The basic therapeutic skills in Gestalt Therapy

April 6, 2024

Remembering the different interventions that I have been able to carry out in different workshops and therapeutic processes, specifically those that dealt with the establishment of roles, I want to reflect on the important role of therapeutic listening, specifically the Gestalt listening .

Observations and analysis that have given me many conclusions about the role that it holds in this double direction about the self that every therapist seeks: inward and outward.

Know more: "Gestalt therapy: what it is and on what principles it is based"

Clarifying some concepts

Internal listening

The internal listening , as the capacity for questioning from self-observation, is nothing more than the virtue of looking inward, allowing us to become aware of the self and attend to those processes that are awakened in established communication.

And it is that although "being available to the other does not mean forgetting us" (Peñarrubia, 2012), the harsh self-criticism, arising from that "keeping up appearances" in therapy -like the attention of the self in the experiential process-, forgets that the Gestaltists not only attend to what happens to the other, but they must also keep in mind (be aware) of what is happening to them at that moment (in the here and now).

Interior listening

Is listen inside , which at the beginning we thought was a burden for the patient's full attention, gives way to a more friendly version, exemplifying the excellence of his method as an accompaniment, without having to interfere in the attention of our interlocutor.

Paraphrasing J.B. Enright (1973) exemplified this new vision and awareness of the aforementioned: "To carry out a suitable clinical task, mental health professionals need to have access to the flow of their inner experience." The first and subtlest sign for to understand the anguish, the hostility ... of the other, is the consciousness of some similar or complementary state in oneself ".

External listening

Refering to external listening , he forgets that more important than listening to what is said, is to decipher how he says it. It is common to see how listening to verbal content is important (showing our ability to listen once more with the repetition of what we have attended with the utmost fidelity: words and textual themes transmitted), but even more important is listening to the non-verbal content.

And in my experience in group dynamics, although we develop attention and concentration on words and issues, we relegate the gestures, the tones of voice, the body posture, which, more than words, give us more honest information than their narration in sentences.

Undoubtedly, this shows that a good therapist should not only limit himself to a passive listening of what is exposed, but that must attend in an active way the sound of the voice, its tones, the rhythm of the musicality in its words , because in short, verbal communication is nothing more than a lie (Peñarrubia, 2006).

My experience in congruence with the above has allowed me to understand that in addition to listening to words, we must attend in a more conscious way what the voice tells us, what the movements narrate, the posture, its facial expression, its psychosomatic language; in short, and in the words of Fritz Perls himself (1974): "it is all there, if they allow the content of the sentences to be only a second violin".

Keys and benefits of therapeutic listening

The therapeutic listening should be treated as an attitude: availability, attention, interest in the other ... If we materialize it in two indissociable operative lines (listening to content and perception of the form) we will understand the purpose of the training that every good therapist should attend:

Listen to the content (what the other says), retain and reproduce it literally; it is a test of attention. Considering the purely theoretical nature of his explanation, we find that, almost permanently, what is forgotten, what is changed, corresponds to or indicates conflicting areas of the therapist, referring us to his own unfinished business and that allude to the internal world itself. We could conclude that memory is therefore selective and that both rescued and rejected alludes to the neurosis of the therapist.

Listening to the nonverbal requires the therapist to be a good observer , capacity and perception that transcends beyond the word. The attention of the how on what, bet on the non-verbal in case of dissonance.

Communication in Gestalt Therapy

We have talked about the attitude of Gestalt listening, which inevitably leads us to also talk about a certain attitude of communication (communication in Gestalt). It is already common in the workshops, the correction in several colleagues, among whom I find myself, of forms of expression that distort the rules of communication in Gestalt.

We went on to enunciate and exemplify the most common ones (Peñarrubia, 2006):

Speaking in the third person and in the past / future tense may be the most frequent correction during the therapeutic processes. The theoretical basis that sustains that correction of the tutor that forces us to "speak in the first person and in the present tense", affirms that impersonal language dilutes the responsibility of what is being said. Speaking in the present tense (even if one talks about the past) facilitates the experience, making accessible and available the emotional content that the narrated experience contains.

Do not take responsibility for the expression , emphasizing the recommendation to incorporate it as the speech progresses, with the introduction of phrases (which facilitate taking charge of what is narrating) Examples of these experiences in real sessions are: expressions about "I feel my neck tense up" , being able to hold the patient responsible for this experience in a more committed way since "I am feeling tense".

Use of the conjunction "but" instead of "and" and the question "why" instead of "how" . It is common in the clinic to ask questions about the "why" trying to get some rationalization or explanation, should exercise the return that relational dynamics. This will never lead us to a global understanding and that if we change the "how" we will look at what happens, we will observe the structure of the process and it will give us perspective and orientation. Also with the use of "and" instead of "but" we will avoid the dichotomy of language, integrating instead of dissociating.

Gestalt Therapy and the therapeutic relationship

To conclude and take up the origins of Gestalt Therapy, we are debtors (either by position or by opposition) of Freud and his psychoanalysis (Rocamora, 2014): "what a relationship damages in its origin or childhood, another can heal it- psychotherapy" , allowing to speak of therapeutic relationship, to detect certain models of patient-therapist relationship. Relationship that when talking about Gestalt listening, highlights the peculiarity that in relation to its fundamental principle of "realization", points to an interaction where the therapist (the self) is used as a reference map or experience with his patient (balance Gestalt).

What attitude should we then maintain: "hear? Or listen?" If listening is something that is done intentionally and hearing is something independent of the will, Gestalt Therapy is the first priority. This, in congruence with the objective of it (focused more on the processes than on the contents), puts the emphasis on what is happening, is thinking and feeling at the moment , above what could be or have been. Listening globally, as they show us in the workshop (verbal and non-verbal), is therefore the key to the success of a therapeutic process.