Aspects and Features of Gestalt Therapy - Coursework Example

Introduction Gestalt is a German word, which does not have an equivalent in the English language. It means a “configuration or whole, an entity that is more than the sum of its parts” (Craighead & Nemeroff, 2000.) Gestalt therapy was founded by Frederick (Fritz) and Laura Perls in the 1940s. Gestalt therapy can be considered as a phenomenological-existential therapy. Basis of Gestalt therapy Gestalt therapy teaches therapists and patients the phenomenological method of awareness, wherein “perceiving, feeling, and acting are distinguished from interpreting and reshuffling preexisting attitudes” (Yontef, 1993.) The focus of Gestalt therapy is more on the process (what is happening) rather than content (what is being discussed). Instead of stressing on what was, might be, could be, or should be, the emphasis is more on what is being done, thought and felt at the moment (Yontef, 1993.) The theory of gestalt therapy has 3 major sources. The first is psychoanalysis; the second is humanistic, holistic, phenomenological and existential writings, and thirdly, Gestalt psychology (Nevis, 1996). Psychoanalysis contributed to some of its major principles concerned with the inner life. Humanistic, holistic, phenomenological and existential writings center on personal experience and everyday life. Gestalt psychology is concerned with the nature and structure of perceptual experience (Nevis, 1996) The Phenomenological Perspective Phenomenology can be considered as a discipline that assists people in thinking in a manner that they can differentiate between what is actually being perceived and felt in the current situation and what is residue from the past (Yontef, 1993). In order to achieve insight, Gestalt therapy uses focused awareness and experimentation. The phenomenologist studies both personal awareness and the awareness process, and the patient learns how to become aware of awareness (Yontef, 1993.) The Field Theory Perspective According to the field concept “all organisms exist in environmental contexts with reciprocal influences on each other”(Kirchner, 2000). No single organism is broken down into to separate components but understood in its organized, interactive, interconnected, and interdependent totality (Kirchner, 2000). The organism is co-created and not powered only from within or impacted only from outside (Kirchner, 2000.) Rather than being speculative, interpretive, or classificatory, field approaches are descriptive, with an emphasis on observing, describing, and explicating the exact structure of that being studied (Yontef, 1993.) The Existential Perspective Existentialism is based on the phenomenological method, and focuses on the direct experience of one’s existence, joys and suffering, relations with each other, etc., “The existential view holds that people are endlessly remaking or discovering themselves”(Yontef, 1993.) An important part of Gestalt therapy is existential dialogue, which is a manifestation of the existential perspective on relationship. Rather than using therapeutic manipulation, Gestalt therapists prefer experiencing the patient in dialogue (Yontef, 1993). In Gestalt therapy, an active use of the immediate experience of the patient is made. The emphasis is that “whatever exists is here and now and that experience is more reliable than interpretation”(Yontef, 1993). The patient is made aware that there is a difference between talking about what happened some time back and experiencing the present (Yontef, 1993). In Gestalt therapy there are no "shoulds" and “Gestalt therapy stresses awareness of what is (Yontef, 1993.) Goal of Gestalt Therapy The main goal of Gestalt therapy is “to assist the client in restoring (or discovering) his/her own natural ability to self-regulate as an organism and have successful and fulfilling contact with others (environmental others), as well as with disowned aspects of oneself (internal others)” (Kirchner, 2000.) The client is able to enhance how they live their lives, and how they engage with others and themselves, by being aware and experimenting with bodily sensations, desires, cognitive assumptions and emotional responses (Kirchner, 2000.) Process of Psychotherapy Gestalt therapy is practiced in groups, workshops, individual therapy, families, couples, and with children. The location could be hospitals, clinics, family service agencies, private practices, etc., with a varying style in each modality (Yontef, 1993.) The common factors in all styles and modalities of Gestalt therapy are: use of direct contact and personal presence (dialogic existentialism), emphasis on direct experience and experimenting (phenomenology), and emphasis on the field concepts of what, how, here and now (Yontef, 1993.) Applications of Gestalt therapy Gestalt therapy can be effective in any patient that the therapist understands and feels comfortable with. It is essential to adapt the general principles to the particular clinical situation. Different approaches may be required in a schizophrenic, a sociopath, a borderline or an obsessive-compulsive neurotic (Yontef, 1993.) The traditional belief has been that Gestalt therapy is most effective with anxious, perfectionist, phobic and depressed clients, while it is more difficult working with psychotic, disorganized, or otherwise severely disturbed people (Yontef, 1993.) Many psychosomatic disorders including ulcerative colitis, migraine, and spastic neck and back conditions have shown good results with Gestalt therapy (Yontef, 1993.) Psychotic individuals and those with severe character disorders have also benefited from Gestalt therapy (Yontef, 1993). Gestalt therapy has also found to be useful as awareness training for mental health professionals, as adjunct to visual problems, in children with behavior problems, in creativity teaching for teachers, to train staff for a day-care center, and in organization development (Yontef, 1993.) Treatment Normally, the assessment and screening procedures are not done as a separate period of diagnostic testing and social history taking but done as a part of the ongoing relationship. The assessment data (the patients willingness and support for work within the framework of Gestalt therapy, match between therapist and patient, professional diagnostic and characterological discriminations, frequency of sessions, the need for adjunctive treatment and for medical consultation) is obtained by starting the work (e.g. by therapeutic encounter) (Yontef, 1993.) The first contact with the client starts the Gestalt therapy. On an average, the frequency of sessions is once a week, and it might depend upon how long the patient can manage between sessions without any loss of continuity, decompensation, or relapse (Yontef, 1993.) The intensity could decrease if the frequency of sessions is less than once a week, unless the patient is attending a weekly group with the same therapist. On the other hand, frequency of sessions that is more than twice a week is not normally required, except in psychotic clients and is contraindicated in those with borderline personality disorders (Yontef, 1993). Frequently, workshops, group therapy, family therapy, meditation, movement therapy, or biofeedback training might be combined with individual therapy (Yontef, 1993.) The time duration in Gestalt therapy groups may vary from 1 ½ to 3 hours, with an average duration of two hours. About ten participants may take part in a 2-hour Gestalt therapy group (Yontef, 1993). Gestalt therapists feel a maximum sense of involvement with heterogeneous groups, having a balance of men and women. Participants are generally screened, and while there is no prescribed age limit, the typical private practice group would have clients in the 20 to 65 age group (average 30 to 50 years) (Yontef, 1993.) Workshops may range from as short as one day to weekend workshops, which range from 10-20 or more hours. Longer duration workshops range from one week to several months. A typical weekend workshop might comprise of one Gestalt therapist and 12-16 clients. The help of co-therapists is used if there are more than 16 clients (Yontef, 1993.) Limitations of Gestalt therapy Although Gestalt therapy has numerous applications, it does have some limitations. There is a lack of a distinct, clearly defined, and fully elaborated theory of human development with Gestalt therapy (Kirchner, 2000). Because of this “psychological sufferings that are developmental in origin are void of consistent theoretical explanations within a Gestalt theoretical framework” (Kirchner, 2000). By not having knowledge of the conditions that are necessary for healthy development, the therapist is unsure of the most effective way to deal with clients who are affected by certain kinds of developmental damage and/or deficiencies (Kirchner, 2000). Gestalt therapy might also be ineffective or have reduced effectiveness in acute cases where crisis intervention is required (e.g. suicidal or homicidal ideation), and those clients with severe impairments related to mood and/or mind altering substances (Kirchner, 2000). Another important limitation of Gestalt therapy is that since a therapist use themselves as a therapeutic medium for change, a strong personal commitment to abide to the principles of Gestalt therapy and a high level of self-awareness is required. This may not be found in all therapists (Kirchner, 2000) Conclusion Fritz and Laura Perls discovered Gestalt therapy in the 1940s, which is considered as a phenomenological-existential therapy. The 3 major sources of the theory of gestalt therapy are psychoanalysis; humanistic, holistic, phenomenological and existential writings; and Gestalt psychology. The main goal of Gestalt therapy is to help the client in restoring (or discovering) their own natural ability to self-regulate as an organism and have successful and fulfilling contact with others, as well as disowned aspects of oneself. Gestalt therapy is practiced in groups, workshops, individual therapy, families, couples, and with children, in different setups. It is most effective with anxious, perfectionist, phobic and depressed clients, as well as in many psychosomatic disorders. It has also been found useful in psychotic individuals, those with severe character disorders, for awareness training for mental health professionals, as adjunct to visual problems, in children with behavior problems, in creativity teaching for teachers, to train staff for a day-care center, and in organization development. On an average, the frequency of sessions is once a week, and workshops, group therapy, family therapy, meditation, movement therapy, or biofeedback training might be combined with individual therapy. The time duration in Gestalt therapy groups may vary from 1 ½ to 3 hours, with an average duration of two hours. Workshops may range from as short as one day to weekend workshops, which range from 10-20 or more hours. Longer duration workshops range from one week to several months. Although Gestalt therapy has numerous applications, it does have some limitations. There is a lack of a distinct, clearly defined, and fully elaborated theory of human development with Gestalt therapy. It might also be ineffective in acute cases like those with suicidal or homicidal ideation, and those clients with severe impairments related to mood and/or mind altering substances. A strong personal commitment to abide to the principles of Gestalt therapy and a high level of self-awareness is required from the therapist. References Craighead, WE, Nemeroff, CB (2000). The Corsini Encyclopedia of Psychology and Behavioral Science. John Wiley and Sons. Kirchner, M (2000). Gestalt Therapy Theory: An Overview. 4(3). Nevis, EC (1996). Gestalt Therapy: perspectives and applications. Routledge. Yontef, GM (1993). Awareness, Dialogue & Process: Essays on Gestalt Therapy. Gestalt Journal Press. Read More