Gestalt Therapy And Hypnosis

The Gestalt approach to therapy can be termed "phenomenological-existential" as it is concerned with an awareness of the here-and-now, working away from concepts and towards pure awareness (Clarkson, 1989). By the client becoming aware of their thoughts, feelings, etc the goal is for the individual to achieve insight into the situation under examination. As Yontef (1993) writes, insight is gained by studying the phenomomenological focusing, experimenting, reporting, and dialogue of the client. The philosophy behind this approach is that most people do not function in the world based on how the world, including themselves, is, but through a filter of self-deception, whereby one does not have a clear picture of oneself in relation to the world. Living that is not based on the truth of oneself leads to feelings of dread, guilt, and anxiety (Yontef, 1993).

The historical antecedents of Gestalt therapy are the experiences of its co-founder, Fritz Perls. Trained as a psychoanalyst, Perls rebelled against the dogmatic style of Freud's approach (as had other notable founders of schools of psychotherapy, Jung and Adler. In the preface to the 1969 edition of "Ego, Hunger and Aggression" Perls wrote of this period of time as follows, "Started seven years of useless couch life." (Perls, 1969)), and incorporated aspects of holism into the belief that ultimately the individual is responsible for creating his or her existence.

Additionally, the early decades of the 20th century are notable for their refutation of Newtonian positivism and its replacement with phenomenology. These two themes were then combined within the scaffolding of Gestalt psychology to produce an approach centred on the individual's relationship to their existence. The structure that Gestalt psychology offered was that perception should be considered as the recognition of patterns and relationships between items in the perceptual world which fulfils the central human need of giving meaning to perceptions, experiences and existence (Clarkson, 1989).

Reductionist approaches could neither account for the richness of perception, and its immediacy (for example, see Koffka, 1935; Gibson, 1966), nor take into account the importance of the observer. This led Perls to the idea that the actual awareness of an individual is more trustworthy than an interpretation of any data that a person might provide a therapist with and is primarily a description of movements between 'figure' and 'ground'. The figure is the item of attentional focus at any one time, and the ground is the remainder of perceptual awareness. These movements, or 'cycles of experience' can become disrupted by being incomplete or unresolved and it is this 'unfinished business' which Gestalt therapy attempts to address. These ideas probably did not constitute a therapeutic approach until 1951 when Perls opened the New York Institute for Gestalt Therapy, despite the fact that the first recognisable Gestalt therapy book was published in the 1940's (Perls, 1969).

Accompanying this combination of ideas, based on the thinking of Gestalt psychologists, philosophers (e.g., Lewin, 1952), and politicians (e.g., Smuts), was the fundamental concept of the person as basically healthy, striving for balance, health, and growth (Clarkson, 1989). The unfinished business referred to earlier is seen as an obstacle to these processes, restricting the person's ability to function fully, often termed by Gestalt therapists as 'dis-ease'. Van de Riet (Van de Riet et al., 1980) encapsulates the idea that dis-ease is a consequence when people do not experience themselves as being psychologically and physiologically in balance with their environment.

"As action, contact, choice and authenticity characterize health in gestalt therapy, so stasis, resistance, rigidity and control, often with anxiety, characterize the state called 'dis-ease'"

The stasis, resistance, rigidity, and control prevent graceful flow through cycles of experience.

Having briefly outlined the core of Gestalt therapy it is necessary to consider some of the techniques that Gestalt therapists use in order to consider how they might be incorporated into hypnotherapy. Although there are techniques that are closely associated with a Gestalt approach, there are two caveats we must bear in mind. First, as Berne (1970) noted, gestalt therapy does use any techniques exclusively:

"Dr. Perls is a learned man. He borrows from or encroaches upon psychoanalysis, transactional analysis, and other systematic approaches. But he knows who he is and does not end up as an eclectic. In his selection of specific techniques, he shares with other 'active' psychotherapists the 'Moreno' problem: the fact that nearly all known 'active' techniques were first tried out by Dr. J. R. Moreno in psychodrama, so that it is difficult to come up with an original idea in this regard" (Berne, 1970: 163-4).

Second, that in Gestalt therapy, technique is considered secondary to the relationship developed between the therapist and the client, as Resnick (1984) writes:

"every Gestalt therapist could stop doing any Gestalt technique that had ever been done and go right on doing Gestalt therapy. If they couldn't, then they weren't doing Gestalt therapy in the first place. They were fooling around with a bag of tricks and a bunch of gimmicks" (1984: 19).

Based on these two caveats we might argue that anything of an 'active' nature which is incorporated into hypnotherapy would constitute Gestalt, or alternatively that without explicit training in the Gestalt client-therapist relationship there is nothing we could do which would be Gestalt. However, as the spirit of Gestalt therapy is very much identified by its use of specific techniques that is the approach that will be taken in the following discussion.

The techniques that are associated with Gestalt therapy are closely related to the idea that clients should want to work towards self-awareness through a mastery of their awareness processes. This is in contrast to patients who firstly are actually seeking relief from discomfort, although they may claim that they wish to change their behaviour, and secondly clients who expect that relief will come via the efforts of the therapist. Thus, Gestalt therapy is "an exploration rather than a direct modification of behaviour?the goal is growth and autonomy" (Yontef, 1993). The techniques are modifications and elaborations of the basic question, "What are you experiencing now?" and the instruction, "Try this experiment, or pay attention to that, and see what you become aware of or learn" (Zimberoff & Hatman, 2003).

Perhaps the most well known of all techniques that are identified as Gestalt is the empty chair. This is where clients project their representation of a person or an object, or part of themselves into an empty chair and they then present a dialogue between what is projected into the chair, and themselves. In some cases the client moves between the chairs, but either way, the idea is that inner conflicts become expressed and so the client heightens their awareness of them. This in turn forces the client to take responsibility for their difficulties so that they can make choices to resolve the sources of unfinished business (Stevens, 1975). As Becker (1993) writes, this is the whole point of Gestalt, to "take people who are conditioned and automatic and put them in some kind of aegis over themselves."

Similar to the empty chair, another common technique is known as topdog/underdog. A dialogue is performed between two aspects of the client's personality, the topdog representing the introjecting demander of perfection, expressed by "should" and "must", and the underdog, which is a manifestation of resistance to external demands. Through the dialogue "resolution, compromise, understanding or permanent divorce becomes possible" (Clarkson, 1989). This is attained by the individual becoming aware of their internal battles, which often lead to feelings of guilt, anxiety, and depression.

The Gestaltist focus on awareness is not confined to awareness of cognitive processes, such as dialogue, but also physiological processes through a process termed bodywork. This involves the client consciously noting where they experience tension in particular situations, or how their pattern of breathing changes. Once aware they can learn strategies to reduce these reactions, which have produced both physical and mental discomfort.

As Zinker (1978) writes, "this may include the person's awareness of his body, its weight on the chair, its position in space, its minute sounds and movements." Here the individual is taking responsibility for their body and taking charge of choosing how they want to react. Sometimes these tensions are based on a preoccupation with earlier circumstances. If the client is not responding to the current circumstances then they are seen as projecting the past to the present, so old patterns of responding, rather than new, experimental approaches are dominating their life (Parlett & Hemming, 2002). Working to release the physical manifestations of those old patterns can lead to greater engagement and awareness of one's thoughts and feelings (Zimberoff & Hatman, 2003). This approach is also known as establishing sensation function (Clarkson, 1989) and is considered useful for clients who have become 'alienated from their senses' or those with narcissistic attributes who have 'experienced it all' (Clarkson, 1989).

The importance of bodywork is made clear by Becker (1993) who suggests that physical expressions are closer to truth because the mind is engaged in deception and sabotage: Perl's basic assumption was that the body and its total processes are somehow anterior to and bigger than the mind. Gestalt conceives of the mind as an interference, as a way of blocking the total momentum of the organism in some way. Not only that, but the mind is not even the noble part of the organism that we always thought it was. For most people the mind and the creations of the mind work against the body. They work against the best interests of the total person.

In line with other psychodynamic approaches, Gestalt therapy includes dream work. The Gestalt position is dissimilar to Freud, in that Perls did not think of the unconscious as an inaccessible region of the mind which dreams could provide access to if interpreted correctly ? Freud's 'royal road to the unconscious' was Perl's royal road to integration. His view was more in line with Jung, who saw dreams as existential messages for the dreamer. In dream work the client is typically asked to relate the dream in the present tense as if they were experiencing the dream in that moment. From this the client develops an awareness of the existential message and how it consists of projected parts of the self.

The above descriptions of some of the techniques associated with Gestalt therapy should neither be considered exhaustive nor exclusive. As cited earlier, Resnick (1984) amongst others clearly believes that Gestalt therapy is not and cannot be tied to particular techniques, it is about the relationship between the client and the therapist.

An important part of this relationship is that the therapist is acting to guide the client towards greater self-awareness, responsibility and ownership of emotions, thoughts, sensations etc in order to complete any 'unfinished business' so that s/he may move smoothly through cycles of experience. The experienced therapist is able to adapt to the particular client in order to achieve this, relying on a wealth of techniques and skills. This essence of Gestalt therapy allies it more closely with cognitive behavioural approaches than typical psychodynamic methods because it relies less on interpretation of the client and more on their active participation. It is perhaps this that makes it possible to incorporate aspects of Gestalt therapy into hypno-therapeutic practice.

Interestingly Levendula (1963) suggests the view that a Gestalt therapist would be in a more advantageous position if he would combine his approach with hypnotic techniques. For example, the Gestalt therapist teaches the increasing of awareness through experimental exercises. The hypnotherapists can achieve this much more easily by directing the patient's attention to become sharply aware of an idea or sensation or memory which thereby becomes a "bright Gestalt" while the rest of the perceptual field recedes into a background. The hypnotic state itself corresponds to the Gestalt-background principle, and the Gestalt formation becomes more or less an automatic function of it. ?the combination of Gestalt therapeutic principles with hypnosis enriches both approaches.

From this it is clear that Gestaltists are being advised to incorporate hypnotherapy into their practice. The following discussion will consider whether hypnotherapists can introduce aspects of Gestalt therapy into their work.

One of the central tenets of Gestalt therapy is that clients experience events in the present, that is they re-enact past events in the present. By re-living them they can focus on their experiences, both psychological and physiological and thus gain understanding. Awareness was considered "the key to unlock insight and ultimately bring behaviour change" (Zimberoff, & Hartman 2003). Bringing the experienced past into the experiential present is one important property of hypnosis.

Through hypnotic age regression, working with dreams etc clients can re-experience events that have occurred at some other time as if they were happening in the here and now. This is not merely a cognitive reliving of a copy of the event, but a fully nuanced resurrection of the experience. As Zimberoff, & Hartman (2003) state, "Keeping the client's awareness on concrete detail is a constant in hypnotic age regressions, because it promotes presentness emotionally and viscerally (emphasis in original). Of equal importance is that the client's awareness can be focused on different aspects of their experience through repeated re-experiencing of it, allowing for a detailed, and concrete re-living of the experience in all its original strength and from physiological and psychological perspectives. This then fulfils Rosen's (1972) view that "Patients move best when they are moved" (emphasis in original).

It is clear that the Gestalt concern with realistic, present, re-experiencing of events is an important aspect of hypnosis. The concerns of Gestalt therapy with direct insight, rather than insight through interpretation would be a novel addition to hypnotherapy. To include this perspective is a philosophical and conceptual shift rather than a technical one and depends on the therapist's own preferences. However it is quite possible to achieve.

Hypnosis is also useful in intensifying aspects of an experience, by directing the client to pay closer attention to particular details. For example, someone who wishes to stop smoking might be asked to strongly feel the sense of relief and strength from being able to take deep breaths of fresh, clean air. Greenberg and Malcolm (2002) have demonstrated that success in using such techniques as the empty chair are at least partially determined by the degree of emotional arousal experienced during the use of this technique. Here we can envisage that the client can be asked to imagine a dialogue, or in the case of multiple actors in the re-lived scenario, a conversation, where they can concentrate on aspects of themselves or others that are blocking their ability to resolve past issues.

Many hypnotic techniques are relatively passive in that the client is asked to view an event, rather than to participate in it, but there is no conceptual reason why this more active, almost didactic approach could not become a more integrated aspect of hypnotherapeutic practice. Indeed, in clients who are able to speak whilst hypnotised it might allow the therapist even greater understanding of the experiences that the client is reliving, and for the therapist to take a more active, flexible role in directing the client's interactions.

As described earlier, Gestalt therapy makes use of experimentation in order for client's to experience new sensations, and to become aware of old patterns of responding. For this to work we are effectively asking the client to suspend disbelief, for example to suspend the idea that they cannot say something to their parent. This may be difficult for some clients, especially where they have developed strong conscious strategies to protect them from predicted negative outcomes. Hypnosis, by inducing an altered state of consciousness, may be able to circumvent these strategies, allowing the client to explore options in a safe fantasy world that is experienced as vivid and real. S/he can then explore conversations with others, actions etc that may not be considered options when in a non-hypnotic state.

As suggested earlier, this active participation of clients is not common, but there is no reason why clients who have strong powers of visualisation cannot be directed under hypnosis to engage in experimentation. Usefully as a single scene can be replayed many times under hypnosis it allows the client to perform a variety of experiments and to compare and contrast the resultant emotions etc. Naturally they can also be directed to pay close attention to the details of these new experiences, so that they can be vividly recalled post-hypnotically.

As Gestalt therapy is primarily concerned with the client's willingness to take responsibility, and the therapist's ability to develop novel ways in which the client can come face-to-face with aspects of their life they have projected onto others, or denied control of, the main way in which hypnotherapy can incorporate aspects of Gestalt technique is twofold. Firstly hypnotherapeutic practitioners must be trained in Gestalt conceptual philosophy so they fully understand their role, and have the intuition and flexibility to carry it out in a range of situations and across a broad spectrum of clients. Secondly, just as Freud selected patients who were willing to accept his fundamental law of psychotherapy, perhaps the hypnotherapist must be selective at consultation with clients who show a motivation to change and a willingness to take responsibility for that change. Without these two features hypnotherapy cannot truly address "the key problem of people in our times?inner deadness" (Clinebell, 1981).

References

Becker, E. (1993). Growing up rugged: Fritz Perls and Gestalt therapy. The Gestalt Journal, 16(2). Available at http://www.gestalt.org/becker.htm

Berne, E. (1970). Review of gestalt Therapy Verbatim by F. Perls (1969). American Journal of Psychiatry, 10, 163-4.

Clarkson, P. (1989). Gestalt counselling in action. London: Sage.

Clinebell, H.J. (1981). Contemporary growth therapies. NY: Abingdon Press.

Gibson, J.J. (1966). The senses considered as perceptual systems. NY: Houghton Mifflin Company.

Greenberg, L.Sl. & Malcolm, W. (2002). Resolving unfinished business: relating process to outcome. Journal of Consulting and Clinical Psychology, 70(2), 406-416.

Koffka, K. (1935). Principles of Gestalt psychology. NY: Harcourt, Brace & World.

Levendula, D. (1963). principles of Gestalt therapy in relation to hypnotherapy. American Journal of Clinical Hypnosis, 6(1),22-26.

Lewin, K. (1952). Field theory in social science: Selected theoretical papers. London: Tavistock Publications.

Parlett, M. & Hemming, J. (2002). Gestalt therapy. In W. Dryden (Ed.) Handbook of individual therapy. London: Sage.

Perls, F.S. (1969). Ego, hunger and aggression. NY: Vintage Books (first published in 1942).

Resnick, R.W. (1984). Gestalt therapy East and West: Bi-coastal dialogue, debate or debacle? Gestalt Journal, 7(1), 13-32.

Rosen, S. (1972). Recent experiences with Gestalt, encounter and hypnotic techniques. American Journal of Psychoanalysis, 32, 90-105.

Stevens, J.O. (1975). Gestalt Is.Utah: real people Press.

Van de Riet, V., Korb, M.P., & Gorrell, J.J. (1980). gestalt therapy, an introduction. NY: Pergammon Press.

Yontef, G. M. (1993). Awareness, dialogue, and process: Essays on Gestalt therapy. Highland, NY: The Gestalt Journal Press.

Zimberoff, M.A. & Hartman, D. (2003). Gestalt therapy and heart-centred therapies. Journal of Heart-Centred Therapies, 6(1), 93-104.

Zinker, J. (1978). Creative process in Gestalt therapy. NY: Vintage Books.

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Gantz refuses to be an alternative  HaaretzWhy is a man presuming to offer an alternative to Benjamin Netanyahu's rule unwilling to expose his position on the most critical issue in Israel?
Broncos’ alternative to onside kicks is reportedly generating a lot of interest  Kansas City StarThe Denver Broncos have proposed an alternative to the NFL's onside-kick rule and it will be voted on by owners at their annual meeting, which begin Sunday.
A Texas Non-Profit Vying To Become A National Alternative To Planned Parenthood, Applies for Millions of Dollars in Grants  WBAP News/TalkHOUSTON (AP) – An anti-abortion group hired by Texas to bolster women's health services is seeking federal family planning funding after the state cut ties with ...
New cholesterol-lowering drug could be an alternative to statins  NBCNews.comBempedoic acid is a new type of cholesterol-fighting drug that doesn't come with muscle-related side effects common with statins and could be an alternative.
Texas Football: Intriguing alternative RB solutions  Hook 'Em HeadlinesOne of the bigger question marks for the Texas football program in spring camp lies with the lack of depth in the running back room.
The best alternative Mother's Day cards to stand out from your siblings  The IndependentFinding the perfect Mother's Day card can be a real ordeal. You want your mum to know just how long you spent carefully assessing each card in the shop, ...
SCCM Alternative  Security BoulevardAs IT organizations continue to struggle with system management in the era of mixed-platform environments, many IT organizations are wondering if there is an ...
Who is Liverpool’s most creative player? Our alternative stats provide the answer  This Is AnfieldOn the face of the statistics, Liverpool are not one of the creative forces in Europe this season, but our alternative stats reveal that certain players are contributing ...
Xiaomi Redmi AirDots: The AirPods alternative that cost less than US$15  Notebookcheck.netXiaomi only released its first set of completely wireless headphones a few months ago, but it has now followed them up with the even more affordable Redmi ...
Society Desperately Needs An Alternative Web  ForbesIn a world of rampant technology, and what will be the future of our planet, it is inflicting harms in the very fabric of society who depends on it. Is it too late to steer ...
Agriculture now alternative to oil in many nations– Utomi  P.M. NewsMr Joe Utomi, the Commissioner for Agriculture and Natural Resources in Delta, has said that the dwindling fortunes in the global oil market has forced many ...
Scaling small businesses with alternative finance  Economic TimesAlthough some platforms are still actively working, there is no proper regulatory framework for equity-based crowd funding and has remained as a grey area ...
India-Pakistan crisis includes war on facts and alternative facts  Aljazeera.comThough India and Pakistan retreated from the brink of war, an information conflict is on over tit-for-tat air raids.
Angela Price says she follows 'alternative' vaccine schedule  Montreal GazetteCritics warn parents unwittingly expose their children to potentially fatal infectious diseases when shots are given at later ages.
Raising The Bar Alternative school options becoming more available for parents Bryan Callahan 5:35 PM  KTNV Las VegasThe freedom to teach what they want at the speed their kids need is one of the main factors when it comes to parents deciding to home school their children.
Bayern Munich scouting Benfica’s Joao Filipe as an alternative to Callum Hudson-Odoi  Bavarian Football WorksIn a new report by O Jogo (via Sport Bild), it appears that Bayern Munich may be looking at alternatives to Callum Hudson-Odoi in the event that the club fails to ...
Leaked Powerbeats Pro images show off Apple's upcoming AirPod alternatives  TechRadarImagery of Beats' true wireless Powerbeats Pro has been revealed in the iOS 12.2 update.
Cornwall Alternative School facing closure after provincial budget cut funding  Regina Leader-PostCornwall Alternative School is facing closure after the government eliminated the school's funding in the 2019-2020 provincial budget.
Stronger action urged against homeopathic products touted as alternatives to vaccines  CBC NewsHealth Canada's recent warning that homeopathic remedies are not an alternative to vaccines doesn't go far enough to prevent the damage the products could ...
WATCHING NOW Homeless man's Cramped alternative to a shelter  CityNews VancouverOne man has come up with a solution to his own homelessness which could be an alternative to those opposed to going to a shelter. It's a portable residence ...
Netflix streamers in the UK just wanted to watch 'The Notebook' and sob. Instead, they got a bird scene  CNNThe last few minutes of "The Notebook" are a tearjerker -- and a beautiful ending to Noah and Allie's love story. Unless they're cut out of the movie.
Boost for alternative energy | Weekend Argus  Independent OnlineTired of being without power, sometimes up to 12 hours a day, South Africans are looking elsewhere.
How CPPIB is tapping ‘alternative data’ to refine its investment processes  Regina Leader-PostCPPIB has assembled a team to experiment with different kinds of information in making longer-term investment decisions.
Cass County Board: Alternative gravel road treatments still too...  Brainerd DispatchBACKUS—Environmentally friendly alternatives to calcium chloride gravel road treatment might be an option to try, but the price has to come down first, Cass ...
Top 5 Alternative Romance Movies  ComingSoon.netWhat is an “alternative romance movie”? We're talking about films that grab you by the heart and then rip it out. They don't necessarily have a “happy ending” ...
EURL Ecvam reviews EU alternative test training  Chemical WatchThe provision of resources for education and training on alternative test methods in EU member states is not well defined and shows apparent differences in the ...

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