GESTALTHERAPY

One of the most popular directions of modern psychotherapy is gestalt therapy, which many authors include in humanistic psychotherapy. It originated from Gestalt psychology. The word gestalt can be translated from German both as a complete image and as a construction, in such a broad sense it is understood.

Gestalt psychology, as well as gestalt therapy, proceed from the statement that psychology (and especially psychotherapy) should not deal with individual personality elements, isolated mental processes, factors of psychological influence, but consider them in a single complex and relationship.

Many theoretical approaches and practical techniques not only from gestalt psychology, but also from psychoanalysis, bodily therapy, existential therapy (this will be discussed later) are reflected in gestalt therapy. However, this is not just a mechanical connection of various ideas and techniques, but a rather well-balanced and reasonable system, which is considered to be an independent direction of psychotherapy.

In the West, gestalt therapy was the most common among non-professional psychotherapists. Psychologists, social workers, and teachers master it in a fairly short time. There she has perhaps the closest links with the social work system.

Federick (Fritz) Perls (1893-1970) is rightfully considered the author of gestalt therapy. At first, he became interested in psychoanalysis, but while working in the hospital with patients who had suffered craniocerebral injuries and shock states, he felt the need for more effective assistance to them.

Pearls rejected classical psychoanalysis (although he left many of his work items), considering the Freudian “digging” in early childhood memories to be erroneous and ineffective. Pearls believed that a person and his psychological problems were not so much influenced by past (and especially earlier childhood memories), but primarily by today's and to a certain extent expected events. This principle of working with the present , and not with the past, Pearles called "here and now." (It must be said that this principle is somehow present in behaviorism and even in some post-Freudian schools of psychoanalysis.)

Here and now

When working with the client, the “here and now” principle reminds the psychotherapist of the importance of constantly returning the client’s attention to the actual situation he is experiencing, tune in to the upcoming work with the psychotherapist to resolve this situation, rather than thinking about the past and the future. Along with this principle, gestalt is distinguished by a number of fundamental provisions.

The shape and background

This is the already mentioned principle of integrity and figurativeness . Emphasizing the need for holistic perception, taking into account the interaction of all internal and external factors affecting the client, Pearls identified the figure and the background in this holistic picture. Such an integrated approach helps to more objectively evaluate each of the elements of the gestalt, because what individually looks like a disadvantage in the complex can be an important factor in the mental adaptation and interaction of other elements.

Gestalt therapy sees its task in destroying the vicious gestalt of the client (wrong, traumatic perception of himself and the situation), and then help himself construct a new positive gestalt. In fact, only the client himself can build a new, more positive from his point of view, the gestalt of his life.

Often, as a visual example of the different gestalt of perception of the same situation, different pictures are given, turning over which we get the completely opposite expression of emotions. These techniques emphasize that our perception is very subjective and often depends not on the object, but on how we look at it.

Another major principle of gestalt therapy is the principle of expanding consciousness.

Expansion of consciousness

This term, as well as “here and now”, has been extended in other types of psychotherapy and even in philosophy and pedagogy. The essence of it is to allow the client to see the seemingly intractable situation from the other side (or from different sides), and thus exit from it. In a broader sense, the expansion of consciousness allows a person as a whole to look differently at his whole life and at himself in this life, to see not only the ways to overcome obstacles, but also the possibility of more complete self-realization.

Often the techniques of the expansion of consciousness are purposefully used to swap the figure and background, that is, the background (or its fragments) to make the figure (bring to the fore, the center of attention), and the figure (unnecessarily occupying a central place in the mind and interfering with the correct vision of the situation) translate into background.

Work with opposites

The next principle is working with opposites. Our perception "slag" stamps. We voluntarily or unwittingly attribute people and their actions (including our own) to various evaluative categories such as “good - evil”, “good - bad”, “useful - harmful”, “defending-assailant”, “we - they” and t .d

The gestalt therapy includes exercises that allow us to be convinced of the bias of our assessments, and often in their duality. Such a duality of emotional perception of the same person, act, event in psychology is called ambivalence of feelings.

Ambivalence of feelings

Ambivalence (duality) of feelings is not necessarily a sign of any mental disorder. This is a completely normal property of any mentally healthy person: so, with jealousy, we can both love and hate. The same can periodically occur in the relationship of children to parents and parents in relation to children, in the relationship of brothers and sisters, etc. Or, for example, a person who has received help may experience both a sense of gratitude and a sense of humiliation.

Returning to the beloved home from the holidays, we can feel at the same time both the joy and the sadness that the holiday was over.

Any outstanding writer, musician, artist, athlete, any professional who fanatically loves his work, has moments or even lags of failures or overstrain, when he literally with disgust forces himself to continue working, but if he is deprived of this work, he will become even more miserable .

Doesn’t it happen that we rejoice at someone’s success, are proud of this person (especially if this is our close one) and at the same time envy him?

I repeat, all of these are normal moods for every person, which, as a rule, do not cause us serious problems, at least those with which we cannot cope ourselves.

The work of a psychotherapist begins where this ambivalence of feelings becomes “incoherent”, they enter into a contradiction tormenting a person, which he cannot resolve himself. Perlz believes that the main task at this stage is to help the client find something “third” that lies somewhere between these painful and emotionally opposite relations for him and reconciles them.

In the ideal case, a “third relationship” can be formed, which is generally “from another dimension” and eliminates both previous extreme feelings (simultaneous love and hate, gratitude and humiliation, etc.) from consciousness.

Sequential Freudians see in such repression from the consciousness of traumatic feelings the causes of the aggravation of neurosis, but Perls does not think so and cites enough examples from his therapeutic practice. (To be fair, it should be noted that Freud's conclusions are also based on a great deal of practical experience.) Perls agrees with Freud that the consciousness of an individual has certain defense mechanisms against stress and other psychological problems in the form of various forms of avoiding them, biased perception, blunting of sensitivity to them and so on However, he emphasizes not only the negative, but also the active adaptive role of such treatments, even in delusions and hallucinations. The individual unknowingly stops contact with the real, traumatic his reality.

According to Pearls, only such “leaving” (such protection), which, instead of protecting the psyche, only aggravates the problem, evading its solution into self-deception, can be considered negative. Therefore, the psychotherapist must distinguish normal protection (even in the form of self-deception) from negative, aggravating neurosis, and help the client not to be freed from any, but only from such negative protection that prevents them from better understanding themselves and the problem. And only after that does work begin to solve the problem that caused the neurosis.

As you know, the concept of mental health is very conditional and has different definitions.

In gestalt therapy, the state of mental health is characterized by so-called maturity . We can say that it is a question of social maturity, which does not always correlate with biological and even with what is commonly called mature life. Social maturity is characterized primarily by the realism of the attitude towards oneself, towards others, towards the surrounding reality, with the ability and willingness to bear responsibility for one’s actions.

This is precisely what many neurotic personalities lack, for whom, regardless of age, a “childish” care of problems, shifting responsibility for them and leaving them to other people and circumstances is typical. And this, of course, not only does not solve the problem, but also aggravates it.

An important condition for gaining social maturity is finding an individual with the help of a psychotherapist of support in the outside world and finding such support in oneself.

One of the signs of an awakening maturity can be considered the willingness to accept a certain risk on oneself undertaken by active attempts at independent (albeit with the advisory guidance of a psychotherapist) getting out of the frustration impasse . We remember that the frustration impasse differs from the real impasse in that this provision is not objectively hopeless, but only as perceived by this person. Therefore, the psychotherapist should bring to the consciousness of the client that his deadlock is frustration, not real, and that there are exits from him, but they are possible only with the determination and activity of himself. These are the ways out to the reality of perception of oneself and a problem from that contrived state which justified the departure from making one's own decisions and actions. In this case, the therapist reduces his support to the necessary minimum, gradually transferring more and more responsibility to the client.

Support mainly consists in creating for the client (both in the group and in individual therapy) an atmosphere of comfort, safety and at the same time benevolent criticality, which does not allow self-deception of hopelessness from real responsibility for oneself and solving one's problems.

The therapeutic interaction creates a safe critical situation due to the fact that the situation is both real and model, as well as a security atmosphere formed in individual therapy or in a group, allowing you to make risky decisions.

WORKSHOP

Currently, gestalt therapy is most often practiced in the group version. Technically it looks like this.

Hot chair

The members of the treatment group sit on chairs in a circle. One of the members of his own accord, who is tactfully “provoked” by the therapist, sits in the middle of the circle on the so-called “hot chair” and begins to speak frankly about his problems and answer questions from other members of the group.

The therapist begins to work with this person, and the group creates a benevolent atmosphere of support for this work and the revitalization of the individual. Such support not only helps to gain courage and independence for this individual, but also allows other members of the group to penetrate into their own problem and begin to look for similar ways to solve it, through their own activation.

Here and now

We have already talked about this important principle of gestalt therapy. He must be constantly remembered.

The psychotherapist, and with it the group, try to hold or return, if necessary, consciousness to today's problems, without being distracted without objective necessity (for example, to briefly communicate important information for a given moment) to the past.

As soon as the individual turns to the past to explain his current psychological problems, the psychotherapist or someone from the group tactfully interrupts him and asks him to “play” these past moments again as today, finding at the same time the end of these situations that he failed to .

Based on the fact that some internal or external conflict turned out to be a traumatic factor for a client, gestalt therapy helps the client to recreate a conflict situation in the present and look at it from the perspective of both conflicting parties or factors.

A typical exercise in solving this problem is the following.

Two roles

An empty chair is placed opposite the client sitting in the “hot chair”; it supposedly contains an imaginary person with whom the client has an open or hidden, but frustrating and unresolved conflict.

The client begins to play two roles. From his chair, he turns on his own behalf to an imaginary partner, and after transplanting in his chair, he tries to understand the state of the other and answer for himself.

Sometimes, a member of the group chosen by the client may be located opposite the client, to whom he explains the role of that person. In the process of such an explanation, he involuntarily begins to look at the conflict through the eyes of the other side — it is better to understand the other.

By the same principle, dialogue with oneself is built up in the event of an insurmountable inner contradiction. Then the other person of the individual person becomes an imaginary partner, that is, attempts to establish a dialogue between the conflicting parties of the same person begin.

I repeat, the most important condition for gestalt therapy is to consider all the traumatic events and factors not in the past, but to actively experience them at the present moment, as if all this is happening here and now . In this case, the client should try to feel as vividly as possible not only the spiritual, but also the bodily sensations that accompany this experience.

It is believed that in this way (although not only this way), an expansion of consciousness is achieved, which allows one to get out of the "shor" of the previous perception of the situation as insoluble.

The psychotherapist intervenes only as a last resort of a clearly wrong or too painful development of the situation.

In most cases, the client needs only to feel the presence of a psychotherapist. Then he has a feeling of security similar to that experienced by a novice swimmer, knowing that in case of danger he will always be picked up by the hand of an experienced instructor.

The next most important condition for successful gestalt therapy is the so-called feedback.

Feedback

This is a constant psychological connection between the client and the psychotherapist, who becomes like a mirror for the client, in which he begins to better see himself, his situation (problem), more objectively evaluate his states and their behavioral manifestation.

Act

The third important condition for gestalt therapy is action, i.e. customer activity. The therapist in every way "provokes" the independence, activity and initiative of the client in the processes of self-awareness and behavior that helps such self-awareness and the solution of his problem.

The awakening of independence and decisiveness in the choice of one of two chairs begins, each of which conditionally corresponds to one of the alternative solutions. That is, the internal solution is immediately supported by a specific physical action.

The fourth condition for successful gestalt therapist is his ability to organize and conduct the so-called gestalt experiment.

Gestalt experiment

The essence of the gestalt experiment is as follows.

The therapist acts by trial and error, that is, he changes various model situations and offers the client different behaviors. Such creative searches, while constantly provoking the activity of the client himself, continue until the psychotherapist together with the client find something that helps to solve the problem or at least move in this direction.

For example, a client complains that he cannot overcome the barrier of alienation in a relationship with someone close to him (usually this happens between spouses, parents and children, brothers and sisters).

The therapist suggests that the client inspire himself that he has successfully overcome this barrier. This self-hypnosis he fixes the real action. That is, the client gets up from his chair, steps over the mental barrier (or a line drawn with chalk, a stretched rope) and passes to the chair of the one who (imaginally) was on the other side of the barrier.

Now the client should listen carefully to himself and analyze how he felt, overcoming this barrier and going over to the side of the other. He should try to get into this state of overcoming the barrier and feel how relationships and interactions between him and this close person are built without a barrier.

Sometimes both real participants of a given situation can participate in such a game, if both of them (for example, spouses who respect each other and want to keep the family) are equally concerned about this alienation that cannot be overcome and together turn to a psychotherapist for help.

К сожалению, в результате такого гештальтэксперимента клиент обнаруживает, что этот барьер создавался им (или тем человеком, или ими обоюдно) подсознательно как некая буферная система, без которой их несовместимость станет еще более очевидной и мешающей.

Разумеется, психотерапевт, должен путем нескольких экспериментов и тщательного анализа реальных и воображаемых состояний клиента (или клиентов) убедиться, что это действительно так, а не ошибка эмоционального прогнозирования. Однако даже при установлении того факта, что данный барьер непреодолим или что попытка его разрушения лишь усугубит ситуацию, не может быть однозначных решений. Нужен всесторонний анализ проблемы и возможных последствий тех или иных действий.

Легче всего посоветовать несовместимым людям разойтись. И если с объективной точки зрения так для всех будет лучше, то следует готовить людей к такому решению, особенно если их возраст и другие индивидуальные особенности позволяют им надеяться еще встретить более совместимых партнеров.

Однако в реальной жизни это не всегда возможно. И к тому же от этого могут пострадать и они сами, и их близкие и общее дело и т.п. В таком случае надо помочь клиенту осознать, что этот барьер некоторой отчужденности надо принять не как несчастье, порожденное тобой или другим, а как наиболее оптимальную форму сосуществования с этим человеком и смириться, не мучая ни себя, ни его.

Очень часто после такой психотерапевтической работы отношения этих людей переходят в другое качество, взаимные упреки и самообвинения заменяются спокойной взаимоуважительностью и готовностью к взаимодействию и взаимопомощи.

Разумеется, это происходит не сразу и лишь при готовности клиентов к активному сотрудничеству с психотерапевтом, а главное друг с другом.

Эффективная работа с группой предусматривает определенную психологическую подготовку ее членов к работе на «горячем стуле» и вообще к активному сотрудничеству друг с другом и с психотерапевтом.

Для этого существует множество упражнений, способствующих, говоря терминами гештальттерапии, расширению сознания . Приведем наиболее популярное из них.

Сейчас я осознаю...

Сущность этого упражнения - тренировка активности и усилий клиента, направленных на анализ содержания своего сознания в данный конкретный момент в соответствии с уже упоминавшейся главной установкой гештальттерапии: здесь и теперь .

Упражнение состоит из периодически повторяющихся усилий такой концентрации внимания, начинающихся после произнесения клиентом «пусковой» фразы; «Сейчас я осознаю...» Клиент повторяет периодически эту фразу в течение нескольких минут, добавляя к ней описание содержания своего сознания в данный конкретный момент.

Это и другие аналогичные упражнения гештальттерапии, направленные на концентрацию сознания на самом себе (здесь и теперь) и способствующие расширению сознания, освобождая его от оков прошлого и штампов, широко используют элементы техники медитации (см. медитативную психотерапию), дзен-буддизма, йоги и других восточных систем психофизического совершенствования.

Не подражая полностью психоаналитическим приемам З.Фрейда, гештальттерапия все же уделяет значительное внимание работе со сновидениями. Несмотря на большое количество различных технических подходов к этой работе, суть их состоит чаще всего в том, что клиент выступает в роли одного из персонажей своего сновидения, говорит от его имени, пытается осознать и передать его чувства, объяснить поступки.

Считается, что в каждой из разыгрываемых ролей клиент так или иначе выдает самого себя, хотя иногда это происходит крайне завуалированно и требует большого искусства правильной интерпретации со стороны психотерапевта. Тем более что практика применения этих упражнений показала, что клиент чаще «выдает» свою сущность не в главном, а в одном из второстепенных персонажей сновидения, который может не привлечь внимания самого клиента и членов группы (если это проводится в группе, а не индивидуально).

Интерпретируя вместе с активно сотрудничающим клиентом его сновидения, психотерапевт помогает ему лучше осознать себя самого, свои проблемы и взаимоотношения с другими.