Gestalt Psychotherapy – an overview

Quick Summary: For this post I will give an overview of Gestalt psychotherapy, which is popular for both its’ experiential nature and its large amount of techniques.
 
Key Concepts
View of Human Nature

  • Fritz Perls viewed clients as manipulative and apt to avoid responsibility.

 

  • Contemporary Gestalt therapists view the desired relationship between client and their environment as one of interdependence.

 

  • Human beings are capable of knowledge via the immediate experience of the perceiver.

 

  • Views individuals as striving toward actualization and growth

 

  • Believes that people have the ability to self regulate

 

  • People change when they become more aware of who they are.

 

Four Basic Underlying Principles

 
Holism: The whole is different from the sum of its parts
Field Theory: A client must be understood within their context, which is always changing.
Figure – formation Process: How the client organizes his or her environment from moment to moment.
Organismic Self-regulation: When our equilibrium is disturbed by the emergence of a need, we do our best to restore the equilibrium.

The Now

 

  • The present time is the most significant tense in Gestalt Therapy.

 

  • One of the main contributions of Gestalt Therapy is its emphasis on learning to appreciate and fully experience the present moment.

 

  • When the past comes up in therapy, the Gestalt therapist tries to bring it into the present as much as possible.

 

Unfinished Business

 

  • When figures (or issues) emerge from the background (field) but are not completed or resolved, what is left is unfinished business.

 

  • Can manifest as unexpressed feelings, grief, guilt, resentment, etc.

 

  • Are carried into present life and interfere with effective contact with others and ourselves.

 

  • Persist until they are faced and dealt with

 

Personality as Peeling an Onion

 

  • 5 layers of neurosis:

 

  1. The phony/cliché
  2. The phobic/phony
  3. The impasse
  4. The implosive
  5. The explosive

Contact and Resistance to Contact

 

  • In Gestalt therapy, contact with the environment is necessary for change and growth to occur

 

  • Effective contact means interacting with self and others without losing sense of individuality

 

  • Prerequisites for good contact are:

 

  •  
    1. Clear awareness
    2. Full energy
    3. Ability to express oneself

 

  • According to Gestalt Theory there are 5 major ways people try to resist contact:

 

  •  
    1. Introjection
    2. Projection
    3. Retroflection
    4. Deflection
    5. Confluence

 

Energy and Blocks to Energy

 

  • Gestalt therapists pay attention to energy – where it is located in the body, how it is used and how it is blocked.

 

  • Blocked energy is another form of resistance

 

  • The therapist actively seeks to bring these blockages into the client’s awareness by helping them experience what they are blocking.

 
The Therapeutic Process
 

Goals of Therapy

 
The basic goal of therapy is attaining awareness and thus greater choice. Involves:

  • Knowing the environment and what is happening around us

 

  • Knowing ourselves and accepting all aspects of ourselves

 

  • Being able to make contact with the internal and external world

 

Other Possible Outcomes

 

  • Gradual ownership of one’s experience

 

  • Development of skills and values that allow one to satisfy his/her own needs without violating rights of others

 

  • Increased awareness of one’s senses

 

  • Acceptance of responsibility

 

  • Movement from external to internal support

 

  • Ability to ask for and give help

 
 

Therapist’s Role

 

  • By engaging with clients the therapist assists them in developing their own awareness and experiencing how and who they are in the present moment

 

  • Creates safe space for client to explore him or herself and try out new behaviors.

 

  • Encourage clients to attend to their sensory awareness in the present moment.

 

  • Pay attention to client’s body language as a provider of rich information regarding his or her feelings and potential avenues to increase awareness.

 

  • Pay attention to client’s language patterns as avenues to increase awareness and experience in the present moment

 

Client’s Role/Experience

 

·        Active participant in the process

  • Treated as an equal
  • Client decides what changes to make
  • Willingness to explore oneself
  • Tolerate spontaneity within sessions
  • Capable of insight
  • Willingness to try out new behaviors with therapist and others outside of session
  • Willingness to try often “bizarre” techniques

 

Relationship Between Client and Therapist

 

·        Trust very important

  • Involves person-to-person relationship where therapist is affected by client and client is affected by therapist
  • The relationship with each other is experienced in the here and now
  • One of complete acceptance
  • Therapist is genuine – fully themselves
  • Therapist self discloses in appropriate way
  • Therapist is a therapeutic instrument
  • Therapist is willing to explore client’s fears, expectations, blockages, resistances, and feelings

 
Application of the Theory: Techniques and Procedures 
 
The techniques and experiments that a Gestalt therapist uses usually evolve out of the process – what is happening in the here and now.

Techniques versus Experiments

 

Techniques

 

  • A ready-made technique used to evoke emotions and awareness

 

  • Used to make something happen within the session or reach a goal

 

Experiments

 

  • Grow out of interaction between client and therapist

 

  • Aimed at helping client learn by experience

 

  • What is learned is usually a surprise

 

  • Are spontaneous and usually one of a kind

 

  • Designed to bring out internal conflict by making the struggle an actual process in the room

 

  • Help the client gain fuller awareness, experience internal conflicts, resolve inconsistencies, and work through an impasse

 
IMPORTANT: When using an experiment in session it is important that the client be well prepared for it!

The Role of Confrontation

 
Confrontation can be viewed as a way of inviting clients to examine their behaviors, attitudes and thoughts in a gentle and respectful manner.

Techniques

 

The Internal Dialogue or “Empty Chair”

 
Bringing a conflict between two opposing poles in the personality (or personal struggle) into the room to increase awareness. Can also be used to help client dialogue with another person.

The Rehearsal Exercise

 
Rehearsing with therapist in session before doing it outside of session.

The Exaggeration Exercise

 
Asking the client to exaggerate a movement or gesture repeatedly usually results in an intensified feeling attached to the behavior making the inner meaning clearer.

Dreams

 
Dreams in Gestalt therapy are brought to life and relived as though they are happening now. The dream is acted out in the present.
Evaluation
 
Contributions
 

·        Very experiential in nature

 

  • Dynamic way of helping clients deal with the past in the here and now

 

  • Very unique approach to dreams

 

  • Very holistic approach

 

  • Very creative approach that encourages creativity, spontaneity and present-centeredness in both client and therapist

 

  • Sessions can be very fun

 

Limitations and Criticisms

 

  • Therapist can get too technique oriented because of the plethora of techniques available to the therapist

 

  • Not much room for psychoeducation because client comes up with things and the therapist is the facilitator

 

  • Requires therapist to have high level of personal development and self-awareness.

 

Multicultural Strengths

 

  • Techniques and experiments are tailored to the individual

 

  • Approaches clients opening without preconceived notions

 

  • Paying attention to nonverbal cues may be helpful with clients from cultures here indirect speech is the norm

 

  • Because of the holistic approach, the Gestalt therapist attempts to understand fully the client’s culture and context.

 

Multicultural Limitations

 

·        Focus on affect may be putting off to some individuals

 

  • Need to be careful not to intimidate client through confrontation

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