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The Gestalt approach to therapy can be termed "phenomenological-existential" as it is implicated 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 private to accomplish understanding into the situation under examination. As Yontef (1993) writes, understanding is gained by learning the phenomomenological focusing, experimenting, reporting, and dialogue of the client. The philosophy behind this approach is that most population do not function in the world based on how the world, together with themselves, is, but straight through a filter of self-deception, whereby one does not have a clear photograph 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).
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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 famous founders of schools of psychotherapy, Jung and Adler. In the preface to the 1969 edition of "Ego, Hunger and Aggression" Perls wrote of this duration of time as follows, "Started seven years of useless couch life." (Perls, 1969)), and incorporated aspects of holism into the belief that finally the private is responsible for creating his or her existence.
Additionally, the early decades of the 20th century are famous for their refutation of Newtonian positivism and its exchange with phenomenology. These two themes were then combined within the scaffolding of Gestalt science of mind to furnish an approach centred on the individual's relationship to their existence. The buildings that Gestalt science of mind offered was that perception should be considered as the recognition of patterns and relationships in the middle of 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 list for the richness of perception, and its immediacy (for example, see Koffka, 1935; Gibson, 1966), nor take into list the importance of the observer. This led Perls to the idea that the actual awareness of an private is more trustable than an interpretation of any data that a person might supply a therapist with and is primarily a description of movements in the middle of 'figure' and 'ground'. The shape 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 come to be 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 design for Gestalt Therapy, despite the fact that the first recognisable Gestalt therapy book was published in the 1940's (Perls, 1969).
Accompanying this composition of ideas, based on the reasoning of Gestalt psychologists, philosophers (e.g., Lewin, 1952), and politicians (e.g., Smuts), was the basic view of the person as basically healthy, striving for balance, health, and increase (Clarkson, 1989). The unfinished company referred to earlier is seen as an obstacle to these processes, restricting the person's potential 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 population do not taste themselves as being psychologically and physiologically in equilibrium with their environment.
"As action, contact, option and authenticity describe health in gestalt therapy, so stasis, resistance, rigidity and control, often with anxiety, describe the state called 'dis-ease'"
The stasis, resistance, rigidity, and control forestall graceful flow straight through cycles of experience.
Having briefly outlined the core of Gestalt therapy it is significant to reconsider some of the techniques that Gestalt therapists use in order to reconsider how they might be incorporated into hypnotherapy. Although there are techniques that are intimately connected 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 option of exact 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 customary idea in this regard" (Berne, 1970: 163-4).
Second, that in Gestalt therapy, technique is considered secondary to the relationship developed in the middle of 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 exact techniques that is the approach that will be taken in the following discussion.
The techniques that are connected with Gestalt therapy are intimately connected to the idea that clients should want to work towards self-awareness straight through a mastery of their awareness processes. This is in distinction to patients who firstly are surely seeking relief from discomfort, although they may claim that they wish to convert 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 increase 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 come to be 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 in the middle of what is projected into the chair, and themselves. In some cases the client moves in the middle of the chairs, but whether way, the idea is that inner conflicts come to be expressed and so the client heightens their awareness of them. This in turn military the client to take responsibility for their difficulties so that they can make choices to decree the sources of unfinished company (Stevens, 1975). As Becker (1993) writes, this is the whole point of Gestalt, to "take population who are conditioned and automatic and put them in some kind of aegis over themselves."
Similar to the empty chair, another base technique is known as topdog/underdog. A dialogue is performed in the middle of 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. straight through the dialogue "resolution, compromise, understanding or permanent disunion becomes possible" (Clarkson, 1989). This is attained by the private 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 straight through a process termed bodywork. This involves the client consciously noting where they taste tension in single situations, or how their pattern of breathing changes. Once aware they can learn strategies to cut these reactions, which have produced both physical and reasoning 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 itsybitsy sounds and movements." Here the private 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 come to be '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 former 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 view it was. For most population 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 different to Freud, in that Perls did not think of the unconscious as an inaccessible region of the mind which dreams could supply 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 describe 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 connected with Gestalt therapy should neither be considered exhaustive nor exclusive. As cited earlier, Resnick (1984) surrounded by others clearly believes that Gestalt therapy is not and cannot be tied to single techniques, it is about the relationship in the middle of the client and the therapist.
An prominent part of this relationship is that the therapist is acting to guide the client towards greater self-awareness, responsibility and proprietary of emotions, thoughts, sensations etc in order to unblemished any 'unfinished business' so that s/he may move smoothly straight through cycles of experience. The experienced therapist is able to adapt to the single client in order to accomplish this, relying on a wealth of techniques and skills. This essence of Gestalt therapy allies it more intimately 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 maybe this that makes it potential 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 incorporate his approach with hypnotic techniques. For example, the Gestalt therapist teaches the increasing of awareness straight through experimental exercises. The hypnotherapists can accomplish this much more surely by directing the patient's attention to come to be 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 composition of Gestalt therapeutic theory with hypnosis enriches both approaches.
From this it is clear that Gestaltists are being advised to incorporate hypnotherapy into their practice. The following consulation will reconsider whether hypnotherapists can introduce aspects of Gestalt therapy into their work.
One of the central tenets of Gestalt therapy is that clients taste 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 understanding and finally bring behaviour change" (Zimberoff, & Hartman 2003). Bringing the experienced past into the experiential present is one prominent asset 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 taste straight through repeated re-experiencing of it, allowing for a detailed, and concrete re-living of the taste in all its customary vigor 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 prominent aspect of hypnosis. The concerns of Gestalt therapy with direct insight, rather than understanding straight through interpretation would be a novel increasing 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 potential to achieve.
Hypnosis is also useful in intensifying aspects of an experience, by directing the client to pay closer attention to single details. For example, person who wishes to stop smoking might be asked to strongly feel the sense of relief and vigor 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 considered by the degree of emotional arousal experienced while the use of this technique. Here we can envisage that the client can be asked to imagine a dialogue, or in the case of complicated actors in the re-lived scenario, a conversation, where they can incorporate on aspects of themselves or others that are blocking their potential to decree 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 imagine why this more active, approximately didactic approach could not come to be 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 taste new sensations, and to come to be 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 safe them from foreseen, negative outcomes. Hypnosis, by inducing an altered state of consciousness, may be able to circumvent these strategies, allowing the client to contemplate options in a safe fantasy world that is experienced as vivid and real. S/he can then contemplate 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 imagine 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 accomplish a variety of experiments and to compare and distinction the resultant emotions etc. Simply 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 implicated with the client's willingness to take responsibility, and the therapist's potential to design 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 superior patients who were willing to accept his basic law of psychotherapy, maybe the hypnotherapist must be selective at consultation with clients who show a motivation to convert and a willingness to take responsibility for that change. Without these two features hypnotherapy cannot truly address "the key problem of population 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). describe 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). Modern increase 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). theory of Gestalt psychology. Ny: Harcourt, Brace & World.
Levendula, D. (1963). theory of Gestalt therapy in relation to hypnotherapy. American Journal of Clinical Hypnosis, 6(1),22-26.
Lewin, K. (1952). Field theory in collective science: superior theoretical papers. London: Tavistock Publications.
Parlett, M. & Hemming, J. (2002). Gestalt therapy. In W. Dryden (Ed.) Handbook of private 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, turn over 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 population 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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