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Gestalt Two-Chaired Technique

Counselling Interventions 471 Presentation
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Jen Palma

on 20 June 2013

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Transcript of Gestalt Two-Chaired Technique

Affective Interventions:
Gestalt Two-Chair Technique

Affective Orientated Counselling Theories
Include: Gestalt (Perls), Psychoanalysis (Freud), Person-Centred (Rogers), Adlerian (Adler).

Fredric "Fritz" Perls founded Gestalt Therapy which is a complex psychological system that stresses the development of client self-awareness and personal responsibility.


Two-Chair Technique
The intervention is delivered through the creation of dialogue between two aspects of the self. Typically clients are asked to move back and fourth between chairs when expressing opposing aspects of themselves.

This intervention is grounded in Gestalt therapy’s main goal of raising clients’ awareness regarding themselves and how they function in their environment. Based on this understanding, it is essential for our client to focus their attention to what he/she is experiencing, in order to attend to unacknowledged aspects of experience into awareness. By equipping clients with awareness of their contrasting aspects; this contact will foster integration and conflict resolutions (Perls, 1969).

Appropriate Uses
Benefits of the Two-Chair
This intervention has shown to "evoke strong emotion which, when accurately focused, resolves impasses, finishes old business, and heals polarities and splits so that the patient has not just a powerful experience, but a powerfully healing experience” (Fagan et al., 1974).

This practice provides people with preparation prior to encountering difficult situations.

The disclosure of internal dialogues allows counsellors to identifies areas where cognitive restructuring would be beneficial. One’s critical—often irrational—voice which is the centre of debilitating motivations, restricting clients from moving forward.

It is a simple procedure to implement in an array of situations. For example, it can be beneficial to employ this intervention for assertiveness training and other problems related to communication.

Affective Therapy
Feelings are described as being basic to all human experiences; however, not everyone can make sense of their feelings. Some have trouble understanding them, others face cultural restrictions. As a result, some emotions are a source of embarrassment to express/experience.
Affective Therapists
Focus is on the feeling domain where emotional experience leads people to the "wisdom of the organism, which is regarded as having rationality that integrates all the affective and cognitive information available to the organism" (Clarke & Greenberg, 1986).

This is achieved by interpretting the feelings of their client through speech, observation of their behaviour and non-verbal behaviour.
Help clients to
EXPRESS their feelings
Help clients SORT OUT their feelings
Help clients FOCUS
Help clients CHANGE feelings states
Components of Affective Intervention
Since Fritz, many theorists have embraced and re-envisioned the two-chair technique:

Kellogg, S. H. (2004). Dialogical encounters: Contemporary perspectives on “chairwork” in psychotherapy. Psychotherapy: Research, Theory, Practice, Training, 41, 310-320.).

Contemporary perspectives on "Chairwork" have reworked this technique through the lens of five psychotherapies: (1) Gestalt (2) Process-Experiential therapy (3) Redecision therapy (4) Cognitive-Behavioural therapy and (5) Schema therapy.
This study aligned this technique to Cognitive Restructuring (Edwards, 1989).
After the therapeutic relationship has been established (potential for self-consciousness)
You notice the client expressing any sort of polarity, conflict, or split
“Inner Critic” (e.g. `I’m dumb’ )
“Top dog” (is demanding,, authoritarian, moralistic, bossy) vs. “Underdog” (helpless, apologetic, defensive) (Garrett, 2006)
This struggle for control results in the individual becoming fragmented into controller and controlled.
Your client is having interpersonal problems
When you believe your client could benefit from more fully experiencing a feeling (or another’s feeling) or from greater self-awareness
The movement itself is actually powerful

When
With Which Client
Limitations/Risks
Gestalt therapy in general (Encyclopedia of Mental Disorders, 2013):
High-intensity interaction (might be too disruptive for some)
Therapists using the techniques of Gestalt therapy with other theories of therapy without having the appropriate training
Because Gestalt therapists are very directive and active during the session, care must be taken that they have characteristics that include sensitivity, timing, inventiveness, empathy, and respect for the client.
Lack of scientific research evidence supporting the effectiveness (Encyclopedia of Mental Disorders, 2013).

A little unpredictable
Range from conflicts that are very peripheral (even playfully resolved) to very central (involving prolonged and deeply painful struggle) (Fagan et al., 1974).
Might not be suitable across all cultures
Asians value emotional control (Garrett, 2006)
Clients culturally conditioned to emotionally withhold might be uncomfortable with experiential techniques
Clients may believe that to show one's vulnerability is to be weak

Men might not initially be as comfortable with an affective intervention

References
Support For it:
Numerous studies have demonstrated and supported the Gestalt two-chair technique (Perls, Hefferline, & Goodman, 1951) as being an effective tool to resolve conflicts (Greenberg, 1983; Greenberg & Clarke, 1979; Greenberg & Dompierre, 1981; Greenberg & Webster, 1982).

The two-chair has shown to be more effective than empathic reflections (Carkhuff, 1969) and focusing (Gendlin, 1978).

Furthermore, studies corroborate its efficacy in generating greater depth of experience and shift in awareness during decisional conflict (Klien, Mathieu, Kiesler, & Gendlic, 1969).

Lou, T. (2012). The effectiveness of the gestalt two chair counseling technique in reducing paper presentation anxiety. http://hdl.handle.net/123456789/1885

Using "dramatization" clients viewed their cognitions through different perspectives to alleviate anxiety regarding their performance. Participants exposed to the two chair experienced a significant reduction in anxiety and an improvement in mood, in addition to performance. This was compared to control group including pretests and posttest.
Self-critical, self-dissatisfied, or rejecting a part of themselves (Fagan et al., 1974)
Indecisive (Clarke & Greenberg, 1986)
Unresolved grief (Field & Horowitz, 1998)
Unresolved interpersonal relationships (Greenberg & Paivio, 1995)
Catastophisizing in anxiety disorders (Greenberg, n.d.).
Anger
Phobias (Johnson & Smith, 1997)

What is put in the other chair is basically endless (therefore, range of experience expected):
Other People
Objects
Symptoms
Aspects of personality
A stereotype
Children to adults (Kumaria, 2010)

Demonstration
Class Exercise
Discussion:
1) Do you anticipate your experiences with what what emotions are appropriate to show, to impact the way you handle your clients' expression of emotion (or lack thereof)?
2) What would you do if you had an Asian client and you felt that this intervention would be beneficial for them but you knew they weren't as comfortable with displaying their emotions?
Clarke, K. M. & Greenberg, L. S. (1986). Differential effects of the Gestalt two-chair intervention and problem solving in resolving decisional conflict. Journal of Counseling Psychology, 33(1), 11-15.
Carkhuff, R. (1969). Helping and human relations. New York: Holt, Rinehart & Winston.

Clarke, K. M. & Greenberg, L. S. (1986). Differential effects of the Gestalt two-chair intervention and problem solving in resolving decisional conflict. Journal of Counseling Psychology, 33(1), 11-15.

Encyclopedia of Mental Disorders (2013). Gestalt therapy. Retrieved June 16, 2013, from http://www.minddisorders.com/Flu-Inv/Gestalt-therapy.html#b

Fagan, J., Lauver, D., Smith, S., Deloach, S., Katz, M., & Wood, E. (1974). Critical incidents in the empty chair. The Counseling Psychologist, 4, 33-42.

Field, N. P. & Horowitz, M.J. (1998). Applying an empty-chair monologue paradigm to examine unresolved grief. Psychiatry: Interpersonal and Biological Processes, 61(4), 279-287.

Garrett, J. (2006). Chapter 10 Gestalt therapy. Retrieved June 13, 2013, from http://mucounseling603theories.blogspot.ca/2007/10/chapter-10-gestalt-therapy-updated.html.

Gendlin, E. (1978). Focusing. New York: Bantam Press.

Greenberg, L.S. (n.d.). Two-chair technique. Retrieved from http://www.commonlanguagepsychotherapy.org/fileadmin/user_upload/Accepted_procedures/twochair.pdf

Greenberg, L. S. (1983). Toward a task analysis of conflict resolution in Gestalt therapy. Psychotherapy: Theory, Research and Practice, 20, 190-201.

Greenberg, L. S. & Clarke, K. M. (1979). Differential effects of the two-chair experiment and empathic reflections at a conflict marker. Journal of Counseling Psychology, 26, 1-9.

Greenberg, L. S. & Dompierre, L. (1981). Special effects of Gestalt two-chair dialogue on intrapsychic conflict in counseling. Journal of Counseling Psychology, 28, 288-294.

Greenberg, L.S. & Paivio, S.C. (1995). Resolving "unfinished business": Efficacy of experiential therapy using empty-chair dialogue. Journal of Consulting and Clinical Psychology, 63(3), 419-25.

Greenberg, L. S. & Webster, M. (1982). Resolving decisional conflict by Gestalt two-chair dialogue: Relating process to outcome. Journal of Counseling Psychology, 29, 468-477.

Goldfried, M. R. (1988). Application of rational restructuring to anxiety disorder. The Counseling Psychologist, 16, 50-68.

Janis, I. L., & Mann, L. (1977). Decision-making: A psychological analysis of conflict, choice and commitment. New York: Free Press.

Johnson, W.R., & Smith, E.W.L. (1997). Gestalt empty chair dialogue versus systematic desensitization in the treatment of phobia. Gestalt Review Special Issue, 1, 150-162

Klien, M., Mathieu, P., Kiesler, D., Gendlin, E. (1969). The experiencing scale. Madison: Wisconsin Psychiatric Institute.

Kumari, K. (2010). Empty chair technique. Retrieved June 14, 2013, from http://www.buzzle.com/articles/empty-chair-technique.html.

Mackay, B. A, N. (1996). The Gestalt two-chair technique: How it relates to theory. Dissertation Abstracts International: Section B: The Sciences and Engineering, 57 (3-B), 2158.

Perls, F. S. (1969). Gestalt therapy verbatim. Lafayette, CA: Real People Press.

Perls, F. S., Hefferline, R., & Goodman, P. (1951). Gestalt therapy. New York: Dell Books.

This compared the effectiveness of two-chair with problem-solving, a cognitive-behavioural technique.

Results showed two-chair reduced indecision more effectively than problem solving and the no-treatment group.

Two-chair counsellors revealed the original decision a person wished to make often unfolded into a deeper, related decision. As a result, clients left more decided and often new decisions or resolutions emerged.

Clients in the two-chair group reported being more decided than clients who tried to decide on a logical basis because they had fully attended to the feelings underlying the conflict.
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