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GESTALT THERAPY AND SOCIAL WORK R. FELTON
This paper intends
looking at groups, their use in social work practice, and the of the approaches derived from the human potential movement social work group practice.
specific application to
more than ever, with the gradual reduction of the resources available to social services department, the use of group settings is becoming more and more in social work practice. No longer does the social worker have time available to devote to each individual client in such a way as to pursue in-depth case work in many cases. A good alternative, especially for the client that does not need such a deep level of involvement, but nevertheless seeks constant and continuous support, is that of group treatment. In addition to the economic rationale behind starting group forms of treatment or work within a social services setting, thus enabling one worker to deal simultaneously with over ten clients, there is what Slawsonl calls, ’the recognition that man is essentially a group animal. The destiny of man, savage or civilized, is irrevocably tied up with the group. His growth and development are conditioned by the group’s values and attitudes. In the healthy personality, group associations expand to include ever wider areas and larger numbers of persons.’ Slavson lists a series of different group treatments that he differentiates according to what he calls ’depth’ of the therapeutic effort. The three distinct levels of depth that he distinguishes, he calls counselling, guidance, and
NOW, the important
psychotherapy.2 In addition to the difference in technique between a psychoanalytical type of group, such as Slavson describes, and a humanistic-oriented group, such as the ones which the author has been running, there exists the difference between the type of leadership that the social worker is expected to provide to these groups. John Rowan calls this difference the ’same-level leadership’ and the ’other-level leadership’. In a paper entitled ’A Humanistic Psychologist Looks at Groups’, he describes same-level leadership as ’the establishment of such a climate (of psychological safety) is largely the responsibility of the trainer. Although he makes it clear that the group members are responsible for setting their own goals and making their own he sets the pace by expressing his own feelings openly and honestly, by supporting the honest expression of feelings by others, and by serving as a helpful model in absorbing expressions of hostility and frustration without becoming defensive. He also gives and encourages others to give descriptive, rather than evaluative feedback : for example, not, ’you’re being bossy’, but ’it made me uncomfortable when you said that!’ Rowan continues to describe other levels of leadership as that where ’we find that the leader acts out a role of being neutral or of being interpretative. By ’acts out a role’ I mean that he does not behave as he would normally behave in any group in which he was trying to be himself. By ’neutral’, I mean that he may refrain from commenting when it would be normal or natural for him to comment, or even refuse to answer questions addressed to him. Or, he may simply reflect back what is said to him without disclosing anything of himself at the same time or at any time. By ’interpretative’ I mean that he utters sentiments which sound as though they are meant to be objective judgements on what is happening in the group, or what individual behaviour means. They are not put forward as personal reactions of his own. (though often they may be put forward with mock-modesty ’it seems that...’ or ’it would appear that...’ or ’it is as if ... 1.3...
analysis,
,
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The same-level leadership, and humanistic or human potential group treatment is not more than twenty years old. It is an alternative approach that aims at both objective and subjective aspects of human functioning, and uses both objective and subjective methods of research. It bases its stand-point on bettering the human condition. It aims at self-fulfilment and self-actualization, not only of the persons who are the object of research or therapy, but also of the researcher or the therapist himself. This implies an orientation on human values which differs fundamentally from the values of behaviourism and psychoanalysis. The main value is in enhancing the intrinsic potential of every human being. The human potential movement assume that man is innately good, capable of love, joy and creativity. Man is considered emotional and intuitive as well as a cognitive and rational being. One of the main goals for the social worker working in this field of group treatment is to try and change or alter the life-style of the individual. This is in contrast with attempting to change separate behaviour patterns (as behaviour therapy might aim) or to better control and understand the instinctive impulses (as psychoanalysis might aim). Humanistic forms of group therapy were considered by one of the forefathers of the human potential movement, Abraham Maslow, as ’a viable third alternative to objective, behaviouristic (mechanomorphic) psychology, and to orthodox Freudianism. It is beginning to be used especially in education, industry, religion, organization and management therapy, and self-improvement ...’.4 The philosophy of the human potential movement can be traced back to the writings of Husserl (1859-1938), Max Schler, (1874-1928), and Heidigger (1889- ) who worked towards emphasizing subjective investigation, and opposed positivism. They all argued that the nature of science is essentially unclarified. Phenomenologists argue that mental life is susceptible to scientific enquiry by the method of understanding, thus, phenomenology attempts to understand the nature of subjectivity. The idea of holism comes also from a different school, the Berlin Gestalt school; Wertheimer (1945), Kohler (1929) and Koffka (1935) discovered that, in perception, the whole is more than the component parts. They demonstrated that perception might be a basic entry into the study of fundamental psychological processes. Their scientific methodology discovered some basic principles that became of great influence later in this century (e.g. the field theory of Kurt Lewin, Gestalt therapy of Perls, of which a further discussion follow, and others). Within the human potential movement, and with clear potential to be used by social workers in their practice, either individually or in groups is a technique developed by Carl Rogers forcounselling called client-centered therapy. By stressing the points that the therapist, 1) be empathetic to his client, 2) accepts the client as he is, and 3) acts in congruence to his own nature Rogers established the principles fundamental to his counselling approach. In this way, the emphasis was on the quality of the relationship between the social worker or counseller, and client. Rogers believed the self-actualizing nature of man will lead an individual to personality growth when that individual is given the right climate for selfexploration. Another technique was developed by Eric Beme, and is a method of psychotherapy called Transactional Analysis, in which, popularizing some of the basic principles of Freudian psychology, Berne offers an easy to gasp language to use in his treatment. For example, the id ago and super ego of Freud’s originating are renamed Child, Adult, and Parent respectively. The interactions that go on between these three now-embodied ego states are described in several of Berne’s books, the most popular being Games People Play. Wilhelm Reich and his work focus mainly on how the social environment distorts and inhibits the physical
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141 structure of the human body. Reich believed that healthy personality was an impossibility so long as an individual defended himself from totally experiencing sexuality and other vital emotions. Reich was convinced that by repressing the emotions, one produces a chronic muscular tension which he called ’muscular armour’. Reich’s psychotherapy includes forms of direct physical massage, placing his patients in body-stressing exercises and giving breathing instructions. Reich’s ideas have recently grown into a school of psychotherapy loosely known as bioenergetics. The form of group treatment that the author is mainly concerned with is that developed by a German-born psychiatrist, Fritz Perls. Perls conceptualized and developed a theory of health and neurosis called Gestalt therapy. This theory, based upon studies of psychoanalysis and Gestalt psychology stresses the phenomenological and existential point of view. By including the here and now philosophy of Zen Buddhism, Perls succeeded in combining the above disciplines into one integrated
theoretical framework. Within the human
potential movement, we see some diversity of approaches (Rogers, Beme, Perls, Reich, etc.) but they have one thing in common : they all view man as a self-creating being. That is to say they see man as creating his own destiny in life. Each views psychological disorders as blocking the natural creative process of living. Thus, these humanistic approaches work toward increasing capacity one’s own life, and to make one’s own existential choices, i.e. to become the of one’s own fate. In social work practice, Gestalt therapy can be useful as a system of integration that emphasizes the essential unity of all systems involved in person and personality. ’One way that this is manifested is in the emphasis that Gestalt places on the different languages, both verbal and non-verbal, with which a person speaks : for example, one language concerns the content of what I am saying; the second language concerns the music and rhythms of my voice and breath : the third language concerns the postures and gestures of my body.’5
to live master
Part II of
Methodology commencing therapy group (as used by author in settings during 1977). A) the here and now principle. By far the most important principle of humanistically oriented Gestalt therapy groups is conceptually being ’here and now’. The a
Gestalt
two
author suggests to the group to use sentences such as ’here and now’ and ’now I am aware of ...’. ’These sentences are chosen not only to bring out the top layer of the patient’s character formation, and some of the more primitive resistances, but also to clear the path to the recognition of all his functions, especially his disfunctions, conflicts, attitudes of escape.’6 Past situations can also be expressed in the present tense, i.e. ’I used to be frightened of my father’ can be turned into ’I am frightened of my father’. The use of the present tense acts to bring the experience to a closer and clearer perceptual focus. This allows the client to express the experience in a more complete way, and appreciate the significance of the situation. By including the postulate of ’being here and now’, the experience of sensations and feelings is heightened, and this leads in a group situation to a mutual exploration of feelings. This, of course, is in opposition to using purely verbal and intellectual terms. B) communications are placed in an ’I-Thou’ configuration. The purpose of this is to obtain the impact of clear, direct communication, cause and effect and counter cause and effect thus occur. By not employing the ambiguity of generalized Downloaded from isp.sagepub.com at NANYANG TECH UNIV LIBRARY on May 22, 2015
142 statements, the social worker is able to heighten the feeling level where group interaction and effect become dominant, and verbalizing again diminishes. Fritz Perls in ’The Rules of Gestalt Therapy’ suggests several linguistic changes. It to I, can’t to won’t, thus putting greater responsibility upon the abilities of the client. But, and if to and, thus allowing the ambivalence of a statement to be self-discovered. Would, want, should, must, have to and ought, into need or like to, thus showing the confusion between real needs and trivialities which assume an unreal level of
importance. C) changing WHY questions into how, what, who, where, when. This is a technique which dissolves rationalization and places the therapeutic importance on the degree, extent, and modality of the experienced behaviour. D) form and context. The therapist needs to listen to the voice as well as the material spoken. As stated before, in the introduction to this paper, when the voice and material match each other, the patient is then expressing a unified Gestalt. E) appreciations. These are used for reinforcement to behaviour and thoughts that one is expressing or exhibiting. Usually, actions are overlooked when appropriate, and only criticized when inappropriate. In a group with Gestalt orientation, the social worker is encouraged to give reinforcement that is positive to behaviour that is experienced as healthy or nourishing. e.g. ’I appreciate the way that you speak directly about yourself’. F) resentments. Behaviour that is toxic, and experienced as painful or uncomfortable is very often harshly criticized. When doing this, one learns which behaviour is disliked, but the patient acts towards this particular behaviour as his critic would, becoming the punisher of his own impulses. Instead of allowing this harmful language structure to persist, the Gestalt worker encourages the expression of ’resentments’ and also the ’demands’ that are also implied. e.g. ’I resent the way you speak so softly, and would like you to speak more forcefully.’ In this way, negative reinforcement is implied, but a positive alternative is expressed for assimilation and reintegration. G) rehearsals. As few clients say exactly what they think, by asking them to say what they are rehearsing, it often allows them to 1) become aware that there is an internal dialogue going on in their minds, and 2) realize this holding back of speech is unhelpful to the spontaneity of the therapy session. H) reversals. When a patient expresses an aspect of himself that seems ’improper’ or ’out of context’ the therapist can suggest to the patient that he say exactly the opposite. The effect of this reversal may reveal where the patient has failed to integrate a part of his personality. The reversal can demonstrate to the patient how he has overcompensated for a situation which he could not cope with at an earlier time. A verbal description of a feeling may conceal a wish or need to express the opposite, e.g. ’I hate you’ may conceal ’I like you very much and would like you to like me’. This, sometimes, provides surprising insights for the patient. Many of the techniques described above can he clearly seen in the verbatim transcript of a session of Gestalt therapy conducted by the author. As the transcription of this session has been done verbatim f and therefore no comments are incorporated simultaneously), it might be useful for the reader not familiar with the techniques of Gestalt therapy to refer to this methodological passage in trying to understand what is taking place in this therapy session. FOOTNOTES
1.
Slavson,
S. R.: An Introduction to
Group Therapy,
International Universities Press,
p. 1.
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1973,
143 2.
S. R.: ’Types of Group Psychotherapy’ in The Challenge of Group Psychoed. Stefan de Schill, International Universities Press, N.Y. 1974, p. 55. 3. Rowan, J.: ’A Humanistic Psychologist Looks at Groups’, MS. 4. Maslow, A.: Towards a Psychology of Being, 2nd ed. NY, Van Nostrand Reinhold, 1968,
Slavson, therapy,
p. 3.
5.
Balogh, P.: ’Gestalt Awareness’ International Journal ofSocial Psychiatry, vol. XXII/I, Spring, 1976, p. 65. 6. Perls, F.: ’Theory and Technique of Personality Integration’, The American Journal of Psychotherapy, vol. II, part 4, 1948, p. 576. ADDITIONAL BIBLIOGRAPHY ON GESTALT on
which much of the
methodological part
THERAPY, is based.
Levitsky, A. and Perls, F.: The Rules and Games of Gestalt Therapy; published in Gestalt Therapy Now, Editions Fagen, J. and Shepherd, L, Penguin Books Ltd, Harmondsworth, Middlesex, England, 1972. Selman, R. H.: Unpublished doctoral thesis on Gestalt therapy, University of Surrey. Perls, F. S.: Ego, Hunger and Aggression, N.Y. Random House, 1947. - Gestalt Therapy Verbatim, Lafayette, California, Real People Press, 1969. Perls, F. S., Hefferline, R. and Goodman, P.: Gestalt Therapy, New York, Dell Publishers, 1951.
BACKGROUND INFORMATION What follows is a transcript of a group run by Ronnie Felton at Accept on 25th October, 1976. This was the third session with this group. A previous attempt to record a second session was unsuccessful due to technical failure. In this particular session there were nine people present apart from the therapist, eight of them patients at Accept and one co-therapist/student Miss Pat Bellamy. Three of the patients are present for the first time, of the remaining five, I wish to draw the attention of the reader to Mary who already in a previous session has expressed her desire to work on her anger, and at the same time was unable to pursue this matter any further due to her own inhibition. Mary had promised the group that she would work on her anger in the following session (second session) but failed to turn up to this session. On commencing the group and whilst installing the tape recorder some coffee was spilled accidently on one of the new patients’ foot. This gave cause to a great amount of laughter relieving some of the tension present in the room.
Monday,
,
Ronnie, Mary, and Fred.
are trying to work in this group not with thoughts if possible, but with feelings. Feelings that can start with just your body feelings to feelings that you can feel deep inside you. Anne: While I have had a very frustrating day I’ve been to the labour exchange and to social security. Ronnie: What do you feel right now at this moment?
Ronnie: We
Anne: Resentful. Ronnie: Where do you feel resentful? Anne: Because I (interupted by Ronnie) Ronnie: Not why, where do you feel resentful? where because if you’re feeling it, it must be somewhere. Where do you feel it? (Ronnie repeats) Where do you feel resentful ? Anne: In my head. Ronnie,: Can you place it somewhere specific in your head? Downloaded from isp.sagepub.com at NANYANG TECH UNIV LIBRARY on May 22, 2015
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Anne : Well it goes to thoughts. Ronnie: Where in your head see, try this a minute, close your eyes then take a deep breath of air, try being as relaxed as you possibly can, just explore the whole of your body with your awareness, try if you can not to smoke just for a few minutes while you are doing this exercise. Try to remain with the air and try to be as relaxed as possible and just try to explore with your awareness. Imagine that your awareness is like a little torch and that you can shine it to different parts of your system (slowly) and you become aware of your feet and then aware of your knees and now you can become aware of your nose, now where do you feel resentment, you say you feel resentment in your stomach? Do you feel resentment in your heart? Do you feel in your head? Anne: In my heart. Ronnie: How does it feel like? What kind of feeling is this feeling of resentment? Anne: Frustration mostly. Ronnie: Yes, and how do you pick it up, what is your perception of the feeling? (long silence) What do you feel with your heart? (long silence) Anne: Oh just resentment with red tape. Ronnie: I am interested in how you feel this resentment can you describe it, is it a pain, is it pressure? You said you felt it in your heart, do you feel it? Try to stay in contact with how this feeling manifests itself physically. How do you pick it up? Because what you are talking about is what you are thinking about a feeling, you are telling me that you know the reason i.e. you’ve had a lot of hassle with the social security and therefore you are explaining at a rational level why you are supposed to feel something. What I’m asking is how does this feel? What do you experience? Just how do you pick it up in your body, in your system? Like when I get very frightened. I know I got very frightened because a big man was jumping at me with a stick, that was the explanation that’s like the social security bit, but what I feel is sort of a strong squeeze in my stomach, that is the way I experience fear and I can feel my heart beating very fast. I feel I sort of gasp for air when I’m frightened. Do you follow what I’m trying to say? Anne: Yeah. Ronnie: What I’m asking you is ’How do you feel right now in your body? (silence). Perhaps just try going through your whole body, come on, just close your eyes, tell us how your body feels. See if you can keep your eyes closed and just focus your awareness on your toes. Can you feel your toes? Anne: Yes. Ronnie: How do you feel? Are they warm, are they cold? Anne: There’re warm. Ronnie: Are they relaxed or are they tense? Anne: They are relaxed. Ronnie: What else do you feel in your toes? Do you feel anything else? Anne: No. Ronnie: Move up to the whole of your feet, what do your feet feel? Anne: The same. Ronnie: The same, how? Anne: Warm and relaxed. Ronnie: Do you feel wet or has the coffee dried up? Anne: I suppose the coffee has dried up. Ronnie: You are moving your foot now, how does that feel? (silence) Would you like to stop now? You know you are perfectly entitled to stop wherever you feel like it. resentment
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-Anne: I would rather. -Ronnie,: That’s fine if you feel that at one point you want to stop (addressing the ~est of the members of the group) you just stop. Thank you, Anne o.k. (addressing -other member of the group) You’re also here for the first time. -4lbert: I’m not at Accept for the first time. I liked your group, I think I saw you -for a few moments last week but I was out at work and therefore couldn’t come. My name is Albert. Thinking of what you said to Anne about how do you feel from your toes up, I have a sore ankle and a sore knee and a sore hip; it’s rheumatism, it’s arthritus and there’s nothing they can do with it, I just have to put up with the pain. Ronnie: Is that the main thing in your awareness right now? Albert: Yes, my awareness right now is on the aching. Ronnie: What would you like to do with that pain ? Albert: I’d like to get rid of that, I know that of course and I don’t believe anything can be done with it.. There’s no point fighting. I’ve had medical advice, I could take tablets but then I’d rather not take any tablets. I used to take tablets like peppermints to kill the pain but I don’t take any at all now. I think it is better to put up with pain than to put up with a sick head all the time, at least you’ve got a mind of your own. Ronnie: You were drinking because you wanted to get rid of the pain? Albert: Possibly I started drinking to get rid of the pains. Ronnie: (addressing a new person) I don’t know your name either. Barbara: No, my name is Barbara. Ronnie: I’m Ronnie by the way if you didn’t know who I was (laughter in the room, some comments of, ’oh yes we knew who you were’, ’anyway, we were told last week.’) Barbara would you like to tell us how you feel? Barbara: I feel a little tense ’cause I’ve been rushing around all day, my mother is not well and (Ronnie interrupts) Ronnie: Can I just stop you a minute? Just like Anne, you are telling us the reasons and I would like you to tell us just how you feel. Can you just stop a minute and tell me where do you feel tense? Barbara: Pardon? Ronnie: Just tell me where you feel tense. Barbara: Well, maybe in my stomach. Ronnie: I don’t know if it’s my fantasy or not, but I see you sort of moving your shoulders and I wonder if you feel tense in your shoulders? Barbara moves her head negatively. ’ Ronnie: Well so then it’s in your stomach, can you describe what is your feeling in your stomach, what do you fantasize is making your stomach feel that way? Barbara: I just feel that there’s something there and I can’t relax it. Ronnie: What is there? This is just a fantasy - imagine what do you have there? This is a fantasy, just imagine what is gripping you there, Is it a hand? Is it a tool? Just imagine what it is. Barbara: It isn’t a hand or a tool or anything, it just feels like the nerves in my stomach. Ronnie: The nerves in your stomach : can you try and do an exercise like in imagining things? This is the way we work in Gestalt, would you like to try it? I’ll show you. I need to borrow a pillow, can anybody lend me a pillow. (laughter and comments of ’oh yes, now she’ll have to speak’ and deep embarrassment of Barbara), What I’m trying to do is something quite new and quite different and if you want to just experiment with it. But if you feel very, very uncomfortable, just leave it.
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146 What I’d like to do is that I would like you to imagine that you can take those nerves, those very nerves that are inside your stomach and that are locked up, and imagine that you can take them away from your body and put them on this pillow, it is like a game, it’s like children can imagine that they are King Arthur, or Alice in Wonderland. I want you to take those nerves and put them out on this pillow and imagine that you can talk to them. We will create a role playing situation where you can talk to those nerves that are tensing up your stomach. Barbara: Inwardly? Ronnie: No, outwardly. You see I put out these nerves on the pillow, imagine that you can take those nerves, just the imagining bit, imagine that you can take those nerves and put them on the pillow so that now these nerves are out there sitting on a pillow. O.K. Can you do that? Barbara: You mean I have got to say ... Ronnie: No, you don’t have to do anything, I am suggesting something that you could try. Barbara: You want me to sit there ?
Just try.
Ronnie: No, no. Imagine that the nerves that are gripping your stomach, only that part of you not the whole of you. You are sitting on the chair there right now, right, but you’re taking a part of Barbara, that part that is gripping your stomach that you called ’nerves.’ You take them away just as an exercise, momentarily you take them away from your body and you imagine that you can put them on that pillow there magically, and now you’ve got the nerves that are gripping your stomach, they’re still there in your stomach, and at the same time you have put them sort of out here and you can talk to them. You can have a dialogue with them, you can ask them questions. You can tell them things. See if you can do that. Barbara: I don’t think I could do that. Ronnie: Try it. Barbara: I might want to sit down and sing. No, I’m not able to do that, I’m not able to do it outwardly. Ronnie: Come on, say something. Ask them if they’re there. Barbara: No, no I don’t want to. Ronnie: What do you feel is difficult about this? Barbara: Well, I just feel I’m nervous. Ronnie: Other people have done this last week, Mary was for instance going to work with her anger and (switching towards Mary) I think you were going to work this week wasn’t it, or (sarcastically) was it next week?
Mary coughs. Ronnie: I didn’t hear you. I said I don’t know. /~o7ZM~.’ Do you still feel angry? Mary: Well, I suppose a bit. Ronnie: Can you think at who or at what you feel angry? Mary: Oh well, lots of things, I always feel like that you know. Ronnie: Right now, what do you feel angry about, could it be you feel angry at me because I’m suddenly shifting the attention from Barbara to you? Mary: Yes, yes. Ronnie: You were nice and comfortable there while everybody was focussing on Anne and suddenly I just go boom and I go ’Mary’ and you’re the centre of attention. Mary: (all the time) Yes, yes, yes. Ronnie: That must really piss you off.
Mary:
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Mary: Yes, yes, yes. (to other members of the group) He’s getting me angry. Ronnie: So, how do you feel now, that I have taken you from your quiet and nice and protected little corner over there and now everybody is looking at you and expecting you to be angry ? Mary: Yes, I do feel a bit angry, even though I’m laughing, it’s a sort of an angry laugh. Ronnie: A bit angry, a bit a bit. So look, I’m going to make a suggestion. Take a cushion (laughter in the whole room) and imagine that I am on that cushion. (laughter) So imagine that you can put me on that cushion and I’ll sit back here that I’m really on that cushion, the part of me that’s you, the part of me that you’re angry with will be on that cushion, can you imagine that? Mary: Oh yes.
Ronnie: So go ahead and tell me what you think about me, tell Ronnie what you think about him. Mary: I think your’re a nasty probing person. (laughter) Ronnie: Say that again. Mary: Ronnie, your’re a nasty probing person, Ronnie your’re very nasty, probing and I don’t like you. If I want to be angry leave me alone with my anger. I don’t want you probing. Ronnie: Make that even stronger. Mary: I don’t want YOU probing into it, otherwise I’ll be angry with you. Ronnie: What is it? Mary: It is my ... well I don’t know. Ronnie: Well try me. I don’t want you probing into me. Mary: I don’t want you probing into me. Ronnie: Make that a strong assertion there. Mary: (louder) I don’t want you probing into me. Ronnie: Now what I want you to do is to switch places, sit on the pillow and you be Ronnie, faced right there you will be talking to Mary. Talk to angry Mary there. Now you are Ronnie there, probing Ronnie, go ahead probe into Mary’s anger. Mary has told you she does not want you to probe into her anger, how do you feel about that. React to Mary, talk to Mary who is there in that brown chair. Mary : (angry) But what? Ronnie: You are Ronnie, practise you can say I am Ronnie, I am here for ... tell us what you’re here for. Mary: I am Ronnie (laughter) I am here to help you get rid of your (laughter) ... Ronnie: Come on, you’re doing fine. Mary: I am here to let you get rid of your inhibitions. (silence) Now I’m Ronnie
talking to Mary. Ronnie: Continue ’I am Ronnie, I am here to let you get rid of your inhibitions ...’ I am Ronnie, Mary I am Ronnie and I am here to help you get rid of your anger. Ronnie: How do you do that? How do you help Mary get rid of her anger? (silence) Mary: I don’t know (laughter) if I knew I wouldn’t just sit here. Ronnie: It’s the part of you Mary that knows. Say whatever comes into your mind. You play the role now, you can make all the decisions. How will you help Mary get rid of her anger? Mary: I don’t know. I’m asking her. Ronnie: You are Ronnie now you can do whatever you want. What do you think would be a good idea?
Mary: (real slow)
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148 Well I suppose take away the cause that is causing the anger. Ronnie: Go ahead, tell Mary what you are going to do. Mary: Mary, we must remove the cause that is causing your anger. What is
Mary:
causing
your anger? Ronnie: O.K. switch places. (addressing the whole group) Everytime that we do role playing, when you ask a question, it’s part of the technique that we switch places. O.K. So there is Ronnie asking you all what has caused your anger, now you are Mary so answer Ronnie’s question. Mary: I don’t know what is causing my anger. I think I’m better when I’m myself. I don’t know what’s causing my anger, I just wake up with it. Anger and despair. Ronnie: Tell me what you want of him. Mary: So Ronnie (addressing the pillow) would you please get rid of this anger, I don’t want it to be here Ronnie: That is a request, switch places. So now you’ve got Mary there who has asked you to please help me get rid of this anger. How do you reply to that request? Mary: (very seriously, ’with a professional attitude’) What is causing your anger? Ronnie : You have asked a question again. Switch. Mary: (as Mary) The thing is I don’t know, that is why I’m asking you. Oh I am myself again. Ronnie, can you help me to get rid of my anger? (as though she were rehearsing) Now I am back to square one again. Ronnie: You have got into a vicious circle can you help me to get rid of my anger? What is causing my anger, what is causing my anger etc., etc., See if you can get unstuck, see if you can find another line, what do you want from Ronnie right now? Be more specific. Ah, you want to be Ronnie. Mary: (standing up) I don’t know. Ronnie: Choose whoever you want to be, go ahead choose. Mary: Well if I’m myself I know that I want to get rid of my anger. I think Ronnie has to solve it. Ronnie: O.K. Then tell Ronnie what do you want from him. How do you expect him to get rid of your anger? How do you expect him to do it? Tell him specifically what your expectations are, to the Ronnie there on the pillow. Mary: (very calmly and emphatically) Ronnie, I expect you to help me get rid of my anger, and I expect you to know how, and I expect you, you know, to help me get rid of it. Ronnie: Tell him specifically. Mary: Well you must have a way to help me get rid of it. Ronnie: What kind of way? Tell him specifically, you could either this or you could that... Mary: You should be able to find a way to help me get rid of my anger. Ronnie: What kind of ways do you think he might find, tell him what other kind of things would you expect him to do? Mary: (thinking) I don’t know. I don’t know how you can help me get rid of it. Ronnie: What kind of ways might you use? What would be a good way to help you get rid of your anger? Mary: You could help me to get rid of all these little problems that keep drawing me away. Ronnie: How do you think he can do that? Mary: By helping me to relax. Ronnie: Can you tell him that? O.K., that’s a good one. Helping you to relax. Now what else ? That is something concrete.
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149 Well I think helping me to relax could help me to solve lots of things, ’cause then I could put my problems in a rational way instead of jumping sort of from one thing to the other, thinking about this and then thinking about that and then thinking about this. Ronnie: Well tell him that, say I want you Mary I want you to help me to relax. Ronnie: O.K., switch places. Now listen Mary has asked you for something. She wants you to help her to relax. How do you re-act to that? Mary: Am I Mary now? Ronnie: No, you’re Ronnie now. Mary: Well it’s very difficult for me being you, because you are you and I’m not you. Ronnie: You’re not exactly me, you are the Ronnie inside you. We all have different aspects of our personalities. Ronnie represents the part of you of which you have all your expectations, you expect him to help you, you expect him to be able to provide you, it is your father figure if you want to use those words. It is the person that you are saying to ’I want you to help me sort out my problems’. That part is also inside you. You will find that inside Mary there is also a part, there is a part of Mary’s personality, part of Mary’s person and we have called it Ronnie. Therefore you are Ronnie now. You are the Ronnie to which Mary has just said I want you to help me to relax. What will you answer to that Mary that is there sitting in the chair? Mary: (in a very relaxed and professional voice) Mary, you must try to relax, if you relax you can solve lots of your problems. You can control things better. Ronnie: Instead of ’if’, try - you can relax. Mary: You can relax and therefore you can control things better. The important thing is to relax. Ronnie: Tell Mary how can she relax. How can she achieve this being relaxed? Tell Mary, you now are Ronnie, you are the therapist, you can tell her in a real authoritive manner what she can do to relax. What is a good way of relaxing?
Mary:
Mary: (long silence) Ronnie: She has just said to you ’I want you to help me to relax’ and now you need to help her. How can you help her to relax, because that’s what she wants you to do. She wants you to help her to relax. There’s all kinds of things you could do. Mary: (talking to herself) Mary if you let your mind just slow down a bit and think of each problem as it comes instead of trying to cope with everything (interrupted by Ronnie). Ronnie: Try to make that into a statement instead of using ’if’, tell her what she should do. you should try to cope with each thing individually and not try to solve all your problems at one, that won’t get you anywhere, with that you’re just going round and round and not arriving at anything. Ronnie: Say that again. Mary: You’re going round and round and not arriving at any solution. Ronnie: Say that many times. Mary: You’re going round and round and not arriving at any solution, You’re going round and round and not arriving at any solution. Ronnie: Switch places. You’re Mary - now Ronnie has just told you that you just go round and round and you don’t arrive anywhere. Mary: Well yes this is true. I am going round and round and not arriving anywhere, and this is making me very angry. This is what’s causing my anger because I’m continually searching for a solution to my problems, and that however I think, the further away I’m getting from solving them and it is causing me to be very very angry.
Mary: Mary
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150 are you angry with? I’m angry because I’m not arriving at a solution of my problems. Ronnie: How is that? Mary: Because I’m not finding a solution to my problems. Ronnie: So who are you angry at? Mary: I am angry at my mind. Ronnie: Well we started off that you were angry with me and now, (addressing other members of the group) could I have another pillow please? O.K. Here we’ve got another cushion, so now the cushion over there, that is Ronnie and while you’re sitting on the chair that is you Mary, and try to put your mind on this new cushion here. So now we find out that it is not actually Ronnie that you are angry with, you’re angry with your mind, so go ahead and tell your mind what you feel about it. Mary: Mind, I’m very annoyed with you. Ronnie: (interrupting) Well done, go ahead, be really annoyed - allow yourself to be really annoyed. This is your chance to get really annoyed. Mary: (shouting) I am annoyed with you, in fact I’m furious with you. Ronnie: Go ahead, be furious.. Mary: I’m really furious. Ronnie: This is your big opportunity, you can really be furious. Mary: (addressing her mind) There you’ve got me every day going round and round and in circles. It is going on for hours and days and weeks, I can’t stand anymore from you. Ronnie: Tell that again. Mary: I can’t stand anymore from you. (shouting) Ronnie: Say that again louder. Mary: (shouting) I can’t stand anymore from you, I can’t stand anymore from you. Ronnie: Come on make it even louder. They should hear you in the other room. Mary: (shouting even louder) I can’t stand anymore from you. Ronnie: Louder. Mary: (screaming) I can’t stand anymore from you. (once again screaming even louder) I can’t stand anymore from you. Ronnie: (very gently) Try not stopping yourself, just allow your anger to come out. Mary: (once again screaming) I can’t stand anymore from you. (shows signs of
Ronnie: What
Mary:
beginning to get tired) Ronnie: (very gently) Carry on. Express some more
of your anger, tell him what else
you want to say to him.
You’re not solving anything, you’re just a continual eternity of problems. I can’t stand it anymore (very loudly) You don’t solve anything. I have these problems going round and round in my head and you don’t do anything to help me. You don’t solve anything. It’s the same thing day in and day out. You’ve got me nervous and upset and tut tut tut. Ronnie: Go ahead blame him, you can really blame him, he’s got you nervous, he’s got you upset, what else ? Go ahead tell him. Mary: You know to do anything. I can’t function properly because of you, you are the cause of all my unhappiness. Ronnie: Say that again. Mary: You are the cause of all my unhappiness. Ronnie: Say it again louder. Mary: You are the cause of all my unhappiness. (louder) Ronnie: Try and really blame him, put the accent on the you - you are the cause.
Mary:
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151
Mary: YOU are the cause of all my troubles, you are the cause of my unhappiness. Why don’t you do something about it? Ronnie: Switch places. That was a question. O.K. Now you are Mary’s mind, now you can answer Mary, why don’t you do anything about it? You are the cause of all her unhappiness, you are the cause of all her problems. Mary : (playing mind) Mary, why are you so upset with me? Ronnie: She’s told you, you are the cause of all her problems. (long silence) Mary: Mary why don’t you stop, why do you keep running away from your mind? Ronnie: Why do you keep running away from me? Mary: Why do you keep running away from me? You seem to be something apart
from your mind sometimes. Ronnie. : You seem to be something apart from me sometimes. Mary: You seem to be something apart from me sometimes. And therefore it is very difficult to help you. I’d like to help you at times but you just seem to be like something apart and it is very difficult to do anything to help you. Ronnie: Can I suggest a sentence? If you feel that it feels o.k., you can say it and if not, you just leave it. Mary: O.K. Ronnie: I’ll try to be with you but you won’t accept me. Mary: I don’t think that’s true. Ronnie: O.K. then leave it. Mary: (slowly thinking again about the sentence) I don’t think that’s true, it seems as though the two things are apart, the body is sort of trying to go one way. Ronnie: Say then,I am apart from you, your mind right and you’ve got Mary sitting over there in the chair. Mary: (addressing herself in the chair) Mary, why don’t you try. You’re not - you’re not co-operating with your mind. Ronnie : You’re not co-operating with me. Mary: You’re not co-operating with me, and therefore I don’t think I can help if you are not co-operating with me. Ronnie: What do you want then? Make a demand. Say ’I want you to’ ... tell her what you want, make a demand, you’ve said ’if you.’ You mind - tell Mary what you want from her. Mary: Mary, I want you to think of me as something that is here to help you, but if you do not use me then I can’t do anything to help you. Ronnie: Make a demand without any ’but’s’, just tell her what do you want. Mary: Mary, why don’t you use your mind? Ronnie: That’s it - make a demand. Mary: Mary, use your mind. Mary, why don’t you use your mind? Ronnie: That’s a question, I am suggesting that you make a demand. Say ’I want you to ...’ Mary: I want you to use your mind. Ronnie: Mary, I want you to use me. Mary: Mary, I want you to use me. Mary, I want you to use me (repeating ’I want you to use me’). Ronnie: Switch places. How do you reply to the request that your mind wants you to use him? Mary: Mind, this is true. I haven’t used you properly and I think I’ve forgotten how. I used to use you properly and then suddenly I just came away from you. Ronnie: How did you get away from your mind? Can you tell your mind how you
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152 did this? We seem to have drifted apart somehow, I seem to have lost you somewhere. Ronnie: How did you do this? How did you loose your mind - your contact with your mind ? How did you loose your relationship with your mind ? Mary: I don’t know, Mind, what happened? One day I just, suddenly, decided to get rir of you. I don’t know what happened. Ronnie: Who do you think might know what happened? Mary: I don’t know. Ronnie,: How about asking Ronnie? Mary: (addressing pillow with Ronnie) Ronnie, do you know how my mind and I drifted apart? Ronnie: O.K. Switch places. Mary has just asked you a question. How come that she and her mind drifted apart? Mary: (being Ronnie, very professional) Mary, you’ve drifted away from your mind and you feel a sense of loss and bewilderment and you are concerned that you are not getting very far. Ronnie: (addressing Mary on Ronnie’s pillow) Can you explain to Mary how she drifted away from her mind? How did this happen? Mary: (very very slowly) Mary, you drifted away ... because ... you like to rebel against pain, you felt you could do your own thing and - but you can’t - it is not possible (addressing the therapist) That’s not going to solve how to get my mind back (at this point three of the members of the group sit up stating that they have to leave and Mary interrupted her train of thoughts and wondered if she had been boring the rest of the members of the group) Ronnie: If you think you’ve been boring the members of the group, why don’t you ask them? Fred: You’re not boring me, I am very interested in what you are doing. Ronnie: What do you feel about Mary’s work Fred, do you feel she is getting anywhere right now ? At this point the tape came to an end and as it was nearly time to bring the group to a close. No further recording was attempted.
Mary:
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GESTALT THERAPY AND SOCIAL WORK R. FELTON
This paper intends
looking at groups, their use in social work practice, and the of the approaches derived from the human potential movement social work group practice.
specific application to
more than ever, with the gradual reduction of the resources available to social services department, the use of group settings is becoming more and more in social work practice. No longer does the social worker have time available to devote to each individual client in such a way as to pursue in-depth case work in many cases. A good alternative, especially for the client that does not need such a deep level of involvement, but nevertheless seeks constant and continuous support, is that of group treatment. In addition to the economic rationale behind starting group forms of treatment or work within a social services setting, thus enabling one worker to deal simultaneously with over ten clients, there is what Slawsonl calls, ’the recognition that man is essentially a group animal. The destiny of man, savage or civilized, is irrevocably tied up with the group. His growth and development are conditioned by the group’s values and attitudes. In the healthy personality, group associations expand to include ever wider areas and larger numbers of persons.’ Slavson lists a series of different group treatments that he differentiates according to what he calls ’depth’ of the therapeutic effort. The three distinct levels of depth that he distinguishes, he calls counselling, guidance, and
NOW, the important
psychotherapy.2 In addition to the difference in technique between a psychoanalytical type of group, such as Slavson describes, and a humanistic-oriented group, such as the ones which the author has been running, there exists the difference between the type of leadership that the social worker is expected to provide to these groups. John Rowan calls this difference the ’same-level leadership’ and the ’other-level leadership’. In a paper entitled ’A Humanistic Psychologist Looks at Groups’, he describes same-level leadership as ’the establishment of such a climate (of psychological safety) is largely the responsibility of the trainer. Although he makes it clear that the group members are responsible for setting their own goals and making their own he sets the pace by expressing his own feelings openly and honestly, by supporting the honest expression of feelings by others, and by serving as a helpful model in absorbing expressions of hostility and frustration without becoming defensive. He also gives and encourages others to give descriptive, rather than evaluative feedback : for example, not, ’you’re being bossy’, but ’it made me uncomfortable when you said that!’ Rowan continues to describe other levels of leadership as that where ’we find that the leader acts out a role of being neutral or of being interpretative. By ’acts out a role’ I mean that he does not behave as he would normally behave in any group in which he was trying to be himself. By ’neutral’, I mean that he may refrain from commenting when it would be normal or natural for him to comment, or even refuse to answer questions addressed to him. Or, he may simply reflect back what is said to him without disclosing anything of himself at the same time or at any time. By ’interpretative’ I mean that he utters sentiments which sound as though they are meant to be objective judgements on what is happening in the group, or what individual behaviour means. They are not put forward as personal reactions of his own. (though often they may be put forward with mock-modesty ’it seems that...’ or ’it would appear that...’ or ’it is as if ... 1.3...
analysis,
,
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140
The same-level leadership, and humanistic or human potential group treatment is not more than twenty years old. It is an alternative approach that aims at both objective and subjective aspects of human functioning, and uses both objective and subjective methods of research. It bases its stand-point on bettering the human condition. It aims at self-fulfilment and self-actualization, not only of the persons who are the object of research or therapy, but also of the researcher or the therapist himself. This implies an orientation on human values which differs fundamentally from the values of behaviourism and psychoanalysis. The main value is in enhancing the intrinsic potential of every human being. The human potential movement assume that man is innately good, capable of love, joy and creativity. Man is considered emotional and intuitive as well as a cognitive and rational being. One of the main goals for the social worker working in this field of group treatment is to try and change or alter the life-style of the individual. This is in contrast with attempting to change separate behaviour patterns (as behaviour therapy might aim) or to better control and understand the instinctive impulses (as psychoanalysis might aim). Humanistic forms of group therapy were considered by one of the forefathers of the human potential movement, Abraham Maslow, as ’a viable third alternative to objective, behaviouristic (mechanomorphic) psychology, and to orthodox Freudianism. It is beginning to be used especially in education, industry, religion, organization and management therapy, and self-improvement ...’.4 The philosophy of the human potential movement can be traced back to the writings of Husserl (1859-1938), Max Schler, (1874-1928), and Heidigger (1889- ) who worked towards emphasizing subjective investigation, and opposed positivism. They all argued that the nature of science is essentially unclarified. Phenomenologists argue that mental life is susceptible to scientific enquiry by the method of understanding, thus, phenomenology attempts to understand the nature of subjectivity. The idea of holism comes also from a different school, the Berlin Gestalt school; Wertheimer (1945), Kohler (1929) and Koffka (1935) discovered that, in perception, the whole is more than the component parts. They demonstrated that perception might be a basic entry into the study of fundamental psychological processes. Their scientific methodology discovered some basic principles that became of great influence later in this century (e.g. the field theory of Kurt Lewin, Gestalt therapy of Perls, of which a further discussion follow, and others). Within the human potential movement, and with clear potential to be used by social workers in their practice, either individually or in groups is a technique developed by Carl Rogers forcounselling called client-centered therapy. By stressing the points that the therapist, 1) be empathetic to his client, 2) accepts the client as he is, and 3) acts in congruence to his own nature Rogers established the principles fundamental to his counselling approach. In this way, the emphasis was on the quality of the relationship between the social worker or counseller, and client. Rogers believed the self-actualizing nature of man will lead an individual to personality growth when that individual is given the right climate for selfexploration. Another technique was developed by Eric Beme, and is a method of psychotherapy called Transactional Analysis, in which, popularizing some of the basic principles of Freudian psychology, Berne offers an easy to gasp language to use in his treatment. For example, the id ago and super ego of Freud’s originating are renamed Child, Adult, and Parent respectively. The interactions that go on between these three now-embodied ego states are described in several of Berne’s books, the most popular being Games People Play. Wilhelm Reich and his work focus mainly on how the social environment distorts and inhibits the physical
I
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141 structure of the human body. Reich believed that healthy personality was an impossibility so long as an individual defended himself from totally experiencing sexuality and other vital emotions. Reich was convinced that by repressing the emotions, one produces a chronic muscular tension which he called ’muscular armour’. Reich’s psychotherapy includes forms of direct physical massage, placing his patients in body-stressing exercises and giving breathing instructions. Reich’s ideas have recently grown into a school of psychotherapy loosely known as bioenergetics. The form of group treatment that the author is mainly concerned with is that developed by a German-born psychiatrist, Fritz Perls. Perls conceptualized and developed a theory of health and neurosis called Gestalt therapy. This theory, based upon studies of psychoanalysis and Gestalt psychology stresses the phenomenological and existential point of view. By including the here and now philosophy of Zen Buddhism, Perls succeeded in combining the above disciplines into one integrated
theoretical framework. Within the human
potential movement, we see some diversity of approaches (Rogers, Beme, Perls, Reich, etc.) but they have one thing in common : they all view man as a self-creating being. That is to say they see man as creating his own destiny in life. Each views psychological disorders as blocking the natural creative process of living. Thus, these humanistic approaches work toward increasing capacity one’s own life, and to make one’s own existential choices, i.e. to become the of one’s own fate. In social work practice, Gestalt therapy can be useful as a system of integration that emphasizes the essential unity of all systems involved in person and personality. ’One way that this is manifested is in the emphasis that Gestalt places on the different languages, both verbal and non-verbal, with which a person speaks : for example, one language concerns the content of what I am saying; the second language concerns the music and rhythms of my voice and breath : the third language concerns the postures and gestures of my body.’5
to live master
Part II of
Methodology commencing therapy group (as used by author in settings during 1977). A) the here and now principle. By far the most important principle of humanistically oriented Gestalt therapy groups is conceptually being ’here and now’. The a
Gestalt
two
author suggests to the group to use sentences such as ’here and now’ and ’now I am aware of ...’. ’These sentences are chosen not only to bring out the top layer of the patient’s character formation, and some of the more primitive resistances, but also to clear the path to the recognition of all his functions, especially his disfunctions, conflicts, attitudes of escape.’6 Past situations can also be expressed in the present tense, i.e. ’I used to be frightened of my father’ can be turned into ’I am frightened of my father’. The use of the present tense acts to bring the experience to a closer and clearer perceptual focus. This allows the client to express the experience in a more complete way, and appreciate the significance of the situation. By including the postulate of ’being here and now’, the experience of sensations and feelings is heightened, and this leads in a group situation to a mutual exploration of feelings. This, of course, is in opposition to using purely verbal and intellectual terms. B) communications are placed in an ’I-Thou’ configuration. The purpose of this is to obtain the impact of clear, direct communication, cause and effect and counter cause and effect thus occur. By not employing the ambiguity of generalized Downloaded from isp.sagepub.com at NANYANG TECH UNIV LIBRARY on May 22, 2015
142 statements, the social worker is able to heighten the feeling level where group interaction and effect become dominant, and verbalizing again diminishes. Fritz Perls in ’The Rules of Gestalt Therapy’ suggests several linguistic changes. It to I, can’t to won’t, thus putting greater responsibility upon the abilities of the client. But, and if to and, thus allowing the ambivalence of a statement to be self-discovered. Would, want, should, must, have to and ought, into need or like to, thus showing the confusion between real needs and trivialities which assume an unreal level of
importance. C) changing WHY questions into how, what, who, where, when. This is a technique which dissolves rationalization and places the therapeutic importance on the degree, extent, and modality of the experienced behaviour. D) form and context. The therapist needs to listen to the voice as well as the material spoken. As stated before, in the introduction to this paper, when the voice and material match each other, the patient is then expressing a unified Gestalt. E) appreciations. These are used for reinforcement to behaviour and thoughts that one is expressing or exhibiting. Usually, actions are overlooked when appropriate, and only criticized when inappropriate. In a group with Gestalt orientation, the social worker is encouraged to give reinforcement that is positive to behaviour that is experienced as healthy or nourishing. e.g. ’I appreciate the way that you speak directly about yourself’. F) resentments. Behaviour that is toxic, and experienced as painful or uncomfortable is very often harshly criticized. When doing this, one learns which behaviour is disliked, but the patient acts towards this particular behaviour as his critic would, becoming the punisher of his own impulses. Instead of allowing this harmful language structure to persist, the Gestalt worker encourages the expression of ’resentments’ and also the ’demands’ that are also implied. e.g. ’I resent the way you speak so softly, and would like you to speak more forcefully.’ In this way, negative reinforcement is implied, but a positive alternative is expressed for assimilation and reintegration. G) rehearsals. As few clients say exactly what they think, by asking them to say what they are rehearsing, it often allows them to 1) become aware that there is an internal dialogue going on in their minds, and 2) realize this holding back of speech is unhelpful to the spontaneity of the therapy session. H) reversals. When a patient expresses an aspect of himself that seems ’improper’ or ’out of context’ the therapist can suggest to the patient that he say exactly the opposite. The effect of this reversal may reveal where the patient has failed to integrate a part of his personality. The reversal can demonstrate to the patient how he has overcompensated for a situation which he could not cope with at an earlier time. A verbal description of a feeling may conceal a wish or need to express the opposite, e.g. ’I hate you’ may conceal ’I like you very much and would like you to like me’. This, sometimes, provides surprising insights for the patient. Many of the techniques described above can he clearly seen in the verbatim transcript of a session of Gestalt therapy conducted by the author. As the transcription of this session has been done verbatim f and therefore no comments are incorporated simultaneously), it might be useful for the reader not familiar with the techniques of Gestalt therapy to refer to this methodological passage in trying to understand what is taking place in this therapy session. FOOTNOTES
1.
Slavson,
S. R.: An Introduction to
Group Therapy,
International Universities Press,
p. 1.
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1973,
143 2.
S. R.: ’Types of Group Psychotherapy’ in The Challenge of Group Psychoed. Stefan de Schill, International Universities Press, N.Y. 1974, p. 55. 3. Rowan, J.: ’A Humanistic Psychologist Looks at Groups’, MS. 4. Maslow, A.: Towards a Psychology of Being, 2nd ed. NY, Van Nostrand Reinhold, 1968,
Slavson, therapy,
p. 3.
5.
Balogh, P.: ’Gestalt Awareness’ International Journal ofSocial Psychiatry, vol. XXII/I, Spring, 1976, p. 65. 6. Perls, F.: ’Theory and Technique of Personality Integration’, The American Journal of Psychotherapy, vol. II, part 4, 1948, p. 576. ADDITIONAL BIBLIOGRAPHY ON GESTALT on
which much of the
methodological part
THERAPY, is based.
Levitsky, A. and Perls, F.: The Rules and Games of Gestalt Therapy; published in Gestalt Therapy Now, Editions Fagen, J. and Shepherd, L, Penguin Books Ltd, Harmondsworth, Middlesex, England, 1972. Selman, R. H.: Unpublished doctoral thesis on Gestalt therapy, University of Surrey. Perls, F. S.: Ego, Hunger and Aggression, N.Y. Random House, 1947. - Gestalt Therapy Verbatim, Lafayette, California, Real People Press, 1969. Perls, F. S., Hefferline, R. and Goodman, P.: Gestalt Therapy, New York, Dell Publishers, 1951.
BACKGROUND INFORMATION What follows is a transcript of a group run by Ronnie Felton at Accept on 25th October, 1976. This was the third session with this group. A previous attempt to record a second session was unsuccessful due to technical failure. In this particular session there were nine people present apart from the therapist, eight of them patients at Accept and one co-therapist/student Miss Pat Bellamy. Three of the patients are present for the first time, of the remaining five, I wish to draw the attention of the reader to Mary who already in a previous session has expressed her desire to work on her anger, and at the same time was unable to pursue this matter any further due to her own inhibition. Mary had promised the group that she would work on her anger in the following session (second session) but failed to turn up to this session. On commencing the group and whilst installing the tape recorder some coffee was spilled accidently on one of the new patients’ foot. This gave cause to a great amount of laughter relieving some of the tension present in the room.
Monday,
,
Ronnie, Mary, and Fred.
are trying to work in this group not with thoughts if possible, but with feelings. Feelings that can start with just your body feelings to feelings that you can feel deep inside you. Anne: While I have had a very frustrating day I’ve been to the labour exchange and to social security. Ronnie: What do you feel right now at this moment?
Ronnie: We
Anne: Resentful. Ronnie: Where do you feel resentful? Anne: Because I (interupted by Ronnie) Ronnie: Not why, where do you feel resentful? where because if you’re feeling it, it must be somewhere. Where do you feel it? (Ronnie repeats) Where do you feel resentful ? Anne: In my head. Ronnie,: Can you place it somewhere specific in your head? Downloaded from isp.sagepub.com at NANYANG TECH UNIV LIBRARY on May 22, 2015
144
Anne : Well it goes to thoughts. Ronnie: Where in your head see, try this a minute, close your eyes then take a deep breath of air, try being as relaxed as you possibly can, just explore the whole of your body with your awareness, try if you can not to smoke just for a few minutes while you are doing this exercise. Try to remain with the air and try to be as relaxed as possible and just try to explore with your awareness. Imagine that your awareness is like a little torch and that you can shine it to different parts of your system (slowly) and you become aware of your feet and then aware of your knees and now you can become aware of your nose, now where do you feel resentment, you say you feel resentment in your stomach? Do you feel resentment in your heart? Do you feel in your head? Anne: In my heart. Ronnie: How does it feel like? What kind of feeling is this feeling of resentment? Anne: Frustration mostly. Ronnie: Yes, and how do you pick it up, what is your perception of the feeling? (long silence) What do you feel with your heart? (long silence) Anne: Oh just resentment with red tape. Ronnie: I am interested in how you feel this resentment can you describe it, is it a pain, is it pressure? You said you felt it in your heart, do you feel it? Try to stay in contact with how this feeling manifests itself physically. How do you pick it up? Because what you are talking about is what you are thinking about a feeling, you are telling me that you know the reason i.e. you’ve had a lot of hassle with the social security and therefore you are explaining at a rational level why you are supposed to feel something. What I’m asking is how does this feel? What do you experience? Just how do you pick it up in your body, in your system? Like when I get very frightened. I know I got very frightened because a big man was jumping at me with a stick, that was the explanation that’s like the social security bit, but what I feel is sort of a strong squeeze in my stomach, that is the way I experience fear and I can feel my heart beating very fast. I feel I sort of gasp for air when I’m frightened. Do you follow what I’m trying to say? Anne: Yeah. Ronnie: What I’m asking you is ’How do you feel right now in your body? (silence). Perhaps just try going through your whole body, come on, just close your eyes, tell us how your body feels. See if you can keep your eyes closed and just focus your awareness on your toes. Can you feel your toes? Anne: Yes. Ronnie: How do you feel? Are they warm, are they cold? Anne: There’re warm. Ronnie: Are they relaxed or are they tense? Anne: They are relaxed. Ronnie: What else do you feel in your toes? Do you feel anything else? Anne: No. Ronnie: Move up to the whole of your feet, what do your feet feel? Anne: The same. Ronnie: The same, how? Anne: Warm and relaxed. Ronnie: Do you feel wet or has the coffee dried up? Anne: I suppose the coffee has dried up. Ronnie: You are moving your foot now, how does that feel? (silence) Would you like to stop now? You know you are perfectly entitled to stop wherever you feel like it. resentment
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-Anne: I would rather. -Ronnie,: That’s fine if you feel that at one point you want to stop (addressing the ~est of the members of the group) you just stop. Thank you, Anne o.k. (addressing -other member of the group) You’re also here for the first time. -4lbert: I’m not at Accept for the first time. I liked your group, I think I saw you -for a few moments last week but I was out at work and therefore couldn’t come. My name is Albert. Thinking of what you said to Anne about how do you feel from your toes up, I have a sore ankle and a sore knee and a sore hip; it’s rheumatism, it’s arthritus and there’s nothing they can do with it, I just have to put up with the pain. Ronnie: Is that the main thing in your awareness right now? Albert: Yes, my awareness right now is on the aching. Ronnie: What would you like to do with that pain ? Albert: I’d like to get rid of that, I know that of course and I don’t believe anything can be done with it.. There’s no point fighting. I’ve had medical advice, I could take tablets but then I’d rather not take any tablets. I used to take tablets like peppermints to kill the pain but I don’t take any at all now. I think it is better to put up with pain than to put up with a sick head all the time, at least you’ve got a mind of your own. Ronnie: You were drinking because you wanted to get rid of the pain? Albert: Possibly I started drinking to get rid of the pains. Ronnie: (addressing a new person) I don’t know your name either. Barbara: No, my name is Barbara. Ronnie: I’m Ronnie by the way if you didn’t know who I was (laughter in the room, some comments of, ’oh yes we knew who you were’, ’anyway, we were told last week.’) Barbara would you like to tell us how you feel? Barbara: I feel a little tense ’cause I’ve been rushing around all day, my mother is not well and (Ronnie interrupts) Ronnie: Can I just stop you a minute? Just like Anne, you are telling us the reasons and I would like you to tell us just how you feel. Can you just stop a minute and tell me where do you feel tense? Barbara: Pardon? Ronnie: Just tell me where you feel tense. Barbara: Well, maybe in my stomach. Ronnie: I don’t know if it’s my fantasy or not, but I see you sort of moving your shoulders and I wonder if you feel tense in your shoulders? Barbara moves her head negatively. ’ Ronnie: Well so then it’s in your stomach, can you describe what is your feeling in your stomach, what do you fantasize is making your stomach feel that way? Barbara: I just feel that there’s something there and I can’t relax it. Ronnie: What is there? This is just a fantasy - imagine what do you have there? This is a fantasy, just imagine what is gripping you there, Is it a hand? Is it a tool? Just imagine what it is. Barbara: It isn’t a hand or a tool or anything, it just feels like the nerves in my stomach. Ronnie: The nerves in your stomach : can you try and do an exercise like in imagining things? This is the way we work in Gestalt, would you like to try it? I’ll show you. I need to borrow a pillow, can anybody lend me a pillow. (laughter and comments of ’oh yes, now she’ll have to speak’ and deep embarrassment of Barbara), What I’m trying to do is something quite new and quite different and if you want to just experiment with it. But if you feel very, very uncomfortable, just leave it.
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146 What I’d like to do is that I would like you to imagine that you can take those nerves, those very nerves that are inside your stomach and that are locked up, and imagine that you can take them away from your body and put them on this pillow, it is like a game, it’s like children can imagine that they are King Arthur, or Alice in Wonderland. I want you to take those nerves and put them out on this pillow and imagine that you can talk to them. We will create a role playing situation where you can talk to those nerves that are tensing up your stomach. Barbara: Inwardly? Ronnie: No, outwardly. You see I put out these nerves on the pillow, imagine that you can take those nerves, just the imagining bit, imagine that you can take those nerves and put them on the pillow so that now these nerves are out there sitting on a pillow. O.K. Can you do that? Barbara: You mean I have got to say ... Ronnie: No, you don’t have to do anything, I am suggesting something that you could try. Barbara: You want me to sit there ?
Just try.
Ronnie: No, no. Imagine that the nerves that are gripping your stomach, only that part of you not the whole of you. You are sitting on the chair there right now, right, but you’re taking a part of Barbara, that part that is gripping your stomach that you called ’nerves.’ You take them away just as an exercise, momentarily you take them away from your body and you imagine that you can put them on that pillow there magically, and now you’ve got the nerves that are gripping your stomach, they’re still there in your stomach, and at the same time you have put them sort of out here and you can talk to them. You can have a dialogue with them, you can ask them questions. You can tell them things. See if you can do that. Barbara: I don’t think I could do that. Ronnie: Try it. Barbara: I might want to sit down and sing. No, I’m not able to do that, I’m not able to do it outwardly. Ronnie: Come on, say something. Ask them if they’re there. Barbara: No, no I don’t want to. Ronnie: What do you feel is difficult about this? Barbara: Well, I just feel I’m nervous. Ronnie: Other people have done this last week, Mary was for instance going to work with her anger and (switching towards Mary) I think you were going to work this week wasn’t it, or (sarcastically) was it next week?
Mary coughs. Ronnie: I didn’t hear you. I said I don’t know. /~o7ZM~.’ Do you still feel angry? Mary: Well, I suppose a bit. Ronnie: Can you think at who or at what you feel angry? Mary: Oh well, lots of things, I always feel like that you know. Ronnie: Right now, what do you feel angry about, could it be you feel angry at me because I’m suddenly shifting the attention from Barbara to you? Mary: Yes, yes. Ronnie: You were nice and comfortable there while everybody was focussing on Anne and suddenly I just go boom and I go ’Mary’ and you’re the centre of attention. Mary: (all the time) Yes, yes, yes. Ronnie: That must really piss you off.
Mary:
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Mary: Yes, yes, yes. (to other members of the group) He’s getting me angry. Ronnie: So, how do you feel now, that I have taken you from your quiet and nice and protected little corner over there and now everybody is looking at you and expecting you to be angry ? Mary: Yes, I do feel a bit angry, even though I’m laughing, it’s a sort of an angry laugh. Ronnie: A bit angry, a bit a bit. So look, I’m going to make a suggestion. Take a cushion (laughter in the whole room) and imagine that I am on that cushion. (laughter) So imagine that you can put me on that cushion and I’ll sit back here that I’m really on that cushion, the part of me that’s you, the part of me that you’re angry with will be on that cushion, can you imagine that? Mary: Oh yes.
Ronnie: So go ahead and tell me what you think about me, tell Ronnie what you think about him. Mary: I think your’re a nasty probing person. (laughter) Ronnie: Say that again. Mary: Ronnie, your’re a nasty probing person, Ronnie your’re very nasty, probing and I don’t like you. If I want to be angry leave me alone with my anger. I don’t want you probing. Ronnie: Make that even stronger. Mary: I don’t want YOU probing into it, otherwise I’ll be angry with you. Ronnie: What is it? Mary: It is my ... well I don’t know. Ronnie: Well try me. I don’t want you probing into me. Mary: I don’t want you probing into me. Ronnie: Make that a strong assertion there. Mary: (louder) I don’t want you probing into me. Ronnie: Now what I want you to do is to switch places, sit on the pillow and you be Ronnie, faced right there you will be talking to Mary. Talk to angry Mary there. Now you are Ronnie there, probing Ronnie, go ahead probe into Mary’s anger. Mary has told you she does not want you to probe into her anger, how do you feel about that. React to Mary, talk to Mary who is there in that brown chair. Mary : (angry) But what? Ronnie: You are Ronnie, practise you can say I am Ronnie, I am here for ... tell us what you’re here for. Mary: I am Ronnie (laughter) I am here to help you get rid of your (laughter) ... Ronnie: Come on, you’re doing fine. Mary: I am here to let you get rid of your inhibitions. (silence) Now I’m Ronnie
talking to Mary. Ronnie: Continue ’I am Ronnie, I am here to let you get rid of your inhibitions ...’ I am Ronnie, Mary I am Ronnie and I am here to help you get rid of your anger. Ronnie: How do you do that? How do you help Mary get rid of her anger? (silence) Mary: I don’t know (laughter) if I knew I wouldn’t just sit here. Ronnie: It’s the part of you Mary that knows. Say whatever comes into your mind. You play the role now, you can make all the decisions. How will you help Mary get rid of her anger? Mary: I don’t know. I’m asking her. Ronnie: You are Ronnie now you can do whatever you want. What do you think would be a good idea?
Mary: (real slow)
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148 Well I suppose take away the cause that is causing the anger. Ronnie: Go ahead, tell Mary what you are going to do. Mary: Mary, we must remove the cause that is causing your anger. What is
Mary:
causing
your anger? Ronnie: O.K. switch places. (addressing the whole group) Everytime that we do role playing, when you ask a question, it’s part of the technique that we switch places. O.K. So there is Ronnie asking you all what has caused your anger, now you are Mary so answer Ronnie’s question. Mary: I don’t know what is causing my anger. I think I’m better when I’m myself. I don’t know what’s causing my anger, I just wake up with it. Anger and despair. Ronnie: Tell me what you want of him. Mary: So Ronnie (addressing the pillow) would you please get rid of this anger, I don’t want it to be here Ronnie: That is a request, switch places. So now you’ve got Mary there who has asked you to please help me get rid of this anger. How do you reply to that request? Mary: (very seriously, ’with a professional attitude’) What is causing your anger? Ronnie : You have asked a question again. Switch. Mary: (as Mary) The thing is I don’t know, that is why I’m asking you. Oh I am myself again. Ronnie, can you help me to get rid of my anger? (as though she were rehearsing) Now I am back to square one again. Ronnie: You have got into a vicious circle can you help me to get rid of my anger? What is causing my anger, what is causing my anger etc., etc., See if you can get unstuck, see if you can find another line, what do you want from Ronnie right now? Be more specific. Ah, you want to be Ronnie. Mary: (standing up) I don’t know. Ronnie: Choose whoever you want to be, go ahead choose. Mary: Well if I’m myself I know that I want to get rid of my anger. I think Ronnie has to solve it. Ronnie: O.K. Then tell Ronnie what do you want from him. How do you expect him to get rid of your anger? How do you expect him to do it? Tell him specifically what your expectations are, to the Ronnie there on the pillow. Mary: (very calmly and emphatically) Ronnie, I expect you to help me get rid of my anger, and I expect you to know how, and I expect you, you know, to help me get rid of it. Ronnie: Tell him specifically. Mary: Well you must have a way to help me get rid of it. Ronnie: What kind of way? Tell him specifically, you could either this or you could that... Mary: You should be able to find a way to help me get rid of my anger. Ronnie: What kind of ways do you think he might find, tell him what other kind of things would you expect him to do? Mary: (thinking) I don’t know. I don’t know how you can help me get rid of it. Ronnie: What kind of ways might you use? What would be a good way to help you get rid of your anger? Mary: You could help me to get rid of all these little problems that keep drawing me away. Ronnie: How do you think he can do that? Mary: By helping me to relax. Ronnie: Can you tell him that? O.K., that’s a good one. Helping you to relax. Now what else ? That is something concrete.
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149 Well I think helping me to relax could help me to solve lots of things, ’cause then I could put my problems in a rational way instead of jumping sort of from one thing to the other, thinking about this and then thinking about that and then thinking about this. Ronnie: Well tell him that, say I want you Mary I want you to help me to relax. Ronnie: O.K., switch places. Now listen Mary has asked you for something. She wants you to help her to relax. How do you re-act to that? Mary: Am I Mary now? Ronnie: No, you’re Ronnie now. Mary: Well it’s very difficult for me being you, because you are you and I’m not you. Ronnie: You’re not exactly me, you are the Ronnie inside you. We all have different aspects of our personalities. Ronnie represents the part of you of which you have all your expectations, you expect him to help you, you expect him to be able to provide you, it is your father figure if you want to use those words. It is the person that you are saying to ’I want you to help me sort out my problems’. That part is also inside you. You will find that inside Mary there is also a part, there is a part of Mary’s personality, part of Mary’s person and we have called it Ronnie. Therefore you are Ronnie now. You are the Ronnie to which Mary has just said I want you to help me to relax. What will you answer to that Mary that is there sitting in the chair? Mary: (in a very relaxed and professional voice) Mary, you must try to relax, if you relax you can solve lots of your problems. You can control things better. Ronnie: Instead of ’if’, try - you can relax. Mary: You can relax and therefore you can control things better. The important thing is to relax. Ronnie: Tell Mary how can she relax. How can she achieve this being relaxed? Tell Mary, you now are Ronnie, you are the therapist, you can tell her in a real authoritive manner what she can do to relax. What is a good way of relaxing?
Mary:
Mary: (long silence) Ronnie: She has just said to you ’I want you to help me to relax’ and now you need to help her. How can you help her to relax, because that’s what she wants you to do. She wants you to help her to relax. There’s all kinds of things you could do. Mary: (talking to herself) Mary if you let your mind just slow down a bit and think of each problem as it comes instead of trying to cope with everything (interrupted by Ronnie). Ronnie: Try to make that into a statement instead of using ’if’, tell her what she should do. you should try to cope with each thing individually and not try to solve all your problems at one, that won’t get you anywhere, with that you’re just going round and round and not arriving at anything. Ronnie: Say that again. Mary: You’re going round and round and not arriving at any solution. Ronnie: Say that many times. Mary: You’re going round and round and not arriving at any solution, You’re going round and round and not arriving at any solution. Ronnie: Switch places. You’re Mary - now Ronnie has just told you that you just go round and round and you don’t arrive anywhere. Mary: Well yes this is true. I am going round and round and not arriving anywhere, and this is making me very angry. This is what’s causing my anger because I’m continually searching for a solution to my problems, and that however I think, the further away I’m getting from solving them and it is causing me to be very very angry.
Mary: Mary
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150 are you angry with? I’m angry because I’m not arriving at a solution of my problems. Ronnie: How is that? Mary: Because I’m not finding a solution to my problems. Ronnie: So who are you angry at? Mary: I am angry at my mind. Ronnie: Well we started off that you were angry with me and now, (addressing other members of the group) could I have another pillow please? O.K. Here we’ve got another cushion, so now the cushion over there, that is Ronnie and while you’re sitting on the chair that is you Mary, and try to put your mind on this new cushion here. So now we find out that it is not actually Ronnie that you are angry with, you’re angry with your mind, so go ahead and tell your mind what you feel about it. Mary: Mind, I’m very annoyed with you. Ronnie: (interrupting) Well done, go ahead, be really annoyed - allow yourself to be really annoyed. This is your chance to get really annoyed. Mary: (shouting) I am annoyed with you, in fact I’m furious with you. Ronnie: Go ahead, be furious.. Mary: I’m really furious. Ronnie: This is your big opportunity, you can really be furious. Mary: (addressing her mind) There you’ve got me every day going round and round and in circles. It is going on for hours and days and weeks, I can’t stand anymore from you. Ronnie: Tell that again. Mary: I can’t stand anymore from you. (shouting) Ronnie: Say that again louder. Mary: (shouting) I can’t stand anymore from you, I can’t stand anymore from you. Ronnie: Come on make it even louder. They should hear you in the other room. Mary: (shouting even louder) I can’t stand anymore from you. Ronnie: Louder. Mary: (screaming) I can’t stand anymore from you. (once again screaming even louder) I can’t stand anymore from you. Ronnie: (very gently) Try not stopping yourself, just allow your anger to come out. Mary: (once again screaming) I can’t stand anymore from you. (shows signs of
Ronnie: What
Mary:
beginning to get tired) Ronnie: (very gently) Carry on. Express some more
of your anger, tell him what else
you want to say to him.
You’re not solving anything, you’re just a continual eternity of problems. I can’t stand it anymore (very loudly) You don’t solve anything. I have these problems going round and round in my head and you don’t do anything to help me. You don’t solve anything. It’s the same thing day in and day out. You’ve got me nervous and upset and tut tut tut. Ronnie: Go ahead blame him, you can really blame him, he’s got you nervous, he’s got you upset, what else ? Go ahead tell him. Mary: You know to do anything. I can’t function properly because of you, you are the cause of all my unhappiness. Ronnie: Say that again. Mary: You are the cause of all my unhappiness. Ronnie: Say it again louder. Mary: You are the cause of all my unhappiness. (louder) Ronnie: Try and really blame him, put the accent on the you - you are the cause.
Mary:
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Mary: YOU are the cause of all my troubles, you are the cause of my unhappiness. Why don’t you do something about it? Ronnie: Switch places. That was a question. O.K. Now you are Mary’s mind, now you can answer Mary, why don’t you do anything about it? You are the cause of all her unhappiness, you are the cause of all her problems. Mary : (playing mind) Mary, why are you so upset with me? Ronnie: She’s told you, you are the cause of all her problems. (long silence) Mary: Mary why don’t you stop, why do you keep running away from your mind? Ronnie: Why do you keep running away from me? Mary: Why do you keep running away from me? You seem to be something apart
from your mind sometimes. Ronnie. : You seem to be something apart from me sometimes. Mary: You seem to be something apart from me sometimes. And therefore it is very difficult to help you. I’d like to help you at times but you just seem to be like something apart and it is very difficult to do anything to help you. Ronnie: Can I suggest a sentence? If you feel that it feels o.k., you can say it and if not, you just leave it. Mary: O.K. Ronnie: I’ll try to be with you but you won’t accept me. Mary: I don’t think that’s true. Ronnie: O.K. then leave it. Mary: (slowly thinking again about the sentence) I don’t think that’s true, it seems as though the two things are apart, the body is sort of trying to go one way. Ronnie: Say then,I am apart from you, your mind right and you’ve got Mary sitting over there in the chair. Mary: (addressing herself in the chair) Mary, why don’t you try. You’re not - you’re not co-operating with your mind. Ronnie : You’re not co-operating with me. Mary: You’re not co-operating with me, and therefore I don’t think I can help if you are not co-operating with me. Ronnie: What do you want then? Make a demand. Say ’I want you to’ ... tell her what you want, make a demand, you’ve said ’if you.’ You mind - tell Mary what you want from her. Mary: Mary, I want you to think of me as something that is here to help you, but if you do not use me then I can’t do anything to help you. Ronnie: Make a demand without any ’but’s’, just tell her what do you want. Mary: Mary, why don’t you use your mind? Ronnie: That’s it - make a demand. Mary: Mary, use your mind. Mary, why don’t you use your mind? Ronnie: That’s a question, I am suggesting that you make a demand. Say ’I want you to ...’ Mary: I want you to use your mind. Ronnie: Mary, I want you to use me. Mary: Mary, I want you to use me. Mary, I want you to use me (repeating ’I want you to use me’). Ronnie: Switch places. How do you reply to the request that your mind wants you to use him? Mary: Mind, this is true. I haven’t used you properly and I think I’ve forgotten how. I used to use you properly and then suddenly I just came away from you. Ronnie: How did you get away from your mind? Can you tell your mind how you
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152 did this? We seem to have drifted apart somehow, I seem to have lost you somewhere. Ronnie: How did you do this? How did you loose your mind - your contact with your mind ? How did you loose your relationship with your mind ? Mary: I don’t know, Mind, what happened? One day I just, suddenly, decided to get rir of you. I don’t know what happened. Ronnie: Who do you think might know what happened? Mary: I don’t know. Ronnie,: How about asking Ronnie? Mary: (addressing pillow with Ronnie) Ronnie, do you know how my mind and I drifted apart? Ronnie: O.K. Switch places. Mary has just asked you a question. How come that she and her mind drifted apart? Mary: (being Ronnie, very professional) Mary, you’ve drifted away from your mind and you feel a sense of loss and bewilderment and you are concerned that you are not getting very far. Ronnie: (addressing Mary on Ronnie’s pillow) Can you explain to Mary how she drifted away from her mind? How did this happen? Mary: (very very slowly) Mary, you drifted away ... because ... you like to rebel against pain, you felt you could do your own thing and - but you can’t - it is not possible (addressing the therapist) That’s not going to solve how to get my mind back (at this point three of the members of the group sit up stating that they have to leave and Mary interrupted her train of thoughts and wondered if she had been boring the rest of the members of the group) Ronnie: If you think you’ve been boring the members of the group, why don’t you ask them? Fred: You’re not boring me, I am very interested in what you are doing. Ronnie: What do you feel about Mary’s work Fred, do you feel she is getting anywhere right now ? At this point the tape came to an end and as it was nearly time to bring the group to a close. No further recording was attempted.
Mary:
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