(Disclaimer – what follows is an encapsulation of a wikipedia article with my own interpretations about the relationship between Gestalt therapy and other modalities).
I’m kind of excited to write about Gestalt therapy because its practitioners seek to embody qualities that are congruent with social work ethics and training, because it is relatively simple as theories go, and because it is based partially on Buddhist teachings on mindfulness, which I have found really helpful with both therapy clients and patients in the ER.
Indeed, Gestalt Therapy (GT) was influenced by Eastern spiritual teachings of present-centered awareness and acceptance of the moment, as well as by findings of 20th century physics, existential phenomenology, and of course psychoanalysis. GT is based partly on Kurt Goldstein’s Organismic theory and the idea that “self actualization is only achievable by self-transcendence.” Similarly, Buddhist teachings state that we only find freedom by letting go of the illusion of self, and that clinging to the ego is the basis of neurosis and suffering.
GT represents a pretty radical departure from psychoanalysis in its focus direct experience as an agent of change. While in traditional psychoanalysis patients introject interpretations provided by therapists, in GT clients change by making discoveries – emotionally and physically – about present experience.
Fritz Perls, Laura Perls (who reportedly got little credit for her contribution), and Paul Goodman were GT’s founders. Its greatest popularity was in the 1960’s and 70’s, a period of self-discovery and empowerment informed in part by eastern (Asian) teachings. A split emerged between east and west coast GT practitioners over time, with GT in the east being contained more in therapy offices while in the west it became a lifestyle movement with workshops being held at Big Sur at the Ensalem Institute. GT never really gained a foothold in academic settings, and training continues to be at private institutes to this day.
Following is a summary of some of the key elements of GT:
- GT is holistic, encompassing mind, body and culture as elements of a person’s potential for illness or health. This is congruent with the person-in-environment perspective of SW training. - Environment includes social context. GT posits a self that can only be known in relation to others, as opposed to a fixed self, unchanging over time. - Experience of self is viewed on a spectrum, either as fixed and rigid (neurosis) or overly loose and disorganized (psychosis). Therapy is about creating unpredictability, or loosening the “fixed gestalt” of neurosis and helping patients to respond to experience more flexibly. - GT focuses on experience in the present moment rather than the past. - GT is experiential rather than interpretive, and focused more on process than content. In this way it departs from psychoanalysis, which is more concerned with the “material” of clients’ past. - GT focuses on awareness as a path to self-acceptance. - Present centered-awareness leads to freedom from the baggage of the past. (Considerable neuropsychological research on mindfulness meditation supports this idea.) - Change comes about “as a result of ‘full acceptance of what is rather than a striving to be different.”
GT rests on four theoretical constructs whose principals are mostly contained above, so I won’t elaborate too much. But here they are:
1. Phenomenological Method – The therapist sets aside biases and judgments about the course or content of therapy, bringing a clean slate to the process. (Compare this to Winnicott’s idea of emptying the mind and receiving whatever arises.) The therapist focuses on immediate and concrete observations rather than interpretations, and the therapist refrains from ranking material in a hierarchical manner, giving everything equal weight. In this way the therapist does not try to steer the process. 2. Dialogic Relationship – The therapist brings her authentic self to the process instead of adopting a professional role or persona. The therapist also attends to her own present-centered awareness in order to be present to what arises. (This is congruent with mindfulness-based therapeutic approcaches.) 3. Field Theoretical Strategies – I think this is the idea that self is made up of a combination of place and social context and that it is dynamic. 4. Experimental Freedom – Therapists support direct experience rather than talking theoretically about the possibility of change. Therapy is based on movement toward action. Therapy includes role playing and experimenting with different modes of behavior from maladaptive fixed patterns of the past.
There it is. For myself, I find nothing in this approach to argue with as a basis for good practice. I am curious to hear others’ responses. Thanks for reading.
I know this wais last week topic, but I was watching a show on television that was entitled born with schizophrenia. It was about this family that had a little girl that was diagnosed with schizophrenia at a very young age; I believe it was 5 years old or so. What made it so interesting is that the family before they knew this diagnosis they videotaped almost everything from the day this little girl was born.
When the little girl was a newborn, she never slept, maybe a half a hour if that each day. She was very alert from day 1 she was born. By 4-5 months she was able to point to point to her head, toes, ears, etc when her parents asked. The parents were thinking that she was a genius or something. When she was about 4 or so, she would talk about an imaginary friend that she had. They have videotapes of her behavior at school and it was similar to behaviors seen with folks with schizophrenia.
The parents had a son later and they were concerned how she would be around him. They were concerned about her hitting him or worse. They ended up having to have two apartments: one for each kid, so when the little girl had an episode, she wouldn’t hurt her baby brother.
What was so interesting they had a videotape of the little girl taking her medications and the way she spoke about the medications, and what they were and how they helped her was truly amazing, her language skills were beyond normal.
I will see if I can find more info about cases like these, Derek: Have you heard about kids being diagnose this young?
Thanks Will. I enjoyed reading your post. I do not find much to argue with either; however, I am curious about two things: (1) It appears that a GT therapist does not provide a client with direction, and I wonder how the therapist would be able to influence the client in pursuing a desirable direction/goal. I feel that helping a client to feel reality is helpful, but it is not completed. (2) In practice, I wonder if a GT therapist would review with a client about what have been discussed previously or just work with whatever thoughts/ feelings of the client at the moment.
In a GT office there is usually an extra empty chair in the office, which is used to have simulated conversations with someone that you are experiencing conflict with. The client is often asked to move back and forth between their own chair and that of the empty chair, speaking both sides of the conversation. It sounds very much like role playing but in this case you are kind of role playing with yourself.
The idea is that by being forced to provide both sides of the conversation you have to open yourself up to feeling/thinking like that person that you are conflicted with, which can help increase your understanding of that person. By asking a client to do this, you are asking that person to not only see the conflict from their side but from the other. It can help a person become aware that part of the conflict can arise from an image of their own creation and thus understand that the conflict is theirs to deal with. Often times we assign blame/fault with others, which also leads one to believe that the other should be responsible for solving the problem. However, the empty-chair technique wants the client to realize where their power for change comes from, as it comes from within.
I can definitely see the value in this. A lot of patients in the ER are struggling with problems with others and in life and helping them distinguish between things they have control over and the things that they don’t often minimizes some of that anxiety. Personally, I understand the part about realizing that often times the conflict can be of one’s own making. I certainly have co-workers that I dislike working with and often times I just see them coming to talk to me and I already feel annoyed before they have even opened their mouth. That is an image and conflict that I have built up for myself, albeit based on previously negative interactions. I guess I should consider keeping an empty chair in my office :)
Great Post Nicole, I love the humility two. There are many therapists in the psychotherapy community that consistently incorporated this technique in there practice as there are many therapist that hold gestalts methods in high regard. I do think it places a lot of ownership for problems on the individual which is why others are quick to criticize it but remember I want you to understand these theories and techniques in their purist forms and then we can talk about their short comings IE lack of cultural considerations and euro-centric ideologies
Team, tomorrow I want you to be prepared to role play the empty chair technique. I want you to understand gestalt and be able to hold an intelligent conversation about this Gestalts ideas and methodologies in any therapeutic realm. You don't have to have the language mastered but be familiar with the general principals
The empty-chair technique really shows Gestalt's focus on a relationship between a person and a social context. By role playing, one can not only understand the other person's view point but also the context which created certain feelings on both parties. I like how this technique does not focus on the "material" of a client's past but the process... Also, it encourages clients to talk about the direct experience rather than a possible change..If we can create a common ground with our clients by taking about here and now, it will empower clients to create their own path way to change that comes from within. I think this is a great technique!
Hi All,
ReplyDelete(Disclaimer – what follows is an encapsulation of a wikipedia article with my own interpretations about the relationship between Gestalt therapy and other modalities).
I’m kind of excited to write about Gestalt therapy because its practitioners seek to embody qualities that are congruent with social work ethics and training, because it is relatively simple as theories go, and because it is based partially on Buddhist teachings on mindfulness, which I have found really helpful with both therapy clients and patients in the ER.
Indeed, Gestalt Therapy (GT) was influenced by Eastern spiritual teachings of present-centered awareness and acceptance of the moment, as well as by findings of 20th century physics, existential phenomenology, and of course psychoanalysis. GT is based partly on Kurt Goldstein’s Organismic theory and the idea that “self actualization is only achievable by self-transcendence.” Similarly, Buddhist teachings state that we only find freedom by letting go of the illusion of self, and that clinging to the ego is the basis of neurosis and suffering.
GT represents a pretty radical departure from psychoanalysis in its focus direct experience as an agent of change. While in traditional psychoanalysis patients introject interpretations provided by therapists, in GT clients change by making discoveries – emotionally and physically – about present experience.
Fritz Perls, Laura Perls (who reportedly got little credit for her contribution), and Paul Goodman were GT’s founders. Its greatest popularity was in the 1960’s and 70’s, a period of self-discovery and empowerment informed in part by eastern (Asian) teachings. A split emerged between east and west coast GT practitioners over time, with GT in the east being contained more in therapy offices while in the west it became a lifestyle movement with workshops being held at Big Sur at the Ensalem Institute. GT never really gained a foothold in academic settings, and training continues to be at private institutes to this day.
Following is a summary of some of the key elements of GT:
- GT is holistic, encompassing mind, body and culture as elements of a person’s potential for illness or health. This is congruent with the person-in-environment perspective of SW training.
ReplyDelete- Environment includes social context. GT posits a self that can only be known in relation to others, as opposed to a fixed self, unchanging over time.
- Experience of self is viewed on a spectrum, either as fixed and rigid (neurosis) or overly loose and disorganized (psychosis). Therapy is about creating unpredictability, or loosening the “fixed gestalt” of neurosis and helping patients to respond to experience more flexibly.
- GT focuses on experience in the present moment rather than the past.
- GT is experiential rather than interpretive, and focused more on process than content. In this way it departs from psychoanalysis, which is more concerned with the “material” of clients’ past.
- GT focuses on awareness as a path to self-acceptance.
- Present centered-awareness leads to freedom from the baggage of the past. (Considerable neuropsychological research on mindfulness meditation supports this idea.)
- Change comes about “as a result of ‘full acceptance of what is rather than a striving to be different.”
GT rests on four theoretical constructs whose principals are mostly contained above, so I won’t elaborate too much. But here they are:
1. Phenomenological Method – The therapist sets aside biases and judgments about the course or content of therapy, bringing a clean slate to the process. (Compare this to Winnicott’s idea of emptying the mind and receiving whatever arises.) The therapist focuses on immediate and concrete observations rather than interpretations, and the therapist refrains from ranking material in a hierarchical manner, giving everything equal weight. In this way the therapist does not try to steer the process.
2. Dialogic Relationship – The therapist brings her authentic self to the process instead of adopting a professional role or persona. The therapist also attends to her own present-centered awareness in order to be present to what arises. (This is congruent with mindfulness-based therapeutic approcaches.)
3. Field Theoretical Strategies – I think this is the idea that self is made up of a combination of place and social context and that it is dynamic.
4. Experimental Freedom – Therapists support direct experience rather than talking theoretically about the possibility of change. Therapy is based on movement toward action. Therapy includes role playing and experimenting with different modes of behavior from maladaptive fixed patterns of the past.
There it is. For myself, I find nothing in this approach to argue with as a basis for good practice. I am curious to hear others’ responses. Thanks for reading.
I know this wais last week topic, but I was watching a show on television that was entitled born with schizophrenia. It was about this family that had a little girl that was diagnosed with schizophrenia at a very young age; I believe it was 5 years old or so. What made it so interesting is that the family before they knew this diagnosis they videotaped almost everything from the day this little girl was born.
ReplyDeleteWhen the little girl was a newborn, she never slept, maybe a half a hour if that each day. She was very alert from day 1 she was born. By 4-5 months she was able to point to point to her head, toes, ears, etc when her parents asked. The parents were thinking that she was a genius or something. When she was about 4 or so, she would talk about an imaginary friend that she had. They have videotapes of her behavior at school and it was similar to behaviors seen with folks with schizophrenia.
The parents had a son later and they were concerned how she would be around him. They were concerned about her hitting him or worse. They ended up having to have two apartments: one for each kid, so when the little girl had an episode, she wouldn’t hurt her baby brother.
What was so interesting they had a videotape of the little girl taking her medications and the way she spoke about the medications, and what they were and how they helped her was truly amazing, her language skills were beyond normal.
I will see if I can find more info about cases like these, Derek: Have you heard about kids being diagnose this young?
Will: Thank you, very informative!!! great job!!!
Thanks Will. I enjoyed reading your post. I do not find much to argue with either; however, I am curious about two things:
ReplyDelete(1) It appears that a GT therapist does not provide a client with direction, and I wonder how the therapist would be able to influence the client in pursuing a desirable direction/goal. I feel that helping a client to feel reality is helpful, but it is not completed.
(2) In practice, I wonder if a GT therapist would review with a client about what have been discussed previously or just work with whatever thoughts/ feelings of the client at the moment.
Can anyone discuss Gestalts Empty Chair Technique
ReplyDeleteGestalt Empty-Chair Technique
ReplyDeleteIn a GT office there is usually an extra empty chair in the office, which is used to have simulated conversations with someone that you are experiencing conflict with. The client is often asked to move back and forth between their own chair and that of the empty chair, speaking both sides of the conversation. It sounds very much like role playing but in this case you are kind of role playing with yourself.
The idea is that by being forced to provide both sides of the conversation you have to open yourself up to feeling/thinking like that person that you are conflicted with, which can help increase your understanding of that person. By asking a client to do this, you are asking that person to not only see the conflict from their side but from the other. It can help a person become aware that part of the conflict can arise from an image of their own creation and thus understand that the conflict is theirs to deal with. Often times we assign blame/fault with others, which also leads one to believe that the other should be responsible for solving the problem. However, the empty-chair technique wants the client to realize where their power for change comes from, as it comes from within.
I can definitely see the value in this. A lot of patients in the ER are struggling with problems with others and in life and helping them distinguish between things they have control over and the things that they don’t often minimizes some of that anxiety. Personally, I understand the part about realizing that often times the conflict can be of one’s own making. I certainly have co-workers that I dislike working with and often times I just see them coming to talk to me and I already feel annoyed before they have even opened their mouth. That is an image and conflict that I have built up for myself, albeit based on previously negative interactions. I guess I should consider keeping an empty chair in my office :)
Great Post Nicole, I love the humility two. There are many therapists in the psychotherapy community that consistently incorporated this technique in there practice as there are many therapist that hold gestalts methods in high regard. I do think it places a lot of ownership for problems on the individual which is why others are quick to criticize it but remember I want you to understand these theories and techniques in their purist forms and then we can talk about their short comings IE lack of cultural considerations and euro-centric ideologies
ReplyDeleteTeam, tomorrow I want you to be prepared to role play the empty chair technique. I want you to understand gestalt and be able to hold an intelligent conversation about this Gestalts ideas and methodologies in any therapeutic realm. You don't have to have the language mastered but be familiar with the general principals
ReplyDeleteThe empty-chair technique really shows Gestalt's focus on a relationship between a person and a social context. By role playing, one can not only understand the other person's view point but also the context which created certain feelings on both parties. I like how this technique does not focus on the "material" of a client's past but the process... Also, it encourages clients to talk about the direct experience rather than a possible change..If we can create a common ground with our clients by taking about here and now, it will empower clients to create their own path way to change that comes from within. I think this is a great technique!
ReplyDelete