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I am an integrative therapist and I use a different array of therapies ranging from Gestalt, Acceptance and Commitment Therapy, Person Centred, Cognitive behaviour therapy and psychodynamic
Gestalt Therapy
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Gestalt therapy emerged in 1950s and was developed by Franz Perls. According to Perls the basic premise of Gestalt psychology is that human nature is organised into patterns or wholes (Perls 1973) and that a 'need' arises when an imbalance occurs with the person, or to their environment. In fact there could be several imbalances or needs at any one time but it is the one that stands out or is more dominant at the particular time - the Gestalt.
According to Gestalt theory, a persons awareness of self is often depicted as a circle of awareness, in which there are 9 stages: 1 sensing and feeling, 2, becoming aware, 3, mobilising, 4, taking action, 5, engaging, 6 in final contact, 7, integrating, 8, letting go and 9, equilibrium - balance/harmony.
The cycle can be interrupted at every stage. For instance a “block” may occur near the beginning, so that the individual fails to sense or feels they have particular need. Alternatively, a person maybe aware of a particular need but cannot do anything about it (the mobilising stage). Or perhaps a person cannot be fully involved as they cannot let go of a previous thought (engaging). A block at any stage of the cycle prevents its completion and the person remains dissatisfied. Uncompleted cycles or incomplete gestalts Perls called ‘unfinished business’ and which cause distress and restlessness. This translates into anxiety, depression, self-defeating behaviour and relationship issues.
Gestalt deals very much with the here and now as the person is always in the now, however it recognises that unfinished business or incomplete gestalts affect a persons life to the point they may be stuck in the past which affects how they feel.
The goal of Gestalt is awareness of self. The awareness cycle involves increasing awareness of self which leads to excitement which leads to contact and action and gradually assuming ownership of their experience, as well as developing skills and acquire values that will allow them to satisfy their needs without violating the rights of others (Clarkson 1996).
Importantly, Gestalt views language as central to its theory, in particular focusing on pronoun ‘I’ rather than ‘it’ in order for clients to take ownership of their emotions. Gestalt uses elaborate techniques, the most famous being the empty chair address an empty chair as if were another person or another part of the client, helps clients get in touch with others views. Other techniques include exaggeration whereby the person is told to go ‘overboard’ with their feelings or behaviours. They use games such as Reversal. Where someone quiet and mild is told to be loud and overbearing.
Acceptance and Commitment Therapy
Acceptance and Commitment Therapy (ACT), is a mindfulness-based behavioural therapy created by Steve Hayes1986.
Central to ACT is that it does not have symptom reduction as the objective of its therapy. This is based on the view that the ongoing attempt to get rid of ‘symptoms’ actually creates clinical symptoms. ACT aims is to transform the relationship with difficult thoughts and feelings so that they are no longer perceived as symptoms. Accordingly, clients are taught that thoughts are harmless, even if they are uncomfortable and as fleeting psychological events, like passing clouds. Ironically, it is thorough this process that ACT actually achieves symptom reduction but what Hayes saw as a by-product and not the goal.
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ACT sees individuals as using a device called experiential avoidance. This is where there is a problem; something we don’t want and the solution is to figure out a way to avoid it. And thus, the more time and energy we spend trying to avoid or get rid of unwanted thoughts and/or feelings the more we are likely to suffer psychologically in the long term.
The ACT therapist does not attempt to try to reduce, change, avoid these anxious thoughts and/or experiences but instead, the client is shown how to learn to reduce the impact and influence of unwanted thoughts and feelings, through the effective use of mindfulness. Clients learn to stop fighting with their private experiences and to open up to them, make room for them and allow them to come and go without a struggle.
Thus ACT interventions focuses A = Accept your reactions and be present C = Choose a valued direction and T = take action.
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Person Centred Therapy
Person Centred Therapy, more commonly referred to as PCT was developed by Carl Rogers in the USA in the 1950s. His theory was humanistic which focuses on the whole person and which sees individuals as unique. The client is central to the therapeutic process.
Rogers maintained that in order for a person to grow, psychologically then the therapeutic relationship had to have certain core conditions, and if such conditions were present then this would provide a climate conducive to client growth. These conditions he labelled as Unconditional positive regard, Empathy and Congruence also known as genuineness.
Unconditional positive regard according to Rogers was that a therapist accepts the client unconditionally and thus does not judge them. This is extremely important. An environment with unconditional positive regard, Rogers argued sets the client free in which to explore all their thoughts without fear of rejection, repulsion or condemnation. He considered this condition was crucial for client growth.
The second element to his theory, empathy which means according to Rogers, that the therapist accurately understands the client’s thoughts and feelings and any meanings they are trying to rely in doing so. In other words the therapist enters the client’s world, a world from their viewpoint. This is in stark contrast to sympathy which is feeling simply sorry for a client.
Lastly, Rogers considered congruence or genuineness had to be present. The therapist has to be authentic and genuine at all times. Thus, the therapist cannot be aloof but is present and transparent during the therapy session. Rogers argued congruence was necessary to avoid any air of authority which the client may then defer and thus damage the therapeutic relationship. Moreover, Rogers stipulated that the therapist had to be genuine and accepting at all times during the therapy, in order that the client did not have to speculate and thus ‘guess’ what the therapist was really like.
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Cognitive Behaviour Therapy
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This is a therapy often referred to by the acronym CBT, has had much publicity and has been adopted widely by the NHS for the treatment of a number of psychological issues. It is a therapy mainly for symptom reduction and practised over time can assist with intrusive thoughts and behaviours.
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CBT maintains that psychological disturbance is caused by distorted thought patterns, and that such patters of thinking can impact upon your emotion e.g. low mood, anxiety and anger which than can then impact upon your behaviour. CBT aims to help people become aware of their distorted thinking through a process of evaluation. Practical exercises including homework is important for the client to see the types of thoughts, emotions and behaviours they engage with which may be consistent according to the situation they find themselves in.
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Psychodynamic Therapy
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This therapy was originally created by Freud. It is a holistic therapy which looks at the client's emotions, thoughts and beliefs. The therapy concentrates upon the emerging self (Self-awareness) and the clients thoughts, feelings and beliefs in relation to their past childhood.
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This therapy places a great deal of emphasis of the past, especially childhood and that chronic conditions may be rooted in there and held at an unconscious level. A person may adopt a number of defence mechanisms - an automatic process, to avoid a stressful or highly stressful conflict.
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The aim of therapy is self-awareness and the reduction of defence mechanisms.
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