Also by Pauline Connolly:
and Now in Gestalt therapy
This essay will include ‘something of the essence’ of Gestalt Therapy; focusing primarily upon awareness – as a goal and process, and the therapeutic relationship, including some aspects of the therapist’s role.
Gestalt therapy – as an existential/phenomenological approach – teaches individuals the phenomenological method of awareness of perceiving, feeling and acting (Yontef and Simkin, 1989). Focusing on the client’s perception of reality, it considers direct experience to be more reliable than explanation; and emphasizes individual responsibility for thoughts, actions and immediate experience – the ‘now’, ‘what and how’, and the ‘I-Thou’ relationship (Patterson, 1980).
Central to the approach is the ‘continuum of awareness’, and learning to appreciate and fully experience/live in the moment (Litt, 1996). For Gestaltists, the ‘power is in the present’ (Polster and Polster,1973, cited in Corey, 2001); it is only in the here-and-now that experience, awareness, responsibility, and growth can take place.
The goal of therapy is “to bring the client’s awareness back to actuality, to the now, where he can face himself and take responsibility for his actions” (Litt, 1996, p. 7). Focus on the present does not imply that the past and/or future are ignored, but rather that they are rooted in the now, and experienced only in the immediate present. When/if the past or future bear significantly upon one’s present attitudes or behaviour, it is dealt with by bringing it into the present as much as possible (Corey, 2001). Since at least some re-structuring/organization of the life script is required in facilitating organismic balance, the past can not be overlooked. Thus, while references to experiences outside the session occur, the therapist – sensitive to how the here-and-now includes residues of the past (including Reich’s ‘body armor’, etc) – is likely to enquire about their significance, by asking ‘what?’ and ‘how?’ questions; as opposed to ‘why?’ questions; which according to Perls, lead to rationalizations, self-deceptions, and away from the immediacy of experiencing (ibid).
Given that for most individuals“… the mind and the creations of the mind work against the body … against the best interests of the person” (Becker, 1970, p.1), ‘thinking’ rather than integrative, “creative synthetic knowing” (Bohart & Todd, 1988, p.162) is discouraged. Gestalt therapy, however, is not anti-intellectual; it simply recognizes intellectualizing /theorizing as just one dimension of our cognitive capacity. And since direct awareness is often more important – in terms of organismic self-regulation – it disesteems exclusive focus on one aspect of our total processes; not thinking, abstracting, symbolizing, etc, per se. Fundamentally, gestalt therapy helps the client develop the choice and disciplined ability to focus his attention either intellectually, or in direct awareness depending on forming gestalts, i.e. enhance healthy boundary functioning and alternate between ‘contact’ and ‘withdrawal’ mode, rather than unwittingly become lost in his intellect (Daniels, 2002, p.1). Accordingly, Perls advocates that we “lose our mind and come to our senses”, and thus become liberated from the maya. This loss of mind implies a shift from future-oriented thinking and theorizing to a present-centered sensory awareness (Corey, 2001).
From an existential perspective, the focus is the individual’s existence – relations, joy, suffering, etc – as directly experienced. Most of us, through self-defeating self regulation (deception) are unable to face reality, and be authentic, including in our relationships and choices. Full awareness, implying sensory, cognitive and emotional contact with self/environment field, better enables us to choose and organize our life more meaningfully – become self-governing/ responsible (Yontef and Simkin, 1989). However, in terms of addressing the fundamental anxieties and givens of the human condition, including the ‘existential paradox’, gestalt therapy (or more accurately Perls) has been accused of overlooking, rather than explaining or helping to resolve such dilemmas. Becker (1970, p.6), for example, (along with Laura Perls and others) remarks that “…there’s a sense in which Perls himself was limited. I don’t think he had this awareness … he tended to overlook the haunting anxieties of the human condition …Where are you going to get support for your painful self-consciousness? … answer the question of the mystery of your life? … get the equanimity to face your own death? …”
Gestalt therapists aim to establish a contact-orientated relationship (creating a ‘safe emergency’ within the therapeutic encounter), which supports and promotes clients’ exploration in immediate experience. Within this dialogic relationship, characterized as an ‘I-Thou’, person-to-person encounter, direct experience of both participants, as well as, therapist’s observations of what is not in the clients awareness, (‘advanced empathy’, or ‘depth reflection’) are emphasized. As Corey (2001) notes, “The therapist’s experiences, awareness and perceptions provide the back-ground of the therapeutic process, and the client’s awareness and reactions constitute the foreground” (p.236). This ‘I-Thou’ dialogue, embodying authenticity, acceptance, warmth, self-responsibility, etc, helps the client to “ de-automize the blocks” (L.Perls in Rosenfeld, 1978,p.8) and develop his own support for desired contact or withdrawal. Yontef and Simkin, (1989) emphasize four characteristics of such dialogue: inclusion, presence, commitment to dialogue and dialogue is lived. Inclusion implies putting oneself as fully as possible into the other’s experience “without judging, interpreting or analyzing while simultaneously retaining a sense of one’s separate autonomous presence” (p.3). This is almost identical to
Through dialogue and awareness – Gestalt’s primary therapeutic tools – the core life scripts that determine the client’s significant interpersonal experiences are uncovered, explored and reorganized (Erskine,1995). Rather than avoiding the present through inauthentic games or roles (‘the phony’), or ways of relating such as ‘talking about’ feelings (rehearsing), clients experience them directly. By attending to the continuum of awareness, it is not necessary to dig up the past (as in psychoanalysis); important incomplete gestalts emerge and can be dealt with in an experiential and experimental manner (Yontef and Simkin, 1989). “Forget Freud’s archaeological seeking of past memories; by being aware from second to second of what is going on, by concentrating on the immediate present, major concerns are brought up and confronted” (Litt, 1996, p.2). Such awareness allows clients to work on the healthy gestalt principle: that unfinished business will always emerge and can be resolved. A healthy/good gestalt describes a clearly organized perceptual field, with a well-formed figure (dominant need) standing out against a less distinct ground (context/field) (Yontef and Simkin, 1989). According to Gestalt’s ‘holistic principle’, individuals are unified organisms (i.e. mind and body function as a totality), fundamentally, striving for balance; a process whereby needs are satisfied, and equilibrium constantly upset and restored. This unitary concept of motivation, recognition that interests/needs emerge as they take priority in the process of actualization, is almost identical with that of Rogers.
and environment exist in a dialectical relationship (the point of interaction
being the ‘contact boundary’), individuals are often unaware of self and
environment; loosing touch with reality, and relinquishing authentic
self-control/support for self-esteem. In an attempt to escape reality, the real
self, and thus avoid facing the ‘holes’ and disowned aspects of self, the
individual resorts to game and role playing, i.e. acting ‘as if’ he were
someone he is not, in order to receive (conditional) love and environmental
Full awareness – being ‘in touch’ with self/others, involves ‘owning’, i.e. “the process of knowing one’s control over, choice of and responsibility for one’s behaviour and feelings” (Yontef & Simkin, 1989, p.11). Responsibility (Response-ablity) means that the individual is autonomous, self-supporting/directed, and “the spontaneous source of his own activity” (Becker, 1970, p.3). Far from being individualistic, narcissistic, etc, this way of being entails ‘creative adjustment’: a social, ethical responsibility for the ecological balance between self and others/environment (Yontef and Simkin, 1989). Accordingly, therapists – recognizing the moral implications/obligations inherent in choosing and valuing – help clients to discover their own sense of morality (rely on their own ‘locus of evaluation’).
“A psychotherapy that only led people to impose themselves on the world without considering others would engender pathological narcissim and a world-denying realization of self isolated from the world” (ibid, p.12).
responsible and fully functioning, however, is only likely if the individual
tries to be ‘what he is’. According to Beisser’s (1970) ‘paradoxical theory of
change’ (Yontef and Simkin, 1989), the more he tries to be something other than
he is, or when he denies his true/real self, the more he stays the same.
Organismic self-regulation, thus requires an integration - knowledge and
acceptance - of the polarities within oneself. Lack of integration
(incongruence), creates ‘splits’ or ‘defensive contact-interrupting processes’
(Erskine, 1995) and retards growth. Through direct experience and
experimenting, dialogue, and therapist’s ‘attuned presence’ (ibid), internal
interruptions to contact can be dissolved/diminished; “dichotomies such as
self-ideal and needy self, social requirements and personal needs can be healed
by integrating into a whole differentiated into natural polarities” (Perls,
1947, cited in Yontef and Simkin, 1989p.14).
Gestalt therapy encourages clients to break through the self-protective phony layer of existence (maya); and not allow their ‘rehearsals’, ‘stage fright’, ‘shoulds’, etc, to distract them from their true nature, and preclude them transcending from environmental to self-support (Prochaska and Norcross, 1994). Such liberation however, can be a painful experience. While clients may wish to be ‘free’ – authentic, self-supporting, etc, they may (succumbing to ‘stage fright’) be less ready/ able to risk confronting and moving beyond the various layers of neurosis (e.g. the phony, phobic, impasse, implosive, and explosive layer); relinquish script beliefs, or ‘ego-defense mechanisms’(Corey, 2001) – resistances to ontact. Yet, suffering/ endurance, and courage are necessary in order to ‘grow up’. As Perls, (cited in Patterson,1980, p.443) remarks, “the awareness of, and ability to endure, unwanted emotions are the condition sine qua non for a successful cure.” Therapists will, thus, be “looking for the person’s ability to free up some of the blocks – to take a risk” (L.Perls, see Rosenfeld, 1978, p.6).
In raising consciousness, and working with resistance, the therapist ‘frustrates’ the client’s demands for support/help so that he can discover, within himself, the resources (including how he is blocking his strengths) for resolving his own conflicts, i.e. recognize his own expert status. This is done, “in such a way that he is forced to find his own way, discover his own possibilities, his own potential, and discover that what he expects from the therapist, he can do just as well himself” (Perls, cited in Patterson,1980, p.447). Energy then expended trying to secure environmental support (including therapist), and actualize a self-image, can be more beneficially used to actualize the self. Without frustration the client has less need/reason to mobilize his resources, and face his ‘holes’ and disowned parts of his personality, and thus more likely to remain ‘stuck’ in his pseudosocial (rather than natural) existence (Prochaska and Norcross, 1994).
emphasis on an egalitarian relationship and onus upon clients to make their own
meaning/interpretations, the therapist – notably, the Perlsian type –
in practice does function as an ‘expert’ and conveys this to ‘patients’;
directing attention, verbalizations and activities (Patterson, 1980). (In
successful therapy, however, much/most of the work is client-directed). Indeed,
Perls himself functioned very much as an active, process-director; “…an expert
directing the process by which the patient comes to the impasse, breaks it, and
then achieves awareness and independence” (ibid, P.445). It is, however,
possible to practice Gestalt therapy in such a way that it appears almost
unrelated to Perls’s approach. Mearns (2003), for example, notes how Laura
Perls’(‘New York’ school) practice is virtually identical to Person-Centred
therapy; remarking how she is “particularly strong in emphasizing the
timeliness of interventions in relation to the client’s process and a highly
relational empathy as the only real way of sensing that timeliness”(p.3). Thus,
individual therapists can be process-oriented but behave quite differently
depending upon the timeliness of interventions in relation to client’s
Traditionally, Gestalt therapy has been considered most effective with “overly socialized, restrained … constricted individuals”, i.e. anxious, perfectionistic, phobic and depressed clients (Shepherd, 1970 cited in Yontef and Simkin, 1989, p.243). Current practice, however, extends to a much wider range of problems. Yontef and Simkin (1989), for example, have noted its effective employment in the treatment of a broad range of ‘psychosomatic’ and severe character disorders. Particular client groups, however, may require different approaches, alterations in focus, etc, thus, modifications are made by therapists according to personality, therapeutic style, experience, diagnostic considerations, etc. (ibid).
The ‘Perlsian’ workshop style, however, has a more limited application, and work with severely disturbed individuals can become “a risky proposition” and “with some even contraindicated” (Shepherd, 1976 cited in Prochaska and Norcross, 1994, p.186). (Particularly, if therapist long term commitment and auxiliary support are not feasible; ibid). Thus, general restrictions/cautions, are especially pertinent to therapists lacking adequate training and/or experience with such client populations.
Notwithstanding, Yontef and Simkin (1989), are keen to point out that Gestalt therapy can be used with any group that the therapist feels comfortable with, i.e. psychological contact and/or therapist attunement/empathy is possible. If the therapist can relate to the client, the central Gestalt principles of dialogue, contact, trust in organismic self-regulation, and direct experiencing can be applied. With each client “general principles must be adapted to the particular clinical situation” (ibid, p.23); in order to be effective and ethical. “Thus, the competent practice of Gestalt therapy requires a background in more than Gestalt therapy” (ibid, p.24); including knowledge of personality, psychodynamic theory, psychopathology, diagnosis, theories and applications of therapy, etc.
different client group, although for similar reasons, L. Perls (see Rosenfeld,
1978, p.7) concedes that therapist’s awareness, experience and knowledge extend
beyond (that of clients and) their ‘professional stuff’; so that when
working with well educated, erudite clients, their ‘lack of background’, does
not result in their floundering/not copying.
Gestalt exercises and experiments, help to make internal conflicts actual experiences/processes, i.e. ‘they bring struggles to life’(Corey, 2001), and are designed to expand awareness and flexibility with new modes of thought/ behaviour. Exercises e.g. top dog/underdog or empty-chair techniques, guided fantasy, dream work – ‘the royal road to integration’, exaggeration, responsibility giving, reversals, ‘may I feed you a sentence?’ etc, encourage clients to externalize interjects and experience conflict more fully. According to Greenberg and Dompierre (1981, cited in Prochaska and Norcross, 1994),Gestalt empty chair intervention achieved greater depth of experiencing, conflict resolution, and awareness than Rogerian empathic reflections. This enactive dimension is designed to help clients become aware of the phony roles and games they play; and learn how and what is interfering with their ability to be present-centered. Emerging from phenomenological work (dialogue), and thus spontaneous, not predetermined, techniques/experiments, therapist disclosure/feedback, by focusing on specific actions, verbalizations, feelings, etc, are all directed toward greater integration between internal polarities, (resolution of splits, or boundary disturbances) and ultimately greater self-acceptance and autonomy.
Central to this work is the quality/type of contact, and resonance between the therapist’s attitude, enquiry/focus and the client’s needs (level of functioning).A careful balance between risk and support is necessary so that clients are “neither blasted into experiences that are too threatening nor allowed to stay in a safe but infertile territory”(Corey, 2001p.238). The role of frustrator and enquirer, nevertheless, implies an inconsistency between theory and practice; “It is not easy”, Perls (1969) recognized, “to find the way through this inconsistency, but once the therapist has resolved the psychotherapeutic paradox of working with support and frustration, both his procedures will fall correctly into place” (cited in Patterson, 1980, p.469). Many (e.g. Patterson, Corey, etc), however, doubt that he ever did resolve this paradox.
Contemporary gestalt work has moved beyond what Yontef (1993, cited in Corey, 2001, p.240) refers to as the Perlsian style “boom-boom-boom therapy”, with greater emphasis on therapist attunement, involvement, or presence, dialogue, etc; and less emphasis on techniques divorced from the relationship. “Certainly, techniques are still important in gestalt practice, yet they must always be a phenomenological part of the therapeutic encounter”(Corey, 2001).
Ethical practice is dependant upon the level of training and supervision; with the most effective application of gestalt techniques resulting from personal experiences gained in professional training (workshops) with competent therapists and supervisors (Passons, 1975). In addition to personally experiencing techniques and sound supervision, an appreciation of the theoretical framework underlying the approach/techniques, and an awareness of one’s own limitations, or ‘boundaries of one’s competence’ (Corey, 2001, p.253) is crucial. Typically active and directive therapists are also encouraged to have the characteristics mentioned by Zinker (1978, cited in Corey, 2001) e.g. sensitivity, timing, empathy, acceptance respect for client, etc; and reiterated by the BACP.
Fundamentally, one could say that the most immediate limitation of Gestalt therapy is the training, skill, resourcefulness, experience, wisdom/judgment, etc, of the therapist (rather than the approach per se.); i.e. that it “has been simplified and falsified and distorted and misrepresented” (L. Perls, see Rosenfeld, 1978, p.10).
 Perls (1967, cited in Erskine, 1995) used the concept of the life script, focusing on how individuals use fantasy, ‘catastrophic expectations’, ‘shoulds’, fixated defensive reactions, and others to reinforce the script.
 In some cases, the script beliefs – which function as a cognitive defense against awareness/contact in relationships – are manifested as (psychosomatic)‘physical reactions’, e.g. headaches, stomach tensions, etc (Erskine, 1995).
I.e. Ruminations, analytical dissection, etc, which interrupt the organismic assimilating process.
 In fact, growth occurs through accurate symbolization and abstraction; they constitute “natural self-regulatory functions” which can , “help organize and integrate experience”(Bohart & Todd, 1988, p.166).
 L.Perls makes the ‘existential paradox’ central to her work; see Rosenfield (1978); Becker (1970).
 Particularly of body language and verbal-nonverbal incongruities, blind spots, etc. According to Buber (1962, cited in Schmid, 2001b, p.5) inclusion transcends empathy, and is a way of perception that means to be existentially touched/affected.
 Even empathy is
‘process directive’. While not guiding clients in terms of making particular
decisions, taking actions, etc, Rogerian therapists, by emphasizing certain
utterances, etc, invite clients to reflect/focus in some way (Mearns,
 Concept of ‘organismic balance/homeostasis’.
 The single ‘life force’/ ‘actualizing tendency’ – the crux of the PCA.
 E.g. confluence, projection, introjection, etc.
 In respectful inquiry, confrontation/challenge, the therapist acknowledges how the script beliefs or resistance, helps the client maintain – albeit ineffectively – psychological homeostasis, i.e. they value his attempt at self-support/ management (Erskine, 1995)
 I.e. the locus of evaluation/responsibility lie with him.
 Despite the ‘no interpretation’ rule, in ‘Three Approaches to Psychotherapy: Gloria (interview), I felt Perls’ ‘feedback’ was akin to interpretation (‘one-upmanship’). Moreover, his presence, ‘I-Thou’ dialogue was somewhat absent.
 Criticized as always playing Top dog, and in no way demonstrating ‘I’[in the ‘I-Thou’ context], ‘impersonal’ Perls has been called a puppeteer, manipulator, director… (Templer,1973 in Patterson, 1980)
‘normal’ but inhibited, intellectually controlled. The ‘patients’ with whom
Perls mainly (successfully) worked.
 In part a manifestation of therapist self-responsibilty/support.
 Perls never accepted the Rogerian concept of UPR; viewed as collusion - rescuing or infantilizing on the therapist’s part.
© Pauline Connolly