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Gestalt Therapy Theory of Creative Adjustment

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Gestalt Therapy Theory of Creative Adjustment)

In Gestalt Therapy: Advances in Theory and Practice (Advancing Theory in Therapy), Talia Bar-Yoseph Levine

Book cover for Gestalt Therapy: Advances in Theory and Practice (Advancing Theory in Therapy), Talia Bar-Yoseph Levine

Page: 4 creative adjustments of id, ego, and personality describe procedural embodiments of the self

Page: 4 interruptions to contact (anachronistic “creative adjustments”) articulate disruptions in the continuum of awareness in a contact episode.

In Awareness Dialogue & Process: Essays on Gestalt Therapy Gary Yontef

Page: 399 The diagnostic process is a search for meaning. In Gestalt therapy theory meaning is the relationship between figure and ground.

Book cover for Awareness Dialogue & Process: Essays on Gestalt Therapy Gary Yontef

Page: 426 Neurotics show reduced awareness, elevated anxiety, depression and internal conflict. But they continue to manifest an interest in and a capacity for understanding consensual reality, including the phenomenological reality of others. They also show a continuity of personal identity, at least some minimal sense of self-esteem and esteem of others, and make a creative adjustment to their context.


In Gestalt Therapy in Clinical Practice: From Psychopathology to the Aesthetics of Contact (Gestalt Therapy Book Series 2) by Gianni Francesetti, Michela Gecele, Jan Roubal

the Gestalt concept of psychopathology as creative adjustment, (Kindle Location 635).

Creative adjustment is in fact the result of this spontaneous strength of survival that allows the individual to be differentiated from the social context, but also to be fully and importantly part of it. Every human behavior, even pathological behavior, is considered a creative adjustment. (Kindle Locations 899-901).

Book cover for Gestalt Therapy in Clinical Practice: From Psychopathology to the Aesthetics of Contact (Gestalt Therapy Book Series 2) by Gianni Francesetti, Michela Gecele, Jan Roubal

What led the group of founders to create a new theory of the self was a weakness in the psychoanalytic theory of the ego: «In the literature of psychoanalysis, notoriously the weakest chapter is the theory of the self or the ego. In this book, proceeding by not nullifying but by affirming the powerful work of creative adjustment, we essay a new theory of the self and the ego» (Perls, Hefferline and Goodman, 1994, p. 24). (Kindle Locations 1013-1014).

What does it mean to say that the self, as function, expresses a capacity or a process? … If the child is forbidden to suck (bite, chew, stand, walk, etc.), s/ he must compensate by doing something else to make contact, thereby seeking a creative adjustment to the situation. For example, if a child is given bad milk or punished for trying to crawl, stand, or walk, s/ he is significantly influenced by this experience. However, Gestalt therapy is not interested in judging the quality of the milk or the parents’ behavior; rather, it is focused on how the child reacts. … What helps patients rediscover their spontaneity is not only knowing what was not good but also experiencing new possibilities of making contact or rediscovering their ability to spontaneously make a new creative adjustment (Kindle Locations 1033-1035)

The personality-function, in fact, pertains to how we create our social roles (e.g., becoming a student, a parent, etc.), how we assimilate previous contacts, and creatively adjust to changes imposed by growth. (Kindle Locations 1113-1114).

the ego-function intervenes in the process of creative adjustment by making choices, identifying with some parts of the field, and alienating itself from others. The ego is that function of the self that gives an individual the sense of being active and deliberate. This intentionality is spontaneously exercised by the self, which develops it with strength, awareness, excitement and ability to create new figures. Kindle Locations 1127-1130)

The basic understanding of resistances as creative adjustments leads us think of psychopathology in a remarkable way. We believe that any symptom or behavior that is usually defined as pathological is a creative adjustment of the person in a difficult situation. The so-called losses of ego-function are creative choices to avoid the development of excitement during the various phases of the experience of contact with the environment. This excitement, as it is not supported, would lead to an experience of anxiety, (Kindle Locations 1205-1209).

consider human development and psychopathology as creative adjustment (see Spagnuolo Lobb and Amendt-Lyon, 2003). There are not some behaviors that are mature and right and other behaviors that are mistaken or immature. The terms “healthy”, “mature”, or “pathological”, “immature” all make reference to a norm external to the experience of the person, set by so-meone who is not immersed in the situation (and who for precisely this reason can claim to be “objective”). The phenomenological perspective, though in the dilemma between subjectivity and objectivity that is a central question in the thought of many philosophers (from Husserl to Heidegger to Merleau-Ponty and in some respects also Kierkegaard and Adorno), considers experience to be that which gives the knowledge, and which can in no way be replaced by conceptual analysis (Watson, 2007, p. 529). Hence it is important to consider the intentionality of a behavior, in other words the contact that animates and motivates it. (Kindle Locations 1277-1284).

Defense, which in a psychodynamic perspective has traditionally been seen in its impedimental aspect to the therapeutic process, in the Gestalt approach is seen, in contrast, as a relational ability based on a process of creative adjustment to be supported. This permits psychotherapy to move from an extrinsic model of health to an esthetic model, based on the current perception of the encounter between therapist and patient, so on factors intrinsic to the relationship (Kindle Locations 1287-1290).

our perspective, psychopathology is the suffering of the contact boundary. It may or may not be felt as subjective pain. When the subject does not fully perceive that which happens at the boundary, no subjective pain is felt. However the other, or a third party, may feel it. From a clinical point of view, it is not the pain which is pathological, but rather the impossibility of sustaining it and of being fully aware of it at the individual, family and social levels. In order to reduce subjective pain, it is the between, the boundary, which is made to suffer. In this way, the level of pain perceived is lowered, but so is awareness. In developmental terms, this capacity to reduce unsustainable pain is a creative adjustment that protects the individual, the family, and society. But now, that same capacity inhibits the individual from feeling, living, and acting to the full, from fully experiencing the self and the environment with which he is in contact. Kindle Locations 1534-1541).

From a Gestalt perspective symptoms are products of a creative self and display human uniqueness (Perls, Hefferline and Goodman, 1994). Psychopathology is a co-creative phenomenon of the field, which represents a unique creative adjustment in a difficult situation. (Kindle Locations 1621-1623).

the suffering of a relationship is the outcome of creative adjustments made within a difficult field. Original creativity may have been lost and have become a fixed Gestalt, though it may still have held positive meaning in the person’s life (Perls, Hefferline and Goodman, 1994; Zinker, 1978; Spagnuolo Lobb, 1990; 2003b; 2005a). This can easily be seen in neurotic adjustment, where a creative adjustment made at some stage in a person’s history results in her diminished presence at the contact boundary. The case of psychotic experience is different. Psychosis is the expression of a lack of basic ground. Here, the goal is not to restore awareness of interrupted contact, and in so doing assimilate it, with the result that the possibility for new creative adjustments is restored; rather, the task of the therapeutic relationship is to build a ground that has never been created (Spagnuolo Lobb, 2003a; Salonia, 2001a; Conte, 2001) (Kindle Locations 1688-1694).

Loc: 1,687- Loc: 2,578 Oriented towards creativity: the suffering of a relationship is the outcome of creative adjustments made within a difficult field. ... Loc: 2,547 the actual evidence in contact and the developmental process respond to the Gestalt principle of creative adjustment. ... Loc: 2,548 we need to describe how the patients’ creative adjustment has developed ... (in) time within significant relationships. ... the intentionality of contact and its fulfilment through creative adjustment ... guide to work with the bodily process. ... the block of development coincides with a block of the bodily process, ... implies a reduction (or loss) of sensitivity ... hence the reduced ability to tune in to the other. ... we examined the case of an 18-month-old child, ... Note: FOR EXAMPLE ... had “resolved” an obvious tension between his parents by leading them to sing: ... In terms of developmental theories, this behavior on the part of the child is “atypical” and not appropriate to his growth: ... For Gestalt therapy this behavior is appropriate and creative, ... it allows the child not only to fulfil his intentionality of contact towards his parents ... also to find a solution in which everyone feels better ... it solves the problem that arose at that moment in the phenomenological field, ... gives the child an important confirmation for his growth. ... if the behavior should become repetitive, it would be a sign of desensitization: the child would carry it out without the freshness of the spontaneous contact, and it is this that would create the problem, not the behavior in itself. … does not help us … to think of pre-established stages or norms with which to confront the child’s bodily evidence, … rather it helps us to assess how the child organizes … with a view to appreciating his creative adjustment and supporting it.

we need to describe how the patients’ creative adjustment has developed in time within significant relationships. What is helpful to us is not seeing whether the patients have reached certain goals, but how they have fulfilled the intentionality of contact adjusting creatively to difficult situations. (Kindle Locations 2548-2550)

For Gestalt therapy, the intentionality of contact and its fulfilment through creative adjustment are the guide to work with the bodily process. Kindle Locations 2554-2555).

We can regard taking benzodiazepines as a creative adjustment. For the patient using drugs actually presents the best possible and available way of handling the difficult situation. If we observe the effect of benzodiazepines in a phenomenological way, we can see they slow down the contact cycle and make it smoother. They only have a short-lasting effect, but they can interrupt the vicious circle of anxiety and activate the patient’s self-healing forces. We present several examples of such effects: - Some perceptions can be so strong they lead to a massive anxiety that blocks awareness. If benzodiazepines moderate the intensity of perceptions, they can help the patient become at least partially aware and free to make conscious choices to handle the situation (Kindle Locations 3922-3927).

usually vague «until it finds some object to work on; it is the work of creative adjustment that heightens awareness of what one wants. But in cases of extreme need, extreme physiological deficit or surfeit, the spontaneous appetite may make itself definite, bright, and sharply delineated to the point of hallucination. In the defect of an object it makes an object, largely out of the fragments of memory. (This occurs, of course, in the neurotic “repetition”, when the need is so overpowering in its influence and the means of approach are so archaic and irrelevant than an ordinary creative adjustment, assimilating a real novelty, is impossible.)» (p. 404).

The context in which we live is very complex and the level of complexity increases further when we deal with intercultural issues. The lack of awareness of backgrounds becomes more and more limiting. Too many stimuli overwhelm us at any moment. Figures have difficulty in forming and run the risk of becoming «a false integration of experience» (Perls, Hefferline and Goodman, 1994). Creative adjustment means mainly selecting stimuli and being able to “stay” in the background. It is important to tolerate the anxiety that can come from avoiding looking for the figures too early. But creative adjustment means also to be open to complexity. These two directions, seemingly opposite, are connected because if you cannot comprehend and distinguish the stimuli there are fewer possibilities to choose from. The consequence of this is a random selection that removes complexities but not difficulties. (Kindle Locations 5111-5119).

One of the consequences of globalization is that in the background there is the “whole world”, which is not the background that we make up and feel through awareness but the excess of stimuli, lack of breaks and unfinished contacts. Only a small part of this world made up of pieces of information, images, sketched experiences can be absorbed through contact processes and creative adjustment. In a way every item is present and handy but grasping it becomes difficult. This can create confusion and renunciation as one does not feel able to find one’s way and give shape to chaos. (Kindle Locations 5120-5124).

Getting in contact with each other, the new experience, always involves a great deal of risk. Adequate support is needed in order to create the right space/ time for the meeting, so that the relational intentionality can unfold and the consequences of contact is a new creative adjustment. The support comprises the relationship itself, real life stories, emotional ties, experiences, roles, roots, language, habits, the meaning we give to life and our existence in the world. (Kindle Locations 5256-5260).

Prejudices as pre-judgments affect the way we can orient ourselves in the world and are determined by past knowledge. When pre-judgments are flexible they are useful. They become an obstacle to creative adjustment when identified as absolute truth, the risk being higher in fragmented social settings. (Kindle Locations 5284-5286)

Creative adjustment, then, is the sophisticated solution that allows individuals to live within painful and damaging situations in a way that they perceive to be as protective of themselves as possible. However, some ramifications of frequent lapsing into one such pattern may mean repeatedly getting stuck in unwanted situations without managing to release oneself. (Kindle Locations 6190-6193).

What is called “behavioural problems” (the result of the psychopathology), is in fact a creative adjustment to the situation. (Kindle Locations 6827-6828).

the theoretical process is toward a creative adjustment, that all living beings adapt instinctively to new situations; (Kindle Locations 7278-7279).

If the figural new and experimental creative adjustment forms too rapidly and stands upon a shifting ground we create a recipe for fragmentation rather than integration. (Kindle Locations 7953-7954).

5.3. Delusion and Hallucination as Creative Adjustments The two most striking psychotic symptoms, delusion and hallucination, are an attempt to make sense of an experience of non-differentiation or of disconnection. Delusion is a creative adjustment that builds a web of unilateral and rigid meanings where it is not possible to access them through the co-construction of meaning and boundaries. Delusion gives a meaning that is narratable and, therefore, at least communicable, albeit at the lower limit of what can be shared, to an experience that is constitutionally ineffable. It is an extreme attempt to reach the other through communication that is not shared, but which always holds within it a grain of truth to be communicated. (Kindle Locations 9523-9530)

Hallucination can be a creative adjustment by constructing a res ob-jecta, something cast out, to become a reality that can be relied upon; the boundary may not be accurate, but it constitutes a reality that placates a more sinister and more distressing atmosphere. Clinical examples will provide, further on, an outline of clinical work on the ground and on the experiential truths that lie in psychotic experience. (Kindle Locations 9543-9544).

The figure that predominantly rules the co-constructed figure/ground dynamics of the field is a loss of hope when facing the inability to reach the other. ... two other concepts, that enable us to see depression either as a form of a creative adjustment or as a fixed Gestalt. ... The depressive experience also has an interpersonal nature, it is a co-created phenomenon: ... if a person uses a depressive way of relating in a rigid and stereotypical way in her/his life, the depressive functioning becomes a fixed Gestalt. Loc: 10,475 - Loc: 10,491

If the broad, gradual nature of the depressive experience is seen as a means of saving energy in fields where contact has become difficult, then mania is the failure of this creative adjustment. … even increased drive, dispelled energy, and effort beyond hope can be seen as a functional creative adjustment within a field. Loc: 10,956 - Loc: 10,957

retroflection enables engagement to be slowed down, making it possible to readjust the emotion, correct the ground and hence reconsider the emotion. ... is called self-control, and is linked to the exercise of will. ... appropriate to slow down or not engage in aggressive activity, considering the context ... A retroflection may then rightly be considered a creative adjustment. ... Thinking (re-flecting) is a type of retroflection, talking to yourself. ... Thinking as a way of preparing to relate is not the same as thinking as a way of avoiding action. Loc: 11,523 - Loc: 11,530

eating disorders are ... an expression of a person’s intentionality to grow, ... the best creative adjustment ... possible to the complexity of post-modern society, to changes in family relationships, ... Such a dramatic creative adjustment ... lies in the intersection between three fields of experience ... These three fields of experience concern the body ... the construction of female gender identity; ... adolescent contact processes. Loc: 12,577 - Loc: 12,582

The step to vomiting becomes a creative adjustment that enables a partial outline of the self to be restored and, as a result, the perception of a contact boundary (“ I’m still beautiful, with my feminine figure. I have power over food, and hence over relationships”). Vomiting takes the experience back to the underlying ground, to the initial condition of possibility – the renewed hope that the contact process can, sooner or later, start over again from a whole sense of self and from an unequivocal intentionality for contact, to achieve real, nourishing contact. “I’ll finally be able to draw my fill of nourishment from you and feel unequivocally whole”. Hope is «focused […] not on what is not there, but rather on what is not there yet» (Borgna, 2008, p. 65). (Kindle Locations 12819-12824).

Gestalt theory is trans-typological, that is to say, it reflects the common patterns of creative adjustment on the neurotic level and is dialectic throughout, which means that it is built up of contradictions and paradoxes, which is not always easy to comprehend for people in general and even for therapists in particular. (Kindle Locations 13218-13220)


In Absence Is the Bridge Between Us: Gestalt Therapy Perspective on Depressive Experiences (Gestalt Therapy Book Series 4)

The second type of depression, which I have defined as an “embodied” configuration of the experience with the other, is characterized by a tendency not to ad-gredere: the person creatively adjusts to the organism-environment field renouncing full participation in his/her own actions. “Embodied” depression has to do with a permanent renunciation of the movement-towards, with a structured experience of non-involvement in the situation while maintaining the perception of the border between oneself and the other. Loc1048

Book cover for Absence Is the Bridge Between Us: Gestalt Therapy Perspective on Depressive Experiences (Gestalt Therapy Book Series 4)

no co-created figure of contact emerges and intentionality does not spread its transcendental wings. What can be encountered is an oppressive emptiness where nothing emerges, or otherwise it is a fixed figure that is obsessive and delusional. Various contents may fill this fixed figure, such as, as we said, an obsessive and delusional concern for one’s health (hypochondria theme), or for one’s financial situation (bankruptcy theme), or for an act that has been committed or omitted (guilt theme). The fixed figure is a creative adjustment which serves what is probably a protective function; its task is to reduce suffering by giving form and a frame of meaning to suffering itself – a suffering that would otherwise be a timeless and boundless nothingness. Loc2238

retroflexion is an effective way of withdrawing from pain in this situation. To protect from the suffering felt in each of the stages of this experience, various systems step in, each of which constitute a creative adjustment. Loc 2473

someone who cannot anchor herself to the world through the id function can currently find other creative adjustments to save her from melancholia. Perhaps even the extraordinary media connections of our age play a protective role in this sense. Loc 2758

We hold that psychotic experiences are not creative adjustments per se, but rather one of the different human ways of being-in-the-world, which, as we will see, gives us a photographic negative of some of the most fundamental human characteristics. This does not mean that psychotic depressive experiences are not creative adjustments – to the contrary, what we encounter is the outcome of a long, hard and creative adjustment to given conditions of life. But we do not wish to view melancholic depression naively as a creative effort in itself. Loc 2951

Drugs are of particular importance in the event of delusion, where the figure/background dynamic is stuck and does not permit compatible figures to emerge. Remember, it is pointless to try and overturn the delusion. As we have said, it is a creative adjustment to protect the person from a much vaster sense of anguish. Loc 3943

Contacting proceeds as a temporal sequence. Only pathological creative adjustment seems to hold onto time in an eternal moment. I think we can say that there are manic experiences that without a doubt are fixed adjustments that repeat fruitless human suffering. But if we truly mean that the contact boundary in which we experience one another is a relational and phenomenal process, each of us is a co-creative participant in any manic process. Loc 9652

PHG tells us that creative adjustment is self process as a function of the possibilities and constraints of the organism/environment field. Loc 9689

Somehow mania is an extreme creative adjustment, which is very near to the opposite polarity: disruption of both creativity (peculiar way of being) and adjustment. Loc 9707


In Psychopathology of the Situation in Gestalt Therapy (Gestalt Therapy Book Series)

In Gestalt therapy, we consider psychopathology as a creative adjustment in a difficult (p. 24).

5.1.2 The Polyphonic Development of Domains

Book cover for Psychopathology of the Situation in Gestalt Therapy (Gestalt Therapy Book Series)

In my understanding, the ground can be considered a “Polyphonic Development of Domains”: a complex weaving of vital, acquired ways of introjecting,

projecting, retroflecting, and so on, with more or less anxiety. Not only can the so-called “losses of ego functions” (Perls et al., 1951/1994) be seen as modalities of contact, ways through which the organism has creatively adjusted to difficult situations (see Polster and Polster, 1973; Müller-Ebert et al., 1988), but they can also be viewed as acquired competencies for contacting, as parts of the ground that intertwine to create the experience of the ground, that in the here and now supports the process of contact. (pp. 27-28).

People need to regain the sense that they can rely on the environment and on themselves, to open themselves up to a creative adjustment with the other. The pandemic has certainly increased our feelings of insecurity in terms of the ground, but it has also shaken to the foundations some perceptive inflexibilities of post-modern society, envisaging the emergence of new resources, which will take on a more defined form in the coming years.(p. 38).

The symptom: In Gestalt therapy, the symptom is considered a creative adjustment in a difficult situation, the best way in which the organism has been able to tackle a particularly complex situation starting with the possibilities of self and hetero-support of which he/she can avail him/herself (Perls et al., 1951/1994; Perls, 1992; Wollants, 2012). The symptom is viewed from a standpoint of (relational) contact, not an individual one, and is herein analysed from two perspectives. … Diachronic perspective: This comprises the history of the symptom and the suffering,… Synchronic perspective: Its aim is to analyse “how” the patient contacts the therapist in the telling of their symptom/suffering.(p. 83).


In The Gestalt Field Perspective Gaffney, Sean; O'Neill, Brian

Book cover for In The Gestalt Field Perspective Gaffney, Sean; O'Neill, Brian

The organism has two main needs – balance and growth – and organises the field to meet these needs, e.g. if I’m hungry, I organise the field into food/not food. Over time the contact the organism has with its environment forms patterns, repetitions, habits and creative adjustments to novel stimuli that form a residue of experience. These are the patterns of contact, frequently laid down in procedural memory, that become maintained over time and constitute that portion of the “self” known by gestalt therapists as personality function. Loc 501

People usually come to therapy with this process diminished and blunted in some way through fixed gestalten and redundant creative adjustments. Loc 507


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