Exam 2: Gestalt Therapy (CNS 520) – Flashcards
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Frederick "Fritz" Perls (1893-1970)
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The main originator and developer of Gestalt Therapy; born in Berlin, Germany into a lower-middle-class Jewish family, he identified himself as a source of much trouble for his parents; In 1916 he joined the German Army and served as medic in WWI; his experiences with soldiers who were gassed on the front lines led to his interest in mental functioning, which led him to Gestalt psychology; Perls and colleagues established the New York Institute for Gestalt Therapy in 1952
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Laura Posner Perlz (1905-1990)
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Began a collaboration with Fritz in 1926 that resulted in the theoretical foundations of Gestalt therapy; Laura paid a great deal of attention to contact and support, which differed from Fritz's attention to intrapsychic phenomena and his focus on awareness
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Gestalt Therapy
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An existential, phenomenological, and process-based approach created on the premise that individuals must be understood in the context of their ongoing relationship with the environment; Awareness, choice, and responsibility are cornerstones of practice; The initial goal is for clients to expand their awareness of what they are experiencing in the present moment; through this awareness, change automatically occurs; The approach is phenomenological because it is grounded in the notion that people are always in the process of becoming, remaking, and rediscovering themselves; As an existential approach, Gestalt therapy gives special attention to existence as individuals experience it and affirms the human capacity for growth and healing through interpersonal contact and insight; This approach focuses on the here and now, the what and how, and the I/thou of relating
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Relational Gestalt therapy (contemporary gestalt therapy)
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A supportive, kind, and compassionate style that emphasizes dialogue in the therapeutic relationship, rather than the confrontational style of Fritz Perls; stresses dialogue and relationship between client and therapist; The majority of today's Gestalt therapists employ a style that is supportive, accepting, empathic, respectful, dialogical, as well as challenging; the emphasis is on the quality of the therapist-client relationship and empathic attunement while tapping the client's wisdom and resources
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Field
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A dynamic system of interrelationships; Self-acceptance, knowledge of the environment, responsibility for choices, and the ability to make contact with their field and the people in it are important awareness processes and goals, all of which are based on a here-and-now experiencing that is always changing
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Emotion-focused therapy (EFT)
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Developed by Leslie Greenberg in 2011, rooted in a person-centered philosophy and synthesizes aspects of Gestalt therapy and existential therapy; strategies used are aimed at strengthening the self, regulating affect, and creating new meaning; Entails the practice of therapy being informed by understanding the role of emotion in psychotherapeutic change; similar to Gestalt therapy but emphasizes empirically supported treatments
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Gestalt Therapy View of Human Nature
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The Gestalt View of Human Nature is rooted in existential philosophy, phenomenology, and field theory; Therapy aims at awareness and contact with the environment, which consists of both external and internal worlds; the quality of contact with aspects of the external and internal world are monitored; A basic assumption of Gestalt therapy is that individuals have the capacity to self-regulate when they are aware of what is happening in and around them; therapy provides the setting and opportunity for that awareness to be supported and restored
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Paradoxical theory of change
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A theoretical position that authentic change occurs more from being who we are than from trying to be who we are not; Arnie Beisser, 1970; it is important for clients to "be" as fully as possible in their current condition, rather than striving to become what they "should be"
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Holism
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Gestalt is a German word meaning a whole or completion, or a form that cannot be separated into parts without losing its essence - because Gestalt therapists are interested in the whole person, they place no superior value on a particular aspect of the individual
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Figure
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Those aspects of the individual's experience that are most salient at any moment
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Ground
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Those aspects of the client's presentation that are often out of his or her awareness; Cues to this background can be found on the surface through physical gestures, tone of voice, demeanor, and other nonverbal content; also referred as "attending to the obvious" while paying attention to how the parts fit together, how the individual makes contact with the environment, and integration
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Field Theory
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Paying attention to and exploring what is occurring at the boundary between the person and the environment; asserts that the organism must be seen in its environment, or in its context, as part of the constantly changing field; Gestalt therapy rests on the principle that everything is relational, in flux, interrelated, and in process
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The Figure-Formation Process
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Tracks how some aspect of the environmental field emerges from the background and becomes the focal point of the individual's attention and interest; describes how the individual organizes the environment from moment to moment and how the emerging focus of attention is on what is figural
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Organismic Self-Regulation
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A process by which equilibrium is "disturbed" by the emergence of a need, a sensation, or an interest; the figure-formation process is intertwined with this principle; an individual's tendency to take actions and make contacts that will restore equilibrium or contribute to change
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The Now
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One of the main contributions of the Gestalt approach is its emphasis on learning to appreciate and fully experience the present moment; "Power is in the present"; Gestalt therapists recognize that the past will make regular appearances in the present moment, usually because of some lack of completion of that past experience; it is dealt with by bringing it into the present as much as possible
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Phenomenological inquiry
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Involves paying attention to what is occurring now; to help the client make contact with the present moment, Gestalt therapists ask "what" and "how" questions, but rarely ask "why" questions in order to promote "now" awareness
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Unfinished business
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When figures emerge from the background but are not completed and resolved; this can be manifested in unexpressed feelings such as resentment, rage, hatred, pain, anxiety, grief, guilt, and abandonment; the feelings linger in the background
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Impasse
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Stuck point; the time when external support is not available or the customary way of being does not work; the therapist's task is to accompany clients in experience the impasse without rescuing or frustrating them; by completely experiencing the impasse, they are able to get into contact with their frustrations and accept whatever is, rather than wishing they were different
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Contact
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Made by seeing, hearing, smelling, touching, and moving
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Effective contact
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Means interacting with nature and with other people without losing one's sense of individuality; prerequisites for good contact are clear awareness, full energy, and the ability to express oneself
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Introjection
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A process of taking in the values and standards of others; The tendency to uncritically accept others' beliefs and standards without assimilating them to make them congruent with who we are; When we introject, we passively incorporate what the environment provides rather than clearly identifying what we want or need; If we remain in this stage, our energy is bound up in taking things as we find them and believing that authorities know what is best for us rather than working for things ourselves
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Projection
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The reverse of introjection; we disown certain aspects of ourselves by assigning them to the environment; those attributes of our personality that are inconsistent with our self-image are disowned and put onto, assigned to, and seen in other people, thus, blaming others for lots of our problems; By seeing in others the qualities that we refuse to acknowledge ourselves, we avoid taking responsibility for our own feelings and the person who we are; People who use projection as a pattern tend to feel that they are victims of circumstances, and they believe that people have hidden messages behind what they say
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Retroflection
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Consists of turning back onto ourselves what we would like to do to someone else, or doing to ourselves what we would like someone else to do to or for us; this process is principally an interruption of the action phase in the cycle of experience and typically involves a fair amount of anxiety; EX: people who self-mutilate or who injure themselves are often directing aggression inward out of fear of directing it toward others
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Deflection
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A way of avoiding contact and awareness by being vague and indirect; the process of distraction or veering off, so that it is difficult to maintain a sustained sense of contact; we attempt to diffuse or defuse contact through the overuse of humor, abstract generalizations, and questions rather than statements; When we deflect, we speak through and for others, beating around the bush rather than being direct and engaging the environment in an inconsistent and inconsequential basis, which results in emotional depletion
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Confluence
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involves blurring the differentiation between the self and the environment; A disturbance in which the sense of the boundary between self and environment is lost; as we strive to blend in and get along with everyone, there is no clear demarcation between internal experience and outer reality; Confluence in relationships involves the absence of conflicts, slowness to anger, and a belief that all parties experience the same feelings and thoughts that we do; Characteristic of clients who have a high need to be accepted and liked, thus finding enmeshment comfortable; This condition makes genuine contact extremely difficult
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Blocked energy
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Another form of defensive behavior; it can be manifested by tension in some part of the body, by posture, by keeping one's body tight and closed, by not breathing deeply, by looking away from people when speaking to avoid eye contact, by choking off sensations, by numbing feelings, and by speaking with a restricted voice, to mention only a few
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Six Methodological Components of Gestalt Therapy
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a) The continuum of experience, b) The here and now, c) The paradoxical theory of change, d) The experiment, e) The authentic encounter, and f) Process-oriented diagnosis
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Basic goal of Gestalt Therapy
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Assisting the client to attain greater awareness, and with it, greater choice
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Awareness (Gestalt)
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Includes knowing the environment, knowing oneself, accepting oneself, and being able to make contact; with awareness, clients can face and accept denied parts as well as to fully experience their subjectivity, unity, and wholeness
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Therapist's Function and Role in Gestalt Therapy
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The therapist's job is to invite clients into an active partnership where they can learn about themselves by adopting an experimental attitude toward life in which they try out new behaviors and notice what happens; Gestalt therapists use active methods and personal engagement with clients to increase their awareness, freedom, and self-direction rather than directing them toward preset goals; An important function of Gestalt therapists is paying attention to client's body language; these nonverbal cues provide rich information as they often represent feelings of which the client is unaware
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Examples of the aspects of language that Gestalt therapists might focus on
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"It" talk; when clients say "it" instead of "I", they are using depersonalizing language (EX: Client: "It is difficult to make friends" Therapist: Can ask the client to restate by saying "I have trouble making friends"; "You" talk; the therapist often points out generalized uses of "you" and asks the client to substitute "I" when this is what is meant; Questions - Gestalt counselors often ask clients to change their questions into statement - clients begin to assume responsibility for what they say; Language that denies power; "maybe", "I suppose/I guess", "sort of"; clients are denying their personal power by adding qualifiers or disclaimers to their statements; Listening to clients' metaphors; rich clues to clients' internal struggles
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Miriam Polster's three-stage integration sequence of client growth
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Discovery, Accommodation, and Assimilation
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Discovery (Polster's three-stage integration sequence of client growth)
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Clients are likely to reach a new realization about themselves or acquire a novel view of an old situation, or they may take a new look at some significant person in their lives; such discoveries often come as a surprise to them
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Accommodation (Polster's three-stage integration sequence of client growth)
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involves clients' recognizing that they have a choice; clients begin by trying out new behaviors in the supportive environment of the therapy office, and then they expand their awareness to the world; making new choices is often done awkwardly, but with therapeutic support clients can gain skill in coping with difficult situations
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Assimilation (Polster's three-stage integration sequence of client growth)
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Involves clients' learning how to influence their environment; clients feel capable of dealing with the surprises they encounter in everyday living; they are beginning to do more than passively accept the environment; behavior may include taking a stand on a critical issue; eventually, clients develop confidence in their ability to improve and improvise - improvisation is the confidence that comes from knowledge and skills; clients have learned what they can do to maximize their chances of getting what is needed from their environment
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Relationship Between Therapist and Client in Gestalt Therapy
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As an existential brand of therapy, Gestalt practice involves a person-to-person relationship between therapist and client; Therapists are responsible for the quality of their presence, for knowing themselves and the client, for remaining open to the client, establishing and maintaining a therapeutic atmosphere that will foster a spirit of work on the client's part; Therapists are expected to encounter clients with honest and immediate reactions, and share their personal experience and stories in relevant and appropriate ways; Many contemporary gestalt therapists place increasing emphasis on factors such as presence, authentic dialogue, gentleness, more direct self-expression by the therapist, decreased use of stereotypical exercises, and greater trust in the client's experiencing
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Techniques in Gestalt Therapy
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Yontef and Jacobs point out that techniques in Gestalt therapy are considered experiments and clients hear the message, "try this out and see what it is like for you"; Gestalt therapy methodology is tailored to the needs of clients, and experiments are typically presented in an invitational manner
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Exercises
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Ready-made techniques that are sometimes used to make something happen in a therapy session or to achieve a goal; they can be catalysts for individual work or for promoting interaction among members of a therapy group
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Experiments
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Grow out of the interaction between client and therapist, and they emerge within this dialogic process; they can be considered the very cornerstone of experiential learning; a method that shifts the focus of counseling from talking about a topic to an activity that will heighten the client's awareness and understanding in through experience; •The experiment is fundamental to Gestalt Therapy; Experiments are spontaneous, one-of-a-kind, and relevant to a particular moment and a particular development of a figure-formation process; Experiments are not designed to achieve a particular goal but occur in the context of a moment-to-moment contacting process between therapist and clients; Experiments bring out some type of internal conflict by making this struggle an actual process; it is aimed at facilitating a client's ability to work through the stuck points of his or her life
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Confrontation Usage in Gestalt Therapy
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Perls practiced a highly confrontational approach as a way to deal with avoidance; this model is not representative of Gestalt therapy as it is currently being practiced
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Confrontation
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An invitation for the client to become aware of discrepancies between verbal and nonverbal expressions, between feelings and actions, or between thoughts and feelings; used at times in the practice of Gestalt therapy, yet it does not have to be viewed as a harsh attack; can be done in such a way that clients cooperate, especially when they are invited to examine their behaviors, attitudes, and thoughts; confrontation does not have to be aimed at weaknesses or negative traits; clients can be challenged to recognize how they are blocking their strengths
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Top Dog
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Righteous, authoritarian, moralistic, demanding, bossy, and manipulative; this is the "critical parent" that badgers with "should" and "oughts" and manipulates with threats of catastrophe
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Underdog
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Manipulates by playing the role of victim; by being defensive, apologetic, helpless, and weak and by feigning powerlessness; this is the passive side, the one without responsibility, and the one that finds excuses
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Empty-chair technique
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One way of getting the client to externalize the introjection, a technique Perls used a lot; using two chairs, the therapist asks the client to sit in one chair and be fully the top dog and then shift to the other chair and become the underdog; the dialogue can continue between both sides of the client; A technique in which all parts are played by the client; the introjections can surface, and the client can experience the conflict more fully; This exercise helps clients get in touch with a feeling or a side of themselves that they may be denying; rather than merely talking about a conflicted feeling, they intensify the feeling and experience it fully; The aim is NOT to rid oneself of certain traits, but to learn to accept and live with the polarities
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Top Dog and Underdog Relationship
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The top dog and the underdog are engaged in a constant struggle for control; the struggle helps to explain why one's resolutions and promises often go unfulfilled and why one's procrastination persists; The top dog demands that one be thus-and-so, whereas the underdog defiantly plays the role of disobedient child; The conflict between the two opposing poles in the personality is rooted in the mechanism of introjection, which involves incorporating aspects of others, usually parents, into one's personality
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Making the Rounds
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A Gestalt exercise that involves asking a person in a group to go up to others in the group and either speak to or do something with each person; the purpose is to confront, to risk, to disclose the self, to experiment with new behavior, and to grow and change
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The Reversal Exercise
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Clients take the plunge into the very thing that is fraught with anxiety and make contact with those parts of themselves that have been submerged and denied; this technique can help clients begin to accept certain personal attributes that they have tried to deny; a person who claims to suffer from severe inhibitions and excessive timidity is asked to play the role of an exhibitionist
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The Rehearsal Exercise
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Internal rehearsal's consume much energy, and when clients share their rehearsals out loud with a therapist, they become more aware of the many preparatory means they use in bolstering their social roles; they also become increasingly aware of how they try to meet the expectations of others, of the degree to which they want to be approved, accepted, liked, and of the extent to which they go to attain acceptance
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The Exaggeration Exercise
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Movements, postures, and gestures may communicate significant meanings, yet the cues may be incomplete; in this exercise the person is asked to exaggerate the movement or gesture repeatedly, which usually intensifies the feeling attached to the behavior and makes the inner meaning clearer (EX: slouched posture and bent shoulders, clenched fists, tight frowning)
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Staying with the feelings
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When clients refer to a feeling or a mood that is unpleasant and from which they have a great desire to flee, the therapist may urge clients to stay with their feeling and encourage them to go deeper into the feeling or behavior they wish to avoid
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Gestalt Approach to Dream Work
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Does not interpret and analyze dreams; The intent is to bring dreams back to life and relive them as though they were happening now; The dream is acted out in the present, and the dreamer becomes a part of his or her dream; Suggested format is making a list of all the details of the dream, remembering each person, event, and mood in it, and then becoming each of these parts by transforming oneself, acting as fully as possible and inventing dialogue; Perls's concept of projection is central in his theory of dream formation; every person and every object in the dream represents a projected aspect of the dreamer; According to Perls, the dream is the most spontaneous expression of the existence of the human being; it represents an unfinished situation, but every dream also contains an existential message regarding oneself and one's current struggle
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True
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True or false: Resistance refers to defenses we develop that prevent us from experiencing the present in a full and real way.
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True
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True or false: Blocked energy can be considered a form of resistance.
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False
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True or false: The basic goal of Gestalt therapy is adjustment to society.
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False
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True or false: Recent trends in Gestalt practice include more emphasis on confrontation, more anonymity of the therapist, and increased reliance on techniques.
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True
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True or false: Dreams contain existential messages, and each piece of dream work leads to assimilation of disowned aspects of the self.
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True
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True or false: Gestalt therapy is well suited for group counseling, especially when there is a here-and-now emphasis within the group.
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True
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True or false: One of the functions of the therapist is to pay attention to the client's body language.
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False
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True or false: Gestalt techniques are primarily aimed at teaching clients to think rationally.
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False
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True or false: A major function of the therapist is to make interpretations of clients' behavior so that they can begin to think of their patterns.
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True
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True or false: The founder of Gestalt therapy contends that a frequent source of unfinished business is resentment.
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B
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The main founder of Gestalt therapy is a. William Glasser. b. Fritz Perls. c. Carl Rogers. d. none of these. e. Albert Ellis.
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B
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Which is not true of Gestalt therapy? a. The focus is on integrating fragmented parts of the personality. b. The focus is on the "why" of behavior. c. The focus is on unfinished business from the past. d. The focus is on the "what" and "how" of behavior. e. The focus is on the here and now.
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C
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Which of the following is not a key concept of Gestalt therapy? a. acceptance of personal responsibility b. dealing with the impasse c. intellectual understanding of one's problems d. unfinished business e. awareness of the present moment
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D
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According to the Gestalt view, awareness a. is a necessary, but not sufficient, condition for change. b. consists of understanding the causes of one's problems. c. without specific behavioral change is useless. d. is by itself therapeutic.
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E
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The basic goal of Gestalt therapy is to help clients a. work through the transference relationship with the therapist. b. challenge their philosophy of life. c. recognize which ego state they are functioning in. d. uncover unconscious motivations. e. move from environmental support to self-support.
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C
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The impasse is the point in therapy at which clients a. do not have external support available to them. b. experience a sense of "being stuck." c. do all of these. d. are challenged to get into contact with their frustrations and accept whatever is.
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D
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Gestalt therapy can best be characterized as a. an action-oriented therapy. b. an insight therapy. c. an empirically-validated treatment. d. an experiential therapy. e. a cognitive approach.
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E
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Gestalt therapy encourages clients to a. experience feelings intensely. b. work through the impasse. c. stay in the here and now. d. pay attention to their own nonverbal messages. e. do all of these.
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B
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The focus of Gestalt therapy is on a. the relationship between client and counselor. b. recognizing one's own projections and refusing to accept helplessness. c. all of these. d. understanding why we feel as we do. e. free associating to the client's dreams.
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A
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A contribution of the Gestalt approach is that it a. deals with the past in a lively manner. b. sheds light on transference. c. is primarily a cognitive perspective. d. stresses talking about problems.
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D
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The process of distraction, which makes it difficult to maintain sustained contact, is a. introjection. b. confluence. c. retroflection. d. deflection. e. projection.
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E
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The process of turning back to ourselves what we would like to do to someone else is a. deflection. b. confluence. c. projection. d. introjection. e. retroflection.
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C
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The tendency to uncritically accept others' beliefs without assimilating or internalizing them is a. confluence. b. deflection. c. introjection. d. retroflection. e. projection.
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B
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The process of blurring awareness of the boundary between self and environment is a. retroflection. b. confluence. c. introjection. d. deflection. e. projection.
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E
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What is a limitation (or limitations) of Gestalt therapy as it is applied to working with culturally diverse populations? a. Clients may be looking for specific advice on solving practical problems. b. Clients who have been culturally conditioned to be emotionally reserved may not see value in experiential techniques. c. Clients may believe showing one's vulnerability is being weak. d. Clients may be "put off" by the emphasis on expressing feelings. e. All of these are limitations.
