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
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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.
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[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.
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
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.
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,
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.
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
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.
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
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.
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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American Psychological Association. Presidential Task Force on Evidence-based
Practice. (2006). Evidence-based practice in psychology. American Psychologist,
61(4), 271–285.
Bankart, C. P. (1996). Talking cures: A history of western and eastern psychotherapies.
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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.
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
wide.
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).
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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
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
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
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
Schuster).
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).
Gestalt-thérapie, starting in 1996, published by Collège Européen de Gestalt-
thérapie de langue Française.
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).
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).
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).
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
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.
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
p. 304).
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.”
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.
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.
belongs.
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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.
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
Germany: United Bible Societies.
Jacobs, is a central influence for this emphasis in gestalt therapy.
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
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
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
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.
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.
see Dominique Janicaud’s (2001) critique of this turn toward theology. Chapter 6 Use the Context of Life 145
pneuma.
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Wolterstorff, N. (1995). Divine discourse: Philosophical reflections on the claim that
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
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.
experiment.
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Gallagher, S., & Zahavi, D. (2008). The phenomenological mind: An introduction to phi-
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11(1), 3–16.
Greenberg, L., Auszra, L., & Herrmann, I. (2007). The relationship among emotional
productivity, emotional arousal and outcome in experiential therapy of depression.
Psychotherapy Research, 17(6), 482–493.
Kim, J., & Daniels, V. (2008). Experimental freedom. In P. Brownell (Ed.), Handbook
for theory, research, and practice in gestalt therapy (pp. 198–227). Newcastle,
England: Cambridge Scholars.
Melnick, J., Nevis, S. M., & Shub, N. (2005). Gestalt therapy methodology. In A. Wold
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(Vol. 2, pp. 392–406). Grand Rapids, MI: Zondervan.
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Cambridge, MA: The Belknap Press of Harvard University Press.
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and human experience. Boston: MIT Press.
Watson, J. B. (1924/1997). Behaviorism. Piscataway, NJ: Transaction.
Wojtyla, K. (1979). The acting person: Analecta Husserliana, the yearbook of phenom-
enological research (Vol. X). Dordrecht, Netherlands: D. Reidel.
Wolterstorff, N. (1995). Divine discourse: Philosophical reflections on the claim that
God speaks. Cambridge, England: Cambridge University Press.
Yontef, G., & Jacobs, L. (2007). Gestalt therapy. In R. Corsini & D. Wedding (Eds.),
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.
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,
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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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-
A DIMENSIONAL ASSESSMENT APPROACH FOR GESTALT THERAPY
STEP DIMENSIONAL SCALING
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
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
is the process of figure formation and <––– ––>
resolution? Not flexible; Flexible, showing
no development fluid development
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
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
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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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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theory, research, and practice in gestalt therapy (pp. 90–103). Newcastle, England:
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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
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
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
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
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
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
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