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Gestalt therapy

Psychologist - Gestalt therapyGestalt therapy is the foundation of my approach to psychotherapy (to which I add elements from other psychological therapies – see below). Gestalt therapy is a type of counselling that emphasises the process of becoming whole. Several key principles guide my use of Gestalt therapy:

Change happens in the present
Gestalt therapy emphasises examining experience in the present moment because we live our lives in the present time. Just as past issues create problems in the present, these problems can be resolved in the present. Even though what has happened in the past can not be undone, the way that this impacts on our lives in the present can be changed. Healing happens in the present.

Change happens through becoming more fully oneself
Another key difference between Gestalt and other forms of therapy is the understanding of how change happens. One way that change can occur can be described as a coaching model. This model is very familiar to us all – we have a goal, we get expert help on how to reach that goal, and we practice a lot. It is the kind of model that often underlies cognitive behavioural therapy (CBT).

In contrast, according to a Gestalt therapy approach, psychological change is unlikely to happen by trying harder to change – in fact this may prevent change. Trying harder to change is like having someone push us – the most likely thing to happen is that we push back. Instead, in a Gestalt approach change happens through accepting oneself. This model of change is more closely aligned with what may happen in nature. For example, a tree does not have a conscious goal in mind “to be a big tree” and does not seek out a tree coach. Instead, if the tree is given the nutrients it needs within the ecosystem, then it will unfold as nature intended. This model of change is similar to some Buddhist approaches, and is also seen in Acceptance and Commitment Therapy (ACT).

Change happens through experience
One thing that Gestalt therapy shares with the coaching style is the need for real practice. Change is unlikely to happen if it is just talked about – what is talked about must be felt and put into practice. Similar to CBT, Gestalt therapy may include designing experiments to explore issues or to strengthen our capacity to act.

Change happens in relationships
Our lives are also surrounded by relationships – our relationships with people, our environment, our society and our culture. My belief is that just as harm can be done in relationships, healing also occurs within relationships. Any outcomes achieved in counselling emerge from the relationship between therapist and client. For this reason alone there is value in attending to the quality of the relationship. Within this relationship, issues of trust can be explored, problems can be examined, self-awareness and interpersonal skills can be learnt.

In addition, the relationship between therapist and client often echoes the relationships people have outside the therapy room. This means that examining the relationship between the therapist and client can provide immediate and useful information about the person’s needs, and relationships in the wider world.

Change involves the whole person
Finally, Gestalt therapy accepts all aspects of an individuals being – emotional, psychological, cognitive, social, spiritual, and bodily. However, often in counselling the cognitive and verbal sides of a person are emphasised, at the expense of the other sides – therapy does after all involve a lot of talking. As a result, Gestalt therapy has an emphasis on attending to bodily processes.

To me attending to the body in therapy makes a lot of sense because we live in our bodies, and our emotions are expressed in our bodies. For example, most of us know that the emotional experience of stress can be felt in the body – such as shoulders. Trauma can also be remembered in the body, and at a more subtle level the psychological and emotional process fundamental to being human – such as reaching out to another person – have their counterpart in the muscles and structures used to physically reach out to another person.

For example, body oriented practices can include:

  • Breathing exercises

  • Calming & grounding exercises

  • Observing body actions in respond to what is being discussed

  • Exploring the meaning of posture and movement patterns

  • Practicing staying present to body sensations

Without attending to your bodily experience, therapy may be incomplete, or in some cases ineffective. For some people who have experienced trauma, becoming comfortable in their bodies is a necessary, even essential, part of their healing.

For a downloadable pdf  of the above:  What is Gestalt Therapy 

Research evidence about Gestalt Therapy

 

 

Beyond Gestalt therapy – other psychotherapeutic methods
While I believe in the effectiveness of the Gestalt approach, any one psychological therapy method alone will not suit everyone. For this reason, to Gestalt principles I add aspects of the following psychology models when working with anxiety, depression, and trauma –

  • Self-Trauma model  - see www.johnbriere.com

  • Emotion Focused Therapy  - see http://www.emotionfocusedclinic.org/

  • Healing tasks model for survivors of sexual assault  - see Kepner (2003).  Healing Tasks: Psychotherapy with Adult Survivors of Childhood Abuse

  • Inner Judge  - see Brown (1998). Soul without Shame: A Guide to Liberating Yourself from the Judge Within

Also, research indicates that what seems to matter more than the psychological therapy method is that the therapist has a model of change to work from that he believes in, and most importantly this model fits for the client. I have provided my explanation of Gestalt Therapy here not because I think it’s the best of all therapies for everyone – although I clearly believe in its value – but in order for prospective clients to consider whether this approach suits them. For more information on research into the effectiveness of therapy click here.

A note on touch
In recognition of potential pitfalls and cultural positions regarding touch, my practice rarely involves touch (apart from when I shake someone’s hand).