Mechanisms of Psychotherapy

Old Deficits, New Strengths

The child wants to have a parental relationship which has a nurturant, ecological, organismic/environmental balance. For instance, a mother is obliged to see that the requirements of the person are answered and that the progress of potentialities became easier. A child calls for this warm, fostering type of mirroring. A child also desires space to resist, to be perturbed, and to feel failure. A child wants as well to be restricted with limits and wishes to know what consequences will follow in case he does not behave in a right way. When needs are not met for various reasons the child can get a distorted understanding of boundaries. This is the reason why many parents refuse to follow wishes of their children. This will bring to the wrong understanding, distorted awareness, low self-esteem.

This is sad, but children are frequently shaped to meet parents' support on any occasion when they want something. Therefore the impulsive personality is replaced by an artificial personality. Other group comprises children whose needs are not met without reflection about the independence of others. This brings to the creation of impulsivity more than spontaneity.

Clients require a therapist who will deal with them in a contactful manner, at the same time not losing self by yielding to the wishes of the patient instead of study and working through or causing too much nervousness, embarrassment and frustration as they are considerate, warm, accessible, direct and straightforward.

Clients entering psychotherapy with diminished awareness of their requirements and strengths, more resisting than encouraging their organismic self, are suffering. They strive to make the therapist do something for them they are not able to as they think. If therapists follow this route, clients cannot reown and integrate potential they lost, which was not developed completely. Consequently they are not able to manage organismic self-regulation, with complete responsibility for themselves. They have no opportunity to learn if they are strong enough to exist independently as the therapist answer their requirements but skips such important things as increasing their awareness alongside with ego boundaries (Resnick, 1970).

In the course of Gestalt therapy clients learn how to get awareness and responsibility and how to be in contact, this way they improve their ego functioning. Thus they get instruments for more profound exploration. The experience of the childhood during the formative years are subjected for further exploration without such factors as the regression, extradependency needed in regressive treatment, without the momentary competence loss brought by transference neurosis. Childhood reminiscences are taken upon the current awareness without the supposition that clients are influenced by the events of the past. Clients project transference material on the therapist practicing Gestalt theory, by this means giving possibilities for bigger exploration.

The next two examples demonstrate clients with various defenses, who need special treatment, but with principal issues of the similar type.

A man named Tom was 45. Being proud of his intellect and independence he did not know of unsatisfied dependency wants and bitterness he had. This influenced his marriage much, his spouse sensed that she was undesired and inferior because she showed her feelings and wants. And his self-sufficiency needed reverence - it answered the requirement, was constructive to some extent and was based on his self-esteem.

P: [with pleasure] My mother was very busy when I was a kid, I had to rely only on myself.

T: I value your strength, when I imagine you an independent kid. I wish to stroke you and show a little parenting.

P: [with some tears] Nobody did that.

T: You look sad.

P: When I was little.... [study brought awareness of a reaction of shame to busy parents and a recompensing self-reliance]

Bob was a 45. He felt shame and separated himself in response to any interaction beside absolutely positive. He was constantly unwilling to experiment with nourishment of self.

P: [in a complaining tone] I have no notion what I should do now.

T: [keeps silence]

P: I could tell about the week which passed. [the look is puzzled]

T: it seems to me that you want me to show you the direction what to do. I feel that.

P: Yes. Is it wrong?

T: No. I would prefer not doing it at the moment.

P: Why?

T: You are able to do it on your own. I consider that you are distracting us now from your internal self. I don't wish to do it. [silence]

P: I am bewildered.

T: [keeps silence]

P: You will not show me the direction, will you?

T: You are right.

P: So, let us work on my thinking that I am not able to care about myself. [Client directs a productive part of work that brings to awareness of abandonment worry and shame which was the consequence of busy parents]

Frustration and Support

Gestalt therapy keeps the balance of frustration and support. The therapist investigates more than indulge the desires of the patient. This is the frustrating point for the client. Supplying contact is encouraging, though truthful contact prevents manipulation. The Gestalt therapist shows his self and stresses the importance of exploring, together with wish of exploration, indulgence and frustration. The therapist answers to manipulations by the client not reinforcing them, not giving judging, not frustrating the client on purpose. It is essential to have right gestalt perception and equal amount of warmth and firmness.

The Paradoxical Theory of Change

This is the paradox but the more one pretends to be the other person, the more he remains the same (Beisser, 1970). Many clients try to be the way they "should be" and simultaneously resisting shoulds.

The Gestalt therapist tries to reach integration asking the patient to identify with each contradictory role. The patient is asked about the feelings at each stage. When the patient is aware of two roles, then integrating techniques are applied to go beyond the dichotomy.

Two axioms of Gestalt therapy as "What is, is," and "One thing entails another" (Polster and Polster, 1973). The means of alteration is a relationship between the client and the therapist who establishes contact on the basis of demonstration of who he really is and who accepts and understands the client.

Awareness of the notion "what is" brings impulsive change. If the client manipulating for support comes across the contactful therapist and tolerant, with the one who does not use manipulation, he can obtain awareness of his actions. This Aha! is a new gestalt perception, a new viewpoint, an experience of new opportunity: "I am able to be with some person without manipulation on my and his part." When this person comes across"therapeutic" collusion, mind games, derision, game busting and et cetera, awareness of this type will unlikely take place.

Aha! can come to mind at every point. If the therapist knows the possibilities or the client can see them and he desires to learn, Aha!'s are achievable and growth is possible too. Awareness comes when the client is willing, in case the psychotherapist is aware of it and can unite it with the whole. The subsequent process in Gestalt therapy brings to overall changes in the field. The more careful the investigation is, the bigger intensity the reorganization obtains. Some alternations can be valued only several years later.

Gestalt therapy patients are responsible for themselves and the way the live. The task of the therapist is to make the process easier and to draw attention to opening awareness, which is limited and certain area where contact boundaries are limited; the therapist determines limitations in places with unclear boundaries and makes them firmer. Since sensing raises in precision and clarity, since breathing gets fuller with more relaxation in it and since clients establish deeper contact, they transfer therapy skills to their lives and get better gestalt perception. At times closeness and job progress goes after Gestalt effort as an act of grace, with no client's connecting the intensity to the therapy work. But the growth takes place with contact and awareness. One thing brings another.