Therapeutic Methodology

The following are excerpts from dialogue on the AAGT mailing list, and / or short descriptions on an
issue involving the application of theory. People are encouraged to contact others interested in Gestalt by
bringing their responses to these, and other issues, to the Gestalt community via email.

Send a message to the list (aagt@netride.com).

This section will fluctuate to reflect the changing figures among the AAGT community as they
appear in dialogue on the mailing list.

1. Paradoxical Change
2. Here-and-Now Transference
3. Phenomenological Method
4. Psychodrama and Gestalt therapy

Paradoxical Change

"People often change in spite of themselves."

"Good things happen on ordinary days."
"All that is in therapy does not take place within the parameters of the office visit."

These observations hint at the dynamic of paradoxical change. In contrast to therapeutic approaches that
target specific behavioral goals and identify dates by which these goals should be accomplished, often
seeking to observe some manifistation of it within the therapeutic hour, Gestalt seeks for contact and
awareness, letting the goals of change occur outside, experienced or observed by the client. While
therapists may notice that something is different, they do so after the fact. This is a decided difference,
and often requires a Gestalt therapist to translate his or her process into more palatable terms for the
benefit of third-party payers. However, for many Gestalt practitioners this is one of the reasons they do
not bother courting third-party reimbursment at all.

Change may also occur in front of one, indeed, within the therapeutic hour. The paradoxical does not only
relate to the consideration of time, but also of the quality or character of the process. Change occurs,
movement takes place, insight springs forth, but it happens uninvitedly; it drops in one one by surprise,
and that is what seems paradoxical - almost as if one were purposely tring to avoid such change and just
concentrate on what actually is, at the moment.

Here-and-Now Transference
"My question is: what does the present-centered, contact-oriented, gestalt approach offer this sub-group
of projections (transference and countertransference) that more traditional models do not address?"
-Morgan Goodlander (1996a)

"...I hope you'll say how you determine when a client's reaction to you is transferential and when it is an
honest reaction to you yourself...

...how can you tell if your reaction to a client is counter-transference and when it's an honest human
response? One of the major tenets of Gestalt therapy is that the experience of therapy is 'real experience,'
not just referring to other people in other times and in other places." -Sylvia
Crocker, Ph.D. (1996)

"One of the first things I do when I notice a client is beginning to project a positive or negative
transference is to make sure I am aware of my full response to their behavior. Often this includes some
self disclosure that acknowledges whatever counter-transference may be occurring. My experience is that

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transference acknowledged as a natural part of the contact experience is empowering to the client because
it begins the process of reowning the projection directly in the context in which it occurred and is
empowering to the therapist because it allows s/he to stay fully in touch with their experience, hopefully,
providing less opportunity for disowned projection to influence the work later." -Morgan Goodlander
(1996b)

"From Isadore I understood that transference was transferring...that it is a 'here and now' experience (as is
counter-transferring) and as such allows us GT to attend to the HOW this is happening...I rarely use an
empty chair or pillow - not wanting to possibly deflect from the client's potential impact on me. I want to
allow for the 'fullest meeting' possible and to remain as open, vulnerable and aware as possible - that I
might know what THIS experience of self/other is like...In fact, I have been on something of a crusade
these many years to remind folks that GT is a PROCESS therapy, and that it behooves us to think and talk
of it that way, so that for example, projection becomes projecting, introjection = introjecting, and so on.
Verbs rather than nouns. It is my experience that when I do this, I am forced to stay in the present,
meaningful contact rather than move into more abstract, labeling and thinking (retroflecting)." -Maya
Brand (1996)

"Fritz did us no favors in the mid-60's when he characterized transference as "a lovely game..." Although
this resonated with the popular culture, it diminished our credibility with more established schools of
psychotherapy and I believe it was a reflection of an adolescent stage of Gestalt theory development. This
is not a vendetta against the theory or against Fritz. I am claiming that we have made great technical
strides since that time, as has our abilities to integrate other psychotherapeutic concepts, including
transference...

...Otto Rank's conception of transference as the means whereby the client demonstrates their past, fits
well into my conception of unfinished gestalten and emerging figure. Interruptions to contact protect us
from the full awareness of the unfinished business of relational needs. When these are not met, the
organism has to cope. This coping is the definition of resistance offered by Laura Perls: the organism's
desperate attempt to assert it's integrity...

The client is telling a story and expressing intrapsychic conflict. The organism is demonstrating
developmental needs which have been thwarted, and the boundary processes which were ingeniously
developed in the absence of an environment which could provide those developmental needs. Through
ongoing contact (dialogue, touch, a developing history, etc.), the client gains a new reference for
organizing experiences and creating meaning as the unfinished gestalten emerge in the context of 'the safe
emergency.'

It is the safety of the therapeutic relationship that is my primary tool for creating the safe emergency. As
the transference (the story of unfinished developmental needs) unfolds my task is to be a vessel which
contains and supports the process. As the client shuffles between present external awareness and
unfinished business emerging in the present, I will either provide the 'necessary and sufficient' support for
completion or I will be the container for the client's juxtaposition of affect as he/she realizes a history
which is incongruous with the one originally constructed to compensate for an impoverished
environment. There is only one place, of course, where all of this occurs: in the moment!"
-Charlie Bowman, President of the AAGT (1996).

"...clients, even though there are elements of transference, are making contact in the only way they know
how. And if that contact is diminished (in our eyes) our job is to stay in the room with them where they
are at the moment and help them become aware of the possibility of other choices."
-Todd Butler (1996)
_______

In many ways gestalt psychotherapy can be conceived of as the process of ameliorating the healthy
contact between a person and his or her environment, with a view to satisying of needs.

"For Perls the analytic situation evoked in the patient a present need or opportunity, which

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 could be pursued without reference to the past...What the psychoanalyst terms transference
is conceptualized and referred to as a contact boundary disturbance by the Gestalt
therapist. In psychoanalysis the transference will ultimately assist the patient to understand
past relationships. In Gestalt therapy the boundary disturbance indicates that the patient's
awareness is impaired in the present contact with the therapist." (Frew, 1990, p. 195)

The therapeutic goal is the resumption of growth by means of bringing the individual into closer contact
with and greater awareness of the present. To be more aware in the present moment means risking clear,
unobstructed contact. At the individual level, an observation could be made about a person's breathing or
their physical posture. At the interpersonal level a suggestion could be made to express what one is
experiencing after hearing another speak. In groups the leader might ask about the extent to which a
person's remarks about someone else represent the attitude of the whole group, or in individual work, the
therapist could self-disclose his or her response to the transference and/or relate their own counter-
transference. It should be remembered that transference is a sub-set of that form of boundary disturbance
known as projection. Projection has a healthy, positive side as well, for by means of projection we're able
to empathize with a friend, identify with another person's situation, or understand someone else.
Projection can also be used to deny experience and pretend that it resides in someone else.

"Through projection, individuals perceive the world in their own images and distort
perceptions of people or events in accordance with their beliefs, attitudes, or emotions.
When they perceive what they want to perceive instead of what is really there, they are
projecting...

...The Gestalt therapy position is phenomenolgical: each person construes and constructs a
personal life world that is unique. Each person functions in the world on the basis of
observations about which ideas, assumptions, or fantasies are constructed. No person can
know how the world is for anone else; one can only use one's projective imagination to
construe it. The healthy position is to make clear observations as to what is perceived to be
going on, to recognize and accept responsibility for the observations, to be aware of
projecting, and to be receptive to new information. Projection without awareness,
responsibility, and receptivity to new information leads to the denial of important sensory
information, replacing that information with one's own idea or fantasies." (Korb, Gorell, &
Van De Riet, p. 57-8)

Phenomenological Method
In keeping with the phenomenological method, the Gestalt therapist will focus on the actual experience of
the client. The relationship between the therapist and the client is included as part of the focus. The
Gestalt therapist is taught to "bracket off" his interpretations and hypotheses in order not to impose his
version of reality onto the client. From this method, the client's awareness may develop undebauched by
"shoulds" or other imposed beliefs of the therapist or society.

Awareness is both the primary method and the goal of Gestalt therapy's phenomenological approach.
Phenomenologically enhanced awareness endows clients with better tools for understanding themselves,
their place in the world, and how they create this place. Clients are taught that the lives they create and
maintain for themselves is their responsibility; hence, it becomes their responsibility for changing.

Gestalt therapy provides its practitioners with a rich array of methods and techniques for the
phenomenological enhancement and the exploration of awareness. Almost all methods are are centered
around a "here and now" and a "what and how" approach. The what and how of experience assists clients
in their current, immediate experience of being-in-the-world. In this way, clients can more easily be
aware of their experience of what they are doing literally, in the present. Gestalt therapist's questions,
"What are you doing right now?" or "How do you know that?" reflects the belief in the importance of
present experience and demonstrates our ahistoric and non-interpretive stance.

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How one becomes aware is explored as well awareness itself by the phenomenological oriented Gestalt
therapist. So we study the awareness process and awareness itself. As part of this study, the relationship
between the therapist and the client is explored both dialogically and experimentally.

The Gestalt therapist respects each client's experience of reality as accurate for that client. The dictum,
"What is, is," typifies our phenomenological stance.

Psychodrama and Gestalt therapy

The following are selections from a dialogue on the AAGT list in which various people offered
stimulating persepective enjoyed by all involved. These portions of that interaction have been reproduced
with gratitude.

"I agree with what is being said about psychodrama and trained in psychodrama myself for 3 years before
engaging in full-time training in gestalt. I found the ground of psychodrama, particularly sociometry, has
helped me in seeing the group as a living organism and in working with the group organism in the same
way as I would with an individual.

I also think though that psychodrama, while rich in particular types of practice or experiment does not
have the richness of theory and philosophy of gestalt, which for psychodrama leads to a rather frozen
fixed ground of practice, where the process of group and individual is more proscribed through role
theory and stages of group process, while in gestalt, as a result of a wider philosophical ground,
experiment and practice is unlimited and more flexible.... ie in Bob Resnick terms, from his interview
with Malcolm Parlett, Gestalt can incorporate psychodrama into it's field while, psychodrama needs to
expand to incorporate gestalt.I agree with what is being said about psychodrama and trained in
psychodrama myself for 3 years before engaging in full-time training in gestalt. I found the ground of
psychodrama, particularly sociometry, has helped me in seeing the group as a living organism and in
working with the group organism in the same way as I would with an individual.

I also think though that psychodrama, while rich in particular types of practice or experiment does not
have the richness of theory and philosophy of gestalt, which for psychodrama leads to a rather frozen
fixed ground of practice, where the process of group and individual is more proscribed through role
theory and stages of group process, while in gestalt, as a result of a wider philosophical ground,
experiment and practice is unlimited and more flexible.... ie in Bob Resnick terms, from his interview
with Malcolm Parlett, Gestalt can incorporate psychodrama into it's field while, psychodrama needs to
expand to incorporate gestalt."--Brian O'Neill, 1996

"It seems to me that Psychodrama is relegated to a realm of method and Gestalt is relegated to a higher
order of integrated theory-philosophy-technique. I am positive this is not the view of a passionate Trainer
Educator Practitioner of Psychodrama and Sociometry. Could our tendency to capitolize the G in Gestalt
and use the smaller case p in psychodrama hint at some level of arrogance on our part? I will certainly
own my arrogance in my belief that Gestalt therapy is numero uno!

I studied psychodrama for a year or so intensely with John Nolte and Roy Ford while deciding whether to
leap into it or to devote my time to Gestalt therapy (in Indianapolis we have the Indianapolis Gestalt
Institute and the Midwest Center for Psychodrama and Sociometry). Roy and I had daily contact and
wonderful debate on the merits and pitfalls of the two theories/techniques, and I co-facilitated a
psychodrama group with him and he a Gestalt group with me. The differences seem to me to be similar to
the differences between Portugese and New World Spainish: while both have roots traceable to the same
origin, there would probably be little understanding of meaning in the dialogue!

We avoid 'contaminating' the work with the others 'stuff'. Psychodrama Directors trust in Tele and
process when alter egos are selected--believing the "stuff" will ultimately serve the same purpose. This
and other differences aren't differences in technique, they are fundamental differences in our views of the
therapeutic process. My many discussions with Roy clarified that for me. My experience with

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Psychodrama people, as with Gestalt people, is that the course of study for either is rigorous, requiring
much study and personal involvement. The process of making meaning of the experience of 'contact' for a
Gestalt trainee/trainer is no different than the process of making meaning of 'drama' for a Psychodrama
trainee/trainer." --Charlie Bowman, 1996

"I have been interested in the discusssion about Gestalt therapy and psychodrama, Perls and Moreno,etc. I
am in agreement with the observation that at times both approaches look alike. The key here, in my
opinion, is why Gestalt therapists do what they do and why psychodramatist do what they do. . I suspect
that on this dimension we are different.

Isadore From has cautioned against the use of techniques that produce drama (high drama at times!)and in
the particular case that From was talking about does not dissolve projections. Isadore From went on to
say in his elegant fashion (here I am paraphrasing)--if it is not 'contact making' what is a Gestalt therapist
using a technique for?

The abuses of techniques, whether it be one borrowed from psychodrama or any other Gestalt therapy
technique, occurs when the purpose is forgotten. That is, to assist the client/patient in contact making
and/or to enhance awareness.

A difference I have noted in my limited exposure to psychodrama is that other people from the group may
be involved in a particular drama, representing different people in the patients life. Whereas, in Gestalt
therapy the patient usually is asked to "become" these significant people. I prefer the latter approach
because I think we get to the patient's introjections and projections without the contamination of asking
another person to participate. But whatever appoach one prefers, one key is what is done after the drama,
e.g., is there any integration. And is there 'contact making' between the therapist and the patient, or is
there contact making between the patient and the other group members." --Bob Harman, 1996

"...I use psychodramatic elements, whether individually (as in the case I described) or in group work, it is
just another way of doing Gestalt. I agree with everything you said about the problems with Moreno's
psychodrama, and with From's points about contact and awareness. In the case I described, my having her
talk TO her father, heightened the therapeutic contact she had with him and with herself; and when she
actually dealt with him in new ways her contact was wholly congruent--for the first time--with the way
she felt internally. The quality of the contact in therapy prepared her for the subsequent contact, and the
use of imagination in therapy sharpened both kinds of experiences.

I think Isadore was too narrow for the good of the development of the Gestalt approach. He mistakenly
thought that everything of significance had already been said, or so it seems was his position. I do agree
with him, and with you, that it is a mistake simply to tack on other techniques to Gestalt therapy without
doing them for Gestalt-theoretical reasons. Nor do I think it is ever necessary merely to tack on other
powerful methods without doing so for reasons which are grounded in Gestalt therapy's theory. I believe
that the task of developing Gestalt methods is to understand the reason why they are to be used, always to
increase awareness or facilitate good contact (including action). Our theory is broad and rich enough to
permit us always--with thoughtful effort-- to understand other powerful techniques in our own terms, and
to use them for our own Gestalt reasons. This is one of the ways in which Gestalt therapy can and will
continue to develop and to spread its influence.

I learned the Gestalt-psychodrama blend from Leon Fine, who was from Portland, Or. He had studied
with Fritz and Laura, and with the psychodrama people; he trained people primarily in psychodrama, but
when he trained in Gestalt he used the blend. I had workshops with him both in Gestalt and in
psychodrama. I think his group work was unsurpassed, at least in my experience. Instead of having other
people from the group try (as in psychodrama) to improvise someone's mother, father, and husband, for
example, he asked the person to choose individuals from the group to play these parts, but they never did
any improvisations. Rather, they were people who were spoken directly to by the person who was
working; then when it was time to have the other person, for example the mother, speak, Leon had the
two change places, with the group member playing the part of the client and giving the last sentence as a
cue, while taking on the body posture, the voice tone, and general affect of the client. So when, for

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example, the client was playing her mother she could play off the actual presence of someone who was
imitating her as she had revealed herself to be prior to reversing roles.

This allows the client to see vividly how she reacts when she is dealing with her mother. The same thing
happens whenever the client has a fantasied dialogue with anyone in the piece of work. Thus there was no
contamination by other's stuff, as there is bound to be in classical psychodrama.

The therapist can also do some powerful things as the work progresses. For example, if a client's parents'
message was perceived by her to have been: "We expect great things from you, but you'll never amount
to a damn thing" ( this would have come out earlier), the therapist can heighten the intensity of the
contact--and perhaps help the client to become more fully aware of the futility of continuing to try to
please these people--by having the group members playing the father and mother repeat this message in
unison to the client no matter how the client tries to win them over, and no matter what she says to them.
Projections and introjections are readily dealt with by this method. Also, space can be used more
realistically, since the individuals involved can act out in space some significant scene. On the whole, this
method is more realistic and vivid than empty chair work in a group setting, and certainly more so than
merely talking ABOUT the significant people the client has issues with.

After the work is finished there is the same opportunity for sharing as in other forms of group work. Also,
if one or more persons in the group is chosen repeatedly to play the same kinds of roles as the group goes
on over time, these persons can notice and share how it is for them to be so chosen; also this provides an
opportunity for them to learn something of how they come across to others.

When I did a presentation of this method at a Gestalt Conference some years ago, Richard Kitzler said it
was the first time in years he had seen anything new which was "pure Gestalt". I think this method is an
instance of using techniques from another approach for Gestalt reasons. I think it's a powerful method,
and I also think it makes group work more involving and interesting for all of the members of the group...
--Sylvia Crocker, 1996

...I think (like many other approaches) its not in the public eye so much these days as it was in the past,
but it has influenced a lot of practice--especially in subtance abuse treatment programs. Also, I can see
vestiges of psychodrama in such 'new' techniques as 'family sculpting'. Actually, I feel freer to be creative
when 'doing' psychodrama than I do when 'doing' gestalt (as a counselor educator, I do a lot of
demonstrations and workshops) although I have had more training in gestalt. I don't know what that's
about for me--maybe the 'structure' in psychodrama helps with that. I know that the folks I have trained
with in psychodrama were quite willing to 'experiment' in the gestalt sense with a variety of (I don't want
to say techniques so I'll say) ideas about how to recreate a client's experience. I think the two
methodologies complement each other and bring richness to the work.

As for the theoretical differences, I never understood Moreno's writings well enough to have a broad
understanding of his rationale for what he did--except to understand that Moreno felt that 'talking about' a
problem did not bring change--only action would. For me, what brings momentum to the change process
is awareness and what creates awareness is experiencing my process in all areas of my life. Psychodrama,
for me, brings the dimension of recreating the 'experience' , which then allows for awareness to occur..."--
Martha McBride, 1996

"...I'm much more interested in the therapeutic use of a person's imagination than I am in psychodrama.
Maya pointed out that what I had described as my work with one of my clients was taken from
psychodrama (while Iris Fodor pointed out that it was behavioral therapy!). I don't want let the subject of
the therapeutic use of imagination get lost in the discussion of psychodrama.

When Perls borrowed from Moreno the use of a person's imagination in the service of therapy I think he
simply extended Gestalt therapy's methods, without doing any damage to its theory. Most of the issues
which bring people into therapy have to do with people and situations outside of the therapeutic situation.
Through the therapeutic use of imagination, we can make explicit the psychological presence of the
significant others in the client's life, and the client can work through numerous issues in the here and now,

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which is one of the hallmarks of Gestalt therapy. In a significant sense these others are already present
when the client comes to the therapist, insofar as their influence has been internalized by the client.

If the client and therapist only talk ABOUT these others, rather than having the client talk TO them, then
a great of knowledge that the client has about these others and the situations involving them remains
inaccessible. Additionally, the stories the client tells about these others is far more under the control of
the client than they are when the client "hallucinates" the others, playing both his own part and that of the
others. The actual experience of the shift from mere talking to imagination is clearly different, both
emotionally and physically. Client's register this difference as soon as they are asked to make the shift, or
as any of you know from your own experience of role playing.

The following is an amusing example of the power of imagination to make accessible important
knowledge which the client has had all along. I once had a client whose husband's business frequently
made it necessary for him to drive over a mountain pass in the winter. For years she had begged him to
call her when he got to his destination, but he always refused; and it continued to be a source of conflict
between them. I had her speak to him in fantasy about the situation. She said, "I know why you won't call
me. You're scared you won't make it, and you just don't want me to see that you're scared." When she
reversed roles, her tone of voice changed, she (playing the husband) registered a look of utter shock and
amazement as she replied, "That thought never entered my mind! You just worry about everything all the
time, and I'm not going to go along with it!" When she reversed to her own role again, she sheepishly
said, "You're right." And it was never an issue again. Our clients know a great more about the significant
others and the situations in their lives than they know they know. By accessing their power of
imagination in therapy, they frequently gain access to this information. Mere talk about these matters
does not usually have this effect.

By using only the dialogic method, we can see in therapy many of the ways in which a person interrupts
and distorts his contact, we can work with polarities and other conflicts, we can work with introjects and
other beliefs, and so on. This is an enormously valuable method, and I believe it is a limited method. For
one thing, the content is still too open to unintentional censorship by the client; imagination lessens this
considerably. For another thing, the transference of the learnings in therapy to the client's everyday life is
somewhat problematic when they are acquired in the safety of the therapeutic situation. But when a
person speaks directly to the imagined others, the emotional tension of the everyday life situation is
somewhat replicated, and the learnings immediately begin to connect with those situations outside of
therapy.

Gestalt has always put itself out as more than a "talking cure". The use of experiments, including but not
limited to those using imagination, are what distinguishes it from "talking cures". I think that even though
dialogue is profoundly important, as a pure method it is limited, as all talking is limited in its power to
bring about change. Even when we add to it the dynamics of the relationship, we still have a limited
method, since most of the issues transcend the relationship with the therapist, and will never be replicated
with the therapist. The idea that they can be is, in my opinion, a major fallacy in psychonalysis." --Sylvia
Crocker, 1996

"Well, I agree with most of what you said, but I still have a problem with your use of the term
'imagination'. For me, that term limits the scope of what can and does happen during 'experiments'. The
term 'imagination' also limits the preciseness of the intent of any experiment. For example, the intent of
split-chair dialogue is different from that of the 'empty chair'. The intent of other experiments may also be
different although fantasy may be used.

My problem with all of this (and it is my problem) is that I get concerned when therapists (and
theoreticians) begin using different terms that diverge from the original source of the concept. Perls did
not acknowledge his 'borrowing' from Moreno until his last book (that I'm aware of); Rogers did not
admit his debt to some the precursors of his approach and both Glasser and Ellis have used concepts and
ideas that were first pioneered by Alfred Adler while purporting to have developed something 'new'.

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Anyway,I must have experienced psychodrama training that was much more flexible and innovative than
some of the folks on this interest list. I have gotten many new ideas for 'experiments' from that training
and feel it helped my ability to be creative during individual or group sessions. I do love to use action-
oriented techniques as a part of my approach to gestalt therapy and feel that reenactments do help clients
both become more aware and integrated as well as more prepared to deal with the outside world."
--Martha McBride, 1996