Gestalt Therapy Verbatim (Perls, 1969): Book Review

A thousand plastic flowers 
Don’t make a desert bloom 
A thousand empty faces 
Don’t fill an empty room.

Fritz Perls

I enjoy reading this book, which is written “ad verbatim”, as the title describes. The presentation style gives us an implicit sense of who Perls is, and his first-person perspectives as a therapist.

“Gestalt therapy verbatim” is a unique book that gives readers a firsthand look at the ideas and techniques of Gestalt therapy through the words of its founder, Fritz Perls. The verbatim format, in which Perls’ words are recorded exactly as he spoke them during therapy sessions, lectures, and workshops, provides an authentic and engaging look at the development and practice of Gestalt therapy. It can be a valuable resource for those interested in learning about Gestalt therapy or for those who are already familiar with the approach and want to gain a deeper understanding of Perls’ thought and practice.

The book is segmented into two parts – first, an introductory section that describes Gestalt therapy and provides brief background information about its origins and development; and second, three case histories that show how Perls applied his approach during his encounter with the clients named in the case studies.

This is an aged enjoyable book. I have assembled some excerpts here.

Perls on “techniques”

One of the objections I have against anyone calling himself a Gestalt therapist is that he uses technique. A technique is a gimmick. […] We’ve got enough people running around collecting gimmicks, more gimmicks, and abusing them.

Perls adds that Gestalt therapy is not about providing instant cure, instant joy, instant gratification. That works in psychiatry, in addictions, and in today’s world, through the likes of pop-cultured therapy. Gestalt therapy offers all the opportunity for growth, and growth is an organic process. The client has to invest in themselves and grow.

Perls on Anxiety

Anxiety is the gap between the now and the then. If you are in the now, you can’t be anxious, because the excitement flows immediately into ongoing spontaneous activity. If you are in the now, you are creative, you are inventive. If you have your senses ready, if you have your eyes and ears open, like every small child, you find a solution. (p. 23).

He differentiates this from hedonism, where one seek pseudo sensory stimulation. Let us perhaps reflect on how we can relate this concept with the problem of compulsive disorders like sex addiction.

Perls on what happens in the splitting of the self and pathology

You are already coming to the point where you begin to understand what happens in pathology. If some of our thoughts, feelings, are unacceptable to us, we want to disown them. “Me, wanting to kill you?” So we disown the killing thought and say, “That’s not me — that’s a compulsion.” Or we remove the killing, or we repress and become blind to that. There are many of these kinds of ways to remain intact, but always only at the cost of disowning many, many valuable parts of ourselves. The fact that we live only on such a small percentage of our potential is due to the fact that we’re not willing — or society or whatever you want to call it is not willing — to accept myself, yourself, as the organism which you are by birth, constitution, and so on. You do not allow yourself — or you are not allowed to be totally yourself. So your ego boundary shrinks more and more. Your power, your energy, becomes smaller and smaller. Your ability to cope with the world becomes less and less — and more and more rigid, more and more allowed only to cope as your character, as your preconceived pattern, prescribes it. (p.31)

Noteworthy is that this book was written in the 1960s, when the polyvagal theroey concept of introception was not yet discovered. In my practice I do guide the client to separate their ruminating thoughts (that is a bottom-up introception) from conscious thoughts.

Perls’ thoughts on trying to change oneself and others

[W]e realize that we cannot deliberately bring about changes in ourselves or in others. This is a very decisive point: Many people dedicate their lives to actualize a concept of what they should be like, rather than to actualize themselves. This difference between self-actualizing and self-image actualizing is very important. Most people only live for their image. Where some people have a self, most people have a void, because they are so busy projecting themselves as this or that. This is again the curse of the ideal. The curse that you should not be what you are. (p.39)

When we reflect on attitudes on mental health today, which modality is most sought after? The modalities that promote self-image actualization, where there is a delusion that we can change ourselves, our thoughts and our relationships, or the ones that are based on the theory of authentic and organic self actualization?

Perls on Growth, the Impasse, and the aim of therapy

[H]ow do we prevent ourselves from maturing? What prevents us from ripening? […] We ask the question, what prevents — or how do you prevent yourself from growing — from going further ahead? […]

My formulation is that maturing is the transcendence from environmental support to self-support. Look upon the unborn baby. It gets all its support from the mother — oxygen, food, warmth, everything. As soon as the baby is born, it has already to do its own breathing. And then we find often the first symptom of what plays a very decisive part in Gestalt therapy. We find the impasse. Please note the word. The impasse is the crucial point in therapy — the crucial point in growth.

The impasse is called by the Russians “the sick point,” a point which the Russians never managed to lick and which other types of psychotherapy so far have not succeeded in licking. The impasse is the position where environmental support or obsolete inner support is not forthcoming and authentic self-support has not yet been achieved. The baby cannot breathe by itself. It doesn’t get the oxygen supply through the placenta anymore. We can’t say that the baby has a choice, because there is no deliberate attempt of thinking out what to do, but the baby either has to die or learn to breathe. There might be some environmental support forthcoming — being slapped, or oxygen might be supplied.The “blue baby” is the prototype of the impasse which we find in every neurosis. (P. 48)

The process of maturation is the transformation from environmental support to self-support, and the aim of therapy is to make the patient not depend upon others, but to make the patient discover from the very first moment that he can do many things, much more than he thinks he can do.

Perls on Character

The more character a person has, the less potential he has. That sounds paradoxical, but a character is a person that is predictable, that has only a number of fixed responses, or as T. S. Eliot said in The Cocktail Party, “You are nothing but a set of obsolete responses.” (P. 53)

Character is a fixed response that we develop in childhood to manipulate the environment, to get our needs met. The basic need is love from the child’s caregivers, and manipulation comes in the form of playing roles that keep the individual immature.

On changing every question to a statement

“One fool can ask more questions than a thousand wise men can answer.” All the answers are given. Most questions are simply inventions to torture ourselves and other people. The way to develop our own intelligence is by changing every question into a statement. If you change your question into a statement, the background out of which the question arose opens up, and the possibilities are found by the questioner himself.

[…]Every time you refuse to answer a question, you help the other person to develop his own resources. Learning is nothing but discovery that something is possible. To teach means to show a person that something is possible.

Why and because are dirty words in Gestalt therapy.” (p. 64)

when we ask why we get an explanation and we will fail to get an understanding.

Perls on Resentment

We see guilt as projected resentment. Whenever you feel guilty, find out what you resent, and the guilt will vanish and you will try to make the other person feel guilty. […]

If you have any difficulties in communication with somebody, look for your resentments. Resentments are among the worst possible unfinished situations — unfinished gestalts. If you resent, you can neither let go nor have it out. Resentment is an emotion of central importance. The resentment is the most important expression of an impasse — of being stuck. If you feel resentment, be able to express your resentment. A resentment unexpressed often is experienced as, or changes into, feelings of guilt. Whenever you feel guilty, find out what you are resenting and express it and make your demands explicit. This alone will help a lot. (p. 68)

Perls goes on to explain how resentment that is articulated, then switched to appreciation is healing.

Perls on Nothingness and the Fertile Void

The whole philosophy of nothingness is very fascinating. In our culture “nothingness” has a different meaning than it has in the Eastern religions. When we say “nothingness,” there is a void, an emptiness, something deathlike. When the Eastern person says “nothingness,” he calls it “no-thingness” — there are no things there. There is only process, happening. Nothingness doesn’t exist for us, in the strictest sense, because nothingness is based on awareness of nothingness, so there is the awareness of nothingness, so there is something there. And we find when we accept and enter this nothingness, the void, then the desert starts to bloom. The empty void becomes alive, is being filled. The sterile void becomes the fertile void. I am getting more and more right on the point of writing quite a bit about the philosophy of nothing. I feel this way, as if I am nothing, just function. “I’ve got plenty of nothing.” Nothing equals real. (pp. 77-78)

The concept of the Fertile Void is critical to the understanding of Gestalt therapy, a topic which is discussed in these pages:

Perls on taking responsibility and blaming

All the so-called traumata which are supposed to be the root of the neurosis are an invention of the patient to save his self-esteem. None of these traumata has ever been proved to exist. I haven’t seen a single case of infantile trauma that wasn’t a falsification. They are all lies to be hung onto in order to justify one’s unwillingness to grow. To be mature means to take responsibility for your life, to be on your own. Psychoanalysis fosters the infantile state by considering that the past is responsible for the illness. The patient isn’t responsible — no, the trauma is responsible, or the Oedipus complex is responsible, and so on. I suggest that you read a beautiful little pocketbook called I Never Promised You a Rose Garden, by Hannah Green. There you see a typical example, how that girl invented this childhood trauma, to have her raison d’etre, her basis to fight the world, her justification for her craziness, her illness. We have got such an idea about the importance of this invented memory, where the whole illness is supposed to be based on this memory. No wonder that all the wild goose chases of the psychoanalyst to find out why I am now like this can never come to an end, can never prove a real opening up of the person himself. (P. 62)

Considering that trauma work is a critical part of therapy, could Perls’ words in the above passage put into question his credibility on the subject of trauma? Well, before the “Harry & Meghan” saga at the turn of this year, 2023, and before “woke-ism” lost its meaning, which is compassion, I might have considered Perls’ opinion here archaic. However, now I understand what he’s saying. Perls warns us in 1969 that we will want to redeem ourselves from our low self-esteem, and the easy way out of true healing from this shame is to lay blame or make excuses for ourselves. Laying blame is relinquishing responsibility, not what trauma work or psychotherapy is about.

The work with trauma, revealing and processing traumatic events in psychotherapy functions to bring to light childhood pain that the client was not previously able to access. In childhood, the individual adapts to suffering out of context. Adaption to suffering ultimately becomes a fixed pattern of being in the world. This pattern is the personality. When the pain of the past is revealed, it can be felt, sensed and shared. In therapy, the therapist witnesses the suffering that is shared. When this happens, there is enlightenment. The client can then fully grasp feelings they have dissociated from in childhood and infancy. Only then can these feelings be relegated to the past. Feelings relegated to the past will less likely interfere with the present and future without awareness.

The “woke” movement of popular culture today has used the psychotherapeutic process as a Trojan horse for its agenda. Instead of realising suffering and being compassionate to their child-self, the woke seek to redeem themselves of the shame (‘low self-esteem’) from having to suffer childhood helplessness by taking revenge. Revenge is a need for release, to lash out, to whine at the world, to complain and criticise, and it is cathartic. The act of revenge is infantile. The woke person plays the role of victim and perpetrator. In so doing, they fail to mature. They become toddlers in grow-up bodies that can cause destructive revenge. Revenge is violent, and the acts do not heal anyone. Revenge is the transfer of pain from the sufferer to their victims through violence. Violence is the transference of pain that is absent in the perpetrator to the victim. Pain is transferred until it is transformed (Weil, 1952, in this article).

Perls on Group therapy

Basically I am doing a kind of individual therapy in a group setting, but it’s not limited to this; very often a group happening happens to happen. Usually I only interfere if the group happening comes merely to mind-fucking. Most group therapy is nothing but mind-fucking. Ping-pong games, “who’s right?,” opinion exchanges, interpretations, all that crap. If people do this, I interfere. If they are giving their experience, if they are honest in their expression — wonderful. Often the group is very supportive, but if they are merely “helpful,” I cut them out. Helpers are con men, interfering. People have to grow by frustration — by skillful frustration. Otherwise, they have no incentive to develop their own means and ways of coping with the world. But sometimes very beautiful things do happen, and basically there are not too many conflicts, everybody who is in the group participates. Sometimes I have people who don’t say a single word through the whole five-week workshop and they go away and say that they have changed tremendously, that they did their own private therapy work or whatever you want to call it. So anything can happen. As long as you don’t structure it, as long as you work with your intuition, your eyes and ears, then something is bound to happen. (p. 93)

Reference

Perls, Frederick (Fritz). (1969/1992) Gestalt Therapy Verbatim (p. 93). The Gestalt Journal Press. Kindle Edition.

Fritz Perls: What is Gestalt? 1970 Video

The founder of Gestalt therapy, Fritz Perls tells us in his own voice in this gem of a video. What gestalt therapy is. Listen to this, and we can make up our minds as to how relevant this modality of psychotherapy Gestalt therapy is, and has developed till today.

This is what Fritz tells us…

The idea of Gestalt therapy is to change paper people to real people. To make the hollow men of our time come to life and teach him to use his inborn potential. To be a leader without rebelliousness. Having a center without being lopsided.

The social milieu in which we find ourselves, regulated by “should-isms”, by Puritanism where you do your thing whether you like it or not; or by the other extreme, hedonism, “where we live for fun and enjoyment, being turned on anything goes as long as it is nice.”. We become phobic towards pain and suffering.

We avoid and run away from frustration or pain. The result is the lack of growth. [He is not talking about masochism].

The main idea about Gestalt is that Gestalt is about the whole; about being complete. This involves guiding the person to feel, sense and perceive the present (the now), even painful emotions, and allowing the self understand the now and be integrated in the experience.

We ask how. We don’t ask why. Asking ‘how’ helps us to understand. It is in understanding that we can change structure of our life script.

Upcoming in 2023 : PhD Thesis

Title: Therapeutic Autoethnography

Abstract

Therapeutic Autoethnography is founded on Autoethnography, an emergent field in qualitative research. Therapeutic Autoethnography engages the practitioner as a researcher in the field of the psychotherapy situation. It is a practice-based, practice-driven, practice-informed qualitative research method. It provides an in-depth understanding of what goes on in the diverse naturalistic setting of psychotherapy practice. In Therapeutic Autoethnography, the field being investigated is the therapy situation, which encompasses the individuals attending the session, the therapeutic alliance, and its environment. In the role of researcher, the therapist creates aesthetic accounts of their experiences in the field with their client(s). The writing process is deliberately reflexive and integral to the method. This act of creative writing is a heuristic process where new insights emerge for the researcher. This thesis demonstrates how Autoethnography can be applied as a practical methodology for psychotherapy case study research, especially for explicating the implicit nuances in therapy. 

Keywords: Autoethnography, Therapeutic Autoethnography, psychotherapy research, case study research

Reference

Coming soon

Geštalt Zbornik 9: Understanding Salomo Friedlaender’s Creative Indifference

Understanding Salomo Friedlaender’s Creative Indifference: A Psychotherapy Case-Study.

Abstract

Salomo Friedlaender’s Creative Indifference, or Schöpferische Indifferenz, first published in 1918, is a founding philosophy of Gestalt therapy that has invaluable implications in the process of psychopathology in the psychotherapeutic process. This article features a psychotherapy case study of a client who has been diagnosed with Major Depression and Atypical Anorexia Nervosa. The case story is written by the therapist using Therapeutic Autoethnography, a method of inquiry into the psychotherapeutic process. Writing this case study in an evocative aesthetic form, the understanding of Creative Indifference is fleshed out and enriched. Story and theory are interwoven reflexively to illuminate how aspects and meanings of Friedlaender’s philosophy of Creative Indifference, the centering in the here-and-now, the fertile void and zero point, apply to the real-life, naturalistic situation of psychotherapy practice. Though the case study details but a portion of the client’s work, one can grasp the atmosphere from which the client’s pathos is made visible. Creative Indifference facilitates this process of psychopathology in a powerful way, expanding our understanding of suffering beyond the traditional attitude of clinical diagnosis.

Keywords: autoethnography, psychotherapy case studies, psychotherapy process research, gestalt therapy, aesthetic inquiry

Excerpt from the Case Study: “Stuck”

The leather armchair seems massive as she slumps into it. Min looks almost childlike, dangling her chunky Dr. Martens covered feet. “I just feel hopeless and devastated,” she says. “It’s my birthday today, and I thought I bought myself a gift.” That “gift” , she explains is the “gift of therapy”. I would have mistaken her for another cosplay preteen, wearing a head of neon green dreadlocks, had she not revealed that today she turns 29.

“What do you do here in Vienna?”

“I work at a Konditorei.”

“Are you studying here as well?”

“Not any more. I actually moved to Vienna for study at a university. The exams were too hard and I got stuck.” Min explains that she’s been living in Vienna for three years, shares an apartment with 3 Russian-speaking housemates and has few friends here.

This is our first moments together and I find myself mesmerized by the girl looking back at me. The small body, the square shaped face, the big head that tilts to the left as she smiles reminds me of someone familiar. Very familiar.

I ask her if there is anything that she needs to know about therapy at this point.

“Uh. This is my very first time doing therapy, and I don’t know what I want.”

“How did you choose to contact me?”

“Oh… I saw in your profile that you are social, with group therapy and all… and that you were doing something cultural.”

[…]

“I had to think for myself,” she says, “but now, as an adult, I feel dependent.”


Chew-Helbig-2022-creative-Indifference

Reference

Chew-Helbig, N. (2022). Understanding Salomo Friedlaender’s Creative Indifference: A Psychotherapy Case-Study. Geštalt Zbornik. 9, pp. 5-15 https://www.ceeol.com/content-files/document-1127011.pdf

Find this Journal here: https://www.ceeol.com/content-files/document-1127011.pdf or request a copy from me.

PDF Embedder requires a url attribute

EUJPC 1 (16): A psychotherapist’s lived experience in-session with an asylum seeker and translator

A psychotherapist’s lived experience in-session with an asylum seeker and translator: An autoethnographic case study

Abstract

Featured in this article is a psychotherapy case study recounted from the lived experience of the psychotherapist working with an asylum seeker from Afghanistan, with the help of a translator. The method applied is an aesthetic inquiry adapted from Autoethnography which engages the practitioner as the researcher who enters the ‘field’ of the therapy situation. The reflexive writing of the case story, which is integral to the method, sets off a heuristic process, integrating research and practice. Reading this case study, one may grasp the nuances and the atmosphere of an otherwise linguistically challenging therapeutic situation. The story and Gestalt therapy theory are weaved together, which makes palpable, intangible aspects of the therapeutic process.

Keywords: autoethnography, psychotherapy case studies, psychotherapy process research, gestalt therapy, aesthetic inquiry

An excerpt from the Story in the Article

I want to be confident, but something in my past is stopping me,” Zaya translates.

I give Ali a nod to acknowledge what I am hearing. He smiles back at me. His jacket hangs on a clothes rack by the door. This is the start of our second session.

Ali’s opening sentence this morning feels like an invitation. Ali stands by a threshold between the future and the past. He points us in the direction of the past. I see him shudder. I shudder, though I do not know what it is I am seeing. I am interested, in earnest. I am also wary. I lean back.

***

I ask Ali what he meant by the past stopping him from being confident.

“Uncle.” Ali explains that uncle is the younger brother of his father. Ali was put in the care of uncle and his wife when he was 9 years old. Till he turned 18, Ali lived with the couple and their daughter, who’s a little younger than Ali. “I always hear uncle say, ‘you will come to nothing. Nothing’.”

“What would you say to him right now, if he is sitting here?” I ask.

Zaya translates.

Ali clenches a fist, then promptly holds it down with the other hand. “I have no words, nothing.”

“Yes.” I say. I give space to the young man’s rage. Zaya reaches gingerly for a filled paper cup and takes a sip. Ali and I follow suit.

I ask him how he got to be put in the care of uncle.

 “After school I play football. The playground is near my house. One day, I was playing football, then the bomb of the Taliban exploded on our house.” Zaya translates this, ice cold. They were all home when it happened; Ali’s father Zabi, his mother, Fatemeh and his baby sister Khatere. Ali’s voice cracks as he mentions the name of his baby sister. He stares, glassy-eyed, blank.

The skin on the back of my neck tingles. I glance towards the radiator by the window, as if to check if it was turned on properly. No, the air in the room is not cold. I am being touched by phantoms who have now descended amongst us. I search my bag for paper, only to find a dog-eared stack of neon coloured post-its. I write, “Zabi”, “Fatemeh”, “Khatere”, on three little sheets, careful to get the spelling right. I lay the post-its on the coffee table. I feel tears well up in my eyes. The space between us is saturated.

***

“How… are… you?” Ali asks me in English, then giggles.

“Thank you, Ali,” I say. “I slept well, so this morning you have my fullest attention.”

 Zaya translates.

“How about you, Zaya,” I ask.

I catch a slight blush in her cheeks, as she giggles, “very well.”

“Ali says that he doesn’t sleep well. For example last night he had a bad dream. A nightmare.” Zaya translates.

“There is the mafia,” Ali says, “who is raiding the castle. Me and my friends are hiding in it. The mafia shoots me. I’m almost dying and my friends save me. My father is there. Oh. But that is only for a short time. I fall out of the window and run away.”

 We share a round of chuckling. I offer Ali and Zaya a suggestion to do a chair work. Zaya’s eyes lights up. I’m aware that she had read much about the Gestalt therapy method of working with dreams. “I’m not sure if you’d like to try this exercise.” I say to Ali, who is probably sensing Zaya’s interest.

“Yes. Yes,” is his reply.  

“Well, if at any time either of you are feeling unwell doing this dreamwork, say stop.” I tell them.

 “Yes. Yes,” he says.

Zaya translates, “What do I do?”

So we set the stage with empty chairs around us. I am thankful for having booked this larger room again this morning. Ali puts a chair for “the mafia” a distant right from his. He then says that the rows of chairs stacked up along the wall of the room are where his friends sit. He takes the last chair and places it close behind him slightly to his left; there Ali seats his father.

***

Conference Presentation

Reference

Chew-Helbig, N. (2022). A psychotherapist’s lived experience in-session with an asylum seeker and translator: An autoethnographic case study. European Journal of Psychotherapy & Counselling, 1-16.

Find this Journal here: https://www.tandfonline.com/doi/abs/10.1080/13642537.2022.2156138

or request a copy from me.

The British Gestalt Journal 31(1): Writing evocative case studies

Writing evocative case studies: applying autoethnography as a research methodology for the psychotherapist.

Abstract

This is an introduction to the application of autoethnography, a qualitative research method, an aesthetic inquiry into the psychotherapy process. The method engages the practitioner as researcher-autoethnographer who enters a field, which is their client’s therapy process. The aim is to derive insights and deepen the understanding of process, theory and diagnostics from psychotherapy sessions in practice. The therapist creates a reflexive account of their experiences, recording this in their session notes, which are also the field notes and the data. As an autoethnographer, the therapist begins therefrom a process of creative writing. The writing process is reflexive, and aesthetic. Integral to the research method, the act of writing forms a hermeneutic circle where new insights into the phenomenon of therapy happen for the researcher. The writing is created as an art form, usually a story or poetry. The result of this method is a written, evocative, aesthetic representation of the therapy process, based on the phenomenological experience of the practitioner. Demonstrating this method, a single case study of an online Gestalt therapy session of a male client diagnosed with depression and borderline personality disorder is featured in this article. The outcome of this form of aesthetic inquiry is the embodiment of psychotherapy theory through the aesthetic sensibility of the therapist-researcher.

Keywords: autoethnography, psychotherapy case studies, psychotherapy process research, gestalt therapy, aesthetic inquiry

Excerpt

In Gestalt therapy practice, aesthetic sensibility to the atmosphere is instrumental to the therapist, in order that they can attune to the movement of the phenomenological field (Francesetti, 2015). This is where this research methodology aligns with Gestalt therapy practice. Theory of the phenomenological field is central to Gestalt therapy (Parlett, 1991; Staemmler, 2006; Francesetti, 2019; Philippson, 2009; Robine, 2006; Spagnuolo Lobb, 2013) as it is in psychology (Lewin, 1951). Attunement to the aesthetics of the phenomenological field allows therapists to move beyond the mono-personal, third-person attitude of diagnosing the client’s psychopathology using manuals like the DSM (American Psychiatric Association, 2013) and evaluating clients using psychometrics. It goes even beyond the bi-personal, relational attitude of inquiry into the therapeutic alliance (Greenberg, 1986; Clarkson, 2003; Jacobs & Hycner, 2009; BCPSG, 2010). Aesthetic attunement brings the psychotherapeutic process beyond therapist and client, into the atmospheric realm of the phenomenological field of the here-and-now.

Reference

Chew-Helbig, N. (2022a). Writing evocative case studies: applying autoethnography as a research methodology for the psychotherapist. The British Gestalt Journal, 31(1), 35-42.

Find this Journal here: https://www.britishgestaltjournal.com/shop/british-gestalt-journal-311 or request a copy from me.

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. .

Hermeneutic circle of understanding 

The phenomenological attitude of  putting aside, or bracketing, theories and pre-conceived ideas in favor of un­derstanding the client does not mean the absence of interpreting. It also does not mean that therapists should not have pre-knowledge and theoretical understandings. It is im­possible for anyone, therapists included to not interpret. According to Heidegger, “from the very beginning our essence is to understand and to create comprehensibility.” To interpret and understand is to be human (Staemmler, 2009, p. 65). At the same time, it is through our pre-understandings that we can have any understanding at all. 

For this understanding to be authentic, and not based on blind interpretations of theory, what counts is the attitude towards gaining this understanding. According to Gadamer (Gadamer, 1975/1960), the German word for “understanding” (Verstehen) is also used in the sense of a practical ability (e.g., er versteht nicht zu lesen, “he can’t read”). This is the understanding when one goes beyond simply acquiring scientific knowledge— when one gets well versed in something, like understanding a text, or, in the case of therapy, the client. In efforts to access this kind of understanding, Gadamer writes, one would have “the accomplished understanding (that) constitutes a state of new intellectual freedom” (p. 251). Gadamer likens all such understanding to be ulti­mately self-understanding (sich verstehen). What this means is that understanding in this attitude is a dynamic process of self-involvement. Gadamer explains how when reading words written by someone else for example, the reader projects his/her own meaning for the words as he/she encounters them. As one reads or listens further, one has expectations for what meaning is to come, new meaning then emerges and expecta­tions are revised according to what meaning emerges further. This is the process of un­derstanding the subject matter through self-reflection and reinvestigation of the subject. 

Heidegger (1971), in his writings on what and how art is, says, “What art is should be inferable from the work. What the work of art is we can come to know only from the nature of art” (p. 18). Heidegger adds that in discovering a piece of art, we are lead to a circle of questionings. While we are tempted to avoid this circle, we cannot avoid it if we are to understand that “The artwork is, (…), a thing that is made, but it says something other than the mere thing itself is, allo agforeuei. The work makes pub­lic something other than itself; it manifests something other; it is an allegory. In the work of art something other is brought together with the thing that is made… The work is a symbol” (p. 19). Through this circle of learning and self-reflection, Heidegger de­veloped the concept of the hermeneutic circle. 

Gadamer quotes Heidegger in Being and Time, “(The hermeneutic circle) is not to be reduced to the level of a vicious circle, or even of a circle which is merely tolerat­ed. In the circle is hidden a positive possibility of the most primordial kind of knowing, and we genuinely grasp this possibility only when we have understood that our first, last, and constant task in interpreting is never to allow our fore-having, fore-sight, and fore-conception to be presented to us by fancies and popular conceptions, but rather to make the scientific theme secure by working out these fore-structures in terms of the things themselves” (p. 269). Heidegger defines here the attitude towards authentic inter­pretive understanding. This attitude requires the interpreter to have an awareness of the self, and the prejudices (or fore-having, fore-sight and fore-conception). Gadamer states: “all correct interpretation must be on guard against arbitrary fancies and the limi­tations imposed by imperceptible habits of thought, and it must direct its gaze ‘on the things themselves’.” In the context of psychotherapy, the gaze should be directed on the client and what is happening in the alliance. “For the interpreter to let himself be guided by the things themselves is obviously not a matter of a single, ‘conscientious’ decision, but is ‘the first, last, and constant task’.” In other words, it has to be an attitude towards the understanding process. “For it is necessary to keep one’s gaze fixed on the thing throughout all the constant distractions that originate in the interpreter himself” (p. 269). Gadamer adds that the process of understanding texts— and we can translate this to the verbal and non-verbal communication of the client— involves projection on the part of the interpreter: “He projects a meaning for the text as a whole as soon as some initial meaning emerges in the text.” This projection is necessary in order to make meaning of what emerges— “the initial meaning emerges only because he is reading the text with particular expectations in regard to a certain meaning”. It is the working through of this projection and constantly revising the understanding as new material emerges, “is un­derstanding what is there” (p. 269). It is also worthwhile to note that Gadamer found it important “… to distinguish the true prejudices, by which we understand, from the false ones, by which we misunderstand.” However at the beginning of the Hermeneutic pro­cess it is difficult to tell one from the others (Staemmler, 2009, p. 86).

References

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

Heidegger, M. (1971). Poetry, language, thought . (A. Hofstadter, Trans.) Harper Perennial.

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.