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Gestalt Therapy. What are you doing? What do you feel? What do you want?. Psychopathology. People have problems because they are cut off from parts of themselves. We learn to fragment parts of ourselves that are “unacceptable” or may be “punished”

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Gestalt therapy

Gestalt Therapy

What are you doing?

What do you feel?

What do you want?


Psychopathology
Psychopathology

  • People have problems because they are cut off from parts of themselves.

  • We learn to fragment parts of ourselves that are “unacceptable” or may be “punished”

  • Psychopathology is cured by reintegrating into a whole self


Gestalt principle 1
Gestalt Principle 1

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

  • // // // // // //

    What do you see above?


Gestalt principle 2
Gestalt Principle 2

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

    / \

    / \


Gestalt principle 3
Gestalt Principle 3

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


Gestalt principle 4
Gestalt Principle 4

  • Organismic Self-Regulation- A person’s need to balance polarities and accept opposites in the self.

    • Adult vs. child

    • Worried vs. care free

    • Intellectual vs. emotional

    • Strong vs. weak

    • Etc.


Gestalt concepts
Gestalt Concepts

  • Awareness is the key to positive growth and integration (Behaviors change is not a focus of therapy)

  • Awareness comes from experience:

    • Contact

    • Boundaries

    • Support


Contact boundaries and support
Contact Boundaries and Support

  • Contact: TH/Cl relationship is critical

  • Boundaries connect and separate us

    • Weak boundaries-we confuse other’s needs with our own

    • Rigid boundaries-we feel alone and alienated

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



Shoulds
SHOULDS

  • A form of neurotic self-regulation

    • Occurs when you live according to rules you’ve learned so well that they seem natural

      Sometimes in automatically being polite and agreeable with others, we are “rude to ourselves” disregarding our own interesrts, concerns and opinions. Pearls


Contact boundary disturbances
Contact Boundary Disturbances

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

    • Introjection

    • Projection

    • Retroflection- feeling toward other turned on self

    • Deflection- avoiding contact with self or other

    • Confluence- merging with another thru agreement of opinion or feeling (we are one)


Interruptions automatic self regulation actions
Interruptions-Automatic Self-Regulation Actions

  • Automatically stopping acknowledgement of self or experience, including disowning experiences

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


Intrusions of unfinished business
Intrusions of Unfinished Business

  • Unresolved emotions and issues from the past effect the present.

    • Ex. Transference

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


How do you help your client to realize they have all the inner support they need

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


Therapeutic relationship
Therapeutic Relationship

  • FORGET POSITIVE REGUARD

    • Client’s need direct, in the moment feedback to realize how they are viewed by others

      • Be and show your boredom, irritation, impatience

      • Admit to mistakes and unhealthy behavior in your own life

      • Purposely frustrate your client, don’t protect them from discomfort or responsibility

      • Don’t interpret, client’s need to form their own interpretations


Removing layers of neuroses peeling the onion
Removing Layers of Neuroses- Peeling the onion

  • 1) The Phony Layer- Behaving inauthentically in social settings

  • 2) The Phobic Layer- Energy is spent covering feelings of fear and helplessness

  • 3) The Impasse Layer- Stuck, want help and others to tell them what to do

  • 4) The Implosive Layer- Phony Identity Collapses, thus people feel dead inside or cut off from their former self

  • 5) The Explosive Layer- Letting go of old self, thus energy is freed up to form new self



You are but a magnifying mirror
You are but a magnifying mirror

  • Every thing a patient does and does not do is an expression of the self

  • Therapist asked questions (vs. statements/interpretations) based on these observations to bring awareness to the patient

  • Focus on present moment


Body awareness
Body Awareness

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

    • “Where do you feel your anger?” A feeling that one’s head is about to blow up is different from an ache in the stomach.

    • An unconsciously clenched jaw may be a sign of an impulse to speak being repressed

      • Interventions:

        • If your clenched jaw could speak, what would it say?

        • Really exaggerate your clenched jaw to increase intensity while providing support of therapist


In class body awareness activity
In Class Body Awareness Activity

  • Think of a strong emotion you recently felt

  • Can you locate it in your body?

  • Does it’s location clarify the emotion to you in any way?

  • Feel the emotion and conduct a body scan to determine how you physically express this emotion.


Experimentation
Experimentation

  • Experimental Homework- advise a reversal.

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

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


Experimentation cont
Experimentation cont.

  • Turn statements about others into statements about self (to explore projection)

  • Encourage client to “stay with” emotion in session. (Most clients don’t have practice staying with emotions, most of their energy is spent trying to move past or avoid the emotion)

  • Use client’s imagination to actively fantasize and make experiences vivid


Role playing
Role Playing

  • Client acts out different perspectives, people polarities, conflicts, etc. in session

  • Empty Chair Technique- act out character, emotion, inner conflict for conflict resolution, depth of experience, integration of polarities, and soften the harsh internal critic (which helps to resolve intra psychic splits)


Dream work
Dream Work

  • Role Play dreams

    • 1) Client presents dream in detail and in present tense

    • 2) Client plays roles of persons and objects in dream

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


Psychodrama
Psychodrama

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

    Doing it is always preferable to talking about it


Language modification
Language Modification

  • Client’s language reveals their world view and typical methods of avoidance.

  • Therapist insists on present tense and the use of the word “I”

  • “I Can’t” must be said as “I choose not to”

    • “I have to” must be said “I want to”

    • “I’m not able to” must be said “I decide not to”

    • Adding on “ and I take responsibility for it”


Example
Example

  • A Client says: I might as well get my nose cut now, so I’ll go ahead and turn in my paper.” “My program advisors ganged up on me” and “I was torn to shreds about my paper by my teacher.”

  • How does this client likely view

  • Himself

  • The world


Limitation
Limitation

  • Gestalt therapy is not for people with impulse control difficulties, who run over other’s as a rule of thumb

  • Delinquents

  • Sociopaths

  • Client’s with poorly developed empathy

    Unless modified to fit these populations


Limitations
Limitations

  • Pearls himself loved to shock, loved an audience and was quite the narcissist. He fell asleep during sessions and had sex with clients. His original work may need to be tempered with interpersonal sensitivity and responsibility.

  • VERY individualistic

  • Very emotionally expressive

  • Anti-intellectualism

  • Philosophically sloppy