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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.
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.
Annabelle was concerned about some feedback she had got from others, over what people saw as her conservatism around relationship values. She wondered if in fact she was too rigid, and needed to listen to them, to loosen up a bit. This indicates a willingness to engage in self reflection, and consider feedback. With some people, it might indicate a tendency to swallow other people's opinions - introject in Gestalt language. I asked questions to ascertain who she was and about her context. She was living a life that sounded happy and contented, in a nourishing and healthy marriage, and being productive yet without excess stress. The more I enquired the more it became evident to me that people's criticisms of her were their own agendas. She seemed contented with her values, they were working well for her, she did not impose them on anyone else, and she seemed to have a very good sense of boundaries - her own, and others. I continued probing, trying to find where she may have contradictions we could examine, or perhaps a need or desire to loosen up, or change her values. I could not find anything. She seemed to be a truly balanced person, living her life in a way which was both internally and externally healthy by any parameters I could apply. Sometimes people come to therapy, or groups, not to heal trauma or transform neurosis, but simply to learn and grow. Gestalt is actually very much designed for this, and this was Perls' original vision - a way of living authentically, rather than just a professional type of therapy practice, to 'fix people up'. After some time I stopped asking questions; I did not want to just keep looking for pathology; in Gestalt we take people as they bring themselves - this is the phenomenological method - not to look for hidden motivations. By staying with the person as they are, more gets revealed. In this case, it seemed that Annabelle's presentation was not out of sync with who she was. I told her that she seemed to be living a wholesome and satisfying life, and I felt touched meeting her, and knowing her in this way. I felt my tears - they were tears of joy. I told her that perhaps she had something to teach others - many people would like to find how to live like that. And there are many teachers and therapists who have all the 'knowledge', the models, the maps, and can deliver inspiring words, or coach people well. But its another matter to actually successfully live all those principles. Annabelle was clearly a humble person, without aspirations to be a big name or to big note herself. I told her that made her ideal material as a teacher. She now had tears - again, of joy. She had been seen by me, and we were both touched. This is what we call an I-thou moment. A place of profound meeting between two human beings. I did not need to occupy the teacher or therapist role in an explicit way. Instead, I used my authority to recognise her, to support her to recognise her own capacity, and to move in that direction. I also told her, that was my agenda. Perhaps she did not need or want to step into such a role. I did express my hope she would do so, as I saw she had a lot to contribute. She responded quietly, but positively. So I suggested she consider starting to formalise, in a way that felt just right for her, some kind of teaching role. Gestalt is facilitative, and supportive in that it involves working with the clients reality. It also includes the therapists feelings, bias, hopes, wishes, and agendas - as long as those are made explicit, and are used in service of the client and their needs, and in enhancing the quality of contact in the therapeutic relationship. So my response to her was a significant part of the therapy. She did not need facilitating, rather, to be seen in relationship. People were (and usually are) busy with their agendas. What we can offer as therapists is to recognise people; even 'difficult' qualities a person may have can be contactful if recognised in a non-pejorative way. It is also possible, after that, to bring in an agenda, as I did. But the key is to do so lightly, explicitly, and in a way that gives the other person a lot of space to be themselves.
Jenny talked about wanting to be brave. She was a young woman, enthusiastic, interested in learning, and vocal. I commented on the latter, saying she seemed to be good at getting attention…but it appeared to me that she didn't fully enjoy it the attention she got. She did attention grabbing things, but did not seem to fully notice, or take it in. She said that in fact she would like more attention. I joked about her future profession - perhaps being a performer could bring her the attention she wanted. I asked her to look around the room - everyone was looking at her, she had their full attention. I asked her to take this in, to absorb what was available. Often people are not fully in the moment and are focused on lack, so its helpful to bring them into the present, to be aware of the 'what is', including whats nourishing. The next thing she mentioned was not wanting to hear the criticism of her parents. She was talking in a voice that sounded quite young to me - I asked what age she felt - 8 years old. I connected her limits on taking in attention, to her limits in listening to criticism. She seemed unable to discriminate between negative and positive attention. She then revealed she had certain symptoms - ringing in the ears - which sounded to me as if it was Tinitus she was describing. She explained that she was running away from this ringing sound - distracting herself by various means. It certainly seemed like it was likely to be related to the 'not listening' she had been talking about. She presented me with several other themes, e.g. - 'fear of money'…but I told her she was moving too fast for me. This is important to interrupt a client, who may be skipping from one topic to another. In this case, it was her version of moving on quickly, rather than staying with what was happening. I told her that whilst she was good at getting my attention, I found myself losing interest soon after - she was not good at keeping the attention she was getting. So I asked her to explore patience - slowing down, taking in deeply, being fully present. And from that place, to express herself with presence, rather than drama. She said - 'the ringing in my ears is getting in the way of doing that. Why do I have to have it?' I declined to answer the 'why' question, instead I moved into confrontative mode and said - 'get used to it. Its not going to go away'. This was using my therapeutic authority to stop her in her tracks. Sometimes such strategic interventions, used carefully and in context with the right timing can be helpful and effective for significant avoidances. She had been avoiding dealing with the Tinitus, vaguely hoping it would go away, using it as an excuse to not listen, or to move on quickly. Although I believe that such conditions generally come out of a psychological and field configuration - fairly evident in this case with not wanting to listen to criticism - such things also become physically embedded, and not necessarily so easy to change. Sometimes what is necessary is acceptance, before something might change - or not. In this way, Jenny calmed down, became more still, and was able to experiment with listening despite the Tinitus. This was also part of her growing up process - from the 8 year old, to her young woman self, an adult for whom the creative adjustment of avoidance and attention seeking was no longer necessary or helpful. And an adult who could accept that there were certain limits, and some things had to be lived with. In many ways, therapy is a 'growing up' process, no mater what age the person it. It about supporting maturing, development, awareness, and capacity for quality contact. Sometimes this requires energising a person; sometimes it involves helping them to accept certain limitations, internal or external.
 Linda brought a dream. She was driving a car, and the brakes were not working. Also, she was driving a truck and the same thing happened.
In Gestalt fashion, I asked her to relay the dream in the present tense. Next I asked her to play the different parts - the car, which was broken down, the brakes, which were not protecting her, and herself, driving and being scared.
I invited her to talk to the brakes - she asked them why they were not working. In Gestalt we encourage changing why questions into statements. Her statement was then - 'I need you to work, to keep me secure'.
I then moved from the dream to her life, to find out where this was true. I asked if she felt secure in her current life - with her husband and parents. She replied she was. Yet there was hesitation. She said - 'on the outside, how it looks'.
I wanted to know what was happening on the inside. She paused, then burst into tears. She related a memory that had recently surfaced, that when she was a very young child - in her cot, a man had come into the room, and she said that therefore her mother had not protected her.
I asked if she could remember anything else, but she couldn't. However, the emotion was very strong, and she was clearly in profound pain.
I did not need to ascertain whether this was 'true', or get any more details. The fact is that she felt deep distress, and that security and protection were important issues for her.
I asked her to go back to the dream, but to continue it - to see what would happen if she kept dreaming. She talked about going for help, and then realised she had left her child in the broken down car, which made her very anxious. Then a police car came by, and she asked for directions.
This gave an important clue - an authority figure which was available to provide help.
I then suggested a change in the story of the dream - this was my first intervention. I gave her the idea of stopping and telling the police about the situation, instead of asking for directions, then they offered to bring her back to the car and her child. She rode in the police car, and they got out with her, to help her deal with the situation.
I asked what she felt with this story line I offered to her - she felt much better - both during my suggested change, and afterwards.
I suggested to her that some people have guardian angels - she had guardian policemen.
Then she pointed out that this didn't help with what had happened to her.
That is a trap people can fall into - wanting something that will entirely change their trauma. Gestalt works with trauma, but adding a new direction, rather than looking for a magic bullet.
I suggested that she could invoke these guardian policemen, whenever she felt insecure. She said 'but I don't have much faith'. This was an important indication that she was more attached to the 'problem' of the recalled event, than able to accept some nourishment and support in the present.
This may call for long term therapy, or at the least, an in-depth series of sessions. This however is not always the answer, and its not always available. What is available is support in new forms, and then it becomes a question of how much the client is willing to take that in.
So I proposed some homework - to create a small alter table at home - put some things on it, like a Buddha or relevant sacred object on one side, and a little police car on the other. And then to daily give thanks to the guardian policemen.
These images came out of the dream, from her own ground. Its an odd idea - guardian poliemen, but provides a strong resource, needed to deal with the energy that draws her back to her pain and insecurity. This provides at least an operational intervention - it remains to be seen if its sufficient, or if more therapeutic work is needed.
This relates to 'trailing edge' and 'leading edge'. Trailing edge refers to the past, the trauma, the unfinished business. This needs to be attended to, but it can also pull us down, become endlessly fascinating, more so than the present.
Leading edge is the future, is the present moving into a new future. Its what draws us forward. Its also important in therapy. Good therapy finds the right mix of paying attention to both sides.
I spent some time trying to find what the issue was for Iona. She said she was not in touch with her feelings. Friends said variously she was warm, or angry, or other descriptions, but she could not really identify with any of them. I found this a little odd, as I experienced her as full of liveliness, energy and passion. She was animated when she spoke, she was interesting, and appeared engaged. Of course, many people are out of touch with their feelings, but there was still something more I needed to understand. Then she told me she felt unhappy, a lot of the time. Again... there seemed to be something else going on, more than appeared on the surface. I asked how long she had been unhappy - she said since her pregnancy, 9 years ago. She had conflicts with her mother in law, and her husband, and these had not really abated. Certainly, external factors can contribute to someone's unhappiness. But this sounded more deep set. The fact that it came on during pregnancy, and lasted afterwards made me consider depression. She did not appear depressed. But she I enquired into a range of symptoms that tend to go with depression - lack of pleasure in life, lack of motivation, trouble with sleep - she said yes to all of it - it all added up. Whilst diagnosis can be restrictive and limiting, it can also be helpful to name ongoing patterns, such as depression which indicate something more than passing unhappiness, and which require serious attention. I explained this to her, and also pointed out that this was something that required ongoing support, and would only shift over time. Its important to give people realistic expectations of what therapy can achieve. She said she worked hard to mange her very busy life - child, family, work. She felt exhausted most of the time. It became clear to me that this was what could be called 'high functioning depression' - she is coping with her life, thus masking what she is feeling inside. Her effort was to not sink into the blackness of her unhappiness. Yet, therapeutically, this is what needed to happen, in a supported way. Without going into the depression itself, she would continue in avoidance mode, and therefore be unable to access the feelings which were stuck. So I invited her to notice her clothes. Her pants were black, and her top had some bright colour in it. I suggested this as a metaphor for her life - bright slashes of colour, but black and unhappy underneath. She agreed. So I asked her to look at her pants, and for 2 minutes I would sit with her as she sunk into her blackness. She agreed. This was important, to go into the depression, but do so with company and support. Tears came to her eyes, which was good, as her feelings were starting to flow, and she was able to share them with me. But she reported feeling stuck in the throat. So I asked her to lie down. I held her head with my hands, off of the ground, asking her to let me take the weight. This was a way to support her to feel her 'heaviness' and at the same time, feel held. As I slowly moved her head, it was very stiff. I was careful not to push, but just wait every time there was resistance. I asked someone else to hold her feet, and pull gently, creating some more space in her body for the feelings. I then sat besides her. Her feelings did start to come up, in waves, with little sobs. I invited her to let some voice be there, but that was as much as she could manage at that point. After some time, she reported her arm feeling numb. This was an indication she had done enough. Its important where someone's feelings have not been accessed, to go slowly, and allow time and space for integration. She had take a big step, and it was enough for now. She reported feeling worried that she was a 'bomb, going to explode'. I pointed out that if she kept repressing her feelings, this could be true. But with opening up, and getting support, she could allow the 'bomb' of her feelings to release in a safer way. Its important with major issues such as depression to not got too far, too fast. While Gestalt therapy processes and techniques can quickly take a person into 'their stuff', its essential to move at a pace they can integrate. This indicates long term work - at least 6 months of therapy, if not a year. While this may seem a significant amount to some, the alternative is the 'time bomb', impacts on health and/or functioning, or medication which brings its own problems.
Martin came with the issue that during the group meditation period, he had felt some tension in his stomach. I enquired whether this queasy feeling was familiar - it was not usual. He wondered if it was related to being a young child, and having a medical emergency, which his mother told him about later. I asked him to go into the feeling in his body - it was a shaky feeling. As he went into it, his face softened, tears were in his eyes, and he said he could hear his grandfather and father's voices reassuring him. I asked then about his family context -his field. He said he was loved and supported by his parents, and older siblings. He had a healthy and loving childhood experience. So fear was unusual for him in his current life. This was somewhat unusual in therapy, and meant that his fearful feelings in his stomach had a different meaning than what it may normally mean for someone with trauma and unfinished business. He said he was not a big risk taker, leading a comfortable and settled and happy life, both at work and home. This sounded great…except that the feeling in his stomach indicated that perhaps he wanted something a bit more. I explained that fear is the precursor to the experience of excitement, which is what happens when fear is integrated into one's being. So back to the fear, which I suspected indicated a yearning for more risk, and thus more adventure in his life. He agreed. So I asked him to give me a vision in three areas - personal, work, and relationship. His personal vision was being on top of a tall mountain he had climbed. His relationship vision was a long road trip in a motorhome with his family. His work vision was creating his own company, based on a progressive vision. As he pictured these things, he again had tears in his eyes, and reported feeling deeply grateful to life. I explained about how support helped convert risk, anxiety and fear, into excitement, and we explored what kind of support he might need to enable these things to happen. This case shows how important it is to approach people's experience from a phenomenological stance - not pre-interpreting what any particular symptom means. We do this by bracketing presuppostions, theories etc, and being present with the meaning it has for the client. The result is the client feels heard, seen and understood, and we can know more precisely just where to work with them. It would have been a waste of time going into his family background to try to search for a source of the fear. It was evident he had a healthy upbringing, and there was nothing that he displayed to suggest that he was avoiding something. This allows us to work more with the present, moving into the future. Gestalt work is just as much about the future of the field, as the past of the field, both of which are worked with in the present.
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