Workshop Review: Gestalt Therapy with Borderline Experience

Margherita Spagnuolo Lobb in collaboration with the Irish Gestalt Centre (IGC)
Oaklands House Creative Centre for Psychological Wellbeing, Blessington,
Co. Wicklow
24-25 April 2015
Reviewed by Jim FitzGibbon

Warmth and integrity are part of the overall experience once you move through the gracious grounds to the lovely Oaklands House demesne. The initial experience afforded by the setting was consistent with the expert facilitation of this workshop by Margherita Spagnuolo Lobb. Margherita is a widely published author and founder and Director of the Istituto di Gestalt in Italy.

Describing a shift from a narcissistic society to a borderline one, Margherita argued that the fragmentation of families and increasing substitution of social media for human contact has produced a society in which the most pressing need is for connection and embodied relationship. This shift from the more self-development focused concerns of the late 20th century resonated with the clinical experience of the workshop participants who are encountering more clients who could be defined as displaying borderline tendencies.

Margherita explained how a Gestalt approach is particularly well suited to working with borderline presentations. Building on the work of Otto Kernberg (1984), she clearly explained the benefits of a Gestalt approach which focuses on contact and relationship in the here-and-now when working with borderline clients. She developed the insights we gained, from our work in triads, with her clear exposition of theory and clinical evidence and she encouraged us to differentiate how best to work with the challenges inherent in borderline presentations. She explained the important opportunities to affirm the aesthetic beauty of the client’s capacity to reach out in an integrated way, demonstrating how the therapist can contain the client’s anxiety by accepting and understanding his relational difficulties.

Margherita shared her experience of borderline clients perceiving and experiencing love and autonomy as two mutually exclusive things. Showing compassion for the client’s approach to contact, it became easier to understand how, to the borderline client, both the warmth and the challenge of the therapist can be experienced as an attack on the core self. With remarkable simplicity, she demonstrated how the dialogic approach of Gestalt therapy can assist the client to discover themselves in relationship and affirm their integration. By acknowledging, and making explicit, moments of shared reality, the client can experience contact which is affirming and holds the possibility of a future in which both relationship and self-preservation are possible.

As she linked and contrasted borderline presentation with other disturbances in the DSM-V (American Psychiatric Association, 2013), Margherita brought into clear focus a methodology for treating borderline clients with warmth and integrity. I was personally intrigued to explore how a community or institutional culture can sometimes exhibit extreme borderline behaviour traits in relationship with ‘different others’. I am passionate about applying this understanding to help individuals and communities to resolve relationship issues.

For me, this workshop highlighted how important it is to understand personality disorders and not to diagnose or label clients but to allow ourselves to reflect on and understand their particular presentations. It was arranged as part of the Irish Gestalt Centre’s CPD provision and was the third in a series of workshops offered by eminent European theorists and practitioners.

As a group, we felt privileged to meet Margherita and were grateful to IGC for providing us with this opportunity. We gained great insight from Margherita’s teaching and the sharing of her lifelong passion to change suffering into beauty. We all left wanting more.

Jim FitzGibbon MIAHIP is a graduate of the Irish Gestalt Centre. He practises in Naas, Co. Kildare and Athlone, Co. Westmeath and has special interest in developing awareness of contact in the now and in working with personality disorders. Jim can be contacted through www.irishgestaltcentre. com (087 3397080) and www.personalcounselling.ie (087 7555680).

References:
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders. (5th ed.). Washington DC: Author.
Kernberg, O. (1984). Severe personality disorders. USA: Yale University Press.

Recommended Reading:
Robine, J. M. (2011). On the occasion of an other. USA: Gestalt Journal Press.
Perls, F., Hefferline, R.F. & Goodman, P. (1951). Excitement and growth in the human personality. UK: Souvenir Press.
Spagnuolo Lobb, M. (2014). The-now-for-next in psychotherapy: Gestalt therapy recounted in post-modern society. USA: Gestalt Journal Press.