Gestalt Therapy

The objective of Gestalt Therapy, in addition to overcome symptoms, is to enable the the client to become more fully and creatively alive and to be free from the blocks and unfinished issues. Gestalt therapy falls in the category of humanistic psychotherapies. 

Gestalt Therapy is a type of psychotherapy that focuses on now experience in the now, the therapist-client relationship, and personal responsibility.  In Gestalt Therapy, it is only possible to truly know oneself as we exist in the here and now and in relation to other things. This focus on the experiential present moment, the here and now, is in contrast to other therapeutic approaches which look at the past, the unknown and even unknowable. 

Gestalt therapy is about the aliveness and excitement, the awareness of choice everyone has in creating their lives.

Please recognize that Gestalt Therapy is based on an elaborate theory that has developed since the 1940s and also note that the real practice of Gestalt Therapy is based in the personal experience of both the client and the therapist.  Accordingly, the following points can give no more than a very general and rough feeling for the theory and practice of Gestalt Therapy.

The following has been adapted from the Wikipedia website.

Gestalt Therapy was co-founded by Fritz Perls, Laura Perls- both of whom were originally traditional psychoanalysts, Ralph Hefferline a university psychology professor, and Paul Goodman, a political writer, in the late 1940s to early 1950s. 

At the center of Gestalt therapy lies the promotion of "awareness". The individual is encouraged to become aware of his or her own feelings and behaviors, and their effect upon his environment in the here and now. The way in which a he or she interrupts or seeks to avoid contact with the present environment is considered to be a significant factor when recovering from psychological disturbances. By focusing the individual on their self-awareness as part of present reality, new insights can be made into the their behavior, and they can engage in self-healing.

A core concept in Gestalt therapy is the unifying idea of "contact".

The essence of human life is contact, a meeting with various kinds of others. Contact is where one person meets another person, or meets the outside world. Every organism is capable of effective and fulfilling contact with others in their environment and pursues ways of having contact with others so that the organism can survive and grow to maturity. All contact is creative and dynamic and, as such, each experience unfolds as a creative adjustment of the organism in the environment.  If contact is not interfered with by what Perls-Goodman called disturbances of the contact boundary, the individual can grow, through assimilation of new experiences.

In therapy, the client is encouraged to experience his or her own feelings and behaviors in the here and now, and attention is brought to bear on the way contact is interrupted. The way in which he or she interrupts contact with the present environment is considered to be a significant factor in creating and maintaining dysfunctional patterns of behavior.

Some of the contact interruptions occur through projection (seeing outside one's self what belongs to one's self), introjection (swallowing whole instead of assimilating, chewing, digesting); retroflection (directing impulses towards the self that rightly should be directed to the other, as in anger directed toward self causing depression or psychosomatic symptoms); confluence (dissolving the self-other boundary and merging with the other). By focusing the individual on how contact-making occurs or is disturbed, new insights can be made and the fluid process of adequate contacting resumed.

For a history of Gestalt Therapy development, please see the website Wikipedia: Gestal therapy.

The following is adapted from the above referenced website and focuses on some important aspects of Gestalt Therapy. 

Here-and-now focus
The quintessence of all processes in Gestalt therapy is the here-and-now focus as it is implicit in the phenomenological foundation. Past and future get their bearings continuously from the present and have to be related to it for meaning to occur. Present-centeredness does not deny the importance of the past or the future; rather, it insists that those aspects of time exist in the present as nostalgia, regret, resentment, fantasy, legend, and history or as anticipation, planning, rehearsal, expectation, hope, dread and despair (Perls, 1976). Reality exists in the moment as a novel experience. If attended to, it can lead to personal growth. Predilection of past or future destroy present contact, and lack of contact with the present leads to flight into the past or the future.

The importance of contact
The central focus of the work of a Gestalt therapist is on contact. This includes the plethora of all complex internal responses and external patterns of behavior that are employed in the contact process. Contact is the defining characteristic of all of the methods Gestalt therapists use in order to bring about change. The methods of Gestalt therapy comprise basically five groups: therapeutic relationship, phenomenological method, experiment, work with cognition, and work with the wider field.

The ultimate aim of Gestalt therapy is to assist the client in restoring (or discovering) his/her own natural ability to self-regulate as an organism and have successful and fulfilling contact with others (environmental others), as well as with disowned aspects of oneself (internal others). That allows one to be able to cope creatively with the events of one’s life and to pursue those goals which seem good and desirable to oneself. Through awareness of and experimentation with bodily sensations, emotional responses, desires, and cognitive assumptions, the clients’ range of choices about how they live their lives, especially how they engage with others and themselves, will be enhanced. The question of foremost interest is HOW a person is creating his/her life in a certain way not WHY they came to be as they are. Accepting someone’s experiential validity is key rather than manipulating occurrences and outcome.

The therapeutic relationship
An authentic, nonjudgmental, dialogic relationship between client and Gestalt therapist is the crucible of change. In order to exchange phenomenologies, a Gestalt therapist must bring a willingness and capability to be present as a person in the therapeutic encounter, inclusive of his/her inner world, sense of experience, knowledge, skills, etc. and a genuine interest in understanding the client’s subjective experiences and needs from the environment (I-Thou stance). Both create the relationship and allow a figure to emerge from the dialogue. Verbal as well as nonverbal behavior is considered a valuable part of the encounter to discover together the quality of experiences, awareness, beliefs and typical patterns of contact.

Limitations of Gestalt therapy
Gestalt therapy is lacking a distinct, clearly defined and fully elaborated theory of human development. In the absence of this understanding, psychological sufferings that are developmental in origin are void of consistent theoretical explanations within a Gestalt theoretical framework. Knowledge of conditions that are necessary for healthy development could be expanded to how human development accounts for contact change over the entire life of the human organism. Not having those constructs available leaves the therapist theoretically unsupported of what is most effective in the therapeutic process with clients who are afflicted by certain kinds of developmental damage and/or deficiencies. There have been modest attempts undertaken by Gestalt therapists to change this, and they point towards promising future additions (Wheeler, 1998; McConville, 1995; Lobb & Salonia, 1993).

Concluding Remarks
Gestalt therapy is a well-developed and well-grounded theory with a myriad of tenets, principles, concepts, and methods, even though Gestalt therapy is often misrepresented in college textbooks and lumped together with psychodrama and other emotive and expressive therapies.

Gestalt therapy is a sound science and a powerful means for facilitating and nurturing the full functioning of the human person with the potential of bringing about human healing, growth, and wholeness. In Perls, Hefferline & Goodman’s (1951/1994) terms the “Gestalt outlook is the original, undistorted, natural approach to life, to man’s [and woman’s, added by the author] thinking, acting, feeling” (p.xxiv) with the criteria of therapeutic progress being measured against “the patient’s own awareness of heightened vitality and more effective functioning” (Perls, et al., 1951/1994, p.15). At the end of therapy the client is not necessarily “cured” but able to access tools and equipment to deal with any kind of problems he/she will have to encounter.

Gestalt therapy undoubtedly has the capacity to contribute to and vitalize effectively the field of psychotherapy and fits excellently into the contemporary realm of clinical psychology. With the power of creatively adjusting to psychology’s changing paradigm, Gestalt therapy has the basic prerequisites to be included in mainstream psychology.

An additional view of Gestalt Therapy has been adapted from the website Answers.com: Gestalt therapy.

Introduction
Gestalt therapy is a humanistic therapy technique that focuses on gaining an awareness of emotions and behaviors in the present rather than in the past. The therapist does not interpret experiences for the patient. Instead, the therapist and patient work together to help the patient understand him/herself. This type of therapy focuses on experiencing the present situation rather than talking about what occurred in the past. Patients are encouraged to become aware of immediate needs, meet them, and let them recede into the background. The well-adjusted person is seen as someone who has a constant flow of needs and is able to satisfy those needs.

Description
Gestalt therapy has developed into a form of therapy that emphasizes medium to large groups, although many Gestalt techniques can be used in one-on-one therapy. Gestalt therapy probably has a greater range of formats than any other therapy technique. It is practiced in individual, couples, and family therapies, as well as in therapy with children.

Ideally, the patient identifies current sensations and emotions, particularly ones that are painful or disruptive. Patients are confronted with their unconscious feelings and needs, and are assisted to accept and assert those repressed parts of themselves.

The most powerful techniques involve role-playing. For example, the patient talks to an empty chair as they imagine that a person associated with an unresolved issue is sitting in the chair. As the patient talks to the "person" in the chair, the patient imagines that the person responds to the expressed feelings. Although this technique may sound artificial and might make some people feel self-conscious, it can be a powerful way to approach buried feelings and gain new insight into them.

Sometimes patients use battacca bats, padded sticks that can be used to hit chairs or sofas. Using a battacca bat can help a patient safely express anger. A patient may also experience a Gestalt therapy marathon, where the participants and one or more facilitators have nonstop group therapy over a weekend. The effects of the intense emotion and the lack of sleep can eliminate many psychological defenses and allow significant progress to be made in a short time. This is true only if the patient has adequate psychological strength for a marathon and is carefully monitored by the therapist.

Preparation
Gestalt therapy begins with the first contact. There is no separate diagnostic or assessment period. Instead, assessment and screening are done as part of the ongoing relationship between patient and therapist. This assessment includes determining the patient's willingness and support for work using Gestalt methods, as well as determining the compatibility between the patient and the therapist. Unfortunately, some "encounter groups" led by poorly trained individuals do not provide adequate pre therapy screening and assessment.

Aftercare
Sessions are usually held once a week. Frequency of sessions held is based on how long the patient can go between sessions without losing the momentum from the previous session. Patients and therapists discuss when to start sessions, when to stop sessions, and what kind of activities to use during a session. However, the patient is encouraged and required to make choices.

Risks
Disturbed people with severe mental illness may not be suitable candidates for Gestalt therapy. Facilities that provide Gestalt therapy and train Gestalt therapists vary. Since there are no national standards for these Gestalt facilities, there are no set national standards for Gestalt therapy or Gestalt therapists.

Normal results
Scientific documentation on the effectiveness of Gestalt therapy is limited. Evidence suggests that this type of therapy may not be reliably effective.

Abnormal results
This approach can be anti-intellectual and can discount thoughts, thought patterns, and beliefs. In the hands of an ineffective therapist, Gestalt procedures can become a series of mechanical exercises, allowing the therapist as a person to stay hidden. Moreover, there is a potential for the therapist to manipulate the patient with powerful techniques, especially in therapy marathons where fatigue may make a patient vulnerable.

For more information about Rational Emotive Behavior Therapy and other therapeutic approaches, please click on the linked websites listed below.

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