Gestalt Therapy

Brief History

As a teenager, Fritz Perls was heavily involved in theatre. Later, he was trained as a
psychoanalyst and studied with a number of respected analysts of his day. Among the most
prominent were Karen Horney, Wilhelm Reich, Otto Fenichel, and Helene Deutsch. During the
First World War he was an assistant to the Gestalt physiological psychologist Kurt Goldstein.
His wife Laura, who was the co-developer of Gestalt therapy, was also trained in
psychoanalysis, and she studied under Kohler and Koffka at the University of Frankfurt, as well
as under existential theologians Paul Tillich and Martin Buber. Perls used to hang around the
existential coffeehouses and absorbed the secular existential currents of his day as he had
earlier hung around theatres. After he repudiated psychoanalysis and moved to New York, he
built on his theatre background by studying Moreno's psychodrama, he and Laura developed
Gestalt Therapy, In paying attention to the messages of posture and movement they drew from
Laura's lifelong experience in modern dance as well as Reich's bodywork, and her acquaintance
with Feldenkreis and Alexander techniques of body work. In New York, Gestalt therapy was
primarily awareness-focused and involved considerable individual work. (This variation is
sometimes called "East Coast" Gestalt.)

Fritz continued to develop the technique, moving west to Big Sur, introduced the
innovations of the "hot seat" and the "empty chair," and drew on his experience in theatre and
on psychodrama to bring a more active enactive dimension into the work. Instead of merely
talking to the therapist, the client is asked to act out two or more sides of himself or herself that
are in conflict, or to act out dialogues with one or more other significant people in his or her life.
In so doing, the client temporarily identifies with disowned and projected parts of the self and
eventually assimilates them in an aware manner. Perls also lived for some months in a Zen
monastery in Japan, and it is rumored that at one point he studied with the Russian mystic
George Gurdjieff.

Gestalt therapy, ever growing in popularity and international recognition, is now taught in
training institutes all over the world and is practiced on all continents. The Gestalt Institute of
Toronto is the largest training program for Personal Development and Gestalt therapists in
Canada. Gestalt therapists graduating from the program have completed 5 years of training
including the Advanced Gestalt Leadership Training and the Post-Graduate Program of Training
and Supervision in Gestalt Therapy.

Four Pillars

The gestalt therapy is built upon four pillars, considered to be indispensible for its
functioning. The method based on, the phenomenological method, dialogical relationship, the
field-theoretical strategies and the experimental freedom are the ones that gestalt therapy was
built on.

Phenomenological Method

The goal of a phenomenological exploration is awareness. This exploration works

systematically to reduce the effects of bias through repeated observations and inquiry. The
phenomenological method comprises three steps:
(1) the rule of epoché,
(2) the rule of description, and
(3) the rule of horizontalization. Applying the rule of epoché one sets aside one's initial
biases and prejudices in order to suspend expectations and assumptions. Applying the rule of
description, one occupies oneself with describing instead of explaining. Applying the rule of
horizontalization one treats each item of description as having equal value or significance.
The rule of epoché sets aside any initial theories with regard to what is presented in the
meeting between therapist and client. The rule of description implies immediate and specific
observations, abstaining from interpretations or explanations, especially those formed from the
application of a clinical theory superimposed over the circumstances of experience. The rule of
horizontalization avoids any hierarchical assignment of importance such that the data of
experience become prioritized and categorized as they are received. A Gestalt therapist utilizing
the phenomenological method might say something like, “I notice a slight tension at the
corners of your mouth when I say that, and I see you shifting on the couch and folding
your arms across your chest … and now I see you rolling your eyes back”. Of course, the
therapist may make a clinically relevant evaluation, but when applying the phenomenological
method, temporarily suspends the need to express it.

Dialogical relationship
To create the conditions under which a dialogic moment might occur, the therapist
attends to his or her own presence, creates the space for the client to enter in and become
present as well (called inclusion), and commits him or herself to the dialogic process,
surrendering to what takes place, as opposed to attempting to control it. With presence, the
therapist judiciously “shows up” as a whole and authentic person, instead of assuming a role,
false self or persona. The word 'judicious' used above refers to the therapist's taking into
account the specific strengths, weaknesses and values. The only 'good' client is a 'live' client, so
driving a client away by injudicious exposure of intolerable [to this client] experience of the
therapist is obviously counter-productive. For example for an atheistic therapist to tell a devout
client that religion is myth would not be useful, especially in the early stages of the relationship.
To practice inclusion is to accept however the client chooses to be present, whether in a
defensive and obnoxious stance or a superficially cooperative one. To practice inclusion is to
support the presence of the client, including his or her resistance, not as a gimmick but in full
realization that this is how the client is actually present and is the best this client can do at this
time. Finally, the Gestalt therapist is committed to the process, trusts in that process, and does
not attempt to save him or herself from it (Brownell, in press, 2009, 2008)

Field-theoretical strategies
“The field” can be considered in two ways. There are ontological dimensions and there
are phenomenological dimensions to one’s field. The phenomenological dimensions are all
those physical and environmental contexts in which we live and move. They might be the office
in which one works, the house in which one lives, the city and country of which one is a citizen,
and so forth. The ontological field is the objective reality that supports our physical existence.
The ontological dimensions are all mental and physical dynamics that contribute to a person’s
sense of self, one’s subjective experience—not merely elements of the environmental context.
These might be the memory of an uncle’s inappropriate affection, one’s color blindness, one’s
sense of the social matrix in operation at the office in which one works, and so forth. The way
that Gestalt therapists choose to work with field dynamics makes what they do strategic. Gestalt
therapy focuses upon character structure; according to Gestalt theory, the character structure is
dynamic rather than fixed in nature. To become aware of one's character structure, the focus is
upon the phenomenological dimensions in the context of the ontological dimensions.

Experimental freedom
Gestalt therapy is distinct because it moves toward action, away from mere talk therapy,
and for this reason is considered an experiential approach. Through experiments, the therapist
supports the client’s direct experience of something new, instead of merely talking about the
possibility of something new. Indeed, the entire therapeutic relationship may be considered
experimental, because at one level it is a corrective, relational experience for many clients, and
it is a "safe emergency" that is free to turn out however it will. An experiment can also be
conceived as a teaching method that creates an experience in which a client might learn
something as part of their growth. Examples might include:
(1) Rather than talking about the client's critical parent, a Gestalt therapist might ask the
client to imagine the parent is present, or that the therapist is the parent, and talk to that parent
directly;
(2) If a client is struggling with how to be assertive, a Gestalt therapist could either (a)
have the client say some assertive things to the therapist or members of a therapy group, or (b)
give a talk about how one should never be assertive;
 (3) A Gestalt therapist might notice something about the non-verbal behavior or tone of
voice of the client; then the therapist might have the client exaggerate the non-verbal behavior
and pay attention to that experience;
(4) A Gestalt therapist might work with the breathing or posture of the client, and direct
awareness to changes that might happen when the client talks about different content. With all
these experiments the Gestalt therapist is working with process rather than content,
the How rather than the What.

Principles and theories of Gestalt Therapy

1. Holism
At the core of gestalt therapy is the holistic view that people are intricately linked to and
influenced by their environments and that all people strive toward growth and balance. Gestalt
therapy takes into account the whole person including thoughts, feelings, behavior, body
sensations, and dreams. The focus is on integration, that is, how the many parts of the person
fit together, and how the client makes contact (interacts) with the environment.

2. Field theory

According to this theory, everything is related, in flux, interrelated, and in process. The
therapist focuses on how the client makes contact with the environment (family, work, school,
friends, authority figures).

3. The figure-formation process

Describes how individuals organize or manipulate their environment from moment to

moment.

4. Organismic self-regulation

Is the creative adjustment that the organism (person) makes in relation to the
environment. The person's equilibrium with his or her environment is "disturbed" by the
emergence of a client need, sensation, or interest and is related to the figure-formation process
in that the need of the person organizes the field. For example, if an individual wants coffee, this
coffee need is what comes out of the defused background and becomes "figural" (comes to the
forefront of the client's environment or field) and when the individual enters a room, the "figural"
will be related to the coffee need. The therapist is interested in what is "figural" for a person
because it may provide insight into the person's need(s).

5. The Now

The concept of the here and now is what is being done, thought, and felt at the moment,
and not in the past or the future.

6. Unfinished business

Defined as the unexpressed feelings that are associated with distinct memories and
fantasies. These feelings may be resentment, rage, hatred, pain, anxiety, grief , guilt, and
abandonment that are not fully experienced in awareness, linger in the background, and are
carried into the present life and cause preoccupations, compulsive behaviors, wariness, and
other self- defeating behaviors. Unfinished business will persist until the person faces and deals
with these denied or alienated feelings.
Therapeutic Intervention

A. Therapeutic Goals

Attaining awareness of self and senses coupled with greater choice &
responsibility. Assuming ownership of experiences. Developing skills and acquiring
values that will permit the satisfaction of needs without violating the right of others.

B. Therapist’s Function and Role

Assist the client in developing their own awareness. Focuses on the client’s
feelings, awareness at the moment and body languages.

C. Relationship between Therapist and Client

An authentic, nonjudgmental, dialogic relationship between client and Gestalt

therapist is the crucible of change. A Gestalt therapist must bring a willingness and
capability to be present as a person in the therapeutic encounter, inclusive of his/her
inner world, sense of experience, knowledge, skills, etc. and a genuine interest in
understanding the client’s subjective experiences and needs from the environment Both
therapist and client are changed by their interaction

Therapeutic Techniques

Gestalt therapy focuses on experiencing thought and beliefs rather than simply
discussing these feelings. The process of learning through experimentation provides purpose to
Gestalt therapy rather than simply stating feelings, according to gestalt.org. A Gestalt therapist
wants the client to experience full awareness of his present situation. Techniques of Gestalt
therapy focus primarily on the present day rather than the past. It places the client in the current
state of mind.

1. Chair Technique
This technique requires that the client sit in one chair across from an empty chair. The
client should imagine someone in the chair who has brought conflict to his life. The counselor
encourages the client to talk to the person about how he felt when this person wronged him.
Then the client switches chairs and responds as if he is the person who created the conflict.
This helps encourage an emotional interaction between the client and the other person. This
technique clarifies personal feelings and helps the client understand the other person's motives.

2. Exaggeration
The counselor asks the client to exaggerate certain movements to help the client
understand his true feelings. For instance, if a client is talking about his spouse, it is suggested
that he move like she does. This helps intensify the client's feelings and awareness regarding
the person he is moving like.

3. Guided Fantasy
The visualization of an experience can bring awareness to the cause of the client's conflict,
according to gestalt.org. The counselor asks the client to close his eyes and imagine himself in
the triggering event. The counselor encourages the client to share what he feels in that moment.
This helps the client become aware of the causes of his feelings by recreating the triggering
event.

4. Counselor Disclosure
The therapist shares what she is experiencing during the session. The counselor uses "I"
statements to present what she feels, smells, or sees. The therapist must bring to awareness
the things that the client does not see. For instance, the therapist may say that she notices that
the client continuously taps his foot. This brings awareness to how the client is acting in the
present.
 5. Body
Body techniques help the client see how he can control body movements. The counselor
may notice that the client tenses up by making fists. The counselor may ask the client to breathe
deeply and with each breathe slowly loosen his hands. This helps the client become aware of
his body functions and his ability to control these functions.

Case Study and Process of Gestalt Therapy

The following is an example of how a school counselor might use Gestalt’s “Empty Chair”
Technique to help student in individual counseling deal with his reactions to his parents’ divorce.
Andrew, our fictitious student is angry at his father for leaving him and his mother. Realizing that
Andrew is also experiencing a lot of guilt, the counselor decides to employ Gestalt counseling to
help him increase self-awareness and realize that he has control over, choice of, and
responsibility for those feelings. This intervention will adhere to the framework outlined byu
Martin S. Fiebert in Stages in a Gestalt Therapy Session: An Examination of Counselor
Interventions.

1. Stage One:
The first session(s) should aim at finding out where Andrew is, rather than where
the counselor may think he is. After the introductions and relationship building stage, the
counselor will attempt to focus Andrew's attention to his immediate experience-the what
and how of behavior-and away from speculations as to causes. The counselor
approaches this first phase by exploring what the student is currently experiencing in
awareness. During this process, the student is guided and encouraged to experience the
connection between his verbal and non-verbal behaviors, for example, breathing
patterns, posture, hand gestures, or tone of voice. The counselor also tries to train the
student to accept increasing responsibility (ability to respond, not react) to individual
thoughts, sensations, feelings, by asking him to restate and repeat particular sentences
or expressions, e.g. substituting "won't" for "can't," "want" for "should," and "I" for "it," and
presenting all expressions in the present tense (Fiebert, 1990)

2. Stage Two:
After Andrew has learned to focus on awareness and express feelings and
sensations in the present, the counselor will ask him to explore his conflict by having an
external dialogue with his father. Employing two chairs, Andrew is now asked to
converse with his father-the person with whom those feelings are currently experienced.
The counselor will be paying special attention to the verbal/non-verbal discrepancies in
the student and help him become aware of their connection and may ask Andrew to act
out some of his feelings of anger..In the closing of this phase. Andrew should become
quite immersed in the process of self discovery and need little overt guidance to switch
between chairs, appropriately express feelings, and monitor his own behavioral patterns.
The goal of this phase is to have Andrew express: (a) what are the issues and feelings
he is experiencing in his relationship with his father; (b) what are the hidden feelings
perceived in the relationship; and, (c) what are the desired solutions to the stated
situation.

3. Stage Three:

During phase two the counselor might have witnessed Andrew's inner conflict
emerge with increasing power as his thoughts, feelings of guilt, and bodily responses
associated with anger come into awareness. A variation of "The Empty Chair" technique
can be used in this stage again. The counselor may ask Andrew to establish a dialogue
with himself, to explore this internal tension. For this stage to be successful, Andrew
must recognize that the conflict being explored in the external dialogue with his father
can also be understood and more effectively resolved as a reflection of a deep internal
tension within himself. The accomplishment of this critical shift in self understanding
requires a sufficient amount of objective awareness on the part of Andrew. Thus, if
Andrew is totally immerse in the external problem and still blaming his father (i.e. not
taking responsibility for the way he is feeling) he may feel frustrated and confused if the
counselor tries to shift to this part of the exploring. According to Fiebert, the central focus
of activity at this stage is a growing confrontation between two significant and opposing
 aspects within the Andrew's personality (1990). Andrew is both angry at his dad and
feeling guilty about his anger. The more he can experience, understand, and become
aware of each pole of tension, the more likely he will be able to resolve it. Thus,
counselor behavior is directed at helping Andrew identify and own each aspect of his
inner conflict.

4. Stage Four: Pearls calls this state "Integration" (Yontef, 1989). During this phase, if the
intervention has been successful, Andrew should be more aware of what his is doing,
how he is doing it and how he can change himself-and at the same time, learn to accept
and value himself. In other words, he should be able to experience a feeling of having
gotten in touch with all aspects of his own self.

Therapy sessions are generally scheduled once a week and individual therapy is often
combined with group therapy , marital or family therapy , movement therapy, meditation , or
biofeedback training. Sessions can be scheduled from five times a week to every other week
and session frequency depends on how long the client can go between sessions without loss of
continuity or relapsing. Meetings less frequent than once a week are thought to diminish the
intensity of the therapy unless the client attends weekly group with the same therapist. More
than twice a week in not usually indicated except with clients who have psychotic disorders, and
is contraindicated with those who have a borderline personality disorder .Weekly group therapy
may vary from one and one-half to three hours in length, with the average length of two hours. A
typical group is composed of ten members and usually balanced between males and females.
Any age is thought to be appropriate for Gestalt therapy. There are groups for children as well.
The current practice of Gestalt therapy includes treatment of a wide range of problems and has
been successfully employed in the treatment of a wide range of "psychosomatic" disorders
including migraine, ulcerative colitis, and spastic neck and back. Therapists work with couples
and families, and with individuals who have difficulties coping with authority figures. In addition,
Gestalt therapy has been used for brief crisis intervention , to help persons with post-traumatic
stress disorders , alcohol and drug abuse, depression, or anxiety disorders; with adults in a
poverty program; with seriously mentally ill individuals with psychotic disorders; and those with
borderline personality disorder.

Issues

Gestalt therapy is considered to have pioneered the development of many useful and
creative innovations in psychotherapy theory and practice. However, there is some concern
regarding abusing power by therapist, as well as the high-intensity interaction involved. The
concern is in the nature of therapists being enchanted with and using the techniques of Gestalt
therapy with other theories of therapy without having the appropriate training in Gestalt therapy
theory. Gestalt therapists are very active and directive within the therapy session and therefore,
care must be taken that they have characteristics that include sensitivity, timing, inventiveness,
empathy, and respect for the client. These characteristics, along with ethical practice, are
dependent on the skill, training, experience, and judgment of the therapist. The intensity of the
therapy might not be suitable for all patients, and even disruptive for some, despite the
competence of the therapist. In addition, there is a lack of monitored, scientific research
evidence supporting the effectiveness of Gestalt therapy.

Key concepts of gestalt therapy

Gestalt therapy works through the interconnection of key concepts. These offer insight into the
processes involved in therapy sessions between the therapist and client(s).

1. Person-centred awareness - Focusing on the future, and imagining it divorced from the
present and past is considered essential. The process follows an individual's experience
in a way that does not involve seeking out the unconscious, but staying with what is
present and aware.

2. Respect - Clients, whether an individual, group or family, are treated with profound
respect by a gestalt therapist. Providing a balance of support and challenge is key to
 helping those taking part to feel comfortable about opening up and acknowledging areas
of resistance.

3. Emphasis on experience - The gestalt approach focuses on experience in terms of an

individual's emotions, perceptions, behaviours, body sensations, ideas and memories. A
therapist encourages the client to 'experience' in all of these ways, vividly in the here and
now.

4. Creative experiment and discovery - There is a range of experimental methodology

used by therapists to test their client's experience. These involve highly creative and
flexible techniques to help them open up and acknowledge hidden feelings.

5. Social responsibility - The gestalt approach recognises that humans have a social
responsibility for self and for others. It demands respect for all people and acknowledges
that everyone is different. Ultimately it encourages individuals to adopt an egalitarian
approach to social life.

6. Relationship - Relating is considered central to human experience and gestalt therapy

considers individuals as 'whole' when they have a good relationship with themselves and
others around them. The interpersonal relationship between the individual and therapist
that is developed and nurtured in sessions is a key guiding process if therapy.

How does gestalt therapy work?

Fundamentally, gestalt therapy works by teaching clients how to define what is truly
being experienced rather than what is merely an interpretation of the events. Those undertaking
gestalt therapy will explore all of their thoughts, feelings, behaviours, beliefs and values to
develop awareness of how they present themselves and respond to events in their environment.
This gives them the opportunity to identify choices, patterns of behaviour and obstacles that are
impacting their health and well-being, and preventing them from reaching their full potential.

The unfolding of this therapeutic process will typically involve a range of expressive techniques
and creative experiments developed collaboratively between therapist and client. These will be
appropriate for the client and their specific problems. Below are some of the most common
methods used:

Role-play

Role-play can help individuals to experience different feelings and emotions and better
understand how they present and organize themselves.
The 'open chair' technique

The open chair technique involves two chairs and role-play, and can give rise to
emotional scenes. The client sits opposite an empty chair and must imagine someone (usually
himself/herself or parts of him or her) in it. They then communicate with this imaginary being -
asking questions and engaging with what they represent. Next, they must switch chairs so they
are physically sitting in the once empty chair. The conversation continues, but the client has
reversed roles - speaking on behalf of the imagined part of his or her problem. This technique
aims to enable participants to locate a specific feeling or a side of their personalities they had
'disowned' or tried to ignore. This helps them to accept polarities and acknowledge that conflicts
exist in everyone.

Dialogue

A gestalt therapist will need to engage the client in meaningful and authentic dialogue in
order to guide them into a particular way of behaving or thinking. This may move beyond simple
discussion to more creative forms of expression such as dancing, singing or laughing.
Discussing dreams

Dreams play an important role in gestalt therapy, as they can help individuals to
understand spontaneous aspects of themselves. Fritz Perls frequently asked clients to relive his
or her dreams by playing different objects and people in the dream. During this they would be
asked questions like: "What are you aware of now?" to sharpen self-awareness.

Attention to body language

Throughout therapy, a gestalt therapist will concentrate on body language, which is

considered a subtle indicator of intense emotions. When specific body language is noticed, the
therapist may ask the client to exaggerate these movements or behaviours. This is thought to
intensify the emotion attached to the behaviour and highlight an inner meaning. For example, a
client may be showing signs of clenched fists or frowning, to which the therapist may ask
something along the lines of: "What are you saying with this movement?"

Who can benefit?

Ultimately, gestalt therapy is considered to help individuals gain a better understanding
of how their emotional and physical needs are connected. They will learn that being aware of
their internal self is key to understanding why they react and behave in certain ways. This
journey of self-discovery makes the approach beneficial for individuals who can be guarded
when it comes to their emotions, and find it difficult to process why they feel and act the way
they do. It can also provide support and a safe space for individuals going through times of
personal difficulty.

Gestalt therapy is considered particularly valuable for helping to treat a wide range of
psychological issues - especially as it can be applied as a long-term therapy or as a brief and
focused approach. It has been found effective for managing tension, anxiety, addiction, post-
traumatic stress, depression and other psychological problems that can prevent people from
living life to the full. Overall, people who participate in gestalt therapy tend to feel more self-
confident, calm and at peace with themselves.
References

Perls, Frederick S.; Hefferline, Ralph; Goodman, Paul. Gestalt Therapy, Excitement and Growth
in the Human Personality. Gestalt Journal Press (This edition February , 1977 , but originally
published 1951). ISBN 0939266245.

Perls, Frederick S., In and Out the Garbage Pail. Bantam Books (June, 1981). ISBN
0553202537.

Latner, J. (2000) The Theory of Gestalt Therapy, in Gestalt therapy: Perspectives and
Applications, Edwin Nevis (ed.) Cambridge, MA: Gestalt Press

Corey, Gerald. "Gestalt Therapy." In Theory and Practice of counseling and Psychotherapy. 6th
ed. California: Wadsworth and Thomson Learning, 2000.

Ellis, Michael and John Leary-Joyce. "Gestalt Therapy." In Handbook of counseling and
Psychotherapy, edited by Colin Feltham and Ian Horton. London: Sage Publications, 2000.

Sharf, Richard S. "Gestalt Therapy." In Theories of Psychotherapy and Counseling: Concepts

and Cases. 2nd ed. Stamford: Thomson Learning, 2000.

Fiebert, M. S. (1990). Stages in Gestalt Therapy Session and An Examination of Counselors

Interventions. Retrieved on July 2, 2002, from California State University:
http://www.csulb.edu/~mfiebert/gestalt.htm

Ivey, A. E. & Mary B. (1999). Intentional Interviewing and Counseling.Pacific Grove, CA:
Brooks/Cole Publishins Company.

Myrick, R. D. (2003). Developmental Guidance and Counseling.Mineneapolis, MN: Educational

Media Corporation.