A workshop presented at the joint Association for the Advancement of Gestalt Therapy and European Association for Gestalt Therapy conference, Taormina, Sicily, October 2016| published in hard-copy and online as:

UNIQUE ADAPTATIONS OF METHODS FROM PSYCHODRAMA, MOVEMENT, AND COUPLES AND FAMILY THERAPY

Victor Daniels
Sonoma State University, California

 

ABSTRACT

Gestalt therapy has taken different paths in different regions. Dialogical-relational approaches dominate in much of the U.S. and Europe. In contrast, Mexico, South America, and Japan favor methods with enactive and psychodramatic histories. Both these threads continue to develop. This workshop describes how to use several little-known or unique new working methods grounded in the movement, dramatic, and enactive sides of gestalt therapy. It also adds visual imagery to conversational and movement work, showing how pictorial images can take the place of empty chairs in a projective dialogue or in family constellation work. Finally, it presents two distinct methods of discovering feelings that lie hidden beneath presenting issues.

Introduction

“Field Theory” as Kurt Lewin developed the concept meant not just the limited field of client, therapist, and consulting room as it is sometimes used. For some purposes it makes sense to draw that limited boundary line and focus on the events within it, or a larger and more encompassing boundary line such as a specified group of people, or the neighborhood in which a person lives. The full expression of the concept, however, is the full field of the client’s experienced life-space. Such a definition is inherently phenomenological. Applied effectively, it also leads to enhancement of awareness and more effective action. Within that theoretical context, this presentation is practical and down-to-earth. It describes several therapeutic methods that are useful in therapy, with only a few words about their origins. The central emphasis is on how and when to use them, and why each is useful.

The unifying element of these methods is enactment, which historically proceeds from origins in psychodrama and theater. In gestalt therapy the best-known varieties of enactive expression are projective dialogues (especially in the form of empty chair work), and enactive movement and vocal expression. The roots of these working modalities lie in psychodrama, dance therapy, identification, interactive group process, family constellation work, and most recently the use of visual imagery as a complement to conversational dialogue. A working session may include just one of the methods that will be described below, or may involve two or more in combination. It may use the method or methods described on a stand-alone basis in the style of psychodrama, with the therapist bringing elements of the theater director’s repertoire into his or her own psychotherapeutic approach. It may use one or more of these methods as an adjunct, within the context of a dialogical-relational session – especially when a client is uncomfortable with overtly enacting troubling situations. Or vice-versa, with interludes that have a dialogical-relational focus within a therapeutic hour that on the whole is structured in a dramatic-enactive manner. For the most part the methods are described here as separate and discrete. How to integrate them in a session with a particular client who is working with a particular issue is left to you, the therapist, in the context of working with a particular person in regard to a particular situation.

Hopefully The methods presented below are described here with enough detail and specificity that you can proceed to try them for yourself.

“But wait!” you might object. “Surely you could not have had time to demonstrate all these in your workshop.”

You’re right. Of course not. And so the most novel approaches were presented in demonstration work with volunteers in the workshop and the others were merely described.

The Working Methods

2.1. Doubling.

Doubling is a classical psychodramatic method that is often used used in group work. In psychodrama the client chooses another group member to represent another person with whom there is an issue, or one of his or her contrasting voices in an inner conflict. Then the two talk (or argue) as they present their conflicting views. Another group member may get up, come across the room, and stand behind one or the other two protagonists. When there is a pause, that person makes a statement that he thinks is really going on inside that person at a subsurface level, and then returns to his or her seat. Someone else may do the same with the other person. Sometimes it may happen that three or four people stand in line behind one or the other or both people, waiting to make a statement. In each case, the client or the other person may think, “Yes, that fits” and expand on the suggested statement, or “No, that’s off the mark” and ignore it.

 2.2. Doubling for yourself and others.

This is a specifically gestalt therapy adaptation of doubling. It can be used either in a therapy group or in the consulting room when when only the therapist and client are present. Doubling as described above is sometimes slow and cumbersome, and suited only to group work. In two-chair work (whether the client has “put” another person or one of his or her own conflicting voices in the empty chair), the therapist may seem to sense that another voice or motive is lurking beneath either the client’s “hot seat” persona or empty chair persona. Then the therapist can suggest that the client go around behind the chair in question and perhaps even kneel down to dramatize that this voice is one that is being held back and not expressed. This is especially useful in dialogues with parental figures where there have be clear rules about “what may not . . .” or “should not” be expressed. But often the client knows perfectly well what these statements and rules about them are, and when given permission by this explicitly structured situation, comes right out with them. And the the work continues on a more realistic basis.

2.3. Spectator Dialogues

This tactic was developed by Ann Teachworth in her work with couples that can be effective, and sometimes uniquely so, in individual work as well. She developed a method in which a couple had an initial meeting with each other, and then for some time each member saw her separately. In that individual work, she had each person enact two-chair dialogues between his or her parents, working on their own conflicts to a point of resolution. Then, with the parental conflicts resolved, Ann brought the couple back together. At that point, often they resolved their own difficulties in a single session. (They had been enacting their parents conflicts with one another.) In group sessions, I found that Ann’s method can be used with a single person. Tom, for example, never seemed able to get his energy mobilized for anything. In empty-chair dialogues with each parent independently, I saw no clue as to what was going on. Then I asked him to do a “spectator dialogue: in which he had Mom and Dad interact with each other.   Eureka! Thirty seconds from each parent and it was obvious that Mom was the Commander-In-Chief and Dad meekly did whatever he was told. Tom was re-enacting his father’s role with is mother. This had been invisible in his dialogues with each.

2.4. Using visual imagery as a therapeutic modality.

For most people, the thinking process consists not only of inner verbalization or “self talk,” but also to a substantial degree of mental pictures and “mind movies” or “mental video clips.” If you’re like most people, a few minutes of introspective observation of your own thinking process in action will demonstrate this clearly. Hermann Rohrschach developed his “ink blot test” in 1920 and Henry Miller and Christiana Morgan developed their Thematic Apperception Test filled with highly lifelike and some highly traumatic scenes in 1930. But through all the decades from then until recently both tests have been used almost exclusively for diagnosis and essentially not at all as parts of the therapeutic process. In recent decades, Kooch N. Daniels who holds an M.A. in Jungian Oriented psychology and is also an accomplished Tarot reader and I have been developing explicit therapeutic processes based on visual imagery. Is Europe and Israel, – – – – and others have been following a similar path with OH! Cards, but not, as we have, using explicit gestalt therapy methodologies. To integrate visual images into your own work, Tarot cards are an excellent starting point, especially since they originated right here in Italy during the 15^th century, when the decks were hand painted for wealthy patrons. Look online at Google Images or in stores and find on of the many decks that you especially like. Then with a client after an issue or problem or conflict has been articulated, spread the cards face up on a table or the floor in front of your client (in contrast to traditional fortune-telling, which uses a face-down deck). With an interpersonal dilemma, ask your client to select a card to represent himself or herself and one to represent the other person. With an intrapsychic conflict or problem, have the client select cards to represent the conflicting internal voices.

Then continue with a classical gestalt process of identification with each of the card images Once a clear identification with each of them has been achieved, continue into a two-chair style dialogue between them, moving ahead until some resolution, new awareness, or clarification has been achieved.

You could also do this with TAT cards, OH! Cards, or even create your own deck for a specialized population such as children, teenagers, the aged, veterans, prisoners, or the physically handicapped. Imagery sources include postcards, photo cards, magazine cutouts mounted on cardboard, or printouts from Google Images or Pinterest or other online sources.

2.5. Multiple Others.

This adaptation from family constellation work involves arrangement of visual imagery cards in a layout that demonstrates relationships with people in a given part of the client’s life such as family or workplace. Method 6 just above, “Using visual imagery” forms the basis. But instead of selecting just two or three card, the client selects a card for each member of his or her family. Or workplace. And then lays them out like a sociogram, with cards close to or touching each other to represent people who are close to each other, and cards far away for family members who are distant. A card might be placed diagonally, or upside down, to reflect relations with the client or the rest of the family. One card might be placed to block communication with another one. Then the card that represents the client has a few lines of dialogue with each other card. The client and therapist together assess where the dominant lines of energy seem to lie. That provides a beginning for deeper exploration. Surprises are commonplace. Sometimes communication opens up with a completely different person than the client expected, and explosively powerful work with family dynamics is common. In explorations of dynamics in the workplace or with other groups, clarifications of reasons for conflict or lack of communication are also common. This working method, as well as those described in “6” just above and “8” just below, is explained in detail in Tarot at a Crossroads: The Unexpected Meeting of Tarot and Psychology. (See reference l below.)

2.6. Emotional stacks.

Often enough, a presenting situation is like the surface of a lake, river or ocean in which strong underwater currents that are invisible from the surface are a major part of what is happening. Becoming aware of and working with the closely related emotional (and often also cognitive) events that underlie them is often a necessary element of working with them effectively. The issue, problem, or conflict that a client starts out saying they’ve come to deal with may be a cover for what the person is truly most concerned about. Someone may begin with a conflict involving a parent, for example, but before long it turns out that grief over a death in the family is the main event. Any of a spectrum of events that Erving Polster calls “neon arrows” can point to those “what’s really happening events.” A crack in the voice; a moment of hesitation; a mentioning one event and then suddenly jumping to something completely different—these are just a few examples. That’s where the intuition, sensitivity of the master psychotherapist, in contrast to the journeyman, come it.

There are, however, a few methods that are widely helpful. They can help the journeyman tune into what’s important,–and perhaps even the master when he or she is tired and somewhat inattentive at the end of a long day. The general concept is that emotions almost always travel in groups. One seldom occurs all by its lonely self. underneath the surface feeling is another different one. And beneath that one there may be a yet different one. The classical example is that “Men get angry; women cry.” But beneath his anger are emotional pain, and perhaps hidden tears. Beneath her tears, there is often anger that provoked them, suppressed due to a lifetime of learning.” There may be, however, yet other feelings beneath those. After someone has express a dominant surface feeling I like to say, “Please close your eyes for just a moment. Quiet your mind. Do you have a sense of any other feeling of any kind that underlies the one you just mentioned?” Almost always the answer is yes. After discussing that feeling I repeat the question, and often the answer is yes again. I’ve sometimes found layers of five or six “stuck together” emotions that, together, tell some kind of story. Not infrequently, the last and “lowest” feeling turns out to be the key one. A woman who felt tied up in knots whenever she tried to express herself, for instance, ultimately found that a heavy handed, punitive patriarchal father’s commands had stolen her voice and autonomy—and then she set out to change that.

That same process of identifying the various layers in an emotional stack can be done with visual image cards. The client selects a card from the face-up images for the dominant feeling, then looks back through them for one that reflects an underlying feeling, discussing each in turn. The process continues until he or she says something like, “I think that’s all.” When the second card is chosen, it is placed partway beneath the top card so that both can be seen. So on with the remaining cards, until there is a stack partly visible cards that reflect the “stack” of emotions (and perhaps related thoughts) in the person related to the matter in question. Then the reverse can occur, and the client thinks through the steps he or she would lie to take to develop a new and better pattern to replace the old one.

2.7. Expressive exaggeration, exploration, and then reversal of an attitude in physical movement.

Fritz Perls’ experience in theater and Laura Perls’ experience in dance both contribute to the development of this approach. Robert K. Hall extended it in innovative and useful ways that this author has not seen used by other practitioners. As a gestalt practitioner you are doubtless familiar with the two most basic forms of expressive exaggeration. One is giving physical expression to a verbal statement, such as asking someone who is making angry remarks to make a fist and hit the opposite palm. The opposite is putting words to physical movements or gestures—such as asking someone dealing with the issue just mentioned who begins by hitting his palm as he speaks to finish a short sentence each time he or she does so: “Please finish the line ‘I resent you for . . .'”   He is asked to do so again and again until he has gotten all the resentments out.

A related tactic is to request an exaggeration of an existing mannerism. Someone who chronically speaks in a very low, subdued voice might be asked to try to yell what she’s saying and at the same time internally strangle her vocal chords so that it’s almost impossible to make a sound. In so doing she may become aware of something she almost always does, and discover that she can stop doing it.

When appropriate, a subsequent step is to get up and walk around while enacting a behavior. For example, someone who reports that he feels like he’s going through life like a deadened robot may be asked to stand and walk in a circle with as stiff and robot-like walk as possible. It’s often useful to suggest speaking just one or two words with each step. Our robot might, for instance, say, “Stomp. . . . . stomp . . . stomp. . . ” as he walks. Then he is asked to exaggerate the walk—do it even more so. Our robot’s step may become so heavy that he can barely move. Typically a person will reach a “breaking point” where they can stand it no longer. Our robot-client may suddenly scream “I HATE THIS!” Then he will be asked to exaggerate that.

Scream it again and again until he’s had enough. When the therapist intuits that the time is right, he or she may suggest, “Now do the opposite. Move in a way that’s completely opposed to your robot movement.” The response is individual. One person might begin to dance. Another might reach out toward others (if it’s a group rather than individual session) and say, “I want to play with you.” When the energy for this wanes (usually in 3 or 4 minutes), the person is invited to sit down and discuss his or her experience.

2.8. In a Group Context, Issue-focused dialogues with other group members in a go-around (“Making the Rounds”)

Here, during an enactment and exaggeration, the client is invited to interact with group members during the go-around. One woman who had been “mousy” and downcast for three months acted out being a mouse, and in her reversal became a great and powerful bear, rearing up above people on her rear feet and growling. It was a transformative moment. In the group she was never mousy again.

At the option of the therapist, group members may be invited to respond to the person doing the go-around, in a way likely to facilitate that person’s work

2.9. Situational use of classical psychodrama.

Rather than classical psychodrama, I usually prefer Gestalt adaptations of psychodramatic methods in which the client himself or herself engages in identification, exaggeration, and projective dialogues such as two-chair work. In perhaps one in ten or fifteen sessions, however, pure psychodrama feels more appropriate. (For me, about that same ratio holds for a conversational rather than my more usual ways of working, that involve projective dialogues and enactive movement.)

“Full tilt boogie psychodrama” most often seems appropriate to me when a person is right on the edge of getting into something but can’t quite seem to “make it in” to feeling the situation fully. One example is a person who was working with a history of schoolyard bullies. They just didn’t feel quite real enough as he was trying to enact them. So I asked him to choose several men from the group who could play their roles. They all stood up and one of two of the bullies insulted and pushed him just enough that he went into the long-suppressed appropriately aggressive and assertive response that he had never quite been able to access.

Another example was a woman and her grown-and near-grown children. She needed to talk to all of them at once and have all of them talking to her at once, but couldn’t quite do it with pure gestalt work. With psychodrama it worked. She chose people from the group to be her children, they got up in front of the room, she describe the role of each to them, and it worked.

            I used to teach a course in the family, and each student did a similar enactment of his or her own family and it was very effective.

Similarly, Sylvia Fleming Crocker’s used of full fledged psychodrama in her work with dreams can open up certain dimensions that are more difficult to access through standard gestalt work.

So when it is most useful to use psychodrama? Again there is the old answer, “Use your intuition.” And how do you develop that intuition? By trying a psychodramatic process when it feels appropriate, and taking mental notes of what works and what does not.

Several years ago a training group I was leading at the Humanistic and Existential Institute in Culiacan, Mexico taught me a new psychodramatic approach: “Slow motion psychodrama.” I was demonstrating Sylvia’s dramatic dreamwork. It started out all right, but the trainee and the others he chose were through enactment of the dream and at its end so quickly that we all thought something was missing. One of the students suggested, “Why not try it in slow motion?” So we did, with the modification that after enacting each event in the dream, both the protagonist and the other participants told how they were feeling at that moment. It turned out to be much more therapeutic and a wonderful innovation

Finally, there are situational enactments that can be used in an otherwise “pure” Gestalt session. I have found two of these especially useful.

2.10. The Eulogy (for someone who has died). This is a classical psychodramatic method, with no adaptation to gestalt work needed, because when it is appropriate it can be used just as it was developed within the context of psychodrama. It is used when someone dear to the client has died (recently or long ago) but the client never had a chance to truly say goodbye. (This could probably be adapted to an individual session; I have always used it in a group.)

The client will have already identified the deceased person with whom he or she feels unfinished. The group is asked for a volunteer to play the deceased. That person lies down on the floor and is covered with a blanket, or at least a jacket that covers the head and upper body. Two more people are asked to serve as gravediggers.   The client is asked to imagine that the deceased is lying in a freshly dug, otherwise empty grave. He or she is asked to stand at the head of the grave and deliver a eulogy to all those present about the person who has passed on, including everything he or she would like to have said to or about that person but never did.

The eulogies are often very touching. Tears are commonplace but not required. Then when the Eulogy is finished, the gravediggers are asked to shovel earth over the deceased for as long as the therapist judges it appropriate. Then the client sits down and shares his or her feelings and thoughts. Others in the group may then also speak, but only one statement from each person.

Reflections and Conclusions

Why do I prefer a projective dialogue based dramatic-enactive approach to a primarily conversational form of Gestalt therapy? Because I often find that the voice tone, gestures and body language of enactment give me information in three minutes that would take me three hours (or weekly one-hour sessions) to tease out in conversations. It’s that simple. (This does not imply ignoring transference and countertransference dynamics. They just tend to play a smaller role.) The procedures described here are not “experiments” in the classical Gestalt sense that implies making up a new activity for the client on the spur of the moment. Rather they are procedures that can be useful when the therapist thinks that one of them is likely to be so (like a doctor or dentist who has various instruments for use in different situations). They are, however, experiments in the sense that using one or more of them with a given person at a given moment is an experimental move. They are also experiments in the sense that only brief outlines are described above, with ample room for changing them to fit the client and context.

I work primarily with individuals in a small group context. At the end of each session we have a period in which each group member may make a statement to the person who has just completed a working session. The rules for this feedback are that each person who wishes to speak has just one chance to do so and must include all that he or she wishes to say in that one statement. (This compels members to think carefully before speaking and keeps the session from dragging on.) All statements must be about the feedback-giver’s own feelings, from a personal frame of reference. Analysis, intellectualization and evaluation are not allowed. Anything someone wishes to say after the group feedback may be said privately and individually afterward. When a client feels a little shaky after a session, the facilitator may ask if there is someone willing to spend a few extra minutes with that person, whether in the hallway, the snack bar, or while walking the person to their transportation.

All methods described here have been tested over extended periods.

References

Daniels, K.N,, Daniels, V. (2016) Tarot at a Crossroads: the Unexpected Meeting of Tarot and Psychology. Atglen, PA: Schiffer Publishing Company.

Perls, F.S. (1973) The Gestalt Approach and Eyewitness to Therapy. Palo Alto, CA: Science and Behavior Books.

Polster, E. (1987). Every Person’s Live is Worth a Novel. New York-London: Norton,

Teachworth, A. (1997). Why We Pick the Mates We Do. Metaire, LA: The Gestalt Institute Press.