Client-Therapist Relationship in Gestalt Psychotherapy

Abstract

            There are many theories that have been advanced by psychologists as attempts have been made to explain the human mind, ways of thinking and factors that shape personality – among other issues - Client-Therapist Relationship in Gestalt Psychotherapy introduction. Freud has been shown to have started may trends in the discipline of psychology. Not to be discounted are the various perspectives forwarded by Piaget which are now taken as foundations even in disciplines outside of psychology. Theories established by other psychologists have derived characteristics and tenets from the works of these psychologists, either to refute or reinforce the ideas of the postulated theories. This paper focuses on the Gestalt person-centered therapy as regards what it posits, what its core concepts are and how it works in enhancing self awareness and personal development.

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Client-Therapist Relationship in Gestalt Psychotherapy

According to Rogers (1980), gestalt psychotherapy is a dynamic therapy that, like various other psycho-analytic therapies, builds on the premise that the unconscious mind has great influence on the behavior and conscious functioning of a person in psychotherapy. Psychotherapy builds from the observations made by Freud, whereby clients with mental disorders or hysteria exhibited recovery or improvement as soon as the seemingly unimportant and forgotten events were brought forward to the conscious mind and addressed.

Fall, Holder and Marquis (2003), noted that although gestalt psychotherapy borrows some concepts from the Freudian psychotherapy, it differentiates itself in the sense that it focuses attention current and contemporary events, referred to as ‘here-and-now’ events, as opposed to the childhood events focused on by Freud. Gestalt means whole configuration and gestalt psychotherapy concerns itself with helping clients attain a sense of wholeness in the emotional, mental, spiritual and physical aspects of being that are an interactive whole. It works towards attaining a healthy balance of sorts amongst the several areas of development. Thus, a major concern of gestalt therapy is to develop the individual’s self-awareness and self-support system which would help to sustain a creative, harmonious and spontaneous relationship with others (Joyce & Sills, 2001; Woldt & Toman, 2005). A salient point to note is that gestalt psychotherapy is experimentally oriented and focuses on what is prominent in the here and now (Fall et al., 2003).

            Fall, Holder and Marquis, (2003), argue that the gestalt school of psychology posits that brain functioning has a correlation to psychological events. The inability of a person to reconcile the different constructs of his or her personality to form a holistic image of mental health results in psychological instability. Therefore, a psychologist leaning towards the discipline of gestalt therapy would dedicate more efforts on encouraging the client to reflect on the inner self, particularly regarding the client’s emotions, on how to release and address them for what they are rather than to resort to suppressing them.

            Away from that brief history and introduction, what are the ultimate concerns in gestalt psychotherapy? Gestalt therapy deals with experiences, thought, feelings and behaviors and a person’s ability to become aware of the same, thus a common question for gestalt therapies is ‘What are you feeling’ (O’Leary, Sheedy, O’Sullivan, & Thoresen, 2003). Relationship between the therapist and the client is a dialogic relationship wherein the therapist solicits from the client responses triggered by specific circumstances and events and also manners by which the client envisions that the same may be addressed (O’Leary et al., 2003).Thus, gestalt psychotherapy is concerned with remedial therapy through dialogue and requires not merely conversation solicitous of the concerns of the other, but an honest, open, non-judgmental and comprehensive dialogue where no inhibitions or rules are set to constrain the client’s desired subject of choice. According to Woldt and Toman (2005), an important task for the therapist is to assist the patient in becoming aware of the unconscious way that he or she pushes others away from himself or herself or how the client places himself away from human contact.

            As noted earlier, Gestalt therapy believes that human contact is what brings about healing and thus the therapist-client relationship is of utmost importance. This means that the role of the therapist is basically to explore with the client the current state of affairs in her/his life. The healing comes out better when autonomy and growth through self awareness is fostered (Woldt & Toman, 2005). The relationship here is that the therapist and client relate in a cordial manner and the therapist propels the conversation in an energized tone. This sets the pace for clients to talk about themselves, how they feel about anything and everything surrounding their life. With regard to the aspect of self-awareness, it is presumed that the therapist is ahead of the client in terms of self-awareness and self-understanding thus enabling the scrutiny of client’s input in the conversation (Rowan, 2000). Moreover, this intricate relationship and dialogue with the therapist assist the client with hearing himself or herself and how they experience themselves, how the clinician experiences them, and how they experience the clinician as an individual and friend. This is where the shift from awareness of one’s own authenticity to the awareness of one’s isolation of one’s self comes in; it is not so much a question of realizing the need for other people, rather, it is the awareness of the desire to be with them (Rowan, 2000).

            Needless to say this kind of therapy can be tricky for an inexperienced clinician, especially in the case of two opposite sexes. It may yield a counter transference and create therapeutic distance. This may impede the effectiveness of therapy. Perls(1976) would describe the therapists role through the following statement: “the therapist’s primary responsibility is not to let go unchallenged any statement or behavior which is not representative of the self, which is evidence of the patient’s lack of self-responsibility” (79-80). Rowan (2000) states that a good clinician accompanies the client into the subjects and areas that the client occupies during the session and does not attempt to move the client away from such space into one that is more familiar to him or her. It is therefore important that the therapist be very aware of himself or herself and objective throughout the entire process of therapy. He or she should also closely monitor the evolution of the relationship with the client and vigilant of potential obstruction or abuse of power during the therapeutic session (Rogers, 1980). This, of course, is not only a requirement in gestalt psychotherapy but a requirement of all psychotherapies. This is because in therapy the client is vulnerable to the clinician and may feel pressured to please the clinician; acting upon this impulse or taking advantage of the same would be unethical and improper.

            In gestalt therapy, the most essential aspect is awareness and not dictating what behavior a client should or should not take. The clinician is merely a figure who takes the client through the many choices of behavior that she/he would like to adopt and help them in pointing out the orgasmic reactions as well as the consequences behind their choice and in accordance with their believes and values (Joyce & Sills, 2001). This means that it is not the domain of the clinician to choose for the client what is morally right or wrong since the foundational basic of gestalt therapy is that the client is responsible and capable of charting their own course and behavior. In this therapy, it is not about the ‘should’ and ‘should nots’ so to speak since this impedes spontaneity and the integration of wholesome self awareness (Woldt & Toman, 2005).

            Gestalt therapy follows a humanistic approach to psychotherapy. That is, dealing with problems that make up human life, e.g. love, fear, pride, self actualization, belonging, individuality, and creativity among others (O’Leary & Page, 1990). Dealing with these human issues ensures a better understanding of human beings (Joyce & Sills, 2001). It is also person-centered meaning that it lends itself more to personal relationships in the client-therapist interaction and the main goal is to push the client to a state of realization of one’s self. The gestalt approach provides the client with a firmer base in addressing the issues being coped with. With its emphasis on the present and here-and-now, gestalt therapy encourages the client to integrate the different components of an issue (the past, present and maybe even the anticipated), yet to assess them in terms of the present (Hinksman, 2001). This provides a stronger foundation for change in the clients as they are encouraged not to live in the past but to move within the bounds of their current reality (Hinksman, 2001).

The core concepts of Gestalt therapeutic relationship

Whenever a client presents for therapy of any sort, the mentality held by the client is the clinician holds all the answers. A client enters into therapy emotionally unstable and needy seeking affirmation and guidance, thus the imbalance in the client-therapist relationship (Gross, 2001). Gross (2001) emphasizes that it is the profound feeling of vulnerability along with the lack of knowledge and experience that makes vital a foundation of trust. In Gestalt therapy, the therapist affirms orgasmic trust with the client as well as nurtures or encourages the client to be confident and have faith in their own thoughts. The hallmark of Gestalt therapy lies in the ability of a client to articulate feelings and own his freedom and limitations so as to live a fulfilling life and contribute to the lives of the others (Rowan, 2000).

            Genuineness is essential in the Gestalt psychotherapy session. This means that the therapist should not exhibit a facade or a professional front.  It is all about being one’s self during therapy and indeed, this increase the odds of the client experiencing constructive growth and behavioral change (Rowan, 2000). The therapist-client relationship need be transparent, letting each other in on the flowing emotions of the here-and-now and even when a client may feel uncomfortable to let out some feelings or attitudes, this should not happen on the part of the therapist. It is considered an achievement for a therapist to help a client transcend the border between the projected self and the real self (Rowan, 2000),

Another core concept in the Gestalt relationship between client and clinician is that of unconditional positive regard to the client. Notably, human beings tend to relate better with some individuals than others.  It may therefore be difficult to show acceptance and positive regard to some clients especially when feelings expressed are contrary to the therapist’s own morals and values. Nonetheless, Gestalt therapy points out that therapeutic healing is more likely to occur when the client has positive regard for the client, irrespective of the current feelings or emotions being expressed i.e. anger, hate, fear, pride, disgust, confusion and so on. That is, “the therapist should prize the clients in a total rather than a conditional way” (Rogers, 1980).

            Empathy, one’s ability to sense the feelings and meaning to feelings expressed by the client and communicate them back in an understanding way, is perhaps the most important and facilitative aspects of the gestalt psychotherapy (Rogers, 1980). The therapist must explore the client’s world and classify underlying meanings that the clients may be oblivious of. In this client-therapist relationship it is all about listening, active listening and understanding as the client is accompanied on a journey to self-awareness (Rowan, 2000). The session is characterized by non-judgmental, sensitive communication. In cases where these feelings are not understood, clarification is sought using a paraphrase of the client’s manner of phrasing. This expresses understanding and facilitates client reflection of his or her own thoughts leading to enhanced self awareness (O’Leary et al., 2003). For example, “I heard your say that you are unable to understand why you are always furious with your wife or husband, why do you think that is the case?”

The client’s role in the gestalt session is active and focused. The client should  be willing and ready to open up and express himself or herself and “create atmosphere and attitude toward working  in therapy  that lead to greater awareness of the reality of oneself and how one interacts with others and how one functions in the here and now” (Fall et al., 2003). The Gestalt psychotherapist believes that treatment or leaving of the patients lies in the very relationship that they have with the client (Joyce & Sills, 2001; Woldt & Toman, 2005).

Gestalt therapists point out that some clients avoid the human contact with others or rather avoid contact with others because it makes them feel anxious. For example, a client who spills out the most important subject of her/his visit or the intimate reason for seeking therapy within the first few minutes of the session is said to be avoiding fair contact because of anxiety produced in the unfamiliar environment (Gross, 2001). Notably, everyone at some point experiences this feeling of anxiety although at different levels. This interrupts spontaneous and creative interactions with others. This should first be eradicated in the gestalt therapy as the client and clinician progress towards self awareness. This occurs when the therapist provides an open space for communication exhibiting respect for the client thus resulting in the client’s communication of the real self (Woldt & Toman, 2005; Rowan, 2000). Gestalt therapy is a process of psychotherapy. The goal is to improve ones social contact within the community at large. This is accomplished through spontaneous awareness; a dialogue between client and therapist.  Becoming aware of differences and similarities are encouraged while interruptions to contact are explored in the present clinical relationship and experience (Woldt & Toman, 2005).

The quality of therapeutic relationship between the client and the therapist in gestalt psychotherapy is related on the level of feedback and immediate in the dialogue between the two.  The therapist is seen as a tool of change, and combines the confrontational, supportive and empathetically attributes. The therapist uses the ‘I–Thou’ relationship experienced directly by the client to foster contact and catalyses the here-and-now feelings in the client toward self awareness (Rowan, 2000). The therapist challenges the client when they avoid contact with the therapist by bringing the disturbance to the client’s attention (Fall et al., 2003). The therapist’s responsibility is to ask the question how and not why because the latter sounds judgmental to the client’s issues (Fall et al., 2003).

            The therapy session in gestalt therapy begins with an exploration of both the client and the clinician experiences as a whole then cumulatively narrows down to the clients own experiences (Rogers, 1980). This is basically for the purpose of establishing contact and building rapport so that both parties feel comfortable to open up without inhibitions or facades. Unlike the psychoanalytic approaches which also acknowledge the importance of therapeutic relationship with the client, gestalt psychotherapy uses a phenomenological approach to help the client freely explore the important events in their life as well as experiment with the specific events to that they are more aware of the things that happens in their lives and their response to these events (Joyce & Sills, 2001).  This phenomenological approach in turn ensures that the client develops a ‘let–what–is–stand–out–in-the-open’ approach to life that essentially acts as a mirror to reflecting personal convictions and truth hence leading the client to self-awareness in life. This aspect goes on until it becomes part of the daily life of the client, and beyond the therapy session, and at such a point, it can be said that the client has experienced healing (Rogers, 1980).

The client-therapist relationship in gestalt psychotherapy is exhaustive and goes deep into fostering an environment where the client freely expresses thoughts that he or she may not be aware of and addresses them more and more in order to be more aware of one’s self as an individual. But generally, it is all about revealing the feelings and thoughts of the client and how the same affect actions in daily relationships. By and large, the client-therapist relationship should be intimate enough yet still professional to be sufficient to prevent any abuse by the clinician or the client.

References

Fall, K.A., Holder, J. M. and Marquis, A. (2003). Theoretical Models of Counseling and Psychotherapy.  New York: Brunner-Routledge.

Gross, S. (2001). On integrity. Psychodanimc Counselling 7.2, 207-216.

Hinksmna, B. (2001). The compatibility of feminist theology and gestalt therapy: a study of ‘practical-values’. British Journal of Guidance & Counselling 29(4), 391-402.

Joyce, P. and Sills, C. (2001). Skills in Gestalt Counselling & Psychotherapy. Sage Publications Inc.

O’Leary, E. and Page, R. (1990). An Evaluation of a Person-centered Gestalt Group Using the Semantic Difference. Counselling Psychology Quarterly 3(1).

O’Leary, E., Sheedy, G., O’Sullivan, K., and Thoresen, K. (2003). Cork Older Adult Intervention Project: outcomes of a gestalt therapy group with older adults. Counselling Psychology Quarterly 16(2), 131-143.

Perls, F. (1976). The Gestalt approach. New York: Bantam Books.

Rogers, Carl (1980). A Way of Being. Boston: Houghton Mifflin.

Rowan, J. (2000). The self, the field and the either-or. International Journal of Psychotherapy 5(3), 219-226.

Woldt, A.L. and Toman, S.M. (2005). Gestalt Therapy: History, Theory, and Practice. Sage Publications Inc.

 

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