Understanding Gestalt Therapy

Transcription

1 Understanding Gestalt Therapy Mag. Inci Ardic SFU/SS17

2 Topics of the day History & Influences.Psychoanalysis.Expressionism.Theater.Laura Posner Perls Basic Perspec4ves. Phenomenology. Field theory. Existen:alism. Dialogue: Buber s I- Thou rela:onship Theory of personality Instruments & Techniques in Gestalt Therapy What is Change? Paradoxical Theory of Change Treatment Phases

3 History & Influences Fritz Perls ( ) was in many different ways exposed to leading Gestalt psychologists, existen:al philosophers, and psychoanalysts during his years spent in Germany. Born and lived in Germany :ll 1933 (40 years old).

4 History & Influences Ar:s:c influences: Expressionism & Theater By the :me he was 18, started to be trained in the Deutsches Theater under Reinhardt s direc:on who is referred by Perls as his first crea:ve genius (Bocian, 2010). - - Learned ho to observe ones expresses emo:ons through voice and gestures. Expressionism, art as an immediate inner experience and evolved emo:onal dynamics. Served in WW I, as a medic, worked on pa:ents with brain injuries.

5 History & Influences Psychoanalysis with K. Horney, W. Reich, O`o Fenichel Finding meaning to his sexuality and to his chao:c world theore:cal influences such as, socio- cultural backgr. interp. dynamics, body orienta:on & language, gestures. In 1925, I (32) started seven years of useless couch life. I felt stupid. Finally W. Reich; then s:ll sane, began to make some sense. Also there was Karen Horney, whom I loved. The rest of them I considered opinionated, missing Freud s good inten:ons. Confusing (Perls, 1969).

6 History & Influences Psychoanalysis with K. Horney, W. Reich, O`o Fenichel From Fenichel I got confidence; from Reich, brazenness; from Horney, human involvement without terminology (1969, p.38).

7 History & Influences In 1926, in Frankfurt, Germany became Kurt Goldstein s assistant for a year (neurologist- psychiatrist), and con:nued to work with brain injured soldiers. Goldstein helped him to perceive human being as a whole and not as a sum of their parts, who influenced many like Maslow with his holis:c approach. Laura Posner Perls (1930) Moves to Netherlands first, then to South Africa (Founded Psychoanaly:c Ins:tute), served as an army psychiatrist.

8 History & Influences Ego, Hunger, and Aggression is published in In 1946 moved to New York, worked with Paul Goodman. In 1951 together with Goodman and Hefferline published Gestalt Therapy: Excitement and Growth in the Human Personality.

9 History & Influences In 1960 moved to Los Angeles - Esalen Ins:tute. Increased interest in eastern religions, philosophy and Zen Buddhism. In 1969 moved to Vancouver Island to establish another training ins:tute then a year later he died in Chicago. & How does this all sound to you? What is your resonance, what do you observe within you as you listen?

10 Basic Perspec:ves The Phenomenological Perspec4ve as a method of inquiry The Field Theory Perspec4ve Existen4al Perspec4ve Dialogue: Buber s I- though rela:onship Our antude itself is a technique as well!

11 Basic Perspec:ves I - The Phenomenological Perspec4ve Phenomenology studies the structures of consciousness as experienced from the first- person point of view (Husserl, 1913). It is used as a method of inquiry. It aims to understand how the experiencer experiences the experience (Fylnn, 2006). Basically what we do in therapy. We call this, Gestalt phenomenological explora4on Gestalt therapy treats what is "subjec:vely" felt in the present, as well as what is "objec:vely" observed, as real and important data. This contrasts with approaches that treat what the pa:ent experiences as mere appearances and uses interpreta:on to find real meaning (e.g., psychoanalysis).

12 Basic Perspec4ves II - The Field Theory Perspec4ve Field Theory is basically the soil, what underlies the Gestalt phenomenological explora:on and close to the no:on of figure and ground. The idea is that a person is never completely independent or isolated from (even though the personal experience might be the case) but always in contact and connec:on with everything else. Figure ground rela:onship. Client s significant believes, how a person is influencing and influenced in every circumstance.

13 Basic Perspec4ves II - The Field Theory Perspec4ve Field theory is a method of exploring what describes the whole field of which the event is currently a part of it rather than analyzing the event in terms of a class to which it belongs by its "nature" (e.g., Aristotelian classifica:on) or a uni- linear, historical, cause- effect sequence (e.g., Newtonian mechanics). It studies pa`erns of interac:on between the individual and the total field, or environment. All the parts of the field are in an immediate rela:onship and responsive to each other and no part is uninfluenced by what goes on elsewhere in the field. Introduced by Kurt Lewin in 1940s which may be also formulized as B = f (p, e)

14 Basic Perspec4ves II - The Field Theory Perspec4ve In clinical senng, these three understandings of field is considered Experien4al field (phenomenal field) field of person s awareness, way they organize their experience, their unique reality. Rela4onal field, between the therapist and the client. Larger field, including culture, history or poli:cs.

15 Basic Perspec:ves III - Existen4al Perspec4ve This can be seen as the philosophy of GT. Each pa:ent can, with awareness, choose and shape his/her existence. People are endlessly remaking or discovering themselves, or at least have poten:al to do so. There is no essence of human nature to be discovered "once and for all." There are always new horizons, new problems, and (therefore) new opportuni:es.

16 Basic Perspec4ves IV - Dialogue: Buber s I- thou rela:onship The rela:onship between the therapist and the client is the most important aspect of psychotherapy. Existen4al dialogue is an essen:al part of Gestalt therapy's methodology. I- Thou rela:onship rather than I It rela:onship. I- Thou level tells us to see the pa:ent as another human being (you) as he/she is without s:cking other manipula:ve ideas to it (e.g., regarding pa:ents; sick, source of income, subject of research etc.,). Mar:n Buber ( ) Mee4ng through the Existen4al dialogue. allowing contact to happen rather than making contact, and controlling the outcome Our antude itself is a technique as well!

17 Theory of Personality Gestalt therapy has an emergent- rela4onal view on self. What do I mean by emergent- rela:onal self? Philippson introduced that self is a comparison word, exists only with other (2009). With no other there would be no self and vice versa. So, self is not a thing (like chair or book) but an emergence in a given situa:on. Suppor4ng theories as Intersubjec4ve Matrix by D. Stern, embodiment or neuroscience/ mirror neurons. Mutual spontaneous crea:on of now, dynamic aspects of experience and self through :me and in clinical senng.

18 Theory of Personality So GT sees self as a product of a constant emergence of this rela:onal world, which is also constantly ac:ve and in interac:on with the other. Nothing separated, not from the body, not from the environment, and not from the other. Taking into considera:on the existen:al perspec:ve, self is something we construct through making choices rather than just individual making the choice, which supports the ac:veness of the process (Philippson, 2009).

19 Theory of Personality Contact Boundaries Id Boundary: Organism / Environment Func:on of registering everything which goes into my organism, sight, hearing, touch, smell and taste, which is our experience in the world, physically. The func:on is to experience. Ego Boundary: Self/ Other Self is a co- created en:ty with the other. It is an ac:ve, chosen, differen:ated process. I become myself in rela:on to the other that I now make figural. The func:on of this boundary is contact. Personality Boundary: Me/ Not Me Here we talk about who we believe who we are and what is me. If my personality boundary is flexible then I can deal with the world crea:vely with a proper amount of adap:ng the word into my needs and adap:ng myself to the world. If not, incase of rigid and defensive then I have to cheat the world and get along with it accordingly. The func:on of this boundary is autonomy and self- consciousness.

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21 Interrup:ons of contact - They came known as interrup:ons originally however in recent years they are considered not to be interpreted as bad, good, helpful, or useless but in reference to the meaning and needs of each unique situa:on. Therefore modifica4ons to contact is a be`er way to call since they are to describe a series of processes that are crea:ve adjustments, may or may not be appropriate. - Understanding of health lies along a con:nuum between completely avoided contact, modified or full contact, depending on each situa:on. All of these reac:ons can only be judged in rela:on to the field condi:ons and to the person. (Joyce & Sills)

22 Instruments & Treatment Techniques The ul:mate goal is growth and autonomy through an increased awareness. Techniques serve the purpose increase awareness. we explore rather than a directly modify any behavior increase this awareness, which can be worked on a - bodily (enactment, exaggera4on, focusing on bodily sensa4ons) - cogni4ve - emo4onal level

23 Instruments & Treatment Techniques Ul:mate expected, eventual outcome is integra:on. A successful therapeu:c process brings integra:on. Meaning, iden:fica:on of the pa:ent with all vital func:ons and not some, parts of the personality, ideas, emo:ons or ac:ons. Integra:on means owning, which brings us to our whole. In therapy, we increase awareness to previously alienated parts, and have a look at them, taste them, re- consider them whether it is an op:on, see how it feels, if it works too, and eventually assimilate them if they are ego- syntonic or reject if ego- alien.

24 Instruments & Treatment Techniques Gestalt therapy is experimental, experien,al, and existen,al! What may this mean exactly?

25 Instruments & Treatment Techniques The Gestalt therapist has a wide range of ac:ve interven:ons and may use any technique or method as long as it is (a) aimed towards increasing awareness, (b) arises out of the dialogue and the therapist's percep:on of what is going on with the client (sensing, feeling, thinking in the immediate therapy senng), (c) within the parameter of ethical prac:ce.

26 Instruments & Treatment Techniques Remember what we said about awareness? Polanyi describes awareness as an act of understanding It s a process of comprehending: a grasping of disjointed parts into a comprehensive whole (Polster & Polster, p ).

27 Instruments & Treatment Techniques We can experience the awareness bodily, emo:onally and cogni:vely in 3 zones we call: Inner zone: internal world, sensa:ons (bodily), muscular tensions, breathing, and emo:ons Outer zone: behaviors, speech, vision, hearing, tastes, touches, smells, and movements Middle zone: thoughts, memories fantasies, an:cipa:ons, and beliefs.

28 Instruments & Treatment Techniques Con:nuum of Awareness, Stay with it. The pa:ent here is asked to simply express what he is experiencing. Emphasis on experiencing makes the situa:on very different from free associa:on of thought, abstrac:ons, and/or memories, which produces much of a verbal output and keep us on a cogni:ve level. Our posture, movements of hands and feet, facial expressions, or the tone of our voice, they speak for either the feeling that was excluded from awareness and the effort to block or prevent (counteract) it or both. The func:on of the therapist is to redirect the pa:ent's a`en:on back to the experience (Naranjo, 1975):

29 Instruments & Treatment Techniques - What are you feeling right now? - Can you describe it to me? - I am interested how feels to you? Now I am aware of...' - Stay with it! - Let your self feel it! - Are you aware of what you are doing with your hands? - I no:ce your voice sounds different now, can you hear it? - Can you see where you stopped and went back to defending? Here we encourage:. Staying with the here and now.. Accentua:ng and expanding awareness of ongoing experience.. Direc:ng awareness onto something avoided before or out of awareness.

30 Instruments & Treatment Techniques Abou:sm & Language We care about how to talk about something without sacrificing the immediacy of the experience. A form of depersonaliza4on. Our conversa:ons a`empt to hide distrusted feelings or to show our knowledge or to make a ready- made engagement, to avoid a fight, sex or confusion, which makes life safe but uninteres:ng. Learning to make something personal is a challenge to us all, especially in our western culture (Polster & Polster, 1973).

31 Instruments & Treatment Techniques An example regarding con4nuum of awareness and abou4sm. (See a`achment) "Every 4me you do apply the proper Ego- language you express yourself, you assist in the development of your personality" (Perls, 1966) Present tense is used to help focus here & now Encouraging responsibility for clients of their words, emo:ons, thoughts and behaviors help them accept who they are (see: paradoxical theory of change). I statements are used to encourage clients ownership of feelings rather than placing it (blaming) on others. (see: existen:al aspect)

32 Instruments & Treatment Techniques The Body as a Vehicle of Communica:on We encourage clients to express nonverbal language and try out new forms, alterna:ve op:ons also bodily Loca:ng emo:ons in the body, asking where they are experiencing the emo:on in their body. Repe::on and exaggera:on, may help to increase awareness. Iden:fica:on: Become your leg and give it a voice? Enactment: It is asked from the pa:ent to put his/her feelings into ac:on.

33 Instruments & Treatment Techniques Enactment of an unfinished situa:on from the distant past or a contemporary situa:on. Enactment of a characteris:c. Feeling like :ed up! Discovered: loosening brings fear, new, she wouldn t know who she might become. Enactment of a polarity. Two opposed characteris:cs, like wan:ng to be devilish but being an angel like. Such situa:ons may block us, or bring us confusion but by enac:ng it, they become clear. Helps restore contact (Polster & Polster, 1974).

34 Instruments & Treatment Techniques Empty Chair Method of facilita:ng the role- taking dialogue and used in order to help integrate the split parts of inner self. - Between the pa:ent and other people (between pa:ent and her mother) - Opposing parts of the pa:ent s personality (the strict self and the lazy self) - A physical phenomenon (a s:ff neck, an aching head, a painful back)

35 Instruments & Treatment Techniques Dream Work Perls men:oned once that dreams are the royal road to integra:on (1969, p.66). Let s remember Freud s famous quote on dreams. Every element of the dream is another piece of my personality, which might have been pushed aside into the shadows if the unconscious, which becomes eligible through dreams. Dreams are the most spontaneous expression of the existence of human being. An important difference of dream works in GT. is that the interpreta:on of the dream is only possible by the dreamer. The therapist would never a`ribute any symbolic meaning to it.

36 How is change possible? The Paradoxical Theory of Change! Beisser A. first develops this concept, in 1970 s. Change occurs when one becomes what he is, not when he tries to become what he is not. People are very triggered to get rid of one habit, antude, certain fears or any unpleasant feelings when they come to therapy. Instead of trying to arrive at the ideal picture of the self, the paradoxical theory of change proposes to consider that but follow a path that requires entering as fully as possible into all aspects of his own experience, bringing them into awareness as much as they can, acknowledge them as much as they can.

37 How is change possible? The Paradoxical Theory of Change! Once this achieved, trust is built in person's organism's self- organiza:on, and change happens eventually and naturally. Perls (1969) made a differen:a:on between self- actualiza4on and self- image actualiza4on. We psychotherapists constantly promote encouragement to embrace the isness of the client. This is why the theory is also paradoxical in a way because believes that client needs to give up trying to change, in order to change. Through ongoing awareness and contact, change comes eventually (Joyce & Sills).

38 Treatment Phases (Joyce & Sills) Phase One The beginning. Crea:ng a safe environment for therapeu:c work. Developing the working alliance. Using phenomenological inquiry. Raising awareness and self- responsibility. Offering a dialogic rela:onship. Increasing self- support. Iden:fying & clarifying needs and themes. Priori:zing the important aspects of diagnosis. Considering cultural differences, impacts. Planning preparing for special condi:ons (self- harm, abuse etc.,). Co- crea:ng therapy plan

39 Treatment Phases (Joyce & Sills) Phase Two Working through. Deepening the engagement in the therapist rela:onship. Becoming aware of rela:onal pa`erns. Addressing unfinished business. Re- owning alienated parts. Systema:cally and persistently working on deconstruc:ve, self- limi:ng core, fix beliefs, nega:ve life themes. Experimen:ng with the new behavior expanding op:ons. Facing the impasse, avoided place

40 Treatment Phases (Joyce & Sills) Phase Three Integra8on & Ending. Assimila:on of the new, insights & understandings. Readjus:ng, making changes. Working through transferences. An:cipa:ng the end of therapy. Bringing future in the picture. Lenng go & moving on

41 Quaes:ones & Comments

42 References Bocian, B. (2010). Fritz Perls in Berlin : Expressionism, Psychoanalysis, Judaism, Berlin: EHP - Verlag Andreas Kohlhage, Bergisch Gladbach. Bowman, C., & Brownell, P. (2010). Prelude To Contemporary Gestalt Therapy Gestalt, 4(3) Flynn, T. (2006). Existen4alism: A very Short Introduc4on. Oxford Press, New York. Heidegger, M. (1982). The Basic Problems of Phenomenology, Indiana University Press, Bloomington. Husserl, E. (2002). Ideas. Routledge, USA. Naranjo C. (1975). I and Thou, Here and Now: Contribu:ons of Gestalt Therapy In Stephenson, F. D. (1975). Gestalt Therapy Primer: Introductory readings in Gestalt Therapy. Thomas, Michigan. Jacobs, L. (1978). I though rela:ons in Gestalt therapy. In: Yontef, G. (1993). Awareness, Dialogue & Process: Gouldsboro: The Gestalt Journal Press. Joyce, P. &Sills, C. (2001). Skills in Gestalt Counselling & Psychotherapy. Sage Publica:ons. London. Perls, F.S. (1969). In and Out the Garbage Pail, Real People Press, Lafayette, CA. Retrieved on 15 May 2014 from Perls, F. (1969a). Gestalt therapy verba4m. Moab, UT: Real People Press. Perls, F.S, Hefferline, R., & Goodman, P. (1974). Gestalt Therapy Excitement and Growth in the Human Personality, Penguin Books, Canada. Polster, M., & Polster E. (1974). Contours of Theory and Prac4ce. Random House, USA. Smith, E.W. (1975). The Role of Early Reichian Theory in the Development of gestalt Therapy. Psychotherapy: Theory, Research, Prac4ce, Training, 12(3), doi: /h

43 References Stern, D. N. (2003). On the other side of the Moon. In P. Philippson, The Emergent Self: An Existen4al Gestalt Approach. London: Karnac, pp Walker, E. (2008), Gestalt Therapy: roots and influences. Esther Walker Psychotherapy & Counseling. Retrieved on 27 March 2014 / 15:30 from h`p://estherwalker.files.wordpress.com/2010/04/the- development- of- gestalt- therapy- is- a- reflec:on- of- the- training- and- experience- of- fritz- and- laura- perls.pdf Wertheimer, M., (1945). Produc:ve Thinking. In: Yontef, G. (1993). Awareness, Dialogue & Process: Essays on Gestalt Therapy. Gouldsboro: The Gestalt Journal Press. Wulf, R. (1996). Historical Roots of Gestalt Therapy. Retrieved on 06 Mai 2014 / 10:13 from h`p:// Yontef, M. G. (1993). Awareness Dialogue & Process: Essays on Gestalt Therapy. The Gestalt Journal Press. Online resources: - Stanford Encyclopedia of Philosophy: h`ps://plato.stanford.edu/entries/educa:on- philosophy/