What is Gestalt therapy?

Introduction

Gestalt therapy emerged during the 1960s as a powerful alternative to the two main available therapeutic techniques: psychoanalysis and behavioral therapy. This approach to therapy, founded by Fritz Perls, attempts to integrate clients’ thoughts, feelings, and actions into a unified whole; Gestalt, in fact, is the German word for “whole.” Gestalt therapists believe that emotional problems and some of the dissatisfactions experienced by ordinary individuals are attributable to a lack of recognition and understanding of one’s feelings. The fast pace of technological society and the general loss of purpose in individuals’ lives has led to a numbing of emotions. Gestaltists believe that many people deny or lose parts of themselves when they are faced with the overwhelming task of coping in society; for example, a person may deny anger toward a loved one.

The role for the Gestalt therapist is to help the client become more aware of the split-off emotions. The therapist takes an active role by requiring the patient to talk about current experiences and feelings. The patient is neither allowed to look for explanations or problems from the past nor expected to talk about future plans. Gestaltists believe that anxiety is the result of an excessive focus on the future. The client is expected to attend to current feelings and experiences—to stay in the here and now.

Gestalt therapy arose from
existential psychology and humanistic psychology. Prior schools had portrayed individuals rather pessimistically, believing that human beings are relatively evil creatures whose actions are determined by forces outside their control (such as instincts or the environment). People were seen as adaptive hedonists trying to receive the greatest amount of pleasure for the least amount of effort. The existential-humanistic school of psychology portrays individuals more optimistically, believing people innately strive to achieve their fullest human potential. Failure to do so is not the result of an evil nature but rather the fault of obstacles on this path to perfection. Gestalt therapists agree with the existential-humanistic focus on individual responsibility. One freely chooses one’s actions and therefore is responsible for them. There is no provision for blaming a past situation or one’s current environment. Gestalt therapists encourage independence and uniqueness in their clients. They push them to be themselves rather than adopting the “shoulds” and “oughts” recommended by society. Perls emphasized this focus on independence and responsibility by stating that the process of maturation is moving from environmental support to self-support.

Probably the greatest contribution of the Gestalt style of therapy has been the techniques it developed to increase individual self-awareness. These techniques are consistent with the belief that emotional problems stem from avoidance of or failure to recognize one’s feelings. The Gestalt therapist is very active and confrontational during the therapy session (in fact, in a group setting, talking to the therapist is called “taking the hot seat”) and frequently interprets and questions the client’s statements. The goal is a genuine relationship between two individuals, free of normal social conventions, in which a free exchange of thoughts and feelings can take place.

Therapeutic Techniques

In one technique of Gestalt therapy, called the "dreamwork," the client reports a recent dream. The Gestalt school believes that the events in a dream represent fragmented and denied parts of the personality. Rather than search for explanations in one’s childhood, as in the technique of dream analysis originated by Sigmund Freud, clients are encouraged to bring the dream into the present by acting out different parts of the dream. Rather than saying “There was a train in my dream,” the person is required to act out the part of the train. He or she might say, “I am a train. I am very powerful and useful as long as I stay on track.” This moves the focus of the dream into the here and now.

Another therapeutic technique used by Gestalt therapists involves a focus on and exaggeration of nonverbal behaviors. Gestaltists believe that much denied information is accessible through body language. For example, a client may state that she is happy and content in a relationship, while she is scowling and keeping her arms and legs crossed in a tight and tense fashion. Gestalt therapists help their clients become aware of these feelings by getting them to exaggerate their actions. A man who is talking about his wife while clenching his hand in a fist and tapping it on the table may be told to clench his fist tighter and bang it hard on the table. This exaggeration of nonverbal behavior would be to make him acutely aware of his anger toward his wife.

Another well-known procedure developed by the Gestalt school of psychotherapy is the empty-chair technique. This strategy is employed to bring past conflicts into the here and now, where feelings can be reexperienced. The client often will relate to the therapist a disagreement with some significant other. Rather than ask for details of the encounter (a procedure that keeps the focus in the past), the therapist will encourage the client to address an empty chair in the office as though that person were sitting in it. The client must role-play the relevant situation. The therapist may also get the client to play the part of the significant other in the empty chair. This switching back and forth of chairs and roles is a powerful technique to foster empathy, understanding, and a clarification of feelings. This technique can be used not only for conflicts between individuals but also for discrepant feelings within one person.

Gestalt in Practice

The Gestalt approach to psychotherapy is best explained by examples. A student once reported a dream in which she remembered a gum wrapper being dropped outside a nearby church. Rather than search for a meaning of the dream’s symbols in her childhood, her friend, a clinical psychologist, asked her to become the elements in the dream. She initially chose the gum wrapper. She stated that as a gum wrapper she concealed something very good and appealing and that most people took the good part from inside her and then threw her away. She stated that she felt like trash littered on a beautiful lawn and that eventually some caring person would come and throw her away.

The student then began to play the role of the church in the dream. She stated that as a church she was a beautiful building constructed by caring hands. She indicated that good things happened inside her but that she was used too infrequently. Many people were afraid of or disliked coming to her, she said, and most of the time she was empty inside. The student was surprised as she completed this description of the dream. She talked about the similarity of her explanations of the two elements in the dream. When asked if she felt this way, she stated that this idea at first surprised her somewhat; however, as she continued to elaborate, she became more aware of her feelings of emptiness and loneliness. She had become aware of denied aspects of her emotions.

Gestalt therapy’s active focus on nonverbal behavior and denied portions of the personality often can be quite dramatic. The judicious use of these techniques may allow insights into dynamics that are not available through ordinary interpersonal interactions. In one case, a family was being seen by cotherapists in family therapy. The family consisted of a mother, father, son, and daughter. The son was identified as the troublemaker in the family, and he demonstrated a wide range of symptoms that caused the family much pain and suffering. During the course of therapy, it became apparent that the mother was an unwitting conspirator in these troubles. She often would rescue her son from his precarious and often dangerous situation and restore matters to normal. This served the function of ensuring her role as a “good mother,” while providing the son with the reassurance that he was loved by her. Whenever she threatened not to rescue him, he accused her of not caring for him. She inevitably crumbled and provided for his needs. The father and daughter had their own alliance in the family, and although they complained, they did not interfere in this dysfunctional family pattern that frequently ended in severe problems.

The two therapists hypothesized the pathological nature of this interaction and periodically attempted to present it to the family; however, the pattern was so important and so entrenched in the family’s style of interaction that any mention of it led to vehement protests and denials that it was an issue of importance. During a therapy session, one of the therapists noticed the pattern in which the family members usually seated themselves. The mother and son sat close to each other on one side of the therapy room, while the father and daughter sat near each other across from them. The two therapists sat across from each other on the other sides of the room. One therapist, taking a cue from the Gestalt emphasis on the importance of nonverbal behaviors, moved his chair and sat in the small space between the mother and son. A stunned silence ensued. The mother and son began to show agitation, while the father and daughter, from across the room, became increasingly amused at the nature of this interaction.

The therapists elicited the reactions and analyses of the family to this new seating arrangement. The mother and son continued to display uncertainty and bewilderment, while the father and daughter immediately recognized that someone had dared to come between “Mom and her boy.” This led to a more open discussion of the pathological nature of the family interactions. The father and daughter could see that they had allowed this damaging pattern to continue. The mother and son, while not quite as open to this discovery because of the threatening nature of the disclosure, could not deny the emotions that were aroused by someone physically invading their territory. The insights that resulted from this simple Gestalt technique moved therapy along much more quickly than had previous verbal interactions. It demonstrates the Gestalt tenet that a focus on nonverbal patterns of communication may allow clients to become aware of previously denied aspects of their personalities.

Existential-Humanistic Psychology

Gestalt therapy emerged during a period of increased popularity for the existential-humanistic position in psychology. This approach, sometimes known as the “third force” in psychology, came from opposition to the earlier forces of psychoanalysis and behaviorism. Existential-humanistic proponents objected to the pessimistic psychoanalytic view of humans as vile creatures held captive by primitive, unconscious desires. They also differed from the environmental determinism, set forth by the behavioral school, that people are simply products of past punishments and rewards. The existential-humanistic therapists focused on the human freedom to choose one’s actions (regardless of unconscious desires and past consequences), the relative goodness of the human species, and people’s innate desire to reach their fullest potential. This approach fit well with the period of great social upheaval and change following World War II.

The Gestalt approach often is compared to the person-centered (or client-centered) therapy of Carl R. Rogers. Both types of psychotherapy endorse the basic assumptions of the existential-humanistic school; however, they differ considerably in their approach and techniques. In person-centered therapy, the client is encouraged to express his or her thoughts and feelings about a situation. The therapist remains relatively passive, giving minimal verbal prompts or paraphrasing the client’s statements. The client is responsible for the direction and content of the therapy session; the therapist provides only a clarification of unclear statements or feelings. The idea behind this approach is that the therapist is providing an atmosphere of unconditional acceptance in which the client can explore his or her emotional issues. Eventually, the client’s innate curative ability will take over. The Gestalt therapist, in contrast, is much more confrontational in interpreting statements and asking questions. The Gestalt approach places a greater emphasis on the interpretation of nonverbal behaviors and the usefulness of dreams. Although different in technique, both approaches point to the freedom to choose, the innate goodness of the client, and the strength of the therapeutic relationship as curative factors.

The influence of the Gestalt approach to psychotherapy diminished with the death of Perls in 1970. He was the emotional and spiritual leader of the group, and his charisma was not replaced easily. Gestalt therapy is not considered a mainstream psychotherapy; however, it does have numerous enthusiastic followers. The greatest contribution of the Gestalt orientation has been the techniques developed to assist clients in becoming more aware of hidden thoughts and emotions. Therapists with a wide variety of orientations have adapted and applied these procedures within their own theoretical framework. The impact of dreamwork, the hot seat, nonverbal interpretations, and the empty-chair techniques seems to have outlasted the theory from which they came.

Bibliography

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Tønnesvang, Jan, et al. "Gestalt Therapy and Cognitive Therapy—Contrasts Or Complementarities?." Psychotherapy: Theory, Research, Practice, Training 47.4 (2010): 586–602. Print.