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What is Gestalt?

Gestalt Therapy developed out of Gestalt Psychology in the 1950s and ’60s. In the section I will give a detailed account regarding what GT is and how the process of therapy using GT can be experienced. Please take what you may need from this account.
The aim of GT is to develop awareness and promote awareness of awareness. This does not mean simply developing insight or introspection, but exploring experience as physical and emotional beings making sense of our world and our relationship to others and the environment. The therapist supports awareness for the client and his life world and the process by which awareness is developed. In this way awareness can be seen to increase self-regulation and contact with others. Awareness includes sensory and bodily experience as well as cognitive andemotional awareness.

Awareness is developed and expanded using these core concepts:


Working relationally

Relational perspectives have become central to contemporary GT practice. A relational approach isgrounded in a contextualist framework in whichhuman experience is shaped by context. Hence theconcept of working relationally is not only focused onthe therapeutic alliance, but underscores the meaning making paradigm for GT.
A contextualist framework is paradigmatic in working with the nuances of emotional process, therapist–client interaction, and enduring relational themes.The therapeutic alliance draws on the concepts of‘inclusion’, ‘confirmation’ and ‘presence’. ‘Inclusion’requires the therapist to do more than empathicallylisten and attune to her clients. The therapist leans intothe client’s experience such that she connects with theclient’s existence as if it were a sensation within her ownbody. This is not a merging with the client, but asensitivity that enables a visceral encounter betweentherapist and client. Inclusion integrates the therapist’sawareness of her responses to the client with a deeplyattuned appreciation of the ‘otherness’ of the client’sexperience.
‘Confirmation’ involves a profound acceptance of theimmediate existence and potential of the client. Thetherapist does not control the therapeutic encounter.There is no therapist goal or agenda (except that ofincreasing the client’s awareness). This does not meanthat the therapist mirrors or agrees with everything thatthe client brings to the session. The therapist is committed to the dialogue and this includes genuine moments of dissonance, which are made transparent.
The therapist is part of the relational field. This entailscommitment to change, not only for the client, but alsofor the therapist.
The balance between this gently focused inclusionand commitment to the co-created space of the therapysession requires ‘presence’. ‘Presence’ is evident in agrounded and assured quality in the therapist. Equally,‘presence’ entails a willingness to be uncertain, to workwith ‘creative indifference’ and to offer support to theclient’s expressive capacity. This lends an intrinsicethical quality to the clinical encounter in whichshared meaning-making between the client and therapist is developed through an open exchange about howthe therapist and client are affected by each other.
Shame and other disruption affective states can alsobe triggered within the therapeutic relationship for arange of reasons including when the therapist is attending to one aspect of the client’s situation, withoutmaintaining attention for another co-existent (butpossibly un-named) aspect of his situation. Theseruptures are evident in the withdrawal of the clientfrom the process. It is important for the therapist toattend to ruptures in the therapeutic relationshipthrough offering support and investigating the contribution that the therapist might make in co-creating ashame experience in therapy.
● The therapist follows the client attentively, tracking● the awareness process and the client’s experience, not● following a predetermined agenda.● The therapist responds non-judgmentally to the● client, creating the conditions that allow for the● most effective client expression.● The therapist demonstrates a willingness to be uncertain and to work with creative indifference.● The therapist draws on her relationship with the● client as the ground for challenge and growth.● The therapist seeks to identify and repair any ruptures in the relationship.


Working in the here and now

Immediate experience is the essential material for healing and growth in GT. Laura Perls observed that theactual experience of any situation does not need to beexplained or interpreted: it can be directly contacted,felt and described in the here and now. This is becausethe act of remembering the past or anticipating thefuture occurs in the present. Therefore, in the clinicalencounter, references to the past or future are broughtback to the present: focusing on what and how the clientperceives his situation now. As Gestalt therapists, weconcentrate on ‘what is’ rather than ‘what was’ or ‘whatwill be’, not because we wish to ignore a person’s historyor his future intentions. For example, in the case ofsexual abuse the focus is primarily on how the abuse isbeing communicated now.
The therapist and client work together on the immediacy of a situation: exploring the many dimensions ofthe present behaviour or affect. This is particularly thecase when the behaviour or affect is habitual or causessuffering. Exploration of moment-to-moment awareness of the present situation can assist in understandingthe choices inherent in the broader context of the client’slife space. The past may be considered relevant to thisexploration, when the immediate situation is thematicof habitual or past experiences.
However, the emphasisis always on the immediate encounter, such that if a client wishes to relate an event from the past the therapist would enquire about how it feels to tell that story now. Working in the present supports the client to ‘stay with’ his situation rather than shift or change it. This concept is reflected in the paradoxical theory of change that maintains that the focus of the therapy is not tochange, but to embrace as fully as possible all aspects ofan experience, by increasing awareness of that experience. The aim is not to change, but paradoxically to staythe same, and to engage more fully in that experience.Once full acceptance is reached, then change followsthat process of acceptance.
● The therapist enquires about the client’s immediate presentation.● The therapist supports the client to stay with what is● happening in the encounter between them, by● enquiring and seeking to extend awareness about● immediate sensation, affect, cognitions and somatic presentations. ● The therapist supports the client to accept and deepen his awareness of his presenting issue rather than trying to change it.


Phenomenological practice

Phenomenological practice is more than simply validating the client’s subjective experience. It involvesexploring the life world situations that the clientbrings to each session. This requires attunement to‘the id of the situation’ through enquiry and supportfor descriptive language that captures the embodied andsensate aspects of experience. This process may beguided by the method of moving from the general tothe particular and avoiding abstraction. By using thismethod, the therapist and client are able to grow intothe situation that they are exploring together and toobserve which elements settle into the foregroundagainst the background of the total situation. Themain point is to stay as close as possible to the client’sexperience and to stay with and deepen ‘what is’ for theclient.
This experiential focus takes place in the context ofthree major precepts of phenomenological investigation: bracket, describe, observe. The first precept is therule of epoche, which entails bracketing the question oftruth or falsehood of any interpretations of reality. Thesecond precept is the rule of description, which discourages interpretations and promotes experience–close detailing of the immediate and concrete aspectsof a situation. The third precept is the rule of equalisation. This rule requires the therapist to treat all observeddata as equally important without assigning value orstructuring a hierarchy.
● The therapist supports the client to describe anddeepen and become more present to his experience.● The therapist articulates the different perspectives/experience of the therapist and client.● The therapist encourages the client to widen hischoices rather than establishing a program forchange.● The therapist shares (where appropriate) her ownexperiences that relate to the client’s experience.


Working with embodiment

Attention to the body is a major focus for GT. From itsinception, GT has been informed by Wilhelm Reich’sinsight that past emotional experiences are carried inhabitual bodily tensions. Some therapists might payattention to the body through introducing somaticexperiments. But even without introducing the possibility to exaggerate a somatic habit, or trying a differentway of holding the body, GT increases awareness of theway in which the physicality of the client is engaged inrelating to the therapist and his wider environment.This approach is both mutual and shame sensitive. Thetherapist develops awareness of her own body processduring the session, and this co-creates an embodiedfield, which is supportive to the bodily life experience ofthe client. Shame can often desensitise the body, andencouraging rapid release of physical expression can beoverwhelming. So it is important to grade an embodiedapproach to therapeutic work. Observation of breath(without trying to change breathing patterns) is anexample of the GT approach to embodiment.Therapists may seek to increase a client’s awareness ofa particular movement or gesture through an invitationto exaggerate, or pay attention to that gesture. Therapists may invite a client to put words to a pain in thebody. Connecting embodiment with thought and feelings is essential, as GT does not explore and increasesomatic awareness for its own sake.. ● The therapist makes observations and enquiresabout the client’s embodiment (including breathing).● The therapist invites the client to identify sensations,feelings, emotions, thoughts or images that emerge asa consequence of attending to somatic experiences.● The therapist invites the client to engage with his/herbody through experiment.


Field sensitive practice

Field theory is considered to be the scientific basis ofGT and is fundamental to GT philosophy andmethod. Field theory is a way of analysing causalrelations, such that any event or experience is theresult of many factors in which every emerging figureof interest emerges from the ground of a person’s lifespace. Figure and ground are not seen as separateentities but as embedded elements of the person’sorganism/environmental field.
Field approaches focus on observing, describing, andexplicating the exact structure of whatever is beingstudied in terms of its organisation, contemporaneity,uniqueness, possible relevance and changing process.There are three important aspects of ‘field’ in GT. First,the experiential field, where the client’s perceptions andimmediate subjective experience are explored at thelevel of self-awareness. Second, the relational fieldbetween the client and the therapist. Third is thewider field including social, historical, cultural context(or life space) in which the client is situated.
● The therapist investigates the ground (or context)● from which the client’s presenting figure emerges.● The therapist supports the client to identify how his● perception of his environment and prior relationships and needs organise current experience.● The therapist supports the client to identify the● uniqueness of his experience.


Working with contacting processes

In GT, awareness can be increased by focusing on stylesof contact. The contact cycle is one of the key conceptsin GT’s understanding of how the organism reachestowards the environment and engages in the (full orpartial) satisfaction or frustration of needs and attendant meaning-making. As the client moves towardsanother (or towards a satisfaction of a need by reachingout towards the environment) there are certain characteristics of this movement that the Gestalt therapist is trained to identify as contact processes. Early GTthinkers suggested that psychological disturbancesresulted from interruptions to this contact process, which when completed satisfactorily is regarded as ‘healthy’ self regulation. Seven major styles of interruption to contactwere identified: desensitisation, deflection, egotism(self spectatorship), introjection (swallowing rules ornorms without consideration), retroflection (turningan impulse back on the self), projection (disowningqualities of the self and attributing them to others), andconfluence. More recent GT thinkers revised thisnotion of interruptions as individualistic and inconsistent with field theory and refigured the contact cycle asstyles of moderation to the flow of contact that might beadopted in any given organism/environment. Whethera contact style is useful or dysfunctional will dependupon the context in which it occurs. Every creative adjustment to the environment is considered a form of self-regulation at the contact boundary. Observations about contact style are not based on the content that a client brings to the session, but on the way in which he brings it (or not), including the way he brings (or does not bring) himself to the therapist. The contact styleemerges from the relationship between the therapistand the client. It is not a one-person event.
● The therapist works with the client’s interactionalpatterns as they emerge between client and therapist.● The therapist and the client identify the figure together.● The therapist co-creates a space in which the clientand therapist explore how they are impacting each other.● The therapist identifies experiential processes thathave not yet been named or overted and explores the impact of this on her awareness


Experimental attitude

Awareness can also be explored through working withan experimental attitude. Experiments are introducedfrom material that emerges in the therapeutic encounter. Experiments are co-created by the client and therapist and are graded for risk and challenge in a way thatsupports the client’s capacity to engage with and deepeninto his awareness. The therapist supports an experience where the client tries out new behaviour, potentially leading to new meaning-making and deeper awareness. The therapist is sensitive to the potential that an experiment may be shaming or rupturing of the relationship. The therapist works with the client to integrate material that emerges from the experiment.The result of the experiment produces a fresh figure of clarity for the client (a new awareness arises).
Experiments include:
● An invitation to exaggerate, minimise, repeat orreverse a bodily gesture or behaviour.● Empty chair work: either with an aspect of self, orwith a person with whom the client is relating.● Working with unfinished situations from the past byfocusing on the internal structure of the therapeuticalliance.● Guided visualisation.● Staying at the impasse.● Directing awareness to breath or bodily movementor sensations.● Creating a safe emergency.● Introduction of art materials, movement, music orimagery. The therapist uses material that emerges in thetherapeutic encounter as the basis for introducingexperiments to develop the client’s awareness.● The therapist grades the experiment by elicitingfeedback from the client regarding the degree ofchallenge and support that the client perceives.The therapist supports the client to integrate learningand awareness that emerges from an experiment.

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