Gestalt therapy

Gestalt therapy seeks to treat psychological problems and mental disorders bygaining awareness of emotions and behaviors in the present rather than in the past. The therapist does not interpret experiences for the patient. Instead, the therapist and patient work together to help the patient understand him/herself. Patients are encouraged to become aware of immediate needs, meet them, and let them recede into the background. The well-adjusted person is seenas someone who has a constant flow of needs and is able to satisfy those needs.

In Gestalt therapy (from the German word meaning form), the major goalis self-awareness. Patients work on uncovering and resolving interpersonal issues during therapy. Unresolved issues are unable to fade into the background of consciousness because the needs they represent are never met. In Gestalttherapy, the goal is to discover people connected with a patient's unresolved issues and try to engage those people (or images of those people) in interactions that can lead to a resolution. Gestalt therapy is most useful for patients open to working on self-awareness.

The choice of a therapist is crucial. Some people who call themselves "therapists" have limited training in Gestalt therapy. It is important that the therapist be a licensed mental health professional. Additionally, some individuals may not be able to tolerate the intensity of this type of psychotherapy.

Gestalt therapy tends to emphasize medium to large groups, although many Gestalt techniques can be used in one-on-one therapy. Gestalt therapy probably has a greater range of formats than any other therapeutic technique. It is practiced in individual, couples, and family therapies, as well as in therapy with children.

Ideally, the patient identifies current sensations and emotions, particularlyones that are painful or disruptive. Patients are confronted with their unconscious feelings and needs, and are helped to accept and assert those repressed parts of themselves.

The most powerful techniques involve role-playing. For example, the patient talks to an empty chair, imagining that a person associated with an unresolvedissue is sitting in the chair. As the patient talks to the "person" in the chair, the patient imagines that the person responds to the expressed feelings. Although this technique may sound artificial and might make some people feel self-conscious, it can be a powerful way to approach buried feelings and gain new insight into them.

Sometimes patients use battacca bats, padded sticks that can be used to hit chairs or sofas. Using a battacca bat can help a patient safely express anger.A patient may also experience a Gestalt therapy marathon, where the participants and one or more facilitators have nonstop group therapy over a weekend.The effects of the intense emotion and the lack of sleep can eliminate many psychological defenses and allow significant progress to be made in a short time. This is true only if the patient has adequate psychological strength fora marathon and is carefully monitored by the therapist.

Gestalt therapy begins with the first contact. There is no separate diagnostic or assessment period. Instead, assessment and screening are done as part ofthe ongoing relationship between patient and therapist. This assessment includes determining the patient's willingness and support for work using Gestaltmethods, as well as determining the compatibility between the patient and the therapist. Unfortunately, some "encounter groups" led by poorly trained individuals do not provide adequate pre-therapy screening and assessment.

Sessions are usually held once a week. Frequency of sessions is based on howlong the patient can go between sessions without losing momentum from the previous session. Patients and therapists discuss when to start sessions, when to stop, and what kind of activities to use. However, the patient is encouraged and required to make choices.

Disturbed people with severe mental illness may not be suitable candidates for Gestalt therapy. Facilities that provide Gestalt therapy and train Gestalttherapists vary widely.

Scientific documentation on the effectiveness of Gestalt therapy is limited.Some evidence suggests that this type of therapy may not be reliably effective.

The approach can be anti-intellectual and can discount thoughts, thought patterns, and beliefs. In the hands of an ineffective therapist, Gestalt procedures can become a series of mechanical exercises. Moreover, there is a potential for the therapist to manipulate the patient with powerful techniques, especially in therapy marathons where fatigue may make a patient vulnerable.

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