into tension States

Therapeutic goals

Perls (1969) stated that the goal of therapy is to:

Goal of growth and responsibility

Help individuals mature and grow. Implied in this definition is the emphasis on self responsibility, helping patients depend on themselves rather than on others

Therapy should assist patients in seeing that they can do much

more than they think they can. Thus, patients become more self-aware and

move toward self-actualization.

The goal of achieving integration

Integration implies that a person’s feelings, perceptions, thoughts, and body processes are part of a larger .

When a person is not fully integrated,

there are voids and the individual is likely to experience contact boundary disturbances.

Perls (1948) believed that the integration of previously alienated parts

was an extremely important goal of psychotherapy.

The goal development of awareness

With full awareness the organism or individual would regulate itself and function optimally. Fully aware individuals are aware of their environment, are responsible for their choices, and accept themselves.
Basic goal- Assisting the client to attain greater awareness and choice. When client stay with their awarenes ,important unfinished business will emerge and can be dealt in the therapy.

According to zinker,Goals are:

1.Movement towards increase awareness

2.Assuming responsibility of experiences and taking responsibility

3.Develop skills and acquire  values

4.Become more aware of all the senses

5.Learning to take responsibility

6.Be able to ask and get help

              Role and function of the therapist

·      Gestalt therapist use active methods and personal engagement with clients to increase the awareness, freedom and self direction rather than directing them to certain goals.

·      They value self -Discovery and assume clients discover their own way of blocking their own awareness

·      Although therapist works as a guide the basic work of the therapy is done by the clients.

·      Its task is to create a climate in which clients are likely to try your ways of behaving.

·      Do not force change or confrontation

·      They pay attention to clients non verbal cues and body language.

·      They pay attention to relationship between language  pattern and personality. Focuses on overt speaking habits as a way of increasing client’s awareness of themselves.

                Clients experiences in therapy

Clients in gestalt therapy are active participants who make their own meaning and interpretation.

It is they who increase awareness and decide what they will or will not do with their personal meaning.

 Miriam Polster describes the three stage integration sequence that characterises  client’s experiences in therapy:

1. Discovery -Clients are likely to reach new realisation about themselves

2. Accommodation - involves client recognising that they have a choice 3.Assimilation- which involves clients learning how to influence their environment


 Relation between therapist and client

Gestalt therapy involves a person to personal relationship between therapist and clients.

Gestalt therapy not only allow their clients to be who they are but also remain themselves and do not get lost in a role

They give feedback that allows client to develop an awareness of what they are actually doing.

Current gestalt therapy gives central importance  to I/Thou relationship and the quality of therapist presence as opposed to technical skills.

Contemporary gestalt therapist place increasing emphasis on factors such as presence, authentic dialogue, gentleness ,more self expression by the therapist and decrease use of stereotypical exercises.

Gestalt therapist greater emphasis is on client-therapist relationship rather than on techniques discovered from the context of this encounter.
Polster and polster emphasized the importance of therapists knowing them self and being therapeutic tools. Therapy is a two-way engagement that changes both client and the therapist

                           Procedure of the therapy

1.Experiments
According to Yontef and Jacobs techniques in Gestalt therapy are considered experiments.

It is tailored to the needs of the client and experiments are typically presented in an invitational manner

Exercise or techniques are readymade techniques that are sometimes used to make something happen in a therapy session or to achieve a goal

Experiments grow out of interaction between clients and therapist and the emerge within this dialog process.

Experiment is fundamental to gestalt therapy. This is the way for client to express themselves behaviourally. client test an experiment to determine what does ans what does not fit for them through their awareness

Examples of experiments- imagining a threatening future encounter, setting a dialogue between client and the significant person of his her life ,dramatizing memory of a painful event or role playing focusing on non verbal cues etc.

2.Preparing clients for gestalt experiments

It is important for counsellor to personally experience the power of gestalt experiment and feel comfortable before suggesting them to clients.

It is also essential for counselors to establish a relationship with their clients, so that client will feel trusting enough to participate.

Cients will get more from gestalt experiments if they are oriented and prepared for them .

counselors must avoid directing clients in a commanding manner

If a client is hesitant or stopping the experiment it is helpful to know the reason the client is  stopping

experiment works best therapist is respectful of the client’s cultural background and in a good contact with the person

Others may resist becoming emotionally involved because fear, lack of trust.

The way in which client resist doing an experiment reveal a great deal about the personality and way of being in the world .If therapist meets with hesitance it is good to explore its meaning for client

Role of confrontation

Fritz perls styles of therapy was characterized by more theatrics , abrasive confrontation and intense catharsis.

Newer version of relational gestalt therapy has evolved to include more support and increades kindness and compassion in therapy .

confrontation can be done in such a way that client co-operate when they are invited to examine their behaviour.

confrontation does not have to be aimed at weakness or negative traits clients an be encouraged to recognise how they are blocking  their strengths

 Experiments or Techniques of gestalt therapy

Experiments can be useful tool to help clients to gain fuller experience, resolve conflicts and work through on impasse that is preventing completion of unfinished business


1.The internal dialogue exercise - therapist pay close attention to splits in personality functions.

A main division is between top dog and underdog.

Top dog is righteous, dominating ,bossy and manipulative while underdog manipulates by playing the role of victim, being defensive helpless and weak .

Top dog and underdog are in constant struggle for control, as a result of the struggle for control individual becomes fragmented into controller and controlled. The conflict between the two opposite poles in personality is rooted in the mechanism of introjection

                            Empty chair technique- using two chairs therapist ask the client to sit in one chair and be fully  the top dog and then shift to others chair and become underdog

essentially this is a role playing in which all parts are played by the client, the conflict can be resolved by clients acceptance and integration of both side. This exercise helps clients get in touch with a feeling or a side of themselves that they may be denying.

2.Making the rounds involves asking a person in a group to go up to others in a group and either speak to or do something with each person .The purpose is to confront ,to disclose self ,experiment with new behaviour and grow and change.

3.The reversal exercise behaving in a way which is completely opposite to our usual behaviour .To come in contact with our attribute that we try to deny

4.The rehearsal exercise here, clients share their internal rehearsals out loud with the therapist ,they become more aware of many meaning they used in holstering their social roles

5.Exaggeration exercise  aim of gestalt therapy is for clients to become more aware of the subtle signals and cues they are sending through body languages.

Here, the person is asked to exaggerate their movements or gestures repeatedly ,which usually intensifies the feeling attached to behaviour

6.Staying with the feeling  here, at key moments when clients refer to a feeling or an unpleasant mood which they want to flee,therapist may urge clients to stay with their feeling and encourage them to go deeper into their feelings or behaviour they wish to avoid.

Gestalt approach to dreamwork restaurant approach doesn't interpret and analyse dreams instead intent is to bring dreams back to life and reliving them as though they are happening now dream is acted out in the present and Reema becomes a part of his or her dream the suggested format involves making a list of details of Dream remembering each person events and mode in it and then becoming each of these parts by transforming oneself acting as early as possible and inventing dialogues

7.Dreams: Dreams are used to bring about integration by the client. The focus of a client’s dream is not on the unconscious, rather on projections or aspects of the dreamer (Seligman, 2006). The therapist would get clients to talk about their dream/s in terms of the significance of each role in the dream and this allows clients to take responsibility for the dreams and increase awareness of their thoughts and emotions.

8.Fantasy: Fantasy is used in Gestalt Therapy to increase clients’ self-awareness of their thoughts and emotions and to bring about closure to unfinished business (Seligman, 2006). Therapists use guided imagery techniques (fantasy) to encourage clients to imagine situations such as what they would do in a certain situation or by projecting themselves into different roles.

9.The Body as a Vehicle of Communication: Gestalt Therapy sees that not only are thoughts and emotions important to creating a feeling of “wholeness” for the client, the physical sensations are also important. Seligman (2006) has identified three strategies to help with focusing attention on the physical sensations:

10.Identification: Gestalt Therapists should be able to recognise physical signs of their clients. For example, a client might be tapping their feet on the ground. The therapist may say “Become your leg and give it a voice?” This creates awareness of the client’s physical sensations and emotions.

11.Locating emotions in the body: Gestalt Therapists may ask clients where they are experiencing the emotion in their body. For example, a client may say they are feeling nervous about something. The therapist may ask where this is coming from in the body and the response from the client may be that the feeling is butterflies in the stomach. This helps the client to bring about more awareness into sensations and their emotions.

12.Confusion: The technique of dealing with confusion of the client is about drawing attention to the client’s hesitation in talking about something unpleasant. The hesitation can be shown through avoidance, blanking out, verbalism and fantasy (Patterson, 1986). By drawing attention to the hesitation, it creates self-awareness for the client and allows the client to work through the issue.

13.Confrontation: In Gestalt Therapy, confrontation means ‘to challenge or frustrate the client’. The client is challenged with sensitivity and empathy on the part of the therapist to face the issues important to them. It is an invaluable tool for bringing clients into clear awareness of their realities, when used appropriately. However, confrontation is not a technique that can be used with all clients.

Applications

Originally Gestalt Therapy was predominantly used to treat individuals who were anxious and/or depressed and who were not showing serious pathological symptoms. Although still used in the treatment of anxiety and depression, Gestalt Therapy has been effective in treating clients with personality disorders such as borderline personality disorder.

Gestalt Therapy is also effective in counselling groups, couples, and families (Corsini & Wedding, 2000).

Strengths

1.     There is empirical research to support Gestalt Therapy and its techniques (Corsini & Wedding, 2000). Specifically,

2.     Gestalt Therapy is equal to or greater than other therapies in treating various disorders, Gestalt Therapy has a beneficial impact with personality disorders, and the effects of therapy are stable.

3.     Works with the past by making it relevant to the present (Corey, 2005).

4.     Versatile and flexible in its approach to therapy. It has many techniques and may be applied to different therapeutic issues.

Weaknesses

1.     For Gestalt Therapy to be effective, the therapist must have a high level of personal development (Corey, 2005).

2.     Effectiveness of the confronting and theatrical techniques of Gestalt Therapy is limited and has not been well established.

3.     It has been considered to be a self-centred approach which is concerned with just individual development.

4.     Potential danger for therapists to abuse the power they have with clients (Corey, 2005).

5.     Lacks a strong theoretical base.

6.     Deals only with the here and now.

7.     Does not deal with diagnosis and testing.

Conclusion

Gestalt Therapy focuses on the integration between the “whole” person and his or her environment. This therapy sees a healthy individual as being someone who has awareness in his or her life and lives in the here and now rather than focusing on the past or future. Gestalt Therapy has a number of successful techniques that are applicable in therapy today and may be utilised across a broad spectrum of emotional issues.