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which Gestalt therapy attempts to address. These ideas probably did not constitute a
therapeutic approach until 1951 when Perls opened the New York Institute for Gestalt
Therapy, despite the fact that the first recognisable Gestalt therapy book was published in
the 1940's (Perls, 1969).
Accompanying this combination of ideas, based on the thinking of Gestalt psychologists,
philosophers (e.g., Lewin, 1952), and politicians (e.g., Smuts), was the fundamental
concept of the person as basically healthy, striving for balance, health, and growth
(Clarkson, 1989). The unfinished business referred to earlier is seen as an obstacle to
these processes, restricting the person's ability to function fully, often termed by Gestalt
therapists as 'dis-ease'. Van de Riet (Van de Riet et al., 1980) encapsulates the idea that
dis-ease is a consequence when people do not experience themselves as being
psychologically and physiologically in balance with their environment.
"As action, contact, choice and authenticity characterize health in gestalt therapy, so
stasis, resistance, rigidity and control, often with anxiety, characterize the state called 'disease'"
The stasis, resistance, rigidity, and control prevent graceful flow through cycles of
experience.
Having briefly outlined the core of Gestalt therapy it is necessary to consider some of the
techniques that Gestalt therapists use in order to consider how they might be incorporated
into hypnotherapy. Although there are techniques that are closely associated with a
Gestalt approach, there are two caveats we must bear in mind. First, as Berne (1970)
noted, gestalt therapy does use any techniques exclusively:
"every Gestalt therapist could stop doing any Gestalt technique that had ever been done
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and go right on doing Gestalt therapy. If they couldn't, then they weren't doing Gestalt
therapy in the first place. They were fooling around with a bag of tricks and a bunch of
gimmicks" (1984: 19).
Based on these two caveats we might argue that anything of an 'active' nature which is
incorporated into hypnotherapy would constitute Gestalt, or alternatively that without
explicit training in the Gestalt client-therapist relationship there is nothing we could do
which would be Gestalt. However, as the spirit of Gestalt therapy is very much identified
by its use of specific techniques that is the approach that will be taken in the following
discussion.
The techniques that are associated with Gestalt therapy are closely related to the idea
that clients should want to work towards self-awareness through a mastery of their
awareness processes. This is in contrast to patients who firstly are actually seeking relief
from discomfort, although they may claim that they wish to change their behaviour, and
secondly clients who expect that relief will come via the efforts of the therapist. Thus,
Gestalt therapy is "an exploration rather than a direct modification of behaviour...the goal
is growth and autonomy" (Yontef, 1993). The techniques are modifications and
elaborations of the basic question, "What are you experiencing now?" and the instruction,
"Try this experiment, or pay attention to that, and see what you become aware of or learn"
(Zimberoff & Hatman, 2003).
Perhaps the most well known of all techniques that are identified as Gestalt is the empty
chair. This is where clients project their representation of a person or an object, or part of
themselves into an empty chair and they then present a dialogue between what is
projected into the chair, and themselves. In some cases the client moves between the
chairs, but either way, the idea is that inner conflicts become expressed and so the client
heightens their awareness of them. This in turn forces the client to take responsibility for
their difficulties so that they can make choices to resolve the sources of unfinished
business (Stevens, 1975). As Becker (1993) writes, this is the whole point of Gestalt, to
"take people who are conditioned and automatic and put them in some kind of aegis over
themselves."
Similar to the empty chair, another common technique is known as topdog/underdog. A
dialogue is performed between two aspects of the client's personality, the topdog
representing the introjecting demander of perfection, expressed by "should" and "must",
and the underdog, which is a manifestation of resistance to external demands. Through
the dialogue "resolution, compromise, understanding or permanent divorce becomes
possible" (Clarkson, 1989). This is attained by the individual becoming aware of their
internal battles, which often lead to feelings of guilt, anxiety, and depression.
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neither be considered exhaustive nor exclusive. As cited earlier, Resnick (1984) amongst
others clearly believes that Gestalt therapy is not and cannot be tied to particular
techniques, it is about the relationship between the client and the therapist.
An important part of this relationship is that the therapist is acting to guide the client
towards greater self-awareness, responsibility and ownership of emotions, thoughts,
sensations etc in order to complete any 'unfinished business' so that s/he may move
smoothly through cycles of experience. The experienced therapist is able to adapt to the
particular client in order to achieve this, relying on a wealth of techniques and skills. This
essence of Gestalt therapy allies it more closely with cognitive behavioural approaches
than typical psychodynamic methods because it relies less on interpretation of the client
and more on their active participation. It is perhaps this that makes it possible to
incorporate aspects of Gestalt therapy into hypno-therapeutic practice.
Interestingly Levendula (1963) suggests the view that a Gestalt therapist would be in a
more advantageous position if he would combine his approach with hypnotic techniques.
For example, the Gestalt therapist teaches the increasing of awareness through
experimental exercises. The hypnotherapists can achieve this much more easily by
directing the patient's attention to become sharply aware of an idea or sensation or
memory which thereby becomes a "bright Gestalt" while the rest of the perceptual field
recedes into a background. The hypnotic state itself corresponds to the Gestaltbackground principle, and the Gestalt formation becomes more or less an automatic
function of it. ...the combination of Gestalt therapeutic principles with hypnosis enriches
both approaches.
From this it is clear that Gestaltists are being advised to incorporate hypnotherapy into
their practice. The following discussion will consider whether hypnotherapists can
introduce aspects of Gestalt therapy into their work.
One of the central tenets of Gestalt therapy is that clients experience events in the
present, that is they re-enact past events in the present. By re-living them they can focus
on their experiences, both psychological and physiological and thus gain understanding.
Awareness was considered "the key to unlock insight and ultimately bring behaviour
change" (Zimberoff, & Hartman 2003). Bringing the experienced past into the experiential
present is one important property of hypnosis.
Through hypnotic age regression, working with dreams etc clients can re-experience
events that have occurred at some other time as if they were happening in the here and
now. This is not merely a cognitive reliving of a copy of the event, but a fully nuanced
resurrection of the experience. As Zimberoff, & Hartman (2003) state, "Keeping the client's
awareness on concrete detail is a constant in hypnotic age regressions, because it
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As suggested earlier, this active participation of clients is not common, but there is no
reason why clients who have strong powers of visualisation cannot be directed under
hypnosis to engage in experimentation. Usefully as a single scene can be replayed many
times under hypnosis it allows the client to perform a variety of experiments and to
compare and contrast the resultant emotions etc. Naturally they can also be directed to
pay close attention to the details of these new experiences, so that they can be vividly
recalled post-hypnotically.
As Gestalt therapy is primarily concerned with the client's willingness to take
responsibility, and the therapist's ability to develop novel ways in which the client can
come face-to-face with aspects of their life they have projected onto others, or denied
control of, the main way in which hypnotherapy can incorporate aspects of Gestalt
technique is twofold. Firstly hypnotherapeutic practitioners must be trained in Gestalt
conceptual philosophy so they fully understand their role, and have the intuition and
flexibility to carry it out in a range of situations and across a broad spectrum of clients.
Secondly, just as Freud selected patients who were willing to accept his fundamental law
of psychotherapy, perhaps the hypnotherapist must be selective at consultation with
clients who show a motivation to change and a willingness to take responsibility for that
change. Without these two features hypnotherapy cannot truly address "the key problem
of people in our times...inner deadness" (Clinebell, 1981).
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