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Theory
and Practice of Counseling -
PSY632
VU
LESSON
29
GESTALT
THERAPY
Link
to Previous Lecture: Case
Approach to Client Centered
Counseling
The
following case will be used
to illustrate theoretical concepts of affective and
cognitive-behavioral
approaches
to counseling.
Case
of Farzana (Source:
Modified from Corey,
2001)
·
Appearance:
Dresses
meticulously, speaks rapidly, avoids
eye contact
·
Living
Situation
43
years old housewife, middle
class, Graduate, married,
with 4 children (16-21 age
range)
·
Presenting
Problems:
General
dissatisfaction, symptoms of panic
over reaching the age of 43;
For 2 years has a
range
of psychosomatic symptoms; cries
over trivial matters;
depressed; weight problem
·
Psychosocial
History:
Oldest of 4
children, father distant authoritarian
and rigid; mother critical,
difficult to
please;
was told not to behave
like "bad" girls; took
care of younger siblings; felt
socially
isolated
by peers; wished to become a
teacher
·
History
of Presenting Problems:
Graduated
when children became adolescents;
made her major career as a
housewife and
mother
until children were grown
up.
Not
sure what she wants to do;
she would like to develop a
sense of herself apart from
the
expectations
of others; concerned about "losing
children"; feels unappreciated by
them;
concerns
over aging and losing her
"looks"
Farzana's
Autobiography
·
"I
have become aware of
recently that I have pretty
much lived for others so
far. I have been the
superwoman
who gives and gives
until there is little left
to give"
·
"There
are times when I wake up at
night with my heart beating
very fast, in a cold sweat,
and
sometimes
shaking"
·
"I
feel a terrible sense of doom
but I don't know what over.
I read Qurran
for
comfort but I worry
about
death-about my dying-a lot, about going to
hell"
Farzana:
A client-Centered Perception
·
The
word "diagnose" is derived from a
Greek word that means
"to know" or "to discover",
hence
the
client's discovery of himself is more
important than what the counselor
knows about him.
Usually
a client-centered counselor will
neither use tests nor
make a DSM-IV diagnosis.
All
diagnosis
are reductionist from a client-centered
perspective that they reduce
clients and their
symptoms
to a list of symptoms. That is
why no diagnosis will be
made for Farzana,
and
assessment
of her will be an ongoing
process.
·
A
critical endeavor of this client is the definition
(Who am I?) and redefinition
of the self (Who am
I
becoming?)
·
Key
Issues:
Incongruence
between the person she is
and the selves that are
"trying" to emerge
This
incongruence results into anxiety
and physical symptoms
Excited
and afraid at the same time
Afraid
that life is slipping
by
124
Theory
and Practice of Counseling -
PSY632
VU
Therapeutic
Process and
Techniques:
·
Careful
listening and accurate understanding for
creating a supportive, trusting, safe
and
encouraging
atmosphere is required.
·
Counselor's
ability to communicate his
belief in her resourcefulness;
Helping in becoming the
person
she wishes to be
·
Use
of techniques which will
"fit"
·
Counselors
will be himself/ herself in this
relationship.
Gestalt
Therapy
Gestalt
Therapy drew from a number of sources,
like Gestalt Psychology, Moreno's
psychodrama and
existentialism.
Therapy is associated with Gestalt psychology, a
school of thought that
stresses perception of
completeness
and wholeness, and that when
perceptions become abnormally inaccurate,
they can lead to
psychopathology.
Gestalt then emphasizes the importance of
increasing an accurate perception of
reality.
How
people function in totality.
Fritz
Perls
Frederick
Salomon Perls was born in
1893 in Berlin into a middle
class Jewish family. He had
a younger and
an
older sister. His parents
fought bitterly and Perls
disliked his older sister,
yet he remembered his
childhood
as happy. He loved to read and
was a top student in grade
school. His schooling was
interrupted
by
World War I, when he served
as a medic with the German
army.
Perls
trained as a psychoanalyst in both Vienna
and Berlin. Perls became
associated with Kurt
Goldstein,
from
whom he learned to view
humans as complete entities rather
than individuals made of
separate parts.
In
1936, Perls attended an
international psychoanalytic congress in
Czechoslovakia, where he met Freud.
A
brief
interchange with Freud left
Perls feeling humiliated. Thereafter Perls,
who had been
humiliated
frequently
by his father, dedicated himself to
proving Freud and psychoanalysis
wrong.
Perls
immigrated to the United States in 1946.
Although his ideas initially
were not readily accepted,
he
gained
prominence through the publication of
Gestalt
Therapy (1951). He
also established the Gestalt
Institutes
and offered lectures and
workshops at the Esalen
Institute.
Association
of Gestalt Therapy with Gestalt
Psychology
It
is a matter of controversy whether Gestalt therapy is
based on Gestalt psychology or not.
His biographer
wrote
him as the "traditional gestaltist" but
Perls maintained that "academic
gestaltist never accepted
me".
There
are two different opinions
in this reference as indicated below:
·
"No
one can understand Gestalt Therapy
without an adequate background in Gestalt
Psychology"
(Emerson
& Smith, 1974)
·
"Gestalt
Therapy revolves around Perls' own
personality" (Shane,
1999)
View
of Human Nature
·
Gestaltists
believe that human being
work for wholeness and
completeness in life. Man
is
composite
of interrelated parts. None of these
parts, body emotions, thoughts,
sensations, and
perceptions
can be understood outside the context of
the whole person.
·
The
Gestaltists emphasize here
and now. This emphasis on
now has influenced other
theories also,
for
example, behavioral and cognitive
approaches. It is important that the
person attends the
current
need (figure) and relegate the
other needs to the background, and when
the need is
accomplished
or the gestalt is closed, then it is
relegated to the background and another
needs
becomes
the figure. Hence, one must
avoid fantasizing.
125
Theory
and Practice of Counseling -
PSY632
VU
·
Man
is also part of his own
environment. Each person has
a self-actualizing tendency that
emerges
through
personal interaction with the
environment and the beginning of
self-awareness.
·
The
Gestalt view of human nature
places trust on the inner wisdom of
people, much as
person-
centered
counseling does. Each person
seeks to live interactively and
productively striving to
coordinate
the various parts of the person
into a healthy unified whole.
·
The
Gestalt view is antideterministic: each
person is able to change and
become responsible.
·
According
to Gestalt therapy many troubled
individuals have an over
dependency on intellectual
experience.
Such an emphasis diminishes the
importance of emotions and the senses,
limiting a
person's
ability to respond to various
situations.
·
Another
common problem is the inability to
identify and resolve
unfinished business.
·
Gestaltists
do not attribute either of these
difficulties to any unconscious
forces within
persons.
Rather
the focus is on awareness.
·
Healthy
individuals are those who
are most aware. Such people
realize that body signs
such as
headache
or stomach pains, may indicate a
need to change behavior.
They are also aware
of
personal
limitations. For instance in conflicts
with others one may be
able to resolve the
situation
or
just have to dismiss.
Causes
of Human Difficulties
According
to Gestaltists, a person may
experience difficulty in several
ways:
·
First he or
she may lose contact
with the environment and the
resource in it.
·
Second
the person may become
overinvolved with the environment
and thus out of touch
with the
self.
·
Third
he or she may fail to put
aside unfinished
business.
·
Fourth
he or she may become
fragmented or scattered in many
directions.
·
Fifth
the person may experience
conflict between the top dog (what
one thinks one should do)
and
the
underdog (what one wants to do).
Conflicts involve opposing aspects of the
personality.
Topdog
contains the introjected "shoulds"
analogous to Freud's superego
and underdog as id.
Both
roles are played in a
dialogue to integrate these
two
·
Finally
the person may have
difficulty handing dichotomies of life.
Such as love hate,
masculinity,
and
pleasure pain.
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