Gestaltterapi i helse Norge og litt om utdanningen

Jeg, Linda, håper og tror at gestaltterapi skal være en akseptert og verdifull del av helse Norge.

Jeg takker alle de som forteller fastlege, venner og familie om resultater og erfaringer med gestaltterapi. Det burde være en selvfølge at fastlegen kunne henvise til godkjente gestaltterapeuter, og at klientene fikk dekket kostnadene via trygdesystemet på lik linje med psykolog ordningene.

Gestaltterapeuter i Norge er i hovedsak utdannet ved Norsk Gestaltinstitutt AS (NGI). Dette er en privat høgskole med offentlig godkjent eksamensrett. Dette innebærer at utdanningen er vurdert og godkjent av NOKUT. Studiet gir 120 studiepoeng, tilsvarende 2 års fulltidsstudie. I tillegg kreves det at studenten jobber med relevant arbeid under studiet. Jeg, Linda, jobbet disse fire årene innen psykiatri, privat praksis og rusomsorg, og utdanningen ble en overgang fra arbeid innen lederskap og gründerarbeid. Utdanningen er en deltidsutdanning som går over minst 4 år, fordi prosessen å utdanne seg til gestaltterapeut går over lang tid. Det er en vel utviklet teori i gestaltterapi, og det anses ikke å være godt nok å lese seg til verktøyet. Det kreves derfor at studenter ved NGI skal gå i egenterapi under utdanningen jfr. de krav som stilles av European Association for Gestalt Therapy (EAGT) og European Association og Psychotherapy (EAP). Målet er å ha alle utdanningene som Norsk Gestaltinstitutt kan tilby - under huden. Organisasjonsutviklingen er eterhvert i boks, og tilhøsten begynner jeg på etterutdanningen for gestaltterapeuter. Jeg gleder meg, og håper at helsevesenet ser hvordan jeg og mine kollegaer av gestaltterapeuter er lidenskapelig opptatt av kompetanseheving og fordypning i faget.

Om gestaltterapi

Jeg jobber gestaltterapeutisk, og tar utgangspunkt i hva det er som skjer med deg her og nå. Jeg bruker samtale, øker oppmerksomheten på kropp og pust, rollespill og visualiering for å bygge awareness / en spesiell oppmerksomhet på følelser, kropp, tanker og hele deg. Gjennom denne bevisstgjøringsprosessen kan du tydeligere erkjenne og se deg selv og dine valgmuligheter. I det terapeutiske rom har vi tid til å møte hverandre i et likeverdig forhold, med utgangspunkt i det som er viktig for deg. Arbeidsformen vil være tilpasset dine behov og hva du ønsker. Møtet og samtalen står i fokus, samtidig som vi også bruker andre tilnærmingsmåter for å utforske hvem vi er. Dette kan være ulike eksperimenter, rollespill, bevegelse, utforsking av drømmer og kroppsbevissthet med mer, avhengig av hav du er fortrolig med og hva du ønsker.

Endring kan bare skje her og nå, aldri i fremtid eller fortid. Jeg jobber med dine polariteter for å finne din opprinnelige balanse, samt dine resurser og styrker. Oppmerksomheten omkring dine ressurser styrker jeg gjennom visuelt arbeid og via arbeid med symboler (om dette er komfortabelt for deg).

"Yesterday is history, tomorrow is mystery, today is a gift which is why we call it the present." (nn, Bjørnø og Kværk)

Om gestaltterapi

Terapeut og klient kan i ett aktivt samarbeid lære å forholde seg til verden på en realistisk måte. D.v.s i samsvar med sine ressurser og begrensninger. Målet er ikke å finne lykken eller tilsvarende, men å finne klarhet og kraft til å leve livet på godt og vondt.

Gestaltterapien søker å øke din evne til å støtte deg selv i situasjoner som oppleves som vanskelige

Gestalt terapi er en retning i humanistisk psykoterapi. Den er bygget på eksistensialismen. Dette betyr at vi ikke er så opptatt av å analysere, men heller å utforske det som faktisk er, og hvordan vi forholder oss til det. Det betyr også at vi er interessert i hele mennesket. Vi lever i en verden hvor vi er veldig fokusert på tankene våre. I gestalt er vi opptatt av følelser, kropp, sanser og tanker. Det er utrolig hvor mye du kan forenkle ditt liv ved å bli oppmerksom på alt som er, og hvor mye mer levende en kan føle seg når man dermed er mer tilstede i øyeblikkene.

En grunnleggende idé i gestaltterapien er at hvert menneske selv er ansvarlig for sine egne valg og handlinger (innenfor de begrensninger omgivelsene gir). Gestaltterapien har på bakgrunn av dette utviklet metoder for å hjelpe deg som ønsker det til å bli mer bevisst på dine egne følelser, reaksjoner og handlinger slik at du tydeligere kan se deg selv og dine valg. Og ikke minst konsekvensene av dine valg! For du har valg, og tar valg, hele tiden. Kanskje til og med uten at du er klar over det.

Bevisstgjøringsprosessen skapes hovedsakelig gjennom samtale, eksperimenter og rollespill. Metodene brukes også til bearbeidelse av tidligere uferdige opplevelser, kriser og egenutvikling.

Gestaltterapi bygger på den troen at økt erkjennelse om deg selv skjer i øyeblikket, i situasjoner "her og nå". Den kan ikke planlegges inn i fremtiden, men kommer spontant i arbeidet mellom deg og din terapeut.

Kombinasjonen av økt selvinnsikt og økt selvstøtte kan gi deg mulighet til å i større grad å foreta valg som ivaretar egne behov fremfor å forsøke å leve opp til andres forventninger.

De gestaltterapeutiske teknikker er også redskaper som gjør det mulig for deg å fortsette den utviklingen som har startet i terapien også utenfor terapirommet.

Gestalt passer godt i tiden vi lever i, der ting ofte forandrer seg fort. Vi tar utgangspunkt i her og nå, det som til en hver tid er. Når vi lærer å være helt tilstede med hele oss i omgivelsene, blir ikke forandring og omstilling lenger så farlig. Vi kan være autentiske her nå og ta gode valg.

Fra dette ståstedet kan vi også se på hvordan din fortid påvirker deg. I tillegg til samtale, bruker vi gjerne enkle øvelser, slik at du kan få noen nye erfaringer og aktivisere flere deler av deg. Vi tror på at det er ny erfaring som skaper vekst og positiv forandring.

Når jeg er oppmerksomt tilstede med hele meg, kan øyeblikk forvandles til høytid.

Teksten er hentet fra : Norsk forbund for Psykoterapi
Gestaltterapi er en retning innen den humanistiske psykologien og ble grunnlagt av bl.a. det tyskfødte ekteparet Laura og Fritz (Frederick) Perls sammen med amerikaneren Paul Goodman på slutten av 50-tallet og begynnelsen av 60-tallet i USA.
Gestalt bygger bl.a. på gestaltpsykologiske teorier og ideer fra eksistensiell-fenomenologisk filosofi. Grunnleggende ideer i gestalt er at hvert menneske selv er ansvarlig for sine valg og handlinger innenfor de begrensninger omgivelsene gir.

Gestalt har utviklet metoder for å bevisstgjøre mennesker på egne følelser, reaksjoner og handlinger slik at de tydeligere kan erkjenne og se seg selv og sine valg. Denne bevisstgjøringen skapes gjennom samtale, eksperimenter og rollespill. Metodene brukes også til bearbeidelse av tidligere, uferdige opplevelser (uavsluttede gestalter), kriser, og i egenutvikling. Gestalt bygger på den tro at økt erkjennelse om seg selv bare kan skje i øyeblikket, i situasjoner der f.eks. klient og terapeut møtes. Det kan ikke planlegges inn i fremtiden, men kommer spontant i arbeidet mellom klient og terapeut. Et av de viktigste redskapene i gestalt, er derfor terapeuten selv. Terapeuten er ikke objektiv eller nøytral, men seg selv, villig til å gå klienten i møte i et JEG - DU forhold. Dette betyr at terapeuten må bearbeide sine egne uferdige opplevelser for å kunne være tilgejengelig for det klienten trenger i situasjonen.

Gestalt er derfor prosessorientert, eksperimentell psykoterapi. Den står i motsetning til mer analytiske og innsiktsorienterte retninger. Gestalt egner seg både for individuell-, par- og gruppeterapi, egenutvikling, i undervisning og i konsulentarbeide. Klienter, studenter og kursdeltakere får selv erfare hvordan de er i møte med andre. Gestalt er ingen lettvint eller hurtig 'kur'. Det kan være smertefullt og vondt å gjenoppleve tidligere episoder i livet, erkjenne seg selv der en er i livet og se egne begrensninger. Det kan også være berikende, meningsfullt og inspirerende.

Gestalt er en terapeutisk retning som har spredning over hele den vestlige verden, og er en av de mest utbredte psykoterapeutiske retninger i dag. Gestalt har også fått en solid forankring innen næringsliv, bedriftsledelse, bedriftsrådgivning og alle former for opplæring.

Overview

Edwin Nevis described Gestalt therapy as "a conceptual and methodological base from which helping professionals can craft their practice."^[1] In the same volume Joel Latner stated that Gestalt therapy is built upon two central ideas: that the most helpful focus of psychotherapy is the experiential present moment, and that everyone is caught in webs of relationships; thus, it is only possible to know ourselves against the background of our relationship to the other.^[2] The historical development of Gestalt therapy (described below) discloses the influences that generated these two ideas. Expanded, they support the four chief theoretical constructs (explained in the theory and practice section) that comprise Gestalt theory, and that guide the practice and application of Gestalt therapy.

Gestalt therapy was forged from various influences upon the lives of its founders during the times in which they lived, including: the new physics, Eastern religion, existential phenomenology, Gestalt psychology, psychoanalysis, experimental theatre, as well as systems theory and field theory.^[3] Gestalt therapy rose from its beginnings in the middle of the 20th century to rapid and widespread popularity during the decade of the 1960s and early 1970s. During the '70s and '80s Gestalt therapy training centers spread globally; but they were, for the most part, not aligned with formal academic settings. As the cognitive revolution eclipsed Gestalt theory in psychology, many came to believe Gestalt was an anachronism. Gestalt therapy became merely an applied discipline in the fields of organizational development, social action, and eventually coaching. Gestalt therapists disdained the positivism underlying what they perceived to be the concern of research, and so they largely ignored the need to utilize research to further develop Gestalt theory and Gestalt therapy practice. However, the new century has seen a sea change in attitudes toward Gestalt practice.

Gestalt therapy focuses more on process (what is actually happening), rather than content (what is being talked about). The emphasis is on what is being done, thought and felt at the present moment, rather than on what was, might be, could be, or should have been. Gestalt therapy is a method of awareness practice, by which perceiving, feeling, and acting are understood to be separate from interpreting, explaining and judging. This distinction between direct experience, and indirect or secondary interpretation, is developed in the process of therapy. The client learns to become aware of what they are doing and how they can change. By becoming aware of, and transforming their process of being, they develop self acceptance and the ability to experience more in the "now" without as much interference from psychological baggage of the past.

The objective of Gestalt therapy is to enable the client to become more fully and creatively alive, and to become free from the blocks and unfinished business that may diminish satisfaction, fulfillment and growth. For this reason Gestalt therapy falls within the category of humanistic psychotherapies.

Contemporary theory and practice

Gestalt therapy theory essentially rests atop four "load bearing walls" - phenomenological method, dialogical relationship, field-theoretical strategies, and experimental freedom.^[4] Although all these tenets were present in the early formulation and practice of Gestalt therapy, as described in Ego, Hunger and Aggression (Perls, 1947) and in Gestalt Therapy, Excitement and Growth in the Human Personality (Perls, Hefferline, & Goodman, 1951), the early development of Gestalt therapy theory emphasized personal experience and the experiential episodes understood as "safe emergencies" or experiments. Indeed, half of the Perls, Hefferline, and Goodman book consists of such experiments. Later, through the influence of such people as Erving and Miriam Polster, a second theoretical emphasis emerged: namely, contact between self and other, and ultimately the dialogical relationship between therapist and client.^[5] Later still, field theory emerged as an emphasis.^[6] At various times over the decades, since Gestalt therapy first emerged, one or more of these tenets and the associated constructs that go with them have captured the imagination of those who have continued developing the contemporary theory of Gestalt therapy. Since 1990 the literature focused upon Gestalt therapy has flourished, including the development of several professional Gestalt journals. Along the way, Gestalt therapy theory has also been applied in Organizational Development and Coaching work. And, more recently, Gestalt methods have been combined with meditation practices into a unified program of human development called Gestalt Practice.

Phenomenological method

The goal of a phenomenological exploration is awareness.^[7] This exploration works systematically to reduce the effects of bias through repeated observations and inquiry.^[8]

The phenomenological method comprises three steps: (1) the rule of epoché, (2) the rule of description, and (3) the rule of horizontalization.^[9] Applying the rule of epoché one sets aside one's initial biases and prejudices in order to suspend expectations and assumptions. Applying the rule of description, one occupies oneself with describing instead of explaining. Applying the rule of horizontalization one treats each item of description as having equal value or significance.

The rule of epoché sets aside any initial theories with regard to what is presented in the meeting between therapist and client. The rule of description implies immediate and specific observations, abstaining from interpretations or explanations, especially those formed from the application of a clinical theory superimposed over the circumstances of experience. The rule of horizontalization avoids any hierarchical assignment of importance such that the data of experience become prioritized and categorized as they are received. A Gestalt therapist utilizing the phenomenological method might say something like, "I notice a slight tension at the corners of your mouth when I say that, and I see you shifting on the couch and folding your arms across your chest … and now I see you rolling your eyes back." Of course, the therapist may make a clinically relevant evaluation, but when applying the phenomenological method, temporarily suspends the need to express it.^[10]

Dialogical relationship

To create the conditions under which a dialogic moment might occur, the therapist attends to his or her own presence, creates the space for the client to enter in and become present as well (called inclusion), and commits him or herself to the dialogic process, surrendering to what takes place, as opposed to attempting to control it.^[11] With presence, the therapist "shows up" as a whole and authentic person, instead of assuming a role, false self or persona. To practice inclusion is to accept however the client chooses to be present, whether in a defensive and obnoxious stance or a superficially cooperative one. To practice inclusion is to support the presence of the client, including his or her resistance, not as a gimmick but in full realization that this is how the client is actually present. Finally, a Gestalt therapist is committed to process, following the maxim - trusts process, support process, and get out of the way. From this description one might be hard pressed to envision what a Gestalt therapist really does, or what a session would look like! Since Gestalt therapy is an experiential therapy, it is extremely difficult to summarize it in concepts, like those used here, which Perls probably would have referred to as "elephant shit."

Field-theoretical strategies

"The field" can be considered in two ways. There are ontological dimensions and there are phenomenological dimensions to one's field. The ontological dimensions are all those physical and environmental contexts in which we live and move. They might be the office in which one works, the house in which one lives, the city and country of which one is a citizen, and so forth. The ontological field is the objective reality that supports our physical existence. The phenomenological dimensions are all mental and physical dynamics that contribute to a person's sense of self, one's subjective experience - not merely elements of the environmental context. These might be the memory of an uncle's inappropriate affection, one's color blindness, one's sense of the social matrix in operation at the office in which one works, and so forth. The way that Gestalt therapists choose to work with field dynamics makes what they do strategic.^[12] Gestalt therapy focuses upon character structure; according to Gestalt theory, the character structure is dynamic rather than fixed in nature. To become aware of one's character structure, the focus is upon the phenomenological dimensions in the context of the ontological dimensions.

Experimental freedom

Gestalt therapy is distinct because it moves toward action, away from mere talk therapy, and for this reason is considered an experiential approach.^[13] Through experiments, the therapist supports the client's direct experience of something new, instead of merely talking about the possibility of something new. Indeed, the entire therapeutic relationship may be considered experimental, because at one level it is a corrective, relational experience for many clients, and it is a "safe emergency" that is free to turn out however it will. An experiment can also be conceived as a teaching method that creates an experience in which a client might learn something as part of their growth.^[14] Examples might include: (1) Rather than talking about the client's critical parent, a Gestalt therapist might ask the client to imagine the parent is present, or that the therapist is the parent, and talk to that parent directly; (2) If a client is struggling with how to be assertive, a Gestalt therapist could either (a) have the client say some assertive things to the therapist or members of a therapy group, or (b) give a talk about how one should never be assertive; (3) A Gestalt therapist might notice something about the non-verbal behavior or tone of voice of the client; then the therapist might have the client exaggerate the non-verbal behavior and pay attention to that experience; (4) A Gestalt therapist might work with the breathing or posture of the client, and direct awareness to changes that might happen when the client talks about different content. With all these experiments the Gestalt therapist is working with process rather than content, the How rather than the What.

Noteworthy issues

Self

In field theory, self is a phenomenological concept, existing in comparison with other. Without the other there is no self, and how I experience the other is inseparable from how I experience the self. The continuity of selfhood (functioning personality) is something that is achieved in relationship, rather than something inherently "inside" the person. This can have its advantages and disadvantages. At one end of the spectrum, I may not have enough self-continuity to be able to make meaningful relationships, or to have a workable sense of who I am. In the middle, my personality is a loose set of ways of being that work for me, including commitments to relationships, work, culture and outlook, always open to change where I need to adapt to new circumstances or just want to try something new. At the other end, my personality is a rigid defensive denial of the new and spontaneous. I act in stereotyped ways, and either induce other people to act in particular and fixed ways towards me; or I redefine their actions to fit with fixed stereotypes.

In Gestalt therapy, the process is not about the self of the client being helped or healed by the fixed self of the therapist, rather it is an exploration of the co-creation of self and other in the here-and-now of the therapy. There is no assumption that the client will act in all other circumstances as he or she does in the therapy situation. However, the areas that cause problems will be either the lack of self definition leading to chaotic or psychotic behaviour, or the rigid self definition in some area of functioning that denies spontaneity and makes dealing with particular situations impossible. Both of these conditions show up very clearly in the therapy, and can be worked with in the relationship with the therapist.

The experience of the therapist is also very much part of the therapy. Since we co-create our self-other experiences, the way a therapist experiences being with a client is significant information about how the client experiences themselves. The proviso here is that a therapist is not operating from their own fixed responses. This is why Gestalt therapists are required to undertake significant therapy of their own during training.

From the perspective of this theory of self, neurosis can be seen as fixed predictability - a fixed Gestalt - and the process of therapy can be seen as facilitating the client to become unpredictable - more responsive to what is in the client's present environment, rather than responding in a stuck way to past introjects or other learning. If the therapist has expectations of how the client should end up, this defeats the aim of therapy.

Change

In what has now become a "classic" of Gestalt therapy literature, Arnold Beisser described Gestalt's paradoxical theory of change.^[15] The paradox is that the more one attempts to be who one is not, the more one remains the same. Conversely, when people identify with their current experience, the conditions of wholeness and growth support change. Put another way, change comes about as a result of "full acceptance of what is, rather than a striving to be different."^[16]

Historical development

Fritz Perls was a German-Jewish psychoanalyst who fled Europe with his wife Laura Perls to South Africa in order to escape Nazi oppression. After the World War II the couple emigrated to New York City, which had become a center of intellectual, artistic and political experimentation by the late 1940s and early 1950s.

Early influences

Perls served in the German Army during World War I, and was wounded in the conflict. After the war he was educated as a medical doctor. He became an assistant to Kurt Goldstein, who worked with brain injured soldiers. Perls went through a psychoanalysis with Wilhelm Reich and became a psychiatrist. Perls assisted Goldstein at Frankfurt University where he met his wife Lore (Laura) Posner, who had earned a doctorate in Gestalt Psychology. They fled Nazi Germany in 1933 and settled in South Africa. Perls established a psychoanalytic training institute and joined the South African armed forces, serving as a military psychiatrist. During these years in South Africa Perls was influenced by Jan Smuts and his ideas about "holism."

In 1936 Fritz Perls attended a psychoanalyst's conference in Marienbad, Czechoslovakia, where he presented a paper on oral resistances, mainly based on Laura Perls' notes on breastfeeding their children. Perls' paper was turned down. Perls did present his paper in 1936, but it met with "deep disaproval."^[17] Perls wrote his first book, Ego, Hunger and Aggression (1942, 1947), in South Africa, based in part on the rejected paper. It was later re-published in the United States. Laura Perls wrote two chapters of this book, but she was not given adequate recognition for her work.

The seminal book

Perls' seminal work was Gestalt Therapy: Excitement and Growth in the Human Personality, published in 1951, co-authored by Fritz Perls, Paul Goodman, and Ralph Hefferline (a university psychology professor, and sometime patient of Fritz Perls). Most of the Part II of the book was written by Paul Goodman from Perls' notes, and it contains the core of Gestalt theory. This part was supposed to go first. However, the publishers decided that Part I, written by Hefferline, fit into the nascent self-help ethos of the day, and they made it an introduction to the theory. Isadore From, a leading early theorist of Gestalt therapy, taught Goodman's Part II for an entire year to his students, going through it phrase by phrase.

First instances of Gestalt therapy

Fritz and Laura founded the first Gestalt Institute in 1952, running it out of their Manhattan apartment. Isadore From became a patient, first of Fritz, and then Laura. Fritz soon made Isadore a trainer, and also gave him some patients. Isadore lived in New York until his death, at age 75, in 1993. He was known worldwide for his philosophical and intellectually rigorous take on Gestalt therapy. A brilliant, witty and sometimes caustic man, From was very much the philosopher of first-generation Gestalt therapists. Acknowledged as a supremely gifted clinician, he was unfortunately indisposed to writing, so what remains of his work are merely transcripts of interviews.^[18]

Fritz left Laura and New York in 1960, then briefly lived in Miami, and ended up in California. Jim Simkin was a psychotherapist who became a client of Perls in New York, and then a co-therapist with Perls in Los Angeles. Simkin was responsible for Perls coming to California, where Perls began a psychotherapy practice. Ultimately, the life of a peripatetic trainer and workshop leader was a better suited to Fritz's personality. So starting in 1963, Simkin and Perls co-led some of the early Gestalt workshops and training groups at Esalen Institute, in Big Sur, California, where Perls eventually settled and built a home.

The schism

In the 1960s Perls became infamous among the professional elite for his public workshops at Esalen Institute. Isadore From referred to some of Fritz' brief workshops as "hit-and-run" therapy, because of Perls' alleged emphasis on showmanship with little or no follow-through. But Perls never considered these workshops to be complete therapy. Rather, he felt he was giving demonstrations of key points for a largely professional audience. Unfortunately, some films and tapes of his work were all that most graduate students were exposed to, along with the misperception that this was the entirety of Perls' work.

Jim Simkin began co-leading training groups with Fritz at Esalen, and then purchased property next to Esalen. Simkin started his own training center, which he ran until his death in 1984. Simkin refined his precise version of Gestalt therapy, training psychologists, psychiatrists, counselors and social workers within a very rigorous residential training model.

When Fritz Perls left New York for California, there began to be a split with those who saw Gestalt therapy as a therapeutic approach similar to psychoanalysis. This view was represented by Isadore From, who practiced and taught mainly in New York, as well as by the members of the Cleveland Institute, which was co-founded by From. An entirely different approach was taken, primarily in California, by those who saw Gestalt therapy not just as a therapeutic modality, but as a way of life. The East Coast, New York-Cleveland axis was often appalled by the notion of Gestalt therapy leaving the consulting room and becoming a way-of-life on the West Coast in the 1960s (see the "Gestalt prayer"). An alternate view of this split saw Perls in his last years continuing to develop his a-theoretical and phenomenological methodology, while others, inspired by From, were inclined to theoretical rigor which verged on replacing experience with ideas.

The split continues between what has been called "East Coast Gestalt" and "West Coast Gestalt," at least from a US-centric point of view. While the communitarian form of Gestalt continues to florish, Gestalt therapy was largely replaced in the United States by Cognitive Behavioral Therapy, and many Gestalt therapists in the U.S. drifted toward organizational management and coaching. At the same time, contemporary Gestalt Practice was developed by Dick Price, the co-founder of Esalen Institute.^[19] Price was Perls' prmiary student at Esalen. Gestalt workshops are still offered at Esalen. Price's widow, Christine Stewart Price, continues to lead Gestalt workshops there.^[20] And many Gestalt practitoners continue to be instructed by the life and teachings of Dick Price.

Post-Perls

In 1969 Fritz Perls left the United States to start a Gestalt community at Lake Cowichan on Vancouver Island, Canada. He died almost a year later, on 14 March 1970, in Chicago. One member of the Gestalt community was Barry Stevens. Her book about that phase of her life, Don' t Push the River, became very popular. She developed her own form of Gestalt therapy body work, which is essentially a concentration on the awareness of body processes.^[21]

The Polsters

Erving and Miriam Polster started a training center in La Jolla, California, which also became very well known, as did their book, Gestalt Therapy Integrated, in the 1970s. ^[22]

The Polsters played an influential role in advancing the concept of contact boundary phenomena. The standard contact boundary resistances in Gestalt theory were confluence, introjection, projection and retroflection. A disturbance described by Miriam and Erving Polster was "deflection," which referred to a means of avoiding contact. Instances of boundary phenomena can have pathological or non-pathological aspects. For example, it is appropriate for an infant and mother to merge, or become "confluent," but inappropriate for a client and therapist. If the latter become confluent, there can be no growth, because there is no boundary at which one can contact the other. The client will not be able to learn anything new because the therapist essentially becomes an extension of the client.

Influences upon Gestalt therapy

Some examples

There were a variety of psychological and philosophical influences upon the development of Gestalt therapy; not the least of which were the social forces at the time and place of its inception. Gestalt therapy is an approach that is holistic (including mind, body and culture). It is present-centered and related to existential therapy in its emphasis on personal responsibility for action, and on the value of "I-thou" relationship in therapy. In fact, Perls considered calling Gestalt therapy existential-phenomenological therapy. "The I and thou in the Here and Now," was a semi-humorous short-hand mantra for Gestalt therapy!

Both Fritz and Laura Perls were students and admirers of the neuropsychiatrist Kurt Goldstein. Gestalt therapy was based in part on Goldstein's concept called "Organismic theory". Goldstein viewed a person in terms of a holistic and unified experience. He encouraged a "big picture" perspective, taking in to account the whole context of a person's experience. The word Gestalt means whole, or configuration. Goldstein taught Perls that self actualization could only be achieved by self transcendence, that is, viewing the self as part of a greater whole. Laura Perls, in an interview, denotes the "Organismic theory" as the base of Gestalt therapy.

There were additional influences on Gestalt therapy from existentialism, particularly the I-thou relationship as it applies to therapy, and the notion of personal choice and responsibility.

The late 1950s-1960s movement toward personal growth and the human potential movement in California fed into, and was itself influenced by Gestalt therapy. In this process Gestalt therapy somehow became a "coherent Gestalt", which is the Gestalt psychology term for a perceptual unit that holds together and forms a unified whole.

Psychoanalysis

Gestalt therapy was influenced by psychoanalysis. It was part of a continuum moving from the early work of Freud, to the later Freudian ego analysis, to Wilhelm Reich and his notion of character armor, with attention to nonverbal behavior This was consonant with Laura Perls' background in dance and movement therapy. To this was added the insights of academic Gestalt psychology, including perception, Gestalt formation and the tendency of organisms to complete an incomplete Gestalt, and to form "wholes" in experience.

Central to Fritz and Laura Perls' modifications of psychoanalysis was the concept of "dental or oral aggression". In Ego, Hunger and Aggression (1947), Fritz Perls' first book, to which Laura Perls contributed^[23] (ultimately without recognition), Perls suggested that when the infant develops teeth, he or she has the capacity to chew, to break apart food, and by analogy to experience, to taste, accept, reject or assimilate. This was opposed to Freud's notion that only introjection takes place in early experience. Thus Perls made "assimilation," as opposed to "introjection," a focal theme in his work, and the prime means by which growth occurs in therapy.

In contrast to the psychoanalytic stance, in which the "patient" introjects the (presumably more healthy) interpretations of the analyst, in Gestalt therapy the client must "taste" his or her experience, and either accept or reject it, but not introject or "swallow whole". Hence, the emphasis is on avoiding interpretation, and instead encouraging discovery. This is the key point in the divergance of Gestalt therapy from traditional psychoanalysis - growth occurs through gradual assimilation of experience in a natural way, rather than by accepting the interpretations of the analyst; thus, the therapist should not interpret, but lead the client to discover for himself or herself.

The Gestalt therapist contrives experiments that lead the client to greater awareness and fuller experience of his or her possibilities. Experiments can be focussed on undoing projections or retroflections. The therapist can work to help the client with closure of unfinished Gestalts ("unfinished business" such as unexpressed emotions towards somebody in the client's life). There are many kinds of experiments that might be therapeutic. But the essence of the work is that it is experiential rather than interpretive, and in this way Gestalt therapy distinguishes itself from psychoanalysis.

Principal influences: A summary list

• Otto Rank's invention of "here-and-now" therapy and Rank's post-Freudian book Art and Artist (1932), both of which strongly influenced Paul Goodman.
• Wilhelm Reich's psychoanalytic developments, especially the concept of character armor and its focus on the body.
• Jacob Moreno's Psychodrama, principally the development of enactment techniques for the resolution of psychological conflicts.
• Kurt Goldstein's holistic theory of the organism, based on Gestalt theory.
• Martin Buber's philosophy of relationship and dialogue ("I - Thou").
• Kurt Lewin's field theory as applied to the social sciences and group dynamics.
• European phenomenology of Franz Brentano, Edmund Husserl, Martin Heidegger, and Maurice Merleau-Ponty.
• The existentialism of Kierkegaard over that of Sartre, rejecting nihilism.
• Carl Jung's psychology, particularly the polarities concept.
• Some elements from Zen Buddhism.
• Differention between thing and concept from Zen and the works of Alfred Korzybski.
• The American pragmatism of William James, George Herbert Mead, and John Dewey.

Current status

Gestalt therapy reached a zenith in the United States in the late 1970s and early 1980s. Since then it has influenced other fields like organisational development, coaching and teaching. Many of its contributions have become assimilated into other current schools of therapy.

Gestalt therapy continues to thrive as a wide-spread form of psychotherapy, especially throughout Europe, where there are many practitioners and training institutions.

The form of Gestalt Practice initially developed at Esalen Institute by Dick Price has spawned numerous offshoots. The most important is now called Gestalt Awareness Practice by Price's wife and collaborator, Christine Stewart Price.^[24] She teaches this mode of practice in California, throughout the United States, as well as in Japan.

Training of Gestalt therapists

Pedagogical approach

Many Gestalt therapy training organizations exist worldwide. Ansel Woldt asserted that Gestalt teaching and training are built upon the belief that people are, by nature, health seeking. Thus, such commitments as authenticity, optimism, holism, health, and trust become important principles to consider when engaged in the activity of teaching and learning - especially Gestalt therapy theory and practice.^[25]

Associations

The Association for the Advancement of Gestalt Therapy, (AAGT) holds one biennial international conference in various locations - the first in New Orleans, LA, USA, in 1995, in 2008 in Manchester, England, UK, and one planned for 2010 in Philadelphia.^[26] In addition, it holds regional conferences.

The European Association for Gestalt Therapy (EAGT) founded in 1985, to gather European individual Gestalt therapists, training institutes and national associations, from more than 20 European nations.^[27]

Gestalt Australia and New Zealand (GANZ) was formally established at the first "Down Under" Gestalt Therapy Conference held in Perth in September 1998.^[28]

[edit] See also

• Fritz Perls
• Laura Perls
• Paul Goodman (writer)
• Barry Stevens (therapist)
• Topdog vs. Underdog
• Phenomenology (philosophy)
• Existentialism
• Martin Buber
• Kurt Goldstein
• Kurt Lewin
• Otto Rank

[edit] References

Suggested reading

• Perls, F. (1969) Ego, Hunger, and Aggression: The Beginning of Gestalt Therapy. New York, NY: Random House. (originally published in 1942, and re-published in 1947)
• Perls, F., Hefferline, R., & Goodman, P. (1951) Gestalt Therapy: Excitement and growth in the human personality. New York, NY: Julian.
• Perls, F. (1969) Gestalt Therapy Verbatim. Moab, UT: Real People Press.
• Perls, F. (1969) In and Out the Garbage Pail. Lafayette, CA: Real People Press.
• Perls, F. (1973) The Gestalt Approach & Eye Witness to Therapy. New York, NY: Bantam Books.
• Polster, E. & Polster, M. (1973) Gestalt Therapy Integrated: Contours of theory and practice. New York, NY: Brunner-Mazel.