Section 1 - Gestalt Theory
1.1 Introduction
You can expect a comprehensive exploration of what gestalt therapy is and how you can use it in your practice from this course. You will be able to take your clients on a journey of improvement.
1.2 Defining gestalt
The definition of gestalt can’t really represent what the therapy is all about but it creates a starting point. The therapy itself is an exploration of the client and the patterns they display.
1.3 Completing gestalts
Completing a gestalt means to fulfil a need you have. We have all kinds of needs at once so we journey through them. Once one is completed, a new one surfaces that we have to deal with.
1.4 Creative adjustments
The environment we live in is constantly changing. We have to adapt to the situations we find ourselves in to keep going and fulfil our needs. We have the creativity to come up with these solutions.
1.5 Figure and ground
Our past experiences and current environment determines how we interpret new experiences. Figures need to be differentiated enough that the need they cause can be dealt with fully one at a time.
1.6 Importance of being present
Therapy has a tendency to focus on the past but gestalt therapy is more interested in the present which does reflect the past and the future. It's what is happening in the moment that matters most.
1.7 The self as a process
When we think of the self, most of us think of fixed personality traits. Gestalt therapy approaches the self as actively changing in response to our experiences. We are connected to our environment.
1.8 Id, ego and personality
The id, ego and personality are three structures that make up the self. They determine the possibilities we have, the possibilities we choose and the beliefs we have about ourselves.
1.9 Holistic integration
It is against the principles of gestalt therapy to examine clients by splitting them up in sections. They will look at the client as a whole including the environment they are operating in.
1.10 Medical vs gestalt
The gestalt approach of holism contrasts quite significantly with the widespread medical model. Gestalt therapy has a wider perspective and empowers the client.
1.11 The awareness continuum
Awareness is a key part of gestalt. It is how clients are able to improve their situation through creative adjustments. There are different levels of awareness that we switch between as necessary.
1.12 Paradigms
Our perspective is based on our paradigm. These can vary in nature but always have a cultural influence. Gestalt uses a field paradigm to take into account the interconnectedness between clients and their situation.
1.13 Contact boundaries
We are interconnected with our environment. The interaction happens at the contact boundary where we can vary how open or defensive we want to be according to the situation we are faced with.
1.14 Phases of contact
The process of contacting the environment and dealing with gestalts is cyclical. Once one comes to the forefront and is fulfilled, another one takes its place. There are always various needs in the background.
1.15 Development in cycles
As well as the cycles defined by the founders of gestalt, other cycles have been developed to describe the gestalt fulfilling process. These representations should be used as guides because they cannot be fully accurate.
1.16 Processes of calibration
The kind of contact we have with our environment depends on the situation we are in. Sometimes we have the need to adjust it to get through the situation. There are seven processes of moderation altogether.
1.17 Deflection and egotism
Deflection and egotism are other ways that we can interact with our environment. Sometimes we want to avoid direct contact and other times we observe ourselves so create distance from our experiences.
1.18 Introjection
This next calibration process is about taking on messages from our environment without question. This allows us to learn but without any discretion we are too busy pleasing others to look after ourselves.
1.19 Retroflection
Our feelings aren’t always directed towards the person that is causing them. When we defensively cut off contact with our environment, all emotions are directed towards ourselves.
1.20 Projection
We are able to disown qualities that don’t fit with our self-concept by placing them on other people. This changes how we respond to them and creates a split in ourselves.
1.21 Confluence
Feeling closely bonded with someone is a nice feeling. But it can be taken too far to the point where we rely on other people. Confluence is only healthy if we can move out of it.
1.22 Healthy use of processes
All of the calibration processes we have talked about are neutral. But we can see them as good or bad which causes an aversion to using them. We need flexibility to respond to situations healthily.
1.23 Unfinished business
Humans find patterns in everything. Our brains like to join the dots to make sense of the world and to avoid unfinished business. We have a strong need for completion in everything we experience.
1.24 Remaining impartial
The role of the therapist differs slightly across the psychological approaches. Gestalt takes a stance of caring and creative indifference so the therapeutic relationship is equal.
1.25 Self-acceptance
Many people turn to therapy because they want to change something about themselves. This won’t help them. Accepting who they are allows them to have a much more constructive impact on their life.
1.26 Aesthetic criterion
We need fluidity to form and complete gestalts. When we are able to do this smoothly and appropriately, we are fulfilling aesthetic criterion. This is just one sign of healthy functioning.
1.27 Supporting clients
There is a certain way to support clients. You need to find a balance between helping them and allowing them to support themselves. You are giving them enough stability to develop beyond their problems.
1.28 Self-support through resistance
In gestalt therapy, the opposite of contact is resistance. Sometimes we need to reduce our level of contact with negativity in the environment and provide ourselves with self-support.
1.29 The five abilities
Gestalt therapy identifies five abilities that help us to function and interact with the world. They include our ability to interact with other people as well as be aware of ourselves.
Section 2 - Beginning Practicing Gestalt
2.1 The therapy setting
One of the important elements of starting sessions with clients is the setting. This gives clients a lot of initial information about therapy before it has even started and to an extent before you have even met.
2.2 Expectations about therapy
Our expectations about anything impact our ability to succeed in it. That is the same for therapy. Both the client and the therapist need to turn up to sessions without any misconceptions.
2.3 The therapy contract
There needs to be an official agreement between you and your clients that outlines the practical side of therapy and what they can expect during sessions. Clients should know what they are getting into.
2.4 The client's story
It is important to listen to the client’s story early in the journey of therapy. It gives you a lot of direct information and it allows them to express themselves. Although language does have its limits.
2.5 Process diagnosis
Diagnosis should be used in a way that aligns with gestalt principles. Any diagnosis made should take into account the wider context and be flexible enough to change when the client does.
2.6 Conducting assessments
Assessments are a great information gathering tool. The focus of gestalt assessments are slightly different. You will be looking at how the client makes contact with their environment.
2.7 Discovering the client's situation
As therapists we need a good idea of the client’s whole situation to understand how to help them. Having too much of a restrictive view means you could blame irrelevant factors for their current condition.
2.8 Contact functions
There are various ways to make contact with the environment. Some of these are observable so you can use the information they provide to work out how to help the client better.
2.9 Zones of awareness
The client’s perspective is important and a big part of that is what they are aware of. When a client is reducing contact with their environment they reduce their awareness on all three levels.
2.10 Co-transference
We use information from the past to understand the present and make predictions about the future. This can lead to transference which as a therapist you can encourage even if you don’t mean to.
2.11 Bodying forth
Therapy focuses a lot on the mind but the physical body has a part to play to. It holds our past and represents how we feel about connecting with our environment. Mental processes reflect in our bodily processes.
2.12 Planning the therapeutic journey
The gestalt approach does see therapy as a journey but you still need some level of planning to keep sessions moving in a meaningful direction. Do this in collaboration with clients.
Section 3 - The Therapeutic Journey
3.1 Life space
Lifespace is the combination of the individual and the environment. Everyone has a unique lifespace. To help clients you need to understand and influence theirs.
3.2 Gestalt development theory
The gestalt approach sees development as continuous. We are always making creative adjustments as our environment changes. Although we do need the right field conditions for healthy development.
3.3 Therapy in the present
There are endless possibilities of what we could experience. As a therapist you need to narrow down your focus and look at what is in the present. This often relates to the past.
3.4 Need organising the field
Our perspective changes depending on what we need. We organise our field through that need. So to understand a client’s behaviour we need to have some insight into the need they are organising with.
3.5 The importance of support
Getting the support we need is essential in everyday healthy functioning as well as therapy. A lack of support leads to disconnection which prevents meaningful development.
3.6 The effects of guilt and shame
Most people would do anything to avoid feeling guilt and shame. These feelings enforce a sense of wrongness but this is not always appropriate especially when it stops us from fulfilling our needs.
3.7 The challenge of change
Change is always hard but the more it is avoided, the harder it is to embrace. Experimentation will open them up to change but they need to feel supported as they step away from the familiar.
3.8 Respecting cultural differences
We need to respect the cultural differences we might have with our clients but also the affect Western culture has had on gestalt therapy itself. An equal therapeutic relationship cannot be maintained if the influence of culture is not considered.
3.9 Creative experiments
The experiments used in gestalt therapy should be creative so the client isn’t pushed towards one outcome. They need the freedom to explore and increase their awareness.
3.10 The benefits of metaphor and fantasy
Metaphor and fantasy are tools we can use to open up communication. It is a great way to experiment and even reveal deeper feelings that need to be dealt with for clients to progress.
3.11 Setting experiments as homework
You need to make sure that progress in therapy sessions applies to the outside world. Testing out experiments and new gestalts is a good way to do this as there are different field conditions outside of sessions.
3.12 Experiencing sensations
As we focus in on experience, we need to understand the importance of sensations. They should be embraced even if we don’t have the words to describe them.
3.13 Principles of phenomenology
Phenomenology is a good representation of gestalt practice. It recognises the co-creation of experience, how the past impacts the future and the importance of horizontal relationships.
3.14 Intentionality
Intentionality is how we give our experiences meaning. Based on our own perspective and past experiences. The focus is on the what and how of experience, not the reasons why.
3.15 Transcendental phenomenology
This concept looks at how we find meaning. Some of its elements contradict with the gestalt approach but some are useful to practicing gestalt therapists. This theory definitely made an impact.
3.16 Phenomenological reduction
Having an open mind is a really important part of your job as a therapist. There are three steps you can take to reduce the impact of your own experiences and assumptions.
3.17 Existential phenomenology
Existentialism suits the gestalt approach. It considers awareness, our personal perspective and the freedom of choice we all have when it comes to our reactions and responses.
3.18 Intersubjectivity
We walk around with individual perspectives but that doesn’t mean we don’t interact with and affect each other. We are always looking to assimilate the new things we experience.
3.19 Bodily felt sense
Being more aware of the body opens clients up to being more aware of their experience and their psychology. The mind and body are connected and reflect each other so understanding one can help us to understand another.
3.20 Projective identification
Projective identification is a psychoanalytic concept so it doesn’t fit into gestalt therapy smoothly. There are various viewpoints on how it works and whether it should even be part of the gestalt approach.
3.21 The impact of energy levels
Energy levels fluctuating is a pretty normal experience. But it can signal to problems clients are experiencing. Without enough energy, they will struggle to make contact with the environment.
3.22 Continuum of awareness
Healthy functioning involves moving along the continuum of awareness depending on the field conditions. Getting stuck in one state makes dealing with the present more difficult.
3.23 Patterns of contacting
The patterns of contacting clients use give us information about them. We tend to consistently use the same patterns to keep ourselves organised. There are certain laws of contacting in place.
3.24 Exploring dreams
Gestalt therapy does believe dreams hold insights into the dreamer. This is only relevant to the individual in their current situation so meaning surfaces from the client, not your own interpretation.
3.25 Buber's way of relating
How we approach connecting with other people and things varies. We can focus on the separation or the relationship. Both could be appropriate depending on the field conditions.
3.26 The importance of the between
The between is central to gestalt therapy. It is where contact is made so how relationships form and grow. But it can be intimidating to reach out without the guarantee of making a connection.
3.27 Inclusive therapeutic relationship
Inclusivity is a much more accurate term to describe a healthy therapeutic relationship compared to empathy. You cannot ignore your own lived experience even though it shouldn’t be imposing.
3.28 Adapting your presence
How present we are in sessions with clients varies. We don’t want to overtake sessions but we still need to participate. Being available to clients is important and so is being reflective.
3.29 Encouraging confirmation
It is really important that clients are able to acknowledge their whole being. A lack of this confirmation means they will strive to be whoever they think other people want them to be instead of living authentically.
3.30 Commitment to dialogue
Being committed to dialogue means you are available to fully connect with clients when they are ready to open up to you. It keeps us in touch with our experience and able to explore someone else’s experience.
3.31 Avoiding exploitation
The dynamics of the therapeutic relationship means exploitation is possible. To avoid that you need to accept it is a possibility and put in preventative measures to ensure you aren’t unintentionally doing more harm than good.
3.32 Living the relationship
Living the relationship allows you to focus on the here and now of your connection with clients. This contains a lot of useful information that you can use to help the client in their wider field.
3.33 Attunement
Attunement is a way to connect to and understand clients. Being in touch with their emotional states gives you more information about their experience and therefore how to help them.
3.34 I-Thou attitudes and moments
There are different ways of experiencing I-Thou relating. The attitude is the foundation. Moments can come from this but not always because it is an intense connection.
3.35 Appropriate self-disclosure
A level of self-disclosure is inevitable in any interaction. You can moderate just how much you are sharing to ensure you don’t take over therapy sessions with information about yourself. You shouldn’t be completely closed off either though.
3.36 Connecting through language
Language is powerful but it also has limitations. Looking beyond the content of language can give us more information about the client’s experience and how they are relating.
3.37 Repairing ruptures
You cannot expect yourself to be perfect at any point in your career. You still need to attune to every new client you work with. Ruptures can be repaired in a healthy way that grows the therapeutic relationship.
Section 4 - Therapeutic Transitions
4.1 Healthy aggression
We aggress with the environment when we make contact with it. That is necessary to deal with our emerging needs and complete the figures that come out of our ground.
4.2 Maintaining development
We need to keep developing to be able to respond to the present. If we get stuck, we will use strategies that used to work but aren’t actually functional anymore. Development is a lifelong process.
4.3 Five layer model
Being our authentic selves is a process we have to go through. This model illustrates that. It has received some criticism but it is your choice whether you use it or not.
4.4 Three types of experiments
You can really get creative when it comes to experimentation in gestalt therapy. Most experiments fall into three categories which all provide more information and understanding.
4.5 Support in therapy
Support is an important part of everyday life. We can’t function properly without it. It is particularly important in therapy when discussing sensitive topics and working towards change.
4.6 The necessity of polarities
Without the bad there is no good. So with every quality we have, we have the potential of the opposite quality. This allows us to move along the continuum according to field conditions.
4.7 Aha experience
There are moments of payoff in therapy where the client is able to overcome what they have been struggling with and gain new insights. This is a process that can only happen naturally.
4.8 The use of catharsis
Catharsis is quite a notorious technique. Whether it is beneficial or not depends on the client and their whole situation. Any judgement of techniques only makes sense in context.
4.9 Awareness of awareness
Beyond being aware of problems, clients need to learn the skill of being aware of the construction of their awareness. That gives them the chance to overcome unhealthy patterns.
4.10 Group therapy
The gestalt approach also takes the form of group therapy. The leadership style does change and different practitioners have varying opinions. Use what works for you and your clients.
4.11 Preparing to end therapy
It is inevitable therapy will end for each of your clients whether you are seeing them on a short term or long term basis. Endings can be difficult so approach it in the most positive way possible.
4.12 Factors in ending therapy
There are certain conversations you should have with clients before sessions end. How long the ending phase takes depends on the client and what they need from you.
4.13 Self-therapy
For clients to continue to thrive after they have completed sessions with you, they need to take part in self-therapy. This continued experimentation prevents them from getting stuck in fixed gestalts again.
Section 5 - Ethics
5.1 Therapeutic boundaries
The therapeutic relationship is one where boundaries are essential. Straying from behaviour that helps the client could cause you to harm the client which needs to be avoided at all costs.
5.2 Risk assessment
You need to be aware of the risk of clients taking part in dangerous behaviour. Talking about this openly in sessions is the first step in dealing with it and clients moving to a healthier mental space.
5.3 Looking beyond the centre
Clients will come to you with presenting issues but there is more to the problems they are experiencing. They are at the centre of their field with lots of other influencing factors around them.
5.4 Working with differences
You need to be aware of the differences that might come between you and a client of another group especially if they are from a minority community. Your treatment of them needs to be appropriate.
5.5 Dealing with sexual issues
Sex is going to come up during sessions with clients throughout your career. That could be sexual issues to do with other people or a client being sexually attracted to you. Either way, don’t ignore it. Deal with it.
5.6 Using touch in therapy
Touch is a natural part of the embodied experience but when using it in therapy, we need to make sure we are maintaining an ethical attitude. Informed consent and supervision are key.
5.7 Gestalt supervision
Supervision is important for all therapists. The focus of gestalt supervision is slightly different as the therapeutic relationship is at the centre. It ensures you are working with clients to the best of your ability.
5.8 Supporting yourself
All therapists want to do their job well. But for this to happen we need to look after ourselves. Unless we are supported, we aren’t going to be able to support clients to the best of our abilities.
Section 6 - Reflection
6.1 Spirituality in gestalt therapy
Gestalt therapy has a diverse range of influences. They do include spiritual ones. Many of the concepts to do with the present and wider field come from Eastern spirituality in particular.
6.2 Gestalt research
During gestalt therapy, we explore the experience of our clients. It is research in a way. So discussing the methodology of research is relevant to your work with clients.
6.3 Beyond therapy
Gestalt therapy can have an impact beyond sessions. These principles are powerful and can make a positive change in the lives of individuals, groups and organisations.
6.4 Self-review
To get the most out of your experience and continue to improve take time to reflect after the end of each therapeutic relationship. Examining your experience will give you a lot of useful information.
6.5 The uncertainty of gestalt therapy
Humans are unpredictable so that means they cause a sense of uncertainty. There are various elements of gestalt therapy that have a level of uncertainty but we should see this as an opportunity for growth.
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