Gestalt Therapy

Gestalt therapy focuses on self-awareness and being in the present at the moment to improve a person’s mental health.

Gestalt therapy is a psychotherapy that was developed as an alternative to traditional mental health therapy. It focuses on self-awareness and personal responsibility, encouraging people to understand how their perceptions of the past influence how they react to current situations.

What Is Gestalt Therapy?

Gestalt therapy is an alternative form of psychotherapy that inspires patients to be present at the moment. This therapy emphasizes personal experiences, relationships and emotions.

Gestalt is a German word that means “an organized whole that is perceived as more than the sum of its parts.” Gestalt therapy is based on the holistic view that a person is made up of body, mind and soul, but these entities work together to make that person who they are. It focuses on the idea that an individual best understands themselves when looking through their own eyes.

Most other forms of psychotherapy tend to emphasize the patient’s past, while Gestalt therapy focuses on the present. It still takes into consideration past experiences but uses them in the context of how the past has affected a person’s current psychological state. By actively reliving past experiences, the person can deal with them in the present.

Gestalt therapy aims to improve self-awareness by helping patients recognize how their typical thoughts, emotions, perceptions and actions might be restricting their personal growth. If a person is focusing too much on the past or the future, they may not be aware of the present and may not realize how their choices affect their health and relationships.

History of Gestalt Therapy

Gestalt therapy was founded by Fritz and Laura Perls in the 1940s. Their methods were first published in 1951 in “Gestalt Therapy,” a book which was authored by Fredrick Perls, Ralph Hefferline and Paul Goodman. Perls believed that most mental health issues stem from a lack of awareness and not taking responsibility for moods or actions. He believed that unfinished business is the underlying cause of many issues.

To address these issues, Perls developed Gestalt therapy to promote self-awareness and authenticity. He believed that people could better understand their emotions through experiences. Therefore, Gestalt therapy uses exercises, usually involving physical movement and thoughtful reflection, to evaluate a person’s emotions in response to situations.

To teach the Gestalt therapy approach, Fritz and Laura Perls ran training sessions for therapists in their New York City apartment. Eventually, Fritz began a practice in California where he also taught the methods of Gestalt therapy at Esalen Institute.

Today, there are many variations of Gestalt therapy that all surround the recurring theme of self-awareness, personal responsibility and living in the present. While training for Gestalt therapists focuses on the Gestalt theory, it also encourages therapists to be creative in the exercises they use in therapy sessions. Even so, there are a few techniques that are commonly used among Gestalt therapists.

What Conditions Does Gestalt Therapy Treat?

Gestalt therapy is an effective treatment for many different mental health conditions and issues. It can also be beneficial for people who are interested in becoming more self-aware.

Some examples of what Gestalt therapy can treat include:

• Behavioral health issues: Gestalt therapy can help people who have bipolar disorder, substance use disorder, eating disorders, behavior or mood disorders, grief, loneliness, compulsive gambling and post-traumatic stress
• Physical health issues: Gestalt therapy can help with sexual problems, migraines, ulcerative colitis and back spasms
• Anxiety: Gestalt therapy is helpful for anxiety because it helps people focus on the present and what could be triggering their anxiety in the present moment
• Depression: Gestalt therapy techniques can also be used as a treatment for depression and help people become aware of factors that can lead to depressive episodes
• Relationship troubles: Gestalt therapy can allow couples, either individually or together, to become aware of negative and destructive behaviors that influence their relationship and replace them with more positive patterns
• Self-esteem issues: Gestalt therapy allows people with low self-esteem to discover and overcome the underlying issues that lead to self-esteem problems

How Gestalt Therapy Works

Gestalt therapy is centered around exercises to connect actions with emotions in the present. It is based on the idea that explanations and interpretations of past experiences are unreliable, and a more accurate way to deal with them is to relive them in the present time.

This approach allows a person to perceive and feel the emotions of the event directly. By directly experiencing them, they can better understand the consequences of their actions and let go of unresolved emotions.

The role of the therapist in Gestalt therapy is to guide exercises that connect past issues with present experiences. A therapist leads this exercise through a variety of different techniques, many of which involve role-playing or acting out a situation that is affecting a person’s current thoughts or mood. Gestalt therapists are trained to be unconditionally accepting of a person’s feelings, thereby allowing the patient to feel free to express their genuine emotions.

What to Expect

During a Gestalt therapy session, therapists will focus on the present and how and why the patient is feeling certain ways. Therapists usually do not follow specific guidelines in their practice of Gestalt therapy and are encouraged to use creativity when developing their sessions.

Therapists will usually design the activities used in a session around the personality of the person they are trying to help. The therapist and patient work together to determine what is currently happening in a person’s life and what needs to change for the person to be happy or overcome their issue.

For example, Gestalt therapists may ask a person to talk about a past situation that influences the person’s current state of mind. Rather than describe the incident, the therapist will have the person re-enact it as if it were happening in the present moment. As the patient acts out the scenario, the therapist will ask how it is making the client feel in the present moment. This exercise helps clients deal with the emotions experienced in the past to move on and let go of what may be holding the client back.

The purpose of exercises like re-enactment is to increase a person’s self-awareness of how their actions, or past actions, influence their mood. By understanding this connection, the client can change their behavior in future situations as they happen and consequently, improve their emotions.

Principles and Techniques

The principle of Gestalt therapy is that people are constantly changing, becoming different versions of themselves and discovering themselves. Through self-awareness and taking responsibility for their actions, people can overcome many of their issues.

Some of the techniques and exercises used during Gestalt therapy include:

• Asking questions that are focused on the present and how the individual feels about current issues, often in the form of what and how versus why
• Role-playing, to pretend that the individual is someone else in their life, to allow them to express feelings
• Confrontation, which is a form of role-playing where the individual pretends to confront a person who is bothering them, which allows them to get their frustrations out and move on
• The empty chair technique, which is a form of role-playing and encourages the patient to speak to an empty chair as if a person or themselves were sitting in it
• Dreamwork to see if recent dreams hold key information about what is on the person’s mind; dreams are often acted out during therapy
• Exaggeration or amplification, which involves repeating a movement or expression (such as smiling) to make the person aware of emotions that are associated with that behavior

Goals of Gestalt Therapy

The goal of Gestalt therapy is to switch from reactive behaviors to conscious and thoughtful actions. Perls described this goal as going through a series of levels of awareness that eventually lead to a person being authentic, and therefore “fully alive.” Gestalt therapy helps people move through these levels with the goal of achieving authenticity. Those levels are:

1. Phony: a person is inauthentic
2. Phobic: a person is avoiding pain
3. Impasse: a person is afraid to change
4. Implosive: a person is increasing awareness but is not ready to act on it
5. Explosive: a person is authentic

Effectiveness

Gestalt therapy works well for individuals who are interested in improving their self-awareness or individuals who may not understand how their own thoughts or actions are playing a role in their mental health.

The effectiveness of Gestalt therapy itself has not been proven scientifically, as there are many variations of the therapy. It is both an experimental and experience-based therapy, so no two sessions of Gestalt therapy are alike.

Some case studies have shown patients benefiting from Gestalt therapy, and individual techniques used in Gestalt therapy have positive outcomes, but currently, there is no comprehensive comparison of Gestalt therapy to other psychotherapies.

Benefits of Gestalt Therapy

There are many benefits of Gestalt therapy. Some of these benefits include:

• Becoming more self-aware
• Increased sense of self-acceptance
• Enhanced ability to live in the moment
• Increased sense of ownership of experiences, versus blaming others
• Increased ability to accept responsibility for actions
• Enhanced self-confidence
• Greater ability to handle stress

However, there are limitations to Gestalt therapy. It does not take into consideration the psychological effects that can be inherited or caused by genetics. It also does not consider physiological effects that may not be controlled by a person’s thought processes. Gestalt therapy puts the responsibility of changing a person’s mood entirely on the person. Additionally, it does not consider aspects like how changes in neurotransmitters in a person’s brain might affect their mood or thinking.

Gestalt Therapy in Addiction and Mental Health Treatment

Gestalt therapy can be effective for the treatment of mental health disorders, and can also be beneficial for people with substance use disorders. People with substance use disorders who want to overcome their addiction are ideal candidates for Gestalt therapy. By using Gestalt therapy, they have the potential to understand the circumstances in which they use the substance, the feelings associated with it and ways to overcome their cravings.

If you or a loved one are struggling with a substance use disorder and a co-occurring mental health disorder, The Recovery Village can help. To learn more about our comprehensive treatment plans, call The Recovery Village to speak with a representative.

Editor – Camille Renzoni

Cami Renzoni is a creative writer and editor for The Recovery Village. As an advocate for behavioral health, Cami is certified in mental health first aid and encourages people who face substance use disorders to ask for the help they deserve. Read more

Medically Reviewed By – Dr. Trisha Sippel, PhD

Dr. Sippel is a diversely trained scientist with expertise in cancer biology and immunology. Read more