Psychotherapeutic Models of Intervention

Session 1

Introduction to 21st Century Psychotherapies

- Acceptance and Commitment Therapy (ACT) and Dialectic Behaviour Therapy (DBT -
Marsha M. Linehan)
- Psychotherapy as a domain of science in its modern sense did not clearly emerge until the
18th Century.
- The Unconscious
- The scientific study of the unconscious is commonly thought to have started with
renowned polymath Gottfried Wilhem Leibniz (1646-1716).
- Leibniz studied the role of subliminal perceptions in our daily life (and coined the
term dynamic to describe the forces that operate in unconscious mentation)
- Mentation refers to the process of using one’s mind to consider something
carefully.
- Leibniz investigations of the unconscious were continued by Johann Friedrich
Herbart (1776-1841). Herbart attempted to mathematicise the passage of
memories to and from the conscious and unconscious. He suggested that tacit
ideas struggle with one another for access to consciousness as dissonant ideas
repel and depress one another. Associated ideas help draw each other into
consciousness (or drag each other into unconscious realms).
- Dyadic describes the interaction between two things

Session 4

- Cognitive restructuring to change behaviour

- CBT - thoughts, feelings and behaviour
- Antecedents, Beliefs, Consequences
- Trigger > thoughts > emotions > behaviour > Consequences
- 3 levels of cognition - conscious, unconscious and preconscious
- Negative automatic thought - conscious level - reinforce negative emotion
- Intermediate beliefs - false assumptions - preconscious - assume the worst thing
- Core beliefs - unconscious - belief systems - deep seated belief about ourselves drives the
negative thoughts we have about yourself
Trigger = emotion > thought > feeling cycle which leads to behaviour/consequences
- Therapists need to identify where the real issue is
- Identifying core beliefs

Rational thought worksheets

- Love, Valued, Safe, Fear, Shame, Loneliness

- Top down approach

Cognitive distortions
- All - or - nothing thinking
- Overgeneralisation - seeing a single negative event as a never ending pattern
- Mental filtering
- Jumping to conclusions
- Catastrophising - exaggerating the importance of negative events and expecting
worse case scenario
- Personalisation - thinking that anything negative must be related to you
Maintaining factors - maintain the problem - perpetuating factors
- Avoidance behaviours
- Safety behaviours
- Negative thought patterns
- Reinforcing cycles

Socratic Method - question everything

Person-centred is always validating

Session 2:

ChatGPT said:
ChatGPT

Chapter 2 of Current Psychotherapies focuses on Psychodynamic Psychotherapies, a group of

therapies that are rooted in psychoanalytic theory and practice. Here is a detailed breakdown of
the important concepts, methods, and terms from this chapter:

Key Concepts:

1. The Unconscious: A central tenet of psychodynamic therapy is the belief that much of
our mental life is unconscious. Freud’s notion of the unconscious posits that repressed
 thoughts, desires, and memories influence behavior and emotional functioning without
our awareness. Modern psychodynamic theorists have expanded this idea, suggesting that
dissociation and the failure to integrate experiences into a coherent narrative also
contribute to unconscious processes.
2. Psychic Conflict and Compromise: Freud theorized that mental conflict often arises
when unconscious desires are at odds with conscious beliefs or social rules. This conflict
leads to anxiety, which the psyche resolves through compromise formations, or strategies
that partially satisfy both the unconscious wish and the opposing force.
3. Transference and Countertransference:
○ Transference: This refers to the tendency of clients to project feelings and
expectations from past relationships onto the therapist. It is a cornerstone of
psychodynamic therapy, providing an opportunity to explore unresolved relational
patterns in the therapeutic setting.
○ Countertransference: This is the therapist’s emotional reaction to the client,
which can include unconscious projections from the therapist’s own unresolved
conflicts. Freud originally saw countertransference as a hindrance, but modern
therapists see it as a valuable tool for understanding the client-therapist dynamic.
4. Resistance: Freud identified resistance as the client’s unconscious defense against the
anxiety of bringing repressed material to consciousness. Modern psychodynamic
therapists view resistance not as an obstacle to therapy, but as a reflection of the client's
deeper conflicts and an opportunity for therapeutic work.
5. Intersubjectivity: This is the idea that the therapeutic relationship is co-constructed by
both the therapist and the client. The client’s transference and the therapist’s
countertransference interact in a way that allows both parties to negotiate meaning and
reality within the therapeutic relationship.
6. One-Person vs. Two-Person Psychology:
○ One-Person Psychology: Classical psychoanalysis viewed the therapist as an
objective, neutral observer.
○ Two-Person Psychology: Modern psychodynamic therapy shifts toward viewing
both therapist and client as mutually influencing one another, with the therapist
playing an active role in the relational dynamics.
7. Developmental Arrest Models: These models, such as those proposed by Donald
Winnicott and Heinz Kohut, suggest that psychological problems stem from failures in
early caregiving. Psychotherapy aims to address these developmental deficits by creating
a reparative, corrective emotional experience.

Methods and Techniques:

1. Free Association: This classical psychoanalytic technique encourages clients to verbalize

their thoughts and feelings without censorship, allowing unconscious material to surface.
 2. Dream Analysis: Dreams are seen as windows into the unconscious, where repressed
desires and conflicts are symbolically represented. The therapist interprets dreams to
uncover these hidden meanings.
3. Interpretation: The therapist provides insight into unconscious processes, often through
interpretations of transference, resistance, and dreams. These interpretations aim to help
the client gain self-awareness and resolve internal conflicts.
4. Working Through: This refers to the process of repeatedly examining and
re-experiencing unconscious conflicts, helping the client to integrate these insights into
their everyday life. It is often a gradual and ongoing part of psychodynamic therapy.
5. Relational and Enactment Approaches:
○ Relational Therapy: This modern form of psychodynamic therapy emphasizes
the therapeutic relationship itself as a source of change. The therapist and client
collaboratively explore relational patterns that emerge within the therapeutic
interaction.
○ Enactments: These are situations where the therapist and client unconsciously
play out aspects of the client’s relational conflicts. The therapist’s participation in
these enactments helps to illuminate the client’s interpersonal dynamics and
unconscious scripts.

Key Theorists and Perspectives:

1. Freud’s Classical Psychoanalysis: Freud’s model emphasized unconscious drives,

particularly sexual and aggressive instincts, as the primary forces shaping behavior and
psychological conflict. The goal of therapy is insight into these unconscious conflicts,
achieved through techniques like free association and dream analysis.
2. Object Relations Theory: Theorists like Melanie Klein and Donald Winnicott
emphasized early relationships with caregivers and how internalized representations of
these relationships shape an individual’s emotional life and relational patterns.
3. Self Psychology: Heinz Kohut’s theory focuses on the development of the self and the
importance of empathic attunement from caregivers. Failures in this attunement lead to
developmental arrests, and therapy involves providing a corrective emotional experience.
4. Contemporary Psychoanalysis: Modern approaches, such as relational psychoanalysis,
view the therapeutic relationship as a dynamic, interactive process. Both the therapist and
client contribute to the unfolding of unconscious material, and the therapist’s subjectivity
is seen as a key part of the therapeutic process.

Therapeutic Goals:

● Increasing Awareness: A primary goal is to help clients gain insight into their
unconscious motivations, conflicts, and relational patterns. Through this awareness,
clients can make more conscious choices and alter self-defeating behaviors.
 ● Integration of Self: Therapy also seeks to integrate dissociated or fragmented aspects of
the self, leading to a more cohesive sense of identity.
● Corrective Emotional Experience: Through the therapeutic relationship, clients can
experience a corrective emotional environment, helping them resolve developmental
deficits and heal from relational traumas.

In conclusion, psychodynamic psychotherapies aim to uncover and resolve unconscious

conflicts, with an emphasis on understanding the therapeutic relationship as both a reflection of
past relational dynamics and a tool for fostering change. The therapy is grounded in the
exploration of transference, resistance, and relational patterns, with the goal of achieving deeper
emotional insight and lasting psychological transformation

Session 3:

Client-Centered Therapy, developed by Carl Rogers. This humanistic approach is based on the
inherent worth and autonomy of individuals, emphasizing the therapeutic relationship as the
primary tool for personal growth. Below is a detailed breakdown of the key concepts, terms, and
methods from the chapter:

Core Concepts and Tenets:

1. Actualizing Tendency: Central to Rogers' theory is the belief that all human beings
possess an inherent drive towards growth, self-improvement, and fulfillment. This
actualizing tendency is the fundamental motive behind human behavior. Rogers believed
that under supportive conditions, individuals would naturally move toward
self-actualization.
2. Self-Concept and Incongruence:
○ Self-Concept: This is the organized, consistent conceptual "gestalt" of oneself,
including perceptions and values related to one's identity and relationships with
others.
○ Incongruence: Emotional distress arises when there is a gap between the real self
(who a person truly is) and the ideal self (who they believe they should be).
Therapy seeks to reduce this incongruence by helping individuals become more
self-aware and accept themselves.
3. Internal Frame of Reference: Understanding a client's unique perspective or internal
frame of reference is crucial. This term refers to the way the world is perceived by an
individual, shaped by their personal experiences and meanings. Therapists aim to
understand this frame to truly empathize with the client.
4. Organismic Valuing: Rogers posited that individuals have an inherent ability to evaluate
their experiences based on their actualizing tendency. This means they can discern what
 is beneficial or harmful to their growth. The therapist's role is to help clients reconnect
with this innate capacity.

Core Conditions of Therapy:

1. Congruence (Genuineness): The therapist must be authentic and transparent in the

therapeutic relationship, not hiding behind a professional facade. Congruence refers to
the alignment between the therapist's internal feelings and outward expression.
2. Unconditional Positive Regard: This is the therapist's nonjudgmental acceptance of the
client, offering warmth, respect, and acceptance, regardless of the client's feelings,
thoughts, or behaviors. This environment of acceptance helps the client feel safe enough
to explore difficult emotions.
3. Empathy: The therapist strives to understand the client’s internal world from their
perspective. Empathy involves deeply appreciating and accurately reflecting the client’s
emotions and experiences, helping them feel understood and supported.

Methods in Client-Centered Therapy:

1. Nondirectiveness: A core principle of client-centered therapy is that the therapist does

not direct or lead the session, but rather facilitates the client's self-exploration. The
therapist refrains from giving advice, making diagnoses, or guiding the client toward
specific solutions.
2. Reflective Listening: The therapist listens actively and reflects the client’s thoughts and
feelings back to them, often paraphrasing what the client says to ensure understanding
and encourage further self-exploration.
3. Nonjudgmental Acceptance: This is demonstrated through the consistent expression of
unconditional positive regard. The therapist allows clients to express both positive and
negative emotions without imposing their own values or judgments.
4. Moment of Movement: This refers to breakthrough moments in therapy where a client
experiences significant emotional shifts or self-awareness. These moments are often
marked by a deep, emotional release or a new understanding of the self.

Philosophical Underpinnings:

● Sovereignty of the Person: Client-centered therapy places the responsibility for healing
on the client, not the therapist. Rogers rejected the traditional medical model that viewed
therapists as experts who diagnose and treat patients. Instead, he believed that clients are
the best authorities on their own lives and have the capacity for self-direction and
healing.
● Nondirective Therapy: The role of the therapist is to create a facilitative environment,
where the client can lead the therapy session. The therapist does not impose their own
 interpretations or solutions but respects the client’s autonomy and decision-making
process.

Applications and Evolution:

● Client-centered therapy has been applied in various settings, from individual therapy to
group processes, education, and even conflict resolution. Rogers’ work has been extended
beyond therapy into fields like education and organizational development, showing the
broad applicability of his ideas.
● Therapeutic Outcomes: Research has shown that client-centered therapy leads to
increased self-esteem, greater openness to experience, and more effective
problem-solving skills. Clients often report feeling more empowered and autonomous
after therapy.

Conclusion:

Client-centered therapy is a non-directive, humanistic approach that focuses on the therapeutic

relationship as the vehicle for change. It relies on creating a supportive environment where
clients can explore their emotions, develop self-awareness, and move toward self-actualization.
The therapist’s role is to offer empathy, unconditional positive regard, and congruence, trusting
in the client’s ability to heal and grow.

This approach remains influential and continues to be valued for its emphasis on empathy,
respect for individual autonomy, and its foundational belief in the inherent potential of all people.

Session 4:

Rational Emotive Behavior Therapy (REBT), created by Albert Ellis in the 1950s. It is a
comprehensive therapeutic system aimed at modifying dysfunctional thinking and behavior.
Below is a summary of its essential tenets, methods, and terms:

Core Concepts of REBT:

1. ABC Model: The foundation of REBT lies in this model:

○ A (Activating Event): An external or internal event.
○ B (Belief): The belief held about the event, which may be rational or irrational.
○ C (Consequence): Emotional and behavioral consequences stemming from the
belief, not directly from the event.
○ The key is to recognize that it is the belief (B) about the event (A) that creates the
emotional consequence (C), rather than the event itself.
 2. Irrational Beliefs (IBs): These are dogmatic, rigid, and unrealistic thoughts that lead to
negative emotional outcomes. Common irrational beliefs include:
○ Demandingness (Musturbation): The belief that one must achieve certain things
or that others must behave a certain way.
○ Awfulizing: Exaggerating the negative significance of events.
○ Low Frustration Tolerance: The belief that one cannot tolerate discomfort or
frustration.
○ Self-Damnation: Negative self-judgment based on failure to meet certain
standards.
3. Disputation (D): A central process in REBT, this involves actively challenging irrational
beliefs using logical questioning and empirical investigation. The goal is to replace
irrational beliefs with rational ones.
4. Effective New Belief (E): The outcome of disputing irrational beliefs, leading to
healthier emotions and behaviors.
5. Philosophical Tenets:
○ Unconditional Self-Acceptance (USA): Accepting oneself despite flaws and
failures.
○ Unconditional Other Acceptance (UOA): Accepting others as they are, even
when their behavior does not align with personal expectations.
○ Unconditional Life Acceptance (ULA): Accepting life circumstances that cannot
be changed.

Methods and Techniques in REBT:

1. Cognitive Restructuring: The process of identifying, challenging, and replacing

irrational beliefs with rational alternatives.
2. Socratic Dialogue: Therapists engage clients with structured questioning to help them
uncover the irrationality of their beliefs.
3. Behavioral Techniques: These include:
○ Role-Playing: Patients practice new behaviors in controlled settings.
○ Homework Assignments: Clients are often tasked with exercises between
sessions to test new beliefs and behaviors in real-world settings.
○ Desensitization: Helping clients gradually face their fears to reduce avoidance
behaviors.
4. Emotive Techniques: Focus on changing emotional responses by addressing underlying
irrational beliefs. Techniques include imagery exercises and emotional regulation
strategies to practice healthier responses to situations.

Unique Features of REBT:

 1. Integration of Cognition, Emotion, and Behavior: REBT is holistic, addressing
thoughts, feelings, and actions simultaneously.
2. Philosophical Underpinnings: Unlike traditional cognitive therapies, REBT explicitly
promotes philosophical change, encouraging clients to adopt a more flexible, tolerant,
and self-accepting worldview.
3. Active-Directive Approach: Therapists in REBT are highly active and directive, often
taking an instructional or even confrontational stance to help clients confront their
irrational beliefs.
4. Scientific and Pragmatic: REBT employs a scientific approach, using logic and
empirical evidence to dispute irrational beliefs. It emphasizes practicality, aiming to
reduce emotional disturbance and promote long-term psychological well-being.

Therapeutic Goals:

The ultimate goal of REBT is not just to alleviate symptoms but to create deep, lasting changes
in belief systems that lead to better emotional regulation, increased resilience, and a more
fulfilling life .

Chapter 7 on Cognitive Therapy in Current Psychotherapies outlines key methods, terms, and
concepts that are central to the therapy's practice. Here's a summary of important terms, methods,
and approaches discussed:

Important Terms:

1. Cognitive Distortions:
○ Arbitrary Inference: Drawing a conclusion without evidence.
○ Selective Abstraction: Focusing on a detail taken out of context while ignoring
other relevant information.
○ Overgeneralization: Forming a broad conclusion based on a single event.
○ Magnification/Minimization: Exaggerating or downplaying the significance of
an event.
○ Personalization: Assuming responsibility for external events without sufficient
evidence.
○ Dichotomous Thinking: Viewing situations in black-and-white terms, with no
middle ground.
2. Cognitive Schemas: Deeply held core beliefs developed early in life that shape how
individuals interpret experiences. These schemas can be adaptive or dysfunctional.
3. Cognitive Vulnerabilities: Individual predispositions shaped by cognitive schemas that
increase the likelihood of psychological distress.
 4. Collaborative Empiricism: A key aspect of the therapeutic relationship, where both the
therapist and patient work together as co-investigators to test beliefs as hypotheses.
5. Socratic Dialogue: A questioning technique used by the therapist to help patients explore
their assumptions and cognitive distortions, encouraging them to arrive at new insights
through guided self-discovery.
6. Guided Discovery: A process where the therapist helps the patient uncover and
challenge their maladaptive beliefs through experiential learning and behavioral
experiments.

Methods and Techniques:

1. Monitoring Automatic Thoughts: Patients are trained to recognize their automatic

thoughts during distressing situations and understand how these thoughts connect to
emotions and behaviors. Recording these thoughts outside of therapy is encouraged.
2. Cognitive Restructuring: The patient examines the evidence for and against their
distorted automatic thoughts and replaces them with more realistic, balanced
interpretations.
3. Behavioral Experiments: The patient tests their thoughts and beliefs in real-life
scenarios to gather evidence and modify dysfunctional cognitions.
4. Decatastrophizing: A technique where patients are asked to imagine the worst-case
scenario and explore ways they could cope with the situation, thereby reducing
catastrophic thinking.
5. Reattribution: Encourages patients to consider alternative causes of events, reducing
self-blame and personalizing.
6. Redefining: This involves reframing a problem in terms of the patient’s behavior or
actions, helping them gain control over situations they previously felt powerless to
influence.
7. Decentering: Primarily used for anxiety, this technique helps patients realize that they
are not the center of others' attention, challenging the belief that they are constantly being
watched or judged.
8. Imagery Modification: This is used to change distressing visual images (e.g., traumatic
memories) that trigger emotional responses, empowering patients to modify and control
the imagery to lessen its psychological impact.

Core Beliefs:

Core beliefs are deeply held, often unconscious, convictions about oneself, others, and the world.
They are developed through early experiences and shape how individuals perceive and react to
situations. Dysfunctional core beliefs can lead to cognitive distortions, emotional distress, and
maladaptive behaviors. Cognitive therapy seeks to identify, challenge, and modify these core
beliefs by testing their validity and adaptiveness.
Examples of core beliefs include:

● “I am unlovable.”
● “The world is unsafe.”
● “I must be perfect to be accepted.”

Cognitive therapists help patients to examine these beliefs critically and to replace them with
more realistic, adaptive beliefs.

Automatic Thoughts:

Automatic thoughts are spontaneous, involuntary thoughts that occur in response to a situation
and often reflect a person’s core beliefs. They are typically brief, plausible, and emotionally
charged, appearing so quickly that they often go unchallenged. These thoughts mediate between
an external event and an individual’s emotional and behavioral response to it. Cognitive
distortions, such as overgeneralization or catastrophizing, often occur within these automatic
thoughts.

Example of an automatic thought:

● A socially anxious individual might think, “Everyone will notice how nervous I am,”
before entering a social situation.

Emotions and Behaviors:

Automatic thoughts are linked to emotions and behaviors. When negative automatic thoughts are
left unchallenged, they can lead to maladaptive emotional responses (e.g., anxiety, depression)
and dysfunctional behaviors (e.g., avoidance, withdrawal). Cognitive therapy helps patients
recognize these links and work to change their thinking patterns, thus influencing their emotional
and behavioral outcomes.

Methods in Cognitive Therapy:

1. Monitoring and Recording Automatic Thoughts: Patients learn to identify their

automatic thoughts in real-life situations. They are encouraged to record their thoughts,
feelings, and the associated behaviors to better understand the relationship between
them.
2. Cognitive Restructuring: Once patients are aware of their automatic thoughts, they are
taught to challenge and reframe these thoughts, replacing them with more balanced and
realistic interpretations. This process is called cognitive restructuring, where beliefs are
tested like hypotheses through behavioral experiments.
 3. Decatastrophizing: Patients are guided to think through their worst-case scenarios and
assess how likely these outcomes are, helping to reduce catastrophic thinking.
4. Behavioral Experiments: In these exercises, patients test their assumptions and
predictions by engaging in real-world activities. For instance, a patient who believes they
will fail at a task might be asked to try and evaluate the actual outcome, often discovering
their predictions were overly negative.
5. Homework Assignments: To enhance self-awareness and practice new cognitive
strategies, patients are assigned homework. These tasks often involve self-monitoring,
thought recording, and practicing new ways of responding to situations.
6. Guided Discovery: This involves using Socratic questioning to help patients arrive at
new insights. The therapist helps the patient uncover underlying assumptions by asking
open-ended, thought-provoking questions.
7. Schema Work: Cognitive therapy also addresses schemas, which are long-standing
patterns of thought that represent core beliefs. These cognitive frameworks help organize
and interpret information. Dysfunctional schemas can lead to automatic thoughts and
maladaptive behavior. Therapy focuses on identifying these schemas and challenging
their validity.

By addressing core beliefs, automatic thoughts, emotions, and behaviors, cognitive therapy helps
patients understand the cognitive model of emotional distress and empowers them to make
lasting changes in how they think, feel, and act .

Application and Approach:

● Initial Sessions: The focus is on symptom relief, problem definition, and building
rapport. Patients are introduced to cognitive therapy principles, often receiving
homework to monitor thoughts.
● Middle Sessions: The therapist shifts from symptom management to examining patterns
of thought, with emphasis on automatic thoughts and underlying assumptions.
● Later Sessions: Cognitive therapy focuses on modifying deep-seated beliefs, applying
skills learned to broader aspects of life, and preventing relapse.
Session 5: Gestalt therapy

Chapter 9 of Current Psychotherapies (2019) focuses on Gestalt Therapy, providing a

comprehensive overview of its foundational principles and therapeutic methods. Here are the key
points:

- Mental priming
- Client-centred
- Movement exaggeration
1. Historical Background: Gestalt therapy was developed by Fritz Perls, Laura Perls, and
Paul Goodman in the mid-20th century. It emerged as a holistic alternative to
psychoanalysis and behaviorism, emphasizing present awareness and personal
responsibility.
2. Core Concepts:
○ Holism: This concept sees individuals as integrated wholes, inherently
self-regulating and growth-oriented. Human behavior and symptoms cannot be
separated from the individual's environment.
○ Field Theory: Human experiences are influenced by their surrounding context,
making it impossible to understand a person in isolation from their environment.
○ Organismic Self-Regulation: Individuals are motivated to satisfy needs that
emerge naturally. Awareness of these needs and the ability to address them is
central to psychological health.
3. Therapeutic Focus: Gestalt therapy centers on enhancing a person's awareness of how
they interact with the world. Rather than interpreting unconscious drives, as in
psychoanalysis, Gestalt therapy promotes the active engagement of both therapist and
patient in the present moment.
4. Contact and Awareness:
○ Contact: It refers to the interaction between an individual and their environment.
Effective contact promotes growth, while interruptions in contact can lead to
psychological problems.
○ Awareness: The therapy seeks to expand the patient’s awareness of their internal
processes and behaviors, fostering both self-knowledge and freedom.
5. Phenomenology and Existentialism: Gestalt therapy draws heavily on existential
philosophy, emphasizing personal choice, responsibility, and the subjective experience of
the present moment.
6. Dialogical Relationship: Central to Gestalt therapy is the I-Thou relationship, where the
therapist actively participates in the therapeutic dialogue, sharing personal experiences
and feelings to foster a genuine connection with the patient.
7. Therapeutic Goals: The primary goal of Gestalt therapy is increased awareness,
allowing patients to take responsibility for their actions and improve self-regulation. This
 includes enhancing awareness of emotions, behaviors, and patterns that disrupt their
lives.
8. Therapeutic Methods:
○ Experimentation: Gestalt therapists often use creative experiments like
role-playing, guided imagery (mental priming), and body awareness techniques to
help patients explore their feelings and behaviors.
○ Here-and-Now Focus: Therapy sessions concentrate on present experiences
rather than delving into the past, encouraging patients to fully engage with their
current emotions and thoughts.
9. Paradoxical Theory of Change: This theory suggests that change occurs when
individuals fully accept their current state rather than trying to force change.
10. Flexibility and Creativity: Gestalt therapy is adaptable and can be applied to both short-
and long-term therapy. Its techniques can be tailored to individual needs and
circumstances.

Overall, Gestalt therapy emphasizes a present-focused, experiential approach to therapy, aiming

to enhance self-awareness, personal growth, and responsibility .

- Conscious Awareness: Central to Gestalt therapy, it refers to being fully engaged in the
present moment, focusing on the "here and now." The therapy encourages patients to
become aware of their thoughts, feelings, and behaviors as they happen, helping them
deepen self-understanding.

- Experimentation: Gestalt therapy is experiential, relying on the patient and therapist

trying new behaviors or responses to enhance awareness. These experiments are designed
to reveal emotions or insights previously out of awareness, often involving role-playing
or direct emotional expression.

- Field Theory and Organismic Self-Regulation: Gestalt therapy emphasizes the

interdependence between individuals and their environments. Organismic self-regulation
describes the natural, self-correcting process through which individuals address their
needs in the current context.

- Contact and Contact Boundaries: Contact refers to being in touch with one's
environment and experience. Healthy psychological function requires maintaining
flexible boundaries between self and others, allowing for connection and autonomy.

- Here and Now Focus: Gestalt therapy constantly emphasizes the present moment. It
aims to help patients shift their attention from past events or future worries to what is
happening now, facilitating greater self-awareness.
 - Gestalt Formation (Figure-Ground Perception): This concept from Gestalt psychology
refers to how individuals perceive their experiences as foreground (figure) against a
background (ground), emphasizing the continuous flux of perception and awareness.

- Dialogic Relationship: Gestalt therapy builds on the I-Thou relationship, where the
therapist and patient engage in genuine, transparent dialogue. The therapist actively
shares their experiences and emotions to foster mutual understanding .

In Gestalt therapy, the five layers of neurosis originally articulated by Fritz Perls are described
using specific terms that represent the progression from inauthenticity to authenticity. Here are
the original terms used for each layer:

1. The Phony Layer: This layer refers to the ways individuals present themselves
inauthentically, often putting on a façade to fit in or avoid deeper feelings - someone is
inauthentic
2. The Phobic Layer: This layer involves a fear of confronting one's true feelings and the
anxiety that arises from this avoidance. It signifies a reluctance to face what lies beneath
the phoniness - avoiding pain
3. The Impasse Layer: At this stage, individuals experience a feeling of being stuck or
trapped. They may feel unable to move forward due to unresolved inner conflicts and a
lack of awareness of their true needs - afraid of change
4. The Implosive Layer: This layer represents the internalization of feelings, particularly
anger and frustration. Individuals may begin to turn their emotions inward, often leading
to feelings of emptiness or depression - awareness has heightened but afraid to act
5. The Explosive Layer: This final layer is where individuals can express their true feelings
openly, particularly anger and passion. It signifies a release of pent-up emotions and a
reconnection with the authentic self - authenticity

These layers illustrate the process of moving from a façade of inauthenticity to a more genuine
and self-aware state, emphasizing the importance of recognizing and integrating one's emotions
and experiences in Gestalt therapy.

unfinished business, not taking responsibility, and lack of awareness are critical concepts that
impact an individual's psychological health and overall well-being. Here’s a deeper look at each
of these concepts:

Unfinished Business

● Definition: Unfinished business refers to unresolved issues, feelings, or conflicts from

the past that continue to affect an individual’s present behavior and emotional state. This
can include unresolved grief, unexpressed anger, or unmet needs.
 ● Impact: When individuals have unfinished business, they may experience persistent
emotional disturbances such as anxiety, depression, or anger. These unresolved feelings
can manifest in various ways, affecting relationships and decision-making.
● Therapeutic Approach: Gestalt therapy encourages individuals to confront and process
their unfinished business. Through techniques such as role-playing or guided imagery,
clients can explore these unresolved issues, express their emotions, and gain closure.

Not Taking Responsibility

● Definition: Not taking responsibility involves a refusal to acknowledge one's role in

personal experiences and relationships. This can manifest as blaming others for one’s
problems, avoiding accountability, or denying the impact of one’s actions.
● Impact: This lack of responsibility can hinder personal growth and lead to a cycle of
avoidance and resentment. It prevents individuals from recognizing their agency and
makes it challenging to develop authentic relationships.
● Therapeutic Approach: Gestalt therapy emphasizes personal accountability. Therapists
guide clients to recognize their choices and behaviors, encouraging them to take
responsibility for their feelings and actions. This process helps clients reclaim their power
and facilitates growth.

Lack of Awareness

● Definition: Lack of awareness refers to an individual’s inability to recognize their

thoughts, feelings, and behaviors in the present moment. This can result from defenses,
distractions, or a disconnection from oneself and one's environment.
● Impact: When individuals are not aware of their feelings and behaviors, they may react
automatically rather than mindfully. This can lead to maladaptive behaviors, conflicts in
relationships, and a disconnection from one’s true self.
● Therapeutic Approach: Gestalt therapy places a strong emphasis on awareness and
mindfulness. Techniques such as the "here and now" focus encourage clients to become
more conscious of their present experiences. This awareness fosters insight into their
emotional states, promoting healthier responses to life's challenges.

Integration in Therapy

Gestalt therapy aims to help individuals integrate these concepts into their self-awareness and
personal growth journey. By addressing unfinished business, encouraging responsibility, and
fostering awareness, clients can move towards a more authentic and fulfilling life. The therapy
process often involves:
 ● Experiential Techniques: Engaging in exercises that promote self-exploration and
awareness, such as empty chair work, to facilitate dialogue with parts of themselves or
others.
● Mindfulness Practices: Encouraging clients to stay present and connect with their
feelings in real-time, enhancing their ability to respond to situations mindfully rather than
reactively.
● Emotional Expression: Providing a safe space for clients to express their emotions and
work through unresolved feelings, facilitating healing and closure.

Overall, addressing these elements can lead to greater self-acceptance, improved relationships,
and a more fulfilling life.

The empty chair technique and the two-chair technique are powerful experiential exercises
designed to facilitate self-exploration, enhance awareness, and promote emotional expression.
Here’s an overview of each technique:

Empty Chair Technique

● Overview: The empty chair technique involves placing an empty chair in front of the
client and inviting them to engage in a dialogue with someone they have unresolved
feelings toward, such as a family member, friend, or even themselves. The empty chair
represents the person with whom the client has unfinished business.
● Process:
1. Setup: The therapist sets up the empty chair in a way that feels comfortable for
the client.
2. Dialogue: The client is encouraged to speak to the empty chair as if the person
they want to address is sitting there. They can express their feelings, thoughts, and
even frustrations related to the unresolved issue.
3. Role Reversal: After the client has expressed their feelings, the therapist may
encourage them to switch places and respond from the perspective of the other
person. This helps clients explore different viewpoints and deepen their
understanding of the situation.
● Purpose: This technique aims to help clients process unresolved emotions, gain closure,
and clarify their feelings about the person or situation represented by the empty chair. It
allows for cathartic expression and promotes insight into their emotional experiences.

Two-Chair Technique

● Overview: The two-chair technique is a more advanced version of the empty chair
technique, where the client engages in a dialogue between two parts of themselves,
 represented by two chairs. This method is often used to explore internal conflicts,
opposing emotions, or aspects of the self.
● Process:
1. Setup: Two chairs are positioned facing each other. Each chair represents a
different aspect of the client's self or conflicting emotions (e.g., the "inner critic"
vs. the "inner child").
2. Dialogue: The client starts by expressing their thoughts and feelings from one
chair (e.g., the "inner critic") and then switches to the other chair to express the
contrasting perspective (e.g., the "inner child").
3. Role Reversal: The client may alternate between chairs, allowing them to explore
the dialogue fully and gain insights into the conflicting parts of themselves.
● Purpose: This technique helps clients become aware of and integrate conflicting
emotions or beliefs. It allows them to express and process internal struggles, leading to a
greater understanding of themselves and fostering self-acceptance.

Benefits of Both Techniques

● Increased Awareness: Both techniques promote self-awareness by encouraging clients to

confront emotions and thoughts they may have been avoiding.
● Emotional Expression: Clients can express their feelings in a safe environment,
facilitating emotional release and healing.
● Perspective-Taking: These techniques foster empathy by allowing clients to see
situations from different viewpoints, whether it's someone else’s perspective or different
aspects of themselves.
● Closure and Resolution: By addressing unresolved issues, clients can achieve a sense of
closure, leading to personal growth and enhanced well-being.
1. Figure-Ground Formation:
○ Gestalt therapy is rooted in the concept of figure-ground formation: individuals
structure unstructured sensory data into coherent wholes (gestalts).
○ Psychological problems occur when needs remain unmet or incomplete gestalten
demand attention, disrupting the person’s ability to focus on new gestalten.
○ Pathology arises when this process of need satisfaction is interrupted, leading to
incomplete gestalten.
2. Experience/Contact Cycle:
○ Consists of awareness, excitement, action, and contact.
○ Contact is an exchange between the self and the environment, not simply
physical closeness.
○ Disturbances in this cycle lead to dysfunctions, which are often related to
resistances to contact, such as retroflection, introjection, projection, and
deflection.
 ○ Increasing awareness is the main therapeutic tool, aiming to resolve disturbances
in this cycle.
3. Retroflection, Introjection, Projection, Deflection:
○ Key defense mechanisms that disrupt the contact cycle.
○ Retroflection: when energy is turned inward (e.g., doing to oneself what one
wants to do to another) - the withholding of emotions, thoughts, and behavior and
their redirection back onto the individual.
○ Introjection: accepting others’ ideas uncritically.
○ Projection: attributing personal feelings to others.
○ Deflection: avoiding direct contact with issues.
4. Awareness:
○ Central to the therapeutic process in Gestalt therapy, focusing on present
awareness rather than digging into the past (as in psychoanalysis).
○ Therapists aim to heighten client awareness of emotions, needs, and the present
experience.
5. Two-Chair Technique:
○ Most widely used technique in Gestalt therapy.
○ Involves dialoguing between conflicting parts of the self (e.g., experiencing self
vs. internal critic).
○ Facilitates internal conflict resolution, leading to greater self-acceptance and
changes in cognitive schemas.
○ Empirical research (e.g., Leslie Greenberg) has validated its use for resolving
conflict splits and indecision.
○ Effective for issues like unfinished business, marital conflict, and decisional
conflict.
6. Empty-Chair Technique:
○ A variation of the two-chair technique used specifically for unfinished business
(e.g., unresolved emotions toward a significant other).
○ Clients express repressed or unresolved feelings (e.g., anger) toward an imagined
figure, leading to emotional resolution and clarity.
7. Skillful Frustration:
○ A traditional Gestalt technique involving provoking the client by frustrating their
usual patterns of avoidance, prompting them to face their issues more directly.
8. Therapist-Client Relationship:
○ Modern Gestalt therapy emphasizes the therapeutic relationship, focusing on
genuine contact between the therapist and client, which was less emphasized in
Perls' early approach.
○ Current practice has softened some of Perls' harsher techniques, adopting a more
Rogerian stance.
Methods and Techniques:

1. Experiential Techniques:
○ The focus is on experiential learning rather than cognitive insight or
interpretation.
○ Clients discover emotional truths through direct confrontation with parts of
themselves, facilitated by techniques like the two-chair or empty-chair.
2. Phenomenological Approach:
○ Emphasizes here-and-now awareness, with therapists focusing on what is
happening in the moment with the client, rather than analyzing past experiences in
depth.
3. Process-Experiential Therapy:
○ Integrates Gestalt techniques with Rogerian humanism and emphasizes deep
emotional processing and empathy.

Empirical Research and Modern Developments:

1. Validation of Techniques:
○ Recent research (primarily by Greenberg and colleagues) has shown the
effectiveness of the two-chair technique in resolving internal conflicts and
increasing emotional awareness.
○ The empty-chair technique has also been validated for dealing with unfinished
business.
2. Comparisons with Other Therapeutic Approaches:
○ Two-chair technique has been shown to be more effective than empathic
responding in increasing depth of emotional experience and resolving conflicts.
○ When compared to cognitive-behavioral therapy (CBT), Gestalt techniques
were found to be superior in areas such as reducing indecision and improving
marital conflict.
3. Cautions in Application:
○ The document highlights the risks of using Gestalt techniques with clients who
may be fragile or have conditions like personality disorders or psychosis.
○ Recommendations include proper training and caution when using intense
techniques such as the two-chair and empty-chair with vulnerable clients,
particularly trauma survivors.
Session:

Irvin Yalom

Death
Meaninglessness
Freedom - choose how you think about something and choose your attitude toward it - it cannot
be a privilege you can never not think about yourself
Isolation