Transitions in Gestalt Therapy

 

Gestalt!
The Working Corner
4-19-06

Victor Daniels

ABSTRACT

This article analyzes and categorizes dynamics of therapeutic movement within a Gestalt working session. One kind of movement occurs in the transition from a focus on one issue or concern to another or from one aspect of the same issue or concern to a different aspect. Another kind of movement involves a transition from the surface of an issue into its cognitive, emotional, and behavioral depths. Transitions may be driven by the client’s internal process or by the therapist or counselor’s theory, intuition, or experience. One specific pattern of transitions is elucidated in detail, and then other common transitional movements are described more briefly. Drawing on the work of Perls, Polster, Naranjo and others, patterns examined include interpersonal and intrapersonal working through of traumatic and unfinished past situations, explicitation of paralanguage, intentional frustration and strategic suppression, magnification by exaggeration, teasing out storylines, and others.

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A question I often hear from a student or trainee who has observed a skillfully facilitated Gestalt session is, “How did you get from there to there?” A client will be talking about an apparently innocuous matter, and then just a few minutes later will be in the midst of a deeply traumatic or emotional situation. Such transitions can seem like magic, and the skilled counselor or therapist, facilitator may appear to be a magician who possesses esoteric powers far beyond the ordinary. Such rapid transitions may seem all the more remarkable to someone who has spent months or years in slow-moving counseling or therapy in which the sessions have a laissez-faire quality that seems like going over much the same ground again and again.

Three common questions about transitions are, “How did you get from point A to point B?” “How do you know what direction to go,” and “How did you get so deep so fast?” The general answers are, “Following what the client offers,” and “By using a combination of theory, observation of masters at work, long personal experience, and intuition.” But these replies conceal more than they reveal. The specific answers are far more interesting, and we will look at them in detail.

Being able to make such transitions is indeed one of the most sophisticated aspects of psychological work. Often enough they occur “by themselves,” while the therapist or counselor simply waits, watches, and listens attentively. Patricia Baumgartner makes the vital point that in situations where a person appears stuck, “There is the importance of being satisfied that the patient really is stuck before we introduce facilitating measures. Beware of rushing in to assist the progress. When the patient moves by himself, using his awareness of himself or his world, exploring, he is already doing exactly what we hope for. . . . I am amazed and admiring of how little some people require from me. . . . Fritz is repeating again and again, “Don’t push the river; it flows by itself.” (1975, P. 59).

On the other hand, Fritz expertly used a spectrum of methods for helping a person discover how she was keeping herself stuck, and how she could unstuck herself, when such intervention was appropriate. In the history of psychotherapy it has been fashionable to label such instances of “stuckness” as “resistance” to the progress of therapy. Erving and Miriam Polster view it differently: “Not assuming the person is behaving wrongly, “resisting,” leads us to stay with each expression of the person as it arises, moving always with the actual experience, innocently witnessing the unfolding of fresh drama.” (1999, 121) A client may remain “stuck” not only because he or she is avoiding awareness of something that cause discomfort, such as a challenge to the self-image, but also because the facilitator’s skill in guiding the client in discovering or taking a needed next step is limited.

Erving Polster goes on to articulate the interplay between expert intervention and letting-be. He uses the term “tight therapeutic sequences” for “those sets of experiences where the perceived consequences of any event happen right away-or very soon. . . . Each moment serves as a springboard into its future and will announce that future in sometimes clear, sometimes cryptic, signals. The therapist reads each of these signals, edging forward like a detective, to discern the hints for what is going to happen next.

“But. . . the therapist also must help to create new experiences by leading the patient into the “naturally next expression or feeling. This requires intricate discernment because each moment calls out for a number of possible moves, arrows in a sense, each pointing to a different possible nextness. Furthermore, the patient may not want to go forward and will use diverse means, familiar to all therapists, to avoid the trip. . . . In the face of such fears, pointed and sensitive evocation is required to move the patient’s statements gradually in the direction for which he only gives hints.” (1999, p. 166)

Another book that Polster published twelve years earlier is of my very favorite books on psychotherapy. Every Person’s Life is Worth a Novel (1987 devotes an entire chapter to transitions, with an emphasis on transitions in the stories people tell themselves and others about their lives. In his discussion of a client who had a painful and judgmental relationship with her husband, Polster describes two crucial therapeutic tasks: “One was to turn her raw pain into interesting conversation. . . . The second task was to lead her into discovering how human it is to err [instead of being harshly judgmental toward both herself and her husband]. . . . She became more nearly able to transform her shame—which punitively harrows her—into humility, which offers better proportions in self-acceptance. Humility permits both flaw and forgiveness and is an excellent antidote to shame”(p. 52). These transitions in her view of herself led to major transformations in her life. As a result of therapy, She became “more open to laughing, gained needed weight, has a new glow on her face, has started to have sex again with her husband, is going back to painting and has arranged for future work.” Notice that the words “transition,” and “transformation,” and “transcend” all have the same root.

Here we will look in detail at one common transitional pattern, and then more briefly at a spectrum of transitional events.

Gestalt therapy sessions often begin with one of several common “opening moves” by either the client or the therapist. Sometimes a disturbing dilemma or situation is so “front and center” in the client’s mind and emotions that two minutes after the session begins, he or she is deeply into the middle of the work. When that’s not the case, the therapist may ask something like, “Do you have an agenda?” Sometimes, especially in group work, the client may reply, “I really don’t know. I just had a feeling that it was time for me to work.” In that case, the person may be asked to begin with an awareness continuum, spoken out loud. The flow of associations usually soon turns into an important issue or concern.

A person’s central concern often emerges first, but not always. Sometimes the item that emerges first is a cover for a larger issue that is revealed once the client feels safer and more settled. Then the session may shift from the “opening move” to a more central working theme. Often simply waiting and watching for a brief time, with a few fragments of conversation and inquiry, is enough for that transition to occur.

At that point, a client will often describe an existential dilemma—a troubling life situation that he or she seems to lack the personal resources to handle. The description of such a situation often involves one or more of several elements, such as:

  1. A problem with a specific other person
  2. A recurrent self-defeating pattern of behavior
  3. An intrapsychic battle between two (or occasionally even three) sides of the self that are in conflict.
  4. A past history involving an unfinished situation (or series of related situations), or a conditioned emotional response that interferes with responding realistically and with awareness to the present situation.

Often all these elements are present. Sometimes one is obviously most figural. When there is a clear interpersonal or intrapersonal polarity, the transition from a description of the situation may involve simply putting one side of the polarity in the “hot seat” and the other in the empty chair, and asking the person to enact each side in dialogue. In many cases, just identifying the two sides of the dialogue is not enough to complete the transition into it. Asking the person to identify as fully as possible with each side is helpful. Fritz Perls, with his background in theatre, used to say, “Ham it up!” I prefer more specific “stage directions” like, “Sit or stand as your husband would. Adopt his posture and his gestures. Speak in his tone of voice.”

When two (or even three) of the four elements described above feel equally figural and I have no clear feeling about which one seems most likely to be productive, I may offer a clear description of the alternative avenues of work that occur to me and ask the client to choose one. For example,

“One option is to put your husband in the empty chair and tell him how you feel about this. Or perhaps you’d prefer to have a conversation between the side of yourself that typically goes along with his wishes and the side that wants to stand up for your own desires and needs. Which of these dialogues do you feel most drawn toward right now?”

Offering such a choice has the twin advantages of making the therapist’s (or counselor’s or facilitator’s tentative “cognitive map” of what’s going on (Tolman, 19 ) transparent, which often broadens the client’s awareness. If the “map” is wrong, the client will almost invariably correct it. Offering such alternatives also places the choice about the direction of work in the client’s hands, thereby contributing to his or her development of a greater sense of responsibility. In my experience, when offered such a choice, the client almost always chooses wisely.

Movement among the four situational elements described above may take this form: First, the client describes a troublesome and recurrent pattern, such as, “I keep choosing partners who are unavailable and run away when I want to get close.”

Second, the person chooses a salient relationship in which this pattern has. “Would you care to explore how this is occurring with Rob?” (Or these first two steps may be reversed. First the concrete situation is presented, and then it is described as a recurrent pattern.)

Third, we may explore the origins of the behavior. “Does this remind you of anything that happened when you were a child?” Usually it does.

“Yes, my Dad left when I was three, my brother went with him, I stayed with Mom, and I hardly ever saw them after that.” Then we may move into a vivid récollection of a particular emotionally-loaded scene involved in that childhood trauma, often initially with closed eyes and visual recollection. That often leads into intense emotion and saying things that have never been said but were held onto through the years. Or it may lead to an inhibition of the urge for such expression, in which case developing an awareness of the dynamics of the inhibition becomes the center of the work.

Finally, when that energy has dissipated or when an intense intrapsychic encounter is lurking just beneath the surface, we may move into a dialogue between the two sides of the self. (One side wants love, but the other side chooses men who will leave before she gets close enough to get hurt too deeply.)

For the most part the facilitator follows where the client’s energy is moving, always with the goal of gaining the fullest possible awareness of each figural component of the total situation. As a figure begins to emerge, the facilitator may guide or “lead” the person into actions that help develop fuller awareness. Some transitions that look like “magic” involve no more than adept following. Other interventions are theory-driven or method-driven.

But when the client is inclined to “move on” because of discomfort, the facilitator’s role is not to follow, but to stay with, and encourage “going more deeply into” rather moving away from the discomfort.

In cases when the client’s energy surrounding one figure recedes and no new figure immediately takes its place, the best transition may be into silence: just “sitting with” until something bubbles up in the client’s consciousness—as usually it does. If the silence seems to have gone on long enough, it can be useful to say, “Let yourself speak out loud whatever is going through your mind and feelings, in a stream of consciousness fashion.” Soon something important is apt to emerge.

In other cases when the energy of an interpersonal or intrapersonal dialogue has waned, a more pointed transition can be productive.     Other transitional moves include such possibilities as:

Rogerian reflection
Explicitation of paralanguage
Somatic focus
Following arrows and “neon arrows”
Strategic suppression
Magnification by exaggeration
Thematic transformations
Listening to language
Intuitive hunches

We will briefly consider each of these. Of course you could drive yourself crazy trying to pay attention to all of them at the same time. It’s best to learn to use them one or two at a time, gradually adding to your repertory. Trying to learn to do them all at once is a good way to do none of them well.

If you are an experienced practitioner, you’re probably saying to yourself, “Wait a minute—some of those aren’t really transitions at all—they’re ways of going deeper into an experience.” Of course. Few psychological processes or therapeutic interventions are dualistically just this or that. Most include some both/and rather than either/or. A transition may be from one working focus to another, or it may be from a minimal and limited expression of a thought, feeling, or behavior to a rich and full expression of it. Different as they may first appear, each of these two emphases embodies the quality that Polster calls nextness: “When you consciously lean into nextness, you will probably have tapped into a reservoir of your energy, creating alertness, excitement, and fluidity” (1987, p. 42. Now we look briefly at each of the items just mentioned.

Rogerian reflection. “Wait a minute,” you may protest. “I thought we were talking about Gestalt work. Why are you bringing in Carl Rogers?”

            Actually, certain elements of Rogers’ approach are quite useful in a Gestalt context. Both Rogerian therapy and Gestalt therapy are phenomenological—they seek to understand the client’s own interior world in his or her own terms. And both Carl Rogers and Fritz Perls were remarkably astute listeners, although Rogers focused more on verbal meanings and Perls more on paralanguage. In the early stages of a working session a client may not be ready to move right into an interpersonal or intrapersonal dialogue involving the “empty chair.” And some clients are never ready to do that. Although I prefer to move into the “tight sequentiality” (Polster, 1987) of focused dialogues sooner rather than later, if a client is uncomfortable with them, an entire working session may be more like a “conversation.” Or sometimes in the middle of a session, we may move back into “conversation” in order to “tease out a storyline” as described below. Finally, some practitioners who work within the Gestalt theoretical context do all or almost all their work in a “loose sequentiality” manner involving dialogue between therapist and client rather than empty-chair dialogues.

In all these instances Rogerian reflection can be quite useful. There is, however, a widespread misconception that such reflection involves just paraphrasing what the person has said and repeating it back. Rogers seldom did that. Most of his “reflective” comments drew on his remarkable ability to hear the deeper currents of what clients said, and articulated a deeper and fuller version of the client’s experience than the client had verbalized. If Rogers was off the mark, he listened to the client’s correction. “That’s not exactly what I meant. I was trying to say that . . . .” In the very act of “correcting,” the client often articulated a fuller and more precise awareness of the event or phenomenon in question. A student or trainee who is learning to use this method may find it useful to use the formula, “I think I hear you saying. . . . Is that right?” I sometimes still use exactly those words myself.

Such counseling and therapy, effective as it often is, has been criticized as a “talking heads” approach. For Fritz Perls, with his background in theatre and his analysis with somatically-oriented Wilhelm Reich, and Laura Perls, with her background in modern dance, the whole body was involved in everything a person does. They introduced two distinct body-related dimensions into their therapeutic work.

            Pregnant paralanguage. The first of these two elements, termed “explicitation,” by Claudio Naranjo (1993, 2000), is one of the elements most widely recognized as part of Gestalt therapy. It involves giving a voice to physical gestures, postures, and voice tones. The client may not even realize that she is doing something prior to giving it a voice. She may be pounding her fist into an open hand as she speaks. “Give your fist a voice,” the therapist suggests. “What does it say.?”

Or a tear uns down her cheek: “Let your tears speak. What do they say?”

Or she shrugs helplessly and turns her palms upward as she tells a story or speaks to “another person” in the empty chair: “Keep doing that with your hands and shoulders, this time without speaking. . . . Good, again. . . . Now once more, and this time give your hands and arms a voice—just a few words.”

Or to someone who is clenching her jaws as she speaks: “Tighten your jaws still more and squeeze your words through them.” In this case we see a polarity between the attempt to speak and the attempt to stop speaking. “”Now be your jaws and tell the voice inside you why it had better not come out. . . . Now be that voice and speak to the jaws that are holding you back. . . .”

Or someone’s voice sounds a little like a growl as she speaks: “Forget the words and just growl. . . .”

Almost every gesture and sound has a meaning that can be articulated. After all, long ago humans could gesture before they developed language. Infants can move and gesture, laugh and cry, before they can speak. Our paralanguage that consists of posture, movements, gestures, and voice tones carries messages that we often mask because of our fear or our adherence to social conventions. Noticing these and giving them an appropriate voice can be one of the most direct transitions from a mistaken conception of what is occurring into an authentic experience of what is actually occurring, whether inside us or in the situation outside us.

           Somatic focus. This comes directly out of Wilhelm Reich’s discovery of “muscular armoring” (1949). It is similar to explicitation, but here attention is directed to sensation rather than action. “Without changing what you’re doing, notice how you’re breathing.”

Or, “As you continue to walk slowly in a circle, let your attention scan through your body, and report each sensation you’re aware of.” As Fritz and Laura Perls pointed out, what’s missing in a person’s awareness is just as important as what’s present, and often even more so. Someone who is socially withdrawn may have no sensation in her arms, and may not realize that they’re glued to her sides.

Often enough, when someone starts to pay attention to bodily sensations, they discover feelings that were unobserved and even unsuspected by the therapist. Then

these discoveries often become transitions into the next stage of the work.

Arrows and neon arrows. Erving Polster introduced these terms in a psychological context. Arrows point to a “nextness” in the work. There may be several arrows that point to diverse possibilities, and one therapist may follow one while another follows a different one. “Neon arrows” point to where the work has to go if it is to be most productive. Developing a sensitivity to these is an essential part of the training of a good therapist, counselor, or facilitator. The neon arrow may be a dropped comment that the client quickly moves away from—“Except for what my husband did.” Or it may be a dramatic change in the quality of a person’s voice. Or a tiny facial twitch that indicates a flash of feeling that is quickly suppressed. All these neon arrows point to transitions that will probably lead right into the very heart of the client’s issue or complex.

Strategic suppression. Naranjo substitutes the term “suppressive techniques” for the approach that Fritz called “frustration.” By whatever name, this refers to blocking a person’s expression of well-worn counterproductive old habits that interfere with being genuinely present and authentic. Naranjo notes, “There is little place for the now in ordinary conversation. . . . Much of what we say constitute[s] an act of avoidance of the present” (p. 51). He points to “shouldism” (originally identified by Karen Horney) and “aboutism” as two categories of behavior for which suppressive techniques often are useful (53-67). In the absence of deadening old habits, it is easier for here-and-now awareness and authentic expression to occur. Here the transition is from the repetitive performance of habitual behavior to allowing a new and different alternative to emerge.

Magnification by exaggeration, an important dimension of what has been labeled “expressive techniques” by Naranjo, is one of the most fertile areas of methodological innovation and discovery in Gestalt therapy. Exaggeration of paralanguage is one example. Exaggeration functions like a microscope. When an action that is usually expressed in minimal or barely visible fashion is exaggerated, it becomes easier to see or hear, both for others and for the person who is doing it. Someone who consistently looks to others for guidance and direction, or for assurance that he is “doing it right,” may be asked to say “please tell me what to do,” or even to get down on his knees and beg for guidance. His disowning of his own self-direction and responsibility becomes so painfully obvious that the awareness of it may lead him to actually make his own conscious decision about what to do next.

Exaggeration can also serve as a transitional experience in another way. When we do not express something that we feel, or do not do something that we wish to, it is often due to past punishment of such expression or action. In the therapeutic situation where no such punishment occurs, the person can try out expression in the ways that once were forbidden, and can even exaggerate them. With no present punishment for the old behavior, the conditioned emotional and behavioral responses of fear and avoidance begin to extinguish. Fritz was adept at leading people into this kind of experimentation, using such techniques as “reversal” –that is, suggesting that someone do exactly the opposite of what they habitually do in a given situation. Thus someone who was exaggerating feeling heavy and burdened may “become a butterfly,” flitting gaily about with lighthearted energy. The power and beauty of such reversals can be remarkable.

          Thematic transformations include reversals such as those just described. They also include discovering new ways to think about oneself, such as appreciating qualities one has taken for granted. This is a central element in the “cognitive restructuring” of cognitive behavior therapy (Beck, 1979, Ellis, 1977), the “reframing” of communication theory (Watzlawick, Weakland, & Fisch, 1974; Bandler & Grinder, 1982), and the “theory of positive intent” articulated by family therapists Shirley Luthman and Martin Kirshenbaum (1974).

Sometimes making such transitions is slow and difficult work, while at other times, when a person is ready, it can occur instantaneously, dramatically, and spontaneously.

Teasing out stories is a transitional method used by almost every counselor, psychotherapist, facilitator, or personal coach since Freud first used “free association” as a means of discovering his client’s life-stories. A person may reveal an important story little by little, perhaps in a vague form. Fritz Perls said, “I can’t understand abstract language. I must have something real to work with.” A client called “M” began describing a dream, “I’m with my sister—and we have a lot of fun together. . . we do things together.”

P: What do you do together? . . .

M: We—we escape together, we—

P: You escape together.

M: We escape from people, and—

P: I don’t understand the word “people.” From whom do you escape?”

M: From my parents. (1969, p. 132-3)

At that moment of insistence on a concrete statement, the essential storyline is revealed and the transition is made into a situation in which focused work becomes possible. In Every Person’s Life is Worth a Novel, Polster spells out methods of “mining for stories”: in great detail. (1989, 68-96)

Listening to language is a variation on this theme. In the defense mechanism of “minimization,” for example, a person describes everything in “minimal” terms: “I’m just a little bit concerned about what you’ve said.

Finally, intuition is indispensable. Sometimes I “just have a hunch” that a certain avenue of exploration will prove useful. Usually it does. (But I don’t want to hang onto it when it doesn’t.) Intuition tends to get better with training and experience. If you’ve seen many expert Gestalt therapists at work, you have a broader selection of options from which to intuitively choose. The more experience you have, the better your intuitive sense of what will work and what won’t is likely to be. In my own experience, intuition seldom comes through “trying to figure out” a situation. Rather, it appears when I’m present and receptive. Sometimes it feels almost psychic. For instance, I’ll have an intuition that a given person or element is important in a situation, and half a minute later he or she will mention exactly what I was about to suggest. By following your intuition, you’ll discover when it’s accurate and when its not, and that will sharpen it.

In the end, we want to remember that many of the most profound transitions come out of the paradoxical theory of change (Perls, Hefferline, & Goodman, 1951). In Joseph Zinker’s (1977) words, “Look at the person the way you would look at a sunset or mountain. Take in what you see with pleasure. Take in the person for his own sake. . . .

The therapist, like the poet, is able to appreciate the full . . . landscape of his patient’s existence. . . In order to help someone, you must love the person who is before you and not a goal you set for him.”

REFERENCES

Bandler, R. & Grinder, J. (1982) Reframing: Neuro-linguistic programming and the transformation of meaning.
Moab, UT: Real People Press.  Beck, A.T. (1979) Cognitive therapy and the emotional disorders. New York: Penguin/Meridian.
Ellis, A. (1977) Handbook of rational emotive therapy. Berlin and New York: Springer-Verlag.
Luthman, S. & Kirshenbaum, M. (1974) The dynamic family. Palo Alto, CA: Science and Behavior Books.
Naranjo, C. (1993, 2000). Gestalt therapy: The attitude and practice of an atheoretical experientialism. Nevada City, CA: Gateways/IDDHP Publishing; London: Crown House Publishing Ltd.
Perls, F.S. (1969). Gestalt therapy verbatim. Moab, UT: Real People Press.
Perls, F. & Baumgartner, P. (1975). Gifts from Lake Cowichan/Legacy from Fritz. Palo       Alto, CA: Science & Behavior Books
Perls, F.S., Hefferline, R.F. & Goodman, P. (1951). Gestalt therapy: Excitement and growth in the human personality. New York: Dell.
Polster, E. (1987). Every person’s life is worth a novel. New York: Norton.
Polster, E. & M. (1999. From the radical center: The heart of Gestalt therapy. Cleveland: Gestalt Institute of Cleveland Press.
Reich, W. (1949). Character analysis. New York: Noonday.
Rogers, C. (1977)   Three approaches to psychotherapy II, Part I: Carl Rogers. Orange, CA: Psychological Films.
Rogers, C. (1986)   Three approaches to psychotherapy, Part I: Carl Rogers. Corona del Mar, CA: Psychological & Educational Films.
Watzlawick, P., Weakland, J.M., & Fisch, R. (1974). Change: Principles of problem formation and problem resolution. New York: Norton.
Zinker, J. (1977). Creative process in Gestalt therapy. New York: Brunner/Mazel.

THE WORKING CORNER is devoted to discussing specific aspects of the Gestalt process, including both method and theory. It systematizes and explains recognized Gestalt methods and introduces innovative new ones. The primary focus is on events that occur within a single working session.

Victor Daniels is Emeritus Professor of Psychology at Sonoma State University, Rohnert Park, California 94928