Gestalt Therapy Theory - An Overview - Maria Kirchner

GESTALT THERAPY THEORY: AN OVERVIEW: MARIA KIRCHNER Handbook for Theory, Research, and Practice in Gestalt Therapy: Philip Brownell: Many books have been written about gestalt therapy. Not many have been written on the relationship between gestalt therapy and psychotherapy research. The Handbook for Theory, Research, and and Practice in Gestalt Therapy is a needed bridge between these two concerns, and a timely addition to scholarly literature on gestalt therapy itself. In 2007 an international team of experienced gestalt therapists devoted themselves to create this book, and they have collaborated with one another to produce a challenging and enriching addition to the literature relevant to gestalt therapy. "I recommend this book to anyone who is serious about practicing his or her craft better by supporting it with a broader base, one that demonstrates that merging existential phenomenology with phenomenological phenomenol ogical behaviorism can produce produce verifiable, verifiable, replicable replicable results results for what is essentially an idiographic pursuit." – Edwin C. Nevis, Ph.D. "I applaud Dr. Brownell's thoughtful perspectives on expanding gestalt therapy's dimensions. By his focus on the role of research he is creating the third leg of a tripod composed of thoery, practice and research, promising increased balance and support for gestalt gestalt therapy's procedural positions." – Erving Polster, Ph.D. Abstract: This article is intended to give the reader an overview of Gestalt therapy theory, starting with a short introduction and a definition in its broadest sense. It will then proceed to highlight Gestalt therapy’s philosophical roots and expound the Gestalt view of human nature. A succinct elaboration elaborati on on basic principles prin ciples of Gestalt Gestal t therapy theory, theory, a short exploration exploration of the nature of human functioning and dysfunctioning, and a listing of major methods of Gestalt therapy follows. The remainder of the article summarizes research within the Gestalt approach, reflects on limitations, and includes multicultural considerations. Introduction: Kurt Lewin stated, "There is nothing as practical as a good theory." This being true for all therapeutic modalities, modali ties, it applies to Gestalt therapy therapy as well. Excitement, Excitement, awareness, awareness, contact, and dialogue are all crucial elements that come to life in the therapeutic encounter. Being theoretically anchored and able to conceptualize the therapeutic change process is a prerequisite for contributing to the effectiveness of any therapeutic encounter and therefore growth. growth. Defining and describing theoretical concepts, however, cannot capture the excitement excitement and vitality that is the vehicle for good contact, deepening of awareness and the powerful choices one can access with all their multi-dimensional multi-dim ensional ramifications. ram ifications. DEFINING THE FIELD: A Gestalt therapist addresses the person as a functional, organismic whole that strives towards higher levels of potentiality, actualization, and integration within and as part if its i ts organism/environment organism/environ ment field. Ultimately, this results results in growthful growthful change change and mature self-expression. Gestalt therapy's theory is foremost a theory of growth and education with the focus on health and not on pathology (Latner, 1986). The German word gestalt cannot be translated into an equivalent, single si ngle English term. It encompasses such a wide variety of concepts: concepts: a shape, a pattern, a whole form, and a configuration. Gestalt therapy draws on all of these meanings, meanings, with equal emphasis on the organized whole and on the notion of pattern. Gestalt therapy is a holistic, process-oriented, dialogical, phenomenological, existential, and field theoretical approach to human change with the centrality of contact, awareness, and personal responsiveness and responsibility. Primacy is given to the uniqueness of the individual. The person is never reduced to parts and structural entities but viewed as an integrated whole with innate potential of growth and mature self-expression. Of crucial importance is the interplay between

biological maturation, environmental influences, interaction of the individual and the environment, and creative adjustment (Yontef, 1933). Gestalt therapy is about the aliveness and excitement, the awareness of choice everyone has in creating their lives. The Gestalt that Fritz Perls created, as the official founder of Gestalt therapy (he prefered to be called the finder or re-finder), is predominantly a synthesis of many existing elements and concepts interrelated into a meaningful, new whole. He wove the new Gestalt out of different bodies of knowledge and disciplines, and was particularly influenced by existential philosophy, phenomenology, holism, humanism, Gestalt psychology, bio-energetics, orthodox and interpersonal psychoanalysis, and Eastern philosophies (Clarkson & Mackewn, 1993). The Zeitgeist, the historical and cultural situation that prevailed during his lifetime in combination with numerous political upheavals, and his exposure to different cultures, left clear marks on this revolutionary new theory. Philosophical Roots: Existential philosophy, which began with Kierkegaard and was further developed by Marcel and Marleau-Ponty, focuses on existence as individual existence. Issues of the existential meaning of freedom, destiny, and the existence of God are of major importance (Wulf, 1998). Other contributions came from Sartre and Heidegger with responsibility, freedom, and authenticity at their center. Phenomenology, which grew out of existentialism, is a philosophy that advocates “going to the things themselves,” conceived as a faithful and unbiased description of consciousness. The focus is on studying consciousness in its subjective meaningful structure and function. Edmund Husserl, the founder and principal exponent of phenomenology, whose ideas were embodied in the concepts of awareness and the here-and-now, had a particularly powerful impact on Perls. Holism, and the concept of the whole, were taken up by Jan Smuts (1926) in Holism and Evolution. Smuts considered the organism to be a self-regulating entity with metabolism and assimilation being fundamental functions of all organic wholes. The holistic notion became the epitome of GT with the basic idea that everything is inevitably interrelated and mutually dependent on each other. The whole is more than, and different from, the sum of the individual parts. Thus, any attempt to dissect its aspects is doomed to destroy its nature. One crucial principle of holism is its configuration of a coherent and unified aggregate consisting of lesser wholes. A holistic approach to the human organism embraces and affirms complexity, inclusion, diversity, and resists inexorably any form of reductionism (Wulf, 1998). Humanism, as a multifaceted approach to human experience and behavior, focuses on an individual’s self-actualization and uniqueness, with choice and integration ensuing. The overlap of existentialism and humanism is rich in potential for greater understanding of the human experience and for greater effectiveness in the effort to enrich that experience (Bugental, 1965). Wertheimer, Koffka, Koehler, the representatives of Gestalt psychology, demonstrated that an individual organizes his/her perceptions into meaningful sets. This principle of perception became a basic concept in GT that included the organism’s tendency to perceive wholes even where information is missing. Goldstein’s organismic theory stressed the organismic integrity of individual behavior and its drive to self-actualization. In this theory, combined with Gestalt Psychology, Perls found the ideas for his homeostasis, top-dog and under-dog, contact and withdrawal, and figure-ground formation. Lewin’s field theory was extremely significant and became one of the fundamental pillars upon which Gestalt therapy theory rests. The field concept believes that all organisms exist only in environmental contexts with reciprocal influences on each other. As a corollary, no individual can

be understood independently of his/her surrounding field. Buber’s philosophy of dialogue, dialogic element in the form of the I-Thou relationship, was innovative for integrating the “between”. In Buber’s sense, all living is meeting of a human being with another human being, which equals existence. There is no “I” without an “It” or a “Thou”. In the full meaning of this philosophy, the I-Thou relation, or dialogue, can be understood as a special form of the contacting process (Jacobs, 1989). From Wilhelm Reich, GT borrowed the notion of character armor and body therapy (bio-energetic). It was conjectured that physical tensions are related to the psychological ones. The body is assumed to be the expresser and at the same time the repository of the problems and experiences of the individual. Perls integrated the manifestations of skeletal and muscular armor in chronic character disturbances as the end-result of unresolved emotional conflicts. Although Perls criticized Freud’s psychoanalysis and its variations, its influence on Gestalt therapy is undeniable. Drawing from his psychoanalytic training, Perls used Freud’s developmental sequence as ground for much of his clinical work. He replaced the sexual instinct with the hunger instinct and frequently drew analogies with mental metabolism. From interpersonal psychoanalysis, especially Karen Horney and Harry Stuck Sullivan, Perls adopted a less detached and more active therapeutic stance in addition to their environment-oriented view regarding psychopathology. All ‘forefathers’ and ‘foremothers’ of Gestalt therapy were familiar with eastern philosophies and mysticism, especially Taoism and Zen Buddhism. Living in the moment and transcendence pervade most of the above-mentioned currents that together form the roots of Gestalt therapy. The roughly 50-year-old Gestalt therapy has evolved and changed, built upon and reacted to the root contribution made by Fritz Perls, his wife Laura Perls, and Paul Goodman. THE GESTALT VIEW OF HUMAN NATURE: Gestalt therapy's view of human nature is grounded in four major concepts: biological field theory, the entity of the organism, the need for contact and relationship, and the capacity for making wholes. Biological field theory The field concept believes that all organisms exist in environmental contexts with reciprocal influences on each other. No organism can be reduced to separate components but can only be understood in its organized, interactive, interconnected, and interdependent totality. Every field, be it experiential, social, cultural, etc. is part of a unitary dynamic process. No organism is powered only from within or impacted only from outside, but co-created. Theory of the organism: An organism is an ordered whole, intrinsically self-regulating individual, seeking growth towards maturity and the fulfillment of its nature. Organismic behavior is purposive and goal-seeking, not random. External controls, whether or not internalized, interfere with the healthy working of the organism and its self regulating. Organismic functions include many dimensions: physical, cognitive, emotional, aesthetic, spiritual, interpersonal, social, and economical, each being of equal importance. Concept of contact Contact, as the “lifeblood of growth” (Polster & Polster, 1980, p.101), is paramount for survival and change. It is understood as the responsive meeting with the other (environmental and internal others, i.e., alienated aspects, blocked feelings, thoughts, and memories, whatever is not integrated and therefore experienced as other). It is also the forming of a figure against a ground and defined as “the creative adjustment of the organism and the environment” (Perls, et al. 1956), neither one existing without relating to and being informed by its counterpart. Consequently, relationships are indispensable with relatedness being an irreducible fact of existence (Buber, 1970). Whole-making capacity: Human beings are whole-makers, synthesizers of a wide variety of bodily, perceptual, cognitive, behavioral, and existential gestalts (Crocker, 1999). Learning and change is the result of how an individual organizes his/her experiences and assimilates novelty.

Human beings can neither refrain from meaning making nor from organizing and reorganizing themselves as they have new experiences. Our “wiring for meaning” (Wheeler, 1998) always emerges contextually and relationally. Basic Principles of Gestalt Therapy Theory: Gestalt therapy theory holds a non-materialistic and anti-reductionist position that disavows dualistic and linear thinking. Like all psychotherapies, Gestalt therapy is an approach to human change. Change, however, is not directly aimed at but viewed as an inescapable product of contact and awareness, considered together with their interruptions and/or various degrees of absence. CONTACT: The essence of human life is contact, a meeting with various kinds of others. Every organism is capable of effective and fulfilling contact with others in their environment and pursues ways of having contact with others so that the organism can survive and grow to maturity. All contact is creative and dynamic and, as such, each experience unfolds as a creative adjustment of the organism in the environment (Perls, Hefferline & Goodman, 1951/1994). Contact is the forming of a figure of interest against a ground within the context of the organism-environment field (see figure/ground formation and destruction). It is also defined as “the awareness of, and the behavior toward, the assimilable; and the rejection of the unassimilable novelty” (Perls et al., 1951/1994, p.230). To have the opportunity for functional and existential contacts in the field, as well as the strength to repudiate and/or sustain unhealthy contacts, is the quintessence of growth and change. Processes of contact: There are three major ways of conceptualizing the process of contacting, which is in general a sequence of grounds and figures: The four stages of contact were originally described by Perls, Hefferline, and Goodman, 1951, as fore-contact, contacting, final-contact, and post-contact. This original theory was extended by the Gestalt Institute of Cleveland into the Cycle of Experience (COE) which reflects the following seven stages: sensation (1), awareness (2), mobilization of energy (3), action (4), contact (5), resolution and closure (6), and withdrawal (7). A newly proposed model (Crocker, 1999) is referred to as the Self-Function Analysis of Contact which includes the following six functions of the self: interested excitement; decision-making; choosing; past assimilation of experience, beliefs, attitudes, and ways of thinking; learned patterns (habitual) of response; and styles of contact (and withdrawal). A therapist’s interventions are guided by the place and the degree of difficulties and blockages a person experiences within those six areas. Interruptions of contact Since every contact takes place at the contact boundary, where the organism and the environment meet, every interruption or distortion of contact was/is also called a contact boundary disturbance (Perls et al.), or an interruption of self-regulations (Polsters). There are four major interruptions of contact, which all result in loss of ego-functions: confluence, introjection, projection, and retroflection. In addition, there are the concepts of egotism (Perls et al., 1951/1994), deflection (Polster & Polster, 1973), and proflection (Crocker, 1981). Every interruption reflects the client’s organization of his/her experience. Therefore, it is paramount to work towards change in the ground that supports the experience. Confluence: the condition of no-contact. Instead of an ‘I’ and a ‘You’ there is a ‘we’ or a vague, unclear experience of him/herself. Introjection: the individual experiences something as him/herself when in fact it belongs to the environment (false identification). Projection: the individual experiences something in the environment when in fact it belongs to him/her (false alienation). Retroflection: the individual holds back a response intended for the environment and substitutes it

with a response for him/herself. Confluence, introjection, projection, and retroflection are often in the service of health and are only detrimental to healthy functioning without awareness (e.g. an artists projects into a picture; an employee chooses not to explode at her boss; the confluence of individuals during orgasm). Organismic self-regulation: Self-regulation is a process in which the organism strives for the maintenance of an equilibrium that is continually disturbed by its needs and regained through their gratification and elimination. If functioning properly, it leads to integrating parts with each other and into a whole that encompasses the parts. As self-organizing systems, human beings have the natural capacity to constantly reorganize themselves as they adapt to changing circumstances, assimilate, accommodate, and/or reject influences of others with which/whom they interact. A disturbance of organismic self-regulation happens when contacts are interrupted. Most of the clinical work in Gestalt therapy centers on these interruptions, as they occur in the moment at the contact boundary. The paradoxical theory of changeThe paradoxical theory of change is one of the fundamental organizing principles in Gestalt therapy, with far-reaching implications. Only by being what and who one is can one become something or someone else. Effort, self-control, or avoidance focused exclusively on the future will not bring about change. We must become our truth (ourselves) first before we can move from it (change). Vice versa, if we try to be different without finding what is true for us, we are following someone else’s truth and will not bring about the long-term change to which we aspire. All the energy that can get locked up in the battle between trying to change and resisting change can become available for active participation in our life processes. External as well as internal controls interfere with the healthy working of an organism. Phenomenology: Phenomenology in its broadest sense is a philosophical doctrine that advocates the scientific study of immediate experience as the basis (subject matter) of psychology. A phenomenological attitude is one of openness and humility in the presence of the other with genuine interest in, and profound respect for, the other’s way of creating meaning, seeing, experiencing, and organizing the world. Approaching another person phenomenologically implies focusing on the obvious revealed by the situation in the moment and avoiding interpretation and prescription. The main concern is the immediate grasp of being (what is) and the meeting of the other person within his/her organism/environment field, without preconceptions, presuppositions or speculations.It is not of great importance why clients are as they are; instead, the search for understanding and awareness of their process becomes foreground. Unconditioned acceptance and the bracketing of one's own experiences and preconceptions are the basis for any phenomenological approach. Awareness: Awareness is the beating heart of Gestalt therapy. The fluidity of awareness is equivalent to the perceptual flow of figure/ground (Crocker, 1999). Awareness is always intentional and occurs in the organism-environment field. Characterized by contact, sensing, excitement, and Gestalt formation it is a subjective experience, a being in touch with one’s own existence inclusive of all senses at a given moment. It is more than the pure thought of a problem but is integrative, implying wholeness, allowing for appropriate responses to a given situation in accordance with one's needs and the possibilities of the environment. Different awareness can come to the foreground at different times. It is the person’s awareness of his/her complexity within and inclusive of the field that manifests itself in uninterrupted organismic self-regulation, meaningful growth and long-term change. Consequently, awareness is integral to dialogical relations. Dialogue: The dialogical principle is based on the I-Thou philosophic anthropology of Martin Buber. It assumes that individuals are made fully into people through the meeting between them (Buber, 1970). Intrinsically interrelated with phenomenology and the here-and-now focus is the

openness to and courage for the fluid experience of bringing oneself to share with another in therapy. This attitude of openness to truly meeting the other is the I-Thou stance taken as therapist, but it is not to be identified with the meeting itself. A Gestalt therapist who commits to an I-Thou stance engages in two phenomenologies, his/her own and the client’s (Resnick, 1995). Dialogue is centered in neither person but originates in both (Hycner, 1990) pointing to the genuine meeting between two people with the power of creating something new rather than adding up two states. Dialogue is a special form of contact that becomes the ground for deepened awareness and self-realization (Jacobs, 1989). Here-and-now focus: The quintessence of all processes in Gestalt therapy is the here-and-now focus as it is implicit in the phenomenological foundation. Past and future get their bearings continuously from the present and have to be related to it for meaning to occur. Present-centeredness does not deny the importance of the past or the future; rather, it insists that those aspects of time exist in the present as nostalgia, regret, resentment, fantasy, legend, and history or as anticipation, planning, rehearsal, expectation, hope, dread and despair (Perls, 1976). Reality exists in the moment as a novel experience. If attended to, it can lead to personal growth. Predilection of past or future destroy present contact, and lack of contact with the present leads to flight into the past or the future. THE CONCEPT OF THE SELF: The self in GT is not a reified unit but a process, constantly changing according to needs and environmental stimuli. It is defined as “the system of contact at any moment” (Perls, Hefferline, & Goodman, 1951/1994). It does not exist prior to and apart from relationships. Self-experience is constituted exclusively in and by relationships. There is no self independent of field or contact, it is rather “something given in contact” (Goodman, 1951/1994) that comes to life in the encounter with the world. As such it is the agent of growth, dynamic, and the product of relational experiences. Consistent with field theory, the purpose of the self is to unify the whole field, and the self in this process is the agent and/or process of that unification. The self simply comprises what constitutes the field (Parlett, 1991). According to Crocker (1999), the self, as the process that occurs at the boundary, can be separated into six functions: interested excitement; decision-making; choosing; whole-making; habit-formation; contact and withdrawal. Individuals organize their experiences as much as they are organized by their experiences and therefore an analysis of the self’s functions gives insight into how individuals use levels of awareness to solve problems of contact with the environmental field. Figure/ground formation and destruction The process of figure/ground formation and destruction is dynamic. What emerges in the foreground is the figure. It is contrasted against its background, or that which does not become the focus. Taken together, they comprise the gestalt. In a healthy, functioning organism there is a natural spontaneous flow between figure formation and destruction, and that is the basic, dynamic process in which contact occurs. An individual’s history is the background of his/her existence. Disturbances in the background need to become foreground in order to be attended to. In every figure-ground formation, new figures succeed one another with the person being an energetic participant. Loss of faith in the natural process of figure-ground formation prevents reacting to and engaging in novelty. Movement stops. Unfinished business: It is assumed that it is an inherent drive of an organism to organize the field in a way that gestalts reach closure. Each incomplete (unclosed) gestalt represents an unfinished situation, which interferes with the formation of any novel and vital gestalt. Whenever closure has not been accomplished, interference with free functioning occurs. Instead of growth, one finds stagnation and regression (fixed gestalten, stuck points, or impasses).

Ego functions:  Ego functions enable the individual to identify: What is needed, desired, ‘felt’, wanted, sensed physically, inclusive of an accurate sensory perception of the environment (Id-function). Who one is as a person, i.e. to accurately describe, know, identify the type of person one is and how one characteristically functions (Personality-function). Id and personality functions refer to processes of identification carried out with the ego functions. Goal of Gestalt Therapy: The ultimate aim of Gestalt therapy is to assist the client in restoring (or discovering) his/her own natural ability to self-regulate as an organism and have successful and fulfilling contact with others (environmental others), as well as with disowned aspects of oneself (internal others). That allows one to be able to cope creatively with the events of one’s life and to pursue those goals which seem good and desirable to oneself. Through awareness of and experimentation with bodily sensations, emotional responses, desires, and cognitive assumptions, the clients’ range of choices about how they live their lives, especially how they engage with others and themselves, will be enhanced. The question of foremost interest is HOW a person is creating his/her life in a certain way not WHY they came to be as they are. Accepting someone’s experiential validity is key rather than manipulating occurrences and outcome. The Nature of Human Functioning: In good human functioning the psychologically healthy human being is a person whose organismic self-regulation is working properly. New gestalts emerge with fluidity and are completed. Since all parts of the self are integrated and available, the individual responds adequately to wants and needs (Id functions), and to what happens in the environment. One is capable of realistically evaluating the situation and responsibly initiating actions in accordance to who one is (Personality functions) and what the situation requires. Sufficient self-support and behavior mirrors a freshness of response with a clear-sightedness and willingness to take on responsibility (pro-active instead of re-active). The person with psychological health lives in the present moment with awareness, cognizant of the past and filled with excitement of the future. To move with vigor and liveliness towards higher levels of growth is healthy functioning. The Nature of Human Dysfunctioning: Psychological dysfunction is never viewed as a mental disorder but as an organismic or growth disorder (no mind/body dichotomy). In dysfunction there is a loss of a clear internal awareness (needs, wants, and desires) and self-responsiveness (experiences and good contact). The free flowing and flexible contact is blocked and/or distorted, erroneous conclusions about the world, other people and him/herself are drawn and acted upon. All forms of human psychological dysfunction are attempts at simplifying experience, alleviating uncomfortable feelings, or managing difficult adjustments. Therefore, they are considered “creative adaptations to inhospitable situations in a person’s life” (Crocker, 1999, p.134). The Self becomes fixed and the person presents him/herself with inauthentic layers of existence (cliché, role, impasse). Authenticity is dimmed, and reified patterns occur. Self-support is limited, and excessive environmental support is sought through manipulation. In terms of an individual’s self-functions, psychological disorder exists when a client’s experience is, in part, created by a loss of Ego-functions, which result in disturbed contact due to disturbed Id- and/or Personality-functions. A client who has a diminished range of ego-functions is unable to identify with id- and/or personality-functions and therefore engages in unaware confluence, introjection, projection, and/or retroflection with one or more of these contact interruptions dominating and forming a pattern (style of contact). METHODS OF GESTALT THERAPY: The central focus of the work of a Gestalt therapist is on contact. This includes the plethora of all complex internal responses and external patterns of behavior that are employed in the contact process. Contact is the defining characteristic of all of the methods Gestalt therapists use in order to bring about change. The methods of Gestalt therapy

comprise basically five groups: therapeutic relationship, phenomenological method, experiment, work with cognition, and work with the wider field. The therapeutic relationship: An authentic, nonjudgmental, dialogic relationship between client and Gestalt therapist is the crucible of change. In order to exchange phenomenologies, a Gestalt therapist must bring a willingness and capability to be present as a person in the therapeutic encounter, inclusive of his/her inner world, sense of experience, knowledge, skills, etc. and a genuine interest in understanding the client’s subjective experiences and needs from the environment (I-Thou stance). Both create the relationship and allow a figure to emerge from the dialogue. Verbal as well as nonverbal behavior is considered a valuable part of the encounter to discover together the quality of experiences, awareness, beliefs and typical patterns of contact. Phenomenological method: With a phenomenological attitude the Gestalt therapist is open to and encourages the client to reveal who s/he really is and how she functions in the world. It is the client, not the therapist, who gives meaning to his/her individual ways of being. Applying a phenomenological method allows the Gestalt therapist to attach unique information of the client to theoretical constructs in relation to his/her individual experiences without imposing a particular direction upon the client. It is the actual surface behavior that takes precedence over any and all interpretations. The therapist brackets his/her own experience to describe the presentation of the client, which nurtures the development of awareness and contact. The experiment: All experiments, carefully tailored to a client’s specific wants and needs at a given situation, serve the purpose of enhancing a client’s experience in the here and now. This results in greater self-awareness and preparation for action. Experiments give the client a chance to try out, in the safety of the therapeutic situation, variations of current behavior with new perspectives on new and past situations. This actual living through an event(s) is very different from simply talking about a situation. The emphasis is on what-is instead of what-could-be. The possibilities of experiments are truly limitless, and they include role-playing; amplification, exaggeration, and refraction; work with body, breath, voice tone, gestures; changed use of language and switching between mother tongue and adopted languages; use of metaphors and imagery; dream work; homework. Work with cognition: Clients often hold beliefs about their lives that are erroneous, distorted and filled with contradictions. These have a direct impact on a person’s experience, contact patterns, belief systems and actions. Since words reveal what the client thinks and what his/her guiding assumptions and beliefs are, the Gestalt therapist focuses on the way language is used with the intent of cognitive restructuring when indicated. Work with the wider fieldA Gestalt therapist frequently works directly with those fields that include and reciprocally affect individuals, such as a significant other (couple’s therapy), families, groups, and/or organizations with the goal of bringing about changes to their internal dynamics as well as in their impact on others. Research on the Gestalt Approach: Unfortunately there has been a paucity of research on Gestalt therapy over the years. Some Gestalt therapists argue that the complexity of the Gestalt approach is the main reason why research has not been more thoroughly advanced. Another explanation refers to Gestalt therapy’s philosophical underpinnings, which are thought to be incompatible with an empirical research endeavor. Reducing the holistic and rich therapy process to a mere few techniques, trivializing its wholeness and complexity through oversimplification, or replacing subjectivity with generalizations risks loosing its essence. This may have discouraged potential researchers. Simkin (1978) reported that Gestalt therapy was not even recognized by the Psychological Abstracts as separate from Gestalt psychology until 1973, and Harman’s (1984) conclusion of a

review of Gestalt therapy research literature confirmed the scarcity of quality research in the field. A growing, yet still small number of practicing Gestalt psychotherapists and theoreticians started to counteract this state of affair but the published research in support of the Gestalt approach remains far from being competitive. Gestalt Review (1997) reports that over 300 doctoral dissertations containing research on Gestalt therapy have been conducted, but only a handful were published in professional journals. Recent work by Paivio and Greenberg (1995), Greenberg, Rice and Elliot (1993), and Greenberg, Elliot, and Lietaer (1994) are moderate beginnings of outcome studies that show the effectiveness of Gestalt therapy. Additional findings reported Gestalt therapy bringing about significant positive changes in body image (Clance, Thompson, Simerly, & Weiss, 1994), the effectiveness of the empty-chair dialogue versus desensitization processes (Johnson & Smith, 1997), favorable Gestalt therapy outcome compared to psycho-education of unfinished business (Paivio & Greenberg, 1995), and the efficacy of Gestalt therapy with ‘hard-core’ criminals (Serok & Levi, 1993). A relatively conclusive meta-analysis of the effectiveness of Gestalt therapy was conducted in Germany and is published in German only (Schmitz, 1995). One of the oldest research studies goes back to 1927 when the Russian psychologist Blyuma Zeigarnik discovered experientially that people tend to return meaningfully to any unfinished activity striving for closure to obtain a sense of completion and fulfillment. This research is known as the Zeigarnik effect (Zeiganik, 1972). It is, however, claimed that Gestalt fundamentals provide advantageous training for researchers of qualitative methodology in using themselves as their own instrument. Trained Gestalt therapists have much to offer in the areas of awareness, actuality, complexity, personal responsibility, and staying with the process. These are all desirable skills for the qualitative researcher (Brown, 1997). For the growing research in the realm of contact boundary issues, which is the essence of Gestalt therapy, inventories and questionnaires have been developed and have been modified and further developed (Gestalt contact styles questionnaire; Gestalt inventory of resistance loadings both coming out of the Kent State University). Very recently practitioners within the Gestalt Community created an organization, a Gestalt Research Consortium, to change the current under-representation of research in Gestalt therapy. The members of this group committed to devote a portion of their resources (time, energy, involvement, money, etc.) to a program of research. Judging from the lively discussion that has been going on and the many valuable contributions from well-known Gestalt practitioners from all over the world, decisive and rich results can be expected in the future. Limitations of Gestalt therapy Gestalt therapy is lacking a distinct, clearly defined and fully elaborated theory of human development. In the absence of this understanding, psychological sufferings that are developmental in origin are void of consistent theoretical explanations within a Gestalt theoretical framework. Knowledge of conditions that are necessary for healthy development could be expanded to how human development accounts for contact change over the entire life of the human organism. Not having those constructs available leaves the therapist theoretically unsupported of what is most effective in the therapeutic process with clients who are afflicted by certain kinds of developmental damage and/or deficiencies. There have been modest attempts undertaken by Gestalt therapists to change this, and they point towards promising future additions (Wheeler, 1998; McConville, 1995; Lobb & Salonia, 1993). Consistent with the above, some practitioners and theorists see Gestalt therapy as being limited in relation to more serious forms of psychological dysfunction, namely the psychoses and

those disturbances which are described as “personality disorders” in the DSM-IV (Crocker, 1999; Latner, 1986; Yontef, 1993). Others, however, take an opposing stand and claim that Gestalt therapy is particularly helpful for treating personality disorders (Greenberg, 1995; Shub, 1999). Yontef (1993) reports through own experiences that Perls “demonstrated an extraordinary ability to establish contact with psychotic patients who had not been reached by others” (p.423). For acute cases where crisis intervention is indicated (e.g. suicidal or homicidal ideation), as well as for those people with severe impairments related to mood and/or mind altering substances, Gestalt therapy might have a reduced potential of effectiveness. Level of motivation can also be a negative determinant for outcome. A further and maybe the most important limitation is related to the fact that a Gestalt therapist uses his/her own person as a therapeutic medium for change. The willingness of a Gestalt therapist to be present during the therapeutic contact requires strong personal commitment to abide to the principles of Gestalt therapy and a high level of self-awareness. Yet, to the extent the therapist has unresolved personal issues, and is therefore unable to engage in real contact, the therapeutic effectiveness will be detrimentally impaired. Multicultural Considerations: The field-theoretical and the phenomenological tenets as well as the principles of holism take, per definition, cultural differences into consideration. Implicit in its field-theoretical understanding is the fact that human beings are not islands but impacted by social influences as well as impactful on others. With respect to the existential field, each person shares a world with others in a variety of ways contributing to meaning and value. The belief in and the use of the phenomenological method in Gestalt therapy focuses on the client’s subjective experience and the meaning thereof for him/her, void of the question of right or wrong, true or false, accurate or inaccurate, and/or of any ‘shoulds’ and ‘oughts’. Since the Gestalt therapist is non-judgmental and limits interpretation and analysis, it is exclusively the client who is the ultimate judge of accuracy and validity of any construction placed upon his/her experience. If reports, thoughts, experiences, etc., run counter to the therapist’s own experience of similar situations, due to cultural or ethnic differences, this will be addressed as part of the therapeutic process. An open dialogue of emerging differences will facilitate more awareness of therapists’ and clients’ “objective truth,”and this sharing will contribute to a more authentic and honest therapeutic relationship. Any hypothesis a therapist has according to his/her theoretical understanding and personal experience needs to be checked out with the client and either confirmed, altered, or rejected throughout the interaction (are my cultural perceptions accurate? Non-verbal cues read correctly?). The client is considered the expert of his/her own cultural experience and knowing about it is less important than experiencing it during the therapeutic encounter. Instead of gathering cultural data about clients, the therapist uses him/herself as a person-of-culture and takes into consideration his/her impact on the client as a person-of-culture (Plummer, 1997). By fully understanding his/her own cultural influences (level of self-awareness) the therapist is more apt to provide culturally and ethnically competent therapy. Since the focus of the therapy is the clients’ experiences and contact functions, information about their cultural background becomes inherent and need not be addressed separately within the contact. Any client is uniquely constructed out of the phenomenological data, which get revealed in the dialogical engagement, and this uniqueness cannot be seen apart from the environmental context/field. Concluding Remarks: Gestalt therapy is a well-developed and well-grounded theory with a myriad of tenets, principles, concepts, and methods, even though Gestalt therapy is often misrepresented in college textbooks and lumped together with psychodrama and other emotive and expressive

therapies. Gestalt therapy is a sound science and a powerful means for facilitating and nurturing the full functioning of the human person with the potential of bringing about human healing, growth, and wholeness. In Perls, Hefferline & Goodman’s (1951/1994) terms the “Gestalt outlook is the original, undistorted, natural approach to life, to man’s [and woman’s, added by the author] thinking, acting, feeling” (p.xxiv) with the criteria of therapeutic progress being measured against “the patient’s own awareness of heightened vitality and more effective functioning” (Perls, et al., 1951/1994, p.15). At the end of therapy the client is not necessarily “cured” but able to access tools and equipment to deal with any kind of problems he/she will have to encounter. Gestalt therapy undoubtedly has the capacity to contribute to and vitalize effectively the field of psychotherapy and fits excellently into the contemporary realm of clinical psychology. With the power of creatively adjusting to psychology’s changing paradigm, Gestalt therapy has the basic prerequisites to be included in mainstream psychology. References Brown, J. (1997). Researcher as instrument. Gestalt Review, 1(1), 71-84. Buber, M. (1970). I and Thou. New York: Scribner's Sons. Clance, P. R., Thompson, M. B., Simerly, D. E., & Weiss, A. (1994). The effects of the Gestalt approach on body image. Gestalt Journal, 17(1), 95-114. Clarkson, P., & Mackewn, J. (1993). Fritz Perls. London: Sage. Crocker, S. F. (1981). "Proflection". The Gestalt Journal, 4 (2), 35-42. Crocker, S. F. (1999). A well-lived life: Essays in Gestalt therapy. Cleveland, OH: Gestalt Institute of Cleveland Press. Fagan, J., & Shepard, I. L. (Eds.). (1970). Gestalt therapy now. Palo Alto, CA: Science and Behavior Books. Goldstein, K. (1939). The organism. New York: American Book Company. Goodman, P. (1951/1994). Gestalt therapy: Excitement and growth in the human personality. In F. Perls, R. Hefferline, & P. Goodman (Eds.) . Highland, NY: The Gestalt Journal Press. Greenberg, E. (1995). Healing the borderline. The Gestalt Journal, 12(2), 11-54. Greenberg, L. S., Elliott, R. K., & Lietaer, G. (1994). Research on experiential psychotherapies. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of psychotherapy and behavior change . New York: Wiley. Greenberg, L. S., Rice, L. N., & Elliott, R. K. (1993). Facilitating emotional change: The moment to moment process. New York: Guilford. Harman, R. (1984). Gestalt therapy research. Gestalt Journal, 7(2), 61-69. Hycner, R. A. (1990). The I-Thou relationship and Gestalt therapy. The Gestalt Journal, 13(1), 41-54. Jacobs, L. (1989). Dialogue in Gestalt theory and therapy. The Gestalt Journal, 12(1), 25-67. Johnson, W. R., & Smith, E. W. L. (1997). Gestalt empty-chair dialogue versus desensitization in the treatment of phobia. Gestalt Review, 1(2), 150-162. Latner, J. (1986). The Gestalt therapy book. New York: The Gestalt Journal. Lobb, S., & Salonia, G. (1993). What is the future in Gestalt therapy? Studies in Gestalt Therapy, 2 (26-34). Melnick, J., & Nevis, S. M. (1997). Diagnosing in the here and now: The experience cycle and DSM-IV. British Gestalt Journal, 6(2), 97-106. McCornville, M. (1995). Adolescence: Psychotherapy and the emerging self. San Francisco, CA: Jossey-Bass. Paivio, S. C., & Greenberg, L. S. (1995). Resolving 'unfinished business': Efficacy of experiential therapy using empty-chair dialogue. Journal of Consulting and Clinical Psychology, 63(3), 419-425. Parlett, M. (1991). Reflections on field theory. British Gestalt Journal, 1(2), 69-81. Perls, F. (1948). Theory and technique of personality integration. American Journal of

Psychotherapy, 2, 565-586. Perls, F. (1973). The Gestalt approach and eye witness to therapy. Palo Alto, CA: Science and Behavior Books. Perls, F., Hefferline, R., & Goodman, P. (1951/1994). Gestalt therapy: Excitement and growth in the human personality. Highland, NY: The Gestalt Journal Press. Perls, F. S. (1969). Ego, hunger, and aggression. New York: Vintage Books. Perls, L. (1976). Aspects of Gestalt therapy. unpublished manuscript presented at the American Orthopsychiatric Association. Plummer, D. (1997). A Gestalt approach to culturally responsive mental health treatment. Gestalt Review, 1(3), 190-204. Polster, E., & Polster, M. (1973). Gestalt Therapy Integrated. New York: Brunner/ Mazel. Schmitz, B. (1995). Eine Meta-analyse der Wirksamkeit von Gestalttherapie. Zeitschrift für Klinische Psychologie, Psychopathologie und Psychotherapie, 123(2), 324-356. Serok, S., & Levi, N. (1993). Application of Gestalt therapy with long-term prison inmates in Israel. Gestalt Journal, 16(1), 105-127. Shepard, M. (1975). Fritz: An intimate portrait of Fritz Perls and Gestalt therapy. New York: Saturday Review Press. Shub, N. (1999). Character in the present: Why Gestalt therapy is particularly helpful for treating character-disordered clients. Gestalt Review, 3(1), 64-77. Simkin, J. (1978). Gestalt therapy and the Psychological Abstracts. American Psychologist, 33, 705-706. Smith, E. W. L. (Ed.). (1976). The growing edge of Gestalt therapy. Highland, NY: The Gestalt Journal Press. Smuts, J. C. (1926/1996). Holism and evolution. Highland, New York: Gestalt Journal Press. Stevens, J. O. (1971). Awareness: Exploring, experimenting, experiencing. Moab, UT: Real People Press. Swanson, C., & Lichtenberg, P. (1998). Diagnosis in Gestalt therapy: A modest beginning. The Gestalt Journal, 21(1), 5 - 17. Van De Riet, V., Korb, M. P., & Gorrell, J. J. (1988). Gestalt therapy: An introduction. New York: Pergamon Press. Wheeler, G. (1998). A Gestalt developmental model. British Gestalt Journal, 7(2), 115-125. Wulf, R. (1998). The historical roots of Gestalt therapy. The Gestalt Journal 21(1), pp.81-92. Yontef, G. M. (1993). Awareness, dialogue, and process: Essays on Gestalt therapy. Highland, NY: The Gestalt Journal Press. Zeigarnik, B. (1927). Das Behalten erledigter und unerledigter Handlungen. Psychologische Forschung, 9, 1-85. Zinker, J. (1991). Creative process in Gestalt therapy: The therapist as artist. The Gestalt Journal, 14(2), 71-88 Biographical Data: The author has been studying and practicing Gestalt therapy since 1980. Most of her extensive training experiences have come from Gestalt Institutes in New York, San Diego (Polsters) and Los Angeles (GTILA) but also from abroad. She brings a rich background from other humanistic/existential therapies, like client-centered and Redecision therapy (a combination of Transactional Analysis and Gestalt therapy). She is presently a doctoral candidate in clinical psychology at the Fielding Institute in California working on her dissertation on language and its impact on the therapeutic process. Her main interest is to integrate Gestalt therapy into mainstream psychology as it is presently practiced, inclusive of psychological testing, diagnostics, and research. She has explored broad areas of psychopathology and how it can be viewed from a Gestalt perspective, in particular eating

13 disorders, and obsessive compulsive disorders, and has a deep investment in qualitative research. Other topics she investigated are pros and cons of developmental models for Gestalt therapy and philosophical and practical approaches to change (foremost the paradoxical theory of change within Gestalt therapy and its rich implications for the therapeutic process).