Case #48 - The witch, the money, and the sickness

Song-li had serious health issues over the last year. After several operations, nothing physical had helped much, and things had both got better, then worse. So the psychological was the next explanation. She had done various therapy pieces on the matter...so I was wary about not repeating them, and asked her directly what she had already addressed. Its not good to load too many different approaches onto the same problem, and this requires some careful professional judgement. 

If you go to a doctor, it might be good to get a second opinion, but probably not to get 4 or 5 - thats just confusing. To keep working on the same issue, with the same therapist can produce depth, but ‘shopping around’ can be counter productive. So I didnt want to just automatically dive into the issue.

I asked about the context - what had happened a year ago when she first started experiencing the health problems.  She related how she had been purchasing some paper ‘money’ used in China for burning, generally as memorial for someone. Her father had died 5 years previously, and she was buying it for this purpose.

As she was purchasing it a ‘witch’ (her words) had warned her not to buy too much or she would get sick. She immediately tried to return the purchase, but the shop would not take it back.

Soon after, her illness occurred.

I asked her about her relationship with her father. It had been close, nourishing, and she thought about him daily, often associating him with elements of her life, such as her son.

Finding out the circumstances of someone’s field can be important, rather than just going directly into the emotional issues. The context provides important information which can help guide the direction of the therapy.

So I asked more about the frequency of the thoughts - after 5 years, it seemed to me to be quite a focus, and indicating some kind of unfinished business.

She couldn't really answer what that was about, or even really how she felt when she thought of her father, though it appeared to be positive.

In further sessions it may be possible to go deeper into her awareness, but given the clear lack of entry, I didn't want to just probe, but rather stay with what she presented. This is one of the ways we dont push through ‘resistance’ in Gestalt.

So I sat for some time, taking in what she had said.

I wanted to use the structures she had in place already - the money, the witch, and her (almost) obsession with thinking of her father.

So I proposed to her some homework - an extended Gestalt experiment.

I suggested she purchase one single piece of the paper money. I enquired, and she had a picture of her father on her computer. So I told her that every single day, at the same time, she could use scissors to cut a tiny piece off of the paper money, put it on a burner, turn on the computer picture of her father, ask him to bless her life, and then close the picture.

This is what in brief therapy is known is ‘prescribing the symptom’, and is paralleled in Gestalt by the ‘Paradoxical theory of change’. Being more fully with what is.

She wanted more - clearly an extension of her restless seeking of more therapy on this topic, as well as an isomorph of what the witch had warned her about - ie, don't be greedy for get too much ‘stuff’ of value - as represented by the money.

Nevertheless, I noted her restlessness, and would consider it for further work at another time.

She was on sick leave, so I asked about how she spent her day. She was at home, and basically had 8 hours in which she cooked, rested, and went for walks.

I asked if there were any social issues which mattered to her, and she replied in the negative.

So I suggested that she find a service project that she would like to start up, and establish it in the name of her father.

This changes his symbolism, as a springboard to life and engagement, rather than dwelling on illness, death, and disengagement. It also gave her something positive to focus on during the day - something ‘to live for’.

Case #47 - The end of a relationship is a new beginning

This couple had been struggling for some time.

The first thing Rhonda said in the session was - ‘my parents divorced, and I promised myself I would never ever do that to a family I created’. She was extremely distressed. Brian put his arm around her, but she pulled away. 

I asked him to move opposite her so they could see each other.

The second thing she said was, ‘I am done. I cant go on anymore. This relationship is over for me.’

Brian was shocked. He told her he had heard her say this many times before, and he had been working hard to make changes over the previous few months. He started to explain this...I stopped him. Explaining is seen as a way of avoiding the ‘what is’, from a Gestalt perspective.

I asked him to just tell her what he felt. After a lot of support, he told her he felt panicked and abandoned. He started crying.

She sat there for some time, not saying anything. When I prompted, she said she was blank; it was too much emotionally, and she had exited her awareness. In Gestalt, we don't push someone when this point arises.

So I worked more with him - explaining that she was not available, so no point continuing to push; I sat with him in his feelings, and help him be with himself in that place. I acknowledged how he was feeling, how terrible it was for him in this place, and how it was hard that she had ‘pulled the shutters down’ and was not available at all for him in this hour of need and distress. 

Then Rhonda looked at him, with tears in her eyes. She said - this happened with your mother, and your ex wife, I never wanted to do this to you.

He broke down, and pulled into himself. I encouraged him to stay present, and see that she now had tears, she had become available, and to acknowledge the connection in that moment. This was very hard for him. 

He told her he felt guilty, he felt he had failed, and he started to move into talking about how he wanted to keep trying. But I stopped him, because there was no emotional space from her for any talk of the future.

I then asked asked if she could take that what he said. She looked blank - so I suggested she tell him she had no room to take that in - this was the emotionally true statement from her.

It was very hard for him to hear that. I supported him to reflect that back  to her. Her response was to note the anger, resentment and sadness she saw in his eyes. So I asked him to name what each of those emotions was about for him.

She listened, but then said, I don’t want to keep going, and I feel terrible, because I know this is so hard for you. 

Brian just shut down, pulled into himself, and I could see was not available. I suggested he tell her that he wasn't able to hear her in the present, but it was hard for him to even do that. 

So I told her to talk to me. This is a technique in couples therapy - to support one person, if the other is unavailable, so the pressure is off, and the other person can just be a witness. 

Rhonda said she wanted to give him lots of time to accept this situation, and I told her I thought he would probably never accept it. He loved her, and was not likely to give up. This was a bit of a shock for her.

So I drew out more of her feelings and personal statements. 

Then Brian became available, and she told him she felt very guilty, and was very sorry. They cried together. He wanted to move closer, but she said - no, please keep your distance. 

I asked her about this, she said she didn’t love him anymore. I challenged this statement - its based on a faulty idea of love as purely a feeling. Instead I asked her to make it a personal statement. She said,’ I have shut down my feelings’. 

This was a key statement, as it then becomes about action, choice, and volition. 

But this was not the time to work with that - simply the acknowledgment of that was then an entry into future choice possibilities. 

So I asked him to acknowledge he heard that, and to tell her his feelings. He managed to do so, and they both cried. 

However, something had shifted. In the midst of the impossible - and who knows the future - they had managed to have some profound authentic contact. They had both reached a place of overwhelm, but with my support to the one still on board at those times, they were able to keep going, and be together in this place of loss and despair.

The ultimate outcome was unknown. But the Gestalt focus is on achieving this profound authentic contact; this  becomes a bedrock of real relationship - the thing that was clearly missing to date.

Case #46 - Fun with maggots

Felicity talked about having nightmares. We don’t apply pre-set interpretations to dreams in Gestalt, but nightmares are often about aggression; we see all aspects of a dream are about the dreamer, so nightmares are related to one’s own aggression.

Felicity’s dream, which would reoccur in different forms, went like this:

She was in the basement, and farming maggots. There were hundreds of thousands of them.

Then, in the next scene, she was throwing up maggots - her whole body was full of them. She managed to throw them all up, except for one.

Now, just looking at the dream, you could have a field day with interpretations. At the most basic level, the basement is what lies underneath, and the maggots evidently refer to something pretty rotten in the person.

BUT, we don’t even go this far in Gestalt. 

We just stay with what is, the person’s experience, and their own meaning as it forms experientially.

So I invited Felicity to speak for each role. As a maggot, she talked about being fat, lazy, and powerless.

The sole maggot left inside her voiced that it as wanting to get out as well. 

The next thing to do was play it out. So I joined her, and we played out being maggots, walking around.

I talked about the fact we all have some maggots inside - the things we just don’t want to reveal to others. 

I spoke about some of mine - my nastiness in certain circumstances, and I gave her some examples.

In exposing very difficult material, its important for the therapist to lead the way.

At first she was reluctant to identify anything like that in herself. I noticed the expression on her face - a sort of innocent-girl kind of pout. I remarked on what I saw, and played it back to her. 

I commented - well, thats not the look of someone who has maggots inside of them!

This confronted her with the persona she projects, and brought her to a willingness to be more authentic. 

She named some aspects of herself that were maggot-like, and I acknowledged how hard that was for her. Then she put on the same face. This time I pointed out the immediate incongruity, as if she were trying to discount what she had just shared.

This raised her awareness in a very immediate way about her disowning process. Gestalt awareness is always about immediacy - leading to knowledge of who am I, right now.

I then invited the group to share their own ‘maggot selves’. This further reduced the shame of exposure for Felicity, and created a bonding in the group, sharing our deeper secret selves, and having some fun in the process.

Case#45 - How to deal with misery

Betty wanted to talk about her fear. She couldn't identify what it was about, or what it was connected to.

But before I acquiesced to her focus, I wanted to know more about her. I asked about children, marriage, work. She had recently resigned from a job she had held for 20 years, and was in a transition period. Her family life was settled and secure, her daughter beautiful and talented, and her husband loved her.

But as I looked at her, she didn't really look happy. I asked her if she was happy, and she said, no. Everyone thought she had the perfect life, the perfect family. I asked what was wrong.

She said - my husband loves me more than I love him. I am secure with him, but it was an arranged marriage and he is ‘not my type’. I asked what her type was: a strong character, a clear personal sense of vision in life, and good taste. He was none of those.

This impacted me, and I took some time to take this in. The great life, but something essential is missing. I  looked again into her eyes, and could see how miserable she was. I asked her how old she was - 44 . I asked if she would spend the next 44 years with him, she replied, yes.

So that was clear, her choice was to be there. But the cost of that was some kind of basic dysjuncture in her sense of connection in relationship. Some kind of basic need for passion, meeting, and synergy wasn't there. She had settled for a superficially happy life, but somewhere it didn't meet a more profound need.

In Gestalt, we are interested in choice, and this is understood in terms of existential notions. Life throws us into different situations, but we always have choices. Our sense of imprisonment comes not through external circumstances, but by forgetting our moment by moment choicefulness. 

With choice also comes consequences, and a life well lived is one where we take responsibility for the consequences, rather than try to blame others, or spend our lives wishing we were somewhere else.

This was very much what Betty faced. Her choices were clear, and so were the consequences. But she was miserable, so unless she wanted to remain this way, something had to change. 

What was available were different choices within the structure she decided she would stay with.

I spend quite some time of just being with her, seeing her misery, acknowledging thats how it was. This is the relational space, where nothing has to change, there are no agendas, and the focus is on being, being with, and recognition. This is also known as the I-Thou. 

After this, I moved to the ‘whats possible’ question. To go there at the start would simply mean some kind of ‘solution’ to a situation which in a sense didn't have a solution. But after being present for a while in that being space, we could then explore together other choices and perspectives.

I asked if he knew her misery, if she showed it to him like she did me. She said no. So I shared an incidence from my own life, where my partner revealing her misery about something had a huge impact on me. Because he loved her, this could be the start of some kind of change.

I pointed out that he would never be her ‘type’, but that if he was motivated, he could take a few steps in that direction. The ball was firstly in her court to be able to communicate to him her authentic self and needs. The challenge was to do so in a way which would produce positive results.

I suggested she ask him to look into her eyes for 10 minutes, without conversation, and show him her misery. After that, she could communicate to him some small changes that she would like him to start with, that would be meaningful for her.

But this was not necessarily the solution to her unhappiness. The fact was, she was in a situation where her needs were not getting met. So I suggested to her that she actively explore both her creativity, and some kind of spiritual practice. These could help her find a core of happiness which was not dependant on her external environment. 

To suggest such things as some kind of rote solution is not what Gestalt supports. But in the context of a deep sense of contact with personal stuckness, such possibilities become personally meaningful, and there is a profound motivation to move in that direction. If there is an interest, the person can be helped by practical support - a conversation about how it might happen, and the range of options.

Case #44 - The cocoon, and rebirth

Nicole was clearly distressed. She talked about a dream she had, relating the image of a cocoon that she was afraid to break out of, not knowing if she would be transformed, or just die.

I picked the cocoon image. I suggested an experiment on this basis - sometimes its not necessary to get all the content detail, but just to leap off from a clear and strong metaphor that the client gives. In this case, clearly a transformative metaphor, directly relevant to therapy, and one which contained both the desire for change, and the fear of change. The Gestalt Experiment is also termed the ‘safe emergency’, so this is a balance we always strive for - helping the client move forward with their desire for aliveness, and at the same time, finding a way to make it safe enough to take the risk of trying out the new.

So I invited a half dozen people from the group to gather around her as the cocoon. Straight away, she started crying more intensely, and then sank to the ground. I indicated for everyone to sit around her. I told her not to withdraw into herself, but maintain eye contact. Otherwise someone can just regress, pull into their own world, and out of relationship. In that case, the emotion simply continues to circulate in a way which doesn't actually move it.

As she did that, she looked at one of the women and said ‘I don’t like you’. This however was clearly not about the woman - she was reminded of her mother. So I asked her to speak to her directly, to say whatever she would like to say to her.

‘Why did you abandon me’ she asked. In Gestalt we consider why questions as unhelpful, and ask people to change them into statements instead.

Out of this came her statements - her pain about being abandoned as a child by her mother. Again, I did not need to know any of the story or details to work with it. She was in process, and that was sufficient. 

I had to support her to stay present, to maintain eye contact, to breathe fully. Much emotion arose, for her, as well as for the ‘mother’ representative. 

The support of the circle was important, to give her a feeling of being held in a place where she is normally internally collapsed.

Finally, she was very tired, and just wanted to lie down.

So I got her to lay down on her mother-representative’s lap, and allow herself to fall asleep. 

When she woke 10 minutes later, she felt reborn, and with a sense of warmth and connection in her heart, where previously there had been emptiness and pain.

Case #43 - The Toxic Voice of Mother

Theresa had left a secure job to start her own company. ‘For the challenge’ was the reason she gave.

But she experienced strong anxiety much of the time - except when she knew that something was going to fail. As she approached success, she felt anxious right until the moment when the success was completely secured. The anxiety was also reflected in her personal life.

She didnt understand where it came from, or what she could do about it.

It appeared to me something to do with control - needing to be in control, for things to be a certain way. I asked about her field context. We managed to establish that her mother was very much into control. 

As we were talking about this, she got a headache. It became clear to me that her mother was ‘in her head’. So I invited her to put her mother on the cushion, and talk to her. This is the classical Gestalt experiment - to take intrapsychic dialogues and make them explicit.

I asked her to say something to her mother, then physically swap - sit in the ‘mother’ place, and give reply.

I was rather shocked at the things that her mother was saying. Very shaming, and even worse - for instance putting Theresa down for being ‘ugly’, unlike her beautiful sister; telling her she was a bad person; telling her that she (mother) didnt really want to have children, it was just a duty, and anyway, she would have liked a boy.

This is not just normal poor mothering. It deserves the title ‘toxic mothering’. This is not something that is amenable to dialogue.

I suggested that the mother stop talking to Theresa, and I would ‘interview’ her, to try to understand more about her. 

I did so….and the mother gave various interesting answers, confirming the above ‘diagnosis’. She considered Theresa to be a burden, and was only interested in how her children made her look good. Theresa was a financial success now, so that made her look good, so she was not so annoyed with her anymore.

Now..you might say, this is just all Theresa’s projection. But the statements the mother made to Theresa in this dialogue were actual words she had used to her.

The point is not to pathologise the mother - she obviously had her own struggles. But clearly such devaluing of ones own child is going to be toxic...and produce the lack of confidence which resulted in her anxiety.

So I invited her to speak to her mother, this time putting up very clear boundaries. She started out asking ‘please do not…’. I interrupted her...as this still depended on her mother doing something, which appeared unlikely.

I asked her to rephrase it in a way which came from her.. ‘I will not accept….’. This provided a clear boundary - something that is an important focus in Gestalt.

Making several of these statements was very powerful. She needed help formulating them. Afterwards, she felt more settled, and clearer in terms of what she needed to do to stop allowing the mother voice in her head to undermine her confidence.

This involved use of a classic Gestalt experiment, bringing a stuck internal dialogue into the open, and then providing the support necessary for movement in that place.

Case #42 - Safe and Unsafe

Yasmin had recently divorced. She talked about wanting to mature and separate out more from her parents. She had a lot of emotion in her eyes, which I observed and remarked on, along with various other things about her - a colourful shawls, beads around her neck. 

She said - ‘I feel safe with you’. I responded - ‘in some ways, thats a projection, because I am just me - safe in many ways, and at some point, I am likely to miss you and therefore not be so safe’. She found this hard to hear, and it reminded her of difficulties with her father, and her needing to clarify boundaries with him when she felt confused and foggy.

She said she appreciated being seen by me..and it was something that she needed. She talked about her difficulty of being seen as a separate individual by her parents, and her historical difficulties with them in terms of being loved only conditionally, as a good girl.

As I sat with her, I acknowledged the ways in which I could see her child self, with her needs for approval, acceptance, and care; and at the same time, her adult self, wanting and needing differentiation, being her own person, find her own ground getting clear on her boundaries.

This was profoundly moving for her, to be seen in both those places, and for those to be held at the same time. This was one of those I-thou moments. I talked about how, in this place where I felt spacious and grounded and present, I could indeed create the conditions of safety for her to be able to be both held/supported/attended to, and also released - encouraged to move into her own life, so we could meet as two equals.

This resonated at many levels with her. I spoke to her as an adult, recognising both the boundary between us, and the connectedness as two seekers. I then invited her to speak from the child place, to name what she wanted from me.

She said that what she longed for from her father was acknowledgment that she was important to him. I said I was happy to shift into ‘father’ mode - I had grown daughters of my own...and could speak from that place to her. So I spoke ‘as’ her father, telling her how precious she was to me.

She then asked to hear that she was loved no matter what. I reiterated that, stating that although I might disagree with choices she made, or even not like aspects of her, that my fundamental ground of family relationship was the connection of love.

In this way, I could respond to a profound need she had to be see in this place. In the nature of the therapeutic process, I wasn't actually her father, but the impact was almost the same.

This is a result of establishing a strong and deep relational ground in the therapeutic process, which then allows such statements to have a transformative effect.

She felt more whole, and able to bring together both adult and child parts of herself.