Gestalt Therapy and Behavior

 

Gestalt Therapy

 

Founders: Fritz and Laura Perls

 

Key figures: Miriam and Erving Polster

Key Concepts:

·        This is an experimental therapy stressing awareness and integration; it grew as a reaction against analytic therapy.  Gestalt Therapy integrates the functioning of body and mind.

·        Relational Gestalt Therapy – Stresses dialog and relationship between client and therapist.  The focus is more on process than on content.

·        Emotional-focused Therapy – related to Gestalt Therapy in that it blends the relational aspects of the person-centered approach with the active phenomenological awareness experiments of Gestalt Therapy.

Some Principles of Gestalt Therapy:

·        Holism – attending to the obvious, while paying attending to how the parts fit together, how the client makes contact with the environment and integration.

·        Field Theory – asserts that the organism must be seen in its environment, or in its contest, as part of the changing field.  Gestalt therapists pay attention to and explore what is occurring at the boundary between the person and the environment.

·        The Figure –Formation Process – describes how the individual organizes experience from movement to movement.  Gestalt therapy differentiates between a foreground (figure) and background (ground).

·        Organismic self-regulation – a process by which equilibrium is disturbed by the emergence of a need, sensation or an interest.

The Now:

·        Phenomenological inquiry- paying attention to what is occurring now.  Therapists ask questions about what and how but rarely why.

·        Unfinished Business – When figures emerge from the background but are not completed or resolved and can manifest in unexpected feelings such as resentment, rage, hatred, pain, anxiety, grief, guilt and abandonment.

Contact and Resistance to Contact:

·        Contact – necessary if change and growth is to occur.  Effective contact means interacting with nature and with other people without losing one’s sense of individuality.

·        Introjections – the tendency to uncritically accept others’ beliefs and standards without assimilating them to make them congruent with who we are.

·        Projections – we discover certain aspects of ourselves by assigning them to the environment.

·        Retroflection – consists of turning back onto ourselves what we would like to do to someone else or doing to ourselves what we would like someone else to do or for us.

·        Deflection – process of veering off or distraction, so that it is difficult to maintain a sustained sense of contact.

·        Confluence – involves blurring the differentiation between the self and the environment.

Therapeutic Process:

·        The 6 methodological components considered vital to Gestalt Therapy

o   Continuum of experience

o   The here and now

o   The paradoxical theory of change

o   The experiment

o   The authentic encounter

o   Process-oriented diagnosis

·        Clients are expected to do the following:

o   Move toward increased awareness of themselves

o   Gradually assume ownership of their experiences

o   Develop skills and acquired values that will allow them to satisfy their needs without violating the rights of others

o   Become more aware of all of their senses

o   Learn to accept responsibility for what they do, including accepting the consequences of their actions

o   Be able to ask for help and get help from others and be able to give to others

Therapeutic Techniques:

·        Exercises are ready-made techniques that are sometimes used to make something happen in a therapy session or to achieve a goal.

·        Experiments grow out of the interaction between client and therapist, and they emerge as the therapist gets to know the client in the here and now.

Interventions:

·        The internal dialogue exercise

·        Making the rounds

·        The rehearsal exercise

·        the exaggeration exercise

·        staying with the feeling

·        dream interpretation

 

Behavior Therapy

Key Figures: B.F. Skinner, Arnold Lazarus, and Albert Bandura

Key Concepts:

• Focus is on overt behavior, precision in specifying goals of treatment, development of specific treatment plans, and objective evaluation of therapy outcomes.
• Present behavior is given attentino.
• Therapy is based on the principles of learning theory.
• Normal behavior is learned through reinforcement and imitation.
• Abnormal behavior is the result of faulty learning.

Basic Philosophy:

• Behavior is the product of learning.
• We are the both the product and the producer of our environment..
• Traditional behavior therapy is based on classical and operant principles.
• Contemporary behavior is therapy has branched out in many directions.

Therapeutic Process:

• Goals occupy a place of central importance in behavior therapy.
• The general goals of behavior therapy are to increase personal choice and to create new conditions for learning.
• The client, with the help of the therapist, defines specific treatmet goals at the outset.
• Continual assessment throughout therapy determines the degree to which identified goals are being met.
• It is important to devise a way to measure progress toward goals based on empirical validation.
•  

Theraputic Techniques:

• Positive reinforcement
• Negative reinforcement
• Extinction
• Punishment
• Positive Punishment
• Negative punishment
• Progressive muscle relaxation
• Systematic Desensitization
• Exposure Therapies
• Eye movement desentization and reprocessing
• Social skills training
• Self-management programs and Self-directed behvior
• Mindfulness and Acceptance-based Therapy

 



Existential Therapy and Person Centered Therapy

Existential Therapy

I.                   Key figures:

Viktor Frankl, Rollo May, and Irving Yalom.

Existential therapy is more a way of thinking, or an attitude about psychotherapy than a particular style of practice.  This therapy can also be described as philosophical approach that influences a counselor’s therapeutic practice.  It focuses on exploring themes such as mortality, meaning, freedom, responsibility, anxiety, and aloneness as these relate to a person’s current struggle.

II.                Key Concepts:

            View of Human Nature: It reacts against the tendency to identify therapy with a set of techniques.  Instead, it bases therapeutic practice on an understanding of what it means to be human.  It stands for respect for the person, for exploring new aspects of human behavior, and divergent methods of understanding people.  The existential tradition seeks to balance between recognizing the limits and tragic dimensions of human existence on one hand and the possibilities and opportunities of human life on the other hand.  There are 6 basic dimensions of the human condition, according to this approach.

1.      Proposition 1: The Capacity for Self-Awareness – The greater our awareness, the greater our possibilities for freedom. The core existential position is that we are both free and limited, and we increase our capacity to live fully as we expand our awareness in the following areas:

a.       We are finite and do not have unlimited time to do what we want in life.

b.      We have the potential to take action or not to act; inaction is a decision.

c.       We choose our actions, and therefore we can partially create our own destiny.

d.      Meaning is the product of discovering how we are thrown or situated in the work and then, through commitment, living creatively.

e.       As we increase our awareness of the choices available to us, we also increase our sense of responsibility for the consequences of these choices.

f.        We are subject to loneliness, meaninglessness, emptiness, guilt, and isolation.

g.       We are basically alone, yet we have an opportunity to relate to other beings.

Here are some areas of emerging awareness that individuals may experience in the counseling process.

a.       They see how they are trading the security of dependence for the anxieties that accompany choosing for themselves.

b.      They begin to see that their identity is anchored in someone else’s definition of them; they are seeking approval and confirmation of their being in others instead of looking to themselves for affirmation.

c.       They learn that in many ways they are keeping themselves prisoner by some of their past decisions, and they realize that they can make new decisions.

d.      They learn that although they cannot change certain events in their lives they can change the way they view and react to these events.

e.       They learn that they are not condemned to a future similar to the past, and they can change from their past and thereby reshape their future.

f.        They realize that they are so preoccupied with suffering, death, and dying that they are not approaching the living.

g.       They are able to accept their limitations yet still feel worthwhile, for they understand that they do not need to be perfect to feel worthy.

h.       They come to realize that they are failing to live in the present moment because of their preoccupation with the past, planning for the future, or trying to do too many things at once.

2.      Proposition 2: Freedom and Responsibility

a.       Inauthenticity is referred by Jean-Paul Sartre as not accepting personal responsibility.

b.      Freedom implies that we are responsible for our lives, actions and failures.

c.       Existential guilt is being aware of having evaded a commitment, or having chosen not to choose.

d.      Authenticity implies that we are living by being true to our own evaluation of what is a valuable existence for ourselves or the courage to be who we are.

3.      Proposition 3: Striving for Identity and Relationship to Others: Loneliness, up rootedness, and alienation, can be seen as the failure to develop ties with others and with nature. Rather than trusting ourselves to search within and find our own answers to the conflicts in our life, we sell out by becoming what others expect of us.

a.       The Courage to Be:  By assisting clients in facing their fear that their lives or selves are empty and meaningless, therapists can help clients to create a self that has meaning and substance that they have chosen.

b.      The Experience of Aloneness:  The sense of isolation comes when we recognize that we cannot depend on anyone else for our own confirmation, we alone must give a sense of meaning to life, and we alone must decide how we will live.

c.       The Experience of Relatedness:  When we are able to stand alone and tap into our own strength, our relationships with others are based on our fulfillment, not our deprivations.  When we feel deprived however, we can expect little but a clinging and symbiotic relationship with someone else.

d.      Struggling With Our Identity:  We are afraid of dealing with our aloneness, some of us get caught up in ritualistic behavior patterns that cement us to an image or identity we acquired in early childhood.

4.      Proposition 4: The Search for Meaning:  A distinctly human characteristic is the struggle for a sense of significance and purpose in life.

a.       The Problem of Discarding Old Values: Often clients may discard traditional and imposed values without creating other, suitable ones to replacements.

b.      Meaninglessness:  Faced with the prospect of our mortality we might ask is there any point to what I do now since I will eventually die, will I be forgotten when I am gone?

c.       Creating New Meaning:  Human suffering can be turned into human achievement by the stand an individual takes when faced with it.  Frankl contends that people who confront pain, guilt, despair, and death can effectively deal with their despair and thus triumph.

5.      Proposition 5: Anxiety as a Condition of Living:

a.       Existential anxiety arises as we recognize the realities of our own mortality, our confrontation with pain and suffering, or need to struggle for survival.

b.      Normal anxiety is an appropriate response to an event being faced and can be a great motivation for change.

c.       Neurotic anxiety is anxiety about concrete things that is out of proportion to the situation.

6.      Proposition 6: Awareness of Death and Nonbeing: death is a basic human condition that gives significance to living. A distinguishing human characteristic is the ability to grasp the reality of the future and the inevitability of death. It is necessary to think about death if we are to think of significantly about life.

III.             Therapeutic Goals: Existential therapy is best considered as an invitation to clients to recognize the ways in which they are not living fully authentic lives and to make choices that will lead to their becoming what they are capable of being.  Existential therapy holds that there is no escape from freedom as we will always be held responsible and aims at helping clients face anxiety and engage in action that is based on the authentic purpose of creating a worthy existence.

IV.              Therapeutic Techniques: Is unlike most other therapies in that it is not technique-oriented. Therapists prefer description, understanding, and exploration of the client’s subjective reality as opposed to diagnosis, treatment and prognosis.

Reference: Corey, Gerald (2013). Theory and Practice of Counseling and Psychotherapy (9^th   ed.).  Belmont, CA:Brooks/Cole, Cengage Learning.

Person Centered Therapy

Founder: Carl Rogers (1902-1987) Known as a “quiet revolutionary”

Key Figure:  Natalie Rogers (Carl Rogers daughter) – Used Expressive Art Therapy

This approach was developed in the 1940’s as a nondirective reaction against psychoanalysis.  It is based on a subjective view of human experiencing, and it places faith in and gives responsibility to the client in dealing with problems and concerns.

Key Concepts:

·        Rogers maintained that people are trustworthy, resourceful, capable of self-understanding and self-direction, able to make constructive changes and able to live effective and productive lives.  When therapists are able to experience and communicate their realness, support, caring, and nonjudgmental, understanding, significant changes in the client.

·        3 therapist attributes create a growth-promoting climate in which clients can move forward and be what they are capable of becoming.

o   Congruence – genuiness or realness

o   Unconditional positive regard – acceptance and caring

o   Acute empathetic understanding – an ability to deeply grasp the subjective world of another person

·        Actualizing tendency – a direct process of striving toward realization, fulfillment, autonomy, and self-determination.

·        Maslow taught us earlier that individuals’ becoming self-actualizing is an ongoing process rather than a final destination.

Therapeutic Concepts and Techniques: 

·        Focus is on the person, not on the persons presenting problems.  Rather, the goal is to assist clients in their growth process so clients can better cope with problems as they identify them.

·        When facades are put aside during therapy, Rogers described people who are becoming more actualized as having:

o   Openness to experience

o   A trust in themselves

o   An internal source of evaluation

o   Willingness to continue growth

·        Encouraging these characteristics is the basic goal of person-centered therapy.

·        Stages of change

o   Precontemplation – no intention of changing behavior in the near future

o   Contemplation – people are aware of the problem and are considering changing it

o   Preparation stage – intend to take immediate action

o   Action stage – actually taking steps to modify their behavior to solve their problems

o   Maintenance Stage – work to consolidate their gains and prevent relapse

Reference: Corey, Gerald (2013). Theory and Practice of Counseling and Psychotherapy (9^th ed.). Belmont, CA:Brooks/Cole, Cengage Learning.

Psychoanalytic Therapy and Alderian Therapy

Psychoanalytic Therapy

I.                   Sigmund Freud founded this theory which is the benchmark against which many other theories are measured.

II.                Key Concepts: View of Human Nature

                                                             a.      Life instincts – oriented toward growth, development and creativity.

                                                            b.      Libido – a source of motivation that encompasses sexual energy but also goes beyond it.

                                                             c.      Death Instincts- Accounts for the aggressive drive people at times manifest through their behavior.  This is an unconscious wish to die or to hurt themselves or others.

                                                            d.      Both sexual and aggressive drives are powerful determinants of why people act as they do.

III.             Structure of Personality

a.       Id – is roughly all the untamed drives or impulses, the biological component.

b.      Ego – attempts to organize and mediate between the id and the dangers of the ids impulses.

c.       Superego – internalized social component, moral code that represents the ideal rather than the real and often strives for perfection.

IV.             The Unconscious and Conscious

a.       The unconscious are dreams, slips of the tongue, forgetting, and post-hypnotic suggestions. These are things derived from free association, projective techniques and psychotic symptoms.

b.      The conscious is the thin slice of the total mind or awareness.

V.                Anxiety

a.       Feelings of dread that result from repressed feelings, memories, desires and experience that emerge to the surface of awareness.

b.      Reality anxiety: fear of danger from the external world

c.       Neurotic anxiety: fear that the instincts will get out of hand and cause one to do something for which they will be punished.

d.      Moral anxiety: fear of ones own conscience or guilt.

VI.             Therapeutic Process: the goal is to ultimately increase adaptive functioning which involves the reduction of symptoms and the resolution of conflicts.  Rather it strengthens the ego, to make the unconscious conscious so that behavior is based more on reality than on instinctual cravings or irrational guilt.

VII.          Techniques: these are aimed at increasing awareness, fostering insights into client behavior, and understanding the meanings of the symptoms.

a.       maintaining the analytical framework

b.      free association

c.       interpretation

d.      dream analysis

e.       analysis of resistance

f.       analysis of transference

Reference:

Corey, Gerald (2013). Theory and Practice of Counseling and Psychotherapy (9^th ed.). Belmont, CA:Brooks/Cole, Cengage Learning p. 62-97

Alderian Therapy

I.                   Founder: Alfred Adler followed by Rudolph Dreikurs who is credited for the theory’s popularity in the United States.

II.                Key Concepts:

a.       View of Human Nature: Adler beliefs were contrary to Freud in that human behavior is not determined solely by heredity and environment, but that we have the capacity to interpret, influence, and create events.  Adlerians focus on reeducating individuals and reshaping society.

b.      Subjective Perception of Reality: Focuses on the way people perceive their world.

c.       Unity and Patterns of Human Personality: Individual Psychology – avoids reductionism and stresses that understanding the whole person in the context of his life and how all the components fit and work together.

d.      Behavior as Purposeful and Goal Oriented: Adlerians assume that most decisions are based on past experiences, the present and the future goals.

                                                             a.      Fiscal Finalism – an imagined life goal that guides a person’s behavior. Adler actually used the words “guided self-ideal” and “goal of perfection” to account for striving for superiority and perfection.

                                                            b.      Lifestyle: Often described as our perceptions regarding self, others, and the world.  This includes an individual’s characteristic way of thinking, acting, and feeling, living and striving toward long-term goals.

e.       Social Interest and Community Feeling: Social interest: the action line of one’s community feeling and it involves being as concerned as others as one is about oneself.

                                                             a.      The concept involves the capacity to cooperate

                                                            b.      Begins in childhood

                                                             c.      People express social interest through shared activity and mutual respect.

                                                            d.      Community feeling: the feeling of being connected to all of humanity past, present and future.

                                                             e.      Many of our problems stem from the fear of not being accepted by the groups we value most.

f.       Birth Order and Sibling Relationships: Adler identified five psychological positions from which children tend to view life.

                                                             a.      The oldest child: Lots of attention in the beginning until another sibling arrives.

                                                            b.      The second child: Seems they are always in a race to beat the oldest child.

                                                             c.      The middle child: Often feels squeezed out.

                                                            d.      The youngest child: Always the baby of the family and usually the most pampered.

                                                             e.      The only child: Traits are somewhat same as the oldest child, but often is spoiled by parents and strives to be the center of attention.

III.             Therapeutic Goals

a.       Prefer a growth model of personality rather than a medical model.

b.      The process includes providing information, teaching, guiding and offering encouragement.

IV.             Techniques

a.       Establish the proper therapeutic relationship

b.      Explore the psychological dynamics operation in the client including the family constellation.

c.       Encourage the development of self- understanding (insight and purpose).

d.      Help the client make new choices (reorientation and reeducation).

Reference:

Corey, Gerald (2013). Theory and Practice of Counseling and Psychotherapy (9^thed.). Belmont, CA:Brooks/Cole, Cengage Learning p. 62-97