GESTALT THERAPY

gestalt therapyGestalt therapy refers to a form of psychotherapy that derives from the gestalt school of thought. It was developed in the late 1940s by Fritz Perls and is guided by the relational theory principle that every individual is a whole (mind, body and soul), and that they are best understood in relation to their current situation as he or she experiences it.

Edwin Nevis described Gestalt therapy as "a conceptual and methodological base from which helping professionals can craft their practice". In the same volume, Joel Latner stated that Gestalt therapy is built upon two central ideas: that the most helpful focus of psychotherapy is the experiential present moment, and that everyone is caught in webs of relationships; thus, it is only possible to know ourselves against the background of our relationships to others. The historical development of Gestalt therapy (described below) discloses the influences that generated these two ideas. Expanded, they support the four chief theoretical constructs that comprise Gestalt theory, and that guide the practice and application of Gestalt therapy.

The approach combines this relational theory with present state - focusing strongly on self-awareness and the 'here and now' (what is happening from one moment to the next). In gestalt therapy, self-awareness is key to personal growth and developing full potential. The approach recognises that sometimes this self-awareness can become blocked by negative thought patterns and behaviour that can leave people feeling dissatisfied and unhappy.

It is the aim of a gestalt therapist to promote a non-judgemental self-awareness that enables clients to develop a unique perspective on life. By helping an individual to become more aware of how they think, feel and act in the present moment, gestalt therapy provides insight into ways in which he or she can alleviate their current issues and distress in order to aspire to their maximum potential. Gestalt therapy is not identical with Gestalt psychology but Gestalt psychology influenced the development of Gestalt therapy to a large extent.

Gestalt therapy focuses on process (what is actually happening) over content (what is being talked about).[6] The emphasis is on what is being done, thought, and felt at the present moment (the phenomenality of both client and therapist), rather than on what was, might be, could be, or should have been. Gestalt therapy is a method of awareness practice (also called "mindfulness" in other clinical domains), by which perceiving, feeling, and acting are understood to be conducive to interpreting, explaining, and conceptualizing (the hermeneutics of experience).[7] This distinction between direct experience versus indirect or secondary interpretation is developed in the process of therapy. The client learns to become aware of what he or she is doing and that triggers the ability to risk a shift or change.

Gestalt therapy works through the interconnection of key concepts. These offer insight into the processes involved in therapy sessions between the therapist and client(s).

1. Person-centred awareness

Focusing on the present, and imagining it divorced from the future and past is considered essential. The process follows an individual's experience in a way that does not involve seeking out the unconscious, but staying with what is present and aware.

2. Respect

Clients, whether an individual, group or family, are treated with profound respect by a gestalt therapist. Providing a balance of support and challenge is key to helping those taking part to feel comfortable about opening up and acknowledging areas of resistance.

3. Emphasis on experience

The gestalt approach focuses on experience in terms of an individual's emotions, perceptions, behaviours, body sensations, ideas and memories. A therapist encourages the client to 'experience' in all of these ways, vividly in the here and now.

4. Creative experiment and discovery

There is a range of experimental methodology used by therapists to test their client's experience. These involve highly creative and flexible techniques to help them open up and acknowledge hidden feelings.

5. Social responsibility

The gestalt approach recognises that humans have a social responsibility for self and for others. It demands respect for all people and acknowledges that everyone is different. Ultimately it encourages individuals to adopt an egalitarian approach to social life.

6. Relationship

Relating is considered central to human experience and gestalt therapy considers individuals as 'whole' when they have a good relationship with themselves and others around them. The interpersonal relationship between the individual and therapist that is developed and nurtured in sessions is a key guiding process if therapy.

Fundamentally, gestalt therapy works by teaching clients how to define what is truly being experienced rather than what is merely an interpretation of the events. Those undertaking gestalt therapy will explore all of their thoughts, feelings, behaviours, beliefs and values to develop awareness of how they present themselves and respond to events in their environment. This gives them the opportunity to identify choices, patterns of behaviour and obstacles that are impacting their health and well-being, and preventing them from reaching their full potential.

The unfolding of this therapeutic process will typically involve a range of expressive techniques and creative experiments developed collaboratively between therapist and client. These will be appropriate for the client and their specific problems. Below are some of the most common methods used:

1. Role-play

Role-play can help individuals to experience different feelings and emotions and better understand how they present and organise themselves.

2. The 'open chair' technique

The open chair technique involves two chairs and role-play, and can give rise to emotional scenes. The client sits opposite an empty chair and must imagine someone (usually himself/herself or parts of him or her) in it. They then communicate with this imaginary being - asking questions and engaging with what they represent. Next, they must switch chairs so they are physically sitting in the once empty chair. The conversation continues, but the client has reversed roles - speaking on behalf of the imagined part of his or her problem. This technique aims to enable participants to locate a specific feeling or a side of their personalities they had 'disowned' or tried to ignore. This helps them to accept polarities and acknowledge that conflicts exist in everyone.

The Open or Empty chair technique or chairwork is typically used in Gestalt therapy when a patient might have deep rooted emotional problems from someone or something in their life, such as relationships with themselves, with aspects of their personality, their concepts, ideas, feelings etc., or other people in their lives. The purpose of this technique is to get the patient to think about their emotions and attitudes. Common things the patient addresses in the empty chair are another person, aspects of their personality, a certain feeling etc. was in it. They may also move between chairs and act out two or more sides of a discussion, typically involving the patient and persons significant to them. It uses a passive approach to opening up the patientís emotions and pent up feelings so they can let go of what they have been holding back. A form of role-playing, the technique focuses on exploration of self and is utilized by therapists to help patients self-adjust. Gestalt techniques were originally a form of psychotherapy, but are now often used in counseling, for instance, by encouraging clients to act out their feelings helping them prepare for a new job. The purpose of the technique is so the patient will become more in touch with their feelings and have an emotional conversation that clears up any long held feelings or reaction to the person or object in the chair. When used effectively, it provides an emotional release and lets the client move forward in their life.

3. Dialogue

A gestalt therapist will need to engage the client in meaningful and authentic dialogue in order to guide them into a particular way of behaving or thinking. This may move beyond simple discussion to more creative forms of expression such as dancing, singing or laughing.

4. Discussing dreams

Dreams play an important role in gestalt therapy, as they can help individuals to understand spontaneous aspects of themselves. Fritz Perls frequently asked clients to relive his or her dreams by playing different objects and people in the dream. During this they would be asked questions like: "What are you aware of now?" to sharpen self-awareness.

5. Attention to body language

Throughout therapy, a gestalt therapist will concentrate on body language, which is considered a subtle indicator of intense emotions. When specific body language is noticed, the therapist may ask the client to exaggerate these movements or behaviours. This is thought to intensify the emotion attached to the behaviour and highlight an inner meaning. For example, a client may be showing signs of clenched fists or frowning, to which the therapist may ask something along the lines of: "What are you saying with this movement?"

Ultimately, gestalt therapy is considered to help individuals gain a better understanding of how their emotional and physical needs are connected. They will learn that being aware of their internal self is key to understanding why they react and behave in certain ways. This journey of self-discovery makes the approach beneficial for individuals who can be guarded when it comes to their emotions, and find it difficult to process why they feel and act the way they do. It can also provide support and a safe space for individuals going through times of personal difficulty.

Gestalt therapy is considered particularly valuable for helping to treat a wide range of psychological issues - especially as it can be applied as a long-term therapy or as a brief and focused approach. It has been found effective for managing tension, anxiety, addiction, post-traumatic stress, depression and other psychological problems that can prevent people from living life to the full. Overall, people who participate in gestalt therapy tend to feel more self-confident, calm and at peace with themselves.

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