Tuesday, May 26, 2015

Case #144 - From fed up, to authentic expression

The second session with Zelda went like this.
Having addressed her holding back/letting go process in relation to her family of origin, she was now ready to deal with more current issues. This is often the case - once unfinished business in the person's field is attended to, they are more available for focusing on the present.
In this case, after vomiting previously, Zelda was not more clearly in touch with the things that she was 'fed up' with.
I suggested that perhaps a place to start was by expressing these things to her husband.
So I stepped into the 'husband role' so she could talk more 'directly'. Traditionally, Gestalt therapy has used the empty chair, but in some ways, it can be even better if the therapist steps into the other role, as then its possible to get a more direct experience of what is going on.
So Zelda started talking about things that were not ok her in marriage - her need for more connection, more passion. She spoke about not being able to depend on him, and how he would 'run away' when she tried to talk to him about things.
She was saying all this directly to him in the role play. At times I directed her to use 'I' and 'you' language, rather than talking to me about him. In Gestalt we generally discourage 'about' talk, because its once removed, and more deflective - it reduces energy, intensity, engagement and therefore good contact.
Having expressed all this in a big rush, it was a little like she was vomiting up everything that she had swallowed. It is unlikely that her husband would be able to manage to hear all that, given that at the best of times he would avoid any kind of difficult contact.
Thus being in the therapist role, I could provide her with an opportunity she was unlikely to have in real life. Some people might think this would produce unrealistic expectations. Sometimes thats the case. But what therapy can do is give people the experience of really expressing themselves, and really being heard.
Many people want to change their partner. The focus in Gestalt is on encouraging and supporting the person to empower themselves.
In this case, after expressing herself so fully and clearly, Zelda was shaking. She felt fear. I encouraged her to stay with her breathing, and remain grounded in her body. Her authentic expression is an achievement, in and of itself, and just as we stayed with her wobbly uncertainty in the previous session, staying with the shaky but authentic place in this session gradually gave way to her feeling more solid in her capacity to speak her truth.
The idea is that as a person becomes more grounded in themselves, they become more able to articulate their experience and ask for what they want directly. Clearing resentments allows this to be more present centred, and staying in one's body allows this to be more relational.
These things then are more likely to have a real impact on the other, rather than just eliciting defensiveness or avoidance.
In this case, as Zelda spoke in a clearer and more grounded way, I could feel the impact, and could give her that immediate feedback.

Sunday, May 17, 2015

Case #143 - Letting go of too much responsibility

Zelda reported feeling tension, and conflict. She made two fists with her hands as she said this. She also said 'something wants to come up'.
I said 'let it come'. This is called 'tight therapeutic sequencing' by Erv Polster, and is related to the 'natural nextness' of the moment which we follow as Gestalt practitioners.
As she took up my invitation, she told me that whatever it was, was stopping at her throat. As she breathed more deeply at my encouragement, 'it' went back down.
I pointed out that it appeared that she was swallowing something. This is a clue in Gestalt frames for something being 'introjected' - usually some kind of injunction.
So again I invited her to 'let it come up'.
Again, nothing was clear.
So rather than try to focus on her immediate awareness - when something is blocked we dont push it - I asked about her field - ie the wider context. I wondered about agitation or conflict in her family.
Zelda grew up with her grandparents. Her parents fought a lot. When she saw them, they would be fighting, and she found herself in the position of needing to console them. One time they were going to divorce, and she had to write a letter to them, and as a consequence they decided not to divorce.
She did finally go to live with them, but they couldnt afford to keep her. Her father had to get up very early to work, and so she saw little of him. Still, she wanted to stay with them, but eventually she had to go back to her grandparents.
As she related this, she started vomiting. I encouraged this. It was a very positive sign - she was no longer swallowing her feelings, but letting herself react fully, and releasing what she had kept inside for so long. This was important both organismically, and symbolicallly. This represented a natural undoing of the introjection.
Clearly, she had been put in a position of having to take too much responsiblity for her parents and their situation. So I gave her a counter message: 'as a child, you are not responsible for the adults, for your parents'.
Her response was to vomit more.
I said 'I am disgusted by how much you had to take on as a child'. This gave voice to the feeling of disgust which I guessed was probably behind the vomiting. By bringing myself and my own reaction in, it continued to support her and give her permission to feel her own disgust.
She vomited again.
She then reported feeling guilty. I reiterated the message 'you are not responsible for your parents'. This is something she needed to hear from another authority figure.
Again she vomited.
Next she reported feeling angry. I validated those feelings, and again she vomited.
The she began shaking. I could understand this, and told her that it was made sense, since she had been holding herself together for a very long time. Again, she vomited.
She reported feeling lost and vulnerable. I pointed out this was a good sign of reorganisation, and supported her to stay in that place for a while. In this way, she could allow a new way of being to form, based more on her own needs and grounded in her organism. This is the essence of change in a Gestalt process.

Wednesday, May 6, 2015

Case #142 - A gather in the back of the jumper

Mary Anne came up for a session.
I noted 'the obvious', which is a starting place in Gestalt for a person's phenomenology. This requires observation without interpretation.
I saw - a pink jumper, black blouse, grey socks...and a gather in the back of the jumper. 
I commented on the gather in the back of her jumper - it was an unusual design, and took my attention. Mentioning it is enough - without necessarily focusing on it, unless the client makes more of it.
I then asked Mary Anne what she was aware of. She reported that she had grievances about not being understood. In Gestalt we bring the general into the specific, and into the present, and into the relationship.
So I asked her how understood she felt by me. She said she felt quite held, and understood.
I then asked what she was aware of in her back. This derived from my previous observation, and my interest about what that might be connected to in her experience.
She reported feeling tension there, frequently. I asked her to notice that experience in the present. I asked her where specifically she felt the tension, and she showed me the place. As she stayed with the experience, she felt the tension, but nothing more. So I stayed there with her, present. 
Then, I asked her if I could put my hand on her back in that place. Sometimes that helps focus awareness.
As I did so, her emotion moved. She reported that her father never supported her mother, and that as a child, she took on her mother's resentment about this.
I acknowedged her own need for support - differentiating her need from her mother's need. I invited her to feel my support for her, in the present, and to breathe into the feeling of this in her back.
As she did so, she relaxed, reported the tension being released, and feeling a new strength in her back.

In this way I brought the issue into the present, and into our connection. The hand on her back was part of a Gestalt experiment which then evolved - as good experiments do - into a healing moment.

© Lifeworks 2012


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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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