The Relational Heart of Gestalt Therapy

Contemporary Perspectives

Peter Cole

• Publisher: Routledge
• Year: 2022
• Print ISBN: 9781032186917
• eBook ISBN: 9781000589115
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

This compelling and comprehensive volume is an anthology of current thinking by many of gestalt therapy's leading theoreticians, clinicians, and researchers.

Including many well-known voices in the field and introducing several new ones to the current gestalt therapy literature, the book presents a broad-ranging compendium of essays, scientific articles, clinical applications, and integrative approaches that represent the richness and vibrancy of the field. Each contributor brings intellectual rigor, honest personal reflection, and humanism to their area of inquiry. This ethos—the spirit of relational gestalt therapy—infuses the whole book, bringing a sense of coherence to its seventeen chapters. Following an introduction written by Mark Winitsky, PhD, as an entry point into the field for students and psychotherapists from other schools of thought, the book is organized into three sections: Theory, Clinical Applications, and Integrative Approaches. Readers will encounter new ways of thinking about psychotherapy, new skills they can bring to their work, and new ways of integrating gestalt therapy with other approaches.

The Relational Heart of Gestalt Therapy is essential reading for Gestalt therapists as well as other mental health professionals with an interest in Gestalt approaches.

Section I Relational Gestalt Therapy Theory

Chapter 1 Aesthetic Relational Knowledge and the Dance of Reciprocity in the Therapeutic Field: Post-pandemic Gestalt Therapy in Practice¹

Margherita Spagnuolo Lobb²

DOI: 10.4324/9781003255772-3

Introduction

This chapter aims to focus on the contemporary relational trend of Gestalt therapy clinical practice. This turn was necessary in our approach around the 80s when clinical needs and social trends changed significantly (Spagnuolo Lobb, 2013). Before that time, all Gestalt therapy methods aimed to support individual power. If a client said: “I feel unable to bring my needs forward: when my boss imposes on me to do something, I’d like to tell him that I see the situation differently, but I stay silent….” The therapist might have replied: “What do you feel in your body while you say that?” “I feel some tension in my legs” “Stay with that tension, breathe, and see where it brings you.” The work would have continued with perhaps kicking a pillow and visualising the boss (or the father), until the client experienced a sense of power and a wider sense of self.

Today the scenario has changed. Clients present different problems, which, in turn, call forth different interventions. An example might be: “I feel worried that I will get sick. The doctor says I am fine, but I have a terrible feeling that I will die….” The therapist wants to know more about the “Ground” experience of this client, rather than exploring the figural meanings of his worry and asks: “I see. How do you spend your typical day?” “I wake up early, go to work, it takes one hour and a half to get there. I come back home at 6.30 in the afternoon, I cook something, sometimes I grab a pizza in a place on the way, I go online for a while, chat stupid things with some ‘friend’… watch some TV… go to sleep.” “How do you feel in telling me all this?” “It's strange to speak to someone who listens to you.” “Yes, strange! I’ve noticed that you don’t breathe with full lungs, and don’t pause or look at me. What you said touches me: ‘solitude’ is the word that comes to mind. I’d like you to experience being-with me here. Can you breathe fully and look at me while you breath?” The work might continue without much overt intervention but with a feeling of intimacy and a solid feeling ground between therapist and client. This intervention is based on relational aspects (“tell me”… “I feel touched..”) rather than on the development of personal awareness of the client. Generally speaking, traumatic experiences are more widespread today than in years past (Taylor, 2014; Rubino & Spagnuolo Lobb, 2014), and we have integrated new findings from the neurosciences and the relational perspectives of intersubjective approaches to find a hermeneutic way of developing our method.

Next, I will describe in greater detail new clinical tools that have emerged to address both the new needs of society and new manifestations of human suffering that we encounter with today's clients.

The Emergence of Serious Disturbances and the Relational Turn in Gestalt Therapy

Around the 1980s, Gestalt therapy techniques seemed naïve or even inappropriate to cure the new disturbances. In the face of clients suffering from addictions, personality disturbances or even psychoses, it was ineffective to “talk” with the drug, dialogue with ambivalent parts of the client's self or support creativity in speaking psychotically. Some institutes started to further develop the original theory of Gestalt therapy by studying two theoretical aspects that had been considered out of step with placing a primary value on the “Here and Now.” These aspects were the study of child development and psychopathology. Such efforts hermeneutically brought forth a deeper discovery and development of the core relational spirit of the founding book (Perls et al., 1951/1994). Additionally, the concepts of Contact Boundary and Organism/Environment field became more focused. The further development of these two aspects provided theory and methodology for contemporary Gestalt therapists in treating the serious disturbances our clients are coping with in modern society.³

The study of human development in terms of phenomenological experience (Clemmens, 2012; Spagnuolo Lobb, 2012) and bodily movements (see Frank, 2001, 2016) allowed Gestalt therapists to consider human development as a “Ground” experience of the nowhere and now (Wheeler, 2000), so that to know more about the ground provides support in understanding the figure. Psychopathology is described as the creative adjustment to difficult situations (Perls et al., 1994, p. 6 ff.),⁴ and it is connected with social conditions (Perls et al., 1994, p. 7 ff.; Spagnuolo Lobb, 2013, pp. 29–33; 2016a). The vitality implied in this definition guarantees that the therapeutic intervention aims to recognise the “beauty” of the client's adaptation, supporting the vital intentionality that is in each relational disturbance. Psychopathology manifests itself along a continuum of anxious/desensitised experiences (Spagnuolo Lobb, 2016b): from a desensitisation of the contact boundary (lack of awareness) that doesn’t allow the person to perceive clearly the situation and herself, to a fixation of the figure that doesn't flow back to the ground experience to be assimilated (as in the case of traumatic experiences, see Taylor, 2014; Kepner, 2003; Bosco, 2014; Militello & Malacrea, 2011).

These developments have been supported by the spread of other studies, especially in the fields of neurosciences (Rizzolatti et al., 1996; Panksepp, 1998; Porges, 2009; Damasio, 2010; van der Kolk, 2014; and others) and intersubjective and relational psychoanalysis (Stern et al., 1998, 2003; Beebe & Lachman, 2001; Tronick, 1989; Orange et al., 1997; Mitchell, 2000) which, in the same decades, have discovered and described important relational aspects of human experience.

These researchers have been good allies in the further development of the relational approach contained within Perls, Hefferline & Goodman (PHG). This phenomenological, aesthetic and field-oriented⁵ model provides new understanding in the treatment of current presentations of suffering Gestalt therapists encounter in post-modern society (Spagnuolo Lobb, 2013c).

From all these movements, inside and outside Gestalt therapy, the relational approach emerged as a way to include a better methodology for the treatment of serious disturbances and to address the societal need to increase interpersonal connectedness (Yontef, 1993; Jacobs & Hychner, 2009; Philippson, 2001; Wheeler, 2000). The concepts of contact boundary and organism/environment field became the core principles of the relational approach, and the contribution of the therapist to the experience of the client in the here and now became a tool to work with the field instead of with the individual (Spagnuolo Lobb, 2018a; Macaluso, 2020). As a matter of fact, the feeling of being seen by the other creates in the client (as well as in our lives outside of the consulting room) the feeling of existing for someone. It is here where the unified sense of self is born.

The dilemma which arose inside Gestalt therapy – which was partly created by contradictions inside the founding book itself – was between relational therapeutic praxis and an intrapsychic approach (Wheeler, 2000; Wollants, 2012). In a first moment, they were considered to be different styles of working (cfr. Stemberger, 2018). For instance, when the client says “I feel angry at my mother,” one therapist could ask to imagine the mother sitting on the empty chair and tell “her” his anger, another therapist could ask “what do you feel in your body when you tell me that you feel angry to your mother?” These two ways of working actually differentiated the styles of Fritz Perls – who used to demonstrate his approach to neurotics in workshops – and his wife Laura Posner – who worked clinically with “real” patients and put much more effort in support, relationship and ground.

Considering the contemporary literature of Gestalt therapy, Macaluso (2020) describes three ways of practicing Gestalt therapy: one is focused on the client, a second is focused on the way the client makes contact with the therapist and a third is focused on the phenomenological field, which expresses the contribution of both therapist and patient to the therapeutic change. Philippson (2017) describes in a similar way three levels of Gestalt therapy training. Even if it is possible to use all of these ways, the above-mentioned differences have become separate currents inside Gestalt therapy: basically, individualistic models and relational models. With his book Gestalt Therapy: Therapy of the Situation, Georges Wollants (2012) has tried to solve the inner contradictions inside the founding text Gestalt Therapy, drawing from the phenomenological and Gestalt theoretical concept of situation, which provides a stronger theoretical basis for our relational soul. He states that person and environment are inseparable and parts of the same whole. In our clinical work, we approach not the person of the client but the dynamic between the person and her phenomenological world. Wollants states that we should identify with the relational, situational and contextual perspective described in the first part of the founding book. I fully agree with his definition and I hope that we will be more and more able to develop our very special and unique relational glance, which is procedural, oriented to the concept of the situation (the therapeutic situation), and includes the experience of the therapist as part of it.

Today the “relational” approaches are many, both in the field of clinics and organisations. They are committed to research, both quantitative and qualitative, in particular phenomenological research (see Churchill, 2018; Brownell, 2019; Roubal, 2016; Schulthess et al., 2016; Fogarty et al., 2016; Herrera Salinas et al., 2019). They draw from different psychological and philosophical currents. This development is still in progress. I suggest reading Brownell (2018) for his attempt at describing relational Gestalt approaches applicable to both Gestalt psychotherapy and coaching.

What I have learned from my masters, Isadore From, Erving and Miriam Polster, and from many dialogues with colleagues such as Gary Yontef (1993), Gordon Wheeler (2000), Lynne Jacobs (Jacobs & Hychner, 2009), Ruella Frank (2001, 2016), Jean Marie Robine (2001, 2015), Dan Bloom (2003, 2011), Philip Lichtenberg (1990), Malcolm Parlett (2015), Peter Cole (2018), Peter Philippson (2001, 2017), Michael Clemmens (2019), and others, has inspired me to develop the relational stance into the paradigm of reciprocity, which integrates the focus on aesthetic knowledge (Aesthetic Relational Knowledge; Spagnuolo Lobb, 2018a) and intentionality of contact (the now for next, Spagnuolo Lobb, 2013) with the attention to the ground experience (Polyphonic Development of Domains; Spagnuolo Lobb, 2012) and to the “dance” of reciprocity – the reciprocal intentional movements – between therapist and client (Spagnuolo Lobb, 2019, 2018a, 2017a, 2017b).

A Contextual Method, the Field and the Aesthetics of Contact

Clinical work is seen by Gestalt therapists in contextual and situational terms⁶: it is not only the client who is unable to reach the therapist with spontaneity but it is also the therapist herself who feels unable to reach the client. Here and now the therapist, with her aesthetic⁷ tools, experiences a lack of spontaneity at the contact boundary. The therapist considers herself as involved and part of the same situation (or field) of the client in the therapeutic setting.

The client's suffering is a way of being at the contact boundary, and affects both the client and the therapist. It's a mismatch in the dance, a loss of spontaneity in the reciprocity. It is based on the concept of co-creation of contact boundary between therapist and client in the here and now of the session, with specific limits of two persons in a given time and space. The therapeutic meeting, their contacting, generates an experiential field. The presence of the client is experienced by the therapist who is trained to perceive his/her aesthetic resonance. This is considered in relational Gestalt therapy as the primary diagnostic tool (Spagnuolo Lobb, 2018a; Roubal et al., 2013, p. 87). Diagnosis is a process of “knowing-through” (dia-gnosis) the experience of the patient. The Gestalt therapist uses her own senses, alongside her psychological and personal knowledge, to know-through the patient's suffering. An interesting aspect of the contextualised concept of therapeutic intervention is that it explains positively how the diagnosis is influenced by the therapist.⁸ What emerges indeed between therapist and client is the co-creation of a r...

Table of contents

• Cover
• Half Title
• Series Page
• Title Page
• Copyright Page
• Dedication
• Contents
• Foreword
• Preface
• Acknowledgments
• Front Cover art “Beyond Heart”
• Introduction: The Emergence of the Relational Perspective in Gestalt Therapy
• Section I: Relational Gestalt Therapy Theory
• Section II: Applications of the Relational Gestalt Perspective
• Section III: Integrative Relational Approaches
• Index