1. Gestalt Therapy

2. Examples of Gestalt and Reality Therapy
Gestalt Therapy
The Gestalt Prayer
I do my thing, and you do your thing.
I am not in this world to live up to your expectations
And you are not in this world to live up to mine.
You are you, I am I,
And if by chance we find each other, it’s beautiful.
If not, it can’t be helped.

3. Life of Frederick “Fritz” Perls (1893-1970)
Middle child and only son
Happy childhood; somewhat strained relationship w/ father due to rebellious nature
Failed 7th grade twice and expelled
Completed medical school and served in WWI as a medic
War experiences influenced humanistic behavior, but also contributed to cynicism about human nature
During a brief conversation w/ Freud, Perls felt humiliated by him, perhaps spurring his passion to disprove Freud’s theory
Wife Lore (Laura) Perls contributed to Perl’s writings

4. Gestalt therapy founded in reaction to…
~Behaviorism in the US
~Rising popularity of psychoanalysis
Gestalt believed that society supported “quack” therapy with quick-fixes

5. View of human nature…
“We do not experience things in isolated pieces, but in meaningful intact configurations”
Client is in the here and now, and always in the process of being what she/he is here and now, and becoming the person she/he can be
Humans have the ability to change and are be responsible for their own choices

6. Healthy behavior…
…is when a person is able to be fully aware of who they are while, at the same time, being able to make genuine ‘contact’ with others
…when people act and react as total organisms~ unfragmented and self-regulating

7. Psychopathology via the Gestalt Perspective
There are five layers or levels of psychopathology
The cliché layer of appearing/acting what you are not
The phony-level where we play games act ‘as if’ and give up actualizing themselves, use polarities
The impasse- we are stuck in our own maturation and have no chance of survival
The implosive-is a level of is the dead part of us which needs to be shed, that is the part of us that is our identity
The explosive- is the last level where by the person has shed their old habits and character releasing tremendous energy allowing the person to experience full joy and sorrow

8. Role of Therapist
Therapists engage clients in developing their own awareness and experiencing their feelings in the present
Therapists pay attention to clients body language to provide clues to feelings about situations~ look for contradictions (saying you are in pain and laughing, saying you are mad and smiling, etc.)
Therapist does not ask “why” but “what” and “how”
Helps client identify “energy blocks” in the body and encourages the release of energy

9. Gestalt Therapeutic Techniques
Games dialogue- pt. carry on dialogue between polarities of their personality e.g..M/F
I take responsibility- pt.are ask to end every statement with “I take responsibility for it”
Playing the projection- pt plays the role of another person
Reversals- pt act out the opposite of the way they are to expose some hidden polarities
Rehearsals-pt reveals to the group the social role playing
Marriage and counseling game- spouses take turns revealing the most positive and negative things about each other
May I feed you a sentence-therapist asks permission to repeat and try on for size a sig. statement about the pt.
Empty chair- pt is asked to play one or more roles and speaks for each role, moving btwn chairs

11. Reality Therapy

12. Example of Reality Therapy

13. Life of William Glasser (1925-)

14. Reality Therapy
“The essence of Reality Therapy is the acceptance of responsibility for a person’s own behavior which enables the individual to achieve success and happiness.”

15. Reality Therapy Client
Someone who is unable to fulfill needs in a realistic way and has taken some less than realistic way in unsuccessful attempts to do so.
They are either unvalued in a present unsatisfied relationship, or
Lack what would even be called a relationship.
**All clients have the same issues that are manifested differently through different coping mechanisms
Glasser believes all clients have the same issues, they are simply manifested differently through different coping mechanisms.

16. Behavior
All we do is behave – almost all behavior is chosen and we are driven to satisfy our five basic needs:
Survival
Love
Belonging
Power
Freedom
Fun
Each person functions to satisfy basic human needs. Some people simply don’t know how to get these needs met. Glasser focuses primarily on love and belonging – “the need to love and be loved and the need to feel we are worthwhile to ourselves and others.”

17. Unhealthy behavior is when…
Client choses unhealthy behaviors to deal with feelings of disconnectedness
“Mental illness” should only refer to issues of the brain treated by a neurologist; alcohol, depression, bipolar are not mental illnesses but the behaviors in which a person has chosen to express their unhappiness

18. Role of Therapist Give self – not service
Doesn’t accept mental illness - each person is responsible for behavior
Focuses of “Here & Now”
Increases client’s self-esteem
Accepts and respects
Builds confidence and trust
Increases openness, integrity & honesty
Counseling is something a therapist engages in with a client. The word “with” means it is not a technique, but a relationship. Instead of giving service, a therapist gives herself – time, interest, attention, respect, and understanding. The successful therapist is one who genuinely cares about, and is committed to her client.
Glasser says: “Involvement is the foundation of therapy. All other principles build on and add to it. As soon as possible, the person being helped must begin to understand that there is more to life that being involved with misery, symptoms, obsessive thoughts, or irresponsible behavior. He must see that another human being cares for him and is willing to discuss his life and talk about anything both consider worthwhile and interesting.”
Mental Illness: Disconnectedness is source of almost all human problems, such as what is called mental illness, drug addition, violence, crime, school failure, spousal and child abuse, etc. We choose unhappy behaviors. Unhappiness is not a mental illness. Society if flooded with people who choose to be: anxious, fearful, depressed, obsessive, lazy, hostile, violent, addictive, and withdrawn. Labeling with mental illness gives excuses for behavior, which is not helpful in a therapeutic setting.
Here & Now – Nothing which happened in the past, no matter how it may have affected someone then or now will make any difference once he learns to fulfill his needs at the present time.
Clients need increased self-esteem which is acceptance of self and feeling of self worth. Accept client by being interested in them as individuals, showing respect for opinions and contributions. Taking time to listen to what they have to say. Be interested in them as individuals – showing respect for his opinions and contributions
Acceptance and Respect – Must accept client uncritically and understand his behavior. Understanding happens not by standing on the outside looking in, but by imaginatively getting on the inside and looking out, seeing as the client does.
Confidence and Trust – Respect decisions (even if you don’t agree) – create a trusting environment while employing techniques for helping a person discover what they really want.
Openness, integrity and honesty – Be honest with client

19. Basic Foundation for Counseling
Counselors using Reality Therapy encourage trust in the counseling relationship, promote the view that we are responsible for our own actions and help develop practical steps for quick improvement.

20. Major Components of Reality Therapy
Focus on present
Avoid discussing symptoms and complaints
Understand “total behavior”
Avoid criticizing, blaming, and/or complaining
Remain non-judgmental and non-coercive
No excuses
Focus on specifics
Making plans
Be patient
Focus on present – avoid discussing past because all human problems are caused by unsatisfying present relationships. Get to current relationship in first session. Avoid discussing past because all human problems are caused by unsatisfying present relationships. Tell him the truth about past: “The past is over; you cannot change what you or anyone else did. All you can do now is, with my help, build a more effective present.”
Avoid discussing symptoms and complaints – since these are ways people choose to deal with unsatisfying relationships.
Understand “total behavior” – All behavior is made up of four inseparable components – acting, thinking, feeling, and physiology. Have clients focus on what he can do directly – they can act and think, not feeling and physiology.
Avoid criticizing, blaming, and/or complaining and help clients do the same. These extremely harmful external control behaviors destroy relationships. Don’t do anything with anyone if it seems to increase the distance between you.
Remain non-judgmental and non-coercive – Encourage people to judge what they do with choice therapy axiom:
Is what I’m doing getting me closer to people I need?
If not, help them find new behaviors that lead to better connection.
Teach people that excuses (legitimate or not) stand in the way of making needed connections.
Focus on specifics – Find out who client is disconnected from and help him choose connecting behaviors.
Help them make specific workable plans to reconnect with people they need. Then, follow through on what was planned by helping them evaluate the progress.
Be patient and supportive, but keep focused on source of problem - disconnectness

21. Choice Theory Seven Deadly Habits Criticizing Blaming Complaining
(Goal is to replace the seven deadly habits with the seven caring habits)
Seven Deadly Habits
Criticizing
Blaming
Complaining
Nagging
Threatening
Punishing
Bribing or Rewarding to Control
Seven Caring Habits
Supporting
Encouraging
Listening
Accepting
Trusting
Respecting & Negotiating Differences
Replace seven deadly habits with seven caring habits

22. Reality Theory Paradigm
1. What? After involvement has been established, problem solving takes place by asking the question: What are you doing? What happened? Please tell me exactly with all the details you can think of.” The therapist is not satisfied with a judgment or summations; he wants the story in all its detail. He may ask the client to quote the exact verbiage employed in an argument. He may ask the shoplifter to share the precise technique employed to steal an item of merchandise. He may ask an exhibitionist what precautions he took to avoid arrest for his compulsion. The therapist leads his client through a series of questions such as would be applied by a good criminal defense lawyer. Where, when, and how did the episode occur? Who was there and what did each person say and do? What happened to the loot, victim, witnesses, and so on? A picture of cinema like clarity emerges out of this line of interrogation and demonstration.
2. After the nature of behavior has been established and the client has evaluated it as negative and non-productive, the therapist asks: What is your plan? What can we do to resolve this dilemma if we put our heads together? Do you have any ideas? Would you like to know what idea occurs to me? The client and therapist engage in a sort of brainstorming session to come up with solutions to the problem. They weigh pros and cons. They call a consultant if necessary. They engage in role playing and rehearsal. Telephone calls are contemplated, letters written. A clear-cut strategy is designed to cope with the difficulties.
Contract – After the plan has been devised, the therapist asks: “Are you ready to carry it out?” Will you do your part? He drafts a contract and says in effect: Just to make sure that we understand what this is all about, would you mind putting your signature on this document. The contract is specific to time, place, and degree of effort. All loose ends are neatly tied into the package.
Follow-up – Everything that occurs after the initial four stages comes in the category of follow-up. The therapist arranges to meet with his client to determine how he fared with the plan. If necessary, a new and simpler plan is formulated.
If the client doesn’t abide by the contract, the therapist doesn’t listen to excuses, but asked if he wants another schedule or less difficult assignment. The therapist does not give up, no matter what. From beginning to end, the therapist is tough-minded and gentle, serious and humorous, determined to help his client drop a failure identity and cross the barrier to success, self-worth, and human actualization.