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Gestalt therapy: An exploration of its relevance today 

by Debbie Hegarty  

The journey of aliveness, engagement in the world, risk-taking and connectedness is the grandest journey of all.

(Cole & Reese, 2018: 165)

An attempt will be made in this paper to explore the relevance of Gestalt therapy and practice today. It has been almost 70 years since the first Gestalt therapy publication entitled Gestalt Therapy: Excitement and Growth in the Human Personality (Perls et al., 1951). Co-authors, Frederick (Fritz) Perls, Ralph Hefferline and Paul Goodman, introduced a holistic psychotherapy of personality development and change, as well as a method of practice. Authors were influenced by existing ideas from across many therapeutic modalities and related disciplines including classic Gestalt psychology, social psychology, existentialism, psychodrama, and Eastern European philosophy (Woldt and Toman, 2005). In the late 1940s and 1950s Fritz Perls and his wife Laura Perls, both psychoanalytically trained, developed the theories and techniques of Gestalt therapy. While Perls (1992) acknowledged the influence that Freud and psychoanalysis played in formulating Gestalt therapy, there was an intentional movement away from the more traditional theories and practices of psychoanalysis that asked therapists to assist in working through transference reactions using a “blank screen” (Goldstein, 2000: 168). Instead, Gestalt psychotherapists were encouraged to engage fully and authentically in the moment-by-moment encounter with the client. 

The aim of Gestalt therapy is not to change the client as such (I return to this later) but to assist in fostering awareness: “the promotion and encouragement of full and free-flowing awareness is the cornerstone of Gestalt practice” (Joyce and Sills, 2001: 27). Awareness is an ongoing process and to this end Gestalt therapists employ a range of techniques, namely the empty chair and topdog-underdog experiments, that are tailored towards each client’s unique needs. Increasingly, with enhanced awareness, the client begins to integrate previously disowned self-experiences and develops “a different sense of self that is at once more flexible, less brittle, more human, and less perfectionistic than the old sense of self” (Cole and Reese, 2013: 206). With awareness comes choice, personal responsibility, self-efficacy, self-regulation, self-appreciation and self-acceptance. Integration, “owning our many selves, even the selves that we disapprove of” (Cole and Reese, 2013: 205), may seem like a lofty objective but Gestalt psychotherapists understand that the relationship that we have with ourselves is crucial to wellbeing. In my experience awareness begets integration.

An ongoing task for the Gestalt psychotherapist in nurturing awareness is dialogue. The foundation that dialogue relies on is phenomenology which asserts that human beings are searching for meaning in all of their encounters. Buber (1958) conceptualised dialogue and this notion will be explored later in the paper. For now, I can declare with some conviction that it is a compelling and potent form of enquiry that seeks to understand what happens when my phenomenology meets your phenomenology and at least one of us employs the characteristics of dialogue: namely directness, inclusion, presence and mutuality. Gestalt psychotherapists are encouraged to respectfully confront discrepancies between what is being said explicitly and what is detected implicitly in the field. The imperative is more direct, “confident and even daring” (Polster and Polster, 1973: 70) communication. 
The Gestalt psychotherapist seeks to be much more than a mere witness or bystander, “it is the antithesis of playing a role or trying to give a certain impression” (Joyce and Sills, 2001: 45). Parlett (1991: 80) advocates that “the way we are and the way we live cannot be separated from our work”. The ‘we’ Parlett refers to here is the therapist and he recommends that the Gestalt therapist is engaged in every aspect of the encounter with the client in an honest and sincere way, “all aspects of the total situation are open as it were to scrutiny and experiment” (1991: 79). Finally, in Gestalt therapy the content of the client’s story is only potent in as much as it can be a vehicle to get to the client’s process. Thus, Gestalt therapy becomes less about problem solving and symptom reduction and more about facilitating awareness and therein change.

Background
The poison which destroys the weaker nature strengthens the stronger - and he does not call it poison either.

(Nietzsche, 1956: 101)

For as long as I can remember I have been fascinated by what happens when two or more worlds collide. I was intrigued from an early age by the way my parents responded to each other, to others including myself, and their environment. When speaking of the environment the Gestalt psychotherapist is referring to “other people, to the physical, natural, and social environments within which we individuals exist” (Cole and Reese, 2013: 188). I noticed that the environment was a significant factor in what happened next. I also observed that an individual’s perception of reality is subjective and unique to them. As a student psychotherapist I assimilated the underlying philosophies and concepts of Gestalt seamlessly because they spoke to me in a way that supported my existing, albeit somewhat clumsy formulations, about the individual in their world. The puzzle for me in my ongoing journey of learning, unlearning, relearning and owning disowned selves is: will I ever know myself fully? Getting to know and accept myself has not been easy and as I write I recall the brute force of my resistances (which sooner or later always became ‘aha’ moments). What keeps me interested is discovering that in the long run awareness transforms me.

What prompted this paper was my personal musing regarding the relevance of Gestalt theories and practices to trainees’ experiential learning and client work practice. As a trainer in an institute that includes Gestalt therapy as part of an overall approach to teaching humanistic and integrative values and skills to student psychotherapists, I am struck by the increasing number of theoretical models and frameworks that students can choose to assimilate into their favoured humanistic integrative approach to client work. These include person-centred, transactional analysis, relational psychotherapy, existentialism, pluralism and sensorimotor, to name but a few. Can Gestalt theories and practices remain current and applicable in a 21st century psychotherapist’s toolbox? My intention in this paper is to start a discourse rather than reach a conclusion. I have no desire to influence readers. Instead, I wish to present Gestalt concepts as I understand them and let the reader come to their own decision on whether Gestalt therapy is relevant today. I will now proceed by briefly summarising some of the key Gestalt concepts of self, awareness, contact, field theory, figure and ground and the paradoxical theory of change. Throughout this paper you will note that the term self is italicised except when it is used in a direct quote. I made this conscious choice so as to honour the term in all its glory: “we seek the development of a sense of self, a sense that is formed in relationship, a self that can continue to flow and grow even when life’s most painful issues, conflicts, and challenges feel overwhelming” (Cole and Reese, 2013: 205).

Self
For modern man, the issue boils down to the difference between, and often the incompatibility of, self-actualization and self-concept or self-image actualization.

(Perls, 1992: 4)


Perls (1992) uses the analogy of an onion when describing the journey to the self in therapy and states that as we penetrate one layer and peel it off, another layer emerges. Gestalt therapy proposes that the self occurs at the contact boundary where it meets the environment and is a fluid, active, developing process, “if the self and the total experience of the organism are relatively congruent, then the actualizing tendency remains relatively unified” (Rogers, 1959: 197). According to Spagnuolo Lobb (2005: 31) “the self is defined by the process of contact and withdrawal from contact, in which
the self is drawn to the contact boundary with the environment and, after the fullness of the encounter, withdraws.”
Satisfaction is only achieved when the organism contacts its environment “spontaneously, deliberately and creatively” (Spagnuolo Lobb, 2005: 27). Sounds easy, yet few master it.

Our self includes the idea we have about ourselves, as well as our assessment of other people’s attitude towards us. As a trainer and group facilitator, a phenomenon I have witnessed in group process is that the weaker the self, the more preoccupied we are with other people’s opinion of us. Carl Rogers (1951, 1959 and 1970) observed that there is often an incongruity between the perception a person has of themselves (their self-concept or self-image) and how others experience them which causes stress interpersonally. In addition, there can also be an incongruity between the self and the self-concept which causes stress intrapersonally. The self-concept develops in early childhood as a response to the environment. Over time, because of repeated social experiences, this self-concept becomes entrenched in a person’s view of themselves and ends up being an unconscious projection onto the environment. Human beings are innately social and the developing child’s need for affection, approval and recognition can often override their need for autonomy and individuation. Preverbal children sense the implicit, unexpressed communications in attachment relationships and limit any spontaneous self-expression which they perceive might potentially lead to interpersonal tension. With this process in mind, a desired task for the Gestalt psychotherapist and their client is to narrow the stress gap between the self and the self-concept by co-creating an environment where mutual spontaneity and “true self” (Yontef, 1993: 222) expression become the norm “resulting in the lively and demanding tapestry of figural creation and completion (and frequent incompletion)” (Spagnuolo Lobb, 2005: 227).

Awareness

If the interaction at the contact boundary is relatively simple, there is little awareness, reflection, motor adjustment and deliberateness; but where it is difficult and complicated, there is heightened consciousness.

(Perls et al., 1951: 259)

The road to enhanced awareness is not easy and asks us to take the road less travelled in our encounters with others. “The unaware life is a mechanical life. It’s not human, it’s programmed, conditioned” (De Mello, 1990: 67). According to Husserl (1964, 1977) there can be no accuracy in perception without self-awareness. As Bloom (2019: 24) states, “to be aware is to be awake to immediate possibilities.” Awareness permits personal choice, spontaneity, creativity and sophisticated self-expression. Gestalt therapists understand that heightened awareness also includes “relational awareness” (Joyce and Sills, 2001: 33) and take measured risks with their clients by noticing, and giving feedback on, how the client forms, interrupts or completes their moment-to-moment contact in the here-and-now of the therapeutic relationship.

Psychotherapists come to know that we can only take the client as far in their process as we have dared to journey ourselves. The Gestalt therapist, having developed sufficient awareness, understands that awareness is not possible without taking the courage to confront discrepancies between what the client is saying and what they are communicating non-verbally. Confronting a client’s idealised self-concept is challenging and risky and is certainly not therapeutic unless it is done respectfully and after trust has been established and the ground under the relationship is solid enough to withstand a potential  rupture. Ultimately the style of relating that gives permission to confrontation and constructive feedback takes the relationship to a deeper level and to where interpersonal and intrapersonal. tension (not stress) exists, and transformation is possible. To a fly on the wall, psychotherapist and client appear to be out of their respective comfort zones, with accompanying flushed faces and dilated pupils, but both are most definitely alive and in full contact. There is a conscious movement away from the superficial sharing of content or story to a more phenomenological enquiry into process. In my view, this is the only realm where the work of therapy is truly possible. 

Field theory

There is no field per se that is perceived by one and all.

(Mann, 2010: 111)

Kurt Lewin (1951), a social psychologist, states that various influences act together to produce a unique outcome in a particular situation at a particular time, and as Mann (2010: 111) states, “behaviour is a function of the person and the environment together.” Lewin (1935: 79) saw behaviour as being “embedded in a context which intrinsically includes the person, with all their characteristics and perceptions, and the psychological field with all its forces and influences.” According to Perls (1992) the person, or organism, in Gestalt theory includes the biological self, the social self or self-concept, the life experiences, the immediate environment (the field), their unique perceptions, sensations, feelings, thoughts, ideas, attitudes, assumptions, values, what is within conscious awareness and what is out of awareness. When two or more people meet, their individual fields collide. The field comprises that which is explicitly communicated, as well that which is implicitly withheld, yet intrinsically detectable and nonverbally communicated. Gestalt therapists pay close attention to this fluid, ever changing field and understand that everything in the field has significance. 

Parlett (1991) recommends that if we are to make sense of the field in Gestalt therapy, instead of doing a sub system analysis, we look instead at the whole interdependent, interactive complex interweave of external social influences and internal processes as they impact each other. Field theory asserts that even a seemingly inconsequential unit within the whole environment holds meaning but cannot be understood without paying attention to the context within which it exists (Parlett, 2005).

Figure and ground

If one’s background contains kindness, it is easier for a soft word or an expression of sympathy to emerge as figure than if a background is coloured by sadism.

(Polster and Polster, 1973: 32)

The figure is whatever we are paying attention to at any given moment in time, while the ground is whatever is happening in the (back)ground. In healthy systems the organism can freely and deliberately navigate between what becomes figural as it emerges from a ground that is flexible and evolving. When the Gestalt is fixed, our attention is preoccupied with one ground and consequently any emerging figure that is detrimental to the ground will be distorted or neutralised. 

An example of this phenomenon is an adult learner trying to complete an assignment so that she can submit it on or before the deadline and instead of moving freely between the completion of the essay and other immediate emergent needs, she gets fixated on an unrelated task which causes her to sabotage her attempts to reach her full potential. The ground in this case is a rigid belief that she is lazy and stupid, and the successful completion of an essay will potentially diminish this belief. “The job of psychotherapy is to alter the individual’s sense of his background so that such new experiences may be harmonious with his nature” (Polster and Polster, 1973: 32). 

What interests both psychotherapist and client in any given encounter depends largely on their individual and unique developmental history, their degree of awareness, the nature of their defences, and their current resources. “We take in certain things and bypass others” (Parlett, 1991: 5) but what is “most relevant or pressing is readily discoverable in the present” (Parlett, 1991: 6). 

Contact

When the figure is dull, confused, graceless, lacking in energy (known as a weak gestalt), we may be sure that there is a lack of contact, something in the environment is blocked out, some vital organic need is not being expressed: the person is not all there, that is, his whole field cannot lend its urgency and resources to the completion of the figure.

(Perls et al., 1951: 232)

According to Zinker (1977) the process of making satisfying contact at the boundary between ourselves and our environment involves the seven stages beginning with sensation through to withdrawal. Polster and Polster (1973) assert that contact is only possible when all seven stages of the cycle of experience are negotiated without resistance. In Gestalt therapy “any symptom or behaviour usually defined as pathological is a creative adjustment of the person in a difficult situation” (Spagnuolo Lobb, 2005: 33). One of the basic assumptions in Gestalt theory is that we can “learn to deal with what we are experiencing, if we can learn to deal with how we are experiencing and how we interfere with our experience” (Woldt and Toman, 2005: xx).


Figure 1: The Gestalt Cycle of Experience (Created by Simon Stafford-Townsend, 2018).

Any interaction between an organism and their environment is called contact. Contact is a fluid, dynamic and embodied process that includes physiology, perception, thoughts, feelings and sensations. When we make contact closure is possible, there is no unfinished business and the process of letting go freely follows. Letting go creates a “fertile void” (Frambach, 2003: 101) in which we are ready to fully engage in the next unit of contact without prejudice, predetermination or contamination from a previous incomplete contact. It is important to consider that instinctually and unconsciously we seek to complete contact even if it means filling in the gaps that occur when contact is resisted. A full cycle of contact is not time boundaried. Contact can be achieved in a millisecond, a second, a minute, an hour, a year, or a lifetime. The stages appear sequential in the above diagram of the cycle of experience but in process they can often occur simultaneously. 

In my view, Martin Buber’s (1923/1958) concept of I-Thou relating, which is understood as relating that is mutual, respectful and direct, is applicable in supporting our understanding of the somewhat puzzling concept of contact. The polarity to I-Thou is I-It relating, where the other becomes “an It, for some I, an object of perception and experience without real connection” (1923/1958: 29). I-Thou relating asks us for a willingness to engage with presence, empathic attunement, compassion and truthfulness. Contact using an I-Thou attitude is a flow of awareness between me and you that is spontaneous, creative, mutually dependent, attending, adjusting and sincere. 

A task for the Gestalt psychotherapist is to determine with the client how contact is interrupted. As mentioned above, during early childhood development where independent, spontaneous and autonomous expression causes intrapersonal and interpersonal tension, the developing child creatively adjusts their responses and develops an incongruity between the self and the self-concept. Tragically, the adapted child becomes an adult who continues to believe that they are not free to express themselves without restrictions. They become practised at distorting their reality to fit their projected expectations and employ outdated strategies to their present day relating even when the environment does not ask for it. Deliberate and direct contact is avoided in favour of a more coercive, manipulative and indirect style of communication. Incongruent and indirect relational styles delay and/or block satisfactory contact and in Gestalt terminology this is referred to as a fixed Gestalt. Desensitisation, deflection, introjection, projection, retroflection, egotism and confluence are fixed Gestalts and all block satisfying contact. The Gestalt psychotherapist pays attention to incongruity between what is explicitly communicated and what is being expressed nonverbally. Nonverbal communication is observable in voice tones, gestures, postures, facial expression and physiological expressions such as changes in breathing, muscle tension, pulse rate, pupil dilation, degree of sweating and so on. See Figure 2 below for a brief description of each of the seven ways to block contact. Be curious about the one or more mechanisms that you consciously, or unconsciously, employ that result in a block to contact. Wonder about the relationships you have had, or now have, where some of these strategies have been or are, deemed necessary. It is information when the self has to go into exile in order to connect with someone. 

 Contact DescriptionBlocks to contact Description
SensationSensing requires awareness but is concentrated in our physiological bodies only. A figure emerges from a fertile ground during the sensation phase. We sense something that disturbs our space, but we have not yet articulated it. DesensitisationSensations are produced as a result of a stimulus in the environments but are numbed out. Can include dissociation. 
AwarenessAwareness of feelings, perceptions and thoughts develop as we begin to articulate the need in the here and now.
Deflection The feelings, perceptions and thoughts that accompany the sensation are consciously or unconsciously deflected and avoided. If asked ‘how are you?’ the preferred response is ‘fine, good’. The answer will appear incongruent with what is being communicated nonverbally.
Mobilisation (of energy)  Emerging energy is mobilised, and we are prompted to plan, decide, prepare and prioritise with a view to satisfying the particular need. IntrojectionSwallowing whole. Introjection is fully assimilating and absorbing all that is outside of the self without discretion. It requires passivity and a willingness to surrender our autonomy and identity.
Action
Once a decision is made on how best to satisfy the need energy is released and action follows.  
ProjectionDisowned, disallowed self-experiences are attributed onto others.
ContactFinal contact is made in a direct manner. During contact that which is outside of the self is digested without swallowing it whole (integration). 
RetroflectionRetroflection is when we do to ourselves that which we want to do to someone else. It is a safe bet socially because hurt, anger, aggression and rage are difficult and challenging to express directly. Depression, guilt and shame often accompany this defence mechanism. 
Satisfaction
Satisfaction and transformation are achieved through the process of integration. The need is fully realised without conciliation. 
EgotismSelf-absorbed. Not interested in others except to use them for self-gain. Looking at others without listening. Listening only for what is relevant to the self-concept.
 Withdrawal
A letting go and withdrawal process follows, and we return to the fertile ground ready for the next contact.ConfluenceConfluence is the opposite of contact and describes an inability to distinguish interpersonal boundaries. Merging without withdrawing. Blending and swallowing whole the values, opinions and attitudes of others.  

Figure 2: Contact and Blocks to Contact Descriptors (Created by Debbie Hegarty, 2020)


Paradoxical theory of change

Leave this to the human—to try to be something he is not—to have ideals that cannot be reached, to be cursed with perfectionism so as to be safe from criticism, and to open the road to unending mental torture.

(Perls, 1992: 6)

It is stressful trying to be somebody you are not. Suppressing spontaneous feelings and utterances takes tremendous energy. Perls (1992: 6) delves into the absurdity of human beings pretending to be something they are not, as he states “no eagle will want to be an elephant, no elephant to be an eagle. They accept themselves; they accept them-selves.” At the core of Gestalt theory is the Paradoxical Theory of Change where it is asserted that change occurs when we accept who we are, rather than continually trying to be what we are not,

Change does not take place by trying coercion, or persuasion, or by insight, interpretation, or any other such means, change can occur when we abandon, at least for the moment, what he [or she] would like to become and attempts to be what he [or she] is.

(Beisser, 1970: 77)

Discussion
The only change which we want to effect in the exercise of psychotherapy is the ability to be able to change…we want the patient to have his senses back, his feelings, and his muscle. We want him to have all of himself available once again, so that he can advance and retreat by his choice alone…the work of becoming is the work of being alive.

(Corlis and Rabe, 1969: 120-121)

As I assured you earlier in this paper, my aim is not to draw conclusions as to whether Gestalt theory is relevant today. My musings are such that I am satisfied once I have had the chance to explore them and share them with you. I am satisfied that I did so without needing to use outdated mechanisms such as desensitisation, deflection, introjection, projection, retroflection, egotism and/or confluence. My musings began with a sensation and an awareness, a niggling idea, if you will, to pose a question to others in the field of psychotherapy. I mobilised myself, acted (I contacted the Editorial Board of Inside Out) and managed to achieve satisfaction (albeit overtime with drafts being emailed back and forth, adding, taking out and editing). I am now ready to withdraw.

I will finish with the following reflections. In my view the hallmark of a healthy person is their willingness to be in contact with their environment without compromising too much of the self. An aspiration might be that the self is fully intact at the natural end of every encounter. And yet it has been my experience that little can be achieved interpersonally until the ground under the relationship has sufficient trust and safety established and that sometimes requires compromise. Not the kind of compromise that has one losing a sense of who they are but a conciliation, nonetheless. An outcome, potentially, when at least one party aims to communicate directly, honestly, with spontaneity and creativity, is delightful, energetic contact. Two worlds collide and only those in the immediate field can truly determine when the time has arrived to confront inconsistencies in contact. If you are truly committed to being your self (in as much as your awareness levels allow) it is possible to stay truthfully compassionate while both of you begin to make sense of the unique adjustments that play out until such time as they are not needed anymore. I often find myself puzzling as I try to invite the self out of exile, ‘who is driving the bus today’? Which protective strategy has pushed the self out of the driver’s seat and demoted it to the back seat? I am empathic as my client and I duck and dive using various negative cycles of contact. At times I lose empathy and confront the self-concept too early. I know that I have to withdraw, wounded and sore but determined, and concede to the power of the game of delusion that is deemed necessary in the name of self-concept preservation and self- protection. But I am empathic because I can recall the many years that I needed to strategise, outside of awareness, to get my needs met. Awareness set me free. Free to choose if the environment has earned the right to see my deeper feelings of love, hate, desire and fear of abandonment or rejection. There are, of course, challenges involved in opening up to others, such as the danger of degradation, duplicity, harmful rivalry and seduction. 

As I come to the end of this paper, I am wondering whether I have explored the Gestalt theories and practices I chose to outline sufficiently and given them the respect they so rightfully deserve, given the fact that without awareness I might have been destined to continue to live a life filled with superficial contact with my environment. As I close, I find my heart beating, my cheeks flushing and my eyes dilating. I am me. You can be you.




Debbie Hegarty (MIAHIP, SIAHIP) is a psychotherapist, supervisor and trainer and has been in private practice for 15 years. She is a former member of An Garda Síochána. She began her studies with a degree in social sciences, initially working in adult mental health. She also provided short-term psychotherapy for the NCS. She has a particular interest in Gestalt therapy and relational psychotherapy and has specialized training in working with trauma, PTSD and dissociation. Debbie has a longstanding association with IAHIP having spent time on both the Governing Body and on the Editorial Board of Inside Out. She is currently an IACP Core Trainer and Module Leader on the IACP accredited, validated by Coventry University, BSc (Hons.) Counselling and Psychotherapy (Cork Counselling Services Training Institute).  


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