What is Gestalt Psychotherapy?
By Mike O'Halloran, M.A.(Couns.), B.A., European Certificate in Psychotherapy, M.I.A.H.I.P., M.I.A.C.P, M.L.B.C.A.I., E.M.C.C., E.A.P. Accredited I.A.H.I.P. & I.A.C.P. Supervisor.
As an approach to Psychotherapy, Gestalt is best experienced rather than spoken or written about. This is because it emphasises client awareness rather than understanding as the key to change. And also because Gestalt emerged partially as a reaction to what it's founder, Fritz Perls, saw as the over-intellectualisation of psychoanalysis. Perls held the chief neurotic characteristic of our age to be that we live too much in our heads, that we are desensitised to our bodies and thus often unaware and ineffective in meeting our organismic needs. His catchphrase "Lose your heads and come to your senses," remains a cornerstone of Gestalt, seeking as it does to enable people to change and become more whole through a process of greater self-awareness.
Underlying Gestalt there is a strong philosophical base which I want to highlight, as the method the Gestalt practitioner avails of when working with clients flows from this philosophical base. The Gestalt world view is holistic, existential and phenomenological. Let's examine these terms and see how they help explain how a Gestalt psychotherapist works.
Gestalt Psychotherapists refute the arbitrary division of body and mind that we are accustomed to. Gestalt goes further than agreeing with the idea of the interconnectedness of mind and body, positing instead the concept of the unity of the ‘body-mind.' Thus, a Gestalt practitioner is invariably as interested in what the client's body is doing as much as what the client is saying. The body never lies! This holistic view of people, seeing body and mind as a unity is in marked contrast to the way we have mostly become accustomed to viewing ourselves. The holistic approach says ‘I am a body,' rather than ‘I have a body.' In the course of psychotherapy, unresolved conflicts and trauma (held in the clients body as tension and pain), can be accessed by the client and psychotherapist through concentrating on what the client is doing with his body.
Another aspect of holism is that is views each part of the organism as being representative of the greater whole. In practice this means for example that a seemingly unimportant or small aspect of how a client does a particular thing, such as eating a meal, when examined can reveal significant aspects of how the client lives her broader life.
Gestalt also draws from the existentialist philosophical tradition, one of whose chief characteristics is it's stress on individual freedom and choice. According to existentialists we choose how to live our lives, the kind of experiences we have and how we respond to each emerging situation. By contrast, in everyday life, we tend to blame outside circumstances, others, parents etc for what is happening to us now, especially when things aren't going so well. Existentialism does not deny the reality of external circumstances or the past, yet it still manages to say something like "....but you can still choose to change or respond differently if the same happens again." Not only is the individual responsible for the broad canvass of his or her life, but he or she is also responsible for thoughts, feelings and actions in every millisecond of life. Thus, if I am angry in response to you, it is not me who is making me angry, rather this is how I am freely choosing to respond to you. In Gestalt therapy the existence of human freedom and choice in all circumstances is a core working hypotheses which helps clients towards greater freedom and responsibility.
Gestalt also draws on phenomenology as a way of increasing client's awareness. The phenomenological approach is essentially one which aims to take people as they now are in the moment, through a concentration on what is now happening, and attempts to describe what is happening now, without interpreting the meaning of the phenomena. The consistent application of phenomenology heightens client's awareness of their process and their awareness that it is they who are doing such and such, avoiding such and such, choosing to be angry, sad, and resigned and so on.
As well as having a strong philosophical basis Gestalt has an increasingly detailed theory as to what constitutes good and ill psychological health, or in Gestalt terminology healthy and unhealthy contact. Three key concepts which are relevant here are Contact, Completion and Unfinished Business.
Contact refers to the interaction between the person and the environment or others and between different parts of the person. Each contact a person makes involves a range of processes and therare many ways in which the person can disrupt or impede the quality of the contact he or she makes. A simple example will demonstrate the process of contact:
If you become thirsty there will firstly be some kind of sensation of lack in your body, or perhaps a strong sensation of dryness in your throat which will lead to the awareness that you are thirsty.
This awareness will lead you to mobilise to take the action necessary (e.g. going to the fridge to or tap to get water). You then make contact with the drink(environment), by drinking it, feel satisfied and withdraw to rest, go back to what you were doing, or onto something else.
The words in bold show the range of processes involved in a simple bit of living like quenching a thirst. The sequence of becoming aware of the need and satisfying it is known as a complete gestalt. You have satisfied a need, the gestalt is completed and you are now free to give your attention to whatever emerges next.
Suppose however the telephone rings before you get to the fridge. You answer the phone and get involved in a conversation; then depending on how thirsty you are, you may not be able to give full attention to the phone call. You are trying to deal with one situation,the call, while an unfinished need, your thirst, cries out to be completed. The unrequited thirst could be called an incomplete gestalt, you have unfinished business. Of course we can all get by with a certain number of unfinished situations such as this in our daily lives, problems arise however when our lives are so busy that too many unfinished situations build up; or more profoundly when major unfinished pieces of business from a persons past are impeding the persons ability to make good contact and live satisfactorily in the present.
So how might unfinished business from the past effect the quality of a person's present contact to the extent they might need to seek psychotherapeutic help? And in what specific ways might their unfinished business interfere with specific contact functions such as sensation, mobilisation, awareness etc?
Imagine a young girl whose father is aloof and distant. He is also over demanding and constantly criticises her school work, no matter that she actually performs rather well at school. The girl may develop a view of herself as not being good enough to have a loving man for herself as an adult, and may never feel satisfied with later academic and work achievements. She may always feel she ‘could have done better.'
As an adult she may have a tendency to start relationships with men who are unavailable to her, men who in fact keep their distance an criticise her in more or less the same way as her father did previously. Why is this so?
The answer lies in the strength of her ‘unfinished business' with her father and the natural urge we all have to complete what is unfinished. As an adult the woman will forever try to complete the earlier unfinished situation, forever try to meet the unrequited need for affection and praise from her father, by choosing men who are similar to her father in being both distant and critical.
You now understand something about contact, the human need to complete situations and and how unfinished business interferes with good contact. Let's consider briefly some of the specific ways people use to interfere with the making of good contact, before considering how the Gestalt therapist helps clients to make better contact.
WAYS TO BLOCK CONTACT
Some of the main processes people may use to habitually block good contact are:
Desensitisation involves a shutting down of bodily awareness such that the individual may not even feel basic physical discomfort such as cold, hunger or pain. It often results from physical or sexual abuse and is the child's way of shutting out the pain involved. Whilst this is useful to the child it can mean that as an adult the person remains desensitised and cannot properly orient himself or herself towards their environment. Insofar as we shut down our physical selves we blot out the impact of our environment, and our antennae cannot pick up the information it contains.
Closely connected with desensitisation is the process of deflection. It chiefly consists in a refusal to be aware of what is going on and in an avoidance of good contact with others. The person is afraid that if he or she becomes aware of their real needs, they may not be met. It's safer to remain isolated rather than have good contact with others. Nothing or no-one can get through to the person who deflects habitually. At the same time, the person who deflects does not insert himself into the world, he ‘pulls his punches,' and ends up never quite getting what he might have reasonably expected his actions would have got him.
Introjection refers to the process by which we take into ourselves ideas, thoughts, rules, and attitudes to self and others, in an uncritical way, usually when we are very young. The infant from birth is taking in knowledge of it's world, a view of itself as ‘bad' or ‘good,' and
also rules such as ‘always work hard,' ‘pride comes before a fall,' and so on. Just as the infant must swallow whole and can't chew over it's food, so the infant and later the child swallow whole views about themselves and how to be in the world. Introjection works at this level because it is the initial means by which the child takes in knowledge and views about the world.Harmful introjects such as the belief that one is worthless or doesn't deserve to get much out of life can severely interfere with an individual's ability to mobilise energy in order to reach into the world to get his or her needs met. This is very obvious with people who are depressed. Behind the low level of energy lies a set of beliefs about oneself as being worthless which block the persons energy and which are sometimes verbalised as ‘I'll fail anyway,' or ‘it's no use.'
Whilst introjection can interfere with contact by preventing the person from even trying, the process of projection ensures that if contact occurs it may be damaging to the persons relationships. Projection consists essentially in disowning parts of oneself and instead ascribing those parts to other people. So instead of accepting that you dislike someone, you believe they dislike you. Or instead of owning your own forceful side, you project it onto others and imagine they are bossing you. We most often project disagreeable parts of our personalities and those parts of ourselves that we are unaware of (usually these are the same). It follows that the less awareness we have and the less self-acceptance, the more we are going to project.
People sometimes block contact by redirecting the energy that should be flowing outwards back into themselves. If, for example, a person is angry with another but is afraid or unable to express their anger, then the energy attached to the anger will stay bound up within the angry person. If the failure to express such a powerful emotion such as anger is habitual, then eventually the accumulated anger will get to be held in the body as muscular tension and rigidity. There's a sense that the person is beating up herself instead of the person(s) she is angry with. Retroflection involves doing to oneself what you need to do to someone else, so a person who is afraid to love, may instead pamper himself and choose to live in expensive surroundings for example, the self pampering taking the place of the going outwards towards the other.
Gestalt aims to undo the clients various habitual ways of making poor contact, by helping them become more aware of the various mechanisms by which they interfere with their contact, such as the processes mentioned briefly above.
FREEDOM & RESPONSIBILITY
The existentialist belief that we are free to choose is a marked feature of Gestalt work. The psychotherapist will focus on the present and on how the client makes contact now as opposed to an over focus on the clients past. A client who talks about why he keeps losing jobs antries to show how this is a result of his past, or is caused by others, will be brought back to look at how he keeps getting himself into positions where he gets sacked. The focus on the ‘how' of the clients life helps him to the awareness that he has some responsibility for not being able to hold down a job and that he is an active agent in his own life rather than someone who is a victim.
The client's habitual use of language may be challenged if this is a way the client uses to avoid responsibility. Clients are encouraged to say ‘I,' instead of ‘one,' as in ‘I feel,' ‘I believe,' rather than ‘people believe,' and so on. The client who says ‘She makes me angry,' may be asked, ‘How do you make yourself angry?' The Gestalt psychotherapist constantly helps clients to see how they choose to respond to others can contribute to their own feelings.
A striking feature of Gestalt is its consistent use of phenomenology. This consists essentially in describing what is now happening without trying to interpret. A client can be asked to focus awareness on bodily feelings or sensations which they are strongly aware of, or they may be asked to describe how they are making or avoiding contact with the psychotherapist at that particular moment. Thus a client who is angry and is avoiding eye contact by looking away and sitting rigidly may be asked to describe how he is looking away and holding his body. Gradually the client becomes aware of how he deflects and retroflects (cuts off from others and holds in angerwhen he is angry. This is real learning for the client as opposed to someone telling him that this is what he does.
As the Gestalt psychotherapist is not trying to interpret the client's actions and as client change occurs because of growing awareness, the phenomenological method turns the client-therapist meeting away from a doctor-patient type relationship and more towards the meeting of two human beings. The encounter is more of an analysis/description of what is going on now, and less of a detective investigation, and this lurches the client into growing awareness of how he creates his own life. Fritz Perls said the chief task of Gestalt was to frustrate the client out of every attempt he made to avoid the present. The consistent use of principles which concentrate on what the client is now doing, being, sensing, feeling and thinking is the way this task is achieved.
Gestalt does resolve the unfinished business from the clients past, but it does so through a concentration on the present, using as raw material the client's present feelings, thoughts and behaviours and the interaction between the psychotherapist and client. Underpinning the Gestalt approach is the belief we are all responsible for our lives anwe always have choice. The experience of Gestalt can be profoundly liberating.