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Gestalt Therapy

“I do my thing and you do your thing.
I am not in this world to live up to your expectations
And you are not in this world to live up to mine.
You are you and I am I,
And if by chance we find each other, it’s beautiful.
If not, it cannot be helped.”

(Fritz Perls, 1969, in Gladding, 2000)

Gestalt Therapy was developed in the 1940′s by Fritz and Laura Perls and further influenced by the likes of Kurt Lewin and Kurt Goldstein (Corsini & Wedding, 2000). It was developed as a revision to psychoanalysis and focuses on an experiential and humanistic approach rather than analysis of the unconscious which was one of the main therapeutic tools at the time Gestalt Therapy was employed.

Gestalt Therapy rejects the dualities of mind and body, body and soul, thinking and feeling, and feeling and action. According to Perls, people are not made up of separate components, this is, mind, body and soul, rather human beings function as a whole. In doing so, one defines who one is (sense of self) by choice of responses to environmental interactions (boundaries). The word “Gestalt” (of German origin) refers to a “whole, configuration, integration, pattern or form” (Patterson, 1986).

The form of Gestalt Therapy practiced today utilises ideas, data and interventions from multiple sources, as well as some of the original techniques known to be ‘Gestalt Therapy techniques’. It is noted that Gestalt Therapy has a history of being an approach which creates or borrows specific techniques that are focused on assisting the client to take the next step in their personal growth and development.

Key Concepts

Several key concepts underlie Gestalt Therapy, many of which are similar to that of person-centred and existential therapy. However, what does differentiate Gestalt Therapy from these therapies are some of the ideas added by Perls and associates as well as distinctive therapeutic techniques that will be covered further down (Seligman, 2006). The following are the key concepts of Gestalt Therapy:

Wholeness and Integration: Wholeness refers to the whole person or the individual’s mind and body as a unit rather than as separate parts (Seligman, 2006). Integration refers to how these parts fit together and how the individual integrates into the environment. Often people who come to therapy do not have these parts fitting together in their environment, Gestalt Therapy is about facilitating clients to integrate themselves as whole persons and help restore balance in their environment.

Awareness: Awareness is one of the most important elements in Gestalt Therapy as it is seen as a “hallmark of the healthy person and a goal of treatment” (Seligman, 2006). When individuals are “aware”, they are able to self-regulate in their environment.

There are two main causes lacking awareness:

  1. Preoccupation with one’s past, fantasies, flaws and strengths that the individual becomes unaware of the whole picture.
  2. Low self-esteem.

There are three ways people may achieve awareness through therapy:

  1. Contact with the environment: This is through looking, listening, touching, talking, moving, smelling, and tasting. This enables the individual to grow in his or her environment through reacting to the environment and changing.
  2. Here and now: This is the individual living in and being conscious at the present moment rather than worrying about the past or the future.
  3. Responsibility: This refers to the individual taking responsibility for his or her own life rather than blaming others.

Energy and blocks to energy: Gestalt Therapists often focus on where energy is in the body, how it is used, and how it may be causing a blockage (Corey, 2005). Blocked energy is a form of resistance, for example, tension in a part of the body, not breathing deeply, or avoiding eye contact. Gestalt Therapy is about finding and releasing the blockages that may be inhibiting awareness.

Growth Disorders: Growth disorders refer to emotional problems that are caused by people who lack awareness and do not interact with their environment completely. In doing so, people are unable to cope with the changes in their lives successfully and, instead deal with the problems in a defensive manner (Seligman, 2006).

Unfinished business: Unfinished business refers to people who do not finish things in their lives and is often related to people with a “growth disorder” (Seligman, 2006). People with unfinished business often resent the past and because of this are unable to focus on the here and now. One of the major goals of Gestalt Therapy is to help people work through their unfinished business and bring about closure.

General Ideas about Personality Development

Gestalt Therapy deems that people cannot be considered as separate from their environment or from interpersonal relations. The individual is seen as being self-regulating and is able to motivate oneself to solve problems. Individuals are able to work towards growth and develop as their environments allow.

A psychologically healthy person is someone who is self-regulating through the changes in life and has developed a sense of “wholeness” between mind and body (Corsini & Wedding, (2000).

Therapeutic Techniques & Methods of Working

The most important goal of Gestalt Therapy is that Gestalt Therapists do not aim to change their clients. The therapist’s role is to assist clients in developing their own self-awareness of how they are in the present moment. This will therefore allow them to rectify issues affecting his or her life.

“The therapist’s job is to invite clients into an active partnership where they can learn about themselves by adopting an experiential attitude toward life in which they try out new behaviours and notice what happens”  (Perls, Hefferline and Goodman, 1954, in Corey, 2005).

A focus of developing awareness is that of clients’ awareness of their own realities. In order to do this, clients must first accept responsibility for choosing their present situations. Language plays a big part in accepting responsibility. The client may attempt to use avoidance responses or project individual traits onto other people or external causes, for example “She makes me so angry”; “It’s his fault”. Both avoidance responses and projection of traits attempt to displace ownership and responsibility onto an external cause.

Another goal of Gestalt Therapy is that therapists should work to create an “I-thou” relationship with clients in which both the therapist and client are present in the here-and-now rather than focusing on the past or future (Seligman, 2006).

Also, an understanding of the whole of the client’s experience is required by the therapist. This involves considering the client’s verbal and non-verbal communication. In fact, the nonverbal communication is seen to provide more information about the real essence of the person.

Thus, an important function of the Gestalt Therapist is paying attention to the client’s body language such as the client’s posture, movements, gestures, voice, and hesitations as the body language is considered to be reflective of what the client is going through at that point in time. 

Experiments: Gestalt Therapists use the technique of experiments or learning experiences with their clients. The experiments are designed for the individual and take the form of an enactment, role play, homework, or other activity which promotes the individual’s self-awareness (Seligman, 2006).

An example of this technique is with a man who feels insecure in social situations. He has a work function to go to in two weeks time so the therapist gives him the experiment of starting a conversation at the function with someone he does not normally speak to. Spending time thinking about what he might say promotes self-awareness and the experiment itself gives him more confidence in social situations.

Use of Language: Gestalt Therapists choose language that will encourage change in the client. The following are ways that this can be accomplished (Seligman, 2006):

  1. Emphasis on statements rather than questions to highlight a collaborative client-therapist relationship.
  2. “What” and “How” questions (when questions are used) to keep the client in the present and promote integration.
  3. “I” statements are used to promote clients ownership of feelings rather than placing blame on others.
  4. The present tense is used so the focus is on the present rather than the past.
  5. Encouraging responsibility for clients of their words, emotions, thoughts, and behaviours so they recognize and accept what they are feeling.

Empty Chair: The empty chair technique is a “method of facilitating the role-taking dialogue between the patient and others or between parts of the patient’s personality. It is generally used in a group situation” (Patterson, 1986). Two chairs are placed facing each other: one represents the patient or one aspect of the patient’s personality, and the other represents another person or the opposing part of the personality. As the patient alternates the role, he or she sits in one or the other chair.

The therapist may simply observe as the dialogue progresses or may instruct the patient when to change chairs, suggest sentences to say, call the patient’s attention to what has been said, or ask the patient to repeat or exaggerate words or actions.

In the process, emotions and conflicts are evoked, impasses may be brought about and resolved, and awareness and integration of polarities may develop – polarities or splits within the patient, between the patient and other persons, or between the patient’s wants and the social norms (Patterson, 1986).

Topdog – Underdog: A commonly utilised Gestalt technique is that of the topdog-underdog dialogue. This technique is used when the therapist notices two opposing opinions/attitudes within the client. The therapist encourages the client to distinguish between these two parts and play the role of each in a dialogue between them (Patterson, 1986).

The tyrannical ‘topdog’ demands that things be a particular way whilst the ‘underdog’ plays the role of disobedient child. The individual becomes split between the two sides struggling for control.

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.

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.

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:

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.

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.

Repetition and exaggeration: If there is repetition such as the example of the client tapping their feet on the ground, the therapist would get them to exaggerate the movement and talk about feelings that come up. This in turn focuses on the emotion and should help to release the blocked awareness.

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.

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.

References

  1. Corey, C. (2005). Theory and practice of counseling & psychotherapy. (7th ed.). Belmont, CA: Thomson Learning.
  2. Corsini, R.J., & Wedding, D. (Eds.). (2000). Current Psychotherapies. (6th ed.). Belmont, CA: Thomson Learning, Inc.
  3. Gladding, S.T. (2000).  Counseling: A comprehensive profession. (4th ed.).  Upper Saddle River, NJ: Prentice-Hall, Inc.
  4. Paterson, C. H. (1986). Theories of counselling and psychotherapy. New York, NY: Harper & Row.
  5. Seligman, L. (2006). Theories of counseling and psychotherapy: Systems, strategies, and skills. (2nd ed.). Upper Saddle River, New Jersey: Pearson Education, Ltd.

 

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