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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.

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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.

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Gestalt therapy demonstration sessions

Touching pain and anger: https://youtu.be/3r-lsBhfzqY (40m)

Permission to feel: https://youtu.be/2rSNpLBAqj0 (54m)

Marriage after 50: https://youtu.be/JRb1mhmtIVQ (1h 17m)

Serafina - Angel wings: https://youtu.be/iY_FeviFRGQ (45m)

Barb Wire Tattoo: https://youtu.be/WlA9Xfgv6NM (37m)

A natural empath; vibrating with joy: https://youtu.be/tZCHRUrjJ7Y (39m)

Dealing with a metal spider: https://youtu.be/3Z9905IhYBA (51m)

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