Introduction
“The healing that occurs in psychotherapy is a result of the quality of the meeting that occurs between client and therapist. Practicing in a dialogical manner, Gestalt therapists attempt to be fully present, convey to the client that they comprehend and accept the other’s experience, and vigilantly attend to the impact of each of their interventions” (J. Frew). In the sixth chapter of his book “Case Approach to Counselling and Psychotherapy”, Gerald Corey, Professor Emeritus of Human Services and Counseling at California State University at Fullerton, discusses gestalt therapy, illustrated through the case study of Ruth. The Gestalt approach, which appeared in the 1950s, is based on the patient’s resources to become aware of his or her inner life and interactions with the environment, it aims to improve awareness of the here and now experiencing.
Summary
The chapter begins with a brief theoretical presentation of gestalt therapy. The author emphasises the importance of the patient living the experience rather than talking about it. Indeed, Gestalt therapy focuses on the experience in the here and now rather than on the word itself, unlike psychoanalysis. According to Gestalt therapists, this allows patients to increase their level of awareness of the problems, but also of the resources they have at their disposal in order to better handle them. The therapy is based on the needs satisfaction model, which describes a “cycle of experience”, beginning with physical or emotional sensations and continuing through awareness, arousal, action and contact with the environment. A functional diagnosis enables the Gestalt therapist to help patients understand how they experience interruptions in the natural process of identifying and satisfying needs.
The therapeutic relationship between patient and therapist is a key element in understanding how the patient experiences himself or herself. Indeed, the Gestalt therapist can observe how clients relate to the therapist during the therapy session itself. To illustrate his point, the author offers us the case study of Ruth, relating the different phases of the therapy : the establishment of a functional diagnosis, the identification of key issues and themes related to the client’s problems and the development of basic assumptions. Clients can do homework assignments between sessions and continue to examine their own awareness and contacting processes after the therapy is complete.
- Ruth’s case
The author highlights, from what he discussed with Ruth and her autobiography, several themes to explore. It should be pointed out that a theme always has to be brought by the patient before it is explored. In this case, it seems that Ruth pays more attention to what others want from her, to the detriment of what she wants from others, and is afraid that her desires will scare away the people she loves, such as her husband.
So the therapist sets up an experiment in which he and Ruth have to look at each other, which makes her uncomfortable. Ruth is able to express that she is angry because she does not know what he wants from her. This revealed that Ruth places a lot of importance on what others expect of her, and she even goes so far as to identify a desire of her own: to feel that the therapist is interested in what she says and thinks.
Jerry Corey will, over the course of the therapy, increase the number of experiments in the sessions, all of which are meant to intensify the experience of the here and now. First, the therapist invites Ruth to repeat aloud thoughts that come into her mind that she usually keeps to herself, in order to help her direct her thoughts and emotions (such as anger) to external sources rather than to herself. Then the therapist takes the place of a person to whom Ruth has things to say using the two-chair technique to work on certain ‘parts’ of her personality, the one that does what others expect of her and the uninhibited one. Then they also do a role-play where Ruth plays her father who talks to her.
Through these different experiences, Ruth realises how certain past experiences are related to her present feeling of being blocked in many ways. This understanding is, in itself, a powerful catalyst for her change.
Critical evaluation
- Data & data collection
In this chapter, the methodology used is based on a qualitative analysis, where the exchanges between the two interlocutors are faithfully transcribed. This transcript allows us to follow the therapist’s thought process and to illustrate the way he interacts with the patient, letting her move at her own pace.
This case presentation illustrates the clinical work possible in a Gestalt therapy. The chapter begins with a brief presentation of Gestalt theory, and then Ruth’s case is used to see how this theory can be articulated in a practical application.
- Inovation
This chapter is part of a book presenting the different types of psychotherapy, and its aim is to present Gestalt therapy and illustrate it through a practical case. Nevertheless, the notions discussed remain general and therefore a little superficial. It provides a general overview of this type of therapy, with some examples of application, but the author does not go into much depth in his reflection on the case. There is already a multitude of books or articles presenting case studies of various theoretical-clinical orientations. Thus, it is not very innovative to propose yet another presentation of the introductory concepts of Gestalt therapy without developing an innovative concept. The author could also have explored a particular theme or issue in more depth.
- Writing style
The author uses simple terms throughout the chapter and explains new terms. This has the advantage of making the reading accessible to all types of audience, novices and experts alike. It should be remembered that this book presents case studies of various psychotherapeutic approaches, so it seems to be addressed to readers who are relatively familiar with psychotherapies. Thus, the rather superficial treatment of the case studies could be frustrating for the reader.
Conclusion
This chapter provides an introduction to Gestalt therapy and Ruth’s case study allows us to understand and illustrate the foundations of this type of psychotherapy.
It shows how a therapist can help a patient to become more aware of themselves and their resources in order to resolve both current and past difficulties.
Key terms :
- Awareness : conscience
- Case study : étude de cas
- To experience : faire l’expérience de
- Functional diagnosis : diagnostic fonctionnel
- Inner life : vie intérieure
- The need–fulfillment cycle : le cycle besoin-satisfaction
Words I’ve learned :
- Dialogical approach : approche dialogique
- Embedded : intégré
- Figural: figuratif
- Purely as hunches : purement sous forme d’intuition
- The need–fulfillment cycle : le cycle besoin-satisfaction