Gestalt Counselling in Action

Petruska Clarkson, Simon Cavicchia

• Publisher: SAGE Publications Ltd
• Year: 2013
• ISBN:
  9781446293089
• Edition: 4
• Topic: Psychology
• Subtopic: Psychotherapy Counselling
• Index: Psychology

Simon Cavicchia has oriented Clarkson's seminal work of Gestalt Counselling in Action within a more contemporary context, adding voices of significant and divergent thinkers as counter-point and extensions of the author's work.
Michael Clemmens, Gestalt Institute of Cleveland, USA

This popular and well written book which is now in its 4 th edition provides an accessible and thorough introduction to the Gestalt approach.
Danny Porter, Manchester Gestalt Centre Now 24 years old with over 40, 000 copies sold worldwide, Petruska Clarkson's classic text is the definitive introduction to Gestalt therapy. This fourth edition, updated by Simon Cavicchia, covers the latest in Gestalt theory, research and practice. It includes:

• An extended case study running through the book to help you understand the process of therapy and the techniques used in each of the phases.
• Learning features and case examples translating theory into practice.
• New 'reflection sections' showing you the most recent developments in the field.
• New material on the relational turn and research.

As a student of Gestalt therapy, this is the one book you need to buy; it offers a uniquely practical and accessible approach to an often complex topic.

Petruska Clarkson was a professor and fellow of the British Association for Counselling and Fellow of the British Psychological Society. Petruska sadly passed away in 2006.

Simon Cavicchia is a primary tutor on the MSc in Gestalt Psychotherapy and Joint Programme Leader of the MSc in Coaching Psychology/MA in Psychological Coaching, both at Metanoia Institute, London.

1

Introduction to Gestalt

Definition of ‘Gestalt’

The German word Gestalt is not easily translated into a single English term. It embraces such a wide variety of concepts: the shape, the pattern, the whole form, the configuration. It connotes the structural entity which is both different from and much more than the sum of its parts.

The idea of the family provides a useful example. A family is made up of separate members, each with his or her individual psychology. One could analyse each of them without seeing the others, but the way in which the family operates as a systemic whole is uniquely more than, and different from, the sum total of the individual psychologies of the family members. At the same time, each family member’s inner experience and behaviour is informed by, and arises out of, the interacting dynamics of the family system.

The aim of the Gestalt approach is for a person to discover, explore and experience his or her own shape, pattern and wholeness. Analysis may be a part of the process, but the aim of Gestalt is the integration of all disparate parts. In this way people can let themselves become totally what they already are, and what they potentially can become. This fullness of experience can then be available to them both in the course of their life and in the experience of a single moment.

The Gestalt approach to counselling

The cognitive and experiential wholeness of every person, every moment, every event is similarly central to the Gestalt approach to counselling. Neuroscience has revealed that the two different hemispheres of the brain control different functions. These functions are not simplistically discrete but show a differential emphasis. In a right-handed person the left hemisphere is most often associated with logical thought, causal sequences and deductive reasoning. The right hemisphere is more often associated with the grasp of rhythms, spatial relationships and intuition (Ornstein, 1972). Gestalt is an approach which emphasises right-hemispheric, nonlinear thinking – not at the expense of other ways of knowing but as a complement to these. Thinking with the right side of the brain applies the kind of intuition which can, for example, lead aware people to sense the emotional climate of the family as-a-whole from the atmosphere in its living room. A very tidy room with bare walls and functional furniture creates a different Gestalt from a softly upholstered room with pictures, flowers and space to sprawl.

The Gestaltist’s approach is particularly characterised by the use of metaphor, fantasy and imagery, working with body posture and movement, enactment and visualisation, time distortion and the full expression of feelings involving the whole body in action.

In summary, most of the techniques and procedures used by Gestalt therapists appear to disrupt left lobe functions and to evoke right lobe perception and memories in order to allow past and present experiences to be more adequately symbolised and integrated. (Fagan, 1977: 67)

Fritz Perls was the colourful and iconoclastic originator of Gestalt therapy. He rebelled against the analytic approach of the time (which he saw as reductionist, deterministic and over-intellectualising) to re-establish a balance in psychiatry. Often he would make provocative overstatements such as ‘lose your mind and come to your senses’, and he ridiculed intellectualisation by calling it ‘bullshit’. People with outdated misconceptions of Gestalt sometimes still misunderstand such aphorisms to mean a complete replacement of the left-hemispheric intellectual functions. Modern Gestalt aims for an integration of body, feelings and intellect, seeing the person’s most basic needs within the context of the social environment.

Gestalt is also theoretically an integrative approach to counselling rooted in existential and humanistic orientations which combines psychoanalytic knowledge with procedural inventiveness through use of three primary devices – relationship, awareness and experiment.

For readers who want to understand the historical and philosophical roots of Gestalt before exploring its practical applications, here follows a broad explanation of the Gestalt approach and its theory in the context of the psychological movements of the twentieth century. Others may want to return to this chapter after reading the rest of the book, when the context may hold more meaning.

The Gestalt approach in context

The Gestalt approach originated in the existential-humanistic tradition of psychology. Practitioners sharing this viewpoint characteristically hold that it is impossible to engage in a counselling relationship without involving your values and your basic view of human nature. In this sense Gestalt is essentially a ‘third force’ humanistic psychology. It flowered in the 1950s and 1960s and grew to professional, theoretical and ethical maturity in the 1980s.

At one time the Gestalt approach had been cited as one of the most popular psychotherapeutic orientations in the United States (Polster and Polster, 1974). There are currently several hundred psychotherapists who primarily identify themselves as Gestalt therapists in Britain.

Gestalt therapy finds its roots in one of the three major streams of psychology which all originated around the turn of the twentieth century. Freud’s theory of psychoanalysis came to represent one major stream of psychological thinking and psychotherapy, with his first major work, The Interpretation of Dreams, being published in 1900. Freudian and Kleinian psychoanalytic thinking tends to view human beings as biologically determined and motivated primarily by sexual and aggressive drives. For Freud, the purpose of psychoanalysis is exploration and understanding or analysis, not necessarily change.

The second major stream derives its theoretical lineage from Pavlov (1928), the Russian psychophysiologist who studied conditioned reflexes and other learning behaviours. Theoreticians and practitioners following in his footsteps are usually referred to as learning theorists, behaviour modification specialists or, latterly, cognitive-behaviour therapists.

In 1968 Abraham Maslow coined the term ‘third force psychology’ to distinguish the third grouping which did not originate from either the Freudian or Pavlovian tradition. Gestalt belongs here. This humanistic/existential tradition has as its intellectual and ideological grandfather the originator of psychodrama, Jakob Moreno. Moreno was arguably the first psychiatrist to put ‘the patient’ in a centrally responsible role in his own life drama, and he worked to empower the patient to do his or her own healing. Moreno was applying group psychotherapy with children based on humanistic existential principles and writing about it by 1908 (Moreno, 1979).

Eric Berne, the founder of transactional analysis (which is also an existential/humanistic psychotherapy), wrote a favourable review of Gestalt Therapy Verbatim by Perls (1969b). He highlighted the connection between Gestalt and psychodrama when he wrote:

Dr. Perls is a learned man. He borrows from or encroaches upon pyschoanalysis, transactional analysis, and other systematic approaches. But he knows who he is and does not end up as an eclectic. In his selection of specific techniques, he shares with other ‘active’ psychotherapists the ‘Moreno’ problem: the fact that nearly all known ‘active’ techniques were first tried out by Dr. J. R. Moreno in psychodrama, so that it is difficult to come up with an original idea in this regard. (Berne, 1970: 163–4)

Fritz Perls himself identified Gestalt as one of three types of ‘existential therapy’ along with the Dasein therapy of Binswanger (1958) and the logotherapy of Frankl (1964/1969). However, Perls saw Gestalt as the only psychotherapy based purely on phenomenology – a psychological approach based on a philosophy which works away from concepts and towards pure awareness. In order to discover the meaning of an event, person or situation phenomenologists ‘describe’ experience, they do not interpret or prescribe it. Any judgement is perceived as clouding phenomenological perception and interfering with direct experience.

Many modern Gestalt theorists are of the opinion, even more than Perls realised, that Gestalt practice represents ‘the most complete body of combined theory-technique which implements the major tenets of existentialism as they have application in the psychiatric situation’ (Dublin, 1977: 134).

Historical roots in Gestalt psychology, field theory and psychoanalysis

Gestalt psychology

In 1926 Frederick (Fritz) Perls worked at the Institute for Brain-damaged Soldiers, founded by Dr Kurt Goldstein, an eminent neuropsychiatrist. Goldstein’s work was a major psychological influence on the young Perls. Goldstein (1939) placed great emphasis on the organismic integrity of individual behaviour and its drive towards self-actualisation no matter how damaged the organism may seem. Here Perls also became acquainted with the ideas of Gestalt psychology as articulated by Wertheimer (1944), Koffka (1935) and Köhler (1947/1970). Laura Perls, a Gestalt psychologist, was reputed to have been involved in his decision to change the name of his new therapy from ‘concentration therapy’ to ‘Gestalt therapy’. She later became Fritz’s wife and a leading exponent of Gestalt theory, practice and training in her own right. Throughout the major textbook Gestalt Therapy: Excitement and Growth in the Human Personality (Perls et al., 1951/1969) there are references to the concentrating self as being the core of the personality which seeks organismic self-actualisation.

The principles of Gestalt psychological theory were largely based on experiments in perception which emphasised the holistic, organismic and biological theory of human functioning and growth. Perls incorporated certain of these Gestalt psychology principles, such as the principle of figure and ground, the principle of closure, clear figure, the primary psychological need to create a meaningful personal construction out of the available field of impressions, and above all the human tendency to perceive wholes even where some of the information is missing in the system. ‘The gestalt movement did exert a lasting influence on psychology by wounding mortally the tendency to “atomistic”, building-block constructions, and by getting into the language of psychology the concept of “the organism-as-a-whole”’ (Perls et al., 1951/1969: 26).

In Gestalt theory the central human activity is viewed as people’s need to give meaning to their perceptions, their experience and their existence. The Gestalt approach is therefore concerned with defining the nature of human lives in terms of meaningful wholes, whether these be biological or spiritual. Most of Gestalt practice derived from Gestalt theory is based on an exploration of how such human needs arise, how they are frustrated, and how they are satisfied. The structure of this book is intended to reflect the process: it will elaborate identifiable phases of this process (Gestalt formation and destruction) in a characteristic cyclic pattern reflecting the possible developmental sequences in counselling.

One central Gestalt psychology paradigm for the emergence, identification, prioritising and satisfaction of needs is the relationship between ‘figure and ground’. This is the basic perceptual principle of making the wholes of human needs or experiences meaningful. This relationship is illustrated in Figure 1.1, which can be seen as either two faces or one vase, but both cannot be perceived at the same moment. When the one is figure, the other is background, and vice-versa. For any individual the ‘figure’ is usually that which is most relevant or meaningful to the person, that which draws his or her interest in a compelling manner. In the absence of basic satisfactions, biological hungers such as needs for food or stimulation may be compelling figures determining the person’s whole existential focus. For example, for a hungry Ethiopian, mere porridge would be a more complete and compelling figure than the aesthetic satisfaction which some privileged people may derive from ‘nouvelle cuisine’! However, basic needs, such as nutrition, can also be abrogated in service of higher needs; for example, traditional fasting over certain religious holidays.

FIGURE 1.1Figure and ground

‘Ground’ refers to the background of our figural experiences; for example, when I am paying attention to the letters on this page the music in the room is the ‘background’. Of course by choosing to pay attention to the music, that may become foreground for me at that moment. The Gestalt approach emphasises that good experience is predicated upon the perception of one clear figure after another. A clear figure may be, for example, the biological need for sleep or a social need for intimacy. A good figure is one which is clear, sharply distinguished from the background and of strong interest. The changing pattern of a person’s needs neither merge into one another, nor do they dominate the system once they have been met. When my need to sleep and rest has been met, I move forward with full energy and enthusiasm to my work. Having satiated my need for intellectual stimulation, I freely and completely engage with my friend in playful conversation.

Conceptually, the sequence of moments in the shift between figure and ground constitutes the so-called ‘cycle of experience’. This way of describing what happens dynamically in the alternation between figure and ground will be discussed in detail later. The process of a figure/ground shift may occur slowly over years of training, as for example the need to qualify as a medical doctor. It may also occur in a matter of seconds as in the sudden ‘aha’ experience when a client suddenly integrates a new insight, such as a fundamental similarity between what he needed from his mother and what he continues to need from his wife. Such an insight may completely alter the relationship between past and future, expectation and understanding, figure and ground.

The process of moving flexibly and creatively between figure and ground can be chronically or traumatically interrupted. Either rigidity (fixation) or lack of clear figure formation (fickleness) interferes with the natural completion of an adequate Gestalt. This results in a ‘fixed Gestalt’ or an ‘unfinished experience/situation’ which interferes with good contact with self, others, or the environment in the present. Then the unmet needs become incomplete Gestalten which demand attention and prevent the formation of new Gestalten.

Researchers in Gestalt psychology, such as Zeigarnik (1927) and Ovsiankina (1928), documented the psychological tension that accompanies experiences which are incomplete or unresolved and the human need to attempt to close these ‘unfinished situations’. According to researchers such as Whyte (1954) incomplete patterns (for example, crystalline faces) in nature are trying to become complete. The mathematical symbolism of patterns also displays a tendency of movement either towards completeness or disintegration. Most people are familiar with the kind of nagging discomfort associated with an uncompleted task such as a half-written letter or an undelivered retort.

There is an apocryphal story of a famous composer (sometimes Mozart, sometimes Beethoven) who tried but could not go to sleep because someone had played a concerto on the piano downstairs without completing the final chords. The composer could not rest until he had been downstairs and played the closing bars himself. Having thus ‘finished’ the incomplete auditory Gestalt, he had a peaceful night’s rest.

On a visual or perceptual level this tendency is demonstrated by our need to complete Figure 1.2 in a meaningful way. Counselling deals with such ‘unfinished business’ in people’s lives by removing the impositions, distortions or interruptions to the formation of vital, meaningful and fulfilling figure-ground experiences in everyday life. Of course, all of us can tolerate a certain level of unfinished business, but when these interruptions become chronic or overwhelming, temporary or permanent disability may result. This is the field of the Gestalt practitioner’s endeavour.

FIGURE 1.2An incomplete Gestalt

Unresolved childhood situations are often experienced as ‘unfinished situations’ or ‘incompletely formed Gestalten’. These unfinished situations continue to disturb the person in adult life. They tend to interfere with behaviours, perceptions and thinking related to effective functioning in the here-a...