Each time Mabel spoke about her spirituality, she reported feeling some turmoil. She said she was tense in the stomach. Mabel had not previously been religious, but of recent years had joined the church. There were many things she appreciated, and valued about her newfound religious experience. But there were certain dogmas which she couldnt and wouldnt accept, and these troubled her. This included a negative view of sexuality, and a damning of homosexuality. Her brother was homesexual, and this felt like too much of an affront to her. Yet, she did not want to let go of her spiritulity. So I invited her to have a 'conversation' with a priest. We pulled up a chair for the priest. She told the priest how she felt, and what was true for her. When she took the role of the priest, his response was superior, and dismissive. I supported Mabel to stand her ground, to clearly identify her boundaries and limits - what she would not swallow. The conversation went on back and forth, with the priest sticking to his guns, and she to hers. It seemed unresolveable. I then pulled up another chair for 'God'. I asked to her sit in that chair, and 'talk to Mabel'. 'Gods voice' said - 'have compassion, and accept him [the priest] as he is'. This seemed to be a circuit breaker. Mabel, back in her own seat, was now able to say to the priest 'I disagree with you. I know we will never come to an agreement. I accept that, and respect our differences. I accept you are doing the best you believe, with your sense of God, and I am doing my best, with my sense of God.' Back in the priest role - the response was agreement. As Mabel finished this dialogue, she report feeling greatly peaceful. The inner turmoil, that she had been struggling with for some time, had gone. She felt a genuine resolution and clarity, and a truly spiritual way to deal with this intractable conflict. She also was able to keep intact her spiritual faith, and in fact felt renewed energy for moving forward. By doing this, she claimed her own spirituality, whilst being able to remain in relationship with the dogmatic aspects of the church. This is an issue many people face. Gestalt allows us to find a higher order resolution, without giving direction or advice. In the realm of spiritual issues such as this, it is enormously useful as we are able to use the therapuetic process to support people's spiritual journey.
Rosa was a recovering addict. I asked her what part of her body she associated with the addiction (alcohol). She said her throat. I asked the feeling - she said, like bands, choking her. I asked her to show me, with her fingers. She did so. This is important in Gestalt - to focus awareness, we say sharpen awareness, both for the client, and also for me to be more in touch with their experience in detail. I then suggested an experiment - I would move my hands slowly towards Rosa's throat, and would stop whenever she said to. The Gestalt experiment is a combination of safety (I would stop, she was in control) and risk (the experience of choking). Its also a way to move away from what we call 'retroflection', which is something that you do to yourself - the energy is all internal. This way, I could take over that aspect, to allow her to experience it in a different way. It also creates a relational experiment. So I did this, and she told me to stop when I was 3cm away from her throat. I asked to feel, breate, stay present. This is important, or else the person can dissociate, and then the awareness experiment has no value - there is too much risk. I then pulled back. I asked what she was feeling - she said 'one of the ropes has snapped'. I then noticed 2 marks on her neck, and asked her about them. She told me they were 'from childhood', and she started crying. I did not enquire more- we could go into the story another time. In the present it was more important to stay with the experience. So I moved my hands closer, and this time she asked me to stop at 2cm away. Again, I asked her to breath, feel, stay present. I stepped back I now asked her to make a sound - she found it hard to so so. I asked her to breath out, and let whatever sound could come out. I then moved closer again, and this time she let me put my hands around her neck. I asked her to make a sound. I could feel a small vibration in her throat. She was trying. She felt warmth in her neck and told me the ropes were gone. She said it was hard for her to stay present, and she felt embarassed. This means we had reached her exposure limit. So I invited her to put her hands around my neck. This exposed me, and allowed her to take over that energy. She said she felt more steady and comfortable, and more present with me. She then stepped back. There was a very strong connection between us, and she felt safe, and warm. This was an important transformative experience for her. Some of the energy which drove her addiction was confronted, head on, and then she could experience it, in the safety of the experiment, and the relationship. This relationshiop between us became very strong through the experience, and lay the ground for excellent therapeutic work in the future. There was a high degree of trust, and this is an essential ingredient in successful therapy.
Fay had reached the end of her marriage. She had tried really hard to make it work. They had been so much in love at the start. Together now for 5 years, they had a 3 year old son. She was a competent professional; he had been the house husband. This worked very well for both of them. But the interpersonal dynamics had not worked. Her increasing confidence in the world was matched by his collapse. He did not contribute financially; and although he was caring for their child, she wanted him to be moving ahead towards a career, so she did not ultimately have to carry all the financial weight. He promised, but did nothing. She felt like she was the man in the relationship. He felt disempowered. Part of the issue here was not an interpersonal one. Thus, in the therapy, I pointed out that there was a social context - ideas about how men and women should be, that were influencing both of them in ways which were disruptive in their relationship. Rather than being able to be with each other as they were, they compared each other to an ideal of what a man or woman is 'supposed' to be - women, soft and caring/ men confident and successful. Fay's response to challenges was to become more competent, to apply her intelligence, and figure out soltions. Her husbands response was to become timid, to make promises, and to pull back into himself. This cycle had eventually undermined their marriage. Now, at this time of separation, they had come to an agreement about parenting. Fay, who had not done much of the daily care of her child, took custody (a traditional response in the culture in which she lived). She applied her intelligence and competence, and soon started feeling more confident about being able to care for their child as the main person, despite the fact she worked at a demanding job. Her soon-to-be-x husband was relegated to seeing the child for no longer than a day a week, but he could come and bring him to school, or take the child when Fay had a business trip. Gestalt is oriented towards finding the right balance of challenge and support. 'As much support as necessary and as little as possible' was Laura Perls' dictum. This is the growth edge, and what we strive for in the Gestalt experiment. In this case, I spent a whole session challenging Fay. Firstly, she was operating from an assumption that she could set the frame on the discussions with her husband. She set up the paramaters for the childcare, and then gave him choices within that. He acquiesced. She argued with me that she was acting in the best interests of their child -giving him a stable environment, the least disruption during the separation. I pointed out to her that this was a conflict of interests. She was setting things up as she wanted them, and the lines between what the child needed and what she wanted were blurred. She also took over entirely the child care, virtually pushing her husband to a peripheral role in the picture, where he had been the main carer. She had many rationales for doing so, but what was masked was her own need to be in control. I also pointed out to her that as I listened to her talk about all this, I heard her brusque, business-like voice. I heard strength and resolve. Whilst those were good qualities, and understandable in terms of her marshalling herself to the care of her child, they were also the very things which had contributed to the breakdown of the marriage - her taking over, and not really giving space to her husband, on his own terms. Thus, although they were separating, she was continuing that pattern. I pointed out that she had another two decades of co-parenting with him. And if she simply continued the same pattern they had in their marraige, it would be equally dysfunctional. In that sense, nothing would have changed except they were not living together, and she had taken over charge of child rearing. This was all very challenging to her, and somewhat of a shock. She was coping as best she could in an uncertain situation, and this is how she knew best to do so. I acknowledged that, and also pointed her to the bigger picture -the next 20 years of coparenting, and how that might go. This placed the larger content of the field into our discussion, not just focusing on here and now awareness. The future of the field is as important as the past of the field. And in both cases, we bring that into the present interaction. I highlighted that there were many other choices available to her, other than either relinquishing control over child rearing to her husband, or taking it over entirely herself. And that each choice she made, had consequences. In Gestalt we respect choices, bring them into awareness, and direct people towards taking responsiblity for the consequences - all of them. Fay realised that she was using the child as a way to hurt the husband - a common reaction. This insight was particularly important, as it clarifies the dynamic underlying all the rational reasons. The session was very confronting for her. But she was up for it. And I, in good faith, could not just give her empathy in a place where I thought her actions were unconscious and potentially destructive in the long run. Such confrontation needs to be done very sensitively, maintaining connection with the person. And it requires strength and clarity on the part of the therapist. And then the next session needed to be about support - going into depth about Fay's creative adjustment - her way of being in the world, in terms of needing to always be in control
Fay had reached the end of her marriage. She had tried really hard to make it work. They had been so much in love at the start. Together now for 5 years, they had a 3 year old son. She was a competent professional; he had been the house husband. This worked very well for both of them. But the interpersonal dynamics had not worked. Her increasing confidence in the world was matched by his collapse. He did not contribute financially; and although he was caring for their child, she wanted him to be moving ahead towards a career, so she did not ultimately have to carry all the financial weight. He promised, but did nothing. She felt like she was the man in the relationship. He felt disempowered.
Part of the issue here was not an interpersonal one.
Thus, in the therapy, I pointed out that there was a social context - ideas about how men and women should be, that were influencing both of them in ways which were disruptive in their relationship. Rather than being able to be with each other as they were, they compared each other to an ideal of what a man or woman is 'supposed' to be - women, soft and caring/ men confident and successful.
Fay's response to challenges was to become more competent, to apply her intelligence, and figure out soltions. Her husbands response was to become timid, to make promises, and to pull back into himself.
This cycle had eventually undermined their marriage.
Now, at this time of separation, they had come to an agreement about parenting.
Fay, who had not done much of the daily care of her child, took custody (a traditional response in the culture in which she lived). She applied her intelligence and competence, and soon started feeling more confident about being able to care for their child as the main person, despite the fact she worked at a demanding job.
Her soon-to-be-x husband was relegated to seeing the child for no longer than a day a week, but he could come and bring him to school, or take the child when Fay had a business trip.
Gestalt is oriented towards finding the right balance of challenge and support. 'As much support as necessary and as little as possible' was Laura Perls' dictum.
This is the growth edge, and what we strive for in the Gestalt experiment.
In this case, I spent a whole session challenging Fay.
Firstly, she was operating from an assumption that she could set the frame on the discussions with her husband. She set up the paramaters for the childcare, and then gave him choices within that. He acquiesced.
She argued with me that she was acting in the best interests of their child -giving him a stable environment, the least disruption during the separation.
I pointed out to her that this was a conflict of interests. She was setting things up as she wanted them, and the lines between what the child needed and what she wanted were blurred.
She also took over entirely the child care, virtually pushing her husband to a peripheral role in the picture, where he had been the main carer. She had many rationales for doing so, but what was masked was her own need to be in control.
I also pointed out to her that as I listened to her talk about all this, I heard her brusque, business-like voice. I heard strength and resolve. Whilst those were good qualities, and understandable in terms of her marshalling herself to the care of her child, they were also the very things which had contributed to the breakdown of the marriage - her taking over, and not really giving space to her husband, on his own terms.
Thus, although they were separating, she was continuing that pattern. I pointed out that she had another two decades of co-parenting with him. And if she simply continued the same pattern they had in their marraige, it would be equally dysfunctional. In that sense, nothing would have changed except they were not living together, and she had taken over charge of child rearing.
This was all very challenging to her, and somewhat of a shock. She was coping as best she could in an uncertain situation, and this is how she knew best to do so. I acknowledged that, and also pointed her to the bigger picture -the next 20 years of coparenting, and how that might go.
This placed the larger content of the field into our discussion, not just focusing on here and now awareness. The future of the field is as important as the past of the field. And in both cases, we bring that into the present interaction.
I highlighted that there were many other choices available to her, other than either relinquishing control over child rearing to her husband, or taking it over entirely herself. And that each choice she made, had consequences. In Gestalt we respect choices, bring them into awareness, and direct people towards taking responsiblity for the consequences - all of them.
Fay realised that she was using the child as a way to hurt the husband - a common reaction. This insight was particularly important, as it clarifies the dynamic underlying all the rational reasons.
The session was very confronting for her. But she was up for it. And I, in good faith, could not just give her empathy in a place where I thought her actions were unconscious and potentially destructive in the long run.
Such confrontation needs to be done very sensitively, maintaining connection with the person. And it requires strength and clarity on the part of the therapist. And then the next session needed to be about support - going into depth about Fay's creative adjustment - her way of being in the world, in terms of needing to always be in control
Renee was very frank. She said that her underlying motivation was to impress the group, and, to please me as teacher. I was also frank to her - I said 'I dont need you to please or impress me; and, there's a part of me which would like you to please me.' Gestalt invites us to be honest about our underlying motivations, our selfish or aggressive impulses, and to recognise and own our contradictions. Its especially important as therapist not to be too 'good', too understanding too perfect. I asked Renee what she was feeling - tense in the stomach. Straight away, she recalled a memory from when she was 5 years old. She described being put through an IQ test. There were two containers, and she had to pick the right answer. She was a very smart kid. But it took her 40 minutes, sweating it, and she still hadnt worked out the answer. Then a boy came in, sweating from the playground; a boy who was not the smartest in the class. He was able to choose, straight away, the correct answer. Renee felt stupid at the time. She wanted to impress every one. And everyone expected her to do well, they were watching her. This was clearly an incident that contained shame, trauma, and a mix of strong expectations, at the same time as a failure to meet those expectations. I asked Renee what she felt in the present. This is a common form of shuttling awareness in Gestalt - if we go to the Field - a contextual experience, then we bring it back into the present. She said she felt cold - an understandable reaction to that experience. I told her that I wanted to give her some warmth - a novel experience in the place where she was used to contracting into herself, and a restorative experience in terms of what she probably needed at the time. She agreed, so I sat next to her, put my hand on her back, and invited her to breathe, and take in the support. Renee reported that she felt relaxed after a while. But she said her hands were still feeling cold. So, with her permission, I sat in front of her and held her hands. Straight away she recalled some experiences with her first boyfriend, where he had commented on her sweaty hands. I reassured her that I was ok with her hands in any condition. Her hands warmed up, and she reported feeling more relaxed. She had her eyes shut. I invited her to open her eyes, look at me, and try the sentence 'I am enough, just for myself'. I asked her to breathe deeply, and repeat the sentence, or change it. We often give a suggested sentence to a client, for them to try. In Hakomi this is called a 'probe'. It allows them to 'try out' a new idea, with the flexibility to change it, and with checking in as to how it feels. This prevents it simply being an imposition from the therapist. Renee reported feeling good saying it. She then reported feeling tense in her hips. So then, with permission, I put a hand on the side of one hip. She then relaxed after a while. I invited her to repeat that sentence. Renee started crayig, deeply, and said she felt her chest opening up. This indicated that she was able to feel the deeper feelings from that particular incident, without tensing up, or pushing anything away. After some time, Renee was completly relaxed. She looked at one of the women in the group, made a comment, and they both laughed. This represented a full circle - she was able to be herself, in the group, without having to impress or please, but simply be herself.
I invited Sandy to notice her present awareness. I declared my own awareness - firstly of her - my experience of her warmth, her smile, and then at the same time, her tears, and at the same time, some tension she had mentioned feeling. I also offered my own awareness of myself - feeling touched by her openess, and my feeling of peacefulness, openess, and being happy and connected. In Gestalt, its not just about starting with the client's awareness, like an interrogation - its equally valuable to start with one's own experience as therapist - it opens up the way for the client to feel comfortable to share themselves. So then I asked her what her current experience was. Sandy said she felt fear…and then some terror. I asked how those feelings may be connected to me. In Gestalt we want to take generalised experiences, bring them into the here and how, I and thou. This enables us to focus awareness, and work with it directly, and immediately. Sandy said she was afraid of my coldness, she wanted to see me smile. I acknowledged the validity of her perception: I said, 'yes, you see my coldness, and its truly, I do have some within me'. Its important to recognise the grain of truth in what the client sees. Sandy talked about her feeling of a 'cold wind'. So asked her to personify that, and 'be the cold wind'. At the same time, I drew her attention to the fact that outside of the room, there was in fact a strong wind blowing - we could hear it! This was the perfect setting for what was happening in the room. This utilises 'outer zone' awareness - sensory awareness, of the environment. Sandy said she wanted to feel the warmth again, to see my smile. Her hands were raised when she said this. So I offered to reach out, and touch her hands - offering her contact, but not smiling 'for her'. She said her hands felt numb. This indicated that as much as she wanted contact, she was not fully available for it. I asked her to tell me about being cold. She said her father was warm and understanding, but her mother was cold, and still is, even 50 years later. I suggested that she try a new experience, with her mother. I invited her to imagine I was her mother; I reached out to touch her hands again, and we moved our hands together. I checked her experience as we did this. She went from feeilng warm, to cold, and back and forth. Finally the warm feelings stayed steady. There was a great sense of connection between us. We hugged - the natural culmination for both of us to this experience. I said 'I embrace both coldness and warmth, in you as well as me'. In making this statement I wanted to underline the integration of the elements that had previously been polarised - coldness and warmth. At this point, it was not simply an interpretation, or insight I was offering her. It was an echo of the integration that she now felt in her body.
Abagail said she felt a pain in her heart. She wanted to know why it was there, and what she could do about it. I explained to her that the Gestalt approach neither attempted to answer 'why', nor was I going to give her some sage advice. I would however work with her to go into the experience to understand it more deeply. So I asked her to pay attention to the pain, and describe it to me. She said she felt a movement, and indicated with her hands in an upwards spiralling direction. I asked how she felt, and she said 'dizzy'. Now, knowing something about Abagail, I had encountered previously her tendency to get dizzy. I remarked on this, and asked what would happen if the spiralling kept moving up. She told me she would faint. Now, given this was a familiar tendency of hers, it indicated a basic 'creative adjustment' - her way of coping with a difficult situation. Clearly, this had historical antecedents, but I did not want to go into those on this occasion. I was more interested in staying close to the process. I remarked on this, her way of 'coping' with whatever the pain was, by distancing/dissociating. Rather than try to bring her closer to the pain, the Gestalt way is to 'go with' what the person is doing, but with awareness. So I asked Abagail how far away she would need to be from the pain to be able to look at it. She said 'well it could be on the moon'. I invited her to look at it on the moon then. But she said it was too public, others could see it. So then she looked at a little arrangement of flowers, with a snowman in the middle. It was about 3 metres away. She said she could look at it there. I remarked that was relatively close, and a lot closer than the moon. Abagail said - 'its hard to face it on my own'. So I told her I would accompany her, sitting next to her and supporting her so she didnt have to do it on her own. Going *with* the distancing, then finding the right distance so she could look at it (rather than spiral off and faint), allowed her to consider the possibility of safely being in the proximity of the pain. Offering to sit with her provided the support to be able to take the next step. So I sat next to her, and then asked her to pick something in the arrangement of flowers, to represent the pain. She chose the snowman. I invited her to talk to the pain. She said 'I can see you'. This of course was a very big step. I aksed her to imagine she was the snowman/pain, and to describe her experience. She said 'I need to be released'. I asked her to come back to herself, while she looked at the pain, and asked what she felt. She touched her throat, and said she felt pain and constriction. I asked what else she wanted to say to the pain. Abagail started burping, and continued to do so for several minutes. This is a very good sign, and I encouraged her to continue to allow this to happen. Its an incation that the body is releasing, deep on an emotional level, things that have been held back. Abagail felt very calm and centred, fully came into her body, and was able to be much more present in the connection. This was a new experience for her - to be able to feel internally, and stay with that experience, in relationship.
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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