Gestalt Therapy

Gestalt therapy is a client-centered approach, often tailored to each individual's unique needs and experiences. During therapy, the therapist serves as a guide and facilitator, helping clients explore their thoughts and feelings without judgment.

This approach works on different levels. For example, in addition to listening when people speak about their thoughts and emotions, a gestalt therapist examines their body language to interpret how the emotions manifest through physicality. A primary tenet of gestalt psychology is that the past cannot be changed, so studying unfinished business in the present moment is considered the only way to learn from and work through past events. 

As with many other types of therapy, gestalt therapy is tailored to build trust and rapport so clients are comfortable discussing their experiences in-depth. During the session, the gestalt therapist may ask the individual to consider how context, self-awareness, and other factors contribute to their perception of past and present events. This process may provide an opportunity for self-discovery and understanding, teaching clients to recognize when feelings emerge in daily life and how to control maladaptive thoughts and behaviors that may follow. 

Gestalt therapy can require a collaborative effort between a therapist and a client, focusing on growth and empowerment rather than changing one’s personality. Clients may expect to spend the first sessions with their therapist, establishing connection and trust to become comfortable exploring potentially challenging and emotionally painful experiences. Gestalt therapists may use a few techniques, including but not limited to the following. 

Asking questions that encourage self-exploration

This technique involves prompting individuals to reflect on how they experience past difficulties in the present by asking questions like, "How do you feel about it now?" or "Do you think what happened in the past colors your perception of difficulties now?" These questions may encourage clients to understand their role in past events and the emotions attached to those experiences to establish self-awareness and a sense of personal responsibility in the present. 

Chair work

The empty chair technique in gestalt therapy involves arranging two chairs facing each other. The therapist encourages the client to sit in one chair and engage in a hypothetical dialogue with an "other" figure in the facing chair. They may imagine an actual individual or part of their psyche, such as their "emotional side," inner child, or inner critic. In the two-chair exercise, the individual may move between chairs, acting out both parts of the interaction. 

The goal of chair work may be to support the client in understanding past events, engaging in interactions with others with whom they aren’t comfortable communicating in person or preparing for how they might approach interactions with others in the future. This technique may be helpful for people with post-traumatic stress disorder (PTSD) or social anxiety disorder. 

Roleplaying 

Like the empty chair technique, role-playing involves hypothetical interactions. Some therapists engage clients in role-playing exercises to cultivate empathy and insight into their interpersonal interactions. This exercise may include engaging the individual in a hypothetical scenario to illustrate how their perceptions about experiences affect their reactions. 

Bodywork

Part of the gestalt method includes supporting the client in cultivating more physical self-awareness when they communicate. The purpose is to recognize the behavior and learn to connect it with the thoughts and feelings they may be experiencing at the moment.

For example, if the individual jiggles their knee in agitation when talking about an event, the therapist may direct their awareness to that physical action. In some cases, the therapist may ask the person to repeat the action more exaggeratedly, then explore the details about the thoughts that influence the behavior, giving them more autonomy and control over the impact of their beliefs. 

Dreamwork 

Gestalt therapists may believe dreams can provide a window to the connection between a client’s inner life and how it manifests outwardly. They may inquire about their client’s dreams, asking directed questions about how they felt upon waking from the dream and exploring interactions with others within the dream. Some therapists may ask clients to keep a dream journal to discuss during appointments. 

Gestalt therapy can be beneficial for treating a wide variety of mental health challenges in individuals, and some therapists may use the method in group or family therapy. Outside of a therapeutic setting, many life coaches use Gestalt methods to assist clients in strengthening self-esteem and communication skills. 

Gestalt therapy isn't often used to provide advice, diagnosis, or treatment for people with more severe mental disorders such as schizophrenia or psychotic disorders. Below are some of the conditions gestalt therapy may be beneficial in treating or managing: 

• Anxiety:² Methods of GT encourage individuals to focus on the present, exposing the thoughts and feelings that may cause anxiety and impact how an individual reacts to it.
• Depression:³ Therapists use gestalt methods to treat depression in the same way they may use it to treat anxiety. Focusing on the present moment can allow clients to become more aware of their thoughts and feelings. 
• Other mental illnesses: People with conditions like PTSD, bipolar disorder, and substance use disorders may benefit from gestalt therapy. Using gestalt techniques to uncover present emotions and beliefs may allow individuals to put past experiences into a clearer perspective and change resulting behaviors. 
• Self-esteem difficulties: Identifying the underlying factors contributing to low self-esteem and self-doubt may help individuals overcome and combat them daily. 
• Relationship difficulties: Through gestalt therapy, couples may become more aware of the underlying destructive interactions and behaviors creating conflict within the relationship. With cooperation, couples may use this information to move forward and make productive changes. 

Gestalt therapeutic techniques aim to help individuals assimilate different aspects of their persona and psyche with their experiences to establish self-acceptance, self-confidence, and internal unity. Other goals of this form of therapy may include the following:

• Emphasizing the importance of viewing an individual as a whole and interconnected being rather than an amalgamation of separate parts
• Focusing on how individuals interact with their environments, other people, and themselves, as well as patterns of resistance or avoidance that can prevent growth and self-awareness
• Encouraging clients to take responsibility for their thoughts, feelings, and actions, including acknowledging and owning one's experiences and choices
• Identifying unresolved emotions or experiences from the past that continue to affect their present lives

Studies on gestalt therapy are limited, partially because the intuitive, holistic nature of the technique makes its efficacy challenging to quantify. Client outcomes of phenomenological approaches like gestalt therapy are often reported through papers published by clinicians and scholars who use it. 

However, a growing body of research into gestalt therapy aims to examine its efficacy in different clinical settings by identifying commonalities in client outcomes after treatment. For example, a systematic review of 11 papers published internationally determined that the Gestalt method can be effective in treating a diverse population of people with anxiety, depression, and self-esteem challenges.  

Evidence suggests that this type of therapy may be a successful alternative to medication in some cases. A 2017 study conducted by scientists at Islamic University Sistan and Baluchestan in Iran measured the effectiveness of GT as a treatment for depression compared with medication and found that GT had a more positive effect on symptom reduction. Researchers cite the techniques commonly used in gestalt therapy that expose and explore a client’s emotional difficulties as a critical factor of its efficacy compared to medication alone. 

It is important to consult with a doctor or medical professional before beginning or changing any medication plan. The information provided in this article is not intended as medical advice; please consult a qualified healthcare professional for personalized guidance.