Gestalt Therapy: Definition, Types, Techniques, and Efficacy

Gestalt therapists and their clients use creative and experiential methods to enhance this self-awareness and work through several problems they may have.

Instead of talking about past experiences, clients are encouraged to experience them in the present and take responsibility for their feelings.

Not clinging to past conflicts and feelings is a fundamental requirement to grow and actualize human potential.

Through this therapy, clients learn to become more aware of how their own negative thought patterns and behaviors are preventing true self-awareness and making them unhappy.

What does Gestalt mean?

The word ‘Gestalt’ does not have a direct translation to English, but it is often interpreted in psychology as ‘pattern’ or ‘configuration.’

Gestalt psychology is a school of thought that looks at the human mind and behavior as a whole rather than as separate entities.

When trying to make sense of the world around us, Gestalt psychology suggests that we do not simply focus on every small component; rather, we perceive the small pieces as elements of more complex systems.

Essentially, Gestalt psychology suggests that the whole is greater than the sum of its parts.

Who developed Gestalt therapy?

Gestalt therapy was developed in the 1940s by Fritz Perls with the help of his wife, Laura Perls. Both were trained in traditional psychoanalysis but were dissatisfied with certain Freudian theories and methods.

This ultimately led them to develop their own system of psychotherapy as an alternative to psychoanalysis. Together, along with others such as Paul Goodman, they developed a style of therapy that was humanistic in nature, focusing on the person and the uniqueness of their experience.

According to the Gestalt psychology of perception, people perceive the whole pattern or configuration rather than the pieces that make it up.

Perls applied this concept to human experience, suggesting that healthy people organize their field of experience into well-defined needs to which they respond appropriately.

Who can benefit from this therapy?

Gestalt therapy can be beneficial for many individuals, especially those who struggle with the following:

• Anxiety

• Depression

• Low self-esteem

• Relationship difficulties

• Low self-efficacy

• Physical difficulties such as migraine headaches, ulcerative colitis, and back spasms

People who may benefit most from Gestalt therapy are those interested in working on their self-awareness but may or may not understand the role they play in their own unhappiness and discomfort.

Concepts of Gestalt therapy

Below are some of the main concepts of Gestalt therapy:

Self-awareness

Perls suggests that many people develop mental health symptoms because they aren’t aware of their senses, emotions don’t have good recognition of their bodily sensations, and have poor awareness of their environment.

Perls explained that ‘awareness in itself is healing.’ Thus, Gestalt therapy sessions focus on helping people learn to become more self-aware and to accept and trust in their feelings and experiences to alleviate their distress.

During therapy, some experiential exercises may be used to help increase the client’s awareness. By building self-awareness, Gestalt therapy helps clients to better understand themselves and how the choices they make affect their health and their relationships.

With this understanding, clients can begin to comprehend how their emotional and physical selves are connected and not separate parts. Through this, they can develop more self-confidence to start living a fuller life and more effectively deal with problems.

‘Here and now’

Gestalt therapy focuses on the present moment rather than on past experiences or future possibilities. Focusing on the present doesn’t negate the past or future. In fact, the past is intricately linked to one’s present experience.

The idea is to avoid swelling on the past or anxiously anticipating the future. The idea is that if it’s a current problem, it can be dealt with. If it is in the past, it has already happened and cannot always be resolved.

Clients are urged to discuss their memories and concerns in the present tense. Experiences of the past that are brought up can be explored as to what factors made a particular memory come up in that moment or how past experiences impact the present moment.

Once clients become aware of the present, they can confront past conflicts or unfinished business – what Perls refers to as incomplete Gestalts.

Context is important

It is understood that context is important when the therapist learns about the experience of their clients.

Therapists can use Gestalt therapy techniques to help clients become more aware of their experiences, perceptions, and responses to events in the here and now.

It is thought that a person cannot be fully understood without understanding their context.

Gestalt therapists are taught to accept the validity and truth of their client’s experiences since they recognize that no one can be purely objective, including the therapist whose experiences and perspectives are also influenced by their own contexts.

Experiences can influence perception

The therapist recognizes that a client’s experiences can influence their perceptions, understanding that in this way, no one can be fully objective.

The therapist allows a space for clients to share their truth without imposing their own judgments, which are also influenced by their own experiences.

At the core, Gestalt therapy is the holistic view that people are intricately linked to and influenced by their environments and that all people strive towards growth and balance.

It emphasizes the therapist’s use of empathy, understanding, and unconditional acceptance of the client’s experiences to enhance therapeutic outcomes.

Dealing with painful experiences

Often, the easiest course of action for many people is to push down painful memories to avoid dealing with them. Gestalt therapy offers a space where clients do not have to shut these memories down anymore.

This does not mean that memories will be readily available at the start of therapy, but they may do eventually.

A Gestalt therapist will understand that painful experiences will come into awareness when the client is ready for healing in that area.

Gestalt therapy Techniques

Gestalt therapy is practiced in the form of exercises and experiments either in individual or group settings. Exercises, in general, are practices designed to bring about action, emotion, or goals from the client.

The therapist and the client can then examine the result of the exercise to increase their awareness and help the client understand the here-and-now of the experience.

Experiments, however, may arise throughout the development of the therapeutic process and therapeutic relationship.

Experiments are a core component of Gestalt therapy and allow the person to understand different aspects of a conflict, experience, or mental health issue.

Below are some of the main techniques which are utilized in Gestalt therapy:

Empty chair

The empty chair technique is a popular roleplaying exercise that allows the client to imagine and participate in a dialogue with another person or part of themselves.

This Gestalt therapy technique involves the client sitting in front of an empty chair while the therapist encourages them to imagine that either another person or a part of themselves (such as an angry, critical, or past part) is sitting in the chair.

The client will then engage in a dialogue with whoever they imagine is in the empty chair.

This exercise is thought to engage the person’s thoughts, emotions, and behaviors. It can be useful for helping people to become more mindful of the whole situation and forget or disengage pieces of themself.

This self-dialogue is a very popular technique and can be used by many therapists outside of Gestalt therapy.

Two-chair

The two-chair technique is similar to the empty chair technique in that the client is encouraged to have a dialogue with an empty chair positioned next to them.

However, after speaking to the metaphorical person or part of self, the client can respond to themselves by taking up the role of the other person or self.

The client will physically sit on the other chair and have a dialogue with themselves as if they are the other person or part. The client can go back and forth between the two chairs while the therapist observes and encourages meaningful dialogue.

This can be useful for gaining perspective and awareness of other people’s experiences. It can also help someone to come to decisions that were previously hard to make, as well as help them to have better interpersonal conversations with the person they may have experienced conflict with.

Both the empty chair and the two-chair Gestalt therapy techniques can help draw out important perceptions, meanings, and other information that can help the client be more aware of their emotional experience and how they can start healing.

‘I’ statements

The language a client uses and their tone are important in Gestalt therapy. As clients are encouraged to learn and accept responsibility, they learn to use language that reflects personal ownership rather than focusing on others and outside experiences.

Clients are encouraged to use ‘I’ statements to learn personal responsibility. For instance, instead of saying, ‘It made me feel angry,’ they could say, ‘I feel angry.’

Labeling an emotion as an ‘it’ makes it seem that the emotion is a separate entity to the individual. However, taking ownership and recognizing the emotion as a part of the self improves awareness.

According to Gestalt therapy, the more the client uses the word ‘I,’ the more their awareness will increase.

Confrontation

Confrontation was a key technique in the early days of Gestalt therapy but is not used as much in recent times. When something comes up that the therapist believes requires confrontations, such as when some sort of change is apparent, but the person cannot quite get there, the therapist becomes confrontational.

While this can be effective for some, others may find this technique too aggressive. The confrontational manner of the therapist may put clients off, so it is not used as often nowadays.

Body language

During therapy sessions, the therapist will pay close attention to the client’s body language and movements, such as hand gestures, posture, and facial expressions.

The therapist will likely mention their observations to the client and ask them what is happening for the person at that moment. They could say, ‘I notice you put your hand on your chest when speaking. Why do you think you did that?’

Incorporating language, the Gestalt therapist may even ask the client to give their body parts or facial expression a voice and speak from that place.

The technique of noticing body language helps to make the client more aware of what they are doing and what it means.

Exaggeration

Alongside giving body language a voice, the therapist may ask the client to exaggerate the motion they made or repeat it several times during the session.

This can be especially useful if the client finds it difficult to find the words to put to what is happening at that moment.

This makes them more aware of the emotions attached to the behavior and increases their awareness of immediate experiences.

Locating emotions

Often, a lot of emotions can be brought up during Gestalt therapy. When a client talks about an emotion, the therapist may ask them where they feel that emotion in their body.

For example, they may represent the emotion as a heavy or tight feeling in the chest, a lump in the throat, or tension in the shoulders.

Being able to do this brings awareness to emotions and helps the client stay present and effectively process their emotions.

Through Gestalt therapy, clients learn to discover emotions that may have been pushed down or masked by other feelings. The client can learn to accept and trust their emotions by bringing them to the surface.

Creative activities

Other activities such as painting, drawing, and sculpting can also be used to help clients gain awareness, stay present and learn how to process the moment.

Essentially, any method that can be offered to the client other than traditionally sitting still and talking can prove helpful in increasing self-awareness, awareness of experiences, and the process of healing.

Goals of Gestalt therapy

Maintaining present

Gestalt therapy aims to teach clients to stay in the present moment and be aware of what is happening around them and their emotions in the here and now.

The therapy is focused on what is happening at the moment and finding solutions in the present time. Dwelling on the past and being anxious about future events are thought not to be useful as they cannot be worked on; only the present can.

Increasing self-awareness

Often, people can create roadblocks or push things out of awareness, especially if they are painful.

Although this can help in the short-term, in the long-term, this can create troubles as we will then have more incomplete Gestalts and block self-awareness and growth.

Increasing client awareness allows for these roadblocks to be identified, properly challenged, and moved out of the way so that the person can heal.

The goal of Gestalt therapy is to collaborate with the therapist to increase personal awareness and actively challenge the roadblocks that have been getting in the way.

Teaching people to become aware of significant sensations within themselves and their environment can help them fully respond and reasonably to situations.

Adopting personal responsibility

As clients of Gestalt therapy become more aware of themselves and their senses, the goal is to take more responsibility for themselves, accept the consequences of their behavior, and learn to satisfy their own needs while respecting the needs of others.

When blaming others, people often lose a sense of control and become victims of other people or events.

Learning how to accept personal responsibility allows clients to gain a greater sense of control over their experiences and learn how to regulate their emotions and interactions with others better.

Increasing self-regulation

Gestalt therapists believe that all people want to achieve self-regulation, but sometimes, individuals can use maladaptive techniques to cope with unpleasant experiences.

While these may feel beneficial in the short term, in the long term, it can make people unable to regulate their emotions and feel unable to express themselves. They may find it harder to interact with others and be less able to achieve a sense of wholeness.

However, through the techniques used in Gestalt therapy, clients are taught ways to increase their self-regulation and, thus, drop the previously used maladaptive techniques.

What are the benefits of Gestalt therapy?

Some potential benefits of Gestalt therapy include the following:

• Improved sense of self-control

• Increased awareness of needs

• Improved ability to monitor and regulate emotions

• Improved communication skills

• Increased tolerance for negative emotions

• Improved mindfulness

• Increased emotional understanding

• Improved ability to view things from another perspective

• Increased self-esteem

• Increased decision-making skills

• Increased interpersonal skills

• Increased empathy for others

How effective is Gestalt therapy?

Although Gestalt therapy has been around for a long time, it is difficult to find strong supporting evidence for its effectiveness.

Much of the research that is found provides some support to mixed support, and fewer studies looking at the long-term effectiveness of this type of therapy.

Below is some of the research out there that has investigated the effectiveness of Gestalt therapy:

A study investigated the use of Gestalt therapy on those diagnosed with some form of depression and found that there were statistical differences between pre and post-test ratings of depressed symptoms, but the results were not significant (González-Ramírez et al., 2017).

A systematic review was conducted of all available studies on the effectiveness of Gestalt therapy over the course of 12 years. A total of 11 studies were found with Gestalt intervention shown to improve conduct in the group therapy setting – not only for clinical disorders but also related to other social issues (Raffagnino, 2019).

A study investigated the effectiveness of Gestalt therapy on the self-efficacy of divorced women, delivered over 12 sessions. The results showed Gestalt therapy increased the women’s self-efficacy compared to the control group (Saadati & Lashani, 2013).

A study aimed to examine the effectiveness of Gestalt therapy on the happiness of elderly people.

The results showed that the therapy significantly increased the happiness levels of those in the intervention group, concluding that Gestalt therapy can be helpful in enhancing positive emotions in older people (Saadati et al., 2013).

In school-aged children, Gestalt therapy was shown to be effective in decreasing test anxiety (Hajihasani et al., 2012).

A study examined the impact of Gestalt therapy on anxious parents in Hong Kong. After four weeks of treatment, the intervention group of participants had lower anxiety levels, less avoidance of inner experiences, and more kindness towards themselves when compared to the control group. However, self-judgment levels remained unchanged (Leung & Khor, 2017).

Gestalt therapy has been shown to be effective in decreasing the level of alcohol dependence among adults (Rajeswari, 2016).

A study aimed to determine the effectiveness of integrated group Gestalt therapy and cognitive therapy in improving the quality of life of war veterans.

There was found to be a significant difference between the quality-of-life dimensions (physical health, mental health, living environment, and social relations) between the intervention and control group, concluding that integrated group Gestalt and cognitive therapy influenced the increasing quality of life for these individuals (Sadeghi et al., 2012).

How to get started

You may wish to seek Gestalt therapy for a number of reasons. If you struggle with being aware of yourself or regulating your emotions, this could be a beneficial treatment for you.

Likewise, if you tend to dwell on the past or get anxious about things that may or may not happen in the future, you may find Gestalt therapy useful for keeping you in the present moment.

To find a Gestalt therapist, you can enquire with your primary care doctor or mental health professional to see if they can refer you to a certified therapist.

Alternatively, you can look for a licensed, experienced psychotherapist with a Gestalt approach to therapy.

Once you have established that a therapist has the credentials and experiences you are looking for, be sure to understand and be comfortable with the process as explained by the therapist.

Additionally, if you feel that the approach of the therapist is not right for your needs, you can change the therapist at any time. It can take people some time to find a therapist that they are comfortable with.

What are some things to consider?

Be prepared to answer questions about the present moment – expect the therapist to ask you about your experiences right now. The therapy focuses solely on the present moment, which can feel very limiting for some.

If you feel that revisiting the past is important in identifying what needs to be healed, then Gestalt therapy may not be best for you.

Having body language and emotions concentrated on can leave some people feeling uncomfortable, vulnerable, and defensive rather than safe and supported.

While it can be useful for some people to become more aware of what they are experiencing, it can make others feel uneasy.

Gestalt therapy sessions also do not follow specific guidelines. Therapists are encouraged to use creativity in their approaches depending on the context.

It can be very free-flowing in this way, but if you prefer a more structured approach, then it may be better to consider a different therapy.

Finally, be prepared to engage in the techniques involved in Gestalt therapy to obtain the most benefits. The empty chair and two-chair techniques can feel very unnatural, to begin with, but try to remain open-minded and follow the guidance of the therapist.

References

Dissociative Disorders. (Jul 05, 2021). 2021 Traumadissociation.com. Retrieved Jul 5, from http://traumadissociation.com/dissociative.

Dissociative Identity Disorder. (Jul 05, 2021). Traumadissociation.com, Retrieved Jul 5, 2021, from h

González-Ramírez, E., Carrillo-Montoya, T., García-Vega, M. L., Hart, C. E., Zavala-Norzagaray, A. A., & Ley-Quiñónez, C. P. (2017). Effectiveness of hypnosis therapy and Gestalt therapy as depression treatments. Clínica y Salud, 28(1), 33-37.

Hajihasani, M., Sadei, P.E., Jafari, N. H., Rostami, K., & Pirsaghi, F. (2012). The effectiveness of active music therapy and Gestalt therapy in decreasing test anxiety.

Hender, K. (2001). Is Gestalt therapy more effective than other therapeutic approaches. Southern Health/Centre for clinical effectiveness./Monash Institute of Health Services Research, Melbourne.

Leung, G. S. M., & Khor, S. H. (2017). Gestalt intervention groups for anxious parents in Hong Kong: A quasi-experimental design. Journal of Evidence-Informed Social Work, 14(3), 183-200.

Raffagnino, R. (2019). Gestalt therapy effectiveness: A systematic review of empirical evidence. Open Journal of Social Sciences, 7(6), 66-83.

Saadati, H., & Lashani, L. (2013). Effectiveness of gestalt therapy on self-efficacy of divorced women. Procedia-Social and Behavioral Sciences, 84, 1171-1174.

Saadati, H., Younesi, J., Foroghan, M., & Lashani, L. (2013). Effectiveness of gestalt therapy on happiness of elderly people. Iranian Journal of Ageing, 8(2), 7-15.

Sadeghi, S., Ghaderi, Z., & Jahedi, S. (2012). The effectiveness of gestalt therapy and cognitive therapy on improvement of life quality of war veterans. Armaghane danesh, 16(6), 0-0.

Strümpfel, U. (2006). Research findings on Gestalt therapy. Cologne, Edition Humanistische Psychologie [http://www. therapie-der-gefuehle. de/].

Suchitra, S., Rajeswari, H., Indira, A., & Kalavathi, B. (2016). Effectiveness of gestalt therapy on level of alcohol dependence among adults in selected villages, Nellore. IJAR, 2(8), 784-93.