This is manifest as thoughts that seize the mind most of the time in involuntary ways. For example our conscience may compulsively dialogue with us over an issue. Or it may manifest as a filter that makes us blind to certain information in our environment. For example, someone who has had a history of abuse in childhood might fail to observe issues of power and abuse in relationships in the present day.
The formation process and Gestalt closing is a natural process that works without human intervention or the control of our will. We go through Gestalt processes everyday that form and close naturally in time. Nevertheless, situations sometimes occur which do not get resolved as they are supposed to, sometimes to a point that we forget the original problem exists or we believe that it has been resolved. This class of perpetuatal problem can cause psychological difficulties.
Gestalt Therapy: Overview and Key Concepts
The Gestalt psychotherapist works with this unfinished mental content or filter forms. They help the individual to recognise them and work towards the closing of the Gestalt using various techniques suggested by the psychotherapist. The human being establishes a relationship with his or her surrounding environment; this relationship defines a boundary. This boundary is what allows a distinction to be made between self and non self, but it is also the area where contact takes place. In Gestalt therapy, it is defined as the ego boundary or the contact boundary.
In Gestalt therapy it is considered that the relationships with other people are made at this boundary. When it happens in a healthy manner, then the boundary is flexible, which means that we are capable of distinguishing I from you, but also of forming a we. We are capable of coordinating the appropriate needs with those that surround us and we can see each other as a complete person, and not only as a function of our needs and wishes.
Generally, in a relationship with another person, we are each subject to number of conflicts of interest. In most cases, the individual-societal conflict faces us with a conflict between our needs and the demands of others. Concepts of obligations like must do transform themselves into ideals as to what we must do in a particular situation. We then create rigid formulae for relationships which correspond to these must do obligations. In time these become more and more rigid. In Gestalt therapy, this rigidity is called the character. The structure of a character is an inflexible form of relating which transforms, in the long run, into an obstacle to communications with others.
Another important aspect of the contact boundary is the function of those phenomena known as identification and alienation. Gestalt therapy proposes that we often identify with only small parts of our own true selves. This affects the way we see what is in ourselves and what is in others. We make assumptions that certain characteristics of ourselves belong to others, a process known as identification. We may consider some good qualities as only belonging to others when in reality they are also parts of ourselves.
This also produces the phenomenon known as alienation; for example, when we have no capacity to see some defect in ourselves, we tend to criticize it when we see it in others. Finally, it is possible to emphasize beforehand that as a basic principle to all the described processes, that Gestalt therapy relies on the naturalness of crux of the psychological processes.
Considering organisms as intelligent, any attempt to control or manipulate causes organic imbalance. It is believed that a majority of psychological problems arise from this manipulation or the need of control. The therapeutic principle first kills off control to allow the organism to self regulate naturally. At the base is the belief in that any attempt of directing a change is accostomed to producing the opposite effect, in which the controller part of the person attempts to obtain the objective, but faces another party that refuses that control.
The difference between decisions and preferences, are that decisions are voluntary choices, guided for a form of control external or internal , and preferences are the choices that in each moment the organism shows as important through the process of the formation of Gestalt. The goal of Gestalt therapy is to facilitate the removal of obstacles that lie between a person and the utilization of their full potential.
Gestalt therapy's techniques and attitude create a space in which the patient can recover his or her capacity for living. In this way a person can learn to be aware of the self and aware of his or her interactions with others, living in the moment and assuming responsibility for their actions. For Perls, the appropriate experience, further on from the whole explanation or possible interpretation, is therapeutic or corrective in this sense. This in turn focuses on the emotion and should help to release the blocked awareness. The hesitation can be shown through avoidance, blanking out, verbalism and fantasy Patterson, By drawing attention to the hesitation, it creates self-awareness for the client and allows the client to work through the issue.
The client is challenged with sensitivity and empathy on the part of the therapist to face the issues important to them. It is an invaluable tool for bringing clients into clear awareness of their realities, when used appropriately. However, confrontation is not a technique that can be used with all clients. Although still used in the treatment of anxiety and depression, Gestalt Therapy has been effective in treating clients with personality disorders such as borderline personality disorder.
This therapy sees a healthy individual as being someone who has awareness in his or her life and lives in the here and now rather than focusing on the past or future. Gestalt Therapy has a number of successful techniques that are applicable in therapy today and may be utilised across a broad spectrum of emotional issues. Your email address will not be published. Home Student Support Centres. Toll Free As the buyer of one of our electronic books eBook , you understand, acknowledge and agree to the following: A link to the eBook will be emailed to the email address provided by you during the purchase process.
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On purchase of the eBook you will be added to the e-newsletter of the seller, from which you can unsubscribe at any time. All intellectual property is retained by the seller. Contact with the environment : This is through looking, listening, touching, talking, moving, smelling, and tasting. This enables the individual to grow in his or her environment through reacting to the environment and changing. Here and now : This is the individual living in and being conscious at the present moment rather than worrying about the past or the future. Responsibility : This refers to the individual taking responsibility for his or her own life rather than blaming others.
Emphasis on statements rather than questions to highlight a collaborative client-therapist relationship. Encouraging responsibility for clients of their words, emotions, thoughts, and behaviours so they recognize and accept what they are feeling. Gestalt Therapy is equal to or greater than other therapies in treating various disorders, Gestalt Therapy has a beneficial impact with personality disorders, and the effects of therapy are stable. Versatile and flexible in its approach to therapy. It has many techniques and may be applied to different therapeutic issues.
For Gestalt Therapy to be effective, the therapist must have a high level of personal development Corey, The therapists are ready to gather intentionality and to support its unfolding. It is the intentionality towards contact that brings order to intersubjective chaos. When the arrow of intentionality loses energy and falls, it is recovered by the therapists, who give it new momentum. When the arrow falls and is recovered and re-launched, the emotive intensity of the moment is heightened.
Moments of fullness of contact are always unpredictable: we do not know when they will occur, in which minute or second of contacting. Intentionality orients the therapeutic process. A loss of momentum, a drop, or interruption in intentionality will prompt the therapists to intervene: intervention may also be silence, immobility, or almost imperceptible movement.
The intervention is directed towards the completion of a Gestalt, supports the potential that is ready to appear. How do the therapists notice the movement or interruption of intentionality? These resonances emerge indistinctly, not by cognitive process, but rather by giving time to unfold, and only through later reflection can they be distinguished. A rigorous criterion is what guides this awareness: the aesthetic criterion Joe Lay, in [ 65 ] that leads therapists and clients to co-create a good Gestalt of contact.
Again, in this diagnostic approach, no comparison is made between a model of the phenomenon and the phenomenon itself, as happens with diagnostic maps. Here we have the perception of the fluidity of what happens, or what fails to happen, which is what orients the therapists in adjusting their manner of being-with the clients. It is a note out of key, a brushstroke out of place, a touch too much or a touch too little, a little too soon or a little too late.
It is not an a priori model that guides us, but the unique, special aesthetic qualities of a human relationship in that specific situation. Just as we know how to recognize a note out of key, we can sense that something is out of place or out of time, or so indefinably strange or fatigued in ongoing reciprocal responses. It is, indeed, present for whoever is present in their senses—who is, therefore, aware and participating, implicated and resonating in the situation.
It is beautiful for us to be present in as much as we are touched by what is happening. When involved in contemplating beauty our eyes change, our breath changes: the beauty does not belong to the object or to the subject, but is an emerging contact phenomenon. We are rather concerned with a phenomenon that transforms and seizes us, whose power can have the emotionally disruptive force of a tidal wave or the subtle, penetrating quality of the air high up in the mountains.
Moreover, because it transforms, it leaves behind a trace of itself. The link between aesthetics, awareness, the lifeworld and transformation emerges even more clearly if we probe the etymology of the word in further depth, as did the classical philologist Richard Onians:. The therapists are the sensitive needle to changes in these seismographs, which record via individual resonances the aesthetic values of the relationship here and now, and not individual parameters.
The therapists gauge these variations and continuously position themselves in relation to them, with sensorial-physical unity. In this way, the therapists do not only bring about the intrinsic diagnostic act, but also the therapeutic act itself: this constitutes the unity of the diagnostic-therapeutic act [ 6 , 65 ]. Sensing the interruption of intentionality, the therapists re-position themselves in the relationship, guiding and curing it, moment by moment.
The in-between is the common ground that we constantly co-create at the contact boundary. It is the fabric that connects us to the world and to life moment by moment. In cases of a severe depressive experience, this common ground has ceased to exist and can therefore no longer be traversed. Herein lies the unique quality of melancholic experience. The in-between is no longer a meeting place [ 73 ]. It is impossible to co-create a figure of contact. In short, nothing reverberates in the therapeutic in-between, which is aesthetically perceived by the therapist and thus constitutes the intrinsic diagnosis in the contact with the depressed client.
A central facet of depressive experiences is the lack of any interest. This does not simply mean that the subject is not attracted to or involved in anything. The sense of lifelessness, which is perhaps one of the most distinguishing features of depression, is clearly a manifestation of this condition. The healthy growth of the self requires that the organism be at once separated from and welded to the world. This connection with the world is what is lacking in the severe depressive experience. There are neither interests, stimuli nor impulses of intentionality.
The client often remains silent and immobile on the chair throughout the session. Not even the vaguest hint of a figure peeks through. Nothing is relevant. No intentionality emerges, since intentionality does not belong to any one individual but rather emerges and reveals itself through contact: it is the force that drives all of our encounters at the contact boundary.
When we enter into a severe depressive relational field, our senses encounter a nothingness, a torpid wasteland that seems at some times to be made of stone and at others of a fluid, all-engulfing fog. The mountains, which have always been a source of joy to me, are now just there: unreachable, inert and useless.
Nothing appeals to me. The therapists perceive the lack of direction in a dilation of time and space. These two transcendental cornerstones of human experience have been altered. It would be inaccurate to say that the figure makes use of space and time as pre-existent categories. Rather, time and space emerge at the very moment at which the figure is co-created in the present. When depression creeps up, the present moment fails to emerge.
It lacks the support of both the previous moment that is coming to an end retentio and of the subsequent moment, which is coming into being protentio. When the therapists situate themselves in the relational field of the client, they will become immediately aware of this modified sense of time, which has been dilated to the point of suspension, to a point at which it has almost come to a complete stop.
- A world-wide membership organization addressing the needs of the gestalt therapy community;
- La Solucion Paleolitica: La Dieta Humana Originaria;
- Gestalt Therapy: An Introduction.
- The Fifth Discipline: The Art and Practice of the Learning Organization.
Space, meanwhile, is in a state of constant expansion. The energy required to traverse it comes to appear impossible. However, the very fact that its apparent absence causes such acute distress demonstrates that intentionality is actually present.
Client and therapist
It is present in the very pain, which derives from the perception of its absence. If the painfully felt absence of intentionality exists in the figure, then intentionality must be present in the ground. The depressive experience is situated within a relational field. Time and space are the roads that we conceive of ourselves as we make our way towards that which is loved and necessary.
They are relational-dependent variables, generated through the impetus of the journey itself, which is never just a single movement but always a co-movement. When this movement fails, what we experience is the abyss, which separates us. The affective bridge, upon which our very selves are constituted and from which subjectivity springs, is lost. Depressive experiences are the expression in the individual of a specific relational experience: namely the impossibility of reaching the other.
Depression is the way in which the subject experiences the surrendering of hope in the face of the ineffectiveness of their vain attempts to reach the other. Depression can be understood as a co-constructed relational phenomenon with three intrinsic and essential features: a profound attachment, whereby the other is loved and necessary, the failure of all efforts to reach the other and the emotive absence of the other from the relationship.
The depressive experience also has an interpersonal nature, it is a co-created phenomenon: it appears in relationships and there it is maintained. Considering the context of the life story and web of relationships, the depressive experience can be seen as a function of the field, as a form of creative adjustment. It can help a person to survive a difficult situation, it can signal a life transition and re-focus the search for life meaning, it can facilitate a change in frozen habitual relationship patterns, etc.
However, if a person uses a depressive way of relating in a rigid and stereotypical way in their life, the depressive functioning becomes a fixed Gestalt. It can be described as a vicious circle, which decreases the ability of the organism to cope with its own mental and physical processes as well as external demands.
It leads to more frequent failures, subsequent deepening of the depressive state, and a further decrease in the capacity of the organism. The usual organization of the relational field described above tends to be repeated in the therapeutic situation too.
Later, when this effort is not effective and they become exhausted, they try to protect themselves and withdraw from the depressed person often with more or less hidden aggression. The therapists find themselves in the same relation pattern and they feel impulses to repeat the described reactions to the depressive person. The therapist can, for example, try to encourage the client with well-intended practical suggestions for changing stressful life conditions, and then experiences frustration or irritation, when the client is not able to make any change.
Thanks to their awareness, the therapists have the chance to step out of this rigid relational pattern and respond differently to the depressed person—they remain available for contact, do not blame either themselves or the client, do not give up hope.
In doing this, the therapists change the usual rigid field organization and opens a space for a change also for their client. Fear is a common initial reaction when dealing with a severely depressed client. This may take the form of an undefined yet powerful sense of unease or of an intense fear for the client. Sometimes the therapists may wish to get away from the client, or to send them on to be dealt with by someone else. It is important to frame these experiences in their field context.
It is for this reason that the involvement of a third party provides a vital anchor [ 1 ]. This may take the form of pharmacological support, supervision, meetings with colleagues, or further theoretical training hopefully including reading this chapter. The depressive condition leaves the therapists teetering on the edge of a precipice, feeling a terrible weight pulling them down towards into the abyss, the vacuum, a state of solitude, fear, and extreme impotence where all sense of direction is lacking.
The therapists feel drawn to the client experience as to a magnet. They then either keep a safe emotional distance by keeping a professional mask, keeping the depressive experience unfamiliar for themselves and sometimes taking an inappropriate responsibility for the whole situation. The therapists experience falling off, loneliness, helplessness, shame, and heaviness. It is important for the therapists to be aware of their own experience and not to blame their client or themselves for it, because blaming is a distinct feature of a depressive field organization.
The therapists themselves are endangered in the depressive field organization. There is a clinically observed phenomenon of spreading emotions associated with depression in interpersonal contacts. How can they inhabit such a cavity, such an abyss? The field perspective provides support to the therapists on two counts: it enables them to make sense of their emotions at the same time as enabling them to act.
As psychotherapists, we need both the map an extrinsic diagnosis and the sense of direction an intrinsic diagnosis.
The extrinsic diagnosis is a basis for the work of a psychotherapist. Whenever we create an extrinsic diagnosis, we are fixing the particular way the field of the therapeutic situation has organized itself. We focus on the description of the meaning of the present therapeutic situation and we do not focus on being with the client for the moment. However, if we burdened ourselves with the demand that we should focus on the flow of the therapeutic relationship all of the time, we would paradoxically limit our therapeutic flexibility.
A fluent and nourishing flow of contact can develop if we also allow ourselves time to find orientation and meaning, to anchor in a third party, to diagnose. We can have several kinds of maps, each describing the clinical situation from a different perspective. We can have a map based on observation of the process of co-creation here and now, another one based on observation of roles and interactions within a system and another one based on phenomenological observation of the symptoms. During the process of psychotherapy, we naturally develop maps to give meaning to our experience.
We cannot avoid making some kind of a diagnosis. All that we can do is to remain aware of the process of diagnosing and bring our awareness back into contact with the client. We must keep in mind that a diagnosis is not a description of the person in front of us, it is merely a tool that enables us to meaningfully organize our experience with this person and so it helps us to be grounded and present for an encounter.
Gestalt therapy - children, define, functioning, adults, withdrawal, drug, examples, person
The extrinsic diagnosis becomes progressively less important as the therapist gains greater expertise. All travellers need maps to orient themselves, but it is also true that the more experienced a traveller you are, the more you can rely on your sense of direction.
Sense of direction is something developed moment by moment during your journey, without the use of too many maps. The intrinsic or aesthetic diagnosis is essential in orienting ourselves moment by moment through interaction. It is fundamental in providing specific support in Gestalt therapy. No map will ever be detailed enough to warn us of the potholes in the road and the bends along the track. No map is ever updated to the point of what is happening here and now. This kind of orientation is sufficient when, after having travelled widely and studied countless maps, the traveller is confident of how to move across unknown territories.
The first two authors wrote this article, the first author coordinated the writing. All three authors participated equally in writing chapters about psychopathology, diagnostics and depression from the book Gestalt Therapy in Clinical Practice, From Psychopathology to the Aesthetics of Contact [ 73 ], which served as a bases for this article. National Center for Biotechnology Information , U. Journal List Behav Sci Basel v. Behav Sci Basel. Published online Oct Author information Article notes Copyright and License information Disclaimer.
The text is based on the chapters about psychopathology, diagnostics and depression from the book Gestalt Therapy in Clinical Practice, From Psychopathology to the Aesthetics of Contact. Received Sep 7; Accepted Oct Abstract The diagnostic process in psychotherapy using the aesthetic evaluation is described in this article. Keywords: psychotherapy diagnostic process, aesthetic diagnosis, Gestalt therapy.
Introduction Gestalt therapists have often held caution towards psychopathology and diagnostics. Suffering of Relationship: Gestalt Therapy Approach to Psychopathology For Gestalt therapy, a continuum exists, without clear-cut distinctions, between healthy and so-called pathological experience. Gestalt Therapy Approach to Diagnosis The mistrust of Gestalt therapists towards diagnostics warns us of the risk of becoming experts for the lives of our clients, the risk of treating our image of the client and not meeting the client. Aesthetic Diagnosis There are two kinds of diagnosis when orientating towards a therapeutic relationship [ 1 ].
Conclusions As psychotherapists, we need both the map an extrinsic diagnosis and the sense of direction an intrinsic diagnosis. Author Contributions The first two authors wrote this article, the first author coordinated the writing. Conflicts of Interest The authors declare no conflicts of interest or state. References 1. Francesetti G.