What Are the Treatment Benefits of Gestalt Therapy?

Gestalt comes from the German word meaning form or shape. The term gestalt is meant to reference essence or character. The school of experimental psychologists studying perception developed the form of Gestalt psychology that explains how people perceive objects in their environment.

Gestalt therapy was developed by the psychoanalyst Fritz Perls along with his wife in the 1940s, and it incorporates principles of the psychodynamic paradigm and the humanistic paradigm. Perls was a student of the famous psychoanalyst William Reich and dissatisfied with the overall principles of the psychodynamic paradigm, particularly principles regarding motivation, the emphasis of sexual drives, its emphasis on unconscious motivations, and the depiction of psychopathology as developing as a result of experiences that developed in the past. Perls was more interested in what was actually happening in the moment and in viewing people as autonomous agents who often needed to enhance their awareness and accept responsibility for their actions as opposed to the more mechanistic viewpoint and principles of Freudian psychoanalysis.

Gestalt therapy uses experiential methods to help individuals become more aware of their feelings and to express themselves in productive and meaningful ways on their way to recovery.

What Are the Key Principles of Gestalt Therapy?

Perls accepted the core concept of the humanistic paradigm that all people have an innate desire to move toward balance and growth. There are several important principles that Gestalt therapists embrace:

• The perspective of phenomenology: Phenomenology refers to a discipline that helps people to understand their experiences in such a manner that they can differentiate between what they are actually perceiving and feeling in a situation and how those perceptions are influenced by past experiences. Gestalt therapists believe that individual experiences in the moment are actually real and have meaning as opposed to psychoanalysis that considers behavior symbolic of other issues, such as internal conflicts. Gestalt therapists attempt to help individuals understand what they are feeling in the moment and how to rid themselves of interpretations of events that are not genuine or of acting in a manner that is based on their perceptions or expectations of others.
• Field theory: Events are analyzed as a whole, as opposed to being classified as belonging to some specific type. Gestalt therapists concentrate on what is happening in the immediate timeframe and concerned about how events happening now include influences from one’s past. Gestalt therapists attempt to describe what is going on with the person as opposed to classifying it, interpreting it, or speculating about it.
• The use of an existential perspective: Existentialism focuses on people’s relations with one another, what makes them happy, what makes them sad, etc., as the individual directly experiences it. Gestalt therapists operate under the existentialist assumption that many people go through their existence in a sort of unstated context of conventional thinking that obscures their ability to understand the world the way it really is. Individuals may often use self-deception to interpret events in a manner consistent with how they believe the world should be as opposed to how it really is. This self-deception is the basis of not being authentic. Gestalt therapists work to have individuals experience things as they really happen, become aware of their biases, be honest and truthful, and accept responsibility for their actions.
• Therapeutic relationship: Gestalt therapists believe that the relationship between the therapist and client is the most important aspect of psychotherapy. These therapists use a sort of an existential dialogue with their clients to understand them, help them understand themselves, and help them differentiate themselves – the “me” – from the “not me.” Gestalt therapy works by maintaining this dialogue with the client as opposed to formulating goals, working toward goals, dissecting behavior, etc. The therapist attempts to use caring, warmth, and acceptance to help the individual discover why they act the way they do and how their actions are affected by certain misperceptions about themselves and others. The emphasis is on moving clients to be free to be themselves and at the same time accept responsibility for their actions so they can achieve lasting recovery.

The therapeutic relationship is the key factor utilized by Gestalt therapists to help individuals with the issues that bring them into therapy. The dialogue between the therapist and client is an extremely important facet of Gestalt therapy. There are four characteristics of the dialogue that occurs between the client and therapist:

1. The experience of inclusion: The therapist attempts to experience the perceptions and feelings of the client without judging, interpreting, or analyzing. Through this process, the therapist attempts to get the client to do the same.
2. Presence: The therapist talks to the client in an authentic manner instead of assuming some preconceived role. This fosters the experience of inclusion.
3. Commitment to the dialogue: Much like free association in psychoanalysis, the therapist just lets the dialogue happen as opposed to planning and manipulating it. This way, the therapist and client can understand each other in a more authentic manner.
4. Living the dialogue: The dialogue (the therapeutic interaction) is something that occurs and not something that is talked about or planned. Gestalt therapists are interested in what is happening in the moment, in the here and now, and how this affects the individual as well as what it says about them.

Dialogue in Gestalt therapy can often take many forms. Individuals can be encouraged to sing, move, dance, just talk, etc., as part of the therapeutic dialogue. The idea is to help clients understand what is really being experienced in the moment as opposed to interpreting events based on preconceived notions.

How the Components of Gestalt Therapy Apply to Treatment?

The major tenets of Gestalt therapy are often a bit ethereal for many individuals. Again, Gestalt therapy concentrates on the relationship between the therapist and client and the interactions between them as opposed to looking at the client’s past experiences, trying to identify specific theory driven patterns, or trying to alter a specific behavior. Instead, Gestalt therapists focus on the present and the awareness of the client in treatment for substance abuse or other issues, and emphasize respect for the client’s feelings and actions.

The therapist emphasize the client’s experiences: their emotions, perceptions, memories, behaviors, etc. The therapist attempts to get the client to experience and become aware of these as they occur.

Responsibility is a major emphasis in Gestalt therapy. Gestalt therapists help individuals understand that they are responsible for themselves and for how their actions may affect others. Emphasizing equality in all individuals is a major goal of Gestalt therapy.

The therapeutic relationship in Gestalt therapy underlies the notion that relationships are central to human experience, and improving relationships is the goal of the therapeutic environment. Experimenting and using numerous techniques to help individuals open up and acknowledge their feelings is one of the hallmarks of Gestalt therapy.

Gestalt therapists use a number of techniques to develop awareness in individuals and help them become more genuine. These techniques include:

• Roleplaying:Roleplay helps individuals experience and understand different emotions and how they present themselves to others.
• The empty chair: By far the most famous technique developed by Fritz Perls is the open chair or empty chair technique. The client sits in a chair opposite an empty chair and imagines a specific individual (either oneself, a specific aspect of oneself, or someone else) and then communicates with this imaginary person. Next, they switch chairs and communicate with themselves from the perspective of the person in the empty chair. The technique helps individuals accept different polarities regarding feelings and experience, and acknowledge the perspective of other individuals or other sides of themselves.
• Dream interpretation: The psychoanalytic background of Perls led him to continue to use the interpretation of dreams as a therapeutic tool. Perls frequently used dreams to help people understand certain aspects of themselves as opposed to considering dreams to have some type of symbolic meaning of an unconscious conflict. Perls often asked clients to relive part of their dreams by taking the perspective of different people or objects that were in the dream and then trying to understand what those people or objects were experiencing.
• Interpretation of body language: Perls was very astute regarding the meaning of an individual’s posture. Gestalt therapists use body language to help individuals to understand what they are experiencing in the moment. For example, if an individual is clenching their teeth during a session, the therapist may ask them, “What does clenching your teeth say about what you are feeling?”

The goal of Gestalt therapy is to give clients the opportunity to present themselves in an authentic manner in a safe environment. As they become more comfortable with their feelings and do not attempt to rationalize them, they also begin to identify more positive choices they may have, understand dysfunctional patterns of behavior, and understand obstacles that result in them behaving in manners that are detrimental to their health or emotional wellbeing. Gestalt therapy uses these techniques to get individuals to move toward reaching their full potential as a responsible and autonomous person.

What Is the Overall Effectiveness of Gestalt Therapy?

Gestalt therapy is used for a very wide range of issues and can be delivered as a very brief and focused intervention or as a much more long-term intervention. Research indicates that Gestalt therapy can be a helpful resource in a person’s treatment of trauma- and stressor-related disorders, depression, issues with anxiety, and substance use disorders, whether during treatment or within the aftercare component. Individuals who participate in Gestalt therapy often become more self-confident and happier as they learn to accept themselves, accept others, and take responsibility for their actions, which may help them avoid relapse and stay in recovery.