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Gestalt psychotherapy, as developed by Fritz and Laura Perls, Paul Goodman and others in the 40's, 50's and 60's is an integration of many different strands: Gestalt Psychology, Kurt Lewin's Field Theory, Wilhelm Reich and Body Work, Freudian Psychoanalysis, Theatre, Movement and Dance, Holism, Eastern Religion and Philosophy, especially Zen Buddhism, Existentialism and Phenomenology. (Clarkson & Mackewn, 1993) In the 70's, 80's and 90's it has been further developed and refined, by Zinker, the Polsters, Yontef , Hycner, Jacobs, Parlett, Latner, Kepner and many others.
We are born in relationship and develop our full humanness in relationship to other human beings. The child will learn how best to deal with the human environment in which he finds himself; he will creatively adjust his responses so as to get the most of what he needs from the people around him, especially his parents or other principal carers. As he grows up he may find that this once useful creative adjustment becomes rigid: a fixed way of relating to the world. This rigidity will cut him off from a full a range of behaviour and feeling. Psychotherapy is an opportunity to relate to another person who is willing, for the duration of the therapy, to set aside his own needs, opinions and desires and to offer what Hycner and Jacobs term 'the healing relationship' (1995).
Healing is through dialogue, the full, open, honest contact of one human being with another. Within Gestalt Psychotherapy, the therapist offers a dialogic relationship to the patient.
‘By the dialogical is meant the overall relational context in which the uniqueness of each person is valued and direct, mutual, and open relations between persons are emphasised, and the fullness and presence of the human spirit is honoured and embraced. It is more of a heartfelt approach than a theory Perhaps the most essential healing component in therapy is the dialogic attitude of the therapist.’ (Hycner & Jacobs, 1995:4-5)
The dialogic relation is offered by the therapist holding an 1- Thou attitude towards the patient (Buber) .This is different from the 1- Thou moment, 'the moment of fullest contact of a person's being with another person'. (Hycner and Jacobs, 1995:58)
This may or may not happen within the therapy; it will depend on both the therapist's and the patient's capacity to surrender to this possibility .It cannot be planned or sought as a goal but may happen in a moment of grace (Hycner). In that moment, the roles of therapist and patient become irrelevant; 'the I -Thou moment is a moment in which we are totally absorbed with another, which paradoxically puts us profoundly in touch with our humanity, with the knowledge of being; in this moment the meaning of human existence is revealed.' (Ibid p.58)
The therapist, as a precondition for dialogue, is present, in the sense of 'turning towards' the other, the patient.
'The preliminary, yet essential step in establishing the possibility of a genuine, dialogical connectedness is a 'turning' of my whole person to the other, in order to better engage this person. This 'turning toward the other' is inevitably a momentary turning away from being preoccupied with my self. This 'turning toward' is far more encompassing than what is ordinarily meant by 'attending'. It is viewing the other in his/her unique 'otherness' - which is different from me and any of my needs. Presence is a difficult quality to define. Yet its absence is readily apparent. More than a 'quality', it is an existential stance. It is bringing all of myself to bear in this moment with this person- No other concern is paramount. It is a letting go of all my technical concerns and 'goals'. The only goal is to be fully present -paradoxically a goal that is not achievable by technique. ' (Ibid p.15 -16)
The therapist 'turns towards' the patient and offer real, human contact (which may include being silent) within the therapeutic hour. The patient will, in various ways, block, distort or turn away from contact: with the therapist and with his own feelings. If he does not do this, he does not need to be a patient. The therapist's task is to assist the patient in becoming aware of how he refuses contact: this is the work of raising awareness.
Techniques or experiments such as the suggestion that the patient speak as aspects of a dream or fantasy, may be used to help the patient become aware of how he refuses contact, with the therapist and with himself. (Zinker,1978) Such techniques should always be introduced as a creative exploration of the actual situation, which is emerging. Automatic or mechanical interventions deaden rather than enliven the patient's experience.
The therapist practises inclusion towards the patient, this is 'a willingness to enter into the patient's phenomenological world' (Hycner and Jacobs, 1995:70) He also practises confirmation, which means that 'the person is apprehended and acknowledged in his or her whole being' (ibid p. 71 ). He is authentic, that is, he will be completely open and truthful, in word and spirit. This does not mean indiscriminate self-disclosure or that he says whatever comes into his head. He will choose to speak and act only in the service of the patient's growth and will bracket assumptions and judgments in order to attend to and respond to the patient's reality.
Phenomenology holds that we experience the phenomena of the world, rather than reality, which we cannot know directly. We construct our experiential world and imbue it with ever changing meaning. Although we share constructs and meanings with some or most other human beings (for instance that this page is white, that I am writing a thesis) our experience is unique and cannot be fully apprehended by another. Thus, writing this thesis has certain emotional meanings for me, which I could discuss with another but which no other person could fully understand.
The phenomenological method, as practised by Gestalt psychotherapists, amongst others, involves The Rule of Epoché, or bracketing our own prejudices and judgments, being open to immediate experience, The Rule of Description, where we refrain from interpretation or theorising and The Rule of Horizontalization, where whatever is described has equal significance (Spinelli, 1989). To express this simply, we are interested in how our patients construct and experience their worlds and seek, as far as possible, to understand their experience and to help them explore, clarify and deepen this experience Within the therapeutic relationship, we are also interested in our own phenomenology and may share this with the patient, where we believe that this will serve the patient's growth.
'It is impossible for there not to be transference.' (Ibid, p.110) Both therapist and patient will bring to the relationship ways of being, which are grounded in past experience and, especially, unmet, archaic needs. Hopefully these will be more pressing in the patient than the therapist. Their manifestation within the therapeutic relationship means that the affectively highly charged experiences of the past come alive in the here-and-now encounter and can be understood, worked through and transcended.
The therapist needs both to be fully present and also to be aware of and to understand transference. Other aspects of the therapeutic relationship: the working alliance, the developmentally needed or reparative possibility and the transpersonal dimension (Clarkson, 1995) must also be held in awareness.
Of course the therapist, being human, will sometimes fail to offer the high level of availability, understanding and openness that my brief discussion of Gestalt therapy has described. This inevitable failure is also important: the repair, which may follow, is one of the most healing aspects of therapy.
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