Unlike most of the therapies founded by errant disciples of Freud, Gestalt Therapy is not named after its founder, Fritz Perls. Instead it is named after the psychological movement on which he based his approach.
As a psychologist who knows more about Gestalt Psychology than about therapy, I was intrigued to know how it could possibly be the basis of a therapy. It has nothing to say about neurosis or mental disturbance: it deals with the way we see the world around us. The most important theme is that we tend to impose order on what we see, even when it is actually disordered. We are so good at filling in the gaps in a picture where parts are missing that often we do not realise that the picture we are presented with is incomplete – we see only the completed whole.
This tendency to complete things is the key to the Gestalt view of the way psychological problems arise and the way they can be resolved. According to Ken Evans, of the Sherwood Psychotherapy Training Institute in Nottingham, we have an overwhelming tendency to complete the unfinished business of our interactions with other people. When these interactions are unsatisfactory – as they so often are when we are children – we make what Gestalt therapists term a ‘creative adjustment’ to our view of the way the world works. Psychological problems arise in adulthood when our thoughts, emotions and behaviour are adversely affected by creative adjustments that we made as children and that are no longer appropriate in adult life.
Creative adjustments can be fairly straightforward. A child reprimanded for throwing tantrums may develop the view that it is inappropriate to express emotions. Creative adjustments often involve the child assuming responsibility for the situation, according to Malcolm Parlett, co-founder of the Gestalt Psychotherapy Training Institute. This can have very damaging effects: a sexually abused child may come to identify with their abuser, and may subsequently abuse other children, he says.
The view that today’s psychological difficulties reflect our past experience is reminiscent of the Freudian approach. However Gestalt therapy is not concerned with uncovering and resolving past conflicts but with understanding and adjusting to the present. The past only features in the form of maladaptive behaviour based on past creative adjustments.
The goal is to enable the client to explore their present thoughts and feelings in such a way that they make the creative adjustments that are appropriate for their adult lives. An important aspect of this is to become more emotionally literate: to understand and recognise our own thoughts and emotions. For example, a client who is upset because her boss bullies her may be encouraged to think about the anger she feels at her unfair treatment, and even to role-play discussing the unreasonable behaviour with her boss.
Role play experiments both during therapy sessions and as homework are an important part of the Gestalt approach They enable the client to explore particular aspects of their thoughts and feelings and may help them to make appropriate creative adjustments. Dreams are also important but it is the client rather than the therapist who works out what the dream means.
Therapy sessions are usually fifty minutes once per week although longer sessions are used for group therapy. Group sessions are useful for some clients because they allow a wider range of interactions, according to Parlett. “We like to work with live events rather than looking at the past” he says, “groups offer lots of different sorts of live events”.
Although most therapy groups are formed from clients who just happen to be seeking help at the same time, Gestalt therapists also like to work with pre-existing groups, like those in offices and industrial organisations. Here the aim is to examine the way the organisation works from the point of view of the psychological impact on its members, and to advise on how it could be changed for the better.
Availability & contacts.
In the UK Gestalt Therapy may be available through NHS or privately. In addition to the normal psychotherapy referral organisations (APA and UKCP) it is worth looking at the website of the Association for the Advancement of Gestalt Therapy, which includes information about Gestalt therapy and a geographically organised list of Gestalt Therapists. the url is www.g-g.org/aagt/
US: APA Tel: 1 800 964 2000, or go to http://helping.apa.org/
UK: UKCP Tel: 0171 436 3002 or go to http://www.psychotherapy.org.uk/