Gestalt Therapy

Gestalt therapy refers to a form of psychotherapy that derives from the gestalt school of
thought. It was developed in the late 1940s by Fritz Perls and is guided by the relational theory
principle that every individual is a whole (mind, body and soul), and that they are best understood
in relation to their current situation as he or she experiences it.
The approach combines this relational theory with present state - focusing strongly on self-
awareness and the 'here and now' (what is happening from one moment to the next). In gestalt
therapy, self-awareness is key to personal growth and developing full potential. The approach
recognizes that sometimes this self-awareness can become blocked by negative thought patterns
and behavior that can leave people feeling dissatisfied and unhappy.
It is the aim of a gestalt therapist to promote a non-judgmental self-awareness that enables
clients to develop a unique perspective on life. By helping an individual to become more aware of
how they think, feel and act in the present moment, gestalt therapy provides insight into ways in
which he or she can alleviate their current issues and distress in order to aspire to their maximum
potential.
Key Concepts of Gestalt Therapy
Gestalt therapy works through the interconnection of key concepts. These offer insight into
the processes involved in therapy sessions between the therapist and client(s).
 Person-centered awareness - Focusing on the present, and imagining it divorced from the
future and past is considered essential. The process follows an individual's experience in a
way that does not involve seeking out the unconscious, but staying with what is present
and aware.
 Respect - Clients, whether an individual, group or family, are treated with profound
respect by a gestalt therapist. Providing a balance of support and challenge is key to
helping those taking part to feel comfortable about opening up and acknowledging areas
of resistance.
 Emphasis on experience - The gestalt approach focuses on experience in terms of an
individual's emotions, perceptions, behaviors, body sensations, ideas and memories. A
therapist encourages the client to 'experience' in all of these ways, vividly in the here and
now.
 Creative experiment and discovery - There is a range of experimental methodology used
by therapists to test their client's experience. These involve highly creative and flexible
techniques to help them open up and acknowledge hidden feelings.
 Social responsibility - The gestalt approach recognizes that humans have a social
responsibility for self and for others. It demands respect for all people and acknowledges
that everyone is different. Ultimately it encourages individuals to adopt an egalitarian
approach to social life.
 Relationship - Relating is considered central to human experience and gestalt therapy
considers individuals as 'whole' when they have a good relationship with themselves and
others around them. The interpersonal relationship between the individual and therapist
that is developed and nurtured in sessions is a key guiding process if therapy.
How does gestalt therapy work?
Fundamentally, gestalt therapy works by teaching clients how to define what is truly being
experienced rather than what is merely an interpretation of the events. Those undertaking gestalt
therapy will explore all of their thoughts, feelings, behaviours, beliefs and values to develop
awareness of how they present themselves and respond to events in their environment. This gives
them the opportunity to identify choices, patterns of behaviour and obstacles that are impacting
their health and well-being, and preventing them from reaching their full potential.
The unfolding of this therapeutic process will typically involve a range of expressive
techniques and creative experiments developed collaboratively between therapist and client.
These will be appropriate for the client and their specific problems. Below are some of the most
common methods used:
 Role-play
Role-play can help individuals to experience different feelings and emotions and better
understand how they present and organize themselves.
 The 'open chair' technique
The open chair technique involves two chairs and role-play, and can give rise to emotional
scenes. The client sits opposite an empty chair and must imagine someone (usually
himself/herself or parts of him or her) in it. They then communicate with this imaginary being -
asking questions and engaging with what they represent. Next, they must switch chairs so they
are physically sitting in the once empty chair. The conversation continues, but the client has
reversed roles - speaking on behalf of the imagined part of his or her problem. This technique
aims to enable participants to locate a specific feeling or a side of their personalities they had
'disowned' or tried to ignore. This helps them to accept polarities and acknowledge that conflicts
exist in everyone.
 Dialogue
A gestalt therapist will need to engage the client in meaningful and authentic dialogue in
order to guide them into a particular way of behaving or thinking. This may move beyond simple
discussion to more creative forms of expression such as dancing, singing or laughing.
 Discussing dreams
Dreams play an important role in gestalt therapy, as they can help individuals to understand
spontaneous aspects of themselves. Fritz Perls frequently asked clients to relive his or her dreams
by playing different objects and people in the dream. During this they would be asked questions
like: "What are you aware of now?" to sharpen self-awareness.
 Attention to body language
Throughout therapy, a gestalt therapist will concentrate on body language, which is
considered a subtle indicator of intense emotions. When specific body language is noticed, the
therapist may ask the client to exaggerate these movements or behaviors. This is thought to
intensify the emotion attached to the behavior and highlight an inner meaning. For example, a
client may be showing signs of clenched fists or frowning, to which the therapist may ask
something along the lines of: "What are you saying with this movement?"
 Who can benefit?
Ultimately, gestalt therapy is considered to help individuals gain a better understanding of
how their emotional and physical needs are connected. They will learn that being aware of their
internal self is key to understanding why they react and behave in certain ways.
Behavior Therapy
As its name suggests, behavioral therapy is focused on human behavior and looks to
eradicate unwanted or maladaptive behavior. Typically this type of therapy is used for those with
behavioral problems or mental health conditions that involve unwanted behavior. Examples of
this include addictions, anxiety, phobias and obsessive-compulsive disorder.
Practitioners of behavioral therapy believe that behavior is learned and can therefore be un-
learned via therapy. As well as the behavior itself, behavioral therapists will look at thoughts and
feelings that lead to the behavior or occur as a result of the behavior to understand it on a deeper
level.
Behavioral therapy is an action-based therapy that looks to foster positive behavior change.
Other therapies such as psychoanalytic therapy tend to be more focused on insight and delving
into the past. In behavioral therapy, the past is still important as it often reveals where and when
the unwanted behavior was learned, however it looks more so at present behavior and ways in
which it can be rectified.
Principles of behavioral therapy
There are two key principles that form the foundations of behavioral therapy - classical
conditioning and operant conditioning.

i. Classical conditioning
Behavioral therapy that is based on classical conditioning uses a number of techniques to
bring about behavior change. Originally this type of therapy was known as behavior
modification, but these days it is usually referred to as applied behavior analysis. The various
methods of changing behavior include:

 Flooding
Flooding is a process generally used for those with phobias and anxiety and involves
exposing the individual to objects/situations they are afraid of in an intense and fast manner. An
example of this would be exposing a person who is afraid of dogs to a dog for an extended period
of time. The longer this continues with nothing bad happening, the less fearful the person
becomes.
The idea is that the person cannot escape the object/situation during the process and
therefore must confront their fear head on. Obviously this method can be disconcerting and may
only be suitable for certain situations.

 Systematic desensitization
This technique works on a similar premise to flooding, however it is more gradual. The
therapist would begin by asking the individual to write a list of fears they have. Once this list is
written, the therapist will teach relaxation techniques for the individual to use while thinking
about the list of fears. Working their way up from the least fear-inducing item to the most fear-
inducing item - the therapist will help the individual confront their fears in a relaxed state.
An example of this would be a person who is afraid of small spaces. They may start by
thinking about a small space or looking at an image of a small space while utilizing relaxation
techniques, and work their way up to being in a small space. This pairing of the fear-inducing
item and newly learned relaxation behavior aims to eliminate the phobia or anxiety.
  Aversion therapy
This process pairs undesirable behavior with some form of aversive stimulus with the aim
of reducing unwanted behavior. An example of how this is commonly used is when an alcoholic
is prescribed a certain drug that induces nausea, anxiety and headaches when combined with
alcohol. This means every time the person drinks, they get negative side effects. This hopes to put
off that person from drinking to help them overcome their addiction.

ii. Operant conditioning

Operant conditioning uses techniques such as positive reinforcement, punishment and
modeling to help alter behavior. The following strategies may be used within this type of therapy:

 Token economies
This strategy relies on positive reinforcement - offering individuals 'tokens' that can be
exchanged for privileges or desired items when positive behavior is exhibited. This is a common
tactic used by parents and teachers to help improve the behavior of children.

 Contingency management
A more formal approach, contingency management involves a written contract between the
therapists and individual that outlines goals, rewards and penalties. For some, having this kind of
clear agreement helps to change behavior and add a sense of accountability.

 Modelling
Modelling involves learning through observation and imitation of others. Having a positive
role model can give individuals something to aim for, allowing them to change their behavior to
match their role models. This role model may be the therapist or someone the individual already
knows.

 Extinction
Extinction works by removing any type of reinforcement to behavior. An example of this
would be a disruptive child who is given a time-out or told to sit on the 'naughty step'. By
removing them from the situation (and associated attention) the behavior should stop. This
premise can be carried across to adults too - however the 'naughty step' will probably be given a
different name.