Editing Gestalt therapy

{{short description|Form of psychotherapy}}
{{for|the book by Perls, Hefferline, and Goodman|Gestalt Therapy (book)}}
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'''Gestalt therapy''' is a form of [[psychotherapy]] that emphasizes [[Responsibility assumption|personal responsibility]] and focuses on the individual's experience in the present moment, the therapist–client relationship, the environmental and social contexts of a person's life, and the self-regulating adjustments people make as a result of their overall situation. It was developed by [[Fritz Perls]], [[Laura Perls]] and [[Paul Goodman (writer)|Paul Goodman]] in the 1940s and 1950s, and was first described in the 1951 book ''[[Gestalt Therapy (book)|Gestalt Therapy]]''.<ref>{{Cite book|last1=Perls|last2=Hefferline|last3=Goodman|first1=Fritz|first2=Ralph|first3=Paul|title=Gestalt Therapy: Excitement and Growth in the Human Personality|publisher=The Gestalt Journal Press: New Edition|year=1951|isbn=0939266245|language=English}}</ref>

==Overview==
[[Edwin Nevis]], co-founder of the Gestalt Institute of Cleveland, founder of the Gestalt International Study Center, and faculty member at the MIT Sloan School of Management, described Gestalt therapy as "a conceptual and methodological base from which helping professionals can craft their practice".<ref>Nevis, E. (2000). ''Gestalt therapy: Perspectives and Applications'', "Introduction". Edwin Nevis (ed.). Cambridge, MA: Gestalt Press, p.&nbsp;3.</ref> In the same volume, [[Joel Latner]] stated that Gestalt therapy is built upon two central ideas:
# that the most helpful focus of psychotherapy is the experiential present moment, and that everyone is caught in webs of relationships;
# thus, it is only possible to know ourselves against the background of our relationships to others.<ref>Latner, J. (2000). "The Theory of Gestalt Therapy", in ''Gestalt therapy: Perspectives and Applications'', Edwin Nevis (ed.). Cambridge, MA: Gestalt Press.</ref>
The historical development of Gestalt therapy (described below) discloses the influences that generated these two ideas. Expanded, they support the four chief theoretical constructs (explained in the theory and practice section) that comprise Gestalt theory, and that guide the practice and application of Gestalt therapy.

Gestalt therapy was forged from various influences upon the lives of its founders during the times in which they lived, including the [[new physics]], [[Eastern religion]], [[existential phenomenology]], [[Gestalt psychology]], [[psychoanalysis]], [[experimental theatre]], [[systems theory]], and [[Field theory (psychology)|field theory]].<ref>Mackewn, J. (1997). ''Developing Gestalt Counselling''. London, UK: Sage publications; Bowman, C. & Brownell, P. (2000) Prelude to Contemporary Gestalt Therapy. Gestalt!, vol. 4, no. 3, available at http://www.g-gej.org/4-3/prelude.html {{Webarchive|url=https://web.archive.org/web/20110206100139/http://www.g-gej.org/4-3/prelude.html |date=6 February 2011 }}</ref> Gestalt therapy rose from its beginnings in the middle of the 20th century to rapid and widespread popularity during the decade of the 1960s and early 1970s. During the 1970s and 80s Gestalt therapy training centers spread globally; but they were, for the most part, not aligned with formal academic settings. As the cognitive revolution eclipsed Gestalt theory in psychology, many came to believe Gestalt was an anachronism. Because Gestalt therapists disdained the positivism underlying what they perceived to be the concern of research, they largely ignored the need to use research to further develop Gestalt theory and Gestalt therapy practice (with a few exceptions like [[Les Greenberg]]; see the interview "Validating Gestalt"<ref>Validating Gestalt. An Interview with Researcher, Writer, and Psychotherapist Leslie Greenberg by Leslie Grennberg and Philip Brownell; in: Gestalt!, 1/1997.[http://www.g-gej.org/1-1/greenberg.html] {{Webarchive|url=https://web.archive.org/web/20070208173729/http://www.g-gej.org/1-1/greenberg.html|date=8 February 2007}}</ref>). However, the new century has seen a sea change in attitudes toward research and Gestalt practice. In March 2020, [[Vikram Kolmannskog]] became the world's first Professor of Gestalt Therapy at the Norwegian Gestalt Institute, where he has been teaching and researching since 2015.<ref>[https://gestalt.no/2020/03/ngi-har-fatt-verdens-forste-dosent-i-gestaltterapi/ NGI har fått verdens første dosent i gestaltterapi]</ref>

Gestalt therapy is not identical to Gestalt psychology, but Gestalt psychology influenced the development of Gestalt therapy to a large extent.<ref>Some Gestalt psychologists distanced themselves strongly from Gestalt therapy, like Henle, M. (1978): ''Gestalt psychology and Gestalt therapy'', in: ''Journal of the History of the Behavioral Sciences'' 14 (1), pp. 23-32. Henle, however, restricts herself explicitly to only three of Perls' books from 1969 and 1972, leaving out Perls' earlier work, and Gestalt therapy in general. See Barlow criticizing Henle: Allen R. Barlow: [http://www.gestalt.org/barlow.htm ''Gestalt Therapy and Gestalt Psychology. Gestalt – Antecedent Influence or Historical Accident''], in: ''The Gestalt Journal'', Volume IV, Number 2, Fall, 1981.</ref>

Gestalt therapy focuses on process (what is actually happening) over content (what is being talked about).<ref>{{cite book | title=Counseling and Psychotherapy Theories in Context and Practice: Skills, Strategies, and Techniques, 2nd edition | publisher=John Wiley & Sons |author1=Sommers-Flanagan, John |author2=Rita Sommers-Flanagan | year=2012 | pages=199 | isbn=978-0470617939 | url=https://books.google.com/books?id=RMclh6zR3LEC&pg=PA199 }}</ref> The emphasis is on what is being done, thought, and felt at the present moment (the phenomenality of both client and therapist), rather than on what was, might be, could be, or should have been. Gestalt therapy is a method of awareness practice (also called "mindfulness" in other clinical domains), by which perceiving, feeling, and acting are understood to be conducive to interpreting, explaining, and conceptualizing (the hermeneutics of experience).<ref name="Brownell">Brownell, P. (2010) Gestalt Therapy: A Guide to Contemporary Practice. New York, NY: Springer Publishing</ref> This distinction between direct experience versus indirect or secondary interpretation is developed in the process of therapy. The client learns to become aware of what they are doing and that triggers the ability to risk a shift or change.<ref>Beisser, A. (1970). "The Paradoxical Theory of Change". In J. Fagan & I. Shepherd (eds.). ''Gestalt Therapy Now: Theory, Techniques, and Applications'', pp. 77-80. Palo Alto, CA: Science and Behavior Books</ref>

The objective of Gestalt therapy is to enable the client to become more fully and creatively alive and to become free from the blocks and unfinished business that may diminish satisfaction, fulfillment, and growth, and to experiment with new ways of being.<ref>
{{cite book|title=The Creative Process in Gestalt Therapy|author-link=Joseph Zinker|author=Zinker, Joseph |year=1977|publisher=New York, Vintage Books}}</ref> For this reason Gestalt therapy falls within the category of [[humanistic psychology|humanistic psychotherapies]]. As Gestalt therapy includes perception and the [[meaning-making]] processes by which experience forms, it can also be considered a [[cognitive]] approach.  Also, because Gestalt therapy relies on the contact between therapist and client, and because a relationship can be considered to be contact over time, Gestalt therapy can be considered a relational or [[interpersonal]] approach.  As it appreciates the larger picture which is the complex situation involving multiple influences in a complex situation, it can also be considered a multi-systemic approach. In addition, the processes of Gestalt therapy are experimental, involving action, Gestalt therapy can be considered both a paradoxical and an experiential/experimental approach.<ref name="Brownell" />

When Gestalt therapy is compared to other clinical domains, a person can find many matches, or points of similarity. "Probably the clearest case of [[consilience]] is between gestalt therapy's field perspective and the various organismic and field theories that proliferated in neuroscience, medicine, and physics in the early and mid-20th century.  Within social science there is a consilience between gestalt field theory and systems or ecological psychotherapy; between the concept of dialogical relationship and object relations, attachment theory, client-centered therapy and the transference-oriented approaches; between the existential, phenomenological, and hermeneutical aspects of gestalt therapy and the constructivist aspects of cognitive therapy; and between gestalt therapy's commitment to awareness and the natural processes of healing and mindfulness, acceptance and Buddhist techniques adopted by [[cognitive behavioral therapy]]."<ref name="Brownell" />{{rp|174}}

==Contemporary theory and practice==
The theoretical foundations of Gestalt therapy essentially rest atop four "load-bearing walls": phenomenological method, dialogical relationship, field-theoretical strategies, and experimental freedom.<ref>Brownell, P. (ed.) (2008). ''Handbook for Theory, Research, and Practice in Gestalt Therapy''. Newcastle upon Tyne, UK: Cambridge Scholars Publishing.</ref> Although all these tenets were present in the early formulation and practice of Gestalt therapy, as described in ''Ego, Hunger and Aggression'' (Perls, 1947) and in ''Gestalt Therapy, Excitement and Growth in the Human Personality'' (Perls, Hefferline, & Goodman, 1951), the early development of Gestalt therapy theory emphasized personal experience and the experiential episodes understood as "safe emergencies" or experiments. Indeed, half of the Perls, Hefferline, and Goodman book consists of such experiments. Later, through the influence of such people as Erving and [[Miriam Polster]], a second theoretical emphasis emerged: namely, contact between self and other, and ultimately the dialogical relationship between therapist and client.<ref name="Polster 1973">Polster, E. & Polster, M. (1973) ''Gestalt Therapy Integrated: Contours of theory and practice''. New York, NY: Brunner-Mazel.</ref> Later still, field theory emerged as an emphasis.<ref>Wheeler, G. (1991). ''Gestalt : A new approach to contact and resistance''. New York, NY: Gardner.</ref> At various times over the decades, since Gestalt therapy first emerged, one or more of these tenets and the associated constructs that go with them have captured the imagination of those who have continued developing the contemporary theory of Gestalt therapy. Since 1990 the literature focused upon Gestalt therapy has flourished, including the development of several professional Gestalt journals. Along the way, Gestalt therapy theory has also been applied in [[Organizational Development]] and coaching work. And, more recently, Gestalt methods have been combined with meditation practices into a unified program of human development called [[Gestalt Practice]], which is used by some practitioners.

Richard G. Erskine, the originator of Integrative Psychotherapy (Developmentally Based, Relationally Focused), has written about the treatment of shame and self-righteousness in "A Gestalt therapy approach to shame and self-righteousness: theory and methods" from his book Relational Patterns, Therapeutic Presence: Concepts and Practice of Integrative Psychotherapy (2015).{{Clarify|reason=What did he say about it? Otherwise this provides the reader with no real information.|date=January 2022}}

===Phenomenological method===
The goal of a [[Phenomenology (philosophy)|phenomenological]] exploration is awareness.<ref>{{cite book | last=Yontef | first=Gary | title=Awareness, dialogue & process: essays on gestalt therapy | publisher=Gestalt Journal Press | publication-place=Highland, NY | year=1993 | isbn=0-939266-20-2 | oclc=32049593}}</ref> This exploration works systematically to reduce the effects of bias through repeated observations and inquiry.<ref name="Yontef">Yontef, G. (2005) Gestalt Therapy Theory of Change, in ''Gestalt Therapy, History, Theory, and Practice''. Ansel Woldt & Sarah Toman (eds). London, UK: Sage Publications.</ref>

The phenomenological method comprises three steps:<ref>Spinelli, E. (2005). ''The interpreted world, an introduction to phenomenological psychology'', 2nd edition. London, UK: Sage Publications.</ref>
# Applying the rule of [[epoché]] - one sets aside one's initial biases and prejudices in order to suspend expectations and assumptions.
# Applying the rule of description - one occupies oneself with describing instead of explaining.
# Applying the rule of horizontalization - one treats each item of description as having equal value or significance.

The rule of epoché sets aside any initial theories with regard to what is presented in the meeting between therapist and client. The rule of description implies immediate and specific observations, abstaining from interpretations or explanations, especially those formed from the application of a clinical theory superimposed over the circumstances of experience. The rule of horizontalization avoids any hierarchical assignment of importance such that the data of experience become prioritized and categorized as they are received. A Gestalt therapist using the phenomenological method might say something like, "I notice a slight tension at the corners of your mouth when I say that, and I see you shifting on the couch and folding your arms across your chest ... and now I see you rolling your eyes back". Of course, the therapist may make a clinically relevant evaluation, but when applying the phenomenological method, temporarily suspends the need to express it.<ref>Brownell, P. (2009) "Gestalt therapy". In Irmo Marini and Mark Stebnicki (eds) ''The Professional Counselor's Desk Reference'', pp.&nbsp;399–407. New York, NY, US: Springer Publishing Co.</ref>

===Dialogical relationship===
To create the conditions under which a [[dialogic]] moment might occur, the therapist attends to their own presence, creates the space for the client to enter in and become present as well (called inclusion), and commits themself to the dialogic process, surrendering to what takes place, as opposed to attempting to control it.<ref name="Yontef" /> With presence, the therapist judiciously "shows up" as a whole and authentic person, instead of assuming a role, [[false self]] or persona. To be judicious, the therapist takes into account the specific strengths, weaknesses and values of the client. The only good client is a live client, so driving a client away by injudicious exposure of intolerable [to this client] experience of the therapist is obviously counter-productive. For example, for an atheistic therapist to tell a devout client that religion is myth would not be useful, especially in the early stages of the relationship. To practice inclusion is to accept however the client chooses to be present, whether in a defensive and obnoxious stance or a superficially cooperative one. To practice inclusion is to support the presence of the client, including their resistance, not as a gimmick but in full realization that this is how the client is actually present and is the best this client can do at this time. Finally, the Gestalt therapist is committed to the process, trusts in that process, and does not attempt to save themself from it.<ref>Brownell, 2009.</ref><ref>Brownell, 2012.</ref><ref>Brownell, 2008.</ref>

===Field-theoretical strategies===
Field theory is a concept borrowed from physics in which people and events are no longer considered discrete units but as parts of something larger, which are influenced by everything including the past, and observation itself. "The field" can be considered in two ways. There are [[ontological]] dimensions and there are [[Phenomenology (psychology)|phenomenological]] dimensions to one's field. The ontological dimensions are all those physical and environmental contexts in which we live and move. They might be the office in which one works, the house in which one lives, the city and country of which one is a citizen, and so forth. The ontological field is the objective reality that supports our physical existence. The phenomenological dimensions are all mental and physical dynamics that contribute to a person's sense of self, one's subjective experience—not merely elements of the environmental context. These might be the memory of an uncle's inappropriate affection, one's color blindness, one's sense of the social matrix in operation at the office in which one works, and so forth. The way that Gestalt therapists choose to work with field dynamics makes what they do strategic.<ref name="Brownell" /> Gestalt therapy focuses upon character structure; according to Gestalt theory, the character structure is dynamic rather than fixed in nature. To become aware of one's character structure, the focus is upon the phenomenological dimensions in the context of the ontological dimensions.

===Experimental freedom===
Gestalt therapy is distinct because it moves toward action, away from mere talk therapy, and for this reason is considered an experiential approach.<ref>{{cite book | last=Crocker | first=Sylvia | title=A well-lived life: essays in Gestalt therapy | publisher=Gestalt Institute of Cleveland Press | publication-place=Cambridge, MA | year=1999 | isbn=0-88163-287-2 | oclc=43360600}}</ref> Through experiments, the therapist supports the client's direct experience of something new, instead of merely talking about the possibility of something new. Indeed, the entire therapeutic relationship may be considered experimental, because at one level it is a corrective, relational experience for many clients, and it is a "safe emergency" that is free to turn out however it will. An experiment can also be conceived as a teaching method that creates an experience in which a client might learn something as part of their growth.<ref>Melnick, J.; March Nevis, S. (2005). "Gestalt Therapy Methodology" in ''Gestalt Therapy, History, Theory, and Practice''. Ansel Woldt & Sarah Toman (eds). London, UK: Sage Publications.</ref>
Examples might include:
* Rather than talking about the client's critical parent, a Gestalt therapist might ask the client to imagine the parent is present, or that the therapist is the parent, and talk to that parent directly
* If a client is struggling with how to be assertive, a Gestalt therapist could either:
** have the client say some assertive things to the therapist or members of a therapy group
** give a talk about how one should never be assertive
* A Gestalt therapist might notice something about the non-verbal behavior or tone of voice of the client; then the therapist might have the client exaggerate the non-verbal behavior and pay attention to that experience
* A Gestalt therapist might work with the breathing or posture of the client, and direct awareness to changes that might happen when the client talks about different content.
With all these experiments the Gestalt therapist is working with process rather than content, the ''how'' rather than the ''what''.

==Noteworthy issues==
===Self===
In field theory, ''self'' is a phenomenological concept, existing in comparison with ''other''. Without the other there is no self, and how one experiences the other is inseparable from how one experiences oneself. The continuity of ''selfhood'' (functioning personality) is something that is achieved in relationship, rather than something inherently "inside" the person. This can have its advantages and disadvantages. At one end of the spectrum, someone may not have enough self-continuity to be able to make meaningful relationships, or to have a workable sense of who they are. In the middle, their personality is a loose set of ways of being that work for them, including commitments to relationships, work, culture and outlook, always open to change where they need to adapt to new circumstances or just want to try something new. At the other end, their personality is a rigid defensive denial of the new and spontaneous. They act in stereotyped ways, and either induce other people to act in particular and fixed ways towards them, or they redefine their actions to fit with fixed stereotypes.

In Gestalt therapy, the process is not about the self of the client being helped or healed by the fixed self of the therapist; rather it is an exploration of the co-creation of self and other in the here-and-now of the therapy. There is no assumption that the client will act in all other circumstances as they do in the therapy situation. However, the areas that cause problems will be either the lack of self-definition leading to chaotic or psychotic behaviour, or the rigid self-definition in some area of functioning that denies spontaneity and makes dealing with particular situations impossible. Both of these conditions show up very clearly in the therapy, and can be worked with in the relationship with the therapist.

The experience of the therapist is also very much part of the therapy. Since we co-create our self-other experiences, the way a therapist experiences being with a client is significant information about how the client experiences themselves. The proviso here is that a therapist is not operating from their own fixed responses. This is why Gestalt therapists are required to undertake significant therapy of their own during training.

From the perspective of this theory of self, neurosis can be seen as fixed predictability—a fixed Gestalt—and the process of therapy can be seen as ''facilitating the client to become unpredictable'': more responsive to what is in the client's present environment, rather than responding in a stuck way to past introjects or other learning.  If the therapist has expectations of how the client should end up, this defeats the aim of therapy.

===Change===
In what has now become a classic of Gestalt therapy literature, [[Arnold R. Beisser]] described Gestalt's paradoxical theory of change.<ref>Beisser, A. (1970). "The paradoxical theory of change", in J. Fagan & I. Shepherd (eds) ''Gestalt Therapy Now: Theory, Techniques, Applications''. Palo Alto, CA: Science and Behavior Books.</ref> The paradox is that the more one attempts to be who one is not, the more one remains the same. Conversely, when people identify with their current experience, the conditions of wholeness and growth support change. Put another way, change comes about as a result of "full acceptance of what is, rather than a striving to be different."<ref>Houston, G. (2003). ''Brief Gestalt Therapy. London, UK: Sage Publications.</ref>

===Empty chair technique===
'''Empty chair technique''' or '''chairwork''' is typically used in Gestalt therapy when a patient might have deep-rooted emotional problems from someone or something in their life, such as relationships with themselves, with aspects of their personality, their concepts, ideas, feelings, etc., or other people in their lives. The purpose of this technique is to get the patient to think about their emotions and attitudes.<ref>{{cite web|url=http://www.psychologicalselfhelp.org/Chapter15/chap15_21.html|title=Chapter15 - page 21 of 108|website=www.psychologicalselfhelp.org}}</ref> Common things the patient addresses in the empty chair are another person, aspects of their own personality, a certain feeling, etc., as if that thing were in that chair.<ref>{{cite book |last1=Nichol |first1=M. P. |name-list-style=amp |last2=Schwartz |first2=R. C. |year=2008 |title=Family Therapy: Concepts and Methods |edition=8th |location=New York |publisher=Pearson Education |page=[https://archive.org/details/familytherapycon00nich_0/page/227 227] |isbn=978-0-205-54320-5 |url-access=registration |url=https://archive.org/details/familytherapycon00nich_0/page/227 }}</ref> They may also move between chairs and act out two or more sides of a [[discussion]], typically involving the patient and persons significant to them. It uses a passive approach to opening up the patient's emotions and pent-up feelings so they can let go of what they have been holding back. A form of [[role-playing]], the technique focuses on exploration of self and is used by therapists to help patients self-adjust. Gestalt techniques were originally a form of psychotherapy, but are now often used in [[counseling]], for instance, by encouraging clients to act out their feelings helping them prepare for a new job.<ref>{{cite book | author1=Daniel L. Schacter | author2=Daniel T. Gilbert | author3=Daniel M. Wegner | title=Psychology|url=https://archive.org/details/psychology0000scha | url-access=registration | year=2011|publisher=Worth Publishers | location=New York, NY | isbn=978-1429237192 | edition=2nd | page=[https://archive.org/details/psychology0000scha/page/602 602–603] }}</ref> The purpose of the technique is so the patient will become more in touch with their feelings and have an emotional conversation that clears up any long-held feelings or reaction to the person or object in the chair.<ref>{{cite web | url=http://www.psychologytoday.com/blog/in-therapy/201001/cool-intervention-9-the-empty-chair-1 | title=Cool Intervention #9: The Empty Chair | website=Psychology Today}}</ref>

==Historical development==
[[Fritz Perls]] was a German-Jewish [[psychoanalyst]] who fled Europe with his wife [[Laura Perls]] to [[South Africa]] in order to escape [[Nazi]] oppression in 1933.<ref name="Bernd2010">{{cite book | last=Bocian | first=Bernd | title=Fritz Perls in Berlin 1893-1933: Expressionism, Psychoanalysis, Judaism | publisher=EHP - Verlag Andreas Kohlhage | publication-place=Bergisch Gladbach | year=2015 | isbn=978-3-89797-068-7 | oclc=1162413729}}</ref> After World War II, the couple emigrated to [[New York City]], which had become a center of intellectual, artistic and political experimentation by the late 1940s and early 1950s.

===Early influences===
Perls grew up on the bohemian scene in Berlin, participated in [[Expressionism]] and [[Dadaism]], and experienced the turning of the artistic ''avant-garde'' toward the revolutionary left. Deployment to the front line, the trauma of war, anti-Semitism, intimidation, escape, and [[the Holocaust]] are further key sources of biographical influence.<ref name="Bernd2010" />

Perls served in the German Army during World War I, and was wounded in the conflict. After the war he was educated as a medical doctor. He became an assistant to [[Kurt Goldstein]], who worked with brain-injured soldiers. Perls went through a psychoanalysis with [[Wilhelm Reich]] and became a psychiatrist. Perls assisted Goldstein at Frankfurt University where he met his wife Lore (Laura) Posner, who had earned a doctorate in [[Gestalt psychology]].<ref name="gestalt.org">For Goldstein's influence on the theory and practice of Gestalt therapy see: Allen R. Barlow:  [http://www.gestalt.org/barlow.htm Gestalt Therapy and Gestalt Psychology. Gestalt-antecedent influence or historical accident], ''The Gestalt Journal'', Volume IV, Number 2, (Fall, 1981)</ref> They fled Nazi Germany in 1933 and settled in South Africa. Perls established a psychoanalytic training institute and joined the South African armed forces, serving as a military psychiatrist. During these years in South Africa, Perls was influenced by [[Jan Smuts]] and his ideas about "[[holism]]".

In 1936 Fritz Perls attended a psychoanalysts' conference in [[Marienbad, Czechoslovakia]], where he presented a paper on oral resistances, mainly based on Laura Perls's notes on breastfeeding their children. Perls's paper was turned down. Perls did present his paper in 1936, but according to him, it met with "deep disapproval."<ref>Perls, F. (1969) ''In and Out the Garbage Pail''. Lafayette, CA: Real People Press.</ref> Perls wrote his first book, ''Ego, Hunger and Aggression'' (1942, 1947), in South Africa, based in part on the rejected paper. It was later re-published in the United States. Laura Perls wrote two chapters of this book, but she was not given adequate recognition for her work.<ref name="history">{{cite book |last1=Wysong |first1=Joe |last2=Rosenfeld |first2=Edward |date=1982 |title=An Oral History of Gestalt Therapy: Interviews with Laura Perls, Isadore From, Erving Polster, Miriam Polster |location=Highland, NY |publisher=Gestalt Journal |isbn=0939266024 |oclc=9281232}}</ref>

===Seminal book===
Perls's seminal work was ''Gestalt Therapy: Excitement and Growth in the Human Personality'', published in 1951, co-authored by Fritz Perls, [[Paul Goodman (writer)|Paul Goodman]], and [[Ralph Hefferline]] (a university psychology professor and sometimes-patient of Fritz Perls). Most of Part II of the book was written by Paul Goodman from Perls's notes, and it contains the core of Gestalt theory. This part was supposed to appear first, but the publishers decided that Part I, written by Hefferline, fit into the nascent self-help ethos of the day, and they made it an introduction to the theory. [[Isadore From]], a leading early theorist of Gestalt therapy, taught Goodman's Part II for an entire year to his students, going through it phrase by phrase.

===First instances of Gestalt therapy===
Fritz and Laura founded the first Gestalt Institute in 1952, running it out of their [[Manhattan]] apartment. Isadore From became a patient, first of Fritz, and then of Laura. Fritz soon made From a trainer, and also gave him some patients. From lived in New York until his death, at age seventy-five, in 1993. He was known worldwide for his philosophical and intellectually rigorous take on Gestalt therapy. Acknowledged as a supremely gifted clinician,<ref name="history" /> he was indisposed to writing, so what remains of his work is merely transcripts of interviews.<ref>{{cite web|url=http://www.gestalt.org/Fromint.htm|title=Oral Link|website=www.gestalt.org}}</ref>

Of great importance to understanding the development of Gestalt therapy is the early training which took place in experiential groups in the Perls's apartment, led by both Fritz and Laura before Fritz left for the West Coast, and after by Laura alone. These "trainings" were unstructured, with little didactic input from the leaders, although many of the principles were discussed in the monthly meetings of the institute, as well as at local bars after the sessions. Many notable Gestalt therapists emerged from these crucibles in addition to Isadore From, e.g., Richard Kitzler, Dan Bloom, Bud Feder, Carl Hodges, and Ruth Ronall. In these sessions, both Fritz and Laura used some variation of the "hot seat" method, in which the leader essentially works with one individual in front of an audience with little or no attention to group dynamics. In reaction to this omission emerged a more interactive approach in which Gestalt-therapy principles were blended with group dynamics; in 1980, the book ''Beyond the Hot Seat'', edited by Feder and Ronall, was published, with contributions from members of both the New York and Cleveland Institutes, as well as others.

Fritz left Laura and New York in 1960, briefly lived in Miami, and ended up in California. [[Jim Simkin]] was a psychotherapist who became a client of Perls in New York and then a co-therapist with Perls in Los Angeles. Simkin was responsible for Perls's going to California, where Perls began a psychotherapy practice. Ultimately, the life of a peripatetic trainer and workshop leader was better suited to Fritz's personality—starting in 1963, Simkin and Perls co-led some of the early Gestalt workshops and training groups at [[Esalen Institute]] in [[Big Sur]], California, where Perls eventually settled and built a home. Jim Simkin then purchased property next to Esalen and started his own training center, which he ran until his death in 1984. Simkin refined his precise version of Gestalt therapy, training psychologists, psychiatrists, counselors and social workers within a very rigorous, residential training model.

In 1997 Chuck Kanner founded Kanner Academy and Community Schools in Sarasota Florida. These residential schools for struggling kids and families were the first example of a consensus based therapeutic community grounded in gestalt principals.<ref>Robert G. Lee Ph.D, Chuck Kanner M.A., (2004) The Value of Connection: A Relational Approach to Ethics. (Chapter 5 The Relational Ethic in the Treatment of Adolescents)</ref>

===Schism===
In the 1960s, Perls became infamous among the professional elite for his public workshops at [[Esalen Institute]]. Isadore From referred to some of Fritz's brief workshops as "hit-and-run" therapy, because of Perls's alleged emphasis on showmanship with little or no follow-through—but Perls never considered these workshops to be complete therapy; rather, he felt he was giving ''demonstrations of key points'' for a largely professional audience. Unfortunately, some films and tapes of his work were all that most graduate students were exposed to, along with the misperception that these represented the entirety of Perls's work.

When Fritz Perls left New York for California, there began to be a split with those who saw Gestalt therapy as a therapeutic approach similar to psychoanalysis. This view was represented by Isadore From, who practiced and taught mainly in New York, as well as by the members of the Cleveland Institute, which was co-founded by From. An entirely different approach was taken, primarily in California, by those who saw Gestalt therapy not just as a therapeutic modality, but as a way of life. The East Coast, New York–Cleveland axis was often appalled by the notion of Gestalt therapy leaving the consulting room and becoming a way of life on the West Coast in the 1960s (see the "[[Gestalt prayer]]").

An alternative view of this split saw Perls in his last years continuing to develop his a-theoretical and phenomenological methodology, while others, inspired by From, were inclined to theoretical rigor which verged on replacing experience with ideas.

The split continues between what has been called "East Coast Gestalt" and "West Coast Gestalt," at least from an [[Americentrism|Amerocentric]] point of view. While the [[Communitarianism|communitarian]] form of Gestalt continues to flourish, Gestalt therapy was largely replaced in the United States by [[cognitive behavioral therapy]], and many Gestalt therapists in the U.S. drifted toward organizational management and coaching. At the same time, contemporary [[Gestalt Practice]] (to a large extent based upon Gestalt therapy theory and practice) was developed by [[Dick Price]], the co-founder of Esalen Institute.<ref>{{cite web|url=http://www.esalen.org/air/essays/dick_price.htm|title=Esalen Founders - Esalen|website=www.esalen.org}}</ref> Price was one of Perls's students at Esalen.

===Post-Perls===
In 1969, Fritz Perls left the United States to start a Gestalt community at Lake Cowichan on [[Vancouver Island]], Canada. He died almost one year later, on 14 March 1970, in Chicago. One member of the Gestalt community was [[Barry Stevens (therapist)|Barry Stevens]]. Her book about that phase of her life, ''Don't Push the River'', became very popular. She developed her own form of Gestalt therapy body work, which is essentially a concentration on the awareness of body processes.<ref>Stevens, B. (1970) ''Don't Push the River (It Flows by Itself)'', Lafaette, CA: Real People Press.</ref>

====Polsters====
Erving and Miriam Polster started a training center in [[La Jolla]], California, and published a book, ''Gestalt Therapy Integrated'', in the 1970s.<ref name="Polster 1973" />

They were influential in advancing the idea of contact boundary phenomena, which is a key part of Gestalt theory. The standard contact boundary resistances were confluence, introjection, projection, and retroflection, but the Polsters added "deflection" as a way of avoiding contact. Boundary phenomena can have good or bad effects, depending on the situation. For example, it's normal for a baby and mother to merge, but not for a therapist and client. If the therapist and client become too merged, then there can be no progress because there is no boundary for them to connect with. The client will not be able to learn anything new because the therapist will just become a part of them.<ref>{{Cite web |last=Jameel |first=Mohammad |title=Gestalt Therapy Concepts In Psychology |url=https://scales.arabpsychology.com/2022/11/19/gestalt-therapy/ |access-date=19 March 2023 |language=en-US}}</ref>

==Influences upon Gestalt therapy==
===Some examples===
There were a variety of psychological and philosophical influences upon the development of Gestalt therapy, not the least of which were the social forces at the time and place of its inception. Gestalt therapy is an approach that is holistic (including mind, body, and culture). It is present-centered and related to [[existential therapy]] in its emphasis on personal responsibility for action, and on the value of "I–thou" relationship in therapy. In fact, Perls considered calling Gestalt therapy ''existential-phenomenological therapy''. "The I and thou in the Here and Now" was a semi-humorous shorthand mantra for Gestalt therapy, referring to the substantial influence of the work of [[Martin Buber]]—in particular his notion of the [[I and Thou|I–Thou relationship]]—on Perls and Gestalt. Buber's work emphasized immediacy, and required that any method or theory answer to the therapeutic situation, seen as a meeting between two people.<ref>{{cite book|url=https://books.google.com/books?id=GBxLBLdQDmQC|title=The Martin Buber - Carl Rogers Dialogue: A New Transcript With Commentary|first1=Martin|last1=Buber|first2=Carl Ransom|last2=Rogers|first3=Rob|last3=Anderson|first4=Kenneth N.|last4=Cissna|year=1997|publisher=SUNY Press|isbn=9780791434383}}</ref> Any process or method that turns the patient into an object (the I–It) must be strictly secondary to the intimate, and spontaneous, I–Thou relation. This concept became important in much of Gestalt theory and practice.

Both Fritz and Laura Perls were students and admirers of the neuropsychiatrist [[Kurt Goldstein]]. Gestalt therapy was based in part on Goldstein's concept called ''Organismic theory''. Goldstein viewed a person in terms of a [[holistic]] and unified experience; he encouraged a "big picture" perspective, taking into account the whole context of a person's experience. The word ''Gestalt'' means whole, or configuration. Laura Perls, in an interview, denotes the Organismic theory as the base of Gestalt therapy.<ref name="gestalt.org"/>

There were additional influences on Gestalt therapy from [[existentialism]], particularly the emphasis upon personal choice and responsibility.

The late 1950s–1960s movement toward [[personal growth]] and the [[human potential movement]] in California fed into, and was itself influenced by, Gestalt therapy. In this process Gestalt therapy somehow became a ''coherent Gestalt'', which is the Gestalt psychology term for a perceptual unit that holds together and forms a unified whole.

===Psychoanalysis===
Fritz Perls trained as a neurologist at major medical institutions and as a Freudian psychoanalyst in Berlin and Vienna, the most important international centers of the discipline in his day. He worked as a training analyst for several years with the official recognition of the International Psychoanalytic Association (IPA), and must be considered an experienced clinician.<ref name="Bernd2010" />
Gestalt therapy was influenced by [[psychoanalysis]]: it was part of a continuum moving from the early work of [[Freud]], to the later Freudian ego analysis, to [[Wilhelm Reich]] and his character analysis and notion of character armor, with attention to [[Nonverbal communication|nonverbal behavior]]; this was consonant with Laura Perls's background in dance and movement therapy. To this was added the insights of academic [[Gestalt psychology]], including ''perception'', ''Gestalt formation'', and the tendency of organisms to ''complete an incomplete Gestalt'' and to form "wholes" in experience.

Central to Fritz and Laura Perls's modifications of psychoanalysis was the concept of ''dental'' or ''oral aggression''.  In ''Ego, Hunger and Aggression'' (1947), Fritz Perls's first book, to which Laura Perls contributed<ref>{{cite web|url=http://www.gestalt.org/perlsint.htm|title=Oral Link|website=www.gestalt.org}}</ref> (ultimately without recognition), Perls suggested that when the infant develops teeth, he or she has the capacity to chew, to break food apart, and, by analogy, to ''experience'', ''taste'', ''accept'', ''reject'', or ''assimilate''. This was opposed to [[Freud]]'s notion that only [[introjection]] takes place in early experience. Thus Perls made assimilation, as opposed to introjection, a focal theme in his work, and the prime means by which growth occurs in therapy.

In contrast to the psychoanalytic stance, in which the "patient" introjects the (presumably more healthy) interpretations of the analyst, in Gestalt therapy the client must "taste" his or her own experience and either accept or reject it—but ''not'' introject or "swallow whole." Hence, the emphasis is on avoiding interpretation, and instead encouraging discovery. This is the key point in the divergence of Gestalt therapy from traditional psychoanalysis: growth occurs through gradual assimilation of experience in a natural way, rather than by accepting the interpretations of the analyst; thus, the therapist should not ''interpret'', but lead the client to ''discover'' for him- or herself.

The Gestalt therapist contrives experiments that lead the client to greater awareness and fuller experience of his or her possibilities. Experiments can be focused on undoing [[Psychological projection|projection]]s or retroflections. The therapist can work to help the client with closure of unfinished Gestalts ("unfinished business" such as unexpressed emotions towards somebody in the client's life). There are many kinds of experiments that might be therapeutic, but the essence of the work is that it is experiential rather than interpretive, and in this way, Gestalt therapy distinguishes itself from psychoanalysis.

===Principal influences: a summary list===
{{Unreferenced section|date=September 2021}}
* [[Otto Rank]]'s invention of "here-and-now" therapy and Rank's post-Freudian book ''Art and Artist'' (1932), both of which strongly influenced [[Paul Goodman (writer)|Paul Goodman]]
* [[Wilhelm Reich]]'s [[psychoanalysis|psychoanalytic]] developments, especially his early character analysis, and the later concept of ''character armor'' and its focus on the body
* [[Jacob Moreno]]'s [[psychodrama]], principally the development of enactment techniques for the resolution of psychological conflicts
* [[Kurt Goldstein]]'s holistic theory of the organism, based on [[Gestaltism|Gestalt theory]]
* [[Martin Buber]]'s [[philosophy of dialogue]] and relationship ("I–Thou")
* [[Kurt Lewin]]'s field theory as applied to the social sciences and group dynamics
* European [[Phenomenology (philosophy)|phenomenology]] of Franz Brentano, Edmund Husserl, Martin Heidegger, and Maurice Merleau-Ponty
* The [[existentialism]] of [[Søren Kierkegaard|Kierkegaard]] over that of [[Jean-Paul Sartre|Sartre]], rejecting nihilism
* The [[Jungian psychology]] of [[Carl Jung]], particularly the polarities concept
* Some elements from [[Zen Buddhism]]
* Differentiation between ''thing'' and ''concept'' from [[Zen Buddhism|Zen]] and the works of [[Alfred Korzybski]]
* The American [[pragmatism]] of [[William James]], [[George Herbert Mead]], and [[John Dewey]]

==Therapies influenced by Gestalt therapy==
Psychotherapies influenced by Gestalt therapy include:
* [[Acceptance and commitment therapy]]<ref>{{cite journal |last=Dougher |first=Michael J. |date=Fall 2002 |title=This is not B.&nbsp;F. Skinner's behavior analysis: a review of Hayes, Strosahl, And Wilson's ''Acceptance and Commitment Therapy'' |journal=[[Journal of Applied Behavior Analysis]] |volume=35 |issue=3 |pages=323–336 (323) |doi=10.1901/jaba.2002.35-323 |pmc=1284396 |quote=Instead of the familiar litany of behavior analytic-terms and concepts, this book is replete with terms and themes that are more commonly associated with such philosophical and therapeutic traditions as existentialism, humanism, Zen Buddhism, Gestalt, and other experiential-based therapies.}}</ref><ref>{{cite AV media |date=24 July 2017 |title=Steven C. Hayes – Interview about ACT |medium=Video |url=https://www.youtube.com/watch?v=xZHCpazRg0o  |archive-url=https://ghostarchive.org/varchive/youtube/20211212/xZHCpazRg0o| archive-date=12 December 2021 |url-status=live|time=18:21 |access-date=5 August 2021 |location=Los Mochis, Sinaloa, Mexico |publisher=Centro Integral de Psicología |via=[[YouTube]] |quote=I would have to say a lot of what's in ACT is in Gestalt, is in Est, is in mindfulness-based traditions, but I'm not embarrassed by that; I think it's to be expected that things like the wisdom traditions, spiritual traditions, human potential/growth traditions, Gestalt, these things were there because very very creative people put them there.}}{{cbignore}}</ref>
* [[Emotion-focused therapy]]<ref>{{cite journal |last1=Sutherland |first1=Olga |last2=Peräkylä |first2=Anssi |last3=Elliott |first3=Robert |date=2014 |title=Conversation analysis of the two-chair self-soothing task in emotion-focused therapy |journal=[[Psychotherapy Research]] |volume=24 |issue=6 |pages=738–751 |pmid=24576145 |doi=10.1080/10503307.2014.885146 |s2cid=2961270 |url=https://strathprints.strath.ac.uk/46526/ |quote=Emotion-focused therapy (EFT) is a process-experiential approach to therapy that incorporates assumptions and practices from Gestalt and other humanistic therapies (Elliott, Watson, Goldman & Greenberg, 2004; Greenberg, Rice & Elliott, 1993).&nbsp;... Enactment tasks (or enactments) represent the adaptation and elaboration of Gestalt therapy two-chair techniques.|url-access=subscription }}</ref>

==Current status==
Gestalt therapy reached a zenith in the United States in the late 1970s and early 1980s. Since then, it has influenced other fields like organizational development, coaching, and teaching.{{citation needed|date=May 2021}} Many of its contributions have become assimilated into other schools of therapy. In recent years{{when|date=May 2021}}, it has seen a resurgence in popularity as an active, psychodynamic form of therapy which has also incorporated some elements of recent developments in attachment theory.{{citation needed|date=May 2021}} There are, for example, four Gestalt training institutes in the [[New York City]] metropolitan area alone, in addition to dozens of others worldwide.

Gestalt therapy continues to thrive as a widespread form of psychotherapy, especially throughout Europe, where there are many practitioners and training institutions.{{citation needed|date=May 2021}} Dan Rosenblatt led Gestalt therapy training groups and public workshops at the Tokyo Psychotherapy Academy for seven years. Stewart Kiritz continued in this role from 1997 to 2006.

===Training of Gestalt therapists===
====Pedagogical approach====
Many Gestalt therapy training organizations exist worldwide. Ansel Woldt asserted that Gestalt teaching and training are built upon the belief that people are, by nature, health-seeking. Thus, such commitments as authenticity, optimism, holism, health, and trust become important principles to consider when engaged in the activity of teaching and learning—especially Gestalt therapy theory and practice.<ref>Woldt, A. (2005) Pre-text: Gestalt pedagogy: Creating the field for teaching and learning, in Ansel Woldt & Sarah Toman (eds), ''Gestalt Therapy, History, Theory, and Practice''. London, UK: Sage Publications.</ref>

===Associations===
'''The Association for the Advancement of Gestalt Therapy''' holds a biennial international conference in various locations—the first was in New Orleans, in 1995. Subsequent conferences have been held in San Francisco, Cleveland, New York, Dallas, St. Pete's Beach, Vancouver (British Columbia), Manchester (England), and Philadelphia. In addition, the it holds regional conferences, and its regional network has spawned regional conferences in Amsterdam, the Southwest and the Southeast of the United States, England, and Australia. Its Research Task Force generates and nurtures active research projects and an international conference on research.<ref>{{cite web|url=http://www.aagt.org|title=AAGT – Association for the Advancement of Gestalt Therapy|website=www.aagt.org}}</ref>

'''The European Association for Gestalt Therapy''', founded in 1985 to gather European individual Gestalt therapists, training institutes, and national associations from more than twenty European nations.<ref>{{cite web|url=http://www.eagt.org/|title=EAGT European Association for Gestalt Therapy|website=www.eagt.org}}</ref>

'''Gestalt Australia and New Zealand''' was formally established at the first Gestalt Therapy Conference held in Perth in September 1998.<ref>[http://www.ganz.org.au/ GANZ Gestalt Australia & New Zealand]</ref>

==See also==
* [[Role reversal]]
* [[Topdog vs. underdog]]
* [[Violet Oaklander]]

==References==
{{Reflist}}

==Further reading==
* Perls, F. (1969) ''Ego, Hunger, and Aggression: The Beginning of Gestalt Therapy''.  New York, NY: Random House. (originally published in 1942, and re-published in 1947)
* Perls, F. (1969) ''[http://commons.wikimedia.org/wiki/Gestalt_therapy_verbatim Gestalt Therapy Verbatim]{{Dead link|date=October 2018 |bot=InternetArchiveBot |fix-attempted=yes }}''. Moab, UT: [[Real People Press]].
* Perls, F., Hefferline, R., & Goodman, P. (1951) ''Gestalt Therapy: Excitement and growth in the human personality.''  New York, NY: Julian.
* Perls, F. (1973) ''The Gestalt Approach & Eye Witness to Therapy''. New York, NY: Bantam Books.
* Brownell, P. (2012) ''Gestalt Therapy for Addictive and Self-Medicating Behaviors''. New York, NY: Springer Publishing.
* Levine, T.B-Y. (2011) ''Gestalt Therapy: Advances in Theory and Practice''. New York, NY: Routledge.
* Bloom, D. & Brownell, P. (eds)(2011) ''Continuity and Change: Gestalt Therapy Now''. Newcastle, UK: Cambridge Scholars Publishing
* Mann, D. (2010) ''Gestalt Therapy: 100 Key Points & Techniques''. London & New York: Routledge.
* {{cite book | last=Truscott | first=Derek | title=Becoming an effective psychotherapist: adopting a theory of psychotherapy that's right for you and your client | chapter=Gestalt therapy | publisher=American Psychological Association | publication-place=Washington, D.C. | year=2010 | isbn=978-1-4338-0473-1 | oclc=612728376 | pages=83–96 }}
* Staemmler, F-M. (2009) ''Aggression, Time, and Understanding: Contributions to the Evolution of Gestalt Therapy''. New York, NY, US: Routledge/Taylor & Francis Group; GestaltPress Book
* Woldt, A. & Toman, S. (2005) "Gestalt Therapy: History, Theory and Practice." Thousand Oaks, CA: Sage Publications.
* {{cite journal | last1=Bretz | first1=HJ | last2=Heekerens | first2=HP | last3=Schmitz | first3=B | title=Eine Metaanalyse der Wirksamkeit von Gestalttherapie | trans-title=A meta-analysis of the effectiveness of gestalt therapy | journal=Zeitschrift für klinische Psychologie, Psychopathologie und Psychotherapie | volume=42 | issue=3 | year=1994 | issn=0723-6557 | pmid=7941644 | pages=241–60 | language=de | url=https://www.researchgate.net/publication/15256882 }}
* {{cite book |editor1-first= Sarah |editor1-last= Toman |editor2-first= Ansel |editor2-last= Woldt |title= Gestalt Therapy History, Theory, and Practice |publisher= Gestalt Press |isbn= 0761927913 |edition= pbk. |year= 2005}}

==External links==
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