GESTALT THERAPY METHODS AND PROCEDURES:SELF-DIALOGUE

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Clinical Psychology (PSY401)

LESSON 32

GESTALT THERAPY

METHODS AND PROCEDURES

Gestalt is a German word referring to wholeness and the concept that a whole unit is more than the sum of

its parts. Gestalt therapy was developed in the 1940s and 1950s by Frederick (Fritz) Perls, a German-born

psychiatrist who immigrated to the United States. Like person-centered therapy, Gestalt therapy tries to

make individuals take responsibility for their own lives and personal growth and to recognize their capacity

for healing themselves. However, Gestalt therapists are willing to use confrontational questions and

techniques to help clients express their true feelings. In the following example, the therapist helps the client

become more aware of her own behavior and her responsibility for it:

DEFINITION: `

Gestalt therapy is a complex psychological system that stresses the development of client self-awareness

and personal responsibility.

PURPOSE:

The goal of Gestalt therapy is to raise clients' awareness regarding how they function in their environment

(with family, at work, school, and friends). The focus of therapy is more on what is happening (the

moment-to-moment process) than what is being discussed (the content). Awareness is being alert to what

are the most important events in clients' lives and their environment with full sensorimotor, emotional,

cognitive, and energy support. Support is defined as anything that makes contact with or withdrawal from

with the environment possible, including energy, body support, breathing, information, concern for others,

and language, for example.

In therapy, clients become aware of what they are doing, how they are doing it, and how they change

themselves, and at the same time, learn to accept and value themselves. Individuals, according to this

approach, define, develop, and learn about themselves in relationship to others, and that they are constantly

changing.

ORIGIN AND DEVELOPMENT OF GESTALT THERAPY:

The theory of Gestalt therapy has three major sources. First is psychoanalysis, which contributed some of

its major principles concerned with the inner life. Humanistic, holistic, phenomenological and existential

writings, which center on personal experience and everyday life, constitute a second source. Gestalt

psychology, the third source, gave to Gestalt therapy much more than its name. Though Gestalt therapy is

not directly an application or extension of it, Gestalt psychology's thoroughgoing concentration on

interaction and process, many of its important experimental observations and conclusions, and its insistence

that a psychology about humans include human experience have inspired and informed Gestalt therapy.

Gestalt therapy emerged from the clinical work of two German psychotherapists, Frederick Salomon Perls,

and Laura Perls. Frederick Perls, known to many of his students as Fritz, was trained as a psychiatrist. He

worked with Kurt Goldstein, a principal figure of the holistic school of psychology, in his inquiries into the

effects of brain injuries on veterans of the First World War Later, in the 1920s; he trained in psychoanalysis

with Karen Homey and Wilhelm Reich. Laura Perls--she adopted the anglicized spelling after she came to

the United States--studied with the existential philosopher Martin Heidegger and was awarded a doctorate

in psychology for her graduate studies. The most important of her teachers was the Gestalt psychologist

Max Wertheimer. F. S. and Laura Perls fled Western Europe in 1933 ahead of the onslaught of Nazism to

Johannesberg, South Africa, where they practiced until the termination of hostilities in 1945.

Gestalt therapy is "unpredictable" in that the therapist and client follow moment-to-moment experience and

neither knows exactly where this will take them. Gestalt therapy is complex and intuitive, but it is based on

the following principles:

Holism. Gestalt therapy takes into account the whole person including thoughts, feelings, behavior, body

sensations, and dreams. The focus is on integration, that is, how the many parts of the person fit together,

and how the client makes contact (interacts) with the environment.

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Field theory. According to this theory, everything is related, in flux, interrelated, and in process. The

therapist focuses on how the client makes contact with the environment (family, work, school, friends, and

authority figures).

The figure-formation process describes how individuals organize or manipulate their environment from

moment to moment.

Organismic self-regulation is the creative adjustment that the organism (person) makes in relation to the

environment. The person's equilibrium with his or her environment is "disturbed" by the emergence of a

client need, sensation, or interest and is related to the figure-formation process in that the need of the person

organizes the field. For example, if an individual wants coffee, this coffee need is what comes out of the

defused background and becomes "figural" (comes to the forefront of the client's environment or field) and

when the individual enters a room, the "figural" will be related to the coffee need. The therapist is interested

in what is "figural" for a person because it may provide insight into the person's need(s).

The Now. The concept of the here and now is what is being done, thought, and felt at the moment, and not

in the past or the future.

Unfinished business is defined as the unexpressed feelings that are associated with distinct memories and

fantasies. These feelings may be resentment, rage, hatred, pain, anxiety, grief, guilt, and abandonment that

are not fully experienced in awareness, linger in the background, and are carried into the present life and

cause preoccupations, compulsive behaviors, wariness, and other self- defeating behaviors. Unfinished

business will persist until the person faces and deals with these denied or alienated feelings.

The current practice of Gestalt therapy includes treatment of a wide range of problems and has been

successfully employed in the treatment of a wide range of "psychosomatic" disorders including migraine,

ulcerative colitis, and spastic neck and back. Therapists work with couples and families, and with

individuals who have difficulties coping with authority figures. In addition, Gestalt therapy has been used

for brief crisis intervention, to help persons with post-traumatic stress disorders, alcohol and drug abuse,

depression, or anxiety disorders; with adults in a poverty program; with seriously mentally ill individuals

with psychotic disorders; and those with borderline personality disorders.

DESCRIPTION METHODS AND PROCEDURES

STAGES IN A GESTALT THERAPY SESSION AND AN EXAMINATION OF COUNSELOR

INTERVENTIONS

Introduction

Gestalt therapy alerts us to the interrelationship between awareness and energy. When awareness is

scattered and bound up in unknown feelings and thoughts, energy flow is diminished throughout one's

personality. A Gestalt counselor, by suggesting the practice of certain "experiments" in awareness focusing,

aids and amplifies a client's effort to free him- or herself from energy blocks mentally, emotionally, and

physically. From this perspective, every psychological problem can be explored and resolved as a polarized

conflict between two aspects in personality. Four stages in the unfolding of a therapeutic session and

corresponding counselor behaviors which serve to guide a conflict into awareness expose its ramifications

in a client's external and internal experience, and aid in its resolution will be examined.

Stage 1: Emergence of the Problem

Each client, each session is unique -- interplay of skill, experience, levels of growth, actual needs and

random factors present in the encounter between participants. The subtle blueprint of this first stage

involves a client bringing into awareness with increasing intensity a major conflict in the "here and now" of

a counseling session. Initial interventions guide the client's attention to his or her immediate experience --

the "what and how" of behavior -- and away from speculations as to causes -- the "whys" for such action.

During this process, clients are encouraged to assume increasing responsibility (ability to respond) for

individual thoughts, feelings, and sensations; and to experience the intimate, basic connection between

verbal and nonverbal behaviors.

The Gestalt therapist operates in a more dynamic and active manner than that of a client-centered counselor

who relies primarily upon receptive qualities expressed through empathic reflection of feelings. In Gestalt

work, one approaches the first phase of a session by exploring what a client is currently experiencing in

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awareness. As feelings and sensations are reported, links to body awareness are emphasized and one may be

asked to give the selected physical areas a "voice." If a client has difficulty bringing into awareness and

expressing such material, attention can be directed to obvious body correlates of verbal expression such as

breathing pattern, hand gestures, voice tone, posture. To facilitate greater clarity of experience of a

particular body area, one can suggest that a client repeat, exaggerate, or spontaneously develop a particular

physical action in nonverbal form or express with increasing loudness and meaning key words and

sentences. A Gestalt counselor pays special attention to the subtle discrepancy between verbal and

nonverbal action as this often indicates a block in awareness which can mask a significant tension area.

Clients can be guided to experience greater degrees of personal responsibility by the simple means of

restating and repeating particular phrases in communication, e.g., substituting "want" for "should," "won't"

for "can't," "I" for "it," and presenting all material in the present tense.

Avoid interpreting and evaluating a client's behavior as this can block immediate experience and provoke

defensiveness, thus hampering the flow of a session. Intuitive insights into a client's behavior patterns can

be effectively utilized by suggesting experiments in awareness focusing in which a client can experience

possible factors that are believed to tie into the current problem. If experiments are presented with much

hesitancy and fear of failure, they are often weakly complied with or rejected. Therefore, one is encouraged

to present such tasks with a firm and helpful attitude; one which allows no shame or blame for the apparent

unproductiveness of a particular exercise. Projections of mistrust directed at an observing group or

counselor may be worked with by asking the client to give them a voice, then to reply, and to maintain this

dialogue until negative feelings are reowned and tension released. Deal with any projections toward you as

a counselor within a framework of external dialogue (see Stage 2). Take the opportunity to work through

personal defensive reactions in a session where you can function as a client. The end phase of Stage 1 is

marked by a client's ability to readily focus awareness when directed and express feelings and sensations in

the immediate present. At this point, a specific emotional problem is often present in awareness along with

a corresponding physical area of tension. In addition to awareness probing ("What are you aware of now?")

which aims to establish a link between body and feeling states, fantasy work, nonverbal explorations and

direct questions can be utilized to bring an unfinished issue into focus. Guided fantasy work often allows

clients to symbolically present unresolved problems with minimal resistance, while nonverbal activities

encourage overly intellectual or verbally blocked individuals to more spontaneously express themselves.

The direct questions, "What do you want to work on today?" or "What do you want to avoid working on

today?" can at times elicit important material to explore.

Clients display varying resistance to Gestalt work. Overall resistance serves to inhibit natural growth

processes and functions to manipulate the external environment. Appropriate to the skill and experience of

the counselor, the frustration of such resistance patterns throughout the first stage is a necessary intervention

for continued movement. The labeling of the game the client is "playing" (e.g., helpless, stupid, confused,

seductive) a dramatic withdrawal of the therapist's interest, or the suggestion of a seemingly extraneous

nonverbal action for client to engage in, e.g., singing or jumping, are possible tactical responses.

Strategically, such encounters require advanced counseling skills practiced with a Zen-like attitude:

courage, compassion, and a nonattachment to the outcome.

Stage 2: Working with External Polarities

The client is now asked to take the growing tension that is experienced and explore it within the framework

of an external dialogue. Whether the conflict is presented as an intra- or interpersonal one, it is most often

necessary to initiate the dialogue as a conversation between two people, the client and a significant other.

Underlying internal polarities (Stage 3) are typically obscure and require the experience of emotional

intensity resulting from an external conversation to bring them into fuller awareness. Work with internal

polarities at this phase tends toward superficiality and an emphasis on a purely intellectual approach to

conflict resolution.

With an interpersonal problem, there is little difficulty in employing two chairs and having the client change

places as a conversation unfolds. If a client is eager to work within an area of perceived personal deficiency

(too submissive, lonely, angry) direct that the dialogue involve another person with whom such feelings are

currently experienced, or historically have been experienced, or even hypothetically can be experienced.

When appropriate, suggest that clients engage in a dialogue with a parent or sibling who was critical in

early emotional conditioning. Continue to be alert to the verbal/nonverbal discrepancy and utilize

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techniques discussed earlier. At times it will be helpful to have a client try a particular line (on for size) or

intensify nonverbal activity (e.g., hitting a pillow, standing up) to accompany the dialogue. The major thrust

of the work at this point is to bring hidden feelings into awareness by dramatizing the outer manifestation of

an inner conflict. In the closing phase of Stage 2, clients can become quite immersed in the process of self

discovery and need little overt guidance to shuttle between chairs, appropriately express feelings, monitor

and modify behavior patterns. While each dialogue will have its own rhythm and momentum, it is useful to

have the client sequentially express: (a) what are the direct issues and feelings present in the relationship

with the significant other; (b) what are the covert feelings and hidden agendas perceived in the relationship;

and, (c) what are the desired solutions to the stated issues and conflicts. Be alert to a sudden withdrawal of

involvement, confusion, and reluctance to continue. This behavior can signify the "impasse" in Gestalt

work, reflecting the emergence of the "implosive layer" of personality which requires more active

intervention from the counselor.

Stage 3: Working with Internal Polarities

All external difficulties, in a Gestalt framework, can be reperceived and potentially resolved as internalized

tensions. Inner imbalances, cognitive, emotional, physical, are based on conditioning in our personal history

and tend to be maintained by reinforcement of established behavior patterns. It is clear that such imbalances

focus and shape our perceptions and emotional reactions to external reality, and less obvious but profoundly

critical in our experience is the fact that these very imbalances draw into our lives a further compounding of

external problems. In Gestalt work, one validates the principle that factors in consciousness determine

behavior. A major growth step for a client is to recognize that the conflict being explored in the external

dialogue can simultaneously be understood and more effectively resolved as a reflection of a deep internal

tension. The accomplishment of this critical shift in self understanding requires a sufficient amount of

objective awareness on the part of the client. Thus, if a counselor directs a client who is totally identified in

the external problem to shift to Stage 3, frustration and confusion will result. In such sessions, it is best to

aim for integration (Stage 4) of the conflict within the form of a more external solution. Those clients who

do respond to a refocusing of the dialogue in terms of internal polarities often require precision of labeling

and clarification of meaning from the therapist regarding the polarities they are exploring. While a

reclarification of meaning and refinement in labeling by both client and counselor is necessary in order to

reduce confusion, it is more productive to explore one major polarity per session.

The central focus of activity at this stage is a growing confrontation between two significant and opposing

aspects within the client's personality. The more fully each aspect or pole of tension is dramatized and

experienced, the more likely it can be resolved. Thus, counselor behavior is geared to aid clients in giving

each aspect its full voice, appropriate gestures, and nonverbal stance. During a session, one can observe an

inner conflict, initially latent, emerge with increasing power as the thoughts, feelings, sensations and bodily

responses associated with an historical trauma come into awareness. The basic ambivalence, the polar

nature of tension, strikes us as we observe each aspect surface in its identity. As each polarity expands its

"territory" in awareness, the tension may painfully stretch until, from the client's point of view, it is

unresolvable, unbearable, a desperate void. This phenomenon, while not present in all sessions, is indicative

of the "implosive layer" of personality and is a necessary precondition for the formation of a new Gestalt.

Stage 4: Integration

When successful, this stage celebrates the triumph of unifying over separative factors within the client's

personality, signals the emergence of a new Gestalt, and reflects that within the struggle between the yin

and the yang is the Tao. The core element here is a resolution of the internal conflict resulting from a major

reorganization and reperception of the problem. The more powerfully the conflict rises into awareness, the

greater the potential for release. In its more dramatic form, the release is a spontaneous, uncontrolled

physiological outpouring -- tears, laughter, and rage -- a manifesting of the "explosive layer" of personality.

Explosive expression of integration, like an initial satori, can have a lasting effect as blocks to inner sources

of energy are released. However, the intensity of a reaction does not necessarily reflect the growth

producing value of an integration, many of which can take a more gentle outer form with profound inner

consequences for development.

Integration is a continual, evolutionary, life-sustaining experience -- there is no "final" Gestalt. In the

process of integration, factors that were opposing each other in consciousness mutually move to accept each

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other's actual identity that was hidden behind a conditioned mask of pain, rage, or weakness. With this

accomplished, these elements begin to relate more harmoniously and the whole personality experiences a

fresh flow of life energy, an increased capacity for enjoyment, and a more expanded awareness into areas of

existing and still unresolved tensions.

As you are empathically unified with your client, you will sense when an integration of the polarities has

taken place. Explosive integrations are quite clear and, in addition to external observation of change, one

often finds sympathetic responses in one's own body corresponding to the client's breakthrough. Less

intense breakthroughs can also be perceived externally in the form of relaxation of muscles, smiles,

laughter, quiet sighs, and sobs. It is important to be alert to the less intense expressions of integration, so

that you can acknowledge that the session is completed and make no further demands on the client to

produce a more intense reaction. Most sessions fall short of full spontaneous integrations (which probably

reflects clients' resistances to change, and level of the skill of the counselor). Much can be accomplished by

working with clients to harmonize a conflict through the use of guided integration techniques. Four types of

approaches, which can be applied singularly or in combination will be indicated. One can encourage clients

to express verbally what each opposing aspect can truly appreciate and respect in the other. Some clients

will respond more effectively to the opportunity to express these attitudes in a nonverbal manner, through

gesture or movement. A guided fantasy of mutual acceptance can be presented by the therapist which

incorporates the positive qualities of each aspect; perhaps taking the form of each polarity moving toward

each other, and embracing. Some clients who are responsive to meditation methods may choose to work

with a meditation technique which allows them to harmonize and integrate the polar tension.

To facilitate a client's cognitive reorganization you may at times present your perceptions of the changes

you observed from the beginning to the end of a session. In order to close the psychological distance

between client, counselor and group, some limited sharing of reactions are often helpful after the client

leaves the hot seat. Keep in mind, however, that the sharing phase is still part of the therapeutic session and

prolonged interactions among participants can seriously scatter a client's awareness and hamper the subtle

integrations taking place.

EXERCISES AND EXPERIMENTS

Many therapeutic interventions called exercises and experiments have been developed to enhance

awareness and bring about client change. Exercises are defined as ready-made techniques that are

sometimes used to evoke certain emotions (such as the expression of anger) in clients. Experiments, on the

other hand, grow out of the immediate interaction (dialogue) between client and therapist. They are

spontaneous, one-of-a-kind, and relevant to a particular moment and the particular development of an

emerging issue such as the client's reports of a need, dream, fantasy, and body awareness. Experiments are

done with full participation and collaboration with clients and are designed to expand clients' awareness and

to help them to try out new ways of behaving rather than to achieve a particular result. These experiments

may take many forms. According to Gerald Corey, some are:

"Imagining a threatening future event; setting up a dialogue between a client and some significant person

in his and her life;

Dramatizing the memory of a painful event; reliving a particularly profound early experience in the

present; assuming the identity of one's mother or father through role-playing;

Focusing on gestures, posture, and other nonverbal signs of inner expression; carrying on a dialogue

between two conflicting aspects within the person."

While participating in experiments, clients actually experience the feelings associated with their conflicts or

issues in the here and now. Experiments are tailored to each individual client and used in a timely manner;

they are to be carried out in a context that offers safety and support while encouraging the client to risk

trying out new behavior. The Gestalt therapy focus is on the entire person and all parts--verbal and

nonverbal behaviors, emotional feelings-- all are attended to.

Gestalt therapists are said to rely on spontaneity, inventiveness, and "present-centeredness" and a range of

possible therapeutic encounters, interactions that leads to exercises and experiments that are potentially

infinite but can be categorized as follows.

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THE USE OF STATEMENTS AND QUESTIONS TO FOCUS AWARENESS.

Many interventions have to do with simply asking "what the client is aware of experiencing;" or asking

simple and direct questions as, "What are you feeling?" "What are you thinking?" The client may be

instructed to start a sentence with "Now, I am aware..." or is asked to repeat a behavior, as in, "Please wring

your hands together again." A frequent technique is to follow the client's awareness report with the

instruction, "Stay with it!" or "Feel it out!"

CLIENT'S VERBAL BEHAVIOR OR LANGUAGE.

Awareness can be enhanced and emphasized through the client's verbal behavior or language since client

speech patterns are considered to be an expression of their feelings, thoughts, and attitudes. Some aspects of

language that might indicate the clients' avoidance of strong emotions or of self-responsibility are the

general pronouns such as "it" and "you." Clients are instructed to substitute, when appropriate, the

personal pronoun "I" for these pronouns to assume a sense of responsibility for his or her feelings or

thoughts (ownership). Sometimes clients may be asked to change their questions into direct statements in

order to assume responsibility for what they say. Other examples of helping clients to be more in control

using language are to have them omit qualifiers and disclaimers such as "maybe," "perhaps," or "I

guess" from their language patterns. This changes ambivalent and weak statements into more clear and

direct statements; to substitute "I won't" for "I can't" because often "can't" gives the feeling of being

unable to do something. It may be more accurate to say "I won't" meaning "I choose not to do this for any

of various reasons," or use the word, "want" instead of "need" which is considered an indication of

urgency and anxiety, and is less accurate. Other changes might be to change "should" and "ought" to "I

choose to" or "I want to" increasing the clients' power and control of their lives.

NONVERBAL BEHAVIOR.

Awareness can also be enhanced by focusing on nonverbal behavior and may include any technique that

makes the clients more aware of their body functioning or helps them to be aware of how they can use their

bodies to support excitement, awareness, and contact. The parts of the body that therapists may attend to

include the mouth, jaw, voice, eyes, nose, neck, shoulders, arms, hands, torso, legs, feet, and the entire

body. The therapist, for example, may point out to and explore with the client how he or she is smiling

while at the same time expressing anger.

SELF-DIALOGUE.

Self-dialogue by clients is an intervention used by Gestalt therapists that allow clients to get in touch with

feelings that they may not be unaware of and, therefore, increase the integration of different parts of clients

that do not match or conflicts in clients. Examples of some common conflicts include "the parent inside

versus the child inside, the responsible one versus the impulsive one, the puritanical side versus the sexual

side, the 'good side' versus the 'bad side,' the aggressive self versus the passive self, the autonomous side

versus the resentful side, and the hard worker versus the goof-off." The client is assisted in accepting and

learning to live with his or her polarities and not necessarily getting rid of any one part or trait.

The client is engaged in the self-dialogue by using what is called the empty-chair technique. Using two

chairs, the client is asked to take one role (for example, the parent inside) in one chair and then play the

other role (for example, the child inside) in the second chair. As the client changes roles and the dialogue

continues between both sides of the client he or she moves back and forth between the two chairs. Again

according to Corey, other examples of situations in which dialogues can be used include "one part of the

body versus the other (one hand versus the other), between a client and another person, or between the self

and object such as a building or an accomplishment."

ENACTMENT AND DRAMATIZATION.

Enactment increases awareness through the dramatizing of some part of the client's existence by asking him

or her to put his or her feelings or thoughts into action such as instructing the client to "Say it to the person (

when in group therapy)," or to role-play using the empty chair technique. "Put words to it" is also often said

to the client. Exaggeration is a form of enactment in which clients are instructed to exaggerate a feeling,

thought or a movement in order to provide more intensity of feelings. Enactment can be therapeutic and

give rise to creativity.

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GUIDED FANTASY.

Guided fantasy (visualization) is a technique some clients are able to use more effectively than using

enactment to bring an experience into the here and now. Clients are asked to close their eyes (if

comfortable) and, with the guidance of the therapist, slowly imagine a scene of the past or future event.

More and more details are used to describe the event with all senses and thoughts.

DREAM WORK.

Work is most important in Gestalt therapy. The aim is to "bring dreams back to life and relive them as

though they are happening now." Working with the clients' dreams requires developing a list of all the

details of the dream, remembering each person, event, and mood in it and then becoming each of these parts

through role-playing, and inventing dialogue. Each part of the dream is thought to represent the clients' own

contradictory and inconsistent sides. Dialogue between these opposing sides leads clients toward gradual

insight into the range of their feelings and important themes in their lives.

AWARENESS OF SELF AND OTHERS.

An example of how this technique is used by the Gestalt therapist is having the client to "become" another

person such as asking "the client to be his mother and say what his mother would say if the client came in at

2:00 A.M." This provides more insight for the client rather just asking what the client thinks his mother

would say if he came home at 2:00 A.M.

AVOIDANCE BEHAVIORS.

Awareness of and the reintegration the client's avoidance behaviors are assisted by the interventions used to

increase and enhance awareness of feelings, thought, and behaviors.

HOMEWORK.

Homework assignments between therapy sessions may include asking clients to write dialogues between

parts of themselves or between parts of their bodies, gather information, or do other tasks that are related to

and fit with what is going on in the therapy process. Homework may become more difficult as the

awareness develops.

Therapy sessions are generally scheduled once a week and individual therapy is often combined with group

therapy, marital or family therapy, movement therapy, meditation, or biofeedback training. Sessions can

be scheduled from five times a week to every other week and session frequency depends on how long the

client can go between sessions without loss of continuity or relapsing. Meetings less frequent than once a

week are thought to diminish the intensity of the therapy unless the client attends weekly group with the

same therapist. More than twice a week in not usually indicated except with clients who have psychotic

disorders, and is contraindicated with those who have a borderline personality disorder.

Weekly group therapy may vary from one and one-half to three hours in length, with the average length of

two hours. A typical group is composed of ten members and usually balanced between males and females.

Any age is thought to be appropriate for Gestalt therapy. There are groups for children as well.

Gestalt therapy is considered by its proponents to have a greater range of styles and modalities than other

therapeutic systems and is practiced in individual therapy, groups, workshops, couples, families, and with

children, and in agencies such as clinics, family service agencies, hospitals, private practice, growth centers.

According to Corey, "The therapeutic style of therapists in each modality vary drastically on many

dimensions including degree and type of structure; quantity and quality of techniques used; frequency of

sessions, abrasiveness and ease of relating, focus on body, cognitions, feelings; interpersonal contact;

knowledge of work within psychodynamic themes; and degree of personal encountering."

THE RULES:-

The "rules" of Gestalt therapy (Levitsky & Perls, 1970) include the following:

1. Communication is in the present tense (looking backward or forward is discouraged).

2. Communication is between equals lone talks with, not at).One uses "I" language rather than "it"

language (to encourage the acceptance of responsibility).

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3. The client continually focuses on immediate experience (for example, the therapist will ask, "How

does it feel to describe the hostility?" "Tell me what you are feeling at this moment").

4. There is no gossip (talking about someone else).

5. Questions are discouraged (because questions are often quiet ways of stating opinions rather than

seeking information).

MORAL PERSPECTS:-

The "moral precepts" (or rules for patients to live by) of Gestalt therapy are described by Naranjo (1970Jj.

1. Live now (Be concerned not with the past or the future but with the present.)

2. Live here. (Be concerned with what is present, not with what is absent.)

3. Stop imagining. (Experience only the real.)

4. Stop unnecessary thinking. (Be oriented toward hearing, seeing, smelling, tasting, and touching.)

5. Express directly. (Do not explain, judge, or manipulate.)

6. Be aware of both the pleasant and the unpleasant

7. Reject-all "shoulds' and "ought" that are not your own.

8. Take-complete responsibility for your actions, thoughts, and feelings.

9. Surrender to being what you really are.

RISKS

Gestalt therapy is considered to have pioneered the development of many useful and creative innovations in

psychotherapy theory and practice. However, there is some concern regarding abusing power by therapist,

as well as the high-intensity interaction involved. The concern is in the nature of therapists being enchanted

with and using the techniques of Gestalt therapy with other theories of therapy without having the

appropriate training in Gestalt therapy theory. Gestalt therapists are very active and directive within the

therapy session and therefore, care must be taken that they have characteristics that include sensitivity,

timing, inventiveness, empathy, and respect for the client. These characteristics, along with ethical practice,

are dependent on the skill, training, experience, and judgment of the therapist. The intensity of the therapy

might not be suitable for all patients, and even disruptive for some, despite the competence of the therapist.

In addition, there is a lack of monitored, scientific research evidence supporting the effectiveness of Gestalt

therapy.

CONCLUSION:

Gestalt therapists expect that as result of their involvement in the Gestalt process clients will improve in the

following ways: have increased awareness of themselves; assume ownership of their experience rather than

making others responsible for what they are thinking, feeling, or doing; develop skills and acquire values

that will allow them to satisfy their needs without violating the rights of others; become aware of all their

senses (smelling, tasting, touching, hearing, and seeing); accept responsibility for their actions and the

resulting consequences; move toward internal self-support from expectations for external support; to be able

to ask for and get help from others and be able to give to others.

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