Trisha's husband, Mac, was in the group. They were a couple in their late 50's. After Trisha's personal work, the group gave feedback. They were impacted by her deep but wordless feelings. Mac however, was silent. I invited him to give feedback. He said that he was glad she was able to feel supported. But in Gestalt terms, this is not the feedback we are after. What is important is not simply appreciation, approval, or acknowledgement. The inclusion of self is essential - the impact someone's sharing has on the other person, especially on an emotional level. Mac found it very difficult to share on this level. He seemed as wordless as Trisha when it came to feelings. So I invited them to sit in front of each other. I asked them to place on hand on each other's chest, to breathe, and look in the other person's eyes. They did so, and there was clearly much emotion going on. I invited them after some time to see if they could say a word or two, expressing their experience. Trisha said 'connected'. Mac said 'me too'. This was a very strong intervention, meaning, this would not have naturally occurred. Such interventions always need to be thought through very carefully, weighed up, and permission sought. They can have a radical effect on people, opening up whole new experiences, outside of their famliarity or comfort zone. But they can also be impositions, and of little use unless people are really able to integrate them. This experiment provided the scaffolding for a level of intimacy in this couple. The question is whether such an experience opens up possibilities for them, or is a little frightening, and they simply go back to safer and more familiar ways. This is the reason that ongoing therapy work is so important. Single interventions, no matter how powerful, need to be embedded over time. We need to check back as to the impact, how much the person was able to absorb, and whether they may need the therapy process to proceed much slower. There is no point going at the therapists's pace - it is the client's pace that is important. When we do experiments, we try to find the right balance between challenge and support. 'Right' meaning what is right for the client - our brilliant ideas are of little use if they are too far/too fast.
Trisha's issue was that her teenage son refused to go to school. As she spoke, I could see a great deal of emotion on her face. Her eyes were teary, her forehead wrinkled, her mouth shook a little, and she also seemed very timid and scared. Although I very much wanted to explore the issue with her, I also wanted to check in with how she was feeling, as simply diving into the story would have been disrespectful of her process, and of attending to the relationship between us. She wanted to tell me more, but I interrupted her. I asked her again how she was feeling. But she seemed unable to answer. Again, she started telling me a story, this time about previous therapy work she had done, related to a miscarriage. I asked her how she was feeling. She replied by launching into another story about the suicide of a relative. I interrupted her. Whilst these stories would all be important and have relevance, to simply proceed without attending to her in the present would have been neglectful. Yet, focusing her attention on the present was not something she was willing to do. I remarked that I would not keep pushing by asking for her feelings as clearly she did not want to talk about them, even though they were strongly present. I also said I was not wiling to go into the stories, I wanted to stay in the present with her. So I shifted gears and talked about myself. I told her that when I was upset, I liked someone close by. I wanted to know from her what the right distance between us was. She said 'this is ok' In this circumstance 'OK' is not a feeling, its an evauation. And she was so quick to declare it, I was not sure that this was really true. So I proposed an experiment. I moved closer, and farther away, to find the right distance for her. She kept saying 'this is ok', wherever I went. I asked her to tell me if it was better or worse. Again, she seemed reluctant to do so, to take a stance, to ask for what she wanted. So I moved very close. She said she was tense - clearly too close. I moved much further away, and she said it was too distant. So I moved somewhere in the middle, and she said she was comfortable with that. This was important, to get her to own some of the therapy, otherwise I could see she would just either follow what I wanted, or complete resist. Next I sat with her - at the distance she had specified, acknowledging her feelings, telling her I was comfortable with them, and fine to sit with her in that place. I did not push for words. Occasionally I would say something about my observation or my experience. And more occasionally I would ask her about her experience. She said she was lonely - I asked how much: she said 50%. I asked her to look at me, and breathe, and stay with her feelings. She would do this for a while, then look down. At those times, I would acknowledge she was pulling into herself, into her lonely place After a while I would invite her to come back into the connection. This went on for some time. After a while, I asked again how she was feeling, and she said 'comfortable'. I drew the session to a close. There was a whole worldless world there. And we had taken some important steps into that place. You can not push a client, demand they become authentic, or show up, or take responsibility. But to proceed with therapy as some kind of facilitation exercise without any of those things is a waste of time. So, we have to be with the client in some way that involves as much contact as they will allow. In cases such as this, that involves work on my part, building a bridge to the client's world, finding ways to make clear, simple contact, in the present, and not be distracted by the stories of trauma, or induced into doing too much work on the client's behalf. The work we did do - where she admitted her loneliness, and brought some awareness to the way she created that (pulling back from contact), may seem very small, but is very significant. The refusal of her son to go to school is paralleled by her own tendency to isolate. Bringing more awareness into her process is an important start.
Lucinda brought the issue of pleasing her mother. She described the situation as a bottleneck - how she would force herself not to feel emotions. She said it was hard to ask others for help. Not everyday things, but in deeper ways, when she felt stuck. I asked her for an example. She worked for a firm, but wanted to strike out on her own, open her own practice. She had talked with her boss about this, but not done it as yet. She wanted to talk more with him, to make sure that she would still have his support, but she had not done so. She described 'not being able to lift my head up, to grow'. I asked what was holding her head down. She said her father. So rather than talking about this further, I moved directly into an experiment with her. I played her father, and held her head down. She tried to push her head up. I made sure that it replicated her exact experience, including just how much pressure I applied, and the exact position (as per her description and guidance). I felt aggressive, and uncomfortable as I played this role. She pushed up, I pushed down. We were locked in that position. I understood her stuckness. She wanted to ask her mother for help. But her mother didn't offer help. Lucinda was angry about this, and asked 'why' she didn't help. In Gestalt we see 'why' as an unhelpful question, deflecting from a more direct experience. In this case, that her mother was simply not available (for a variety of reasons), and attempting to understand why would not help; in fact it kept Lucinda in her avoidance of her feelings. When I declined to engage with the 'why' question, then Lucinda felt her anger towards her mother. But I didnt want to dwell there, as she was still stuck in the position. So I asked who else she could ask for help to. She said her grandmother. But then, she said her grandmother would not be strong enough to get her father off of her. So I invited her to ask, right now, out loud, for help. She said, 'theres no point'. This was her collapse, her unwillingness to ask for help. So I encouraged her, to try asking anyway. I asked who she would like to come help her. 'A woman' she replied. So I coached her on how to ask for that. She said 'but I dont have enough emotion, I am not in touch enough with my emotions to show in my voice how much I need help'. I encouraged her to ask anyway. She also wanted to ask the woman to 'kill' her father. I said, just ask for help to get him off you, and we can deal with your anger later. So she made her request: 'I want some women to come help me'...and 4 women in the group came and pulled me off of her. This was a powerful moment. I said, 'now you are free to grow up'. She lifted her head, felt her freedom. There was deep emotion present. I pointed out - 'you called for help, it came, you are free now'. I called the women who came to help her 'guardian angel ninjas'. Now, she felt her anger, towards her mother and her father. She had wanted her mother to come rescue her. I pointed out that her mother was also stuck, and would probably never be able to hear her call. She wanted her mother to change, and it probably wasnt going to happen in this lifetime. Lucinda needed the reality check of this, so she could feel her feelings on the other end of the lack of support. Then she said 'I want to punish him' (father). So I moved to another experiment. I said, 'ok, I will be father again, now punish me by pushing my head down'. She gleefully moved to do this, and the straight away, felt very bad (as I did, in father's role). She said 'I dont want to do this, I dont want to be that person'. Now she was feeling very deeply. This was a powerful turning point for her. Finally, I suggested that the aggressive anger she felt could be directed into growing in her career - striking out on her own. She could use her energy to do so, in a place she had felt stuck before. The Gestalt experiments are very important to help people transform. They provide power experiential learning, as compared to cognitive insights. The insights which follow from the experiment tend to be much more deeply embedded, not just 'helpful ideas', but integrated transformation.
Barry was a conservative man, quiet, and unused to sharing his feelings. We had some discussion about this. He said that one of his issues was fear of rejection, and his sense of alienation from others. I asked how alienated he felt in the group: I want to take a general issue, and bring it into a more immediate context, one that can be worked with immediately. Otherwise people easily stay at a generalised level of an issue; I want to 'sharpen' the contact. He said he did pull back in the group, out of the fear of rejection. In Gestalt, we always encourage interpersonal contact, in the place of the fantasies that people have about others. So I set up an experiment where group members shared with Barry the amount they accepted or rejected him - expressed in terms of percentages. I set it up this way to be very precise in the feedback. Barry had a broad notion of rejection - but in fact people reject and accept different aspects of a person all the time: its a spectrum. One by one, group members spoke of feeling between 90-100% acceptance of him. Barry was very surprised - he expected the number to be much lower. However, he also said he didnt fully believe them. I asked by how much. He believed them 70%. I accepted this - we always work with where people are. I said that even at this rate, the acceptance was still significantly higher than he expected. I checked for his feelings - they changed singificantly, from alienation, to a cautious sense of belonging. 'Good contact' in Gestalt consists not only of positive contact and feelings, but also negative ones. To know where one stands with others, including the difficult parts, is a more authentic position and gives useful points of dialogue. In future sessions, I would explore with Barry and the group, what was in the 10% they didnt accept him. Thats useful information, and rather than remaining unsaid - silently projected in Barry's mind - to actually talk about this results in grounded relationship. Good contact is the grounded experience, in the here and now, of being with oneself fully, and with others fully - as we are, and as they are. It involves moving out of the realm of imagining into a much clearer connection.
Jane asked about working with body symptoms. She talked about her knees - one knee felt 'normal', the other 'abnormal'. She explained this meant her right knee felt fine, the left one she felt pain in, a 'lack of power', and that she didnt 'get enough support' from it. So she walked in an unbalanced way. I was curious about these words - support, lack of power, and normal vs abnormal. The latter words contained some explicit judgements. I kept asking about her experience of the various words, but mostly she replied more about how she thought. The focus in Gestalt is on experience - otherwise people stay too much with their stories or interpretations about their experience. I asked her - 'if we were friends, and I you were to ask me for support, what would that look like?' Her reply was it would be to help her feel more relaxed. This gave a clear relational direction for the work. I said that I felt a kind of spontaneous desire to support her, and wondered how that was for her. I asked her about the association she had with 'normal' and 'abnormal'. These words contain some potency of judgement, indicating there is some significant energy with them. I often pay attention to such 'power' words a person uses, as they generally indicate important figures. Jane said that there was such a thing as a normal family life, and there were abnormals ones. I asked about the latter. She said where parents yelled at kids, like her parents did - that was an abnormal family life. I replied that parents did, in the course of normal parenting, yell at kids, so what was different about her experience? She then revealed that her parents had never done something with her that indicated love. I didnt question this, just took it at face value as her experience. She said she now saw them in a different light - but again, this was about her thinking, not her feeling. I then got it - my sense of warmth towards her was cocreated - she was drawing out the nourishment with her embedded longing, and I was automatically responding, in a parental kind of way. I remarked on this - I spontaneously wanted to give something to her. I asked how that was for her. She gave me a thinking answer, so I asked her to notice her feeling. This was hard for her - she was not used to recognising and taking in such nourishment. Its important to keep a person focused on their feelings, as otherwise the intensity and power of the therapeutic relationship and interventions is diluted. I proposed an experiment - I used the word 'love' - as she had indicated this was missing from her parents. I said - 'for a few minutes, we can sit silently, and I will send some love towards you, and you just need to receive it'. I made it clear this felt natural and spontaneous to me - I was responding to something in her, so it was real in that sense. We did that. I checked how that was for her. She said her eyes, which had been dry before felt better - I noticed they seemed a bit watery. She felt relaxed and calm. I asked how her knee felt - rather surprised, she noted that her knee felt much better, more balanced, less weak. This arose from noting my natural response - this was not an artifice of therapy. We use our own spontaneous reactions in Gestalt to guide us - positive or negative, both are valuable.
Wendy came up enthusiastically. She seemed very nervous, and asked me what she was supposed to do. I explained that I was not going to direct her. She mentioned that her parents had many strong ideas of what she should do. Clearly, she was trying to queue me in to the role of directing her; already there was a lot of information I received about her field. Instead, I focused on the present: I reported what I saw - her black and white chequered jacket, a black and white shirt, her jeans, boots, and square glasses. This kind of noticing the obvious has several benefits. Its grounding, for me, and the client, and brings us into the present. Its a way of making contact, allows the person to be seen, without interpretation; and it can invite their own meaning making to emerge. In Wendy's case, she offered up that she chose dark colours in clothes, because she thought thats what other people would like. Again, she asked me what I wanted her to do now. I again declined. She was clearly very other-oriented. I told her instead that I was interested in her 'dark side' - following on from the dark colours she said she chose. I shared with her some details about my own 'dark side'. She then told me that in fact she would prefer to buy bright colours, but wanted to fit in. She clearly had a big issue about doing what others wanted. I could have gone into this, and into her parents expectations etc. But she was so extremely oriented in this way, I wanted to do something significantly different. So I told her I was intersted in her inner world, her authentic self: her colourful preferences. I asked what colours she would pick if she bought the clothes she wanted. She named several colours. I asked the best one - she chose green (which had been the first one she mentioned). So I asked her to have a little fantasy picture involving the colour green. Her picture was: a willow tree by a river. I invited her to imagine herself as the willow, and decribe herself. She said 'I am beautiful' I then told Wendy, 'I am interested in your beauty'. I asked her to come into her body, and into the connection with me. I said this again: 'I am interested in your beauty'. She had not realised I was talking to her, as she had simply been identified as the tree in the fantasy. She laughed, and tried to squirm out of the experience. I asked her to stay present, stay with me in connection, and stay with her feelings. I repeaated again: 'I see your beauty'. (I will note that Wendy was not an outwardly beautiful woman in the normal sense of the word. So this was not a description of her appearance, but of her inner self). She found it hard to stay present, and take this in, but she tried for a little while. I asked her to feel her own beauty as we stayed looking at each other. This was very challenging for her, and after a while she shifted the conversation. It was clear that was as much as she could take in. I was doing what we refer to in Gestalt as 'following the figure'. Starting with the outer figure of her clothes colours, and then following on with the figure of her authentic choice - the real Wendy - the colour green, her beauty. In this way, I am following the flow of her awareness. I am interested the points at which the client interrupts their awareness - in the first instance, its the orientation to what other's want. But once we got past that interruption, the flow evolved naturally until the next interruption - being with her 'colour', her beauty. Whilst I could then work with this interruption, its important to also respect the natural limit someone reaches, and return to the subject another time.
As Chanelle sat down, she commented on being distracted by something in the room which was out of place. She talked about how her attention often wandered; it was hard for her to stay focused on something. She said she was often not fully present, or not for very long. I shared with her my own 'fog', especially when I woke up, but also at other times during the day, when I would drift off a little. I asked how present she felt right now, with me, and commented that for me, it was about 85% - and told her about the 15% which was going on in the back of my mind. She said she was about 80% present. I told her that some mornings I was only 30% present, and asked about her. She said, with her husband, she was often 0% present. I asked her feelings - sadness. I commented that to have intimacy required one to be present, so it seemed there was a lack of intimacy in her relationship. Chanelle was a little surprised - she had equated intimacy with what you do in relationship, not how you are. I pointed out that to be present required a sense of being in ones body, and senses…so this could be a good place to start. To give an example, I told her some of the things I saw when I looked at her - without evaluation, simply reporting to her. This engages the senses, what we call the 'outer zone' in Gestalt. It is present centred, moving away from projections into the future or past. I invited her to tell me what she saw. She talked about my socks, which were colourful and had a flag on them. I told her something of my personal context, related to that. I checked in with her feelings. She sad she felt numb, with some pain in her shoulders. Staying with this, breathing more deeply, she started to feel some pain in her heart - a sense of contraction. As she told me this, she showed me by making a fist. I got her to stay with the fist, and she talked about feeling angry; as she squeezed her fist, she felt it more deeply. I asked her to look at me, and show me how angry she felt. She did that, and then reported that she couldn't focus on me anymore - a sign she had reached a limit. She sighed…as I brought this to her attention, she got in touch with her sadness…she had an image of a white boot. Then this was replaced by an image she had of thorns. She reported feeling much more peaceful. These thorns clearly indicated that there was more anger to be processed, but this was enough for now. Not all things can be solved, all at once! Finally we spoke about intimacy, with her husband, and the ways in which that could increase the intimacy without 'doing' anything different, but just being fully present with herself, and then the other person. She had an experiential understanding of this now, as well as a clear path to the unfinished business of anger and sadness which was absorbing her attention away from being present.
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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