creative adjustment

8/13/2019 creative adjustment

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GESTALT FOUNDATION

ΚΕΝΤΡΟ ΨΥΧΟΘΕΡΑΠΕΙΑΣ & ΕΚΠΑΙΔΕΥΣΕΙΣ

Cr !"#$ A% '(") *"I* T+ r!, '"#- . /!"#0*(+#,

being a dissertation submitted in partial fulfilment of

the requirements for the title of

Gestalt Psychotherapist

in Gestalt Foundation, Athens

by

10!**! 2!"0M.Sc. of psychology Catholic Uni ersity of !ublin

Speech "herapist of Uni ersity M. Curie#S$lodo%s$a of !ublin

A3ST.ACT

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"he interest of this dissertation is the presentation of the concept of creati e

ad'ustment in Gestalt therapy and its meaning in a therapeutic relationship

e(emplified by cases of the therapist)s practice.*n the beginning a re ie% of the rele ant literature is presented regarding a. the

philosophical influence on the concept of creati ity and of the creati e

therapist, b. the concept of creati ity, c. the concept of the creati e therapist.

Subsequently the literature re ie% includes a. the concept of ad'ustment in

Gestalt therapy, b. the understanding of creati e ad'ustment. +n the follo%ing

pages literature re ie% follo%s presenting a. the characteristics of the

therapeutic relationship therapist)s tas$ and responsibilities to%ard the client, b. the role of the therapeutic relationship including the *#thou concept, the

concept of contact, of a%areness and of change-. +pinions about the place of

therapeutic relations in society are also mentioned. "he ne(t part of this

dissertation sho%s the affiliation bet%een contact and relationship based on a.

the e(perience of the self and the b. contact boundary. *n the final part

e(amples of creati e ad'ustment in therapeutic relationships are presented as

percei ed in the therapist)s practice. Fe% cases are described and analy ed

according to the factors mentioned in the presented literature.

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AC2NO4LEDGE5ENTS

* %ant to than$ my therapist Gianna Giamarelou for guiding me through the process of education in Gestalt approach and supporting me through all theyears * ha e been in therapy %ith her.

* also %ant to say than$ you to all the therapists %ho %ere in ol ed in mytraining process the last si( years, starting from Gianna Giamarellou, 0espoina1aliou, Antonia 2onstantinidu and 2atia 3at ila$ou. * %ant to than$ 3armSiemens, 0ic$ !ompa, Margarita Spaniuolo#!obb, 4urit !e i, PeterSchulthess, Malcolm Parlett, 2en 5 ans, 6oseph Melnic$ for sharing$no%ledge, e(perience and quality of contact.

* %ant to say than$ you to my super isor 2atia 3at ila$ou for supporting meduring the ery difficult period of the first years of %or$ing as a psychotherapist and for sho%ing me %hat fle(ibility means.

* am saying than$ you to my colleagues and friends 1ianca 5llinger, 5lpida2alait i, Mariola 2ochano%ic for being there for me and listening, forhelping %ith ideas and ad ice.

* %ant to say than$ you to all my clients %ho contributed to this dissertation fortrusting me and sharing their li es %ith me. 7ithout them this dissertation%ould not e(ist.

* am saying than$ you to my sister * abela 2ato for her contribution in readingand chec$ing my te(t, pic$ing up the phone and reading my mails e ery time *as$ed her.

* am saying than$ you and e(pressing gratitude to all the members of myfamily and to the nanny of my children for supporting my effort.* am than$ing my ery close friend for listening complains and still belie ingin me, and all my friends %ho supported me in se eral %ays during the time *%as %riting. 7ithout them this tas$ could ne er be accomplished.

INT.ODUCTION

"his dissertation is a partial fulfillment of the requirements for the title of

Gestalt psychotherapist. "he sub'ect concerns creati e ad'ustment in

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therapeutic relationship. "herapeutic relationship is the ery base of therapeutic

%or$ in Gestalt therapy approach. Gestalt therapy is a phenomenological and

e(istential approach to therapy and concentrates on the phenomenology of theclient and the therapist during their meeting.

"he basic theoretical meanings of Gestalt therapy are9

the field theory, the phenomenological perspecti e, the e(istential perspecti e,

dialogue, inclusion, presence, the interdependence9 organism: en ironment #

the organismic self#regulation.

"he therapeutic %or$ in Gestalt therapy is done in the ;here and no%< during

the meeting bet%een the therapist and the client through the dialogue. *n orderfor this to happen, both, therapist and client need to adjust do the best they

can- to each other and to the en ironment, including date, place, circumstances,

personal history, age, culture, society, goals of therapy etc.

M. Spagnuolo#!obb =>>?- states that ; Creativity is one of the basic concepts

of "he Gestalt approach, a quality of adaptation in interpersonal relationship. *t

includes e erything that happens in the field in relation to contact


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the ;same< principles of Gestalt therapy to e ery ne% client and at the same

time to maintain a fle(ibility regarding the field %ith all its components

culture, life story, language, therapeutic setting etc.0uring the process of super ision the ery different needs of e ery ;case<

emerge, de elopmentally, and in life history, as much as at personality le el.

Seeing the differences in the dynamic of the therapeutic relations, the

circumstances, the field, the different %ays of %or$ing, using the methodology

and building ground for therapeutic relationship leads to the process of

creati e ad'ustment.

*n this dissertation the sub'ect of creati e ad'ustment is restricted to thetherapeutic relationship, the conte(t of the therapeutic %or$ %here it can be

obser ed, considered the fact that therapeutic relation and its process are the

beginning and the end in Gestalt approach. *n therapy client and therapist li e

a relation and learn to gi e a meaning to it by ad'usting to %hate er emerges in

the process. "his is e ery time a li e e ent and the analy e of it caused interest

in loo$ing closer to %hat happens to therapist and client during its duration.

"heory and e(periences are described on the follo%ing pages.

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C6A7TE. I

CREATIVITY AND ADJUSTMENT

Creativity in Gestalt therapy is considered to be a quality of spontaneous

adaptation in interpersonal processes, as well as important ingredient of

healthy social living.(A. Sichera, !!" p#"$

"he purpose of this chapter is to present the meaning and

understanding of the terms creativity and adjustment in Gestalt therapy and

theory.

"he abo e %ords ha e a range of meanings. "hey are connected %ith

e(istential philosophy, Gestalt psychology, de elopmental psychology, they

also refer to the concept of creati ity in philosophy and psychology.

+n the follo%ing pages references on the sub'ect, those %hich influence the

process of Gestalt psychotherapy and are connected %ith the ideas of creati ity

and creating %ill be presented.

G ("!/" "+ r!,8 9!(#- ,r#*-#,/ (

As G. Bontef states in his article =>@>- Gestalt therapy %as founded by

Frederic$ and !aura Perls in the => Ds. *t is a phenomelogical#e(istencial

approach to therapy and concentrates on the phenomenology of the client and

the therapist during their meeting. ;Patients and therapist in Gestalt therapy

dialogue , that is communicate their phenomenological perspecti es.< G.

Bontef ,=>@>-

*n the Gestalt approach the focus is on process, that is on %hat is happening

bet%een the therapist and the client. "he content, that is the discussed sub'ect,

is considered to be of less importance. *t is a sample from the client)s life, on

%hich therapeutic %or$ can be done. *t brings the client in touch %ith emotions

%hich accompany an e ent. 5motions %hich se eral times are repressed,

forgotten and reappear in inadequate situations. According to this dissertation

the therapeutic relationship and the process of ad'ustment are a meeting

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through a%areness. As Gestalt literature supports the goal of therapy is for the

client to become a%are of his beha ior, feelings, belie es, attitudes and %hat

they can do to others. "he therapeutic setting is a safe place %here ne% feelingsmight be e(perienced and e(pressed, ne% %ays of acting and e(pressing might

be disco ered in e(periments performed during the therapeutic session. 7ith

the therapist support the client might dare feel and act as he is not permitted in

e eryday life and gain a%areness of it. "he therapeutic %or$ is done in the

;here and no% /- a philosopher and a

humorist, influenced by Schopenchauer. 3is basic concepts are presented in

the boo$ ; Creative %ndifference < =>=@-. "hose concepts are9 indifference and

polar differentiation. According to Friedlaender the indifferent center emerges

from the balance of opposite polars. "he indifference is the creati e central

dimension of reality, the ;immension of all dimensions


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ero#point, naught, oid, pre#difference, equilibrium, balance, centering

opposites, poles and polari ation.< Frambach, ?DD -

"he ability to percei e equally both polarities allo%s energy to emerge andcreate ;ne%< possibilities %hich ha e been unnoticed but al%ays e(isted. *n

therapy this means that a person might be able to $no% %ho he is first through

the process of polar differentiation and than by finding the ;melting of the

opposite polars into polar indifferentiation and state of being< 3. Ste enson,

?DD -.

+tto Ean$ =@@ #=> >- a psychologist and a philosopher. Ean$ %as

interested in olitional psychology, %ill, artistic creati ity. 3is philosophicalconcept refers to polarities and processes.

According to Ean$ all polarities are grouped around one central life impulse

%hich he calls creative will . "his impulse %ill ego Hpo%er- is responsible

for forming the human indi iduality and his ability to be responsible. "he

human ego is being shaped through life, mostly in the person)s relation to the

mother, but is also self shaping by its o%n strong %ill. "he denial of this %ill is

the base for neuroses. "he identification %ith it, especially as distinct from the

en ironment allo%s a person to fully e(perience his e(istence. *n therapy the

healer is supposed to pro ide help into the process of 'oining and separating

different aspect of the ego, there %here both mother and child %ant and need it.

;"herapists do not heal through means and techniques9 nor through simple or

mere e(pressions of their creati ity. "hey heal through their personality, %hich

is professionally restrained and at the same time capable of spontaneous

response-

*n order to understand better the concepts of adjustment and creativity

in Gestalt theory it is important to refer to the basic concepts of this approach.

+ne of them is ;the field theory< %hich means ;loo$ing at the total situation<

!e%in, =>&? p.?@@-. *n Gestalt therapy it means a holistic perspecti e to%ards

a person including en ironment, the social %orld, organi ation, culture.

According to !. 5strup ?DDD- the basic lenses of Gestalt the therapy are : &he

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'ield &heory e erything is constantly changing and in flu(. 5 erything is off

the field and cannot be separated from it. "he field is our history. "he second is

&he henomenological erspective each person)s feeling and understandingof the field depends on the position he:she has on the field. "he third important

lens is )ialogue %here in a relation t%o people are impacted and responsi e

to each other.

"he abo e mentioned terms and concepts %ill be more analytically discussed

in the follo%ing chapters, %here their connection to the terms creative

adjustment and therapeutic relationship %ill also be presented.

A; C.EATI


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the en ironment. Creati ity is an attribute of contact. Contact is creati e

ad'ustment. "he self helps to find and gi e meaning to our e(periences.

"o adjust creatively , according to Gestalt literature means to do the best a person can %ithin the gi en situation, considering the circumstances, the age,

the possibilities, the number of a ailable solutions. 7hen for some reasons the

chosen %ay to ad'ust becomes a pattern and no longer benefits the person, the

energy in ol ed in this process is trapped and might create arious, sometimes

bothering or painful symptoms. "hose symptoms still are creative adjustment ,

a creati e solution to difficult situation. "he therapeutic %or$ is to gain

a%areness about the %ay a person ad'usts and if the chosen %ay is no longernecessary, no longer the best, redirect the energy to the proper goal. *n other

%ords creati e ad'ustment in ol es ;letting go of chronically dysfunctional

beha ior patterns, using one)s perceptual functions and a ailable resources

optimally in the interchange %ith the gi en circumstances< 7ertheimer,

=>/ -.

*n order to get a larger perspecti e on the concept of creati ity some

remaining concepts related to it %ill be described, as they are presented in

literature.

A creati e %ay to relate to the en ironment and a positi e ability to ad'ust is

mentioned by F. and !. Perls in ; *go +unger and Aggression . ; )ental

aggression < %hich includes biting , che%ing, destroying %hat is gi en to $eep

only the needed parts and let go of the rest-. is a process of responding to ones

needs and ad'usting to the en ironment using the tools ones has and ta$ing

ad antage of the possibilities the en ironment offers. *t also is a big step and

achie ement in the childs) de elopment process.

"he meaning of e-istential, e-periential and e-perimental inter entions in

therapeutic %or$ refer to %or$ %ith the phenomenology of the client and the

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therapist, to %or$ %ith %hat client and therapist e(perience in their bodies, %ay

of thin$ing and feeling and finally to create e(periments in %hich a different,

ne% phenomenology is percei ed and felt, sometimes ne% %ays of acting are performed. G. Bontef, =>@>-

"he style of the therapist is a ery personal matter. *t has not to do %ith

the therapist)s professional s$ills, abilities and responsibilities to%ards the

client but is part of his personality. 6. Iin$er, =>88-

Creati ity here is the %ay the therapist assimilates and in ol es his personal

talents and interest in his therapeutic %or$."his means that the style of one Gestalt therapist might be much different from

another Gestalt therapist and also that the style of one therapist might differ

from client to client.

"he concept of dialogical relationship in Gestalt psychotherapy , is

Martin 1uber)s % &hou ( M. 1uber, =>/8-. "his means that both client and

therapist are of the same importance. "he relation bet%een them is equal in

terms of respect e en if it might be not equal in terms of po%er. "ransference

and countertransfrerence issues are sub'ect of dialogue in the present, during

the client)s therapist meeting. M. Spagnulo !obb, ?DD -.

"he ne(t is the concept of polarities , deri ed from Salomo

Friedlaender)s philosophical theory of creati e indifference.

5 erybody)s personality consists of many opposites. Some of them are %ell

$no%n to the person, of some other he has no a%areness. "hat is %hy some

polarities:opposites are e(perienced une enly. *n this case poles seem to ha e

no relation to each other. Creati ity means such an e(ploration of the poles and

the ;fertile oid< bet%een them that they can both be percei ed, noticed and

then integrated in personality

!. Frambach , ?DD -.

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"he last mentioned is the concept of the creative quality of the ego

function. *n psychology and philosophy it is related %ith +tto)s Ean$ concept

of creative will . *n life all of us ha e the tendency to identify %ith certain partsof the en ironment and at the same time to alienate from others. "he artist %ho

identifies himself as different and distinct from the en ironment might

e(perience the fullness of e(istence. "his creati e quality of ego allo%s him to

create and fully li e his life e en if he is al%ays a%are of death. 4. Amend

!yon , M. spagnuolo !obb, ?DD -.

As described abo e the concept of creati ity emerges as ery important

and essential in Gestalt therapy. +n the follo%ing pages the meaning of the%ord creati ity for a Gestalt therapists %ill be presented, %ith emphasis on its

impact on the therapeutic relationships.

A description of ! -r !"#$ "+ r!,#(" and his %or$ as mentioned in

Gestalt literature %ill follo%.

;"herapy is the tas$ of the self, %hich disco ers and feels, in the dar$ painful

areas, in danger and in difficulty, that space in %hich a creati e Jlan is

possible&= p.?/-. "hings that had

been bloc$ed, forgotten, that a person %as not allo%ed to feel might be brought

bac$ in therapy. "he come bac$ of certain feelings and e(periences might be

ery painful. *t also may allo% to gain a ne% perspecti e, ne% feelings,

disco er ne% themes. 7ith the support of the therapeutic relationship the

e(perience might be integrated by the person. *t might become his o%n. "he

therapist and the patient co#create the condition of contact, of the 'ourney they

commit themsel es to do together.

*n order for this to happen the therapist needs se eral capacities, abilities and

techniques but also and mainly certain alues and attitudes. "o represent those

attitudes and alues the therapist goes through a long process of disco ering

and $no%ing himself, through his education, therapy and super ision.

"he abo e attitudes and capacities are described ery specifically

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by 6. Iin$er. *n ;Creati e process in Gestalt therapy< =>88- he presents a

creati e therapist, an artist in the already mentioned categories.

According to 6. Iin$er for a Gestalt therapist to be creati e, he needs to focuson his:her alues and attitudes as much as concentrate on his:her capacities,

abilities and techniques.

Follo%ing Iin$er)s thoughts a creati e therapist has a rich personal

bac$ground and e(perience in emotional and intellectual de elopment, he had

e(posure to a range of e(perience. 3e celebrates life, another person)s beauty,

goodness, capacities and future possibilities. 3e is an aesthetically sensiti e

person, has a sense of grace, structure, order and rhythm of life. 3e lo es playand is aroused by un$no%n possibilities beneath the surface of human life 6.

Iin$er, =>>8 pp @# =-

As much as capacities and abilities are concerned a Gestalt ;creati e therapist<

is e(perimental his attitude is one of using himself, his client and ob'ects in

the en ironment in the ser ice of in enting no el ision of the person. 3e has

insights he encourages articulation of a%areness ;ma$ing the familiar strange

and the strange familiar< after 7. Gordon, =>/= p. ?-. "he personality of the

therapist and the alues he considers important are strongly related %ith his

s$ills and ho% he uses them in the therapeutic process. "herapist s$ills and

beliefs become quality of the process of psychotherapy G. Giamarelou, ?DD/-.

3e also possesses some characteristics related to %or$, %hich according to 6.

Iin$er are essential. 3e has a good sense of timing, the capacity to detect

%here the person can be reached, energi ed, mo ed emotionally, he has a

$no%ledge of %here psychological ;buttons< are and %hen to push them, he

has the ability to shift gears to let go of some things and mo e on to other,

more li ely areas, he has the %illingness to push, confront, persuade, energi e

the person to get the %or$ done and also he has the %isdom to $no% %hen to

let the person stay confused so that he may learn to e ol e his o%n clarity. 3e

has ability to integrate t%o modes of consciousness, t%o modes of being in the

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%orld grabbing hold on and being acti e and li ing in loose, passi e,

recepti e %onderment.

As stated in ; Creati e Process in Gestalt "herapy< the psychotherapysituation, %hich is e(perimental and safe, gi es to the client the possibility to

loo$ at himself from different points of ie%, li$e obser ing himself in arious

mirrors. "his might happen %hen the therapist is ;imaginati e88-.

A creati e therapist is part of the field in therapy, part of the contact ma$ing,creati e ad'ustment process. 1efore e(ploring further the creati e ad'ustment

process in the relation bet%een the client and the therapist a reference to the

understanding of the term ad'ustment %ill be presented.

3; AD1UST5ENT

U*% r("!*%#*> 0? creative adjustment #* G ("!/" /#" r!"'r

According to the !ongman dictionary of Contemporary 5nglish =>@8- to

adjust means9 to change slightly, especially in order to ma$e right or ma$e

suitable for a particular purpose or situation. "he %ord is being compared to

the %ord adapt that is 9 to ma$e or become suitable for ne% needs, different

conditions.

"he terms adjustment, self regulation, and creativity appear in Gestalt

literature as synonymous or related to each other.

Creative adjustment is a de elopmental capacity of doing ;the best * can< or

an organismic self#regulation process. 7hen a creati e %ay of acting becomes

fi(ed and is no longer suitable or becomes an obstacle in the de elopmental

process of a person it is called ;a fi(ed Gestalt


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of a gro%th and destruction process, the organi ation of phenomenal field into

figure and ground, or the process of figure and ground formation:destruction

G. Bontef, =>@>-.People adapt to difficult situation and circumstances %hen gro%ing up and in

society, follo%ing rules, doing the best they can at the ery moment. "his %ay

of acting, at the time creati ely, allo%s them to sur i e and mo e on %ith their

li es. Sometimes %hat %as creati e ad'ustment becomes a fi(ed %ay of acting.

"hen people might no longer $no% %hat they feel. *n other cases they might

not be able to name their feelings. Some other people a%are of %hat they feel

and still do not $no% ho% to act. ;7hat is common to all of us is that %e ha edone the best %e could in an imperfect %orld9 %e made %hat Gestalt calls a

creati e ad'ustment< A. Foo$es, ?DD?-.

"he terms self regulation and homeostasis %ere introduced to Gestalt

therapy by F. Perls, %ho state that ;the homeostatic process is the process by

%hich the organism maintains its equilibrium, therefore its health under

arying conditions. 3omeostasis is the process by %hich the organism satisfies

its needs< F. Perls, =>8 , p. -.

"his means that the organism tries to maintain a steady state %hen the

en ironment changes. "o satisfy its need the organism has to also to approach

and hold of ne% things and let go %hat is no more needed. "his is the<

aggression and destruction< process described as part of contact ma$ing, part

of the process of creati e ad'ustment.

;Creati ity and the organism:en ironment ad'ustment are polar9 one

cannot e(ist %ithout the other. 4o ad'ustment %ould be possible by the self#

regulation aloneK contact must be a creati e transformation8?, p. D/-.

"he term creati e ad'ustment replaces the term ;resistance< in the ocabulary

of Gestalt therapy. Eesistance means an opposition to change, means that the

client is not %illing to accept the therapist guidelines. Accepting guidelines

from the therapist might suspend the therapeutic process and open the

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resistance belo% it. *n the ;here and no%< the resistance is a healthy, protecti e

process. *t allo%s to a oid pain, real or imaginary %hich cannot be ta$en. *n

psychology, generally, therapists try to o ercome resistance, in order the clientto change. "he client should stop being resistant. *n Gestalt therapy the

therapist stays %ith the resistance 3. Siemens, ?DD -. "he resistance is

creati e ad'ustment. *t is the %ay the client is in the %orld. 0uring the process

of life gi es the possibility to sur i e, to sol e a present problem. "he %ay of

;resisting< stops sometimes to %or$ de elopmentally. "his is %hy Gestalt

therapy e(plores resistances, brings them into a%areness, %or$s %ith conflicts

bet%een them so they can be reintegrated as ne% meaning ma$ing %holes.;*n Gestalt therapy e ery symptom or defense is ie%ed as an attempt

to sol e a problem through creati e ad'ustment<

6. Melnic$, ?DD -.

7hen these ad'ustments, at first bringing profit in a person)s de elopment are

no longer helpful and become rigid, the natural figure:ground process of

formation:destruction is bloc$ed. "he distortion of this process called also

resistances to contact, includes9 projection, retroflection, introjection,

confluence, deflection and proflection Polsters 5, M,=>8 -.

3erb Ste enson ?DD - mentions the follo%ing understanding of resistances9

introjection s%allo%ing the %hole e(perience %ithout che%ing, projection

attributing my o%n feelings or needs to another person, deflection a oiding

contact by paying suddenly attention to something else, not related %ith the

sub'ect, using humor, confluence lac$ the ability to distinguish myself from

the other, agree al%ays %ith other)s opinion, desenti/ation a oiding physical

or emotional a%areness9 more details in Appendi( =-.

S. Ginger =>>&- presents a picture of resistance %hich include

organism, the contact boundary and the en ironment9 in confluence the

organism and the en ironment cross the contact boundary bac$ and forth

%ithout noticing %here each begins and ends. *n introjection all the energy

goes bac$ to the organism, in projection energy is directed only outside the

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organism to the en ironment. 0etroflection %or$s as a u turn bac$ inside the

organism, deflection turns energy else%here in relation to contact, inside or

out. roflection is a mi(ture of pro'ection and retroflection %here * pro'ect myretroflected need to somebody else, as$ somebody else to fulfill my need, and

finally egotism is the state %here * $no% and * am a%are but still * a oid

contact. the graphic representation of the abo e in Appendi( ?-.

*n common language the term resistance brings sometimes negati e

associations. "he synonyms are opposition, battle, conflict , struggle, hostility

!ongman 0ictionary of Contemporary 5nglish, =>@8-. *n psychology, G.

7heeler =>>=- introduced a positi e meaning to the understanding ofresistances. 3e presents resistances as ;the dimension or function of the contact

process< %hich means resistances might be percei ed as creati e, positi e,

components to contact styles. Contact styles are placed on a continuum and are

dysfunctional %hene er mo e to one of the e(tremes of it. "he pairs are the

follo%ing 9 confluence s. differentiation, pro'ection s. retention, literalness,

intro'ection s. che%ing, destruction, retroflection s. e(change and encounter,

desenti ation or egotism- s. merging, deflection s. focusing and

concentration Appendi( -.

"hose mechanisms of a oiding contact might be placed in the

subsequent phases of the ;contact %ithdra% cycle< called also the a%areness

cycle, the cycle of e(perience, the cycle of Gestalt formation and destruction,

the need and satisfaction cycle-, P. Clarc$son , ?DDDK 0elisle G, =>>>-. *n

Gestalt therapy there is no contact %ithout %ithdra%. "he therapeutic process

includes both the ;%hen< and ;ho%< of the contact %ithdra% cycle is the

creati e part.

*n the contact %ithdra% cycle the base is a need of being autonomous and of

belonging to. "he point is to find such a %ay to ad'ust not to loose oneself

this means ta$e %hat * need and re'ect %hat * don)t need. "he contact %ithdra%

process is a healthy process. "he boundary bet%een the organism and the

en ironment should be fle(ible. 5 ery single moment a figure the strongest

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need- emerges and the rest becomes bac$ground. "his is the f orecontact phase,

%here the e(perience is the sensation. *nterruption of contact in this phase is

confluence. *t has to do %ith the *d function. After this phase orientationfollo%s, ta$ing note of feelings, needs, ideas. "his is the a%areness phase, still

in forecontact. "he ne(t step is a mobili ation of energy, %hich might be put on

hold or e(pressed. 3ere the interruptions of contact ha e to do %ith the loss of

ego function pro'ection, intro'ection, deflection, retroflection-. Subsequently

the contact phase arri es, %here %e ma$e a choice, follo%ed by action. "his is

the final contact, %ith self, %ith the others. +ur choices and %ay of ma$ing

contact ha e to do %ith the personality function, %ith %ho * am. "he last is the post contact , %ithdra%al or rest phase, %here %e bac$ off in relation to self or

to the en ironment 6. Iin$er, =>88- see Appendi( -.

"he understanding of resistances including a creati e component is important

for the process of therapy, for staying %ith the resistance and gaining

a%areness of it. *n the therapeutic process methodology itself helps the

therapist to be creati e. Ma$ing contact is ery important at the beginning of

the therapeutic relation:process. Gaining a%areness of the resistance and

staying %ith it, gi es to possibility to ma$e contact, to proceed into the

therapeutic relation.

Graphic representation of the contact %ithdra% cycle is attached

in Appendi( .

0e elopmentally, %e satisfy our needs in contact %ith the en ironment. 1y

contacting %e organi e the %ay %e e(ist in the field. For e eryone of us, in

e ery situation the ad'ustment is a unique, indi idual, creati e process. *t is

unique for e ery person in an indi idual situation, under specific

circumstances. *t does not follo% general rules. "he process of ad'ustment is

e ery time creati e and unique, it is the best solution in the gi en conditions.

;"he process of ad'ustment is mutual. *n creati e ad'ustment, our achie ements

and solutions are made by us and gi en to us both in the gi e and ta$e of our

creati e partnership %ith the rest of the field<

?


19/56

4. Amend#!yon, =>>?-. A further and important analyses of the concept of

the concept of creative adjustment is presented in ;Creati e Ad'ustment as

field based psychotherapy


20/56

C6A7TE. II

THE THERAPEUTIC RELATI NSHIP

3 %n the beginning is the relation 3 M. 1uber =>&@,p.=@-

"his chapter is a re ie% of literature concerning the definition and meaning of

therapeutic relationship in Gestalt "herapy. "he characteristics and the role of

a therapeutic relationship, including its philosophical and ethical aspects %ill

be presented on the follo%ing pages.

According to !ynne 6acobs =>>&- the nature of a therapeutic relationship can

be described in t%o aspects9 one is the role of the relationship ho% curati e

and important is the relation itself in therapy, and the second refers to the

characteristics of the relationship the structure of the relation and the

allo%ed therapists beha iors.

*n this chapter both aspects %ill be presented starting %ith the characteristics.

Eeflections regarding the role of the relationship %ill be presented after%ards

since this sub'ect is strictly related %ith the material presented in chapter ***.

T+ -+!r!-" r#("#-( 0? "+ "+ r!, '"#- r /!"#0*(+#,

"he therapeutic relationship is both a technique and a transcendence of

techniques !. 6acobs, =>>&-.

+n the pages of ;"he 3ealing Eelationship in Gestalt therapy< =>>&-

the therapist)s tas$ are presented and analy ed9 those tas$s are patterning,

control, potency, humanness and commitment.

)iagnose is a process, %hich starts during the first client#therapist

meeting and goes on during therapy.

*n Gestalt therapy, according to the authors the emphasis is on the

process of interaction itself. *t includes clients s$ills and patterns of

?


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beha ior, ris$ ta$ing in interaction, bloc$ing contact and change.

"he therapy situation may become a model of se eral situations in

the outside %orld. "he %ay %e interact in therapy %e also do

outside. "he therapy process allo%s testing ne% s$ills in a safe

environment.

Control by control Gestalt therapy understands that the conte(t of the

therapy process has to be controlled by the therapist. *t is the therapist)s 'ob to

in ol e the patient in the process of therapy. ;*n essence, it becomes the

therapist responsibility to establish the conditions for dialogue<

M. Friedman, =>8/-.

"he ne(t characteristic is potency 2 the potency of the therapist means that it is

the therapist that should be able to follo% the client)s needs at his pace. 3e has

to be able to assist the client %here he is e(pected to and at the same time

pro o$e changes %hich help the process of maturing and gro%ing.

+umanness means that the therapist cares about his client, supports him in

difficulties, recogni es his effort and commitment to the process of therapy. 3ealso sincerely shares his emotional responses and e(periences. 3e is be able to

choose %hen and ho% much to share so it %ill be profitable for his client. 3e is

himself committed to the process of his o%n gro%th so it can be a model for

the client.

Finally commitment. "he therapist commits himself to the process of therapy,

to e ery indi idual client, to continue the self gro%th process %hich includes

training, therapy, super ision, research etc.

;Commitment is the continuing in ol ement and acceptance of assumed

responsibilities8D-. Commitment means to be there for the

client according to the made contract, to respect client)s phenomenology, to

discuss therapist)s themes during super ision, to %or$ on self de elopment in

psychotherapy and in psychotherapy training, to $no% therapist)s limitations

?


22/56

including %or$ing %ith patients the therapist is able to %or$ %ith. Commitment

also means staying in therapy process %ith all its difficulties and ;teach the

client ho% to learn about himself< 3. Siemens , ?DD -.

Apart from the abo e mentioned characteristics it is important to stress the

Gestalt therapist responsibilities to%ard the clients.

"hose ha e been carefully described by F. Perls =>&=-. According to Perls

the therapist is responsible for both, $no%ing himself and the client, for the

quality of his presence in therapy, for being open to the client and being able to

$eep this openness. "he therapist is also responsible for creating and sustaining

a therapeutic atmosphere %hich %ill moti ate the client to %or$. *n Perls)

understanding the e(periences, a%areness and perceptions of the therapist, are

the bac$ground of the therapy process, %hile and the client)s reaction and

aquatinted a%areness form the foreground.

*t is therapist Ls responsibility to share his perceptions, reactions and thoughts

regarding the client, %hile they emerge in the process of therapy. "he most

important part of therapy is the dialogic relationship, techniques per se are not

important.

;"echniques are not the issueK rather the therapist)s attitudes and beha ior and

the relationship that is established are %hat really count&= p.? /-

. Some techniques such as e(aggerating- intensify and clarify current

e(perience, others focus on the e ol ing a%areness process. A technique

should not become a %ay ;to ma$e something happen< but should be part of a

dialogic attitude !. 6acobs, =>@>-.

A technique might be used after establishing ground and as a part of

e(perimenting, %hen an e(periment is appropriate in the therapy process.

"echniques need to become a quality of contact. ;"he important thing is that

techniques emerge organically from the ongoing dialogue< -Polster and

Polster, =>8 , p.? >-.

?


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Gestalt literature often mentions that the therapeutic setting is an e(perimental,

model situation, a micro#%orld %here all the social rules might be applied as in

the macro#%orld %e li e. Social relation are ery important to us, in socialrelation %e li e our li es.

5. 0oubra%a ?DD=- presents ho% therapeutic relations are connected %ith

society and ho% society influences the therapeutic relations. According to his

article ;the client therapist relationship cannot sustain the *#"hou relationship

to the last consequence


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T+ r0/ 0? "+ "+ r!, '"#- r /!"#0*(+#,

*n Gestalt therapy the role of the relationship is basic. 0e elopmentally

the emphasis %as first on awareness Perls, 3effeline, Goodman- and oncontact *. Fromm and the Polsters-. 4o%adays the

relationship is the base of the therapeutic %or$, of contact ma$ing, of healing.

*t is the bridge bet%een the t%o %ho meet. *t is a process, it is dialogue. *t

includes e ery aspect of the client)s and the therapist)s field. Content itself is

not so important. "he content might become a creati e aspect of therapy %hen

is included in the process. Using the Gestalt methodology allo%s to put the

content into the dialogue. "his is %hy dialogue becomes content and process.Methodologically this is done by using %ords. Putting in %ords ;%ho * am ;

and ;%hat * say< and also ;ho% do * say it< allo%s to create a process %hich is

a dialogue.

"he therapist client relationship is hori ontal. Client and therapist ha e their

history and phenomenology. "he relationship is supposed to be li ed ;here and

no%


25/56

1uber =>/ -. Gestalt therapy theory includes many of 1uber)s ideas. +ne of

the most important is# the *# "hou concept and the distinction bet%een the *# *t

and *# "hou."he * it relation is the one, %here %e are interested in the outcome. *ts

meaning is close to manipulation.

"he *#"hou relation is a meeting, %here %e don)t $no% the other. *n order to

meet the other person %e need to enter the meeting ta$ing the ris$ of feeling

lost. Eeferring to Gestalt terms, the closure or the completion of a gestalt in not

possible during this meeting. "he only a ailable figure in the *#"hou meeting is

openness.;*n otherness this openness is the ground from %hich %e offer oursel es to the

meeting.< S. Schoch 0e 4euforn, ?DD=,p.=&&-.

"he distinction bet%een the *#"hou process and the *# "hou moment. *s

analy ed by E. 3ycner =>>&- . "he *#"hou moment is a special moment. "he

e(perience of it pro es to the person, that he can restore his relation to the

%orld. *t is the e(perience of reintegration, of ma$ing a ne% meaningful entity.

*t is %hat Polster and Polster =>8 - call ;a contact episode


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something to come closer to the %orld of the client and then pull bac$. "he

ne(t comments are on resence . Sho%ing presence means pointing out chosen

aspects of the phenomenology. "he therapist should $no% %hen to sho% presence, ho% to enter into the %orld of the client and at the same time, $eep

enough distance not to be completely absorbed by it. "herapist should be

a%are of both his o%n, and his client)s phenomenology. Sho%ing presence

should ha e a function in dialogue %ith the client. "he ery base of the

relationship is )ialogue 2 the *# "hou meeting. ;"he therapist needs to use

dialogue professionally, as a therapeutic instrument< in the process of therapy.

0ialogue is not 'ust a technique. Although the abo e are considered to be s$ills%hich a therapist requires, they also are e(istential meeting qualities.

"he ne(t mention therapist s$ill, but also a quality of the process of meeting is

awareness . A%areness in both, a method and a tool in therapy. ;A%areness

can be restored through ne% e(perience<

3. Siemens, =>>/-. "his e(perience might be co#created by therapist and

client in the process of therapy, through e(periments and dialogue. "he client

might gain a different phenomenology than he %as familiar %ith. 7hat the

therapist does is ;to lo ingly ser e the a%areness process of the client<

Nernon an de Eiet, after E. 6arose%ith, =>>&-. A%areness is a continuum

the first step of it is the a%areness of the outside %orld noises, smells etc. -

%ith %hich %e are in contact through our senses. "he second step is the is

a%areness inside the body, the reaction of our body to the impulse and the

emotional connection %ith the e(perience inside the body. "he third step

concerns the fantasies %e ma$e and includes consciously reflecting oursel es

P. Schulthess ?DD/- .

Another important component of the process bet%een the client and the

therapist is change. # ;Change occurs %ith supported a%areness of it< E.

3ycner, !. 6acobs , =>>&-. Gestalt therapy no more ta$es a%areness as a goal,

but rather dialogue and relationship. A person is able to be present in the

relationship %hen he:she has a%areness of it. "he process of a%areness allo%s


27/56

to respond to a situation according to one)s needs and the gi en possibilities.

;7hen one is a%are, one does not alienate aspects of one)s e(istenceK one is a

%hole< G. Bontef, =>8/,p./8-Change arri es %hen one in ests in the present e(perience %ith no 'udgment

nor demand to change. "he acceptance of the *#"hou relation is the acceptance

of %hat is. "his means surrender to %hat emerges in the dialogue, bet%een the

therapist and the patient. *t also means that the therapist is changed by the

interaction as %ell as the patient. "he interdependence bet%een a person and

the en ironment concerns also the process of meeting in Gestalt therapy !.

5strup, ?DDD-. "he ;ho%< t%o people meet and change during this continuous process of interdependence is the creati e part.


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C6A7TE. III

CREATIVE ADJUSTMENT IN THERAPEUTIC RELATI NSHIP

3 0elationship means to contact and help people to discover how they can help

themselves. %n the place where they can meet and be aware of who they are .

(5. 6elnic7$

*n this chapter the lin$s bet%een creati e ad'ustment and the therapeutic

relationship %ill be presented according to ho% as they are discussed inGestalt literature.

An important affiliation bet%een contact and relationship is mentioned

in Gestalt psychotherapy theory.

"he process of creati ity is an aspect of relationship, e(isting bet%een the self

end the en ironment.

"he self is the ability of the human organism to be in contact, and contact is

one of the basic roles of the therapeutic relationship in the therapeutic

relationship the therapist helps the client to restore the ability to function

spontaneously, to ad'ust to the ne% aspects of the present situation in order not

to repeat stereotypes, %hich might be no longer helpful. ;1eing spontaneous

means to de elop the process of contact#%ithdra%al<

M. Spagnuolo !obb, ?DD=, p.&@- "his process concerns the %hole human

being and might be analy ed on thee different le els9 "hose le els consist of

the e(perience of the self . Self is a function. "his is a no elty referred by M.

Spagnuolo !obb, Gestalt therapy deals %ith the fullness that comes from

staying %ith the e(perience. "he therapist co creates the ability to fully

e(perience the ;here and no%


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"he 5d, 5go and Personality are ;special structures< of e(perience %hich the

self creates for special purposes.

@ T+ B, r# *- 0? "+ ( /?

+n the *d le el this is the ability to identify physiological needs and

needs inside the s$in, and also e(periences %hich are related to our body. *t

refers to sensory and motor learning, breathing, first learning in life.

7hen there is a distortion on this le el the person does not feel the difference

bet%een id and not id, that is %hat is and %hat is not related to the body

e(perience. 3e:she does not ha e a clear perception of boundaries. "his is the

case of psychotic patients. A psychotic patient has an enormous need for

en ironment, for confluence ,does not differentiate bet%een himself and

boundaries. Psychotic patients do not percei e themsel es as different. "hey

fear to be dangerous for others and carry a sense of huge responsibility in front

of the %orld. "hey ha e no fear to damage themsel es. A Gestalt therapist in

such cases %or$s on creating ground, through rules, therapeutic setting,

dialogue and e(perience. Creating ne% healthy en ironment is the goal of

Gestalt therapy on this le el."he e(perience of the self on ego le el, it is the ability to use %ill, ta$e

decisions, identify or alienate %ith parts of the en ironment. +n this le el one

is able to ma$e decision and identify %ith choices or alienate from them. *f the

en ironment is healthy, a person at this le el achie es the ability recogni e

his:her needs and to ta$e an action to fulfill them. *f choices are healthy a

person acquires this ability. 7hen action in not related %ith the persons needs

the therapist needs to deal %ith the loss of ego function. "he creati e %or$ ofthe Gestalt therapist is to allo% e(perience of action ma$ing and gi e attention

to action that %or$s %ell for the client.

+n the personality le el the e(perience of the self has to do %ith the ability to

ans%er the question ;%ho am *


30/56

therapist on this le el is organi ing e(perience in meaningful %holes, to gi e

meaning to the persons) e(perience in the e(istential process of life.

Follo%ing again M. Spagnulo !obb reflections ;the self is ne er passi e andne er acti e. *t is al%ays both. *n contact, it is in the space bet%een not in

you and not in me. *t is the middle mode<

M. Spagnuolo !obb, ?DD?-.

An interesting analy e of three boundaries %hich in themsel es and in the

relationship bet%een them ma$e up the e(perience of the self is presented by P.

Philipson ?DD=-.

"he first is "+ 0r>!*#() *$#r0*) *" 90'*%!r8 "+ I" *0" I"90'*%!r8 %hich separates and lin$s the processes inside and outside my s$in.

"he second is "+ ( /? 0"+ r "+ >0 "+ I *0" I 90'*%!r8

responsible for the sense of self and other, %hat is my e(perience and %hat is

not my e(perience. +n this boundary, the interaction is contact.

"he third is "+ , r(0*!/#"8 90'*%!r8 ) *0" ) responsible for

alienating or identifying %ith some aspects of functioning. "he personality

functioning includes memory and stable en ironment. "he processes here are

ma$ing choices, not ma$ing choices or neurotics.

Ma$ing choices includes9 life choices, commitments, alues and ethics,

culture. 4eurotics is connected %ith polarities une en perception and

e(perience of polarities, fi(ed gestalt and intro'ections.

Creati ity ta$es place in the dynamic bet%een the indi idual and the

en ironment ;%here the self meets the other< 6. Melnic$, S. 4e is, ?DD -. *n

this understanding the creati e process occurs in a relationship, in this case in a

therapeutic relationship, in the process of contact bet%een the self and the

en ironment.

4. Amend#!yon states that the creati e processes eg creati e ad'ustment- ;are

triggered in no man)s land, at the contact boundary< 4. Amend#!yon, ?DD -.

T+ -0*"!-" 90'*%!r8


31/56

"he relation bet%een the patient and the therapist includes t%o modalities the

content and the conte-t of both the therapist and the patient. ;"herapist and

patient both interact in the process and are in the process. "he focus, or thefigure, change during the process of dialogue< M. 0enes, =>@D-.

"he process of change and transformation of the self in contact %ith the

en ironment is creati e ad'ustment 6. Melnic$, S. 4e is, ?DD - .

"he process of psychotherapy is a contact %ithdra% process %here both

therapist and client are in ol ed. Creati e ad'ustment occurs on the contact

boundary, in ;no man)s land< bet%een them. "herapist and client might

communicate from their common e(perience. "hey find the boundaries fromthe differences bet%een them.

*n clinical practice, according to 6. M. Eobin ?DD=- contact in Gestalt therapy

is follo%ing the mo ements to%ards differentiation and to%ards integration in

the field. "herapist either helps to open to clients) e(perience options to%ards

the integration of the field or to%ards the differentiation of it. All the %or$ is

concentrated on the balance bet%een them.

According to P. Philippson ?DD=- reflections about meeting for the

first time a client on the mentioned three boundaries le els, a therapist should

concentrate on the follo%ing9

At the %d boundary1

0oes the client allo% himself the moment of not $no%ing, of not ma$ing

figureO

0oes he allo% himself to see %hat emerges or does he ha e a $ind of

stereotyped figure fi(ed Gestalt- he usesO

*f he allo%s *d then he has to become creati e in that moment he has freedom

%ith the an(iety of that freedom, he has also to be a%are of his freedom and the

confusion it brings so he can ac$no%ledge his free %ill.

Same questions and processes concern the therapist.

"herapist has to be able to loo$ %ithout attaching anything, since the meaning

of %hat happens in the process has to be created together


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At the ego (self4other $ boundary the questions are9

7hat $ind of choices does the client ma$eO 7hat does he e(pect from meO

3o% does he e(press thatO 3o% is the self:other process bet%een usO And fromthe therapist part9 3o% do * e(perience myself %anting him to beO 7hat do *

li$e and %hat * don)t li$eO 3o% open am * to different aspects of his lifeO

At the personality boundary is the client)s personality supporti e and open to

changes through ne% e(periences or is it rather a range of fi(ed beha iours and

intro'ectsO 0o those intro'ect permit the client to e(periment %ith ne%

beha ioursO +r is he committed to the old attitudes %hich do not allo% him

effecti e functioning todayO

"he contact boundary is made up of contact functions. "he functioning

of a client can be obser ed by the therapist upon the use of contact functions.

;*n therapy %e obser e the appearance, erbal, auditory, mo ement and

touching contact functions< G. 0elisle , =>>>-.

*n the contact cycle dysfunctions might be obser ed in the phases of sensation,

a%areness, mobili ation, action, final contact and %ithdra%al. "he

dysfunctions are maintained through resistance and ad'ustment to contact and

also by not ma$ing appropriate use of one)s support system cogniti e, emoti e

and beha ioural see appendi( @-.


33/56

C6A7TE. I<

E!EMPLI"ICATI N "R M CASE STUDIES

&he therapist 3has to love the client on a very basic level, in a very simple

manner. &he therapist should love the human being before him < 6. Iin$er,

=>>8-.

Gestalt therapy from the beginning and in its history %as ery much based on a%areness. Social condition and changes contributed to changes in

Gestalt therapy approach. 4o%adays it is much more concentrated on contact

and process. Contact ma$ing is a primary concern. "he therapist should be

a%are of contact ma$ing, obser e %hat the contact does to the other person,

find the strength and ulnerabilities of the therapeutic situation. "his is part of

the process of therapy.

*n this chapter e(amples of creati e ad'ustment in therapeutic relationship as

e(perienced in Gestalt therapy practice %ill be presented.

"he first case %hich %ill be presented and discussed comes from

therapy %ith a & year old girl, %ith mental and speech retardation and

beha iour problems. She poorly communicates erbally, pronounces ery fe%

%ords and communicates miming things and situations. Mother comes to

therapy as$ing for speech impro ement. "he girl does not %ant to come, gi es

parents difficult time t%ice a %ee$ %hen is time to go to therapy. 7hen she

does not obtain %hat she %ants she screams and bites. She beha es li$e

described also at home, at family friends during isiting, in super mar$et

creating situation %here parents are at big discomfort and manipulating them.

3er perception of boundary is ague she does not feel other people personal

space.


34/56

She does not ha e the ability to identify her needs, she has no sense of s$in

boundaries. 3er touch is hea y and she does not respond %ell to guiding by

touch. She often steps on other people coming to close, she %al$s unbendingly,her mo ements are stiff, her body is ery tense. She has no sense of her body

strength. She actually is ery strong for her age and misuses the strength.

Contact ma$ing %ith A. %as a challenge since she had negati e reaction to

e ery trial to start an acti ity, no matter if it %as related to speech , beha iour

or play. "he girl is in therapy for o er t%o years no% and she starts percei ing

and respecting rules of the therapeutic setting. *n this case it means

%or$ing:playing for about D minutes %ith the therapist %ithout calling hermother, lea ing the office %ithout screaming and ta$ing some ob'ects %ith her,

playing %ith one toy or one acti ity at the time and communicating her needs

%ithout pulling the therapist hair nor hitting her. "he creati e ad'ustment in

this relation from the therapist part %as establishing physical boundaries

sessions %here the main impact %as on the physical place client and therapist

occupied during the session ;this is my pillo% and this is yours< ,


35/56

e ery time, reacting to %hat therapist as$s her. "%o isits on three the girl

comes and lea es quietly %ithout anger outburst %hich therapist and parent

agreed to ignore."he de elopment of personality of this girl is stuc$ at the negation le el and

this does not allo% her to e(periment %ith ne% beha iors. 3er ;no; attitude

stops also the child)s de elopment procedure. Ad'usting to this pattern

creati ely included commitment to %or$ again and again on the same issues

introducing rules in and out of therapy, li$e ;session duration is & minutes and

then you lea e< or ;%e %ill play %ith dough for =& minutes and then %e %ill

do speech e(ercises for & minutes in front of the mirror


36/56

inter entions %ere couple session %ith t%o therapist so a holistic approach to

the case %as possible. *mportant part of this therapeutic setting %as also

consulting the case %ith the psychiatrist on regular bases.0uring therapy after a phase %hen things %ere going %ell and client seemed to

be ready to %or$ on personal themes in therapy he suddenly got ery depressed

again, stopped %or$ing, stopped going out of the house. 3e called therapist to

tell he is not going out of the house and %ill not attend therapy sessions for a

%hile.

A creati e inter ention at that time %as going out of the regular therapeutic

setting and rules and calling the client at home. A transcript of the phonecon ersation follo%s9

"herapist 9 ;3i M., this is 6oanna. * called to as$ ho% are you doingO<

Client9 ; things are really bad. * don t go out almost at all. * stay in the house

mo ing from the bed to the couch. * cannot thin$ clearly. *t is ery hea y and

stressful. * don)t ans%er my cell phone because *)m afraid it is a client. And *

cannot %or$ right no%. * don)t ans%er the phone also. * pic$ed it up because

my %ife told me she %ill call at =@. D so * thought it %as her.<

"herapist9 ;* can hear also in your oice you are not %ell. * %ant to as$ you if

you %ould li$e to mo e our session to your place until you feel better. * could

isit you in your house for a session. 3o% do you feel about thatO<

Client9< no, * don)t thin$ this is a good idea<

"herapist9< %ould you li$e to thin$ about it .O<

Client9 ;4o, * don)t %ant to. * %ill come to see you %hen * am ready. * %ill call

you


37/56

$no%ledge at that time, he could not accept his condition. 3is en ironment %as

ery supporti e. 3e could see it but could not feel for them. Client %ould not

e(periment %ith ne% solution nor ne% beha iours e en %hen therapist %asery directi e and his attitudes %ould not allo% him to function in e eryday

life could not %or$, help in the house nor going out-.

"he client)s choice %as to come to therapy and then %ait for changes to happen

;* %ill tell you about it %hen * feel a little better< or ;%e %ill discuss this

another time no% * don)t ha e the strength


38/56

Client9< * though %e could spea$ Gree$ from no% on because *)m ta$ing

lessons and it %ill also help me socially9

"herapist9< +$, *)m fine %ith both languages. 7e could e(periment for today)ssession and see ho% %e both feel %ith that. 3o% does that sound to youO<

Client9 ;*)m o$, let)s try it for today<

After a fe% sessions 5. as$s9

Client9< * thought * could spea$ my o%n language so * can e(press myself

better and you could spea$ yours. +ur mother languages are indeed similar

enough and %ith some practice this could be done-

"herapist9 ;*)m a little bit hesitant about that .. 1ut still %e can try it. !et)sstart our session as you say and see ho% it goes <

And after sometime during the same session9

"herapist9 ;*)m sorry * cannot do it this %ay. *)m to much concentrated on

trying to understand the %ords and * cannot see nor feel anything else. Could

%e s%itch bac$ to 5nglish or Gree$O<

Client9< *t)s a pity. !et)s try bac$ in Gree$ then


39/56

sometimes you as$ about thin$s * could not find searching by myself so

question help me to loo$ in other areas that * had in mind so far


40/56

translate for them %hen there %as need. 3e %ould understand %hat people %ho

%ere arrested go through and %as a fatherly figure. 3e is &? years old.

Creati e inter ention from the therapist part in this case %as calling Ahmed inthe doctor)s office e ery time a translation from Arabic %as needed. Another

part of it %as as$ing 3. to $eep an eye at other patient during afternoon and

sometimes night hours. *n ol ing Ahmed in ta$ing care of others helped him to

feel better. 3is presence %as ery helpful for therapist during session %ith

other patients since a relation of trust has partially already been built bet%een

3., %ho %as the translator, and the other patient. "he issue of insomnia

reappeared and 3. disclosed that he %as doing drugs in the past. 3e %asabused by them. 3ere is the con ersation %hich follo%ed9

"herapist 9 ;so ho% long ha e you been doing drugsO<

Client 9 ;for many years .after that * %ent to prison but *) m clean no%<

"herapist9 ;Bou understand that starting medicine for impro ing your sleep

might bring you bac$ to abuse, don)t youO<

Client9 ;* $no% that. *)m ery tired. * need to get some sleep. * promise you *

%ill not ta$e more than one pill at night, the one %hich the doctor %ill

prescribe<

"herapist9 ;*t is your decision. * trust you. * also appreciate ery much %hat

you are doing here. *)m 'ust %orried you might go bac$ to a condition %hich

%ill not be good for you


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dealing %ith her o%n stereotypes of ;a prisoner< and respecting the fact 3.

%ould not tal$ about his past e(perience related to that.

Client is a%are of his needs and of rules of contact ma$ing in the detentionunit)s doctor)s office. 3is ability to organi e past e(perience allo%s him to

ad'ust to e eryday reality and also help other people.


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CONCLUSION

"he concept of creati e ad'ustment is ery significant in Gestalt therapytheory and practice. *t also is described as an essential factor in de elopment

and in the %ay a person can function, communicate and meet or a oid contact

in his:her en ironment. 5 ery $ind of reaction is creati e ad'ustment, at least

at its beginning, %hen it ser es a specific purpose. *t stops being efficient

%hen becomes a ;fi(ed gestalt< no longer ser ing the best interest of the

person. "he process of creati e ad'ustment concerns both, the therapist and the

client and is a crucial part of the therapeutic relationship.Creati e ad'ustment occurs in the space< in bet%een


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sharing the ob ious and the simple in a %ay, that can meet and benefit both

persons in ol ed in the relationship.


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SU55A.=

10!**! 2!"0 Cr !"#$ A% '(") *" #* T+ r!, '"#- . /!"#0*(+#,H1eing partial fulfilment of the requirements for the title of GestaltPsychotherapist in Gestalt Foundation, Athens

"he purpose of this dissertation %as to present the concept of creati e

ad'ustment and therapeutic relationship %ith emphasis on affiliation bet%een

those t%o concepts as published in Gestalt literature as %ell as sho% samples of

creati e ad'ustment in a relation bet%een patient and therapist as e(perienced

in Gestalt psychotherapy practice.*n the first chapter %hat Gestalt therapy is including its basic meanings

and $ey %ords is briefly described. "he description is follo%ed by a literature

re ie% on the meaning of creati ity, a portrayal of a creati e therapist, a re ie%

of the understanding of the terms ;ad'ustment< and ;creati e ad'ustment< in

Gestalt therapy. "he philosophical trends %hich had impact on the mentioned

abo e terms ha e also been presented.

Chapter t%o contains information about the role and the characteristics

of the therapeutic relationship including the *# "hou concept, the description of

contact and a%areness as it is understood in Gestalt therapy. *n this chapter the

therapist)s tas$ and responsibilities to%ards the client and the influences the

society might ha e on a therapeutic relationship ha e been described.

*n chapter three the affiliation bet%een contact and relationship ha e

been presented and are follo%ed by the description and the e(perience of the

self formation. *ts relation to the contact boundary as referred in Gestalt

literature is also mentioned.

Finally in chapter four an illustration of creati e ad'ustment in therapeutic

relationship is presented. "he described e(amples come from therapist)s

e(perience. "he descriptions are based on notes from therapeutic sessions.


45/56


46/56

A,, *%#B @

UNDE.STANDING OF .ESISTANCES 6 r9 S" $ *(0* JJK. (#("!*- (

*ntro'ection "a$ing in or s%allo%ing an e(perience Q%hole.Q 4otfiltering e(periences for %hat resonates %ith personaltruth. 1eing naR e or gullibleK e.g. parental guidance ofho% to safely %al$ across the street is a positi eintro'ection.

Pro'ection Attributing one s o%n feelings or actions to another.

1laming. For e(ample, unable to ac$no%ledge that %hiteis a form of race and loo$ing to define race ia people ofcolour, instead of in deathly loo$ing to understand %hat itmeans to be %hite by loo$ing at the larger population as%ell as one)s life.

0eflection A oiding direct contact %ith another person. For e(ample,using 'o$es to bloc$ the seriousness of a situation or toignore a compliment.

Confluence "he inability to differentiate oneself. For e(ample,merging %ith others opinions to a oid ha ing to ta$e a

position, often percei ed as a ;yes< person %ith no personal opinion.

0esensiti ation 4umbing sensations. For e(ample, a oiding a%areness physically, emotionally or mentally. 0issociating.

&


47/56

A,, *%#B

.ESISTANCES IN GESTALT S; G#*> r @ M

C0*?/'

*-

I*"r0 -"#0*

7r0 -"#0*

. "r0?/

-"#0*

D ?/-"#0

*

7r0?/ -"#0*

E>0"#()

+thersen ironment-

-0*"!-"90'*%!r8

me organism-

&


48/56

A,, *%#B

CONTACT ST=LES G; 4+ / r @ @

Confluence 8s. 0ifferentiationPro'ection 8s. Eetention, literalness

*ntro'ection vs. Che%ing, destructuringEetroflection vs. 5(change, encounter 0esensiti ation or

5goism-

vs. Merging, yielding

0eflection vs. Focusing, concentration

&


49/56

A,, *%#B K

T6E CONTACT 4IT6D.A4AL C=CLE 7; C/!r (0*

"35 CBC!5 +F G5S"A!" F+EMA"*+4 A40 05S"EUCC"*+4"he a%areness cycle"he contact and %ithdra%al cycle"he need and satisfaction cycle

choice and implementation full and ibrantofappropriate AC"*+4 phase F*4A! C+4"AC"

of contact

M+1*!*IA"*+4 SA"*SFAC"*+4and e(citement or post#contact phase of contact and gestalt completion

7*"30EA7A!A7AE545SS or organism at restof emergingsocial o biological needfore#contact phase S54SA"*+4

fore#contac

EN


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T6E IT NOT IT 3OUNDA.= P Philippson P, ?DD=- "hree 1oundaries ofSelf#Formation. Contact and Eelationship in a Field Perspecti e. G"in,l)e(primerie, 1ordeau(

r#anism$envir%nment &%undar'( it$n%t it

Field

boundary process interactionB, r# *-

4ot my e(perience

&


51/56

A,, *%#B Q

T6E SELF OT6E. 3OUNDA.= T6E EGO T6E I NOT I3OUNDA.= Philippson P, ?DD=- "hree 1oundaries of Self#Formation.Contact and Eelationship in a Field Perspecti e. G"in, l)e(primerie, 1ordeau(

Se)*$%t+er&%undar' %r

E#%&%undar'(

I$n%t I

+ther figure-

+ther ground-

boundary process contact

Self

&


52/56

A,, *%#B R

T6E 7E.SONALIT= 3OUNDA.= 5E NOT 5E Philippson P, ?DD=- "hree 1oundaries of Self#Formation. Contact andEelationship in a Field Perspecti e. G"in, l)e(primerie, 1ordeau(

Pers%na)it' &%undar'( me$ n%t me

Memory

Stable en ironment

7ill

Autonomy 4ot me

1oundary processes

C+0#- ?'/ N 'r0"#-

Safe choices Polarities

Commitments Splittings

Nalues:ethics Fi(ed gestalts

Culture O *ntro'ects

A,, *%#B S',,0r" (8(" )(H: 0elisle G, =>>>- Personality 0isorders.

C*G Press, +tta%a

T+e ,i%)%#ica) Su--%rt S'stem(

Me

&


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30* ("r'-"'r ( P bones might be used as le ers and %ay toput strain on them

can result in in'ury.

T+ )'(-'/!r (8(" ) can be used to establish contact %ith the en ironmentor to retroflect.

T+ r (,#r!"0r8 (8(" ) P the dispenser of energy. 3olding breath interferes

%ith the circulation of energy, pre ents e(citement and transforms into an(iety.

T+e C%#nitive Su--%rt S'stem

"his mode is the locus for assigning a meaning to something. "hin$, reflect,

plan, anali e or remember. "herapy concentrates on ho% thought can influence

the mobili ation and channeling of energy. "herapist uses thoughts forcogniti e reframing and restructuring.

T+e Em%tive Su--%rt S'stem

"his mode consist of the range of feelings %e are capable of e(periencing9 fear,

'oy, sadness, anger. +ur capacity to reason lucidly may be diminished or

restricted depending on %hether the feelings %ith %hich %e approach a gi en

situation are more or less recent or significant.

T+e ,e+avi%ra) Su--%rt S'stem

"his is a set of contact functions. "he beha ioral pole is another representation

of the contact boundary.

T+e Inter-ers%na) Su--%rt S'stem

"his is a net%or$ of friends or acquaintances. "he quality of this net%or$ is

frequently an indicator of the indi idual self esteem and opinion about himself.

&


54/56

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creative adjustment

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