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Blogging from a Gestalt Therapy perspective.

Speak up!

Ask your MP to oppose NICE’s draft guideline for depression

UKCP recently issued a press release urging NICE not to publish its guideline for depression in adults. They provide a bullet pointed list of highlighted concerns, including definitions of depression used, and the focus on Randomised Control Trials to the exclusion of other valuable evidence.

Of particular concern is the proposal to limit first-line treatment to CBT or medication:

Despite acknowledging the importance of offering a choice of treatments, the draft Guideline proposes Cognitive Behavioural Therapy (CBT) or medication as the first-line treatment for all forms of depression, denying adults with depression the opportunity to benefit from alternative talking therapy treatments.

I’ve written to my MP, from my perspective as a therapist, to ask her to support UKCP’s call, and am encouraging fellow counsellors and psychotherapists to do the same.

What’s also important is that people who aren’t practitioners of some sort, especially those with experience of accessing treatment for depression through the NHS, also contact their MP to share their concerns.

The end result of these guidelines will be less variation in the support available for people struggling with depression. Which will inevitably mean less effective support.

I have been practising gestalt psychotherapy for the past ten years. In that time, I have worked with many clients who have previously sought out counselling for depression via their GP, and who have received a few sessions of CBT through the NHS. In general, these clients have reported gaining much more benefit in gestalt therapy with me than from the CBT they received.

But that isn’t because I’m an amazing therapist. It’s because depression can’t be treated in a standardised way, and the CBT available through the NHS isn’t what a lot of people need. Which in turn isn’t to bash CBT; it’s equally valid to say some people do need that approach. The problem is the attempt to standardise something that can’t be standardised.

The key here is that therapy needs to be tailored to fit the client. And this is only possible if someone has access to a range of clinicians, coming from a range of traditions. Contemporary research in psychotherapy points to the client-therapist relationship being the biggest influencing factor in “successful” therapy.

If you want to write to your MP about this, and if you don’t already know who your MP is, you can find their details via Write To Them.

Documents from the consultation are still online here if you want to look through the draft guidelines yourself.

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Image credit: Speak up, make your voice heard by Howard Lake, shared under Creative Commons.

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Stressed person

Millennial stress: the more things change, the more they stay the same

This year, Mental Health Awareness week is themed around stress. As part of this, the United Kingdom Council for Psychotherapy (UKCP) is running a series of articles zooming in on the idea of millennial stress. A boiled down version of this post appears on the UKCP blog here: What (some) millennials think about millennial stress.

As a psychotherapist who is a millennial (born 1980) the idea of millennial stress is both interesting and confusing to me.

On the one hand, I’m aware of the millennial experience being drastically different to that of both older generations (who are often bewildered by the technology millennials consider commonplace), and the emerging, younger generation z (who are often bewildered at the very idea that there was a time before such technology). On the other hand, I’m aware of how arbitrary and forced these generational divisions feel, and question how much someone’s birth year can tell me as a therapist about a client that the client can’t tell me themselves.

The 1980 to 1995 timeframe is also incredibly broad, covering a current age range of 22 through 38. To put that in perspective, consider the global financial crisis of 2008. I was 28 that year, employed in a full-time, permanent, Local Government role. The youngest of the millennials were 12, and several years away from entering the workforce.

By the time these younger millennials came to consider University, tuition fees were rising to £9k a year, and student loans were no longer covering the cost of living in many places. Meanwhile, those who left education were entering a highly competitive job market characterised by an emerging gig economy. This is partly why the term xennial has been proposed to describe people born between the end of generation x and start of millennial timeframes.

Millennial stress: familiar themes

Maybe it’s the millennial in me, but to help inform this article I set up an online survey, and used social media to reach out to other millennials to find out what they thought about millennial stress. With the caveat that such a survey is limited, both in sample size and by a respondent self-selection bounded by my social media reach, familiar themes emerge.

The most common source of stress in responses was money and financial concerns generally. Renters worry about making rent, homeowners worry about meeting mortgage payments. One of the millennial edges to this is the belief that homeownership is out of reach, based on high house prices, the consequent high deposit needed, and the incredibly strict post-crash constraints on getting a mortgage even with a deposit and stable employment.

This combines with a rental market that is often insecure; private landlords can and do refuse to renew contracts for tenants who “cause trouble” by, say, requesting that basic repairs are carried out to heating systems or plumbing. And further combines with the increasing percentage of take home pay that goes towards rent, which landlords are free to hike.

Millennials overlap heavily with the idea of Generation Rent, and the housing crisis is our everyday life. Having grown up poor in social housing, I feel viscerally the difference between how secure that housing felt compared to the precariousness of the private rental market. Especially so in a context of rapidly diminishing social housing stock.

After this, a wide range of responses can all be grouped under the core therapeutic material of personal issues. That is to say, the concerns a person has about the unfinished business of their past; their present concerns about relationships, loneliness, self-esteem, health (self and others, physical and mental), the roles they occupy (as parents, as partners, as workers) and how those roles impact each other (especially working and parenting!); and their fears for the future, that great expanse into which all our demons get free reign to paint the nightmarescape of our personal shadow.

After these, two other strong themes are work stress, and current affairs; together with money, these form the social context in which millennials find ourselves. Work is stressful for a myriad reasons; bullying by leadership, intermittent periods of unemployment, being off sick long term for physical and mental health reasons, worrying about career prospects, and dealing with promotion bringing new stresses.

Current affairs places everything else in a political context, one dominated by Brexit fears, Donal Trump, climate change, welfare cuts, and social justice; stressors combine with social identities like class, gender, disability, race, sexuality etc in unique ways, and these social identities stack.

Importantly, whilst I’m writing from a UK perspective, a couple of respondents were based elsewhere in Europe. And yet, whilst the particular political situations is those respondents’ countries will be different, the over-arching themes remain broadly in line with UK respondents. Which of course raises the question of the extent to which “millennials” is primarily a western / first world / global north phenomenon.

The importance of intersectionality to the practice of psychotherapy starts to become clear.

The message for therapists

Where does consideration of these themes take us within a contemplation of “millennial stress”? I included a question about what psychotherapists need to know about millennials, and a clear message came through. Millennials want to be seen as individuals, not simply typecast as millennials, and are especially wary of older generations viewing us through pre-conceptions that paint us as workshy or over-sensitive.

And not all millennials think “millennial stress” is a thing. Maybe contemporary ideas of stress are exaggerated compared to what older generations faced. Or maybe people in their late 20s now face the same stresses as people in their late 20s did 30 years ago.

At the same time, it’s seen as important that psychotherapists (who are more likely to be from an older generation and financially secure) remain mindful that the social context for millennials is one in which jobs are less secure. I’ve found in my experience with clients that the younger my client is, the more likely they are to be caught in the gig economy; characterised by zero hour contracts and low skill, low paid work.

Further to this, automation is predicted to replace a significant proportion of current jobs over the coming decade. Millennials will bear the brunt of this change. Homeownership is less attainable (regardless of avocado intake!) and the world is both drastically different, and still undergoing rapid and unpredictable change.

The more things change, the more they stay the same

For me, the lesson for psychotherapists can be summed up in the expression, “the more things change, the more they stay the same“. Millennials are, by and large, stressed by the same things every generation is stressed by, including frustration at older generations for not understanding the younger! The work of psychotherapy – of creating a space in which a process of discovery about how a person creates themselves in the midst of various forces over which they have varying degrees of control can take place – remains more or less the same.

It is maybe important that psychotherapists are mindful of the age of their client more than the generation to which they belong, and this brings me back to the idea of intersectionality. Beautifully summed up in the concise comment that “being a woman of colour does not help with any of the above”, intersectionality emphasises the way in which aspects of social identity intersect, creating a more nuanced understanding of social freedom and oppression.

I may be a millennial, but I am also white, male, straight, University educated, working class, cis-gender. Change male to female, or white to black, or working class to middle class, and the kinds of social forces I’m subject to change dramatically. It may be that knowing I’m a millennial is less important than knowing that I’m currently 37, and contemplating how my stage of life interacts with current social forces.

Go back to the financial crisis example: that didn’t just affect millennials. It’s just that it had different implications for 20 year olds than for 40 or 60 year olds. Ten years on, and one of the impacts for me is homeownership being out of reach. But years of austerity measures mean that there are also impacts for older generations in the form of service cuts. Whilst the younger generations face impacts through cuts to education budgets.

If the idea of millennial stress is going to be useful to psychotherapists, then it needs to be rooted in an understanding of how millennials experience the world events and social forces that have shaped and continue to shape our lives. The best way of achieving this is to ask millennial clients about their experience from a nonjudgmental position of compassionate curiosity.

Fortunately for us, this is the meat and potatoes of what psychotherapists are trained to do.

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Image credit: IMG_2753 by Eric, shared under Creative Commons.

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dandelions in a field

Weeds or flowers? How neurosis is all about context

One of the core concepts in gestalt psychotherapy is contact. Specifically, gestalt therapists are interested in what happens at the contact boundary; itself an emergent phenomenon that arises wherever self meets other.

In gestalt’s founding text, Perls Hefferline & Goodman’s Gestalt Therapy (PHG), the self is defined as “the system of contacts at a given time”. This is an idea of the self as an emergent, moment-to-moment, constantly created and re-created entity (a theme explored in broad terms in Philippson’s The Emergent Self).

But what is in contact with what?

In concise terms, this is the work of the ego, described in PHG as having the task of alienation and identification. It is the ego’s job to define me and not-me at any given time, for any given information. This is in contrast with the id, which can be taken to be the sum of all experiential information at any given time. And this is in further contrast to the personality, which can be taken to be the cumulative effect of our preferences over time; the story we tell ourselves about who we are to make the ego’s work easier.

Note: this outline of id, ego, and personality differs to the use of these terms in psychoanalysis, and is one of gestalt’s points of departure with that tradition.

Back to the contact boundary, and it’s fair to say that the ego’s main function is to determine where the contact boundary is by dividing experience into two sides: me and not-me, self and other, organism and environment.

The contact boundary mediates experience, and this is where the concept of modifications to contact comes in. I find two ways of thinking about this to be particularly useful: information, and experience.

The contact boundary serves an important information gathering function. I hear the world through my ears, but I don’t hear all the sound that comes into my ears. I can tune out background noise, just as I can suddenly tune in to a distant conversation if I hear my name. That is the work of the contact boundary, distinguishing between useful and useless information.

The contact boundary also serves an important experiential function. Some experiences are pleasant, some are neutral, some are unpleasant, some are painful, and some are overwhelming. Part of the contact boundary’s function could be understood as keeping experience within a tolerable range. Reflexively moving my hand away from a burning surface is part of the contact boundary’s work. So is moving to the beat in a satisfying way.

Modifying experience, modifying information

Modifications to contact become important when withdrawing from contact with something is difficult or not possible. Back to the sound example. If we’re having a conversation in the park on a busy day, I can’t simply withdraw from all that sound. But I can focus my awareness on the sound of your voice, and automatically relegate most other sound to background noise. That process involves a degree of desensitising to all or most other sound.

Alternatively, consider the flow of information, and the difficult job of taking in information in a meaningful way. Suppose I read something or someone tells me something. I need a certain amount of time and space to register that information, make sense of it, ensure I understand it. Now suppose someone is giving you a stream of information, rapidly, moving from one subject to the next without a moment’s notice. If you can’t get that person to stop and go slowly, then you might find yourself zoning out and trying to absorb as much of what’s being said as possible.

This is a merger strategy called confluence, where you try to lose the boundary between yourself and the other person and enter a we-state. Much of the information you take in during this state will likely be introjected, that is taken in uncritically and not given much reflection or contemplation.

The ego’s work of discriminating between me and not-me is bypassed by the temporary erasure of the contact boundary. Later, much of this information will come to feel alien because it hasn’t gone through the integration of being received, broken down, and re-created; it remains something someone else said that I pseudo-identify with, not something I broke down and reconstructed out of my own thoughts.

A plant in the wrong place

Gestalt therapists work with various defined modifications to contact. Their therapeutic value is in identifying how awareness of the here and now is being in some way impeded. They are somewhat like weeds in the sense that a weed is simply a plant in the wrong place. In other words, modifications to contact are only problems when they are problematic.

The initial therapeutic task is becoming aware of how contact is being modified. From there, it is sometimes appropriate to work with that modification (eg applying some critical thinking to the introjected views of parents that are holding you back from pursuing something important to you). It is also sometimes appropriate to leave things be (eg respecting that a memory fragment from a past trauma needs to stay desensitised because you don’t feel ready to go there yet).

Context is everything, and modifications to contact give gestalt therapists an important concept for exploring how and to what end a client adjusts to their present situation.

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Image credit: dandelions by Mike Mozart shared under Creative Commons.

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The Swan Project premises on 1 Fairlawn Road, Montpelier, Bristol

Job opportunity at The Swan Project (Bristol)

The Swan Project in Bristol are looking for a new Service Manager:

“A small, warm and unique charity in the heart of Bristol are looking for a Service Manager to help run our project and manage the day to day running of the organisation. We are a specialist in providing counselling to those with addiction issues and have up to 60 counsellors working from our premises at any one time.

Reporting directly to the Project Leader and Trustees, we need someone with great organisational skills, an awareness of how counselling works and some experience of managing people.

The role will be up to 16 hours per week, flexible working (some work can be done from home) and is remunerated at £12 per hour.

For more information, contact the Project Leader swanhannah@hotmail.co.uk“.

The Swan Project holds a special place in my heart. It’s where I gained a significant proportion of my training hours as a volunteer counsellor, offering one of the few placement opportunities where it’s possible to do long-term therapy. I then served as a Trustee for quite a few years, and had the honour and challenge of Chairing the Board through a period of transition in which the organisation’s original founder retired.

The Service Manager role has huge scope for shaping the overall tone of the organisation, and is a bit of a linchpin, being a point of first contact for new clients, and a regular contact point for volunteer counsellors. All the Swan Project’s counselling takes place in its premises at 1 Fairlawn Road in Montpelier, so the building generates a strong sense of community that is tangible for me even now as I write about it.

In short, it’s a wonderful community to work within, providing a valuable and increasingly rare service.

Statue of Arjuna

The Golden Arrow: how to live a more or less fulfilling life

The Golden Arrow is a heuristic tool I’ve been thinking about for a while now to help frame my understanding of what is happening in therapy at a given time. Really, it’s an app running off the gestalt cycle api; the theoretical cycle of gestalt formation and destruction chunters away in the background, and gets expressed through the Golden Arrow.

I originally intended this to be a single blog post running through each element of the arrow, but the content exploded. I figure that means the process of writing this out is helping me integrate a bunch of stuff (what David Tennant’s Doctor (the best Doctor) might term gestalt-walty stuff), so I’ll let this emerge in its own time, then thread everything together once it’s complete.

The overall idea is simple. The cycle of gestalt formation and destruction describes how a gestalt comes into and out of being by breaking the process down into seven stages. This aids therapy by providing a diagnostic tool geared towards the mechanics of how we construct our experiences. But it can sometimes become too abstract.

So for me, keeping that theory close to practice is about asking what’s happening now within the active gestalt; what is the overall kind of action to which this current situation is geared?

That’s led me to describe four modes of gestalt functioning with a natural direction of travel:

Needing > Wanting > Choosing > Doing

The arrow metaphor is by no means original, and comes from the concept of karma being explained through the metaphor of archery. A blog post for another day perhaps, but I think karma has huge potential as a solid clinical concept in therapy. I think what we essentially work with in therapy is a person’s karma (a word whose meaning is to do with certain kinds of action).

For The Golden Arrow, I’m using the metaphor to describe the way an arrow points and flies from one point to another. This is to emphasise how needing leads to wanting which leads to choosing which leads to doing. This movement from one mode to another is the natural progression of a given gestalt. Left to our own devices in a relatively simple environment, we can mostly relax control and allow our arising needs to progress into actions.

But therapy exists because we aren’t left to our own devices in a relatively simple environment. We live in complicated environments, often subject to extreme frustrations and dangers, and usually subject to some degree of external imposition that opposes our own needs of the moment.

Many, maybe most, of these needs can just be dropped. But chronically frustrated needs and significant unmet needs create the classic unfinished business of gestalt therapy. And given severe frustration, and/or the need to survive environments characterised by intolerable and contradictory psychological pressures, entire modes of being can become problematic.

It’s possible to adapt ourselves to hostile environments to such an extent that we are unable to identify our own needs; be aware of what we need but feel no desire for it; be unable to decide things for ourselves; or consistently fail to follow through on our own decisions. Or all of the above in various combinations at various different times as we try to navigate our own personal hellscape.

For the purposes of doing therapy, The Golden Arrow is an attempt to frame therapeutic dialogue. It also provides a usable model for developing a background sense of feeling more or less fulfilled (whilst acknowledging that fulfilment in life can’t be reduced to a four step exercise!). Roughly speaking, the formula is this:

If you want what you need, choose what you want, do what you choose, and need what you do, then you will live a more or less fulfilling life.

But all those elements must be there, and the foundational work is being able to connect with a mostly accurate sense of what you need. Which involves developing an ability to return to the ultimate basics of gestalt therapy: what am I aware of now?

The main advantages of focusing on these four ideas are accessibility and action-orientation.

Needing, wanting, choosing, and doing are accessible themes for conversation because they are themes people struggle with. And those struggles are scalable, meaning you can do an experiment about needing easily in the therapy room, and it will be directly applicable to major needs outside of the therapy room. As above, so below.

Action-orientation relates to the words being verbs rather than nouns, and so already being rooted in directly experienced action. It’s tempting to talk about needs as if they are neatly packaged things we can pick up and examine. But our lived experience isn’t of picking up and putting down needs, it’s of need*ing*.

With both needing and wanting, there is a visceral experience of the absence of something. With choosing there is an often tortuous process of weighing up options and being pulled in different directions before having to actively commit to something over something else. And with doing there is a dazzling array of different actions and combinations of actions that go into fulfilling our intentions. For me at least, this helps with grounding theory in both practice and every day experience.

I’ll link here to each additional part as I get further posts written.

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Photo credit:Arjuna” by tbSMITH, shared under Creative Commons.

the gestalt cycle of figure formation and destruction

Rising and falling: the cycle of gestalt formation and destruction

My first encounter with what pre-gestalt Fritz Perls would have recognised as concentration therapy, came in the form of two exercises from a book called Concentration & Meditation. These were exercises designed to lead into wider Buddhist practice, but I was using them to still and focus my otherwise drastically scattered mind.

One of these exercises is the simple yet surprisingly trippy process of focusing on a simple object, and ignoring any other sensations, thoughts, objects etc. It was wild, but irrelevant to this post.

The other exercise is (eventually) beautiful in a hard to express way. It involved observing the rising and falling nature of experience and, by extension, reality itself. I was in the 3rd year of my undergraduate degree, sharing a house in a suburb near campus. Consequently, whilst there was a moderately busy road nearby, during the day there was regular but not incessant traffic passing by my bedroom window, which overlooked the road.

So the way I trained myself in observing the rising and falling nature of experience was to sit by my window and listen out for cars. If I construct a memory of it now, then I remember it going something like:

I am sitting and listening. I am hearing all sorts of sounds: now a bird singing, now someone yelling in the distance, now the traffic on the busy road further away. Now I am hearing the sound of a car starting to move towards me. I am focusing on this sound, and hearing it get louder and closer. I can also see the car now, and hear the whooshing noise it makes as it passes by me. I see it moving away from me, and hear the sound of it moving further away. I notice how it sounds different moving away than it did as it approached. I listen to the sound of the car fading away until I can no longer hear it.

That’s an idealised version that happened every now and again when the day was quiet and traffic at its least busy. More often than not, at some point, the sound of the car would be interrupted by another car. Maybe several cars would come past in quick succession, and my focus would change to the sound of the cars as a group, instead of just the one.

But the rising and falling of the sound stayed the same: the sound of cars got louder, then quieter. The sound of traffic began to remind me of the sound of sitting next to the Thames back in my hometown, listening to the waves crash when the tide was in, over and over.

Even now, this exercise brings me a level of peace and contentment that I can’t adequately describe. I gain, momentarily, a perspective on reality in which the inevitable rising and falling of all things implies an impermanence that speaks of freedom from suffering. It’s like the universe itself has popped into a social media exchange to declare, “and this too shall pass lol”.

All of which provides the basic experiential material for explaining the cycle of gestalt formation and destruction, which essentially attempts to map out the rising and falling of experience in a therapeutically useful way.

An overview of the gestalt cycle

The cycle of gestalt formation and destruction is generally broken down into seven stages: sensation; awareness; mobilisation; action; final contact; satisfaction; withdrawal.

Zinker gives a pretty good walk through of the cycle from sensation to satisfaction. I’ve used square brackets to annotate his description with stages of the cycle:

“The power of this description is that it gave greater depth and understanding to figure/ground formation. The figure would surface during sensation, [sensation] where the individual experiences something happening that disturbs the steady state. If the sensation holds sufficient attention of the individual, awareness [awareness] of a need would sharpen. Awareness begins to develop through a mixture of feelings, thoughts, perceptions that seek to interpret the sensation. Energy mobilizes [mobilisation] in response to this awareness of a specific need that is seeking satisfaction. The energy is released [action] and Contact is made with that which will satisfy the need [final contact]. During contact, whatever is other than the self is digested by destructuring to find what is new or different and assimilating (or integrating) it. When what is new or different has been satisfactorily destructured and assimilated, change occurs within the organism (individual) [satisfaction]. Once the original need has been satisfied, the individual returns to a steady state by withdrawing from the experience and closing the cycle [withdrawal]. When the cycle has been completed, the individual would return to sensation and wait for a new figure to emerge from the fertile ground of the individual.” (Zinker, 1977, 90-91; quote lovingly snaffled from Cleveland Consulting Group)

When I talk about “a gestalt”, I am talking about a clear figure/ground composition, an experience in which a clear focus for attention stands out from a background of other elements of experience. What’s interesting about the rising and falling exercise with passing cars is that when the figure of interest is the passing of a car, the whole experience holds up a mirror to the inherently rising and falling nature of the gestalt cycle itself.

Each of these stages is more appropriately thought of as a descriptive element of a good enough gestalt, ie the more or less smooth arrangement of experience into a figure of interest, clearly differentiated from a broader experiential background, that enables meaningful action in pursuit of the dominant need of the moment.

Withdrawal – Imagine you’ve just woken up from a deep sleep, opened your eyes, and are in a state of calm that feels empty but in a good way. Or imagine you’ve just finished a big task, sat down, and are just taking a minute before doing anything else. That’s more or less the withdrawal stage, characterised by not just a lack of any clear figure, but a lack of potential figures, and little to no sense of emerging feelings or background sensations.

Sensation – In my rising and falling example, “I am sitting and listening. I am hearing all sorts of sounds: now a bird singing, now someone yelling in the distance, now the traffic on the busy road further away”, is an example of the sensation stage. There are various proto-figures bumping up against my awareness, but I don’t invest much energy in them. Nothing “disturbs the steady state” as Zinker puts it. Maybe fuzzy thoughts, memories, or images pass briefly through my mind without sticking or commanding much attention.

Awareness – It helps to think of awareness as a light. In the sensation stage, there is a very soft, low level light, tricksy like moonlight. In the awareness stage, something has captured enough interest to begin developing into a fully fledged figure. That low level light intensifies into something more like sunlight, centred on the developing figure of interest. This is where the overall gestalt starts to dramatically re-arrange, as the figure of interest primes consciousness by pulling relevant associations into the background.

Mobilisation – A pithy gestalt saying I like is “awareness supports response-ability”. As a figure of interest develops in awareness, we mobilise ourselves in preparation to respond to the active situation. If I am aware of a glass of water, am I mobilising to drink it or pour it on a stray ember or clean my paintbrush in it? The context of the active situation influences how I mobilise, which is why in gestalt meaning is formulated as a figure considered against its ground. It isn’t the figure of interest alone that mobilises me, it is the relationship between the emerging figure of interest and its immediate context.

Action – “The energy is released”, as Zinker puts it. Action in the context of the gestalt cycle refers to whatever moment of release you have mobilised towards. It’s easy to identify the action stage of, say, swatting a fly. But looking at my example of listening to passing cars, it’s less immediately obvious, and this leads to possible objections of gestalt being overly action-oriented. In my rising and falling exercises, the key action is the passing of the car: “I can also see the car now, and hear the whooshing noise it makes as it passes by me”.

One of the things that quickly became apparent to me in observing the rising and falling of experience, was the occurrence of a peak moment. In listening to cars passing, mobilisation is covered well by the anticipation of the whooshing of the car as it passes. The action is *hearing*, which requires the action of putting energy into focusing concentration into that sense at the expense of others. It may not come with obvious bodily movements, but it remains a movement of the self, and an action of the contact boundary.

Final contact – “Contact is made with that which will satisfy the need”. Final contact can be hard to describe because it is heavily experiential and without much obvious objective manifestation. Try remembering a time you had a really insistent itch, one that needed a good few seconds of scratching. Maybe you were scratching around the area for a bit before really hitting the satisfying bit that makes you go “ahhhhhh, that’s the spot”. That, “ahhhhhhh”, is the moment of final contact; it’s the combination of the release of mobilised energy in the action stage with the experiential target of that action. It’s when you finish writing and checking an email and finally click send (ahhhhhh), or drink some water to quench your thirst (ahhhhh). It’s also the point where you get smacked in the face after bracing for impact (paf!), or when you open that bill you’ve been dreading and finally have a concrete number of £££s you can’t afford (oooof). Final contact is the gestalt’s flavour; it is fully experiencing the taste of the food of experience before you swallow it.

Satisfaction – The after glow of final contact is satisfaction. If a really good itch scratch has a final contact of “ahhhhhh”, then satisfaction is the pleasing sense of “mmmmm” afterwards, when you can still enjoy the absence of the itch. Satisfaction carries a positive value judgement, usually referring to a good thing, so it can be harder to apply it to getting smacked in the face or opening a horrific bill. But even here, there is a “sinking in” feeling that follows final contact (though with unpleasant experiences, we’re least likely to want to spend time in satisfaction, and are more prone to skipping straight into withdrawal or jumping into some kind of action to avoid those feelings). The satisfaction stage of a smack in the face is the relief of the act of violence having passed. The satisfaction stage of finding out what the damage is for a hefty bill could be a kind of resigned “well at least now I know”. If I was to rename the satisfaction stage with a more neutral word, I’d use resolution or completion, possibly even demobilisation. It is simply the feeling of the aftermath of something having happened as it falls away.

I personally think the gestalt cycle focuses more on gestalt formation than gestalt destruction, so think there’s work to be done on describing how a completed gestalt breaks down. This is potentially a side-effect of the early gestalt focus on the analogy of chewing and swallowing food. It’s fairly easy to map the process of putting food in your mouth, chewing it, then swallowing it, onto the gestalt cycle as it stands. But if satisfaction is the stage that follows swallowing, and sensation leads us into our next mouthful, where is the cycle describing the food’s journey through the rest of the digestive tract?

The gestalt cycle in practice

At this point, I am required by ancient gestalt custom to mention how Kurt Lewin once said, “there’s nothing so practical as good theory”, because the gestalt cycle is ultimately a practical tool. It’s useful for understanding what is going on with someone’s process, and pointing the way towards what to do about it.

The main function of a gestalt is to organise experience in a coherent way to allow situationally appropriate action. To this end, the gestalt cycle describes more or less how a gestalt comes into and out of being.

A common occurrence in therapy is for someone to talk about a problem they have had for a while, and experience a sudden rush of emotion. One of the most common phrases I’ve heard from clients when this happens is, “saying it out loud makes it more real”. Often, this simple experience is enough to start shifting a person out of an inner conflict and into action to rectify the situation.

The reason things feel more real when they’re spoken out loud to another person is because the process of that deliberate, purposeful communication supports contact with the content of what is being said. In terms of the gestalt cycle, we’re working with “final contact” here. There is already a sense of something being problematic (sensation), which is in the clients thoughts (awareness), and which they want to talk about (mobilisation).

The act of talking about it (action) then supports final contact with the entire gestalt, hence the rush of emotion and sudden sense of it being more real. Typically, this is then followed by a sense of calm as the tensions caught up in the problem are (for now at least) released (satisfaction).

This doesn’t mean that everyone needs to talk about something before they can make it real, just that this seems to often be the case for significant personal issues.

In the therapy session itself, the gestalt cycle offers me a way of thinking about what is happening in the therapeutic encounter at a given time, especially when things feel stuck or repetitive. It also gives me a kind of road map for a “good” gestalt. This needs to be applied gently, as otherwise all I’m doing is enforcing a different kind of shouldistic regulation: you should be forming better gestalts! You haven’t done the cycle properly!

Gently applied, it’s fairly easy to avoid that danger. The stages of the cycle simply offer one way (and a good way to avoid reification of a concept is to remember it is only one possible useful concept) of describing how to create and destroy an experience; it is primarily descriptive not prescriptive.

So in-session, it is a reflective tool that sits in the background of my attention, ideally only becoming a figure of interest to me when I spontaneously connect some aspect of the cycle with what is currently happening in the therapy. I’ve found that applying the cycle analytically just disrupts the flow of the therapy and becomes confusing. The most valuable application is when I’m talking with a client, and suddenly think, “there is mobilisation here but no action”. This is an optimal time to talk about what needs to be done and support someone in planning for action. Better yet, that mobilisation can be channelled into an experiment that rehearses or otherwise prepares for appropriate action.

On the other hand, if a client makes a huge breakthrough in therapy, and then quickly starts talking about a new topic, a kind of satisfaction klaxon goes off because we’re now skipping straight from final contact in one gestalt to sensation in another. It is rarely possible (in the beginning) with these examples to make someone “do satisfaction” (nor would it be desirable if it could), but I can at least draw attention to the process of moving quickly from one experience ending to another beginning.

Incidentally, I think the use of “satisfaction” to name this stage is exemplary, as the most effective way to live a dis-satisfying life is to never bask in the glow of being at rest between two tasks. And of course, the most effective way to become overly self-satisfied is to spend too much time resting on your laurels!

What hopefully stands out from the above is that the gestalt cycle works best as a meditation on the nature of processing experience. The more I contemplate the experiential nature of each stage, and of the progression from one stage to another, and the felt sense of what it is to spend too little or too much time in each stage, the more I assimilate the overall concept. This makes it more available to me in practice spontaneously as needed.

Recursive spiral clocks.

Timing is everything. I repeat, timing is everything!

the bristol therapist facebook page digest – january 2018

Quite a while back, I got excited and over-committed myself to an in-depth process of chewing over everything I read online that would culminate in a weekly digest. The two main outcomes of that experiment were an inability to get beyond week two, and a consequent reduction in how much online content I read.

The original point was to reduce the risk of introjecting ideas and values by ensuring that what I was reading was subjected to at least some degree of critical thought. As I couldn’t keep up with what I was reading, I was forced to question the behaviour as it started to seem compulsive. The end result was of becoming more discerning about what and how much online content I read; the unforeseen and welcome side effect of a gestalt experiment.

I still like the core idea though, so am resurrecting it in amended form for this therapy blog. I’ll aim to make it monthly rather than weekly, and focus on the articles I share through my facebook page. This also opens more possibility for dialogue, as I’m open to being sent links to interesting articles in a broadly therapy/psychology/being-human kind of vibe.

January was a quiet month for me on the facebook page, so I can overview everything here instead of choosing a top few articles. I imagine that in months where I post more, I’ll likely stick to a top five to stop this spiralling out of control.

I’m also going to err on the side of sloppy as this is meant to be about initial responses and chewing things over, so feel free to have at me in the comments.

~ ~ ~

If It’s Important, Learn It Repeatedly.

This blog post is a reflection on Cal Newport’s book Deep Work, which seems to be all about practices for focusing on in-depth pieces of work and not getting distracted. (I’ll let you know if I ever manage to read it!)

Reflecting on the inspiration he felt whilst reading the book, and how even by the end of the book that feeling was disippating, Ben says:

“The window to act on a timely idea is very small. The heat of inspiration only lasts a few days, or even hours, and if it runs out before you’ve formed and implemented a plan, you’re essentially back at the status quo.”

This resonates greatly for me in my work as a therapist (and reflecting on my own time in therapy as a client). The problem with breakthrough moments in therapy, the insights and the ah-ha of realisation, is that these moments by themselves aren’t usually enough to shift actual behaviour.

As therapists, we kind of rely on a naive assumption that, following such a breakthrough experience in the therapy session, the client will then automatically go out and change things in their everyday lives. But even a brief reflection on my own process reveals that I’m more likely to lose the “heat of inspiration” than turn it into tangible action.

This is in part why gestalt therapists assimilated the behavioural therapy practice of setting homework tasks to be carried out between sessions. This practice also lives on in modern day Cognitive Behavioural Therapy.

Then again, what we alos find in therapy is that the insights that are most important and driven by organismic need tend to recur. So at least part of the point of being in therapy long-term is to allow the repetition of gaining the same insight several times to take place in order to reinforce the necessary changes.

So when Ben talks about re-reading books:

“If you’ve ever read a book a second time, you may have noticed that it’s an entirely different experience from the first time. It doesn’t feel redundant or repetitive. Instead, it feels like gaps are being filled in. Different details strike you as important. The points you do remember now have the benefit of context, and much of it seems entirely new.”

He’s also summarising why the same insights need to be discovered and talked over in therapy. The analagy is with chewing food. Most mouthfuls of food need to be chewed several times before they are ready for swallowing. The same is true of insights in therapy; talking them over, then rediscovering them later and talking them over again allows us to assimilate the lessons and the changes more effectively.

TL;DR: “If it’s worth learning, it’s worth learning repeatedly.”

~ ~ ~

Antidepressants: Please, PLEASE, do not just abandon your meds!

This article is part of a continuing backlash against erstwhile journalist Johann Hari’s new book, Lost Connections: Uncovering the real causes of depression – and the unexpected solutions.

In short, Johann’s book seems to rely heavily on a simplistic medication = bad formulation that gives the impression people should abandon anti-depressants in pursuit of real “cures” for depression. This particularly article is a simple plea that people wanting to come off any kind of medication for depression, anxiety etc don’t just stop their meds, and at least go talk to their GP about it.

As for the wider issues with Johann’s book, well I’ve not read it so can’t comment directly on the text. However, one of the reasons I haven’t read it, and am wary of reading it, is that the very title contains two huge red flags. One is “real causes of depression”, and the other is “solutions”. The very idea that depression can be reduced to something that has identifiable causes and solutions is facile, and flies in the face of what most people discover about depression for themselves, both in and out of therapy.

I don’t mean that reasons for being depressed can’t be found, or that ways out of being depressed can’t be found. Just that, for the most part, you can’t say to someone, “your depression is caused by x, and if you do y, you will be cured”. Depression isn’t a disease to be cured.

Johann also doesn’t seem to be aware that there is a decades long tradition in psychotherapy of challenging the reductive idea of depression as a problem of brain chemistry. And performs a classic throwing out of the baby with the bathwater by seeming to conclude that medication can simply be jettisoned. Many people need to work on their depression through both medication and therapy.

So in part I shared this article to siugnal that I’m not in the “medication is inherently bad” camp. I’m still skeptical about the extent to which medication like antidepressants are prescribed, and think that a society that took depression seriously would be able to support most cases of depression without medication. But then, almost by definition, such a society would most likely experience very low levels of depression in the first place, such is the problem with any “in an ideal world” formulation!

In our current society, very little room is made for people to work through depression in the ways they need and in their own time. I get the sense that Johann Hari is arguing more or less the same thing, but presents it as a unique idea that has only just been stumbled on, and gives the impression that it’s possible to simply throw away the meds and kickstart that world right now.

TL;DR: It’s ok if you need meds. If you want to stop your meds, always work out a plan with your prescriber first.

~ ~ ~

This Is The Best Time To Do Anything: 4 Powerful Secrets From Research.

I’m a sucker for “secrets from research” type posts, even though the secrets have clearly been published in books and journals, so aren’t that much of a secret.

In the context of gestalt therapy, stuff like this plays to the idea that you’re better off tuning in to your own experience and working out what you need (organismic self-regulation) than adapting yourself to externally imposed ideas about what you should need (introjective or shouldistic self-regulation).

Which of course immediately throws up the objection that following our own needs is largely impossible given the consistent demands of school timetables and the workplace. But therapy doesn’t end at individual behavioural changes. To me, one of the signs of effective therapy, is getting people to the point at which they are able to challenge their own society and take political action.

Yes, school timetables are often rigid and tend to prioritise the needs of the school over the needs of the children and parents. So find parents who agree and channel that frustration into political pressure. Yes, the workplace grinds people into dust. So join a union, organise politically, negotiate explicit demands with other workers, and be prepared to engage in long-term political action.

Practically every course of therapy hits the boundary between individual need and social demands. These conflicts can’t be solved in one to one therapy. But they can be brought into awareness, explored, and a subsequent movement into political action can be supported.

TL;DR: Highlights from Dan Pink’s book When: the scientific secrets of perfect timing, especially for larks, night owls, and third birds.

~ ~ ~

Here’s what the evidence shows about the links between creativity and depression.

I really enjoy the British Psychological Society’s research digest. It’s a really good example of using blogging to make academic research accessible to a wider audience.

This post is based on a meta-analysis looking at the link between creativity and mental illness, prinipally mood disorders as this seems to be where the most research focuses. It suggests that a fruitful focus for further research would be into how creativity links to mood disorder.

Interestingly, in considering possible explanatons, Alex suggests creative lifestyle and the possibility that creativity simply expresses in a way that is more likely to match the symptomology of mood disorders eg:

“many aspects of the “flow state” – extended bursts of activity, disregarding the need for sleep or food, absorption or attentional wandering, rapidly flowing thoughts – are also treated as markers of bipolar disorder”

Working regularly with creative people in therapy, I’d suggest that highly creative people tend to also be more sensitive and emotionally oriented, and this opens them up to being more easily hurt by a society that tends not to value creatvity. The arts tend to be undervalued in education for example, and many of the creative clients I’ve worked with have reported feeling like they were a square peg being hammered into a round hole.

So yes, the lifestyles of creative industries likely contribute to the development of mood disorders, but the way creative people experience their world might be more casutive. Especially if you’re going to reference “the profligate substance misuse” as a given aspect of the creative lifestyle without asking from where the need for substance misuse arises.

TL;DR: Creative people are more likely than average to have a mood disorder, but people with mood disorders are not more likely than average to be creative.

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Want to take your psychotherapy to the next level? Ask for what you want.

As will become clear as I unfold The Golden Arrow, wanting offers a major in-road into understanding what we need. What I like about this post is that it encourages clients to ask for what they want from their therapist.

I’d extend that to most relationships. It’s useful to ask yourself every now and then, “what do I want from this relationship?”. This is often hard for people because it feels like a very selfish or transactional thing to ask of a relationship. But ultimately, healthy relationships develop out of some kind of mutual need, and it’s ok to ask if the relationship is still mutually needful.

Asking for what you want is a way into that, not necessarily an end in itself. And in therapy at least, it can make for really interesting sessions that can redefine where the therapy is going.

TL;DR: It’s ok, and actively good, to tell your therapist what you want.

~ ~ ~

Photo credit: “…Time…” by Darren Tunnicliff, shared under Creative Commons.

What is the purpose of emotion?

Every theoretical system has its biases, and gestalt is no exception. Along with gestalt’s bias towards here and now experience, gestalt also has a bias towards emotion and feeling.

There is a general wisdom in gestalt that emotions are Good Things, and that feeling one’s emotions is better than not feeling them. Whilst I agree with this outlook, I had tended to be fairly vague on why I agree with this outlook. So a while back I explored my thoughts about the nature of emotion in order to arrive at a better understanding of my stance on the matter as distinct from what I’ve simply picked up (ie introjected) through training, practice, supervision, and my own therapy.

What I arrived at is a relatively simple maxim: emotions mobilise situations for action.

A simple maxim, but one that requires some unpacking.

Let’s start with another foray into my good friend, the Online Etymology Dictionary:

Emotion: 1570s, “a (social) moving, stirring, agitation,” from M.Fr. émotion (16c.), from O.Fr. emouvoir “stir up” (12c.), from L. emovere “move out, remove, agitate,” from ex- “out” (see ex-) + movere “to move” (see move). Sense of “strong feeling” is first recorded 1650s; extended to any feeling by 1808.

And compare with Cambridge Dictionaries Online:

Emotion: a strong feeling such as love or anger, or strong feelings in general.

Emotions are active forces. Whilst the dictionary definition above captures the sense of strong feelings, it loses much of the background sense of emotional activity. All emotion is bodily activity. That doesn’t mean I reduce emotion to mere ‘chemical imabalance’, only that I recognise the physical basis for the experience of emotion. All emotion involves physical, bodily activity. Hence the background sense of agitation and outward movement expressed in its etymology.

Given that any mobilisation of the body involves a significant investment of energy and resource, the kinds of activity that emotions support deserve attention. This is where simple here and now description of what actually happens comes into its own. What actually happens when someone doesn’t just feel sad but emotes sadly? What happens when someone emotes angrily or expresses fear or hate or love?

What happens is that the situation they are part of responds.

At the heart of gestalt sits field theory, the observation that behaviour is a function of an organism in an environment. In crude terms, my issues are the result of my interactions with my environment, making my behaviour as much an expression of my environment as an expression of myself. I cannot be separated from my environment; at all times, I must exist in some situation or other.

Emotions are distinct from feelings in that where feelings are sensations, emotions are actions that arise out of feelings. There is a notable difference between feeling angry and being angry. That difference is physical activity. Feeling angry is becoming aware of a certain range of sensations that make a range of activity possible. Being angry is an elevation of those potentials into actual bodily expression.

The end result, if a feeling is allowed to grow into an emotion, is that some outward movement is made. Expressions of anger tend to involve raised voices, growling noises, and hitting things. Expressions of sadness tend to involve fallen faces, shedding tears and softer voices. And both have different effects on the situation a person exists within.

When someone cries with sadness, the most common supportive responses tend to be to offer comfort and to ask what’s wrong. The emotion of sadness mobilises the situation for supportive action. When someone growls with anger, again a common response is to find out what’s going on, what’s got that person mad. Where there’s a clear physical threat, the situation can then divide into support for physical violence and peacemaking. Anger mobilises the situation for conflictive action and resolution.

These are simplified examples but my general point is that emotion isn’t just about feeling something in a private internal world. Emotion is physical activity that gets responded to; British culture may be commonly described as generally repressive of emotional expression but even that is clearly a response. And a very instructive response. Where emotional expression meets with hostility and repression the lesson is clear: there is no support for your feelings here, this situation will not mobilise to support you. Other strategies then have to be found for dealing with forbidden feelings without emoting them.

So, how does this underpin my opinion that emotions are Good Things?

Because emotional expression allows for an open and honest expression of need. The result of suppressing emotion isn’t that the feelings out of which emotions arise go away (though we may block our awareness of them); the result is that we find different ways of coping with them that, to a greater or lesser extent, result in our genuine needs being frustrated. And repeatedly frustrated needs become cravings that continue to seek completion in the present out of our awareness.

I say open and honest because I’m not suggesting that emotional expression should always result in a meeting of needs. Rather, it allows for open and honest negotiation, based on the complex needs of other people, and the range of support available at the time. Emotional expression simply allows people to be aware of the range of need in a given situation. When emotions are suppressed, the underlying needs continue to seek completion but secretly and manipulatively.

Feeling one’s emotions instead of not feeling one’s emotions means knowing what one needs instead of not knowing what one needs. Furthermore, being able to express emotions means that when what you need is available, you will be able to get it. When emotions are suppressed to the point that feelings give rise to an automatic shutting down of emotive activity, it becomes impossible for the original need to be met. Think of your need as sitting in a room with a locked door; it isn’t enough to know intellectually what’s behind the door and what it needs. At some point, to be truly satisfied, the door has to be opened to allow what’s needed to get through. Feeling is becoming aware of the need behind the door; emotion is opening the door.

In order to enjoy the taste of your food, you need to chew it and savour it; physical activity that takes effort. Likewise, in order to enjoy human interaction, to be truly satisfied as a social animal, you need to engage in another physical activity that takes effort; emoting.

So, emotions are Good Things, and their purpose is to mobilise situations for action.

~ ~ ~

Photo credit: Emotion by Peter Dutton.

Resistance is fertile

Resistance is fertile

At the heart of every course of therapy sits a struggle between change and resistance.

Traditionally, the therapist is seen as an agent of change. In this view, it is the therapist’s job to help bring about change, be that the explicitly desired change of the client, or an unwanted albeit necessary change.

In gestalt therapy, this agent of change view of the therapist is rejected as a barrier to organismic self-regulation. By positioning myself as an agent of change for the client, I encourage a conflict between two sides of the client to play out as a conflict between the client and me.

Which in traditional psychoanalysis is the whole point of the analysis; to evoke the core transference that is taken to be the root of the problem, and resolve it. This sets the scene for successful therapy (the transference is resolved by change winning over resistance), and unsuccessful therapy (resistance overcomes change, and the transference stays in place).

That’s why in gestalt we talk about working with resistance by understanding the environmental context that demonstrates its necessity. And we approach that work with an openness to the range of possibilities that work entails: maybe change will win out over resistance, maybe resistance will win out over change.

Of course, the gestalt therapist smiles wryly about all this because the very act of exploring the struggle between change and resistance is in itself a change to the previous situation of keeping the conflict out of awareness. So whatever happens, the paradoxical theory of change wins out because just to contemplate one’s struggles is to act from organismic need.

The difference is that the gestalt therapist introduces awareness into the conflict. And our observation is that awareness supports response-ability. Resistance is no longer a kind of abstract disembodied force. It is me, resisting. “I can’t” becomes “I won’t”. I won’t because I don’t want to. I don’t want to because you’re asking too much of me, it’s hard, I’m afraid. Whatever is in there, awareness draws it out.

And that isn’t a magic cure; it’s not a trick. I don’t for a second think that, once we draw out the difficult thoughts and feelings and memories and fantasies that generate a resistance to some otherwise desired change, a sunbeam will break through the clouds and my client will see the light and rise up a different person. That’s not how it works; that’s not what this is all about.

Much of the time (maybe even most of the time), the end result of bringing that conflict into awareness is returning to the comfort of the starting point, of not changing.

But the power of changing I can’t into I won’t mustn’t be underestimated (and it is a therapist’s duty to explore in good faith whether that “I can’t” is in fact true; a blind person isn’t resisting sight).

It plants a seed. Maybe that’s a seed that never germinates because the end result of that conflict is a choice to give up on that previously desired change. In which case, rejoice! The gestalt is complete! Or maybe that conflict demands further rounds of struggle. In which case, “I won’t” becomes a question of motivation and support. What do you need to make this change possible? How can you get that support? Who could you turn to? What’s missing?

In the course of that exploration, the past must be contended with as unfinished business in the present. So someone told you years ago that you could never do it? How do you keep that memory active now? What is their hold over you now? It’s shocking, actually, to realise that a great number of disembodied voices holding us back turn out to be children. We introject them at a formative age, then keep the message alive as a conviction of truth. Then one day, you put that message back into context, and you’re a grown up dealing with the memory of a 7 year old child.

Resistance is also a deeply political phenomenon. When protests spring up, it’s usually an attempt to resist people in power. The French resistance against Nazi occupation stands out in Europe as an archetype of resistance. And as we’ve seen with police sending undercover operatives to infiltrate campaign groups, and the use of agent provocateurs to disrupt popular movements, the State often responds to resistance with both overt and covert violence.

This is not metaphorical. This is actual resistance in the form of one set of human beings exerting their will against another set of human beings. The hellscape that is the ongoing civil war in Syria began with resistance.

Resistance is ultimately about a clash of wills, and a loss of dialogue. The gestalt therapist’s aim is to bring that clash of wills into awareness, where it has the opportunity to develop into a conversation. Maybe that eventually supports a negotiated settlement, maybe it doesn’t.

Whatever happens, the principle objective is awareness.

~ ~ ~

Photo credit: featured image is “resistance is fertile” by Nicolas Nova.

What is gestalt psychotherapy?

From time to time, I like to return to first principles to remind myself of what I’m doing, and to what end. I haven’t written a “what is gestalt therapy?” post for a while, so here we go.

“What is gestalt psychotherapy?” is really three questions in one. And I think those questions are best approached through a consideration of the words we’ve decided to use to refer to what it is we (as gestalt psychotherapists) are doing. It’s a different way of explaining gestalt to the inside-out way of starting with how I’ve been trained to do gestalt therapy.

What is psychotherapy?

I think psychotherapy is best understood by reference to its etymology. Psychotherapy is a word with two roots.

The first, psycho, is a common prefix generally taken as relating to anything to do with the mind. Its own origin is in psyche, which refers to soul in the sense of “animating spirit”. Within the context of what psychotherapy *does*, it is this sense of the soul as animating spirit that offers a better fit than the more cognitively-weighted sense of mind.

The second, therapy, has its origin in the Greek therapeia, concerned with curing and attending to in a medical sense. It can be used to mean healing in the widest possible sense, but I particularly like the description “attend, do service, take care of”. If I ground myself in the lowest common denominator for what I do in actual therapy sessions, “attending” stands out as the most basic theme. To the point that, for some, literally feeling able to attend the therapy session in the first place is the primary therapeutic issue.

Overall then, I take psychotherapy to mean something like, attending to the animating spirit. If I lean into my more mystic side, this can become soul healing. If I lean into my more rationalist side, this can become treating the mind. But right there in the middle, I think “attending to the animating spirit” points towards the range of activity that is covered by the term psychotherapy.

What is gestalt?

In the most basic sense, gestalt is a German word that seems to get translated into English most roughly as “shape” or “form”. More descriptively, a gestalt can be called a configuration or structure that is more than the sum of its parts. Neither of these quite captures the sense of gestalt that comes from the consideration of gestalt psychology that inspired the original naming of gestalt therapy.

For me the gestalt concept is the sense of an overall meaning that emerges out of, and then organises the ongoing experience of, a combination of elements. It’s about how we come to perceive something as a recognisable object by breaking it down into specific features that combine in a certain way.

Suppose you take a load of lego blocks and make a dinosaur. Then you take the dinosaur to pieces and use the exact same blocks to make a spaceship. The parts you are using are the same in both, but the way they are arranged is different. And, crucially, the starting point for both is the final whole; it is the meaning of dinosaur or spaceship that organises my arrangement of the lego blocks into a shape.

So gestalt isn’t just about meaning in a general sense; it is about a meaningful whole organising perception. It’s about context shaping meaning. Gestalt Therapy could just as well be called Context Therapy and not lose much in the translation.

Overall then, I take gestalt to mean something like a meaningful context. So when we talk about the gestalt of something, we are talking about the contextual qualities that give that thing its meaning, the key features. We’re describing the perceptual cues that explain how we know that this something is the something this is. And we are also describing how, once the overall context is established, it shapes how we understand the things that arise within it.

What is gestalt psychotherapy?

Putting the above together, gestalt psychotherapy emerges as a way of attending to the animating spirit by investigating the meaningful context from which that spirit emerges.

This is core to viewing what might otherwise be called neuroses, issues, or behavioural problems, as creative adjustments. Rather than work in the spirit of solving problems, gestalt therapy involves working in the spirit of seeking out the meaning of behaviour and experience. That is, I ask myself, “what is the context that makes sense of this?”.

This in turn connects two important aspects of gestalt therapy theory: field theory and the here and now. My starting point for understanding field theory is the phrase, “behaviour is a function of an organism in an environment”. Not only does this emphasise contextualising what is happening, it also emphasises the need to work in the here and now, on what is happening right now.

Overall then, I take gestalt psychotherapy to mean something like attending to the meaningful context from which the animating spirit emerges. Which in practice is about attending to the relationship between the animating spirit and that context.

I’m still not sure what that should sound like as an elevator pitch; I’m not sure that, “I investigate the relationship between a person’s animating spirit and the meaningful context from which it emerges” is going to be cutting much mustard.

For now though, something like, “make sense of troubling experiences by putting them in context”, might work as an ice-breaker for what gestalt therapists actually do in practice.

~ ~ ~

Photo credit: Context is King by Rebecca Jackson

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