Gestalt Therapy

What are you doing? What do you feel? What do you want?

Psychopathology

People have problems because they are cut off from parts of themselves. We learn to fragment parts of ourselves that are unacceptable or may be punished Psychopathology is cured by reintegrating into a whole self

Gestalt Principle 1

Principle of Proximity- when stimuli are close together they tend to form one perceptual unit // // // // // //

What do you see above?

Gestalt Principle 2

Principle of closure- incomplete figures are usually perceived as closed by the mind

/ \

Gestalt Principle 3

Figure/Ground Relation- we organize what we see into a shape in the foreground (figure) and a rather formless background (the ground). This distinguishes between important and unimportant elements of the environment and applies to thoughts, feelings and behaviors as well.

Gestalt Principle 4

Organismic Self-Regulation- A persons need to balance polarities and accept opposites in the self.

Adult vs. child Worried vs. care free Intellectual vs. emotional Strong vs. weak Etc.

Gestalt Concepts

Awareness is the key to positive growth and integration (Behaviors change is not a focus of therapy) Awareness comes from experience:

Contact Boundaries Support

Contact Boundaries and Support

Contact: TH/Cl relationship is critical Boundaries connect and separate us

Weak boundaries-we confuse others needs with our own Rigid boundaries-we feel alone and alienated

Support: Anxiety occurs when we do not believe we have or will have the support we need. (ex. Fear of future events)

Signs that you are out of touch with your emotions or needs

SHOULDS

A form of neurotic self-regulation

Occurs when you live according to rules youve learned so well that they seem natural Sometimes in automatically being polite and agreeable with others, we are rude to ourselves disregarding our own interesrts, concerns and opinions. Pearls

Contact Boundary Disturbances

You believe your thinking and emotions really belong to or are shared by someone else (examples from couples therapy-219)

Introjection Projection Retroflection- feeling toward other turned on self Deflection- avoiding contact with self or other Confluence- merging with another thru agreement of opinion or feeling (we are one)

Interruptions-Automatic SelfRegulation Actions

Automatically stopping acknowledgement of self or experience, including disowning experiences

Ex. A client smiles and changes topic after reporting the death of her grandmother, without noticing having done so

Intrusions of Unfinished Business

Unresolved emotions and issues from the past effect the present.

Ex. Transference

To get unstuck one must accept the past vs. trying to relive it correctly.

HOW DO YOU HELP YOUR CLIENT to realize they have all the inner support they need

Therapeutic Relationship

FORGET POSITIVE REGUARD

Clients need direct, in the moment feedback to realize how they are viewed by others

Be and show your boredom, irritation, impatience Admit to mistakes and unhealthy behavior in your own life Purposely frustrate your client, dont protect them from discomfort or responsibility Dont interpret, clients need to form their own interpretations

Removing Layers of Neuroses- Peeling the onion

1) The Phony Layer- Behaving inauthentically in social settings 2) The Phobic Layer- Energy is spent covering feelings of fear and helplessness 3) The Impasse Layer- Stuck, want help and others to tell them what to do 4) The Implosive Layer- Phony Identity Collapses, thus people feel dead inside or cut off from their former self 5) The Explosive Layer- Letting go of old self, thus energy is freed up to form new self

Techniques of Gestalt Therapy

You are but a magnifying mirror

Every thing a patient does and does not do is an expression of the self Therapist asked questions (vs. statements/interpretations) based on these observations to bring awareness to the patient Focus on present moment

Body Awareness

Mind vs. Body Polarity-Not a discussion, but an experience

Where do you feel your anger? A feeling that ones head is about to blow up is different from an ache in the stomach. An unconsciously clenched jaw may be a sign of an impulse to speak being repressed

Interventions:

If your clenched jaw could speak, what would it say? Really exaggerate your clenched jaw to increase intensity while providing support of therapist

In Class Body Awareness Activity

Think of a strong emotion you recently felt Can you locate it in your body? Does its location clarify the emotion to you in any way? Feel the emotion and conduct a body scan to determine how you physically express this emotion.

Experimentation

Experimental Homework- advise a reversal.

Ex. Cl complains husband does not chat with her when he comes home from work. She has tried pursuit of him with no success. Advise her to pleasantly retreat into an activity of her own interest.

The client is not looking for a solution or relief from distress, but rather for some deeper understanding thru experimenting

Experimentation cont.

Turn statements about others into statements about self (to explore projection)
Encourage client to stay with emotion in session. (Most clients dont have practice staying with emotions, most of their energy is spent trying to move past or avoid the emotion) Use clients imagination to actively fantasize and make experiences vivid

Role Playing

Client acts out different perspectives, people polarities, conflicts, etc. in session Empty Chair Technique- act out character, emotion, inner conflict for conflict resolution, depth of experience, integration of polarities, and soften the harsh internal critic (which helps to resolve intra psychic splits)

Dream Work

Role Play dreams

1) Client presents dream in detail and in present tense 2) Client plays roles of persons and objects in dream

Each part of a dream represents a projections or aspects of the dreamer. Helps to integrate parts, make sense of and utilize dreams

Psychodrama

Uses a group of people to act out past experience of client, with client acting as the director. This is used to bring past into present. The client can act as self and experiment with alternative ways of interacting.

Doing it is always preferable to talking about it

Language Modification

Clients language reveals their world view and typical methods of avoidance. Therapist insists on present tense and the use of the word I I Cant must be said as I choose not to

I have to must be said I want to Im not able to must be said I decide not to Adding on and I take responsibility for it

Example

A Client says: I might as well get my nose cut now, so Ill go ahead and turn in my paper. My program advisors ganged up on me and I was torn to shreds about my paper by my teacher. How does this client likely view Himself The world

Limitation

Gestalt therapy is not for people with impulse control difficulties, who run over others as a rule of thumb Delinquents Sociopaths Clients with poorly developed empathy
Unless modified to fit these populations

Limitations

Pearls himself loved to shock, loved an audience and was quite the narcissist. He fell asleep during sessions and had sex with clients. His original work may need to be tempered with interpersonal sensitivity and responsibility. VERY individualistic Very emotionally expressive Anti-intellectualism Philosophically sloppy