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Friday, November 27, 2015

Case #164 - Building ground

Bethany came forward to work. She was clearly shy. I made some comments, about myself, my own slight nervousness, my interest in meeting her. She didn't say much in response. There was a slightly awkward silence between us. I let the silence be there, noticing what I was feeling, staying present with her.
I invited her to ask me questions, so it wasn't just me asking her questions. In other words, I made it clear this was a two way relationship - building ground for an I-thou connection.
She mentioned feeling insecure. I talked about my age now, and that I felt less insecure these days than when I was younger. She said her father was my age. I shared that I did feel insecure when I had first started doing therapy, and that insecurity continued for a few years. She asked me if I ever felt insecure in my current life. I replied that I did, in small ways, at times; but that I was more comfortable with that, and with not-knowing all the answers. For instance, not knowing what we were going to talk about in this session.
These self disclosures were all building ground in our relationship. I was being authentic, transparent, sharing both my strengths and vulnerabilities. I also was showing my own trajectory, from being younger, to the present.
I noted our differences culturally, and that I knew very little about her Chinese background. She shared some aspects of her cultural background.
I asked her what she noted about our differences - she said, that I was a stranger, and a man. I invited her to ask about me, to get to know me. She asked about my curly hair, and I explained my Jewish heritage.
We were slowly building ground.
She then made a general comment, asking about how unfinished business was dealt with. I said I was more interested in specifics, than addressing topics in general. This is the Gestalt awareness focusing process.
I shared about some unfinished business of mine - again, leading the way in being authentic, showing my willingness to dive into personal awareness.
This provided the ground for her to respond to my question, about some unfinished business of hers.
She talked about her parents fighting at night, in the same room, on a regular basis, from the time she was very small, until she left home. She spoke about wishing she could magically go back, and change that experience.
I could see her emotion, and acknowledged the pain she felt. She spoke of feeling very alone in that place.
I invited her to notice her experience in the present, stay with her feelings, breathe, and connect with me. We then spent some time cycling between these elements. I would acknowledge her, and her pain, talk about my sense of connection to her in that place, acknowledge the difficulty of her experience, invite her to get in touch with her body.
After this cycling, she started taking what are called 'integrative breaths'. These have a particular character, of a more settled nature. They represent the person taking something in, letting go, an embodied shift.
We finished up. There was a whole world yet to be addressed, but we had taken an important first step. We had built relationship, dived into unfinished business in a way which moved towards healing, and she had experienced for the first time, someone else with her in that place in which she had been so alone. She had gone back to that place, and found some healing.
It is the quality of relationship in the place of previous isolation that is even more important than just the intensity of the emotional experience, or the emotional release. It provides the basis for new type of experience, where pain is met in ways which were not previously possible.

Saturday, November 21, 2015

Case #163 - Dot points

Tanya described a layer of heat in her shoulder, and neck.
I asked her what these feelings were connected to. She said that when she heard 'twisted words' she felt violent. She explained that her mother had been wild and irrational…and that when Tanya had talked to her, Tanya felt like she was getting squeezed by a snake.
Tanya mentioned that there was a woman in the group who had the opposite effect on her - talking to her felt a steady, cooling stream. Tanya felt attracted to being with this woman.
I took some time to reflect on this. The themes were clear - words had a big impact on her, and she could easily feel trapped on the other end of words which did not have responsibility embedded in them.
I thought of words on a page, a different media. I asked what kind of writing she liked reading. Tanya said she enjoyed autobiographies; ones that were written in a simple direct and local style.
I gave an example from my own experience about when I was too wordy, and a friend asked me to talk to them in 'dot points' - that is, direct and to the point.
Tanya said 'yes, thats exactly what I want'.
So I suggested that she had the right to ask for that herself from people. I explained to her how to do it in a non-shaming way. This involves making it about myself, rather than a direct or implied criticism of the other. For instance 'I am not following you right now. I need you to put it more simply and directly for me'.
Tanya remarked that she also had a problem being simple and direct when she spoke. I pointed out that she could still ask for that from others, and after a while that would orient her to thinking in that way.
I invited her to practice this in the group, so someone would start in on a long story, and she would ask them to be simple and direct. Tanya enjoyed doing this, and it built up her confidence in being able to do so.
Next, I gave her some homework - to write her mother a letter a day, talking about things important to Tanya, in a very simple and direct way. I continued using those words, which she had previously described. By using the client's language, we stay closely within their phenomenological world.  I explained that it didnt really matter how her mother responsded, the focus was on expressing herself in this way.
I also mentioned the feeling of violence she had described - we would need to deal with this in another session, as it represented significant unfinished business. Its important in Gestalt processes not to attempt too much. Generally one figure gets covered per session - thats as much as someone can integrate at a time.

Wednesday, November 18, 2015

Case #162 - Jack in the box

Melissa talked about having 'lost her memory' of her childhood. She could only remember a few things - everything seemed to be lost in some inaccessible mist. This was annoying to her, and concerned her, and she kept asking why her childhood memories were not available to her.
I asked her to recount the memories she did have - a few incidences, where her father - and another time her mother - had taken her to hospital for something. She also remembered her father doing calligraphy.
That was it.
Melissa said her mother told her that as a baby and toddler, she was very quiet -made almost no sound, and didn't start talking until late.
This suggested that something happened very early on to her.
Melissa was very nervous. This was apparent to me. She was nervous with me, which was fair enough as she didn't really know me very well. But it seemed that she was nervous as a person. This was very evident.
I told her that I didn't want to try to get an explanation for why she had lost her memories - that there was a good reason for it, and in due course, that would become clear.
This is because people like to pursue the question of 'why' in a very linear fashion, wanting crisp answers; my interest is in following the rhythm of the organism, the natural arising of awareness, and as people are ready and the time is right, things become clear.
So I wanted to come more into the present, with the phenomena which was most obvious - her nervousness.
She seemed like an extremely frightened person. I imagined that if I blew on her, she would fall over.
However, I noticed a devilish impulse arising in my mind. I wanted to scare her. Not in a mean way, but in a kind of playful way.
In Gestalt, we generally want to step 'into' whatever experience that people are avoiding, with appropriate support and agreement.
Her fear was so all consuming, so on the tip of her tongue, that it seemed to me important to deal with it directly.
So I reported my impulse to her. I told her I wanted to scare her, in a playful way. I wanted to say 'boo'. Even as I said that word, she startled, though I did so with almost no energy at all.
So I played a little game with her of 'boo', as one would with a child. I did so incredibly gently. She still startled.
My image evolved - I talked to her about a jack-in-the-box that my grandson had. When I would open it, he would startle. But then he would want me to do it again. I would have to do so very slowly, or it was too much for him. But he loved it popping out each time, and he was startled each time, although he knew exactly what was coming.
I gave this image to capture the nature of the game with her. I would be the jack in the box. I would 'pop out' slowly enough that it wasn't too scary, but enough to startle her.
I did this several times, very slowly and gently. She was started but also laughed a little.
She reported an ache in her back.
However, the spot she showed me that was aching was in fact her adrenals. I was not surprised, and explained to her this wasn't a back ache, but the result of her over active adrenal glands. I suggested that on a physical level she get some kind of tonic that was good for the adrenals. In Gestalt we like to work holistically; and after a lifetime of being nervous her adrenals were far too active. Psychological work is good, but it also may need to be accompanied by physical treatments when something is deeply embedded.
Next I asked Melissa to scare me. Then to scare some people in the group.  There was laughter. She was picking up on the game. This is because we are interested in moving to the other polarity in Gestalt - if someone projects something onto others, we invite them to swap roles, and become active rather than passive.
I then explained to her, that excitement was the same as nervousness, except the difference was the level of support. With enough support, the energy can be pleasurable. I gave the example of sex - excitement and pleasure. I wanted to help her realise that her energy could be joyful, not just fearful.
This was all a revelation to her. That her sensitivity could also mean she could experience more positive excitement, if she learned to manage it.
Managing it I explained to her, started with the breath.
I got her to stand, and showed her what was happening with her breathing. It was completely constricted. She breathed only with the upper portion of her lungs - very shallowly. So I spent some time, showing her how to breathe differently. I showed her how to draw breath into the lower section of her lungs. This was a completely new experience for her. She got dizzy -she was unused to so much oxygen in her body. I moved my hands down her legs to her feet, to help her draw her energy down and ground her. She needed a lot of support, with the breathing, with keeping her energy in her body.
This was a radically new experience for her, and I pointed out this is something she would need to practice, all day, every day, and that the result would be a reduction in her fear, and an increase in her pleasure.

Saturday, November 7, 2015

Case #161 - Peaceful but lonely

Deb talked about her sadness.
I told her I wanted to get to know a bit about her first, before going to that place. I need a sense of contact with a client, some grounding in the relationship between us. She talked about her life, her professional, her family. She said that she had a peaceful marriage. I found this phrase 'a peaceful marraige' to be interesting - its not something I hear a lot from clients. Mostly their marriages contain some conflict.
I was curious. As Deb looked at me, she said that she was afraid I would' see something' in her. As she said this, she put her hand on her tummy, and then on her womb area. She said although she was afraid, she also wanted me to see this part of her.
This gave a clear direction of how to proceed with her - she welcomed exploration, and she also needed sensitivity from me. I asked how she experienced the connection with me. She said 'peaceful'. Again, I found this a slightly strange word - reassuring, but unusual in the context of her sadness. Especially given she also reported feeling sad, and afraid.
Her emotion seemed very non-verbal, very internal, and complex. Her words were not filled out with stories and examples. The hiddenness of what was inside her gave me the idea of working somatically with her.
So I suggested she lie on the floor. Thats one way to start somatic psychotherapy work. Stop talking, and focus on the body.
For some time, I was with her, especially watching her breathe.
Deb said she couldn't feel anything in her body.
I asked her to wiggle her toes - to bring the awareness into her body.
She felt uncomfortable - she said that I was too close, so I moved back a little.
As she wiggled her toes, tears came to her eyes, and a memory of being 6.
Her parents had sent her to live with her aunt, and only saw her every few years.She said she felt terribly lonely, but it was 'peaceful' at her aunt's place.
I asked to touch her belly. I could see the interruption in her breathing there. I asked her to touch herself there in order to bring awareness to this place, and to help guide her awareness into her body through this as a starting point. She agreed.
She started to feel a little more - she said 'I feel alive for the first time'.
Another memory surfaced of being 8; she thought of 'leaving' - she felt terribly empty in her life.
She then found a sense of purpose at school - to excel. But she was still lonely.
As she spoke, I put some pressure on her belly, especially as she breathed. This was to help move the energy there, and to intensify the emotional experience, as it seemed that her 'calmness' was in fact her creative adjustment, to avoid the feelings.
Deb felt an increased sense of connection with herself and me. I asked her to put her hand on her womb area. She felt reported that she felt soft.
She said 'I feel as if I don't have a heart' - again, then effect of the long loneliness. So I (after asking) put my hand on her heart. We stayed like that for some time
Deb then reported feeling fully alive, whole, and connected. Her sense of loneliness was gone.
As I looked in her eyes, I told her 'I feel connected to you'. I asked her experience. She said that she experienced connection, for the first time, from that place of loneliness.
Working somatically is generally part of Gestalt - we are interested in peoples embodied experience, and many aspects of Gestalt process utilise body awareness, rather than just cognitive awareness.
Sometimes, it is useful to focus more on the body, when someone has less words, or when they have too many words, or when their words are very contradictory, as in this case.
Being still, and present with a person, their breathing, helps them become more present to themselves. Then, whatever the unfinished business is, will arise to the surface of their awareness. We dont have to do too much questioning, or prodding. They will themselves get in touch with what is most important. Then we can focus that awareness, bring it into relationship, and support movement in the direction the person needs to go.

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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.

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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)

Interactive group: https://youtu.be/G0DVb81X2tY (1h 57m)