Early Conceptualisation of Gestalt Therapy’s Understanding of Introjection

Gestalt therapy, a distinctive form of psychotherapy, developed by Lore and Fritz Perls, offers a nuanced approach to understanding and facilitating human growth and development. This method emerged from the Perls’ personal and professional experiences, as well as the influence of their peers and the cultural environment surrounding them.

In the early stages of their exploration, Lore Perls focused on what might seem mundane—infant feeding and weaning practices. However, her observations provided profound insights into human behavior and psychology. She noted that the manner in which food is introduced to infants—often hurried and without allowing the child to “chew”—parallels how people are introduced to new knowledge and experiences. Lore Perls identified this rushed process as “introjection,” where individuals absorb information without fully processing it, a concept that would become central to Gestalt therapy.

Expanding on this idea, Lore argued that true understanding and learning require time and patience, akin to the physical act of chewing. This metaphor highlighted the importance of fully engaging with and processing new information, rather than passively accepting it. In her 1939 lecture “Child Raising and Peace,” she further discussed the role of aggression in creative change, warning against the suppression of aggressive impulses as it could lead to intellectual inhibition and a lack of critical thinking.

Her insights were complemented by Fritz Perls’ contributions. At the 1936 International Psychoanalytic Congress, Fritz presented a lecture on “Oral Resistances,” where he explored children’s natural resistance to forced feeding. He argued that such resistance is not limited to eating but can extend to intellectual matters as well. Fritz observed that most people conform to the intellectual “diet” they are allowed, while only a few question and choose what truly resonates with them.

These ideas were further elaborated in Fritz Perls’ book “Ego, Hunger and Aggression,” co-written with Lore during their exile in South Africa. The book critiqued traditional psychoanalytic techniques, emphasizing the need for a self-directed assimilation of experiences—a stark contrast to the often authoritarian approach observed in conventional psychoanalysis. Fritz criticized these methods for projecting predetermined notions onto patients, which he termed “intropress,” borrowing from the concepts discussed by Sándor Ferenczi, another influential psychoanalyst who advocated for considering psychoanalytic interpretations as mere suggestions.

Gestalt therapy, thus, encourages individuals to actively engage with their experiences and emotions in the present moment. It promotes awareness and personal responsibility, enabling individuals to navigate their own psychological landscapes independently. This approach stands in contrast to the intellectual passivity and reliance on authority that the Perls critiqued, particularly within the rigid educational and political systems of their time.

By integrating these psychological insights with broader socio-political observations, the Perls developed Gestalt therapy not just as a therapeutic method, but as a form of intellectual and emotional liberation, advocating for a more mindful, autonomous, and critically engaged way of living and learning.

References

Bocian, B. (2015). Fritz Perls in Berlin 1893-1933: Expressionism Psychoanalysis Judaism. EHP-Verlag Andreas Kohlhage.

Perls, L. (1997). Der Weg zur Gestalttherapie. Lore Perls im Gespräch mit Daniel Rosenblatt. Wuppertal

Self-Criticism: Adam Phillips

Adam Phillips, argues that self-criticism stems from our ambivalence towards ourselves. We all have mixed feelings about ourselves, but ambivalence goes beyond that. It’s about having opposing feelings that are dependent on each other. We might criticize ourselves because we’re frustrated with ourselves for not achieving something, but that frustration stems from a desire to succeed, which is a form of self-love.

I summarise here the lecture published on YouTube.

“Jacques Lacan famously remarked that there must surely be something ironic about Christ’s injunction to love thy neighbour as thyself, because actually people hate themselves.”

Christ’s Injunction and Self-Hate: Jacques Lacan observed the irony in Christ’s command to “love thy neighbor as thyself,” since people fundamentally struggle with self-love. This highlights the complex nature of our relationship with ourselves.

 Adam Phillips argues that self-criticism stems from ambivalence – holding opposing feelings about ourselves that are intertwined. For example, criticizing ourselves for not achieving something might be fueled by an underlying desire for success (a form of self-love).

What is Ambivalence?

Ambivalence goes beyond simply liking some things about yourself and disliking others. It’s the experience of holding two strongly opposing feelings or attitudes towards a single object, situation, or even yourself. These feelings are not merely mixed; they coexist simultaneously and can feel conflicting.

A classic example is the love-hate relationship. You might love someone deeply, yet at times experience strong feelings of dislike or frustration towards them. Ambivalence makes these seemingly contradictory emotions both exist at the same time

The Paradox of Self-Criticism

“Self-criticism can be our most sadomasochistic way of loving ourselves.”

Self-criticism can be harsh and unrelenting, preventing us from moving forward from our mistakes. The lecture uses the super-ego concept from Freudian psychoanalysis to illustrate this point. The super-ego acts as our moral conscience, and it can be very critical and judgmental. This constant criticism from the super-ego is excessive.

What is the Superego?

In Freudian psychoanalysis, the superego is one of three parts of the personality (along with the id and the ego). The superego represents our internalized sense of morality, social rules, and ideals. It houses our conscience.

The superego develops during childhood as we internalize the rules, values, and expectations of our parents and society. It acts as a kind of watchful eye, constantly monitoring our behavior and thoughts against those ideals.

The Superego and Our Inner Critic

The superego, our internalized moral compass, is often the source of unrelenting self-criticism. Its constant judgments and unrealistic expectations fuel negativity.

“The super-ego is, like all propagandists, relentlessly repetitive.” The self-critical part of ourselves is incredibly narrowminded, with an impoverished vocabulary, and cruelly intimidating. It is the stuck record from the past, unimaginative.

  • Freudian Breakdown: In psychoanalysis, the superego has two parts:
    • The Ego Ideal: Our aspirations and positive self-image.
    • The Conscience: Source of guilt and shame when we violate internalized rules.
  • Unrealistic Critic: The superego’s ideals are often unattainable, leading to perpetual self-criticism. “The super-ego is, like all propagandists, relentlessly repetitive.”
  • Source of Our Inner Critic: Recognizing this helps us see our self-critical thoughts not as objective reality, but as the superego’s exaggerations.
  • The Never-Satisfied Voice: The superego is rarely satisfied, even when we achieve our goals. It constantly moves the goalpost, fueling an endless sense of inadequacy and the need for further self-critique.

Hamlet: A Case Study in Self-Doubt

  • Paralysis of Conscience: Phillips analyzes Hamlet’s relentless self-scrutiny and struggle with revenge to illustrate the destructive power of the inner critic. Hamlet’s conscience, fear, and desire for honor become obstacles to action.
  • “Conscience Does Make Cowards of Us All”: This famous line showcases how internal conflict can hinder decisive action, even when morally motivated.
  • The Superego at Work: Hamlet’s harsh self-judgment mirrors the superego’s exaggerated demands and constant punishment.

Limits of Being & Unforbidden Pleasures

Self-criticism is nothing if it does not define and over define the limits of being (Brian Cummings).

“Self-criticism is not a reliable way to understand ourselves.” While self-criticism may be negative, it also stems from a kind of self-love. Our critiques arise from the standards of conduct we have internalised, showing a twisted desire to improve ourselves.

Conscience makes something out of us. The superego claims to know the consequences of our actions.

“Self-criticism is an unforbidden pleasure.” Unlike many pleasures which are explicitly condemned by society (like certain desires or indulgences), self-criticism is readily available and even encouraged in some contexts. We are told to be humble, to always strive for improvement, and not to be overly self-satisfied.

While seemingly negative, Phillips suggests that self-criticism carries a perverse sort of pleasure. It can make us feel morally superior and provides a false sense of control over our shortcomings. There’s a satisfaction in wallowing in self-critique.

Our ambivalence towards ourselves can make even painful emotions feel familiar and comforting in their own way. Self-criticism, because it’s often a long-standing habit, can offer a distorted sense of safety.

While painful, our superego’s harsh pronouncements become intertwined with our sense of self. We might derive a strange pleasure from its constant critiques, even while wishing to silence them.

  • Self-Criticism Misleads: “Self-criticism is not a reliable way to understand ourselves.”
  • Twisted Self-Love: Ironically, our negativity stems from internalized standards, showing a desire to improve ourselves.
  • Pleasure in Pain: “Self-criticism is an unforbidden pleasure.” It’s readily available, morally acceptable, and offers a false sense of control and superiority.
  • The Superego as Narcissist: Our inner critic, with its repetitive critiques, focuses narrowly on our flaws, ignoring the bigger picture.

Cowadice

Hamlet, while contemplating suicide in his “To be or not to be” soliloquy, asks the pivotal question:

“Whether ’tis nobler in the mind to suffer/ The slings and arrows of outrageous fortune,/ Or to take arms against a sea of troubles,/ And by opposing, end them?”

In essence, Hamlet is questioning whether it is braver to endure the pain and suffering life inevitably brings or to end his own life.

Cowardice as a Theme

  • Fear of the Unknown: Hamlet’s fear isn’t physical pain but a deeper fear of the unknown – of death and potential suffering in the afterlife. This fear of what lies beyond life leads to inaction, which he associates with cowardice.
  • Conscience and Moral Cowardice: Hamlet’s conscience weighs heavily upon him. He sees inaction against his father’s murderer as a moral failing, a different kind of cowardice. His conscience, fueled by his desire to uphold his father’s memory and ideals, prevents him from rash action but also tortures him.
  • The Cowardice of Overthinking: Phillips might also suggest that Hamlet is trapped in a paralysis of excessive contemplation. Overthinking, questioning every motivation and potential outcome, becomes another form of cowardice, preventing him from taking decisive action.

“Conscience makes cowards of us all.” The cowardly part of ourselves is like a person who must not have a new experience.\

Self-criticism is a judgment without a jury. The self-criticism, if it weren’t useful for self correcting, is self-hypnosis. It is an order not a recommendation.

The superego is the supreme narcissist; it is a boring soliloquist with an audience of one.

What is self-criticism for?

  • Alternatives to self-criticism: The lecture suggests self-praise as an alternative to self-criticism. Instead of dwelling on our shortcomings, we should focus on celebrating our accomplishments. This can help us develop a more positive self-image. By praising ourselves, we challenge the negative judgments of our super-ego and cultivate a more compassionate inner voice.
  • Lacan’s view on self-criticism: The lecture also mentions Jacques Lacan, a Freudian psychoanalyst, who believed that people misunderstand Freud’s concept of love. According to Lacan, Freud saw stories about love, like the story of Christ, as a way to cover up our ambivalence. This ambivalence can manifest as self-criticism; we criticize ourselves out of a complex mix of love and hate for ourselves.
  • Befriending Our Conscience: He proposes: “If only we could catch our conscience like a fish or a criminal, and then befriend that part of ourselves…”
  • Alternative Selves within Us: He suggests psychoanalysis can help us realize, “…that fragmented, fragmentary repository of alternative selves that are like a troupe of actors. Not so much to get rid of any of them, but to see them for who they possibly are.”
  • The Limits of Traditional Psychoanalysis: Phillips acknowledges that not all psychoanalytic approaches are suitable. He critiques forms of psychoanalysis focused solely on uncovering a singular, hidden truth about ourselves, as this can sometimes reinforce a self-critical narrative.

Psychoanalysis

Phillips’s viewpoint on psychoanalysis in addressing self-criticism:

  1. Understanding, not Eradicating, Our Inner Critic: Phillips advocates understanding the origin and function of our harsh inner critic rather than trying to simply eliminate it. By “befriending” our conscience, we can lessen its power over us.
  2. Discovering Inner Complexity: Central to his argument is that we are not a monolith. Psychoanalysis should help us discover multiple “selves” within us with varying motivations. This challenges the relentless narrative of our inner critic, leading to a more nuanced self-understanding.
  3. The Importance of Approach: Phillips highlights that choosing the right type of psychoanalysis matters. He favors approaches that value multiplicity and interpretation over uncovering a singular “real” self which the superego might latch onto in its critiques.

How This Connects to Self-Criticism

Phillips suggests psychoanalysis can help us:

  • Gain Agency: By understanding the origins of our inner critic, we realize it’s not an objective truth but a construct influenced by our past and unconscious dynamics. This knowledge gives us power to choose whether to listen to it or not.
  • Develop Self-Compassion: Recognizing the complexity of our inner world, including both positive and negative aspects, allows us to be gentler towards ourselves. We no longer see ourselves purely through the lens of the critical superego.
  • Shift Our Narrative: Psychoanalysis, when done well, offers alternative interpretations of our actions and motivations. This helps us develop a new, less self-critical story about ourselves.

What Is Self-Criticism For?

  • Alternatives Exist: Phillips promotes self-praise to counter negativity, cultivating a kinder inner voice.
  • Lacan on Love: Lacan saw stories of love as masking deeper ambivalence, which can manifest as self-criticism.
  • Psychoanalytic Solutions
    • Befriending the Critic: “If only we could catch our conscience like a fish or a criminal, and then befriend that part of ourselves…” Understanding the origins of our inner critic lessens its power.
    • Inner Complexity: “…that fragmented, fragmentary repository of alternative selves…” Psychoanalysis helps us see the multiple facets of ourselves, not just the flaws.
    • Choosing Wisely: Not all psychoanalytic approaches are helpful. Look for those that emphasize multiple perspectives rather than uncovering a singular negative truth.

My Comments

Maybe it’s my self-critic, and I am taking a bit of time to digest the contents of this lecture, before adding my input. I love Phillips’ writing and thoughts on the topic of self-criticism. The self-critic is a phenomenon in the therapy room that has got me feeling oftentimes stuck as a practitioner… What with two punishing super-egos in the therapeutic dyad! Listening to his lecture is like untangling a bunch of wires. I do, however, have evolving thoughts on this, and will write more in time… watch this space.

Reference

Phillips, A. (2014, May 13). Against self-criticism [Video]. YouTube. https://www.youtube.com/watch?v=a8mcaCWGFmg

Bassat: Linking Immunology with Psychoanalytical Psychotherapy

The groundbreaking metaphor of “the body keeps the score,” found in trauma research, aligns seamlessly with Bassat’s article exploring the profound impact of embryonic experiences on human development. Her work underscores the convergence of modern biological research with earlier theoretical and clinical insights into primitive mental anxieties, explored by pioneers like Tustin in the 1980s.

Bassat emphasizes that from conception, the human embryo faces a biological challenge: overcoming the mother’s immune system to implant in the uterine lining. This process lays the foundation for what Bassat terms a “neuro-immuno-psychoanalytic” discourse, revealing how the formative experiences of embryonic life shape both our psychological and physiological makeup.

Building on this concept, Bassat references authors like Wilfred Bion, who posited a link between autism and immune system dysfunction during early pregnancy. She further explores the idea that adverse environmental factors in the prenatal period can evoke unbearable states of dread within the fetus, disrupting psychological development and leading to the formation of autistic defenses.

Bassat redefines autistic states as psychophysical protective reactions rooted in bodily sensations rather than solely psychodynamic defense mechanisms. The overwhelming sense of vulnerability and threat experienced in the pre-verbal stage can lead to profound anxieties: a dread of annihilation, disintegration, a sense of boundlessness, or the absence of a safe, containing presence. This bodily experienced terror is not susceptible to rationalization.

Consequently, the autistic infant may resort to clinging behaviors, fixating on autistic objects or shapes. They experience a profound terror of separateness, which equates to a fear of death in their perception.

The author describes how the immune system, with its function of recognizing and responding to ‘self’ vs. ‘non-self’, mirrors the mental processes that determine our sense of individuality and connection with others.

As a psychotherapist with a background in biochemistry and microbiology, I find Bassat’s work both fascinating and deeply resonant. Her writings illuminate the profound impact of prenatal development on psychological wellbeing. Clinically, we frequently encounter clients with deep-rooted anxieties, dread, emptiness, irrational fears, and uncontrollable compulsions – states resistant to rationalization or traditional talk therapy.

These psychophysiological states defy cognitive resolution because their origins lie in pre-verbal trauma. Such experiences, occurring before language acquisition, cannot be consciously recalled. Many psychotherapists recognize the importance of physical presence, movement, and aesthetic connection alongside verbal processing. Metaphors and imagery often prove more potent than purely rational problem-solving in talk therapy.

The Podcast

Episode 129: From Immunology to Psychoanalysis: Reflections on Primitive Mental States with Shiri Ben Bassat (Tel Aviv)

MARCH 4, 2023 00:45:21

The Psychoanalytic Case study

This podcast case study @26:42 is compelling for several reasons. Firstly, it documents the author’s initial case as a psychoanalyst, highlighting the challenges and rewards of working with a child diagnosed with autism and psychosis. The dedication of both the analyst and the child’s adoptive mother to persisting through the child’s violent reactions to therapy demonstrates remarkable commitment. Additionally, the therapist’s innovative use of movement as an embodied mode of communication aligns with psychoanalytic theory, showcasing a thoughtful and adaptable approach within this framework.

In her paper, Bassat (2021) writes: “

  1. I created a stable, consistent setting of five sessions a week at a regular hour – a
    concrete action- needed to rebuild a functional container that would hold her, while
    also remaining flexible and changing, allowing her to take objects from the room
    (Quinodoz, 1992).
  2. I cultivated an accepting and total presence – offering the room, my body, and my
    internal objects so that they could be invaded and even destroyed. I thus enabled her
    to destroy my books, scrawl on my walls, bite me, dribble, and leave behind a
    destroyed, chaotic room – only to re-encounter it in a clean, orderly state upon her
    return. My internal objects had similarly been attacked and injured by evoking
    unbearable memories of my own personal traumas. I understood to what extent Yael’s unrepresented traumas were destructive and painful, in need of a mother-analyst womb to be contained in as Klein’s notion that our consulting rooms are equated, in the unconscious, with the maternal body (1961)
  3. An extensive use of a live, active presence and reparation in action (Alvarez, 1992,
    Pollak, 2009) aimed to distinguish and connect bodily functions, inside and outside,
    self and object, and different emotional states. So, by standing behind the wall to
    concretely separate myself from her, darkening the room, remaining silent, averting
    my gaze, and attempting not to breathe, I was trying to prevent the exterior world
    from intruding while she was still unready. Later, I helped her to envelop herself in
    tape so that she would feel less disintegrated.”

Further reading on Immunology and Psychotherapy

This podcast covers the following topics that warrant specialization and inspires further study:

Epigenetic link to Object Relations

Martin, S. (2014) R. Yehuda, N.P. Daskalakis, A. Lehrner, F. Desarnaud, H.N. Bader, I. Makotkine, J.D. Flory, L.M. Bierer, & M.J. Meaney (2014). Influences of maternal and paternal PTSD on epigenetic regulation of the glucocorticoid receptor gene in Holocaust survivor offspring. American Journal of Psychiatry 171:872-880.

Karla Ramirez , Rosa Fernández , Sarah Collet , Meltem Kiyar Enrique Delgado-Zayas , Esther Gómez-Gil , Tibbert Van Den Eynde , Guy T’Sjoen , Antonio Guillamon , Sven C Mueller , Eduardo Pásaro (2021) Epigenetics Is Implicated in the Basis of Gender Incongruence: An Epigenome-Wide Association Analysis. Front Neurosci Aug 19; 15:701017

Primitive Anxieties

Durban, J. (2019) ““Making a person”: Clinical considerations regarding the interpretation of anxieties in the analyses of children on the autisto-psychotic spectrum” The International Journal of Psychoanalysis 100:5, 921-939.

Prenatal and Postnatal Influence on the Psyche

Meltzer, D. & Williams, M. H. (1988) 2. Aesthetic Conflict: It’s Place in the Developmental Process. The Apprehension of Beauty: The Role of Aesthetic Conflict in Development, Art, and Violence 146:7-33

Bion, W. R. (1976) “On a quotation from Freud.” In Clinical Seminars and Four Papers, Ed. F. Bion. Abingdon: Fleetwood Press, 1987.

Joanna Wilheim (2004) The trauma of conception. Presented at a Meeting of the Brazilian Society of Psychoanalysis of São Paulo (SBPSP) on October 7, 2004.

Trnsformation of the mother’s immune system. Mandelboim, O. et al’ (2006). Decidual NK cells regulate key developmental processes at the human fetal-maternal interface. Nature Medicine 12: 1065 – 1074.

Bibliography

Bassat, S.B. (2021). “War in times of love”- Prenatal cell relations as a prototype of
autistic anxieties, defenses and object relations. Paper that won the 24th Frances Tustin Memorial Prize, 2021. Tel Aviv University, November 5th, 2021. Download pdf.

The Psychodynamic Diagnostic Process: Nancy McWilliams

This lecture by Nancy McWilliams delves into the intricacies of psychodynamic diagnosis, exploring the complexities beyond the DSM and offering insights into therapeutic approaches for various personality types. Here’s a summary of key points with timestamps for your reference:

Levels of Personality Functioning (1:00):

  • McWilliams emphasizes the importance of considering different levels of personality functioning, ranging from high-functioning to psychotic.
  • High-functioning (neurotic to healthy): Individuals exhibit good attachment security, engage in reflective thinking, and can manage complex emotions.(1:00)
  • Borderline: Characterized by intense emotions, unstable relationships, and difficulty tolerating frustration. Therapists need to set clear boundaries and provide consistent support. (2:00)
  • Psychotic: Individuals grapple with severe anxiety and may experience delusions or hallucinations. Treatment focuses on symptom management and building a sense of safety. (3:00)

DSM vs. Psychodynamic Approach (4:00):

  • McWilliams critiques the limitations of the DSM, arguing that it overemphasizes categorical diagnoses and neglects individual context and complexity.
  • Psychodynamic diagnosis, in contrast, considers a person’s history,temperament, defense mechanisms, and attachment patterns to provide a richer understanding. (5:00)

Therapeutic Considerations for Different Personalities (6:00):

  • Obsessive-compulsive: Helping them find healthier ways to manage anxiety and intrusive thoughts, rather than focusing on eliminating obsessions entirely. (6:00)
  • Depressive: Exploring the underlying causes of their self-criticism and encouraging them to develop healthier coping mechanisms. (7:00)
  • Self-defeating: Recognizing the pattern of seeking help while sabotaging progress, and setting clear boundaries to prevent manipulation. (8:00)

Qualities of a Good Therapist (50:00):

  • Caring and empathetic: Building a genuine connection with the patient is crucial for effective therapy.
  • Humble and willing to learn: Therapists should be open to feedback and continuously seek to improve their skills.
  • Interested in the patient: A genuine curiosity about the patient’s experiences fosters a deeper understanding and better treatment.

McWilliams emphasizes the importance of individualizing therapy based on a patient’s unique personality and level of functioning. By moving beyond the limitations of the DSM and adopting a psychodynamic approach, therapists can provide more effective and meaningful support.

Note: This summary provides a brief overview of key points. For a more comprehensive understanding, watching the full lecture is recommended.

How does Psychotherapy Work? General Systems Theory and Synchronization

How do we explain the transformative work of psychotherapy? The therapist and client of the psychotherapeutic encounter do not exist in an isolated bubble; both exist integrated with the environment we call the field. The field encompasses the biological, psychological, physical and sociological environment in which the therapist and client are embedded. The psychotherapy situation is in constant flux with the field. Psychotherapy is an open system.

Change in psychotherapy is complex, non-linear, and perceived as organic. The psychotherapy profession has long understood this concept, which differs from the paradigm of the broader field of the medical model of healing that views the patient as a unique entity disconnected from the environment.

The medical model approach considers the patient and their issues unique to the individual, often ignoring the environmental contribution to the patient’s suffering. The patient sees the medical professional and gets treated for their symptoms. Usually, the patient is offered medication to relieve symptoms, and healing is expected to happen spontaneously. Sometimes healing does not occur, but just an alleviation of suffering. Diagnosing and treating the patient this way is the mono-personal approach to therapy.

The figure below illustrates the different dimensions ‘ways of seeing’ psychopathology (suffering and symptoms), treatment and diagnosis in therapy. The relational attitude is adopted by contemporary psychotherapeutic schools, where the study, focus and treatment is experienced in the therapeutic relationship.

Three different attitudes and focus on treatment and diagnosis: 1) the mono–personal attitude where the client and their suffering is attributed to the individual alone disregarding the environment, 2) the relational where the client’s suffering is encountered and treated within the therapeutic relationship, and 3) the field theory, or the aesthetic attitude where the client is treated as a co-creator of the field.

The field theory is unique to Gestalt therapy. Contemporary Gestalt therapists have attuned themselves to investigating psychopathology and therapy even further by looking at the aesthetics of the co-created field.

A Gestalt therapy perspective of psychopathology is necessarily grounded in a field epistemology. The field concept enables us to understand experiential phenomena as being emergent from a dimension that cannot be reduced to the individual, or to the sum of individuals at play. Every relational situation actualises a new, original field. Subjective experience is not the product of a single mind or isolated individual; it is an emergent phenomenon of the actualised field.

Francesetti, 2015

The co-created field encompasses the client and therapist in their bio-psycho-social environment and is unique to the encounter. Read also: Notes on Field Theory in Gestalt Therapy. Field theory renders the therapeutic encounter an open system. Neither is the client treated as an individual nor is the therapeutic situation treated as separate from the outside world. The field theory includes everything relevant to the here-and-now of the therapeutic session. Attunement to the field involves noticing and focusing on the atmosphere of the therapeutic situation. Change is effected through the field. Movement in the field facilitates meaningful psychotherapeutic change and transformation.

As we consider the concept of the co-created field in psychotherapy, we will also realize that psychotherapy is an open, dynamic and complex system.

Buy this poster by clicking on image. Notes on how psychotherapy works based on dynamic systems theory or general systems theory.

General systems theory

General Systems theory is an interdisciplinary practice applied to many fields of sciences, including cybernetics and biology. The concept was published in 1934 by Austrian biologist Karl Ludwig von Bertalanffy (1901-1972), who proposed that the classical law of thermodynamics, which applies to closed systems, has limited relevance to open systems (Wikipedia, 2020).

The phenomenon of Synchronization

The videos below demonstrate the phenomenon of synchronization. Unique objects with their own stable pattern, influence the co-created environment, causing their own patterns to change.

Two metronomes are placed on a common base. The metronome on the left is set at 192 beats per minute. The one on the right is set at a slightly lower rate. The metronome pendulums are initially out-of-phase. The two pendulums oscilate in phase due to conservation of momentum and coupling via the base. A true physics masterpiece!

This is another example with the use of several metronomes, each with their own temporal settings. After a while, all metronomes sync together.

This video illustrates the temporal synchronization of metronomes coupled via a common ground plate. This (well-known) phenomenon goes back to the observations of Christiaan Huygens (die Pendeluhr: Horologium oscillarium, 1763). Timeline: 0:00 – Setup and “What’s going to happen?” 0:21 – Synchronization from arbitrary positions 1:04 – Re-synchronization after disturbance

Synchronization happens in biological systems. All biological systems are attracted to the field which guides their growth and movement.

We know a lot of factual information about the starling—its size and voice, where it lives, how it breeds and migrates—but what remains a mystery is how it flies in murmurations, or flocks, without colliding. This short film by Jan van IJken was shot in the Netherlands, and it captures the birds gathering at dusk, just about to start their “performance.” Listen well and you’ll be able to hear how this beautiful phenomenon got its name.

Psychotherapy and General / Dynamic Systems Theory

Psychotherapy is an open complex system, like all biological systems and groups. Open complex systems are self organizing, and creatively adjust to their environment. They dynamically change with time. This change is continuous and non-linear.

Open systems oscillate dynamically and try to find stability. Transformative change involves the process of deconstruction, reorganization and reconstruction. In psychotherapy, pathos or suffering is sensed, grasped, and brought to the surface. The client learns to frustrate old patterns by attempting behaviour change and meeting the therapist at the contact boundary. This process can happen through experimentation and (sometimes accidental) confrontation of transferences.

The client’s “pathological” situation is an autonomous pattern formation, which the client would like to change. This pattern is, however, a stable pattern that has developed through life experiences and trauma. It is a meaningful pattern, though often dysfunctional that the individual has adapted to since childhood. In psychopathology, some patterns have more severe consequences for the person, like obsessions and compulsions, and anxiety. In less severe states, the individual suffers setbacks in relationships due to personality and unstable attachment styles. This pattern is played out in therapy and felt in the field. The attuned therapist can grasp how the therapy situation impacts them in the co-created field with the client.

In therapy, the client’s pattern is challenged. The challenge brings about resistance. We can say that the old pattern repels this challenge. The client may get used to this challenge and change. This may manifest as the ability for the client to attend therapy as a routine. This initial influence of therapy on the client is the first -order change. Here lies a comfortable synchronization in the field.

Transformation happens at the second-order change. This process takes time. The second-order change is the lasting permanent change of the pathological pattern. Second-order change requires the deep modification of the system’s way of functioning. In Gestalt therapy, this is a phase of change called the impasse. Read also: Gestalt Theory: 5 Phases of Therapeutic Change. When the client can stay in therapy long enough to find themselves in a situation of the impasse, which is often an uncomfortable state, a transformation phenomenon happens. At this stage, there is a re-synchronization, and the new pattern becomes stable. The client experiences a shift.

In trauma therapy, the synchronization that happens in the therapeutic encounter is also a physiological one. The therapist provides the client with a safe space and a centred presence in the therapeutic field. The client who shares the field, like the opposing metronome in the videos above, begins to operate in sync with the therapist.

Therapeutic change and transformation works through synchronization, and this involves the passage of time. Psychotherapy is a powerful resource that offers deep organic change and psychotherapeutic treatment. Shortcuts and quick fixes has never been the premise of psychotherapy.

References

Francesetti, G. (2015). From individual symptoms to psychopathological fields. Towards a field perspective on clinical human suffering. British Gestalt Journal24(1), 5-19.

Ludwig von Bertalanffy. (2022, November 20). In Wikipedia. https://en.wikipedia.org/wiki/Ludwig_von_Bertalanffy

The change moments in psychotherapeutic practice 

The challenge with humanistic psychotherapy today is to realize the philosophical con­cepts and theory put into practice. How do we see an I-thou moment in a therapy ses­sion? 

My personal conviction in this topic is borne by the fact that I have experienced change moments – as a client of psychotherapy. Over the years, I have also been able to tell if these change moments had a lasting effect, or if they were just cathartic or tempo­rary because of suggestion and coercion. Perception of from the client’s point of view recorded over lifetime (a couple of years), may be essential aspect of psychotherapeutic process research. 

The process of defining the healing I-Thou moments (Buber, 1936) in psychotherapy often gets lost in language. What some call the transcendental phenomenon (which I have in this paper related to an aspect of Clarkson’s framework), is also called “miracle moments” (Santos, 2003), “sacred moments” (Pargament, 2007), and “moments of meeting” (The Boston Change Process Study Group, 2010). 

What is typically experienced in this moment is typically described like this: “Every therapist knows that there are some special moments in psychotherapy. I experi­ence them as “sacred moments” when immediate realities fade into the background, when time seems to stand still, when it feels as if something larger than life is happen­ing. In these moments, I believe, a meeting of souls is taking place. This was one of those times” (p. 6). 

I had the benefit of attending a presentation at a Gestalt Associates Los Angeles (GATLA) Summer Residential in Lisbon this year which discussed this very topic of defining these moments of encounter. Entitled, I-thou moments in psychotherapy, the study is the result of meta-analyses of psychotherapeutic literature and interviews with therapists. Hence it was found that these I-thou moments: 

  • are memorable, exists in psychotherapy and appears every now and then.
  • are recognizable, significant events.
  • is based on the quality of dialogue.
  • short lasting (in seconds).
  • is rare.
  • is mutually experienced.
    During these moments 
  • perception gets narrowed.
  • there is an unusual level of understanding and acceptance of the other
  • there is experience of being on the edge of something spiritual.

These moments lead to long term change in the therapy and result in motivation for the client to further therapy work. It strengthens the alliance, and has no negative affects (unlike transference relationship). It is also a qualitatively viewed process, and is often arises from sharing of heavy topics and staying long enough at an oftentimes uncomfortable place. Playing the role “I am the therapist, you are the client” prevents these moments from happening. The challenge in studying these moments is the very fact that in trying to grasp the moment, that moment is lost (Pernicka, 2016).

References

Buber, M. (1936). Ich und Du. Berlin: Schocken.

Pargament, K. (2007). Spiritually integrated psychotherapy: Understanding and addressing the sacred. NY: Guilford Press.

Pernicka, M. (2016, July). I-Thou moments in Psychotherapy. Lisbon, Portugal.

Santos, A. M. (2003). Miracle Moments: The Nature of the Mind’s Power in Relationships and Psychotherapy. iUniverse.

The Boston Change Process Study Group. (2010). Change in psychotherapy. NY: W. W. Norton & Co. .

Empathy and Buber’s I-thou contact

I do not fully agree with Schmid’s implication that empathy is about “try(ing) to understand, as exactly as possible, the accurate meaning of what goes on inside another person in the very moment”. This is the common understanding of empathy, but it actually contradicts the principle of Buber’s (1970) I-Thou contact. “Trying to un­derstand” is a process of someone doing something with an aim to furnish a need in oneself. In this case, it is the need to understand “as exactly as possible”. If a therapist has this kind of goal, his/her goal may become a blockage to contact because he/she is distracted by the need to interpret and the need to establish his/her identification as therapist in the relationship. 

Wouldn’t this amount to using the client to find-out-something-so-that-I-can-do­my-therapist-job? This kind of objectifying the Other in the relationship leaves room for transference and countertransference neurosis. If empathy is as what is generally under­stood as described above, it is then not part of the I-Thou relationship, because the I­Thou relationship excludes objectification. 

The I-Thou contact requires seeing the Other first, and not seeing the other in re­lation to oneself. This movement towards the other first is what Emmanuel Levinas considers the ethical movement (Schmid, 2001). 

Schmid clarifies this disparity later in the article in stating the difference between Roger’s and Buber’s comprehension of the activity of making empathic contact. Be­sides what is mentioned, Rogers also believes that it is necessary “to put one’s own un-derstanding completely apart” if one wants to enter the world of another person empath­ically. Buber, on the other hand believes in the mutuality of the process. 

That which lies beneath the I-thou contact is not empathy but something more than empathy. Buber (1970) uses the word, Umfassung, a phenomenon of embracing, which is “more than empathy”. This process requires the recognition of 2 poles, in en­countering the other “as a partner in a bipolar situation” (p. 178). This implies a dynam­ic relationship of “swinging into” (einschwingen) into the experience of the other and at the same time maintain one’s own reality of the self. It shows a dynamic process of be­ing existentially affected by the other, and including the other person into one’s own existence (Schmid, 2001). 

This is not the same as to “trying to understand someone as exactly as possible”, or to step into someone’s shoes. It is rather about me being me, seeing you, and show­ing you how you affect me— at this present moment. 

This way of relating in the present moment is what Buber calls, personale Vergegenwärtigung. It is an elementary way of relating and means to expose oneself to the presence of the other. This is a personal way of becoming aware of, a way of ac­ceptance instead of perception, a way of acknowledgment instead of knowledge (Schmid, 2001). 

The I-Thou relationship is basic existential relationship without the complications of identity and needs. The healing power of this relationship is in the confirming of the other for who he/she is. Buber is quoted to use the word Realphantasie, which indicates that what is happening is that “the Other’s reality is touched” (ibid.). What is experi­enced through this form of relationship is the transpersonal, intersubjective acknowl­edgment of the other, affirming the identity of the other through the presence of the self. Both partners in the relationship attains affirmation of the self. This benefit is mutual, and the relationship is symmetric. What happens in this mutual exchange, Staemmler (2009, p. 96) explains is not a “fusion of horizons”—which happens with just empathy alone— but a widening of each other’s horizons in such a way that that it is integrated with each other’s personal background.

References

Buber, M. (1936). Ich und Du. Berlin: Schocken. 

Buber, M. (1970). I and Thou (Kindle ed.). (W. Kaufman, Trans.) Charles Scribner’s Sons.

Gadamer, H. G. (1975/1960). Truth and method . (G. Barden, & J. Cumming, Trans.) NY: Seabury. 

Schmid, P. F. (2001). Comprehension: the art of not-knowing. Dialogical and ethical perspectives on empathy as dialogue in personal and person-centred relationships. Empathy, 53-71.

Staemmler, F.-M. (2009). The willingness to be uncertain: Preliminary thoughts about intepretation and understanding in Gestalt Therapy. In L. J. Hycner (Ed.), Relational approaches in Gestalt Therapy (pp. 65-110). NY: Gestalt Press.

What’s behind the transforming power of dialogue?

Exploring the Power of Dialogue

Dialogue extends beyond mere verbal communication; it’s a profound act of connection. At the core of genuine dialogue lies the “I-Thou” relationship. Could this be what we commonly understand as empathy? While the concept of empathy itself invites debate, for this discussion, I’ll draw from Schmid (2001).

In “Comprehension: The Art of Not Knowing,” Schmid explores Buber’s philosophy through a psychotherapeutic lens, offering a perspective relevant to this analysis (though I have reservations about certain aspects, which we’ll address later). Schmid argues that empathy is an inherent quality that transcends identification or interpretation. It’s the willingness to be moved by another while remaining authentic in their presence.

In true empathic connection, whether through spoken words or nonverbal cues, we prioritize the other person’s needs above our own. We shed the urge to analyze their identity or assert our own. There’s no fixed objective – just the process of authentic presence, extending an invitation for the other to do the same. This is where dialogue finds its transpersonal potential.

(This is a revised version.)

Read also: Empathy and Buber’s I-thou

References

Buber, M. (1936). Ich und Du. Berlin: Schocken. 

Buber, M. (1970). I and Thou (Kindle ed.). (W. Kaufman, Trans.) Charles Scribner’s Sons.

Gadamer, H. G. (1975/1960). Truth and method . (G. Barden, & J. Cumming, Trans.) NY: Seabury. 

Schmid, P. F. (2001). Comprehension: the art of not-knowing. Dialogical and ethical perspectives on empathy as dialogue in personal and person-centred relationships. Empathy, 53-71.

Staemmler, F.-M. (2009). The willingness to be uncertain: Preliminary thoughts about intepretation and understanding in Gestalt Therapy. In L. J. Hycner (Ed.),Relational approaches in Gestalt Therapy (pp. 65-110). NY: Gestalt Press.

Healing through dialogue is an eminently hermeneutical phenome­non indeed

“Healing through dialogue is an eminently hermeneutical phenome­non indeed.”

Gadamer, quoted in Staemmler (2009, p. 65). 

The psychotherapeutic alliance is a dialogue which is action. Through this dialogue, understanding takes place. This understanding comes about through a hermeneutic pro­cess. This process requires the authentic inclusion of the self of the therapist. 

Staemmler goes on to emphasize that in the process of understanding, one needs to be asked to ask authentic questions, bearing in mind the tendency for therapist (per­haps to hide his/her own shame) of not being authentically available to the client by asking pseudo-questions, which includes pre-prepared list of questions or repetitive questions like “how do you feel?” without actual curiosity. Pseudo-questions also in­clude questions that predestine their answers. Authentic questioning requires the bring­ing into the open what is unexpected, with the knowledge that the client has the answer. This means that the therapist needs to be open to listening, and living with the uncer­tainty of the answer that he/she is given. This requires that the therapist relinquishes any control over the client’s answers and meaning-making, and this includes predicting what the client’s answer should be before even asking the question. 

This relinquishing of control in dialogue leads us away from Buber’s “I-it” and towards the “I-Thou” way of relating. Incidentally, this forms the “symmetrical” aspect of the psychotherapeutic alliance as discussed earlier described by Altemeyer, and con­nected to Clarkson’s the person-to-person relationship (point 4) and the transpersonal relationship (point 5). 

Another way of understanding the “I-It” form of understanding is “to claim to understanding the other better than she or he understands herself or himself”. Looking closely this can also be seen as an abuse of professional power “disguised as benevo­lence” (ibid. p. 91-92). The consequence to such behavior to the profession is the dis­trust caused by fear of the client from being misinterpreted and misjudged. 

That which happens in an authentic I-thou dialogue is a mutual exchange. This happens in the “between”. Gadamer, in agreement with Buber: “The dialogue has trans­forming power. When a dialogue succeeds, something remains for us and in us, which has changed us” (ibid. p. 93). “Dialogue that succeeds”, is no ordinary dialogue, but that which is inclusive of the self and the other. Converse to the ‘I-It’ way of relating, it exists, as Carl Roger’s is noted to have explained, “without any techniques, means, aims or intentions” (Schmid, 2001). This kind of dialogue is what Buber terms the ‘I-Thou’. This is the dialogue with transforming power. 

This is the transformative contact which many schools in psychotherapy strive to establish in the therapeutic hour. I use the word ‘strive’ to give meaning to the elusive nature of such a healing contact, and the powerful benefits in the event when such con­tact happens.

What’s behind the transforming power of dialogue ?

References

Buber, M. (1936). Ich und Du. Berlin: Schocken. 

Buber, M. (1970). I and Thou (Kindle ed.). (W. Kaufman, Trans.) Charles Scribner’s Sons.

Gadamer, H. G. (1975/1960). Truth and method . (G. Barden, & J. Cumming, Trans.) NY: Seabury. 

Schmid, P. F. (2001). Comprehension: the art of not-knowing. Dialogical and ethical perspectives on empathy as dialogue in personal and person-centred relationships. Empathy, 53-71.

Staemmler, F.-M. (2009). The willingness to be uncertain: Preliminary thoughts about intepretation and understanding in Gestalt Therapy. In L. J. Hycner (Ed.), Relational approaches in Gestalt Therapy (pp. 65-110). NY: Gestalt Press.

Unconscious feelings and countertransference within the Therapeutic Alliance 

To illustrate how a therapist’s emotions towards client, though brought to awareness and allowed to be revealed, can also be mistaken for authentic reaction to the client’s process, a mentor of mine, in a private lecture on experiences of unconscious effects on a therapist in therapy sessions, narrated a rather simple story he entitled, Chanel No. 5: the client, a middle-aged woman had come to therapy to work on very traumatic and emotionally tragic experiences in her life. The therapist found himself deeply moved by her experiences, and would find himself in tears each time she entered his practice. He questioned his emotionality towards the client only weeks later because he, like many would have, assumed that he was naturally moved by the client’s plight. He subsequent­ly noticed the client’s perfume as she entered the office and asked her what she was wearing. ”Chanel No. 5”, she replied, which was the same perfume his beloved mother had worn for most part of her life. 

In the story, the client instilled emotions in the therapist in which the therapist was unaware of. This gets interpreted somewhat inaccurately at first until the therapist was able to come to a self-awareness. This kind of experience faced by therapists is termed by Freud in a 7 June 1909 letter to Carl Jung, as countertransference, to which Freud explains, “(s)uch experiences, though painful, are necessary and hard to avoid. (…) (W)e need to dominate ‘countertransference’, which is after all a permanent prob­lem for us; they teach us to displace our own affects to best advantage. They are a ‘blessing in disguise’” (Freud, 1909). The unconscious nature of countertransference makes it difficult for the analyst to differentiate between the analyst’s own unresolved difficulties and emotional reactions and impressions that come to the the therapist’s consciousness that are activated by the projective identification of the client. 

While unlike Freud and Klein who considered strong countertransference feelings to have negative affect on analysis and something analysts should work on by gaining more insight into themselves instead, many analysts like Bion have found usefulness in the phenomena. Therapists of the intersubjective and relational schools share counter­transference that they have (and are aware of) as a means to bring authentic contact to the alliance. 

Awareness of therapist’s countertransference is supportive to the therapeutic process 

Countertransference, with awareness, supports rather than interferes with the therapist’s work. Freud’s mention of the need to “dominate” countertransference, can be taken as a call to be aware of dealing with the emotions within the alliance rather than rejecting them and becoming emotionally detached. Heinmann (1950, p. 81) considers this use of countertransference as “one of the most important tools for his/her work. The analyst’s counter-transference is an instrument of research into the patient’s unconscious” as a means of bringing to consciousness of the client what he/she does (consciously or un­consciously) to “get under the analyst’s skin”. How can the awareness of countertrans­ference experienced by the therapist be an advantage to the therapeutic alliance?

“(T)he analysis of the transference, i.e., that part of it which deals with the breaking down of the resistances, constitutes the most im­portant piece of analytic work.”

Wilhelm Reich, 1945/1984, p. 5

The answer is explained by Racker (1953) who acknowledged that the therapist may react emotionally to a patient’s enactments or behavior or personality, but he/she is not prevented from “identifying him/(her)self intellectually with his/(her) defense mecha­nisms and object images”. When the therapist is aware of his/her own emotional reac­tion, this countertransference is actually instrumental into “bringing to his notice a psy­chological fact about the patient” for the feelings helps the therapist to detect the pres­ence of the client’s psychological games. Even though the countertransference feelings are neurotic, the therapist who is aware of this is able to react with understanding. For this understanding to be possible, Racker adds, the therapist has to first analyze and overcome his/her own situation and be able to identify him/herself with the patient’s ego. Within the therapeutic alliance and hour, the patient reenacts and recreates situa­tions that are recurrent in his/her daily situations. These undisclosed and undetected activities, is an unconscious means of avoiding the therapeutic process, and thus “prompted by a desire to retain a defensive organization and probably to recruit the ana­lyst into its personnel” (Britton, 2003, p. 77). In order for the impasse to be broken and the “enactments” to discontinue and therapeutic work can progress, Britton suggests that “until the enactment is recognized and described, the belief system that lies behind it cannot be disclosed, but, at the same time, until the patient’s beliefs that drive it are disclosed the enactment will continue” (Mawson, 2011, p. 4-15). 

Transference and countertransference is a phenomenon in the therapeutic alli­ance, Racker’s comment— quoted also in Britton (2003, p. 55)— highlights the attitude towards acceptance of this human condition and working with it’s existence in psycho­therapeutic relationship: “The neurotic (obsessive) ideal of objectivity leads to repres­sion and blocking of subjectivity and so to the myth of the … ‘analyst without anxiety or anger’ The other neurotic extreme is that of drowning in countertransference. True objectivity is based upon a form of internal division that enables the analyst to make himself (his own countertransference and subjectivity) the object of his continuous ob­servation and analysis” (Racker H. , 1968, p. 132). Objectivity, in many respects, is the priced commodity in psychotherapy. If the therapist is caught up in countertransference and is unaware of the fact, his/her endeavors to work with the clients in an objective manner would be unproductive. 

Objectivity as a concept itself needs some careful consideration. For this we can turn to Maturana & Varela (1980): “(O)bjective knowledge seems possible and through objective knowledge the universe appears systematic and predictable”. Objective knowledge, according to the authors, seems possible. It is prized for the very fact that it gives the impression of predictability. When things are systematic and predictable, we feel safe. The authors go on to explain: “Yet knowledge as an experience is something personal and private that cannot be transferred.” The explanation for this is that objec­tive knowledge must be created by the listener. The listener understands and the objec-tive knowledge appears to be transferred (p. 5). The therapist therefore needs to be aware of this phenomenon: that the information being shared between him/herself and the client is experienced and mentally processed by both parties. The reality is, howev­er, that the assumption that common understanding is achieved is only apparent. 

The benefit of keeping this in mind to the therapist is that he/she will be constant­ly on guard and self reflective of his role as observer. The therapist as an observer is part of the system (in this case the client) in which he/she is observing. Since he/she communicates with the client and the client communicates back, and the client is also the observer in return. “Anything said is said by an observer” (p. 8). The observer can­not but interact with the system; the observer is also observed. 

The observer, if self-reflective, is also able to observe him/herself. So in the ther­apeutic setting, the therapist has the work of observing two individuals: the client and himself. What is achieved is a hermeneutic and cyclical process of understanding. This is discussed later in the paper. Maturana & Varela explains this as such: “If an organism can generate a communicative description and then interact with its own state of activity that represents this description, generating another such description that orients towards this representation…, the process can in principle be carried on in a potentially infinite recursive manner” (p. 29). 

This back-forth movement of allowing experiences (via emotions) to occur and then stepping away from the self in acknowledgment and understanding of what has arisen. This acknowledgment of “what-is” happening at the moment describes what Gestalt therapy literature describes as the paradoxical theory of change (Beisser, 1970), whereby healing change happens not by forcefully eliciting change itself (in this case, by repression or ignorance), but by understanding and acknowledging what is happen­ing to the self at the moment. Through assimilation of the situation, in the case of a countertransference effect encountered by the therapist, the therapist is able to under­stand what is going on in him/her. The clarity of this self awareness and acceptance empowers the therapist to overcome and make informed choices. Self-awareness has much to do with being in contact with the self, existentially, in the here-and-now. This is a phenomenological attitude in observing what-is in the present in contact with the client, while being conscious of one’s own biases. 

With the awareness of the self as observer, there will also be an awareness that the other person is different; the other person actually processes his/her own objective knowledge. We will be able to appreciate that there is room for questioning and discuss­ing the ‘facts’ and ‘truisms’, and to investigate the differences between the self and the other. Resnick (2016) tells us that it is the differences between two individuals that ini­tiate the contact. Without awareness and acceptance of these differences—as often hap­pens when people operate in confluent relationships— there is no sense of the other person for who he/she is. Confluent relationships result in the feeling of loneliness in the presence of others, because there is a push for consensus and the authentic presence of persons are thereby not felt. In therapy, this kind of relationship happens when client tries to please therapist and therapist tries to help client. Both try to find compliancy without first looking at the differences. The result is often an alliance without real con­tact.

References

Beisser, A. (1970). The paradoxical theory of change. In Gestalt therapy now (pp. 77-80). https://static1.squarespace.com/static/572d003b40261d2ef97e5b0b/t/59d64989bce1767a9d98ebbb/1507215754788/G+Paradoxical+Theory+of+Change.pdf

Britton, R. (2003). Sex, death, and the superego: Experiences in psychoanalysis. Karnac Books.

Freud, S. (1909). Letter to Jung. The Freud-Jung Letters. Princeton University Press.

Heimann, P. (1950). On counter-transference. The International Journal of Psychoanalysis.

Maturana, H. R., & Varela, F. J. (1980). Autopoiesis and cognition: The realization of the living. London, England: D. Reidel Publishing.

Mawson, C. (2011). Introduction: Bion today—Thinking in the field. In Bion Today.

Racker, H. (1968). Transference and Countertransference . London: Karnac.

Reich, W. (1945/1984). Character Analysis (3rd ed.). (M. H. Raphael, Ed., & V. R. Carfagno, Trans.) NY: Farrar, Straus and Girouy.

Resnick, R. (2016). New Contemporary Gestalt Therapy Demonstration Films. Vimeo.