Interrupting the Conversation: Gestalt Therapy Here and Now

• Jim: A Case Study
• The Here and Now: A Historical Perspective
• Moving Forward
• Staying in the Present While Working With the Past
• Jim's Turning Point
• Jim's Ability to Live a Fuller Life: The Goal of Gestalt

It’s well established in the clinical literature that the therapeutic relationship is of key importance; attending to client-therapist contact is a useful lens for any therapeutic practice, whatever the orientation. But how this knowledge is played out in the course of our work can be unclear. It is easy to get caught up in our clients’ ever-urgent presenting problems and try to “fix” whatever is wrong.

Part of the power of Gestalt therapy is that its focus is not on problem solving or on getting people to think differently. Rather, Gestalt calls us to attend closely to the here and now of the relationship, creating an encounter in which the client can develop awareness of the therapeutic encounter—what is happening to him and between us in the moment.

Jim: A Case Study

Jim came into therapy because he was feeling “stuck” in his life. When he strode into my office for the first time, grabbed my hand, and pumped it a few times. He seemed like he was in a hurry to catch a bus. But despite his energetic demeanor and polished appearance, Jim was deeply unhappy. Forty-one years old and divorced, Jim had two children from his previous marriage. He felt that he was in a dead-end job in finance. He was also unhappy with his ability to have deep, enduring positive relationships with women and peers.

In the first two minutes of our initial session, as I went briefly over what I do and how I do it, Jim interrupted me. “That’s really good,” he said, “but here is what I want to talk to you about.”

“Jim, let me just finish,” I replied, and continued what I was saying.

“Yeah, yeah, yeah—I’ve got it.” Jim then barreled forward in great, great detail – overwhelming detail – explaining his concerns.

As he wrapped up his first monologue, I attempted to interject some thoughts about what he was saying; I particularly wanted to explore his relationships with women. As I asked my questions, he rolled right over me and continued to explain what it was that he thought I needed to know – completely oblivious to the idea that I was trying to explore what he had just said. I began to feel frustrated.

After a while, I said to him, “Jim, are you aware that every time I want to say something to you, you cut me off?”

But rather than respond to what I said, he raced on with his story about a terrible first date he’d recently been on. He explained that he had regaled his date with wild tales of his life. All the while he delivered his story, he did not look at me.

A few minutes later, I stopped him again and said, “Jim, I want you to notice as we talk what happens. I just want you to pay attention to what’s going on between us as we are talking. Not just what you’re saying to me, not just the ideas, but what’s happening between us.”

He answered me with a jerk of his head. “Okay, okay. Well, you did say that I don’t give you a chance.” He went on to tell me in greater detail the content of some of these stories with which he had entertained this beautiful young woman. “I can’t figure out,” he said, “how she couldn’t want to go out with me again!”

Now, in response to my repeated attempts to respond to him, Jim had raised his voice, was speaking even more quickly, and was leaning into me, gesticulating forcefully, as he explained to me in intricate detail how, after being so entertaining on this date, he couldn’t possibly have failed to get this woman’s attention.

Several minutes later, as I was preparing to say something, he raised his hands high, looked right at me, and said, “I know, I know. I need to let you talk.” But immediately he dropped his eyes and started up again. Clearly, he had noticed what I was doing but then had plunged forward into another rush of content.

This time I cut in firmly. “You don’t ‘have’ to let me talk,” I said. “I’m just trying to help you notice what happens between us as I try to have this conversation. It’s very hard to get a word in edgewise.”

He stopped for a minute. Then, in a lower voice tinged at the end with an edge of sadness, he said, “You know, some of the women I’ve dated have complained to me about that.”

“Really?” I said wryly, with a slight amount of mock curiosity.

“They say I’m so enthusiastic that I never ask them about themselves.”

“What do you think it’s like to be in a relationship with somebody who does that, Jim?”

He paused again. “Ahh…Probably not great.”

“Probably not.”

“You know,” he said, “what you’re saying reminds me of the way it was at my dinner table. Everybody talked non-stop, especially my father and my brothers. It was hard to get a word in edgewise. We all fought for the mike, trying to get someone to listen to us.”

“Well, it’s obvious from the way you are now that it’s something you are still doing,” I replied.

“You’re right.” His face grew sad. “Do you think that has anything to do with my problem developing close relationships?”

“Of course I do. You’ve already told me that people have pointed this out, but clearly their pointing it out hasn’t had much of an impact on you.”

He shook his head sheepishly and looked down. “You’re right,” he repeated. After this, he began to look at me with a little bit of interest, with more respect and curiosity. He became a little more interested in what I had to say, as well as to notice his own voice. From a Gestalt perspective, he started becoming more aware of how he was interacting in the session. This, in turn, heightened his awareness of his internal experience as well as the impact of his behavior on me.

As the session continued, Jim began to be more aware not just of what he was saying, but how he was saying it. By the end, he was noticing how often he interrupted me. He seemed sadder, and his bullet-train monologue had slowed down. As I looked in his eyes, I could see a slight clouding and the beginning of a sorrowful look, as opposed to his earlier wild, intense expression. As he started to calm down, he paid more attention to me, and in the process, his sadness began to well up inside of him.

At the end of the session, he asked, “Is there something I can do?”

“I just want you to pay attention the best you can, between now and the next time we meet, to see if you can notice when you feel like interrupting anyone—before you do it.”

“This was really helpful,” he said, leaving.

The Here and Now: A Historical Perspective

Unlike other forms of psychotherapy, what was important to me with Jim in this first session was not understanding his history or his concerns in detail. Rather, from the very beginning of the session, I was paying attention to how we were together. What was important to me was the nature of contact, how we engaged each other. In this case, what I focused on was the experience of Jim not being able to listen to me, his talking a mile a minute, his inability to respond, and the fact that he was semi-disengaged from me and what I was saying.

So, from the very beginning of the session, I focused on raising his awareness, helping him to begin to notice how he was saying what he was saying as well as the quality of our engagement. Throughout the first session, I did not concentrate on gathering details of his life, trying to teach him how to combat the thoughts in his head, or trying to establish a relationship by getting to know him. I was primarily interested in helping him to experience the process of how we are together.

The Gestalt approach originated in the late ’40s with a group of New York intellectuals objected to psychoanalysis, which they saw as severely limited because it focused on pathology, as opposed to potential. These intellectuals—Laura and Fritz Perls, Paul Goodman, and Ralph Hefferline, among others—responded to this lack by creating a more open, engaged, enlivened psychotherapeutic experience, one focused on liberation and growth, which allowed the human personality to transcend the limitations of the defenses.

Gestalt took people off the couch and put them into a face-to-face encounter with the therapist. Rather than intellectual analysis, Gestalt’s primary vehicles were awareness and contact. In focusing on the “here and now” encounter, Gestalt made a left turn from psychoanalysis and brought the idea of the experience of the client into the therapy process, as well as the presence of the therapist into the encounter. It’s a relationship, and the therapeutic process emerges out of the relationship.

In its early days, Gestalt was closely connected to the work of Fritz Perls, who rightly or wrongly, was perceived as narcissistic and at times insensitive. Because of his aggressive approach, Gestalt got an unsafe, brutal, almost encounter-group-like reputation. But Perls was also incredibly bright and able to develop great insight into clients’ processes. In the years since its origins, Gestalt has emerged as a philosophy and methodological approach that is used by psychotherapists all over the world. While it is still true to the basic foundational principles outlined by its founders, Gestalt has evolved into a model that truly allows clients to experience themselves and use their resources to create fundamental change in themselves.

Moving Forward

In the Gestalt process, as the client makes contact and begins to experience himself in relationship to the other, his self becomes more visible to him and to his therapist. As Jim became more aware of what was going on inside of him, his self began to emerge in the moment. He began to be able to access his internal world in a different way than he had before, and he began to be more aware of the impact of his behavior on others.

As the therapy progressed, he began to feel and express sadness about his low quality of life; and as he experienced his feelings more, his engagement with me improved. Rather than talking at me, he made eye contact and talked to me about his sadness and loneliness, and his inability to be successful in the way he wanted to be with women and with peers.

One of the things that he discovered in our encounters was that as he began to interrupt less and focus more on what I had to say, he became more anxious and unsure of himself. He realized talking so much was an effort to relieve his anxiety—he was scared to slow down and engage people in a more intimate way. Clearly, Jim began to encounter on a deeper level the core issues that were troubling him about his current existence.

Staying in the Present While Working With the Past

One of the myths that have floated around the therapy world for many years is that Gestalt is only about the present. Somehow the here-and-now focus of the Gestalt approach created an impression that the past was never dealt with in Gestalt therapy. What is different about Gestalt is not whether the past is dealt with, but how it is dealt with.

As I worked with Jim through our relationship in the moment, his past began to emerge in a historical way. At one stage, when I pointed out to him that he never responded to what I said, but rather told me whatever came to mind in reaction to my words, some childhood memories emerged forcefully. As a child, he told me, his parents had always been telling him what to do, talking at him, and very seldom listening to him or taking what he said and making that the focus of the conversation. In other words, as I pointed out in our sessions what was happening in the present, Jim’s past began to emerge organically.

In another moment in the therapy when Jim tuned into a feeling of sadness at his current lack of relationships, he began to talk about how difficult it was that his family was isolated. They didn’t have very many family friends, and didn’t spend much time together as a unit. As a result, Jim did not have a lot of practice at engaged relationship building.

In this way, the past is slowly unwound and filtered into the present. Early childhood issues emerge in the moment and are dealt with in the moment, rather than being called up intellectually by taking a history.

When the past does emerge in Gestalt therapy, we frequently bring it back into the present. For instance, when Jim brought up his mother, I often asked him to imagine her in the room and to say something to her, so that he was able to experience vividly his feelings about the past, in the present. As a result, he was more able to encounter and engage the impact of the past on his behavior today.

Jim's Turning Point

Jim slowly became able to notice his own tendency to coopt conversations with his own thoughts rather than respond to what others were saying. He recognized that this was keeping him from deepening his relationships. As Jim’s therapy continued, he began not only to listen, but for the first time also to respond to those around him.

At this point in the therapy process, he met a woman named Sarah. The interesting part for Jim was that he met her on a flight home from a business trip. While he was sitting next to her on the plane, he had what he called his “little Norman bird” on his shoulder, who told him he needed to listen to what she had to say, draw her out, and try to understand her perspective, instead of regaling her as he always did with vignettes from his life.

He spent time talking to Sarah and really used his newfound skills. They got into what he called “a wonderful conversation.” They had so much fun on the plane that Sarah gave him her number. He asked her out and she accepted. They began to date.

It was important for Jim to handle the dating process a completely new way. Rather than focusing on trying to interest her in himself and thereby driving her away, he actually reversed the process and listened; and as he spent time getting to know her, she became increasingly interested in learning about him.

In addition to his budding relationship with Sarah, Jim began to do a better job in his work environment. He had always been semi-successful professionally, but as he became more engagement savvy and able to build relationships with people, his rapport with his employees began to flourish. Previously, those who reported to him at work had seen him only as a windbag and taskmaster. As he began to change, his employee satisfaction scores rose and he even got promoted, solely because his employees began to experience him as a more effective manager and leader.

Jim's Ability to Live a Fuller Life: The Goal of Gestalt

As Jim engaged more fully in life by actively listening and responding to what was happening around him, life in turn rewarded him. This is one of the most powerful parts of psychotherapy, and of Gestalt therapy specifically. Jim received more attention from women as they began to feel like he was interested in them. Jim’s colleagues noticed his new responsiveness and relative ease at engagement. All of these changes emerged as a result of struggling in the encounter.

Of course, my work with Jim was much richer and more multifaceted than it has been presented here, but focusing on this particular issue illustrates what happens in the Gestalt therapy process and how the world can begin to seem different to our clients. He heard more. He was more aware. He took more personal responsibility. He really heard what people said and it had more of an impact on him, he was able to be touched by others. He got more positive feedback and support from the world as his self evolved.

This, then, is the heart of Gestalt therapy: to help our clients expand and meet their potential for fuller, more rewarding lives, while always starting in the moment, wherever they happen to be. For Gestalt therapists, strengthening the therapeutic relationship by attending to contact in the here and now of the session is not merely an end in itself; rather, it is by attending to the quality of connection in that moment that the client learns how to be present, both with his own internal experience and in relationship with the therapist. This awareness itself is the catalyst for change, opening new doors of possibility to both the past and the future.

© 2011 Psychotherapy.net.