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Gestalt Therapy

A Guide to Contemporary PracticePhilip Brownell completed a doctoral program in clinical psychology from

George Fox University in which he was trained as a scientist-practitioner. Following

completion of his Psy D, he completed six years of post-graduate level training

in Gestalt Therapy through the Portland Gestalt Therapy Training Institute and

worked as a Mental Health Therapist for four years on the Intensive Care Unit of a

dual-diagnosis psychiatric facility. Dr. Brownell is the Editor of the Handbook for

Theory, Research, and Practice in Gestalt Therapy, which is being translated into

several languages. He has facilitated the gestalt-focused discussion group, Gstalt-L,

for thirteen years, is co-chair of the AAGT’s Research Task Force, and is actively

engaged in supporting research focused on gestalt therapy. He is a licensed clinical

psychologist, gestalt therapist, organizational consultant, and coach. He is seminary

educated, an ordained clergyman, and President of the Gestalt Training Institute

of Bermuda.Gestalt Therapy

A Guide to Contemporary Practice

PHIL IP BRO W NE L L , MDi v, P sy DCopyright © 2010 Springer Publishing Company, LLC

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The author and the publisher of this Work have made every effort to use sources

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Library of Congress Cataloging-in-Publication Data

Brownell, Philip, Psy. D.

Gestalt therapy : a guide to contemporary practice / Philip Brownell.

p. ; cm.

Includes bibliographical references and index.

ISBN 978-0-8261-0454-0

  1. Gestalt therapy. I. Title.

[DNLM: 1. Gestalt Therapy—methods. WM 420.5.G3 B884g 2010]

RC489.G4B76 2010

616.89’143—dc22 2009048998

Printed in the United States of America by the Hamilton Printing CompanyI dedicate this book to all the people who trained me in gestalt therapy;

most profoundly that would be Maya Brand and Carol Swanson and

my discussion partners at Gstalt-L. My gestalt training group with Maya

and Carol broadened my view beyond my doctoral program and Gstalt-L

broadened my view beyond my gestalt training group.

I also want to thank my wife, Linda, and my children, Matt, Zac, and Stasia,

and my good friend Pat Roberts. Pat is a writer and lover of books and in

many ways has been like a spiritual mother.

So, here’s to good friends, stacks of books, and cups of coffee around

which to talk about the Kingdom of God.

—Philip BrownellThis page intentionally left blank Contents

Foreword xi

Preface xvii

Acknowledgments xxi

Introduction xxiii

PART 1: ORIENTATION 1

1 What Is Psychotherapy? 3

The Talking Cure 4

Factors Common to Diverse Forms of Psychotherapy 8

Does Psychotherapy “Work”? 10

Conclusion 16

2 What Is Gestalt Psychotherapy? 21

Background 22

Theoretical Overview 35

Conclusion 38

3 The Growth of Gestalt Therapy 43

The First Cycle: Originators and Their Trainees 44

Second Cycle: Trends in Gestalt Therapy’s

Development 56

Conclusion 69

PART II: HOW TO DO GESTALT THERAPY 73

4 Deal with Personal Experience 75

Awareness and Consciousness 77

vii viii Contents

Intentionality 82

Phenomenological Method in Psychotherapy 89

Conclusion 93

5 Work the Therapeutic Relationship 97

Alterity 98

Contact 102

Dialogue 105

Relationship 111

Conclusion 114

6 Use the Context of Life 119

The Concept of Field 120

The Hermeneutics of Field 128

Field-Relative Perspectives 136

Field-Theoretical Psychotherapeutic Strategies 141

Conclusion 144

7 Move to Action 149

Behavior, Enactment, and Experience 150

Action as Discourse 153

Experiment 154

Experimental Options 158

Conclusion 165

8 Practice a Unified Approach 167

The Unity of Praxis 169

The Concept of a Unified Approach 172

Common Factors 174

Conclusion 181

PART III: SPECIFIC CLINICAL ISSUES 187

9 Assessment in Gestalt Therapy 189

Preliminary Considerations 190

Assessment as Diagnosis 198 Contents ix

Assessment as Psychological Testing 199

Assessment as Gestalt Therapy “Analysis” 203

Assessment as Therapeutic Process 204

A Suggested Method of Assessment and Diagnosis 206

Conclusion 209

10 Treatment Planning and Case Management in

Gestalt Therapy 213

Treatment Planning 213

Case Management 222

Conclusion 225

PART IV: TRAINING AND CERTIFICATION 229

11 Training, Certification, and Professional

Development in Gestalt Therapy 231

Training 232

Certification 236

Continuing Education 237

Gestalt Training Organizations 237

Professional Affiliations and Gestalt Communities 242

Conclusion 243

Epilogue 247

Index 249This page intentionally left blank Foreword

It is raining in Bermuda as Phil Brownell writes the Preface to his

comprehensive look at contemporary gestalt therapy. The rain fills

cisterns all over his island and fills dry streams. It is fitting that this

is how he begins his Preface since gestalt therapy is a metaphori-

cal stream. Or rather, gestalt therapy is the convergence of many

streams: streams that flowed from Europe, America, and Asia; con-

verging streams of existentialism and pragmatism, phenomenol-

ogy and hermeneutics, biology and psychology, social science and

neuroscience, psychoanalysis and politics, the arts and sciences,

Buddhism and Western theology. With such a broad headwater, no

single view of gestalt therapy can be the final word on the subject.

This is Dr. Brownell’s encyclopedic overview, which is both tradi-

tional and original.

I have described gestalt therapy’s development with the earth-

bound metaphor of water; Dr. Brownell characteristically looks to

the heavens for his metaphor: “Gestalt therapy is not a supernova

shining alone in the darkness. It is built from an assimilation. . .”

(p. 35) Dr. Brownell’s book describes today’s gestalt therapy as a

widely accepted theory and method (praxis).

This book is accessible as an introduction for the reader who has

heard something about gestalt therapy and wants to know more. It

is also a resource for the experienced gestalt therapist who needs

a deeper understanding of gestalt therapy history, development,

theory, and practice. He accomplishes this by offering a book that

meets these varied needs of readers at different levels of interest,

modality, and experience.

xi xii Foreword

In this Foreword I will situate Dr. Brownell’s contribution

within the history and the current world of gestalt therapy, from

my own point of view, of course.

Dr. Brownell describes the founding of gestalt therapy some

60 years ago by Fritz Perls, Laura Perls, and Paul Goodman, who

brought together their diverse European and American back-

grounds to synthesize a new psychotherapeutic and social theory.

He takes the reader through gestalt therapy’s later development

and makes gestalt therapy come alive by introducing actual practi-

tioners who, in their own words, describe how they became gestalt

therapists. Dr. Brownell offers his personal insights into gestalt

therapy to show heretofore unexplored possible influences on its

founders and original practitioners as they developed gestalt ther-

apy. At all times, he is ecumenical in his presentation of the vari-

ous contemporary approaches within gestalt therapy, offering the

reader a sense of a world of differences in the gestalt therapy uni-

verse. The world of gestalt therapy is, and has always been, a world

of differences. However at relative peace these various approaches

may now be with one another, gestalt therapy’s history was not

without conflict.

The postwar years in the United States were a time of social con-

formity; this was reflected in the dominant psychotherapies, which

encouraged individual adjustment to social pressures. Gestalt ther-

apy “debuted” in 1951. This new modality offered reform of tradi-

tional or authoritarian modalities of psychotherapy that stressed a

model of health based on adjustment to societal norms dictated by

the psychotherapist himself (the therapist was most often a man).

To some people’s perceptions, the established psychotherapies

offered an often-cerebral process of social adjustment, while gestalt

therapy offered an opportunity to release the creative potential of

the person. Gestalt therapy presented a psychotherapy with crea-

tive novelty at its core and proposed an egalitarian psychotherapy

relationship of more or less mutual partners. Most importantly, and

famously, gestalt therapy accented a person’s creative potential and

supported individual difference, not conformity. It is no wonder that

in its early days it attracted so many artists, social nonconformists,

and miscellaneous “refugees” from then authoritarian mainstream Foreword xiii

psychotherapies. The social complacency of conformity and the

psychotherapies that supported it were begging to be challenged,

to come under siege. Gestalt therapy would be the modality most

identified with supporting this siege.

The 1960s was a time of social tumult; it was the time of this

siege. “The human potential movement” and the social revolutions

of the decade formed a synergy with the social and clinical values

of gestalt therapy. Gestalt therapy became the unofficial “anti-Es-

tablishment” psychotherapy. Its popularity got ahead of itself. In

the hands of popularizers and amateurs, “gestalt therapy” some-

times seemed to morph into often-unidentifiable variations and

sometimes careless or reckless parodies of the original, serious psy-

chotherapy. The reputation caused by this popularization, that is,

the mistaken impressions that gestalt therapy is nothing but theat-

rical techniques that could be done to people, that mere emotional

catharsis such as pillow banging and screaming was psychotherapy,

that gestalt therapy is nothing but its techniques, and so on, is some-

thing gestalt therapy continues to have to correct. Dr. Brownell’s

book is an important contribution to gestalt therapy’s ongoing work

of addressing what remains of these false beliefs.

Claims of dilution as a consequence of gestalt therapy being out-

stripped by its popularity were further complicated by gestalt ther-

apy’s initial success among serious psychotherapists in the 1950s,

too. Clinicians were eager to learn gestalt therapy as one of the

modalities in the humanistic reformation of psychotherapy. There

was an increasing demand to learn gestalt therapy quickly. Trainers

from the original institute, The New York Institute for Gestalt

Therapy, were invited to teach gestalt therapy around the country

and soon across the world. These skilled trainers were under pres-

sure to teach gestalt therapy as quickly as possible. There was a

need to streamline the training of gestalt therapists, and indeed, to

streamline the gestalt therapy.

Fritz Perls rejected the original model of gestalt therapy that

he helped develop in New York. He developed a new, simple, more

easily understandable and learnable version of gestalt therapy. His

version of gestalt therapy became widespread and identified as

gestalt therapy itself. Those in New York who continued to practice xiv Foreword

and teach the model he rejected felt Perls’s new version of gestalt

therapy strayed too far from its source in the service of simplifica-

tion. They insisted that gestalt therapy could not be taught quickly

since it was a nuanced, phenomenological approach. Unfortunately,

the tensions between what was known as the “East Coast Model,”

identified with Laura Perls in New York, and the “West Coast

Model,” identified with Fritz Perls in California, colored gestalt

therapy’s history.

As gestalt therapy spread, gestalt therapy institutes sprang up

and flourished as people who were trained by the original trainers

trained their own students. Newer conflicts emerged as institutes

inevitably offered their own understandings of gestalt therapy to

which other institutes objected, sometimes aggressively. The dif-

ferences among various models, approaches, or perspectives within

gestalt therapy proliferated over the decades. There was no peace

among the adherents of the different models. Intramodality con-

flicts are not unique to the history of gestalt therapy. A glance at

the history of psychoanalysis, for example, shows similar scuffles.

Over time, gestalt therapy itself continued to develop as a

modality that embraces change. The fractionalization of gestalt

therapy eased from the rigid defense of particular perspectives on

gestalt therapy to inclusive notions that we each may have different

points of view within a common heritage.

The streams of gestalt therapy that once flowed apart have

come together. Naturally, different approaches to gestalt therapy

remain and there are hearty disagreements. These energize gestalt

therapy and assure its development.

Gestalt therapists meet in conferences with attendees from all

over the world. There are transnational organizations such as the

Association for the Advancement of Gestalt Therapy, an interna-

tional community, to transcontinental organizations such as the

European Association for Gestalt Therapy, Gestalt Australia and

New Zealand, and the International Gestalt Therapy Association,

which is primarily oriented toward the Spanish communities.

There are many national and regional organizations as well. Gestalt

therapy has its own journals such as Gestalt Review, Studies in

Gestalt Therapy: Dialogical Bridges, The British Gestalt Journal, Foreword xv

and Gestalt! to name only the English language journals, and its

own publishers (The Gestalt Press, The Gestalt Journal Press).

This brings me back to this book. Dr. Brownell’s description of

gestalt therapy is an example of the contemporary perspective in

that he offers us a broad view of gestalt therapy itself. But this is not

to say that he offers us a generic, one-size-fits-or-pleases-all model

of gestalt therapy. To be sure, he offers an excellent survey of the

basic, important concepts and offers illustrative clinical examples.

The latter are crucial for any reader to be able to see how gestalt

therapy is applicable across so many different dimensions of prac-

tice. Dr. Brownell excels in reaching out to the broadest audience

of readers. At the same time, he offers the more informed reader

an opportunity to see gestalt therapy from his own perspective.

Make no mistake about this. Just as in this Foreword I offer

my own perspective on the history of gestalt therapy, Dr. Brownell

does the same in this book. Readers may differ with my point of

view here; and readers may sometimes differ with Dr. Brownell’s.

Gestalt therapy’s liveliness often comes from its support of differ-

ences and its commitment to meeting one another on the basis of

our differences. It is this liveliness that now characterizes gestalt

therapy as its different perspectives continue to develop around the

world. Each perspective is a special point of view from a different

vantage point, yet each looks upon a world of shared experiences.

Gestalt therapy continues to develop, like the stream with which

I began this Foreword. Dr. Brownell’s contribution adds to this

development.

Dan BloomThis page intentionally left blank Preface

As I put the finishing touches on this book it is raining in Somerset;

it’s raining all over Bermuda. That is good, because in Bermuda

people catch their water as it rolls off limestone painted roofs and

lands in cisterns beneath the houses. It’s been dry here for weeks

and we were just about ready to order a truckload of water.

When one’s line of work goes dry, it’s hard to imagine getting

excited because everything seems stale, washed out, and bleached

from overexposure. The same may be true of gestalt therapy. Many

books have been written exploring one aspect or another, such

as those of Perls, Hefferline, and Goodman (1951), Erving and

Miriam Polster (1973), Joel Latner (1989), Gary Yontef (1993), Sylvia

Crocker (1999), Jennifer MacKewn (1997), Gaie Houston (2003),

Edwin Nevis (2000), and Ansel Woldt and Sarah Toman (2005) to

name just a few in the English language. So why another one?

The most honest answer is because I wanted to write one. I

wanted to include things in this book that I’ve been discussing

with my friends and colleagues at Gstalt-L, an online community

of gestalt theorists, trainers, trainees, and practitioners. For more

than thirteen years it’s been like a think tank where people have

fought for their opinions and argued passionately and cogently for

their ideas. Recently, Seán Gaffney (2009) indicated that his arti-

cle in Gestalt Review came about in part due to such discussion

at Gstalt-L. Because of the drama that can be seen there, some

people report that they maintain a subscription to see what the

characters are going to do next. It’s like watching a soap opera. At

any rate, some of the ideas expressed there over the years have not

made it to print yet, and I want to give them voice in a different

format.

xvii xviii Preface

I also wanted to give myself the gift of writing. For me, writing

is a learning experience. I frequently propose projects to publishers

because I want to pursue a particular idea and learn from it. Then

I go into research mode as I prepare to write. Even in the process

of writing, as I thrash about with something, I discover resources

I never knew existed and expand my world. I run sections of the

manuscript past friends and colleagues to see how they play with

them. Their responses help me calibrate what I’m doing.

Finally, I wanted to write a book that would inform people who

are unfamiliar with gestalt therapy–perhaps to bring them a little

water if what they already knew had gone dry. That is why, for this

book, I have selected the mainframe of gestalt praxis—phenom-

enology, dialogical relationship, the field, and experiment. I don’t

want to blur that focus. There are many other things that could

have been put into this book, but if a mental health professional

wants to understand gestalt therapy, especially with a view to even-

tually becoming fully trained and to practice it, then the starting

place is to grasp these four tenets. In addition, I knew from years

of experience, both in private practice and in community mental

health, that there are pragmatic concerns, if not sound professional

protocols, that needed to be included. So, I chose the issues of

assessment, treatment planning, and training.

My hope is to bring a little water to people who have become

thirsty in their work, including established gestalt therapists. I’ve

tried to keep the jargon to a minimum, but I realize it is necessary

to use the terms that have meaning within the field in order to help

those unfamiliar learn the necessary concepts. I’ve also included

some subjects gestalt therapists have thus far neglected in the lit-

erature, as well as new slants on subjects that have already been

covered.

I guess the last thing is that I speak from where I’m at. Where

I’m at is partly due to where I’ve been. I’m the oldest of five chil-

dren. I grew up in an alcoholic, dysfunctional family, and I went

through years of therapy to deal with it. I’ve been a road manager

for a rock band. I’ve been a neuropsychiatric technician in the

United States Navy during a time of war. I’ve been a longhaired Preface xix

counter-culture freak, and I’ve been a Jesus freak. I’m still a Jesus

freak. I’ve been a seminary student. I’ve worn three-piece suits try-

ing to fit in while working as a minister of children at a large, multi-

staff church in central California, and I’ve been a laid-back pastor

of a rural congregation along the north Tillamook coast in Oregon.

I’ve ridden a motorcycle to work. I’ve been a liberal and I’ve been

a conservative. Right now I’m what I like to call a conliberative.

I’m the father of three great children, and I’ve been married three

times. I’ve been a single parent. I’ve been homeless, and I’ve lived

in beautiful, even luxurious, homes including the place from which

I write at the moment, which is located atop a hill looking south

and west across the expanse of the Atlantic Ocean.

Each therapist brings to his or her work as a professional his

or her whole self. That means that if I am to be of help to others I

must attend to myself, making sure that I’m grounded, balanced,

available, and courageous enough to meet the courage that brought

my clients to me in the first place. When I do that, I bring my

whole self to that meeting. People get a whole person—an inte-

grated person at peace. That is what I also hope the reader picks

up on in this book, even though what they get is a huge dose of my

mind grappling with various issues.

Philip Brownell

June 2009

REFERENCES

Crocker, S. (1999). A well-lived life: Essays in gestalt therapy. Cambridge, MA: Gestalt

Institute of Cleveland Press.

Gaffney, S. (2009). The cycle of experience re-cycled: Then, now . . . next? Gestalt

Review, 13(1), 7–23.

Houston, G. (2003). Brief gestalt therapy. Thousand Oaks, CA: Sage Publications.

Latner, J. (1989). The gestalt therapy book. Highland, NY: The Gestalt Journal Press.

Mackewn, J. (1997). Developing gestalt counselling (Developing Counselling Series).

Thousand Oaks, CA: Sage Publications.

Nevis, E. (Ed.). (2000). Gestalt therapy: Perspectives and applications. Cambridge, MA:

Gestalt Press.xx Preface

Polster, E., and Polster, M. (1973). Gestalt therapy integrated: Countours of theory and

practice. New York: Vintage Books.

Woldt, A., and Toman, S. (Eds.) (2005). Gestalt therapy history, theory and practice.

Thousand Oaks, CA: Sage Publications.

Yontef, G. (1993). Awareness dialogue and process: Essays on gestalt therapy. Highland,

NY: The Gestalt Journal Press.Acknowledgments

There are many people to thank. First, I want to thank Phil

Laughlin at Springer for his encouragement and his work as edi-

tor. Phil left before the project was done in order to follow a great

opportunity in publishing elsewhere, and so I also want to thank

Jennifer Perillo, who took over for him.

Second I want to thank Dan Bloom and Peter Philippson who

at various times read and commented on portions of the book. As

always, we did not agree on everything, but that is the beauty of

having people like this in one’s life. No matter how much we may

struggle over various things, no matter how different we are from

one another, we find a common ground in our interest in gestalt

therapy theory and practice. I have gone to war with Peter while

conducting organizational business, but then I can turn the page

and find in him a thoughtful and considerate thinker who will take

what I write seriously and give his best shot at critical response.

I respect that very much. Dan is much the same way, except in

him I have found a man who thinks like me on crucial subjects

and sometimes speaks directly and forcefully as I also tend to do.

Neither of these men share my faith in Jesus, and what I find truly

amazing and priceless is that we can talk with one another the way

we do and can respect, if not love one another, in spite of what has

separated other people.

Last, I want to acknowledge the sacrifice that my wife has made

as I have worked on this book. I have been unavailable to her, and

that has been difficult. While I worked hard writing, she worked

hard waiting—waiting to get her husband back. And now the book

is done; and now I am back.

xxi This page intentionally left blank Introduction

This is a book about gestalt therapy, but it is not a book that tells

everything there is to know about gestalt therapy. Some things are

left out and other things are only treated in passing. Why? It is

because I want to keep a focus on the core of gestalt therapy. To

practice gestalt therapy, one must know these core concepts.

So the claim is that this book tells the reader what gestalt

therapy is and that it can serve as a template or treatment manu-

al.1 However, this would only be a beginning for a true student

of gestalt therapy. Vast sections on gestalt therapy’s theory of self,

especially as it relates to contact in the person-world/organism-

environment field, are either left out or only mentioned in passing.

Why is that? Because to utilize the core of gestalt therapy praxis

will inexorably lead one into person-world/organism-environment

self-formation. Self emerges from the action of the person in his or

her world. Utilize the core, and all else will follow.

The primary audience for this book is practicing clinicians;

counselors and psychotherapists who are working with people in

a variety of settings (or those in training to do so). This would also

extend to anyone interfacing with people in a helping profession

such as nursing, the clergy, corrections, or social work.

During my internship at a large hospital on the southeast side

of Portland, Oregon, I was an adjunct instructor at the Walla Walla

School of Nursing. My purpose was to teach the nurses about the

field of psychology during their rotation through the psychiatric

units in the hospital. What I emphasized was making good contact

with the patients they served instead of simply coming into a room,

attending to the medical necessities, and charting. Contact is heal-

ing. Often, one of the greatest factors leading to positive outcomes

xxiii xxiv Introduction

can be the support that meaningful human contact can have for a

patient during a stay in the hospital. Nurses can benefit from learn-

ing how to do gestalt therapy.

I was a line staff member at several residential treatment cen-

ters for children and adolescents. The line staff are the ones who

spend most time with the residents. I realize now that I could have

done a much better job if I had been trained in gestalt therapy

back then, and that goes for my time as a pastor or minister to chil-

dren as well. So, with a bit of hindsight, I contend that anyone in a

position that requires working in groups and interfacing with other

people could benefit from learning gestalt therapy.

There are people who train in gestalt therapy, however, with

no intention of using it professionally. They just want to live by its

philosophy. They like how it contributes to an existentially satisfy-

ing way of life and they want to know more about it and to use it as

a discipline for living. This book is for those people as well.

Gestalt therapy is an experiential approach and must be

learned in experiential training groups (an explanation of this will

be included in chapter 11). But the reader can gain a foothold in

obtaining the expertise needed to practice gestalt therapy by read-

ing this concise and practical guidebook written about complex

clinical and interpersonal processes in mostly ordinary language

even though the subjects in question do require reference to tech-

nical terms used in the field.

The practicing and experienced clinician, on the other hand,

will recognize many of the elements covered in the book, but

might know them under different titles and terms and might dis-

agree with my conceptualizations. That’s okay. I don’t expect every-

one to agree with all of my claims. However, I do believe this book

will contribute to the establishment of a baseline in the core of

gestalt praxis and extend into new ground on several facets of that

core. This book, then, could provide self-study enrichment for

those currently in practice. It would be appropriate for professional

organizations of counselors and psychotherapists, formal academic

programs and gestalt postgraduate-level training organizations. It

could also be used as an ancillary text in any people-helping train-

ing program, including pastoral counseling programs in seminaries, Introduction xxv

school counselor training programs in college, and graduate pro-

grams for clinical social work.

Following an orientation to psychotherapy in chapter 1, chap-

ters 2 and 3 address the question, “What is gestalt therapy?”

These chapters grew from a conceptual statement of the theory of

gestalt therapy to its practice and then into the actual community

of gestalt practitioners. I realized the reader needed to sense who

gestalt therapy was and not just what it was (the “who,” and how

they did what they did, helps define the “what”). So I contacted

many of the people mentioned there and asked what attracted

them to gestalt therapy in the first place, with whom they trained,

and how they began training others. Chapter 3 gives a feel for how

gestalt therapy spread throughout the world since its birth at the

first gestalt training institute in New York in the early 1950s.

Part II of the book, How to Do Gestalt Therapy, presents the

core of gestalt therapy praxis.

Chapter 4, “Deal with Personal Experience,” covers the role

of phenomenology in gestalt therapy and presents a modified

phenomenological method that adapts a philosophical practice to

a psychotherapeutic purpose. This is a mild corrective to many

previous writings in gestalt therapy that called for the phenom-

enological method and pointed rightfully to Edmund Husserl,

but did not distinguish between his projects and the domain of

psychology.

Chapter 5, “Work the Therapeutic Relationship,” first deals

with the issue of alterity, an important concept for anyone working

with people. It then goes into the nature of dialogical relationships

and the concept of contact.

Chapter 6, “Use the Context of Life,” addresses field theory

in gestalt therapy, showing that gestalt therapy is not unique as a

field-oriented approach. It orients the reader as to the place of phe-

nomenal experience and relationship within a unified field that has

both phenomenal and ontic dimensions.

Chapter 7, “Move to Action,” deals with the experiential aspects

of gestalt therapy, which are for some people what gestalt therapy is

all about. It defines what a gestalt therapy experiment is and shows

how experiment is integral to every other theoretical tenet.xxvi Introduction

Chapter 8, “Practice a Unified Approach,” describes how every

part of gestalt therapy is related to and organized by the whole of

gestalt therapy. Gestalt therapy is not multimodal; it is holistic and

a unified praxis. It is not possible, while working with a client, to

be phenomenal without being relational and field theoretic within

a process that is experienced by both therapist and client. It’s all of

the same tapestry.

The last two parts of the book deal briefly with some clinical

and professional matters: assessment, treatment planning and case

management on the one hand and training, continuing education

and professional associating on the other.

If I had to choose the top five books on gestalt therapy to rec-

ommend to an English-language reader, aside from this book, I

would choose:

1 Gestalt Therapy: Excitement and Growth in the Human

Personality (Perls et al., 1951)

2 Gestalt Therapy Integrated: Contours of Theory and

Practice (Polster and Polster, 1973)

3 Gestalt Therapy History, Theory and Practice (Woldt and

Toman, 2005)

4 Handbook for Theory, Research, and Practice in Gestalt

Therapy (Brownell, 2008)

5 Brief Gestalt Therapy (Houston, 2003)

I chose the first book because it’s the seminal book on the gestalt

approach. In number 2 the Polsters moved the focus from individual

experiencing to contact between one person and the environment

or one person and another person, and that moved the emphasis to

dialogue. Woldt and Toman (number 3) is a thorough and contem-

porary treatment of gestalt therapy that also does well by the clas-

sic theory behind it and it presents field theory as an encompassing

tenet in the core of gestalt therapy. I chose number 4 (the book I

edited with an international team of contributors) because it estab-

lishes the core of gestalt therapy as represented in this book, and

it addresses the issue of research in the gestalt community, some-

thing absolutely necessary for gestalt therapists to undertake. Gaie Introduction xxvii

Houston’s description of gestalt therapy (number 5) used in a brief

approach is particularly relevant to today’s concern for cost reduc-

tion that does not reduce effectiveness as a by-product.

This book fits somewhere around numbers 3, 4, and 5 for rel-

evance. My hope is that it will be clear and understandable to the

novice and provocative enough for the seasoned gestalt therapist so

as to help in the evolution of gestalt therapy praxis.

NOTES

  1. Most gestalt therapists loathe the term “treatment manual,” because it brings to

mind a positivist approach to science and research they feel is out of place in gestalt

therapy’s worldview. I do not share that opinion. I think every treatment manual is a

map and every gestalt therapist learns that the map is not the territory. A treatment

manual is also a tool; it’s just one kind of tool for a special job. Only an idiot would

try to use one tool to do every job. Just so, a treatment manual is created for the pur-

pose of guiding practice and to accomplish the job of random, controlled research

studies. And I’m okay with that. A treatment manual, and certainly this book, is

not a cookbook with recipes or a paint-by-numbers project that makes robots out

of therapists, and it doesn’t tell everything there is to know and do about any given

clinical approach.

REFERENCES

Houston, G. (2003). Brief gestalt therapy. Thousand Oaks, CA: Sage Publications.

Brownell, P. (Ed.). (2008). Handbook for theory, research, and practice in gestalt therapy.

Newcastle, UK: Cambridge Scholars Publishing.

Perls, F., Hefferline, R., and Goodman, P. (1951). Gestalt therapy: Excitement and

growth in the human personality. New York: Julian.

Polster, E., and Polster, M. (1973). Gestalt therapy integrated: Contours of theory and

practice. New York: Vintage Book/Random House.

Woldt, A., and Toman, S. (Eds.). (2005). Gestalt therapy history, theory and practice.

Thousand Oaks, CA: Sage Publications.This page intentionally left blank Orientation PART

IThis page intentionally left blank 1 What Is Psychotherapy?

This chapter provides a working definition of psychotherapy,

describes common factors present in all established approaches to

psychotherapy, and explores the issue of whether or not psycho-

therapy is effective. In dealing with the evidence-based movement,

it advocates for practice-based evidence that is more relevant to the

clinical work mental health professionals do.

If you regard yourself as a mental health professional, then

chances are you already think you know what psychotherapy is.

You are either doing it now, have seen someone do it, have been a

patient/client/customer in the process, or help manage it in some

way. If you are just starting out, however, you might approach psy-

chotherapy with wonder and excitement. You might also feel uneas-

iness about your future as a psychotherapist.

This chapter provides a description of psychotherapy as a

general ground for the subsequent exploration of gestalt therapy

in particular. Various types of psychotherapy are mentioned (i.e.,

individual, dyad, or group). Psychotherapy research is discussed,

including those common factors identified as being effective to

positive outcomes across all major clinical perspectives. Regarding

evidence-based practice, forms of warrant are briefly discussed so

as to identify the means by which justification is established and to

3 4 Part I Orientation

orient toward “evidence” as warrant for the practice of any particu-

lar approach to psychotherapy.

THE TALKING CURE

If you were a bug on the wall in a therapy session, what might you

see? You would see two people sitting in a room talking. You might

see one of the people crying, fidgeting, speaking rapidly, or you

might see two people sitting in relative quiet, but the tension in

the room would throttle your senses. You might see three people

in the room, or you might see a whole group. You might see a fam-

ily in the room with the therapist acting like a policeman directing

traffic.

Many people believe the concept of psychotherapy originated

with Sigmund Freud in 1900 (Bankart, 1996), in his work titled

The Interpretation of Dreams (since republished in numerous edi-

tions and translations). Others trace the origins of psychotherapy

to the collaboration five years earlier between Josef Breuer and

Freud, and the publication of their book Studies in Hysteria;

Breuer’s patient, Anna O., is said to have called the hypnosis she

experienced “the talking cure” (Winick, 1997). Because of these

associations, psychotherapy, “the talking cure,” has been attributed

largely to Sigmund Freud. With the advent of such a talking cure,

the psychotherapist became the doctor of the interior (Cushman,

1992), and psychotherapy’s focus became what takes place when

two people sit down to speak with one another about one person’s

subjective experience. It is any form of treatment using verbal or

nonverbal communication between a therapist and a patient/client/

consumer that is understood to be a professional relationship

(Winick, 1997).

The word psychotherapy is a compound word coming from

two Greek words: psychē and therapeuō . Psychē means “soul” and

therapeuō means “heal” or “cure”; the compound, therefore, refers

to a process that heals the soul. Perhaps more difficult to put into a

compound was another Greek word, iaomai. Therapeuō originally

meant to serve a superior, and eventually it came to include curing a Chapter 1 What Is Psychotherapy? 5

person of various ills. Iaomai was the more direct word for healing;

it resulted in a person becoming hugiēs, or healthy. Iaomai included

healings and cures from physical and psychological ills. Thus, the

implication in the compound “psychotherapy” is that the therapist

serves the client for the purpose of healing the client’s soul and mak-

ing him or her healthy, sensible, and of sound mind (Brown, 1976).

Psychotherapy is not a legal matter, even though it often has legal

implications or focuses on someone’s legal process. Psychotherapy

is not just a conversation; it is a dialogue. Psychotherapy is not a

medical procedure (even though clinical psychology bought into

the medical model years ago), so no linear process of cause and

effect is involved in the cure. Psychotherapy is not social work, so

the emphasis is not on procuring community services, even though

it may result in the client becoming more proactive and researching

these same resources on his or her own. Psychotherapy is also not a

game in which two people waste each other’s time and energy; it is

not a farce or a futile process.

When I was a neuropsychiatric technician for the U.S. Navy

during the Vietnam War, I worked on a ward with a psychiatrist

who was rumored to have been associated with Harvard before

joining the ranks of the officers involved in the war effort. I knew

nothing of analysis, but many of the other corpsmen were saying

that making an appointment with this psychiatrist was “the thing to

do,” so I did. At the first appointment, he sat in one chair smoking

a pipe, and I sat in another. We faced each other, but I had a hard

time looking at him, because I did not want him to discover that

I was basically on a joy ride. I said nothing, and he said nothing.

Occasionally, we exchanged one-syllable trivialities. I recall making

several appointments with him, but none of them went anywhere

beyond what I have just described. There was not much talking in

that version of the talking cure.

On the same unit, a civilian psychologist who had been driving

down the coast to the Esalen Institute to train in gestalt therapy

with Fritz Perls was conducting a “gestalt group.” I was assigned

to work with that group as a support to the psychologist, and I

observed a lot of talking, but I also observed enactment as people

were asked to “be your foot,” “let your hand speak,” and so on.6 Part I Orientation

These were two ways of doing psychotherapy. In each case, a

theory guided the method used, and the combination of theory

and method produced a distinctive praxis. Praxis is the process by

which a theory becomes animated in the actions of its adherents.

Thus, the praxis of gestalt therapy is different from that of cog-

nitive behavioral therapy (CBT), even though the gestalt therapist

and the cognitive behavioral therapist may at times be doing what

looks, to any reasonable observer, like the same thing. This would

be the case in both approaches’ use of mindfulness:

Gestalt therapy, influenced by Zen Buddhism and Eastern

thought since its inception, has always understood the impor-

tance of awareness and subjective experience (phenom-

enology), and understood the value of the experiential “felt

sense” (as opposed to thinking and the conceptual), both

important aspects of mindfulness. These concepts as well as

gestalt therapy’s understanding of the change process, and

the importance of the acceptance of “what is” have recently

been incorporated into other systems such as CBT and ACT.

The mindfulness-based therapies (MBSR, MBCT) would

therefore have some overlap with aspects of gestalt therapy,

as there has now been a change in these approaches from

cognition and behavior change to being with and acceptance

of “what is.” (E. Gold, personal communication, April 5, 2009

[used by permission])

Mindfulness is mindfulness, but gestalt therapy and cognitive

behavioral therapy are two different theoretical systems.

Corsini and Wedding (2007), in their book surveying a number

of approaches to psychotherapy, have claimed that, in general, the

praxis of any form of psychotherapy is a learning process that con-

cerns the way people think, feel, and act:

All psychotherapies are methods of learning. All psychothera-

pies are intended to change people: to make them think dif-

ferently (cognition), to make them feel differently (affection),

and to make them act differently (behavior). Psychotherapy

is learning. It may be learning something new or relearning

something someone has forgotten; it may be learning how to Chapter 1 What Is Psychotherapy? 7

learn, or it may be unlearning; paradoxically, it may be learn-

ing what one already knows. (p. 6)

Gerald Corey (2009) disagreed that a psychotherapist’s chief

goal is to change people, but he admitted that people come to psy-

chotherapists in order to change and that change takes place. He

further identified the relational aspects of psychotherapy that are

integral to change:

Psychotherapy is a process of engagement between two per-

sons, both of whom are bound to change through the thera-

peutic venture. At its best, this is a collaborative process that

involves both the therapist and the client in co-constructing

solutions to concerns. … Therapists are not in business to

change clients, to give them quick advice, or to solve their

problems for them. Instead, counselors facilitate healing

through a process of genuine dialogue with their clients. The

kind of person a therapist is remains the most critical factor

affecting the client and promoting change. (Corey, 2009, p. 6)

Writing in a practical way for those contemplating the services

of a psychotherapist, Elaine Klonicki (2002) described psychother-

apy as being in a relationship with a person specially trained to lis-

ten in a supportive and nonjudgmental fashion so as to guide one’s

personal discovery to relieve pain and restore emotional balance.

She also asserted that psychotherapy teaches practical skills that

help people become more successful. She contrasted and compared

three similar activities—counseling, psychotherapy, and psycho-

analysis—which she described as increasingly more involved and

aimed at in-depth work with patients/clients/consumers: Counseling

offers short-term opinion or advice, psychotherapy offers help for

ongoing dysfunctional or ineffective patterns of behavior one has

not been able to change on one’s own, and psychoanalysis helps

those whose patterns are so stubbornly reinforced outside of their

awareness that they need several sessions a week to go deep enough

to understand themselves.1

Psychotherapy takes place in dyads (the traditional one-to-one

therapy), triads (what many call “couples” or “marital therapy”), small 8 Part I Orientation

groups, and families. Therapeutic principles are also employed by

organizational consultants working with large groups and complex

systems. Sometimes therapists work together in teams, especially

when conducting group therapy. Sometimes a therapist will have

an observing group of “consultants,” who remain behind a mirror

and call by phone to affect the process.

As mentioned previously, all psychotherapists are guided by

a psychotherapeutic theory that can be thought of as a cognitive

system defining how things are related and how things happen

(Crocker, 2008). Even so-called eclectic or integrative psychothera-

pists use such cognitive systems, usually ones based on some form

of personalized pragmatism and/or positivism. The theories that

have found most allegiance and support, however, are cognitive

behavioral, psychoanalytic, person-centered (or interpersonal), exis-

tential, and experiential. These systems include many subcatego-

ries, and elements of several of them can be reformulated into still

other theories. Two examples are multimodal therapy and gestalt

therapy. Gestalt theory is a revision of psychoanalysis (Freudian

theory) that includes (but is not restricted to) elements of cognitive,

behavioral, existential, and interpersonal theory. Gestalt theory is

described more completely in chapters 4 through 8, but the point

here is that therapists need some kind of theory to guide them, to

avoid just wandering around in the client’s story, trying different

techniques, and giving advice in a loosely and intuitively subjective

fashion.

FACTORS COMMON TO DIVERSE FORMS OF PSYCHOTHERAPY

All major approaches to psychotherapy share some characteristics—

things that contribute to the effectiveness of psychotherapy in one

way or another. These factors also help define psychotherapy. Thus,

whether a psychotherapist follows a cognitive behavioral approach,

a psychodynamic perspective, an interpersonal approach, transac-

tional analysis, rational emotive behavioral therapy, reality therapy,

a Jungian approach, or gestalt therapy, he or she will engage the

client and some common factors will influence the outcome. Chapter 1 What Is Psychotherapy? 9

In the Handbook for Theory, Research, and Practice in

Gestalt Therapy, I described the factors inherent to all approaches

to doing psychotherapy, relating them to gestalt therapy as fol-

lows (an experienced gestalt therapist would immediately rec-

ognize these features as belonging to gestalt therapy theory and

practice):

■ Client and Extra-Therapeutic Factors: This is the field—

all things having affect, especially the view of the field most

associated with the life spaces of both client and therapist.

These factors include what the client brings to therapy that

bear on the process of therapy and the issues to be visited

during that process. They include the client’s cognitive-

intellectual capacities and those elements of culture, history,

financial resources, and legal impact that affect the course of

therapy.

■ Therapist Qualities: This relates to the therapist as an

authentic person, the capacity of the therapist for contact,

and his or her training and experience. It includes the life

space of the therapist.

■ Relationship: This concerns the relational qualities of the

working alliance, and it relates directly to the gestalt therapy

concepts inherent to dialogue—presence, inclusion, commit-

ment to dialogue, and the creation of conditions permissive

and conducive to dialogue.

■ Specific Method: Certainly, this encompasses the aspects

of theory referred to earlier, but more specifically it relates to

gestalt therapy’s reliance on a phenomenological method and

experiment, for gestalt therapy is decidedly phenomenologi-

cal and experiential.

■ Expectancy: This relates to faith in the paradoxical theory

of change; it is a faith position more generally as well, in that

gestalt therapists trust the field will supply what is necessary

(Brownell, 2008, pp. 98–99).

The most salient features of psychotherapy are those extra-

therapeutic events and factors that the client and therapist bring to 10 Part I Orientation

therapy. Some studies suggest these factors account for about 40%

of positive outcomes, so what are they more specifically?

In Bermuda, where I write this, the extra-therapeutic factors

affecting psychotherapy include the economic conditions. A slow-

down in construction of new homes is the result of the dwindling

workforce, as major companies have let some of their workers go.

Extra-therapeutic factors in this case include tension between guest

workers and Bermudians; race; the systemic dysfunction within

some organizations which, like stubborn mold, keeps coming back

no matter what you do; and clients’ developmental, physical, and

intellectual characteristics.

This is not an exhaustive list, but it will suffice. It illustrates

how psychotherapy needs to deal with relevant factors in a cur-

rent situation, which is a mix of spatial, environmental, and social

contexts. At times it might be necessary to revisit one’s childhood,

but the current context is a more salient ingredient in psychother-

apy; psychotherapy is therefore some kind of process, verbal and/or

experiential, that in some way addresses the current experience of

the client, the person who comes for help.

Psychotherapy is also an agreement between two people in

which one is seeking help and will pay for it, and the other has

wisdom, training, and experience to offer in facilitating the seek-

er’s quest for answers, solutions, skill building, insight, and/or

awareness. Thus, a contract is formed in which the provider gives

informed consent about what he or she has to offer, its limits, and

the conditions under which the psychotherapeutic process will be

conducted.

All these things are involved in “the talking cure,” no matter

how much or how little actual talking takes place.

DOES PSYCHOTHERAPY “WORK”?

If something “works,” then it attains an expected effect or outcome.

It functions in a desired fashion. A bucket can be used to carry

water, for example, but if it is riddled with holes, all the water flows

out and the bucket does not “work.” The question often asked (not Chapter 1 What Is Psychotherapy? 11

so much any more, actually) is, “Does psychotherapy work?” Or is

psychotherapy so riddled with holes that it cannot carry water? That

question has been answered,2 but there are facets to the answer,

and they concern the basic issues of justification (is a certain type

of psychotherapy—or even psychotherapy itself—warranted),

types of outcomes research, evidence-based practice, and practice-

based evidence. These concepts are treated only briefly here, but

the reader may want to explore these issues in more depth at some

other time.

Efficacy, Effectiveness, and Warrant

For the last 50 years or so, people have been concerned with the

question of whether or not, or how much psychotherapy works. In

the late 1980s and 1990s, the pace of outcomes research in the

practice of psychotherapy picked up, and it was dominated by the

term efficacy. Efficacy is a concept that grew out of the randomized

trials used to test the cause-and-effect relationships between tak-

ing a medication and symptom reduction. The greater the desired

effect, the greater the efficacy. In the late 1990s, some psycholo-

gists began to investigate the patient satisfaction associated with

various kinds of treatments, not just medications, and their stud-

ies became associated with the term effectiveness. The greater the

patient’s/client’s/consumer’s satisfaction (in one form of such study),

the greater the effectiveness. In addition to these concepts, the

question of a methodology’s efficiency also became increasingly of

concern. Haynes and Johnson (2009) provide a succinct summary

of all three concepts:

Efficacy is the degree to which interventions result in

positive outcomes in ideal settings. Ideal settings are often

research laboratories or experimental conditions pro-

viding studies with a high degree of internal validity. …

Effectiveness is the extent to which treatments provide pos-

itive patient outcomes in real-world settings. … Efficiency is

the extent to which one treatment provides relatively better

outcomes than other treatments. (Haynes & Johnson, 2009,

pp. 302–303)12 Part I Orientation

The term efficacy is usually reserved for statements of causal-

ity associated with randomized and controlled studies of manual-

ized treatments and the systematic review of such clinical research

using meta-studies of effect sizes. Effectiveness usually refers to

feasibility in studies with measurable positive effects across broad

populations in clinical situations. Efficacy studies emphasize inter-

nal validity and replicability, but effectiveness studies emphasize

external validity and generalizability (Nathan, Stuart, & Dolan,

2003). Although randomized, controlled studies have become the

standard for research providing evidence, their applicability to psy-

chotherapy research has been questioned, and the issues intrinsic

to this concern over their appropriateness further illustrate how

psychotherapy contrasts with medical treatments:

The controlled clinical trial method was initially designed by

medical science for use in studies of medications. A physi-

cian administers a specific medication knowing it is the only

medication being administered to compare the results with

a placebo or standard of care condition. Unlike medication,

psychotherapy cannot be administered in such pure form,

and adherence is much more difficult to measure. The social

nature of the interaction must be considered. The controlled

clinical trial methodology is effective in investigating medical

interventions for comparing psychotherapy to pharmacother-

apy or their combination. It is limited however, when imposed

on psychotherapy alone, which is an entirely different enter-

prise because of the complex and dynamic nature of social

interaction. (Ablon & Marci, 2004, p. 667)

Warrant, on the other hand, is a philosophical and general term.

It refers to the level of justification for any given action and has var-

ious bases (Brownell, 2008). Warrant, as a philosophical construct,

stands behind all assertions and arguments pertaining to efficacy,

effectiveness, and efficiency.

For instance, warrant can be based on personal experience

and assertion. In this situation, a psychotherapist claims to know

what he or she does is effective, because the therapist has seen

the results in the clients’ changed lives and general satisfaction. Chapter 1 What Is Psychotherapy? 13

A person might say, “I don’t need research to tell me this works;

I know it works from watching my clients.” A person’s esteemed

trainer might say, “Believe me. This stuff works!” Either statement

would be a low level of justification, but a valid method of ascer-

taining whether or not warrant exists.

Warrant can also be based in foundationalism; that is, one

belief is based on another more “foundational” belief. For instance,

early analysts believed they should remain unobtrusive (and they

believed they could actually do that) so as to present a blank slate on

which the client could project in the therapy room; this was based

on their belief that free association was the avenue to the uncon-

scious and was obscured by transference, and that the unconscious

is where the intrapsychic and psychosexual conflicts of neurosis lay.

Foundationalism is usually rejected because it results in an infinite

regress of beliefs, none of which, perhaps, can be independently

supported.

Somewhat related is the coherency view of warrant, in which

justification is achieved through a web of beliefs and the war-

rant is not subject to a linear regress but stands or falls as a unity.

This view can be compared to a ship at sea that requires constant

upgrading and maintenance to remain afloat. In the same way, a

web of meaning is in a perpetual state of construction. Related to

coherentist warrant is the web of factors and theoretical tenets cre-

ated through the consilience that unites them.

Consilience is a unity of knowledge. A good theory unifies data

and laws from diverse domains; one classic example is the suc-

cessful unification of Kepler’s laws and Galileo’s laws by means of

Newton’s theory (Niiniluoto, 2007). Newton established a larger

category that accounted for the observations of Kepler and Galileo,

thus assimilating them into his theory. William Whewell asserted

that coherence is a type of consilience, in that coherence extends

the hypothesis to colligate a new class of phenomena without hav-

ing to adjust the hypothesis to make it fit (Snyder, 2006).

For example, if the cognitive approach of imaginal desensitiza-

tion is shown to be effective and that approach shares the charac-

teristics of the gestalt use of imagination in experimental enactment

(a consilience of praxis between the two perspectives, CBT and 14 Part I Orientation

gestalt), then part of a coherent web forms, and the fact that people

coming at a phenomenon from two different perspectives arrive at

virtually the same procedure, construct, theory, and so on suggests

they have independently discovered the same approach. In this

case, not only would the research support both the CBT and gestalt

versions of the shared intervention, but the consilience between

the theories would also suggest warrant on the basis of coherence.

Another basis for warrant is in evidence. Evidentialism in psycho-

therapy claims that unless there is conclusive evidence for the efficacy

of a certain practice, one lacks warrant and should not engage in that

practice. Stated more positively, warrant is attained through conclu-

sive evidence. Unfortunately, all evidence is partial; evidence is incon-

clusive, even though it can sometimes be quite compelling. There is

always error. Effect sizes fall short of perfection. Only relative evi-

dence is available and therefore only relative certainty is attainable.

Even so, warrant is linked to evidence-based practice of psycho-

therapy through concern for efficiency and effectiveness. The use

of any particular approach to psychotherapy is warranted on the

basis of the various kinds of evidence different types of research

generate. If an approach is said to be evidence-based, it is deemed

to be warranted on the basis of evidentialism. It may be that more

can be said about warrant based on coherentism and consilience

in the future, but that remains to be seen. Finally, if the evidence

supporting one approach indicates it is more effective than another

approach, then the more effective approach is more efficient and

relatively more warranted.

Evidence-Based Practice

The concerns for efficacy, effectiveness, and efficiency are at the

heart of the movement for evidence-based practice in psycho-

therapy. The two considerations that loom largest in any particular

intervention or approach to psychotherapy are “does the treatment

work—a question of its efficacy, which is most related to internal

validity, and does it generalize or transport to the local setting

where it is to be used—a question of its effectiveness, which is most

related to external validity” (Brownell, 2008). Chapter 1 What Is Psychotherapy? 15

According to the American Psychological Association,

evidence-based practice in psychology is the integration of the best

available research with clinical expertise in the context of patient

characteristics, culture, and preferences (APA, 2006). That task

force identified multiple forms of support as “evidence.” The range

of research designs that contribute to the body of knowledge rel-

evant to evidence-based practice includes:

… clinical observation, qualitative research, systematic case

study, single-case experimental designs to examine causal

factors in outcome with regard to a single patient, process-

outcome studies to examine mechanisms of change, effective-

ness studies in natural settings, random controlled treatments

and efficacy studies for drawing causal inferences in groups,

and meta-analysis for observing patterns across multiple stud-

ies and for understanding effect sizes. (Brownell, 2008, p. 94)

In addition to this list, some have argued for the need to remain

sensitive to, and make a place for, the clinical judgment of experi-

enced clinicians (Zeldow, 2009) and to make the clinical setting a

natural laboratory (Borckhardt et al., 2008; Brownell, 2008; Fago,

2009; Westen & Bradley, 2005) for the production of practice-based

evidence. Clinical judgment and reasoning have been defined by

Shapiro, Friedberg, and Bardenstein (2006) as a mix of informed

analysis and decision making leading to case planning based on

such things as research findings, client observation, consideration

of etiology, credible clinical theories, compelling authors and train-

ers, as well as past experience in the use of various techniques.

Practice-Based Evidence

Practice-based evidence has been characterized as a bottom-up

process of gathering data that relies on the experience of practicing

clinicians to inform treatment (Dupree, White, Olsen, & Lafleur,

2007). Practice-based research networks (PBRNs) have been used

among clinician-researchers across diverse organizations in preven-

tive medicine, because these PBRNs increase external validity and

the generalizability of results. They are useful.16 Part I Orientation

Psychotherapists who track the quality of their own work and

who use sound research methodology, such as single-case, timed

research designs, to do so provide themselves with evidence that sur-

passes assertion based on personal experience and declaration based

on foundationalism. They also produce a form of evidence that is

critical to the evidence-based movement, and that is practice-based

evidence. It is precisely what is in question in studies of the effec-

tiveness of psychotherapy or any particular kind of psychotherapy,

and it qualifies as a valid form of research design that many believe

rightfully stands beside random, controlled trials (Borckhardt et al.,

2008). Among the factors making this approach appealing is the fact

that it can be carried out at the clinical level without a major cost

and relatively nonintrusively. It is a psychotherapist-friendly method

of generating outcomes research that can then be analyzed to assess

typical patterns for an individual therapist’s practice, including the

effectiveness of the psychotherapy that therapist used.

CONCLUSION

Psychotherapy is a general term referring to a process of treating

psychological pain and functional ineffectiveness. Thus, it is related

to one’s individual, subjective experience and focuses on such forms

of distress as depression, anxiety, disruptions of thinking, dissatis-

faction with one’s body, compulsive repetition that seems out of

control, psychosis, and extreme mood disturbance. Psychotherapy

addresses one’s functional effectiveness, taking into consideration

such factors as organizational capacity, conscientiousness, agree-

ableness, and openness to experience, and it has been shown to be

a warranted response to pain and dysfunction with a relatively high

degree of effectiveness.

The term psychotherapy is often used interchangeably with

“counseling.” It represents the meeting of two people, one of whom

is trained and asserts competence and the other who comes to

address pain or discomfort and functional decline. These two indi-

viduals form a therapeutic or professional agreement in which the

therapist offers services for which the client agrees to pay. Because Chapter 1 What Is Psychotherapy? 17

of the nature of this relationship, ethical and legal guidelines and

parameters have been formulated over time to assist the therapist

and to protect the patient/client/consumer. That is because the

therapist has heightened influence with regard to the patient/cli-

ent/consumer, and that person’s level of vulnerability intensifies

when a therapeutic relationship is deeply rooted.

Psychotherapists are guided by clinical and theoretical systems.

They typically learn these in formal, academic graduate programs

or postgraduate training institutions, and they are supervised in

their practical experience by trained, competent, and licensed clini-

cal supervisors. Often, their practices are regulated by certification

and licensing boards in the jurisdictions in which they practice.

The various systems of psychotherapy (psychoanalytic, psy-

chodynamic, cognitive, behavioral, cognitive behavioral, human-

istic and existential, etc.) all have their literature bases. This book

focuses on gestalt therapy, providing a practical guide for the men-

tal health professional who would become competent to practice as

a gestalt therapist.

NOTES

  1. Corisni and Wedding (2007) would disagree that this kind of distinction can be made

between psychotherapy and counseling, claiming the overlap is too great. Along the

same lines, it is difficult to see much real difference between counseling and coach-

ing; coaching, counseling, and psychotherapy now overlap extensively.

  1. In the middle of the 20th century, several prominent researchers/writers questioned

whether the benefits of psychotherapy exceeded what occurred naturally over time

without treatment. Since then “thousands of well-controlled outcome studies …

have been completed, reviewed, and meta-analyzed,” resulting in the evidence that

psychotherapy does, indeed, work; in fact, the evidence is so massive that the ques-

tion now is which forms of therapy work better than others and under what condi-

tions (Kazdin, 2008, p. 146).

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tive practice. Psychotherapy: Theory, Research, Practice, Training, 46, 1–10.This page intentionally left blank 2 What Is Gestalt Psychotherapy?

In this chapter, gestalt therapy is briefly contextualized in terms

of theoretical development. The existential, phenomenological,

and behavioral aspects of gestalt therapy are identified, and the

complexities of gestalt therapy theory are briefly expressed in

ordinary language. What gestalt therapy is and what it is not are

clearly defined so that the reader might distinguish it from other

approaches; it is also compared and contrasted with other major

clinical perspectives.

Some people think of gestalt therapy as an existential field the-

ory. Others think of it as a combination of existential phenomenol-

ogy and phenomenological behaviorism. Broadly, gestalt therapy

fits in the category of humanistic approaches. However, gestalt

therapy developed as an expression of the revolutionary science that

led to the paradigm shift from positivism to postpositivism—or to

what many understand as postmodernism or deconstructionism.

Thus, it is not simply a quirky version of person-centered therapy

or an embodiment of Maslow’s ideas. Gestalt therapy shares con-

cepts with Rogerian and existentialist approaches, and it points

to many of the same philosophers in the foundational and ideo-

logical development of its theory; but it is a complete theoretical

and clinical system of its own. It was birthed in a unique mix of

21 22 Part I Orientation

continental philosophy and German science and conceived of as a

revision of Freud’s psychoanalytic approach. Its theory has been

developed extensively since Frederick and Laura Perls started

the first gestalt therapy training institute, and certainly since the

time when Fritz Perls demonstrated gestalt therapy at the Esalen

Institute at Big Sur, California. Today, gestalt therapy is a grow-

ing theory that is applied diversely by various therapists all over

the world.1 Its principles have also been adapted by consultants

working with organizations and, most recently, by coaches helping

individual executives.

To grasp more fully what gestalt therapy is, reading a descrip-

tion of its theory or practice is not enough. One must sense what

led up to it, how it took form in the lives of the people who became

gestalt therapists, trainers, thinkers, and writers, and what the chief

interests are in the work of its contemporary theorists. This chapter

provides a prelude to gestalt therapy, and chapter 3 outlines the

history of its growth in the world as well as offering a glimpse of

some of its contemporary leaders.

BACKGROUND

The background to gestalt therapy can be organized into an Eastern

influence and a Western influence. A general description of a few

prominent individuals and philosophical currents provides a sense

of the developmental ground from which gestalt therapy emerged.

Eastern Influence: Zen and Tao

Buddhism is an Asian religion, or philosophy, founded in India by

Siddartha Gautama during the 5th century b.c. Buddhism advo-

cates the eightfold path, which is a subset of the four noble truths:

life is suffering, the cause of suffering is craving or desire, suffering

ceases only at nirvana (the extinction of desire), and nirvana may

be achieved by following the eightfold path. The eightfold path

consists of understanding, thinking, speech, action, livelihood,

effort, mindfulness, and concentration. “Thus Buddhist teaching

provides a set of beliefs about reality, a theory of the human mind Chapter 2 What Is Gestalt Psychotherapy? 23

and behavior, and recommendations on how to live (Kelly, 2008);

these all involve the way a person navigates life, and thus are also

process in nature” (Brownell, in press a, np).

One of the more important emphases of Buddhism is on mind-

ful awareness.

The most common Buddhist method of awareness training is

mindfulness of breathing. Two classical Buddhist texts deal

with this in detail: The Sattipathana Sutta (Anãlayo, 2003)

and the Anapanasati Sutta (Rosenberg, 1998). They both

explore awareness under four headings: Awareness of the

body; Awareness of feelings; Awareness of mind, Awareness of

phenomena. (Kjønstad and Halvorsen, in press)

Zen Buddhist spirituality is

not about thinking about God when one is peeling potatoes;

it is being fully engaged in peeling the potatoes. Indeed, Zen

teaches that all daily activities can be done with the same

kind of undivided presence in the moment, where we give

ourselves wholly to whatever we do, without second-guessing

ourselves, without self-consciously observing how we are doing

what we are doing, without being double-minded. (Crocker &

Philippson, 2005, p. 75)

In very brief summary, Eastern spirituality largely concerns the

way in which a person lives. It is practical. It is concerned with

method and action, with attention to the current flow of experi-

ence and awareness, and it is characterized by acceptance of what-

ever is currently happening, trusting in the natural flow of events

that will bring about wholeness and healing.

Taoism is a Chinese philosophy based on the writings of

Lao-tzu, who lived somewhere between the 6th and 4th centu-

ries b.c. Taoism has a naturalistic ethos that promotes a process

approach for understanding life. It emphasizes a “way” that allows

it to encompass many movements and local belief systems, avoid-

ing conflict with their tenets–the “what” or the content of those

belief systems–by emphasizing the manner of the process of living 24 Part I Orientation

with that content. As such, it can be assimilated today as a har-

monic complement to the contents of belief systems and clinical

perspectives.

The Tao, or the “way,” refers to direction, movement, and

method in thought, while living in and with nature. Spontaneity

and naturalness are its chief virtues, and when reflected in a

clinical setting, the task of the therapist is to “engage the client

in ways that allow nature to do the healing and the growing”

(Crocker, 2005, p. 74; cf. also Dahlsgaard, Peterson, & Seligman,

2005).

In summary, the Eastern thought that influenced gestalt ther-

apy was not something the founders of gestalt therapy studied in

depth, but it was “in the air” in their spheres of influence as gestalt

therapy was being formed. Eastern thought was a useful metaphor

in their thinking. Eastern influence concerns the way in which a

person lives. It focuses on method and action, “with attention to the

current flow of experience and awareness, and it is characterized

by acceptance of whatever is currently happening, trusting in the

natural flow of events that will bring about wholeness and healing”

(Brownell, in press a, np).

Western Influence: Judaism, Christianity, Philosophy,

and Science

The Western influence in the ground of gestalt therapy, by con-

trast, is huge. It starts in ancient Greece and concludes in post-

World War II France and North America.

Most Western systems of thought can be traced back to the

Greek philosophers Socrates, his student Plato, and Plato’s stu-

dent Aristotle. Aristotle tutored Alexander the Great and started

his own school of philosophy, the Lyceum, in Athens. His writ-

ings on logic, physical science, and metaphysics have had a strong

influence on subsequent thinkers, especially on medieval and

Renaissance writers. Sylvia Crocker (1999) described gestalt ther-

apy as Aristotelian, and her description is a good starting point

for tracing the Western influences in the development of gestalt

therapy: Chapter 2 What Is Gestalt Psychotherapy? 25

While Aristotle was interested in coming to an understand-

ing of the general nature of the processes of change which

are everywhere apparent, he was particularly interested in

those functions of living organisms which explain both their

morphology and their behavior. Plato’s vision looks away from

nature to those universals which are imperfectly exemplified

there, while Aristotle’s vision looks into nature to find the

organizing principles which govern its processes. For Plato,

knowledge comes primarily from rational thought, while

Aristotle’s approach to knowledge begins with experience,

which is processed by rational thought and is then applied

back to experience. (Crocker, 1999, p. 111)

Among the various concerns that Aristotle considered was his

observation that there is a process and a faculty to living things:

“[S]hould the process of thinking come first or the mind that thinks,

the process of sensation or the sensitive faculty?” (Aristotle, 2006,

p. 4). This logical ordering is echoed today in curiosity about wave

and particle, field and organism, and the emergent properties of

self. In terms of gestalt therapy the question is, “Should the indi-

vidual come first or the field of which he or she is a part?”

There was a long period in which common reference to think-

ers such as Plato and Aristotle were almost lost. The Greek texts

suffered as familiarity with the Greek language waned and all but

disappeared; however, a few people advanced Aristotle’s ideas.

Peter Abelard, John Buridan, John Duns Scotus, Thomas Aquinas,

and William of Ockham, among others, developed medieval phi-

losophy focused on metaphysics, natural philosophy, science, and

epistemology (Spade, 2004).

Fast forward to the 18th century. Immanuel Kant was born

in 1724 in East Prussia (now Kaliningrad, Russia). His productive

philosophical life extended from 1745 to 1802. His ideas continue

to be studied all over the world for their relevance to science, cul-

ture, religion, and philosophy proper.

One of the more relevant issues for gestalt therapy is the way

Kant defined the terms noumenon and phenomenon. He used

noumenon to refer to an object itself, as it exists in the real world

apart from any person’s experience of it, and he used phenomenon 26 Part I Orientation

to refer to how that object appears to a given subject. This is a

distinction between what is independent of the mind and what

is dependent on it (Langton, 1998), a distinction congruent with

Kant’s assertion that knowledge is contingent on experience. Kant

argued that

there is no such thing as “bare perception,” that we never

experience the raw data of experience, that our processes of

sensation and perception always filter and organize the data

according to the mind’s own innate rules. According to Kant,

we can never know what, if anything, the resemblance is since

we can never escape our own way of perceiving. (Crocker,

1999, p. 137)

In terms of culture, Kant was influenced by Taoist and

Confucian thought, which were disseminated in continental Europe

by Jesuits based in China and popularized by Leibnitz, Wolff, and

their students. One example is the idea of dialectics that Bulfinger

found in the Chinese classical literature and Kant encountered in

the Russian academy. “Kant was unaware of the Far Eastern roots

of the notions that influenced him, and the historical irony is that

he dismissed nonwestern cultures while being deeply influenced

by their insights.” (Schonfeld, 2007, np)

The belief that knowledge is contingent on experience was

picked up by Friedrich Schleiermacher, a second-tier philoso-

pher in a world more at home with theism than the current age.

Although comfortable with German idealism, Schleiermacher was

a contemporary and rival of G. W. F. Hegel in academic circles, and

the two ended up quite at odds with one another.

Schleiermacher is significant for two reasons, one of which was

his development of the concept of religious “feeling.” He is often

contemplated along with William James, Søren Kierkegaard, and

Jonathan Edwards regarding religious emotions; however, to lump

Schleiermacher’s term “feeling” into a simple affective category

would be to miss his point. He was talking about what today would

be called spiritual experience.

Schleiermacher grew up in a part of the world dominated by

theism and Lutheran Pietism, the latter of which promoted an Chapter 2 What Is Gestalt Psychotherapy? 27

experiential knowledge of God (Jones, Wainwright, & Yarnold,

1986). Schleiermacher referred to himself as a Pietist of a higher

order, for in his world philosophy often pivoted off religious issues.

Thus, Schleiermacher became a renowned philosopher-theolo-

gian, who was considered the father of liberal Protestant theology

because he sought to incorporate philosophy and science into his

thinking about God.

Schleiermacher described individual experience as a “starting

point in understanding religious life (McGrath, 2004). Although he

revered Plato, he was also a student of Aristotle and understood

religious experience as the feeling (Crouter, 2005) of absolute

dependence on God, ‘… identical with the consciousness of being

in relation with God’” (Brownell, in press b, np; Feinberg, 2001, p.

  1. Thus, for him the ongoing flow of one’s experience became

a crucial focus of life. He had a great influence on Rudolph Otto

(1923/1958), who distinguished between the experience of the mys-

terium tremendum (awe and fear) and that of mysterium fascinans

(fascination and attraction), when it came to contact with divinity,

the experience of the numinous.

Schleiermacher had a tremendous influence on Willhelm

Dilthey’s work in hermeneutics. Dilthey studied under two of

Schleiermacher’s students at the University of Berlin, and in 1859

he was asked to complete the editing of Schleiermacher’s let-

ters. That year the Schleiermacher Society organized an essay

competition, and Dilthey’s submission titled “Schleiermacher’s

Hermeneutical System in Relation to Earlier Protestant

Hermeneutics” (1860) won. Subsequently, he was commissioned

to write Schleiermacher’s biography. Dilthey then wrote his dis-

sertation on Schleiermacher’s ethics (Makkreel, 2008). In Dilthey’s

final productive period, he broadened hermeneutics to include a

method for the recovery of meaning out of experience, and thus

applied an essentially theological process to social sciences. He is

well known for proposing two models of psychological investigation:

a natural science that seeks causal explanations and is examined by

experimentation and a cultural science that seeks an understand-

ing of psychological phenomena and is examined by hermeneutics

(Kashima & Haslam, 2007).28 Part I Orientation

This leads to the second significance of Schleiermacher, which

is, for some, the most important impact of his work—his influence

on hermeneutics. In the development of the rules for literary inter-

pretation, the question, “How do we read this text?” in his hands

became “How do we communicate at all?”

Without such a shift, initiated by Friedrich Schleiermacher,

Willhelm Dilthey, and others, it is impossible to envisage

the ontological turn in hermeneutics that, in the mid-1920s,

was triggered by Martin Heidegger’s Sein und Zeit and car-

ried on by his student Hans-George Gadamer. (Ramberg &

Gjesdal, 2005)

Schleiermacher was nearing the end of his life as Søren

Kierkegaard was entering his most productive period. Rather than

Kierkegaard being a disciple of Schleiermacher, it is more likely

that Schleiermacher provided Kierkegaard an intellectual and

theological anvil against which to hammer out his own thinking on

such issues as religious experience, being, and the dialectics of life.

Thus, whereas Schleiermacher held dialectic to be conversation

and the art of knowing, Kierkegaard viewed it as the contradictory

nature of existence and the art of paradox leading to existential

earnestness (Crouter, 2005).

On June 10, 1836, Kierkegaard wrote in his journal

An ambulant musician played the minuet from Don Giovanni

on some kind of reed-pipe (I couldn’t see what it was as he was

in the next courtyard), and the druggist was pounding medi-

cine with his pestle, and the maid was scouring in the yard,

and the groom curried his horse and beat off the curry-comb

against the curb, and from another part of town came the dis-

tant cry of a shrimp vendor, etc., and they noticed nothing

and maybe the piper didn’t either, and I felt such well-being.

(Rhode, 1960/1988, p. 13)

This is the quality of existential wonder in the mundane flow of

life, of being alive and mindful of the lives of others in the hum of

the community. However, it was Kierkegaard’s investigation of the Chapter 2 What Is Gestalt Psychotherapy? 29

individual person—the individual’s experience of such community

rather than of community itself—that marked him as the father of

existentialism.

In the liturgical ecclesia of his day, stale and rigid in its reli-

gious routines and its dogmatic creeds, the individual’s subjective

experience, to Kierkegaard, was more true, more valuable, than

simple adherence to ethical norms and rational precepts (Crowell,

2008). This led to the development of the construct of authenticity

in 20th-century existential philosophy and to what gestalt thera-

pists would later understand as spontaneity and fluidity in respond-

ing to novel figures.

In regard to religious experience, Kierkegaard expounded

faith, personal and passionate entrusting of oneself, animated by

acts in which one made faith a living contrast to the relatively dead,

Hegelian rationalism he often criticized. It was not a matter of

the object of belief, nor what was said about that object, as much

as it was about the quality of believing or the way in which one

expressed one’s faith (Amesbury, 2005).

Kierkegaard lived in a time similar in some ways to our own.

He objected to a prevailing contempt for the individual. He

observed a search for science and objectivity motivated by Kant

and Hegel, but in place of that Kierkegaard substituted “subjec-

tive truth,” choice and passion, and he turned attention back to

the individual, away from the idea of the collective (Solomon,

2004). His ground was his own Christianity and his rejection of

Hegel and the Church as burdens imposed on free people. He

lived as an existing individual, and he propagated both the con-

cept and the lived experience of existence in a way that directly

influenced Brentano, Husserl, Heidegger, Sartre and Jaspers.

With this influence, he became the ground for European exis-

tentialism. (Brownell, 2008a, pp. 214–215; Gaffney, 2006)

Franz Brentano was born in 1838 in Germany. He belonged

to a family of intellectuals who were deeply given to German

Romanticism. His family were devout Catholics, and their home

was a constant meeting place for intellectuals. Brentano obtained a

classical European education, and during his final years in school 30 Part I Orientation

his interests ranged from philosophy to mathematics and geometry,

but it was his reading of Aristotle that became the foundation and

impetus for his choice of philosophy as a focus for his life’s work.

He studied for the priesthood and took orders with the understand-

ing from his bishop that he could continue his studies and teach.

Eventually, he renounced the priesthood because he could not

abide the doctrine of the infallibility of the Pope, but he remained a

devout theist. Among his students were Stumpf, Erenfels, Husserl,

and Freud (Albertazzi, 2006).

Brentano is credited with reviving the medieval construct

of intentionality and using it in his conception of act psychol-

ogy. Intentionality addresses the “aboutness” of experience.

Everything we think, feel, value, imagine, perceive, and expe-

rience is about something. Each of these mental acts takes an

intentional object.

Franz Brentano considered the qualities that character-

ize mental acts, or phenomena, and is credited with the first

serious inquiry into phenomenology. Reaching back to the

Scholastics for a term, he re-introduced “intentionality,” plac-

ing it into phenomenological vocabulary. In the discourse of

philosophy, intentionality is the aboutness of mental phenome-

na. To think is to think of something. All thought has an object,

either inexistent (for example, a unicorn) or actual (for exam-

ple, a house). The name most associated with phenomenology

is that of Brentano’s student, Edmund Husserl. With Husserl,

phenomenology became a philosophical movement… . [I]nten-

tionality describes the relationship of the knower, the process

of knowing, and that which is known, and it is comprised of the

quality of knowing, or noesis, and the content of knowledge, or

noema. (Burley & Bloom, 2008, pp. 152–153)

It is Husserl, rather than Brentano, who is considered the

founder of phenomenology. He was a prolific theorist who wrote on

many subjects and passed through various stages in developing his

own thinking. With regard to gestalt therapy, his form of phenome-

nological inquiry, called the phenomenological method, has become

most influential. Its adaptation to a therapeutic process is one of the Chapter 2 What Is Gestalt Psychotherapy? 31

factors that makes gestalt therapy a phenomenological perspective

(D. Bloom, personal communication, May 7, 2009a. Throughout his

career, Husserl assumed that the best way to approach knowledge

was to focus on the meaning-making acts of consciousness and that

the best way to do that was by concentrating on what was given

or apparent to an individual in immediate experience. Thus, both

phenomenology and gestalt therapy begin with the appearance of

phenomena to consciousness (Moran, 2000).

The scientific roots of gestalt therapy can be traced largely to

two individuals, Kurt Goldstein and Kurt Lewin. They are rep-

resentatives of the school of gestalt psychologists that arose in

Germany just before World War II. Both immigrated to the United

States, where each influenced American psychology.

Kurt Goldstein was both a scientist and a philosopher. As such

he was particularly heartened by what he believed to be consilience

between his findings, through his work with brain-injured people,

and the phenomenological philosophy of Edmund Husserl. In par-

ticular, it was Husserl’s concept of the lebenswelt (lived world) in

the natural attitude that corroborated Goldstein’s philosophy of sci-

ence. The interest of phenomenologists such as Aaron Gurwitsch

and Maurice Merleau-Ponty in his conceptions of abstract and con-

crete processes provided him with a satisfying affirmation toward

the end of his career.

Each person comes by a system of thought or a practical solution

in the context of other people. Just so, Goldstein credited contem-

poraries as well as predecessors who have since become obscure

influences in his development of a holistic approach. He was a phy-

sician and neurologist, and he is most noted for his work treating

and investigating the effects of brain damage in soldiers following

World War I. He wrote about his findings and his approach in The

Organism, which remains one of the classic works of psychological

literature and was reprinted in 1995. Interestingly, Skinner (1940)

reviewed that book and criticized Goldstein for being metaphysi-

cal instead of scientific. It may be that Skinner was picking up on

Goldstein’s conviction that there is something about the human

being that is not reducible to reflex arcs, atomization, and sim-

ple association—materialities to which Skinner was committed. 32 Part I Orientation

Contrary to Skinner, Goldstein asserted:

Security needs the material world, that is, a product of the

application of natural science by which the spiritual side of man

is intentionally by-passed. Existence in the living world presup-

poses qualitative experience, not simple “order.” To understand

how we can move from the quantitative results of natural sci-

ence to the qualitative activity of life is a problem that has always

caught the imagination of man. (Goldstein, 1967, p. 155)

Goldstein had been working some time and developed his

thinking before he found confirmation in Claude Bernard’s 2 asser-

tion, “Living is a contact between the organism and the outer world,

if one suppresses the one or the other of the two conditions, life

ceases.” In 1938–1939, Goldstein delivered the William James lec-

tures at Harvard, which he entitled “Human Nature in the Light of

Psychopathology.” 3 In these talks he described the conclusions for

which he found support in Bernard:

the biological knowledge we are seeking is akin to this phe-

nomenon in which the capacity of the organism becomes

adequate to environmental conditions. This is the fundamen-

tal biological process by virtue of which the actualization of

the organism, and with that its existence, is made possible.

Whenever we speak of the nature of the organism, of the idea,

the picture, or the concept of the organism, we have in mind

the essentials for the occurrence of an adequate relationship

between the organism and its environment. From these, in

principle, that picture arises which we have to grasp in deter-

mining the nature of man. In doing so we are subjected to

practically the same difficulties of procedure as the organism

is learning: we are obliged to discover what the relationship is

between concept and reality. (Goldstein, 1940, pp. 25–26)

With regard to the relationship between a person and the world,

Goldstein claimed that

The mentioned behavior forms have usually been considered

as the effect of the use of the mental capacity of a subject. Chapter 2 What Is Gestalt Psychotherapy? 33

I came to the conclusion that they are not determined by

consciousness and that it would be meaningless to call them

unconscious. They represent living events and are not the

result of intellectual activities. I could no longer accept the

assumption that experience is the product of mind or brain

functions alone, especially after it became my conviction that

the external world is always connected with it.…The study of

the world of the brain-injured proved to be no less important

to our knowledge than the study of the disturbance of the per-

formance. Indeed, though the patient’s behavior is certainly

determined by the brain defect, it can only be understood as a

phenomenon going on in the totality of his modified personal-

ity in relation to the world. The holistic approach induced me

to bring psychophysical relationship into the foreground. It

became obvious that it was directed by the tendency to come

to terms with the world in which the individual feels he lives.

There are two different behavior forms in his being in the

“man-world” entity. …Sickness cannot be understood correct-

ly if one assumes that it is something that befalls the individual

from the outside. Our task is not simply to eliminate the dis-

turbance or fight the effect of the sickness. Sickness seen from

a higher aspect has to be considered as a disturbance of the

relation between man and world, a disorder involving both.

The patient primarily experiences his overt distress, but what

is more important is that he is so much incapacitated to come

to terms with the world in an adequate way that he becomes

unable to realize himself. (Goldstein, 1967, pp. 161–163)

This situated existence, this relationship between the organism

and the world, is something that was most thoroughly explored by

Kurt Lewin. Gordon Allport described Lewin as a genius, claiming

that he possessed the traits inherent to genius: intellectual solitude,

originality, periods of fallowness and confusion, hard work, situa-

tional factors (World War I, political conditions in Germany, oppor-

tunity to observe and live in the United States where democracy

was working), and tenacious devotion to one or more nonhedonistic

values (Allport, 1947).

Kurt Lewin contributed to the understanding of personality,

learning, social psychology, and group dynamics and was identified 34 Part I Orientation

with the gestalt school of psychology, maintaining that any given

response is governed by all the forces in the field of behavior

(Brown, 1929; Hartmann, 1935; Westerhof, 1938). Regarding his

philosophy of science, he asserted, “Structural properties are char-

acterized by relations between parts rather than by the parts or ele-

ments themselves.” His overall theoretical approach was composed

of three emphases: the interconnection of person and environment,

relational rather than object concepts, and systematic rather than

historical concepts of causation (Deutsch, 1992).

Lewin was also given to the study of the interaction between

theory and practice. He believed basic laws and dynamics of human

behavior could be used to effect social change, and for him, theory

and application were entirely compatible. He was convinced that

social psychology could make the world a better place in which to

live (Fong, Hammond, & Zanna, 2006), and that was important to

him, coming out of the German society of World War II.

Lewin’s ideas have variously been called dynamic theory, topo-

logical theory, vector psychology, and field theory. He is most associ-

ated with the last of those categories. By the 1960s, his field theory

had become one of several phenomenological approaches to under-

standing personality—along with Henry Murray’s needs and press

formulation, Goldstein’s organismic theory, Carl Rogers’ theory of

self, and the biosocial-eclectic point of view of Gardner Murphy

(Lazarus, 1961). Hall and Lindzey (1957/1959) identified the three

principal features of Lewin’s field theory as behavior as a function

of the field, which exists at the time the behavior occurs; analysis

that begins with the situation as a whole, from which contributing

parts are differentiated; and the concrete person in a concrete situ-

ation, represented mathematically. The most salient description of

the field, however, came from Lewin himself, who described it as

“the totality of coexisting facts which are conceived of as mutually

interdependent” (Lewin, 1951, p. 240).

In summary, the Western influence on gestalt therapy origi-

nated with Aristotle’s emphasis on empirical data achieved from

direct experience, took a phenomenological turn through Kant’s

depiction of experience as represented and his distinction between

the objective world and the presentations made manifest to our Chapter 2 What Is Gestalt Psychotherapy? 35

perception, and eventually resulted in the thinking of Brentano

and Husserl. Meanwhile, Schleiermacher had affirmed spiritual

experience as opposed to propositional affirmation, and Otto fol-

lowed up with his contention that religious experience constituted

direct contact with divinity, the experience of the numinous. All

this, along with the philosophical reaction to Kant and Hegel,

and the condition of the church in his day, brought Kierkegaard

to develop his emphasis on faith as a means of actualizing one’s

existence. Thus, firmly embedded in the philosophical ground of

gestalt therapy were emphases on experience, the phenomenologi-

cal basis for understanding that experience, and the existential call

to put one’s beliefs to the test of living. As science and philoso-

phy began to differentiate, gestalt therapy was preceded by Kurt

Goldstein and Kurt Lewin. Goldstein emphasized holism and the

relationship between any given organism and the world, whereas

Kurt Lewin applied the concept of a physical force field to the

world of social science in order to explicate the nature of the rela-

tionship between an organism and its environment. He argued that

a person’s behavior and personality could be understood as a func-

tion of the field.

Aristotle and Schleiermacher spoke of experience. Kant claimed

all experience is interpreted through what is presented rather than

through what actually and objectively exists. Kierkegaard claimed

that only authentic responses of faith to what life presents are worth

one’s existence. Brentano claimed all experience takes an object of

awareness, an intentional object. Husserl provided a phenomeno-

logical method in his attempt to get back to the objects themselves,

Goldstein spoke of the organism that experiences, and Lewin spoke

of the field in which experience takes place.

THEORETICAL OVERVIEW

Gestalt therapy is not a supernova shining alone in the darkness.

It is built from an assimilation of ideas, and it shares some simi-

larities with other approaches. Indeed, a consilience exists between

gestalt therapy and various aspects of cognitive behavioral therapy, 36 Part I Orientation

contemporary psychoanalysis, and neuropsychology. Today’s gestalt

psychologists, for instance (following in the tradition of Goldstein),

are investigating consciousness, perceptual-motor relationships, mir-

ror neurons, decision making, executive functioning, and self-reg-

ulation. Gestalt therapy theorists today are attempting to integrate

science and the phenomenological and existential philosophies that

continue to evolve in Europe, and exploring how these developments

might apply to the clinical processes in gestalt praxis. Gestalt ther-

apy is not a dead language that one can find only in ancient texts;

it is alive, thriving in various parts of the world, and continuously

evolving.

Following is a general overview, or forecast, of the more in-

depth exploration of gestalt therapy’s chief theoretical tenets and

practices in the chapters to follow.

Phenomenological Method

The use of the phenomenological method makes gestalt therapy

a phenomenological approach. That is what a person observing a

gestalt therapist at work would notice, but actually it is the com-

mitment to phenomenology that drives the utility of the phe-

nomenological method. Consequently, the developing thought

in phenomenology—starting with Brentano and continuing with

Husserl, Heidegger, Merleau-Ponty, Levinas, and the more contem-

porary French phenomenologists such as Jean-Luc Marion, Michel

Henry, and Jean-Louis Chretien—remains a major resource in the

ongoing development of gestalt therapy theory and practice. For

the practicing therapist, the question is, “How does the client make

meaning out of experience?” In that respect, gestalt therapy is con-

silient with much of the constructivism and mindfulness found in

contemporary cognitive behavioral therapy and with any approach

using the hermeneutical thinking of Heidegger and Gadamer.

Dialogical Relationship

The dialogical relationship in gestalt therapy is most notably asso-

ciated with the thinking of Martin Buber. For many years fol-

lowing the turn from awareness of an individual’s experience in Chapter 2 What Is Gestalt Psychotherapy? 37

contacting in the environment to the contact possible between two

individuals, Buber’s way of conceptualizing relationships served as

the backbone of the gestalt therapeutic alliance. Today, matters of

alterity, in the thinking of Emmanuel Levinas, have an increasing

influence. All in all, the question for a therapist is, “How do I forge

a connection, a meaningful relationship with this client?” Because

of the common concern with intersubjective process, gestalt ther-

apy is consilient with interpersonal psychotherapy, client-centered

integrations such as emotion-focused therapy, and with relational,

or contemporary, inter-subjective systems psychoanalysis.

Field Theoretical Strategy

Field theory in physical science was adapted by Kurt Lewin to

describe the systemic operations at various levels of the environ-

mental surround in which we live. Field theorists following Lewin,

especially among gestalt therapists, have spent a lot of time and

energy describing how field forces and dynamics affect current

processes. In this respect, gestalt therapy is consilient with sys-

temic family systems and multisystemic interventions in social psy-

chology. For the therapist, the question that moves philosophical

speculation to the pragmatic level is “So what?” “How can I use

it?” “What must I do if I am going to be appreciative of the field

and if I am going to become strategic in my work with the client?”

Experimental Freedom

Gestalt therapy is not based on a cause-and-effect, linear theory of

change. Thus, it does not really follow the medical model of simple

symptom reduction by means of critical interventions. Rather, the

gestalt therapy model makes mystery virtuous and open systems, in

which many things are always possible, adventuresome. Gestalt ther-

apy is essentially experimental. The gestalt therapist asks, “What might

happen if…?” Something is thrown into action to create an experi-

ence that can be mined and used to increase awareness and under-

standing, and the experienced gestalt therapist finds his or her own

stride in just how to craft novel and clinically relevant experiments.38 Part I Orientation

CONCLUSION

Gestalt therapy is a contemporary system of psychotherapy. It is

a relevant and effective theoretical approach that has also been

adapted for organizational work and for coaching. Gestalt therapy

is one of the established ways in which psychotherapy can be con-

ducted, and it comes with ever-increasing evidence for its practice.

Gestalt therapy is associated historically with the “Third Wave” in

clinical psychology, but it is best conceived of as a holistic and assim-

ilating approach capable of integrating essential tenets of cognitive

behavioral, psychoanalytic, systems, and body-oriented modali-

ties. It is experiential. It is existential. It is phenomenological, and

it is behavioral. Gestalt therapy provides a therapist with a natural

way of being with clients, but it defies easy mastery or simplistic

reduction.

NOTES

  1. See chapter 3 for a description of the growth and application of gestalt therapy world

wide.

  1. In autobiographical statements, Goldstein stated, “I was still more encouraged when

I learned that my basic concept was much in accordance with the theoretical inter-

pretation of the French physiologist Claude Bernard, as published in An Introduction

to the Study of Experimental Medicine (1866). Claude Bernard, as famous as he was

in Germany for his medical discoveries, was to me and most other physicians there

completely unknown for his theoretical interpretation, which he had developed from

his practical work” (Goldstein, 1967, p. 158).

  1. These lectures have since been published in book form under the same title.

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www.gestalt.org/wulf.htm.This page intentionally left blank 3 The Growth of Gestalt Therapy

This chapter outlines the beginnings and growth of gestalt therapy

from a historical standpoint. To understand what gestalt therapy

is requires not only comprehension of its theoretical base—the

what—but also an understanding of the people who were taken

by its relevance and what attracted them to it in the first place.

In the foreground of the history of gestalt therapy are Frederick

(Fritz) and Laura Perls, Isadore From, and Paul Goodman, but in

the background are all the people who preceded them. In addition,

this history is still being written, so there is a horizon that stretches

out from the recent past, through the present moment and into the

things that will come about in the near future.

In light of this, the following divisions in the history of gestalt

therapy are an organization after the fact. The actual events and

development were much messier, with generations overlapping and

people moving out from training under the originators to train still

more gestalt therapists, and then returning for more training them-

selves without ever having written much or established long-lasting

training institutes; thus, gestalt people exist all over the world, with

many more waves, cycles, and generations of training than can be

described in detail here. This chapter includes the genealogies of

trainers and trainees to illustrate the connections among these

43 44 Part I Orientation

cycles and generations. This is a broad-stroke approach, but it does

provide a general and relatively valid understanding of what gestalt

therapy developed from and how it is still evolving.

If a drop of ink falls onto wet paper, it spreads out in all direc-

tions at the same time. That is what happened after the first train-

ing groups were established in New York, Cleveland, Los Angeles,

and San Diego. The people discussed in the following section are

representative of that movement. This chapter offers one descrip-

tion of what happened, with one list of individuals; many perspec-

tives would configure the story with other players, but the general

drift is accurate and would still be evident in any other version of

the story.

THE FIRST CYCLE: ORIGINATORS AND THEIR TRAINEES

Gestalt therapy was not forced on people by academic regulation; it

grew because people found it attractive and in harmony with what

they already sensed, a pathway for them to travel in a direction

they were already headed.

Frederick and Laura Perls

As a young man, during the period immediately following World

War I in Germany, Frederick (Fritz) Perls worked as an actor, learn-

ing about the emphasis on nonverbal communication from Max

Reinhard. Later, he would adopt elements of psychodrama from the

work of Jacob Moreno. Perls was part of the left-wing, creative and

artistic Bauhaus school in Germany, which emphasized harmony

between an object’s function and its form or design. At this time,

Perls was also influenced by the thinking of Salomon Friedlander,

with his concept of polarities and the neutral point between two

poles (Wulf, 1996). In 1925, he began what would become 7 years

of psychoanalysis with Wilhelm Reich and then Karen Horney. In

1926, he was exposed to Kurt Goldstein’s organismic theory, and

gleaned ideas of homeostasis, contact and withdrawal, and figure

and ground; but it was not until he had moved to South Africa and Chapter 3 The Growth of Gestalt Therapy 45

was exposed to Jan Smuts’s thinking on holism that he developed

a more robust concept of the organism as a whole, embedded in

its environment (Perls, 1969). By that time, he had married Lore

Posner (later to be known as Laura Perls), a woman he had met in

Goldstein’s lab. Together they embarked on the project that later

became known as gestalt therapy, but which they always conceived

of as a revision of Freud in the light of their continental philosoph-

ical and scientific influences.

Laura Perls was born and educated in Germany. As a young

girl, she was influenced by Elsa Gindler, who taught her to be at

home in her body and to attend to movement; she studied dance

from the age of 8 (Perls & Rosenfeld, 1977). She was 12 years

younger than her husband and had a more formal base of training.

For instance, she had studied with Goldstein for years before she

obtained her analysis (whereas Frederick had obtained his analy-

sis and then assisted Goldstein for only a few months). Laura also

read the existentialist thinkers, and she studied for a time with

both Paul Tillich and Martin Buber. When it came time to name

the new approach they were developing, she was outvoted by her

husband and others, wanting to call it “existential therapy” instead

of “gestalt therapy.” Laura’s way of working in gestalt therapy was

more dialogical, more patient, much less given to experiment, as

contrasted with Frederick’s demonstrations of gestalt therapy that

used vivid enactments to achieve quick “breakthroughs.” More con-

cerned that a breakthrough not become a breakdown, Laura devel-

oped a balance between contact and support in all her work and

mentoring. She also took a back seat to her husband, allowing him

the credit for such things as writing Ego, Hunger, and Aggression

(Perls, 1947/1969), when she had actually been an equal partner

in its conception and production. She abstained entirely, however,

from the production of Gestalt Therapy: Excitement and Growth

in the Human Personality (Perls, Hefferline, & Goodman, 1951),

because she was busy raising her two children, conducting her

practice, and helping to organize the first gestalt therapy institute

in New York.

While Frederick Perls was living at Big Sur, California, Laura

was in New York. While she acted as a single parent to their two 46 Part I Orientation

children, Frederick ignored them, living like a showman, a sort of

guru, during the late 1960s, often sleeping with women who came

to train with him. Laura lived the professional and ethically sound

life of a psychotherapist and became the center of gravity for the

activities of the New York Institute for Gestalt Therapy.

Paul Goodman

Paul Goodman is credited with writing the theoretical half of the

book Gestalt Therapy: Excitement and Growth in the Human

Personality (referred to as PHG, for the names of its three authors).

Goodman (1911–1972), was a sociologist, writer, and poet. Though

he was married and had three children, he was an avowed homo-

sexual. His anarchist values and lifestyle cost him several teaching

jobs. He is best known for his book, Growing Up Absurd.

Goodman was part of the group that started the first gestalt

institute in New York. At a pivotal moment, Frederick Perls asked

him to write up some notes about gestalt therapy, and Goodman

used his understanding of the new approach, along with his knowl-

edge of Otto Rank, to craft the theoretical half of PHG. Goodman is

better known for his other writings than for his work as a gestaltist;

still, within the field, he is appreciated for his efforts in early train-

ing of new converts to gestalt therapy, and he became enshrined as

a theoretical mastermind.

Paul Goodman’s contribution to gestalt therapy theory in PHG

has not been precisely identified. Without question, several of its

chapters had been previously published as essays written by him

in critical journals such as Dissent. Goodman’s later writings also

reflected his continuing use of the gestalt therapy principles first

articulated in PHG, while Fritz Perls famously distanced him-

self from PHG. Goodman’s exact contribution notwithstand-

ing, he brought a Walt Whitmanesque Americanism to gestalt

therapy, reflecting not only his natural exuberance but also his

free- ranging intellectual knowledge, both of which comple-

mented Fritz Perls’s own personality. Increasingly, the influence

of American pragmatism is being identified in gestalt therapy.

This would be from Goodman’s, and not Perls’s, background. Chapter 3 The Growth of Gestalt Therapy 47

Many gestalt therapists continue to identify Goodman’s influ-

ence in gestalt therapy and teach gestalt therapy in his name.

(D. Bloom, personal communication, May 17, 2009b)

Isadore From

In 1945 Isadore From came to New York to attend the New School

for Social Research. He soon felt in need of psychotherapy and

sought the services of an analyst. Because he did not have much

money, he ended up asking Frederick Perls, who had newly arrived

in the United States from South Africa. Perls, who believed From

knew something about phenomenology, took him on as a patient.

When Perls learned what From wanted from him, he referred him

to Laura for therapy.

From was a friend of Paul Goodman, having known him in

Chicago, and he was an early reader for the PHG text. From even-

tually apprenticed as a therapist with Frederick. He also became

the therapist “in residence” for trainees at the Gestalt Institute of

Cleveland, meeting with its first cohort twice a month for 10 years

and then once a month for another 10 years (From & Rosenfeld,

1978). From became one of the central leaders of the New York

institute, and he was instrumental in training early gestalt thera-

pists in Europe, Cleveland, and Portland, Oregon. While in Europe,

he influenced many people, including Therese Tellegen, a Dutch

therapist who later immigrated to Brazil, and Jean-Marie Robine.

Unfortunately, From was not a writer, so his influence, though

great, was not captured directly in the gestalt therapy literature.

In the immediate years following the deaths of Frederick Perls

and Paul Goodman, gestalt therapy began its global expansion. In

New York, Isadore From, Laura Perls, and Richard Kitzler main-

tained the integrity of the New York institute, and Joe Wysong

began to organize conferences and publish the first journal devoted

to gestalt therapy; he called it The Gestalt Journal.

Edwin and Sonia Nevis

Edwin and Sonia Nevis were among the first group of gestalt trainees

outside of New York. They joined with others in the training group 48 Part I Orientation

Frederick Perls and Paul Weisz had started in Cleveland, and, together

with Elaine Kepner, Bill Warner, Rennie Fantz, Miriam Polster,

Erving Polster, Joseph Zinker, Cynthia Harris, and Dick Wallen,

they helped to create the Gestalt Institute of Cleveland. Later, in

the 1970s, Edwin and Sonia created the Gestalt International Study

Center (GISC) in Cape Cod, Massachusetts. In a personal communi-

cation, Edwin Nevis recalled the sequence of events:

I went to graduate school at Western Reserve University in

Cleveland, from 1949 to 1953, with people like Erving Polster,

Elaine Kepner, Marjorie Creelman, Rainette Fantz, and

Bill Warner. Richard Wallen was one of our teachers. After

working in Chicago for 18 months I returned to Cleveland in

1955 to find that these folks had started to invite Fritz Perls

to do workshops for them and other psychologists. I started

taking workshops immediately at the suggestion of Richard

Wallen and helped organize an association which became

the Ohio Center for gestalt therapy in 1956. I soon took over

the administration and became President of what became

the Gestalt Institute of Cleveland in 1957 or 1958. Shortly

afterwards, Joseph Zinker, Sonia Nevis, Cynthia Harris, and

Miriam Polster became part of our core group. I remained as

President until 1972.

I trained with Fritz Perls, Laura Perls, Paul Goodman,

Isadore From, Virginia Satir, Carl Whitaker, Paul Weisz, and

Richard Wallen.

I participated in about 10 training workshops a year for

6 years (1956–1962). I also did individual and group therapy

with Erving Polster (1959–1962) and training therapy with

Isadore From (1959–1963).

The people listed in the first paragraph above began to

conduct our own workshops and training programs in the ear-

ly 1960’s—when we concluded that we had enough training

to do this. (Keep in mind that most of us had PhD degrees

before we discovered GT, and some were practicing for sev-

eral years).

In 1979 Sonia and I created the Gestalt International Study

Center (GISC) as an independent yet sister research and

development organization. Chapter 3 The Growth of Gestalt Therapy 49

After getting GISC established in its home on Cape Cod

(2002), I gave up being president (2007) and chairman of the

board (2009). I now do some teaching and help in planning

and implementing specific new programs. I do some coaching

of organization consultants and maintain a consulting rela-

tionship with one long-term client.

In 2002, GISC built its meeting house on the Cape. In addition to

their training programs, they support various annual or biennial

international conferences, and they publish Gestalt Review, edited

by Susan Fischer and Joseph Melnick.

Joseph Melnick

Joseph Melnick was finishing his studies at Cincinnati as his super-

visor was completing the training program at the Gestalt Institute

of Cleveland (GIC). He returned with stories about his work with

Erving and Miram Polster, Joseph Zinker, Elaine Kepner, and

Edwin and Sonia Nevis, stimulating Joe to read about gestalt ther-

apy. For a graduation gift, he gave himself a weekend lab at GIC,

and that is when he “got hooked” (J. Melnick, personal communica-

tion, May 22, 2009). Melnick continued training in Cleveland, tak-

ing a 6-week course and then advanced courses in couples, family,

and individual therapy. His trainers included Maurice Creelman,

Sonia Nevis, Joseph Zinker, and Elaine Kepner. He became active

in the workings at GIC, and he became a member of the board.

Today, he exemplifies the continuing exploration of diverse issues

that gestalt therapists undertake. “Edwin and I are just finishing an

edited book of social change, and I have become fascinated with

the concept of contempt. As soon as the book is done, I will start

focusing on this topic, and I am halfway through writing a book

with Sonia on the ‘Cape Cod Model’ ” (J. Melnick, personal com-

munication, May 22, 2009).

Erving Polster

Erving Polster’s early training in gestalt therapy was principally

under Frederick Perls, complemented by workshops by Paul Weisz, 50 Part I Orientation

Laura Perls, and Paul Goodman. The original cohort at Cleveland

formed itself into an organization in about 1955, and they immedi-

ately began creating training experiences. In their first workshops

they invited Frederick Perls to work weekends with the groups, pre-

ceded by three evenings of theory and clinical demonstrations with

Erving and Dick Wallen. After a time, the Cleveland group brought

Isadore From in from New York on a biweekly basis for more exten-

sive and more individuated training. As a group, they also trained

themselves, in leaderless weekly meetings over an extended period

of time (E. Polster, personal communication, May 11, 2009). At first,

these trainings were directed to members, but before long they

started training programs for the larger psychological community.

Erving and Miriam Polster moved to San Diego, where they

opened their own training center. In 1973, they wrote what became

the best statement of gestalt therapy theory 1 in the three to four

decades following the publication of PHG. It established “contact”

of a person with environmental “other” as central to gestalt therapy.

Reminiscing about how he became exposed to gestalt therapy in

the first place, Erving Polster said:

I was invited by some friends to come to a workshop Fritz

Perls was going to be conducting in Cleveland. I had heard

that gestalt therapy had created some exercises which people

could do on their own and I was intrigued by the idea of ther-

apy outside the guidance that office therapy provided. That

didn’t turn out to be true about gestalt therapy, but I did find

that it was hospitable to some of the populist ideas I had about

therapy and I was enthralled with Perls’ magical entry into

each person’s psyche and the communal setting in which peo-

ple revealed their deep feelings. It was very unusual in those

days for therapy to be conducted among peers. (E. Polster,

personal communication, May 11, 2009)

This interest in therapeutic, or growth, experience outside the

confines of formal psychotherapy led him time and again to study

congregations of people, and that eventuated the development of

his concept of life focus groups, in which people blend the thera-

peutic aspects of both psychotherapy and religious community.2 Chapter 3 The Growth of Gestalt Therapy 51

In thinking about the course his work has taken over more than

50 years, Polster said:

My only concerns are with the relevance, clarity, sensitivity,

effectiveness, illuminations or inspirational effects my work

may offer. If these are lacking, I am being deficient. I follow

“principles” of gestalt therapy because of all theories I like

them best to guide my mind. But none of these principles are

so sacrosanct as to replace common sense, the reconciliation

of human complexity and simplicity, and the invitation we face

to enter each other’s minds and make strong and thematically

timely human connectedness. (E. Polster, personal communi-

cation, May 11, 2009)

Jean-Marie Robine

In 1975, Jean-Marie Robine attended gestalt trainings conducted

in Belgium, at an institute called Multiversité, in collaboration

with the French-speaking trainers from the Gestalt Institute of

Cleveland—Janine Corbeil, Lois Meredith, Gordon Wheeler, Bill

Warner, and others. Following that, Robine attended several groups

with Erving and Miriam Polster, Sonia Nevis, and some others

from the Cleveland orientation. About 1980, he met Isadore From

during one of From’s European periods and joined his training and

supervision group, working with them until Isadore stopped teach-

ing. He began coordinating other trainings with his wife and with

Jean-Marie Delacroix, a French colleague who returned to France

after several years in Quebec, Canada. He also collaborated with

Ed Lynch, Michael Vincent Miller, and colleagues from Belgium.

As the French gestaltists began to organize into training institutes,

Robine facilitated the cooperation among those with conceptu-

alizations close to his own (and with foreign institutes as well),

exchanging trainers and organizing summer universities together.

This effort culminated in an international, postgraduate training

for professionals called the Gestalt Therapy International Network,

involving Michael Vincent Miller, Gary Yontef, Philip Lichtenberg,

Peter Philippson, Margherita Spagnuolo Lobb, Lilian Meyer

Frazao, and himself. They completed two summer programs—one 52 Part I Orientation

near Montpellier, France, and the other in San Miguel de Allende,

Mexico.

Today, Robine considers his vocation to be the continuity of

Goodman’s and From’s work in developing the theory of gestalt

therapy and the sustenance of a clinical practice grounded in that

theory. Robine has widely taught the gestalt therapy theory of self

and its clinical usefulness (in France, Russia and Ukraine, South

America and Mexico, Africa, Belgium, and Spain). He has also

developed the field perspective, the concept of the “id of the sit-

uation,” psychotherapy as aesthetics, and other fundamental con-

cepts in gestalt therapy. In order to broaden gestalt therapy ideas,

he created two French journals,3 functioning as editor in chief for

20 years, and served as associate editor of many other journals (i.e.,

Gestalt Review, International Gestalt Journal, Studies in Gestalt

Therapy). He wrote six books about gestalt therapy,4 published

in seven languages. Robine describes his interests as “the clinical

work and theoretical deepening of our theory … supporting human

psychic suffering and in teaching young therapists this art” (J-M.

Robine, personal communication, May 8, 2009).

Serge Ginger

Serge Ginger had practiced psychoanalysis and psychodrama when

he attended trainings in gestalt therapy at Esalen in 1970 and later

at the fledgling Gestalt Institute of San Francisco. He went on to

receive training from Erving and Miriam Polster, Alberto Rams,

Jean-Marie Robine, George Thomson, and Joseph Zinker. Ginger

and his wife, Anne, have been part of the cooperative movement

for training in France. They were the founders, in 1980, of the Paris

School of Gestalt Therapy (École Parisienne de Gestalt, or EPG).

In 1991, he founded and became the president of the International

Federation of Gestalt Training Organizations (FORGE), gathering

30 training institutes from 20 countries.

Malcolm Parlett

In 1975, Malcolm Parlett attended a gestalt workshop conducted by

Carolyn Luckensmeyer, part of the gestalt community in Cleveland. Chapter 3 The Growth of Gestalt Therapy 53

He was smitten with the gestalt approach, and 2 years later started

training at the Cleveland institute. His trainers included Edwin

and Sonia Nevis, Bill Warner, Rainette Fantz, Isobel Frederickson,

Marjorie Creelman, Elaine Kepner, and subsequently Rich

Borofsky. Back home in England in 1986, he founded the Gestalt

Psychotherapy and Training Institute with Petruska Clarkson and

Gestalt SouthWest with Marianne Fry. He was the founding edi-

tor of the British Gestalt Journal, which had its inaugural issue in

  1. He has since retired from clinical work, but he maintains his

interests, which he describes as consulting, in writing, “and in the

application of our approach to social, political, and ecological ques-

tions, and the relation of gestalt to spirituality” (M. Parlett, per-

sonal communication, May 8, 2009).

Robert Resnick

Robert Resnick studied with Frederick Perls and Jim Simkin

at Esalen and in Los Angeles. Along with Bob Martin, Perls,

and Simkin, he was one of the founding members of the Gestalt

Therapy Institute of Los Angeles (GTILA), a training group that

was started in 1969. GTILA has since divided into two training

organizations—Gestalt Associates Los Angeles (GATLA) and the

Pacific Gestalt Institute (PGI)—and exists today as a membership

organization. In 1969, Frederick Perls selected Resnick to respond

to an invitation by Nels In de Vid in the Netherlands to introduce

gestalt therapy to Europe. He has been training gestalt therapists

in Europe ever since, through summer residentials sponsored by

GTILA and GATLA.

Gary Yontef

In 1964, Gary Yontef attended a training workshop given by

Frederick Perls at the Metropolitan State Hospital in Los Angeles.

Arnold Beisser 5 was director of psychiatrist training at that time,

and Gary was a psychiatric social worker. When Perls came to the

hospital, Yontef was amazed at how he could get to staff members.

Yontef recalled one Horneyian training analyst who came to Los

Angeles to semi-retire. “Fritz reduced him to tears. I did not know 54 Part I Orientation

what to make of that. But was curious” (G. Yontef, personal commu-

nication, May 15, 2009). Perls also talked about Chinese thought,

and that attracted Yontef. It was partially because he detected

errors in Perl’s thinking on Chinese thought that Yontef imagined

there might be a place for him in the group associated with what

Perls was doing.

Yontef eventually went to Esalen for an advanced workshop with

Fritz Perls and Jim Simkin. At the workshop, he felt met, under-

stood, and guided by the experiential work. He joined a group for

training and therapy led by Simkin, and because of his experience

of feeling accepted and understood, including his growing under-

standing of himself through the process of gestalt therapy, he pur-

sued a career in gestalt therapy. He joined the faculty of GTILA in

1972 and became head of its training program for 18 years. When

GTILA became a membership-only organization, he cofounded

the Pacific Gestalt Institute with Lynne Jacobs. They were joined

by Jan Ruckert, who was also, and is still, part of the fundamental

planning and administration.

Leaders in Other Countries

In 1969, Walter Kempler visited New Zealand, where he presented

the first demonstration of gestalt therapy for New Zealanders.

In 1982, Fred Grosse continued attending regularly, and in

1991, together with Anne Maclean and Gill Caradoc-Davies, he

formed the Gestalt Institute of New Zealand (Maclean, Levien, &

Jarosewitsch, 1997).

Meanwhile, gestalt therapy arrived in Australia in 1971, when

William Schutz taught the “Esalen Spirit” to students at the

University of New England at Armidale. In 1974, James Oldham

arrived from Toronto, Canada, having completed a 3-year train-

ing at the Gestalt Institute of Toronto, and he established train-

ing groups in Melbourne and Perth. In 1976, Patti Oliver-Nolan

and Peter Mullholland began sharing their training with Miriam

and Erving Polster. Associated in this was Barry Blicharski.

In 1978, Yaro Starak arrived, having completed his training in

Toronto and after serving as part of the training faculty there Chapter 3 The Growth of Gestalt Therapy 55

for 4 years. He established a formal, 3-year training program in

Brisbane (Starak, 1997).

In 1976, Bob Martin met Therese Tellegen, Tessy Hantschel,

and Raquel Vieira da Cunha at a gestalt workshop led by Erving

and Miriam Polster in San Diego, and they invited him to Sao

Paulo, to conduct workshops and supervision. After that, other

trainers came to offer workshops in Brazil, including Janette

Rainwater, John Wood and Maureen Miller, Gary Yontef, Violet

Oaklander, Richard Hycner, Michael Vincent Miller, Jean-Marie

Robine, Serge and Anne Ginger, and Joseph Zinker. In 1980, due

to the interest shown by students and professionals, Abel Guedes,

Jean Clark Juliano, Therese Tellegen, and Lilian Frazao were

invited to offer a brief course in gestalt therapy at the Institute

Sedes Sapientiae, in which several approaches to psychotherapy

were taught. Due to student demand, it turned into a 3-year,

weekly course involving 8 hours each week. Lilian Meyer Frazao

has been teaching at the Psychology Institute of the Sao Paulo

University, where gestalt therapy has been part of the minimum

curriculum for psychology students since 2005 (L. Frazao, per-

sonal communication, May 7, 2009).

The Chilean psychiatrist, Claudio Naranjo studied with Fritz

Perls and Jim Simkin at Esalen, and returned to Chile in the early

1970s to teach gestalt there. In 1974, the gestalt practitioners and

psychiatrists Dr. Adriana Schnake and Dr. Francisco Hunneus

began coming once a month from Chile to lead seminars and work-

shops in Buenos Aires. Myriam Sas de Guiter was one of their

students. At that time, the dominant theory in Argentine psycho-

therapy was psychoanalysis, but these students were looking for

new approaches. Drs. Schnake and Hunneus continued coming

for several years until, in 1980, they joined with Myriam and the

other students to create the Asociacion Gestaltica de Buenos Aires.

Other trainers who influenced Myriam Guiter and her colleagues

were Dr. Norberto Levy, Claudio Naranjo, Joseph Zinker, Philip

Lichtenberg, Theo Skolnik, Jean Clark Juliano, and Margherita

Spagnuolo Lobb. The Asociacion Gestáltica de Buenos Aires took

shape in 1982 with a 3-year training program that still continues.

In 1997, Myriam Guiter organized the Colloquium of Gestalt in 56 Part I Orientation

Buenos Aires to enhance training and attract international teach-

ers. Zinker, Lichtenberg, Skolnik, Juliano, and Lobb became fre-

quent contributors.

SECOND CYCLE: TRENDS IN GESTALT THERAPY’S

DEVELOPMENT

Contemporary gestalt therapy is marked by the thinking and influ-

ences of various persons and organizations. Some of them are

described below, but many of the people and ideas mentioned pre-

viously are still active as well. These trends help answer the ques-

tion, “What is gestalt therapy?” by pointing to some of its growing

edges and what it is becoming.

Gordon Wheeler, Field Theory, and the Esalen Institute

For many people, the initial attraction to gestalt therapy has not

been the impact of its theory but the sense that they have met an

unusually fascinating and competent person doing something novel

and intriguing. This is what happened for Gordon Wheeler. He

attended a training given by Carolyn Lukensmeyer and Bill Warner

at the National Training Laboratory and was so taken by them that

he went to the Gestalt Institute of Cleveland for training in gestalt

therapy. In the late 1980s, Edwin Nevis founded Gestalt Press and

handed it over to James Kepner and Wheeler. Gordon went on to

become a prolific writer and the head of Gestalt Press.

In the 1990s, Wheeler moved to the West Coast and joined

the community at the Esalen Institute, eventually to become its

president (Wheeler, 2009). The Esalen Institute was founded in

1961–1962, and the communal aspects of the Esalen Institute are

heavily infused with a gestalt spirit. That is because Richard Price,

cofounder of Esalen, became associated with the form of gestalt

work demonstrated at Esalen by Frederick Perls, and he continued

for years to conduct gestalt work after Perls, Simkin, and others

had left. Wheeler’s influence has been one of building on what was

already there to develop the field perspective more fully at Esalen. Chapter 3 The Growth of Gestalt Therapy 57

Margherita Spagnuolo Lobb

Margherita Spagnuolo Lobb has been a gestalt therapy trainer since

  1. She has served as president of the European Association

for Gestalt Therapy (EAGT) for 6 years, president of the Italian

Umbrella Association for Psychotherapy (FIAP) for 2 years, and

president of the Italian Association for Gestalt Therapy (SIPG) for

two decades. She founded the European Conference of Gestalt

Therapy writers and has served as editor of the Italian journal

Quaderni di Gestalt since 1985. She is co-editor of the journal

Studies in Gestalt Therapy—Dialogical Bridges. Her writings,

which cover both epistemological and practical issues, have been

published in many languages.

When Lobb was 23 years old, she was attending university

in Rome. One of her teachers had just trained with Erving and

Miriam Polster in California, and gave a demonstration of what

he had learned. Lobb was so fascinated by this approach that

she wanted to go to La Jolla, California, to train with the Polsters

as soon as she completed her degree. In addition to Erving and

Miriam, she trained with Isadore From in Europe and New York;

he also became her therapist. She trained with many other psy-

chotherapists as well, from both the gestalt therapy field and other

approaches, including Daniel Stern. As with many gestalt therapists,

the peer exchange she enjoys in communities of her colleagues has

been a strong and formative experience for her in recent years—the

New York Institute for Gestalt Therapy, the European Association

for Gestalt Therapy, and the Association for the Advancement of

Gestalt Therapy. These are “homes” where she continues to learn

(M. Lobb, personal communication, May 21, 2009).

Lobb started to work as a trainer in Italy in 1979. At that time

no school of gestalt therapy existed there, just sporadic training

events. She invited those who had trained her, as well as other

gestalt psychotherapists, to teach regularly in Italy. Gradually, a

group of local colleagues was formed, subsequently becoming the

resident trainers in her institute.

This Italian group of trainers and clinicians developed their

own, original theoretical and clinical application of gestalt therapy. 58 Part I Orientation

The model of Lobb’s institute became well known around the

world and was accredited by the Italian minister for universities as

a postgraduate school of psychotherapy.

Over the years, Lobb has elaborated two basic ideas evident in

gestalt therapy literature and clinical work. One is the concept of

the contact-boundary as a practical perspective on basic psycho-

therapeutic “events” such as transference and countertransference,

and the relational meaning of therapeutic dialogue. She views

events in the psychotherapy setting as “a co-creation of the contact-

boundary between therapist and client, where emotions, relational

patterns, values and personal styles interweave in a beautiful dance

which brings forward the intentionality of contact for each of them”

(M. Lobb, personal communication, May 21, 2009). This perspec-

tive overcomes the traditional individualistic, one-mind perspec-

tive in psychotherapy, and it allows gestalt therapists to describe

psychotherapy as the art of improvising a real relationship rather

than of analyzing the mind of the client. The other idea is that of

supporting aesthetic experience as a guide for the psychotherapist.

She developed clinical tools to “help the client to do better what

he already does, to support the beauty of his process. This view on

psychotherapeutic aim changes a lot the traditional epistemology

of psychotherapeutic work, that is to make explicit what is implicit”

(M. Lobb, personal communication, May 21, 2009). Lobb believes

that gestalt therapy epistemology requires the therapist to support

the positive process that presents itself in the client, the aesthetic

of the client’s process, rather than to dichotomize that process into

good and bad.

The European Association for Gestalt Therapy

In 1985, 13 people representing gestalt institutes and regional

associations in Europe, involving 11 countries, met in Germany

to found the European Association for Gestalt Therapy (EAGT).

The aim of the EAGT is to promote gestalt therapy in Europe, to

combine and exchange knowledge and resources, to foster a high

professional standard for the discipline of gestalt therapy, and to

promote research. The founders set high standards leading to a Chapter 3 The Growth of Gestalt Therapy 59

certification that is commensurate with a European certificate to

practice psychotherapy.

One of the current governing board members for the EAGT is

Daan van Baalen. Like Lobb, van Baalen practices the European

approach to gestalt therapy, infused with the need to certify quali-

fied gestalt psychotherapists and to approve their credentials. The

EAGT is not just an advocacy and membership group for gestalt

therapists, but also a regulatory body. To that task van Baalen

brings his background in gestalt therapy and his own interests. He

was a general practitioner in Rotterdam, where his patients were

considered socially depraved; they were immigrants, criminals,

prostitutes, and social dropouts. Being newly trained as an MD in

a teaching hospital, he was not prepared for these kinds of clients;

by coincidence he took a course titled “MDs and Gestalt Therapy,”

where he found an approach that worked with the type of people he

had been seeing. In 1976, he started functioning as a trainer at the

Dutch Instituutt voor Comunicatie (IVC), and in 1986, in Norway,

he cofounded the Norsk Gestaltinstitutt. He has developed train-

ing programs in gestalt psychotherapy, coaching, and organiza-

tional development in Norway, the Netherlands, and Belgium and

is a visiting trainer in several European countries. While a univer-

sity lecturer at the Erasmus University, the Netherlands, he also

engaged in research investigating chronic diseases and psychother-

apy. He has written articles in several languages and is co-editor of

the European Journal for Qualitative Research in Psychotherapy.

Van Baalen is the external relations officer for the EAGT and chair

of the Norwegian Association for Psychotherapy. He is a member

of the board and recognized expert for the European Association

for Psychotherapy, a member of the International Federation of

Gestalt Training Organizations (FORGE), and serves on the edito-

rial board of Gestalt Review.

Lynne Jacobs, Relational Psychoanalysis,

and Gestalt Therapy

Lynne Jacobs is a gestalt therapist and a training and supervis-

ing psychoanalyst. She is a pioneer in what has become known 60 Part I Orientation

as r elational gestalt therapy, a movement that deemphasizes indi-

viduality and instead emphasizes relationship and community.

Jacobs was introduced to gestalt therapy by a teacher and coun-

selor at the university where she earned her undergraduate degree,

who showed her the book Gestalt Therapy Verbatim. She was

immediately drawn to the person-to-person, emotionally honest

encounter. “That seemed like a life-saver to me, since in my home

I felt like I was speaking into an empty darkness. Perls’ responsive-

ness gave me hope” (L. Jacobs, personal communication, May 14,

2009). She then moved to Los Angeles to attend graduate school

and took up training at the GTILA. There, she was exposed to sev-

eral trainers over time. The two most important were Bob Martin

and Gary Yontef, who were attractive to her because of their focus

on contacting. Jacobs entered a long-term therapeutic relationship

with Yontef.

By 1984, Jacobs had joined the faculty of GTILA. In 1998,

when GTILA became a membership-only organization, she sug-

gested to Yontef that the two of them form their own training

institute. “That was a very easy decision in that we were still both

actively interested in training, and our philosophies of gestalt ther-

apy were very similar (close attention to the relational dimension

that is the ground for contacting)” (L. Jacobs, personal communi-

cation, May 14, 2009).

Jacobs’s current work as a leader in the field of gestalt therapy

is an extension of what led her into gestalt therapy to begin with. “I

am invested—as are so many others—in carrying gestalt therapy

thinking into a consistent, radical, post-Cartesian worldview, which

I believe is an inevitable outgrowth of conceiving of all experience

as relationally-emergent” (L. Jacobs, personal communication,

May 14, 2009).

Peter Philippson, Neuropsychology, and Gestalt Therapy

Peter Philippson went to a gestalt workshop in 1979 at a group work

conference and fell in love with it—the immediacy, the sense that

things and he himself could change. The therapist was Beverley

Edwards, who offered “Taoist Gestalt,” which suited Philippson Chapter 3 The Growth of Gestalt Therapy 61

well, as one of his abiding interests is martial arts. Philippson went

on to train with Petruska Clarkson, and he also attended work-

shops with Gary Yontef, Erving and Miriam Polster, Bob Resnick,

Malcolm Parlett, Marianne Fry, Maria Gilbert, Sue Fish, and

Hunter Beaumont. Eventually he collaborated on the establish-

ment of two training organizations, the Gestalt Psychotherapy and

Training Institute (GPTI) and the Manchester Gestalt Centre.

Philippson is a prolific influence in gestalt therapy and his

expanding work focuses largely on the assimilation of neuroscien-

tific research into a gestalt understanding of both psychotherapy,

including body process, and the functioning of groups. His most

recent book, The Emergent Self: An Existential-Gestalt Approach

(2009) is a synthesis of these interests, and it illustrates a “coming

home” of sorts for the field of gestalt therapy.

This coming home is a full expression of the interest in neu-

ropsychology that has consistently been a subtle influence among

gestalt therapy thinkers, harkening back to Kurt Goldstein and his

study of brain function (Brownell, 1998, 2009). It is also seen in

the assimilation of the thinking of Antonio Damasio, which has

been underway in gestalt therapy ever since his book, Descartes’

Error: Emotion, Reason, and the Human Brain (1994). Others

who attract the attention of gestalt therapists to neuropsychol-

ogy include Joseph LeDoux, Warren Brown, Elkonen Goldberg,

Vilayanur Ramachandran, Muriel Lezak, and Oliver Sacks.

Dan Bloom and the Association for the

Advancement of Gestalt Therapy

In the mid-1970s, Dan Bloom was fresh from 7 years of psychoanal-

ysis. Armed with what he thought to be an abundance of enlight-

enment, Bloom moved to New York City in the hope of offering

himself as a volunteer counselor to the gay community. At that

time, gay-affirmative counseling was a radical notion. Counseling

and psychotherapy for the most part was still aimed at encourag-

ing lesbians and gays either to make a heterosexual adjustment, or,

failing that, to make the best of a bad situation. This was changing,

however, and Bloom was looking for the edge in that change.62 Part I Orientation

He found it in Identity House, a volunteer peer counseling not-

for-profit center in Greenwich Village. He became a peer coun-

selor, and, unknowingly began his training as a gestalt therapist.

Identity House had been formed by gestalt therapists a year

or so prior to my joining. Peer counselors were trained with a

gestalt therapy model that emphasized the social field, rela-

tionship, and authenticity. We all met in regular supervision

groups facilitated by gestalt therapists who attended to figure/

ground, contact interruptions, and used 1970s-ish gestalt

therapy techniques. The organization was committed to a

non-hierarchical and emergent structure.

This was all new to me. I challenged it, of course. My new

friends started to describe gestalt therapy to me and urged me

to read The Gestalt Therapy Book (Latner, 1974). I argued with

each page of the book. But I increasingly became engaged by

counseling and drawn to the gestalt therapy method of being

with another person in a helping way. The community became

an important part of my life. (D. Bloom, personal communica-

tion, May 7, 2009a)

His curiosity led him to a gestalt therapy practicum led by

Patrick Kelley, but it lacked depth, and at the same time he was feel-

ing the need to consult with a therapist of his own, so he decided to

try a gestalt therapist. He was referred to Richard Kitzler. “Richard

had depth, education, respect for intelligence, respect for words

and attention to feeling. He brought it all together and made gestalt

therapy a complete modality for me. Up until then, gestalt therapy

had a side-show quality” (D. Bloom, personal communication, May

7, 2009a).

Sometimes I think of myself as an intellectual conservative

with a radical temperament. By this I mean that from my ear-

liest approach to gestalt therapy, I questioned its assertions,

challenged its basis, and subjected all its principles to ongoing

reevaluation as I practiced gestalt therapy. Some of us may do

this more scientifically than I, but I am content to pursue this

with an historical and philosophical method. I am studying

American pragmatism, phenomenology (especially Husserl Chapter 3 The Growth of Gestalt Therapy 63

and most especially Heidegger. Merleau-Ponty, and Levinas

are next, of course), and their contemporary proponents.

Currently, I am exploring the sufficiency of the organism/

environment field as a means to describe human experience.

Can it account for human relationship? Personal values? I’ve

been experimenting with a supplement to the organism/envi-

ronment field—the self/world—field to account for this.

How can we further develop our notion of the person as

a function of the phenomenal field, of the world, and of the

therapy itself?

What are the implications of this for our practice?

How can we understand “dialogue” within gestalt therapy

and, more importantly, situated within the sequence of contact?

I am turning the lens of my interest on the actual meet-

ing at the heart of the therapy session—therapeutic contact—

to see if we can learn even more about our process. What is

emergent? What is disclosed in contact?

Is our traditional understanding of “contact” sufficient, or

must it be retooled as our sense of our work has developed—

as we’ve come to appreciate the implicit ethics of the human

relationship?

I have no doubt that gestalt therapy has changed over its

60 or so years. The world has changed. Our core theory may

be intact, but a core is only the center that can support sta-

bility. We must continue to teach and train from this core,

but we must also radically address the changing world around

us. That is, in fact, one of the core values of gestalt therapy.

(D. Bloom, personal communication, May 7, 2009a)

After his training, Bloom eventually became president of the

New York Institute for Gestalt Therapy, serving for two terms. In

addition, he is currently executive editor of the international jour-

nal Studies in Gestalt Therapy: Dialogical Bridges, which fosters

cross-pollination among clinical paradigms for the field of gestalt

therapy.

As of this writing, Bloom is the president of the Association

for the Advancement of Gestalt Therapy (AAGT), an international

community. The AAGT’s philosophy is that advancement of the

field of gestalt therapy can best be accomplished by association of 64 Part I Orientation

gestalt-minded people, who spontaneously generate ideas, collabo-

rations, and other creative responses to the needs in the field when

they gather. The association has grown from mostly U.S.-based meet-

ings to a truly international organization, with regional representa-

tion in Scotland, England, Denmark, Germany, the Netherlands,

Belgium, Spain, Italy, eastern Canada, western Canada, Japan,

the Philippines, the southeastern, southwestern, and midwestern

United States, Bermuda, Turkey, Australia, and New Zealand. Brian

O’Neill, of Australia, is a past president of the AAGT who currently

heads its regional contact network, which meets regularly for tele-

conferencing. The organization views itself as an experiment and is

constantly reforming its identity. One thing is clear however: it is

not a certifying body. Its abiding interest is the theory and practice

of gestalt therapy itself and advancing the clinical discipline known

as gestalt therapy, but it is not interested in regulating its members.

Indeed, it has no structures by which to accomplish such a thing.

Talia Levine Bar-Yoseph, Cross-Cultural Dialogues,

and Gestalt Therapy

Talia Levine Bar-Yoseph became interested in gestalt therapy while

doing her master’s study at Hebrew University, and enrolled in formal

training through GTILA. In 1997, she and Hanan Gur-El founded

the Jerusalem Gestalt Institute. Bar-Yoseph is currently active with

a training group in Greece as well. In 2005, she edited The Bridge,

Dialogues Across Cultures (Gestalt Institute Press), and in 2009

completed her doctoral work while editing a book on advanced con-

cepts in gestalt therapy and another on organizational development.

Bar-Yoseph is increasingly recognized as someone who tran-

scends many cultural boundaries. In Israel, where she grew up, the

grocer counted in Polish, the green grocer in Arabic, their neigh-

bor was Hungarian, her grandfather and grandmother yelled at one

another in Russian, but when things were peaceful they all spoke

in Hebrew. She claims that

Gestalt therapy enables a dialogue across the divide by

means of the value it gives to heritage, subjective experience, Chapter 3 The Growth of Gestalt Therapy 65

difference, and context. The bridge it builds across the divide

is composed of meeting through separateness, listening, trust,

interest in the other, and conviction of the ther’s [sic] right to

exist no more or less than one’s own. (Bar-Yoseph, 2005, p. 17)

Alan Meara, Complexity, and Gestalt Australia and

New Zealand

Alan Meara came to gestalt therapy through practicing Chinese

medicine. As a new graduate, he discovered that he was not

equipped in that modality to process the emotional reactions of

his clients. A quick search through his bookshelf unearthed a copy

of PHG, and a scan of that book intrigued him. Subsequently, he

found a course that was starting within a few weeks, and he has

gone on to establish a long-term relationship as assistant trainer with

GATLA. Meara described his training and practice as follows:

Of course, the personal learning and confronting of my own

habits was challenging, as well as exciting and humbling. My

main trainers were Yaro Starak, Bill and Eileen Wright, and

Mac Hamilton. My practice has been a mix of OD, individual

clients, couples, and supervision. The OD component is main-

ly process facilitation, where I can introduce gestalt processes

in facilitating dialogue that opens new possibilities in relat-

ing, goal redefinition and achievement. It was also the ground

for my interest in researching and applying complexity theory

to group work and change theory within gestalt, and more

recently the potential contribution of Merleau-Ponty to this

field. My overriding interest is linking theory to practice—

guiding what happens in the therapy relationship. (A. Meara,

personal communication, July 28, 2009)

Meara became involved with the professional association in

his region (Gestalt Australia and New Zealand—GANZ) and has

served as president since 2002. In Australia, gestalt (like all other

psychotherapies) is not recognized by the health system for employ-

ment or medical insurance. GANZ is a member of a larger body

(Psychotherapy and Counselling Federation of Australia—PACFA), 66 Part I Orientation

which is lobbying for recognition in providing services within the

health care system in which, ironically, clients cry out for services

that include gestalt therapy.

Jungkyu Kim and Growth in Asia

Dan Rosenblatt led training groups in Japan for several years. Paula

Bottom taught gestalt therapy in Japan and China during the 1980s

and 1990s and was instrumental in starting the Gestalt Network of

the Pacific Rim (GNPR). Today, the Gestalt Network of Japan is an

outgrowth of that work, but it is in Korea where gestalt therapy has

most flourished in Asia thus far.

Jungkyu Kim was exposed to gestalt therapy by attending a

gestalt therapy group in Bonn, Germany, in 1986, while studying at

the University of Bonn. Afterwards, he attended a gestalt therapy

group at the Fritz Perls Institute in Germany, in 1993 and again in

  1. For 3 years, starting in 1994, he trained with the Polsters in

San Diego, and in 2001 he joined the gestalt training group with

Lynne Jacobs and Gary Yontef at PGI.

Kim was the first person to introduce gestalt therapy to Korea.

He founded the Korean Gestalt Therapy Research Association in

2002, with over 200 affiliates, many of whom are licensed psycholo-

gists. In collaboration with the Korean Gestalt Therapy Research

Association, he has been translating gestalt therapy books into

Korean, teaching gestalt therapy by means of workshops and aca-

demic meetings, and offering supervision to trainees. As of this writ-

ing, there are seven private gestalt therapy counseling centers run by

his former students and many more counseling centers where gestalt

therapists now work in Korea (for example, the university student

counseling center, company counseling centers, public counseling

and social welfare centers, civilian or religious counseling centers,

and school counseling centers). Gestalt therapy is quite well known

in Korea, ranging in the middle stratum of preferred modalities.

Research in Gestalt Therapy

In 1992, Eleanor O’Leary published her book Gestalt Therapy:

Theory, Practice, and Research, and in 2006, Paul Barber published Chapter 3 The Growth of Gestalt Therapy 67

Becoming a Practitioner Researcher: A Gestalt Approach to Holistic

Inquiry. In 2007, I organized a number of established gestalt prac-

titioners to produce a new volume on research and gestalt ther-

apy (Brownell, 2008b). The Handbook for Theory, Research, and

Practice in Gestalt Therapy presented a philosophy of science, a

call for research specifically focused on gestalt therapy, a review

of the chief methods in the praxis of gestalt therapy, and a chal-

lenge for gestalt therapists to collaborate in practice-based research

networks. At the 2009 annual meeting of the AAGT, I became

co-chair, along with Christine Stevens, of the Research Task Force

for the AAGT and began consulting with established researchers,

among whom was Leslie Greenberg at York University in Toronto.

Leslie Greenberg first became aware of gestalt therapy while

reading PHG during a graduate course in psychotherapy, and then

trained in gestalt therapy at the Toronto Institute with Harvey

Freedman and Jorges Rosner. He later collaborated with Dolores

Bate in Vancouver to found the Gestalt Experiential Institute. His

greatest contributions to gestalt therapy have been in his research.

His studies emphasize the processes of change working with emotion

in both individual and couples therapy. He conducts psychotherapy

process and outcome research, and has developed an evidence-

based approach that integrates the person-centered relationship

with gestalt therapy methods, including chair dialogues, embedding

these in a dynamic systems and emotion-theory framework.

In May of 2009, the research task force identified five possibili-

ties for the AAGT to support research involving gestalt therapy:

■ Start a collaborative research project.

■ Create a team of research-oriented trainers to help existing

training institutes augment their programs with regard to

research.

■ Collaborate with existing research projects at university

laboratories.

■ Create a research resource “barrel” where gestalt research-

ers might use tests, scales, designs, and tools for data

assessment.

■ Hold periodic conferences focused on research.68 Part I Orientation

Spirituality and Gestalt Therapy

My own practice as a gestalt therapist has also been influenced

by my first career in Christian ministry. I am an ordained clergy-

man who completed a Master of Divinity from Western Seminary

in Portland, Oregon, taught New Testament Greek at Simpson

College, served as a minister of children in a large, multistaffed

church in central California, and then pastored two small, rural

churches before going back to school for a doctorate in clinical

psychology.

I had been exposed to gestalt therapy while in the navy during

the Vietnam war. As a neuropsychiatric technician, I was assigned

to cofacilitate “the gestalt group” with Evan Wolf, a civilian psy-

chologist who was part of the San Francisco Gestalt Institute

and who, with colleagues such as Cyndy Sheldon, had been driv-

ing down to Esalen to train with Frederick Perls and returning

to practice on the psych wards. I liked what I was seeing, and I

seemed to pick it up quickly and get into step with Dr. Wolf. So, I

started learning by doing before I really knew what gestalt therapy

was. Then, in my doctoral program, the faculty kept telling us we

had to choose a clinical orientation. I saw a notice about a local

gestalt therapy training institute, and it all clicked into place for

me. I ultimately committed to what became a 6-year formal train-

ing with Carol Swanson and Maya Brand. Other trainers were Bob

and Rita Resnick, Todd Burley, Jan Ruckert, Lynne Jacobs, Philip

Lichtenberg, Steve Zahm, and Nan Narboe.

I still remember the day I invited Maya Brand to demonstrate

gestalt therapy for a class I was taking on experiential therapy.

After her work with one of the students, the entire class of about 20

people broke out in spontaneous and enthusiastic applause. Gestalt

therapy had always just felt right to me, and the chance to be around

such accomplished, broadly influenced, well-educated people who

were outside my usual circle of associates was stimulating; that my

cohort would sense the value in what Maya did in front of them was

satisfying and confirming. I made every one of my papers into an

intellectual exploration of gestalt therapy and became nauseatingly

predictable to my friends; I was the lone “gestalt guy” among a sea

of budding cognitive behavioral therapists. Chapter 3 The Growth of Gestalt Therapy 69

My current work in the psychology of religion includes the inte-

gration of Christian thought in gestalt therapy praxis. In 2008 and

2009 I contributed several chapters to a series of books exploring

miracles, gestalt therapy, and the healing power of spirituality, and

in each of them I contributed to an integration of gestalt theory

and theology.6 I continue to develop an integration of Christianity

and gestalt therapy, including an exploration of the implications of

the turn toward theology in French phenomenology. In the pro-

cess, I have become one of a few people investigating spirituality in

gestalt therapy from a theistic perspective.7

CONCLUSION

Gestalt therapy grew in the minds of its originators from a consil-

ient brew of many influences, and this is how it continues to evolve.

Gestalt therapists, consultants, and coaches will no doubt assimi-

late whatever presents itself on the horizon. Already, some fertile

influences are evident: neuroscience and neuropsychology, spiri-

tuality (including theology and theistic spirituality), philosophy,

developmental psychology, kinesiology, experimental psychology,

and psychotherapy research.

NOTES

  1. Gestalt Therapy Integrated: Contours of Theory and Practice (1973, Simon &

Schuster).

  1. These ideas are more fully developed in Erving Polster’s Uncommon Ground:

Harmonizing Psychotherapy and Community to Enhance Everyday Living (2006,

Zeig, Tucker, and Theissen) and Brian O’Neill’s edited volume titled Community,

Psychotherapy and Life Focus: A Gestalt Anthology of the History, Theory, and

Practice of Living in Community (2009, Ravenwood Press).

  1. Gestalt, starting in 1990, published by Société Française de Gestalt; Cahiers de

Gestalt-thérapie, starting in 1996, published by Collège Européen de Gestalt-

thérapie de langue Française.

  1. Formes pour la Gestalt-thérapie (1989, Bordeaux: Presses de l’IFGT); La Gestalt-

thérapie, Essentialis, Ed. (1994, Paris: Bernet-Danilo); Pli et dépli du self, (1997,

Bordeaux: Presses de l’IFGT; reprinted as Gestalt-thérapie, La construction du

soi, Ed. Paris: L’harmattan); Contact and relationship in a field perspective, (2001, 70 Part I Orientation

Bordeaux: L’exprimerie; reprinted in International Gestalt Journal, 31(1), 2008);

S’apparaître à l’occasion d’un autre, (2004, Bordeaux: L’exprimerie); La psy-

chothérapie comme esthétique, (2006, Bordeaux: L’exprimerie).

  1. Arnold Beisser’s chapter on “The Paradoxical Theory of Change” has become a clas-

sic of gestalt therapy literature and one of the “givens” in its theoretical base. That

chapter first appeared in a book edited by Joen Fagan and Irma Lee Shepherd titled

Gestalt Therapy Now: Theory, Techniques, Applications (1971, Harper Collins

College Division).

  1. These chapters include. Intentional spirituality, in The Healing Power of Spirituality:

How Religion Helps Humans Thrive, vol.1, The Healing Power of Personal

Spirituality, J. Harold Ellens (Ed.) (in press, Praeger/Greenwood); Healing poten-

tial of religious community, in The Healing Power of Spirituality: How Religion

Helps Humans Thrive, vol. 2, The Healing Power of Religion, J. Harold Ellens

(Ed.) (in press, Praeger/Greenwood); Spirituality in the praxis of gestalt therapy,

in The Healing Power of Spirituality: How Religion Helps Humans Thrive, vol. 3,

The Psychodynamics of Healing Spirituality and Religion, J. Harold Ellens (Ed.)

(in press, Praeger/Greenwood); Spirituality in gestalt therapy, in From the Here

and Now to the Future—Advancing Gestalt Theory and Practice, Talia Levine

Bar-Yoseph (Ed.) (in press, Routledge); Personal experience, self-reporting, and

hyperbole, in Miracles: God, Psychology, and Science in the Paranormal, vol. 3,

Para-psychological Perspectives, J. Harold Ellens (Ed.) (2008, Praeger/Greenwood);

Faith: An existential, phenomenological, and biblical integration, in Miracles: God,

Psychology, and Science in the Paranormal, vol. 2, Medical and Therapeutic Events,

J. Harold Ellens (Ed.) (2008, Praeger/Greenwood).

  1. Others include Brian O’Neill, Sylvia Crocker, Christine Stevens, Tilda Norberg, Ed

Harris, and Des Kennedy.

REFERENCES

Bar-Yoseph, T. L. (2005) Introduction–making a difference. In T.L Bar-Yoseph (Ed.)

The bridge: Dialogues across cultures, pp. 17-34. Metairie, NO: Gestalt Institute

Press.

Barber, P. (2006). Becoming a practitioner researcher: A gestalt approach to holistic

inquiry. London: Middlesex University Press.

Brownell, P. (1998). Renewing our roots in neuropsychology: A gestalt perspective on

the work of Joseph LeDoux. Gestalt! 2(1). Downloaded May 14, 2009, from http://

www.g-gej.org/2-1/ledouxreview.html.

Brownell, P. (Ed.). (2008). Handbook for theory, research, and practice in gestalt ther-

apy. Newcastle, England: Cambridge Scholars.

Brownell, P. (2009). Executive functions: A neuropsychological understanding of self-

regulation. Gestalt Review, 13(1), 62–81.

Damasio, A. (1994). Descarte’s error: Emotion, reason, and the human brain. New York:

Putnam. Chapter 3 The Growth of Gestalt Therapy 71

From, I., & Rosenfeld, E. (1978). A conversation with Isadore From. Downloaded

May 3, 2009, from http://www.gestalt.org/fromint.htm.

Latner, J. (1974). The gestalt therapy book. New York: Bantam.

Maclean, A., Levien, B., & Jarosewitsch, R. (1997). Gestalt in New Zealand. Gestalt!,

1(3), np. Downloaded July 19, 2009, from http://www.g-gej.org/1-3/histories.html.

O’Leary, E. (1992). Gestalt therapy: Theory, practice, and research. New York: Chapman

& Hall.

Perls, F. (1969). A life chronology. Downloaded on May 3, 2009, from http://www.

gestalt.org/fritz.htm.

Perls, F. (1947/1969). Ego, hunger and aggression. New York: Vintage Books/Random

House.

Perls, F., Hefferline, R., & Goodman, P. (1951). Gestalt therapy: Excitement and growth

in the human personality. New York: Julian Press.

Perls, L., & Rosenfeld, E. (1977). An oral history of gestalt therapy—part one: A con-

versation with Laura Perls. Downloaded May 3, 2009, from http://www.gestalt.org/

perlsint.htm.

Starak, Y. (1997). Gestalt in Australia. Gestalt!, 1(3), np. Downloaded July 19, 2009,

from http://www.g-gej.org/1-3/histories.html.

Wheeler, G. (2009). Intention, boundary, and shadow: Forty years of gestalt community

life and practice at Esalen. In B. O’Neill (Ed.), Community, psychotherapy and life

focus: A gestalt anthology of the history, theory, and practice of living in community,

pp. 87–108. Wollongong, Australia: Ravenwood Press.

Wulf, R. (1996). The historical roots of gestalt therapy theory. Gestalt dialogues:

Newsletter for the integrative gestalt centre, np. Downloaded May 3, 2009, from

http://www.gestalt.org/wulf.htm.This page intentionally left blank How To Do Gestalt PART

Therapy I IThis page intentionally left blank 4 Deal With Personal Experience

This chapter describes the phenomenological method as applied

to psychotherapy. The method was initiated out of the act psychol-

ogy of Franz Brentano, including his construct of intentionality,

and developed by Edmund Husserl as a tool for philosophy. It has

since been used in qualitative research, but as a method in psy-

chotherapy it is a valuable way of observing and describing the

cognitive, affective, physical, and spiritual experience of the cli-

ent. The method is used to increase awareness leading to insight

and change.

Cognitive science has two faces. With one face it gazes at

nature and sees cognitive process as behavior, but with the other

it looks at the life world of human beings and sees cognition as

experience (Varela, Thompson, & Rosch, 1991). These are two

pictures of the same thing. This observation is the open door

of consilience between gestalt therapy and cognitive behavioral

therapy, neuropsychology, and phenomenology. Neuropsychology

and phenomenology both belong in gestalt therapy’s conceptu-

alization of the situated individual and his or her being in the

world, because neuropsychology studies the physiological corre-

lates of behavior and phenomenology studies the mental corre-

lates of experience.

75 76 Part II How To Do Gestalt Therapy

Because gestalt therapy has traditionally been located in the

third wave of humanistic approaches, it has not been recognized

for its own cognitive perspective; however, it is just as much a cog-

nitive approach as cognitive behavioral therapy. Compare cogni-

tive behavioral’s baseline principles 1 below with gestalt therapy’s

consilient understanding of each one, as shown in Table 4.1.

Gestalt therapy’s perceptual and conceptual gestalts, shift-

ing between foreground and background, the hermeneutics of

experience, the nonreductive relationship between mind and

brain, and the self-regulation in executive functions all involve

cognitive processes. They are embodied cognition (Gallagher &

Zahavi, 2008) and occur in the whole person; the gestalt thera-

pist is thus not concerned just with a mind that thinks, dissoci-

ated from the phenomenal experience of the whole person, but

also with a body that feels and a spirit that aches with ultimate

concern.

Table 4.1

COMPARISON BETWEEN COGNITIVE BEHARIORAL THERAPY AND

GESTALT THERAPY

GESTALT THERAPY CONSILIENT

COGNITIVE BEHAVIORAL PRINCIPLES PRINCIPLES

Interaction between cognitions, Holistic approach weaves together

affect, and behavior every level of functioning

Experiences evoke cognitions, Immediate, situated and pre-reflec-

explanation, and attributions about tive experience gives rise to interpre-

the situation tation for relevance and meaning

Cognitions may be made conscious, Awareness of holistic function can be

monitored, and altered heightened through experiment, dia-

logue, and phenomenological inquiry,

leading to creative adjustment

Emotional and behavioral change Change is multidirectional, contex-

can be achieved through cogni- tual, idiographic, and paradoxical;

tive change, just as cognitive it emerges from supported con-

change can be altered by actions or tact, acceptance, and heightened

emotions awareness Chapter 4 Deal With Personal Experience 77

AWARENESS AND CONSCIOUSNESS

Consciousness and awareness closely approximate one another in

meaning. If someone is conscious of the fan twirling around above

on the ceiling, then that person is aware of it. If a person is aware of

his or her posture, then that person is conscious of it. Interestingly,

a person can be aware of a state that is not itself a conscious state.

One can be conscious of one’s posture, but posture itself is not a

conscious state (Kim, 2006). If I am awake, I am in a conscious

state; however, if I am in a coma, I am not in a conscious state,

but I may be aware, at some level, of what people are saying in my

presence. To be aware is to shine the light of interest and personal

investment into one’s state of consciousness. Awareness in gestalt

therapy consists of the first person perspective of self-conscious

experience in which one “owns” his or her experience.

Antonia Damasio (1999) suggested that consciousness is a mat-

ter of generating sensory data, the qualia that come from sensory

experience, into a coherent flow (like making a movie from a series

of snapshots), and of producing the sense of self in which a person

tells himself or herself that this movie is his or her movie—it is part

of the story of his or her life. In fact, it is his or her life currently

taking place, currently being “filmed.” Using a different metaphor,

consciousness is the improvisational music of one’s existence, cur-

rently being played, and the self is the artist currently creating the

improvisation.

The First-Person Agent of Experience

In Greek, the personal pronoun used to designate the first person

is ego. Freud used it to point to the subject in view in such state-

ments as, “I did this” or “I want that.” Gestalt therapy turns the

ego into a function, pointing to the “capacity of the self in contact:

the capacity to identify oneself with or alienate oneself from parts

of the field” (Lobb & Lichtenberg, 2005, p. 30), while maintaining

the sense of ego as the agent of experience. Consequently, con-

ceptions of the self are analogous to the ego in action. Whether it

is the ego as function, the ego as agent of experience, or the self 78 Part II How To Do Gestalt Therapy

and self-experience, what one is talking about is a person’s sense of

being alive and existing in a world with others—of the relationship

between oneself and everything else, which constitutes “other.” 2

The self in gestalt therapy is both the system of contacting and

the agent of experience (Crocker, 1999). “The self is the experi-

encer and organizer of contact at the boundary between self and

other and plays the crucial role of organizing our perceptions of

people and circumstances and making meaning out of the per-

ceived world in which we live” (MacKewn, 1997, p. 74). Self is both

process and concept—the process of contacting and the enduring

sense of identity. This is what John Searle pointed to when he said,

We do not just have disordered experiences; rather, all of the

experiences I have at any instant are experienced as part of a

single, unified conscious field. Furthermore, the continuation

of that conscious field throughout time is experienced by the

possessor of that conscious field as a continuation of his or her

own consciousness. (Searle, 2004, p. 201)

Contact, Emergence, and Self-Experience

Contact is what happens when people move about in the world.

In a very rudimentary way contact is what happens when a person

bumps into a wall. There is a sudden meeting between soft, sensi-

tive face and hard, resistant wall. They touch. Contact in the gestalt

vernacular involves a bit more. There is a meeting, but this meeting

constitutes the awareness of the relationship between self and other

and makes explicit the way in which self and other touch. It, too,

gets one’s attention, because contact is exciting. “Primarily, contact

is the awareness of, and behavior toward, the assimilable novelty;

and the rejection of the unassimilable novelty” (Perls, Hefferline, &

Goodman, 1951/1972, p. 230). Erving Polster and Miriam Polster

(1973) described contact as the lifeblood of growth and the means

by which a person changes himself or herself and the experience of

the world.

Contact takes place at a boundary, conceived metaphorically as

an organ or membrane connecting oneself to one’s environment.

The contact boundary is the point at which a person experiences Chapter 4 Deal With Personal Experience 79

“me” as opposed to “not me.” It is not a place located in physical

space, but its physiological correlate can be located in the frontal

lobes and prefrontal cortex (Brownell, 2009a), where the organiza-

tion of a person’s “touch” with the world comes together, results in

conscious responding, and involves the executive functions of self-

regulation.

The choices we make are not inherent in the situations at

hand. They are a complex interplay between the properties

of the situations and our own properties, our aspirations, our

doubts, and our histories. It is only logical to expect that the

prefrontal cortex is central to such decision making, since it

is the only part of the brain where the inputs from within the

organism converge with the inputs from the outside world.

(Goldberg, 2001, p. 78)

That is a good description, from a neuropsychological perspec-

tive, of the contact boundary at work. It could be said that the self

is drawn to the contact boundary where something of interest or

concern in the environment is met, but actually, the whole person

is involved in the environment and various features of the self take

shape at the boundary of the organism and the environment. The

human being is of the environment and not a separate entity from

the environment with only a potential for meeting it. The whole

person is always in some kind of contextual situation, and it is the

emergent and supervenient activity of the mind that continually

forms and reforms at the boundary, contributing to the overall self

(Brownell, 2009a).

In gestalt therapy, the self is one whole system integrating vari-

ous capacities of the whole person. The self has three operative

means by which it works, serving as the subject, and they are identi-

fied as functions: Id function tells the person what he or she is feel-

ing and sensing, ego function distinguishes between self and other,

and personality function tells the person what kind of person he or

she happens to be (Lobb & Lichtenberg, 2005; Perls, Hefferline,

& Goodman, 1951/1972). With the id function, a person becomes

aware of needs, curiosities, desires, excitement, and disaffected-

ness. With the ego function, a person makes choices, identifies with 80 Part II How To Do Gestalt Therapy

figures of interest or alienates them, and navigates contact at the

boundary. With personality function, the person constructs the

ongoing story of one’s life in a characteristic style of responding,

forms a history that orients the person with regard to a way of life,

including a world view, and uses the residue of experience to make

as efficient a way as possible for the person to live among others in

the world.

That said, some attention needs to be paid to the concept of

emergence, because “the self is not constructed by something more

potent; it comes into being as the most potent aspect of the person,

exercising will and providing downward causation on everything

from which it emerges, and the best word for that process is ‘emer-

gence’ ” (Brownell 2009a, p. 72). So, what is this thing called emer-

gence and how does it work?

Emergence is the process by which properties or substances

arise out of more fundamental entities but are distinct from them

and irreducible to them (O’Conner & Wong, 2006). Emergence

relates to gestalt therapy in that gestalt therapy maintains an

emergent theory of self, and therein resides a problem. Gestalt

therapists face a conundrum in attempting to integrate neurophysi-

ological evidence with the gestalt therapy theory of self, because

this boils down to the issue of how the brain (or the nervous sys-

tem) is related to the mind. Gestalt therapists adhere to substance

monism but property dualism. That is, they believe the immate-

rial self arises from the functioning of the material brain as the

organism contacts the environment. Property dualism occurs when

“the ontology of physics is not sufficient to constitute what is there”

(Robinson, 2007, np). When a gestalt therapist encounters a client,

there is more there than a simple firing of synapses, the reflect-

ing chorus of mirror neurons, and the memory of emotionally

laden experience stored in the amygdala. Nonreductive physical-

ism maintains that mind emerges as the brain engages; the work-

ing of the fundamental nervous system generates a complex order

of properties, a mind, that is distinct from, but dependent on the

working of the brain.3 No brain; no mind (Stoeger, 2002). Thus,

the gestalt therapy experience of self belongs in discussions of the

theory of mind, because it is so similar to the properties of mind Chapter 4 Deal With Personal Experience 81

as to be synonymous. Conversely, gestalt therapists enhance their

understanding of a client when they assess that person’s neuropsy-

chological capacities, because self depends on the individual’s neu-

rological capabilities.

The triangulation of sensory perception yields the experience

of being in the world of objects. When I sit at a table, look down

and see its wooden pattern of browns, tans, and even yellows and at

the same time feel its hardness with my elbow and its cold smooth-

ness with my fingers, and tap on it and hear the solid sound, I get a

triangulated sense, through multiple streams of perception, of the

nature of this object. I am situated, contextualized, and I exist as a

being in triangulation with other beings. That produces an experi-

ence that is both encountered directly and constructed internally.

This, by the way, is near the crux of couples work, for in a dyadic

relationship both people attempt to reconcile the fact that they

each directly share the same situation, yet internally construct or

interpret it differently. This gestalt structuring is

not only a matter of organizing our perceptions into coherent

wholes, but within the entire conscious field, we make a dis-

tinction between the figures that we are perceiving and the

ground on which they are perceived. So, for example, I see

the pen against the background of the book, the book against

the background of the desk, the desk against the background

of the floor, and the floor against the rest of the room, until

I reach the horizon of my entire perceptual field. (Searle,

2004, p. 100)

Self-experience can be thought of as self-conscious in nature.

As such, it amounts to the awareness of one’s self in situ or in vivo.

When a biologist examines a phenomenon where it occurs, without

moving it to a Petri dish, that is in situ. However, it is not necessar-

ily in vivo. When a biologist examines a cell in an organ that is still

part of the living organism, that is in vivo, or “within the living.”

When gestalt therapists work with clients they work in situ and they

work in vivo; that is, they are working with the client’s experience

of a part of life extracted from the whole context of life. They do

not go home, eat dinner, go to bed, wake up, and have breakfast 82 Part II How To Do Gestalt Therapy

with their clients. Similarly, they do not extract the thinking part

of the whole person and isolate it in its own “Petri dish” (in vitro).

Rather, gestalt therapists work with their clients’ sense of being

caught up in some kind of situation in which they carry elements of

their ongoing life, intact, into each session, and the gestalt therapist

works with the whole person in situ, “in the place,” often moving

from the transplanted situation to the lived experience of the client

in session (in vivo).

For example, one client came for therapy because he felt lonely,

isolated, and depressed, and he complained that he could not keep

conversations with other people moving. He would inevitably reach

a point at which it all stopped. He would exhaust himself following

a script of questions he had devised, and then not have anywhere to

go from there. It seemed to him that others would lose interest in

him, and he would then drift apart from the group and find himself

alone in a crowd, looking for some way to escape. Through a phe-

nomenal exploration of his narrative of one specific event like this,

the therapist attempted to slow down the sequence to more closely

examine that situation. The client described the situation, and the

therapist listened and asked clarifying questions about what was

happening, what happened next, how the client had been feeling,

and what he had been thinking. Finally, he stated that while listen-

ing to the client he got a sense of the client drifting, diffuse, in a

cloud and not connecting with people. The client agreed; that is

what it felt like to him. The therapist asked what the connection

taking place at that moment between himself and the therapist felt

like to the client, and the client stated that it felt the same as the

others; the gestalt therapist then moved to a phenomenal explora-

tion of that moment-by-moment interaction. Together, they moved

from an in situ to an in vivo phenomenal investigation.

INTENTIONALITY

Franz Brentano retrieved the term intentionality from the scho-

lastics’ development of the concept in medieval philosophy. As

suggested in chapter 2, intentionality in phenomenology does not Chapter 4 Deal With Personal Experience 83

mean purpose; it signals the aboutness of experience, and it is the

starting point for a phenomenological approach to anything. How

is intentionality, this aboutness, related to gestalt therapy? It is the

dynamic factor in figure formation, in which interest, need, or curi-

osity brings to mind a focus. It is the move from diffuse and vague

sensory perception, a kind of awareness, to the clarity that intensi-

fies general awareness into a signal indicating what that sensory

experience is about. It’s the move from an empty feeling in the pit

of one’s stomach to the realization, “I am hungry.” As such, inten-

tionality has three facets worth considering: voice, attitude, and

horizon.

Voice

The subject thinking or feeling is connected by the act of thinking

or feeling to the thought being contemplated or the feeling being

experienced. In admiring, something is admired. In fearing, some-

thing is feared. There is a subject acting, and there is an object

intuited, represented, or perceived. Thus, the object in question

is called an intentional object. It is the object of one’s attention

and intention. In the work of Edmund Husserl, the object became

known as a noema and the process of intending became known as

a noesis (Spinelli, 2005). The noema is an enduring mental repre-

sentation of either tangible things existing in the world, such as an

apple, or constructs of contemplation, such as “justice.” Although

the apple might grow brown and rot away, the noema constituting

the apple cannot be destroyed, because the mental act at the cen-

ter of intentionality creates an enduring image (Moran, 2000).

Willhelm Dilthey described this relationship of the subject to

the intentional object:

I only appear to live among things that are independent of

my consciousness; in reality, my self distinguishes itself from

facts of my own consciousness, formations whose locus is

in me. …The system of my representations extends as far as

these objects which appear to me. Whatever is encountered

in objects—the hardness that demolishes, the glowing heat

that melts—is to its very core a fact of my consciousness, and 84 Part II How To Do Gestalt Therapy

the thing is, so to speak, a synthesis of just such mental facts.

There are no distinct objects to which my representations

refer; the object simply is the representation. …Existence

itself, reality, being—these are only expressions for the way

in which my consciousness processes its impressions and its

representations. (Dilthey, 1991, pp. 245–246)

The aboutness of the experience makes intending a transitive

process as the person creates his or her own experience. As described

earlier, then, the grammatical construct of “voice” stands for the

implicit relationship between subject and the action of intending.

Voice is a grammatical feature in verbal systems; it “is that prop-

erty of the verbal idea which indicates how the subject is related to

the action” (Dana & Mantey, 1927/1955, p. 155). The active voice

describes the subject as producing the action or representing the

state intrinsic to the object, the passive voice shows the subject

receiving the action, and the middle voice describes the subject as

participating in some way in the results of the action; it relates the

action more intimately to the subject (Dana & Mantey, 1927/1955).

The active voice emphasizes the action, but the middle voice

emphasizes the agent, thus is more immediately relevant to self

experience. Hindu grammarians described the active voice as

parasmai padan (word for another), while they described the

middle voice as atmane padan (word for one’s self). (Brownell,

in press, np)

The middle voice has several nuances of meaning indicating how

the subject participates in the action, but the three most salient are

the following:

1 The direct middle in which the results of the action are

referred directly to the agent with a reflexive force, that is,

“I found myself.”

2 The indirect middle in which sometimes the stress is on the

agent as producer of the action rather than participant in its

results and the action is related to the agent in some special

way, that is, “I, myself, found myself.” Chapter 4 Deal With Personal Experience 85

3 The permissive middle in which the agent voluntarily yields

self to the results of the action or seeks to secure those

results for his or her own self-interest, that is, “I found

myself for myself.”

Thus, I intend—think, feel, experience in some way some

“thing,” some aspect, some feature of my phenomenal land-

scape—in the middle voice. It is this reflexive self-reference,

this self-interest that connects the subject to his or her inten-

tional object, and it is an immediate action. That is, the first-

personal givenness of experiential phenomena is accounted

for by a pre-reflective self-consciousness, which is present

whenever a person is living through an experience; that is,

whenever one is consciously perceiving the world, thinking a

thought, feeling an emotion or sensing a sensation (Zahavi,

2006). One is having an experience, not noticing oneself

having an experience. However, if one begins to attend, on

a meta level, and thinks about oneself having an experience,

then the pre-reflective self-consciousness, the middle voice

of intentionality, shifts to another intentional object, but the

flow of intentionality keeps moving in that same middle voice

(Brownell, in press, np).

In gestalt therapy the middle voice is prominent in such state-

ments as “the self is the agent of experience,” or “the self is the

artist creating one’s life.” However, voice has not been developed as

a useful construct by gestalt therapists, even though grammatical

voice is inherent in the gestalt ideas of self, responding, and sponta-

neity. Paul Goodman attempted to explicate the concept of voice in

PHG, but he mixed up Greek grammar and referred to a “middle

mode.” There is no such thing in Greek grammar, but the context

of his comments clearly indicates he was working the idea of voice:

In English we have mostly only active or passive verbs. …

Greek has a regular middle mode [sic] … But we must make a

careful distinction: just what the middle is not is action on the

self—this we shall later call “retroflection,” often a neurotic

mechanism. The middle mode means, rather, that whether

the self does or is done to, it refers the process to itself as 86 Part II How To Do Gestalt Therapy

a totality, it feels it as its own and is engaged in it. (Perls,

Hefferline, & Goodman, 1951/1972, footnote, p. 376)

Attitude

Attitude is the tint coloring one’s identity and the flavor in one’s

interest that influences one’s relational stance toward the world.

Attitude is the parameter in which one reaches out to the world.

Saying one has a “bad” attitude is a common expression; it

means that one is rancorous, vitriolic, irritable, or even hostile in

one’s stance toward the world, and if a person is like that, then the

manner in which he or she meets others influences the kind of

experience all will have. This is understandable, but it is not exactly

the kind of attitude involved here.

The attitude in which one engages his or her intentional objects

influences the experience one has of those objects. That is true.

However, the emphasis is not so much on one’s affective stance as

it is on one’s identity and interest and the bearing or the pose one

assumes as an expression of them. Attitude can be thought of as

a measure and a description of one’s openness in any given situa-

tion. It also includes the direction of such openness (toward, away,

beside, etc.).

For instance, if I walk through a shopping mall with a design-

er’s attitude, then I will gravitate to clothing and furniture stores

but perhaps away from sporting goods, and I will stop to admire

the colors and the composition in various displays.

It is a natural way of approaching whatever one is experiencing,

and it takes percepts as they come without questioning whether

or not objects are actually there—or how they are there. Such a

designer’s attitude would be a subset of the natural attitude.

On the other hand, if I walk through the same mall with a phe-

nomenological attitude, then I throw relevant percepts into relief

and assume a detached, observing, and critical posture—a meta-

level cognition—with regard to them.

In the natural attitude, I see a painting, and as the designer I

may evaluate its color scheme and theme for an appropriate fit in

some project I am doing, but I approach the painting in the course Chapter 4 Deal With Personal Experience 87

of my everyday life and do not notice myself thinking about the

painting as painting. In the phenomenological attitude, however, I

do think about the painting as painting. I think about how I am per-

ceiving and thinking about the painting; if I see that same painting,

I am observing its features in order to conclude what it actually is,

its essence, but I am not actually incorporating it into the mundane

flow of my life.

My specific interest in a certain entity, my situation in oth-

er words, is always embraced or surrounded by an attitude.

The attitude is like a halo (or an aura) around a certain act

of interest. Being in the attitude of the businessman, let me

call it the “business attitude,” my intentional rays of interest

will be carried out according to this attitude. Likewise, I can

shift my attitude, as an act of my free will, to the architectural

attitude, or I can shift to an aesthetic attitude and view the

selfsame thing, the house in my example, as a work of art.

Strictly speaking, my active life is always already carried out

in a certain attitude of which there are many, some of which

may still be unknown to me. (Luft, 1998, p. 157)

In phenomenology the two main attitudes of interest are the

natural attitude and the phenomenological attitude (see below for

more on these). The first comes with a measure of naiveté that

accepts beliefs about the world as given without much question,

the chief of which is that the objective world actually exists. It is

this belief, this basic ontological naiveté, that even undergirds the

scientific method, and it illustrates how, at the core, all other atti-

tudes arise from the natural attitude. This is because all attitudes

assume the universe exists and move on from there in some way

(Luft, 1998).

In gestalt therapy a therapist may move in and out of several

subsets of the natural attitude, one of which could be called the

therapeutic attitude. In this attitude the stance in relation to the

client is a felt experience as the therapist is aware of clinical issues

and procedures. The therapist does not adopt a false persona of pro-

fessionalism and force himself or herself to maintain professional

distance, but the therapist does realize an identity (the therapist 88 Part II How To Do Gestalt Therapy

self) and he or she does follow clinical interests (open to the cli-

ent for clinical purposes). What is important to understand, and is

addressed below, is that the therapist, even though using a modi-

fied phenomenological method, does not assume a philosophical

attitude and conduct a phenomenological reduction. This has been

confused and misunderstood in many treatments of gestalt therapy

methodology, and this is one difference between gestalt psycho-

therapy and phenomenological psychotherapy (they are sisters but

not identical twins).

Horizon

The openness one has toward potential objects encountered in

any given attitude is called the horizon that correlates to that atti-

tude, and for each horizon there is a corresponding world. Thus,

for the business attitude there is a horizon and world of business.

For the designer’s attitude, there is a horizon and world of design.

The objects encountered in these attitudes and worlds exhaust a

person’s attention so that one is unaware of the given attitude or

the given world as such, even as they act like channels that steer

one’s considerations. In gestalt therapy, this is called identifying

with one’s figure of interest. In addition, the total influence of one’s

culture and society create a grand horizon and its corresponding

world, and that is called the individual’s homeworld; the home-

world is what provides one’s sense of normalcy such that objects

and experiences are considered either normal or alien by virtue of

their relationship to the homeworld.

In gestalt therapy, the therapist seeks to meet the home world

of the client in the natural attitude. There is no attempt to achieve

a realization of things as they exist absolutely. The attempt is to

understand the experience of the client, and in order to do that

the therapist may take a therapeutic stance with regard to the

client, but it is a posture that is actually subsumed in the natural

attitude of the therapist as well. Therapist and client, in order to

meet and have contact, must share the common medium of expe-

rience that is accepted for what it is rather than objectified and

thematized. Chapter 4 Deal With Personal Experience 89

PHENOMENOLOGICAL METHOD IN PSYCHOTHERAPY

The situated individual is what psychotherapists deal with. The

experience of the client itself is phenomenal, and the study of that

experience is called phenomenology. Gestalt therapy is a phenom-

enological discipline, building on the thinking of philosophers in

the phenomenological tradition, but gestalt therapists are not phi-

losophers; they are psychotherapists who find just as much interest

in behavior as they do in experience. When gestalt therapists prac-

tice their professions, therefore, they work within the phenomenal

field, not the phenomenological field. The insights of phenomeno-

logical philosophy must be “bent” somewhat to support a therapeu-

tic process.

Adapting a Philosophical Method for Use in Psychology

Edmund Husserl’s project was to retrieve philosophy from what he

saw as an overwhelming capitulation to naturalism—the empirical

exploration of consciousness (Jennings, 1986). Ironically, it some-

times seems as if gestalt psychotherapy has surrendered to philoso-

phy, not just settling for the guidance philosophy can provide any

endeavor, but also introjecting Husserl’s philosophical method to

suffice for a psychological process. Giorgi and Giorgi commented

on experimental psychology’s use of the phenomenological method,

and a similar criticism could be lodged against some gestalt thera-

pists, because they both use

[Husserl’s] description of the steps of the method without

modification without realizing that such a description is in the

service of a philosophical project. Thus, Moustakas (1994) also

provided an independent interpretation of Husserl’s philosoph-

ical method, and he used Husserl’s transcendental articulations

as a guide. However, our perspective is that the transcendental

perspective is wholly philosophical and should not be a guide

for psychological analyses. (Giorgi & Giorgi, 2003, p. 245)

Toward that end, Sylvia Crocker wrote about, and she and Peter

Philippson (2005) discussed, the nature of the phenomenological 90 Part II How To Do Gestalt Therapy

method as developed by Edmund Husserl and then adapted to the

existential process inherent in gestalt therapy. Todd Burley and Dan

Bloom (2008) struggled with the same task and became a bit more

explicit in defining the ways in which the “bending” of Husserl’s

philosophical method takes place. Crocker and Philippson indi-

cated that the goal of Husserl’s phenomenological method is knowl-

edge, but the goal in gestalt therapy is a practical one—healing and

growth. The concern in gestalt therapy “is not to find out whether

the client is telling the truth as she tells her story but to under-

stand the meanings the client gives to the people and events in

her life. The therapeutic task thus becomes, in part, hermeneutic”

(Crocker & Philippson, 2005, p. 68). The gestalt therapist is inter-

ested in how the client’s beliefs and understandings of experience

function as the ground for her cognitive, emotional, and behavioral

responses to the people and ongoing events in her or his life. This

is accomplished in part by “turning this philosophical method back

on itself, that is, ‘doubling back’ to the natural attitude … and not

taking the reduction into the phenomenological (and philosophical)

attitude” (Burley & Bloom, 2008, p. 155). By this turning back,

the phenomenological method returns to the sensuous, con-

crete experiencing of the lived-body. By returning to the lived-

body and not moving toward the non-empirical eidetic realm,

gestalt therapy’s perspective prepares for the emergence of

those forms of experiencing, gestalt forming and destructur-

ing, that are the hallmarks of its method. (Burley & Bloom,

2008, p. 160)

The Adapted Phenomenological Method

Three rules apply in a phenomenological process: (1) epoché, (2)

description, and (3) horizontalization (Brownell, 2009b; Crocker &

Philippson, 2005).

In the rule of epoché, one sets aside his or her initial biases

and prejudices in order to suspend expectations and assump-

tions. In the rule of description, one occupies himself or

herself with describing instead of explaining. In the rule of Chapter 4 Deal With Personal Experience 91

horizontalization, one treats each item of description as hav-

ing equal value or significance. (Brownell, 2009b)

These are all conducted in the therapeutic attitude. What

gestalt therapists do in therapy is all done in the natural atti-

tude; however, the therapeutic attitude is a subset of that. This is

so because the therapist does not leave behind the normal flow

of experience, and therapists track the client in terms of the real

world in which both therapist and client live. The meta-stance is a

watered down version of the meta-cognizing of the transcendental

reduction, but it does not take a philosophical posture. Thus, the

designer mentioned above does see the painting with the every-

day eyes of a designer, but according to the homeworld of that

person, and in the same way the therapist does see the client with

the everyday eyes of the therapist, according to his or her familiar

homeworld.

Here is another example. In a discussion of Heidegger’s “new”

phenomenology, James K. A. Smith (2002) contrasts “the ontic, or

positive science (theology), and the ontological field of research

(phenomenology). Theology’s field is particular and concrete: one’s

faith community. In addition, theology functions within and makes

no epoché. A phenomenology of religion, on the other hand, is able

to range across religions and communities. . . . Theology, then, would

always be particular and concrete—the theology of this particu-

lar believing community. A phenomenology of religion, however,

brackets such participation and is able to range across religious

communities” (p. 101).

This is exactly what gestalt therapists do in not using a (philo-

sophically based) phenomenological method in dealing with the

phenomenal field of the client. Gestalt therapists are experience

near, specific, and concrete. They are not abstracting and theoriz-

ing when they use a modified phenomenological method, which

amounts to observing, bracketing “noise,” and describing what they

are observing. As soon as a gestalt therapist starts theorizing, he or

she moves from this level to something else, perhaps even to a field

theoretical strategy, which Kurt Lewin described as not a theory at

all but a method for detecting causal influences.92 Part II How To Do Gestalt Therapy

When the gestalt therapist bends the method created by

Husserl, he or she uses it as a paradoxical intervention. By aiming

to make as clear as possible the current experience of the client (by

observation, bracketing, description, and experiment within the

support of a dialogical relationship; see chapters 4 and 6 below),

the therapist trusts that the client may seize the opportunity to

actualize himself or herself in the moment, leading to adjustment

in subsequent moments. It may or may not happen, but whatever

takes place, that becomes the ground of the next phase in the

process.

In observing, the therapist fine tunes his or her ability to sense

the other person. The therapist uses every available perceptual

portal and waits on the presentation the client provides. He or

she notices clothing, colors, skin tone, musculature, posture, body

movement and carriage, facial expressions, grooming, and so on.

The therapist tracks shifts in nervous energy and split off body

movements, surges or retreats of emotional energy. The gestalt

therapist develops skill in observing all that is possible to sense and

available to be perceived.

In bracketing, the gestalt therapist puts aside, as much as pos-

sible, interpretations, theories, and initial models—even the initial

foundations of theories—about the client. The therapist puts them

aside with permission to come back to them later, and in a similar

manner the therapist puts aside any unfinished personal issues trig-

gered by the client’s way of presenting (what is commonly known as

countertransference).4

In describing, one simply speaks the observation back to the

client, introducing with such phrases as, “I see that …” “I notice

you …” or “Now you are ….” As an extension of this, the therapist

might choose to self-disclose what it is like for the therapist to be in

the presence of the client. This is not a loss of the therapeutic atti-

tude, in some kind of slip into another dimension of identity, direc-

tionality, and interest; that is, this is not using the client to take care

of the needs of the therapist. Rather, this kind of self-disclosing is a

dialogical disclosure, a description of the total impact of being with

the client. In any case, the therapist presents the descriptive state-

ment and then stops. Chapter 4 Deal With Personal Experience 93

The potency of the phenomenal intervention is most effective

when not watered down by excessive verbiage. Observe carefully,

bracket effectively, and describe succinctly. Then stop describ-

ing, and wait on the client, while continuing to observe, and

to bracket. If necessary, if the client says nothing, continue to

describe in accordance with where the process has moved to in

time at that time.

The phenomenological method is just one among several options

available to gestalt therapists, who practice a coherent and unified

approach (Brownell, 2009b; Crocker, 2008; Yontif & Philippson,

2008). It is not the be-all and end-all of therapeutic process. As will

be seen, gestalt therapists also work dialogically and experimentally

with reference to the field, but the phenomenological method is

used specifically to clarify and make explicit what the client expe-

riences, what it is like to be him or her and how he or she makes

sense of life from his or her unique vantage point in some difficult

situation.

CONCLUSION

Gestalt therapy does not address a person’s thinking as if it were dis-

eased and needing to be changed by something the therapist does;

it approaches a person’s thinking and explores it with the client in

order for the client to sync up his or her thinking with everything

else going on in the whole person who is situated in a psychosocial-

environmental surround called “the field” (see chapter 5). It is a

growth model of change focused on what the client does, and not

a medical model focused on what the therapist prescribes.5 Gestalt

therapy deals with the personal experience of the client, with the

quality of the client’s contacting and the meaning-making that

arises from the flow of the process of the client’s life. In order to

make clear what the client is going through and the ways in which

the client is dealing with that, the gestalt therapist employs a modi-

fied phenomenological method as a paradoxical intervention, trust-

ing that the heightened awareness and clarity it engenders will lead

the client to his or her own, best creative adjustment. This form of 94 Part II How To Do Gestalt Therapy

treatment is conducted as one aspect of an overall approach that

also includes the relationship between therapist and client, all those

extratherapeutic factors the client and therapist bring into session

that are affecting the client’s life (also known by gestalt therapists as

“the field”), and the experimental freedom that turns talking about

something that happened somewhere else at some other time into

a current and conducive experience.

NOTES

  1. Cognitive behavioral basic principles adapted from Freeman and Freeman (2009,

p. 304).

  1. “Other” is an important technical term in phenomenology. It stands for what is not

the same; that is, whatever is not of the self and its thematizations—its cognizing

and constructions of meaning—and in some thinkers, such as Emmanuel Levinas,

the other is separate, held in the transcendent mystery he called “alterity.”

  1. This also relates to the concept of supervenience. When the emergent entity super-

venes, then:

a. The two entities are ontologically (i.e., numerically) distinct; B is not simply a

further description of A.

b. A relationship exists between properties in A and B.

c. Property G in A supervenes on property F in B if and only if x’s instantiating G is

in virtue of x’s instantiating F under circumstances c (Murphy, 2002).

“That was a tight, logical statement defining supervenience. What it means is that in

supervenience there are two entities (A and B). B is distinct from A but related to it.

B has properties that correlate with properties in A and supervenes on them because

any change in A results in a change in B, under a given, specific set of circumstances.

Therefore, supervenience is context specific” (Brownell, 2009a, pp. 74–75). A more

detailed explanation of supervenience is beyond the scope of this chapter.

  1. Countertransference can be useful, and this putting aside does not mean the gestalt

therapist never comes back to it. It just means that in the service of the adapted phe-

nomenological method, the gestalt therapist does not use it at that moment.

  1. Which is not to say that the therapist does nothing, but to put the emphasis where it

belongs.

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self-consciousness-phenomenological.5 Work the Therapeutic Relationship

This chapter describes the relational aspects of gestalt therapy. The

intersubjective philosophy of Martin Buber and the philosophy of

alterity as developed by Emanuel Levinas provide the ground for

an exploration of the therapeutic relationship. This is understood in

gestalt therapy as “dialogue,” and the reader is shown how to prac-

tice in a dialogical attitude.

This chapter covers four important concepts fundamental

to gestalt therapy: (1) alterity, (2) dialogue, and the (3) relational

matrix that emerges through (4) contact. The discussion of these

ideas explicates gestalt therapy’s understanding of the therapeutic

relationship. Since outcomes research indicates that the working

relationship accounts for approximately 30% of positive results in

psychotherapy (Brownell, 2008a, 2008b), an understanding of what

this is and how it works is essential. Such an understanding devel-

ops by attending to the individual encountered as Other, the con-

tact between self and Other, the concept of relationship itself, and

the web of relationships one navigates in dyads, families, groups,

organizations, and communities. All four concepts (alterity, con-

tact, dialogue, and relationship) are essential to an ability to use the

therapeutic relationship effectively, and each may be in the fore-

ground at any given time.

97 98 Part II How To Do Gestalt Therapy

ALTERITY

Discussions of alterity can become filled with what feels like

opaque reasoning and hopeless philosophical jargon; but hopefully

this section will not become tediously arcane. To make the discus-

sion more “user friendly,” this chapter in no way approximates a

rigorous philosophical explanation.

“Alterity” is Emmanuel Levinas’s term. Husserl’s system of

phenomenology concerns how an individual might know—the

subjective perspective—but Levinas views phenomenology as an

ethic focused on the implications of the other in general and the

Other person, specifically, which concerns how an individual might

be—that is, how an individual lives in relation to other individuals.

The application is to how the therapist might approach being with

and relating to clients.

Alterity as a construct is incompatible with philosophical reduc-

tion, because the reduction is understood to be a violence perpe-

trated against an Other by making immanent what is transcendent.

One therefore needs to appreciate what these two terms mean. It is

no accident they have a theological ring to them, for Levinas was a

believing Jew who also participated in phenomenologically relevant

philosophical conferences held by Karol Wojtyla (Pope John Paul

II) at Castel Gandolpho (along with Paul Ricoeur and others).

Transcendence and Immanence

Whereas Husserl privileges the individual and his or her immedi-

ate experience, Levinas privileges the “face” of the Other and his

or her mysterious difference. Therein resides the essential contrast

between the terms immanence and transcendence.

To Levinas the face of another person does more than simply

express emotion; it presents an ethical obligation, an imperative,

that calls to a subject (Waldenfels, 2002). Transcendence is the

trace of a paradox that points to the relation with what is separate.

“It is a way for the distant to give itself” (Hayat, 1999, p. ix).

His main point is that the “other” is not another me, nor is

it something defined by its relationship with me, but rather Chapter 5 Work the Therapeutic Relationship 99

something or someone completely other and unique. The

other is incommensurate with me. Moreover, the other, as

that which calls to me, calls for a response from me. (Moran,

2002, p. 337)

Outside of Levinas and those following him, the concept of

“other” can indicate someone else quite similar who shares many

of one’s own traits and tendencies and with whom one might empa-

thize (just another person numerically), but it can also mean some-

one who is quite strange and so different as to be incomprehensible

(another person qualitatively). This distinction is related to the con-

cepts of “same” and “other” and is essential in Levinas. The “same,”

however, does not mean someone or something similar to oneself,

nor does “other” just mean one’s concept of someone very different

from oneself.

Bear with me and consider a text taken from the New

Testament. By contemplating two Greek words, allos and heteros,

and recognizing a grammatical construction used to communicate

obvious or strong contrast (such constructions introduced one item

with men and contrasted it with another item preceded by de), one

can appreciate what “Other” really means. Although allos and het-

eros eventually merged in usage to become interchangeable, the

contexts in which they occur in ancient texts show that sometimes

the Greeks pointed to another of the same kind, but at other times

they pointed to another of a different kind. Both were considered

to be “other,” but one usage communicated more sameness and the

other indicated more difference. So, when Paul wrote to the church

in Corinth about the resurrection, he contrasted the earthly body

that goes into the grave with the spiritual body that comes out of

it, and he used both allos and heteros in that classical, syntactical

construction for communicating contrast:

That which you sow will not be coming to life unless it dies,

and you do not sow what is being made alive, but a naked

grain. … Not all flesh is the same flesh; quite so, some (men)

are of human beings while (de) others (allos) are the flesh of

beasts; some (men) are flesh of birds, while (de) others (allos)

are of fish. There are heavenly bodies and there are earthly 100 Part II How To Do Gestalt Therapy

bodies; in fact, the glory of the heavenly is one thing (men) but

(de) the glory of the earthly is another (heteros). (1 Corinthians

15:36–40)1

The religious content of this illustration is irrelevant to the point

of contrast—the distinction between another of the same kind and

another of a different kind is the distinction between that which

is immanent and that which is transcendent. When someone the-

matizes another person, they make that person into another of the

same kind (the same as oneself). One may contemplate a differ-

ence, but it is a superficial difference overlaying a meta-level cogni-

tion that draws on all one’s definitions and previous experiences.

The other person is not, obviously, the same numerical person as

oneself, but in constructing a theory about him or her, even in

allowing an “aboutness” to form, a therapist creates a picture that is

made from all the raw material of the therapist’s own life, and thus,

the other becomes another of the “same” kind (allos). In order to

break clear of that, the therapist must sow that “other” of the same

kind into the ground where it can die, and the therapist must let

the other of a different kind (heteros) rise from the grave of his or

her own subjectivity, so to speak, through a novel revelation of the

other person, who is not an object of intentionality at that point, but

a kind of saturated phenomenon (Smith, 2002).

How Alterity Relates to Gestalt Therapy

Martin Buber believed that to regard the Other in the scope of one’s

phenomenological knowledge would be to approach the other with

an I-It perspective (Zank, 2007). To conduct any kind of phenom-

enological reduction, then, instantly eliminates the possibility of

dialogue. Further, when one constructs a view of the Other, which

is what therapists do when they begin to conceptualize the client

as a “case” or when they assess and diagnose a person, one cannot

help but construct that view out of one’s own world, one’s own atti-

tude at the time, and the horizon of all possibilities one associates

with that world. Thus, the Other’s true otherness becomes violated

by the first person’s conceptualizing—his or her thematizing. What

makes the Other the same is that through intentionality, one brings Chapter 5 Work the Therapeutic Relationship 101

the Other within the scope of one’s subjective meaning making,

and that shreds the transcendence of the Other, making the Other

immanent. This is the “violence” to which Levinas points and to

which Buber alludes.

I-Thou is the primary word of relation. It is characterized by

mutuality, directness, presentness, intensity, and ineffability.

Although it is only within this relation that personality and

the personal really exist, the Thou of I-Thou is not limited to

men but may include animals, trees, objects of nature, and

God. I-It is the primary word of experiencing and using. It

takes place within a man and not between him and the world.

(Friedman, 2002, p. 65)

What Friedman points to here is what Levinas identified as

the “same.” It is affirmation that the phenomenological approach

to experience is a represented experience that takes place within

a person and not between that person and the world. Even though

gestalt therapists are concerned for the phenomenal field of the

client, there must be a way beyond, a way out of the prison of sub-

jective intentionality, and that way is through dialogue. As soon as

one accepts the reality of the Other, and receives the revelation of

the Other as saturated phenomenon, then direct contact is pos-

sible, and the representationalism of Kant and Husserl drops away.

A gestalt therapist encounters, meets, a transcendent Other when

he or she dialogues with a client.

When people use clients’ diagnostic labels, saying things such

as, “Today we had to deal with a borderline,” they are referring to

their model or representation of the actually existing Other made

into an object—an intentional object—by virtue of the aboutness

of experience in the phenomenological system. Levinas considers

such things unethical, calling them a violence against the Other

(the Other being an actually existing and transcendent Other).

Alterity provides an ethical value for one’s stance as a thera-

pist in meeting people. Although the dialogic approach in gestalt

therapy always advocates acceptance of however the client enters

the circle of dialogue, alterity demands, and by implication the

therapist owes it to the client, that the therapist hold at bay every 102 Part II How To Do Gestalt Therapy

meta-level thought about the client in order to not only accept how

the client enters the circle, but also to be amazed by the revelation

of a transcendent Other.

There are times when clinical business must be carried out, and

a gestalt therapist is no different in that respect from a psychoana-

lyst. If the third-party payer needs a diagnosis, then the therapist

needs to do an assessment. If charting and other documentation

needs to be accomplished, then it simply does. The trick is to do

these tasks with awareness and to make deliberate room for the

ethics of alterity wherever one can find professional room to do so.

CONTACT

Directing a musician’s gaze toward the audience, so that perform-

ers’ and audience’s eyes meet, increases enjoyment of musical per-

formance as a piece of music (Antonietta, Cocomazzi, & Iannelo,

2009). Having connection to a spiritual world can contribute to the

sense of purpose in life among the very old (Hedberg, Brulin, &

Aléx, 2009). Putting groups together that are normally prejudiced

against one another reduces the prejudice in some ways, but in

other ways it reduces their associating (Binder et al., 2009). Simply

imagining social proximity between such groups, though, can often

lead to more positive intergroup relations (Crisp & Turner, 2009).

Introducing skin-to-skin contact during early postpartum can facil-

itate breastfeeding and help prevent breastfeeding cessation among

mothers who desire to sustain it (Chiu, Anderson, & Burkhammer,

2008). Carl Rogers regarded psychological contact between thera-

pist and client as essential to positive outcomes in psychotherapy

(Rogers, 2007). Finally, in 2009, as President Barack Obama con-

templated closing the detention center at Guantanamo Bay, Cuba,

the Pentagon did a study to see how well that prison complied with

Geneva Conventions. The study indicated it met criteria for humane

treatment of detainees, but it recommended one thing: increasing

human contact for prisoners (Glaberson, 2009).

In all the examples listed above some form of touching, prox-

imity, and connection is involved, but what makes contact what it Chapter 5 Work the Therapeutic Relationship 103

is? Contact is a central construct in gestalt therapy, so it needs a

closer look.

Definition of Contact

Contact has been described as the central fact of human life, as

well as the life of all organisms, and it can be understood as “meet-

ings of various kinds with others” (Crocker, 1999, p. 18). Contact

also means being in touch with what is emerging in the moment

(Yontef & Jacobs, 2007). Contact is the means for changing oneself

and one’s experience of the world (Polster & Polster, 1973). In the

context of gestalt therapy, contact means “aware meeting with the

other. Such contact is possible only where there is awareness of dif-

ference, of what is not-me” (Crocker, 2008, p. 132).

The Gestalt therapy interest in awareness in the field leads to

a focus on the relation of the elements of the field. Seen from

our individual point of view, rather than another position in

the field, it is a focus on our relation to the environment. We

call this encounter, or meeting, or even dialogue, but primar-

ily we call it contact. … Contact can be described in terms of

its distinguishing characteristic, its location, and its primary

dimension. Its distinguishing quality is the meeting of differ-

ences. Its location we call the contact boundary, and the fun-

damental organizing quality of contact we call figure/ground.

(Latner, 2000, p. 22)

Contact, then, can be rather vague, but it can also be specific

and sharp. Being in the physical proximity of another person is a

meeting of a kind that may come with a low level of awareness of

the nearby individual and his or her differences; it may not be very

satisfying, and the figure of that other person might be unclear. At

that level, contact is superficial and a poor gestalt. However, on the

occasion that someone emerges for me from a crowd, and I intro-

duce myself and start talking with that person about himself or

herself, the figure of that other person becomes clear, the contact

becomes more bright, and the gestalt takes on heightened quality.

The difference between these two experiences is such that many 104 Part II How To Do Gestalt Therapy

gestalt therapists would say the first is not really contact at all (or at

best fore contact—the initial stage in contacting ). Others would say

that being embedded in some kind of environmental surround pro-

vides at least minimal contact without which we could not survive.

Another way of looking at contact, though, is not as an object

in itself but more of a process. Contacting consists of connecting,

separating, moving, and being aware (Yontef, 1993), and people are

always in some stage of contacting with regard to the people and

things that inhabit their worlds.

We are built for contacting, and we are programmed to learn

and grow through contact.3 At a basic developmental and sensory

level, the reaching-for and the touching-while-seeing of objects in

early infancy (6–9 months or so) lays down an initial neural map

for physical contact between a human being and his or her envi-

ronment that provides a neural capacity for subsequent contactful

experience (Corbetta & Snapp-Childs, 2009). Mirror neurons are

generated through perceptual-motor activity (for instance as the

infant senses himself or herself reaching and grasping), and sub-

sequently, the person is primed to intuit meaning in the observed

actions of others (Del Guidice, Manera, & Keysers, 2009), estab-

lish meaningful social communication, and understand others’

intentions, emotions, and sensations (Gallese, Rochat, Cossu, &

Sinigaglia, 2009)—all this at a pretheoretical level. However, this is

not a confluence, a blurring of the sense of self and other; rather, it

is what provides the subvenient capacity for the supervenient expe-

rience of self-and-other.

Mind, or self, is said to emerge from the activity of the brain as

the person meets the actual world (or the imagined or remembered

world) and the brain is engaged in whatever situation is at hand,

even while sleeping. Mind is said to be supervenient on brain,

which is then understood as subvenient. These are two distinct

characteristics of a person—a substance monism but a property

dualism.

Emergence has been defined as what happens when enti-

ties or processes are combined at a higher level of integra-

tion. Some features of the world emerge out of others. Not all Chapter 5 Work the Therapeutic Relationship 105

the qualities of these new features are necessarily logical or

predictable consequences of the properties of the components

(Hefner, 2000). Furthermore, whereas “the emergent prop-

erty is dependent on the lower-level abilities (i.e., cannot exist

in the absence of these lower abilities), the emergent property

cannot be understood by close scrutiny of the lower abilities,

nor can the behavior in the realm of the emergent property

be totally accounted for using the descriptive concepts of the

lower-level phenomena.” (Brown, 1998, p. 102) Gestalt thera-

pists understand this, because we have long affirmed that the

whole is greater than the sum of its parts. Thus, when the

organism engages in the process of contacting in the environ-

ment, the material components interface at a heightened state

of excitement and what emerges is the immaterial experience

of self. I claim in this article that the higher level of integra-

tion required for emergence takes place in the frontal lobes,

where self-regulation takes on aspects of agency and helps

form the experience of self. (Brownell, 2009, p. 73)

The sense of the transcendence of the other, which at this

pretheoretical level is a saturated phenomenon that surprises and

exceeds one’s expectation, overwhelming one’s horizon (Smith,

2002), is what creates the sense of self-and-other in contact. It is

unpredicted, abrupt, and unlooked-for. Gestalt therapists know this

flood-of-other experience to be exciting and potentially unnerving.

In dialogue (see below), it is the I-Thou moment.

DIALOGUE

If a relationship is contact over time, then dialogue is the discourse

of relationship. This is true regardless of what dimension of the

field one is talking about. Martin Buber, for instance, originated the

philosophy of dialogue by considering his sense of his own dialogic

relationship with God (Seltzer, 1952/1988). Maurice Friedman,

Buber’s biographer, wrote

The basic paradox of the Hebrew Bible is the dialogue between

eternal God and mortal man, between the imageless Absolute 106 Part II How To Do Gestalt Therapy

and man who is created in God’s “image.” If that dialogue is

to take place, it must take place not in eternity but in the pres-

ent—in the unique situation of a limited man who was born

yesterday and will die tomorrow. (Friedman, 1992, p. 5)

Dialogue can take place between one person and another, and

it can take place between a human person and the Divine Person.

That is the crux of a theistic approach to a spiritual perspective

in gestalt therapy, and it underlies therapeutic work with many

religious clients (Brownell, 2006, in press a, in press b; Carpenter,

1997; Norberg, 2006). Gary Yontef asserted that a gestalt therapy

notion of spirituality included the I-Thou and the I-It: “man’s dia-

logue with God depends on the dialogue of person-to-person and

the person-to-person dialogue can exist only against the back-

ground of the dialogue between humanity and God” (Yontef,

1993, p. 17).

Dialogue in gestalt therapy is most associated with the work of

Martin Buber. However, the intersubjectivity present in dialogue

has also been described by psychoanalytic writers such as George

Atwood, Donna Orange, and Robert Stolorow (Jacobs, 2002), and

many gestalt therapists have begun to identify themselves as “rela-

tional” gestalt therapists 2 in the process of following their discus-

sion. Dialogue emerges out of the dialogic attitude in support of

presence, acceptance, and commitment to the process.

The Dialogical Attitude

The dialogic attitude is a stance the therapist takes with regard to

the client. It is not necessary for the client to return such a stance,

although, if the client were to do so, then a dialogic moment might

ensue (Hycner & Jacobs, 1995). What is necessary is that the thera-

pist assume this orientation toward the client, such that the thera-

pist practices presence, acceptance, and commitment, as described

below. This is not the same thing as unconditional positive regard;

this is a process orientation, and it goes beyond a way of think-

ing about the client as a separate object to orienting the therapist

toward the connection that is forming between them. Chapter 5 Work the Therapeutic Relationship 107

Presence

Presence is self-disclosure. It is a decision to be real. It is an ori-

entation the therapist takes with regard to the client; the therapist

shows up as the authentic person he or she happens to be (Gold &

Zahm, 2008). This comes with a relative degree of transparency

(Yontef & Bar-Yoseph, 2008). This transparency is both verbal and

nonverbal; the therapist cannot help but reveal, and instead of fight-

ing this, or putting on a façade of professionalism, the therapist “sits

down” with the client as he or she actually is.

Authenticity is a matter of living the truth about oneself,

which presupposes that a person actually knows him or her-

self. People have wondered for centuries if there might be a

“self” inside somewhere that can be discovered. The classic

statement of the mid-life crisis is, “I’ve got to find myself,” but

where can one find that? There is no outward trip, no spa, no

guru outside oneself that can lead the way. Rather, it’s a mat-

ter of settling down into the daily process of experiencing in

which one finds such things as attraction or revulsion, interest

or boredom. (Brownell, 2008b, pp. 216–217)

The interest and respect the therapist has for the client

shows in gesture, tone, affect as well as in what the therapist

says and how he or she says it. The therapist may share how

he or she is affected at the moment, associations of emotional

experiences, imagery triggered by what the patient is going

through, and so forth. (Yontef & Bar-Yoseph, 2008, p. 190)

Therapist presence is not something unique to gestalt therapy

(Viederman, 2008), but it has been resident in gestalt praxis from

the inception of the gestalt approach. It extends to being courteous

in caring for the client’s sense of being accepted and considered

(Pinkerton, 2008), the use of the body (Avstreih, 2008; Kepner,

2001), and the trust that develops between therapist and client

(Barth, 2008). This is a particular kind of trust; it’s the belief that

the therapist will not deceive or take advantage of the client, that

the therapist will “be real.”108 Part II How To Do Gestalt Therapy

For example, once a mother brought her young adolescent son

to me, because he had instigated an intimidating assault on another

boy at school. He lured the boy into an area where others were

waiting for him; someone grabbed the boy’s arms from behind and

held him while others harassed him and my client threatened him.

As my client told this story, he smirked gleefully, and I felt anger

rising within me. I felt compassion for the boy who had been bul-

lied. I let the anger out enough for it to be evident in my demeanor,

and I said to the young client, “That makes me angry! I would not

like it if someone did that to you.” I said it with congruent affect,

and he was startled by my presentation. His own affect changed,

and he became more subdued; in subsequent sessions he set aside

his aloof and superior attitude, and he began to share more of his

own torment at having to be at that school.

Acceptance

Acceptance of what is has been magnified to a form of therapy

often used to augment cognitive and behavioral therapies, which is

known as Acceptance and Commitment Therapy (ACT) (Roemer,

Erisman, & Orsillo, 2009; Roemer & Orsillo, 2009). In ACT,

acceptance “refers to the conscious abandonment of a mental and

emotional change agenda (when change efforts do not work) and

an openness to one’s own emotions and the experience of others”

(Callaghan, Gregg, Marx, Kohlenberg, & Gifford, 2004). These are

things that make ACT consilient with the paradoxical theory of

change in gestalt therapy (Beisser, 1970; Yontef, 2007). While these

things are not exactly what is meant by acceptance with regard to

dialogue, they convey some key ingredients.

Acceptance (also called “inclusion” in gestalt therapy) is a wel-

coming, a receiving, a tolerating, a confirming, and a trusting deci-

sion of the self with regard to an Other. When the therapist adopts a

dialogical attitude and attempts to create the conditions that might

support meaningful contact and dialogue, he or she accepts the cli-

ent however that person might enter into fore contact and then pro-

ceed through to completed contact without an agenda for change.

The therapist extends himself or herself to greet or embrace the Chapter 5 Work the Therapeutic Relationship 109

client. The therapist then “collects” whatever is given, whatever the

client is presenting of himself or herself, and the therapist tolerates

(in the sense of bracketing) whatever seems odd, awkward, strange,

or offensive. In confirming the presentation of the client, the thera-

pist extends trust in the client, and trust that this tentative meeting

will turn out well, trust that the client will respond and further the

process, and trust in the process itself—that, come what may, the

field will provide what is necessary.

In clinical practice this can be illustrated by contrast-

ing two individuals with whom I worked on the locked unit of

a co- occurring disorders psychiatric hospital. The first was

schizophrenic and was floridly psychotic, while the other was a

sociopathic murderer.

When I sat down with the hallucinating patient, I accepted his

presentation as it was. He was having a hard time talking with me,

because the chorus of voices in his mind made it sometimes impos-

sible to listen to me. I did not demand that he blot them out or that

we give up talking until his medications had blunted his psychotic

symptoms. Rather, I observed that at times he was not responsive

to something I had said, and he admitted that it was because he

often could not pay attention or could not tell it had been me talk-

ing. The effort for him to stay there with me and try to communi-

cate was exhausting for him, and I accepted that as well, observing

aloud the various phenomena associated with his presence and the

courage and tenacity it required of him to try to communicate.

The sociopathic patient was often sullen and dismissive of staff,

if not downright intimidating. He was a large man. If you knew his

history, it was difficult not to fear in his presence. I did not demand

that he be nice and obey all the rules before I could talk with him.

I purposefully determined to practice a dialogical inclusion or

acceptance with him. I had come fresh from a training lecture with

Lynne Jacobs in which I had raised the issue of antisocial people

who do horrible things in my questioning of this acceptance, and

she had remarked, “Phil, I think you’re still trying to change the

person.” She meant, change the person in order to make him or her

acceptable in some way. So, with my sociopathic patient I deter-

mined to accept him as a person who was as much a mystery to 110 Part II How To Do Gestalt Therapy

me as any other, and to make myself present to him for whatever

kind of contact he might be able to muster. It took some warming,

some time. Eventually, though, his attending psychiatrist wrote me

a note thanking me for my work with the man and remarking that

he believed I may have been the only person this murderer had

ever trusted with his feelings.

This acceptance of the client by the therapist opens up the pos-

sibility of the client’s acceptance of himself or herself (Hycner &

Jacobs, 1995). When both client and therapist accept their experi-

ence of being-in-situation—that is, with one another (which is an

in vivo experience), at that instant—then a dialogical moment has

arrived.

Commitment

Commitment is a devotion to the process of what is going on

between therapist and client. It is a dedication and faithfulness;

it is the resolution that one is engaged for the duration. Seen from

the perspective of the therapist, commitment means that the thera-

pist will not turn and run from resistance, impasse, his or her own

anxiety, boredom, or whatever else presents itself in the process of

meeting the client. The therapist is given to abiding with the Other

to the extent possible (Crocker, 1999).

For example, I once had a young boy who refused to talk

with me. His mother brought him to the community mental

health center where I was working at the time, but the boy sim-

ply refused to talk. We spent several sessions in which I waited

on him. We sat in complete silence for an hour each time.

Eventually, circumstances changed at home, and he became a

ward of the court, at which time he was transferred to a residen-

tial facility. That is when he softened with me a bit. As soon as he

did that, I engaged him and we began working together looking

at truck designs he was interested in and that we could find on

the internet. If I had not simply waited on him, being commit-

ted to the process, however that process was unfolding, he would

not have had a therapist when his family situation became more

challenging. Chapter 5 Work the Therapeutic Relationship 111

RELATIONSHIP

Relationship can be impersonal or personal. Impersonal relation-

ships could be a causal relationship between two variables or sim-

ply a correlation between them. Personal relationships could be

a sexual relationship between two people or simply a friendship

between them. A relationship is a connection between two or more

variables, objects, or subjects. When this connection is between

two people, it can be thought of as contact over time.

Gestalt therapy is thoroughly relational in its philosophy, per-

sonality theory, clinical methodology, and practice. The gestalt

therapy perspective is that all phenomena are constructed

and organized by relational processes. Even inanimate events

and configurations that appear to be set by their nature rather

than their relationship with contextual forces are viewed as

constructed and organized by the relationship of the multiple

influences of the entire field of which they are part. (Yontef &

Bar-Yoseph, 2008, p. 184)

Martin Buber and Emmanuel Levinas shared the same per-

spective regarding the importance of the Other, but whereas Buber

was focused on the relationship between I and Thou, Levinas was

focused on the other person in an I-Thou relationship. Whether or

not it is a human person or the Divine Person, whether the relation-

ship is between one human being and another or between a human

being and God, Buber and Levinas regarded the same issues to be

relevant:

Martin Buber (Buber, 1952/1988) asserted that a complete

inclusion of the divine within the sphere of the human would

effectively abolish its divinity. Levinas would say that it would

make the divine Other the “same” as oneself, confining God

to one’s thematization(Levinas, 1998, 1999). Buber further

claimed that if a person were to dare to turn toward God, in

a face-to-face meeting, and to call out to Him, then “Reality”

would meet him. Levinas would say that this sentient meeting

constitutes the enjoyment of God, experienced directly and

immediately in the course of embodied living, as opposed to 112 Part II How To Do Gestalt Therapy

an objectification of God through intentional representation

(Critchley, 2002). With such a perspective, if a person refuses

to limit God to the transcendent, he will have a fuller concep-

tion of God than the one who does so limit Him; conversely, if

a person limits God to only the immanent, then it is not actu-

ally the divine Being one is talking about. (Brownell, in press

a, in press b, np; Buber, 1952/1988)

If you insert “another human being” where the preced-

ing quotation refers to God, the same things would apply. In a

relationship, if a person refuses to limit the other person to the

unknowable and inscrutable (i.e., transcendent), a more complete

conception of that person will emerge; conversely, if a person lim-

its the other in a relationship to only what is immediately seen

and heard, one will not be considering the actual being of the

other person, for we are all more than what is available for others

to observe.

Just what a relationship is changes depending on the anteced-

ent in the construction, “A relationship is _______.” A relation-

ship is a partnership. A relationship is a romance. A relationship

is a friendship. A relationship is a kinship. A relationship is an

alliance.

What is in view is some kind of connection between two people.

Interestingly, when researchers conduct dyadic data analysis, they

admit to one overarching construct in dyadic relationships—non-

independence (Kenny, Kashy, & Cook, 2006). Whatever the descrip-

tive antecedent might be in the statement, “A relationship is _____,”

nonindependence characterizes the statements and behaviors of

each individual in it.

Nonindependence is a technical term that addresses a dis-

tinctive feature of the two people involved with one another.

Experimental psychologists describe nonindependence as

follows:

If the two scores from the two members of the dyad are non-

independent, then those two scores are more similar to (or

different from) one another than are two scores from two peo-

ple who are not members of the same dyad. The heightened Chapter 5 Work the Therapeutic Relationship 113

similarity (or dissimilarity) of scores from dyads is the criti-

cal issue. … Our discussion tends to focus on nonindepen-

dence that results from close interpersonal relationships such

as friendships, married or dating couples, and roommates.

However, similar issues may arise when the two individuals

are initially strangers who have just met in the laboratory or

on the Internet. Nonindependence can even occur when two

people never actually interact but share a common experi-

ence; for example, two patients of the same physician. (Kenny,

Kashy, & Cook, 2006, p. 4)

Here, in the language of the statistician, is recognition that in a

relationship between two people one has left behind the sheer indi-

viduality of one-person dynamics. A relationship is a two- person

field that may, in turn, be embedded within wider and more com-

prehensive fields. In a relationship, the contact over time can be

understood only as a couple process, and the same is true when

the dyad in question is the therapist–client relationship. It is never

a matter solely of what the therapist does, nor solely of what the

client does. Rather, it is an interaction of nonindependence and a

matter of what they do together.

This relational matrix is shown in Table 5.1.

By extension, nonindependence applies to webs of relationships,

extending from couples to families, small groups, and communities.

In these webs of relationships, one can imagine various matrices

like the one in Table 5.1, for they constantly form and dissolve, and

reform with different partners, and they are the basis for under-

standing larger networks in the field.

Table 5.1

THE RELATIONAL MATRIX

THERAPIST PRESENCE THERAPIST ACCEPTANCE

Client presence

Client acceptance114 Part II How To Do Gestalt Therapy

CONCLUSION

One might say that the developments from the early 1970s to the

present around contact and relationship in gestalt therapy parallel

those in other approaches to psychotherapy, but gestalt therapists

claim that the seminal ideas in Perls, Hefferline, and Goodman

(1951) parallel or precede Carl Rogers’s interpersonal ideas (both

were part of the same humanistic third wave, but gestalt therapy

really has a different root in continental philosophy and neurosci-

ence). Indeed, from one perspective, the wider field of psychother-

apy is catching up to the revolutionary ideas that were present in

gestalt therapy from its beginning. As an example, consider the fol-

lowing list of clinical and theoretical innovations in contemporary

psychodynamically oriented psychotherapy:

■ A shift from understanding clinical material in terms of a

one-person model to understanding these issues through a

two-person model or field;

■ A similar shift from attributing therapeutic gain to accurate

therapist interpretations to attributing improvement to the

provision of a collaborative therapeutic relationship;

■ A shift from therapeutic neutrality and detachment toward

acceptance of the usefulness of overt expressions of the ther-

apist’s caring;

■ A similar shift from analytic anonymity toward acceptance

of the usefulness of therapist disclosure to clients (Farber,

2007, p. 292).

This list indicates that a dialogical relationship is related to the

field (see chapter 6), and it identifies the recognition by colleagues

outside the discipline of gestalt therapy that therapist presence and

authentic self-disclosure are beneficial aspects of a therapeutic

relationship. A therapeutic relationship in gestalt therapy is built

on contact, a dialogical attitude, presence, acceptance, commit-

ment, and the realization that the dialogic relationship is a two-

person field in which both therapist and client are affected and apt

to change in some way. Chapter 5 Work the Therapeutic Relationship 115

NOTES

  1. Original translation from the text of the Greek New Testament (3rd ed.), Stuttgart,

Germany: United Bible Societies.

  1. The Pacific Gestalt Institute (www.gestalttherapy.org), led by Gary Yontef and Lynne

Jacobs, is a central influence for this emphasis in gestalt therapy.

  1. The contact cycle consists of four stages: fore-contact, contacting, full contact, and

post contact. These are elucidated in a number of texts starting with Perls, Hefferline,

and Goodman (1951) and continuing through Seán Gaffney’s (2009) useful article

comparing the contact cycle with the cycle of experience. The cycle of experience

has various versions but usually consists of six stages: sensation, awareness, mobiliza-

tion of energy, action/contact, assimilation, and withdrawal.

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This chapter describes gestalt therapy’s understanding of “the

field,” a concept brought from physical to social science in the work

of Kurt Lewin, as constituting all things having affect through

overlapping spheres of influence. Thus, the “life spaces” of both

the client and the therapist become relevant to therapeutic pro-

cess, and the reader is shown how to utilize the field in practice.

Comparisons with and contrasts to organizational and family sys-

tems are also provided, and the dyadic field constructed in the

therapeutic alliance, so in view with intersubjective systems psy-

choanalysis/relational psychoanalysis, is also considered.

Gestalt therapists have been chewing on field theory since

Perls, Hefferline, and Goodman (1951) wrote their basic text. The

implications of field theory for gestalt’s approach to psychother-

apy are still being worked out. Gordon Wheeler introduced a more

contemporary discussion of it in Gestalt Reconsidered (1996), con-

tinued that discussion in Beyond Individualism (2000), and added

still further to it in his collaborative work with Mark McConville

(McConville & Wheeler, 2001; Wheeler & McConville, 2002).

Malcolm Parlett is also known for his explorations of field theory

in gestalt therapy (Parlett, 1991, 1997, 2005), and Frank Steammler

(2006) wrote a wonderful article clarifying the terminology used to

119 120 Part II How To Do Gestalt Therapy

refer to the field. Brian O’Neill (2008) and his responders discussed

field theory from the perspective of the relativistic, quantum field,

and Brian O’Neill and Seán Gaffney (2008) developed their “field

perspective” by bringing together Lewin’s conception of the field

with that of contemporary physics.

In virtually every text on gestalt therapy for nearly the past two

decades writers have considered field theory as theory, which is

ironic, as the man most closely associated with the development

of field theory for the social sciences, Kurt Lewin (Kounin, 1963;

Massarik, 2000), did not consider it so much a theory as a method.

Field theory, therefore, can hardly be called correct or incor-

rect in the same way as a theory in the usual sense of the

term. Field theory is probably best characterized as a method:

namely, a method of analyzing causal relations and of build-

ing scientific constructs. This method of analyzing causal

relations can be expressed in the form of certain general state-

ments about the “nature” of the conditions of change. (Lewin,

1943, p. 294)

That field theory is a method is reflected in the title of O’Neill’s

and Gaffney’s (2008) chapter, which refers to a field-theoretical

strategy in gestalt therapy. Whereas Lewin conceived of field the-

ory as a way of conducting research, gestalt therapists utilize field

theory as a way of doing psychotherapy. As such, it shares kinship

with the conceptualization of complex, adaptive systems and is

consilient with family systems and group therapy as well as with

organizational dynamics for people working with large groups or

groups within organizational systems.

This chapter will discuss the theory of the field as understood

in gestalt therapy in order to talk about how gestalt therapists might

use the field perspective in working with their clients.

THE CONCEPT OF FIELD

Kurt Lewin contributed a great deal to the concept of the field,

but he was not the only one to do so. Henry Murray spoke of a

needs-and-press, Kurt Goldstein spoke of the organism and its Chapter 6 Use the Context of Life 121

relationship to the environment, and Gardner Murphy spoke of

the biosocial situation. All four have something to say to gestalt

therapists about the field, even though only Goldstein and Lewin

were direct influences in the development of gestalt therapy.

What this shows, however, is that the developing idea of a field

was a widespread phenomenon and one that continues to evolve

as the ripples of these various theorists spread throughout clinical

psychology.

Goldstein came to his field-theoretical conceptualizations

while working with brain-injured patients after World War I and

in adopting a holistic view of the human organism. As Richard

Lazarus (1961) described Goldstein’s thinking,

Self-actualization requires that an individual come to terms

with the environment. It must take place in an environment

that impinges upon the organism, disturbing its equilibrium

and requiring it to act to restore the balance. To actual-

ize itself, the organism must search in the environment for

what it needs. Coming to terms with the environment rep-

resents a kind of adaptive interaction between the organism

and the environment. The environment provides the means

by which self-actualization can be achieved, although it can

also obstruct self-actualization by excessive demands or by the

scarcity of the means to self-actualization. (p. 120)

In referring to what he called a “man–world entity,” Goldstein

himself said that he considered the mental capacity of a subject and

came to the conclusion that what he observed was not a function

of the mind/brain alone. Rather, the behavior he observed repre-

sented living events and was not the result of intellectual activi-

ties—the brain/mind alone directing the person:

I could no longer accept the assumption that experience is the

product of mind or brain functions alone, especially after it

became my conviction that the external world is always con-

nected with it. … The study of the world of the brain-injured

proved to be no less important to our knowledge than the

study of the disturbance of the performance. Indeed, though

the patient’s behavior is certainly determined by the brain 122 Part II How To Do Gestalt Therapy

defect, it can only be understood as a phenomenon going on

in the totality of his modified personality in relation to the

world. The holistic approach induced me to bring psychophys-

ical relationship into the foreground. It became obvious that

it was directed by the tendency to come to terms with the

world in which the individual feels he lives. (Goldstein, 1967,

pp. 161–162)

Kurt Lewin’s term for the field was “life space,” and to him that

meant “the totality of coexisting facts that influence the behavior of

an individual at a particular time” (Kounin, 1963, p. 142). Although

Lewin spoke of a psychological field, he included as contributing

aspects of such a field one’s perception, the character of the per-

son, one’s motivation, one’s cognitive processes, thus one’s way of

perceiving and making meaning out of experience, and what he

called the stimulus distribution “by physical processes outside the

organism” (Lewin, 1943, p. 307). That sets up a bipolar perspective

on the field in which one contemplates a person’s experience (one’s

phenomenal field) and environmental context (one’s ontic field).

How to Talk About the Field

Obviously, some time has elapsed since Lewin worked on his ideas.

Gestalt therapists do not approach the field by utilizing the math-

ematical formulas that Lewin did in his topological psychology.

Many gestalt therapists do not recognize a separation of the person

from the person’s various contexts of life. They do not speak of the

person and the field, or of the field exerting pressure on the person;

they speak of the person–environment field or of the organism of

the field. Some gestalt therapists have also begun speaking of the

field as if it were alive and sentient. In this way of seeing things, the

person becomes the aware agent of the field and a means for the

field to choose, change course, and direct itself. For other gestalt

therapists, that goes too far and leaves behind the individual.

Frank Steammler (2006) asked that gestalt therapists define

what they mean by the term “field” whenever they refer to it,

because he observed that usage of the term had become quite

sloppy, such that one never was quite sure whether a person meant Chapter 6 Use the Context of Life 123

the field as Lewin (1951) conceived of it, as Perls, Hefferline, and

Goodman (1951) conceived of it, or just as a catch-all category for

mysterious forces at work in people’s lives, and he called for more

precision that would also admit that the field is specific to a given

person. That is, there is not one giant field that is the same for all

people; rather, there is a unified field relative to each person.

I will attempt in this chapter to define further what I mean by

“unified” and “relative to each person,” for I hold to a field perspec-

tive that integrates Lewin’s and Goldstein’s perspectives on the

field, as well as some of the ideas of other field theorists not usually

mentioned in the history of the development of gestalt therapy the-

ory. The reason for this approach is that gestalt therapy is a living

and evolving praxis; it assimilates wherever helpful concepts and

practices can be found that harmonize with its core.

The Situation as Field

The person who comes for therapy is regarded as part of a situa-

tion; thus, to observe that person and to understand the direction

and force, so to speak, of what is going on with them, a therapist

must take stock of the scope of the situation. Thus, another way of

conceptualizing the field is to refer to the “situation.”

The field consists of “all the complex interactive phenomena of

individuals and their environment. Gestalt field theory looks at the

total situation, affirming and respecting wholeness and complexity”

(MacKewn, 1997, pp. 48–49).

In an early description of field dynamics, Gardner Murphy

described the situation by saying that whatever is real at any given

moment is part of the interaction of the organism and environment

that makes up the situation. In this way of speaking he anticipated

the language of contemporary field theorists, but he used the term

“situation” to identify the person’s field in action.

The complexities of the environment are specified at the

same time that the complexities of organic response are spec-

ified; personality is the going concern which is expressed by

the interaction of the living system with the outer world. . . .

But this seems to grant a good deal; hence the bewildered 124 Part II How To Do Gestalt Therapy

psychologist decides next to ask whether perceptual habits

as well as emotional habits are part of the situation. When

you speak of a situation, he says, do you mean the situation as

you see it or as your subject sees it? Does not each stimulus

field have a different stimulus value for each person? Does not

each person experience the situation differently, selecting cer-

tain aspects of it, remaining blind to the others, and making

his own personal organization of its attributes? Is not each sit-

uation, as a functionally real thing, determined in part by the

individual who confronts it? . . . the situation is an expression of

the full organism-environment relation; the individual’s own

perceptual habits are part of the situation. The situationist

has had to grant the importance of much that goes beyond

the question of roles played. Although the psychologist could

hardly have wanted more, he asks a final question: Is not the

present situation, then, a projection into the present of the

structure of past situations; are not individual heredity and

past experience relevant to the definition of today’s situation?

Surely, answers the situationist; all science follows the stream

of time and regards the emergent present as an expression of

continuing dynamic factors. (Murphy, 1947, p. 881)

Richard Lazarus (1961) considered Murphy to be fundamen-

tally a field theorist like Lewin. For Murphy “the culture and the

person cannot be independently defined. The personality is depen-

dent upon the culture or the environment, and the culture cannot

be conceived independently of the personalities of its members”

(Lazarus, 1961, p. 133).

Dimensions, Networks, Domains, and Layers

Over time I have described field dynamics in various ways and so

have my colleagues. Sylvia Crocker (1999) referred to “insepara-

ble and interpenetrating dimensions,” claiming that every human

being “exists in numerous overlapping fields which influence his

cognitions, feelings, and behavior” (pp. 17, 35). She later referred

to the field as a “domain of interest” (2008, p. 129). People have

used “sphere” in the same way as Crocker used “domain,” say-

ing, “the field is a sphere of influence in which experience occurs” Chapter 6 Use the Context of Life 125

(Brownell, 2009a, p. 403). Joel Latner (2000) said, “The field per-

spective views all phenomena as inextricably linked, part of a vast

network of interaction which is called the field” (p. 20). Kepner

(2003) referred to an energetic field. More recently, Brian O’Neill

(2008) referred to the “relativistic quantum field” and asserted that

in that view people are the “instruments” of the field.

In 2001 portions of discussions on field theory held at Gstalt-L

in 1998 were published in Gestalt! At that time Gerhard Stemberger

made a helpful observation when he said:

One has to distinguish strictly between the experienced,

phenomenal world at the one hand, and the physical, trans-

phenomenal world on the other hand. (1) My experienced, phe-

nomenal world comprises not only my perceived environment

(including my perceived body) but also my perceived bodily I

(or, as LEWIN says: my life space comprises person and envi-

ronment, meaning exclusively the phenomenal person and

its phenomenal environment, not the physical organism and

its physical environment). And this phenomenal world is not

“neutral,” but full of affordances, attractions, repulsions—it is

a phenomenal FIELD in the strict sense of the EINSTEIN

definition of a field. The physical bases of this phenomenal

world are brain processes, but these cannot be perceived; they

belong to the (2) transphenomenal world, which comprises

my physical body and its physical environment (including the

physical bodies of other persons). There is NO field relation of

any known quality (electric, magnetic, gravitational) between

my physical body and my physical environment (though there

is a physical field in the physical brain). The attraction, repul-

sion etc. which links me to the persons or distances me from

them are not the outcome of any field between our physical

bodies, but in first instance of the field relations in my (and

their respective) phenomenal worlds between the experienced

I and the experienced others.

[Viewed from this perspective, “organism,” “environment”

and so on are very ambiguous terms: one would have to clarify

in each case, whether one is speaking of the physical body

or the experienced body, of the physical environment or the

experienced environment. Also the term “boundary” needs 126 Part II How To Do Gestalt Therapy

to be specified: is one talking about the boundary between

the physical body and its physical environment—which would

be the physical skin—or is one talking about the boundary

between my perceived person and my perceived environ-

ment.] (Stemberger, 1998, np)

In 1998 I used “layers” to describe what I later called “spheres”

and also have referred to as “dimensions of a unified field.” Frank

Staemmler (2006) distinguished among several conceptualizations

of “field,” emphasizing the difference between Lewin’s concepts

and those expressed by Perls, Hefferline, and Goodman. (He also

echoed Stemberger’s thoughts along the way.) Perhaps it helps to

see the consistency between two gestalt theorists working indepen-

dently almost a decade apart; the two perspectives can be com-

pared in Table 6.1.

Consider the following integrative description of Lewin’s and

Goldstein’s/Perls, Hefferline, and Goodman’s conceptions:

As Lewin has described them, there are the lifespace (one’s

field), what is in the physical and social world that doesn’t

affect the life space (what is not one’s field), and the bound-

ary of the life space, which constitutes parts of the physical or

social world that do effect the life space but which may be out

of awareness. These boundary entities, then, are actually part

of the field, for everything having an effect is part of one’s

field, or as Goldstein called it, one’s milieu. In his metaphor,

the organism adapts to fulfill these boundary requirements of

its environment. (Goldstein, 1995, p. 99)

That the boundary itself is part of the life space was described

at an early point in the development of Gestalt therapy.

Bringing together both the functional and structural meta-

phors, Perls and Goodman stated, “. . . contacting occurs at

the surface-boundary in the field of the organism/environ-

ment.” (Perls, Hefferlein, & Goodman, 1951, p. 303)

The boundary constitutes the substantive layer of the field,

with which one forms a contact style, and from which one

organizes the experiential layer of the field. Perls described

this relationship by saying, “. . . we assume there is an objec-

tive world from which the individual creates his subjective Chapter 6 Use the Context of Life 127

world . . .” (Perls, 1969, p. 38). Elements of this objective world

that have effect comprise Lewin’s boundary, and he observed

that the process of perception “is intimately linked with this

boundary zone because what is perceived is partly determined

by the physical ‘stimuli’, i.e., that part of the physical world

which affects the sensory organs at that time” [Lewin, 1951,

p. 57]. (Brownell 1998, np)

Contrary to the thinking of Stemberger, Staemmler (2006),

O’Neill and Gaffney (2008), and I (1998) have affirmed a physical

Table 6.1

DIFFERENT EXPRESSIONS/SIMILAR MEANINGS

STAEMMLER 2006 BROWNELL 1998

Lewin: The phenomenal person and Experiential layer: Lewin’s model,

the phenomenal environment form the lifespace, is a functional figure

a shared field, within which their (what would now be called the phe-

respective forces influence each nomenal field)

other in the lifespace

Goldstein: The transphenomenal Substantive layer: Goldstein’s field

field of organism and surround is a structural/biological figure (what

would now be called the ontic field)

Perls, Hefferline, and Goodman: Experiential and Substantive layers

Organism and environment cannot of the unified field

be separated, as they are integral

parts of the same unitary field

A “boundary zone” of the life space: Goldstein wrote of an organism

Certain parts of the physical or with a membrane that acts as a

social world do affect the state of buffer connecting it to its environ-

the life space at that time. The pro- ment; Lewin spoke of a boundary

cess of perception, for instance, is that actually constitutes part of a

intimately linked with this boundary person’s lifespace. The substan-

zone because what is perceived is tive layer of the field is this buffer/

partly determined by the physical boundary, carrying engrams of expe-

stimuli; i.e., that part of the physical rience through contact with things

world that affects the sensory organs as they are (in a critically realistic

at that time (Lewin, 1951, p. 57) understanding).

Source: Adapted from Staemmler, 2006, and Brownell 1998.128 Part II How To Do Gestalt Therapy

aspect to the field in Perls, Hefferline, and Goodman’s thinking,

and recently I maintained that there is a physical correlate to the

boundary—the executive system of the brain largely associated

with the frontal and prefrontal cortex. Quoting Goldberg (2001),

I wrote:

The choices we make are not inherent in the situations at

hand. They are a complex interplay between the properties

of the situations and our own properties, our aspirations, our

doubts, and our histories. It is only logical to expect that the

prefrontal cortex is central to such decision making, since it

is the only part of the brain where the inputs from within the

organism converge with the inputs from the outside world.

[Goldberg, 2001, p. 78]

In saying this, Goldberg marked the anatomy of what

gestalt therapists would recognize as the “boundary,” making

a case for the frontal lobes as the neurological center of the

experience of self. … This is an important point. As will be

seen, the neurological processes of the brain correlate directly

with the resulting emergent self of the organism, and both are

intrinsically related to the executive functions associated with

self-regulation as the human organism negotiates contacting.

(Brownell, 2009b, pp. 70–71)

THE HERMENEUTICS OF FIELD

Hermeneutics is a whole subject in itself. For the purposes of

this discussion, what started as a means of understanding biblical

texts was transformed by Schleiermacher, Dilthey, Heidegger, and

Gadamer into a means of understanding the facticity of life. This

method presupposes a field perspective:

if we are to understand anything at all, we must already find

ourselves “in” the world “along with” that which is to be

understood. All understanding that is directed at the grasp of

some particular subject matter is thus based in a prior “onto-

logical” understanding—a prior hermeneutical situatedness.

(Malpas, 2009, np) Chapter 6 Use the Context of Life 129

In Heidegger–Gadamer, hermeneutics is not a set of rules by

which one recreates the subjective experience and meaning of the

author of some text of antiquity; it is the means of discerning the

situated interest of the contemporary person seeking to under-

stand, for it is that which is most related to the meaning of the

text or the work of art or the experience at hand for the one seek-

ing understanding (for whom it might be said that the situation is

that person’s field). Having said that, Gadamer was not so much

opposed to the standard rules of interpretation as interested in a

priority that he regarded as preceding them. He conceived of the

process of interpretation as a dialogue, a conversation, between the

familiar and the alien in which one’s horizons (Klein, Blomberg, &

Hubbard, 1993/2004; Malpas, 2003) presented an existing interest

that drew one to the issues inherent in the situation but also posed

a limit upon what one might discover. Thus, the dialogue was a

means of challenging and enlarging a given horizon. In this regard,

Gadamer’s interpretation resembles Jean-Luc Marion’s under-

standing of the saturated phenomenon that overwhelms one’s hori-

zon in the presentation of what could not be imagined or expected

because it comes from a truly transcendental Other (Marion, 2004;

Smith, 2002).

Meaning-making is the activity of interpretation, and it is so

whether one is interpreting texts, dramatic enactments, or the

drama of everyday life. Blending perhaps the most prominent

“rule” of traditional interpretation with Heidegger–Gadamer, one

comes to the importance of contextualizing. In writing of biblical

hermeneutics, Klein, Blomberg, and Hubbard (1993/2004) capture

the twin horizons involved:

Contextualizing biblical truth requires interpretive bifocals.

First, we need a lens to look back into the background of the

biblical world to learn the intended meaning. Then, we need

another lens to see the foreground to determine how to best

express—contextualize—that sense for today’s world. (p. 231)

Thus, a field-theoretical interpretive process will be concerned with

the meaning-for-Other and the meaning-for-self (and there may be

numerous “Others” involved in any given complex situation). These 130 Part II How To Do Gestalt Therapy

twin horizons then suggest dual contexts—the context of the self

and the context of the Other (or the context of the therapist and the

context of the client).

As we have seen already, there are various ways in which to view

what a given context is, but I will reduce them to three categories

relevant to any given situation: time, the process of figure forming

(which is phenomenal), and the extratherapeutic factors brought to

the meeting of client and therapist that constitute an ontological

condition accounting for about 40% of outcomes in psychotherapy.

Time and Field

Lewin and other field theorists believed that any behavior or any

other change in a psychological field “depends only upon the psy-

chological field at that time” (Lewin, 1943, p. 294). Rather than

looking at the history of a situation, one might gain more useful

and relevant information by testing the present situation itself, and

in order to do that one might consider the direction and velocity of

change going on in the current moment.

The principle of contemporaneity (that one is concerned with

the client in the current moment) calls for the consideration of a

period of time. Think of it as a dot, and the size of that dot can be

very small or rather large; if the situation is macroscopic, the dot

will have a greater diameter, but if the situation is more micro-

scopic, the dot may be quite small. Lewin (1943) drew a com-

parison between time–space quanta in physics and time–field in

psychology, and he maintained that the current experience of the

client in his or her situational unit (the dot) might contain aware-

ness of more than simply the current activities:

The individual sees not only his present situation; he has cer-

tain expectations, wishes, fears, daydreams for his future. His

views about his own past and that of the rest of the physi-

cal and social world are often incorrect, but nevertheless

constitute, in his life space, the “reality-level” of the past.

In addition, a wish-level in regard to the past can frequent-

ly be observed. The discrepancy between the structure of

the wish–or irreality-level of the psychological past and the Chapter 6 Use the Context of Life 131

reality-level plays an important role for the phenomenon of

guilt. The structure of the psychological future is closely

related, for instance, to hope and planning. . . . It is important

to realize that the psychological past and the psychological

future are simultaneous parts of the psychological field exist-

ing at a given time. (p. 303)

The Process of Figure Forming

Figure forming is a phenomenal process related to perception,

cognition, and consciousness, but taken as a whole it forms an

important context for the interpretation of experience and, thus, a

field-theoretical hermeneutic.

We focus on figures of interest that loom large against a back-

ground by which they can be understood. For instance, if I give you

the following statements, what words fit in each one (the context of

the other words in a sentence suggests what fits in the blank)?

1 The ________ barked loudly as the stranger approached

the house.

2 The deer were so numerous and so hungry that they

__________ the fence between them and the garden and

___________ all our leafy vegetables.

The classic gestalt shift in figure-ground in which one can focus

on the silhouettes or the vase, but not on both at the same time,

has been seen over and over again. That is because the perception

shifts according to which part of the graphic one attends. In order

to understand the nature of the figure in the foreground, one must

see it against the background to which it is related. There are vari-

ous kinds of background possible.

Clinical History as Background

When a psychologist interviews a client in order to gain a history

of the presenting problem, it is a phenomenal recollection, a recre-

ation of the past, that is obtained. There are no recordings of raw

footage in the client’s life that can be consulted; it is the client’s 132 Part II How To Do Gestalt Therapy

memory that supports such an interview. That is why it is helpful

to ask “What was that like?” when gathering disjointed facts such

as “In the sixth grade I crashed my bike and was in the hospital” or

“When I was ten, my brother’s friend messed with me.” Observing

the client while asking for such clarification allows one to regis-

ter emotional surges, dead spots, and various split-off experiences

as otherwise bare facts are being shared, and all that provides an

understanding of some of the ground of a person’s life.

One must conduct a thorough history in order to ascertain

whether perhaps there are field factors active in the person’s life

that he or she is not aware of. Here, it is the implications of vari-

ous phenomenal symptoms that may point beyond the phenomenal

field to the ontic field (see below for discussion of these concepts),

which is still relevant to the person’s unified field. For example,

Hux, Schneider, and Bennett (2009) screened 1,991 people for

traumatic brain injury and found that 531 of them (26.56%) were

positive to such a degree that it impacted their quality of life. These

people struggled with memory challenges, headaches, depression,

inability to concentrate, and anxiety. Although the gestalt therapist

can certainly work with the phenomenal field of such people (what

it is like to have memory challenges, headaches, depression, lack

of concentration, and anxiety), the etiology of these symptoms for

the 531 people in question was neurological and physical in origin,

and so the approach to treatment would be rehabilitative and not

psychodynamic. In other words, for such people headaches, seen

against the background of traumatic brain injury, are not a reac-

tion formation; they are a physical malady. The gestalt therapist can

certainly work with a client who has a physical malady, but it helps

to know what one is dealing with.2

Meaning as Ground for Subsequent Experience

Often the product of one hermeneutic process will serve as ground

in another. Imagine a man who comes to a party but is not greeted

by anyone upon entering the room. He interprets that to mean that

he is not truly welcome, and then someone says to him, “Why’d you

come to the party?”—at which point he feels ashamed, assumes Chapter 6 Use the Context of Life 133

people think he’s an unwelcome intruder, and looks for the first

chance to leave without calling even more uncomfortable atten-

tion to himself. This building and cascading effect is common in

relationships where two people assume things about one another

and then build on such assumptions with cascading consequences.

The interpretation of experience provides meaning which serves as

ground for subsequent experience.

Worldview as Background

A worldview is what Kant called a Weltanschauung, and it is a point

of view on the world, or a way of looking at the whole order of exis-

tence from a particular perspective.

A worldview is a system of assumptions and frameworks about

the nature of reality that people use to organize their lives (Hiebert,

2008). Phenomenologically, it can be thought of as the sum of a

person’s worlds and the integration of his or her attitudes (Luft,

1998).

The concept was used by Kierkegaard, Engels, and Dilthey to

talk about Western culture (Hiebert, 2008). Worldviews are global

images that explain elements of personal experience. They provide

an orientation as a background anchor for dealing with life’s various

challenges. Any given worldview is

a system of coordinates or a frame of reference in which every-

thing presented to us by our diverse experiences can be placed.

It is a symbolic system of representation that allows us to inte-

grate everything we know about the world and ourselves into a

global picture, one that illuminates reality as it is presented to

us within a certain culture. (Aerts et al., 2007, p. 9)

Among those who study worldviews some believe individuals

can construct them, but others believe that they are based on lan-

guage, that they take years to form, and that only communities and

societies form worldviews. This resembles the difference between

those in gestalt therapy who emphasize the individual’s phenom-

enology and those who emphasize the field that gives substance to

the individual.134 Part II How To Do Gestalt Therapy

Discourse as Foreground

Discourse is not just what is said; it includes any given act of “speak-

ing” and assumes there is speaking (an ontological consideration).

This can be described by the formulation x performs the action

of y by way of performing the action of z (Wolterstorff, 1995).

For example, a client comes out of silence, finding that speaking

out suddenly seems possible, and she expresses herself by way of

throwing the box of tissues across the room. Thus, there are differ-

ent ways in which discourse can occur.

What Is “Said” What is said is just that—what is said. It can be

recorded, spoken, written, sung, and so on. It is, however, subject

to the receiving capacities of others. In an exercise with couples,

one person was asked simply to repeat what he heard his wife to

be saying, exactly as he heard it said and without any commentary.

He got it wrong. He added bits and pieces. He used other words for

what he thought was the same concept. The concrete words them-

selves are in question here, and they are subject to the lexical and

grammatical norms of customary speech.

How It Is “Said” This is the way in which the concrete words are

communicated. This includes the medium one uses. One might

use a handwritten note, an e-mail message, a voicemail message, a

telephone conference call, and so on. Then there is the emotional

tone that comes across in the presence of another person, his or her

relative energy, the way he or she holds his or her body, and his or

her facial expression. One of the standard tests in assessing a per-

son’s capacity to comprehend another person’s inner world (called

a theory of mind) is the ability to read the other person’s facial

expression, and that is based on the fact that we express our feel-

ings through facial expressions, often before anything is actually

said out loud.

The Foreground and Background of Discourse

As gestalt therapists know, in much of everyday life we do not

have simple perceptual shifts such as the silhouette/vase figure of Chapter 6 Use the Context of Life 135

classic gestalt figure-formation fame to account for; our situations

are more complex, and it is the background that provides the clue

about the significance of the foreground. What matters is what

a person attends to out of all the various things he or she could

attend to. The same is true for the impact of what we say to other

people. How we say what we say is important. Just as the general

background is a stronger cue to meaning, because it contextualizes

the figure in the foreground, our mannerisms as we speak are read

as speaking more quickly than our concrete words, so both what is

said and how it is said must be considered together. For instance,

ponder the difference between someone saying “I promise I’ll mow

the grass before the weekend is over” while smirking and rolling

his eyes and someone saying the same thing while looking you in

the eyes, standing straight, and never hesitating, emphasizing the

word “promise.”

Thus, the words are foreground and the affect and physical

presentation are background, but at another level the two together

constitute a unified discourse. Discourse is not just audibly speak-

ing out loud or the product of writing. Discourse is the whole per-

son in coordinated expression. This is the basis for understanding

gestalt’s emphasis on observing the whole person and pointing to

split-off behavior such as a bouncing foot, crossed arms, or sighing.

The person is saying something by what he or she does, includ-

ing speaking, and that whole discourse can be understood as fore-

ground to the overall situation.

Extratherapeutic Factors

When the Other meets the therapist, he or she presents as an onto-

logical reality, a truly Other—another person who is not merely

an extension of the therapist’s own imagination. This is the alterity

mentioned in chapter 5. What that other person brings to the pro-

cess of therapy is critical. Also, therapist and client meet in the flow

of actual events with social and cultural factors. Often, the situ-

ation changes and moves the ground under each one’s feet: a cli-

ent gets a new and better job, an economic downturn affects both

client and therapist, or the weather provides days of sunshine or

weeks of dreary overcast.136 Part II How To Do Gestalt Therapy

Clients and therapists agree that the client contributes most to

change in a therapeutic process (Thomas, 2006), and that can be

laid at the feet of the client’s field-relevant circumstances; it is, after

all, the client’s situation that is the subject matter of a therapeutic

process (Hubble, Duncan, & Miller, 1999).

It appears that client factors account for 40% of improvement

in successful outcomes; the therapeutic relationship accounts

for 30% of improvement in psychotherapy; placebo, hope, and

expectancy accounts for 15% of the improvement; and spe-

cific techniques/models of treatment account for 15% of the

improvement . . . the essence of “what works in therapy” are

[sic] curative processes present in the client that become acti-

vated within a warm, empathic therapeutic relationship. The

artistry of this process has much to do with the fostering of

hope and expectancy and techniques that draw out the heal-

ing aspects in the client. (Mones & Schwarz, 2007, p. 315)

FIELD-RELATIVE PERSPECTIVES

There are many perspectives one could list here. Murray’s sense of

needs-and-press coincides with the gestalt therapy understanding

of field being developed in this chapter and allows a succinct way of

conceptualizing field dynamics.

Murray maintained that the environment as it is apprehend-

ed by the individual determines behavior. This phenomeno-

logical emphasis can best be illustrated by reference to the

concept of press. The environment or stimulus is phenomenal

in nature; that is, it is based on a personal frame of reference.

The stimulus is relevant to behavior because of its effect con-

ceived by the individual; that is, the environment or a partic-

ular aspect of the environment is apprehended as relevant or

irrelevant and as facilitating or obstructing important needs.

The conceived harmful or beneficial effect of the stimulus is

called “beta press.” One may ask: “Does the object physically

harm the subject, nourish him, excite him, exalt him, depreci-

ate him, restrain, guide, aid, or inform him?” In essence, the Chapter 6 Use the Context of Life 137

aspect of the stimulus most correlated with behavior is the

beta press. The objective situation, called “alpha press,” is not

the significant determinant of action, although the discrep-

ancies between the objective environment and the perceived

environment throw light on the reality-testing capacities of

an individual and suggest areas of conflict. (Lazarus, 1961,

pp. 109–110)

Beta press is the phenomenal field, and alpha press is the ontic

field. To these I add the pneumenal field for those whose work

makes that relevant and also to reflect the fact that some of the

more interesting and contemporary thinking in phenomenology is

being accomplished by French phenomenologists who have taken a

“theological turn.” 3

Phenomenal Field

The phenomenal field can be thought of as the universe of experi-

ence open to a person at any given moment (Combs, 1952). This is

what gestalt therapists work with directly. It is epistemic in nature,

for it has to do with how a person experiences/knows whatever he

or she is experiencing/knowing. Working from within this field, a

therapist is not concerned with what “really” happened; rather, it is

what the client reports about what happened, or is currently hap-

pening, that is of concern.

For example, one client came to therapy telling the story of

being abused and belittled by her supervisor at work. She described

one particularly shaming incident in which the supervisor had

stood before her in an overbearing posture and yelled at her, say-

ing, “You are worthless!” As she spoke about it, she trembled, her

voice wavered, and her eyes grew moist. The tone of her voice was

mildly complaining, as if to provide a subtext: “That is not fair.” But

she had to collect herself and move out of that moment to express

the injustice of it more directly. Everything in her presentation was

an expression of her phenomenal field—what it was/is like to be her

in that situation. Whether the supervisor actually stood over her

is not known. Whether he yelled is not known. Whether he said

she was worthless is not known. Some would say these things are 138 Part II How To Do Gestalt Therapy

irrelevant, but that is not always the case. What is certain is that

both the content of what she asserted (which is her version of real-

ity on the subject) and the way she experienced herself in the tell-

ing of the story are aspects of her phenomenal field. The therapist

is with the client inside the situational unit, because even though

the incident happened in the past, the phenomenal field includes

the current moment of retelling something that is clearly unfin-

ished. The dyadic field of the therapist and client, then, becomes

enveloped by the client’s situation so that the therapist can actually

sense what it is like to be the client at that time.

Ontic Field

The ontic field is about what actually is, what has being, and there-

fore is ontic. Ontological concerns focus on the study of Being,

which undergirds each individual manifestation of Being in one

being or another. Being as a whole comes to focus in the ontic

(Parkes, 1992). Describing ontic fields, M. C. Dillon (1988/1997)

wrote:

Merleau-Ponty’s ontology is predicated on the thesis of the

ontological primacy of phenomena, and, as I have sought to

show, he understands phenomena as both immanent and tran-

scendent. Thus, the lived body, as a phenomenon, includes

both the immanent agency of my conscious life and the tran-

scendence of worldly objects. (p. 143)

This is consistent with the thinking of Levinas and others who

view the Other as transcendent to the point of violence were one

to thematize the Other in the effort to make a model of the Other

from one’s existing understanding rather than to accept the Other

as given. It is the “as given” that connects one to an ontic field, and

this occurs in gestalt therapy through contact.

Integrating the Phenomenal and Ontic Fields

Although there are many kinds of fields and many overlapping

spheres of influence, ultimately they all fall into one of the two Chapter 6 Use the Context of Life 139

categories mentioned above. How these two kinds of fields are

related to one another in a unified field theory has been described

well by Donn Welton (2000):

The world is understood in terms of the phenomenological

notion of horizon. An epistemic characterization of the horizon

attempts to clarify the constitution of significance or meaning-

fulness itself. An ontic characterization attempts to describe

the constitution of regionally configured spheres or fields in

which particular types of experience and discourse are situ-

ated. They are internally related in at least three ways:

1 The epistemic characterization accounts for the structure of

significance on the basis of which we can have a world. The

ontic characterization treats the world we do have in term

of the transformations of significance that constitute it.

2 An epistemic account describes spheres of existing sig-

nificance; an ontic analysis describes spheres having sig-

nificant existence. The spheres of significance articulate

spheres of existence; spheres of existence deploy spheres

of significance.

3 The epistemic characterization accounts for the pregiven

horizon of our embodied and discursive involvement with

objects in the world. The ontic characterization gives us the

pregiven horizon of the world’s involvement with us. (p. 373)

Pneumenal Field

Exactly how many gestalt therapists believe in God or work com-

fortably and competently with those who believe in God is impos-

sible to know. Suffice it to say that a concern for working with

spirituality has been growing in clinical psychology generally, and

in gestalt therapy as well. Here, I share a perspective on the uni-

fied field with which not many of my colleagues agree, but perhaps

those who do not believe in God can appreciate it as an example

of the application of field theory to a particular population (theistic

oriented people from among the religions of Judaism, Christianity,

and Islam). The approach might stand for applications to different

populations and communities.140 Part II How To Do Gestalt Therapy

The pneumenal field is spiritual.4 This field is all things having

effect for a given person who is in contact with God in the ontic

field. Building on Welton (2000), in the pneumenal field one finds

existing significance having significant existence. The pneumenal

field is the unified field viewed with a spiritual attitude, in which

the spheres of significance articulate spheres of existence, and the

spheres of existence deploy spheres of significance.

For any given person, the awareness of God’s presence is a

feature of the person’s phenomenal experience. This includes the

sense that God speaks, and it emerges from contact between that

person and God in which faith provides the eyes to see and the

ears to hear. Ontic contact and faith are the subvenient properties

from which the awareness of God emerges and upon which the

awareness of God, and thus one’s conscious relationship with God,

supervenes.

Conversely, it is the awareness of God that exercises a down-

ward causation deepening one’s faith and contributing to one’s

sanctification. A person must believe that God exists. A per-

son must develop the spiritual attitude that organizes his or

her interests, perceptions, needs, experiences, and curiosities

in such a way as to find God in the world where others, oper-

ating with a natural or unspiritual attitude, find no God at all.

(Brownell, in press a, np)

Is this just a solipsism dressed up in metaphysical attire? There

is a circularity to it, but it is one that is not in the form of a logi-

cal argument. Rather, it is the circularity one sees in feedback

loops and relational dynamics, in which trust begets deeper lev-

els of experience. In order to even begin in a relationship with a

being one cannot perceive by the usual means, one must start with

faith. Whoever hopes to come to God must believe that He exists

and rewards those who seek Him (Hebrews 11:6); otherwise, one

skips right past the presence of God without ever sensing that He is

there. Faith opens up awareness.

The pneumenal field can also be understood as ground for the

lives of individuals in Christian community. Figure 6.1 is a schematic

conceptualization showing that the pneumenal field is relevant to Chapter 6 Use the Context of Life 141

⎛ ⎞

( − )I+ comm ⎟

⎜ (N I)(Alt)(D)

⎜ → (Vo × × ⎟

G VoM VoE)

⎛ ( )⎞ ⎛ ( I+

(FoS)(GoS) (N − I)(Alt)(D)) div

⎜ ⎞ ⎟

⎜ ⎝⎜ DoS ⎠⎟ ⎜ ⎟ ⎟

⎝ ⎝ DoS ⎠ ⎠⎟

= ChComm

PneuF

Figure 6.1 Relational factors in Christian community.

Note: Alt = alterity; ChComm = Christian community; D = dialogue;

DoS = depth of sanctification; FoS = fruit of the spirit; GoS = gifts

of the spirit; I + comm = relationships between an individual and others

in community; I + div = relationship between an individual and God;

N-I = non-independence; PneuF = pneumenal field; VoE = varieties of

effects; VoG = varieties of gifts; VoM = varieties of ministries. (From

Brownell [in press b, np]).

the situation of the community, as relationships between individu-

als and community are affected by nonindependence, alterity, and

dialogue. It also shows that the relationship between an individual

and God is affected by the same nonindependence, alterity, and

dialogue, but attenuated by a person’s depth or growth spiritually, a

person’s responsiveness to God—what is known as “sanctification.”

Rather than being isolated factors apart from the field, such things

are parts of the whole. The field determines how many parts might

be relevant to a situation, but in any given situation some parts are

more proximate and salient than others, and those parts are such

things as are listed in Figure 6.1. This kind of schematic can be

drawn to represent field factors present in any given situation.

FIELD-THEORETICAL PSYCHOTHERAPEUTIC STRATEGIES

O’Neill and Gaffney (2008) listed seven strategic principles that

serve the therapist working from a field-theoretical position. These

are shown in Table 6.2.

To make things a little more concrete, let’s start with the fact

that ontic elements will have phenomenal antecedents. So, the ther-

apist might want to attend to his or her office. Is it warm, rich, and

nurturing, or is it bleak and sterile? Comfortable chairs or couches 142 Part II How To Do Gestalt Therapy

Table 6.2

O’NEILL AND GAFFNEY’S SEVEN STRATEGIC PRINCIPLES

STRATEGIC PRINCIPLES DESCRIPTION

Work from the whole to Pay attention to the environment, history, and

the parts culture. Consider phenomena from many perspec-

tives, because nothing unconnected happens

Consider self to be A person is always of some field, fields are in

process flux, and personality can be seen as slow moving

process1

Follow the organization The needs and interest of the person organize his

of the field or her field

Surrender to the para- Let things happen rather than try to make things

doxical agency happen

Attend to part-to-whole Converse to the first principle, there are times

relationships when the part weighs more heavily than the

whole, even though the relationship between

them remains intact

Watch for the field in Watch for unfolding patterns of homeostasis,

action polarization, and growth

Make way for emergent Creativity is the generative nature of the field;

creation get into step with and risk floating on the current

which the field provides

1I acknowledge Gary Yontef for this concept.

Source: Adapted from O’Neill and Gaffney (2008).

arranged in configurations that support encounter without forcing

premature intimacy would be in order. An easy-to-follow proce-

dure for entering and maintaining attendance in therapy, including

payment for services, would be helpful.

Second, expect phenomenal elements to lead to ontic adjust-

ments. This is at the core of the paradoxical theory of change in

gestalt therapy. If an exploration of the client’s phenomenal world

is effective and the client settles down in the current experience of

being who he or she is at the moment, it will lead to adjustments Chapter 6 Use the Context of Life 143

being made by the client outside of therapy in the “real world” of

the client’s situation. The therapist would do well to expect such a

thing and to work with an in-session/out-of-session mentality. When

psychotherapy is working, the client will make changes in the ontic

field apart from the physical presence of the therapist.

Third, watch with a wide-angle lens. Instead of focusing nar-

rowly on the client, as is described in the process for diagnostic

interviewing using the DSM, this kind of focus is an observation

of the situation in motion, and it takes into consideration what is

happening outside the therapy room as well as inside it; it consid-

ers what is happening for the therapist as well as the client, for the

therapist is at some stage or another in joining the situation of the

client.

Be willing to experiment with the complexity of the situation.

This builds on O’Neill and Gaffney’s point about creativity and it

relates to the next chapter, on experimentation. The field will strive

to maintain homeostasis, so if the therapist purposefully introduces

something new, that will necessitate some kind of shift, and the

results can be mined for understanding. Although this is not an

intervention in the sense that a gestalt therapist can always know

what the results will be, sometimes case management to broker

new services for the client can be a very potent field-theoretical

strategy (see chapter 10). Instead of continued psychotherapy for

one elderly and depressed woman, I once recommended a home

health nurse who would come in, not take no for an answer, and get

the woman up, bathed, fed, dressed, and out of her apartment at

least three or four times a week. That was not psychotherapy as we

have traditionally thought of it, but it was a gestalt-consistent and

field-theoretical strategic experiment.

Recognize that everything else that is true about gestalt ther-

apy is present in the field; thus, a therapist who is working phe-

nomenologically is working from a field perspective. The therapist

who is involved in dialogue is working with a field. The therapist

doing group work is in a field. All-things-having-effect is true for

the phenomenal field Lewin called the “life space” and the ontic

qualities of the organism and its surroundings incorporated into

Perls, Hefferline, and Goodman.144 Part II How To Do Gestalt Therapy

CONCLUSION

Field theory has become the largest current consideration in the

ongoing development of gestalt therapy praxis. It is being applied

across the board to various kinds of clinical work by gestalt ther-

apists, organizational consultants, and coaches. The term itself

became so ubiquitous that it began to lose salience, but that trend

has begun to turn around with the desire among gestalt therapists

to be more refined in how they define the term.

The unified field is relative to any given person, and it is a unity

of phenomenal and ontic characteristics. In addition, this unified

field can be seen and experienced as any number of subsequent

fields depending on the attitude with which one views it (which

gives the appearance of there actually being many, many fields

instead of a unified field for each person). An example of this was

given in the form of the pneumenal field for those viewing the uni-

fied field with a spiritual attitude.

Finally, I agree with Lewin that field theory is a practical

method. It has certainly become more of a theory that undergirds

psychotherapy, group practice, and communal process than it was

in Lewin’s day, but mostly it is still a method. As such, it is a way of

working with people rather than a means of drawing a map of what

people do.

NOTES

  1. Their work was preceded by many others in the wider context of psychology, includ-

ing Lewin (1943), who defined field theory at an early period of its understand-

ing; Hall and Lindzey (1957/1959) and Murphy (1947, 1949/1950), who explored

the development of personality from a field perspective; and Hartmann (1942) and

Lewin (1942), who explored learning from a field perspective.

  1. Along with a history, one can also do neuropsychological assessment; psychological

testing is a possible support for gestalt therapists (Brownell, 2002), not antithetical

to the approach, and the therapist can benefit by using simple instruments such as a

genogram with which to investigate the client’s relational history or the performance-

based assessments of cognitive function in tests such as the NEPSY or the D-KEFS.

  1. Consult the work of Jean-Luc Marion, Michel Henry, and Jean-Louis Chrétien. Also

see Dominique Janicaud’s (2001) critique of this turn toward theology. Chapter 6 Use the Context of Life 145

  1. The Greek word for “wind in motion,” later used for the concept of “spirit,” is

pneuma.

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God speaks. Cambridge, UK: Cambridge University Press.This page intentionally left blank 7 Move to Action

Gestalt therapy is experiential in nature. It was once described as

phenomenological behaviorism. That is because, in gestalt therapy,

people do not merely talk about something; they experience it

directly in the moment through a variety of means gestalt thera-

pists call “experiments.” This chapter describes experiment and

discusses how the move to the experiential can be strategic in sup-

port of awareness and change.

Gestalt therapy is perhaps best known for its experiential nature—

what some have referred to as its “boom-boom” dramatic techniques.

Because of that, unfortunately, many people think gestalt therapy is

no more than an experiential method. They learn how to perform

those techniques and think they are practicing gestalt therapy. See

chapter 8 for the full description of why that is not so, but for now,

know that gestalt therapy praxis is a unified approach, and one can-

not extract its experiential experiments, turn them into techniques,

and think that is all there is to “doing a little gestalt.”

What follows is a general orientation to the “experiment” in

gestalt therapy, more on action as a form of discourse, and then

some descriptions of general categories of experiments with the

understanding that a creative and spontaneous practice will modify

and shape these categories to generate novel experiences.

149 150 Part II How To Do Gestalt Therapy

BEHAVIOR, ENACTMENT, AND EXPERIENCE

Gestalt therapy has occasionally been referred to as phenomeno-

logical behaviorism, but it is not behaviorism at all. Behaviorism

uses associative learning to train people in a predetermined path

through stimulus and response, punishment or reward. John Watson

viewed behaviorism as a scientific endeavor built on the idea that

one attends only to what can be observed—what people do (with

the idea that speech is something people do). Watson wrote,

The rule, or measuring rod, which the behaviorist puts in front

of him always is: Can I describe this bit of behavior I see in

terms of “stimulus and response”? By stimulus we mean any

object in the general environment or any change in the tissues

themselves due to the physiological condition of the animal,

such as the change we get when we keep an animal from sex

activity, when we keep it from feeding, when we keep it from

building a nest. By response we mean anything the animal

does—such as turning towards or away from a light, jumping

at a sound, and more highly organized activities such as build-

ing a skyscraper, drawing plans, having babies, writing books,

and the like. (Watson, 1924/1997, pp. 6–7)

Just because something is observed does not make the act of

observing into a form of behaviorism. It is true that through the

phenomenal method the gestalt therapist observes the client and

attempts to become very good at doing so. It is also true that exper-

imentation takes place, introducing stimuli into people’s lives. It is

not true that this is done to train desired responses or behaviors

or that gestalt therapy conceives of a line of cause-and-effect, as

is implied in Watson’s statement. There are causes and effects in

gestalt therapy, but gestalt therapists understand the situation to

necessitate multivaried, multidetermined, and complex contextual

logic rather than linear causality.

Enactment is the process of acting something out. As such, it

is not the same as spontaneously “acting out” and thereby express-

ing one’s unconscious desires and conflicts. Often, children act out

the frustrations and fears they cannot verbalize to themselves and Chapter 7 Move to Action 151

others; just as play is a means for them to process life, so acting out

is a means of accomplishing difficult emotional and psychological

tasks. As necessary as acting out can be as the person makes cre-

ative adjustments to do his or her best with a difficult situation, it is

not the same as the enactment of experiment in gestalt therapy.

Enactment puts into action something imagined, contingent, or

potential. I once interviewed for a job as a road manager for a rock

band, and the man who put these bands out on the road needed

someone who could move to action when necessary. So, he asked

me, “What would you do if you were walking down the sidewalk

and you saw a house with smoke rolling out one of its windows?”

I told him that I would go up and see if anyone was in the house,

at which point he said, “Okay. Do it.” I then attempted to simulate

what I had previously described, and that was an enactment.

A special form, and more technical definition, of enactment is

seen by Varela, Thompson, and Rosch (1991) and Thompson (2007)

as perceptually guided action that includes cognitive structures

and sensorimotor patterns. These authors integrate the study of

consciousness with neuroscience and phenomenology. Accordingly,

enactment is the action of the whole person, body and mind, in a

situated plain of perception and contact.

Perception itself can be thought of as an enactive process,

meaning that it includes sensorimotor activity and not just sen-

sorireceptive activity (Gallagher & Zahavi, 2008). Such perception

is often one part of an intersubjective dynamic in that perceiv-

ing involves the neural structures and functions that make inter-

subjectivity what it is. Through perception–action (motor activity

associated with perceptive stimuli), a very young person (prenatal

to neonatal) lays down “reference points,” called mirror neurons,

in his or her perceptual–motor pathways. Because these neurons

sit right next to the motor neurons in the perceptual–motor path-

ways, the relationship between mirror neurons and motor neurons

is important. People are able to understand the movement, or the

verbal reference to the action of others’ movement—and it “gets to”

them at a visceral level—because observing others, hearing about

others’ actions, and so forth, stimulates a corresponding simula-

tion in the perceptual–motor pathways of the observer. From a 152 Part II How To Do Gestalt Therapy

neuropsychological perspective, then, enactment can take place

within the systems of the organism; it does not have to be a macro-

level, outwardly visible form of behavior.

Goal-directed motor acts are the nuclear building blocks

around which action is produced, perceived, and understood.

Taking advantage of the motor system’s functional organiza-

tion in terms of motor goals and motor intentions, the mirror

neuron matching mechanism enables a direct comprehension

of the actions of others. Such comprehension is prereflexively

accomplished because the behavior of others consists of goal-

directed motor acts and is recognized as such by virtue of the

activation of the observer’s brain of the neurons presiding over

the motor accomplishment of that same act. (Gallese, Rocaht,

Cossu, & Sinigaglia, 2009, p. 110)

To experience is to go through something. One must be situ-

ated, locked down to a time and a place. There must be an environ-

mental and social context, for all of life is situated in some way, and

the details of such a place help create what it is like to go through

something there. It is one thing to meet with friends at an Irish

pub, but it is another to meet with friends in judge’s chambers.

To have experience is to learn, to come to know, because we

also carry the residue of experience which forms the background of

many figure/ground experiences. For instance, I have experienced

a hurricane. I was in a particular time and place where a hurricane

came through and I know, because I lived through it, what that is

like. It produced experiential knowledge that I sometimes lean on

when a big storm approaches.

The Greek verbs ginōskō and geuōmai refer to tasting, sensing,

or perceiving something and, by extension, coming to know some-

thing through the senses—that is, to experience that something or

to have experiential knowledge. The terms are used in this context

from Aristotle forward (Schmitz, 1976). Thus, I can know about

blueberries. I can know what a pie is. I can imagine what a blueberry

pie might be like, but until I see one and taste a piece of blueberry

pie, I do not really know what it is like. In the same way, I had taken

classes on death and dying, I was a consultant to a hospice program, Chapter 7 Move to Action 153

and as a minister I had been with many people who had lost loved

ones, did grief counseling, and conducted funerals. However, I did

not know what deep grief was like until my youngest brother was

killed suddenly in an auto accident. That cut through me. It was

then that knowing about grief became the experience of grieving.

Theoretical knowledge is made more sure through experience. To

know through personal intercourse is to have experience of some-

thing. Thus, this knowing is in the biblical sense of “to know,” which

actually refers to having sexual intercourse—to have intimate sexual

knowledge of someone based on intimate experience.

“Experiment” in gestalt therapy is behavior, and it is enactment.

Going through an experiment creates experience, and people learn.

They come to know by means of doing; by means of experience.

Still, this experience is not just receptive; it is also expressive. The

result of an experiment is not just that a person might hear from,

but also that a person might speak to.

ACTION AS DISCOURSE

Potentia is a potentiality—something available or even at hand but

not fulfilled; actus is the fulfillment of potentia. To act is to realize or

make real some kind of potentiality, and this is what Goldstein and

later Maslow meant when they used the term actualization referring

to making one’s potential real—becoming self-actualized. A person

comes more into being through action, through what he or she does.

In discussions of discourse, the idea of conventional generation

alerts a person that he or she can accomplish one thing by doing

another thing (Wolterstorff, 1995). For instance, a person can sig-

nal a turn by sticking an arm out of the window or by using the

blinker. Standing at the airport and watching loved ones depart

through the security lines, a person can say good-bye by waving

a hand and smiling, or by crying with a hand on one’s head, or by

shouting loudly, “Good-bye!” All three will do, and one is not nec-

essarily more right than the others; however, one form of saying

good-bye may express a different kind of internal potential than

another. These are all actions; they actualize the potential at hand 154 Part II How To Do Gestalt Therapy

and express the agency of a person as creator of his or her experi-

ence. One person remains composed and simply waves; another

person expresses utter dismay and actualizes emphatic grief by cry-

ing and putting a hand on top of her head.

Karol Wojtyla (1979) asserted that people reveal themselves by

action. Someone might have an experience, in the sense that some-

thing happens to him or her, but when someone acts, he or she

becomes the agent of experience. When I wave good-bye, I am the

one expressing that sentiment through what I do. In action, both

subjectivity and agency are united.

Viewing subjectivity solely from the metaphysical standpoint,

and stating that man as a type of being constitutes the true

subject of existing and acting, autonomous individual being,

we abstract, to a large extent from what is the source of our

visualizations, the source of experience. It is far better, there-

fore, to try to coordinate and join together the two aspects, the

aspect of being (man, person) with the aspect of conscious-

ness; the aspect of acts (acting and action) with the aspect of

experience. (Wojtyla, 1979, p. 57)

In other words, being/person is to consciousness as action/act-

ing is to experience. Discourse depends on someone actually exist-

ing with whom conversation might be established, but once being

is accepted, then the person is manifest in action. When a person

acts, he or she self-actualizes and communicates a potential in some

way, to some extent, to other beings, and that is discourse.

Thus, when a gestalt therapist moves from talk to action, it is

not really a move from one category to another but from one aspect

of a single category to another. Both talk and action are forms of

discourse. The related action in experiment helps bring into clearer

relief who the person is by what he or she does.

EXPERIMENT

Much is said these days about evidence-based practice, which peo-

ple usually think of as the need to back up practice with facts based Chapter 7 Move to Action 155

on research about the outcomes of psychotherapy. Experiment is

so critical to research that a whole division of psychology is called

“experimental psychology,” referring to those who conduct research

using experimental designs.

Experimental psychologists and gestalt therapists use the term

experiment in different ways. Experimental design at one extreme

consists of null hypothesis testing based on comparisons between a

control group and a group in which some variable is being examined,

with random assignment of subjects. For example, someone might

compare a group of depressed clients receiving gestalt therapy with

a group of depressed clients in some kind of waiting group (control

group). The subjects would be randomly assigned and the therapy

would be manualized to ensure that reasonably similar treatment was

being applied across all patients by all therapists. Testing would be

conducted at least pre- and posttreatment. This structured process

would then be analyzed statistically to see if there were a significant

difference, essentially, between doing nothing and doing gestalt ther-

apy. This is not at all what a gestalt therapist means by “experiment.”

A gestalt therapy experiment is a purposefully created experi-

ence in the support of increased awareness that facilitates change;

it is unpredictable, and that is why experiments are also referred to

as “safe emergencies.” It is paradoxical in the sense that the thera-

pist is not aiming to change the client (but to support the natural

change that often occurs in the course of increased awareness); the

therapist is aiming to help the client more fully experience himself

or herself in some kind of behavior or enactment he or she would

not otherwise likely have imagined or ventured into. For instance,

in working with a young woman who had lost her first child during

childbirth, I invited her to imagine the baby across from her in a

cradle perched on the chair. I invited her to speak to the baby who

had died, and then I asked her to imagine she was the baby talking

back to herself. She did both, released herself from the guilt she felt

because she had pushed during labor and the baby had strangled in

its cord, and that facilitated her overall grieving.

Experimentation is the act of trying something new in order

to increase understanding. The experiment may result in 156 Part II How To Do Gestalt Therapy

enhanced emotions or in the realization of something that

had been kept from awareness. Experimentation, trying

something new, is an alternative to the purely verbal meth-

ods of psychoanalysis and the behavior control techniques of

behavior therapy. (Yontef & Jacobs, 2007, p. 330)

So, through experiment people can unleash and experience

emotions that serve as catalysts for catharsis, and that provides an

affective rationale for doing experiments. However, that is not the

whole story. Experiments also provide information.

For example, in a couple I was once working with, the woman

was dying to connect emotionally with her husband, whose basic

approach was to go “into his head” and think his way through a sit-

uation to find a solution by which he could fix it. She did not want

to be “fixed” by his solutions; she wanted to sense him beside her,

and to understand what she was feeling as they both traversed the

situation together. As they were talking in one session I noticed

that while he was sharing his ideas with her, the muscle that con-

trolled his jaw was tightening, as if he were chewing on something.

So, I asked him to touch that part of his face and then to speak

from that place. He looked somewhat put out, but he did it, and as

he was speaking his voice began to quiver and grow raspy as if his

throat were going dry or tightening up. I said, “Do you hear that?”

And he looked amazed. He said, “I feel that.” Then I turned to

his wife and asked, “Do you see that?” And she was jubilant. “Yes!

He’s feeling something.” Out of this experiment, which was in the

service and flow of dialogue, the couple learned that the man had

the capacity for emotional experience, which opened up a whole

new plane on which they might be able to walk together in the

future.

As Melnick, Nevis, and Shub described it,

Experiment is a teaching method that creates an experience

in which clients can learn something that is part of their next

growth step. Experiment is what transforms talking into doing,

reminiscing and theorizing into presence and action. …Every

experiment has a strong behavioral component. (Melnick,

Nevis, & Shub, 2005, p. 107) Chapter 7 Move to Action 157

Jungkyu Kim and Victor Daniels stated that experiment

can guide a client toward discovery by participating in direct

experience.

She is invited to act or to do something rather than simply to

talk about it. In the process of enactment, the “story” about

the problem becomes a present event. Out of that event,

unexpected dimensions of realization and discovery often

emerge. … Experiment, as used in gestalt therapy … brings

the client’s words alive by drawing the client into the dimen-

sion of action, emotion, sensation, imagination, and verbal

expression. (Kim & Daniels, 2008, p. 198)

While doing couples work, it is frequently the case that two

people will open up and start talking. In fact, they frequently tell

me that that is the only place where they do talk. I have also noticed

that they often talk to me instead of to each other. I have found

this diagnostic of the state in which they are with one another;

if they engage each other directly, they are stronger than if they

talk instead to me. So, one experiment I often suggest is to talk to

each other (which means to face each other as well as address each

other). This often changes the dynamic considerably, and it creates

new experience that can be mined for understanding, especially if

the therapist follows up by asking what it was like to talk directly

to one another.

Sylvia Crocker described experiment as moving from talking to

action, noting various benefits of experiments:

Under the guidance of the therapist, the client actively

experiments with elements of his experience, partly in the

service of the client’s greater self awareness, and partly as

preparation for action. Through the use of the experiment

in the safety of the therapeutic situation, the client can try

out variations of current verbal and non-verbal behavior.

In doing this he can practice different ways of interacting

with significant others, and can get new perspectives on

both current and important situations in the past. (Crocker,

1999, p. 29)158 Part II How To Do Gestalt Therapy

Creating an Experience That Supports Awareness

Our object-directed, intentional experience emerges out of the

background of a precognitive intentionality that includes affective

sensibility, motivation, and attention (Thompson, 2007). “The idea

is that whatever comes into relief in experience must have already

been affecting us and must have some kind of ‘affective force’

or ‘affective allure’ in relation to our attention and motivations”

(Thompson, 2007, p. 30). It may be on the periphery of life, slightly

out of focus. It might be an aspect of our ontic field that is having

effect, but not yet part of our phenomenal field.

The most effective experiments are “in the room” before they are

given structure and form. They arise out of the shared sense of the

therapist and client. They feel like they belong to the process. It may

be a polarity that emerges from dialogue or phenomenal exploration.

It may be the client’s split-off body behavior that grows on the thera-

pist’s attention. The most effective experiments are not “canned” and

waiting on the shelf to be taken down and inserted; thus, an effective

experiment is a response to and part of the ongoing experience.

If a therapist wants to create an experience that supports aware-

ness, he or she therefore needs to step off of the experience that is

already going on between the therapist and the client. One need

not think up something totally new. The trick is not remembering

10 techniques that one can use and knowing which one is the right

one to use at any particular moment.1 The “trick” is to loosen up and

brave the anxiety of an unpredictable situation, a ride the therapist

suggests taking with the client. To suggest such a ride, the therapist

can refer to various such “excursions” that gestalt therapists have

taken with their clients in the past and modify one of them; but he

or she can also think imaginatively of something unique, something

that seems to suggest itself in the moment.

EXPERIMENTAL OPTIONS

There are many ways to organize possible experiments.2 The fol-

lowing should be considered general categories that might lend Chapter 7 Move to Action 159

themselves to the flow of any given therapeutic process. They

should all be employed with ample support for both the client and

the therapist.

Bilateral and Unilateral Experiments

A therapist can choose to negotiate with the client around a poten-

tial experiment or simply implement something on his or her own

without warning. The first is a bilateral experiment, because it

requires the consent of both parties, but the second requires only

the decision of the therapist.

The first is negotiated, which means that the therapist intro-

duces it with something like, “I am thinking of something we

might try right now; would you be interested?” If the client signals

tentative interest, then the therapist describes what he or she has

in mind: “What would happen if you sat in this chair, and I sat on

the couch?” The therapist puts out the crux of the experiment as a

proposal or a question (what might happen, if …?), and the client

has a chance to respond and to say, “Yes” or “No.” Following the

experiment there is a debriefing in which the therapist explores

with the client what it was like to go through that experience.

Often, no words will capture the impact, and all that is necessary

is to say, “Wow.”

A unilateral experiment is something the therapist has con-

trol over and can implement without any cooperation from the cli-

ent. Thus, in couples therapy I may on occasion tell a client to say

something directly to his or her partner, and then I may tell them

to say it again but look into the other person’s eyes. Since experi-

ment also undergirds other ways of working in gestalt therapy, in

the service of dialogue, and as a unilateral experiment, I may self-

disclose what my experience is like while being with the client,

and then ask what it was like to hear me say that. When using

unilateral experiments it is important to gauge and understand the

client’s level of support, and provide support as needed so that

the client might not become overwhelmed during experimental

contact.160 Part II How To Do Gestalt Therapy

Augmenting

As stated previously, it is not necessary to create something com-

pletely new. One can simply augment, or heighten, what is already

going on. For example a therapist might tell the client to notice

what he or she is experiencing in the moment and describe that.

When the client skips over something, the therapist might call the

client back to it. The therapist might ask the client to say something

again, and then to say it even again. Often saying something like “I

never felt I belonged to anybody” can open up the client to areas

long since submerged. The therapist can ask the client to empha-

size one word above others (“I never felt I belonged to anybody” or

“I never felt I belonged to anybody”). The therapist might ask the

client to magnify some mannerism that the client is already doing.

“I notice you waving your hand; can you wave it more? Keep wav-

ing it.” Then, the therapist might ask the client to give that gesture

some words. The therapist might ask the client to “go deeper” into

a particular thought or “stay with” a specific feeling. The thera-

pist might ask the client to make abstract statements concrete; if

a person says it was a good day at work, the therapist might ask,

“What made it a good day?” The therapist might discern that the

client is speaking in minimizing language, either on purpose or out

of awareness, and the therapist might ask the client to enlarge on

something, and make it bigger, more serious, more troubling than

it seems at that moment.

In a form of augmenting, the client can be invited to bring into

the current meeting with the therapist matters about which he or

she had been speaking as if they were abstract or distant. The ther-

apist asks the client to speak about the issue, some event, or that

other person as if these were right there in the same room. While

the client is describing something that happened “out there,” for

example, the therapist asks, “What is it like to be telling me these

things right now?” In other instances, the client might be encour-

aged to phrase things in the first person and to introduce them

with, “I am thinking …” or “I am feeling …”

Since we are holistic beings, it makes sense that a person would

have a physical side to any given psychological symptom or disorder.

Therefore, one can direct the client’s attention to his or her physical Chapter 7 Move to Action 161

body, asking, “What sensations are you feeling in your body right

now?” or “Where in your body do you feel that?”

Each of these examples takes a process or a manifestation

already present, some presentation of the client, and works with

it to enlarge it and call attention to its facets. In some cases, this

augmentation triggers or jars loose something to which it is related,

and then there is an emotional moment that can become quite

important to positive outcomes (Greenberg, 2004). Greenberg,

Auszra, and Herrmann (2007) discerned the following elements in

good outcomes in psychotherapy, and I maintain that they are all

relevant to the use of augmenting experiments in gestalt therapy:

(1) the emotion in question is a primary emotion that is experi-

enced in the present in a contactful and fully aware manner, (2) the

experience involves the emotion being owned by the client, who

experiences himself or herself as an agent instead of a victim of

the feeling, (3) the emotion is not overwhelming, (4) the emotional

process is fluid instead of blocked, and (5) the emotion is related to

a therapeutically relevant issue.

Enacting

Enactment as a concept has already been described. Various forms

of enactment lend themselves to gestalt experimentation.

Sometimes a person can be asked to put into embodied motion

a thought previously expressed. A person who says she feels help-

less might be asked to assume a posture that expresses her helpless

feelings. Family sculpting is a form of enactment in which a person

“paints” a picture of his family by putting people into a configura-

tion, a “still life” of how he or she sees them.

In what is now a classic gestalt technique, the use of the “empty

chair” allows a person to address polarized elements in his or her

own mind, unfinished events, and interpersonal problems.

An empty chair placed facing the client may carry out a projec-

tive dialogue, whether with another person or between parts

of himself. This technique is often used to complete an unfin-

ished situation from the past, in which case the person not

available in the present is imagined to be sitting in the empty 162 Part II How To Do Gestalt Therapy

chair. Sometimes it is better to address issues in this manner

than in a real encounter with the other person, because feel-

ings can be expressed and acted out more safely in this situa-

tion. Once the cathartic expression of sadness, anger, jealousy,

or other emotional behavior has been fully expressed toward

the “person in” the empty chair, the client may more easily

find a way to open up communication with the other. (Kim &

Daniels, 2008, p. 214)

Sometime a client can be asked to “be the person” he or she

is talking about. When I was in supervision with a gestalt thera-

pist, he routinely asked me to “be” the client I was talking with

him about, whereupon he would assume my role in that relation-

ship, and we would play out the process. A variation on this is that

sometimes a person can be asked to be the opposite of whatever

is manifest. For instance, if a person is coming across as helpless

and dependent, the therapist might ask him to “be” the strong and

independent person.

Imagining

Imagination, the ability to imagine, involves forming mental images,

including sensory approximations and cognitive concepts, when

they are not perceived directly through sight or other perceptual

operations. An early Muslim philosopher, Ibn Arabî (1165–1240),

claimed that the heart has two eyes, reason and imagination. “The

heart, which in itself is unitary consciousness, must become attuned

to its own fluctuation, at one beat seeing God’s incomparability

with the eye of reason, at the next seeing his similarity with the

eye of imagination” (Chittick, 2008, np). One can see that imagina-

tion’s link to what a person thinks has been around for a long time.

Imagination is not a free-floating fantasy, untethered from cogni-

tive process—one’s reason. To imagine is to imagine something,

to be able to hold it in one’s mind and turn it this way and that in

order to consider it. That is imaginal.

A therapist might request that the client visualize certain sce-

narios. Someone fretting over receiving a poor review at work was

asked, “What is the worst that could happen to you? Imagine that Chapter 7 Move to Action 163

you are in that situation.” A great deal of imaginal work can support

working around phobias and various kinds of anxieties. The client

is asked to imagine himself or herself near the feared object, and

then to “hold” there and to relax the body. This is a form of desen-

sitization, but it is not conducted as a behavioral intervention. It is

done as a gestalt experiment in which no one really knows what

will happen when this unique client attempts to do it. The results

need to be monitored and processed within the in vivo context of

the therapy session.

In classic gestalt dream work, the client imagines himself or

herself as each aspect of the dream and describes or speaks from

that position in the dream. “How does it feel to be that thing or

that person?” “Is there someone in the dream you want to talk to?”

“What do you want to say to that person?” “How safe do you feel?”

“How hungry do you feel?”

One woman was dealing with the infidelity of her husband.

She was having trouble letting go of the offense and fully recon-

ciling, even though she consistently stated she was committed to

the relationship. Her head told her she needed to move forward,

but her heart told her to make sure she would not get hurt again. I

asked her to imagine that it was 6 years down the line and she had

given herself to the relationship, forgiven her husband, and moved

on. I said, “One day a woman comes to your door and tearfully,

regretfully confesses that she’s been having an affair with your hus-

band.” Let that sink in. Each person will take such an experience

in a unique direction. She could have realized it was not worth the

chance of such pain ever again. She could have realized that she

would hurt but that she could live through it. The point is that such

an imaginal experience, an experiment, changes the inner arrange-

ment in one’s perception of the situation, and it is impossible to

simply remain in exactly the same place one inhabited before the

experiment. Thus, experiment also leads to paradoxical change.

Diminishing

Sometimes a suppressive technique works nicely, particularly with a

practice that is counterproductive. In a group setting, for instance, 164 Part II How To Do Gestalt Therapy

telling theories about why members do what they do is not as helpful

as direct contact and experience between members; consequently,

some groups create a “no aboutism” rule to suppress the tendency

to figure out “why” and allow people to move on to more produc-

tive ground (Kim & Daniels, 2008). In a similar vein, “shouldisms,”

which rule how a person ought to be or act, what a person should

believe and value, are sometimes better simply confronted rather

than set aside. When an introject (something accepted uncritically

that rules in some manner) appears, it can be directly challenged.

“What happens if you say to yourself, ‘That is not true’?” Or if a

client lacks sufficient self support but is suffering under the load

of some rule-bound existence, the therapist can simply offer a new

introject (on the way to a better solution), by saying, “That doesn’t

fit with the facts.” Again, these are done as experiments and need

to be tracked for the ongoing process.

Giving Homework

Often, giving a client something to try in the world outside of ther-

apy can lead to discovery, for example, keeping diaries; making

schedules; use of relaxation techniques. Making suggestions as to

what a person might do in the midst of his or her troubled situa-

tion is homework. A client may not attempt these suggestions, or

may throw himself or herself into them wholeheartedly. They may

“work” or not, but that is not the main point. There is no success or

failure with an experiment, only more experience that one can sift

through to build understanding.

One couple came to me complaining of not being able to com-

municate. I suggested that they take a walk together on the beach

and explicitly not talk about anything. Just walk together down the

beach. They agreed to do it. The next time we met, the man declared,

“Well it didn’t work.” I wondered what happened, and he said, “We

didn’t do it.” Brushing aside the assertion that something had not

“worked,” I asked, “How did you not do it? What happened?” In the

process of reviewing what each had done, we discovered that their

practice was to defer to the other and then respond to someone

else’s initiative. So, the work then focused more on that pattern. Chapter 7 Move to Action 165

CONCLUSION

Experiment, broadly understood, is the action step of gestalt ther-

apy theory. Experiment is moving to action, but when one considers

that anything a person does is action, and any action says something

about who that person is, then we see experiment is intrinsically

linked to individual experience, relational dialogue, and field theo-

retical strategies. Without experiment, nothing would be accom-

plished. The modified phenomenological method is experimental.

Dialogue is experimental. Field theory is experimental.

Experiments are the tools by which a gestalt therapist explores

the client’s phenomenal field and encounters the client in a thera-

peutic relationship. Experiments arise out of the natural ground

of the situation and are not canned techniques a therapist takes

down from the clinical shelf to prescribe like medication to reduce

symptoms. Experiments are the behavioral and experiential com-

ponent of gestalt therapy, but gestalt therapists employ them and

understand them differently, differentiating gestalt therapy from

behaviorism and experiential therapy even while finding some con-

silience in these approaches.

NOTES

  1. Incidentally, that is one reason gestalt therapy does not easily lend itself to a prac-

tice of empirically supported treatments—gestalt therapists do not prescribe treat-

ments like medications to reduce symptoms; they work with the whole person,

moving from in situ to in vivo and back again, and they flex with a novel and living

experience.

  1. For this section, I am largely in debt to Kim and Daniels’s (2008) chapter on

experiment.

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Yontef, G., & Jacobs, L. (2007). Gestalt therapy. In R. Corsini & D. Wedding (Eds.),

Current psychotherapies (8th ed., pp. 328–367). Florence, KY: Cengage.8 Practice a Unified Approach

Gestalt therapy is not simply multimodal. That is, at any given

time all the elements of its theory are at play in the therapeutic

process. The unity of practice is discussed in terms of the holism

inherent in gestalt therapy, and therapists are shown how to make

space for all the elements even though they might, at any given

time, emphasize one over another as a way of working in the

moment.

Gestalt therapy has a mix of influences. As Sylvia Crocker and

Peter Philippson (2005) described them, many threads make up

the tapestry of gestalt therapy’s theory and method. Among the

most important of such threads are the following:

1 The psychoanalysis of Freud, Horney, Rank, and Reich

2 The holism of Goldstein and the gestalt psychologists

3 Kurt Lewin’s development of field theory for the social

sciences

4 The experimental and problem-solving approaches of prag-

matists like Dewey and James

5 The philosophy of Aristotle and Kant

6 The phenomenology of Brentano, Husserl, Merleau-Ponty,

and Levinas

167 168 Part II How To Do Gestalt Therapy

7 The existentialism of Hiedegger, Kierkegaard, Tillich, and

Buber

8 Several ideas from Taoism and Buddhism

From this, one might think that gestalt therapy is not really a

coherent system. Certainly, all its various contributions were not

aligned; each has been a movement or system in itself. Gestalt ther-

apy might seem simply like a number of rocks one finds along a

hiking trail; they were all found on the same journey, but each came

to be on the trail through very different processes. Yet, what started

out as separate influences has continued to develop, as if all the

rocks were taken to a foundry and melted down into one, new gem.

Charlie Bowman described how that “melting down” process,

toward an integrated praxis, developed over the years:

The broadest overview of Gestalt therapy identifies a chang-

ing weltanschauung as responsible for Gestalt therapy’s devel-

opment. Weltanschauung connotes more than the dictionary

definition, “a shared worldview.” It is how we apprehend the

world—how we are involved in it, perceive it, and bring our

personal history to bear on it. This collective perspective cre-

ates momentum and becomes an engine for change. In Gestalt

therapy, the result has been movement (a) from deconstruc-

tive views of the world toward holistic models of existence;

(b) from linear causality toward field theoretical paradigms;

and (c) from individualistic psychology toward a dialogical or

relational perspective. (Bowman, 2005, pp. 4–5)

One might be tempted to consider gestalt therapy to be merely

multimodal—not one gem but several newly formed stones all lined

up together. Instead of having a coherent system, gestalt therapy

would then be seen as additive—incorporating phenomenology

plus existentialism, plus intersubjectivity and relational philoso-

phies, plus holism and field theory, plus behavioral and experiential

experimentation. This view would allow one to factor out various

parts for study without doing damage to any of the other parts, or

seriously affecting the overall approach. It is tempting to do this in

research, for instance, if one simply wants to study the dialogue of Chapter 8 Practice a Unified Approach 169

gestalt therapy as it relates to dyadic assessment; one could then

pretend that dialogue had nothing to do with individual experience

or the complex and unified field. However, things do not work that

way, and in practice gestalt therapy does not work that way; so, one

would need a practice-based approach (Brownell, 2008) to doing

research on gestalt therapy and that would require maintaining the

integrity of gestalt therapy’s theoretical core. Gestalt therapy is a

holistic approach that is also a unified system of praxis.

Praxis is a word that denotes theory and practice combined.

Thus, in the same book Sylvia Crocker (2008) identified compo-

nents of gestalt therapy’s unified theory, and Gary Yontef and Peter

Philippson (2008) identified elements of gestalt therapy’s unified

practice. Just how theory and practice are related to one another

in gestalt therapy stands behind the claim of a unified praxis (see

below).

THE UNITY OF PRAXIS

Theories explain or predict experience and guide practice (Crocker,

2008). That is the basic relationship between theory and practice

that forms the nature of one’s praxis. How well does one’s theory

inform and guide one’s practice? Can gestalt therapists actually

track the use of theory through the course of therapy? Yes. That

can, and is done both in training and in private practice.

Holism

Holism asserts that the whole is larger than the sum of its parts.

Methodological holism asserts that an understanding of a complex

system requires examination of principles governing the whole sys-

tem as opposed to those governing individual parts. Metaphysical

holism breaks down into three categories: ontological holism, prop-

erty holism, and nomological holism. Ontological holism asserts that

some objects are not wholly composed of parts. Property holism

asserts that some objects have properties that are not determined

by the physical properties of their basic physical parts, and nomo-

logical holism asserts that some objects obey laws not determined 170 Part II How To Do Gestalt Therapy

by fundamental physical laws governing the structure and behavior

of their parts (Healey, 2008).

In terms of a whole family, then, it is the communal nature of

a family that organizes the being and action of its individual mem-

bers. In terms of a community of professional therapists, such as

the Association for the Advancement of Gestalt Therapy (AAGT)

or the European Association for Gestalt Therapy (EAGT), it is

the nature of the association that gives meaning and outlines the

parameters of behavior of its members. The AAGT is concerned

with the advancement of gestalt therapy as a discipline and a prac-

tice, but the EAGT is concerned with the advancement of gestalt

therapists as disciplined practitioners. The AAGT is nonregulatory,

grants no certificates, and exercises no ethical authority over its

members, while the EAGT is regulatory, grants certificates, and

exercises ethical authority over its members. The nature of the

whole determines the function and experience of the parts.

Gestalt therapy theory applies holism at several levels of its

structure, and gestalt therapy practice views that practice as one

whole process. The theory of gestalt therapy is both a property and

a nomological holism; that is, its characteristics can only be under-

stood in the context of the whole approach, and its principles work

together. The practice of gestalt therapy is a methodological holism,

given that the laws of each part of gestalt therapy are shaped by all

the laws of all the parts working together rather than by any set of

laws alone.

As a gestalt therapist, I cannot ignore all other elements of

gestalt therapy to simply use one particular tenet in its theory. I

might focus on that one thing, but what I find is that, because of

my experiential training and the overall system being what it is,

all the various tenets come along. Frankly, this is what allows me

to enjoy the practice of gestalt therapy, because I can settle into a

natural way of being with people, confident that other elements of

the approach are not being neglected.

The characteristics of gestalt therapy theory are not simply

additive; rather, personal experience influences gestalt’s dialogical

way of being with another person, and dialogue is the forming of

a two-person field, all of which is worked out in the lives of people Chapter 8 Practice a Unified Approach 171

through action—what people do in therapy. What people do is in

contexts and speaks about who they are at any given moment. These

are theoretical commitments in gestalt therapy theory. They point

to the properties and “laws” that inform about what gestalt ther-

apy theory is and how it operates. The theoretical tenets of gestalt

therapy may once have been separate “parts” of diverse wholes, but

they have come together—they have been forged into a new whole

in which no part is separate from other parts, and each part is in

play whenever one part is focused on.

The principles governing the system of gestalt therapy prac-

tice do not constitute isolated interventions that can be employed

or studied on their own outside the whole system of gestalt ther-

apy methodology. At any given moment in therapeutic practice,

one or another way of working as a gestalt therapist may be in

the foreground while others are in the background. In addition,

during “choice points” in that process a therapist may choose to

work experimentally, phenomenologically, dialogically, or with

the field, but when moving to one of these methods, a therapist

is not abandoning all the other options. Some simply recede to

the background as others move into the foreground of the thera-

pist’s figure–ground dynamic. This process itself is a current flow-

ing between the therapist and the client in which each has effect

on the other, but the therapist takes responsibility to facilitate or

navigate that flow, and all elements of theory are always present in

his or her practice.

A Tracking Matrix for Gestalt Therapeutic Process

It is possible to track the way any given therapist “navigates” the

flow in the therapist–client field by (1) watching the therapist’s fig-

ures of interest, on the one hand, and (2) the ways in which the

therapist chooses to work, on the other (keeping in mind that how

one works in gestalt therapy is a matter of emphasis). These things

can be cast in a matrix (Brownell, 2000, 2005), which could then

be used by students in training groups and by researchers check-

ing to see how much a truly gestalt practice was being used. (See

Figure 8.1.)172 Part II How To Do Gestalt Therapy

Ways of Working

Modified

Focuses of Work Phenomeno- Field

logical Dialogic Theoretical Experimental

Method Relationship Strategy Freedom

Therapist

and/or

Client

Figure # 1

Therapist

and/or

Client

Figure # 2

Therapist

and/or

Client

Figure # 3, etc.

Figure 8.1 A gestalt therapy matrix for training, practice, and research. (Adapted from

Brownell [2000, 2005])

THE CONCEPT OF A UNIFIED APPROACH

People have long thought that everything is connected. Religious

convictions over centuries prior to the Enlightenment found that

connection in the mind and work of God. When people began

questioning and wanting to know more about how God did

what had been done, they started investigating the principles

by which the universe worked, and putting together theories

about its various parts. The first to develop a unified theory of

everything was Roger Boscovich, a Dalmatian Jesuit, poet, and

architectural advisor to popes, who extended Newton’s thinking

to propose a grand, unified force law that eventually influenced

Faraday, Maxwell, and Kelvin. He introduced ideas new for his

time that “still form the intuition of scientists” today (Barrow,

2007).

He emphasized the atomistic notion that Nature was com-

posed of identical elementary particles and then aimed to

show that the existence in Nature of larger objects with finite Chapter 8 Practice a Unified Approach 173

sizes was a consequence of the way their elementary constitu-

ents interact with one another. The resulting structures were

equilibrium states between opposing forces of attraction and

repulsion. … Boscovich proposed a grand unified force law

which included all known physical effects … he was the first

to envisage, seek, and propose a unified mathematical theory

of all the forces of Nature. (Barrow, 2007, pp. 20–21)

In thinking holistically, and using mathematics to explain

forces in a unified theory of everything, Boscovich is the ultimate

predecessor of Goldstein’s holism and Kurt Lewin’s approach to

field theory. Grand unifying theories have come and gone since

Boscovich. For instance, string theories have recently been sup-

planted by M-theory. Those working on psychotherapy integra-

tion are also seeking a version of a grand theory of everything. The

Society for the Exploration of Psychotherapy Integration’s official

journal, Psychotherapy Integration, is published by the American

Psychological Association and carries articles reflecting the desire

to enhance the interface, or rapprochement, and bring about the

convergence among these various clinical approaches.

I contend that gestalt therapy could function as a grand uni-

fying theory of psychotherapy—a heuristic of convergence—and

I understand that that is an audacious claim. Three factors sup-

port this assertion: the construct of consilience (and the consilience

that exists between gestalt theoretical tenets and those of other

approaches), the observation of common factors in psychotherapy

outcomes research (that embody basic gestalt therapy commit-

ments), and the emerging convergence of various schools of psycho-

therapy along the lines of existing gestalt therapy theory (whether

they recognize that as such or not).

Consilience

Consilience as a construct points to the unity of knowledge. It is an

idea developed by William Whewell when he wrote of the construct

of induction as it pertained to his philosophy of science. Whewell

said that the evidence in favor of an induction was more potent

when it enabled a person to explain different kinds of cases from 174 Part II How To Do Gestalt Therapy

those contemplated in forming the hypothesis. Whewell called this

kind of evidence a “jumping together” or “consilience” of induc-

tions. “An induction, which results from the colligation of one class

of facts, is found also to colligate successfully facts belonging to

another class” (Kockelmans, 1999, p. 74; Snyder, 2006, np).

Consilience, as I am using that term, is related to abduction in

science. Abduction is the inference to the best explanation from sev-

eral possible theories contemplated at the same time. “Abduction,

by its very nature, forces people into estimates of consilience, or

how well a theory fits with theories from other domains” (Brownell,

Meara, & Polák, 2008, p. 9). If one can contemplate several theories

for consideration of the best explanation of a phenomenon within

one domain of study, then one can contemplate several domains as

well, considering aspects of each to find any matches. If matches

occur, then where they are indicates a “point” of consilience—

something that explains how things work in divergent domains.

When gestalt therapy is compared in this way to other domains,

one can find many matches, or points of consilience. Probably the

clearest case of consilience is between gestalt therapy’s field per-

spective and the various organismic and field theories that pro-

liferated in neuroscience, medicine, and physics in the early and

mid-20th century. Within social science there is a consilience

between gestalt field theory and systems or ecological psycho-

therapy; between the concept of dialogical relationship and object

relations, attachment theory, client-centered therapy, and the

transference-oriented approaches; between the existential, phe-

nomenological, and hermeneutical aspects of gestalt therapy and

the constructivist aspects of cognitive therapy; and between gestalt

therapy’s commitment to awareness and the natural processes of

healing and the mindfulness, acceptance, and Buddhist techniques

adopted by cognitive behavioral therapy.

COMMON FACTORS

Psychotherapy research has identified various “common factors”

resident in all major forms of psychotherapy that also contribute to Chapter 8 Practice a Unified Approach 175

positive outcomes. Many research studies have identified an over-

lapping array of factors (Asay & Lambert, 1999; Beitman, 2005;

Bickman, 2005; Drisko, 2004; Duncan, 2002; Gallo, Ceroni, Neri,

& Scardovi, 2005; Meione & Chenail, 1999), and Table 8.1 shows

how some of the most common are consistent with gestalt therapy

theory.

Table 8.1

COMMON FACTORS RESIDENT IN GESTALT THERAPY

COMMON FACTOR GESTALT THERAPY MANIFESTATIONS

Client and extratherapeutic This is the field—all things having effect/

factors the lifespace of the client. This is what the

client brings to the therapeutic process; it

includes the client’s cognitive-intellectual

capacities, elements of culture, history,

finance, and any legal issues related to the

client

Therapist qualities This relates to the authentic presence of

the therapist, the capacity of the therapist

for contact, and his or her training and

experience. It includes the lifespace of the

therapist

Relationship This concerns the relational and dialogical

skills of the therapist in the working alli-

ance: presence, inclusion, commitment to

dialogue, and the creating of conditions

supportive of dialogue

Specific method This relates to the gestalt therapist’s reli-

ance on a modified phenomenological

method, dialogue, strategic use of the field,

and experiment (among other things)

Expectancy This relates to faith in the paradoxical theory

of change; it is a faith position more gener-

ally as well because gestalt therapists trust

in the desire for growth in the client and

that the field will supply what is needed

Adapted from Brownell (2008).176 Part II How To Do Gestalt Therapy

People who advocate a common factors approach to under-

standing psychotherapy effectiveness use the outcomes data to

argue against the need for an empirically supported treatments’

approach, but the point here is that there are common factors. What

is effective in one approach is effective in all major approaches, or

so the theory of common factors goes. The idea of common factors

levels the ground between diverse clinical perspectives. It takes

the idea of consilience and provides research data delineating just

how divergent systems of psychotherapy like cognitive behavioral

therapy (CBT), psychoanalysis, and gestalt therapy are consilient.

Convergence

If there is a general consilience that is made more specific in com-

mon factors, then what makes gestalt therapy so special? Could

we not just as easily say that everything is converging around one

of the other approaches? No. Not really. I say that, because these

other two main approaches (CBT and psychoanalysis) are adopting

long-held main tenets of gestalt therapy instead of the other way

around.

Occasionally, but it seems consistently, I will read of someone

doing some kind of psychotherapy, and when I read the details—

the description of the work in question—I say to myself, “That’s

gestalt therapy.” I am not the only one to notice this (Gold & Zahm,

2008). I do not believe these psychotherapists are ruthless thieves

who knowingly steal gestalt therapy’s thunder and lack the ethical

standards to at least acknowledge where they got it from; I think

they are discovering things, given the march of thought, that were

known in gestalt therapy all along.

Probably the most direct convergence to date can be seen in

a form of psychotherapy called existential–phenomenological psy-

chotherapy (Langdridge, 2004) with a close second in dialogical–

existential therapy (Portnoy, 2008). Exponents focus on the

continental philosophy that was the foundation of gestalt therapy,

and, like gestalt therapists, they continue to track the contemporary

developments in writers from both existentialism and phenomenol-

ogy. For instance, the staff at Seattle University has developed a Chapter 8 Practice a Unified Approach 177

graduate program emphasizing the existential–phenomenological

approach (Halling, McNabb, & Rowe, 2006) and a brochure avail-

able at the Web site for that program describes it without mention-

ing gestalt therapy at all:

This approach to psychology is inspired by the philosophical

tradition developed by thinkers such as Buber, Kierkegaard,

Nietzsche, Husserl, Heidegger, Gadamer, Sartre, Marcel,

Merleau-Ponty, and Emmanuel Levinas. Existential-

phenomenology seeks to develop an in-depth understanding

of human existence. It challenges traditions that study the

person in a reductionistic manner or promote dualistic modes

of thinking (e.g., mind vs. body or freedom vs. determin-

ism). … Existential–Phenomenological Psychology is human-

istic in that it challenges the modern tendency to interpret the

human condition through narrow technological lenses. It also

appreciates the wisdom accumulated by the long tradition of

the humanities. The existential dimension deepens our under-

standing of persons living in their everyday circumstances

through in-depth reflection on the psychological meanings

expressed in both experience and action. The phenomenologi-

cal dimension encourages openness toward psychological real-

ity by identifying and putting aside theoretical and ideological

prejudgments. As a whole this approach is therapeutic in that

it focuses on the psychosocial conditions that help people deal

with the difficulties of life. (Seattle University, 2009, p. 2)

For some time now, relational psychoanalysis has been flirt-

ing with the intersubjective nature of the working alliance. Lynne

Jacobs described some of the aspects of this converging toward

gestalt therapy’s perspective when she wrote that the schools of

intersubjectivity theory and American relational psychoanalysis

seem to me to have a closer affinity to gestalt therapy than

they have to early, “classical” psychoanalysis. The intersubjec-

tivity theorists have even been campaigning to develop a phe-

nomenological psychoanalysis, one that they in fact describe as

“a phenomenological field theory or dynamic systems theory”

(pg 6)! That is a campaign that might warm the heart of Perls, 178 Part II How To Do Gestalt Therapy

Hefferline and Goodman, who championed phenomenologi-

cal field theory in their 1951 opus, Gestalt Therapy. Notice

how closely the following paragraph aligns with statements in

PHG:

“It is our view that the persisting dichotomies between the

intrapsychic and the interpersonal, between one- and two-

person psychologies, are obsolete, reified, absolutized relics

of the Cartesian bifurcation. The very phrase two-person

psychology continues to embody an atomistic, isolated-mind

philosophy in that two separated mental entities, two think-

ing things, are seen to bump into each other. We should

speak instead of a contextual psychology in which experiential

worlds and intersubjective fields are seen to mutually consti-

tute one another. Unlike Cartesian isolated minds, experien-

tial worlds—as they form and evolve within a nexus of living,

relational systems—are recognized as being exquisitely con-

text-sensitive and context-dependent. In this conception, the

Cartesian subject-object split is mended, and inner and outer

are seen to interweave seamlessly. We inhabit our experiential

worlds even as they inhabit us. Mind is pictured here as an

emergent property of the person–environment system, not as

a Cartesian entity localized inside the cranium.” (p. 9) (Italics

added) (Jacobs, 2002, np)

In addition to these psychoanalytic and psychodynamic trends,

Gold and Zahm (2008) take note of converging trends from other

directions:

Another example is the importance many approaches now

place on acceptance of what is, awareness, and the present

moment—as if these are novel concepts for psychotherapy

when they are, in fact, cornerstones of gestalt therapy theory

and method. … Steven Hayes, developer of acceptance and

commitment therapy, or ACT (Hayes, 2007) writes that in

the last ten years, a number of approaches to therapy have

entered the mainstream based on the core idea that the more

we struggle to change or get away from what our experience

is, the more stuck we can become. He lists mindfulness based

cognitive therapy (MBCT), dialectical behavior therapy (DBT)

and ACT, as all agreeing that a first step toward fundamental Chapter 8 Practice a Unified Approach 179

change is to embrace the present moment, even if the experi-

ence is difficult or painful. (Gold & Zahm, pp. 30–31)

Living in the current moment, the “here and now,” is basic to

gestalt therapy, so gestalt therapists have had an interest in open-

ing dialogue with Daniel Stern (Jacobs, Philippson, & Wheeler,

  1. when he began theorizing about the power of exactly that—

the current moment. Stern wrote of the importance of contact

(“moments of meeting”) in what he called “now moments” (Stern,

2007). However, Stern’s work also emphasizes (1) the shift to a two-

person psychology—intersubjective and interpersonal processes

rather than on intrapsychic dynamics—and (2) the impact of home

visits, where in-home facilitators come face to face with the family

as a system, or a defined element in the infant’s overall field (Stern,

2008). Because of Stern’s work, his psychoanalytic colleagues have

wondered if he has not actually become more gestalt than psycho-

analytic, but at least one concluded that his work is revolutionary

and relevant for the field of psychoanalysis (Wilkinson, 2003).

The affective-focused body psychotherapy (ABP) approach

is similar to gestalt’s commitment to tracking a holistic process

through the modified phenomenological method and has elements

of dialogue and experiment:

The ABP therapist attempts to facilitate the patient’s aware-

ness of his or her experience by directing the patient’s attention

to various aspects of his or her in-the-moment experiencing,

both while working hands-on or by instructing the patient

to perform a movement and while simply being in the room

together. (Levy Berg, Sandell, & Sandahl, 2009)

Remaining with the body for a moment, the impact of Antonio

Damasio’s (2005) studies in neuroscience ignited the interest of

gestalt therapists with his rejection of Descartes’ dualism (Descartes’

Error: Emotion, Reason, and the Human Brain) and his explora-

tion of consciousness in daily experience (The Feeling of What

Happens: Body and Emotion in the Making of Consciousness).

Damasio, while writing firmly from within the domain of neurosci-

ence/neuropsychology, shares many interests with gestalt therapists. 180 Part II How To Do Gestalt Therapy

The neurological antecedents for conscious experience also lead

gestalt therapists back to their roots in Goldstein and neuropsy-

chology (Brownell, 1998).

Addressing the issue of a unifying core for the integration of

psychotherapy, Anchin suggested that some kind of mix between

what he called systems theory and a biopsychosocial model pro-

vided enough scaffolding on which to hang meta-theories and

interventions. He claimed that

foundational to systems theory is an all-inclusive, holistic con-

ception of the human being that at one and the same time

embraces the multilevel structural complexity of human per-

sonality and yet the inherently unified manner in which this

structure functions within the contextual circumstances at

hand. The biopsychosocial model of health and illness compre-

hensively defines the composition of this integrated complex-

ity. It encompasses and delineates the multiple and intricately

constituted subsystems, from microlevels to macrolevels, that

in thoroughly interdependent fashion comprise the individu-

al qua living system: in the biological domain, genetic, ana-

tomical, physiological, and biochemical subsystems; in the

psychological domain, cognitive, affective, and motivational

subsystems, each of whose constitutive processes occur along

a continuum of awareness ranging from acute consciousness to

thoroughgoing unconsciousness; and in the social domain, the

verbal/linguistic subsystem of speech and the overt behavior-

al subsystem, which is itself composed of multiple nonverbal

channels. Further, the social domain of the biopsychosocial

model underscores that events occurring within and among

all of the aforementioned subsystems continuously spin out in

relation to and are reciprocally interpenetrated by an individ-

ual’s social surround, a multiplex environment that is itself a

domain of systems-within-systems (e.g., dyadic, familial, com-

munity, cultural groups, society). (Anchin, 2008, p. 325)

And once again there is convergence, because what Anchin states

could stand as a reasonable description of gestalt therapy’s holistic

field theory, wedded to gestalt’s relational and phenomenological

tenets. A rose by such another name does smell just as sweet. Chapter 8 Practice a Unified Approach 181

Finally, Scott Henggeler and his colleagues (2009) indicated

another convergence in the multisystemic approach he champions

in the treatment of antisocial adolescents. He pointed to the medi-

ators of change in the use of multisystemic therapy to treat juvenile

sex offenders, but multisystemic therapy is a field-theoretical con-

cept; it is a social-ecological theory of development and behavior

(Saldana & Henggeler, 2006).

CONCLUSION

Magnavita (2008, p. 275) maintained that, to be a unified theory,

a theory of psychotherapy would have to include the following

characteristics:

■ Unified theory emphasizes the essential function, structure,

and processes common to all human systems.

■ Unified theory attempts to establish the interconnectedness

of all the domains of human functioning.

■ Unified theory attempts to shift to a meta-theoretical model

or total paradigmatic matrix.

■ Unified theory attempts to offer a theory of the functioning of

the entire ecological system of human functioning, including

all pertinent areas of psychology, especially psychopathology/

maladaptation, personality theory, developmental processes,

as well as psychotherapeutic processes.

■ Unified theory attempts to recognize all the major domain

systems of the human biosphere.

■ The personality system is seen as the central organizing sys-

tem of human adaptation, function, and dysfunction.

■ Unified theory relies on multiple paradigms for knowing,

believing that each one offers some aspect that deepens

understanding.

In order for a psychotherapy theory to be both unified and

unifying, a clinical perspective must accomplish Magnavita’s tasks

but also the theory must find consilience with significant features 182 Part II How To Do Gestalt Therapy

of other approaches, obviously manifest the common factors that

make for good outcomes across the board of all major approaches

to psychotherapy, and constitute a point of convergence as other

approaches either borrow directly from its theory and practice or

discover anew the features in its praxis.

This is the picture of gestalt therapy. This book has not made

much of the extensive development of gestalt therapy’s theory of self,

because exploring every facet of the gestalt therapy approach would

take too much space for one volume; however, gestalt therapy’s theory

of self is fully developed in Perls, Hefferline, and Goodman’s (1951)

original text and also in such recent volumes as Peter Philippson’s Self

in Relation and The Emergent Self: An Existential-Gestalt Approach

(2009), and in Ansel Woldt and Sarah Toman’s book, Gestalt Therapy

History, Theory, and Practice (2005). In addition, Mark McConville

and Gordon Wheeler (2001, 2002) offered a two-volume set with a

developmental model built around gestalt therapy’s phenomenologi-

cal field theory. With the addition of the theory of self, then, gestalt

therapy satisfies all of Magnavita’s requirements for a unified the-

ory of psychotherapy; it finds many points of consilience with other

approaches, manifests the most salient common factors, and provides

a very suitable focal point for convergence.

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a psychoanalyst? The creative tension between the present moment and the past

in psychoanalytic and existential psychotherapies, in Daniel Stern’s The Present

Moment, and his humanistic-existential partners in dialogue. International Journal

of Psychotherapy, 8(3), 235–254.

Yontef, G., & Philippson, P. (2008). A unified practice. In P. Brownell (Ed.), Handbook

for theory, research, and practice in gestalt therapy (pp. 257–276). Newcastle,

England: Cambridge Scholars.This page intentionally left blank Specific Clinical Issues PART

II IThis page intentionally left blank 9 Assessment in Gestalt Therapy

In this chapter assessment and diagnosis are defined. Elements of

dimensional scaling, currently being debated and assimilated into

the thinking on the Diagnostic and Statistical Manual of Mental

Disorders, 5th edition (DSM-V), are discussed as more consilient

to gestalt therapy. The features of a gestalt system of diagnosis are

compared and contrasted to the DSM so that therapists can work

within both and accomplish the tasks required by the profession.

At various times, gestalt therapists have either shunned assess-

ment or yearned for a distinctively gestalt therapy version of it.

Related to that, many gestalt therapists have also turned away from

psychological testing (not trusting anything that resembles a posi-

tivist philosophy of science) as a means of understanding people.

Gestalt therapists also live in the real world, however, and they

have a pragmatic need to operate professionally and responsibly

in that world. Whether one uses the DSM or the International

Classification of Diseases (ICD), he or she will need some kind of

rationale for assessing and diagnosing clients—if for no other rea-

son than to be able to bill correctly and stand shoulder to shoulder

with professional colleagues from other modalities. A much better

reason, in my opinion, is that case conceptualization guides a thera-

pist in his or her work. Therefore, it behooves one to think through

189 190 Part III Specific Clinical Issues

the implications of the concepts in this chapter and to work out

one’s own integration of the divergent conceptions of assessment

and its place in a clinical practice of gestalt therapy.

This chapter discusses diagnosis, psychological testing, and a

within-process form of analysis, and concludes with a suggested

method for gestalt therapists to use in assessment and diagnosis.

PRELIMINARY CONSIDERATIONS

Before getting into the pragmatic issues, a basic question of phe-

nomenological ethics pleads for attention. What of Emmanuel

Levinas’s quarrel with thematizing? Is not assessment thematizing

magnified? Is there not a tendency to evaluate someone and then

speak as if that assessment is what the person is? In this way, the

process of evaluation leads to an end—a complete understanding.

The person is a borderline, the person is an anxiety disorder, or

in the watered-down version, we refer to the person by name but

think of his or her disorder instead of regarding the person with a

fresh perspective each time we meet.

Emmanuel Levinas and Jean-Luc Marion would call this “vio-

lence” because it steals transcendent personhood from the client.

How do we speak about the client without doing damage to the

client?

James K. A. Smith (2002) found a way through the apparent

impasse that Levinas poses in his concept of alterity. To simplify

somewhat opaque philosophical reasoning, the problem resolution

goes something like this:

1 We cannot think or speak about another (intentionality)

without objectifying, conceptualizing, or thematizing that

Other.

2 If we do think or speak about another, we destroy the per-

son’s transcendent status as Other by limiting him or her

to our own horizon, our own world, our own thinking and

frames of reference, making the person not other at all, but

the same—an extension of ourselves. Chapter 9 Assessment in Gestalt Therapy 191

3 However, not all thought about another, not all predicat-

ing of various factors to another, makes the Other an object

that is an end in itself.

4 Building on the thought of St. Augustine, there are idols

that are ends in themselves, and there are icons that point

beyond themselves to something greater.

5 Thoughts and words about another can be idols or icons;

when thoughts and words about another are icons, they are

held loosely as pointers to a transcendent entity that is ulti-

mately mysterious and wondrous and that can be experi-

enced but never grasped completely.

6 Iconic intentionality does no violence to the Other.

The therapist faces two questions when assessing a person in a

situation using iconic intentionality: (1) to think in terms of nouns

and categories or in terms of verbs and processes; and (2) to con-

ceptualize in regard to structures or dimensions.

Nouns and Categories, Verbs and Dimensions

Nouns lend themselves to categories, because we tend to put things

into boxes. From childhood we are taught to clean up our stuff and

put it away. This thing goes with that thing.

In one of the subtests of the Wechsler Intelligence Scale

for Children, 4th edition (WISC-IV), a block of several boxes is

arranged in a matrix, with a figure in all but one box, which is

empty. Below the matrix are a number of figures that could pos-

sibly fit in the empty block. What the test pulls for is that part of

our intelligence that can see patterns and recognize what goes with

and what falls outside (or does not go with) the pattern presented

in the overall gestalt of the matrix.

At one level of assessment, the evaluation process is like taking

this matrix reasoning subtest. The therapist is attempting to find

which gestalt in the DSM or ICD the person’s symptoms go with,

and he or she uses a categorical system to do this, identifying an

array of symptoms and adding them up until a threshold is reached

in which the client either qualifies/matches the overall gestalt of a 192 Part III Specific Clinical Issues

certain disorder or does not. One person may “go with” posttrau-

matic stress disorder while another fits with generalized anxiety

disorder.

Often, a client actually displays symptoms from many different

disorders, and the therapist first has to identify a general category:

mood disorder, anxiety disorder, substance disorder, thought disor-

der, and so on. Sometimes it is not a clear call, because a client will

have points that match several categories or not enough matching

points to “qualify” as any one disorder. In such instances, when the

general category (family) can be identified but the client’s presen-

tation and history do not provide enough evidence to refine the

diagnosis to a specific disorder (genus), let alone its severity and

longevity (species), catch-all categories of “not otherwise specified”

are useful. Thus, the categorical system of assessment encourages

people to deal in symptoms (nouns) and clusters of systems (cat-

egories), and these form taxonomic structures such as found in the

DSM and the ICD.

When verbs are used to structure assessments, therapists are

looking at what people have done or are doing, and this leads to a

focus on process. A verb is not a thing; it is an action or a state of

being, and in gestalt therapy verbs point to functional processes

in self experience (Crocker, 1999; van Baalen, 1999). Something

is happening; something is going on. What is happening, and how

is it going on? These are the classic questions of gestalt therapy:

“What?” and “How?” To be more precise, the phrasing goes like

this: “Here and now; what and how?” One question identifies a

process and sets it apart for study, and the other investigates the

means, relational components, dynamic factors, and dimensions of

time and place in which the flow of experience has been or is going

on. Kurt Lewin called this the situational unit (see chapter 6), and

it relates to the speed and direction of behavior (Corsini, 1999).

When people reduce a complex situation into manageable

parts, they often sort the gray into black and white. Something is

either this or that. Gestalt therapists are familiar with the concept

of polarities, but they often view them as pathological, because

typically a person will identify with one end of a polarity and reject

or deny the other. However, that is not a necessary condition of Chapter 9 Assessment in Gestalt Therapy 193

forming a polarity; a person can hold both ends at once and gradu-

ally work toward the middle.

A polarity is simply one of the first organizations of meaning

when dealing with complexity; it serves as a useful concept here,

because it relates to the issue of dimensional scaling in assessment.

Instead of locating a person in this or that box, as being a this

or a that, dimensional assessment locates the current functioning

of the client within a range, or along a continuum. Dimensional

systems also have the advantage that they can use interval-type

data instead of nominative data, so they lend themselves more to

research. One example of this is the NEO-PI-R, a test built on

the Big Five personality theory; it provides a read on the client’s

position along five dimensions of functioning: neuroticism, extra-

version, openness to experience, agreeableness, and conscientious-

ness (Piedmont, 1998).

■ Neuroticism assesses affective adjustment versus emotional

instability. People who score at the high end of this dimen-

sion experience psychological distress, unrealistic thinking,

excessive cravings, and maladaptive coping.

■ Extraversion measures the quality and intensity of interper-

sonal interaction, the need for stimulation, and the capacity

for joy. People at the two ends of this dimension are sociable,

active, person-oriented at one end and reserved, sober, retir-

ing, and quiet at the other.

■ Openness to Experience is the proactive seeking and appre-

ciation of experience for its own sake and tolerating the

exploration of the unfamiliar. The contrast in this dimen-

sion is between curious, original, untraditional, and creative

functioning and conventional, unartistic, an nonanalytical.

■ Agreeableness examines an individual’s attitudes toward oth-

er people. These attitudes can be “pro-person, compassion-

ate, trusting, forgiving, and soft-hearted on one end to very

antagonistic, cynical, manipulative, vengeful, and ruthless on

the other.”

■ Conscientiousness assesses a person’s degree of organiza-

tion, persistence, and motivated, goal-directed behavior. 194 Part III Specific Clinical Issues

“This dimension contrasts dependable, fastidious people

with those who are lackadaisical and sloppy” (Piedmont,

1998, pp. 84–90).

Consistent with such dimensional scaling, Daan Van Baalen

(1999) developed a dimensional approach to gestalt diagnosis

involving several scales or polarities and described their impli-

cations for assessment. He formulated seven steps in making an

assessment, and developed dimensional scaling for the first three.

Table 9.1 extends the dimensional scaling of his system to all seven

steps. Psychological and relational disorder and dysfunction can be

correlated to the characteristics and dynamics of each step. For

instance, van Baalen sees psychotic process associated with dys-

function of the first step; this remains to be researched, but the

heuristic in the table provides a dimensional scaling system that

lends itself to such an effort.

Structures and Processes

Gary Yontef and Talia Levine Bar Yoseph refer to personality struc-

ture as “slow moving process” (Yontef & Bar Yoseph, 2008, p. 184),

but is there really an enduring personality that might be conceived

of as a structure—not a process but a fixed thing? That is a sub-

ject that goes way beyond the scope of this book. However, it is

important to point out that gestalt therapists do not hold to a per-

son within a body—the homunculus. Rather, the “self” is viewed as

constantly forming at the boundary of contact in the environment.

Thus, there may be many different experiences of self—many

“selves,” all related to the various contexts in which one is situated

at any given time. The self, though, when it emerges, is composed

of id, ego, and personality functions.

A function is an activity natural to a person. Thus, the per-

son has self-experience and engages in activities that involve the

three major ways in which a person might manifest himself or

herself in gestalt therapy: id function, ego function, and personal-

ity function. Chapter 9 Assessment in Gestalt Therapy 195

The id function is defined as the organism’s capacity to make

contact with the environment by means of (a) the sensory-

motor background of assimilated contacts; (b) physiological

needs; and (c) bodily experiences and sensations that are per-

ceived “as if inside the skin” (including past unfinished situ-

ations). . . . Ego function expresses a different capacity of the

self in contact: the capacity to identify oneself with or alienate

oneself from parts of the field (this is me, this is not me), the

power to want and to decide that characterizes the uniqueness

of individual choices. . . . In Gestalt therapy, personality func-

tion expresses one’s capacity to make contact with the envi-

ronment on the basis of one’s given definition of self. (Lobb &

Lichtenberg, 2005, pp. 28–30)

Thus, when I have sensations and my body does its physiologi-

cal thing as I bump my way through the ontic field, my body reg-

isters that experience and my brain gives rise to my mind, and this

first elemental level is the id function of my emergent self. When, I

begin to make choices, and especially when I distinguish between

what is syntonic and what is dystonic, then my mind starts to exert

downward causation, guiding my brain–body, and I operate using

the ego function of my self. When I look back over time, or when I

realize the dissonance that comes from doing something “not like

me,” then my mind is engaged in comparing the current circum-

stances with the residue of my past experiences, and I use the per-

sonality function of my self—I tell myself a story about who I am

in order to make sense of my life. That story has a structure; so, at

least in part and in some way, the personality is not just a slow mov-

ing process:

Gestalt therapists have traditionally maintained that self

forms at the boundary and is a constantly reforming sense of

one’s experience. As such, the self has been characterized as

“the figure/background process in contact situations” (Perls,

Hefferline, & Goodman [hereafter PHG], 1951, p. 374). Still,

self as process is not the only way to think about it, for self as

concept is also important and present in every contact epi-

sode. As such, it is through meeting what is not me that one Table 9.1

A DIMENSIONAL ASSESSMENT APPROACH FOR GESTALT THERAPY

STEP DIMENSIONAL SCALING

  1. Is contact boundary formed, or does 0----1----2----3----4----5----6----7----8----9----10

the field organize? Does a situation of <––– ––>

fore contact lead to contacting? Field does not organize; Field organizes;

no contact boundary possible contact boundary possible

  1. Contact boundary forms. The field 0----1----2----3----4----5----6----7----8----9----10

organizes yet collapses easily with little <––– ––>

dynamic and/or organizes in a fixed, Field organization or Field organization/contact

stereotypical figure/ground formation. contact boundary collapses easily boundary does not collapse

  1. Which figures form and how flexible 0----1----2----3----4----5----6----7----8----9----10

is the process of figure formation and <––– ––>

resolution? Not flexible; Flexible, showing

no development fluid development

  1. How does the appearance and disap- <––– Fore contact supports the forming of a figure ––>

pearance of figure formation proceed; 0----1----2----3----4----5----6----7----8----9----10

how does the contact cycle develop? <––– Contacting results in identification with a figure ––>

0----1----2----3----4----5----6----7----8----9----10 <––– Final contact that prepares for transition––> 0----1----2----3----4----5----6----7----8----9----10 <––– Post contact that moves back to spontaneity ––> 0----1----2----3----4----5----6----7----8----9----105. What is the field that fits a certain 0----1----2----3----4----5----6----7----8----9----10

figure? What is the next wider gestalt <––– ––>

in which the figure/ground formation No sense of context and Sense of context emerges

organizes? wider developmental field with awareness of position in field

  1. How are awareness of the capacities 0----1----2----3----4----5----6----7----8----9----10

of the field formed by the diagnostician <––– ––>

and the one being diagnosed? Diagnostician as subject to Diagnostician as subject to

client as object client as subject

  1. How is the self-organizing taking <–––Id function evident and clear––>

place? Id function = “I need/I want,” 0----1----2----3----4----5----6----7----8----9----10

personality function = “I am,” ego <–––Ego function evident and moderating––>

function = “I choose” 0----1----2----3----4----5----6----7----8----9----10

<–––Personality function evident and orienting––> 0----1----2----3----4----5----6----7----8----9----10 Adapted from Van Baalen (1999).198 Part III Specific Clinical Issues

sketches the outlines of what is me (Polster & Polster, 1973;

Yontef, 1993). Over time these distinctives take on continuity,

and the story one tells oneself regarding one’s identity persists,

but is it the story that sets up the contacting or the contact-

ing that results in the story? What one believes about oneself

contributes to the support one organises for contacting (Korb,

Gorrell, & Van De Riet, 1989). (Brownell, 2002, p. 100)

ASSESSMENT AS DIAGNOSIS

In a gestalt-informed diagnostic process, the client, through dialogue,

informs the therapist, and the two construct an intersubjective aware-

ness regarding the nature of the situation. This is accomplished by the

quality of contacting within the relationship they enjoy (Francesetti

& Gecele, 2009; Schmid, 2004). This is true of all dialogic processes,

some of which are found in client-centered therapy as well.

In the broader field of mental health, axis I disorders (in the

DSM system) are id- and ego-function based while axis II disorders

are personality- and ego-function based. This is an important dis-

tinction even though it is impossible to completely compartmental-

ize these things, because an axis I disorder is found in a person with

personality function and a person with an axis II disorder still has id

and ego function to account for. When a person has major depres-

sion, for instance, that is a DSM categorical way of speaking about it,

but in each case it is true that the unique person sitting in front of a

therapist is doing major depression his or her own way. That person

is experiencing bodily sensations and choosing and making meaning

out of the experience he or she is going through. It is a phenomenal

field that the therapist encounters, and that field is a combination

of id functional processes and ego functional processes (the per-

son feels lethargic and decides to be isolated and lay around on the

couch all day). Similar things could be said about an axis II disorder

such as narcissistic personality disorder. The therapist encounters a

phenomenal field, which is a combination of personality functional

processes and ego functional processes (the person tells himself that

he is smarter, better, and more competent than those around him

and decides those others are not worth his attention). Chapter 9 Assessment in Gestalt Therapy 199

In arriving at a full DSM diagnosis, the clinician uses five

axes. The first is for disorders relatively amenable to change with

adequate treatment (arrived at through a categorical identifica-

tion of key symptoms). The second is for relatively fixed, or slow-

moving disorders of the personality that can change but only over

a longer period of time (again through categorical identification of

symptoms). The third axis is for physical conditions relevant to the

situation (this is what a gestalt therapist might call a field factor

that the client has some kind of id-ego experience around). The

fourth axis is for psychosocial stressors, or what Murray would have

called “press,” and this too is a field dynamic for the client. Axis V

is a dimensional scale called the Global Assessment of Function

(GAF); the scale ranges from 1 to 100 (1 represents low functioning

and 100 is high functioning). The GAF scale is composed of what I

call a pain scale and a performance scale. Pain refers to discomfort

that motivates one to change the situation because of the degree

of unacceptable suffering. Performance means the ability to get

things done and remain organized in accomplishing goals in the

various contexts of life. As pain goes up, performance goes down

and the composite of these two subdimensions results in the GAF

score, usually a short range, such as GAF = 55–60 (current).

In the latest version of the DSM, a relational dimension has been

added—the Global Assessment of Relational Functioning (GARF)

scale. The GARF scale is designed to be used in relationship sys-

tem functioning rather than individual functioning; therefore, it is

appropriate for use in working with family systems, but it can be

adapted to work with any relational system, such as in organizations,

or any subsystem within a family structure (Yingling, 1998).

ASSESSMENT AS PSYCHOLOGICAL TESTING

In some ways, psychological testing is a catch-all term. There are

many psychological tests, because some people make a living at gen-

erating and selling them. Like software, best sellers are constantly

being upgraded and improved and new ones being created. Beyond

that, psychological tests fall into different categories according to 200 Part III Specific Clinical Issues

their use. Some are for assessing axis I psychological disorders and

others are primarily for working with axis II personality disorders.

Some tests evaluate the cognitive and intellectual capacities of a

person, while others address neuropsychological functioning, and

still others are designed for various kinds of perceptual-motor or

achievement-oriented evaluations.

For gestalt therapists, it does not matter how many tests there

are, because the real question in their minds is how valid they are

and how relevant to the actual person who meets with them in a

novel, intersubjective encounter in which both therapist and client

contribute to the experience in a moment-by-moment process.

Validity is an overall evaluative judgment of the degree to

which empirical evidence and theoretical rationales support

the adequacy and appropriateness of interpretations and

actions on the basis of test scores or other modes of assess-

ment. . . . Validity is not a property of the test or assessment

as such, but rather of the meaning of the test scores. These

scores are a function not only of the items or stimulus condi-

tions, but also of the persons responding as well as the context

of the assessment. (Messick, 1998, p. 241)

Psychological testing can be understood in gestalt therapy

terms as experiment (Brownell, 2002). The giving/taking of any

given psychological test is a unique experience using a fixed form

that has been carried out under rigorous conditions so that the

test-taker’s responses can be assessed statistically compared to

a norm group. However, the basic question of a gestalt experi-

ment holds for psychological testing: “I wonder what might hap-

pen if . . .”; “I wonder how the client will respond to the test taking

challenge.”

The Minnesota Multiphasic Personality Inventory (MMPI-2)

has validity scales that indicate whether or not a person is respond-

ing in a haphazard fashion, trying to look good, or trying to look

bad. What response pattern is the client adopting? This goes to

the results of the test in terms of content, but process results can

also be included. Many peripheral observations can be made of the

client as he or she enters the testing environment, and a gestalt Chapter 9 Assessment in Gestalt Therapy 201

therapist can learn something about how the client responds to

a performance demand in the testing process. This information

is not related just to the client’s history; the test-taking situation

creates a mini-crisis in which the person understands he or she is

going to be evaluated in some way. As a clinical psychologist and a

gestalt therapist, I have learned to make abundant use of the test-

ing process in order to be with my clients at those times so as to

learn more of what it is like to be that person. These are things that

can be followed up on between the therapist and the client. Test

results are something a therapist can go back over in the debriefing

that accompanies psychological testing, to more fully understand

the world of the client. Thus, the experiment of psychological test-

ing includes the reason for such an undertaking, the approach to

test taking, the manner in which the person takes the test, and the

debriefing afterwards. All of this is a kind of safe emergency that

arrives with a set scaffold.

In one instance, a young man came for evaluation at the request

of his mother, because he had declined in most spheres after

attempting college. The man agreed to have his mother attend the

debriefing session; he sat on one couch, while she sat on the other.

Each reacted to the findings of the brief assessment in a differ-

ent way. She looked thoughtful and considered each point seriously,

while he smiled inappropriately, let his eyes wander, rolled his head

on his shoulders, and spoke in hushed whispers as if telling himself

inside jokes that nobody else was included in. The results suggested

an emerging schizophrenia that was consistent with his inappropri-

ate affect and loose associations. However, there were other pos-

sibilities, and as I interacted with the two people, I laid out these

possibilities and suggested a course of action for each. All of this

was done in a dialogical fashion, checking with the two people and

at times pointing the mother to her son’s bizarre behavior. Indeed,

it was no surprise to her, as that was part of the reason she had

asked him to come in the first place; it constituted a significant part

of the situation.

Every occasion for assessment and diagnosis is embedded

within the stream of life of the client, in which various things have

been going on. Seen that way, the assessment is merely one part in 202 Part III Specific Clinical Issues

an unfolding process, and it offers just as many clinical opportuni-

ties as anything else traditionally associated with gestalt therapy.

Although every occasion for psychological testing can be seen as an

experiment in which some kind of action is taking place (i.e., taking

a psychological test), the tests themselves can largely be sorted into

self-report questionnaires and performance-based tasks.

Self-Report Assessment Procedures

A self-report assessment instrument asks a number of questions to

which the test taker responds, usually indicating something as being

true or false about him or her. Sometimes the possible responses

are cast in Likert scales offering a range of possible answers from

extremely in one direction to extremely in the opposite direction, and

the subject selects his or her degree of agreement along a continuum.

Such self-report instruments have been used to predict major affec-

tive disorders in adolescents (Aebi, Mezke, & Steinhausen, 2009),

to evaluate executive functioning (Janssen, De May, & Egger, 2009;

Walker & D’Amato, 2006), to assess one’s ability to attend to one’s own

psychological states and processes and to reflect on them, resulting in

insight (Nyklíček & Denollet, 2009), and to evaluate the outcomes of

psychotherapy (Lambert, Okiishi, Finch, & Johnson, 2003).

One of the values of self-report scales and questionnaires is that

often they provide information that no one else knows (Baldwin,

2000). In such cases, concise definitions and clear questions are

important. Often the juxtaposition between self-report and perfor-

mance-based measures, when multiple methods are used in assess-

ment (Eid & Diener, 2006), provides depth and human interest to

the process of evaluation. However, self-report is suspect, given

people’s tendency to discern the intent of such scales when face

validity is high. For instance, one sorting test used in the managed

care of employee assistance clients asked such questions as when

was the last time you lied or conned others, when was the last time

you shoved or hit someone, made and sold drugs, or took some-

thing from the store without paying for it? Obviously, a person can

figure out that if they have done these things and answer truth-

fully, they might get into trouble or suffer loss. To account for this, Chapter 9 Assessment in Gestalt Therapy 203

some self-report instruments like the MMPI-2 have built-in valid-

ity scales sensitive to self-serving response sets.

Performance-Based Assessment Procedures

Performance-based assessment is just what it sounds like. Someone

does something—chooses from among several options to complete

a gestalt in matrix reasoning; sorts eight cards with pictures of ani-

mals, in various colors and borders, into two groups of four cards

each; or responds to the projective pull in an inkblot—and the

result is compared to how a norm group performed on the same

exercise. This is done in the presence of the test giver, who moni-

tors the way the test taker handles the demands made on him or

her. Does the person make side comments, go off task, fidget, or

just glide right through as if he or she is not bothered in the least?

All such things are part of the phenomenal field, and so not outside

the concern of a gestalt therapy–oriented psychologist.

In education, performance-based assessments have been used

to help teachers target specific academic goals for students and

promote productive and practical learning experiences (Gallavan,

2009). Students provide evidence of what they can actually do, and

that is related to what the teacher has been attempting to teach

them. In the same way, the feedback available to a gestalt therapist

through dialogical encounter gives evidence to the change taking

place in the client.

Performance-based measures allow clinical psychologists to

avoid the variety of ways in which people defend against recognition

of true mental distress (Fowler & Groat, 2008). In clinical psychol-

ogy, performance-based assessment is accomplished with projective

tests such as the Rorschach and the Thematic Apperception Test.

ASSESSMENT AS GESTALT THERAPY “ANALYSIS”

Many gestalt therapists approach the analysis of a situation in a dif-

ferent way. Instead of a top-down judgment, in which a deduction

is made and put upon the situation or person, gestalt analysis, as

described by Perls, Hefferline, and Goodman (1951), is a bottom-up 204 Part III Specific Clinical Issues

presentation of the situation in an experience-near fashion—as if

one is attempting to recreate the experience for the purpose of

observation.

Perls, Hefferling, and Goodman referred to such a method of

assessment, when they said (in typically demanding construction)

that

the only useful method of argument is to bring into the picture

the total context of the problem, including the conditions of

experiencing it, the social milieu and the personal “defences”

of the observer. That is, to subject the opinion and his hold-

ing of it to a gestalt-analysis. A basic error is not refuted—

indeed, a strong error, as St. Thomas said, is better than a

weak truth—it can be altered only by changing the conditions

of raw experience. Then, our method is as follows: we show

that in the observer’s conditions of experience he must hold

the opinion, and then, by the play of awareness on the limiting

conditions, we allow for the emergence of a better judgement

(in him and in ourselves). (Perls, Hefferline, & Goodman,

1951, p. 243)

Thus, a gestalt assessment might not present the conclusion

but the process by which a conclusion might emerge. This would

be frustrating to many people who just want that code number to

input into the third-party payer system. They want the conclusion.

However, gestalt assessment is more interested in processes that

develop out of what people do over time and how they navigate

contact in the unified field.

ASSESSMENT AS THERAPEUTIC PROCESS

What people do over time in therapy results in a felt sense of the

other for each one. That is informative, and it can be diagnostic.

Recently, for instance, in a meeting with a couple, the woman

complained that she was always having to remind the man and fol-

low up after him. I listened and began to wonder if the man had

an attention deficit that had never been assessed in childhood. I Chapter 9 Assessment in Gestalt Therapy 205

offered dialogically my curiosity and then painted a word picture

of a person with adult ADD; the woman’s eyes brightened and she

said, “That’s him!” While understanding a dynamic as an executive

dysfunction instead of a lack of caring did not remove the annoying

behavior, it did put a different set of clothes on it.

Whenever I get a referral of a child from a parent who comes

with voluminous documentation of what is going on with the child,

I always insist on meeting with the child him or herself before

interacting with the data from schools and other clinicians; this is

so I can get a “feel” for that child myself. Each person is different,

and I want to see what it is like to be with that person. The contact

provides first-person experience that contextualizes any observa-

tions made by others.

Sometimes the need for formal assessment procedures emerges

from the therapeutic context, because a clinician realizes something

is going on about which he or she would like to find out more. In

the course of a dialogical approach, this interest in what the results

of psychological testing might show can be shared with the client.

Conversely, when the process begins with the need for assessment,

the results of testing can become quite important therapeutically.

For instance, when I do assessments that are formal psychological

evaluations to begin with (i.e., referrals from another clinician, an

agency, or a department of community mental health that expressly

request a certain kind of psychological evaluation), I always meet

with the subject afterwards to go over the results, not just to satisfy

ethical propriety but actually to get a sense of the person’s reac-

tion. That reaction becomes part of the assessment because hear-

ing those results affects the client and must be monitored for its

significance. A counseling piece accompanies the process of giving

feedback on the testing. In that sense, all assessment is, to me, part

of an advancing therapeutic relationship.

Two different horizons exist in which to situate diagnosis in

therapy: the first is the naturalistic model, the second the

hermeneutic model. The naturalistic model implies an objec-

tifying relationship that is not oriented towards intersubjec-

tive contact. It is the medical model whereby the clinic maps

symptoms and then uses this map for treatment, without 206 Part III Specific Clinical Issues

concerning itself with the subjectivity of the patient. In the

hermeneutic model, on the other hand, the diagnostic pro-

cess is co-constructed, pooling together the knowledge (and

foreknowledge) of the therapist and patient. (Francesetti &

Gecele, 2009, np)

Assessment in a therapeutic situation is, by nature, a constantly

evolving process.

The therapist and client are always noting, evaluating,

responding, or reacting to the transactions of therapy, each

person using his own internal process to interpret and com-

prehend what has transpired. It is difficult, therefore, to com-

prehend any form of assessment as truly static or objective.

Assessment is multisided. Three basic observational positions

are recognized in formal, structured assessment. Outsider

evaluation is described as the use of a clinical rating scale

by an observer/therapist/team or researcher. Insider methods

use client self-report about his or her experience of system

functioning. Insider-outsider methods use a more collabor-

ative process whereby the client and therapist develop cri-

teria delineating desired change in a well-defined manner.

(Yingling, 1998, p. 36)

A SUGGESTED METHOD OF ASSESSMENT AND DIAGNOSIS

We now come to how assessment and diagnosis might be handled by

a gestalt therapist, especially by a gestalt therapist working within a

mental health system dominated by the DSM (or the ICD).

First, one must attend to the pragmatic demands of the system.

That means attending to the categorical sorting that results in a

DSM code/diagnosis, and if one is preparing an official report, it

also means preparing the five-axes diagnosis. These are not merely

busy work, for as stated previously, elements in those five axes tap

field factors and processes of suffering and performance that are

represented in a dimensional scale. These can be conceptualized

from a gestalt perspective without losing ground. Chapter 9 Assessment in Gestalt Therapy 207

Beyond this level of assessment, however, the gestalt therapist

is interested in the manner in which the client navigates contact

in the two-person field comprising the therapeutic relationship

(or beyond that to the more extended field outside of the therapy

room). Does the client show sustained ability to maintain contact

and to show presence, or does he or she interrupt the contact in

some fashion by externalizing and projecting on others, going up

“into the head,” being overly intellectualized and analytic about

everything, or does he become deflective and divert attention to

peripheral issues and objects and away from the meeting that is

possible? There are many ways in which a person can break con-

tact. Further, it is possible to develop a contact style in which one

characteristically interacts with others. When that style becomes

fixed and rigid, and also interpersonally problematic, people begin

to suspect an axis II disorder.

The gestalt therapist is also interested in how the client makes

meaning out of his or her experience. First, the therapist is inter-

ested in how the client senses and navigates the ontic field, which

cannot be seen or understood except through the byproducts of

such navigation; with a modified phenomenological method, how-

ever, it is possible to slow down a client’s process as if to take one

frame at a time and examine what is happening in the whole per-

son at that time.

Now all this is done, as implied, in the midst of the two-person

field, the working alliance. And further, the therapist works out

the assessment by using that relationship and presenting to the cli-

ent his or her observations and self-disclosures of what it is like to

be with the client. As the client responds, the therapist and cli-

ent together come to an understanding about the nature of what is

going on with the client. This does not mean that the client knows

just as much about it as the therapist, but the client knows more

about his or her own experience than the therapist. As that expe-

rience is made more available to the therapist (through explora-

tion of the client’s phenomenal field and the dialogic encounter

between them), the therapist is able to come to a more informed

understanding and diagnosis. Yet, this is something they work out 208 Part III Specific Clinical Issues

together rather than something the therapist alone performs on or

for the client.

Some gestalt therapists have made much of assessing the cli-

ent’s figure formation and resolution skills, using the cycle of expe-

rience (Melnick & March Nevis, 2000), but I am not going down

that road. The cycle of experience is regarded as a useful teaching

heuristic but not a diagnostic instrument that assumes the exis-

tence of such a thing in itself.

Each gestalt therapist will get the feel of the client in his or

her own way. This assessment emerges out of the whole process of

therapy; however, this is how I do it in my own practice:

1 In the first meeting, I note if there is an openness in the cli-

ent that engages with me, or if we avoid one another in some

way. Does he or she tell a coherent story or throw out one-

liners that do not go anywhere? I may have my first glimpse

of a contact style, and I notice in myself if I am working

harder than usual, fearful that I will not make something

happen, and so on. I regard this, if I see it, to be a product

of the meeting between myself and this particular client.

2 I want to get a sense of the need and press, the field dynam-

ic, all things having effect, and so I might ask the client to

tell me parts of his or her history that do not have an appar-

ently direct relationship to the situation at hand.

3 In assessment, I am evaluating the situation, not the indi-

vidual person detached from the situation. And when the

client comes to me, I suddenly have become part of that

situation. So, the work with the client becomes similar to

a piece of action research, which is a form of hermeneutics.

Hermeneutics, from which are derived appreciative

inquiry, cooperative inquiry and action research, seeks to

derive a rich understanding of the context and focuses on

the formation of meaning. In its pursuit of knowledge, it

opens a recursive dialogue between subjects and the object

of inquiry to mine deeper into an understanding of what

exactly happens to generate a more complete interpretation

of events. This approach investigates the researcher as much Chapter 9 Assessment in Gestalt Therapy 209

as the topic, and involves the researcher in the explanatory

process (Barber & Brownell, 2008, p. 44).

4 I hold all theories loosely and continually check them out

with the client; I watch for the reaction to answer the exper-

imental question: What happens when I share this with the

client?

5 I ask myself if the client’s primary problem is (a) one of indi-

vidual experiencing (i.e., an inability to sense herself in her

body, form good figures, make good contact with nonper-

sonal aspects of her ontic field and process percepts, etc.),

(b) one of interrupting or not even establishing contact with

personal Others—people—and thus of relating, or (c) a

matter of disabling field effects or unfinished business from

past relationships and/or events.

6 I am constantly weaving my awareness of the DSM into

the ongoing process so that my growing understanding of

the client informs my professional responsibility, shaping

my understanding of the process elements and dimensional

scaling possible that complements the categorical system in

the DSM. Should the DSM-V include more obvious dimen-

sional considerations in differential diagnosis, then gestalt

therapy would be poised to use it more explicitly, referring

to verbal processes instead of nominative categories.

CONCLUSION

Diagnosis is a critical need in mental health practice, and the field

is already dominated by the DSM and the necessity of inputting

DSM-based code numbers into various databases. Rather than

argue for a totally new system, gestalt therapists need to become

proficient in using categorical assessment systems such as the DSM

and the ICD in order to fulfill their professional requirements. To

be sure, gestalt therapists working in government-funded and non-

profit-based community mental health do this. So do those working

in practices largely funded by third-party payers that are highly

managed. Further than that, though, it would be helpful if more 210 Part III Specific Clinical Issues

gestalt therapists worked at integrating the established method,

with its emphasis on nouns, categories, and structures and a sys-

tem of assessment built on verbs, dimensions, and processes that

is more in keeping with gestalt therapy theory and practice. As in

many related clinical issues, the gestalt therapy perspective pro-

vides a coherent alternative and check against potentially harmful

objectifying of clients and simplifying of the processes of assess-

ment and diagnosis.

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Newcastle, England: Cambridge Scholars.This page intentionally left blank 10 Treatment Planning and Case

Management in Gestalt Therapy

This chapter discusses case conceptualization, treatment planning,

and case management as relevant to gestalt therapy. Approaches to

treatment planning are offered, with hypothetical examples from a

gestalt perspective, and a field theoretical consideration of case man-

agement that assimilates it as a strategy available to gestalt therapists.

Treatment planning is often driven by a problem–solution

approach that has proven counterintuitive to solution-focused and

strengths-based therapies. While gestalt therapy is not essentially

solution focused, it is very much strengths based. Therefore, this

chapter offers a gestalt-friendly approach to treatment planning

that works around what gestalt therapists know as the “figures of

interest” for the client. In addition, case management is often a

related task required of clinicians; therefore, this chapter provides

a gestalt therapy orientation to case management as a decidedly

field-theoretical strategy.

TREATMENT PLANNING

It is now common practice to construct a treatment plan and to

do so in conjunction with the client. This is a practice in keeping

213 214 Part III Specific Clinical Issues

with gestalt therapy; specifically, it includes a dialogical negotia-

tion between the therapist and client with respect to the amount of

time and money that will be spent on any given therapeutic process.

Gestalt therapists do not conceptualize cases, nor conduct their

practices, in straight lines between cause and effect, between prob-

lem and solution, or between interventions and results. They are

trained to think more contextually, relationally, and with a view to

unfolding process. Consequently, gestalt therapists do conceptual-

ize cases and do organize themselves to meet the perceived figures

of interest emerging from the meetings between themselves and

their clients. This presents some interesting alternatives to people

unfamiliar with gestalt therapy, even as it necessitates that gestalt

therapists operate with a parallel process to forge treatment plans

commensurate with professional standards in mental health, on the

one hand, as well as those that make more sense theoretically to

gestalt therapists, on the other.

Treatment planning is a standard subject taught in most

accredited graduate programs in psychotherapy. We do not need

to start from scratch on the subject. As most people know, it is a

problem–solution kind of process that is commonly worked out in

conjunction with the client so that the client actually “signs off”

on it at the end. When I worked in community mental health in

North Carolina (before the state went out of the business of pro-

viding direct services), it was standard practice to meet with the

client, do a diagnostic interview, and then, using the screen-driven

computer system, create a treatment plan identifying at least two

“problems,” and each with several options for meeting the client’s

needs expressed in that problem. Thus, to me, and probably to all

my clients, this was a fairly task-driven process that offered little

time to build rapport or for the client to really tell his or her story.

We had only an hour, after all, to accomplish it all!

That said, treatment planning is directly related to case concep-

tualization (Hersen & Porzelius, 2002), which is related to assess-

ment and diagnosis (see previous chapter). Case conceptualization

organizes assessment data into a meaningful outline, apply-

ing research and theory to make sense of a client’s current Chapter 10 Treatment Planning and Case Management 215

presentation. Although the diagnosis summarizes a client’s

symptoms, it is not enough. Therapists must know more about

their clients than symptoms and diagnosis. Therapists must go

beyond diagnosis, developing hypotheses to explain how the

clients came to have a particular set of psychological and inter-

personal problems. Therapists review all potential contributors

to the problem, examining distal and proximal factors; causal,

maintaining, and precipitating factors; and internal and envi-

ronmental factors. Therapists then identify the most central

contributors, develop explicit hypotheses about clients’ prob-

lems, develop treatment plans based on the hypotheses, and

intentionally test the hypotheses during treatment. (Hersen &

Porzelius, 2002, p. 4)

That is a great deal of objectifying of the client; so, how might a

gestalt therapist approach responsible case conceptualization, lead-

ing to effective treatment planning? For that matter, how might a

gestalt therapist translate such a linear process into a more contex-

tual logic? There are philosophical and ethical considerations as

well as evidence-based, professional considerations. This book is

not the place for a complete development of these two subjects, but

a brief overview will alert the reader to what is involved.

Philosophical and Ethical Considerations

Philosophically, of course, gestalt therapy is built on continental

philosophy, more specifically on phenomenology, and it incor-

porates Heidegger’s sense of being in the world among others.

However, in terms of assessment there are also hermeneutical con-

siderations to keep in mind; by what principles does one interpret

one’s experience of the client, and what happens when one reduces

such a human being to a set of symptoms and then evaluates that

set against the criteria in various clinical categories? These ques-

tions concern the ethical thinking of Emmanuel Levinas and the

hermeneutics of Hans-Georg Gadamer (Bruns, 2004).

To the point, Levinas (as stated previously) abhorred objectify-

ing other people, calling it an ethical violence. Rather, he viewed

the Other (in this case, the client) as a stranger who calls to him 216 Part III Specific Clinical Issues

(the therapist), and calls him out of his usual ways of knowing. The

therapist does not exist for herself, but for the Other. This alters the

syntax of relationship—the case in which a therapist operates—

setting her in the accusative, so that she becomes a me instead of

an I. Thus, the process goes like this: the client affects me rather

than I figure out the client. The client transcends my usual ways

of knowing, and the client must be allowed to do so free from the

therapist’s conceptualizing. This ethical principle presents a practi-

cal problem for the therapist, who must figure out what is going on

with the client in order to organize his or her approach to the work

they do together.

That leads to the subject of hermeneutics. Instead of a system

that provides for the interpretation of texts, this kind of herme-

neutics provides an orientation for the interpretation of experience.

The therapist operates with at least a tacit guideline that informs

how he or she will make sense of meeting the client and coming to

know the client experientially.

Related to this, Gadamer offered a way of knowing that avoids

extreme objectifying:

Gadamer, for example, thinks of understanding on the model

of Aristotle’s concept of ϕϱόνησις, or practical wisdom, which

is a ground-level or dialectical mode of thinking different both

from theoretical consciousness (έπιστήμη), or knowing what

things are, and from technical know-how (tecnhv), or knowing

how things are made or how they work. ϕϱόνησις involves

responsiveness to what particular situations call for in the way

of action, where knowing how to act cannot be determined in

advance by an appeal to rules, principles, or general theories

(WM304–5/TM321–22). Knowledge here cannot be concep-

tualized or codified in general terms because it has to do with

singular and unprecedented states of affairs, particularly as

these involve us with other people. (Bruns, 2004, p. 34)

This fits well with a gestalt approach because both Gadamer’s

hermeneutic and gestalt therapy are concerned with a situation and

not just with an isolated individual who bears the markings of vari-

ous symptoms and can be classified accordingly. This harkens back Chapter 10 Treatment Planning and Case Management 217

to Francesetti and Gecele’s (2009) point in the previous chapter

about the diagnosis of action at the boundary between self and

other.

Case conceptualization, like therapeutic process itself in gestalt

therapy, is the interpretation of situational and relational elements

contributing to the client’s clinical presentation. Just as the client

and the therapist are a two-person field in therapy, the client is

part of a larger field including therapy, and the therapist’s task is to

be with the client, to perceive the client as an icon pointing to the

situation of which the client is a part. This is true for the process of

case management as well as it is for psychotherapy.

An icon can be contrasted with an idol. An idol is an object of

adoration, and one’s attention and interest are focused on it as an

end in itself. Much of diagnosis, case conceptualization, and treat-

ment planning in the past has been focused on the individual and

his or her symptoms as if the client were the sole factor involved. An

icon, by contrast, is not an end in itself. It is a symbol and a pointer

to something beyond itself, usually conceived of as a greater reality

and a more salient consideration (Smith, 2002).

Thinking of the client as iconic, a therapist can avoid the ethical

violence of shattering alterity by objectifying and thematizing the

client; a gestalt therapist sees the client as an icon pointing beyond

the individual to the transcendent reality of the individual in situ.

This is how a gestalt therapist conceptualizes any given case, pay-

ing attention to the ways in which the client affects contact at the

boundary of self and other in a complex field.

It is also a process consideration, that is, the configuration of

contact for any given current moment (field is a current consider-

ation), so it can change in the next moment, and then again in the

next. Thus, case conceptualization leaves one open and watchful,

realizing that the client in situ is not static.

Evidence-Based and Professional Considerations

As in medicine, social science has adopted an evidence-based

approach to mental health services. Evidence-based practice can

be defined as the purposeful and explicit use of the best available 218 Part III Specific Clinical Issues

scientific evidence in decision making; “it is the use of treatments

for which there is sufficient persuasive evidence to support their

effectiveness in attaining desired outcomes” (Roberts, Yeager, &

Regehr, 2006, p. 6). To help refine the definition of evidence-based

practice, the American Psychological Association commissioned

work to define both the means and the results of achieving “evi-

dence” in the construct of evidence-based practice:

The American Psychological Association adopted a working

definition of evidence-based practice, and they asserted that

evidence-based practice in psychology (EBPP) is the integra-

tion of the best available research with clinical expertise in

the context of patient characteristics, culture, and preferenc-

es (APA, 2006). They went on to make a critical distinction

between empirically supported treatments and evidence-

based practice and to open up multiple and relative streams

of support as “evidence:” … The APA task force pointed to a

range of research designs that all contribute to the body of

knowledge relevant to evidence-based practice. They include

clinical observation, qualitative research, systematic case

study, single-case experimental designs to examine causal fac-

tors in outcome with regard to a single patient, process-out-

come studies to examine mechanisms of change, effectiveness

studies in natural settings, Random Controlled Treatments

and efficacy studies for drawing causal inferences in groups,

and meta-analysis for observing patterns across multiple stud-

ies and for understanding effect sizes. With regard to any par-

ticular treatment intervention, the task force identified two

considerations: does the treatment work—a question of its

efficacy, which is most related to internal validity, and does

it generalize or transport to the local setting where it is to be

used—a question of its effectiveness, which is most related to

external validity. (Brownell, 2008, pp. 94–95)

Questions that arise from practice, that are practice-based

(Brownell, 2008), and questions that focus on benefits to the cli-

ent—the type of client, the proposed course of action, and the per-

tinent findings in research literature (Yeager & Roberts, 2006)—are

most conducive to evidence-based case management. Here, it is not Chapter 10 Treatment Planning and Case Management 219

necessary to find an exact match for population, disorder, and treat-

ment in the research literature. The best fit is what carries the day,

and in regard to that, it is helpful to pay attention to the consilience

that might exist between one construct in a piece of research and

another construct used in a parallel approach to therapy.

For instance, much is made these days of mindfulness and

acceptance therapy, especially as practiced in cognitive behavioral

therapy (CBT), but gestalt therapy has been practicing mindful-

ness and acceptance from its very inception, and gestalt therapists

locate these ideas nested in the constructs of awareness and para-

doxical growth. Therefore, it is reasonable that research directly

supporting mindfulness and acceptance therapy would be appli-

cable to gestalt therapy’s use of awareness and paradoxical change

by virtue of consilience. Indeed, the assimilation of mindfulness

and acceptance techniques and strategies run along the lines of

awareness work relying on gestalt therapy’s paradoxical theory of

change. This goodness-of-fit in accordance with consilience is also

similar to what happens when studies conducted on one population

are attributed as relevant to a different, but similar (in many ways),

population somewhere else.

According to Vourlekis, Ell, and Padgett (2005), a comprehen-

sive, evidence-based practice in social services and case manage-

ment includes four sets of activities: (1) It uses evidence-based

strategies to identify people for social work services within certain

settings; (2) it demonstrates the accuracy and validity of assessment

processes that lead to clinically relevant decisions; (3) it uses inter-

ventions or treatments with established effectiveness and guide-

lines based on systematic inquiry; (4) it examines practice processes

and outcomes for quality and goal achievement.

With regard to the assessment and case conceptualization foun-

dational to treatment planning,

cognitive strategies that have demonstrated potential for

improving judgment outcomes include (a) needing to simul-

taneously consider several alternative diagnoses, explanations,

and treatment plans; (b) addressing environmental as well

as internal factors influencing client behaviors; (c) decreas-

ing reliance on memory alone in decision-making tasks; and 220 Part III Specific Clinical Issues

(d) using formal decision aids such as diagnostic criteria,

norms, and base rates to improve accuracy. (Falvey, Bray, &

Hebert, 2005, p. 348)

Two Metaphors for Treatment Planning

A treatment plan can be like a budget, and it can also be like a road

trip. When a treatment plan is like a budget, the therapist essen-

tially knows that he or she has only so many sessions that man-

aged care will likely fund, after which the client will have to pick

up the rest or simply stop. So, the therapist makes a plan to cover

x, y, and z in the amount of time available. In identifying several

problems, for instance, the therapist might sort them and negotiate

with the client to choose the one thing they will work on together.

That would leave other issues either to be addressed at a later point

or for the client to attend to with other people or by his or her

own means. Further, the therapist writes goals, like commodities

to be purchased with the time available, in terms of client accom-

plishments. Thus, a typical treatment plan, from a gestalt therapist

working in community mental health or managed care, might look

like what is depicted in Figure 10.1.

Notice that it is not good enough to “prescribe” a whole form of

therapy as an intervention (such as, “cognitive behavioral therapy

Client/Customer: Joe Smith

Problem #1: Mood darkens and energy dissipates

Experiment #1-1: Client will engage in cardiovascular exercise for at

least 30 minutes daily

Intervention #1-1: Client will debrief and explore experiment #1

dialogically

Problem #2: Defeatist introjects ruling awareness and destroying hope

Intervention #2-1: Client will engage therapist in exploration of the

client's phenomenal field, keeping watch for (a) negative cognitive

processes; (b) defeating introjects; (c) lagging hope

Experiment #2-1: Client agrees to challenge an introject in vivo with

two-chair work and therapist support

Figure 10.1 Example of a budget-model gestalt therapy treatment plan. Chapter 10 Treatment Planning and Case Management 221

for depression”). Rather, the descriptions of the problems are experi-

ence-based and phenomenal, and the interventions and experiments

are process-oriented. These are the kinds of things a gestalt thera-

pist would include in his or her “budget” for spending the resources

of time and third-party funding that support therapy. In addition,

in order to be evidence-based, the gestalt therapist needs to refer

to research evidence supporting gestalt therapy and/or demonstrate

points of consilience with established research in other modalities.

In other ways, a treatment plan is like a road trip. A road trip

is an adventure in which the charm is the purposeful encounter of

the unexpected. A person planning a road trip will establish some

general parameters but leave open and undefined most of what will

take place, because the person wants to be flexible enough to adjust

and take advantage of the opportunities that arise along the way.

Using that model, a gestalt-oriented treatment plan might resemble

Figure 10.2.

Notice that in the road trip metaphor the treatment plan

is written in terms of therapist-driven procedures, and that is

because it is the therapist who is driving. He or she takes respon-

sibility to fill that tank, kick the tires, and keep the car on the

road; but beyond that, the driver must remain aware of the scen-

ery, the opportunities that present themselves as the car goes

down the road, and the experience of the passenger who wanted

to go on the road trip to begin with. Neither passenger nor driver

Client/Customer: Joe Smith

Problem #1: Mood darkens and energy dissipates

Experiment #1-1: Establish presence and wait on Mr. Smith to enter

into dialogue; stay present in the dialogue

Intervention #1-2: Track the phenomenal experience of the client

with a modified phenomenological method.

Problem #2: Defeatist introjects ruling awareness and destroying hope

Intervention #2-1: Turning to the client’s field, explore where he got

those rules, how old he feels with them, who taught them to him, etc.

Intervention #2-2: Stay attentive to the client’s figures and possible

open doors to in vivo experiments

Figure 10.2 Example of a road-trip model gestalt therapy treatment plan.222 Part III Specific Clinical Issues

can know what he or she will encounter (the client’s issues and

responses; the therapist’s countertransference), but the therapist/

driver can be reasonably sure of some of the first turns he intends

to make on the process.

Two Criteria for Planning Therapy

Both outcome research and clinical reasoning need to be used by

the therapist in constructing and monitoring responsible treatment

plans.

If the major theoretical orientations all have a respectable

standing nomothetically, then idiographic questions become

especially salient, particularly the old, venerable question of

what works best for whom. To clinicians, comparing the group

effects of alternative treatments might be less important

than assessing the etiology of disturbance in a given client.

Treatment planning based on individual case formulation has

the potential to link the nomothetic and idiographic levels of

psychotherapy. (Shapiro, 2009, p. 51)

Since, as has already been discussed, gestalt therapy would be

expected to enjoy roughly the same outcomes as CBT, and since the

research that has compared the two shows favorable comparisons,

Shapiro’s point that clinical reasoning is important looms large.

When writing a treatment plan, the gestalt therapist will want to

pay close attention to the individual needs and interests of the spe-

cific client in question.

CASE MANAGEMENT

When I was program coordinator and clinical supervisor at a com-

munity resource center for children and families in mid-Multnomah

County, Portland, Oregon, one of my jobs was to help therapists

adapt to the growing demand that they also shoulder the role and

responsibilities of case managers. They did not train for that. They

did not sign up for that. They viewed themselves as therapists, and Chapter 10 Treatment Planning and Case Management 223

that is what they wanted to remain. Unfortunately, that was not the

direction in which the profession had been running. Consequently,

it was satisfying to realize that case management is an exquisite way

in which to conduct therapy according to a gestalt therapy under-

standing of field dynamics.

Case management is just what it sounds like: case management.

Instead of providing services, the case manager identifies client

needs and matches them to provider resources in the community.

The case manager is a service broker, not a service provider (if

case management is not seen as a service in itself). The case man-

ager monitors the provision of services, and that involves interface

with the service provider and the client. The case manager keeps

responsibility for the case, even as various service providers assume

responsibility for certain aspects of the client’s case. The case man-

ager organizes and superintends all that. Case management is not

simply referring the client to someone else and then letting go,

because an active role of involvement, monitoring, and continuity

of care with regard to the client remains for the case manager, and

this takes place within a complex of various community and social

elements.

Case management has been shown to play important roles in

the complex situations facing patients in medical care and clients

in mental health care (Olbort et al., 2009; Walsh & Holton, 2008).

It is most apparent in the demands for highly effective coordina-

tion and organization inherent to multisystemic therapy (Leonard,

2009 Tolman, Mueller, Daleiden, Stumpf, & Pestle, 2008), which is

consilient with field theoretical strategies in gestalt therapy.

If the field is all things having effect (a phenomenal consider-

ation) and also all actual effects (an ontic consideration), then chang-

ing anything in a person’s ontic field may well result in changes in

his or her phenomenal field. Let me explore that a bit more.

Lewin’s life world (all things having effect) is a phenomenal con-

struct; that is, it is all things the subject is aware of affecting him

or her. The effects in the phenomenal field are actual (existent),

but not all things existent are phenomenal effects (the currents of

liquid gas on one of the outer planets, a traveler hiking in Nepal,

etc.). However, some things that are effects (for any given person) 224 Part III Specific Clinical Issues

are not phenomenal (a matter of a person’s aware experience); some

things affect a person unawares. There is a part-to-whole relation-

ship here; the phenomenal field is part of the ontic field. All phe-

nomenal effects are therefore actual, but not all actual effects are

phenomenal. Do ontic effects result in phenomenal effects, and if

so, how and how much?

It seems that the phenomenal field emerges from the ontic field

and supervenes on it. It could emerge without supervening, but if

the phenomenal field does supervene on the ontic, then no change

in the phenomenal field can take place without a concomitant

change in the ontic field (gestalt therapists must hold to this if they

hold to an emergent and supervenient self/mind). I do not believe

we can say that any change in the person’s ontic field results in a

change in the person’s phenomenal field (and this is one difference

between field theory and systems theory), not immediately anyhow.

Someone can develop cancer unawares. On the other hand, the

slowdown in metabolism as a person ages definitely results in phe-

nomenal experience. We are all in process, so that some elements

of the ontic field affect the phenomenal field when they attain a

certain threshold of awareness.

Thus, case management can be seen as active intervention at

the level of the field, because the case manager is actively intro-

ducing new effects into the client’s field, and each time the case

manager brokers services and the client meets with a new service

provider, an experiment is underway (to say nothing of the effect

of the relationship between the client and the case manger him

or herself!). How will these two get along? Will the client get what

he or she needs? What happens when I, as a gestalt therapist, case

manage in this way?

In one study, homeless people who were offered housing

and case management experienced less need for hospitalization

(Sadowski, Kee, VanderWeele, & Buchanan, 2009). A study of the

seriously and chronically mentally ill who received case manage-

ment in Hong Kong indicated that case management reduced the

number of hospitalizations and shortened durations of inpatient

treatment when they were hospitalized (Wong, Yeung, & Ching,

2009). In a good example of how such case management works, Chapter 10 Treatment Planning and Case Management 225

Wohl et al. (2009) found that 72% of goals established at baseline

were achieved and 74% of referrals were completed in a case man-

agement approach for HIV-positive patients in a public care setting.

The most common goals were adherence in taking medications and

cooperating with case management interventions, housing, and

nutrition.

Because the patient is sent out into the community to gain these

supports and services, this approach constitutes a huge experiment

at the level of the client’s field. What happens when the client has

to navigate the dentist? the rapid transit system? the local parent-

teachers’ association? applying for a job? How far will the therapist

go in following up with service providers involved with his or her

client? A thoroughly field theoretical strategy that opens up to the

potential in case management changes the concept of gestalt ther-

apy from a one-to-one individual therapy to a complex, situational,

socially active approach.

For gestalt therapists in private practice and perhaps working

with a higher functioning or less stressed population, a case-man-

agement experiment might be quite appropriate. On one occasion,

the daughter of an elderly, severely depressed woman came to help

in processing her anxiety and concern. After meeting with her,

and after meeting with her mother, I suggested that the daugh-

ter employ a home health nurse to visit her mother’s apartment,

not take “no” for an answer, and get the woman up, showered, and

dressed for a walk in town at least three times a week. We could

have sat for a long time discussing the concepts involved with time

of life, depression, reversed generational roles, and so forth, but the

provision of the home health nurse changed something in the field

and made all the difference.

CONCLUSION

Treatment planning and case management are linked because

the treatment plan will often require some case management.

Treatment planning can be goal oriented and written in terms of

client benchmarks, considering the expenditure of resources from 226 Part III Specific Clinical Issues

a budgetary viewpoint, or it can be open-ended and exploratory,

following a few principles that allow the process to direct the out-

come and written in terms of therapist facilitation, considering the

unpredictability of psychotherapy as a road trip. Ultimately, case

management is a field-level intervention that relies on the paradoxi-

cal theory of change and contextual logic for positive outcomes.

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Brownell, P. (2008). Practice-based evidence. In P. Brownell (Ed.), Handbook for

theory, research, and practice in gestalt therapy (pp. 90–103). Newcastle, England:

Cambridge Scholars.

Bruns, G. (2004). On the coherence of hermeneutics and ethics: An essay on Gadamer

and Levinas. In B. Kajewski (Ed.), Gadamer’s repercussions: Reconsidering philo-

sophical hermeneutics (pp. 30–54). Berkeley: University of California Press.

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and diagnosis. British Gestalt Journal, 18(2), 5–20.

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ning for adults: A step-by-step guide. Mahwah, NJ: Lawrence Erlbaum Associates.

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69(9), 5771.

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social work. In A. Roberts & K. Yeager (Eds.), Foundations of evidence-based social

work practice (pp. 3–20). New York: Oxford University Press.

Sadowski, L., Kee, R., VanderWeele, T., & Buchanan, D. (2009). Effect of a housing

and case management program on emergency department visits and hospitaliza-

tions among chronically homeless adults: A randomized trial. JAMA: Journal of the

American Medical Association, 301(17), 1771–1778.

Shapiro, J. (2009). Integrating outcome research and clinical reasoning in psychotherapy

planning. Professional Psychology: Research and Practice, 40(1), 46–53. Chapter 10 Treatment Planning and Case Management 227

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London and New York: Routledge.

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multisystemic therapy in a statewide system of care. Journal of Child and Family

Studies, 17(6), 894–908.

Vourlekis, B., Ell, K., & Padgett, D. (2005). Evidence-based assessment in case manage-

ment to improve abnormal cancer screen follow-up. Health and Social Work, 30(2),

98–106.

Walsh, J., & Holton, V. (2008). Case management. In W. Rowe, L. Rapp-Paglicci,

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Wohl, A., Garland, W., Witt, M., Valencia, R., Boger, A., Squires, K., et al. (2009). An

adherence-focused case management intervention for HIV-positive patients in a

public care setting. Journal of HIV/AIDS & Social Services, 8(1), 80–94.

Wong, D. F. K., Yeung, M. P. M., & Ching, C. K. (2009). Evaluating a case management

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based social work practice (pp. 47–58). New York: Oxford University Press.This page intentionally left blank Training and Certification PART

IVThis page intentionally left blank Training, Certification, and

11 Professional Development in

Gestalt Therapy

This chapter describes the means by which people become

trained and certified as gestalt therapists. It includes means for

attending continuing education. It describes the historical devel-

opment of postgraduate-level gestalt therapy training institutes

worldwide, and provides identifying and contact information

for a number of them. This chapter also helps the reader under-

stand the experiential nature of gestalt therapy training. In addi-

tion, as certification conveys different connotations, depending

on where one practices, these are discussed, describing options

for credentialing that coordinate with interests and professional

needs. Finally, gestalt therapists have affiliated with one another

in various regional and even international associations. These are

described so that the reader can fully understand their similari-

ties and differences.

Training and certification often go hand in hand, but not always.

Some forms of training do not lead to certification, because the

professional landscape does not require it.

Beyond the issue of certification, though, is the issue of what it

takes to train a competent gestalt therapist.

231 232 Part IV Training and Certification

TRAINING

There are all kinds of training models that one might encounter in

the field of mental health. Formal academic requirements prevail

in most jurisdictions, but they are not uniform. Thus, in most places

in the United States, the term psychologist is restricted to those

with an earned doctorate, while psychological associate is reserved

for those with an earned master’s degree. In the United Kingdom,

someone with less than a doctorate can become chartered and

attain to the title of psychologist. In Europe a psychotherapy cer-

tificate is like licensing in the United States. Many gestalt training

institutes in Europe are accredited to grant such a certificate, and

so their training programs reflect the more stringent requirements

of a regulated field.

As can be seen in chapter 3, the gestalt therapy training insti-

tutes spread rapidly as those trained began sharing their newly

developed expertise with others, and the spread was in all direc-

tions: Europe, South America, Australia, and beyond. Joe Melnick

described that growth as follows:

The gestalt approach developed not in higher institutions of

learning but in evolving communities, in the gestalt institutes.

The growth of these institutes was influenced by a number of

varying factors that impacted the various institutes in differ-

ent ways. As a result, each institute, even today, is both differ-

ent and similar to other gestalt institutes. For example, they

differ in terms of training (short term vs. long term, beginner

vs. advanced students) scope of application (individual psycho-

therapy vs. organizational development), internal organization

(hierarchy vs. collective), theoretical approach (orthodox vs.

expansionistic), etc. However, they are similar in terms of a

large number of basic values, such as an emphasis on self-

awareness and personal experience, living in the here-and-

now, the co-creation of the moment, and a phenomenological

approach to experience. (Brownell & Melnick, 2008, p. 281)

Usually, the standard training program in gestalt therapy is 3

or 4 years. The 4-year program at the Gestalt Training Institute Chapter 11 Training, Certification, and Professional Development 233

of West Australia (Perth) starts with 100% experiential learning in

the first year. In the second year, trainees begin to augment expe-

riential training with supervision and reading, and by the third and

fourth years, the mix of experiential and supervision and reading

is 50%–50%. The Gestalt Institute of Cleveland, however, has no

multiyear program as such; they offer a cafeteria-style, elective sys-

tem of workshops and classes, some being prerequisites for others.

It is up to the trainee to take those workshops that directly ben-

efit and advance specific goals in personal and professional growth.

The Gestalt Training Institute of Malta is built on the model cre-

ated by the European Association for Gestalt Therapy (EAGT).

It provides what it calls a basic course in gestalt therapy during

the first and second years, and an advanced course in the third

and fourth. The Gestalt Centre of London breaks up a Master’s in

Gestalt Therapy Theory Studies into 3 years, with a fourth post-

master’s year for those who want a Psychotherapy Practitioner

Diploma. This reflects the growing trend toward accreditation of

gestalt therapy training programs in Australia, New Zealand, the

United Kingdom, and Europe more generally.

What people actually learn in these various years and systems

varies. In the regulated programs under the guidance of the EAGT,

subjects are made explicit, but when they are taken over the 4 years

required to complete the programs varies. Table 11.1 shows the

breakdown of EAGT course requirements.

I trained in the United States, where there is no regulated need

for certification. I was simultaneously completing a doctorate in

clinical psychology, so I knew that the demands of the profession of

clinical psychology would be met by completing my formal course

of study at the university—that, and the licensing process, which is

regulated at the state level.

In my training group were massage therapists and body workers,

one shamanistic counselor, a psychiatrist, several social workers, a

nurse, several licensed professional counselors, a college professor,

some students like myself, and one conductor of a national sym-

phony orchestra. In gestalt training groups, trainees commonly do

actual pieces of personal work, for when the trainees practice—

the experiential learning referred to above—they do not play a 234 Part IV Training and Certification

Table 11.1

EUROPEAN ASSOCIATION FOR GESTALT THERAPY CURRICULUM

REQUIREMENTS

Topic 1 History and Roots of Gestalt Therapy: philosophy; anthropology;

psychoanalysis; existentialism; phenomenology; gestalt theory;

Eastern philosophies

Topic 2 Theory of Gestalt Therapy: organism/environment field; figure/

ground resolution; creative adjustment; model of change;

authenticity; contact-withdrawal experience; theory of self;

awareness/consciousness; polarities; resistances; therapeutic

process, and so on

Topic 3 Human Organism and Environment: theory of personality;

health and sickness; child development; person in society

Topic 4 Techniques of Gestalt Therapy: experiment; amplification;

dream work, and so on

Topic 5 Diagnosis: differential diagnosis; DSM-IV; psychodynamic diag-

nosis; gestalt diagnosis

Topic 6 Different Clinical Approaches: neurosis; psychosis; borderline;

psychosomatic; addictions

Topic 7 Fields and Strategies of Application: individual; couple; fami-

lies; groups; addictions; therapeutic communities; organiza-

tions, and so on

Topic 8 The Gestalt Therapist in the Therapeutic Relationship: transfer-

ence; countertransference; dialogue; contacting

Topic 9 Principles and Applications of Ethics

Adapted from EAGT (2008).

role and assume an “as if” posture. No one says, “Now I’ll be a

depressed person and you can practice working with a depressed

person.” Rather, one trainee works as client and the other as ther-

apist for about a 20-to-30–minute piece of work, and it is around

the real figures of interest, the real issues in the life of the trainee

who is assuming the place of the client. When the piece of in situ

work is done, the other trainees typically offer the impact that had Chapter 11 Training, Certification, and Professional Development 235

on them, so those working feel supported, and then the training

group considers and discusses that piece of work so they might all

learn from it. The purpose of such an experience is to allow people

to learn what gestalt therapy feels like. Just as learning a foreign

language is often enhanced by immersion in an environment where

the language is spoken, these experiential pieces of gestalt work,

and the theoretical and supervisory debriefing that follows, provide

for a kind of immersion in the world of gestalt therapy.

Because gestalt therapy is what it is, this kind of experiential

learning is a must. It is not enough to read about gestalt therapy or

even to discuss it with colleagues. One must gain a “feel” for it. Here,

I am reminded of Schleiermacher’s construct of feeling in reference

to religious experience. He was against the hyper-rational approach

that created dry dogma detached from daily living, and suggested

instead that people needed to experience God and complement any

cognizing about God with feeling. In gestalt therapy, one must know

in one’s gut where to turn in the lively encounter with the client. It

is not enough to just think one’s way through it. One must combine

feeling with any cognizing about gestalt therapy, and that comes

through the experience of working as therapist, working as client,

conducting experiential exercises, and then debriefing the process.

There are core concepts that need to be learned, as seen in

Table 11.1. Every institute has a sense, either explicit in a tangible

curriculum or more implicit in the flow of working together, of

what a competent gestalt therapist knows and can do. Thus, in some

cases, an institute will also adopt a set of competencies that their

trainees must demonstrate before being certified. For example, the

Illawarra Gestalt Institute sees a relationship between core areas

of philosophy and core abilities in practice (Bar-Yoseph, Philippson,

O’Neill, & Brownell, 2008):

The practice competencies are to be acquired via theoreti-

cal understanding, demonstration and experimentation sup-

ported by on-going [sic] supervision. There is a need for an

ongoing honing of the student’s skills through feedback and

reference to theory. These skills are taught through each unit,

and are particularly focused on in the supervision meetings.

(Bar-Yoseph et al., 2008, p. 115)236 Part IV Training and Certification

What cannot be stressed enough is that gestalt therapy is not a

bag of tricks. It is not a set of techniques that can be patched into

an existing eclectic practice in the sense some people might say, “I

do a little gestalt.” Either one does gestalt therapy or one does not.

Either one practices a unified approach that uses, in a practical

therapeutic flow, all the major tenets of gestalt theory, or one rips

up the theoretical core of gestalt therapy and practices a counter-

feit hybrid that is essentially technique driven, but cannot be called

“gestalt therapy.” When gestalt therapists assimilate aspects of other

approaches, they identify consilient points of commonality in theory

and practice, and they digest those aspects so that what emerges is

a thoroughly consistent practice of gestalt therapy. It takes several

years of training to get to that point. Thus, to be trained to function

as a gestalt therapist, say for a research project in which therapists

followed a manual and provided gestalt therapy, requires that the

therapists in question stick close to the central theoretical core of

gestalt therapy outlined in this book and others (Brownell, 2008;

Houston, 2003; MacKewn, 1997; Woldt & Toman, 2005).

CERTIFICATION

Certification in the United States amounts to little more than a

given institute providing a piece of paper showing that so and so

completed one of their programs. That is because the regulation

of psychotherapy is handled by state governments, and it has more

to do with completion of a formal course of study at the university

than with completion of an ancillary training course.

As mentioned previously, however, certification in Europe and

Australia is part of the regulatory process, and gestalt therapy there

is well-situated to provide certification that satisfies regulatory rig-

orousness. Gestalt training institutes often struggle with the admin-

istrative demands necessary to satisfy government regulation, but

the benefit is that people practicing as gestalt therapist, having com-

pleted such a program, have a bit of “heft” to go with their training. Chapter 11 Training, Certification, and Professional Development 237

CONTINUING EDUCATION

Continuing education is usually available through various train-

ing institutes. Therapists can also attend the national and inter-

national conferences of various associations of gestalt therapists.

Novices or those outside the gestalt community (just looking to

pick up some needed continuing education credits), can contact

the closest gestalt training institute to see what might be available

or check out the Web site of a major association of gestalt thera-

pists and attend their next major conference. The Association for

the Advancement of Gestalt Therapy (AAGT) conducts an inter-

national conference every 2 years, and information about upcom-

ing conferences is available at www.aagt.org. Conferences not only

offer numerous workshops, but also introduce attendees to the

people who practice gestalt therapy. In addition to the biennial

conferences, regional conferences are also held in the southwest,

southeast, and northeast United States, and a growing regional

network promises increased development of regional conferencing

in other countries as well.

GESTALT TRAINING ORGANIZATIONS

The programs of training organizations themselves vary in scope,

cost, duration, and requirements. The reader would be best served

to use the world wide web to examine some of the institutes listed

in Table 11.2.

The information in Table 11.2 is not exhaustive; rather, it lists

select organizations based on criteria such as number of years as a

training organization, presence of significant faculty, contribution

to the field, and availability for inspection on the Internet. In addi-

tion, the reader can find European national gestalt organizations

with links to local training centers and institutes in most countries

in Europe, the Middle East, and Russia at http://www.eagt.org/

national_organizations_list.html.238

Table 11.2

EXAMPLES OF GESTALT TRAINING ORGANIZATIONS

NAME (LOCATION) FACULTY PROGRAMS CONTACT INFORMATION

Gestalt Associates Bob Resnick, Rita Gestalt therapy training for work www.gatla.org Training Los Angeles Resnick, and Todd Burley with individuals and couples

(Los Angeles,

California, USA)

Pacific Gestalt Gary Yontef, Lynne Training in relational gestalt www.gestalttherapy.org Institute (Los Angeles, Jacobs, Lillian Norton, therapy

California, USA) Jan Ruckert, Friedemann

Schulz

Portland Gestalt Carol Swanson, Jeffrey Training in gestalt therapy www.pgti.org

Therapy Training Sher

Institute (Portland,

Oregon, USA)

Gestalt Therapy Steve Zahm, Eva Gold, Training in gestalt therapy; begin- www.gttcnw.org Training Center- and Jon Frew ning and advanced groups

Northwest (Portland,

Oregon, USA)

Gestalt Institute of Numerous faculty includ- Training in gestalt therapy, orga- www.gestaltcleveland.org Cleveland (Cleveland, ing Marlene Blumenthal, nizational development, and

Ohio, USA) Michael Clemmens, and coaching

Isabel Fredericson

Gestalt Therapy Mary Lou Schack, Philip Training in gestalt therapy and www.gestaltphila.org Institute of Lichtenberg, David coaching

Philadelphia, Henrich

Pennsylvania, USA 239

New York Institute for Some members include Seminar approach to ongoing self- www.newyorkgestalt.org Gestalt Therapy (New Bud Feder, Dan Bloom, learning

York, New York, USA) and Susan Gregory

Gestalt Associates for Many faculty, among Four-year training program in www.gestaltassociates.org Psychotherapy whom are Alan Cohen, gestalt therapy

Ruella Frank, and Arleen

Maiorano

Gestalt International Edwin Nevis, Sonia March The Cape Cod Model of www.gisc.org

Training Center Nevis, Penny Backman, Individual and Couples Therapy;

Joe Melnick, and others Organizational Development

Gestalt Institute of JoAnne Greenham, Jay Training in gestalt therapy www.gestalt.on.ca

Toronto, Canada Tropianskala, and others

Gestalt Training Philip Brownell, Sue Training in gestalt therapy, orga- www.gtib.org Institute of Bermuda Congram, Talia Levin Bar- nizational development, and

Yoseph, Dan Bloom coaching

Manchester Gestalt Peter Philippson, Joy Training and supervision in indi- www.mgc.org.uk Centre, Manchester, Appleby, Danny Porter, vidual and group gestalt therapy

England others

The Metanoia Lynda Osborne, with many Training, Supervision, credentialed www.metanoia.ac.uk Institute, London, others course in gestalt therapy and other

England approaches

The Gestalt Centre of Michael Ellis, Toni Training in gestalt therapy and www.gestaltcentre.co.uk London, England Gilligan, and several organizational work

others

(Continued)240

EXAMPLES OF GESTALT TRAINING ORGANIZATIONS (Continued)

NAME (LOCATION) FACULTY PROGRAMS CONTACT INFORMATION

The Istituto di Margherita Spagnuolo Training and supervision in gestalt www.gestalt.it Gestalt, H.C.C., Italy Lobb, Giovanni Salonia, therapy; publishing of gestalt

and others literature

Institut Francais Jean-Marie Robine, Gestalt therapy training and www.gestalt-ifgt.com de Gestalt-théraie, Brigitte Lapeyronnie- supervision; publishing of gestalt

France Robine, and others literature

MultidiMens, Training in gestalt therapy and www.multidimens.be

Antwerp, Belgium and organizational work

The Netherlands

Gestalt Institut Köln, Erhard Doubrawa Training in gestalt therapy and www.gestalt.de

Germany publishing

Instytut Terapii Katarzyna Weglorz- Training and supervision in gestalt www.gestalt.pl Gestalt, Kraków, Makuch, Tomasz Rebeta, therapy leading to a European

Poland and others certificate; publishing the Gestalt

Magazine

Norsk Gestaltinstitutt, Daan van Baalen, Gro Training in gestalt therapy and www.gestalt.no Oslo, Norway Skottun, Svein Johansen, organizational development

and others

Moscow Institute of Oleg Nemirinsky, Olga Training in gestalt therapy and www.gestalt-therapy.ru Gestalt Therapy and Silnova, and others organizational work

Counseling, Russia1 241

Riga Gestalt Institute, Artur Dombrovsky, Training in applications of gestalt www.gestalt.lv Riga, Latvia Nikolay Shcherbakov, therapy to individual, couples and

Daiga Auzina, and Baiba families

Pumpina

Centro de Estudos de Elaine Magaldi Daemon, Training in gestalt therapy www.cegest.org.br

Gestalt Terapia de Fádua Helou, and others

Brasilia

Centro de Estudos Angelo Carlos Mineri, Training and supervision in www.gestalt.com.br e Atividades Christiane Silveira Becker gestalt therapy and organizational

Gestálticas, Brasilia Correa, and Mria Goretti development

Bunn Zomer

Instituto Humanista Myriam Munoz Polit and Extensive training program related www.gestalthumanista. de Psicoterapia others to gestalt psychotherapy com

Gestalt, A.C.

Sidney Gestalt Philip Oldfield, Rhonda Training in gestalt therapy in www.gestaltsydney.com Institute Gibson-Long, and others accord with GANZ guidelines

The Illawarra Gestalt Brian and Jenny O’Neill, Training in gestalt therapy and www.illawarragestalt.com Centre Seán Gaffney, and others couples work

Gestalt Institute of Brenda Levien, Stephen Training in gestalt therapy in www.gestalt.org.nz New Zealand Parkinson, and others keeping with national and GANZ

standards242 Part IV Training and Certification

PROFESSIONAL AFFILIATIONS AND GESTALT COMMUNITIES

Gestalt therapy is alive and evolving through the communal efforts

of gestalt therapists all over the world. What started in New York in

the mid-20th century has spread, and at this writing gestalt therapy

is more popular and prevalent in Europe and South America than

it is in the United States, its birthplace. National associations have

formed to support the individual gestalt therapists in those areas.

For instance, in Argentina the Asociación Gestáltica de Beunos

Aires serves as a national association of gestalt therapists and it

frequently sponsors national conferences. In England the Gestalt

Psychotherapy & Training Institute (GPTI) is actually a member

organization attending to training standards across the board in the

United Kingdom. It is a member of the United Kingdom Council

for Psychotherapy (UKCP) and can list its qualified members on

the Register for Psychotherapists. GPTI supports an e-mail discus-

sion list for the networking of its members and the discussion of

current and relevant topics in the field.

Beyond national groups like those mentioned above, however,

three multinational or international associations of gestalt thera-

pists stand out.

Gestalt Australia and New Zealand (GANZ) is an association

of gestalt therapists in these two nations. It holds conferences,

publishes a journal, and attends to the regulatory needs of gestalt

therapists who want to practice in those two countries. Because of

its need to advocate in the midst of an increasingly regulated envi-

ronment, GANZ also attends to training standards for its member

training organizations.

The European Association for Gestalt Therapy (EAGT) is much

the same kind of organization as GANZ, only it involves many more

nations in the European fold. It holds conferences but does not

publish a journal. It sees to training standards consistent with the

requirements in Europe and offers a certificate that qualifies as a

European authorization to practice psychotherapy.

Unlike either GANZ or EAGT, the Association for the

Advancement of Gestalt Therapy (AAGT), an international commu-

nity, has no regulatory function. It does not grant any certificates. Chapter 11 Training, Certification, and Professional Development 243

It is a member organization whose stated purpose is to advance

gestalt therapy through the associating of its members. The focus

is not on permission to practice gestalt therapy but rather on the

subject of gestalt therapy itself and the enjoyment of fellowship and

camaraderie with other gestalt practitioners. The AAGT is not geo-

graphically limited. It has a regional system with regional contact

people all over the world, and many of these regions hold mini-

conferences of their own. Biennial conferences are held in various

locations, where more intensive training and therapeutic experi-

ences are available in preconference format, and about 50 peer-

reviewed conference presentations are routinely offered within the

conference itself.

Many gestalt therapists are members of two or three such asso-

ciations: GANZ or EAGT and AAGT, and a regional subgroup of

the AAGT. They provide a well-developed network of support for

both individual members and organizational members.

As gestalt therapy continues to spread and to evolve, these two

kinds of associations—those largely focused on the advancement of

gestalt therapists and those focused on the advancement of gestalt

therapy—will continue to be needed. They represent two facets of

the same concern, for where gestalt therapists are shut out by regu-

latory and public policy decisions, the discipline of gestalt therapy

must be sublimated to some other approach.

CONCLUSION

More could be said about the diverse training approaches. Training

is sometimes done in an apprentice model, sometimes in a mentor

model, and sometimes in an academic model. Brownell, Levin, and

O’Neill (1997) offered several metaphors reflecting on such mod-

els and training practices. The various competencies many gestalt

training institutes expect their trainees to demonstrate for certifi-

cation, and how they ascertain such competencies, could have been

described in more detail, but these requirements vary and it is best

to consult the particular institute of interest for more information.

The original gestalt institute in New York, for instance, does not 244 Part IV Training and Certification

regard itself as a training organization at all; rather, it is a collegial,

membership organization that meets regularly for the presentation

and discussion of papers presented by its members.

Being a gestalt therapy trainer is a career in itself, because it is

an absorbing pursuit. Many people continue the trend set by the

early gestalt trainers, who traveled often great distances to offer the

gestalt approach to people who had never heard of it. Today, most

people have heard of it, but they often have a poor base in theory

and practice, having simply sampled gestalt techniques during a

graduate program. Today’s gestalt therapy trainers are also often

writers who are extending and evolving gestalt therapy theory (see

chapter 3).

NOTES

  1. As in many places, there is an extensive development of gestalt training organizations

and online resources in Russia. The following list of places and Web sites illustrates

that fact:

■ The Byelorussian Gestalt Institute (http://gestalt-by.org);

■ Workshop of the Gestalt of Elena Petrovoj (http://www.gestalt.sp.ru);

■ The Moscow Institute the Gestalt and Psiphodrem (http://www.migip.ru);

■ SPb Institute of the Gestalt (http://www.gestalt.spb.ru);

■ Moscow the Gestalt of Institute (http://www.gestalt.ru);

■ The East Europe Gestalt Institute—EEGI (http://www.vegi.ru);

■ One more site EEGI (http://www.vegizerkalo.narod.ru);

■ Moscow Institute Geshtaltterapii and Consultations (http://www.gestalt-

therapy.ru);

■ The Kiev representation, Moscow the Gestalt of Institute (http://gestalt.kiev.ua/

our_partners)

■ NIKA—a Gestalt the center in Kiev (http://www.nika.net.ua/);

■ Gestalt the Line—club of professional psychologists (http://gestaltline.com);

■ The Byelorussian Gestalt center (http://www.gestalt.by);

■ Mihail Papush center (http://www.psychotechnica.ru);

■ Articles on the Gestalt of therapy (http://www.kulichki.com/inkwell/special/

psyho/gestalt.htm);

■ Novosibirsk Gestalt the Center (http://gestaltnsk1.narod.ru);

■ Gestalt therapist, Polina Gaverdovskaja. Moscow (http://www.gaverdovskaya.ru);

■ Gestalt therapist, Jarosh Natalia (http://gestalt.in.ua/);

■ Nina Rubshtejn’s Educacional Center (http://rubstein.ru/);

■ Gestalt therapist, Shelepova Olga (http://www.psy.by/);

■ Gestalt therapist, Konstantin Loginov (http://www.psyforum.ru). Chapter 11 Training, Certification, and Professional Development 245

REFERENCES

Bar-Yoseph, T. L., Philippson, P., O’Neill, B., & Brownell, P. (2008). Training of thera-

pists. In P. Brownell (Ed.), Handbook for theory, research, and practice in gestalt

therapy (pp. 104–121). Newcastle, England: Cambridge Scholars.

Brownell, P. (2008). Handbook for theory, research, and practice in gestalt therapy.

Newcastle, England: Cambridge Scholars.

Brownell, P., Levin, J., & O’Neill, B. (1997). Ethics and training practices. Gestalt!, 1(2),

np. Downloaded June 26, 2009, from http://www.g-gej.org/1-2/issues-n-ethics.html.

Brownell, P., & Melnick, J. (2008). Gestalt therapy research communities. In Handbook

for theory, research, and practice in gestalt therapy. Newcastle, England: Cambridge

Scholars.

European Association for Gestalt Therapy (EAGT). (2005). The accreditation of gestalt

institutes, NOG’s and organizations. Downloaded March 14, 2008, from http://www.

eagt.org.

Houston, G. (2003). Brief gestalt therapy. London: Sage.

MacKewn, J. (1997). Developing gestalt counselling. London: Sage.

Woldt, A., & Toman, S. (2005). Gestalt therapy history, theory, and practice. Thousand

Oaks, CA: Sage.This page intentionally left blank Epilogue

This book has outlined the core of gestalt therapy theory and

practice. It has not tackled everything. Many people have written

thought-provoking essays on a multitude of facets in gestalt praxis,

and many more are exploring the still growing edges in gestalt

therapy. This has not, hopefully, been a watered-down version of

gestalt therapy, for I realize I have raised some difficult issues and

taken slants on them that not everyone would agree with. However,

this is a limited view, not necessarily a safe view.

The discussion has been limited to the core of gestalt therapy—

phenomenology, dialogue, field theory, and experiment—for the

purpose of making it more explicit. My interest here is in contribut-

ing to the establishment of a heuristic, an easily understood defini-

tion of what gestalt therapy is and how it is practiced. My critics

will say, “Well, you left out this,” and “You left out that.” Correct.

But I included those major tenets that make gestalt therapy what it

is, that hang together in a clearly unified approach, and that com-

prise a core that can also be researched.

One of my concerns is that gestalt therapy will generate its own

research tradition. In a dialogue in American Psychologist, Alan

Kazdin (2008, 2009) engaged his colleagues in an encouraging

discussion about the need for research to “bridge” to practice. He

suggested “evaluating the mechanisms of change in psychotherapy

so we know what is critical to include in practice, evaluating who

responds to treatment in ways that can be integrated into prac-

tice, and increasing the use of qualitative research” (Kazdin, 2009,

p. 276). His colleagues were energized and contributed several

thoughts of their own. Looking at this, I sense that gestalt therapy

is poised on a ledge and about to leap off. Gestalt therapists have

247 248 Epilogue

just begun to wake up to the possibilities in research, and I believe

we can contribute successfully to all of Kazdin’s forward-thinking

suggestions.

In 2009, the AAGT sanctioned the creation of a Gestalt

Research Task Force, and that task force is considering implement-

ing various initiatives in support of research, including research

into the mechanisms of change and the use of qualitative meth-

ods. The Handbook for Theory, Research, and Practice in Gestalt

Therapy is currently being translated into French, Spanish, Czech,

Chinese, Russian, and Korean. There is a growing way forward in

the expansion of gestalt therapy, including its active dialogue with

other modalities and its legitimate contribution to the fields of psy-

chotherapy, organizational consulting, coaching, and research.

I’m looking forward to seeing how it comes together.

REFERENCES

Kazdin, A. (2008). Evidence-based treatment and practice: New opportunities to bridge

clinical research and practice, enhance the knowledge base, and improve patient

care. American Psychologist, 63, 146–159.

Kazdin, A. (2009). Bridging science and practice to improve patient care. American

Psychologist, 64(4), 276–278.Index

Note: Page numbers in italics indicate tables

Acceptance and Commitment Therapy Contact-boundary, 58, 78

(ACT), 108 Convergence, 176–181

Adapted phenomenological method, 91–93 Counseling, 7

rules in, 90 Countertransference, 92

“Alpha press,” 137

Alterity, 98–102, 141, 190, 217 Description, 90

immanence, 98–100 Dialogical disclosure, 92

immanence vs. transcendence, 98–100 Dialogic attitude, 106–110

relation with gestalt therapy, 100–102 acceptance, 108–110

Assessment, 215 commitment, 110

as diagnosis, 198–199 presence, 107–108

gestalt, 203–204 Dialogue, 105–106, 141, 198

performance-based, 203 and the dialogical attitude, 106–110

as psychological testing, 199–204 intersubjectivity in, 106

self-report, 202 Discourse, 134–135

as a therapeutic process, 204–206 action as, 153–154

Association for the Advancement of Gestalt

Therapy (AAGT), 57, 63, 170, 237, 242 École Parisienne de Gestalt, 52

Attitude, 86–88 Ego function, 194

natural, 87 Emergence, 80–81, 104

phenomenological, 86–87 Epoché, 90

Awareness, 219 Esalen Institute, 22, 56

as compared to consciousness, 77 European Association for Gestalt Therapy

and contact, 103–104 (EAGT), 57, 58–59, 170, 233, 242

through experience creation, 158 Evidence-based practice, 14–15

Evidentialism, 14

Bar-Yoseph, Talia Levine, 64, 194 Experimentation

“Beta press,” 136 augmentation and its role, 160–161

Bloom, Dan, 61–64 and awareness, 158

Breuer, Josef, 4 bilateral vs. unilateral, 159

diminishing or suppressing, 163–164

Case conceptualization. See treatment enactment, 161–162

Cognitive behavioral therapy (CBT), 6, 75, 176 giving homework, 164

vs. Gestalt therapy, 76 nature of in therapy, 158

Consciousness role of imagination, 162–163

as compared to awareness, 77 Extra-therapeutic factors, 10, 135–136

Consilience, 13, 37, 173–174, 219

Contact, 102–105 Field theory, 37, 56, 91, 119

and awareness, 103–104 concept of, 120–122

definition, 103 the concept of “situation,” 123–124

249 250 Index

Field theory—Continued training and requirements, 232–236

“dimensions,” 124–125 as a unifying theory of psychotherapy, 173

interpretations of, 128–136 vs. cognitive behavioral therapy, 76

“layers,” 126 vs. phenomenological psychotherapy, 88

Lewin’s boundary, 127 Western influence on, 24–35

meaning of field, 122–123 noumenon vs. phenomenon, 25–26

perspectives of, 136–141 see also treatment

strategic principles for therapists, 142 Gestalt Therapy Institute of Los Angeles

unified field theory, 139 (GTILA), 53

First-person agent of experience, 77–78 Gestalt Therapy International Network, 51

Foundationalism, 13, 16 Global Assessment of Function (GAF), 199

Freud, Sigmund, 4 Global Assessment of Relational Functioning

From, Isadore, 47 (GARF), 199

Goldstein, Kurt, 31

Gestalt Associates Los Angeles (GATLA), 53 Goodman, Paul, 46

Gestalt International Study Center (GISC),

the, 48 Hermeneutics, 128, 216

Gestalt Journal, the, 47 and contextualization, 129

Gestalt therapy, 5, 8, 35, 176, 213 extratherapeutic factors, 135–136

and behavior, 150 figure forming process, 131–135

categorical system of assessment, 192 time, 130

characteristics of, 9 Holism, 169–171

characteristics of the theory of, 170–171 nomological, 169

and the concept of self, 78, 79 ontological, 169

concepts fundamental to, 97, 175 property, 169

contact in, 78–80 Homeworld, 88, 91

developmental trends, 56–67 Horizon, 88

and the dialogical attitude, 106–110 Horizontalization, 90

dialogical relationship in, 36–37

dimensional scaling, 193 Id function, 194

Eastern influence on, 22–24 Immanence, 98–100

ego as a function, 77 Inclusion. See acceptance under dialogical

and enactment, 150–152 attitude

and experience, 152–153 Intentionality, 30, 82–83, 85, 190

experimental options, 158–164 facets of, 83–88

and field theory, 37 Intentional object, 83

freedom for experimentation in, 37, 149, International Federation of Gestalt Training

154–157 Organizations (FORGE), 52

goals of, 90

as an humanistic approach, 21 Jacobs, Lynne, 59–60

and the middle voice, 85

originators, 44–47 Kim, Jungkyu, 66

as a phenomenological perspective, 30–31,

36, 89 Lewin, Kurt, 31, 120

and relationship, 111–113 Lobb, Margherita Spagnuolo, 57

relation with emergence, 80–81

relation with intentionality, 82–88 Meara, Alan, 65

research in, 66–67 Middle voice, 84–85

role of awareness in, 77 direct middle, 84

role of consciousness in, 77 indirect middle, 84

role of self-experience in, 81–82 permissive middle, 85

and spirituality, 68–69, 106 Minnesota Multiphasic Personality Inventory

trainees, 47–56 (MMPI-2), 200 Index 251

New York Institute for Gestalt Therapy, 46 warrant, 12–14

Noema, 83 coherency view of, 13

Noesis, 83 consilience, 13

Nonindependence, 141 evidentialism, 14

Noumenon vs. phenomenon, 25–26 foundationalism, 13, 16

Ontic field, 138, 223–224 Relational gestalt therapy, 60

see also “alpha press” Relationship, 111

meaning of, 112

Pacific Gestalt Institute (PGI), 53 nonindependent nature of, 112–113

Perls, (Fritz) Frederick, 22, 44–45 types, 111

Perls, Laura, 22, 45

Personality function, 194 “Self,” the, 78, 79, 194

Phenomenal field, 137–138, 223–224 Self-experience, 81–82

see also “beta press” Situational unit, 192

Phenomenological method, 30, 36, 75, 89–93, Substance monism, 80, 104

150, 179

effectiveness of phenomenal intervention, 93 “Talking cure, the”. See psychotherapy

Phenomenology, 89, 98, 215 Therapeutic attitude, 87, 91

Philippson, Peter, 60–61 Therapeutic dialogue, 58

Pneumenal field, 139–141 Transcendence, 98–100

Practice-based evidence, 15–16 Treatment, 216

Practice-based research networks (PBRNs), 15 case management, 223–225

Praxis, 6, 67, 107, 169 criteria for therapy planning, 222

gestalt vs. cognitive behavioral therapy, 6 evidence-based practice, 219

holism and its parts, 169–171 philosophical and ethical issues, 215–217

unity of, 169 ethical violence, 215

Property dualism, 80, 104 planning, 213–215, 220

Psychoanalysis, 7, 176 see also hermeneutics

Psychotherapeutic theory, 8

Psychotherapy, 7 van Baalen, Daan, 59

attributes of, 5 Voice, 83–86

effectiveness of, 11–12 active, 84

efficacy of, 11–12 middle, 84

evidence-based practice, 14–15 passive, 84

factors affecting, 10

and its origins, 4 Wheeler, Gordon, 56

practice-based evidence, 15–16 Worldview, 133

Notes

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