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What is Gestalt therapy?

A brief explanation for people considering therapy.

Why might people come to therapy?

People come to psychotherapy when their ways of ‘doing things’- their patterns - have become unsatisfactory, counter-productive, perhaps distressing. They may want to change how they feel about themselves, and how they relate to others. They often want relief from the distress that goes with these old patterns.

Throughout life, we can become stuck in these habitual ways of doing things. The pattern may have worked well for us in the past, and is now creating problems, for example, relationships, personal distress, physical conditions, and so making the challenges of life more difficult to manage.

Gestalt therapy aims to explore these patterns so that people are more aware of how the patterns are formed and are still active, affecting their present life.

What is Gestalt?

Gestalt is a German word which refers to the total shape of something. Gestalt psychology, which has influenced gestalt therapy, maintains that we are “hard wired” to find meaningful patterns in life. These patterns are integral to the organisation of memory, relationships, imagination and ideas about the future.

We absorb our experience using all our faculties – sensations, emotions, thoughts and ideas, and memory. We experience everything in relationship to others and the world around us. Some of our experiences happen outside of our awareness, some lead us to reflect on what has occurred.

Experiencing a gestalt means having a sudden moment of clarity, sometimes described as “the penny dropped” or the “ah-ha” moment. After this moment our understanding of ourselves shifts. We feel changed.

What is Gestalt therapy?

Gestalt therapy defines Health as the ability to identify, acknowledge and prioritise our needs, both in relation to ourselves, to others important to us, and to society in general, and consequently mobilising to satisfy those needs. It does not consider Health in the context of illness, nor the person in therapy as a ‘patient to be cured’.

Therefore, Gestalt therapy can be considered as an optimistic therapy.

Coming to therapy is one way of finding support to realise this human capacity and experiment with new options.

So how does Gestalt therapy effect change? In what has now become a “classic” of Gestalt therapy literature, Arnold Beisser described Gestalt’s Paradoxical Theory of Change. Change emerges as a result of "full acceptance of what is, rather than a striving to be different".  The paradox is that the more we attempt to change ourselves, the more we stay the same. It is in the relationship with the therapist that new awareness emerges. It is in awareness that change begins.

What happens in a Gestalt therapy session?

A gestalt therapy session offers a safe environment in which you will be able to explore how you relate to others (known as exploring boundary dynamics). Using the relationship with the therapist, you can practice and experiment with this.

The therapist will pay a lot of attention to how you and she interact – and invite you to notice some of the ways this happens (known as the phenomenological approach). She will from time to time invite you to try a different way of interacting, solely as exploration and without any ‘right or wrong’ expectation. This is the ‘experimental’ stance, one of the hallmarks of gestalt therapy.

In learning how you respond to another, you may discover which of your needs you are meeting, and which you are unaware of, or setting aside. You will practice moment-by-moment awareness, and use this to discover new relational possibilities. This art of dialogue as practiced in a gestalt therapy session uses awareness, the therapist’s skill in attuning to the person in therapy, the person's expert knowledge on themselves and their context, and the commitment of both to explore the unfolding experience.

What is of interest in a gestalt therapy session is the person's total situation, from the concern they have brought to therapy today, such as bereavement, parent-child or other relationship issues, trauma, stress, problems at work, addiction, and many other concerns of modern living, to how they are experiencing themselves in the world at this time, including what they still carry from their past as unfinished, and how they think of their future. This is known as the field of the person.

Gestalt is a present-centred approach. While many gestalt therapists will not require, at the outset, a complete history of the person’s life, most importantly they will want to hear what meaning the person makes today of their experiences. That meaning naturally evolves from session to session, as does the person’s relational style and their awareness of themselves in relation to others.

Gestalt therapy work can be brief or medium to long-term. It can be time-bound or open-ended. The length, frequency and duration of sessions are agreed between therapist and person in therapy, will vary from person to person, and are always negotiable.

As a result of the work you do with your therapist you can expect:

  • a growing awareness of yourself in relation to other people and your environment
  • a growing sense of your own capacity to manage your life and make choices
  • a growing capacity for dialogue – the basis of effective relationships

Some elements of Gestalt Therapy theory and practice

Briefly outlined below are a number of guiding principles for working with a Gestalt approach:

Working in the present - Here and Now - Gestalt therapy focuses on what is emerging, or happening, in the present moment between therapist and person in therapy. Known as the ‘figure of interest’ this may relate to friends, job, family, hopes for the future, memories of the past. However, Gestalt is present-centred: therefore what has happened in the past or is imagined about the future form part of how the person understands their current experience. Exploring the past is not the focus of the person's work – nor is the future. They are considered only insofar as they can shine some light on – and affect – the current situation.

The therapist will encourage the person to distinguish and describe what they notice, imagine and feel about their experience as it emerges and impacts on the therapeutic conversation, in order to deepen their awareness and understanding. This is known in Gestalt therapy as the phenomenological stance.

Field theory: Gestalt therapy intervenes with the person’s whole situation, taking account of all the forces at play on the person’s unique experience at the time. Working with the whole situation of a person means bringing awareness to:

  • the past and the future only as they impact on this person’s present experience
  • the interconnectedness of this person and his or her environment
  • the importance of this person-therapist relationship
  • the ever-changing nature of experience as people impact one on the other.

Dialogue

The relationship between the therapist and the person in therapy is the most important aspect of psychotherapy. This relationship is a microcosm of all other relationships the person has, and is used by them as a safe space to explore and experiment with their patterns of relating.

The Gestalt therapist works by engaging in dialogue in which the person is the acknowledged expert in their own life experience, and is met by the Gestalt therapist's experience and imagination in a therapeutic context. The Gestalt therapist says what he or she means and experiences during the therapy session. By doing so the person is invited to do the same, and experience their difference. In turn this will support the person's growing awareness and trust in his/her own experience .

Existentialist perspective

Gestalt therapy works with the understanding that there is no fixed notion of ‘human nature’. We become who we are as a process of engagement with our environment, and so there are always new possibilities.

The existentialist perspective in Gestalt therapy is a focus on the big questions of human existence: who am I, where do I belong, my place in the world, the meaning of my existence. As a person in therapy becomes more aware of their experience, they also become more aware of their impact on their world, and the world on them: their expectations of themselves and others' expectations, their hopes for themselves and other people's hopes for them, the person's freedom to choose what they want in their lives, how to achieve that, and the consequences of those choices.

Boundary dynamics

An important focus of the work is the way in which we respond to others in the moment, whether we choose to join with them or stay apart, whether we express our experience or hold it in, whether we accept or reject others’ influence. These ways of relating to others, whether aware or unaware, whether chosen or part of our learned behaviour, are known as ‘boundary dynamics’. They are a useful way to describe and understand patterns of interaction between us and others, and how these shape our relationships, and ultimately change us over time.

Gestalt Therapy and other approaches

Gestalt therapy has a lot in common with many other forms of psychotherapy, shares its origins with the more radical developments in psychoanalysis, and many of its philosophical tenets with existential and humanistic therapies. Nevertheless the essence of Gestalt therapy is that:

  • it views behaviour as the outward expression of the person's ‘best shot’ at managing his or her experience.
  • it does not have behavioural change as its goal
  • it does not limit itself to the verbal exchange but rather includes the whole experience of the client for their consideration and experimentation: sensations, affects, meaning making, behavious, use of language and imagination, nervous system responses.
  • it further holds that change emerges organically as people engage in the process of accepting that how they are is their most effective self-organisation in the current circumstances.

In this way Gestalt therapy creates the ground for the next step.

 

With thanks to Seán Gaffney for its continued support of the development of Gestalt practice in the north of Ireland, and also to other authors including: Gary Yontef, Lynne Jacobs, Peter Philippson, Ruella Frank, Jim Kepner, and beyond Gestalt, authors such as Peter Levine, Stephen Porges, Larry Heller...