Monday, January 11, 2010

Gestalt Therapy and Humanistic Psychology

Psychology is a discordant discipline. The beginning of the 1900s saw the rise of behaviourism in the laboratory, and the ascendancy of psychoanalysis in the treatment room. Around mid-century a new trend appeared, opposing both of these entrenched positions and dubbed 'The Third Force' by Prof. Abraham Maslow. Within this broad rubric, Maslow includes all of the psychological approaches which focus on a more humanistic view of man.
Today there are probably more than four hundred different schools of psychotherapy. The Freudian empire is no longer all-powerful; in fact, many recent books (e.g., see Webster, Crews and others) have helped to diminish Freud's status, but he is hanging on a bit longer than that other revolutionary 19th-century thinker, Karl Marx, who also founded an authoritarian movement.
Humanistic psychology is rooted in respect for the individual; it is not a specific theory of psychology per se, but represents a new orientation – putting the person in the centre, not abstract theory. For example, today people who visit a psychotherapist are no longer considered 'sick' or 'neurotic'; therapy is instead seen as an educational process concerned with personal growth. An individual who is already quite successful may simply wish to expand his horizons a bit further; it's not just a question of curing some mental illness. The goal is no longer 'adjustment to society' (a general Freudian aim), but to become more human, more oneself. Maslow applied the elegant, but perhaps by now over-used term 'self-actualization'.
One of the leading schools in this field is Gestalt Therapy, which can be traced back to the collaboration of Fritz Perls and Paul Goodman (see the basic text, Gestalt Therapy, 1951). Perls was originally trained as a Freudian analyst in Germany but became disillusioned with the abstractions and rigidities of psychoanalytic practice. His first book (Ego, Hunger, and Aggression), criticizes Freud from the holistic and semantic viewpoints. Instead of postulating abstract terms such as ego, unconscious, id, etc., Perls' primary concern is with the actual continuum of awareness – the contact at the boundary point – a concrete, existential approach refreshingly free of any extraneous interfering outlook or 'ism'.
In constructing his new approach to psychotherapy, personality theory, and psychopathology, Perls drew together ideas from a variety of sources: Kurt Goldstein's organismic framework; the academic gestalt perceptual theory of Köhler and Wertheimer; the Moreno psychodrama technique, Wilhelm Reich's focus on non-verbal aspects (i.e., breathing, the body, etc.), and the use of 'feedback' from Carl Rogers. He applied to this new mixture a radical existential thrust: the Here and Now.
In a gestalt session, the focus is always on the immediate present, the existential Here and Now. What this means is that by paying attention to the continuum of awareness, it is not necessary to dig up the past; instead one finds that the most important unfinished situations emerge and can be dealt with in an experiential and experimental manner. Forget Freud's archaeological seeking of past memories; by being aware from second to second on what is going on, by concentrating on the immediate present, major concerns are brought up and confronted.
The basic idea of concentrating on the immediate present may seem like an easy task, but in reality it presents a challenge, since people generally avoid it either by reminiscing about the past ("The good old days were much better." "Last winter I was in Spain." "Yesterday I saw a great film on TV.") or ruminating about the future ("If only I could find a better job." "If I get a good grade on my exam, I'll be able to graduate next year."). The central problem is that we spend much of our time avoiding the present by gliding into the past or the future, but the body is always in the Here and Now. Thus, the individual is split and a great deal of energy is wasted by being somewhere else, past or future, rather than being focused on what is happening right now. So if our energy is split up in this way, there's not much left to work on present concerns and problems.
The goal of gestalt therapy is to bring the person's awareness back to actuality, to the now, where he can existentially face himself and take responsibility for his actions.
If conflicts emerge, they are not to be explained as in psycho-analysis by tracing everything back to childhood, but to be resolved here and now. Instead of asking "Why?" – the usual analytic question, leading to a theoretical explanation of causes, the gestalt therapist asks "How?" – through the living and re-living of a painful situation in the now.
Unlike psychoanalysts, gestalt therapists do not stress the concept of the unconscious. Perls uses an alternative theoretical model for his therapeutic work: the gestalt psychological theory.
It is not necessary to postulate a hidden, unknown unconscious driving human behaviour, as in the Freudian school. Rather than being mere passive recipients of instinctual forces, human beings impose their own perceptions on the world. Thus, to a certain extent, we structure our existence and must take responsibility for our actions. The well-known gestalt illustrations of figure/ground configuration (see Figure 1 below) shows that we don't just resond
Gestalt illustrations of figure
passively but interact with the environment. I can choose to organize the picture one way, for example, by focusing on the two profiles; or I can turn it around using my powers of concentration (i.e., reversing the figure/ground gestalt) and see the vase in the foreground with the remainder dissolving into the background. We structure our perceptual reality; in the same manner I can focus on my breathing, or on parts of my body, etc. and put everything else in the background.
In the same way, we can select certain memories from the past to focus on, neglecting others. This existential application of the gestalt psychological principles means that it is a 'cop-out' (bad faith) to blame one's parents for one's own behaviour.
Fritz Perls was one of the great innovators of group therapy. While gestalt therapy is also applied to individual and family therapy, it was his group methods that are perhaps best known. Each of us, according to Perls, uses only a fraction of our total ability; but growth is possible through improved self-contact and contact with others, which can best be achieved in a group setting.
Around this time, the 1960s, the cultural revolution in the USA led to many radical new forms of therapy, – personal growth groups, etc. Their rise in popularity was partially due to the success and fame of Fritz Perls. This was the time of encounter groups, sensitivity training and a plethora of 'wild therapists', many with minimal training or experience. One problem with the many new therapies in this burgeoning 'humanistic psychology' movement was the complete rejection by many of all theory and structure. Because there may be sound reasons to reject some of the Psychologies we were taught in school is no reason to assume, therefore, that anything goes. The new demand for 'spontaneity' led to many injurious groups, for example, with patients as well as therapists being violently attacked, thrown out of windows, etc.
We see this fallacy operating today in the many variations of group therapy (or 'personal growth' groups) now foisted upon the public. Most of these stem from the early group techniques of the 1960s and 70s; the same ploys wrapped up in a new packaging, with slick-sounding labels, etc. It is as though having for once rid ourselves of the Freudian archaic structure, with its archaic and unnecessarily rigid rituals and restrictions, the floodgates have opened and anything goes. Just about anything is allowed which is considered to be therapeutic … as long as it is done within the group …with a charismatic leader or guru. Well, there are groups, and then there are groups.
But clearly, denial of all structure is not the answer. Whether the leader recognizes it or not, there are certain 'group dynamic' principles evolving in any group situation. And not to be aware of these vectors is simply to give in to chaos, or even worse, 'group fascism'. The aggression games used by some leaders are more likely an expression of their own unresolved sadism than any system of therapy.
For example, many group leaders operate in a mode which might be called 'group fascism', coercing all group members to participate in whatever activity the leader may suggest. Obscured is the relevant point that not all members may be ready for this step; and thus such a manoeuvre works against the goal of freeing people from their dependence on others, and often actually inhibits the development of independence and personal growth.
Often this is done under the false guise of 'spontaneity'. True spontaneity, it ought to be said, does not come from forcing people to express some programmed emotion which they do not feel, but emerges by providing a supportive structure and then awaiting the appropriate situation.
One sees this type of phoney expression of emotion in many guru-led groups today: the members are requested to touch, hug, or kiss each other, all at the call of the Leader. Various individuals even develop a special 'all-purpose hug' which they call forth indiscriminately. Others may not want physical contact with anyone, but reach out blindly and become even more deadened.
A person in a group setting should always feel that he, as an individual, always has the alternative of saying NO. Any other approach obliterates self-identity and results in the nauseating spectacle of scapegoating, wherein other members form a wolf-pack and attack the exposed individual ruthlessly for refusing to go along with the group.
Usually, such bloodletting is spurred on by the Leader, who perhaps feels hurt because his instructions were not followed. Thus a command such as 'embrace everyone' may lead to enormous pain and hostility and is counterproductive of the feeble attempt to encourage warmth and cooperation.
In other 'fascistic' groups, this pressure toward complete conformity is exerted in a more subtle manner. Especially insidious is the type of group where the individual becomes 'swallowed up' and coerced by approval of others into submission to the group line.
This denial of individual boundaries is an indication of an incompetent group leader; such bulldozer tactics have nothing to do with humanistic psychology per se, but unfortunately they are endemic in most guru-driven groups, whatever they are called.
Naturally, Perls follows the existentialists in holding for free choice; in a true gestalt group, there is always a 'go-around' in the group to give each person a chance to air his opinion. The style is democratic; the leader is 'first among equals' not a dictator. And every individual always has the right to say NO to whatever the leader or group suggests; such a NO is respected. Even if the NO stems from weakness, the attitude is: this is the best he can do at this time. The therapist's aim is not to 'break down' the defences of the patient using a bulldozer, but to allow the strengths of each person to gradually grow so that novel ventures into the unknown can be attempted, at the proper time.
Many of Perls' new group methods have been adapted by others with the limitation that they lack his background in making genuinely effective use of them. In addition to years of therapeutic experience, Perls had studied theatre and his experimental use of dramatic elements is one stimulating feature of gestalt therapy. The general notion behind these therapeutic moves is the idea that the therapist (as a kind of Zen master) guides the patient to try out things in a new experimental way, sometimes by suggesting various scenes (what would happen if…), never interpreting, because if you tell them what to do or what it means, they are robbed of self-awareness and self-discovery. In the best case, the patient gets his own message and forms his own new gestalt. Thus, if a man mentions his mother, we don't encourage him to reminisce about her or about childhood interactions with her, but instead, if appropriate, ask: "Can you imagine your mother sitting in that empty chair right now: what would you like to say to her?" (This is a radical shift from the usual therapeutic reliance on the past mode of remembrance into an approach which brings the event into a lively here-and-now situation.)
This empty chair method is a special adaptation of the Moreno psychodrama technique, modified by Perls to bring such memories of the past into an actual, experiential here-and-now encounter, with all the present liveliness and interest that go with it. Note the difference between the two methods: in Moreno's approach, various group members are brought in to play 'mother', whereas Perls introduced the more individualist style of having the same person play all roles. (Imagine having a dialogue between you and your mother then shift from one to the other alternately changing seats.) This inner encounter drama often makes more clear how one relates to significant others (e.g., notice how your voice becomes shaky when you speak to her, etc.). Never interpreting, always cleaving to the here and now, with the therapist stating only what is obvious – just what he sees and hears, in a kind of witness attitude.
The Moreno method perhaps has one advantage, that of achieving greater group participation. But in my experience, the Perls' empty chair exercise is better for reaching understanding on the part of the individual involved, since only he knows his mother, and often by role-playing her in this experimental dialogue, he achieves new insight into his behaviour and hers.
The goal of the leader here is to set up what Perls calls a 'safe emergency', i.e. an existential moment of truth. The person in the hot seat is put to a difficult test, an emotional challenge, yet at the same time it's relatively safe since both the leader and the group are there to offer support. Given these factors, the person may outdo himself and his usual expectations, reaching a new 'Aha' experience.
Some ambitious, charismatic or quasi-religious group leaders may use a group to break down people, wearing down resistances in a ruthless manner, but this has nothing to do with the genuine therapeutic process and leads down the road to group fascism.
Gestalt therapy is not just about whatever Fritz Perls happened to be doing at any particular time. In general, though every therapist has his own individual style, one can discern two divergent schools of gestalt therapy today. Laura Perls remained in New York and headed the Institute there for many years after Fritz moved on to the Esalen Institute where he developed a more flamboyant theatrical 'California' style. At this time, Fritz travelled all over the USA, specializing in razzle-dazzle workshops for professionals. In a typical group, he focused on one person at a time in the 'hot seat' while the rest of the group acts as a kind of Greek chorus in the background. Fritz wanted to leave his mark on the coming generation of therapists, and he was an impressive figure with his flowing white beard, sensitive eyes, and flower-power clothes. The 'New York' school, on the other hand, holds to a more egalitarian group style, with each member of the group participating equally. Frequent 'go-arounds' elicit feed-back from participants, a process which keeps the group centered on concrete, democratic concerns.
Beyond the fringe there are many other groups that utilize various powerful gestalt techniques and exercises, without the underlying values of tolerance and respect for the individual. In any true gestalt group, each person reserves the right to remain silent, 'pass' on occasion and not take part in a particular exercise, etc. Unfortunately, many of today's groups have gone beyond the edge here, resulting in the master/slave mentality of many groups and cults.
For a true therapy experience is a relatively short-term visit that should give an individual tools that he can take home to use in his life; ultimately, the group goal is for each person to return to his own life. A group should not be a recruitment procedure for a life-time commitment to a cult of look-alike slaves.
One obvious sign that a group, whatever label it may use – personal growth, learning workshop, an anagram, etc. – is veering toward an unhealthy cult, is the requirement that everyone look alike, dress identically, and think collectively. This is more an example of the introjection of an authority figure, which leads to unhealthy dependence. Many of today's leaders tend unfortunately, in this direction, keeping the group members in constant subordinate position.
But the tyrannical leader, whatever label he uses, omits the last, most vital lesson of Zarathustra: "Now, do without me!"


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