Supporting Adolescent Contact Boundary Development through Creative Process

by Gerry Mitchell

Contact boundary is a central theoretical notion in the Gestalt therapy paradigm. When we speak about contact boundary development we mean the growth and development of the adolescent’s intrapsychic and interpersonal fields of experience, and the interplay that takes place between both these domains.

What is creative process?
Living life requires us to be creative in every moment. Creativity is not the preserve of the avant-garde, it is interwoven into the fabric of being human, irrespective of one’s social class, creed or colour. The Gestalt therapist’s primary focus in working therapeutically with adolescents is to enable them to become aware of and contactful with self, and in that process to tap into their creative energy and develop new insights and motivation to unblock that which is not working. I feel Antonio Sichera substantiates what I am attempting to articulate here when he says:

Therapy is thus a vital space in which the creative power of the self is taken seriously, in the strongest and most intense manner…you cannot be a Gestalt therapist unless you have learned to admire the creating effort of the self.

(Sichera, 2003: 95)

I believe creative energy is always alive in the young person. The adolescent can mobilise the self to respond to a situation either in a healthy or unhealthy way in order to meet their basic needs: that is fundamentally about being creative. Therapeutic contact with an adolescent presents the therapist with an opportunity to shape and influence the boundary conditions for him or her to become more aware of and contactful with the self and the surrounding social field, particularly when the creative adjustments the young person makes are rigid and apparently self-destructive.

Building the therapeutic relationship and the process of assessment
The question of how the adolescent psychotherapist might support contact boundary development through creative process is first and foremost about building relationship. The concept of relationship is everything in Gestalt. As Joyce and Sills (2002) remind us, “we see the therapeutic relationship as the core of Gestalt practice, both as a focus for vibrant contact and for the healing connection of an authentic meeting between two human beings” (43). In my therapeutic work with adolescent clients my primary objective is always to begin to establish rapport and a sense of trust. Becoming attuned to the young person’s contact style, I will adjust my efforts accordingly in order to make a connection. For example, I will place an emphasis on the contact function of my voice by deliberately speaking in a low and gentle tone. I will aim to hold my posture in a calm and anchored manner whilst being careful not to give too much direct eye contact, as this can have the effect of re-stimulating those characteristic feelings of self-consciousness and unease. From the first moments of meeting the client I am taking an interest in a whole range of details within the encounter: his or her contact style, contact functions, creative adjustments, meaning making, and so on. Gently and unobtrusively I will move rhythmically back and forth between I-Thou and I-It modes of relating, as I embark on a process of trying to gain an insight into the young person`s phenomenological world. This is what Gaie Houston (2006) refers to as “analysing the structure of the contact” (12). For me, it is this process of relational assessment that paves the way for creative intervention work to begin.

Creative process in action
The adolescent psychotherapist needs to pitch his or her interventions in a developmentally appropriate manner. This of course presumes that there is an awareness on the part of the therapist regarding the particular characteristics which indicate the developmental stage the young person is situated at. Here we are talking about the three dynamically interrelated phases of adolescent development that describe the young person’s transition from childhood to adulthood: ‘disembedding’, ‘interiority’ and ‘integration’. This is a process of growth and change that is characterised by one developmental phase interweaving into another in a movement that spells transformation and eventual culmination into a Gestalt formation (McConville, 1995).

Cognitive and emotional functioning, belief about self, body image, capacity for contact, creative adjustments, meaning-making, and more, are to be observed. In my own work situation, some of the adolescents I meet with on a daily basis are entrenched in the disembedding stage of development. These young people often present with a range of challenging behaviours, such as impulsive angry outbursts, drug misuse, being uncooperative with staff, experiencing episodes of depression, self-harming, displaying poor concentration, irregular attendance, etc. It is quite easy to identify at times how these behaviours are often symptomatic of an under-supported developmental process (Starrs, 2014); one that is couched in a social field where availability, and a quality of contact, from those adults who matter is wholly insufficient.

A noticeable inclination that often characterises young people in this category is their projective judgement and blame on others for the trouble they find themselves in. Taking ownership of their own behavioural choices can be hugely difficult for them because it can mean the pouring of salt on the wound of an already fragile self-process. In the adolescent`s family field, or in that of the broader field (including school), where support might have been insufficient, and the child did not have a voice, there is a likelihood of their carrying a sense of shame (Lee, 1994). In my engaging with a disembedding stage adolescent I try and keep in mind that I am, through a therapeutic relationship-building process, supporting him or her to become more reflective and creative; for the purpose of navigating his or her way further down the developmental pathway.

I take the view that a key orientation in the role of an adolescent psychotherapist is to facilitate the young person to make contact with and develop his inner world of private experience. Contact boundary disturbances can provide a useful lens to pick up on what might be impeding the natural flow in one’s cycle of experience. Engaging in dialogue, exploring, linking, tracking, reframing and meaning-making; following the use of projective techniques, such as Gestalt Sand Therapy Process (developed by Starrs, 2014), artwork, use of clay, etc., all help us to co-create a picture of what is happening in the adolescent’s phenomenological world and support the kind of direction we might take.

Case example
In the following clinical example I have changed the name and details of my adolescent client to ensure anonymity.

Breen and I met on Thursday afternoons for our weekly counselling sessions. He had missed last week’s appointment without contacting me, and it appeared that this was about to happen again this afternoon. So, I decide to phone him and check that everything is okay. On phoning him I immediately sense he is in a state of emotional arousal by the tone of his voice. There is some noise in the background. He removes himself to a place where it is possible for us to talk. Breen proceeds to tell me that he has just been accused of stealing some food items by one of the staff in the shop where he is presently located. He describes to me his feelings of rage and the murderous thoughts that are, as he states, ‘wrecking my head’. This is in regard to the shop assistant whom he alleges has accused him in the wrong. While we speak I support him to find ground and to breathe deeply and gently. I also encourage him to take control right now this moment of both his thinking and what he is doing. He is aware from our work up to now that a vital step in taking control in a highly charged situation like this is to walk away altogether. I then suggest that he makes his way to the centre where I am based so we can ‘check in on what’s been happening’. Breen agrees to meet me in ten minutes.

Breen is 19 years of age and is the sole guardian of his two-year-old daughter. We have been working together for the past 11 months following a recommendation from the HSE that he engage in counselling. This relates to a child protection concern, which had previously been reported to the social work department, concerning incidences of alleged violence between Breen and the child’s mother, who is alcohol-dependent. After one year of taking care of his child, along with support from his family, the supervision order which had been ordered by the court is no longer required. Breen was now hopeful about the prospect of being granted full custody of his child. Having been in and out of the care system from mid-childhood up to two years ago Breen knows first-hand the experiences of abandonment and of shame. He possesses a sense of pride now in how he has proven himself to be both a resourceful and caring dad and believes the social work department no longer has any valid reason to be involved in his life.

As I had anticipated, he is in a high state of arousal and on entering the counselling room he launches into the story of what had taken place in the shop. He refuses to sit down on the small sofa in front of me and paces instead over and back on the floor, and at one point removes his T-shirt. I am aware right at that moment of a tightness in my stomach with his removal of his clothing and the exposure of his upper body. I also get in touch with emerging thoughts and feelings pertaining to the question of whether or not I have the resources to provide a safe enough holding for him in this room right now this moment. In order to support us both, I slowly breathe into the pit of my stomach, knowing too well the futility of becoming immersed in anxious thinking. Anchoring myself in the present moment of the situation I pick up on some of his trauma, the re-stimulation of his internalised shame. Added to this is my deep desire to do the best job I can here; not to make a mess of it and have to face my own feelings of inadequacy.

I begin to develop a distinct sense, in the passing moments of this encounter, of the depth of our connection which we have cultivated over months of meeting in this space. This includes the understanding I have gained of his phenomenological world and of the social field that has influenced him so strongly. I begin to trust the relational ground that nests our therapeutic relationship, and whilst I am aware of my edginess in attending to what is figural, in all its immediacy, that is where we need to be. In the moments that go by in our session I move rhythmically from contact with myself and then coming out from there to be in contact with my client. I decide to avoid intervening with him around changing his thoughts and thinking about the consequences of his actions. I trust that will emerge from Breen himself in the process of our dialogue. Instead, I listen to him and speak in a soft tone to validate his feelings of justified anger. I praise him for his strength in not carrying out the violent deeds which are contained in his thoughts. I can hear…sense…see…more clearly now, his hurt in being rejected, of not being believed, of having been shamed in public. There and then in that moment I can sense how much we are set apart in phenomenological terms: with all its intertwining particles that includes subjective experiencing, early attachment experiences, social class, culture, world view. I feel an anger, as I have done so many times before, with the level of deprivation he has experienced; and that I have been lucky to escape. How he carries its effects, yet draws with determination from his reserves to create a meaningful path for himself. As Gordon Wheeler (1998) reminds us, “Political and social conditions… become something more than the background: they are integrated into the self-structure of the developing subjective person” (181).

Shifting from my thinking process to what is happening to me at a visceral level I begin to intuit the build-up of distress in Breen’s body, as he continues to move around the floor. I gently invite him to experiment with something that will help him to safely let go of his inner rage. As he stands there uncertain as to what I might have on offer, I reach over for the boxing pad and mitts. He knows of course this routine. He tells me he doesn’t want to use the mitts, that he will use his bare knuckles as he has always done. He begins to punch the large pad with tremendous ferocity. He flings his punches into the heart of the pad, one after another, as I stand there holding it in front of him. I find it hard to stand firm due to the power of his punches. I have already coached him on keeping the focus on discharging the rage from his body, through this cathartic work, and not on any person who may have breached his personal boundaries. Otherwise there is the danger of this experiment acting to reinforce his violent thoughts towards, for example, the shop assistant.

His face is now grimaced and beads of sweat show themselves on his forehead and bare chest. After about two minutes of nonstop aggressive punching he falls back into the sofa. He pauses for a moment to get his breath back and then begins to describe that ‘something has lifted’. As John Lee (1993) writes, “Until you get that emotional charge out of your body you`re going to be subject to your anger” (50). This then helped create the conditions for Breen and me to engage more contactfully together. His state of arousal had visibly lowered and he was better placed to regulate his thoughts and feelings. Standing back, as it were, I could see how we were co-creating the field together in the process of our dialogue and involvement in an experiment. This included working creatively together in re-evaluating the trigger situations vis-a-vis the shop incident, his internal responses, the subsequent choices he made and the learning points he could take away. For myself, the key creative task here was to set out to enable Breen to experience enough field support, i.e., from myself as therapist, plus experiencing enough self-support for himself. And with this, to begin to ‘strip down’ what had taken place, both externally and internally, and to grasp its enormous relevance to the development of his self-process. In this 70 minutes or so of working intensely with Breen I witnessed the oscillation of traits between the different developmental processes. From the disembedding trait of being pre- occupied with what took place at the interpersonal boundary and then onto a more interiority stage characteristic of taking control of his inner world. Eventually, what came more to the fore was the focus on himself. In the process of our work, towards the latter stages, I could sense him thinking… ‘What do I want here…I have a child…I don’t want to lose what I have…to mess up as my parents did!’ The theft allegation potentially challenged so much of the identity and way of being which he had worked so hard to create: interpersonal integrity, non-aggressive contact in the world, sobriety, pride in who he was becoming, fatherhood, and hope for his future. Our therapeutic contact created an awareness of the meaning of the situation for Breen. That fragment of his self-process that pointed to the moving forward to a more integrated self was showing signs of coming to the surface, and I witnessed a possession of self that I had not picked up on as figurally before. Needless to say, this was not something which had emerged spontaneously and without a context all of its own. It can be best understood when we look at the co- created field of our therapeutic engagements over the eight-month period. How the signs of an evolving adolescent self-gestalt emanated from a process of dialogical contacting, where attending to phenomenological reporting and/or exploration, reframing, new meaning-making and organismic self- regulation were what characterised the therapeutic work.

Conclusion
The contact boundary is what defines the self and simultaneously organises and regulates the self’s interaction with the internal world. And in the process of adolescent growth and development the contact boundary matures as it moves recursively through three developmental processes: ‘disembedding’, ‘interiority’ and ‘integration’ (McConville, 1995). A fundamental factor in assisting the adolescent to make the journey from childhood to adolescence is that of experiencing support from the social field. By its nature the period of adolescence can prove a tricky terrain to navigate. This of course can be attributed to factors that can emerge at the young person’s interpersonal boundary and/or at an intrapsychic level.

Enter the adolescent psychotherapist into this space. Here he or she is expected to adopt an approach which hinges on a range of qualities such as respect, compassion, patience and the fullest appreciation for the client’s subjective experience in accordance with the paradoxical theory of change. This of course includes an in-depth understanding of the adolescent developmental process and a richness in the quality of contact with self. It is my firm belief that these essential qualities take on a vibrancy all of their own when I assimilate the concept and practice of creative process into the Gestalt therapeutic frame.

Gerry Mitchell is a psychotherapist and works with both adolescents and adults. He holds an MA in humanistic and integrative psychotherapy and is a graduate of the Advanced Post Qualifying Diploma programme in Gestalt Adolescent Psychotherapy and member of Blackfort Adolescent Gestalt Institute. Contact details: gerrymitchellopenway@eircom.net or 087- 9880107.

References:
Houston, G. (2006). Brief Gestalt Therapy, London: Sage Publications.
Joyce P., & Sills, C. (2002). Skills in Gestalt counselling and psychotherapy. London: Sage Publications.

Lee, R. (1994). Couples shame: The unaddressed issue. In G. Wheeler & S. Backman (Eds.), On Intimate Ground: A Gestalt Approach to Working with Couples (pp. 262-291). San Francisco: Jossey-Bass Publications.

Lee, R.G., & Wheeler G. (1996). (Eds.). The Voice of Shame: Silence and Connection in Psychotherapy, San Francisco: Jossey-Bass Publications.

Lee, J. (1993). Facing the Fire, New York: Bantam Books.

McConville, M. (1995). Adolescence: Psychotherapy and the Emergent Self, SanFrancisco: Jossey-Bass Publications.

Wheeler, G. (1998). Towards a Gestalt developmental model. British Gestalt Journal, 7(2), 115-125.

Sichera, A. (2003). Therapy as an aesthetic issue: Creativity, dreams and art in Gestalt therapy. In M. Spagnuolo Lobb & N. Amendt-Lyon (Eds.), Creative Licence: The Art of Gestalt Therapy (pp. 93-101). New York: Springer Wien.

Starrs, B. (2014). Contact and despair: A Gestalt approach to adolescent trauma. British Gestalt Journal, 23(2), 28-37.