GESTALT PSYCHOTHERAPY

INTRODUCTION

Psychotherapy is a form of treatment for mental health disorders that aims to help individuals

improve their psychological well-being by exploring their thoughts, feelings, and behaviors.

This therapeutic process is conducted through a collaborative relationship between the

therapist and the patient, where the therapist provides a safe and supportive environment for

the patient to explore their feelings and experiences. There are several different approaches to

psychotherapy, including cognitive-behavioral therapy (CBT), psychodynamic therapy,

humanistic therapy, Gestalt therapy and others. Each approach has its own unique techniques

and goals, but all aim to help the patient gain insight into their emotions, thoughts, and

behaviors, and develop coping strategies to deal with the challenges of life.

Gestalt psychotherapy emphasizes the importance of the experience of the present moment

and aims for the integration of the mind, body as well as emotions. Based on the principles of

Gestalt Psychology which focuses on understanding and perceiving experiences as a whole

rather than individual parts (Kohler, 1929), this therapeutic technique is a unique approach

towards experiencing the here and now, where the therapist helps the client to explore their

experiences of the present, including their cognitive, emotional and physical experiences

(Woldt &Toman, 2005). Gestalt therapy was developed in the 1950s by Fritz Perls, Laura

Perls, and Paul Goodman, and it has since been expanded and developed by numerous

therapists and theorists (Yontef, 2005). The approach draws on a range of philosophical and

psychological traditions, including existentialism, phenomenology, and Eastern spirituality

(Woldt & Toman, 2005).

The goal of Gestalt therapy is to help clients develop greater self-awareness and self-

acceptance, which can lead to more authentic and fulfilling relationships with others (Woldt
& Toman, 2005). The therapy approach focuses on helping clients to identify and work

through their unfinished business, which are the unresolved issues from their past that may be

affecting their present experience (Perls, 1969). Gestalt therapy is typically conducted in

individual or group settings, and it can be used to address a wide range of mental health

concerns, including anxiety, depression, relationship issues, and trauma (Yontef, 2005). The

therapy approach may involve a range of techniques, such as mindfulness, role-playing, and

body awareness exercises, and the therapist may also use various forms of expressive arts

therapy, such as movement, music, and visual art (Woldt & Toman, 2005).

Gestalt psychotherapy includes several elements, as described:

Phenomenological perspective: Phenomenology enables individuals to distinguish between

current perceptions and emotions from past experiences. In Gestalt therapy, immediate

perceptions, free from prior learning, are valued and considered important, treating subjective

and objective observations as real data. Unlike other approaches, it does not dismiss patient

experiences as superficial, instead emphasizing the formation of patterns that reveal

significant realities. Insight is the goal of Gestalt therapy, where it provides clear

understanding of the situation's structure. Systematic exploration is necessary to develop

insight, using focused awareness and experimentation. The process of awareness is also

studied, and the patient is taught to become aware of their own awareness. Gestalt therapy

gives special attention to the relationship between the therapist and patient. (Yontef, 1976,

1982, 1983).

The field theory perspective: The field theory explores the whole field of which the event is a

part. The parts in a field are in immediate relationship and responsive to each other, with no

part uninfluenced by what goes on elsewhere in the field. Gestalt therapists work in the

present, acknowledging how it incorporates residues from the past, such as habits, beliefs,
and body posture. Field approaches describe, rather than interpret or classify, the emphasis on

observing, describing, and explaining the exact structure of whatever is being studied.

(Yontef, 1982, 1983).

Existential perspective: Existentialism focuses on people's existence, relationships, joys, and

suffering as directly experienced. Many people operate within an unstated context of

conventional thought, obscuring or avoiding acknowledging how the world is, especially

concerning their relationships and choices. Inauthenticity arises from self-deception, leading

to feelings of dread, guilt, and anxiety. Gestalt therapy offers a way of being authentic and

meaningfully responsible for oneself by becoming aware and capable of choosing and

organizing one's own existence. The existential view is that people continuously discover and

remake themselves, and there is no essence of human nature to be found once and for all; new

horizons, problems, and opportunities constantly arise. (Jacobs, 1978; Yontef, 1982, 1983).

HISTORY OF GESTALT PSYCHOTHERAPY

Fritz Perls paved the way for the development of Gestalt psychotherapy in the late 1920s

when he started his career as a psychoanalyst, inspired by the works of Karen Horney and

Wilhelm Reich, among others (F. Perls, 1947, p. 3). Notable influencers of Perls’ intellectual

development include Sigmund Friedlander, whose works were pivotal in development of

concepts such as differential thinking and creative indifference; Jan Smuts, who was the

Prime Minister of South Africa, where he had moved to after having escaped from the Nazis.

Smuts’ book on holism and evolution had used the Gestalt perspective for a wider view of the

world. The last notable influence was that of Alfred Korzybski.

Laura Posner Perls, the well known co-founder of Gestalt therapy, had a prime role in its

development. She wrote a chapter in “Ego, Hunger and Aggression”. She was inspired by the

works of existential theologians Martin Buber and Paul Tillich.

“Gestalt” refers to the configuration of a set of elements. They were of the belief that we

perceive patterns in whole rather than as parts and this tendency was instinctive. According to

the Gestalt perspective, perception is not simply the reception of sensory stimuli, but an

active and dynamic process that involves the interpretation and organization of sensory

information by the individual. This means that all situations have a certain inherent structure

that is perceived by the person. Humans possess the capacity for accurate perception when

they use their innate ability to experience the present moment. The goal of phenomenological

research and therapy is to utilize this capacity for immediate experience in order to gain

insight into the structure of the situation being studied. Gestalt therapists place more trust in

actual awareness rather than interpretation and preconceived beliefs or ideas.

Perls published his work “Ego, Hunger and Aggression in 1946. In 1966, its subtitle was

changed to ‘The beginning of Gestalt Therapy’. This was followed by the establishment of

the New York Institute for Gestalt Therapy at Perls’ apartment, where seminars and

workshops were held. During the 1950s there were considerable workshops and study groups

conducted across the country. During its early stages, Gestalt therapy introduced many ideas

that have since been adopted into eclectic psychotherapy practices. These ideas included

direct contact between therapist and patient, a focus on immediate experience, active

experimentation, emphasis on the present moment, patient responsibility, organismic self-

regulation, the interdependence of person and environment, assimilation, and other novel

concepts. These concepts were revolutionary and not well-received by the traditional

psychoanalytic establishment, which was the prevailing approach to psychotherapy at the

time. The integration and further development of these principles were left to the future, such

as exploring the nature of a healing dialogic presence, despite pioneering the use of the active

presence of the therapist in a contactful relationship.

The gestalt cycle of experience is a fundamental concept in gestalt therapy that describes the

pattern of how people organize their experiences. The cycle involves four stages: sensation,

awareness, energy mobilization, and action.

The first stage is sensation, where people experience something in their environment through

their senses. For example, they may see a person walking towards them or hear a sound.

The second stage is awareness, where people become conscious of the sensation and give it

meaning. They may interpret the person walking towards them as friendly or threatening, or

the sound as pleasant or annoying.

The third stage is energy mobilization, where people respond emotionally and physically to

their interpretation of the sensation. They may feel excited, anxious, or angry, and their body

may respond with physiological changes such as increased heart rate or muscle tension.

The fourth stage is action, where people respond to their emotional and physical state by

taking action. They may approach the person walking towards them, avoid them, or engage in

other behaviors based on their interpretation and emotional state.

The Gestalt cycle of experience is not a linear process, as people can move through the stages

in a variety of ways and at different speeds. Additionally, people can get "stuck" in one stage,

such as becoming overly focused on sensation or avoiding action.

The goal of Gestalt therapy is to help individuals become more aware of how they cycle

through these stages, so they can take more intentional and effective action in their lives.

Therapists may use techniques such as mindfulness, role-playing, and focusing on body

awareness to help individuals explore their experiences and break through any barriers in the

cycle.
EXPLANATION OF THE THEORY

The Gestalt theory is a psychological framework that originated in Germany in the early 20th

century. Gestalt theory proposes that the whole is different from the sum of its parts, meaning

that we cannot fully understand something by analyzing its individual parts in isolation, but

rather we must consider the whole context or experience. The Gestalt theory is based on the

idea that people actively organize their experiences into meaningful wholes or patterns.

According to the theory, perception is not just a result of passive reception of sensory

information but an active process of interpretation and organization.

Gestalt theory posits that people have an innate tendency to perceive patterns and forms in

their environment, even when they are not present in the sensory input. For example, when

we see a partially obscured circle, we tend to perceive it as a complete circle rather than a

series of disconnected arcs. Another key concept in the Gestalt theory is the emphasis on the

here and now. According to the theory, people are most able to understand and make sense of

their experiences when they focus on the present moment, rather than dwelling on the past or

worrying about the future. The theory also places a great emphasis on the importance of

context.

Gestalt therapy views people as being fundamentally interconnected with their environment

and believes that we cannot fully understand a person's experiences without taking into

account the broader context in which they occur. Gestalt therapy also emphasizes personal

responsibility and encourages people to take an active role in their own growth and

development. The therapist's role is to facilitate the client's exploration and understanding of

their experiences, rather than providing a diagnosis or prescribing a treatment plan.

According to Beisser (1970), paradoxically, trying to be someone else only leads to staying

the same. Many patients struggle with the conflict between what they believe they should be

and what they resist being. To integrate conflicting roles, a Gestalt therapist encourages the

client to identify and experience each role. By doing so, integrating techniques can be used to

transcend the dichotomy. In Gestalt therapy, two fundamental axioms are "What is, is," and

"One thing leads to another" (Polster and Polster, 1973). The process of change occurs

through a relationship with a therapist who establishes contact by being authentic,

understanding, and accepting. Becoming aware of "what is" leads to spontaneous change.

When a person seeking support encounters a therapist who is contactful, accepting, and not

colluding with manipulation, they may experience an Aha! moment, a new gestalt, and a new

perspective of possibility. Conversely, when a person meets "therapeutic" collusion, derision,

mind games, or game-busting, their awareness is unlikely to increase.

Throughout the therapeutic process, new realizations or "Aha!" moments can occur at any

point as long as the therapist and patient are open to new possibilities and the patient desires

growth. The focus of Gestalt therapy is on increasing awareness and expanding areas of

constricted contact boundaries, with the therapist facilitating and providing limits when

necessary. As the patient's sensing and contact skills improve, they can apply these skills to

their daily lives, leading to potential improvements in areas such as relationships and work.

While some changes may only be fully appreciated years later, the growth that occurs through

increased awareness and contact is a continuous process that can lead to positive changes in

various aspects of one's life.

Contact boundaries in Gestalt psychotherapy refer to the limits and boundaries that

individuals have in their contact with others, as well as with their own internal experiences.

These boundaries are seen as dynamic and changeable, rather than fixed and rigid. Contact

boundaries can be healthy and adaptive, allowing individuals to have fulfilling relationships

and interactions with the world around them. However, contact boundaries can also become

rigid and inflexible, leading to difficulties in relationships and an inability to fully engage

with life.

Gestalt therapy seeks to help individuals become more aware of their contact boundaries and

work towards making them more flexible and adaptable. This involves exploring how

individuals establish and maintain boundaries, as well as how these boundaries may be

limiting or contributing to their problems. The therapist may also work with the individual to

experiment with new ways of establishing contact boundaries and to develop greater

awareness of the impact of their boundaries on their interactions with others.

Research in gestalt therapy has explored the relationship between contact boundaries and

psychological functioning. One study found that individuals with rigid and inflexible contact

boundaries reported higher levels of anxiety and lower levels of self-esteem compared to

those with more flexible boundaries (Seligman & Reichenberg, 2014). Another study found

that individuals who were able to establish clear and adaptive contact boundaries had greater

psychological well-being and more positive relationships (Elliott & Greenberg, 2017).

Creative adjustment

Creative adjustment is a concept in Gestalt psychotherapy that refers to the ability of

individuals to adapt to their environment in creative and flexible ways. It involves being able
to adjust to changing circumstances and to find new and innovative ways to cope with

problems and challenges. According to Gestalt therapy theory, creative adjustment is a natural

and ongoing process that allows individuals to maintain their equilibrium and to thrive in

their environment.

In Gestalt therapy, the therapist helps the client to explore their creative adjustment process

and to identify any blocks or obstacles that may be preventing them from adapting in healthy

and flexible ways. This may involve examining patterns of behavior or thought that are no

longer serving the individual, and helping them to find new and more effective ways of

coping.

For example, a person who is struggling with anxiety may have developed rigid coping

mechanisms that are no longer effective. Through Gestalt therapy, the individual can explore

new and more creative ways of coping with their anxiety, such as through mindfulness

practices, expressive arts, or other self-care strategies.

Research has supported the effectiveness of Gestalt therapy in helping individuals to develop

greater creative adjustment. For example, a study published in the Journal of Counseling

Psychology found that Gestalt therapy was effective in helping individuals with depression to

develop more adaptive coping strategies (Brettschneider et al., 2014). Another study

published in the Journal of Humanistic Psychology found that Gestalt therapy was effective

in helping individuals to develop greater self-awareness and creativity (Crespi & Reidbord,

2015).

APPLICATIONS OF GESTALT PSYCHOTHERAPY

applications of gestalt psychotherapy are in individual psychotherapy, group therapy, trauma

therapy, mindfulness-based therapy and in the treatment of substance use disorders

Individual psychotherapy: One of the key features of Gestalt psychotherapy in individual

treatment is its focus on the present moment experience and the integration of conflicting

aspects of the self. The application of Gestalt psychotherapy in individual psychotherapy has

been well-researched and shown to be effective. For example, a study by Elliott et al. (2004)

found that Gestalt therapy was as effective as cognitive-behavioral therapy for treating

depression. Another study by McLeod and Arnold (2017) found that Gestalt therapy was

effective in treating anxiety disorders. Additionally, Gestalt therapy has been shown to be

effective in treating post-traumatic stress disorder (PTSD) in a study by O'Leary and

colleagues (2018). These studies provide evidence for the effectiveness of Gestalt

psychotherapy in individual psychotherapy.

Group therapy: Gestalt psychotherapy can be applied to group therapy settings, where it

emphasizes the importance of interpersonal relationships and group dynamics. In gestalt

group therapy, the therapist facilitates the group process by encouraging members to be

present and aware of their experiences in the here-and-now moment, and to share their

feelings and thoughts with the group. Through interactions with others, individuals can gain

insights into their own patterns of behavior and learn new ways of relating to others.

Research studies have shown the effectiveness of gestalt group therapy for a variety of

populations, including adults with depression, anxiety, and interpersonal difficulties (Yalom

& Leszcz, 2005; Orkibi & Ronen, 2017). A meta-analysis of 18 studies found that gestalt

group therapy was associated with significant improvements in psychological well-being and

interpersonal functioning (Elliott, Greenberg, & Lietaer, 2003).

and Leszcz (2005). In their book, "The Theory and Practice of Group Psychotherapy," they

discuss how Gestalt therapy principles can be applied in group settings. They emphasize the

importance of focusing on the here and now, encouraging members to take personal

responsibility, and facilitating a sense of community within the group. They also suggest

techniques such as the "empty chair" and "top dog/underdog" exercises to help group

members explore their emotions and relationships with others.

Trauma Therapy: Gestalt psychotherapy can be applied in trauma therapy to help clients

process and integrate their traumatic experiences. This approach emphasizes awareness of the

present moment and encourages clients to fully experience and express their emotions in a

safe and supportive environment.

Research has shown the effectiveness of Gestalt therapy in treating trauma-related symptoms.

For example, a study by Price and Boucouvalas (2001) found that Gestalt therapy was

effective in reducing PTSD symptoms in female survivors of childhood sexual abuse.

Another study by Castro-Fornieles et al. (2011) demonstrated that Gestalt therapy was

effective in reducing symptoms of PTSD and depression in children who had experienced

sexual abuse.

In Gestalt trauma therapy, the therapist helps clients to become more aware of their bodily

sensations and emotions related to the traumatic experience. Through techniques such as

empty-chair dialogue and two-chair work, clients are encouraged to express and process their

emotions related to the trauma. The therapist also helps clients to identify and challenge any

maladaptive coping mechanisms that may be hindering their healing process.

Mindfulness based therapy: Gestalt therapy can be applied in mindfulness-based therapy as it

emphasizes being fully present in the moment and focusing on one's experience without
judgment or distraction. The combination of Gestalt therapy and mindfulness can help clients

become more aware of their present experience, gain insight into their patterns of behavior

and thinking, and develop greater self-acceptance.

Research studies have shown the effectiveness of incorporating mindfulness in Gestalt

therapy. For example, a study by Pritzker and Mullan (2012) examined the effectiveness of

combining Gestalt therapy and mindfulness in treating depression. The study found that the

combination of Gestalt therapy and mindfulness was effective in reducing depressive

symptoms and improving overall well-being.

Another study by Kezelman and Stavropoulos (2012) explored the effectiveness of a Gestalt

therapy approach to working with trauma survivors, incorporating mindfulness practices. The

study found that the integration of mindfulness practices into Gestalt therapy was helpful in

reducing trauma symptoms and improving overall functioning.

Substance use disorders: Gestalt therapy has been found to be effective in treating substance

use disorders (SUDs) by addressing the underlying emotional issues that contribute to

addiction. One of the key principles of Gestalt therapy is the emphasis on living in the present

moment and experiencing one's emotions and sensations fully. This can help individuals with

SUDs to develop greater awareness and acceptance of their emotional experiences, which in

turn can reduce the urge to self-medicate with drugs or alcohol.

Several studies have shown the effectiveness of Gestalt therapy in treating SUDs. A

randomized controlled trial conducted by Lee and colleagues (2012) found that a six-week

group therapy program based on Gestalt therapy was effective in reducing alcohol use and

improving mental health outcomes in adults with alcohol use disorders. Another study by

Ribeiro and colleagues (2016) found that Gestalt therapy was effective in reducing substance
use and improving psychological well-being in individuals with SUDs who were undergoing

treatment at a Brazilian outpatient clinic.

Gestalt therapy can also be integrated with other approaches to SUD treatment, such as

cognitive-behavioral therapy (CBT) and mindfulness-based interventions. A study by

Morgenstern and colleagues (2003) found that an integrated treatment approach that

combined CBT, motivational interviewing, and Gestalt therapy was effective in reducing

substance use and improving mental health outcomes in individuals with co-occurring SUDs

and psychiatric disorders.

ADVANTAGES

There are several advantages to using Gestalt psychotherapy as a form of treatment. One of

the main advantages is that it is a holistic approach that focuses on the individual as a whole,

rather than just their symptoms or problems. This means that it can address not just the

immediate issues but also the underlying causes of those issues, leading to more lasting and

profound changes.

Another advantage of Gestalt therapy is that it emphasizes personal responsibility and self-

awareness. Clients are encouraged to take an active role in their therapy and to become more

aware of their thoughts, feelings, and behaviors. This can help them to develop a greater

sense of self-awareness and control, leading to improved mental health and overall well-

being.

Gestalt therapy is also a highly adaptable approach that can be tailored to meet the unique

needs of each individual client. The therapist and client work together to identify specific

goals and develop a treatment plan that is tailored to the client's unique needs and

circumstances.

DISADVANTAGES
There are several potential disadvantages to the application of Gestalt psychotherapy. Firstly,

Gestalt therapy requires active participation from the client, which can be challenging for

some individuals who prefer a more passive role in therapy. Also, while the focus on the

present moment can be an advantage, it may also be a disadvantage for individuals who

struggle with unresolved trauma from the past or have difficulty envisioning the future.

Gestalt therapy may not be appropriate for all mental health disorders or conditions, such as

severe psychotic disorders or those requiring medication management.

While there are some studies that support the effectiveness of Gestalt therapy, there is limited

empirical research compared to other therapies such as cognitive-behavioral therapy. The

emphasis on the therapeutic relationship in Gestalt therapy may also create potential

boundary issues between the therapist and client.

It is important to note that not all individuals may experience these disadvantages, and the

effectiveness of Gestalt therapy may vary depending on the individual and their specific

needs. A trained and licensed therapist can help determine if Gestalt therapy is an appropriate

approach for the client.

CONCLUSION

Gestalt therapy is a humanistic and holistic approach that emphasizes present-moment

experience and the integration of mind, body, and emotions. It promotes self-awareness,

personal responsibility, and growth by focusing on the individual’s here-and-now experience,

rather than simply analyzing the past. This therapy also places a great emphasis on the

therapeutic relationship between the therapist and the client. Gestalt therapy has been applied

in various settings, such as individual and group therapy, trauma therapy, substance use

disorder treatment, and mindfulness-based therapy. While gestalt therapy has several

advantages, such as its focus on the present and the holistic approach, it also has some
limitations, including the potential for emotional intensity and the need for a highly skilled

therapist. Nevertheless, research has supported the effectiveness of gestalt therapy in

addressing a wide range of mental health concerns.

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