Case Approach to Gestalt Therapy
Theory Assumptions
In accordance with the Gestalt approach to therapy, the individual or client must be understood by the therapist and others in the context of their relationship with the environment. This involves gaining awareness of one’s experiences both personally and socially. There is an assumption that through awareness, change can and will occur in an individual’s internal dynamics. This awareness is gained through appreciating and fully experiencing these dynamics and life experiences. While this process does not call for understanding why things occur, it does focus on the here and now and the what and how behind one’s experiences. By understanding these things, one can be better in touch with his or her awareness, which according to the Gestalt approach, can cure internal conflicts alone. In Gestalt therapy, the role of the therapist is to enable the client to come into contact with his or her experiences, whether past or present. By bringing the individual’s past experience to the present, the therapist helps the client to understand exactly how those experiences felt and impacted him or her. Understanding why certain events occurred is not a part of this process. Instead, understanding what they are and how they impacted the individual’s psyche is more important and imperative to gain awareness, thus ultimately resolving conflict.
Assessment Methods
In the case of the present client, it would first be important to gain a sense of trust in order create a safe environment for the client to open up to me as the therapist. After building this sort of rapport, it will then be easier for the client to open up about both her past and present life experiences. It will be important for the client to make contact with her past experiences with family members and peers, by experiencing in the present those sounds, sights, smells, and feelings that occurred in the past. For example, the client may share her experience with being a perfectionist as a child, remember how that feels and comparing it to her current thoughts and experiences of being a perfectionist. Contact with other experiences, such as playing softball may also be appropriate to better understanding the experience of both playing and not playing. For example, the client may remember how exhausted she felt after pushing herself mentally and physically for so long while playing softball, and this may lead to presently feeling more comfortable with the decision to quit several years ago. Coming into contact the feeling of exhaustion, the smell of dirt, the feel of the blazing sun, and the sound of cheers from the dugout and stands may bring about mixed emotions about softball for the client, but bringing them to her awareness will be helpful in resolving conflict that may be related to her past experiences with playing and quitting.
Other methods of assessing the client may include resolving “unfinished business” with past experiences. This may involve pretending to be a child again and coming into contact with the senses at a time during childhood when the client felt alone or abandoned by peers and family members. The client would make statements implying the childhood feelings are being felt now, like “I feel that…,” instead of “I felt that…” In putting herself in that position in the present and yet having a more mature perspective now, she may be able to resolve some “unfinished business.” As a Gestalt therapist, I would pay particular attention to the client’s body language and affect while she expresses these experiences. I may notice her lack of eye contact when talking about things that she feels embarrassed about or ashamed of, or her poor posture indicating a lack of confidence. Other expressions that I pay particular attention to may include her soft and often mumbling style of speaking when expressing her feelings about peers and how she sometimes feels isolated, both as a child and today. As a Gestalt therapist, I would also pay attention to specific language, such as the replacement of the pronoun “I’ with “you” or words of uncertainty, such as “I guess,” “perhaps,” and “maybe,” which she uses very often. Without deflecting, or veering away from the client’s expressing herself, it would be important to share my perception of these experiences, as the therapist, at an appropriate time. These would not necessarily be confrontationally overbearing, but rather insightful and hopefully helpful to the client’s ability to gain awareness of her experiences. For example, helping her to understand that she seems unsure of herself because she so often uses words of uncertainty or indecisiveness would make her more aware that she does so, and help her to use words that are more certain and clear.
Goals
The ultimate goal of participating in Gestalt therapy with the client is for her to gain a better awareness of both her past and present experiences, thus resolving the internal conflict. In gaining awareness, the client should become more content with who she is and what she does, rather than feel sad or anxious about what she has done in the past or who she will become in the future. In coming in contact with her feelings during specific experiences, the client will open herself up to making her own interpretations of those experiences and find meaning in them. Finding meaning in particular experiences may take a long time, and thus should be a long-term goal. However, a short-term goal could be gaining awareness of one experience at a time, and interpreting the meaning of each on an individual basis. For example, as mentioned above, if she could come into contact with her past experiences of playing softball, she may currently be able to understand why she quit and be more confident in her decision to quit several years ago. Also, there is a more pressing issue that revolves around the client’s feelings about her mortality, the meaning of life, and whether she is living a life worth living. This conflict may be ongoing, but a short-term goal may involve making contact with the feelings she had when her friend committed suicide, and remembering how that impacted others, as well. This experience may help the client to understand that despite the fact that the meaning of her life may be unclear, the importance of her life is very clear. While the short-term goal in this case is understanding the importance of staying alive now, the long-term is truly understanding her ultimate purpose in life.
Intervention Techniques
As mentioned above, trust between the therapist and the client is imperative in being successful in the therapeutic relationship. In order for interventions to be successfully implemented, as the therapist, I must walk a fine line of being nonjudgmental and yet sharing my perceptions and being mildly confrontational when necessary and appropriate. As the ultimate goal is for the client to gain increased and enriched awareness, my job as the therapist is to create the best environment for doing so. This may include encouraging the client to experiment, or shift from talking to experiencing certain events in her life. Other exercises include the internal dialogue, whereby the client engages in dialogue between the two polarities that exist internally. In the “making the rounds” exercise, the client can practice interacting with others (which in this case, would occur outside the therapeutic setting) by confronting, risking, and sharing herself with others, which is truly a challenge for this introverted client. In the reversal exercise, I would ask the client to behave opposite her natural self, such as extremely extraverted or energetic in order to allow her to recognize and accept both her natural characteristics, as well as others that do not come so naturally. Finally, in the rehearsal exercise, it will be important for the client to realize how much she wants to be liked and accepted by peers, as well as family members by sharing her rehearsals aloud.
Thought I'd spice things up and add a pic-since I talked about softball, I thought I'd include a couple pics from back in the day-when I was good.
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