DIALOGUE AND EXPERIMENT

We are in a strange time for Gestalt therapy. Coming from a background of the highly challenging and experimental Gestalt work of Perls and some of his followers, many Gestaltists have now moved to another pole, with support, empathy, attunement and dialogue much more to the fore. Instead of alignment with the anarchic 'happenings' of the sixties, we are asked to align more with the gentleness of Rogers and Kohut. Amazingly, Buber has been brought in as one of the 'gentle people', whereas I would see his capacity for challenge as quite the equal of Perls.

The question I would like to address here is: what is the meaning and place of dialogue and experiment in Gestalt therapy? I shall also connect this with the question of the meaning and place of self-support and environmental support in Gestalt.

What is dialogue?

My contentions here are that there is a particular sense in which Gestalt therapy is dialogic, that this kind of dialogue includes experiment, and that in that sense Fritz Perls was often highly dialogic. This kind of dialogue emphasises differentiation rather than empathy and attunement. To take an example of the Buber scholar, Maurice Friedman [1990], of his relationship with a suicidal student:

"At the end of the quarter she said, 'I don't have a paper for you but I'll write you a letter about the paper I will write.' Again I said, 'Fine.' Then she announced to me that she was going to go to Helen Lynd instead of myself for the rest of the year. Once again I said 'Fine, but you still have to write that paper for me.' Then she would come to me and say, 'I'm getting closer to the subway trains. What's more important to you? That paper or my life?' I said, 'You're the one who wants credit. What's more important to you?' I held out...I was the one person she kept in touch with after she graduated...I could not confirm her life saying, 'Oh well, Margie is in danger and therefore I just have to play it soft.' I mean I had to risk, even, the possibility of her suicide. That's real confirmation."

All Gestalt 'objects' are relational: self, other, meaning, awareness, all are activities of the contact boundary. A therapy based on such a relational outlook cannot fail to be dialogic, i.e. to emphasise that growth occurs in the contact and relationship between the therapist and the client, rather than 'internally' in the client. The contact boundary both joins and separates self and other, organism and environment. The task of the therapist is to act as an 'other' in relation to which the client can explore and develop 'self'. What is 'between' (using Buber's term) is the contact boundary. The contact is the differentiation, followed by the meeting, leading to a moment of 'final contact', where the boundary between contacter and contacted falls and both are open to change, which to me is precisely analogous to the 'I-Thou moment' of Buber, with the added emphasis that it is not seen as being possible merely with another human being. Buber has sometimes been wheeled in to make our contact with other human beings absolutely central, with a corresponding neglect of our non-human environment (something which, with global warming and the destruction of the ozone layer, human beings need like a hole in the head!). One of the nice aspects of PHG is how it places human awareness in the wider context of the natural world. In fact, Buber is not so totally geared to human-to-human contact, and talks about the individual being:

"...in real contact, in real reciprocity with the world in all the points in which the world can meet man. I don't say only with man, because sometimes we meet the world in other shapes than that of man." [Buber in Kirschenbaum & Henderson (eds.), 1990]

An important part of the Gestalt dialogic approach is that it is primarily non-verbal. Perls took from his analysis with Reich the latter's insight that what the client does is a far more reliable guide to the process of the client than what s/he says. Gestalt therapy is not a 'meeting of minds'. In fact, PHG understands 'mind' as an unavoidable illusion in a complex society where "there exists a chronic low-tension disequilibrium, a continual irk of danger and frustration, interspersed with occasional acute crises, and never fully relaxed" [PHG] which keeps us in a continuous state of 'chronic low grade emergency'. In such a society, whenever we introspect, we become aware of ourselves thinking, and thus inevitably interpret this thinking as coming from a separate 'part' of ourselves. In a simpler society, much of our action would not need to be prefaced by thinking, and thus thinking would be merely one of the things we do. (Incidentally, given that this is how Perls understands 'mind', his dictum "Lose your mind and come to your senses." becomes a much more interesting and complex idea than it is usually taken for!)

This emphasis on the non-verbal brings back into the Gestalt dialogic approach the analytic concept of therapeutic abstinence. I can uphold my side of the dialogue by my attention and interest, the expression in my eyes, or my adjustment of distance between me and the client, rather than by finding a verbal response every time. Harris [1996] has written cogently on the value and power of silence in therapy, and also [personal communication] that as the therapist's skill level increases, s/he can "have the knack of doing 'as much as necessary, as little as possible'".

Dialogue, empathy and attunement

The distinguishing feature of Gestalt dialogue is the emphasis on the 'otherness' of the therapist as a prerequisite of the selfhood of the client and the possibility of meeting. In such a dialogic approach, empathy is quite a problematic concept, as Buber [in Kirschenbaum & Henderson (eds.), 1990] also pointed out. Strangely, some Gestalt writers, particularly Lynne Jacobs, have tried to straddle both dialogic therapy and Kohut's Self Psychology, which to me are entirely incompatible. To quote Resnick [1995]:

"The constant empathic response a la Kohut is an attempt to establish and maintain 'attunement' with the client. Functionally, this requires the frequent (if not constant) denial of the therapist's phenomenology in favour of the client'sphenomenology, making any kind of real contact or dialogue completely impossible." [Italics in original]

Often, those Gestaltists interested in Self Psychology discuss the 'need for empathic attunement' in terms of 'developmental needs': this is what was lacking in childhood, and therefore the client cannot continue to the next developmental phase until s/he gets it from the therapist.

"However, with the additional information provided by a [Self Psychology] developmental theory, Gestalt therapists will increase their likelihood of making correct choices based upon the developmental needs of the patient."

[Breshgold & Zahm, 1992]

When a child's pet dog dies, there is a temptation for the parents to immediately buy the child another dog 'to replace it'. This is an attempt to avoid the child experiencing the pain of grief, and thus to avoid the parents' discomfort at seeing their child in pain. Of course, none of us would do that! However, if we see ourselves as providing what wasn't provided in infancy, the 'developmental needs of the patient', we are doing exactlythe same thing.

Our clients come with 'unfinished business' from childhood and elsewhere, and have become adept at finding spurious ways to finish it. The neurotic limits his/her world to those areas where the painful feelings stay in the background. The borderline clings confluently to someone else or to a drug or sex in an attempt to drown out the pain of making contact or just being seen - and flips into rage and despair when the other person tries to make some distance. The narcissist essentially splits him/herself in two and primarily relates across the split (retroflection) rather than with the environment. These are all avoidances of the pain of saying goodbye to the hope of ever getting what I wanted from the person I wanted it from, in the way I wanted it. Marvellously, having allowed myself to grieve, I can find that the world is now big enough to provide the things I now developmentally need: contact, affirmation, challenge, love, play, places to withdraw. Now I can get a new dog, not as a 'replacement' for the one that died, but as a new relationship, which is definitely different from the other dog, and provides similar companionship.

In therapy, I can get some of this contact from the therapist, not as a prerequisite to healing, but as a result of the healing that comes from saying goodbye to childhood hopes. This is the 'impasse' leading to the implosive 'death layer' of Perls' [1969] five-layer model of neurosis. Before this saying goodbye, the Gestalt therapist interested in real dialogue must avoid playing a replacement parent (just as a good parent will avoid giving a replacement dog until the old one has been said goodbye to). The therapist needs sensitivity to the client's need for pacing and grading of this giving up, and this is where contact skills are important. Some clients will not be willing to undertake this work and will leave, and this will sometimes be to do with mistiming of therapist interventions; often it will be an unwillingness to face the pain they begin to feel as being inherent in the work. This is fine, and not a therapist blunder.

The opposite view is presented by Tobin [1982]:

"An example of [being more confrontative than the patient could tolerate] and its results is a patient who left therapy after only one session and returned for group three years later. I said to this man, 'I don't feel any contact with you' in our first session. I said this in what I thought was a kindly voice and for the purpose of letting him know that I thought an important feature of his was his inability to make real contact with others and that this would be something we would work on. Three years later, when he returned in great despair as a last resort to try group therapy with me, he told me that he knew that what I had said three years earlier was true, but that he had felt so hurt by my comment that he didn't think he could work with someone who was so insensitive to him."

My question is, why is this an 'error'? Interestingly, I don't think Buber would have seen it as an error at all! Tobin's assumption is that his comment 'hurt' the client. This is like saying that the parent who didn't buy the replacement dog hurt the child. My assumption is that the client's acknowledgement of the validity of this comment opened the door for him to experience the hurt and shame he brought with him. At that stage he made the choice to leave therapy rather than stay with a therapist who would not be confluent with his wish to avoid the hurt. However, he remembered him! He returned to Tobin after three years 'in despair' ready to work. Fine: that one session gave him a link to someone he knew told the truth, and was willing to make contact. His process continued, he reached his point of despair, and returned to Tobin. And for this he only paid for one session! Would that man's life have been better if he'd stayed with a therapist who 'empathically attuned' with him for three years instead? We don't know, and shouldn't act as if we do.

Environmental support and self-support

So we go on to the debate around 'self-support' versus 'environmental support'. I have often heard it stated that Perls went too much onto the individualistic 'self-support' end, and ignored environmental support. This is sometimes a valid criticism. But let us look at Perls [1973]:

"The individual's chance of physical survival is almost nil if he is left entirely to himself. Man needs others to survive physically. His psychological and emotional survival chances are even lower if he is left alone...Man's sense of relatedness to the group is as natural to him as his sense of relatedness to any one of his physiological survival impulses." (p. 25)

How does this fit with an emphasis on 'self-support'? Look at the next sentence:

"The gestalt approach, which considers the individual as a function of the organism/environment field, and which considers his behaviour as reflecting his relatedness within that field, gives coherence to this conception of man as both an individual and as a social creature."

The 'self' in 'self-support' is PHG's self, not Descartes' ghost in the machine! This self comes as much from environment as from the organism. It is what chaos theory calls 'emergent': self emerges from the interaction rather than from the participants in the interaction. Self then acts on both sides of the contact boundary to support its selfhood. This is feedback or homoeostasis. The organism will be opened to - and move towards - what is novel and/or nourishing in the environment and closed to - and move away from - what is toxic; the environment will be altered (aggressed upon) to provide food, human contact, pleasure in various forms. Part of the balance will be that I/organism need to be in good contact with I/environment. Thus, it is not just that part of self-support is getting support from the environment; rather, 'self', arising on the contact boundary, pertains to environment as much as to Peter- organism. For example, a client making eye-contact with me, seeing my willingness to be present with him/her, and taking support from that is(contact-based) self-support.

If I rely on environmental support, on the other hand, I will be parcelling up I/organism and dumping it onto the environment, saying "Look after this." These interactions do not arise from contact, but from manipulation. Paradoxically, such interactions are much more 'selfish' than the contactful interactions arising from self-support. Extreme versions of this are 'nervous breakdowns', where people in effect deny their own input into their behaviour and even their survival. In one sense, they are not contactable; in another, they are powerfully manipulating those around them. For example, a client not looking at me, but wanting me to say the words "I support you" (whatever that means!) to make her/himself feel better is both a manipulation of me, and also of her/himself. Not only might I be lying: I would be lying, since I would be uttering an entirely vacuous phrase as if it were meaningful.

Full contact is lost by the accretion of 'unfinished business', which pushes for attention and takes energy from the present contacting. Restoration of contact comes through the therapist's frustration of the client's unaware neurotic strategies for avoiding contact, attempts to manipulate the world into supporting a familiar pattern (even where the client knows that pattern does not serve her/him well). Some styles of therapists like to give clients what they want; I assume (like Perls) that what clients want from me when they come into therapy will not be helpful for them - if they could ask so easily, they wouldn't have needed to ask for it from a therapist! - and I make absolutely sure that I don't give them what they want. I offer contact in a different way, or ask them what would happen if I did as they asked, or get them to play the therapist and reply, or tell them I want to get to know them better and what is it like to be here with me now? Later, when they are more open to spontaneous contact, I am much more willing to give them what they want. If this seems very loaded onto the pole of frustration, I want to emphasise that the aim is to restore contact, and for this I need to be available as fully as possible for contact. I need to be clear that I am not frustrating out of malice, or some sadistic wish to hurt the client, but out of interest and respect for the whole of the client, not just the neurotic demands.

The significance of this for a Gestalt dialogic approach is that I am present in the therapy as another real person, and not as a 'supporter' or a 'helper'. Sometimes I might support or help, sometimes I will challenge or frustrate, but these will flow out of our contact, from what is genuine, rather than to manipulate the client into feeling better, or to help me feel more altruistic.

Experiment

This brings us on to the role of the experiment in Gestalt therapy, and its relation to the dialogue. Some writers on 'dialogic Gestalt therapy' very much downgrade experiments, on the basis that the therapist giving the client an experiment to do removes the horizontal relationship between therapist and client. The therapist becomes the expert, the client becomes the one who obeys and takes the prescription. This is an argument that must be taken seriously. Every intervention that I make as a therapist affects my relationship to the client, because every intervention involves a configuration of our field, and is an invitation to the client to act in a complementary way.

The concept that seems most relevant to me here is the balance of expertise. This is a boundary issue. The client's sphere of expertise is to be him/herself; to choose her/his own present and future; to find his/her best creative adjustment to the environment unless s/he has disrupted the process out of anxiety; and to show these areas to the therapist in the therapy relationship. The therapist's area of expertise is on a different level entirely: to make and explore a therapeutically bounded relationship; to be able to use her/his senses (seeing, hearing, etc.) acutely and accurately; to be in good contact with his/her own experience, especially response to the client; and the creativity to target an experiment to the stuck areas, combined with the creativity to know when it is or is not appropriate to suggest an experiment.

Thus there is no inherent problem in me as a therapist showing my expertise: after all, the client is paying me for doing this! However, part of the expertise is knowing that some clients will turn any suggestion of mine into a demand, and abase themselves before my power; other clients will, equally unchoicefully, refuse any suggestion of mine. I would not suggest any experiment with clients who do this. Some experiments are still possibly in order: with a client who raises me up, I could sit lower, or even prostrate myself in front of him/her. The experiment then involves me doing something, rather than suggesting that the client does something. The client can, if s/he wishes, notice how s/he responds.

The experiment in Gestalt therapy fulfills a particular function. It is not, in my opinion, a form of behaviour modification - although, unfortunately, Zinker [1977] does describe it in this way. I connect the Gestalt experiment with the concept of the safe emergency and the move in Perls' 'five layer' model of neurosis from the 'role-playing layer' to the 'impasse' [Perls, 1969 for all these concepts]. That is, the client is offered an opportunity to explore the limits they impose on their acting and relating; and via this to open the prospect of reintegrating alienated possibilities, while knowing their anxieties round doing so.

There are essentially three experimental methods in Gestalt therapy: enactment with awareness (slowing down), exaggeration and reversal. I shall describe these in turn.

Enactment with awareness

C: I find it very difficult to look at you.

T: Would you be willing to look away, then move your eyes slowly towards me and describe what you notice as you do that: bodily sensations, what you see, thoughts, fantasies?

C: OK. I'm moving my eyes towards you...my stomach feels tense...I feel frightened...I am imagining you looking at me with cold, angry eyes, disapproving.

T: As your eyes, what might you be saying to me?

C: I don't want to see your anger, so I keep away from you. That's what I used to do with my father!

In this experiment, something the client habitually does is enacted in a new frame: an experiment, freely chosen, done slowly with awareness. This new frame allows the fantasy of cold, angry eyes to emerge in awareness. My fantasy is then of a dialogue of eyes, and I suggest speaking as the eyes. This allows for the fantasy to be connected to a memory, in this case. Notice though that I am not 'going for' a fantasy, or a memory, or anything in particular. What emerges is what emerges. Most of the experiments that I do are of this kind. For me the key is slowing down. Even a client's fantasy of killing me or hitting her/his head against a wall becomes enactable if done slowly with awareness.

Exaggeration

T: You could experiment with saying to your father, "I will not stay with your anger."

C: I find that scary - I could never say that to him openly. I'll give it a try though...I will not stay with your anger [small jerk of right hand and arm].

T: Will you repeat that, and exaggerate the arm movement?

C: I will not stay with your anger [hitting the settee she's sitting on].

T: Again.

C: [Angry voice] I will not stay with your anger [hitting settee]...and I'm angry too now.

The point of the exaggeration - of definiteness ("I don't want to..." to "I will not..."), and of physical movement - is that parts of the action have been minimised. The aim is not to exaggerate it beyond its rightful place, but to its rightful place, to experiment with going beyond the habitual limitations. Thus I might encourage someone who is breathing shallowly to breathe more deeply, but not to breathe beyond a natural level of breathing (although it might seem unnatural to the client). My aim is not the 'discharge' of emotion, merely the contactful expression of what is there. It is easy to get carried away by the drama of high emotion. For me, whatever drama there is in Gestalt therapy must be a real drama, rather than poor melodrama.

Reversal

T: Now could you be father's eyes and reply: I am cold and angry...

C: I am cold and angry, you are an ungrateful girl and I'm glad you stay away from me. I'm glad I sent you away to school.

T: Switch back, and speak to father in the same way, cold and angry.

C: I am also glad that I went away from you. I had so much love to give you and you pushed me away. Every time I tried to come close I got hurt. You do not deserve my love...and yet I still do love you and miss you.

This reversal is the classic Gestalt 'empty chair' (whether or not the client actually moves). This method is very easy to misunderstand, and to treat as a behavioural learning in assertiveness, finding new ways of relating to father. For me, this is not the point. The 'father' is not really father, it is a disowned pole of the client, disowned because she did not like it when father acted like that. However, in disowning that polarity she made it very problematic to relate to people acting in that way. She either clings or hides. She does not allow herself the separated contact, tinged with anger, that might be the only contact available, though other contact can grow from it, as it does at the end of this vignette.

Other possible forms of reversal are: to reverse posture (e.g. sitting closed to sitting open); to reverse voice tone (e.g. loud to soft); to reverse physical distance (e.g. standing distant to standing close); to reverse characteristic (e.g. someone who characteristically gives experiments with taking).

Dialogue and experiment

Experiment viewed in this way is part of my dialogic relationship with the client, giving the client the opportunity to approach me and the rest of his/her environment, in different ways. Part of the dialogic aspect of this is the fact that we are both coming from our own area of therapeutic expertise, and that I will be aware that there are circumstances when I would not be willing to suggest anything:

T: I see a difficulty. I get the sense that you are waiting for me to give you something to do. My fantasy is that you would then do it for me, rather than checking out with yourself your willingness to do it, or its rightness for you at this moment. Since the aim of this therapy is finding yourself, that would be self-defeating. I'm not sure how we can resolve this.

Here, staying with this dilemma is the impasse. The only way we can resolve it (or any therapeutic impasse) is if the client acts authentically from her/his needs and wants. The experiment makes figural the impasse inherent in our dialogue, and thus acts in service of the dialogue rather than detracting from it.

Peter Philippson, 11.7.96

References

Breshgold, E. & Zahm, S. (1992) A Case for the Integration of Self Psychology Developmental Theory into the Practice of Gestalt Therapy. Gestalt Journal, Vol. XV No. 1, Highland, NY.

Friedman, M. (1990) Dialogue, Philosophical Anthropology and Gestalt Therapy.Gestalt Journal, Vol. XIII, No. 1, Highland, NY.

Harris, J.B. (1996) Silence in Groups. British Gestalt Journal, Vol. 5 No. 1

Kirschenbaum, H. & Henderson, V.L. (eds.) (1990) Carl Rogers Dialogues.Constable, London.

Perls, F.S. (1969) Gestalt Therapy Verbatim. Real People Press, Moab.

Perls, F.S. (1973) The Gestalt Approach, and Eye Witness to Therapy. Bantam, New York.

Perls, F.S., Hefferline, R. & Goodman, P. (1994) Gestalt Therapy: Excitement and Growth in the Human Personality. Gestalt Journal Press, Highland, NY

Resnick, R. (1995) Gestalt Therapy: Principles, Prisms and Perspectives. British Gestalt Journal Vol. 4 No. 1.

Tobin, S. (1982) Self-Disorders, Gestalt Therapy and Self Psychology. Gestalt Journal Vol. V No. 2, Highland, NY.

Zinker, J. (1977) Creative Process in Gestalt Therapy Vintage Books, New York.

(c) 1996 Manchester Gestalt Centre

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