Gestalt Psychotherapy is a phenomenological-existential
psychotherapy founded in the 1940s by Frederick and Laura Perls and subsequently developed by others. It teaches both therapist
and client the phenomenological method of awareness in which perceiving, feeling and acting may be distinguished from interpreting
and re-arranging pre-existing attitudes, values and opinions. What is directly perceived and felt is considered more reliable
than explanations or interpretations. In Gestalt psychotherapy therapist and client DIALOGUE, i.e. communicate their separate
phenomenological perspectives. Differences of perspectives are the focus of experimentation and further dialogue. The goal
is for the client to become aware of what they are doing, how they are doing it and how they can change themselves and learn
to value and accept themselves.
Gestalt psychotherapy is a process orientated psychotherapy
focusing more on what is happening (process) than what is being discussed (content). What is being experienced at the moment
is given more emphasis than what was, might be or should be (Yontef, GM 1993).
Basic Assumptions of the Gestalt Model
1. Gestalt Theory of Personality
Gestalt therapy personality theory has evolved
primarily our of clinical experience. The focus has been a theory of personality that supports our task as psychotherapists
rather than an overall theory of personality. The constructs of Gestalt therapy theory are field theoretical rather than generic,
and phenomenological rather than conceptual (Yontef 1993).
The Organism/Environment Field
A person exists by differentiating self from other
by connecting self and other. Contact with the environment requires the risk of reaching out and discovering one's own boundaries.
Healthy self-regulation includes contact in which a person is aware of what is potentially nourishing, or toxic, in the environment.
That which is nourishing is assimilated and that which is toxic is rejected. This kind of differentiated contact leads to
growth (Polster & Polster 1973).
Discrimination
Good contact requires a person to be willing to
trust their judgement. Discrimination requires actively sensing outside stimuli and processing these exteroceptive stimuli
along with interoceptive data.
Regulation of the Contact Boundary
The boundary between self and other must be sufficiently
permeable to allow in what is nourishing and sufficiently firm to keep out what is toxic. What is nourishing also needs to
be determined according to the dominant need. When the boundary between self and other becomes blurred, lost or impermeable,
there is a disturbance of distinction between self and other, a disturbance of contact and awareness (Perls 1973).
Organismic Self-Regulation
Human regulation may be organismic, based on a
relatively accurate knowledge of what is, or 'shouldistic', based on an arbitrary imposition of what others think. This applies
to the regulation of interpersonal relationships, to intrapsychic regulation and to the regulation of social groups. In organismic
self-regulation, choosing and learning happen with a natural integration of mind and body, thought and feeling, i.e. holistically.
In shouldistic regulation cognition is in the driving seat and there is a separation of mind and body.
Awareness
Full awareness is the process of being in contact
with what is most figure in the individual/environment field with full sensorimotor, emotional, cognitive and energetic support
(Yontef 1993). Awareness is of a self in the environment, in dialogue with the environment. From the perspective of Gestalt
psychotherapy the Self is formed at the contact boundary. Our sense of self is therefore relational and continuously evolving.
The Paradoxical Nature of Change
The Gestalt theory of change (Beisser 1970) maintains
that change occurs when a person becomes what they are, not when they try to become what they are not. Change does not take
place through coercion but takes place if a person takes the time and effort to become who they are. When awareness of what
IS does not emerge then Gestalt psychotherapy is one way of increasing awareness and hence, choice and responsibly.
2. Theory of Psychotherapy
Goal of Therapy
In classical Gestalt psychotherapy the goal is
awareness. This includes greater awareness in a particular area and also greater ability for the client to bring habitual
patterns of thinking, feeling and behaviour into awareness. Awareness of content and awareness of process proceed to deeper
levels as the therapy progresses.
Contemporary Gestalt psychotherapy focuses on the
Client within a therapeutic relationship that seeks horizontality. The therapist and client speak the same language, of present
centredness, which emphasises the direct experience of both therapist and client. Complete equality is impossible since the
focus is ultimately the wellbeing of the client. The Gestalt therapist is responsible for the quality and quantity of their
presence, knowledge about themselves and their client, for maintaining a non-defensive posture and for keeping their awareness
and contact processes clear and matched to the client.
Dialogue is central to Gestalt therapy's methodology
and is a manifestation of the existential perspective on relationship. The personal 'I' has meaning only in relation to others,
in the I-Thou dialogue or in I-It manipulative contact. Gestalt therapists choose to experience the client in dialogue rather
than using therapeutic manipulation (I-It). If we manipulate the client towards some therapeutic goal the client cannot be
in charge of their own growth and self-support. Dialogue is based on experiencing the other person as they really are and
experiencing oneself, sharing reciprocity and co-operation which in turn requires a willingness to be responsible and authentic.
The contemporary dialogical approach of Gestalt therapy supports, and is supported by, the views of modern feminist scholarship
that maintains the importance of relationship and affiliation in the development of identity (Gilligan 1982) and dialogue,
reciprocity and co-operation in the pursuit of understanding (Miller 1976; Belenky, Clinchy, Goldberger and Tarute 1986).
Gestalt is a phenomenologically oriented psychotherapy.
What happens first is not the past (Childhood) but what is experienced 'now'. 'Now' starts with the present awareness of the
client. Prior events may be the object of present awareness but the awareness process is here and now. 'Now' is the only moment
in which a human being has any direct control. We have no power to change the past and we can only guess about the future.
The Role of the Therapist
Gestalt therapy seeks to explore rather then directly
modify behaviour. The aim is growth and autonomy through an increase in awareness. The therapist's active presence is authentic
and energised, honest and direct. Clients may see and hear how they are experienced, how the therapist experiences them and
what the therapist is like as a person. Clearly this demands that the therapist is cognisant of the counter-transference and
has developed sufficient self-awareness to monitor the potential for the abuse of power within the therapeutic relationship.
Gestalt psychotherapy seeks to facilitate exploring
in ways that maximise what continues to develop after the therapy session and in the absence of the therapist. Perls believed
that the ultimate goal of psychotherapy was the achievement of that amount of integration which facilitates its own development
(Perls 1973).
Styles and Modalities of Gestalt Psychotherapy
Gestalt psychotherapy has a wide range of styles
and modalities. It is practised in individual therapy, groups, workshops, couples, families and with children. It is increasingly
practised in NHS outpatient clinics and community based inter-disciplinary teams, social service departments, education welfare
departments, private psychotherapy practices and growth centres. It is currently enjoying significant interest from human
resource departments seeking ways of implementing change. The styles in each modality vary greatly in quantity and quality
of techniques used; frequency of sessions; focus on the body, cognition, emotions, interpersonal contact; work with psychodynamic
themes. All styles and modalities will have in common an emphasis on phenomenology - direct experience and experimentation;
dialogic encounter - use of direct contact and personal presence; field theory - emphasis on what and how and here and now.
Within there parameters, interventions will vary depending on the context and the personalities of the therapist and the client.
Techniques
The techniques of Gestalt psychotherapy are intended
solely to facilitate awareness of self and other and not to manipulate the client toward some goal. Course members will learn
how to apply many of the techniques of Gestalt psychotherapy but, more importantly, will be encouraged to create and design
their own techniques within the overall Gestalt framework. Creativity and spontaneity of experimentation is an important feature
that permeates the whole of the modular programme.
While the techniques of Gestalt psychotherapy are
helpful and important they are always secondary to the I-Thou relationship. In the I-Thou meeting of therapist and client
there emerges, in microcosm, the therapist and clients 'way of being in the world'. In the I-Thou meeting we learn how the
self of the client is being created and how healthy functioning is being supported and interrupted.
Statement of Values
In Gestalt therapy morality is based on organismic
needs. There is no vision of what behaviour is more desirable for the client. Where the client has a choice of behaviours
the therapist works on increasing the client's awareness of antecedence, organismic reaction, consequences of behaviour etc.
Gestalt therapy enables clients to discover what
is moral in accordance with their own choices and values. People are response-able, the primary agents in determining their
own behaviour. When people confuse responsibility with 'shoulds' they manipulate themselves and are not integrated and spontaneous.
The therapist may disclose a feeling or share something
of their own values but only in the interest of expanding the client's own awareness of alternatives and not as a means of
inculcating values.
Maturity is a continuous process and not a fixed
stage. A mature person engages in a process of creative adjustment. Creative adjustment is a relationship between a person
and their environment in which a person takes responsibility for creating conditions conducive to their own well-being. Adjustment
without creativity is conformity to an external standard. Creativity without adjustment might result in nihilism.
Gestalt therapy views aggression and conflict as
natural biopsychosocial forces and encourages experimentation to stay with so-called 'negative' feelings and directly express
them verbally. Violence however is seen as an attempt at annihilation of self or other and is antithetical to awareness, open
expression of feelings and the I-Thou relationship.
Gestalt therapy seeks a non-exploitative and non-manipulative
relationship in which the therapist regards each client as an end in themselves.
Health & Disease
The Gestalt programme will enable students to understand
the notion of health as the creative interplay between the individual and the environment. It will raise awareness of the
innumerable ways in which the configuration of the individual-environmental field may hinder or overwhelm a person's capacity
to organise the field, effectively resulting in varying degrees of impairment of social and occupational functioning and subjective
distress.
Gestalt therapy is a relationship therapy in which
both the technical skills and the personal contacting of the therapist are indispensable. The qualities of good contact require
course members to commit themselves to:
- Increasing awareness
- Becoming response-able
- Engaging in and assessing risks
- Making choices
- Being open to feedback
- Monitoring tendencies to justify, explain or defend
- Critically examining attitudes, opinions and values
- Recognising social, cultural and political components
of personal distress
"If we were to choose one key idea to stand as
a symbol of the Gestalt approach, it might well be the concept of authenticity, the quest for authenticity. If we regard therapy
and the therapist in the pitiless light of authenticity, it becomes apparent that the therapist cannot teach what he does
not know. A therapist with some experience really knows within himself that he is communicating to his patient his (the therapist)
own fears as well as his clarity. The therapist's awareness, acceptance and sharing of there truths can be a highly persuasive
demonstration of his own authenticity. Obviously such a position is not acquired overnight. It is to be learned and relearned
ever more deeply not only throughout one's career but throughout one's entire life."
Levitsky A & Simkin J (1972) Gestalt Therapy
in Solomon L & Berzen B (Eds.) New Perspectives on Encounter Groups. San Francisco: Jossey-Bass.
