Chapter 7 Gestalt Therapy CHAPTER OVERVIEW Gestalt theory, created by Fritz Perls, is founded upon a positive view of human nature. Viewing the person as a total organism, Perls believed that full awareness of self can be curative. With a high level of concentration, undistracted by environmental stimuli, mentally healthy people can solve their problems, resolve their conflicts with others, and know when resolution is impossible. The Gestalt counselor facilitates the client’s ability to focus, to attend, and to be in touch with the present. Gestalt theory contains a variety of techniques suitable for use when counseling children. CHAPTER OBJECTIVES After completing this chapter, the student will be able to: 1. 2. 3. 4. Explain the philosophical assumptions of Gestalt therapy. Discuss the Gestalt understanding of the nature of people and the process of change. Explain the etiology of maladaptive behavior according to the Gestalt viewpoint. Describe the necessary conditions under which psychological growth and behavioral change occur in the Gestalt school of thought. 5. Demonstrate specific procedures and techniques from Gestalt therapy. 6. Specify the limitations and contributions of Gestalt therapy. 7. Explain a case study as it would be conceptualized and treated by a Gestalt therapist. CHAPTER SUMMARY Fritz Perls discussed Gestalt therapy as a theory in progress, frequently revised to fit his observations of human behavior. He believed the most important areas of concern to be the thoughts and feelings people are experiencing in the moment. Viewing the person as a total organism, Perls believed that full awareness of self could be curative. With a high level of concentration, undistracted by environmental stimuli, mentally healthy people can solve their problems, resolve their conflicts with others, and know when resolution is impossible. The key to successful adjustment is the development of personal responsibility – responsibility for one’s life and response to one’s environment. The healthy person will focus sharply on one need (or figure) at a time while relegating other needs to the background or ground. When the need is met - or the Gestalt is closed or completed - it is relegated to the background, and a new need comes into focus (becomes the figure). The smoothly functioning figure-ground relationship characterizes the healthy personality. Neurotic people are unable to attend to one need at a time and use their potential to manipulate others to do for them what they have not done for themselves. Six categories of neurotic living have been identified which include lacking contact with the environment, confluence, unfinished business, fragmentation, topdog/underdog conflicts, and unresolved polarities. 41 The five layers of neuroses that Perls proposed serve as the benchmarks of the counseling process in a Gestalt framework. Ideally the client would move through the following: a phony layer to a phobic layer to an impasse, implosive, and finally explosive layer. Emphasizing direct experiences, Gestalt therapy focuses on a person's awareness of the here and now. Deeper awareness promotes a sense of living fully in the here and now. The ultimate measure of success in Gestalt therapy is the extent to which clients grow in awareness, take responsibility for their actions, and move from environmental support to self-support. A Gestalt counselor facilitates the client's ability to focus, to attend, and to be in touch with the present by using direct experiences. The central goal in Gestalt therapy is deeper awareness which promotes a sense of living fully in the here and now. Other goals include teaching people to assume responsibility for themselves and facilitating their achievement of personal integrations. Gestalt interventions are breakthrough mechanisms that help clients reframe their problems into manageable projects, resolve decision-making conflicts, and find a reasonable balance between taking too much or too little responsibility in their lives. Gestalt techniques appropriate for children include teaching a child to use "I" language; to substitute "won't" for "can't; and to use “what” and "how" for "why." Other techniques include not gossiping, changing questions into statements, taking responsibility, and using incomplete sentences. The topdog versus underdog techniques, the empty chair technique, “my greatest weakness”, resent-demand-appreciate, fantasy games, and dream work are other experiential activities from Gestalt therapy. Violet Oaklander explained the Gestalt approach to play therapy and compared the process to a dance where sometimes the counselor leads and other times the child leads. When children are anxious or troubled, they do not use their senses fully and they block emotions. The goal of the therapy is to restore the child’s natural functioning and self-regulatory processes. She recommended projection through art and storytelling as ways to increase a child’s selfawareness. She also discussed fantasy and imagery as ways to tap intuitive thought, and the empty chair method as a way to handle unfinished business, frustration, and anger. Gestalt techniques in working with children are focused on the development of inner strength and confidence in the child through opportunities to make choices, achieve mastery, own their projections, participate in imaginative play, and expel aggressive energy appropriately. Gestalt therapy has certain aspects that appeal to some cultures and others that the same cultures might find offensive. Gestalt counselors believe that teaching clients how to behave in an authentic, honest, and open manner will be sufficient for handling any problem that might arise. This perspective is not sufficient to meet the cultural expectations of each client. Other implications for cross-cultural counseling are discussed, as are implications for work in managed health care. Gestalt counseling can compete well on cost and client satisfaction, but not as well as other therapies on accountability, quantifiable outcomes, and brevity. Gestalt techniques should not be used with fragile children, adolescents, and adults who cannot handle the emotional intensity that some methods generate. While it may be effective with overly-socialized, restrained individuals, Gestalt therapy may not be appropriate or beneficial for severely disturbed clients 42 KEY CONCEPTS 1. 2. 3. 4. 5. 6. Gestalt theorists hold that people should be encouraged to focus on thoughts and feelings being experienced in the moment. According to Gestalt theory, healthy behavior occurs when people act as total organisms rather than fragmenting parts of their lives. According to Gestalt theory, healthy people focus on successfully meeting one need at a time while neurotic people try to attend to many needs at once and are not able to meet any needs. Gestalt therapy involves the use of several language, game, and fantasy methods in order to maintain the focus on the here and now. Gestalt therapy can be adapted for use with children through play therapy and confidence courses. Gestalt therapy is effective with overly-socialized, restrained individuals, but it may not be as beneficial for severely disturbed clients KEY TERMS, CONCEPTS, and PERSONALITIES Body armor – The association of psychological defenses with muscular position or body language. Confluence – The incorporation of self into others to the extent that an individual loses touch with his/her self. Empty chair – A Gestalt technique that is utilized to help an individual resolve a conflict within the self or with others. Fantasy games – A Gestalt technique that allows children to become aware of their current feelings. Figure-ground – The figure symbolizes the need in focus, while the ground symbolizes other needs. When a need is met, the new need that comes into focus becomes the figure. Five layers of neuroses – Five layers of functioning in which individuals keep themselves from succeeding. These include phony layer, phobic layer, impasse layer, implosive layer, and explosive layer. Fragmentation – Denying a need, thus resulting in the inability to find and obtain what one needs in life. Fritz Perls – The founder of Gestalt therapy. Perls saw individuals as total organisms and stressed the importance of awareness. Polarities – Competing dichotomies within an individual, causing him/her to fluctuate back and forth between the two opposite positions. 43 Topdog/underdog – A split in individuals’ personalities: what people think they should do (topdog), and what they want to do (underdog). Unfinished business – Unfulfilled needs, uncompleted situations, or incomplete Gestalts that require the attention of the client. REVIEW QUESTIONS 1. According to Gestalt theory, the most important areas of concern are: A. clients’ past behaviors. B. clients’ present thoughts and feelings. C. clients’ present self-actualization. D. clients’ future plans and ambitions. 2. Perls said that people would be better off losing their and coming to their . 3. The concept that a person focuses on one need at a time, while the other needs are relegated to the background is known as . 4. Perls said that people cause themselves additional problems by not handling their lives appropriately in any of six ways. Which of the following is not one of these? A. polarities B. fragmentation C. coordination D. confluence 5. List Perls’ proposed five layers of neuroses: 6. Gestalt theorists primarily focus on: A. the future. B. the here-and-now. C. the past. D. all of the above 7. What did Perls call the connection between psychological defenses and muscular position? 44 8. Which of the following outcomes would be considered a success to a Gestalt therapist? A. The client takes responsibility for his/her actions. B. The client increases his/her awareness. C. The client moves from external to internal support. D. All of the above 9. Gestalt therapists focus on , or the capacity to focus and be in touch with the now. 10. A child whom you are counseling says, “you know how it feels when you fail a test and your parents get mad at you.” As a Gestalt therapist, you would most likely: A. indicate that you do know how that feels. B. encourage the child to change the “you” to “I” or “me.” C. discourage the child from commenting on others’ feelings. D. say, “No, I don’t know. Why don’t you tell me.” 11. Gestalt therapy utilizes a variety of techniques. Which of the following is not a Gestalt technique? A. Topdog/underdog B. Bipolarities C. Paradox D. Incomplete sentences 12. When a child begins to talk about a person not present in the session, it would not be unusual for a Gestalt therapist to: A. tell them not to talk about other people. B. listen and reflect feelings. C. encourage the child to talk “to” the person using an empty chair to symbolize that person. D. encourage the child to transfer feelings about that person to the therapist. ESSAY QUESTIONS 1. Some Gestalt counselors focus solely on the here-and-now. Explain what you see as the benefits and the disadvantages of this approach. How important are the past and the future? Does this approach miss something in not focusing on them? 2. Gestalt therapists utilize a wide variety of techniques in their work. What do you think a counselor must do to prepare to utilize these techniques? Are there any that require more training than others? Do you believe that, as a therapist, you must experience these techniques first as a client before using them in practice? How comfortable would you be in using some of these techniques? 45 ACTIVITIES 1. Think about a dream you have had recently. Try to recall as many details as possible about it. Be as free as possible, without worrying about correctness. Focus on the here-and-now, and remember that Gestalt therapists focus on integration rather than analysis of dreams. Pay attention to people, roles and messages that emerge. In dyads (take turns being the client), work with the dream using Gestalt methods. “Become” the different elements of the dreampeople, objects, etc. Discuss what you became aware of during the process. 2. Complete the Resent, Demand, and Appreciate activity in the text. Note your reactions to the activity. What insights (if any) did you gain from doing this? 3. Violet Oaklander has a sequence of experiencing a ball of dough in her book Windows to our Children. If you have the book, ask someone to read her suggestions to you as you work with dough. If you do not have access to her script, try this. Find some dough and knead it, pound it, caress it, poke it, smooth it, touch it with your feet, elbows, wrist, tips of your fingers, top of your hand. Concentrate on playing with the dough for at least fifteen minutes. After you have finished, discuss what you have felt and thought during that time with a classmate. 46