Wednesday, December 24, 2014

Case #125 - Fear turns to excitement

Martin came with the issue that during the group meditation period, he had felt some tension in his stomach. I enquired whether this queasy feeling was familiar - it was not usual.
He wondered if it was related to being a young child, and having a medical emergency, which his mother told him about later.
I asked him to go into the feeling in his body - it was a shaky feeling. As he went into it, his face softened, tears were in his eyes, and he said he could hear his grandfather and father's voices reassuring him.
I asked then about his family context -his field. He said he was loved and supported by his parents, and older siblings. He had a healthy and loving childhood experience.
So fear was unusual for him in his current life.
This was somewhat unusual in therapy, and meant that his fearful feelings in his stomach had a different meaning than what it may normally mean for someone with trauma and unfinished business.
He said he was not a big risk taker, leading a comfortable and settled and happy life, both at work and home.
This sounded great…except that the feeling in his stomach indicated that perhaps he wanted something a bit more. I explained that fear is the precursor to the experience of excitement, which is what happens when fear is integrated into one's being.
So back to the fear, which I suspected indicated a yearning for more risk, and thus more adventure in his life. He agreed.
So I asked him to give me a vision in three areas - personal, work, and relationship.
His personal vision was being on top of a tall mountain he had climbed.
His relationship vision was a long road trip in a motorhome with his family.
His work vision was creating his own company, based on a progressive vision.
As he pictured these things, he again had tears in his eyes, and reported feeling deeply grateful to life.
I explained about how support helped convert risk, anxiety and fear, into excitement, and we explored what kind of support he might need to enable these things to happen.
This case shows how important it is to approach people's experience from a phenomenological stance - not pre-interpreting what any particular symptom means. We do this by bracketing presuppostions, theories etc, and being present with the meaning it has for the client.
The result is the client feels heard, seen and understood, and we can know more precisely just where to work with them. It would have been a waste of time going into his family background to try to search for a source of the fear. It was evident he had a healthy upbringing, and there was nothing that he displayed to suggest that he was avoiding something. This allows us to work more with the present, moving into the future. Gestalt work is just as much about the future of the field, as the past of the field, both of which are worked with in the present.

Monday, December 15, 2014

Case #124 - Meeting in spite, hate and acceptance

Abby spoke sharply. She was annoyed by another man in the group, and the way he expressed his feelings. She was critical, and somewhat condescending.
I was interested in her energy, more than the words. There was a sharpness, and liveliness about her manner that I wanted to engage with. I asked her to personalise the feelings. She admitted to feeling sadistic towards me. And she showed me a particular action with her hands. I was feeling quite engaged with her - her explicit willingness to show her aggression, and authentically express it.
I did not feel defensive at all. Instead I was interested in her energy, and wanted to meet her in that place. I invited her to show me again the aggressive action towards me, using movement with her hands.
I invited her to stand up, so we could both mobilise and move some more. I asked her to show me with her face and hands what she felt. She did so, but also used sharp angry words. I ignored the words, and matched the energy - she showed me a hostile face, so I made a hostile face back. I was careful to match her as exactly as I could, neither less, nor more. Every nuance, every move I reflected back. Both in terms of expression, and the anger behind it. I did not feel angry towards her, but I summoned my angry feelings and used them to meet her. When she showed spite, I showed spite back. I encouraged her to put less emphasis on the words, but she sill wanted to use them. She amped up - with stronger, more hateful words, and energy, and I kept pace with her - not using any words back, only energetic meetings.
This escalated. She wanted to hit, so I got a pillow and encouraged her to hit it. But this wasn't enough, she really was furious, and hateful, and voiced hate at the human race. I asked her to personalise that, to whom exactly what she so hating and despising. She said - 'father, mother'. But she kept speaking about the human race - two eyes, two legs. I kept drawing her into the present - 'I have two eyes and two legs'.
Then she went inwards, talking about hating herself as a human, wanting to stab herself. She clutched her hands at her chest. I pointed there and asked what she was feeling. It took several times repeating my question until she spoke about how much she just wanted to kill herself - a retroflection of her energy and hatred. I kept pointing to where she was clutching her chest, and asked her about the feeling. Tears appeared in her eyes, and her hatred and anger towards me was now mixed with other feelings. She softened, there was an opening of vulnerability.
At this point, I moved forward and held her. I could see that the hatred was never ending, and that no amount of matching it was going to satisfy her. I could see both the window of vulnerability, and could also see she was out of control. So I held her, and allowed her to both cry and rage. She was clutching onto me with one hand. The other hand, I encouraged her to hit my back. She did this, as well as squeezing me aggressively with that hand. It did not hurt me. I was fully grounded in the moment, in my body, with all my resources available.
Then she started to soften and sob. She cried 'father', and was wracked with intense emotion. I supported this for some time, and then asked her to look at me. She could hardly do so. I wanted to bring her into contact, with what was available in the present.
She went back into her sobbing, and after holding her, I again asked her to look at me. We did this several time. Finally, I could feel her letting go into me, and held her, with the same firmness she had been grabbing onto me. After some time, I sat down with her, as she was now quieter, and allowed her to curl up and be held by me. She became completely quiet and calm, and I asked her to really take in the nourishment available to her in this place.
This process entailed the Gestalt element of relationship. Dialogue was less about words, and more about energy, emotion, and meeting. By staying with her, and meeting her in each place she went to, she was able to move forward. I originally moved from her words, to the experiment, which involved meeting her anger. To stay with the content of her words would have been distracting from the relational interaction going on underneath. Gestalt is always oriented towards process, towards embodied energy, and towards bringing things as far as possible into the present therapeutic relationship. As I went down this track, she was able to move into a place of openess, and then taking in the nourishment she had been wanting but pushing away previously. By representing this taking in/pushing away, with her two hands, she was able to move past that impasse place.

Monday, December 8, 2014

Case #123 - In search of the elusive feelings

Lenny wanted to feel. He was not in touch with his feelings, at all.
I asked at what point he had lost contact with his feelings. This is a field oriented question, paying attention to context.
He said before the age of 30 he felt them more. I asked what happened when he was 30: he got married; for 3 years. We were now 13 years later, and he had not remarried.
Clearly, something happened at this point. I asked him what - it seemed that the trauma of whatever had happened in the marriage had somehow been associated with him cutting off from his feelings.
I said - 'so its a woman that hurt you'; he agreed.
So I asked a woman to come up from the group. I found the right distance for her to sit. We experimented with different distances, and at each distance, I asked him how he felt. He was able to differentiate. If she was too distant,  he couldn't sense her at all. Too close, and he felt some pressure.
I then invited him to notice how he felt sitting there with her. He reported a sense of wanting support. This was significant for him, as he had explained that normally he was a person who supported everyone else - one of the reasons he suspected that he had distanced himself from feeling.
So I asked him to express this to her directly - that he wanted support from her. I asked how she felt when she heard this. She actually didn't feel much. I could see this was because she was not really taking the process of the experiment - or him and his feelings - very seriously. He did not have any big dramatics, no strong feelings, so it was hard for her to respond. When men have buried their feelings, sometimes its hard for women to perceive anything there.
So I explained to her that this was actually a very vulnerable process for him, to sit in front of a woman, that he had wounds that meant he distanced from feelings, that he found it hard to express himself, and that it was hard for him to ask for support.
I did this as an intervention to support him, and to support her to move into her own feelings. Somehow, she seemed to be also distancing from her feelings - perhaps affected by the field effect as we call it in Gestalt.
She reported wanting to support him and feeling kind towards him.
So, back and forth - I asked him what he felt on the other end of her intentions and feelings... then to express that to her... then what she felt hearing that... and to express that to him. In other words, I supported a dialogue between them.
In this process a variety of things happened. He moved towards receiving support from her, then automatically found himself wanting to give support. She moved away from offering support as he became less receptive, then back towards him as he again expressed his vulnerability and need. This was the dance of relationship, unfolding before our eyes.
At each juncture, I asked him how he felt. This was very hard for him to identify and express, but he was able to notice small changes -  like feeling tense, or feeling strong, or his heart beating, or feeling 'swollen' though he couldn't necessarily identify the specific feelings.
I then asked him to hold out one hand as the giving one, the other hand as the receiving one. Then I asked her to hold both his hands, and for him to give with one, and receive with the other. This was another version of the Gestalt experiment, that expressed what was happening in the process, and embodied it, to help focus the figure of awareness.
He could do this for a little while, but then reported feeling dizzy, and 'swollen'. So I asked her to sit back down, and did a little more exploration with him. However, he was not able to identify the feelings any further. The dizzy showed he was actually feeling too much to handle it. And the swollen indicated that he was very full of feelings. But as he was unable to identify them, it was time to stop. As homework I asked him to continue to monitor his feelings, and see what he could identify over time.

Thursday, November 27, 2014

Case #122 - A complicated relationship

I told Rosemary that I wanted to get to know her. She came with a very open and positive attitude towards me.
She said she wanted to know something beautiful about me. This I found a difficult question - somehow easier to answer a question that requires me to be self critical. Nevertheless, this was her request, and so I looked into myself - and told her that I am an open person that people felt very comfortable around - which is true.
She told me that something similar was true of her. I said - 'well, then its going to be easy for us to get along'. This affirmed our similarity, and created a sense of joining.
She visibly relaxed. In fact she sort of curled into herself, as if about to lie down…she told me she felt dizzy.
Given there was clearly a connection between us, and that her movement suggested that some kind of support was missing, I invited her to lean against me, rather than simply collapse into herself. This takes a movement that is 'retroflected' -that is directed back to self rather than to the other. So in Gestalt we encourage this to be directed into relationship.
So I sat next to her, and she leaned her head against me - in the same way and with the same movement that her falling over had been.
I reported my feeling of warmth in the connection and asked hers. She was relaxing, but also afraid of rejection. So she was not fully letting the warmth in - only as far as her skin. She spoke of feeling 'chilled' inside.
This indicated that she was active in the process of rejection - something that she had put onto me as a fear. It also showed a polarity - warmth and cold.
So I invited her to talk about her own rejecting process - she said that her fear was about the future, about the loss of connection. Clearly, this was her method of not being fully present. Rather than look for the field context, I drew her into the present, and into our relationship. I asked her to become fully present, and notice where her fear was, between us. This is often the direction we take in Gestalt - into the here and now of the therapeutic relationship.
She said her feeling was 'can't fully take this in'.
I invited her to put this in a relational statement to me - 'I will only let you in so far before pushing you away'. This was the authentic statement we aim for in Gestalt - it increases the quality of contact.
I asked her to feel the combination of warmth in the contact, and her coldness inside. She talked about it as 'coming and going'.
I remarked - 'so we are going to have a complicated relationship'.
This was a way of giving a larger frame to the process - the push and pull which was clearly a part of Rosemary's way of being in relationship.
In Gestalt we are interested in being with 'what is' rather than jumping in to change it. In this case, with her internal contradictions, I indicated I was willing to be in relationship with that complexity rather than be put off by it, and reject her.

Monday, November 17, 2014

Case #121 - Partner blaming

Sally admitted to being a bitch. She would easily berate her husband. There were many things about him that infuriated her. His lack of responsibility with money and his lack of career drive was one of those things.
Sally would quickly reach her limit in conversations, blowing up at him. She hated the repetitive nature of the situations. He would offer what she considered to be his paltry excuses, and she felt like she was pushing him, rather than him having any drive himself.
He seemed to be quite incompetent to her, and would not respect spending limits or other agreements they made. He was clearly passive aggressive, and essentially disrespectful of boundaries.
However, she was the client, and it was her that I needed to work with.
Often when dealing with one person in a marriage, a large laundry list of grievances will be brought by them. These are valid, as are their feelings about the issues.
However, what matters, and what I focus the client on, is where their responsibility is. I bring it back to them, to what they need to do differently. Often they are so focused on the other person's faults that they see their own as secondary. All their efforts go into changing their partner.
In Sally's case, bringing it back to her revealed a number of things.
Firstly, her explosions were quite emotionally violent, and contributed to an atmosphere of alienation.
Secondly, when not exploding, she was in avoidance mode. When she felt strongly about something she would either sob too much to be able to talk, or she would stop herself saying anything before the tears came out. In this way, she prevented herself talking through important issues, and would freeze herself emotionally. This resulted in her freezing him out, not responding to his affection for instance.
These were important themes to work with, and were her part of the negative dynamic.
Its important to not get caught up with the stories people tell about their marriages and partners. The important information is what they do to contribute to the dynamic.
This is the Gestalt emphasis on responsibility; it takes an especially strong focus on this from the therapist to bring it back to the client.
In her case, we started with her response to him when he did approach her in a warm and friendly way. She would pull back. In this was her resentment, and also her feeling of ungroundedness - she couldn't manage the feelings that came up, both positive and negative, and hold onto herself.
In couples, it is very important to work with what is called differentiation - the capacity to be fully yourself, and at the same time, be close to the other. Gestalt pays attention to boundaries, and this helps to do this.
In this case, she was not able to be close, and yet stay in touch with herself, and her feelings.
So I suggested an experiment. I would play her husband, and she would simply work to stay grounded in her feelings. I asked for a particular phrase that he used, when being friendly. I repeated this to her, and supported her to stay present, breathe, and then talk about her feelings.
This was very basic work, yet this is often the kind of support people need in their relationships. The embodied experiment is important, rather than just talking about it. The Gestalt 'safe emergency' allows us to bring up the difficult and provocative situation, but bring lots of support into it, so something different can happen.
The result of this, over a number of sessions, was that Sally learned to hold onto herself. She took the support from the sessions, and could start to support herself in these situations, to just remain with herself. Before even learning to communicate what was happening for her, she first needed to get to first base.
In Gestalt work we are satisfied to work very slowly, as it is in the slow work, with plenty of support, that integration occurs. Simply confronting someone with their responsibility is too harsh on its own. What is necessary is providing the kind of support they don't have, in order that they can indeed take the steps towards responsibility and differentiation.

Monday, November 10, 2014

Case #120 - Lost in a story world

Numi had had what seemed to be very strong emotional reactions to others in the group - not negative, but very sensitive. She had also, in her feedback, tended to tell a large and very big story about herself. So when it came to working with her, I remarked on this. I remarked on her big stories, and the big emotions that she showed. She started talking about her history, which I was interested in. She had been on medication, so I asked her about what had happened so she had to go on medication. She started going into the story in very great details. The story was important and there were many big events that helped me understand what had led to her taking medication. However, the stories led, one to the other, and I we could have sat there all day while she told me stories all day about her distress, her life, what had happened, her difficulties.
In Gestalt, stories have value, but what we are more interested in is coming into the here and now, working with the experiment and attending to the relationship.
So I interrupted her and said, 'I am having an experience right now of getting lost in your stories, and I often have that experience with you'.
She started going into another story and I said, 'I am getting lost right now, and need to find a different way to connect with you'.
So instead of criticising her, telling her to do something different, I was telling her about me, about my difficulties. This is the dialogical approach.   
Her habit was to tell stories, rather than communicate directly and interpersonally. So I guided her to firstly contact her feelings. She told me she felt shaky. I then connected this to our relationship, in the present. I asked her what it was about the experience with me that felt shaky. She replied that she felt comfortable with me, though she was concerned about judgements I might have about her stories.
I gave her one of my judgements - I thought that she had suffered a lot, and at the same time, I thought that she had managed to survive some very difficult circumstances.
Although many people think therapy is non-judgemental, this is a very limited view. Judgements are part of most human interactions; what is important in Gestalt is being able to make clear choices about when and where to bring in judgements - in service of the client. And to identify my own thoughts of judgements clearly and precisely, and articulate them in ways that contain information about myself.
She relaxed some more, and I invited her to come fully into the present of our experience. She tended to be so lost in her own stories, subsequently losing the listener, that it was a new experience for her to come into the actual experience of relationship, especially one that was non-threatening.
This in itself was a healing experience.

Monday, November 3, 2014

Case #119 - Cold jealousy, hot desert

Tilda had problems with jealousy. She did not appear to have a tragic childhood. Her parents were supportive, as were her grandparents. She was finding her way in life, she was creative and energetic.
But when it came to relationship, her jealousy had become quite an issue. She described the jealousy as cold, and the anger that accompanied it as hot. Well, that made some sense. Tilda described the hot and cold as coming in bursts.
She said it felt like 'ice trays' in her gut.
In Gestalt we call this retroflection - directing energy inwards, that wants to go out.
So I invited her to send out a cold wave, and direct it to her partner - this is what she was implicitly doing, so this represented ownership of her action.
She said she felt no control, it had to get out, because she felt so horrible, but she also didnt want to freeze her partner out.
So I asked her to imagine him standing in the desert, a very very hot place, and send her ice cold energy out there. She could feel the ice melting.
This brought together her polarities - hot and cold waves.
She started feeling pain in her chest. This was a good sign, as this is what lay underneath the jealousy and anger. I asked her to stay with that feeling. She talked about her confusion -caring for him, yet wanting to hurt him.
I asked her to imagine him in front of her, and say both things: 'I care for you, and I want to hurt you', and to stay in touch with her pain as she did so.
She started sobbing. This was the authentic feeling underneath the scorching anger and freezing jealousy. After some time, she felt more settled, and was able to ammend her sentence to him: 'when I dont have your full attention, thats really painful for me'.
This opened up a deeper topic, related to the topic of differentiation - the ability to be fully oneself, in closeness with others. When people experience fusion, or 'confluence' in Gestalt terms, they find it hard to have a sense of themselves separate from the other. They need confirmation for their own sense of self.
Of course, we all need some of that in relationship. But when that need becomes a 'have to', then we lose our independent existence, and essentially impose a 'should' on the other person.
Classically, Gestalt would simply confront the client with their responsibility to be fully themselves. In contemporary relational Gestalt we are more willing to respond in, at times, a parental type of way, giving the kind of confirmation that the person may have been lacking, and still long for. This is done, not in the sense of regression, but in the here and now, so it becomes an experience which can be integrated into the person, in the present.

Sunday, October 26, 2014

Case #118 - Aaaaaahhhhh. Oooooohhhh

Marlene came forward. This was my first encounter with her.
I said - I am interested to get to know you, and this is a two way process, so I would also like to hear your curiosities about me.
In Gestalt we are oriented towards a horizontal relationship, developing mutuality, and that includes the client knowing about me, as much as I know about them. This has to be done carefully of course, so that I am not inundating them with information about me, nor inappropriately disclosing more than they are comfortable with, nor doing so for my own needs. This is about enhancing contact and creating the grounds for deepening relationship.
So Marlene made some observations about me, and asked some questions (e.g. about the ring on my necklace). I told her some things about myself, and asked about her as well.
This is more naturalistic than the therapist driving forward with personal questions, where only the client is exposed. It also creates a ground for safety.
I told her the ring was connected to my birthplace, England.
Marlene told me she grew up in the mountains until she was 20, in an isolated place, without running water, or any houses nearby. The environment was completely beautiful, and dangerous - snakes and other wild creatures to contend with. She grew up resourceful, competent and capable.
She expressed this with a gesture of her arms, open wide, and a wonderful sound 'aaaahhh'. This was expansiveness embodied.
She then joined the rest of the world, and wanted to learn to fit in. It was hard for her, as the expectations of being a woman were that she was coy, delicate, and femmine in that sense. Her fearlessness didn't really fit into that.
Nevertheless, she wanted to learn to fit in, to be part of society, to discover a different sense of herself as a woman.
In her marriage she found ways to do this. She was very conscious about playing a role, being dutiful (as a choice) towards her in laws, and constraining her expansiveness.
I asked her for what that gesture was. She made a small circle with her hands, moving towards each other, and a sound 'ooohh', with the cadence going down.
I asked how she felt. She said, patient.
This is not strictly a feeling, but indicates a state of being. A chosen state for her.
This was important to acknowledge, because of its importance to her. And at the same time, I was also interested in her as a person inside her dutifulness and patience. But this was not something she was ready to reveal to me.
So I said - 'when I see your gesture of expansiveness, I feel excitement. When I see your gesture of fitting in, I feel sad'.
This is not a commentary on her. Its a genuine statement of me, as a separate being. She may not feel sad, but I do - thats about my values, which may be different to hers. This is also contact.
In Gestalt contact is about meeting, often at difference, as well as the joining of similarity.
I asked Marlene her experience in the present. She said 'clarified'. There was a lightness about her manner.
She experienced being seen, and met in these places. Just as she was. Further exploration and sessions could unpack much of this, both the context, as well as the experience. But for now, this was a powerful meeting.
In Gestalt we are less about trying to do something, trying to get somewhere, and more about being present with what is, with the person as they are. In this place, healing can take place, and new possibilities can open up, of their own accord. This we call the Paradoxical Theory of Change.

Thursday, October 23, 2014

Case #117 - A life map to follow your bliss

Carlita saw herself with two choices, and she was confused.
On the one hand she was considering going into politics.
On the other hand, she wanted to just 'follow her bliss', and see where life took her, without agendas.
We used a field-mapping process, drawing up all the elements of the situation - and beyond - on a board. This is a way of incorporating the complexity of the field into dealing with decisions like this.
So we mapped many different elements - the pressure from her parents and family to make a mark on the world. Messages from her boss to the effect that she should pursue what was going to get her ahead in life, not necessarily what she really wanted to do.
Included on the map were the things she enjoyed doing - going out, having fun, dancing. I asked how old she was - in her late 20's. This helped me place her in the context of developmental stages.
Dragging down on her from the past, was the pain associated with an abortion, at a time she didn't think she was ready for motherhood.
She said she learned from this that she needed to follow what her heart told her, rather than what she thought about major life decisions.  
I sat with her for a little while, with the pain that talking about this brought up for her.
I felt warmly towards her. I saw her as a bright young woman, full of determination and passion, with a lot to contribute, but not quite having found her groove.
She was about the age of my eldest daughter. As an older man, I wanted to be able to give her something. I told her so.
The authorities in her life - father, boss, family, were all pushing her to fit certain agendas.
So I saw the gift I could give was permission to be herself, no matter what direction she took in her life. I formulated a statement to her, contrary to the one from her boss. I said 'I recognise your strengths, your potentials, and I want to see you follow your own deep knowing'.
This touched her profoundly, and gave her a strength (and approval) to find her own best way.
Ironically, by doing this, I was using the therapeutic relationship to empower her, by bringing in some of my 'authority'. Traditionally in Gestalt the emphasis was on self support, and signals of approval would be very much discouraged, as potentially making the client 'dependant' on the therapist. Whilst caution needs to be exercised, in relational psychotherapy, it can be appropriate to 'live out' the relationship, including  some version of the authority role - therapist, or father substitute - in a way which does empower the client.
In this case, by providing messages to Carlita that supported her autonomy, I provided a counteracting force to the authoritative messages which suggested that she should follow other people's agendas.

Monday, October 20, 2014

Case #116 - Bye priest, hello woman

Brad had been a catholic priest for 10 years. He had left the priesthood a year previously, and was not studying for a new profession. He felt good in his choices, but did not feel he could get close to women in an intimate way. He wanted to find a partner, and raise a family. But the leftover from his priest experience was an automatic distancing from closeness with women, or at least from their sexuality.
The message from the church that he had swallowed - 'introjected' - was that women were 'bad', in that way. This was obviously unhelpful for his present life and future plans, but it was not something that was easily changed.
So I asked him about his father, as I wanted to gauge the attitude towards women in his family. In Gestalt we explore both direct experience, and the context (or Field) of that experience.
He said that his father had actually studied for the priesthood for many years, though he had not taken that step in the end, but got married instead.
This provided a resource in his Field, which I draw on. I pointed out that his father had obviously not found women 'bad', but in fact, had embraced the goodness of sexuality with a woman, and hence Brad's birth into the world.
This was a strong reference point, that could clearly be used to help Brad in his own transition. I asked how long it had take his father after leaving his priest studies, to get married.
Brad replied - 2 years.
I asked Brad how long he had been out of the priesthood - he said 1 year.
This gave me an opportunity to cue in the 'future of the field' - a Gestalt process where we bring the future into the present in the form of an experiment.
I said 'well it looks like its going to take you 2 years as well. Only one year to go. So lets have a rehearsal for when that year is up'. This took the pressure off Brad having to make the transition all at once, gave him a time frame (that sounded realistic and appropriate to me), and gave him some hope that things would change over time.
So I suggested that a woman come out of the group and sit in front of him, for this 'rehearsal'.
She just had to sit there, being present.
I got him to hold up one hand pushing her away (the hand he had used when originally talking about the church idea that woman were 'bad'), and then hold the other hand open to her, in an accepting position. He did this silently at first. He felt a little uncomfortable on both fronts. He found it hard to really take her in, and he also found it hard to let down his guard.
So I could see we needed to do some grounding work.
I asked him about the things that a woman might do to him that were 'bad', and cued those in - she might betray him, she might hurt him etc. In this way, I was converting his abstract fears into more grounded ones - she might indeed do those things to him.
So I got him to make those statements direct to her - 'I am afraid that you might hurt me, or betray me'.
The woman was able to acknowledge - 'yes, I might do those things'.
But then she spontaneously added 'it depends on how you treat me'.
This gave him an important, grounded, and potentially empowering clue - it rested on his choices.
He was then able to let his hand down. The issue was now about his own behaviour, which he did have control over. We always look in Gestalt for places where someone can move from trying to control others, or feeling powerless in relation to them, to a position where they feel the power of their own choice.
However, there was still something blocking him taking her in now.
I asked if he had been through a formal ritual of leaving the priesthood. He said the process was not complete, but that he felt that he had left it.
I was not satisfied with this. Formal processes have profound meaning - divorce, and in this case, getting his final paper from the pope. Until that point, he was not formally 'available'. I asked how much longer that may take - he said, about a year.
This was clear then. Until that point, he would not feel completely free.
So I again suggested the notion of a rehearsal ( example of a Gestalt experiment).
I folded up a piece of paper, and as the 'papal representative' I handed it to him, as a preview of the experience of getting his final paper.
I then invited him to notice what he felt sitting opposite the woman.
He reported feeling a kind of warmth.
'Thats it' I said. 'Thats all you need to do, is feel that warmth, and it will develop naturally from there'. The woman also reported feeling more connection with him.
This piece of work involved references to the field in a number of ways, which helped support, highlight, and direct the process. With such a formal thing as a priest role, there are many external and contextual aspects which also need to be taken into account, above and beyond the specific feelings of the person.

Tuesday, October 14, 2014

Case #115 - Redefining oppressive authority

Angelina reported feeling some feelings of sadness, and guilt, about her 'family'. At first this appeared to include her husband, who she was separated from. But then it became more clear this was about her children - young adults, who she had not seen much of in the last three years of separation.
The situation that she described was that she was enjoying her autonomy, and the freedom that came with pursuing her own dreams. She did not want to give any of this up, it meant too much to her.
I pointed out that sadness and guilt arose in the context of relationship. However, Angelina did not want to talk about or address the relationship with her husband, or her children. She just wanted to feel more at peace.
I could feel there was a power struggle between us. I was not willing to help her do this, without any reference to the relationships that were the context. She did not want to look at them. For me to do this would be to use the therapeutic process to help her block out those relationships better - something I was not willing to do - that did not feel ethical for me.
So rather than continue to push, I took a different tack. I asked her about the context of autonomy. She reported a childhood, growing up in the countryside, with many brothers and sisters. It did not sound problematic in anyway, nor was it clear where and how the importance of autonomy and freedom came from.
Then she mentioned that her father was a strong authority, and I understood. She grew up in a strongly patriarchal family. Her mother was subject to it, she and her siblings were subject to it. There was no autonomy, especially as a girl. She did not get to make any of her own choices. She said her father was not a bad man, just in a role as the unquestionable authority.
Not surprisingly, she married a man who had, for 20 years, been the same. Her husband was not a bad man, but he was also 'the authority', ruling the household in the manner of a patriarch.
Now the context became clear. The only way she could conceive of having her own life was to leave the system entirely, her children included. With the role of wife and mother went the subservience that she was no longer willing to live under. She did indeed value her freedom, after 40 years, more than anything else.
She said she wanted to divorce, but her husband was not agreeing - I suggested it was the last bastion of his control over her. There was a power struggle, and neither of them were going to win that one.
It was clear to me that we needed to work, not with the personalities of father or husband, but the patriarchal order itself. This is what had been oppressing her, and it was hard for her to separate it out from the people.
So I asked a half dozen men to come up from the group, and represent, husband, father, grandfather, etc - the line of men going back.
I invited a woman to come up and stand behind Angelina.
I suggested some lines to Angelina, but was very careful to make sure she said them as she wanted.
The statements were first to her husband - 'I acknowledge you are a good man, and I separate myself from the patriarchal order you are a part of'. We spent some time on this acknowledgement. She felt lighter, but still something of a burden.
So we repeated the process with her father: 'I acknowledge that you were a good man and father, and that I am here because of you. And I separate myself form the patriarchal order you are a part of.'
We did the same thing with her ancestors.
By this point she was feeling much relieved. She was able to be in the presence of these men, without reacting to them, and able to be in relationship to them, yet not agree to being oppressed.
This was a synthesis that she had been unable to achieve to date.
It was a significant experience for her, and she felt greatly relieved.
I finished it there. That was enough for one session, and I was confident that things would flow from that in relation to her children.
The work here was with what we call the Field in Gestalt - the larger and complex context within which we have our experiences, etc. By paying attention to the larger picture, we are able to go beyond the immediate feelings and reactions, and achieve integration with much larger family, cultural and historical forces.
The experiment in this case related to the field, and allowed Angelina find a more settled place within herself, without using the blocking creative adjustment that she had previously been employing. This experiment derived from processes used in family constellation work.
I also stepped out of a power struggle with her - me that man, the therapeutic authority; in Gestalt we never push against the resistance, but always find a way to contextualise it.

Sunday, October 5, 2014

Case #114 - Brewing anger, releasing pain

Melanie was keen to work. However, before we jumped into her issue, I firstly shared something about where I was at in relation to her. This can be a component of the relational Gestalt approach - for the therapist to include their own experience and phenomenology, setting the ground in the therapeutic relationship.
I told her I enjoyed her warmth and sunniness, and at the same time; I felt a genuine desire to support her learning and awareness; and, I also experienced her stubbornness with taking in new information, and integrating that. I told her that I could recognise some of my own stubbornness to learning, as reflected in her way of being.
Sharing my own limitations and similarities helps reduce the shame that could be associated with such feedback and evaluations.
We then attended to her issue. She talked about her pain regarding a boss. She often thought about the situation, one of tension, stress and unhappiness for her, a situation that she felt a lot of pain about.
She outlined some of the details of the situation, as well as some of the previous context.
Then it became clear to me - that is, I got a clear figure myself. In Gestalt, we say that the figure is co-created. It emerges out of both client and therapist ground.
Underneath anger there is generally some kind of pain. Its often useful in psychotherapy to find the underlying pain, and this is the approach used in more subtle approaches such as Family Constellations. It can allow for a less attacking communication.
However, in Melanie's case, she never moved to anger. She always stayed at the pain stage. Anger is useful as it moves the pain forward, outward, and is a spontaneous way to mobilise appropriate action.
So in her case, she needed help in moving her pain into anger. Because she had not being doing that, the pain simply 'sat' there, with no change or resolution.
So I invited her to 'put the boss on the pillow' and speak to her directly. I encouraged her in this experiment to transform her pain into direct anger.
She was able to do this, though she found it difficult.
She felt better, but said 'I usually avoid conflict of this type'.
This was also a key, so I asked a field question - 'what has organised you to be conflict avoidant?'.
She explained about a previous work situation, where she had not been treated well; she had held back and contained herself in that situation, but then had finally exploded. She was warned off any such expressions in the future by her boss at the time.
So it became clear that she was working in a conflict avoidant environment. This gave a context - important in paying attention to the field.
I further explored her historical field; I asked about family context, and she described how as a child she had been the teacher's pet, and so had got a hard time from the other kids. So she learned to try to avoid such conflicts.
I acknowledged the impact of these contexts, and then brought her back to the present, and the possibility of expressing her anger. She said -' but if do, I will get into conflict, and then I will feel pain'.
This represented her 'creative adjustment', her way of processing experience. It can be hard for people to do something different, as the habitual way of responding can be deeply ingrained.
So I tried to give her support on two levels.
Firstly I challenged her belief - this was a cognitive intervention. I suggested that it was in fact the opposite way around - if she was willing to express her anger, she would not be holding onto the pain anymore.
Secondly, I provided the practical support of an experiment which involved helping her explore a skilful way of dealing with the expression of anger in the workplace.
Then came the phrase which I had come to recognise as her stubbornness - 'yes but'.
Fritz Perls would say - anything before the 'but' is a lie. In other words, the so-called 'yes' actually meant 'no' when followed by the 'but'.
Because I had a history of experience with Melanie, and had in fact brought up this very issue right at the start, I knew to decline to 'help' her further.
I said - 'ok, here it is, your pushing me away'.  She said - 'no you are the one who is not going to help me, its you pushing me away'. I said, 'you are pushing away my help - I will leave the work with you'.
Here we see a confusion at the 'contact boundary' - she is not in touch with her pushing away behaviour, so she thinks (quite often) that others are rejecting her, without recognising how she sets this up.
So I stopped. She was not happy at all, but I was not willing to get into a power struggle about her wanting help, but then refusing it when its offered. In the olden days in Gestalt this was called 'bear trapping'. Although this term is rarely used now, and could be used to disparage a client, it does describe a certain phenomena. The trick is to see the behaviour, refuse to pander to it, yet remain supportive and available for real connection.
Melanie brewed on this. Sometime later she started getting really angry. This was a positive step from my point of view.
She said 'I want to pinch you'. I let her show me how- she pinched my arms. I said 'I can feel how angry you are, and I can see in your face how angry you are'.
She wanted to keep pinching me. I said - I really get that you want to hurt me right now.
This was her sadistic side, the product of a lot of stored pain. Now there was a safe place for it to come out, there was a lot of history and a lot of force in it.
However, this is obviously not going to work in relationship. So I invited her to a therapeutic wrestle - meeting hands, pushing against each other.
I could then feel the fury in her arms. We did this for a while. She wanted more.
It was time to finish though. And so I stopped.
Again she was frustrated. What emerged underneath her smiling face, her friendly manner, and her containing the pain within herself... was a fury, and the way she manifested that was though control.
Declining to be controlled is a tricky thing in psychotherapy;  although it is necessary,  it can be easily used to blame or pathologies a client, which is not of benefit.
This is an example where 'frustrating' the client is a healthy intervention - not from an idea that its good to confront the client, but from the necessity in the moment of managing  the 'contact boundary'.  

Tuesday, September 30, 2014

Case #113 - Leadership into intimacy

Jeremy was a genuinely nice guy, sensitive, considerate, thoughtful. He brought up the issue of his speediness, as compared to his wife, who was slower. On the one hand he tried to be considerate of her, telling her that it was ok if she didn't finish some things around the house. On the other hand he was frustrated at how long it took for her to do things - he wanted to take over sometimes. He was also frustrated because there didn't seem to end up being much space for doing things together, as a result of her slowness.
I asked him what he wanted more of in relationship. He said - appreciation for the kind of work he does….and then he mentioned that they had a date night that was supposed to be regular, but rarely happened.
Knowing Jeremy and his considerateness, I asked him more pointedly - so this is ultimately about you wanting more 'relational space' - by which I meant, more intimate space, to talk about personal matters. He agreed. I asked him exactly how much of this space he would like, and in what form. It was hard for him to specifically identify this, although he clearly yearned for it.
He did identify a number of things he wanted more of - the date night to occur weekly, family outings once a month, taking sufficient time to discuss any pressing issues that arose.
This was good, but I also saw that something missing. He wanted more intimacy - and while these things all contributed, he did not mention anything about having relational space at home, when there was not something organised, or pressing.
This kind of at-home relationship space is an important part of creating the ground for intimacy - time to talk interpersonally, sharing thoughts and especially feelings, raising matters that are not necessarily urgent but nevertheless important.
He immediately agreed this is something he would like.
In his mild manneredness, he found it hard to name precisely, and fully, what he wanted. So part of my support was a mutual brainstorming of this matter, contributing ideas, not only drawing them out of him. Gestalt in this ways is participative, and the Gestalt experiment can equally involve the therapist.
He stated however that he felt powerless to bring this into his relationship. It was not such a priority for his wife; she was always busy with other things, and it took her a long time to get things done, so there was not any time left for this type of intimate contact.
I told Jeremy that I had an agenda, and I would speak to him from that place - this involves being explicit and fully owning my own ideas, and ability to influence. This can be a part of therapy - arising from the power differential - whereby a client will be influenced by our opinions, and - as with most people - we like to give our opinion.
The phenomenological process steers away from such advice giving, or providing directions, working instead with the client's experience, and the 'what is'. This existential approach is  not about exerting influence, but 'being with' someone.
However, in a Gestalt mode, there is space for 'showing up' with my perspectives, as long as I am careful not to push them on the client, and pause to check what is right for them.
So I told Jeremy that I wanted to influence him towards a kind of leadership as a man, in relationship, that was not about a traditional 'male boss' or 'selfish male' domination. Instead it is about leading the relationship towards intimacy, in consultation with your partner, but not waiting for her to do so; rather getting in the drivers seat, and using ones power, influence, organisational ability and focus as a man, to achieve this end.
I checked in with him, and he was happy to receive this 'push' that I gave him. In fact it gave him some energy and direction, so was supportive. The main caution is to ensure that the client doesnt swallow such directions, and that if they have any blocks to manifesting such 'good ideas', then we work in a detailed and specific manner with those impediments.

Saturday, September 27, 2014

Case #112 - The devil says: let go

Serena brought the issue of her jaw. Several years previously she had an infection in it. She had it treated, and there was an 80% improvement. But it hadn't got better than that. It annoyed her - her jaw clicked, it didn't feel quite right, there was some uncomfortable feeling in the nerves. She wanted to see if it could get completely better
I asked about her family context. Given this is a somatic issue, family issues tend to be embedded in the body and consequent problems tend to play out family issues.
Her mother was a strict task master. As she relayed this, her eyes were full of tears, and stayed this way, as we talked about different subjects.
She always came top of the class, from a young age. She pressured herself to get things perfect, and was very distressed if she didn't.
This theme continued with her study - taking on an extremely difficult course, and getting through it by sheer grit determination; then her job - having a boss who expected nothing less than perfection, and managing to find a way to work with him over the years.
She said it was like she woke up one morning and the 'devil had got into my jaw…': she just wanted to 'wake up, and it would be gone'.
This gave us the key, so I asked her to describe how the devil had got in? She said through the back of the head. I asked what the devil  looked like - she said it was a black bat, with big teeth.
I suggested we ask the devil to come out in front of her for now so she could talk to it.
The 'devil' said that he liked playful and rigid people, and that he liked her.
This was interesting, showing that the devil was not actually so hostile, and in fact was there very much because of her core issues - her perfectionism.
She asked the devil - 'why are you here?'
He replied, 'to help you let go'.
This was a major revelation. The Devil was actually playing an important role. The jaw situation was in fact a pointed lesson to learn to let go, clearly related to her perfectionism.
I asked about letting go. She said since the jaw situation she had let go of some things she had previously hung onto - trying to get a promotion, buying a bigger house.
I pointed out that letting go is related in some ways to death, mortality, the end of things. This set up a discussion that could occur another time about letting go as a profound process, raising existential issues.
I asked about what she did for relaxation: not much - she worked very long hours. She did some yoga, hung out with friends, went shopping.
The yoga represented some kind of relaxation activity, but clearly more was needed
I asked what else might she need to let go of.
She drew a blank.
I asked her - 'can you let go when having sex with your husband?' She replied - 'no'
This was also a key statement. It was not just about the sex, but the fact that sex is very much about a cycle of the build up of charge, and release.
She said the held back, as she didn't want to get pregnant.
This gave further information about her holding on, versus letting go. Whilst she was not considering children at this stage, the juxtaposition of this kind of holding on - on a deep organic body level - with the holding on that was clearly at the core of the jaw issue, were importantly related in my view.
Sexuality is a template for much else about our experience - our core organismic functioning. It represents our encounter with primeval forces of life, death, pulsation.
So sexuality can be a potential key  for a profound somatic letting-go that clearly needs to occur for Serena. Her perfectionism is deeply embedded in her body - hence the 'devil' coming to change her course. So part of the answer is a cognitive shift - in attitude, and in terms of a symbolic letting go; but more fundamentally it has to be rooted in a body experience of letting go.

Monday, September 22, 2014

Case #111 - Fear of fighting

Lucy was coughing. It wasn't a normal cough. It sounded like a mix between choking and a dry cough of something that couldn't come up. She was also breathing quite heavily. She was in distress, and whatever it was that was happening to her, wasn't moving. She said that she couldn't stand listening to any sounds at that moment.
From previous work with her, the link was very clear: her parents quarrelled almost incessantly, sometimes to the point of violence. But the traumatic effect of this was the result of the fact she only saw them once every year or even two years when she was growing up. She grew up with her grandfather, who preferred her brother. Her aunts likewise preferred her brother. So she felt isolated, unsupported, and unloved at home.
She desperately needed and wanted love from her parents, but instead, she felt embarrassed when they came, because the neighbours could also hear them quarrelling.
As she spoke about this, she was dry coughing, and pinching her throat, which she said was very itchy. The energy was blocked there - in Gestalt we say the energy was retroflected - directed towards herself, rather than outward. So I gave her a cloth and asked her to twist and choke it. This redirected the energy, away from herself, outwards; she started screaming, and sobbing, imploring her parents to stop quarrelling.
I asked a man and a woman to represent her parents, and put them a little distance from her, facing each other.
Just seeing this picture was very provocative for her - she sobbed, screamed and begged them not to quarrel.
Lucy was in the midst of her trauma. This was spontaneously arising, and good in the sense that it gave access to an core piece of unfinished business. However, there was so much trauma that the energy kept blocking (in the form of the coughing), and I had to keep directing her to twist the cloth, which resulted in her screaming some more.
Whilst there is value in the release - better than it being pent up, directed to self, or ignored - there is also limited value in simply staying in the trauma. And it seemed there was no end for Lucy - after some time had passed, she was just as distressed
So I kept bringing her into the present, focusing on my face, the room, breathing deeply and more slowly. This is called 'pendulation' and is a way to work with trauma - moving back and forth from the distress to the present. She would only stay present only for so long, before becoming distressed again.
In some of her distress she said 'I don't know whats the point of living, I just don't suicide because that would hurt others'.
So I asked her to make a 'mission' for herself. We constructed 3 elements - using her experience to help children she worked with; learning from her experience to ensure that when she got married, she did not repeat that; and making sure that when she had kids herself, she did something differently with them.
This created some ground, as otherwise she did not have much solidity, just a sense of trauma.
The experiment I set up was this - the two people who were representing the 'couple' would have a small quarrel. But it would be a 'healthy' quarrel rather than a destructive one.
Lucy was very scared - even suggesting that there would be a conflict was distressing to her. And the prospect it might get out of hand was very restimulating. So I asked her to set some ground rules for the quarrel, which she did. This put her in a power position, and gave her the ability to control the situation in a way she couldn't as a child.
As they started, she needed lots of support from me, by her side, to witness this, and not sink into her trauma again. She did start to scream a few times at the start - she had a lot of terror. But I reminded her that this was part of achieving her mission, and that she needed to be present for it, to learn from it.
So she watched the 'quarrel', including a successful resolution. This was the first time in her life she had seen something like this, so it was a powerful experience. She had needed the space to release her energy, but she had also needed the ability to remain calm, to receive direction, and to have a new experience.
I gave her some homework to watch conflict resolution videos, witnessing people arguing, and then seeing those disputes resolved in a skilful way.

Tuesday, September 9, 2014

Case #110 - Hidden aggression

Macy smiled a lot. She seemed a very genuinely warm and friendly person, hard to dislike on first appearance. She seemed to be there for others, and clearly liked to be helpful.
However, in the group, she kept getting into conflicts. She seemed argumentative, and quick to jump to conclusions. Despite her apparent warmth, she would say things that stirred antagonism, and that contained lots of assumptions and reactions on her part.
In one of these conflicts I came in to support her. I guided her to link an observation statement of her with a feeling statement - she tended to jump from observation to interpretation, without really including herslef. Or sometimes, just directly to interpretation - e.g., 'you are rejecting me'. So I directed her to start with an immediate experience, and to name her emotional response.
This proved very hard for her. She found difficulty identifying the feeling, and seemed reluctant to share it, preferring to move to her imagination about what was happening. She was also reluctant to 'check out' her imagination, asserting it as some kind of reality e.g. 'why are you rejecting me'.
In slowing her down, linking statements with feelings (rather than questions), she started to get more in touch with what was happening for her. Reluctantly, she found she was angry; before this, she had been seeing other people as the problem. The strict form of the 'clean communication' I demanded, confronted her with her own darker feelings, which she could no longer put onto others.
I pointed out that she had some embedded shoulds; even though I guided her to express her wants as requests, she was hanging onto underlying prescriptions for how others should behave, and this was fuelling her anger.
The discipline I guided her into - which included limiting her statements to expressions of her experience rather than justifications or explanations - drew her beneath her sunny demeanour and brought up a lot of sadness. It also highlighted her limits - she wasn't able to listen to any more responses from the other person. Again, this dipped beneath the apparent 'conversation', to show that she needed a lot more attention to herself in this place.
When people are confronted - in this case very caringly by me - regarding their controlling behaviour, their 'racket' is up - they can no longer use their focus on others to avoid their own difficult feelings.
In this case the difficult feelings were those of aggression. Many people find it difficult to recognise, feel and acknowledge their aggression. There is a lot of social conditioning people receive about not being aggressive, or not expressing it. This is especially true for women. The kind of support we can give in therapy for this is to create an atmosphere of permission to feel all sorts of feelings, and then a guided way to express them. Especially important is the owning of feelings, and the clear articulation of them in a way which describes one's own experience, rather than an interpretation of the other. This is one of the things that therapists can do, offer help and guidance for people in this place.

Friday, September 5, 2014

Case #109 - Removing the burden

Sally had reported a number of symptoms - a feeling of chaos, some pain in her upper back, and the experience of blushing, which she connected to fear of a lack of acceptance.
I asked her about these various phenomena. She was looking at me intensely. Generally that indicates the client wants something from me. I asked her about this, but she didn't know.
As I was talking with her, I had a sense that there was a parallel conversation going on - our words, which didn't really seem to connect much, and the emotional tone, which seemed intense to me, but unclear.
She reported feeling foggy.
I also told her I felt foggy.
She had nothing in her thoughts.
But there was a lot of feeling expressed in her eyes, though I could not tell what it was,
I simply acknowledged what I saw, and my own experience. This is called phenomenological reporting.
Her back felt hotter.
So I put my hands on the place it was hot. She reported it was very tight and I could feel this. I didn't massage, but just felt into the tension with my hands, so I could get a direct sense of exactly what she was talking about. Again, I want to enter into her phenomenology as much as possible.
I said, 'it seems as if you are being attacked from behind'.
She talked about her father smacking her as a girl, quite a lot. It was 'normal' smacking, but what was disturbing was she never quite knew when it was coming, so it was a shock.
I then applied some pressure on the spot on her back - just direct steady pressure - this is known as 'taking over' in Hakomi therapy - parallel to the kind of intensifying of experience which we do in Gestalt; the result was she was able to relax a bit.
There was still a lot of emotion in her eyes, very intense.
Then she reported that both parents made her wrong - consistently putting her down, calling her 'stupid'.
This was clearly the key.
So I used my therapeutic authority, and the connection we had built up, to 'remove' those burdens from her shoulders, and tell her I was 'taking away' the bad words - stupid etc, and replacing them with good words.
While we generally are oriented around responsibility in Gestalt, when it comes to shame issues (indicated by the blushing, the lack of self acceptance, and the being made wrong), a person may experience themselves as somewhat powerless. So they may need help from the outside - therapist, or group, in order to experience enough support to move out of the place they are stuck.
This was the support I provided, and she was able to take it in. Support comes in many forms; the issue is finding just the right kind of support the client needs, in the right degree, and delivering it at the right time. This requires setting aside our 'helping' agenda, and being closely tuned into the client's needs. It also involves being willing to be present, and notice what occurs for me, as that also helps guide my choices.

Sunday, August 31, 2014

Case #108 - After abuse, the gift of pleasure

Elise plunged right in. She spoke about being molested as a 5 year old girl. This was the first time in her life she had shared this with anyone, and she was in her mid 40's.
After the abuse, she subsequently believed that she had lost her virginity. But when she first had sex with her husband, she realised that in fact that was not the case. However, the burden that she had been carrying since that age impacted on her negatively and in 20 years of marriage, she was not able to enjoy sex with her husband.
As with many victims of sexual assault, she blamed herself - why hadn't she run away? Why didn't she hate the molester more? Why couldn't she let it go? So many things weighed heavily on her. And now, her husband had been having an affair for 5 years, so that increased her sense of burden, and self hatred.
Firstly, I contextualised her experience - many victims find it easier to hate themselves, than the perpetrator. And victims, whether adult or child, get frozen. So I explained a number of things to reassure her that she was not alone in her experience.
She said she would like to be able to find pleasure in sex.
I said - 'won't it be amazing when you get that gift to yourself - you open up the present, and there it is, a lovely source of pleasure that you can access any time'. I was preparing her for this possibility. In NLP this is called future pacing.
I also suggested that she could do a swap - trade the burden she had been carrying, for this pleasurable gift. I said 'how amazing that will be, you get to give away the burden, and you get the gift of pleasure instead'. I introduced the idea of an exchange.
She relayed that after the molestation, she saw the perpetrator, but there was no further abuse. However, strangely from her point of view, she would ask him to give her a lift on his bicycle to her school. She also gave herself a hard time that she was 'using him'. And that she had allowed herself to get somewhat close to him.
This is quite normal, and I reassured her of that. Victims often have some kind of bond with the perpetrator, which defies black and white categories. Bert hellinger speaks at length about this.
I also pointed out that perhaps her 'using him' for lifts was a kind of exchange - a way of 'punishing' him, allowing him to exchange his guilt for 'being used'.
Again, I wanted to introduce this idea of an exchange.
Next I set up a Gestalt experiment: I asked her to select some objects representing different elements - the burden, her hatred, herself, 'the gift' (pleasurable sex), the abuse behaviour, and her husband. I named it 'abuse behaviour' rather than 'the abuser', as it was clear she did not want to hate the perpetrator.
I then facilitated a process: she swapped her anger at herself, for anger at the abuse behaviour. She swapped the burden for the gift.
I then invited her into another Gestalt experiment, involving her having a dialogue with the object representing her husband; she proposed to her husband that if he finished the affair, she would give him her gift - pleasurable sexuality.
If not, she would take it to a new relationship.
She decided she would separate for 6 months, giving him a chance to either finish the other relationship, or decide not to continue with her.
During that time I suggested she practice 'the gift' - pleasuring herself (she had not masturbated before), reading erotic stories, and reading other helpful books on pleasurable sexuality.
The whole process was filled with a great deal of emotion. By the end, she felt very calm and very clear.
In Gestalt we use a term 'organismic self regulation' - basically, a person knows underneath what they need, and they have natural processes of moving towards that. The problem is that old patterns interrupt this movement, getting in the way. So we provide support at key junctures, helping restore this natural organismic flow. Elise was ready for a change in her life, and so all she needed was some assistance in finding how to move in that direction. The clues were all there, and her resources were also all there. She just needed support to form a complete Gestalt - moving from desire and intention, through to action and satsifaction.

Wednesday, August 27, 2014

Case #107 - Using authority to exit from violence

Kirstie was in a domestic violence relationship
She grew up in a large family; even though her father was away working during part of her childhood, her memories were basically good.
Her husband came from a military family. His father had beaten his mother. His siblings had various problems, including addictions.
Kirstie was a good wife. She worked in the family business. She helped her husband. She helped her inlaws. She was there for everyone - except herself.
Her husband was insecure and controlling, limiting how much she could go out of the house.
Yet, he had had several affairs.
The violence had occurred on a half dozen occasions, but the last incident was fairly recent, and the police were called.
She wanted to separate, but he refused, backed up by his parents.
She told him if the violence occurred again she would leave.
Kirstie had been doing lots of self development courses, reading lots of books, including some on domestic violence. She had been learning self care on a variety of levels. She had been to some group therapy.
Of course, there was lots of emotion as she was relaying her story.
One of the contraindications for therapy is domestic violence. Whilst therapy can be useful to help empower the person in the victim role, it can in some ways make things worse - as the person becomes more independent, the violence may increase, as an attempt to impose control.
So I didn't want to work with feelings, or even behaviours. I didn't want to come up with strategies. I said to Kirstie - what do you want from me?
She said - a direction to head.
I pointed out that she probably had plenty of suggestions from her girlfriends, and that if I was to suggest something to her, she would probably ignore me. She smiled, just faintly, and I knew what i was saying was true.
I tested this out. I asked her point blank - if he beats you again, will you leave?
She paused, baulked, started to cry a little, just faintly shook her head.
This was confirmation that something much more profound was required.
So I wasn't soft, compassionate, understanding, or supportive. That would involve being pulled into a 'sympathy' position, which would not ultimately empower her.
I stepped into my authority role, and told her - 'there is only one thing you can do'.
Now, usually I eschew my authority role, in preference for dialogical communication, or bracketing of myself, to explore the client's reality or their values.
If we had more time, this may have been useful.
But theres very realistic dangers at stake in a domestic violence relationship, and my orientation is more practical.
So I used my authority for dramatic effect, to confront her, and to test out her readiness to truly do something different.
I used polarity theory in Gestalt  - the existence of any one polarity, always implies the other.
She was identified with the victim/powerless/nice girl.
So I said - 'you will have to become like your father in law - a military man'.
I spoke in this way, to use the language of authority - which is in one sense what she was used to responding  to, but I was using for benevolent purpose rather than to hurt her.
I picked up a statue of a patriarch looking guy, and put it in front of her. I directed (notice the authority again) her to come and stand behind the statue, and to 'become him'.
All this authority is setting her up to step into that energetic realm. I asked her to imagine she were a military man. An officer who commanded thousands, sent them into battle. Who was obeyed absolutely, who gave orders, who was willing to sacrifice the lives of others.
She of course found it difficult to occupy this role, but I kept focusing her, showing her how to stand, giving her mental images. At one point she said 'but my father in law is very unhappy'. I said  - this is not about happiness, but about power. Its about you stepping into a role of power. You don't have to stay there, just as long as is necessary, then you can go back to being your nice and caring self.'
I explained how in that role, she wouldnt care about hurting others in her decisions.
This sounds like setting someone up for destructive behaviour. But in fact, for someone like her who is identified with their powerlessness and 'caring', they need a way to step out of so much 'caring' for others, and into a place of 'not caring', so they can act with power to defend themselves.
The one thing her husband was afraid of was her leaving, and thats the one power she wasn't really willing to exercise. To do so would hurt him. So this is an example of a 'strategic' skill, skills which are necessary in life and relationship, just as much as intimate skills are.
She was able to hold this position briefly, then started crying.
So I asked her to sit down.
I explained to her that the things she wanted - better communication, safety, were secondary effects. The first one was finding her power. Without that, there were no bottom lines. She had an identity  as a nice person. To move out of her situation she would have to learn to take on other identities - in this case, the military commander

There may be people who object to me using such violent images. But the irony is, until she could own that ruthless and violent part of herself, she would not be able to truly stand her ground, and be willing to leave him. Until she was willing to do that, she would 'adjust' and put up with anything - probably for a long period. It can take a woman many years to leave a domestic violence relationship.
So I explained to her that she needed to practice this identity every day. To remove her jewellery, to wear masculine clothes when practicing. To really find her authority and power.
And then, when she was fully ready, to plan - strategically - a meeting with her husband where she would step fully into her power, and 'lay down the law'. This is the kind of communication he was used to from his family, and would potentially earn his respect.
It would only be after she was really willing to leave him (i.e. hurt him), step into her power, and deliver him this message, that anything could change.
She agreed.
So in this case, power came first, and everything else came second. Therapy has to be flexible enough to take the approach that is necessary for the situation. To work with her feelings would be inappropriate, when the context was violence. It was necessary to go to that context, and to move her out of her own fixed position, to allow her to gain the respect - and obedience - of her husband.

Friday, August 22, 2014

Case #106 - The thin red line

Jillie started out talking about her marriage. There was very  little sex, and there had been a number of years where her husband was away working for long periods. Now he had returned home.
She had married him for security after some major upheavals in her world, but was not that attracted to him.
So I knew that if her marriage was to last, and to succeed, she would have to be guided by will, rather than by emotion. If there is chemistry, it helps. If there isn't, a good marriage is still possible, but it requires an entirely conscious effort to establish the conditions for intimacy. These conditions were not present in the marriage - in 6 years they had 2 emotionally-based conversations.
I asked her how much she was in the relationship, and how much out. She said 50/50. That indicated that this was a critical juncture, that there was hope, but that something different needed to happen immediately. It indicated the need for input. So that set the tone of the session.
So I asked Jillie to get up, and stand on a line on the floor - the 50/50 line. I asked her which side was which - and I defined the categories - leaving the relationship, or making a quality relationship. I set those polarities, as they made the choice clear. And I didn't want to create a choice of 'stay and nothing change', because that would be to continue the deadness of the relationship, and I did not want to support that.
So then I invited her to step one side - firstly the 'leaving side'.
She reported a number of experiences - fear, excitement, 'freedom', pain. I invited her to step fully into those feelings.
I then asked her to step to the other side - quality relationship. At first she had no idea of what that was, so I defined it again for her - quality relationship and what that might mean, in a few words. She felt stable, peaceful, pleased, balanced, happy, successful.
I took her back to the line. And asked her - 'ok, now if you had to choose, which side?'
She prevaricated. This is the position she is in - unwilling to make choices, staying 'safe' on the line, but meanwhile, dead. This is akin to the passive position that Sartre refers to as 'bad faith'. In Gestalt we are interested in what we call 'existential responsibility', which is a way of living life that involves a sense of choicefulness, rather than being a victim of fate or circumstances.
I could see her unwillingness to step either side.
So I tricked her. I got a coin and told her - heads she leaves, tails she moves to quality relationship.
I was about the flip the coin, and then asked her - which side are you wanting the coin to land?
She said -leaving. So I asked her to step on that side. At least we could 'try out for real' the choice. And get her to experience more fully that side, rather than it just be a fantasy. This is the next phase of our Gestalt experiment.
She said she felt strong and steady. I asked her the specific consequences. And helped her to spell them out - loss of financial security, the impact on her child, and then the impact on her husband - I got her to imagine him there, and see what his response was (sadness, anger etc), and to experience what that was like for her.
For such important decisions its very important to give the person as grounded a sense as possible of the consequences of their choices.
I did not just want to leave it at that though.
One of the features of divorce is that its 'too late', even if the other person changes.
So I said, lets just reverse time for a second, and imagine that just before you step into leaving the relationship, you let your husband know, and his response is 'I will pay whatever price is necessary to build a quality relationship with you'.
This is a dramatic test - just how much she wants to leave, and how much she wants a quality of relationship but doesnt believe that he will come to the party.
This is not just putting words in his mouth, its playing out a scenario when the stakes are high, and the cards are on the table. Sometimes under such circumstances men and women rise to the occasion. I believe its worth giving this a chance.
But she needed help in spelling out what this meant.
I said - what would you ask him for - the list.
She mentioned - he would attend parenting classes, he would get fit, they would have emotionally based conversations once a week, they would go on a family holiday once every 3 months. I said -what about sex? She said - if this happens, I will wholeheartedly give myself to him.
Then I asked her back to the line.
Now, I asked, what side did she want to choose.
Up to this point, I had been neutral, simply facilitating her choices, helping her explore them. My own opinion was irrelevant. I was working to increase her awareness, and therefore capacity to take responsibility for her life. I was facilitating her awareness, working phenomenologically.
Now, she was on the line and she 'couldn't' choose. We hovered there sometime, still no choice.
In a whole series of sessions we might have the luxury of hanging out in that place. But the session was already long, and it was time to draw it to a close.
So rather than leave her there I said - what do you need? She said 'a push'. I said 'so you want my opinion?' She said, 'yes'.
I said 'so you want me to decide your fate?'
I was confronting her with her passivity, and the implications of handing over a decision to me which way to push her.
I asked again - so you really want to hear my opinion? She indicated yes.
This was important - not rushing into giving my 5-bob worth. We all have opinions and we all think them wonderful. But its important to be very careful with clients, as the authority of our opinion as therapist can unduly sway a person, taking away their autonomy.
And, therapy cannot be rigid either. Sometimes, after due exploration, its appropriate to bring in ones own phenomenology. So I decided to do so. I remembered the juncture of a decision about my own divorce. My therapist would not take a position. I wished now they had done so - it would have been helpful for me.
So I told her my opinion, in precise and clear terms.
I believed that she could choose a quality relationship, that if her husband agreed to do anything, she could dictate the terms, which sounded healthy to me. I told her that I saw love as an act of will, and that if she made the choice, she could learn to love him deeply, and create the conditions for intimacy to blossom.
She said - yes, she believed me. It accorded with her deep feelings.
She decided she would do this, and make it a years probation - to be reviewed after that time.
In this way she reached her own integration - to move to a decision, but not to abandon her right to choose the other side. This was a good indication that she had reached her own conclusion.

Tuesday, August 19, 2014

Case #105 - Leaning and pushing

Patty brought the issue of 'stability', as in, she wanted more of it. In trying to understand what this meant for her, she mentioned that she often felt tired, but at the same time, she couldn't really rest well. As I talked about this with her, I not see much emotion going across her face. I asked about this, but she was not aware of her blankness.
This happened several times, each time I would comment on what I saw. This is what we call phenomenological reporting - the observation of the obvious.
Then she started to tear up, I invited her to breathe, and asked how she felt. She reported just a little sadness.
I could see that it was hard for her to 'let down' - a somatic term which indicates letting go both emotionally and physically.
So I suggested an experiment - she would lean against me.
In this way I was offering her a relational experience of 'someone else' being stable for her, so she could allow herself to go more into her emotions. This could potentially give her a source of strength which she could then draw into herself, and at the same time, allow her to go more safely into her feeling
This worked for a little while, she cried a bit, and indicated a blockage on her back. So I put my hand there - as support - and she felt that pain release.
However, I could tell there was some kind of limit, she wasn't letting herself go further.
She reported a sense of 'having to rely on myself'. So I followed that sense, invited her to sit up, and she said - 'I can't fully trust men'.
In Gestalt we always invite someone to make general statements into personal ones - the 'I-thou'.
So I said - 'I am a man, tell me that directly'.
She was reluctant, but I insisted on personalising it.
Then she said - 'its my first husband'.
So that made it clear. She explained how she had put up with a lot of very bad and disrespectful behaviour from him, and had never said anything. So she was angry at herself - she was squeezing her fists tightly.
I then invited her to 'put him on the pillow', and talk to him.
She did not find it easy to do so. She was so used to blaming herself. She needed help from me to frame up statements to him in the format: 'I am angry that you…'. She had for a very long time been angry at herself that she had allowed his bad behaviour.
In Gestalt we refer to energy which is directed at self rather than other as 'Retroflection'.
Her body was habituated to doing this.
So I provided more support for her to direct the energy towards him, by changing her 'I am angry I allowed myself…' statements into 'I am angry that you did…' statements.
She did spontaneously start hitting the pillow. But not terribly hard, and her voice was still somewhat soft.
She clearly found it difficult to really let go her anger.
However, she reported feeling more breathing space, which indicated that she was letting go.
She talked about a male friend of hers who was very nice to her…but she wasn't so nice to him.
So I brought the focus to her and I. I said, 'I care about you' - and she agreed she could take that in a little - because I was the 'good man'.
I also said - 'but like all men, I can also be a selfish man'. This is offering her the experience of polarity - both in the same person, rather than split into 'good guys and bad guys'.
It was hard for her to take that in.
So I invited her to another experiment. I took one of her hands in mine, and said 'can you feel my caring?'. She was passive at first, but I asked her to squeeze my hand - an active participation in accepting caring. (and addresses the problem of what Sartre calls 'bad faith' - a passive way of not choosing in life).
Then I asked her to push her other hand against my other hand. So both hands were doing two different things.
I invited her to make two statements to me:
'I accept your caring'
'I push away your selfishness'
The second statement we amended to  'I won't allow your selfishness to hurt me'
In this way, we were able to contain both elements of relationship - self protection, and openness and nourishment. For a long time she had been pushing men away, but then feeling starved for nourishment, and not able to enter into relationship.
This provided for her the experience of integration, and the ability to hold both elements of relationship.
She reported feeling much more breathing space, and a new sense of how she could be with a man.

Saturday, August 16, 2014

Case #104 - A sensitive young woman

Lucy brought the issue of her sensitivity. What I noticed was her smiling a lot. I asked if she felt happy…and then, what kind of things gave her pleasure, and brought her happiness. Although this gave me some information, it didn't seem to connect up with the issue she brought, so I left it. Sometimes figures of interest such as these may be useful - later in the session, or at other times.
She had done some other therapy work, and read a book recently, that gave her the idea that her problem was over sensitivity. She was also concerned with this in regards to meeting men. She was a young woman who was easily affected by friendship with men - she would soon find herself at the point of wanting to move into an intimate relationship. But she wondered if her sensitivity meant that she moved too quickly, and mistook the signs on the part of the man. Her relationships had not lasted that long, and she wondered if her sensitivity was contributing to the lack of success in engaging in a deepening relationship.
She started telling me a number of stories - about experiences with young men, that hadn't been successful, about a diagnosis that a practitioner had made about blockages in her system, and she started to tell me some other matters to do with her parents, and her unfinished feelings in relation to them.
Although all these stories could have been relevant, I felt a sense of widening circles - too much to grasp, too many images, too much information. In Gestalt we work to ground, focus, and find 'one figure' to work with in a session.
So I interrupted her (an important therapeutic skill), and told her I was getting lost, and wanted to bring the dialogue back to the present, and to focus on the issue she brought. Sometimes other, more relevant figures arise in the course of such story telling, but in this case, it simply generated too many other possibilities, none of which seemed to have more energy.
So I invited her back to the 'here and now, I and thou' - a core focus in relational Gestalt.
I asked her to notice her sensitivity with me, and tell me about that. I expected her to say something about herself, but instead she talked about something she noticed in me - what she described as my loneliness.
Now, this wasn't something I was directly in touch with, at that moment. But in Gestalt, in contemporary terms, we prefer not to label such a thing 'projection'. Because it always has a grain of truth, and there's more valuable dialogue to be had by taking it at face value.
So I looked at my own experience, and shared that although I wasn't immediately in touch with my loneliness, its true I did experience it from time to time travelling, and in many ways, my coping process involved simply putting it aside, pushing it away.
I asked what her own response was to that perception - she said she felt some pity. I asked about the impact on her - she wanted to give me a hug.
Now this was useful to deconstruct. Whilst I may indeed like a hug, especially in relation to any feeling of loneliness I have, what was valuable was to see her process - focusing her sensitivity on the other person, and moving away from herself. I highlighted this, bringing it to her awareness. What was noteworthy was that her sensitivity was finely tuned to the other, but not herself. I pointed out that sometimes my response to someone in pain was to want to offer a hug - but that was more to do with the fact thats what I would like in that place, than necessarily being true for them. I pointed out that by moving away from her experience, she created an unbalanced transaction, in one sense, almost invasive.
So I asked her to 'step back over the fence', and notice her experience - focus her sensitivity on herself.
This was a major realisation for her, and gave her a great deal of valuable information about what tended to go wrong for her in relationship, and what she could do differently.
I also outlined how from a Gestalt point of view, her sensitivity wasnt something to be 'changed', but owned and embraced - the more she knew about herself in that place, the more fully she could bring her uniqueness into relationship with a man, knowing the strengths and limitations of it.

Monday, August 11, 2014

Case #103 - Disciplining Ms Spontaneous

Molly wanted to establish a more regular meditation practice. She was very keen to do so, but, as with many people, found that she would do it for a while, then get out of the rhythm.
I asked for specifics - how often, when, and for how long. She wanted to do one hour, twice a day - in the morning, and the evening.
I asked about her schedule. She did not have a schedule. She worked for herself, her time was open, and every day was different.
This was going to be difficult! Given that she clearly had such a preference for spontaneity, I was interested in her family context, which is often what sets our personal style.
This is what we call a Field question in Gestalt - an interest in the setting of the field and its influence. Deeper patterns tend to come from that place, and its important to enquire about this, as otherwise immediate and behavioural interventions are likely not to stick.
She had a number of brothers and sisters, and grew up in a rural environment. Both parents worked. So there was a very tight schedule. Her father would wake, often sometime around 4.30am, get up, cook lunches for all the children, get them up, and then help her mother feed the kids breakfast. They would then head out with their mother who was a school teacher.
She talked about how when she had an exam her father would wake her earlier to study, but as soon as he was gone she would go back to sleep until it was time to get up for school.
This gave a clear indication that any role I had in being helpful and 'waking her up' to do something - even  in her own interest - was just as likely to be sabotaged by her desire of the moment.
So I knew there had to be some sense for her of working for a result - if it was my direction, it wouldn't work. She had to feel full ownership. I decided that one way to do this would be for her to feel like she was 'paying the price' of getting the result (of regular meditation). It wasn't going to be a 'free' or 'easy' answer, and would have to involve some kind of explicit sacrifice on her part. Otherwise, she 'wants it all' - her freedom, and a regular practice. Things don't usually work like that.
But I also had to find a way that she could retain a sense of control, and spontaneity, so I didn't think that a regular time frame would work.
My solution was this. I proposed to her that everything has a cost. And if she wanted this result, she had to be willing to pay the price.
In this way I prepped her for being willing to pay a cost.
I asked if she was open to 'paying' for the result. She agreed.
I then suggested that she 'pay' by exchanging a meditation session for a meal - that is, until she had completed her morning practice, and evening practice, she wouldn't eat her meal.
This gave her a sense of 'paying' for the meal with the meditation - displacing her focus away from 'having to' keep a meditation discipline, and using her hunger as a motivator instead. Hunger is something fairly stable, it returns each day, and doesnt have to be worked at, so anchoring it as a reference point provided a point of stability in her otherwise chaotic schedule.
It also allowed her to vary the time when she did her practice, satisfying her need for spontaneity.
In Gestalt, as in Ericksonian approaches, we try to use the client's resources, find things which fit in their unique style, and introduce tasks which are integrative, rather than pushing against resistance.

Blog Archive

© Lifeworks 2012


Who is this blog for?

These case examples are for therapists, students and those working in the helping professions. The purpose is to show how the Gestalt approach works in practice, linking theory with clinical challenges.

Because this is aimed at a professional audience, the blog is available by subscription. Please enter your email address to receive free blog updates every time a new entry is added.

Gestalt therapy sessions

For personal therapy with me:

Enter your email address:

Delivered by FeedBurner

© Lifeworks 2012




Informed Consent & Rates


Gestalt Therapy Defined





Book:Advice for Men about Women


• English






Greek ελληνικά

Hindi हिंदी








Russian Русский

Serbian српски

Chinese 中文

Japanese 日本語

Arabic العربية

English Bahasa České Deutsch Español Filipino Français ελληνικά हिंदी Magyar Melayu Italiano 한국의 Polski Português Română Русский српски 中文 日本語 العربية

If you are interested in following my travels/adventures in the course of my teaching work around the world, feel free to follow my Facebook Page!


This Gestalt therapy blog is translated into multiple languages. You are welcome to subscribe


Interested in Gestalt Therapy training?

Contact Us


Career Decision Coaching


and here


Gestalt training and much more

For Men

Here is a dedicated site for my book Understanding the Woman in Your Life

The Unvirtues

A site dedicated to this novel approach to the dynamics of self interest in relationship

Learn Gestalt

A site with Gestalt training professional development videos, available for CE points

We help people live more authentically

Want more? See the Archives column here

Gestalt therapy demonstration sessions

Touching pain and anger: (40m)

Permission to feel: (54m)

Marriage after 50: (1h 17m)

Serafina - Angel wings: (45m)

Barb Wire Tattoo: (37m)

A natural empath; vibrating with joy: (39m)

Dealing with a metal spider: (51m)

Interactive group: (1h 57m)