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Gestalt Therapy

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Megan Campbell

on 16 April 2013

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Transcript of Gestalt Therapy

View of Human Nature Gestalt Therapy is an existential, phenomenological, process-based approach
Phenomenological - client's perception of reality
Existential - people are always in the process of becoming, remaking, and rediscovering

Perls believed clients needed to grow up, stand on their own two feet, and deal with their life problems themselves.

Perls style of therapy involved two personal agendas: Quiz Frederick S. ("Fritz") Perls "I am not in this world to live up to other people's expectations, nor do I feel that the world must live up to mine." Human Nature Basic understanding that people can deal with their problems, especially if they become fully aware

Therapy aims at getting the client to become aware and in contact with their environment
when they become aware, they make better choices and live more meaningful

Problems begin when a person tries to be who they are not
living with "masks" and being inauthentic does not promote change, but rather promotes stagnation

Paradoxical theory of change:
we change when we become aware of what we are, rather than trying to be who we are not Core Concepts The Now The power is in the present Megan Campbell and Angie Crowe Gestalt Therapy The Now Therapist focuses on the "what" and "how of the person without asking "why" questions

"What is happening now?"
"What are you experiencing as we sit here and talk?"
"How are you experiencing your fear?"

These questions help promote an awareness of the moment

"Why" questions lead to rationalizing, and this takes the client away from the now moment The Now If past experiences are significant on the clients present attitudes or behaviors, the therapist may ask the client to bring the past into the present by reenacting it in the present

Example
Imagine your father across from you in a chair. Tell him how you feel when he ignores you

The therapist helps the client live their feelings rather than just talk about them

The past is either brought in the here and now, or feelings about the past are unexpressed Unfinished Business When figures emerge from the background and are not resolved Contact and Resistance to Contact 1. Moving the client from environmental support to self-support
2. Reintegrating the disowned parts of one's personality Holism
Gestalt is a German word that means whole or complete, or a form that cannot be separated into parts without losing essence
Therapists attend to clients thoughts, feelings, behaviors, body, memories, and dreams - may focus on the figure or the ground
Cues to this background can be found on the surface of peoples reactions and therapist call it "attending to the obvious" when they focus on the client's physical gestures, tone of voice, demeanor, and nonverbal cues Field Theory
idea that the client must be viewed in its environment or context
Therapists pay attention to what is going on between the person and the environment
"Field" refers to the situation between the therapist, the client, and all that goes on between them.
The field is ever changing Figure-Formation Process
Describes how people organize experience from moment to moment
Field distinguishes into a foreground (figure) or background (ground)
Tracks how certain aspects of the environmental field comes from the background and becomes the focus point of the persons interest Organismic Self-Regulation
Process where equilibrium is disturbed by a need coming about, a sensation, or an interest
Generally people are able to regulate with the resources in their environment
In therapy, what emerges is the interest that is needed in order for the client to regain this equilibrium
Figure-formation is used as a guide for the focus of therapy Principles The only moment that is significant is the present
Nothing exists except for the "now"
The past is gone and the futures is not yet here

In order to be fully aware, you must live in the here and now
When the client tries to relive the past or worry about the future, they are not able to be truly authentic

Phenomenological inquiry involves paying attention to what is happening right now can result in:
resentment, rage, hatred, pain, anxiety, grief, guilt, abandonment

linger in the background and interfere with effective contact

Persists until the individual faces and deals with the unexpressed feelings
Clients must completely experience the impasse in order to move on

File Cabinet Example Contact - interacting with nature and with other people without losing one's sense of individuality

Contact is necessary for growth and change. It is made by seeing, hearing, smelling, touching, and moving within one's environment - Rose Bush Activity

Resistance to contact- defense developed to prevent the client from fully experiencing the present

Five channels of resistance
Introjection
Projection
Confluence
Retroflection
Deflection Energy and Energy Blocks Special attention is given to
where energy is located
how it is used
how it can be blocked

Therapists help clients identify the ways they are blocking energy and help them find adaptive behaviors Therapeutic Process Therapeutic Goals Therapeutic Goals Move towards increased awareness of themselves
Gradually assume ownership of their experiences
Develop skills to satisfy their needs without violating the rights of others
Become aware of senses
Learn to accept responsibility in what you do, and accept consequences
Move from outside support to internal support
Be able to ask for help from others, and to give help to others Therapist Role Therapist create a climate in which the clients are willing to try new behaviors and take an experimental approach
Pays attention to the clients body language
Focus on language
"it" talk- client says it instead of I
"you" talk- client is asked to use I to make it more specific to the client - Rose Bud Activity
questions- can hide the client-- counselor promotes turning questions into statements to encourage responsibility
language that denies power- therapist wants client to omit qualifiers and change "won't for can't, I guess to I will)
listening to client's metaphors- can clue into the client's internal struggle
listening for language that uncovers a story- because you can get an idea of their struggles The Client's Experience Clients are active participants who make their own interpretations and meaning

3 stages of client growth

Discovery: new view of old situation

Accommodation: clients recognizing that they have a choice

Assimilation: clients learning how to influence their environment Relationship Between Therapist and Client Therapists need to allow themselves to be affected by their clients

Therapist must encounter client with honest and immediate reactions and explore with them their fears, catastrophic expectations, blockages and resistances

Therapists do not manipulate client

The I/Thou relationship, a dialogue relationship

Two way engagement that changes both the therapist and the client Therapeutic Technique Experiments in Gestalt Therapy Role of Confrontation Therapists are sometimes put off by the way that Fritz Perls was so direct and confrontational. Specific Techniques Internal Dialogue Internal Dialogue Cont. 1. Which of the following is not true of Gestalt therapy

a. It can be applied to group counseling

b. It emphasizes the use of experiments

c. It is founded in field theory

d. The focus is on the past 2. According to Gestalt view:

a. dream work holds very little therapeutic value

b. the power is in the present

c. awareness is not a critical factor in the change process

d. dependence is fostered between the client and therapist 3. Which of the following is essential to the Gestalt approach?

a. developing behavior plans

b. accurate diagnosis

c. experiencing emotions in the moment

d. all of the above 4. Which of the following is not a key concept?

a. reflection of feelings

b. awareness

c. the figure formation process

d. the experiment 5. Which is not a Gestalt therapy technique?

a. shame attacking exercise

b. making the rounds

c. staying with the feeling

d. the rehearsal exercise The therapist is viewed as a creative agent of change

Exercises - ready made techniques used to make something happen in a therapy session, or used to achieve a goal

Experiments - grow out of interaction between the client and therapist.
emerges from dialogue between therapist and client

Shift the focus from talking to "doing" and helps the client learn through experience

Brings out some kinds of internal conflict by making the struggle a real situation.

Helps clients work through their stuck points

Takes many forms - imagining threatening encounters, setting up dialogue between the client and someone else, dramatizing a painful memory, assuming identity of someone else

Clients must be willing, but allows them to "try on" new behaviors The newer style of Gestalt therapy is much more supportive, and shows more kindness and compassion in therapy. Goal is to promote a higher level of integration between the polarities and conflicts that exist in everyone
"Top dog" vs. "underdog" conflict
internal game people play to control anxieties within their environment
resolutions and promises often go unfulfilled because of the struggle
top dog role makes demands based upon societal norms and standards - "shoulds" and "oughts"
underdog role makes excuses to why demands should not be met Main division is between the top dog and underdog
Therapy focuses on the war between the two







Using two chairs, the therapists asks the client to sit in one chair and be fully the top dog and then shift to the other chair and become the underdog. It is a role-playing game in which all parts are played by the clients. In this way the introjects can surface, and the client can experience the conflict more fully. This can assist them into integrating the two parts. Empty-Chair Technique The Reversal Exercise Clients are asked to reverse their typical behavior

For example, a client may act very sweet and kind, but they actually feel they are not standing up for themselves. The client may role-play an encounter while behaving as negatively as she can.

This activity allows the client to acknowledge other sides of her personality. Addresses lack of trust
Useful when a group member is having difficulty trusting the other group members.
Client is asked to go to each group member and either speak or do something with each member
"I don't trust you because..."
"Nobody here seems to care much about..."
Allows the client to experiment with new behavior, confront others, and practice taking risks in a safe environment The Rehearsal Exercise Client rehearses aloud what they would say to others

Helps client become aware of how they will meet the expectations others, of the degree to which they want to be approved, accepted, liked, to the desired extent The Exaggeration Exercise
Body Language
Goal is to increase awareness of the subtle signals sent through body language
Examples: postures, gestures, slumped shoulders, crossed arms, frowning, trembling, clinched fists
Client is asked to exaggerate the problem behavior
For example, a client who slouches would be asked to slouch as much as possible, all the way to his lap if possible. The client then describes the feeling associated with the behavior.
There is an underlying feeling associated with the behavior
Exaggerating the behavior will intensify the feeling to bring it into awareness. Staying with the Feeling Doesn't interpret or analyze dreams
Intent is to bring dreams back to life and relive them as if they were happening now
Dreams are acted out and the dreamer becomes a part of the dream
Each part of dream assumed to be a projection of the self & the client creates scripts for encounters between the various characters or parts
Each part is considered expressions of client's contradictory and inconsistent sides
Perls views dreams an unfinished situations, and existential messages regarding one's current struggles Clients are urged to stick with an undesirable feeling in order to work through their fears Making the Rounds Approach to Dream Work Experiments can be tailored to fit the way the individual interprets and perceives their culture
Therapists use open dialogue to check for cultural biases and views
Therapists should explore their own culture in order to be in tune with themselves before working with clients
Very effective for helping bicultural clients reconcile
Also effective for nonverbal clients - therapists ask them to used body language to express themselves
Flexible - not bound bound to certain dictates Limitations of Gestalt Therapy Most criticism comes from older version, or the Fritz Perls style which emphasized confrontation

Therapist is not considered a teacher, but rather a facilitator - allowing for the clients own self-discovery

Takes a lot of supervised training and a strong clinical background

Little emphasis on diagnosis or testing of the client Gestalt Play Therapy Cultural Considerations Pros Cons Limitations for cultures that are emotionally reserved
Sparks high levels of intense feelings A Board Game as Gestalt Assessment Tool for the Child in Middle Childhood Years Use of Gestalt Therapy in School Counseling Students of all ages can express feelings by putting situations into the "here and now"
Role playing activities are useful for all ages
Group therapy techniques of gaining trust among peers
Expressing feelings through play therapy
Focusing on the "what" and "how" of behaviors rather than the "why"
Applicable techniques
Empty Chair
Making the Rounds
Rehearsal Quiz Jeopardy References Board game as Gestalt assessment tool was designed for primary school age children
Focuses on
Therapeutic relationship
Sensory Stimulation
Discover the Child’s process
Used to gather information

During play therapy child is made aware of his process so he can experience his needs and incompleteness.
Once aware, child attempts to find a suitable way to satisfy his needs that accommodates his unique process and circumstances. Board Game Assessment Tool Cont. Through this process child acknowledges responsibility and realizes he has choices with regards to his behavior.
This leads to self-reliance and healthy emotional functioning.

According to the study, utilization of board games as a Gestalt assessment tool make it possible to make observations while playing the game regarding the child’s thinking, feelings, behaviors and expression, as well as verbal skills, attention, perception, body language, single-mindedness and level of development. jeopardylabs.com/play/gestalt-therapy Layers of Neurosis When a person is not in contact with themselves, they may act in these inauthentic ways Phony
Phobic
Impasse Implosive
Explosive

Corey, G. (2008). Theory and practice of counseling and psychotherapy (7th ed.). Belmont, CA: Brooks/Cole.

Botha, E., & Dunn, M. (2009, June). A board game as Gestalt assessment tool for the child in middle childhood years [Electronic version]. South African Journal of Psychology, 39(2), 253-262.

Ray, D. C., & Perkins, S. (2004, April). Rosebush fantasy technique with elementary students. Professional School Counseling, 7(4), 277-278. Retrieved March 10, 2013

Blom, R. (2004). The Handbook of Gestalt Play Therapy Practical Guidelines for Child Therapists (pp. 46-49). Philadelphia, PA: Jessica Kingsley Publishers

Fiebert, M. S. (1990). Stages in Gestalt Therapy Session and An Examination of Counselors Interventions. Retrieved on March 10, 2013, from California State University: http://www.csulb.edu/~mfiebert/gestalt.htm

Yontef, G. & Simkin, J. (1993). An Introduction to Gestalt Therapy. Behavior on Line. Retrieved March 3, 2013, from http://www.behavior.net/gestalt.html
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