hello this is dr grande today's question is what is gestalt therapy and what are my opinions about gestalt therapy this is a question that was submitted by a subscriber and i appreciate the interest in gestalt therapy and in my opinions i'll give a summary of gestalt therapy first and i'll go through and kind of give my take on gestalt therapy so originally gestalt therapy was created by a theorist named fritz pearls and he took components of other therapies and merged them together and then added his own creativity so gestalt therapy is actually a bit unusual compared to a lot of other theoretical modalities i wouldn't consider gestalt therapy by any means to be obscure there are many people that practice it but i wouldn't exactly call it mainstream either it kind of sits in the middle it's certainly not as established with empirical support like cognitive behavioral therapy but there are like i said a number of people that practice it and it's very common for individuals to integrate gestalt therapy techniques into their therapeutic practice so let's take a quick look at gestalt therapy there are actually a lot of aspects to the original gestalt therapies developed by fritz pearls i'm just going to summarize here a major part of gestalt therapy is awareness pearls believed that one of the reasons individuals developed mental health symptoms was because they weren't aware of their senses emotions they didn't have good recognition of their bodily sensations and they had poor awareness of their environment he also believed there were problems referred to as contact boundaries so problems that people had interacting with their environment with other people and these contact boundaries could be problematic he also believed in what he referred to as the five layers of neuroses phony phobic impasse implosive and explosive and he believed that through gestalt therapy through the application of all these various techniques these layers could be stripped away and that these layers did have to be removed for somebody to become authentic so at the phony layer of neuroses someone is inauthentic their reactions are inauthentic at the phobic level they're avoiding pain at the impasse level they're afraid to change at the implosive level their awareness is increased but they're not ready to take action and then at the explosive level they are authentic so really that's the goal in gestalt therapy is to reach that explosive level and be fully alive as fritz pearls put it so other than the lack of awareness that i was just talking about with gestalt therapy pearls had a number of other possible causes to mental health symptoms and the two major ones would be unfinished business meaning if feelings are unexpressed that leads to mental health symptoms and not taking responsibility so when you take unfinished business not taking responsibility and not being aware a lack of awareness those three things represent a large part of the problem as conceptualized in gestalt therapy so to address these conditions or situations and to realize improvement pearls developed a number of techniques confrontation is probably one of the techniques we hear about the most because it was really the most unusual it was kind of a harsh and almost a little bit aggressive therapeutic way of being it was an unusual way to kind of sit with a client compared to say person-centered therapy or existential therapy so this would be when something comes up that the therapist believes requires confrontation when some sort of change is apparent but the person can't quite get there the gestalt therapist would be confrontational they could be a little bit abrasive this isn't really used much anymore in gestalt therapy but this was a key technique in the early days of gestalt therapy another technique and we do see this one now is to keep everything if at all possible in the present so gestalt therapy is interested in the here and now to the extent that if there is something in the past that people are bringing into the session which of course oftentimes there is the gestalt therapist makes an effort to have that past experience acted out in the present almost in a sense whatever the problem was in the past the gestalt therapist is trying to make it the problem now the theory being that if it's the problem now it can be dealt with if it's current it can be dealt with if it's in the past it can't really be resolved now this gets a little bit abstract and philosophical but this is a key part of gestalt therapy this is a technique and this technique is used quite a bit now as i mentioned another technique is to enhance awareness and really this is an overarching technique and there are a lot of techniques underneath of this so there are a lot of different ways that a gestalt therapist helps to enhance awareness this could be through pointing out nonverbal behavior for example somebody could be looking down at the floor a lot they don't realize they're doing it and a gestalt therapist will point that out also that kind of goes hand in hand with the confrontational piece but it's really to enhance awareness another way to enhance awareness is through the use of language so for example gestalt therapists usually believe that the more a client uses the word i the more their awareness will increase so instead of referring to a problem in terms of something external like it's causing me not to have hope a gestalt therapist would encourage somebody say i'm causing myself not to have hope so it's a personal responsibility piece but also identifying in the first person with situations and conditions taking responsibility as a part of it but just even using the language is another part of it whether or not this works i mean again a lot of these techniques are somewhat controversial but that is part of what we see in gestalt therapy another aspect we see in gestalt therapy is role playing so this is when a gestalt therapist ask a client to act like somebody else so let's say that a client has a contentious relationship with their sister so they may be asked to play the role of their sister and they could do this for 5 10 15 minutes and maintain that role in session another technique we see is enactment and this one again is even more controversial than the usual controversial level we see with a lot of gestalt therapy techniques this is when a client is asked to act out something that they indicated in the session for example if the client says right now i feel like a child who's having a temper tantrum the gestalt therapist may say well act like a child who's having a temper tantrum throw a temper tantrum right now and again this could last for several minutes and it would be animated it's not something that would just be verbal where they say the words that a child who's throwing a temper tantrum would say but also the physical movements would be included the last technique i'll cover here is really probably the most easily recognizable the technique that's most associated with gestalt therapy and that's the self-dialogue and it comes in various forms but the most popular form is the empty chair technique we also see another version is fairly popular which is the two chair technique so the empty chair technique an individual is asked to have a conversation with an empty chair but they're supposed to imagine a person in that chair usually of course a person that would have some connection to why they're there in therapy so let's say an individual was abused by a friend of theirs when they were a child their friend in their imagination their friend would be in that chair and they would have discussion with them now with the two chair technique it's a little different with two-chair technique we see the client in one chair and an empty chair across from them just like the empty chair technique but in two chair the individual plays both sides so they act as themselves for one side of the conversation and then when it's the other person's chance to talk they physically get out of the chair they're in and move to the other chair and talk to themselves now there's also another version of this where the client divides themselves into parts we see this both with empty chair and two chair so you may have the angry part of someone talking to the happy part of the same person or for example with empty chair you could have the client as themselves talking to the angry part of themselves so we see this self-dialogue as a fairly popular technique as i mentioned with gestalt therapy and a lot of times even practitioners that don't use gestalt therapy or use a number of the techniques we'll still use this self-dialogue technique so for the second part of the question what's my opinion of gestalt therapy gestalt therapy is an interesting therapy and i have mixed feelings about it as a scientist of course i'm always looking for the truth and sometimes when we find the truth out about a therapy we're happy about that and sometimes we're not as happy to understand gestalt therapy though it's first important understand that there's really two types of gestalt therapy there's the gestalt therapy that fritz pearls invented and had his kind of creative flair to it and his personality infused in it and then there's the gestalt therapy that's used today there's really not a lot of empirical evidence supporting the gestalt therapy used by fritz pearls the crystal therapy that he invented and unfortunately there's not a lot of empirical evidence to support gestalt therapy now however it's really important to understand the differentiation between a theory and techniques so gestalt therapy is a little strange in this sense there's not much support for the theory of gestalt therapy and there's a few reasons for this but there is actually quite a bit of support for the techniques for example the self-dialogue the empty chair and the two chair so for many of the techniques scientific evidence suggests that those techniques work but the overarching theory doesn't really have a lot of support now one of the main reasons for this is because even though there are a lot of places that teach gestalt therapy a lot of institutes for example there is no standard format there is no central theoretical orientation associated with gestalt therapy it's fragmented so really whether it works or not we don't know because we can't test it we can't test one standard format of gestalt therapy now all theoretical modalities have variations if you learn about cbt at one place and then you drive across the country and you learn about somewhere else there's going to be differences but overall there's much more agreement inside a lot of the other theoretical modalities like cognitive behavioral therapy than there is in gestalt therapy i think that someone could effectively argue that because the gestalt therapy techniques are generally effective that if a coherent theoretical model for gestalt therapy could be brought together it's likely that it would be effective it's likely that research would support it however because there is no coherent theoretical model we can't conduct that research and we don't know and when we talk about science and the way science works we just can't make that assumption we just can't say well because the techniques do seem to work if we could put these techniques together then those techniques would work together they might or they might not i think what is supported is the idea that gestalt techniques could be infused in other theoretical modalities for example somebody could use adelarian therapy psychodynamic therapy cognitive behavioral therapy reality therapy and use gestalt therapy techniques as a part of delivering the treatments and the techniques seen at other theoretical modality and a lot of clinicians do this a lot of clinicians combine multiple theoretical modalities and parts of other modalities so research supports that the techniques could be used in other modalities but we don't have a set of guidelines to pull all the gestalt techniques together and use them and really call it gestalt therapy so what's my opinion about gestalt therapy well overall i like it but i wish that we could get one model of gestalt therapy so they could be tested i do believe that overall it is creative i like the creative element of it i like how it uses techniques that are a little different than what we see in traditional therapy certainly a number of clients who are treated with gestalt therapy report that it's engaging and it can even be fun and typically we don't think of therapy as primarily being fun so i really like those aspects of gestalt therapy i like that it's engaging i like that it can be fun i like that it really makes people think in ways they might not think it really pushes people a little bit outside the comfort zone but it does need to have some work with the model being standardized that's important for gestalt therapy to really survive and continue as a theoretical modality it has to be organized so overall i like it but i have some concerns and i'm still a little skeptical in terms of whether it would work if it was put together as a theory i hope you found this description of gestalt therapy and my opinions about gestalt therapy to be interesting thanks for watching