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Friday, April 3, 2015

Case #137 - A terrifying wait at the train station

Evelyn's whole body was tense. She said she found it hard to sleep, since she was a child.
I wanted to know about the tension. I asked what happened to her when she was a child.
She told a story - she was 5 years old. Her mother left her at a train station, to wait, while she went shopping. She told Evelyn to stay there, until she came back. It was quite some time.
Evelyn said a similar thing happened one time with her father - he asked her to wait at the train station until he came back from an errand. But it was dark, and she was scared.
Clearly, these two incidents were highly traumatic, and the fear had remained in her body until adulthood, continuing to manifest in the present, as tension.
This is the 'creative adjustment' in Gestalt, the way of surviving from childhood, which becomes embedded in how we are in the world.
The context was crystal clear - so I wanted to work directly with that setting in the field, bringing it into the present, as we do in the Gestalt experiment, allowing something new to happen.
So I asked the group to wander around, representing people at the train station.
I asked Evelyn to select a woman to represent a female who felt like a safe person when she was little - an aunt. I asked who would have been a man who was a safe person when she was growing up - she said noone. Finally she said the closest person would have been her aunt's boyfriend
So the representative for the aunt  stood on one side, and I (representing the aunts boyfriend) stood on the other side of Evelyn.
Replicating the scene, I asked her how tense she felt - she reported 10/10.
I then held her tightly with one arm around her shoulders, and the aunt-representative did the same from the other side. I talked to Evelyn in the way she might have needed as a child - telling her that her parents were away, but that she was supported right now, and safe, and we would stay with her until they returned.
She shook, she cried, and I kept bringing her into the present experience of support, encouraging her to take in the new experience, to breathe it in, and ground through her feet, at the same time as holding her firmly, so she could also let go, and not have to hold herself together in way she was used to.
The experience was very intense for her. After some time, she started relaxing, becoming more steady and more able to 'stand on her own two feet'.
At the end, she reported her tension was 1/10 - a dramatic change.
This experience may or may not be permanently 'curative'. What is more important is that it introduced novelty - support, into a place where she has never experienced support. It allowed her to not only have a healing experience, but learn to take in support where she is used to holding herself together.

Saturday, March 28, 2015

Case #136 - Turn it around

Nuri was nervous. She described how she couldnt sleep, and mentioned her parents fighting every night.
I said - 'I am 20 years older than you, and could be in the same generation as your father'.
I asked her to show me how her father sat (a little bent over).
I did this both to get a sense of her father, to invite her into his position (and therefore out of her own) - creating some movement from her child position...and also to anticipate and acknowledge any dynamics between us that may echo her relationship. This is important in Gestalt, to pay attention in the present to such dynamics, as they can provide a great deal of material for direct exploration and experimentation.
Next she posed the question - 'does my father like me?'. She mentioned some of the things she thought he didnt like about her.
Rather than get into that, I asked her to turn the statement around, to make a statement about the things she doesnt like about her father...and then 'put him in the chair' and say them directly to him.
She felt relief.
This is a Gestalt process of ownership - people tend to percieve things in other that may or may not be accurate. But the point is, there is a part of themselves projected there. By turning the statement around, Nuri was no longer in the helpless position - dependent on whether or not he liked her. She could move into her own ground, and own what was true for her - the basis of responsibility and authenticity.

Wednesday, March 18, 2015

Case #135 - Up on a pedestal

Lynne came up to work, but seemed unclear as to just what she wanted to work on. She appeared very disembodied to me. Her conversation would constantly go to abstract issues, questions, things where were engaging intellectually, but seemed far removed from who she was as an emotional being. I noticed her shirt - it had sparkly crystals on it. I made several observations about it, as well as trying to bring her into the present in the conversation. She would pull away from the present, and did not respond at all to my curiosity about her own 'sparkliness'. Ok, none of this was engaging her, or enhancing contact.
She did however report that her legs feeling cold - no surprise, as she was hardly in her body. She did feel some warmth in her heart, at our contact. She spoke several times of working with me, the 'maestro'. These references were clearly putting me on a pedestal.
So I grabbed this as a point of contact. I sat up on the edge of my chair, physically above her, and spoke of my experience of being 'above it all'. I then invited her to do the same, and we both sat there, perched up on our chairs, sharing that experience. We were on the level, but everyone else was beneath us. This gave her the experience of being able to be with me, in some more horizontal way.
I then sat down, and asked her to stay up there on the chair, and enquired about her experience. This gave us a chance to explore the other polarity - the way she sees herself above others. She actually felt quite comfortable up there. When she came back down, she reported feeling a lot more warmth in her legs and body.
Talking has significant limits in therapy. Especially when talking does not really facilitate contact, its important to do something different. The Gestalt experiment allows a chance to bring creativity, variety, and presence into the therapeutic contact. It involves taking elements of what actual IS, and bringing them to life, in order to facilitate further awareness and contact.

Tuesday, March 10, 2015

Case #134 - Together on the ledge

Harvey mentioned divorce in his family. His parents were divorced. His brothers were divorced. He was divorced. He was wondering what was going on in his family.
This was a clear invitation to look at family patterns, and examine the field.
I did not follow this obvious line of interest. Partly because he wanted some served up 'answers' on this front, and it was a little too much 'ordered up' for me - I want to get beneath this - to find out more about who he was, and the details of his experience.
People can get fascinated by the field, but this can be more of an intellectual interest, and not necessarily the best start to therapy.
So I asked about his own experience of divorce.
He talked about feeling fairly settled with it. I also shared something of my own experience. There appeared to be no unfinished business left, or at least none that he was revealing.
But then he talked about his son, who he now only saw twice a year. He reported that he would sometimes would wake up crying, thinking about this.
He felt a deep pain in his heart, and he talked about how he would avoid dealing with the topic, or thinking about it, because it was so painful.
I used some awareness processes to invite him more fully into the experience in the present, and was present with him in that place.
But, he only got so far in going deeper. He said that he would like to do a process like this overseas... as there were many of his students and colleagues in the workshop, and he did not feel completely comfortable opening up.
I gave him an image - on one side, the sea of his emotions, on the other, the obstacle of the cliff of his holding back..he was on a narrow ledge between. He agreed.
I did not try to push him on this. I respect people's limits, and their 'resistance' as being valid.
I told him - 'I am with you, in this place, sitting on this ledge'. I stayed with him  in that space for a little while. He got a sense of the support available to him in that place, and it touched him deeply. He said that he would take that experience with him.
The session did not end on a 'finished' or 'resolved' note. We did not go through the whole awareness cycle. Often we can do that in Gestalt, but not always. And, thats ok. Whats more important is the experience of contact, of being present with the client in the 'stuck' place - which in one sense is not stuck, but a place of choice. They choose to stay in that place. Being with them in that way creates the ground for something different to happen - and builds relationship. Then, when there is enough internal and external ground the person can more easily choose something different.
No matter where the client is, no matter how 'resistant', we can be with them in a Gestalt process, and find the place of contact.

Thursday, March 5, 2015

Case #132 - Intimate Communication

Larry had been practicing trying to notice his feelings. He found this enormously difficult. He had set them aside for so many years that most of the time he just 'felt emptiness'. Now, he was able to start recognising, sometimes, small feelings in his body.
So I wanted to build on this. I asked him to pick three people in the group that he had the strongest feelings in relation to, and name those feelings. He did so, then I supported him to bring those statements into relationship with the people. Doing so, he got a heartfelt response. This was encouraging for him. I guided him as to how to continue such conversations, ensuring that if he gave a thought/perception response, he also included a feeling as well.
As he did this, the conversations built. He got some very positive feedback. Others in the group, for the first time, felt touched by him. He started to feel enormous warmth in his body, which continued to build, so he was heating up significantly.
This was the feeling of emotional pleasure, which he was unused to, and constituted a very important ground-building experience for Larry.
The conversations developed. Next came learning for him regarding making enquiry about the other person. As he named his own responses, they contained a lot of positivity towards the other person, but did not include curiosity or asking questions, or checking out his perceptions or imaginations about them.
I showed him how to do this, to check out his projections to find out who the other person really was.
Then the next stage involved talking about the impact on him of hearing the complexity of the person being revealed to him. In his previous emotionally dry world, his understanding and experience of people was more two dimensional. Now this recognition of his own, and then other's emotions gave him a more three dimensional experience, but one which he then needed support to decipher, and understand how to continue to dialogue with.
Everyone appreciated Larry's efforts, including me, and gave him very positive feedback.
This process was significant, as men often do not have the skills to develop intimate conversations. The first stage requires them to get in touch with their feelings. Due to socialisation, and perhaps traumatic experiences, many men are substantially out of touch with their feelings. It requires careful support, both from a therapist, as well as those around, for this to occur. Then support is needed to build on this, into conversation, and dialogue. Because women are more easily in touch with the feelings (for the most part), they can easily take up group time, as they are more easily articulate about their feelings. Men can need additional space and support - and patience, in this process.

Friday, February 20, 2015

Case #131 - A knife in the chest

Aimie spoke of the issue of security. She had fear, and sometimes anxiety about catastrophic things happening. I asked for an example. Her daughter was new to primary school. Aimie made sure that the teacher knew to show her daughter the playground, as she was not familiar with where things were. Aimie was quite anxious that her daughter would know where to go, and waited until the play time, when she saw another man, not the teacher, leading her daughter onto the playground. This brought up great fears in her. She approached the man, and found everything was ok. Nothing bad had happened. But there was a deep pain in her chest the whole day. I asked her about the feeling - she said it was like a knife scratching on her heart. In Gestalt style, I had asked about this in the present, and she showed me the place on her chest she felt this.
Clearly such intense emotions were connected to something deep. Nothing bad had happened in her adult life, to her, or her child. Her life was happy and settled.
Then she spoke of having been left with her grandmother between the ages of 1- 4. During that time, she only saw her mother a few times. Then she went to live with her parents again.
Again, there was the pain in her chest as she was talking about this. She had some some psychoanalysis, and so had gone into addressing this trauma. Yet, the feeling was still very real, palpable, and overwhelming. She understood about the topic. But the feelings were the issue.
So I asked her to show on my chest, the feelings in her chest.
This was because she was deeply caught in the feelings, they were locked inside her, and clearly had not been released.
So she 'cut' my chest with the 'knife' of her hand.
Now her feelings started to move. She shook, she trembled, she cried. She said she felt hate. I encouraged this.
Then she said - 'but I understand, my parents didn't mean badly'. This was the 'insight' she had got from her self reflection, and previous analytic work. But though it produced some measure of understanding, and perhaps a level of calming, it clearly did not address the visceral feelings that were present. So I encouraged her to feel the hate, and express it to me, as if I was the caregiver. This gave her permission, and allowed her to move it out, rather than keep it in. I legitimated her hate - the conclusion of a lot of deeply stored pain.
I tracked her feelings. Next she felt pain in her heart, then her stomach ached, and was shaky. Her face was shaky. I encouraged all these feelings. I gave her a lot of understanding - 'you were left, and even though your grandmother took good care of you, this was devastating for a 1 year old, and impossible to grasp or digest. Its natural that you have all sorts of feelings of fear, loss, anger'.
Then (with her permission), I put one hand on her stomach, and one on her back, opposite the stomach. I felt her shaky feelings, and palpated, in rhythm, emphasising them. She started to cry more fully, cry out. She had locked these feelings in for so long, she needed some help in being able to release them.
I invited her to hold onto me physically. As she did so, she said 'don't leave me'. 'I will be an obedient girl'. Clearly she had, as children do, blamed herself, and tried to internally bargain, hoping that by doing as she was told, her mother would return.
Again, I gave her understanding for this position. At the same time, I invited again the hate feelings  - the unexpressed opposite of the bargaining.
Again she took a 'compassion' position for her parents. I acknowledged the adult understanding she had, but again, invited her into the feelings, and to press my chest with the 'knife' . She did this, and was able to cry out, and speak her anger and hate.
Then she became dizzy. This was a sign she had released a lot of energy, and now needed to integrate it. There is no point continuing to release energy unless it is integrated into the body. She was unused to such a release. So I brought her back into the present. Her arms felt weak. Her back was a bit sore. I contextualised this by talking about her early efforts to 'reach out', finally giving up. Again a wave of emotion came over her. Again she got dizzy.
I walked with her around the room, getting her fully into her body, getting her to look around, come into the present.
She reported feeling very light and clear in her body, in ways she could not remember.

Friday, February 13, 2015

Case #130 - Twisted feelings transform into the vision

Isobel was depressed. She said her issue was a 'twisted feeling'.  
She fought often with her husband. In fact she said it was 'all the time'.  She was a housewife, and stayed mostly in the house. He would take their daughter out to places when he was off work, but Isobel would not accompany them.
She said her wardrobe consisted of clothes that were either black, or white. When she was doing anything, or wearing anything, she was not satisfied, and wanted the opposite. This presents some phenomenology that gives us clues as to the person's field, and how they are in that field. But we dont need to interpret, we can use this as information that the client will give us insights into.
Overall, this sounded like a very unpleasant life to me. I asked if she had any kind of vision of another life, less 'twisted'.
She immediately leapt out of her seat and got her phone. She showed me a picture she kept there - a bench, by a river and a mountain. That was her vision. I asked her to fill  out the vision for me in more detail. She pictured herself living there, alone. Painting drawing, reading. I asked what else. That was it. She pictured herself there, alone, for the rest of her life. That made her happy, thinking of that picture.
However, she did feel uncomfortable (twisted) because she did not even want her daughter there.
This was an extreme vision - total isolation, a life, completely on her own, for herself. This suggests one end of what we describe as a polarity in Gestalt. It also points to one end of the continuum of contact.
I asked how often had she been to a place like this. 'Never', she replied. Not even for half a day.
This surprised me. It was, indeed, a dream. She felt so caught in her current nightmare, she had made no steps at all towards something more nourishing.
I used my therapeutic authority and told her - you don't need therapy for now, you need to change your life. You need to go and be in that place.
I asked what got in the way - what made her hang onto her suffering lifestyle, while twisting herself to look at her vision. She was frank - so her husband would rescue her from her suffering.
I pointed out that after 10 years this hadn't happened, and so it probably wasn't likely to happen. He may not have the emotional intelligence to do so...or in fact, it just may  be that he is not clear  what she wanted from him, and what he could do about it.
So that left her with the existential responsibility to do something different, if she wanted an end to her suffering. Gestalt is all about becoming aware of choices.
I asked about her circumstances. Being at home she was responsible for her daughter, but on weekends her husband would often do things with her daughter.
I pointed out that she could go to her dream mountain place for those weekends. In doing so I was 'giving her permission'. This can be a useful application of therapeutic authority, when someone is stuck. If they don't take it up, it means there are other things in the way. But sometimes, this kind of support is all that is necessary to tip the scales, to help a person change direction.
Isobel became instantly very excited. She could see the realism of my proposition, it would directly meet her hearts desire, and by giving up on her husband rescuing her, this left her free to find her own happiness. She was full of energy. I talked with her more about the details.
I pointed out that if she was willing to find ways to make herself happier, this would benefit her daughter, and her husband as well. It started with her. In this way, therapy supports a healthy selfishness, as a base for healthy relationship.
Someone in the group immediately offered a mountain place he had available for significant parts of the year to her. That evening, spontaneously, her husband phoned and wanted her to go on a trip with her daughter and him. Now she had options. I helped guide her as to how she could explain to her husband her need to be alone. Sometimes its very supportive for people to be given words to be able to articulate their situation. The danger is 'putting words in their mouth', but done with attunement, and respect, it can allow them to hear a direct and clear way of expressing their needs, and acknowledging the other - part of a learning process therapy can offer.

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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)