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Psychotherapy: Theory, Research, Practice, Training Copyright 2004 by the Educational Publishing Foundation
2004, Vol. 41, No. 2, 180–189 0033-3204/04/$12.00 DOI 10.1037/0033-3204.41.2.180
GESTALTTHERAPY:PAST,PRESENT, THEORY,
ANDRESEARCH
LAURAE.WAGNER-MOORE
University of Massachusetts at Boston
Orthodox gestalt therapy suffered a Classical Gestalt Theory and
rather unfortunate fate; gestalt theory Perls’s Eccentricities
has been poorly articulated, and gestalt Fritz Perls has been simultaneously praised for
techniques have received minimal his creative exuberance and criticized for aspects
empirical validation. These weaknesses of his style that simply defy the term scientifi-
are, in part, a consequence of F. cally derived. The “Perlsian” form of gestalt
therapy primarily embodies the history and per-
Perls’s biographical history, which led sonality of Perls himself, rather than a scientific,
to an integration of disparate structured, empirically derived or theoretically
theoretical models that were consistent model of psychotherapy. Gestalt
exacerbated by F. Perls’s haphazard, theory is an intellectually fascinating, philosoph-
ically complex set of diverse but poorly articu-
idiosyncratic personal style. However, lated and poorly substantiated beliefs.
recent empirical research suggests that Conversely, it is interesting that the actual
the 2-chair technique is superior to techniques used by gestalt therapists have been
other therapeutic interventions for clearly delineated and have received some em-
conflict splits, decisional conflict, pirical validation for their effectiveness. This dis-
marital conflict, and unfinished junction between theory and research makes the
study of gestalt theory and technique decidedly
business and that the 2-chair technique Byzantine and perplexing. This review and cri-
is as effective as Rogerian and tique presents the most coherent aspects of gestalt
cognitive–behavioral therapies. therapy that are based on principles of Gestalt
Although F. Perls’s techniques may psychology and provides a review of recent em-
have been generated largely from his pirical work on gestalt techniques.
Historical context dictated a nomadic life for
idiosyncratic personality Perls, with moves from Berlin (where he was
characteristics, these techniques have heavily influenced by psychoanalysis) to Johan-
some validity for very specific nesburg in 1933, to New York in 1946, and later
psychological dilemmas. to California. Geographic location seemed, in
part, to influence Perls’s concepts and practice of
psychotherapy, on the basis of his teacher “du
jour.” As a result, Perls’s approach to gestalt
Laura E. Wagner-Moore, Department of Psychology, Uni- theory and therapy was, at best, eclectic. He bor-
versity of Massachusetts at Boston. rowed some ideas from his analysts, like Reich
This article represents a modified paper written for a gradu- and Horney (Miller, 1974). As Miller (1974)
ate school requirement at the University of Massachusetts at noted, Perls integrated Horney’s notion that “neu-
Boston. Assistance was provided by Joan Liem, Ester Sha- rotic behavior is based on manipulation, designed
piro, and Don Kalick, University of Massachusetts at Boston. to win love” (p. 5-24) and was attracted to “Sar-
Correspondence regarding this article should be addressed trean” existentialism’s idea of individual respon-
to Laura E. Wagner-Moore, PhD, whoisnowattheCenterfor sibility and choice (Miller, 1974). In the wake of
Child and Family Health, Duke University Medical Center,
3518 Westgate Drive, Suite 100, Durham, NC 27707. E-mail: the zeitgeist of World War II, which was so heav-
wagne032@mc.duke.edu ily permeated by phenomenological and existen-
180
Gestalt Therapy
tial thought, Perls rejected much of his analytic 1997). This process is best encapsulated in the
training in favor of the new zeitgeist (Yontef & notion of figure–background gestalt formation
Simkin, 1989). From Jan Smuts, the prime min- and destruction. Gestalt psychology suggests that
ister of South Africa, Perls borrowed the idea of a mass of unstructured individual data in the en-
holism. Ironically, he initially had minimal expo- vironment (i.e., parts) are subjectively structured
sure to or understanding of Gestalt psychology by the perceiver into wholes that have both form
itself and has been criticized for this on several and structure (Perls, Hefferline, & Goodman,
accounts (Wheeler, 1991). Wheeler (1991) noted 1951). The person’s actual experience is deter-
that Perls’s early work, titled Ego, Hunger and minedbythegestalt, rather than the raw pieces of
Aggression, was simply revised and renamed The data. The way in which multiple data are shaped
Beginnings of Gestalt Therapy (renamed at his is based on the individual’s needs, appetites, and
wife’s suggestion) with little description of what impulses.
Perls meant by Gestalt psychology or therapy. These concepts can be applied to the realm of
Perls himself called the book “sketchy,” and psychological needs as well. In theory, a need
WheelerconvincinglyarguedthatPerls’soriginal arises and becomes foreground; if it is satisfied, it
text is full of “vague philosophical musings and becomes background as the gestalt is completed.
self-aggrandizement in the Freudian manner” Pathology arises when this process is disrupted.
(Wheeler, 1991, p. 43). When gestalt formation is
The fate of classical gestalt therapy is a sad blocked or rigidified at any stage, when needs are not recog-
one, which finds itself without a clear set of bind- nized or expressed, the flexible harmony and flow of the
ing theoretical principles and without a prolific organism/environment field is disturbed [and] unmet needs
body of literature dedicated to the critical analy- form incomplete gestalten that clamor for attention . . . and
sis and dialogue that could further its develop- interfere with the formation of new gestalten. (Yontef, 1969,
ment. Miller, a practicing gestalt therapist and as cited in Simkin, 1976, pp. 223–234)
student of Perls, argued that gestalt has “slipped Aneed may be blocked by an unclear sensation
into a middle-aged decline” and is plagued by or a lack of awareness of one’s needs (Greenberg
“a persistent intellectual thinness” (Miller, 1974, &Rice, 1997). Therapeutic work focuses on in-
p. 21). Perls’s striking “anti-intellectual bias” creasing awareness to bring about change, so that
(Miller, 1974) has been transmitted over time. the emerging need may be identified, satisfied,
His famous “Lose your mind and come to your and enabled to retreat into the background
senses” best embodies his preference for acquir- (Simkin, 1976). Awareness of one’s experience
ing knowledge through experiencing and feeling and needs is considered the “royal road to the
rather than through empirically validated or ra- cure” (Greenberg & Rice, 1997).
tional, logical thought processes. Perls’s similar
preference for the idiographic over the nomothet- Experience/Contact Cycle
ic makes the systematic study of gestalt quite The processes underlying gestalt formation
challenging. Despite these difficulties, neo- and destruction were obtusely described by Perls
gestaltists have successfully described Perlsian as the experience/contact, or metabolism, cycle.
notions of gestalt therapy linked to classical ge- Thecycle consists of four main phases, including
stalt psychological theory. The two concepts ex- awareness, excitement, action, and contact. In
plained most completely involve (a) figure– gestalt theory, the term contact does not equate
background gestalt formation and destruction and with the popular definition meaning closeness.
(b) the contact/experience cycle, as they related Gestalt theory uses the word contact as an ab-
to the etiology of psychopathology in gestalt stract, formal concept that refers to the exchange
theory. between an individual person and the surround-
Figure–Background Gestalt Formation ing environment (Miller, 1994). If the boundary
between the self and the environment (or other)
Perls, in keeping with other humanistic ap- becomes unclear or lost, then there is a distur-
proaches, believed in the self-actualizing poten- bance of contact and awareness (Yontef &
tial of the individual, which assumes that an or- Simkin, 1989). When the cycle is functioning
ganism ultimately knows what is best for its self- smoothly, awareness of internal or external
regulation and actualization (Greenberg & Rice, stimuli leads to excitement, which potentiates an
181
Wagner-Moore
action tendency; the action tendency leads to ure, against a background, rather than focusing
need satisfaction (optimally) and contact (Green- ontheentire field. Second, the model is criticized
berg & Rice, 1997). Dysfunction is considered for assuming cycle disturbances can always be
the interruption of the cycle at any stage (Green- traced back to a problem in awareness itself. The
berg & Rice, 1997), and resistances to contact model suggests that if an individual has aware-
account for these disruptions. ness of a goal and attempts to act on that impulse
Perls retained the traditional psychoanalytic but ultimately fails in that action, the failure is
notion of defenses to explain additional disrup- due to misunderstanding the need or not empow-
tions in the contact cycle including retroflection, ering the need from the very beginning. Wheeler
introjection, projection, and deflection. For in- (1991) has noted that failing to meet a goal may
stance, a break in the cycle between excitement not solely be attributed to a problem with aware-
energy and action could be accounted for by ret- ness; instead, the individual may have misper-
roflection, which occurs when a split within the ceived the original problem or the individual may
self and resistance of aspects of the self take have had clear awareness but difficulty following
place, wherein the self either (a) does to oneself through with actions that would lead to a success-
what one wants to do to someone else or (b) does ful outcome.
for the self what one wants someone else to do For instance, survivors of posttraumatic stress
for the self (e.g., being overly self-sufficient, re- may have developed a relatively clear awareness
sulting in isolation). In both cases, the self has a of individual needs and desires while simulta-
need with energy, but the energy is diverted away neously having cognitive distortions or inaccu-
from its natural object and turned back against rate (or accurate) perceptions of environmental
itself (Wheeler, 1991). Increasing awareness is a threat that impede recovery; in other words, con-
primary psychotherapeutic tool because the cycle textual factors are quite relevant in decreasing
can be interrupted at the first stage if a need is personal distress. Perls’s conceptualization
blocked by dull sensation or poor awareness makes the individual unduly responsible for
(Greenberg & Rice, 1997). meeting his or her own needs and simultaneously
Implicit in the model, however, is the assump- fails to account for peculiarities in the environ-
tion that all disturbances in the cycle can be ul- mentthatcounteract or conflict with the individu-
timately traced back to a problem with awareness al’s need.
itself (Wheeler, 1991; Yontef & Simkin, 1989). It Perls’s quirky beliefs, peppered throughout ge-
follows, then, that gestalt psychotherapy uses stalt theory, may help uncover the mystery be-
here-and-now (present-centered) experiments in hind several significant sources of weakness and
directed awareness to increase the individual’s incongruence in the match between gestalt theory
awareness as well as the individual’s awareness and therapeutic practice. There are multiple dan-
of the process of awareness (Yontef & Simkin, gers inherent in considering individual impulses
1989). Contrary to traditional psychoanalytic and needs of primary importance. Miller argued
methods of excavating the past, gestalt therapy that Perls’s “aggressive self-expression borders
focuses on awareness and contact in the present on what Sartre characterized as ‘that diligent and
moment, using methods that ultimately serve to almost sadistic violence I call the full employ-
clarify present experiencing. ment of oneself”’(Miller, 1974, p. 19). One of
Perls’s experience-cycle model has been criti- Perls’s great strengths, however, was his focus on
cized by philosophers of Gestalt psychology for individual potential, although he failed to realize
its insistence on focusing on individual impulses how destructive this position could be in rela-
or desires in isolation; significant contextual is- tional contexts.
sues are either minimized or ignored. This is a Perls believed that freeing oneself from com-
prime example of how gestalt theory often em- mitment and dependence on others was essential
bodies a particular penchant of Perls’s personal- (Perls, 1968). Perls embodied this ideal when,
ity structure rather than a predictable concept after becoming established in New York, he left
driven by theoretical constructs. his wife and children and drifted westward to
The cycle, criticized by Goldstein (as cited in pursue his own goals (Miller, 1974). Impulses
Wheeler,1991),hasbeenlabeled“figure-bound.” and drives that are not moderated by reason, re-
This suggests that the model rests largely on the straint, and consideration of the “other” can end
immediate need or impulse that has become fig- up in frenzied, relatively autistic, and chaotic re-
182
Gestalt Therapy
lationships that lack reciprocity and empathy. tic style led to gimmicky techniques that flour-
Perls’s focus on separateness and self-reliance ished. He was known to “sprinkle his audiences
are reflected in the first few lines of his mantra and trainees with slogans” as he made up new
from Gestalt Therapy Verbatim: techniques “on the fly,” which he presented as
I do my thing, and you do your thing. I am not in this world “the latest essence of Gestalt therapy” (Miller,
to live up to your expectations. And you are not in this world 1994). Theory-driven, empirically validated tech-
to live up to mine. You are you and I am I, and if by chance nique was progressively abandoned and subse-
we find each other it is beautiful. If not, it can’t be helped. quently replaced by the methods generated by
(Perls, 1968, p. 4) Perls’s own dramatic, off-the-cuff flare.
Unfortunately, although classical gestalt therapy Modern-day gestalt therapy has retained
is more than capable of promoting self-reliance Perls’s applied phenomenological approach and
and the drive toward individuation, it fails to ac- creative techniques. Contrary to Perls’s style,
knowledge the benefits inherent in relational and modern gestaltists consider the relationship be-
intersubjective approaches to psychotherapy. The tween the therapist and client one of the most
similarities between the greatest weakness in ge- important aspects of psychotherapy and use less
stalt theory and Perls’s own style are striking and stereotypic techniques (Yontef & Simkin, 1989).
provide a way of understanding the peculiarities Yontef argued that traditional gestalt techniques
of gestalt theory. stressing skillful frustration, client manipulation,
and self-sufficiency served to provoke shameful
The Fate of Classical Gestalt Therapy and reactions in patients (Yontef & Simkin, 1989).
the Rise of Modern Gestalt Therapy Yontef and others argued that modern gestalt
therapy is less harsh (Aleksandrov, 1997; Yontef
Almost 30 years have passed since Perls’s &Simkin, 1989) and has turned its focus to the
death, and gestalt therapy has certainly changed, genuine contact between patient and therapist
moving from the original Perlsian emphasis on (Greenberg & Rice, 1997; Yontef & Simkin,
skillful frustration and self-reliance to a gentler, 1989). Although there are over 60 gestalt therapy
“Rogerian-ized” version of gestalt therapy. The institutes throughout the world, no national orga-
1960s version of gestalt included psychodrama nization or standards have been established
techniques that contained a philosophy that em- as criteria for empirically validated gestalt
bodied existential principles of freedom and re- treatments.
sponsibility, analytic notions of defenses, and ge- Moderngestalt has changed in several respects
stalt psychological principals of gestalt formation but still embodies the majority of Perls’s original
and destruction. Modern gestalt has retained ideas and therapeutic techniques. Despite Perls’s
many of Perls’s original ideas but has also soft- lack of rigorous intellectual explanation of gestalt
ened in many respects. theory, his unique and creative style has given
As Perls’s practice of gestalt therapy pro- modern gestalt therapy several fascinating and
gressed, he wrote less about theory; his seminal effective therapeutic techniques. Even though
work, Gestalt Therapy: Excitement and Growth Perls attempted to connect the puzzle between
in the Human Personality (Perls, Hefferline, & gestalt theory and his own technique, empirical
Goodman, 1951), was considered one of the only validation of Perls’s techniques remained largely
comprehensive texts written about gestalt theory. unsupported until recently.
This work, however, is a rather arcane and un-
successful attempt to illuminate gestalt prin- Gestalt Psychotherapy Techniques
ciples. Jerry Kogan, a well-respected and admir-
ing student of Perls said that he began reading Despite the loose connection between gestalt
Gestalt Therapy and “thought it was terrible,” theory and practice, the techniques of gestalt
although he found Perls himself “a model of a therapy and Perls’s application of them are cre-
brilliant teacher and therapist” (Kogan, 1976, ative and artistic and embody an unusual charis-
p. 255). Perls rarely referred to this text after its matic and authentic approach to treatment. Re-
original printing and instead preferred to print cent research by Leslie Greenberg on the two-
transcripts of his work (therapy seminars) rather chair dialogue and the empty-chair dialogue for
than expositions explaining it (Perls, 1968). As conflict splits and unfinished business has helped
Perls’s focus on theory diminished, his narcissis- explain the two-chair method and has brought a
183
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