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Now-for-Next in psychotherapy

Updated: Feb 1

By Margherita Spagnuolo-Lobb in The Now-for-Next in Psychotherapy: Gestalt Therapy Recounted in Post-Modern Society. 1 ed. Siracusa: Istituto di Gestalt HCC Italy.

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The Now-for-Next in Psychotherapy in Gestalt Therapy Recounted in Post-Modern Society
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now-for-next in psychotherapy (LOC: 125)

a concept – typically phenomenological – that implies a constant attention and empathy, (LOC: 126)

to the intentionality with which the patient is revealed (LOC: 127)

in the here and now of the therapeutic session. (LOC: 127)

some central concepts of Gestalt therapy anticipated recent developments of psychotherapy. (LOC: 138)

concepts of emotional self-regulation, of motivation to the interpersonal relationship and to creative growth, of the need for intuitive understanding between child and mother (LOC: 139)

1. The Reasons for the Book (LOC: 207)

to penetrate into the mesh of contemporary Gestalt clinical work, (LOC: 209)

determine how it has developed, (LOC: 209)

find the necessary interweaving between clinical work and society which defines the epistemological roots of this approach. (LOC: 209)

the therapist’s response evokes with aesthetic power the figure/ground dynamic that moves the patient’s contact. (LOC: 222)

phenomenological perspective, centered on the experiential field (LOC: 223)

therapist, is the post-modern declension of the Gestalt method (LOC: 224)

responding (LOC: 224)

to the new cultural trends and (LOC: 224)

a development of the Gestalt approach that is consistent with its founding principles. (LOC: 225)

2. Gestalt Creativity: a Resource and a Limit (LOC: 243)

Laura Perls used to say, there are as many Gestalt therapies as there are Gestalt therapists. (LOC: 243)

Creativity and the integration of differences have always been the most marked characteristics2 (LOC: 246)

when the whole psychotherapeutic world addressed the relationship (from the 1990s on), at the same time of the discovery of mirror neurons in 1992 (Gallese, Migone and Eagle, 2006), Gestalt therapy did not have to create anything new, (★ LOC: 259)

3. Development of Social Feeling and Psychotherapy (LOC: 262)

1950s-1970s (LOC: 266)

In this period, defined by sociologists as “narcissistic society” (Lasch, 1978), all the new psychotherapeutic approaches were aiming at the resolution of a relational and social problem: how to give more dignity to the capabilities of real life, which had been in the shade in Freud’s last formulations. (LOC: 266)

All the psychotherapeutic currents that arose in the twenty years from 1950 to 1970 (LOC: 276)

had in common the desire to give greater dignity and trust to individual experience, considered of fundamental importance for society. (LOC: 277)

Gestalt therapy, (LOC: 283)

founding a theory of the self (LOC: 283)

grasping the experience during a process of contact of the organism with the environment (LOC: 283)

revealing the creativity of the ego in this process, (LOC: 284)

the description of the self, (LOC: 286)

which “is made” at the boundary between organism and environment, (LOC: 286)

an aesthetic process, awareness, presence to the senses, as an intrinsic quality of a good contact (LOC: 287)

original concept with which Gestalt therapy made (LOC: 288)

refers to the positive nature of conflict in human relationships: (LOC: 289)

suppressed conflict leads either to boredom or to war (LOC: 289)

(Perls, 1969a, p. 7). (LOC: 289)

Going through (LOC: 290)

conflict is a guarantee of vitality and of true growth. (LOC: 290)

typical language of patients in the 1950s? (LOC: 290)

“I want to be free”; (LOC: 291)

“Bonds are suffocating: they stop me fullfilling myself with my potentialities”; (LOC: 291)

“I’m asking for help to free myself from the bonds that oppress me.” (LOC: 292)

1950s-1970s emerged around these experiences. (LOC: 293)

There was a need to expand the ego, to give it greater dignity, a need for independence. (LOC: 294)

intimate relationships were more lasting (LOC: 299)

the primary family relationships were certainly more stable. (LOC: 300)

therapist’s answers (LOC: 300)

“You have the right to be free, to fullfill yourself, to develop your potentialities”; (LOC: 300)

what was supported was self-regulation and separation from bonds, (LOC: 301)

at the cost of caring for what happens at the contact boundary with the other. (LOC: 302)

1970s-1990s (LOC: 302)

characterized by (LOC: 302)

the “technological society”, (LOC: 303)

and (LOC: 303)

put the illusion of controlling the human emotions, (LOC: 303)

a hindrance to productivity, (LOC: 305)

Love and pain, (LOC: 305)

considered irreconcileable. (LOC: 306)

society”, the “technological society” could be defined as “borderline”. (LOC: 306)

on the one hand the strong pressure of successful parents, (LOC: 307)

on the other the lack of support for (LOC: 308)

for their attempts to be someone in the world. (LOC: 308)

The child of God doesn’t make mistakes! (LOC: 308)

This generation, (LOC: 309)

grew up with the illusion of being exceptional, (LOC: 309)

on the other had to conceal the sense that they were bluffing, (LOC: 309)

a borderline relational modality: ambivalent, dissatisfied, incapable of separating (LOC: 310)

to affirm their own values. (LOC: 310)

flight (LOC: 311)

into “artificial paradises”, (LOC: 311)

facilitated the spread of drugs, but also of important group experiences. (LOC: 311)

in psychotherapy these twenty years saw a special interest in groups: (LOC: 312)

one (sometimes the only possible) source of healing. (LOC: 313)

There was a search for the self outside the intimate bonds, (LOC: 316)

to solve the (LOC: 317)

difficulty of being-with (LOC: 317)

In the ’90s, (LOC: 318)

the search for the self was (LOC: 318)

to feel oneself in solitude: (LOC: 318)

The therapist’s answers (LOC: 321)

“Trust yourself – go back to the origins of your being (in phenomenological terms) (LOC: 322)

else: “Let’s see what’s happening between the two of us”. (LOC: 322)

all the methods were addressed (LOC: 323)

to (LOC: 323)

“contact boundary”: (LOC: 324)

a new way of looking at transference and counter-transference. (LOC: 324)

From the 1990s to 2010. (LOC: 326)

ambivalence towards one’s own value gave way to a sense of liquidity, (LOC: 327)

experiencing the absence of intimate, (LOC: 328)

relationships: parents have been absent, (LOC: 328)

worried about the imminent social crisis, (LOC: 329)

grew up in a period of great migratory movements, (LOC: 331)

unable to rely on the intergenerational tradition for support and a sense of rootedness (LOC: 331)

Traditions are often lost (LOC: 332)

village squares have been replaced by the virtual “squares” of (LOC: 332)

The social experience of young people today is (LOC: 333)

incapable of containing the excitement of the encounter with the other (LOC: 333)

The child doing homework, (LOC: 334)

at the moment when s/he has difficulty needs a containment and an encouragement, (LOC: 335)

But there is no one home to tell, no containing wall (LOC: 336)

what s/he feels and what s/he wants. (LOC: 336)

on the Internet, (LOC: 337)

her/his excitement is scattered and strewn round the world (LOC: 337)

but does not find a relational container, a human body, (LOC: 338)

unrestrained excitement becomes anxiety. (LOC: 338)

to avoid feeling it the body must be desensitized. (LOC: 339)

today we have many anxiety disorders (LOC: 339)

difficulty in forming bonds, (LOC: 340)

bodily desensitization. (LOC: 340)

Our patients, (LOC: 340)

say things to us like: (LOC: 341)

“In a chat online I feel free, but with my girlfriend I don’t know what to talk about”, “Nobody really interests me”, (LOC: 342)

Forms of malaise emerge (LOC: 343)

a body insensibility that appears in the relationship. (LOC: 343)

difficult to perceive the other: the field is full of anxiety and worries. (LOC: 344)

The therapist (LOC: 344)

supporting the physiological process of the contact (LOC: 345)

(the id of the situation, (LOC: 345)

“Breathe and feel what happens at the boundary”. (LOC: 345)

supports the ground (LOC: 346)

identifies (LOC: 346)

what modality of contact) (LOC: 346)

patient maintains the figure (or the problem). (LOC: 346)

being healthy (LOC: 349)

today (LOC: 349)

means experiencing the warmth in intimate relationships, (LOC: 349)

twenty years ago (LOC: 351)

difficult to remain in the relationship, (LOC: 352)

today (LOC: 352)

difficult to feel oneself in the relationship, (LOC: 352)

mutual mirroring (LOC: 354)

relational containment, (LOC: 355)

sense of the presence of the other, (LOC: 355)

are lacking. (LOC: 355)

today psychotherapy (LOC: 356)

twofold task: (LOC: 356)

resensitize the (LOC: 356)

body, (LOC: 357)

give tools of horizontal relational support, (LOC: 357)

(see Chapter 5). (LOC: 358)

In this new clinical and social need Gestalt therapy focuses on the concepts of intentionality of contact and contact-boundary, as a synthesis of the two phenomenological (Rosenfeld, 1978b8) and pragmatic (Bloom, 2009) roots. (LOC: 358)

the study of phenomenology with regard to intentionality, the now-for next (LOC: 362)

for the Gestalt approach is always an intentionality of contact with the other. (LOC: 363)

The phenomenological perspective, (LOC: 390)

considers experience to be that which gives the knowledge, and which can in no way be replaced by conceptual analysis (Watson, 2007, p. 529). (LOC: 391)

important to consider the intentionality of a behavior, (LOC: 393)

the contact that animates and motivates it. (LOC: 393)

phenomenological knowledge every time implies a “re-learning to look”: in the world of phenomenology knowledge does not exclude intuition, in that it emerges from perception (Merleau-Ponty, 1965) (LOC: 395)

perception is based on the senses – it is strictly linked to aesthetic judgment. (LOC: 396)

psychotherapy (LOC: 399)

an aesthetic model, based on the current perception of the encounter between therapist and patient, (LOC: 399)

on factors intrinsic to the relationship (see Chapter 4; also Francesetti and Gecele, 2011). (LOC: 400)

Gestalt diagnosis focuses the modality of contact with which the person avoids the anxiety of the excitement of contact, (LOC: 400)

to identify the type of contact on which the therapeutic relationship will be staked (LOC: 401)

(Köhler, 1975), the European academic current of research which offered phenomenology as the epistemological view capable of overcoming the problem of objectifying human perception, (LOC: 404)

The Gestalt therapist (LOC: 407)

intend to (LOC: 407)

to lead her/him to (re)appropriate spontaneity in making contact, (LOC: 408)

to (re)acquire the fullness of her/his being-there in the contact. (LOC: 408)

task consists in helping the person to recognize the creative experience of her/his adjustment, re-appropriating it in an embodied manner, without anxiety, in other words with spontaneity. (LOC: 409)

Broadly speaking, psychotherapeutic approaches consider the therapeutic relationship a virtual tool to improve the real relationships of the patient’s life2. Gestalt therapy, in contrast, attributes to the therapeutic relationship the character of a real experience, (LOC: 490)

it is the real encounter between two people that produces the treatment, an encounter in which there occurs a novelty capable of reconstructing the patient’s ability of contact. (LOC: 507)

3. The Role of Aggression

in the Social Context and the Concept of Psychopathology as Unsupported Ad-gredere4 (LOC: 511)

Fritz Perls’ intuition on childhood development, (LOC: 512)

is based on a conception of human nature as capable of self-regulation, certainly positive as compared with the mechanicist conception in force at the turn of the 19th-20th century (LOC: 513)

The child’s (LOC: 515)

ability to deconstruct reality. (LOC: 515)

This spontaneous, positive, aggressive strength has a function of survival, but also of social interconnection, and allows the individual to actively reach what in the environment can satisfy her/his needs, deconstructing it according to her/his curiosity. (LOC: 515)

The physiological experience of ad-gredere, (LOC: 517)

requires oxygen, (LOC: 518)

in other words has to be balanced and supported by exhalation, a moment of trust towards the environment in which the organism relaxes its tension and control, to go on to take another breath (and oxygen) in a spontaneous, self-regulated manner. (LOC: 523)

When this support of oxygen is lacking, excitement becomes anxiety. (LOC: 526)

“excitement without the support of oxygen”. (LOC: 527)

In Gestalt therapy we speak of “intentionality of contact” (LOC: 561)

we consider both the physiological “aggressive” strength (LOC: 562)

and the evidence of being-there-with, (LOC: 563)

It is precisely the excitement of the senses that allows differentiation (LOC: 569)

I realize that my movement is different from others’, so I identify myself, (LOC: 569)

The contact boundary is defined by meeting one another in diversity, (LOC: 570)

Only faith in the intrinsic ability of the human being to do the best thing possible at a given moment and in a given situation can direct the Gestalt therapist towards being in the therapeutic contact and relationship, not depending on diagnostic patterns outside it. It is this awareness that allows her/him to find a new therapeutic solution every time. (LOC: 584)

the therapist asks her/himself: “How do I contribute to the patient’s experience at this moment?”. The question is not posed in terms of action/reaction, nor in terms of taking on responsibility, but is rather: “From what ground of the experience of the therapeutic contact does the figure that the patient is creating emerge?”. (LOC: 590)

It is a matter of referring not to the transferal logic of projection, but to the figure/ground dynamic. (LOC: 598)

the therapeutic action must support what the patient already is able to do, rather than modify what does not work. (LOC: 638)

Note: this will link with Erskine/Ware Open Door to Therapy analysis; supporting the client through what they know how to do, nudging to the uncomfortable knowing, and in line with the paradoxical theory of change the client will deliver their self into the different

For Gestalt therapy, being in the present is rather a being in the reality of the situation (both the patient’s and the therapist’s), in the reality of their human finiteness, and it is by staying in this shared finiteness that they are both directed towards the therapeutic aim. (LOC: 660)

The basic understanding of resistances as creative adjustments leads us to think of psychopathology in a remarkable way. (LOC: 1,262)

any symptom or behavior that is usually defined as pathological is a creative adjustment of the person in a difficult situation. (LOC: 1,263)

Retroflection is the interruption most often seen by the therapist in the patient. (LOC: 1,270)

Our goal is that of recollecting all experiences in their whole – whether they are physical, mental, sensitive, emotional or verbal – since it is from the unitary work of “body”, “mind” and “environment” (which are just abstractions in themselves) that emerges the lively process of figure/ground. (Perls, Hefferline and Goodman, 1951, p. 331) (LOC: 1,437)

According to Gestalt therapy, the individual makes contact with the environment using the specific physiological supports s/he has at her/his disposal. They are part of her/his experience and are necessary for the spontaneous self-regulation of her/his being-with. (LOC: 1,466)

seeing the body from a positive relational anthropological perspective, in which the creative adjustment to difficult situations is the lens through which to look at the patient’s symptoms, as well as her/his therapeutic resources. (LOC: 1,486)

the attention to the bodily experience in Gestalt therapy cannot be separated from the attention to the development of the processes of contact in the arc of life. (LOC: 1,488)

Until the 1980s, (LOC: 1,512)

the international Gestalt community considered it pointless to make reference to a developmental theory, since the (LOC: 1,512)

work is carried out in the here-and-now. (LOC: 1,513)

it would have been a matter of going back to the need for interpretation, (LOC: 1,516)

In the 1980s, however, (LOC: 1,518)

the increase in serious disturbances necessitated not only a developmental perspective but also the use of diagnostic keys. (LOC: 1,518)

it was realized that the freshness of the contact between the therapist and the patient can be improved, not impoverished, if it is looked at through the lens of a theoretical reference that is consistent with the method. (LOC: 1,519)

The challenge (LOC: 1,521)

remains, (LOC: 1,521)

that of using theoretical references that start from the experience of the patient and of the therapist in the here-and-now of the therapeutic situation. (LOC: 1,522)

there was a move in the 1980s to the concept of “psychology of the life cycle”, (LOC: 1,524)

life, or any developmental path, is constructed by means of phases, characterized by needs, skills, specific existential themes and maturative tasks. (LOC: 1,528)

leads to relational maturity, (LOC: 1,529)

I call the Gestalt perspective the “polyphonic development of domains”, (LOC: 1,532)

I believe that a relational, procedural and phenomenological approach such as that of Gestalt therapy must consider the “given” situation and hence the background of the patient’s developmental experience (diachronic level) and the figure of the present malaise and of the intentionality of contact which s/he seeks to bring to completion (synchronic level). (LOC: 1,542)

Both the bodily evidence in contact and the developmental process respond to the Gestalt principle of creative adjustment. Hence, we need to describe how the patient’s creative adjustment has developed in time within significant relationships. (LOC: 1,553)

helpful to us is (LOC: 1,554)

how they have fulfilled the intentionality of contact adjusting creatively (LOC: 1,555)

the Gestalt therapist needs is a somatic and developmental aesthetic mind, (LOC: 1,596)

we need to retrace, in the patient’s body and words, the evolution of the processes of contact, in order to understand what freshness and vitality they still contain, (LOC: 1,597)

Therapeutic language must start from the “reasons of the body” of the patient, to use Nietzsche’s words, as they reverberate in the body of the therapist. (LOC: 1,599)

4. The Gestalt Therapy Map of Polyphonic Development of Domains (LOC: 1,600)

that in the developmental perspective (LOC: 1,601)

two acquisitions of the modern theories of development must be integrated: (LOC: 1,601)

“Representations of Interactions that have become Generalized” (LOC: 1,602)

(RIG) (Stern, 1998, “Interpersonal World of the Infant”, p. 97) (LOC: 1,605)

the idea of polyphonic development. (LOC: 1,606)

RIGs (LOC: 1,606)

consider how the child learns “ways of being-with” (LOC: 1,607)

The Gestalt modalities of contact (LOC: 1,609)

constitute our hermeneutic category of being-with, (LOC: 1,610)

the competences of the self-in-contact with the environment. (LOC: 1,610)

In Gestalt epistemology it would not make sense to talk about (LOC: 1,611)

domain of explicit or implicit (LOC: 1,611)

relational knowledge, in that the self is a unitary process of contact (cf. Chapter 2), (LOC: 1,611)

the id, personality and ego functions, (LOC: 1,612)

acquired a holistic modality of contacting the environment, not a knowledge. (LOC: 1,612)

The concept of polyphonic development of domains, (LOC: 1,613)

the development of domains rather than phases (Stern, 1985; 1990): (LOC: 1,614)

but comes about like the composition of a melody (LOC: 1,615)

acquiring new themes (LOC: 1,616)

and instruments (LOC: 1,616)

is transformed into a new, ever more articulated and complex harmony (LOC: 1,618)

development (LOC: 1,619)

is seen as a melody to be appreciated and supported. (LOC: 1,621)

A Gestalt developmental theory that hypothesizes a development of the modalities of contact in terms of maturation (LOC: 1,621)

superimposes the synchronic level of the description of the experience of contact (LOC: 1,623)

on the diachronic developmental level. (LOC: 1,624)

The description in sequence of the modalities of contact (LOC: 1,624)

belongs to the epistemological context of the experience of contact between organism and environment in the here-and-now. (LOC: 1,625)

context cannot be transferred to the child’s developmental phases, (LOC: 1,625)

may be recalled in the patient’s competences of contact, in terms of domains. (LOC: 1,626)

The domain becomes, for us, the experiential realm relative to a certain capability of contact. (LOC: 1,626)

the being confluent, introjecting, projecting, etc. cannot be phases of development, (LOC: 1,627)

but are modalities of contact of which the child is capable (LOC: 1,628)

and which continue to be developed throughout life. (LOC: 1,628)

therapist asks, (LOC: 1,629)

how the patient’s present capabilities of projecting, retroflecting etc. (developed through time) are combined in a Gestalt represented now by the patient’s being-in-therapy. (LOC: 1,629)

The domains are competences of an intersubjective experience, (LOC: 1,630)

modalities of contact that become more evident at a certain point of the child’s development (LOC: 1,631)

which are developed throughout the course of life, as autonomous-in-mutual-interaction capabilities. (LOC: 1,632)

development may be understood as a journey towards the complexity of contacts, rather than as a progression from less mature to more mature stages. (LOC: 1,632)

Development is like a melody that is at first played by one or two instruments, to which other instruments are gradually added, (LOC: 1,633)

The clinical task is to judge, not the maturity of development of a person, but how that person deals with the complexity of her/his perceptions. (LOC: 1,635)

Every domain can range from spontaneity to blocked/fixed excitement. (LOC: 1,636)

“risk” (LOC: 1,636)

is implied in every domain when the contact-boundary is desensitized. (LOC: 1,636)

us the possibility of focusing on the spontaneity that is always present in contact making (LOC: 1,637)

in the polyphonic presence of domains (LOC: 1,638)

The aim of the description that follows is (LOC: 1,639)

of observing the child’s behavior without confining it within developmental phases, (LOC: 1,639)

considering it as the momentary Gestalt of a tangle of relational competences (LOC: 1,640)

The advantage of the developmental perspective on the domains (LOC: 1,640)

is that it reads the complexity of situations considering the momentary tangle of factors which, (LOC: 1,641)

each have an independent development, rather than reducing this complexity to the pattern of a phase. (LOC: 1,642)

we consider the present moment as a transversal plane of the development of the various domains (LOC: 1,643)

(see Fig. 1), (LOC: 1,644)

giving rise (LOC: 1,644)

to the Gestalt of the contact in the here-and-now. (LOC: 1,644)

the child’s ability to be a “little therapist” is a spontaneous, natural quality which occurs among human beings every time they find a creative solution in being-with when there are differences. (LOC: 1,659)

The domain of being confluent. The ability of being-with with no perception of boundaries. (LOC: 1,660)

The ability to be confluent derives from our being radically part of the environment (Philippson, 2001). (LOC: 1,668)

the child’s competence of intuiting the adult’s intentions and bringing them to a completion; (LOC: 1,669)

demonstrate the child’s ability (the opposite of autism indeed) to intuit intersubjectively the significant other. (LOC: 1,670)

The domain of introjecting . The ability of being-with taking the environment inside. (LOC: 1,677)

characterized by the assimilation of environmental stimuli, first and foremost language and the whole cultural apparatus within which s/he is inserted (the customs and rules of a given society), the family’s relational patterns (what makes mommy smile when she is tired; what makes daddy decide to give the child permission to go and play and what, in contrast, makes him angry, etc.). (LOC: 1,680)

This causes her/him to acquire a sense of power: (LOC: 1,683)

His whole self is devoted to learning from the world by taking it in. (LOC: 1,685)

risk falling within this domain generally derives from the desensitization that anesthetizes the contact-boundary, so that the world enters the organism without receiving energy in exchange, and the organism is depressed, as it is unable to give a name to what it does not feel is its own. (LOC: 1,688)

The domain of projecting . The ability of being-with by casting oneself into the world. (LOC: 1,690)

The domain of retroflecting . The ability of being-with containing one’s own energy. (LOC: 1,701)

The domain of egotism . The ability of being-with the other in deliberate control. (LOC: 1,711)

5. Gestalt Therapy’s Developmental Perspective as Clinical Evidence (LOC: 1,735)

Our clinical frame of reference is (LOC: 1,738)

development of the processes of contact that the child learns with the caregivers (LOC: 1,739)

later constitutes her/his habitual patterns of contact as an adult, observable in therapy. (LOC: 1,739)

Beebe and Lachmann (2002, p. 20) (LOC: 1,740)

«the fundamental processes which regulate interactions, which are originally at a non verbal level, remain the same for the entire lifetime». (LOC: 1,740)

the developmental perspective finds its clinical evidence in the patient’s words, and above all in her/his bodily experience and in the implicit mutual attunement of the therapist/patient contact. (LOC: 1,749)

an example the phenomenological description that Daniel Stern (2004, p. XII) (LOC: 1,751)

This is what Stern says: (LOC: 1,753)

She enters my office and sits down in the chair. She drops into it from high up. The chair cushion deflates (LOC: 1,753)

we have already played out the main themes of the session, and an important theme in her life». (LOC: 1,763)

if we consider awareness as creative, then resistances and defences are seen as active expressions of vitality (Perls, Hefferline and Goodman, 1951, p. 248). (LOC: 1,899)

for Perls and Goodman the miracle of poetry consists of the revitalization of everyday language (LOC: 1,934)

to recount, one must come out of the confluence with the felt sensation (LOC: 1,936)

identify where we will be carried by the energy by which we are animated (LOC: 1,938)

choose which words to use, how to represent what we feel to the person to whom we are recounting it, (LOC: 1,938)

Recounting is (to paraphrase Gadamer) at one and the same time “acting” the story and “making oneself be acted” by it, it is sinking into a total experience, (LOC: 1,940)

it is making a new experience (Sampognaro, 2008; Spagnuolo Lobb, 2008e). (LOC: 1,942)

2.1. A Therapeutic Narration with Introjective Style of Contact (LOC: 2,014)

2.2. A Therapeutic Narration with Projective Style of Contact (LOC: 2,037)

2.3. A Therapeutic Narration with Retroflective Style of Contact (LOC: 2,059)

2.4. A Therapeutic Narration with Confluent Style of Contact (LOC: 2,082)

Aggression and Conflict in Post-Modern Society and in Psychotherapy (LOC: 2,117)

The relations that exist between individual and society, and between social groups, cannot be understood without considering the problem of aggression. (..) the remedies prescribed for the cure of aggression are always the same old ineffective repressive agents: idealism and religion. We have not learnt anything about the dynamic of aggression in spite of Freud’s warning that repressed energies not only do not disappear but may even become more dangerous and more effective if driven underground (Perls, 1969b, p. 7). (LOC: 2,117)

Aggression and Conflict: (LOC: 2,121)

What is the role of conflict in human relationships? Is it always a sign of dysfunction? Is aggressiveness always a destructive, negative feeling? The answers have to do with the idea that each approach has of human nature and of the relationship between individual and society. (LOC: 2,123)

Aggressiveness is seen in Gestalt therapy as a primary positive strength, (LOC: 2,125)

it is linked to (LOC: 2,125)

the ability to deconstruct realities in order to create (or co-create) a new reality. (LOC: 2,125)

aggressiveness is part of human nature is obvious, (LOC: 2,128)

Psychological theories, in fact, generally consider it a destructive force, because it conflicts with the demands of social living. (LOC: 2,129)

this perspective has at its base a certain kind of anthropology: fundamentally pessimistic (in that it does not consider the possibility of self-regulation) and dichotomizing (LOC: 2,130)

it polarizes realities and experiences between good and bad, individual and social, mental and bodily, political and private etc. (LOC: 2,131)

The reason why Frederick Perls detached himself from psychoanalysis (cf. Perls, 1942) was precisely a conception of aggressiveness different from that implicit in Freudian theory. (LOC: 2,134)

understood aggressiveness as a biological strength fundamental for survival, not only physical/ animal survival, but social too. (LOC: 2,136)

practice, Perls linked what were traditionally defined as “individual experience of aggression” and “social experience of conflict” in a conceptual continuum. (LOC: 2,141)

From introjection as a fundamental method of learning (and of change) proposed by the post-Romantic culture of the early 20th century (cradle of dictatorships, of the patriarchal family, of the sense of belonging as obedience) in which psychoanalysis was born, the focus was moved on to “dental aggression”, to rebellion and to the differentiation of the self as a model of normal growth. (LOC: 2,147)

physiological ability to bite was considered to correspond to the psychological ability to deconstruct reality, so the patient, in order to grow, must be able to say no, must be able to rebel, (LOC: 2,150)

was precisely the opposite formulation to the psychoanalytic, which instead considered it necessary for the patient to accept the analyst’s interpretation, with a view to ensuring the positive transference and therefore the cure. (LOC: 2,152)

The conflict between persons, the social result of aggressiveness, is seen in Gestalt therapy as part of a normal developing of relationships. (LOC: 2,159)

offers the possibility of working through the differences without any one emerging at the cost of others, reaching a new, unimaginable co-created reality, (LOC: 2,160)

In every aggressiveness, then, it is possible to trace an intentionality of contact, and in every conflict that results from it there is a potential for improving the contact1. (LOC: 2,162)

Aggression3, Conflict and Intentionality of Contact in PostModern Society (LOC: 2,170)

the revolutionary perspective of Gestalt therapy on aggressiveness and conflict. The crucial part of this is the faith in the individuals’ intentionality of contact, (LOC: 2,171)

Today, this perspective on aggressiveness and conflict continues to challenge society, (LOC: 2,178)

hand, post-modern society (LOC: 2,179)

is readier to accept the idea of self-regulation: (LOC: 2,184)

there is no longer certainty about anything, in which even the respectable next door neighbor may turn out to be a terrorist, or the air we breathe may be poisoned, self-regulation is the form that may be taken by the need to believe in something positive. (LOC: 2,185)

On the other hand, the feeling of aggressiveness no longer has the emotional structure that it had 60 years ago: in social feeling it actually seems to be detached from conflict, which is its relational context. People are aggressive for no reason. Aggressiveness is felt without the perception of an experiential background that might contain it (LOC: 2,186)

Aggressiveness has become dangerous precisely because it is not supported by the sense of the relationship to which it belongs: one may kill at any age and for any futile reason (or without reason). (LOC: 2,189)

young people today, when they are aggressive, seem angry with the world (LOC: 2,191)

they have a psycho-physical disturbance typical of those who are not nurtured, contained, calmed by the arms of someone who loves them. (LOC: 2,191)

Since the lack of relational containment has not permitted the differentiation of the self in the growth of the young, now, in consequence, they behave in a confluent manner: shooting or killing is unsubtle, makes no distinctions: it strikes in the mass, in the fog of a confluent perception. (LOC: 2,193)

These young people must be provided with strong arms that can contain and relax the terrible stress they feel at having to live without the nurturing other, in an agonizing solitude in which everything is a demand for performance, (LOC: 2,195)

4. From the Need for Aggression to the Need for Rootedness: (LOC: 2,217)

New Clinical and Social Perspective on Conflict (LOC: 2,217)

psychosocial analyses today reveal a change in relational capabilities. (LOC: 2,218)

the “narcissistic society” (1970s-1980s) (Lasch, 1978), (LOC: 2,219)

later developed into (LOC: 2,219)

“borderline society” (LOC: 2,220)

today (LOC: 2,220)

is “liquid society” (Bauman, 2000), (LOC: 2,220)

the lack of relational support and consequent lack of autosupport. (LOC: 2,221)

influences both the perception of people in general and the individual experience of conflict. (LOC: 2,221)

Some decades ago, (LOC: 2,222)

the feeling of aggressiveness was linked to (LOC: 2,223)

fulfilment of the self (LOC: 2,223)

associated to the capability of independence (LOC: 2,223)

Today (LOC: 2,224)

aggressiveness is perceived by individuals with a certain “liquidity”, (LOC: 2,224)

without the support necessary to make its expression functional in contact: (LOC: 2,224)

missing is the ground of taken-for-granted certainties (LOC: 2,225)

from earlier assimilated contacts. (LOC: 2,225)

the act of deliberating (identifying oneself with or alienating oneself from parts of the environment, ego-function of the self) cannot be clearly defined against the experiential background (id-function and personality-function of the self) (LOC: 2,225)

Children at school, for instance, cannot stay still, they have to keep moving continually, they are not accustomed/brought up to concentrate and breathe: their breathing has no container, the experience of a whole body that contains the emotions is lacking. (LOC: 2,228)

It is difficult to speak today of positive aggressiveness. (LOC: 2,231)

The 21st century is strewn with acts of violence by young adolescents, often from families that seem beyond suspicion. (LOC: 2,232)

faced with the question “Why did you do it?”, the youngsters often answer “I don’t know”. (LOC: 2,236)

It appears, (LOC: 2,237)

aggressiveness is experienced without conflict, an unreined aggressiveness, without relational intentionality. (LOC: 2,237)

4.1. The Social Denial of the Need for Rootedness (LOC: 2,238)

Western society has moved from (LOC: 2,238)

denial of aggressiveness to (LOC: 2,239)

denial of the need for rootedness. (LOC: 2,239)

am referring to the move away from mass communications and legislative commitment in young people’s need for work: (LOC: 2,243)

most (LOC: 2,244)

only temporarily employed or are without work; (LOC: 2,244)

I do not think we are sufficiently aware (nor have we been helped to realize this) of the degree to which children, from birth, live in a condition of affective abandonment, (LOC: 2,246)

how rare it is for parents and children to have a close physical relationship 24 hours a day, which should be normal at least in the first year of life. (LOC: 2,248)

Children today grow up adjusting to the absence of caregivers, developing anxiety towards the containment of their emotions (LOC: 2,249)

and accustomed to not sharing them (LOC: 2,249)

society shows itself to be increasingly demanding and falsely nurturing. (LOC: 2,251)

The experiential condition of young people today is that of having to find one’s direction very quickly in a complex world, in which the educators – parents and teachers – know less than those they are educating (LOC: 2,254)

Young people have to find their way without a clear perception of where they are going, of the balance between themselves and the environment, and they have to do this quickly: the videogame goes ahead without pause and waits for no one. (LOC: 2,256)

They cannot relax, there is no orientation phase in their lives: too many emergencies, too little time and no adult who knows more than they do. (LOC: 2,260)

In short, if 50 years ago society showed insensitivity to individuals’ need for differentiation and rebellion against pre-established authority, today it shows insensitivity towards individuals’ need for rootedness. (LOC: 2,263)

4.2. The Co-Creation of the Ground as Rootedness (LOC: 2,264)

What is missing in our society is the ability to be in a relationship starting from the containment of the initial chaos, which would allow individuals to experience that sense of taken-for-granted security that comes from the “obvious” presence of the significant other (LOC: 2,265)

from which the differentiation of the self may emerge. (LOC: 2,267)

The relational ground on which the experience of novelty can rest is missing. (LOC: 2,267)

The experience of the aggressive emotion needs to be supported with a relational ground, in such a way that it can lead to contacting the other rather than to its indiscriminate destruction. (LOC: 2,268)

the experience of a healthy conflict, young people must be made able to experience their ad-gressing with the strength that comes from (physiologically and psychologically) feeling that one is rooted in the earth, and from a harmonious, spontaneous sense of self. (LOC: 2,270)

school start the day with a bodily relaxation exercise, (LOC: 2,272)

This basic experience would allow (LOC: 2,273)

a more boundaried sense of self. (LOC: 2,273)

5. Conflict in the Therapeutic Relationship Today: (LOC: 2,276)

from the Support of the Figure to the Support of the Background (LOC: 2,276)

The clinical problem is no longer that of supporting aggressiveness in the contact, but of supporting the relationship so that the feeling of aggressiveness can find a solid relational containment in order to orient itself in the contact. (LOC: 2,285)

6. Clinical Examples on Supporting the Ground in the Case of Experience of Aggression (LOC: 2,292)

6.1. Example of Aggression Experienced Within an Introjective Pattern of Contact (LOC: 2,318)

6.2. Example of Aggression Experienced Within a Projective Pattern of Contact (LOC: 2,329)

6.3. Example of Aggression Experienced Within a Retroflective Pattern of Contact (LOC: 2,337)

6.4. Example of Aggression Experienced Within a Confluent Pattern of Contact (LOC: 2,346)

Chapter 6 Love in Psychotherapy. (LOC: 2,376)

From the Death of Oedipus to the Emergence of the Situational Field1 (LOC: 2,376)

love is a concept which (though taken for granted) proves difficult to define, for both the therapist and the patient. (LOC: 2,378)

2. The Therapist’s Love (LOC: 2,382)

We can distinguish between two kinds of love the therapist may have for the patient: one linked to the role and one that springs spontaneously from the situation. (LOC: 2,390)

As Gestalt therapists, we answer without a shadow of a doubt that our profession is an art, and that therefore emotional involvement is an intrinsic part of the method of treatment. (LOC: 2,393)

involvement is real, her/his feelings toward the patient are genuine, (LOC: 2,394)

But can this involvement of the therapist be called love? (LOC: 2,395)

Erving Polster (1987) in his book Every Person’s Life is Worth a Novel, when he defined the treatment attitude of the therapist as a search for the hidden fascination of the patient; (LOC: 2,396)

revitalizes the patient’s ability to be interested/interesting. (LOC: 2,398)

Polster (LOC: 2,399)

translates in terms of fascination/interest/aesthetic attraction the concept of the vitality and spontaneity of contact between organism and environment, maintaining the hermeneutic reference to the concept of novelty, excitement, and growth in the human personality from the founding text (LOC: 2,400)

This, for us Gestalt therapists, is a good way of defining the therapist’s love: the task of the therapeutic intuition and “love” is to rediscover the fascination the patient has concealed. (LOC: 2,402)

The healing love is a sort of spotlight illuminating the other’s beauty, a light that makes visible, in the relationship, the harmonic vitality inherent in the integrity with which the other is in the relationship, (LOC: 2,404)

When the therapist wonders: “What really attracts me in this patient?” s/he is directing the spotlight of her/his therapeutic love in such a way that the patient can reawaken, as s/he looks at her/himself in this light, the sense of her/his own beauty, which implies the spontaneity of his/her being-there (Spagnuolo Lobb, 2003b). (LOC: 2,407)

2.1. Ethics of Therapeutic Love (LOC: 2,409)

The professionalization of psychotherapy in Europe in the 1980s and 1990s – with the general acceptance of an ethical code – drew attention to the ethical respect for the patient’s request, and the possible use of sexuality in psychotherapy was clearly and definitely banned in the psychotherapeutic relationship. (LOC: 2,423)

this question must be answered: “What is the specific way in which Gestalt therapy regards sexual feelings and feelings of love?” (LOC: 2,426)

set these feelings at the contact boundary, hence seeing them as functional to (LOC: 2,427)

the relationship, and to the situational field which patient and therapist create. (LOC: 2,428)

3. The Patient’s Love (LOC: 2,429)

The patient’s love obviously cannot be disputed: it is the form taken by commitment in the various therapeutic situations. The patient offers the therapist the access code to an intimate history, (LOC: 2,430)

the “institutional aspect” of the patient’s love: it is the fact of being a patient, (LOC: 2,432)

as a diagnostic tool: excessive trust or reluctance to trust certainly gives the therapist a key to read the patient’s habitual relational patterns. (LOC: 2,435)

every emotion the patient feels for the therapist is (LOC: 2,439)

a specific response, appropriately modulated for that therapist, within the frame of reference of the relational patterns that the patient intends to modify. (LOC: 2,440)

Love in Therapy as an Emergent Event at the Contact Boundary (LOC: 2,449)

love that springs up in certain situations and not in others, and which may imply physical attraction, hence sexual feelings. (LOC: 2,451)

special nature of the therapeutic encounter may involve the profound desire for total intimacy, (LOC: 2,451)

For Gestalt therapists, the perception (and hence also the emotion) of the patient or the therapist is a process that occurs not “inside” the individual, but as co-creation in the space “between” in which their experiences are realized. (LOC: 2,454)

attraction that may be felt (LOC: 2,455)

has meaning in the relational pattern the patient her/himself triggers. (LOC: 2,456)

the therapist who is attracted to a particular patient might discover that this patient is, so to speak, “used to” parental love. (LOC: 2,456)

old love that can be experienced by the patient in a new situation. (LOC: 2,465)

challenge for the therapist is to provide a clearer, more courageous love, so as to relocate the positive aspect of this love in a non-manipulative context, and cause the patient to experience her spontaneity on the ground of a clear relationship. (LOC: 2,466)

The patient’s attraction toward the therapist can be understood (LOC: 2,475)

the healing factor will not be the positive response of the therapist to this attraction (which instead would disorient her), but rather the fact that the patient feels seen and appreciated by him in her intentionality of contact (LOC: 2,476)

this can restore the spontaneity of the patient’s love. (LOC: 2,477)

the patient tells the therapist that she has had a dream about making love with him. The therapist listens to what she is telling him and how, and then he says: “I’m struck by the effort you’ve made to overcome your shyness and embarrassment. I appreciate the trust you have in me, and the courage with which you face your relationship with me”. (LOC: 2,478)

Gestalt epistemology allows the inclusion of the spontaneity of the therapist and of the patient in the therapeutic process, even in borderline cases such as the feeling of love and sexual attraction. (LOC: 2,489)

the Gestalt view the therapeutic relationship is real, in it the habitual relational patterns are brought into focus, in search of a new solution, and in order to find it the therapist and the patient gamble with their true feelings, maintaining the context of the therapeutic situation, in which on one side treatment is sought and on the other it is provided. (LOC: 2,492)

5. The Oedipus Complex and the Relational Knowledge Implicit in the Psychotherapeutic Setting: (LOC: 2,495)

an Overcoming of the Id/Ego Polarity (LOC: 2,495)

the idea of making conscious what is not conscious has generally remained the central core of all psychotherapies. (LOC: 2,501)

in the final analysis the aim of psychotherapy remains for them that of making “sayable” what is “unsayable”. (LOC: 2,506)

Some new techniques used in psychotherapy, for instance, can be said, on the one hand, to have challenged the concept that the client needs to say and understand the experience (LOC: 2,507)

Daniel Stern (Stern et al., 1998b) states that the implicit relational knowledge is what is truly responsible for much therapeutic change, and many psychotherapists have been debating this topic (Spagnuolo Lobb, 2006a). (LOC: 2,509)

the patient does not need an understanding of symptoms to get better. (LOC: 2,511)

implicit relational knowledge is defined as non-verbal, not conscious but not repressed (Stern et al., 1998b); (LOC: 2,514)

Gestalt therapy has been based on procedural knowledge since its birth: it mainly observes the relational patterns the patient comes into contact with together with the therapist, from breathing and bodily relational processes to the relational meaning of dreams told to the therapist (see Isadore From’s theory in Müller, 1993). (LOC: 2,515)

the paradigm of truth that is never external to a happening but arises from the relationship itself and belongs indissolubly to its texture. (LOC: 2,524)

allows us to move away from the intrapsychic viewpoint, (LOC: 2,525)

toward the postmodern viewpoint, where the “power of truth” has been replaced by the “truth of the relationship”. (LOC: 2,526)

6. Intentionality for Contact: the Now-for-Next in Psychotherapy (LOC: 2,527)

Erving and Miriam Polster, (LOC: 2,528)

used to teach that Gestalt therapy has to do with now-for-next rather than with here-and-now (Polster and Polster, 1973). (LOC: 2,528)

the person’s proactive tension towards the fulfillment of an intentionality of contact, not the sublimation of the impulses. (LOC: 2,530)

It is the intentionality of contact implicit in the field that determines the meaning of the experiences, not the inner needs of the single individuals. (LOC: 2,534)

“Treatment” consists of helping the patient not to understand and control, but to live fully, respecting her/his natural ability to regulate her/himself in the situation. (LOC: 2,537)

7. Sexuality and Love in a Situational Field (LOC: 2,538)

Our culture, which has developed the worship of individualism, does not make us accustomed to seeing the plurality of relationships. The word “relationship” generally summons up an individual who encounters another individual. We think of the mother-child relationship, for instance, rather than a field of relationships. (LOC: 2,539)

The intersubjective viewpoint (see, among others, Mitchell, 2000; Stern et al., 2000; Beebe and Lachmann, 2002) may be a valid tool to describe the perception at the contact boundary. If the mother feels neglected by the father, the child (even though this feeling has not been communicated explicitly to her/him) notices the mother’s forced breathing, her sad face, her lowered eyes; s/he looks at the father and sees that the father is pensive and peeking at the mother. So the child knows that the father knows what is wrong with the mother. (LOC: 2,546)

the child’s perception is oriented toward the contact boundary between mother and father, as well as, respectively, toward the contact boundary between her/himself and the mother, and between her/himself and the father. (LOC: 2,552)

In the therapeutic setting, the patient never sees the therapist in isolation but always as part of a relational field. (LOC: 2,568)

interesting to ask the patient: “If you think of someone alongside your therapist, whom do you imagine?”, “What does this person know about your therapist?”, “What do you imagine that your therapist knows about this person?”, “In your opinion, what do they both think of you?”. (LOC: 2,569)

this work brings to light a key aspect of “implicit relational knowledge” and gives the therapist a better-defined understanding of contact-making with the patient. (LOC: 2,573)

The love of both therapist and patient is the context of the therapeutic situation. Feelings, including sexual feelings, are the figures emerging from a ground of complex perceptions in a triadic field. (LOC: 2,645)

the perspective offered by a triadic field can better direct the therapist toward supporting the patient’s intentionality of contact. (LOC: 2,647)

human perception is always in the direction of a contact boundary, (LOC: 2,648)

Integrating experiences of love and sexuality in psychotherapy cannot be reduced to a technical fact; (LOC: 2,649)

requires the co-creation of a contact boundary (LOC: 2,650)

values, personalities, and ways of dealing with life of both patient and therapist play a fundamental part. (LOC: 2,650)

two people who together find possibilities of fulfilling interrupted intentionalities (Spagnuolo Lobb, 2003b). (LOC: 2,651)

the therapist, with all of her/his scientific knowledge and humanity, (LOC: 2,652)

the patient, with all her/his pain and longing to be healed, (LOC: 2,652)

(re-)build the ground on which daily life rests, (LOC: 2,653)

sense of security in the ground and in the other, (LOC: 2,653)

and thus the surrender to intimacy. (LOC: 2,653)

Chapter 7 (LOC: 2,654)

The Now-for-Next in Couple Psychotherapy (LOC: 2,654)

The Gestalt intervention aims (LOC: 2,661)

at supporting the intentionality of contact, (LOC: 2,663)

Through the manner in which they establish or block the contact between them, we make our diagnosis and plan the specific therapeutic support. (LOC: 2,666)

At times the quarrel is the best-known way of overcoming the anxiety of the relational void:(LOC: 2,832)

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