Gestalt therapy

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Gestalt Therapy is a psychotherapy which focuses on here-and-now experience and personal responsibility. It was co-founded by Fritz Perls, Laura Perls and Paul Goodman in the 1940s-1950s.


[edit] General description

Image:Gestalt Therapy cover.jpg
Cover of the seminal 1950 book Gestalt Therapy, 1994 edition from Gestalt Journal Press.

The objective of Gestalt Therapy, in addition to helping the client overcome symptoms, is to enable the her-him to become more fully and creatively alive and to be free from the blocks and unfinished issues which may diminish optimum satisfaction, fulfillment, and growth. Thus, it falls in the category of humanistic psychotherapies.

Gestalt therapy (GT) has its roots in psychoanalysis. It was part of a continuum moving from the early work of Freud, to the later Freudian ego analysis, to Wilhelm Reich and his notion of character armor. To this was added the insights of academic gestalt psychology about perception, gestalt formation and the tendency of organisms to complete the incomplete gestalt, to form "wholes" in experience.

There were additional influences from existentialism, particularly the I-thou relationship as it applies to therapy, and the notion of personal choice and responsibility.

Central to Fritz and Laura Perls' modifications of psychoanalysis was the concept of "dental or oral aggression." Dental aggression is discussed in Fritz Perl's first book (Laura Perls contributed to it, but she was only mentioned in the first preface, 1944, and then left out) "Ego, Hunger, and Aggression." The Perls suggested that when the infant develops teeth, he/she has the capacity to chew, to break apart food, and by analogy experience, to taste, accept, reject, assimilate. This is opposed to Freud's notion that only introjection takes place in early experience. Thus the Perls made "assimilation", as opposed to "introjection" a focal theme in their work, and the prime means by which growth occurs in therapy. In contrast to the psychoanalytic stance in which the patient introjects the (presumably more healthy) attitudes/interpretations of the analyst, in Gestalt Therapy the patient must "taste" his/her experience, and either accept or reject, but not introject, or "swallow whole". Hence, the emphasis is on avoiding interpretation and encouraging discovery. This is the key point in the divergance of GT from traditional psychoanalysis -- growth occurs through gradual assimilation of experience in a natural way, rather than by accepting the interpretations of the analyst; thus, the therapist should not interpret, but lead the patient to discover for him or herself. The Gestalt therapist contrives experiments that lead the patient to greater awareness and fuller experience of his/her possibilities. Experiments can be focussed on undoing projections or retroflections. They can work to help the client with closure of unfinished gestalts ("unfinished business" such as unexpressed emotions towards somebody in the client's life). There are many kinds of experiments that might be therapeutic. But the essence of the work is that it is experiential rather than interpretive, and in this way distinguishes itself from the psychoanalytic.

Perls also derived much from Reich's emphasis on how defenses are embodied, and therefore paid a great deal of attention to nonverbal behavior. This was consonant with Laura Perls' background in dance and movement therapy.

A core concept in Gestalt therapy is the unifying idea of "contact". Contact is where one person meets another person, or meets the outside world. Thus, there can be physical contact, but mostly what is meant by the term is metaphoric. If contact is not interfered with by what Perls-Goodman called disturbances of the contact boundary, the individual can grow, through assimilation of new experiences. In therapy, the patient/client is encouraged to experience his or her own feelings and behaviours in the here and now, and attention is brought to bear on the way contact is interrupted. The way in which he or she interrupts contact with the present environment is considered to be a significant factor in creating and maintaining dysfunctional patterns of behavior. Some of the contact interuptions occur through projection (seeing outside one's self what belongs to one's self), introjection (swallowing whole instead of assimilating, chewing, digesting); retroflection (directing impulses towards the self that rightly should be directed to the other, as in anger directed toward self causing depression or psychosomatic symptoms); confluence (dissolving the self-other boundary and merging with the other). A disturbance introduced by Miriam and Erv Polster is "deflection," referring to a means of avoiding contact by jumping around from one thing to another and never staying in the same place for very long. All of these disturbances have a pathological and a non-pathological aspect. It is appropriate for the infant and mother to become confluent, for example, or two lovers, but inappropriate for client and therapist. When the latter pair becomes confluent, there can be no growth because there is no boundary at which the one can contact the other; the client will not be able to learn anything new because the therapist is simply an extension of the client, so to speak.

Another important aspect of contact, one which can be found in Perls, Hefferline and Goodman, but was neglected by almost everyone except the unfortunately writing-phobic Isadore From, was that contact-making can be deconstructed into stages. One can look at a pathology of the contact making function and relate this to personality disturbances. An example would be that some people grasp onto people and experiences too quickly, without orienting themselves to what is out there. This would be a disturbance at the "fore-contact" stage, and would be part of an impulsive personality style. This aspect of GT is a neglected part of the theory that connect GT to the original work of the Gestalt psychologists on phenomenology and perception.

By focusing the individual on how contact-making occurs or is disturbed, new insights can be made and the fluid process of adequate contacting resumed.

[edit] History

Image:Fritz Perls.jpg
Fritz Perls' photo on the cover of an Hungarian edition of his book The Gestalt Approach and Eye Witness to Therapy (originally published 1973)

Fritz Perls was a German psychoanalyst who fled with his wife Lore to South Africa to escape Nazi oppression. After the war the couple emigrated to New York City, which had become by the late 1940's and early 1950's, a center of intellectual, artistic, and political experimentation.

The school of Gestalt therapy was co-founded in the late 1940s to early 1950s by Fritz & Laura Perls, both of whom were originally trained as traditional psychoanalysts; and Paul Goodman, a political writer and anarchist. The seminal work was Gestalt Therapy: Excitement and Growth in the Human Personality, published in 1951; co-authored by Fritz Perls, Paul Goodman, and Ralph Hefferline (a university psychology professor, and sometime patient of Fritz Perls). As it turns out, most of the original part II of the book was written by Paul Goodman from the notes of Fritz Perls, and contains the meat of the theory. It was supposed to go first. The publishers decided that Part II, written by Hefferline, fit more into the nascent self-help ethos of the day, and made it Part I, making for a less interesting introduction to the theory. Isadore From, a leading early theorist of Gestalt Therapy, taught Part II for an entire year to his students, going through it phrase by phrase.

Gestalt therapy had a variety of psychological and philosophical influences, and in addition was a response to the social forces of its day. It is a therapeutic approach which is holistic (mind/body/culture) present-centered, and related to existential therapy in its emphasis on personal responsibility for action, and on the valuing of the I-thou relationship in therapy. (In fact, its creators considered calling Gestalt Therapy existential-phenomenological therapy.) "The I and thou in the Here and Now," was one Gestalt therapist's semi-humorous mantra.

Fritz and Lore (now Laura) founded the first Gestalt Institute in New York City in 1952. Isadore From became a patient, first of Fritz and then of Laura. Pretty quickly Fritz anointed Isadore a trainer and also gave him some patients. Isadore lived in New York until his death at 75 in 1993 and was known world-wide for his philosophical and intellectually rigorous take on Gestalt Therapy. A brilliant, witty and sometimes caustic man, From was definitely the philosopher of the first-generation Gestalt therapists. He was also acknowledged to be a supremely gifted clinician. Unfortunately, he was phobic of writing. The only things committed to paper are a few interviews, but they are worth reading.[1]

Jim Simkin was a psychologist who also became a patient of Perls and then a co-trainer with Perls in California. Simkin was responsible for Perls coming to California where he attempted to begin a psychotherapy practice. Ultimately, being a peripatetic trainer and workshop leader was a better fit for Fritz' personality. Jim and Fritz co-led some of the early (for California) training groups at Esalen.

In the late 1950's-1960's movement toward personal growth and the human potential movement fed into and was itself influenced by Gestalt Therapy.

With all these disparate influences, Gestalt therapy somehow became a "coherent gestalt", which is the Gestalt psychologists' term for a perceptual unit that holds together and forms a unified form.

In the 1960's Perls became infamous for his public workshops at Esalen Institute in Big Sur. Isadore From referred to some of Fritz' several day workshops as "hit-and-run" therapy because of its emphasis on showmanship with little or no follow-through, but Fritz never considered these workshops to be true therapy. Jim Simkin went from co-leading training groups with Fritz to purchasing a property next to Esalen and starting his own training center, which he ran until his death in 1984. Here he refined his precise laser-like version of Gestalt Therapy.

When Fritz Perls left New York City for California, there began to be a split between those who saw Gestalt Therapy as a therapeutic approach with great potential (this view was best represented by Isadore From, who practiced and taught mainly in New York, and by the members of the Cleveland Institute, co-founded by From) and those who saw Gestalt Therapy not just as a therapeutic modality but as a way of life. The East Coast, New York-Cleveland axis was often appalled by the notion of Gestalt Therapy leaving the consulting room and becoming a way-of-life (see Gestalt prayer) in the West Coast of the 1960's.

The split continues between what has been called "East Coast" GT and "West Coast" GT. However the way-of-life view seems to be fading as people move on from the 1960s. Esalen is still functioning in Big Sur. The widow of Esalen's co-founder Dick Price, Christine Price, continues to hold Gestalt workshops there.

In 1969 Fritz Perls left the USA to start a Gestalt community at Lake Cowichan on Vancouver Island, Canada. He died almost a year later on 14th March 1970 in Chicago. One member of the Gestalt community was Barry Stevens. Her book about that phase of her life became very popular ("Don' t Push the River."). She developed her own form of Gestalt therapy body work which is essentially a concentration on the awareness of body processes.

Erv and Miriam Polster started a training center in La Jolla which also became very well known. Dan Rosenblatt (b. 1925) was part of the early group around Laura. A Harvard-trained psychologist and intellectual, he practiced Gestalt therapy for over 35 years in Manhattan, seeing 30 patients a week in individual therapy and doing groups almost every evening. He did training workshops in Germany, the Netherlands, Japan, New Zealand, Italy for many years. Rosenblatt, who also wrote several books on Gestalt therapy, exemplifies the Gestalt therapist as practicing clinician, rather than would-be guru. All of these therapists had their own distinctive styles, but always with Gestalt Therapy's focus on immediate experience as a central theme. And unlike Fritz Perls, who Isadore From persisted in calling Frederick Perls, these first generation Gestalt therapists maintained thriving therapy practices, mostly in one location, for many years.

Although Gestalt Therapy reached its zenith in the late 1970's and early 1980's and has since waned in popularity, its contributions have become assimilated into current schools of therapy, sometimes in unlikely places. For example, Acceptance and Commitment Therapy (ACT) shares much from Gestalt Therapy yet is considered to be a cognitive behavioral approach. Also, mindfulness is a buzzword as of 2006, yet much of mindfulness work is connected to Gestalt Therapy's emphasis on the flow of experience and awareness. You won't see too much emphasis on Gestalt Therapy in clinical psychology programs in the US, however there are Gestalt institutes all over the world, including Asia and the South Pacific. Dan Rosenblatt led Gestalt training groups in Japan for 7 years and Stewart Kiritz followed with public workshops and training workshops from 1997 through 2005. Gestalt Therapy is a very useful process for therapists-in-training of any persuasion because of its focus on the person of the therapist, barriers to full contact with others, self-awareness. And graduate students still seem to seek it out, even though it is not as recognized by the establishment as it once was.

[edit] Principal influences

[edit] External links

Gestalt Related Organizations

More on Gestalt

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Gestalt therapy

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