Gestalt Theory: 5 Phases of Therapeutic Change

This five phases of change is also termed as five levels of neurosis. Whatever the terminology, it describes a process by which a client goes through when lasting and cathartic change happens.

There are several terminologies for these phases, however for this article we shall use the terms:  Fixation, Differentiation, Diffusion, Vacuum (impasse) and Integration.

Phase 1: Fixation (Cliche Role-playing)

At this level what is noticed in the client is a stiffness, being stuck in ideas / conclusions / habits / patterns, feeling trapped, in other words desperation.  The reason for therapy usually describes this condition. The client is stuck in roles, routines that do not serve him. It causes stress and conflicts in his daily life. The client is often also not aware of this point of what he really needs, because these needs are forgotten or relegated to the unconscious. This feeling of “stuckness” in repeating patterns has become part of his way of life and he cannot imagine things being different. He is however affected negatively by it at the present time.

An example :

Mr D addresses his problem of having long term relationships with women. He says that after a while he gets bored with them and wants to move on. He feels empty and lonely, and expresses this to his therapist.

During therapy a picture of the stagnation in the client’s life is formed. There is now awareness about this. The client can decide if and how he would like to proceed.

Phase 2: Differentiation

With the experiencing of the needs (as in the above case), or the feelings of anxiety, avoidance impulses. The client’s attention to the present moment is distracted by memories of the past or hopes for the future. He escapes into chains of thought, ideas and gets into debates and intellectualization.

This roundabout thoughts and decision making is a sign of unfinished business, which the client cannot complete and there is too much anxiety / anxiety of pain involved for the client to face up to the unfinished situation.

At this point, the therapist’s work is to support the client to stay in the moment. Providing a secure environment to face the anxiety — to relive conflicts, the tension between what he/she needs, emotions, impulses to move forward and its resistance, the blockages to act.

When the client is able to see his polarities, he can come to terms with taking responsibility for which direction he decides to move towards.

Mr D’s talk with his therapist has led Mr D to the knowledge of himself– that he is able to share only superficial parts of himself to the other person. In turn, he gets to know only superficial parts of the other. This superficiality is colorless and gets boring very quickly. When this happens, his impulse is to leave the present relationship for another. 

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Phase 3: Diffusion

This is a phase of acceptance. Acceptance of the Situation without avoidance of the issues. The existing situation is no longer working for the client, but alternatives are elusive to him/her. Usually when clients decide to have therapy, they are open to this phase. It is the phase of acceptance. The client accepts his/her responsibility for his/her situation, and realizes that he/she has the resource to work through the situation. This usually happens after an alliance with therapist is grounded.

Mr. D realizes that it is not that the girl(s) are boring, or that he is more interesting. He takes the viewpoint that since this is his experience with every relationship he faces (even non-romantic relationships), something in his way of connecting with others, has something to do with his own psychic defenses. 

Phase 4: Vacuum

At this stage, the client experiences confusion (not knowing how to react). It would be counter-productive at this phase for the therapist to step in and provide analysis of the situation– even if the answers are glaringly clear. The therapist is advised to wait, and allow the client to assimilate this rather uncomfortable phase. Any solutions-orientated premature direction provided by the therapist would compromise the clients’ healing process. Such intervention by the therapist could lead the client to be fixated on the opposite pole of the problem.

For example, the same client Mr D talks to the therapist who realizes that in their own relationship in the here-and-now, the client avoids deeper communication by answering with the words “”I don’t know” or “I feel bored”. The therapist may have the need to either ignore the “I don’t know” and thereby moving away from the stalemate, or the therapist may “unbore” the session by doing /saying something to fix the situation. This is an example of rescuing the client from the vacuum. 

The client will benefit more if he/she is allowed to endure this momentarily discomfort. Being in a vacuum does not last more than a couple of seconds. The client can be trusted to creatively adjust to the situation and find his/her own solutions. All he/she needs is support to stay in the vacuum long enough for movement to take place.

In this vacuum stage, the client experiences the push and pull of both poles of the problem. He/she feels “stuck in the middle”. The polarities surface from the background of his/her awareness and become clear to him/her.  Through this clarity, the client can make decisions to swing between the poles and not get unconsciously stuck at any extreme. There is freedom of choice.

Phase 5: Integration

A person who is able to stay in the momentary state of emptiness in a vacuum, in confusion, in not knowing which way to turn, eventually reaches an “ah-ha” moment. Fritz Perls (1976) mentions this in his writings often. The problem with us most of the time is that we are afraid of this vacuum. Almost always we bail out by finding solutions, distracting ourselves from the situation, forgetting, being clueless, or deadening our experiences.

In the therapy session, a safe environment is provided for the client to sit into the emptiness long enough to gain valuable “ah-ha” insight / understanding and experiences. The greatest difficulty is abstaining from intellectualizing, and making meaning of what’s going on while in this state of “stuckness”.  This requires the trust of client.

What usually happens is when the client is held by the therapist to stay in position of emptiness, the client does not use his/her old patterns of escaping the problems.  This is an opportunity for the client to reach into past unfinished experiences and experience the needs and feelings involved in these experiences. Here is where enlightenment is achieved.

Mr. D, in sitting with the therapist, and feeling bored, and needing to “flee” the encounter, realizes his anxiety of being seen. He recounts how as a child he was always doted upon by adults, and part of this attention brought also criticism of his emotions, usually negative emotions. He felt lots of expectations on him to be the happy child. 

This is a simple example of how integration of the past experiences to the present takes place. The client sees how his unease with connecting with another person is linked to how he lived as a child.

For the rest of the therapy sessions, Mr. D experiments with being authentic in the presence of the therapist. He is also encouraged to attend group therapy and work through interaction with a group.

Bibliography

Perls, F. S., & Andreas, S. (1969). Gestalt therapy verbatim.

Voitsmeier-Röhr, A., Wulf, R. (2017). GestalttherapieErnst Reinhart Verlag: Munich. p. 143-148.

Gestalt Therapy: Paradoxical Theory of Change

We go through life adjusting to situations that we encounter. In some situations we end up using repeating patterns of behaviors and thought processes, which may or may not suit the situation at hand. When our reactions to situations are incongruent to the situations, it is dysfunctional. Dysfunctional reaction leads to problems in relations, stress and different crises.

 

Oftentimes when we are aware of our patterns and try to make changes in our attitudes or behavior — i.e. we go for behavioral therapy, coaching, read self-help books or listen to friends’ or families’ advice — the effort get thwarted. This is because for every action comes an opposing reaction.

Take for example trying to be nice to a neighbor who is irritating to you. You try not to lash out at him/her for weeks until… snap.

Short Case study:

Tackling symptoms alone, without investigating the root causes of the symptoms sometimes makes the life for the individual worse. A client I knew, who was overworking to point of sleeplessness, decided to stop work for a while and went for a meditation workshop. At the workshop he suffered anxiety attacks and needed to leave the workshop. He was later (more) successfully treated after he discovered his motivation for excessive work– to escape his abusive father. This was only possible because the therapist allowed this patient to delve into his need for work, and sat with him through his re-experiencing of being a child of a bullying father figure.

The paradoxical theory of change is thus explained like this: “don’t just do something, sit there.” As gestalt therapists we are trained to be containers of the client’s unpleasant emotions, helping the clients by being with them long enough in these often painful moments, so that they may gain insight, wisdom and resources to find their solutions.

Bibliography

Beisser, A. (1970). The paradoxical theory of change. Gestalt therapy now, 77-80.

Fritz Perls: Working with Dreams in Gestalt Therapy

Dreams. What are they? For those of us who know already, dreams are the windows to our unconscious. To fall asleep and dream is to let go of our outer world. In doing so, the life of our inner world takes shape. Since our innermost consciousness is in sleep separate from our senses that communicate with the outside world, the life of dreams seem to us mysterious: on the one hand there seem to have meaning in the dreams, and on the other hand the context is an amalgamation of experiences and emotions mixed together, and makes little sense. Most of our dreams are forgotten, and if we try to remember them, we cannot be sure if the memory of the dream is even accurate.

From the 9th Century didactic poem of Titus Lucretius Carus, De Rerum Natura (IV, v. 959),

The unconscious material in dreams are useful and important for psychotherapeutic work. This is especially so when the dream is a recurring one. According to Fritz Perls (1969):

“(T)he most important dreams– the recurrent dreams. (…) If something comes up again and again, it means that a gestalt is not closed. There is a problem which has not been completed and finished and therefore can’t recede into the background.”

Another proof that dreams are the stuff of the unconscious, is the proof that in people who suffer sleep disorders, the problem are the result of the mind not being able to let go of the external world. This is a world of the senses, and of spiraling thoughts.

Dream work in Gestalt Therapy

Sigmund Freud has, in one of his most-read book, The Interpretation of Dreams, gives us an idea of how dreams are interpreted in psychoanalysis (Freud & Strachey, 1964) .

In this article, I focus on the dream work in Gestalt therapy. Gestalt therapy has a tradition of non-interpretation on the part of the therapist. So how does one work with dreams without interpretation? Much of the recorded dream work of Fritz Perls is found in this book, Gestalt Therapy Verbatim. Here are case studies of work conducted by Perls in front of a group. On reading this book alone, some colleagues of mine find Perls’ style brash and some even find it bullying. Before we judge, it is important to ask ourselves if the work that Perls demonstrated served the volunteer. Mostly it has. The members found greater self awareness, and many have experienced a closed gestalt, or an integration of their split parts. Also it is useful to note that Perls’ clients are actually mostly students of therapy themselves, and not “patients” in the true sense of the word.

Below is a video of Perls’ dream work. There is a lot of emotionality that arises from the client herself. Perls as a therapist merely supported her. He does not interpret (or at least that is the intention). What the meaning of the dream really was about is actually not verbalized. The patient derived her own sense of what it meant. She has also experienced the meaning and not only thought about it intellectually.

This non-interpretation is a different attitude from psychoanalysis.  In Gestalt Therapy, the client is asked to play component parts of the dream. They may even play the dream itself. For example, the client says “I am my dream, and I am vague, and I am not there for you to remember me…” or “I am my dream, but I am incomplete.”

In the example below, the lady plays the water, “I am the water…”

This is called projection. It helps the client to feel the part of him/herself that he/she has disowned and has projected onto objects of the dream. Disowned parts of the self are in the unconscious, and integration is the work of therapy.

“Every dream or every story contains all the material we need. The difficulty is to understand the idea of fragmentation. All the different parts are distributed all over the place. A person, for instance who has lost his eyes — who has a hole instead of exes will always find the exes in the environment. He will always feel the world is looking at him.”

Read also: Dreams and Dream Work in Psychotherapy 

References

Freud, S., & Strachey, J. E. (1964). The standard edition of the complete psychological works of Sigmund Freud.

Perls, F. S. (1969). Gestalt therapy verbatim.

How Bobby Mcferrin explains Gestalt Theory with this Act

Bobby McFerrin  is famous for his hit song, “Don’t Worry Be Happy”. In this video, he demonstrates how the crowd intuitively synchronizes to the pentatonic scale. Ferrin says, “What’s interesting to me about that, is, regardless of where I am, anywhere, every audience gets that.”

How can we use this act to explain the Gestalt therapy theory?

    • Closing the Gestalt. The brain of most humans find completion in the pentatonic scale. This is a pattern of notes one would hear when one plays only the black keys on the piano. To the human brain, this note-pattern closes itself in a harmonious way (i.e. it just sound right).  This is how McFerrin is able to rely on the crowd’s intuition to “play” the music.

  • Field Theory. The crowd, the men on stage and the atmosphere make up the field. McFerrin harnesses and motivates to make a unified sound. If, for example, something in the middle of the performance distracts the crowd (for example, an explosion, or if the electricity breaks down) the focus of the crowd would be dissipated, and there would be, instead of a unified presence, chaos.
  • Phenomenology. McFerrin does not push the crowd to play the music like he would push piano keys. This would not be possible. In order to get so many people to sing in the same tune, he has to judge when the right moment is to act (to jump, or to say something or to make a mimic). This sensing of the crowd is the sensing of the phenomenology of the field.
  • Contact. When we can “tune in” to the other, we make contact. Each member in the crowd sings with his own voice and tone. Each is different, but together they are in contact.

McFerrin says, it works all the time. Yes. The theory of Gestalt Therapy is more than humanistic. It is a theory of phenomenon and contact. The other men on stage says that there is some neuro-biology involved. Yes. There is. This is how the theory of Gestalt therapy functions, through contact leading to physiological change.

On Gestalt Therapy

Gestalt therapy is a modality of psychotherapy which is founded on philosophical principles to guide the practicing therapist towards meeting and supporting the client authentically for who he/she is.  The pillars of Gestalt therapy theory include: the field theory, contact process, phenomenology, and the closing of the gestalt.

The therapeutic aspect of Gestalt therapy happens when the client is able to come into contact with his/her disowned aspects of his/her personality (“the dark side”, some would say). Often these are realities that are too painful or shameful to acknowledge, but are at the same time ever-present in the the life of the person. The effort (usually unconscious) of putting away these disowned parts of the self, utilizes a lot of energy, and is the source of inner conflicts, stress, depression and in severe cases, psychosis.

The Gestalt therapy work is to provide the patient a safe environment to play out, and experience these disowned parts of the self. In the process, the patient learns about these parts, and is given the ability to integrate these parts in their present lives. The net result is a better, less stressful quality of life and also better relationship with others.