From the Individual to Relationship

A Gestalt Perspective on the Client-Therapist relationship. By Vincent Humphreys (Eisteach 2004)

A Workshop with Rich Hycner Ph.D.


Therapeutic Artistry: Between Client and Therapist.

The Workshop will include theory, demonstrations and discussion.

  • Date: 13th  – 15th  September 2019, 9.30 to 5.30 Friday & Saturday, 9.30 to 1.00 Sunday
  • Venue: Avila, Bloomfield Avenue, Donnybrook, Dublin. D04 YF66.
  • Cost: €395. Includes Light Refreshments. Full Payment by 1st August.
  • Numbers limited to 30

The Individual

Gestalt therapy is mostly known for its emphasis on individual responsibility. It developed through the 1950s and 60s as a distinct theory of its own. The development of Gestalt is generally associated with the charismatic personality of Fritz Perls though other individuals were involved from the beginning e.g. Laura Perls, Ralph Hefferline, and Paul Goodman. The emphasis on individual responsibility was the main focus of the work of Fritz Perls.

There are several ways in which the focus on individual responsibility was expressed in Perls work. His initial contract inviting people to work was framed in terms of the individual. In Gestalt Therapy (1969) he writes, “I want to clarify my position. I am responsible only for myself and for nobody else. I am not taking responsibility for any of you, you are responsible for yourselves”.

This is also reflected in the famous Gestalt prayer, written by Perls, part of which reads “…I do my thing, and you do your thing, I am not in this world to live up to your expectations”. (Perls 1969 p.4).

To embody an attitude in a prayer is to give it a special place in any theoretical system.
His therapy work focused mainly on the intrapsychic. The holistic approach came to mean the holism of the individual i.e. integrating different parts of the self (e.g. topdog underdog). This is particularly seen in his work with dreams where every character and object in the dream is seen as part of the self. He used dream work to integrate parts of self.

His work in groups was essentially working with individuals in front of a group. This became known as the “hot-seat” approach. Thus there was little, if any, focus on the interactions and relationships with group members or on group themes or process.
Perls was very energetic in publicizing Gestalt. He was a charismatic figure who enjoyed the limelight. He travelled widely in the United States giving appearances and interviews to television, radio and newspaper. He was creative in developing short witty sayings that popularized the gestalt emphasis on the individual for the layperson.

Thus Gestalt therapy is mostly known for its emphasis on the individual. Clarkson and McKewn (1993 p.173)call it the “…polarity of extreme individualism while an American Gestalt therapist Raymond Saner (1989) refers to “…Gestalt therapy made-in USA,” when commenting on the Gestalt focus on the individual taking care of himself.

From Individual to Relationship

Gestalt therapy was first formally presented in 1951 with the publication of the book Gestalt therapy: Excitement and Growth in the Human Personality by Fritz Perls, Ralph Hefferline and Paul Goodman. As Parlett and Hemming (1996) suggest “…the book included the basic philosophical outlook which characterized – and still does – the Gestalt approach; holistic, phenomenological, experimental and field theoretical”. In their 1951 publication Perls, Hefferline and Goodman place a strong emphasis on the interrelationship/interconnectedness between the person and the environment, between self and others. “You and your environment are not separate entities but together you constitute a functioning mutually influencing, total system” (p.104).

Parlett reminds us that “…the original Gestalt agenda was to locate human distress not in the confines of a person’s individual psychopathology, but instead in the interactions between people and their situations”. (In Clarkson & McKewn, 1993 p.193).

Some of the concepts put forward in this book i.e. introjection (the process of taking from the environment), retroflection (the process of doing to ourselves what we would like to do to the environment), and projection (the process of attributing to the environment qualities that belong to ourselves), are mostly to do with how the person relates to the environment. However Perls used them in therapy to underline the responsibility of the individual in reaction to his environment. Two other concepts i.e. contact and confluence relate directly to the mutual relationship between people.

Confluence relates to the idea that two people merge together, become blurred on the boundaries, not knowing where one starts and where the other finishes. Contact on the other hand refers to the process of discovering self in relationship to the other person. With contact there is a sense of openness to exploring difference, to novelty and to feeling a boundary and separateness from the other person yet at the same time feeling the possibility of touching and being touched by the other. These concepts of contact, confluence and boundary permeate the work of Perls Hefferline and Goodman.

Another Gestalt influence on the interrelationship between two people was the existentialist philosopher Martin Buber (1937). He suggested the idea that as two people relate together they can either treat each other as objects thus creating an I/It relationship or they can have a real person-to-person relationship in the form of an I/Thou relationship. It is the I/Thou relationship that has the maximum power to heal. “Such a healing relationship develops when two people, each with his separate existence and personal needs, contact each other recognizing and allowing the differences between them. This is more than a combination of two monologues between two people in meaningful exchange”. (Clarkson and McKewn 1993, p.167). Laura Perls who met Buber was heavily influenced in this direction and used it in therapy sessions. Yontef has defined an I/Thou relationship “…as person-to-person contact or the contact of the core of one person to the core of another person.” (Clarkson and McKewn 1993, p.167). Several therapists (Yontef 1980, Hycner 1985, 1991, Jacobs 1978, 1989 and Clarkson 1990) using the I/Thou model have discussed Gestalt therapy as a dialogic “method”. Yalom(1981) describes how “…the I/Thou is ‘dialogue’, in which, either silently or spoken, each of the participants has in mind the other or others in their particular being and turns to them with the intention of establishing a living mutual relation between himself and them”.

Other independent theoretical developments in the 60s and 70s influenced the emphasis on relationship in Gestalt therapy. The area of systems thinking which informed the development of family therapy was synthesized in Gestalt theory by Kaplan and Kaplan (1982). They put forward the idea that, as individuals from moment to moment we are continuously creating our existence in the present moment, within the context of other individuals creating their existence. This process then becomes a system of individuals co-creating their existence at any given moment. How they co-create their existence can move in the direction of either confluence or contact. This then has obvious implications for therapy because the therapy relationship becomes a process of two people co-creating their existence in the present time of the therapy session.

Parlett (1991) in exploring the field concept put forward a similar idea of people mutually influencing each other.

“So what happens when there are two people, relating together and both constellating their fields at the same time? Instead of thinking only of two separate phenomenal fields, let us acknowledge that when two people converse or engage with one another in some way, something comes into existence, which is a product of neither of them exclusively. What happens between them is a function of both together. It is a co-created reality (Beaumont 1990 p.75) which potentially includes all that is in the experiential fields or life-spaces of each of the two participants but is not simply the two sets of experiences added together, rather there is a shared field, a common communicative home, which is mutually constructed”.

Therapeutic Application
If the therapist and client are mutually creating a reality together then the relationship per se can be a focus of therapy. As Yalom(1995) points out most problems are problems of relationship . Thus how the client is relating to the therapist and how the therapist is relating to the client can be a useful focus. Humphreys (1993) describes it as follows: “In the therapeutic relationship, it is the special responsibility of the therapist to move towards a more and more contractual relationship. This means that the therapist as well as being open to the client’s experience and supporting the client to express this, needs to be open to his own experience in the relationship, to take risks to say what is happening experientially for him and to speak of his experience of the relationship together. Through this interactive process the client is supported in discovering how he can organize differently in respect to another, in this case the therapist”.

There are several areas in which the therapist can usefully focus on the process of the client/therapist relationship. I identify these areas as follows: (a) the context of relationship, (b) flow of contact, (c) the mutual relationship and (d) boundary aspects of the relationship – each of these is defined and discussed below.

The relationship as context.
When the clients are talking about themselves they are doing this in the context that they are talking to another person i.e. the therapist. This is so obvious that it is mostly ignored in therapy. However most of us when we are talking to someone else about ourselves have background feelings about what it is like to do this. For instance I usually tend to imagine the other person will be impatient, won’t wait for me to explain. Thus I tend to speak in shortened concise tones. Asking clients questions such as “how are you feeling as you talk to me about this?” or “what are you experiencing as you tell me this?” serves the purpose of bringing such background feelings or experiences into focus. Feelings such as I imagine you are “bored” or “I am not sure you understand” often come to the fore. Sometimes what the client is getting from talking to the therapist will emerge “I feel relief talking to you” or “I don’t talk to anybody about this.” Something I have discovered through experience is that even though I might experience myself as attentive, present, listening, understanding this is no guarantee that this is how the client is receiving me so it is worth enquiring as the client is talking.

Flow of contact between client and therapist.
Here by contact I mean something like the flow of touch, affect, feeling, excitement, interest, closeness, distance between client and therapist. Also contact in the sense of touching exploring something new. For me there are two ways of processing this; one is to monitor the changing experience within myself as the client is talking or relating.

How is the client impacting on me now? It is, like doing a continuous awareness exercise. Now I feel bored or now I am interested, excited, now I find myself moving closer, now I am moving away. Now I feel touched and sad.

The other way to monitor the flow of contact is to follow aspects of contact such as eye contact as the client is talking. This flow of contact is a felt feeling such as a feeling that the client is moving toward or moving away from the therapist (and usually away from themselves). As the client opens up to contact in themselves they usually open up to contact with the therapist. As they interrupt contact with themselves they will interrupt contact with the therapist. By building on the points of contact such as the client looking directly at the therapist or when the client impacts strongly on the therapist or by interrupting the clients own interruptions the therapist can increase the flow of contact between himself and the client.

With this focus I as the therapist can be aware of such processes as how the client is impacting on me now? How do I feel as they are talking? Do they talk to me or to themselves? Do they reach out to me or withdraw? How am I the therapist relating to the client? Do I feel like reaching out or withdrawing? When I say something does the client ignore what I say or take it in? Have they got a sense that I am here or are they talking as if to themselves? What do I need to do in order to make contact with this person? Do I need to be quiet, interrupt, ask questions, make statements, be challenging? What is my sense of presence to this person?
Mutuality of client-therapist relationship
Parlett (1998) describes how “…an individual client may be attempting to construct the shared field or total situation in such a way that the other, the therapist, fits into his/her stereotyped expectations, fits the bill, fits that cut out role the client wants to create. If I am the therapist, I need therefore to be aware of what is happening and to recognize what ‘dance’ I am being invited to participate in. Provided that I notice what is happening, I can choose how I respond – whether to bend or stand firm against, to comment or not, to decline gracefully or to accept for the time being the role I am being asked to play”.

Sometimes the mutuality in a relationship can be identified by the therapist and client taking complimentary roles e.g. the client doing all the talking and the therapist listening. One client for quite a while treated me as an expert and herself as stupid.

Sometimes the mutuality is in terms of complimentary process such as the client talking very fast and the therapist working had to keep up or the therapist, asking questions and the client avoiding answering or one person speaking very loudly and the other quietly.

Sometimes the mutuality is seen, not so much by difference, but by sameness e.g. both parties talking intellectually or both parties using very quiet voices thus creating an atmosphere where the range of possibilities are limited e.g. if the therapist only stays in his head it is likely the client will follow. Parlett suggests “…a change in the way the therapist acts or feels towards his client and inter-relates will affect the mutual field and have consequences for the client”. Thus if both parties are talking intellectually, and if the therapist changes and introduces feelings it is likely the client might also change.

Kaplan Kaplan and Serok (1991) and also Parlett (1991) have written about the concept of parallel processes. This is the process whereby when a client is talking about a relationship struggle in his life that struggle is sometimes paralleled in the process of the relationship of the therapist/client. Thus if a client is talking about a relationship struggle it is worth exploring if that happening in the room between therapist and client. If it is happening then this offers rich ground for exploration as to how it is being created and rich ground for possible change in the present. If the same struggle is not happening this also offers rich information as to how the difference is being created.

It is my contention that the therapist will nearly always be drawn into a mutually confluent relationship with the client. It is a core part of the therapy for the therapist to accept this, and to struggle to be aware of the nature of the mutuality. To move from mutuality to contact the therapist needs to make the relationship per se the focus of the therapy. This leads to exploration awareness and change of that is what is wanted. In discussing the movement from mutual to contractual relationships in therapy Lichtenberg (2001) talks about “…creating a distinct “I” and a distinct “You” in contacting”. He suggests the therapist includes some of the following : (a), “I am, I want, I desire, I feel” and (b) I react in this way to you, and also to suggest to the client that he tell the therapist what he wants, desires, feels who he is and also to say how he is reacting to the therapist. He suggests that “…with full development of “I” and “you” there is also equity, where each party is ready to meet the other and satisfactions are maximized”.

Boundaries issues in therapy.
The edges around therapy offer a rich ground of information on which to explore the client therapist relationship. Powerful feelings arise for people at the entry and exit points in therapy. Many clients talk vividly and passionately about what it is like for them as they approach or leave the therapy door. This entry and exit point is a powerful metaphor for what it is like to enter and leave relationships. One client on entering the office made disparaging remarks about the décor. On exploring she said that she was trying to pick a fight with me and then leave. She said that would give her the feeling she existed. So for this person the only way she had of feeling she existed in relationship was to fight and leave. Another client always felt shame after leaving the session and felt bad about her self and what she had explored with apparent support in the session. There is a large wooden gate leading to my office. A long-term client discovered that for the first time ever when she arrived the gate was closed. I then came and opened the gate. She described how even though she knew logically that all she had to do was push the gate to open it she felt how she would resist doing this and was about to drive off. Thus the closed gate served as fruitful information as to how she wanted me to take all the initiative in the relationship and for her to be a passive recipient and how she wanted to change this.

Discussion
I am encouraging therapists to attempt to truly meet the client as one person to another to create a true meeting as person to person. I am also interested in how both the client and therapist are either creating or blocking (at any moment they must be doing either) the possibilities of a true person-to-person meeting. As a contrast to this position Beaumont (1997) warns against making the “…I-thou” the basis of therapeutic “dialogue” or “dialogic therapy”, and suggests that “…the position and situation of the client and the therapist are different. Thus “I-thou” as a basis is not possible. To attempt to apply it as a therapeutic technique makes it into an instrument and negates the very nature of the moment”. These comments are valid from one perspective but from another they ignore the paradoxical nature of the client/therapist, person-to-person encounter. The paradox is that when there is an “I/Thou” moment both people know that also at that moment they are also meeting as client and therapist. Both are present at the same time.

It is in the I/Thou moment or the person-to-person meeting that healing occurs. Beaumont (1997) calls it “…the act of participating in creating a full human being”. Like Hyncer (1994), who wants to emphasize “…the peak moment in favour of a discussion of ongoing process , I would also like to reverse the emphasis on the peak moment and stress the healing that takes place in the momentous struggle of both people to engage with the difficulties, frustrations, powerful feelings, possibilities for harming each other, stuckness, that occur as two people this time the client and therapist, are attempting to and at the same time failing to meet each other. This happens as they inch their way towards a possible meeting.

Furthermore it is the development of this powerful dynamic struggle that the yearning for the person-to-person meeting arises. It is out of the combined suffering, pain, together with compassion that the client and therapist feel, because they are not meeting as people, that the powerful yearning to meet arises. It is also out of this dynamic struggle and usually stuckness that the forces of creativity, spontaneity, honesty and courage, that it takes to achieve person-to-person meeting, get activated. It is only through getting stuck sometimes over a long period of time that the seeds of a truly person-to-person meeting are sown. In this stuck process and the aware exploration (and sometimes unaware) of it that the client and therapist are inching (usually one inch forward and two inches backwards) their way towards creating the conditions of a true person-to-person meeting. It is in the courage to face the “…emotional pain of feeling the loss of I/Thou” (Beaumont 1997) that the I/Thou happens. Thus it is everything that happens before the I/Thou moment that is the most important.

Beaumont (1997) suggests that we can teach the “…conditions, skills and values that are most conducive to the “I/Thou” experience”. These are difficult to enumerate. While as it is not possible to “make an I/Thou moment happen” , an I/Thou “attitude” (Hyncer) or an I/Thou “intention” (Yalom) on the part of the therapist will help create the conditions for it. Beaumont suggests skills such as “…clean and clear I messages, sensitive listening to the other, respect, and honesty”. Hyncer suggests “…presence, genuine and unreserved communication, inclusion, and confirmation”. I would add a high level of self-awareness in relation to others on the part of the therapist. This is the awareness of the internal changes to feelings, emotions, thoughts, and bodily sensations in relation to the changing moment encounter or meeting with the client.

It needs courage to tolerate being stuck in relationship to another while at the same time believing in the creativity of two people to find a way through that stuckness. It requires the compassion, courage and patience to tolerate going to the edge of recreating the past abuse-relationships of the client (and sometimes of the therapist) in order to find a fertile nurturing alternative means of being in contact with the client.

Conclusion
This article has outlined the theory and some of the fruitful areas of exploration of the client therapist relationship. While there are many difficulties associated with this approach there is no doubt that if the therapeutic relationship is skillfully, with sensitive timing and with adequate support, explored with awareness then a new depth of richness, creativity and excitement can be brought into the therapy process well as creating a meeting which beings the person “…beyond mere survival into the realm of humanity”. (Hyncer 1995).

Vincent Humphreys is a Gestalt psychotherapist, supervisor, trainer and organizational consultant in private practice. He has a background in psychology and Social Work. He trained in Gestalt Therapy at the Gestalt Centre of Nof Yam, Israel under the direction of Netta and Marvin Kaplan and in Family Therapy at the Mater Family Centre

References


Beaumont Hunter Self-Organization and Dialogue in On Intimate Ground, A gestalt Approach to Working with Couples Jossey-Bass 1994.
Buber M, (1965), I and Thou, (R Gregor Smith, trans) Edinburgh: T and T Clark (first published 1937).
Buber M, (1965) Between Man and Man, New York, Macmillan. Clarkson P & Humphreys V Gestalt Therapy and the Self-Organization Process In Psychotherapy in Ireland E Boyne Ed. Columbia Press 1993.
Hycner Richard and Jacobs Lynn The Healing Relationship in Gestalt Therapy Gestalt Journal Press 1995.
Kaplan M L and Kaplan N R, (1982) Organization of experience among family members in the immediate present: A Gestalt/Systems integration, Journal of Marital and Family therapy, 8, p 5-14.
Lichtenberg P., Creating a distinct “I” and a distinct “You” in contacting. The Gestalt Journal Vol XX111 No. 2.
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Yalom I D (1985), The Theory and Practice of Group Psychotherapy, Basic Books.