The main theraputic approaches - Part 5 - Gestalt

Gestalt was developed in the late 1940s by Fritz Perls and is guided by the relational theory principle that every individual is a whole (mind, body and soul), and that they are best understood in relation to their current situation as he or she experiences it.  The approach focuses on self-awareness and the 'here and now' (what is happening from one moment to the next). Gestalt therapy recognises that sometimes this self-awareness can become blocked by negative thought patterns and behaviour that can leave people feeling low, unhappy and distressed. 

It is the aim of a gestalt therapist to promote a non-judgemental self-awareness that enables clients to develop a unique perspective on life. By helping an individual to become more aware of how they think, feel and act in the present moment, gestalt therapy provides insight into ways in which he or she can alleviate their current issues and distress in order to aspire to their maximum potential.

The key concepts in this approach are:

  • Person-centred awareness - Focusing on the future and imagining it separate from the present and past is considered essential. The process follows an individual's experience in a way that does not involve seeking out the unconscious, but staying with what is present and aware.
  • Respect - Clients, whether an individual, group or family, are treated with profound respect by a gestalt therapist. Providing a balance of support and challenge is key to helping those taking part to feel comfortable about opening up and acknowledging areas of resistance.
  • Emphasis on experience - The gestalt approach focuses on experience in terms of an individual's emotions, perceptions, behaviours, body sensations, ideas and memories. A therapist encourages the client to 'experience' in all of these ways, vividly in the here and now.
  • Creative experiment and discovery - There is a range of experimental methodology used by therapists to test their client's experience. These involve highly creative and flexible techniques to help them open up and acknowledge hidden feelings.
  • Social responsibility - The gestalt approach recognises that humans have a social responsibility for self and for others. It demands respect for all people and acknowledges that everyone is different. Ultimately it encourages individuals to adopt an egalitarian approach to social life.
  • Relationship - Relating is considered central to human experience and gestalt therapy considers individuals as 'whole' when they have a good relationship with themselves and others around them. The interpersonal relationship between the individual and therapist that is developed and nurtured in sessions is a key guiding process if therapy. 

Fundamentally, gestalt therapy works by teaching clients how to define what is truly being experienced rather than what is merely an interpretation of the events. Those undertaking gestalt therapy will explore all of their thoughts, feelings, behaviours, beliefs and values to develop awareness of how they present themselves and respond to events in their environment. This gives them the opportunity to identify choices, patterns of behaviour and obstacles that are impacting their health and well-being, and preventing them from reaching their full potential. 

The unfolding of this therapeutic process will typically involve a range of expressive techniques and creative experiments developed collaboratively between therapist and client. These will be appropriate for the client and their specific problems. Below are some of the most common methods used: 

Role-play 

Role-play can help individuals to experience different feelings and emotions and better understand how they present and organise themselves. 

The 'open chair' technique 

The open chair technique involves two chairs and role-play, and can give rise to emotional scenes. The client sits opposite an empty chair and must imagine someone (usually himself/herself or parts of him or her) in it. They then communicate with this imaginary being - asking questions and engaging with what they represent. Next, they must switch chairs so they are physically sitting in the once empty chair. The conversation continues, but the client has reversed roles - speaking on behalf of the imagined part of his or her problem. This technique aims to enable participants to locate a specific feeling or a side of their personalities they had 'disowned' or tried to ignore. This helps them to accept polarities and acknowledge that conflicts exist in everyone.  

Dialogue 

A gestalt therapist will need to engage the client in meaningful and authentic dialogue in order to guide them into a particular way of behaving or thinking. This may move beyond simple discussion to more creative forms of expression such as dancing, singing or laughing. 

Discussing dreams 

Dreams play an important role in gestalt therapy, as they can help individuals to understand spontaneous aspects of themselves. Fritz Perls frequently asked clients to relive his or her dreams by playing different objects and people in the dream. During this they would be asked questions like: "What are you aware of now?" to sharpen self-awareness. 

Attention to body language 

Throughout therapy, a gestalt therapist will concentrate on body language, which is considered a subtle indicator of intense emotions. When specific body language is noticed, the therapist may ask the client to exaggerate these movements or behaviours. This is thought to intensify the emotion attached to the behaviour and highlight an inner meaning. For example, a client may be showing signs of clenched fists or frowning, to which the therapist may ask something along the lines of: "What are you saying with this movement?"