GESTALT REVIEW

Editor

Joseph Melnick, Ph.D.

Associate Editors

Pauline Rose Clance, Ph.D.

Reinhard Fuhr, Ph.D.
Joel Latner, Ph.D.
Sonia March Nevis, Ph.D.
Robert W. Resnick, Ph.D.
Ansel L. Woldt, Ed.D.

Editorial Board

Jack Aylward, Ed.D., United States Gaie Houston, M.A., England

George Brown, Ph.D., United States Francisco Huneeus, M.D., Chile
W. Warner Burke, Ph.D., United States James I. Kepner, Ph.D., United States
Todd Burley, Ph.D., United States Philip Lichtenberg, Ph.D., United States
Janine Corbeil, M.A.Psych., Canada Margherita Spagnuolo Lobb, Ph.D., Italy
Sylvia Fleming Crocker, Ph.D., United States Lars Marmgren, M.Sci., Sweden
Dalia Etzion, Ph.D., Israel Malcolm Parlett, Ph.D., England
Bud Feder, Ph.D., United States Deborah L. Plummer, Ph.D., United States
Iris E. Fodor, Ph.D., United States Erving Polster, Ph.D., United States
Isabel Fredericson, Ph.D., United States Miriam Polster, Ph.D., United States
Jon Frew, Ph.D., United States Jean-Marie Robine, France
Norman Friedman, Ph.D., United States Ilana Rubenfeld, United States
Leslie S. Greenberg, Ph.D., Canada Paul Shane, United States
Joseph H. Handlon, Ph.D., United States Marta Slemenson, M.A., Argentina
Robert L. Harman, Ed.D., United States Milan Sreckovic, Ph.D., France
Cynthia Oudejans Harris, M.D., United States Gordon Wheeler, Ph.D., United States
Carl W. Hodges, M.S.W., United States Joseph Chaim Zinker, Ph.D., United States

Managing Editor Editorial Assistant
Shari Buchwald Desirae Page Savona

© 1999 by The Analytic Press, Inc., Hillsdale, New Jersey 07642. All rights reserved. No part
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A PUBLICATION OF THE GESTALT INTERNATIONAL STUDY CENTER.

EDWIN C. NEVIS, PH.D., DIRECTOR

Typeset in Palatino by Laserset, Inc., 200 West 79th Street, New York, New York.
 GESTALT REVIEW

Volume 3 1999 Number 4


Editorial
Joseph Melnick, Ph.D. 271

Gestalt Principles in the Courtroom:

An Interview with Judge Joyce Wheeler
Beverly Reifman, LICSW, BCD 275

An Experiment in Community Psychotherapy

Nigel Copsey, MSC and Talia Levine Bar-Yoseph, MA 285

Comments on Copsey and Levine Bar-Yoseph,

An Experiment in CommunityPsychotherapy
Myriam Muñoz Polit 301

Response to Myriam Muñoz Polit

Nigel Copsey, MSC and Talia Levine Bar-Yoseph, MA 305

Narrative Formation and Gestalt Closure:

Helping Clients Make Sense of “Disequilibrium”
Through Stories in the Therapeutic Setting
Peter Mortola, Ph.D. 308

Building Bridges: A Response to Peter Mortola

Stephanie Backman, MSSA 321

Gestalt Therapy as Narrative: A Commentary

on Peter Mortola’s Paper “Narrative Formation
and Gestalt Closure”
Margherita Spagnuolo Lobb 325

Response to Backman’s and Spagnuolo Lobb’s

Commentaries
Peter Mortola, Ph.D. 335
Clinical Films as Training Tools: A Comparison
of REBT and Gestalt Therapy with Children
Sheila Aspinall, Psy.D. and Iris Fodor, Ph.D. 337

Back Pages: Topics and Reviews 341

Book Review of Touch in Psychotherapy:
Theory, Research, and Practice
James Kepner
Prose and Poetry
Joel Latner
Gestalt Review, 3(4):271–274, 1999

Editorial


J O S E P H M E L N I C K, Ph.D.

1960 S, I became fascinated by com-

A
S A GRADUATE STUDENT IN THE
munity psychology. I remember going to sensitivity labs, Black–
White encounter groups, making home visits to families; and
doing training and organizational work with nonprofit agencies. It was
during this period that I and many others discovered Gestalt therapy.
Many of us originally entered the field, drawn not by individual
therapy, but by the possibility of applying our therapeutic learning to
the community. We wished to touch segments of society beyond the
reach and interest of traditional psychotherapy. It was a time of opti-
mism. We believed that the tenants of psychotherapy, shaped to fit
different contexts, could literally change the world.
In retrospect, this human potential movement was “a period of great
flowering, not because organizations changed that much, but because
it became possible to change the consciousness of large numbers of in-
dividuals in all walks of life” (Nevis, 1997, p. 117). Gestalt therapy
played a fundamental role in this movement. For example, there was
Eliot Shapiro applying Gestalt therapy to school systems, Fritz Perls
building his Canadian commune, and of course, Paul Goodman com-
mitting his heart and soul to the antiwar movement.
I am uncertain as to all the reasons why this movement seemed to
diminish in the 1970s and 1980s. Whatever the reasons, our society be-
came more conservative, and psychotherapy became more insular and
narrow. It shifted from an emphasis on growth and expanded aware-
ness to the curing of illness and reduction of symptoms. Whereas symp-
toms in the 1960s had been viewed as reflecting a larger environmental
context, by the 1980s for many, the symptom was the disease.
The pendulum is beginning to swing back. Gestalt-trained people
are moving out into the community, and they are making a difference.
They are working with and within political, legal, and religious sys-
tems; with nonprofit agencies; with environmental groups; and with
the economically disadvantaged. Gestalt values that emphasize aware-
ness, use of self as an instrument, and resistance as the existence of

271  1999 The Analytic Press

272 JOSEPH MELNICK


multiple realities are fundamental components of our field theory base

from which to work with(in) the community.
Gestalt Review, from its inception, has been committed to printing
articles that highlight the reemergence of the Gestalt approach as an
agent of social change. Because of this commitment, I am especially
pleased to complete our third year of publication by featuring two
articles that are outstanding examples of the application of Gestalt
principles to the community.

Our Current Issue

We begin this issue with Beverly Reifman’s interview of Joyce Wheeler,

a district court judge who has had extensive Gestalt training. In this
personal and wide-ranging interview, Wheeler describes how her Ge-
stalt training has become her ground as a judge, by discussing such
topics as gender, self-support, and transferential issues. She discusses
how she has learned to hear “on many different levels . . . hearing in
your body, your heart, and your intellect.” Most of all she describes her
commitment to maintaining a stance of openness and integrity in her
work.
In our second article “An Experiment in Community Psychotherapy,”
Nigel Copsey and Talia Levine Bar-Yoseph describe their application
of Gestalt principles in the inner city of London, an area rich in cultural
and religious diversity. Arguing that providers of mental health ser-
vices have failed to recognize the importance of religions and cultural
belief systems, they discuss their experiment in creating a system of
community support that is neither western nor clinical. What it is in-
stead is the respectful application of Gestalt principles within a spe-
cific cultural milieu. This ongoing experiment in social action that moves
away from traditional therapeutic methods results in the co-creation of
relevant novelty.
In response, Miriam Munoz Polit agrees with Copsey and Bar-Yoseph
that the Gestalt approach, with its emphasis on phenomenology, is well
suited to address people within their own cultural context. However,
she responds from her own cultural perspective, as a woman who has
spent a good deal of her life practicing community psychology in
Mexico. She describes her country’s resistance to outsiders “through
Latin American eyes,” cautioning the authors, as well as all of us, not
to project our beliefs on the individuals that we serve. Last, in contrast
to Copsey and Bar-Yoseph, she describes poignantly how religious faith
in Mexico has severely damaged the mental health of communities.
Copsey and Bar-Yoseph respond by agreeing with Polit on the dan-
gers of religions that view “anything psychological as dangerous.” They
argue for the opening of a dialogue between the worlds of faith and
psychology.
EDITORIAL 273


In “Narrative Formation and Gestalt Closure: Helping Clients Make

Sense of ‘Disequilibrium’ Through Stories in the Therapeutic Setting,”
Peter Mortola attempts to reconcile a Gestalt approach with that of nar-
rative therapy. Elaborating on the theoretical links between the two,
Mortola argues convincingly that both approaches at their core focus
on helping the client make sense out of the “disequilibrium of experi-
ence.” Utilizing a transcript of a case, he describes a therapeutic pro-
cess of moving from equilibrium to disequilibrium and to a modified
equilibrium. He ends by listing the important implications of his analysis
to the Gestalt approach, especially in working with children.
Backman in her response discusses two similarities and one signifi-
cant difference between the two approaches. She agrees with Mortola
that a well-formed narrative and a collaborative process are essential
to both approaches. However, she believes that there is an important
difference between the two. She believes that in their attempt to mini-
mize therapist/patient hierarchy, narrative therapists have substituted
a chaotic and poorly formed format. Thus, the approach focuses on in-
trapsychic work, resulting in a narrow and unnovel outcome.
Lobb, in her commentary, traces the use of narrative in Gestalt therapy
and emphasizes the contribution of Polster. She points out that narra-
tive at its core is a relational event inserted in a field. The individual to
whom the story is being told is as important as the client in creating the
narrative.
Mortola’s article is followed by “Clinical Films as Training Tools: A
Comparison of REBT and Gestalt Therapy with Children” by Sheila
Aspinall and Iris Fodor. Students reported expected differences in the
two approaches, but also some exciting similarities.
We end this issue of Gestalt Review with James Kepner ’s in-depth
review of Touch in Psychotherapy: Theory, Research, and Practice by Ed-
ward W. L. Smith, Pauline Rose Clance, and Suzanne Imes (eds.). The
fact that this book has been written is noteworthy, for as Kepner points
out it is the first overview of this topic. It also comes at a time when
touch is viewed with suspicion by many.
Kepner, drawing from his wide experience as a body-oriented thera-
pist, trainer, and author, raises a number of intriguing questions in his
commentary. While lauding much of the book, he questions whether it
is too “culture bound.” He expresses concern that issues related to gen-
der, cross-gender, cross-ethnic, and cross-racial touch are not addressed.
Joel Latner, the editor of “Back Pages,” adds a more personal per-
spective in his commentary. He talks of the beauty of touch and la-
ments its disappearance from the American scene.
His commentary provides an excellent segue back to my opening
comments. As I said previously, Gestalt therapy is by definition con-
textually sensitive. Therefore, it can flourish in the East End of London
or rural areas of Mexico and inform a judge in her legal work. Gestalt
274 JOSEPH MELNICK


therapy, at its core, is a philosophy of life that transcends its psycho-

therapeutic roots.

From the Editor

I would like to apologize for the lateness of this issue and for the
delay in the completion of our web page. We expect to have
Gestaltrev.com up and running soon.
As I write this, our first issue of 2000 is in production and is
expected to be off press this spring. It features an exciting dialogue
concerning issues of sexuality in therapy, training, and consulta-
tion. These five writers approach this controversial topic from
historical, contemporary, ethical, legal, personal, and of course,
Gestalt perspectives. In addition, this issue also includes a conver-
sation devoted to marital therapy and a research study focusing on
mysticism and Gestalt resistances.
In the new millennium, Gestalt Review will be offering stimulat-
ing and exciting articles covering a wide range of topics such as
Gestalt in the boardroom, an approach to mourning, group therapy,
and self-esteem.
If you have not subscribed, now is the time to do so!

Reference

Nevis, E. (1997), Gestalt therapy and organization development: A historical

perspective. Gestalt Review, 1:2, pp. 110–130.
Gestalt Review, 3(4):275–284, 1999

Gestalt Principles in the Courtroom

An Interview with Judge Joyce Wheeler


B E V E R L Y R E I F M A N, LICSW, BCD

B.R. Would you start by telling me about your current work as a judge
in Maine?
J.W. I am a judge in the district courts in York County in Maine. The
district court is the first tier of the legal system. Basically, it is the
people’s court. It is the place where most people in society have
their one and only contact with the court system. Primarily I deal
with divorces, family matters, parental rights and responsibili-
ties of unmarried parents, protection from abuse, domestic vio-
lence, and small civil and criminal matters.
B.R. Was becoming a judge a conscious, professional goal of yours?
J.W. When I first got out of law school, I clerked for a federal judge in
MA., and I knew then that I wanted to be a judge. But it is not
something I did anything about. I did not live my life in a planned
way. I didn’t think about what kind of contacts I needed to make.
At the end of 1993 I was contacted by a small group of people
who were working with the governor of the state of Maine, look-
ing for candidates for the position of director of a family court
pilot project. At that point I said to myself, “ Why would I want
to do that?” My practice then was primarily educational law that
dealt with legal issues in higher courts, federal courts. I thought
about their proposal and surprisingly realized within 24 hours
that it was exactly what I wanted to do.
B.R. Why did you want this job?
J.W. I realized that I loved the idea of asking each party, “What do
you want?” and then fashioning a solution. I liked that approach

Beverly Reifman, a Gestalt Therapist and consultant in private practice in Cam-
bridge, MA, is also on the staff of the Institute for Couples and Families at McLean
Hospital in Belmont, MA.
Joyce Wheeler is a district court judge in York County, Maine. The interview took
place on February 13, 1999.

275  1999 The Analytic Press

276 BEVERLY REIFMAN


better than being an advocate for one side or the other. When I
was in private practice, I did a few family cases a year. I only did
two child custody cases. In one case I represented the father; in
the other, I represented the mother. In both cases neither side was
wrong. I knew that I didn’t want to do family matters from an
adversarial point of view.
B.R. So you moved from being in the role of advocate for one party to
being in the role of problem solver. That was a significant shift in
your professional stance.
J.W. Yes, it was. Maybe this change was influenced from my place
and role in my family of origin. I was the oldest of six children
and felt responsible for the welfare of my younger siblings. I was
described as an impatient child, wanting my own way. I don’t
think that I was a problem solver as a child. I do think, though,
that I had a sense of justice, wanting to do what was right at an
early age.
B.R. Do any examples of early injustices come to mind?
J.W. I remember, going back to the days of school banking, when the
boys in the family got more to put in their accounts than the girls.
That gender issue appeared at a very early age. Also, I remember
when my parents were members of a country club and there was
a debate whether a Black person should be allowed to join. I felt
outraged at some level even though I didn’t fully understand.
Although my parents were the same parents who administered
the unequal banking policy, they were the voice of injustice about
racial discrimination. They didn’t make distinctions between
people because of class and race. Their friends were not limited
to the medical community (my father was a surgeon) but were
people across many levels. I grew up with the sense of freedom
to move among people. That was very important to me.
B.R. This sense of justice eventually led you to law school. Did you go
straight from undergraduate school to law school?
J.W. No. I went and got my masters degree so I could teach. I taught
high school for three years in Framingham, Massachussetts. I
taught constitutional law and African-American studies. It was
during that time period that I decided to go to law school. I started
to put gender concerns into a political framework and that moti-
vated me as much as anything. Up until that point, women were
mothers, teachers, or school nurses. It became important to me
to enter the professional world where women were excluded.
After law school, I became frustrated with the legal system. I
was focusing on one case, one family. What I dealt with felt so
minute, the problems so repetitive. One direction for my frustra-
tion that I thought about was to try to create some kind of a dia-
AN INTERVIEW WITH JUDGE JOYCE WHEELER 277


logue in junior hgh schools , maybe even earlier, between teach-

ers, judges, writers, artists, philosophers, religious people, and
lawyers to discuss questions such as “What does it mean to live
in a family? What does it mean to live in a community? What is
one person’s responsibility to another? “
Time and time again the problems I was seeing in families and
with juveniles made it clear to me that people did not see be-
yond their own noses. They did not understand their responsiblity
to each other. Neither did they understand their responsibility to
themselves. Their actions were beyond them. I was working at
the end of the line. We really needed to work at the beginning of
the line to teach kids how to grow up with the values that would
help them to operate more effectively and caringly toward each
other.
B.R. Do you think that the sense of isolation and disconnection from a
wider community is increasing among juveniles?
J.W. During my five years in the district court, I am repeatedly asked
that question, “Are things worse?” I do not know how to answer
that question. What I can say is that I see well-entrenched dys-
function being passed on from generation to generation. I see the
parents one day, the children the next day. So many of the kids in
juvenile court are the same kids that are in the abuse and neglect
cases I handle where the state is intervening to protect the chil-
dren . So many of those kids have parents who have the same
history that the kids have. It becomes very clear that it will take
some very drastic intervention to stop the dysfunction in these
families. This dynamic cuts across socio-economic classes but
tends to be more prevalent in families where there is poverty.
The mothers I see in abuse and neglect cases are mothers that
were abused and neglected as children, have borderline person-
alities, or have serious substance abuse problems, with little self-
esteem and self-worth. The kids are growing up with the same
problems although now the kids have ADD (attention deficit dis-
order), ADHD (attention deficit and hyperactivity disorder), or
oppositional personalities. The court system can’t solve these
problems. Only a change in our society will make a difference.
B.R. Is there any format for judges to discuss how to use their accu-
mulated observations and authority to bring about socio-politi-
cal changes?
J.W. Wouldn’t that be wonderful, to sit down with a group of judges
and discuss these issues? We do it to some small degree. We did
it in Maine in order to create the family division within the court
system to deal with families that are separating and divorcing.
That came through a series of dialogues on the impact on kids of
278 BEVERLY REIFMAN


divorce and what the courts could do to make the divorce pro-
cess more sane so that kids do better. In a more abstract, less task
focus, we do not do enough of talking together.
We probably need to do that in order to sustain ourselves on
the bench. It is pretty isolating being a judge. Maine is so geo-
graphically spread out that when we do get together, which is
two to three times a year, we are very focused on concrete tasks.
The Gestalt training progams I’ve done have given me the op-
portunity to step out of the judicial box and think about how to
integrate my values and be more effective as a judge.
B.R. How did you get introduced to the Gestalt model?
J.W. I was going through a divorce and also thinking about changing
my career. I was university counsel at the time, dealing with em-
ployment issues, discrimination, dealing with interpersonal prob-
lems between administrators and teachers and teachers and
students. Many people thought that because I was a lawyer I
would have solutions to all kinds of problems. They didn’t want
or need legal solutions. I felt that I was flying by the seat of my
pants. I needed some training in dealing with interpersonal con-
flict. I thought of the possibility of going back to school for a
Ph.D. in psychology as a way to gather more skills to more effec-
tively work out relationships. However, I knew I did not want to
do a dissertation. Experiential learning was the way I wanted to
learn. My ex-husband’s sister recommended that I do a Gestalt
training program. I did the O.S.D. (Organizational Systems De-
velopment) program from 1993–1995 and the Couple and Fam-
ily program after that.
In the Gestalt program, I learned on different levels. I describe
the experience as learning through my pores. It is almost impos-
sible to articulate what I learned; I can only answer that question
from what I carry with me today from the experience itself. The
question I was asked at the end of each week of the training pro-
gram was, “How do you support yourself?” I hated that ques-
tion. I think my answer for the first several weeks was, “Who the
hell knows?” And so I learned to answer that question.
I learned something else that is enormously helpful now when
I sit in a courtroom. I learned how to be present in a system as
cleanly as possible by distinguishing what is my stuff and what
is the stuff that is coming from the parties before me and the
witnesses. When I hear all these bells and whistles going off, I
can stop a moment and figure out if this person is triggering
memories of my ex-husband, my father or mother, or whatever it
might be, or am I picking up just what this person is emanating?
I recognize that there is a need to make that distinction even if I
AN INTERVIEW WITH JUDGE JOYCE WHEELER 279


can’t always tell. It is very important to separate what is me and

what is not me. I “sit on the margins” of the system in as clean a
way with a great deal of awareness of what I am bringing into
the courtroom.
B.R. You are talking about a kind of integrity that you add to your
sense of integrity by asking that question of yourself.
J.W. The word integrity is probably the most important character trait
or skill one can have in the courtroom or in his or her personal
life and I think that is what I learned to develop—to bother to
ask the questions that distinguish yourself from the other.
In the Family and Couples Program (which I completed after
the O.S.D. program), it became clear to me what integrity meant.
In that program there were four women who went to the pro-
gram together, and we were a group. We got together after the
program was completed to hone the skills of integrity and hon-
est dialogue and work through the issues, to stay with each other,
and to bring the contact level to as deep a place as possible. I’ve
only been able to do this work within the Gestalt process.
B.R. What do you see that process being? When you say Gestalt pro-
cess, what are you describing?
J.W. I’m describing a slowing down, so that there is an opportunity to
truly take in and hear on many different levels. That’s the hear-
ing through the pores, hearing in your body, your heart,and your
intellect—a being present to the other, to the system, taking the
time to feel and honor what is experienced and said. I learned
how to create a heightened awareness of the decision-making
process by slowing down.
In the courtroom, I am really listening to the parties, not just
their words, but their body actions, their tones, their facial ex-
pressions. I then feed back to them what has peaked my interest
that relates to the task that I need to do. I am continuously trying
to keep myself on the margin so I do not get pulled in or manipu-
lated by them or them by me.
In divorce cases sometimes the parties cannot talk to each other
or even be in the same room with each other. People will look at
me. I try to move myself out of the triangle so the parties talk to
each other. Integrity means staying on the margin and not be-
coming part of the system and then feeding back at the end of all
of the testimony. I try to maintain a sense of openness until all of
the testimony is said. I want people to see that I take these issues
seriously. Before I leave the bench, I usually share something so
that they walk out with some minimal input before a written
decision is made.
280 BEVERLY REIFMAN


I use something I learned from Sonia Nevis and Joseph Zinker,

which is to talk about the strengths and the weaknesses, the up-
side and the downside of their ability to work together as par-
ents. Even in a couple that has many abuse complaints against
each other, at least I can acknowledge that they know how to
protect themselves, and then I can talk about what they need to
develop. I often need to talk to parents about the effect of their
conflict on the child. I want them to have a sense that I have heard
them. When I write the decision, I will say again what I observed
of their relationship.
B.R. Sounds like you have a goal in addition to a good legal decision,
which is to increase their awareness of their impact on the people
around them. Whether it is a juvenile brought in for some delin-
quency issue or parents in a divorce, what you discuss with them
is their impact on you. You are not hearing them in an empty
way. You are modeling what you wish them to develop.
J.W. I learned a lot about modeling and providing what is missing in
a system in my Gestalt training. One of the ways I support my-
self as a judge is to see what I do and write as an experiment that
may or may not have an impact. Transforming my sense of mis-
sion to a sense of experiment helps me not to feel like a failure
because I know that I may have no impact on some people.
Most people in my court cannot afford an attorney, and fewer
than 25 percent of cases have an attorney on both sides. How do
you handle that when one party has a lawyer who is articulate
and forceful? It is difficult for me. I can’t act as counsel for the
unrepresented person, but I can give them as much opportunity
to present their perspective. There are some judges who believe
that a judge doesn’t intervene, just simply rules on objections,
doesn’t ask questions. I tend to be much more interactive than
that. I have developed a rather informal system of first swearing
people in and either asking them to tell me their story or, through
a series of questions I ask, I elicit their stories from them. I do
this so that on both sides there is less adherence to the formality
of rules of procedure and evidence. Again, this is on family mat-
ters, not criminal matters.
B.R. If someone who knew you before you attended the Gestalt pro-
grams were to describe how the programs affected you, what
would they say?
J.W. The programs expanded who and what I was. I was living un-
consciously before, going through a divorce, having my whole
world turned upside down. Life then was as if all of my ground
had been pulled out from under me. All I could do was stand
firm and hold on. The Gestalt program enabled me to grow and
AN INTERVIEW WITH JUDGE JOYCE WHEELER 281


make changes at an expediential speed. I woke up. My personal

awareness grew tremendously. I stopped being afraid to ask the
difficult questions. I had been living in fear. I walked into the
fear and the other side wasn’t as bad as being anesthetized.
There’s that gender issue again; I had learned to grow up and
preserve family connections and in doing that, I numbed myself
to my own needs and wants. I learned first to know what it is
that I want and to go after that. I had done that professionally
but not personally, interpersonally.
The discussions about race and gender in the O.S.D. program
have stayed with me. My experience in the family program when
I had an assumed role in a role-play had a lasting effect on me. It
was something I did not want to do. I do not like play-acting.
What allowed me to do it was thinking that we were creating
roles that were outside of us, that had nothing to do with our
lives. I needed that distance in order to participate. I thought I
was safe by playing a grandmother with a single father and two
young daughters. Of course, that was precisely my role as a step-
mother, and all of my personal experiences came out. I became
more and more the role. It is just amazing how that process works.
Something outside of you becomes yours.
Race, gender, those issues are really hard to talk about. With
all of the skilled participants and faculty in the O.S.D. program,
with a lot of experience, nevertheless, it was such an extremely
difficult process. I think it was hardest for us Whites to know
how to address our own racism and not look to Blacks to educate
us and help us through the muck. I don’t think we solved any-
thing or found a way to talk effectively. But we muddled through
it, and that took a lot of courage.
B.R. It does take courage not to make complex issues more simple
than they really are.
J.W. I was the lightning rod, the conscience, that kept raising the gen-
der issues. It’s a role I play in the judicial system. It’s a role I still
play in my family and in other groups. That is my mission. Gen-
der issues for me are less difficult to talk about,maybe because I
am the recipient. It is harder for me to speak as a White person
from the privilege and power that being White has traditionally
given me. I would love to spend more time struggling with is-
sues of gender and race because, as a culture, that is where we
are right now and each of us needs to continue to work. It is too
easy to avoid our work because it is so painful and difficult to
do.
I have a niece who is a Mayan Indian, a niece and nephew
who are Korean, a nephew who is Paraguayan, and two White
282 BEVERLY REIFMAN


nephews. I don’t think I know enough to understand their expe-

rience or have talked with them enough to understand their ex-
perience. That astounds me as I say it. Even in my immediate
family, I don’t have enough of an understanding nor have I taken
enough time to learn what their experiences are, even in such
close surroundings. And I am sure that it must be a complex ex-
perience. I am sitting here now wondering about them. I have to
talk with them more.
Yes, I see that more clearly as we speak. I don’t think I have
created enough structure in my personal life to provide for me
and my nephews and nieces the same experience of telling their
stories that I provide in the courtroom.
B.R. What do you observe about gender issues in the courtroom?
J.W. I worked on the Commission on Gender Justice in the Courts. In
the district court I feel less of the gender issues between the at-
torneys. It feels fairly egalitarian. In the county courts, which are
half women and half men, I do not feel a difference between how
we are treated and treat each other. I feel very fortunate. This is a
good experience compared to what I hear that exists elsewhere.
The legal system is a patriarchial system, for the most part, top
down, managed by males. I feel my rebellion to sytems defined
and structured by male power as the legal system is in general,
but on a day-to-day basis I don’t struggle.
I do see gender issues playing themselves out in the parties
before me. I see real power issues between men and women in
divorce and neglect and abuse cases. Typically, it is a woman who
is being abused, and the man is the aggressor. Occasionally, it is
the opposite.
A woman will come in and get an emergency order for exclu-
sive possession of the home and the children because the man is
being physically abusive or mentally abusive. Within days, she
will come back and drop the order because he has promised to
reform. She will resume the relationship and drop the complaint.
Soon, she will be back in court with another complaint, and the
cycle of violence goes round and round. And when they finally
get into the courtroom, he will still continue to try to manipu-
late, to dominate right in the courtroom. I see the power issues
played out over and over again.
I see gender differences in terms of who has access to the courts.
Women more typically are not represented by counsel, and so
they begin with less information about how the system operates
and therefore less power in effecting the system to achieve what
they want to achieve.
B.R. What role do you take when you see this pattern?
AN INTERVIEW WITH JUDGE JOYCE WHEELER 283


J.W. It’s a very difficult one. For example, if a woman comes in and
wants to drop her complaint, I sometimes will talk to her before
she does to try to ascertain whether she is acting freely or whether
there is some threat. In doing that, however, I feel uncomfortable
because I don’ t want to play “Big Sister is watching you” and
undermine her autonomy to decide. I, nevertheless, take a pro-
tective stance. Then if she wants to dismiss it, rarely do I say,
“No, you can’t dismiss it.” I try to slow down her action.
Here’s another example. We’ll be doing an uncontested divorce.
The parties will come before me, and it is clearly an unfair di-
vorce. There may be a pension plan that he is going to walk away
with and that she will get nothing for retirement. There may be a
huge disparity in their income levels, and she should be getting
some spousal support. I am faced with that same dilemma of how
much I should intervene. Am I stepping over too far and becom-
ing her advocate? What I do is try to bring out the information,
for instance, that a pension is a marital property, that it is some-
thing that both of them have a right to, even though he earned
the money. I advise them of their right to consult with an attor-
ney and tell them that there are free legal services available if
they want to do that. Occasionally, I do say that I will not grant
this divorce until you have time to think about it. Sometimes the
man is very angry and the woman is in tears because she is scared.
It is a risk that I will be setting her up for more control and ma-
nipulation and even abuse because I have evened out the power
for a moment and maybe it will reverberate negatively against
her. It is my responsibility to make sure the divorce is fair and
equitable, yet as a woman, I have enough sensitivity for her need
to be self-defining.
The man often talks about money as if it is his and she accepts
that. I ask about the context, the field, to get information as to
where this divorce plan came from. This is all to be done in ten-
minute slots.
B.R. Do Gestalt principles help you keep track of what you are doing?
J.W. Although I don’t use the words figure and ground in the court-
room, I see figure as the case before me; the ground is the marital
experience. I do need to know about the ground to resolve the
figure issues. I don’t need to take care of the figure in the court-
room. What I want to do is to get a sense of the ground, pulling it
out. Although I’m staying on the margin, I need to enter that fam-
ily and know what the dynamics of that family are and what their
patterns are of contacting each other.
The Gestalt experience is not solely an intellectual process. It
has become part of me. It is there. The Gestalt experience is my
284 BEVERLY REIFMAN


ground as a judge. I wanted to write an article about a new way

of judging within a Gestalt framework and found that I did not
know enough about what judging was to do the article. As I got
more and more into the experience of judging I knew that I liked
the sense of knowing what it is to be a judge. I have a way to go.
This interview makes me think more about this integration.
B.R. You have found a model that you can take into the courtroom,
that allows you to be a judge in a way that makes sense to you as
a professional, a person, and a woman.
J.W. I don’t question my ability to judge. I may question other aspects
of my life. But the place I feel very much at home in is when I sit
in the courtroom as a judge. My mission to do justice, law school,
my Gestalt experience, my experience as a girl and a woman, my
teaching, being a family member—it all comes together for me. I
am very grateful.

47 Wendell Street
Cambridge, MA 02138
Gestalt Review, 3(4):285–300, 1999

An Experiment in Community
Psychotherapy


N I G E L C O P S E Y, MSC
T A L I A L E V I N E B A R-Y O S E P H, MA

This paper reflects on an experiment in community psychotherapy in

an inner-city area of London. The area described has the largest non-
white population in the United Kingdom and contains all the main world
faiths. The paper proposes that community mental health services are
failing to recognize the major changes taking place in the areas in which
they work. By not recognizing and working with the worldview ex-
pressed by those communities, the providers of services are failing to
respond to the mental health needs of the community. Using a Gestalt
lens, the paper proceeds to outline a new paradigm of community
psychotherapy.

E AST END OF LONDON. This inner-city area is the

T
HE SETTING IS THE
most deprived in the United Kingdom. In addition to the prob-
lems facing a community with very high levels of unemployment,


Nigel Copsey is a Christian minister with a passion to integrate spirituality with
mental health. He works with the community mental health services in inner London
and for the Sainsbury Centre for Mental Health. He is also a humanistic psychotherapist.
Talia Levine Bar-Yoseph, past Director of the MSc in Gestalt Psychotherapy, Metanoia
Institute, London, is currently a trainer on the MSc, the course advisor, and a Gestalt
practitioner.
The writing of this article has challenged us both to examine the meaning of co-
writing. You will see that the article is written out of Nigel’s personal experience and in
the first person. However, it came to be created by both Nigel and Talia sharing a jour-
ney together, whereby each was bouncing ideas off the other. It was because Nigel was
in the actual setting that the story reads as his experience. His experience was shared
by Talia both as a supervisor and as a consultant. The content of the article was jointly
created as a result of many hours of discussion and dialogue. Co-writing for this article
has meant co-creating.
This article forms the basis of a forthcoming chapter in Bridging the Divides: A Dia-
logic Approach to Cultural Diversity, edited by Talia Levine Bar-Yoseph, to be published
by GIC Press.

285  1999 The Analytic Press

286 NIGEL COPSEY AND TALIA LEVINE BAR-YOSEPH


poor housing, and high levels of crime, every major report published
in the last year has drawn attention to the crisis facing community
mental health services: the community services simply cannot cope with
the problems they are facing.
In addition to these issues, East London has undergone a major trans-
formation over the past 20 years. The traditional ‘East End’ was a very
settled community centered around the docks that provided employ-
ment for the whole area from the city of London downstream. It has
always been one of the most deprived areas of London; however, the
East End was a tightly knit community, with the majority of the popu-
lation intermarried and living within small communities. With the death
of the docks and the introduction of slum clearance programs, the whole
area began to change.
In the post-war years, large sections of the population moved out of
inner London while many of those remaining were rehoused in tower
blocks. At the same time, large numbers of people drawn from over-
seas communities began to move into London to make it their home. In
the mid-1950s and 1960s, the new population mainly came from the
West Indies, while in the 1970s and 1980s, large numbers of Asians and
Africans moved into East London. It is estimated that in the East Lon-
don Borough of Newham, the nonwhite population now represents over
50% of the population. The new communities have brought a rich di-
versity of life to inner London. They have also settled in defined areas,
with the result that the traditional white population has either moved
out of these areas or has itself moved into a number of more clearly
delineated neighborhoods. The whole map is changing.
One major result of this new population mix is the establishment of
a strong Asian culture within many parts of East London. For example,
there are now 30,000 Muslims, 21,000 Hindus, and 5,000 Sikhs living in
one London borough. In one particular area of the London Borough of
Newham, it is now possible to walk for two miles and pass fifteen
mosques and five temples. In addition, there are as many Africans and
African-Caribbean congregations as there are church buildings: indeed,
some traditional church buildings are host to three different black-led
congregations. It is this change in patterns of religion that has been
both the most unacknowledged and also the most significant in recent
years. In this one London borough, the combined congregations of Chris-
tians, Muslims, Hindus, Sikhs, Buddhists, and other Asian faiths now
represent at least 40% of the population.
The post-1945 experience of church-going in East London was one
of decline. In 1975, it was estimated that, if the decline continued, there
would be no churches left by the year 2000 (Smith, 1996). As late as
1985 the Faith in the City report was bemoaning the decline of urban
AN EXPERIMENT IN COMMUNITY PSYCHOTHERAPY 287


churches: Church of England attendance averaged 0.85% of the popu-

lation (Smith, 1996). The 1991 census showed that the Borough of
Newham was the second most ethnically diverse in the United King-
dom (Smith, 1996). With the wave of Black-led Pentecostal churches
and the growth of African Christian communities from Ghana, Nige-
ria, Uganda, Zaire, and Zimbabwe, along with Christians from the Car-
ibbean, it is now estimated that there are 153 Christian congregations
in Newham of which 66 are Black-led. If the Asian religious groups are
then added to this number, it means that within the space of 20 years,
this inner-city borough has undergone a major transformation from
being a largely agnostic, even atheistic, culture into one in which nearly
half the population lives according to a particular theistic belief
system.
There has been a great deal written concerning multi-ethnic diver-
sity and the importance of culture, but it would appear that there is
little willingness to recognize the importance of religious belief as the
determining factor of culture. For instance, in the most recent report on
the mental health services in inner London (King’s Fund, 1997), it was
recognized that the leaders of religious groups need to be involved in
the provision of community mental health services. However, there was
no attempt to provide any rationale for how this might take place. While
there was a recognition that faith communities are important, it needs
to be understood that, within many inner-city areas of the UK, the faith
communities provide the cultural identity as well as a focus for belong-
ing to those who are struggling to find a “home.” Populations have
gravitated to those areas where the focus of each religious community
is located. It is the faith of these different communities that provides
the foundation for both their culture and values. In particular, it is sig-
nificant that the providers of mental health services fail to recognize
the importance of belief systems within the mental health of an indi-
vidual. Not only does the psychiatric and psychotherapeutic commu-
nity fail to work with the many belief systems, but it also expects users
to conform to what is essentially a Western model of health care. The
services provided reflect the culture of the “host nation.” For example,
it is still the case in many hospitals that single-sex wards are not avail-
able. Moreover, the health care system is only now beginning to recog-
nize that diet, religious practice, and language are very important
aspects of health care. Also the Western system focuses on an individu-
alistic model, whereas in other cultures the individual can only be seen
as part of an extended family, culture, and religion. It is not surprising,
therefore, that the most recent report on mental health care in inner
London highlights the failure of mental health providers to have any
impact upon the new communities.
288 NIGEL COPSEY AND TALIA LEVINE BAR-YOSEPH


The Research and Gestalt Theory

It was Paul Goodman who developed Gestalt thinking within the so-
cial context. Indeed, in Growing Up Absurd he devotes a whole chapter
to what he describes as “The Missing Community” (Goodman, 1960).
Taylor Stoehr (1994), who is Goodman’s literary executor, writes,

Goodman, more the rebel and innovator, though if we take the

broader view of cultural history it is Goodman’s emphasis that
conserves the traditional view of human nature and life in com-
munity [p. 300].

More recently, in Gestalt Review, Selma Ciornai (1998) has drawn atten-
tion to the cultural context of Gestalt in Brazil where the practice of
therapy is responding to the field conditions of a society where the fam-
ily is central to contact. In the same issue, Slemenson (1998) draws out
the relevance of Gestalt theory within a political context. Looking to
the future he observes that future goals should include: increased com-
munity work with mental illness as well as with prevention. He be-
lieves all social classes have equal rights to high-level professional care.
Polster, commenting on Goodman’s focus on developing (Brown, et
al., 1993) Gestalt theory into a social context, says, “In fact, Paul
Goodman, our most elaborative writer, has been almost totally disre-
garded in Gestalt therapy so far as his social commentary is concerned”.
Polster (Brown, et al., 1993) goes on to assert,

Eliot Shapiro with his work as a principal in a Manhattan school

and his innovative procedures for integrating the school within
the community, which were described in Nat Hentoff’s Our Chil-
dren Are Dying, is another example. Hardly anybody within Ge-
stalt circles has any sense of his work because we haven’t
emphasised the communal.

Polster continues to explain why he thinks Gestalt theory has focused

on the individual by pointing out that Gestalt therapy has concentrated
too simply on the figure/ground and health/pathology. It is interest-
ing that he goes on to outline a number of contexts in which he experi-
mented with the communal context, one of which was a religious setting.
Polster concluded by urging all Gestalt therapists to engage with the
communal.
It is against this rich background of both Gestalt theory and experi-
ment that I want to outline an experiment that focuses on the social,
political, religious, and cultural dimensions of Gestalt.
AN EXPERIMENT IN COMMUNITY PSYCHOTHERAPY 289


When I was given the opportunity to research the role of faith com-
munities within a community mental health context in the inner city, it
was like a dream come true! I was commissioned by the Sainsbury Cen-
tre for Mental Health to undertake a two-year project exploring the
mental health needs of the faith communities in East London (Copsey,
1997). Adopting a qualitative method of research, I visited twenty-seven
traditional Christian groups, ten African/African-Caribbean Christian
churches, two Asian Christian churches, four charismatic Christian
churches, four mosques, five Hindu temples, two Sikh temples, one
Buddhist group, and three other Asian groups. In addition, I visited all
groups working in mental health in the voluntary sector. My aim was
to listen to their understandings of the problems facing those with se-
vere mental health problems within their community. I was welcomed
by all, and there was a willingness to talk freely and to be very open.
My passion for East London began when I was a student at London
University studying theology. I lived in East London and began to see
first hand the poverty of the inner city. I lived through the slum clear-
ance programs that contributed to the destruction of a clearly identifi-
able culture, namely the traditional East London cockney. Many families
were forcibly moved to outer London whilst others were rehoused in
tower blocks. What is now acknowledged as a planning disaster re-
sulted in the destruction of a community that had a very strong sense
of identity and history. Cockney London was a tough place in which to
live, but there was a commitment by the community to the community
that was deeply rooted. This identity is retained in the popular media
through television soaps like Eastenders.
While I was training as a Christian minister, I knew that this was the
place where I should live and work. Even at that stage in my journey, I
felt very strongly that there should not be such inequality: the City of
London is one of the wealthiest areas in the UK within walking dis-
tance of Hackney and Tower Hamlets, the most deprived areas in the
UK. My strongly held belief as a Christian is that such polarities are
not part of God’s plan. Once I was ordained, I went to live in the
Docklands area of East London. My job was to establish a nondenomi-
national Christian community. At that time, the population in that area
was almost totally white, and attendance at anything remotely religious
was restricted to about 0.5% of the population. This is in stark contrast
to the new communities of East London (West Indian, African, and
Asian) where religious belief is part of life.
Not only was my initial task to discover ways in which it might be
possible to encourage a spiritual view of life, but also to respond to the
setting in which we lived. It is important to note that most profession-
als lived outside the area, which remains the case. The result is a co-
290 NIGEL COPSEY AND TALIA LEVINE BAR-YOSEPH


created field in which the resident population lives out a position of

being powerless and those with the power retain a clear role with con-
trol. There is very little attempt by either side to change this, hence the
polarity that exists between the City of London (extreme wealth) and
Hackney (extreme poverty).
It was this polarization that challenged me when I first began to live
in the area as part of the field. I could not drive away to the safety of
outer London. I was faced with nails in my car tires, with 50 windows
being smashed in our church facility by young children. I, too, faced
the daily anxiety of wondering if our house would be burgled or van-
dalized. I joined with a community that was facing a slow death. The
loss of jobs combined with slum clearance.
I remember well in my first week visiting a young mom on the 18th
floor of a tower block with a 7-year-old child. There was still a waiting
list of 2000 to be rehoused. The elevators were broken, and she lived in
daily fear for her child’s safety. She was suicidal because she was liv-
ing in such appalling conditions with few resources. These very tower
blocks were destroyed 10 years later because of structural faults. From
that day, a passion burned in me to respond to this situation.
I very quickly got married and our children grew up in the area.
This was our home. The longer I lived in the area, the more I came into
contact with the high level of mental health problems within the com-
munity. I gradually moved into the work of community mental health
while retaining my commitment to the spiritual. During this period,
the first group of Asians began to move into the area. They were so
gentle and genuine. Mr. Singh, a nurse at the local hospital, came with
his extended family. Night after night, his windows were smashed by
teenagers. He called for help from the police who never responded. He
ended up by making a citizen’s arrest on a 12-year-old. Another man,
whose only crime was to wear a turban, was beaten up by youths. Out
of fear he kept his door barricaded. Maybe the Asians represented a
polarity of gentleness and dignity that could not be tolerated. They were
passive, which was in stark contrast to the ethos of the dominant culture.
With the rise of the National Front, a complete reorganization of the
field took place. Those in the white population who could afford to
moved to outer London. Those who remained moved to defined areas.
The new communities, for their own safety, also moved to clearly de-
fined districts. It is the case today that certain districts have a popula-
tion that is 80% nonwhite. Currently, there are very clear boundaries
between the different communities. Each community has created its
own culture that is clearly different from the adjoining culture. Central
to the culture of the new communities is the extended family, the faith
system, and the clear cultural identity. English is not the first language
of the communities. Indeed, for many, English is a poor second lan-
AN EXPERIMENT IN COMMUNITY PSYCHOTHERAPY 291


guage. The mosques and temples dominate the skyline of the East End
streets. Daily, devotees of all ages attend the many places of worship.
The customs of the communities have become the norm: the norms of
dress are Asian. The restaurants and shops are completely Asian. I of-
ten eat in an Asian restaurant where I am the only white person. The
food is wonderful! The shared symbols of religious meaning, dress, lan-
guage, and custom provide a very public display of a shared meaning.
Definable groups with a history from Asia and Africa have established
themselves. Because of easy communication with “home,” a strong link
is maintained. This is illustrated by the numerous telephone shops of-
fering cheap international calls and by the rich and diverse range of
Asian shops. The spiritual focus of each community is often linked to
geographical areas in the home country with imams and priests who
travel between the two countries.
The following polarities form part of the environment in East London:

• the predominant agnosticism of mental health services in contrast

to the spiritual worldview held by half the population;
• the entrenched belief systems of some faith communities in con-
trast to those willing to be more flexible;
• the acceptance of crime and petty theft in contrast to a strongly held
belief about the sanctity of personal possessions;
• the long tradition of tough survival in contrast to softness and
passivity;
• the prevalence of drug addiction and alcohol abuse in contrast to
the moral values held by faith communities;
• the freedom of sexual expression and individualism in contrast to
the honor in which sexuality and community are held by the faith
communities.

Recognizing these polarities is an important first step in providing an

environment where dialogue can begin. As long as the polarities are
exaggerated, little change can take place. The newly formed Depart-
ment of Spirituality in Newham is one initiative that seeks to facilitate
this process. Further reference is made to this department later in the
article.
I have not referred to the African and African-Caribbean communi-
ties. These also exist in this area of East London. Their cultural identity
has been identified with their strongly held religious beliefs, which are
expressed openly in the many communities drawn together around
cultural norms (Bhopal, 1986). These communities do not seem to have
reproduced their own culture as explicitly as the Asian communities,
although the Black-led Christian communities are the fastest growing
religious faith groups in East London.
292 NIGEL COPSEY AND TALIA LEVINE BAR-YOSEPH


I was part of this rapidly moving field while it was happening. I

experienced firsthand the evolution of many different cultures within
a very small geographical area. Each of these communities is very pub-
lic, and each has clearly held beliefs. It has never been politically cor-
rect to acknowledge the differences, particularly in terms of religion.
No one likes talking about faith. It is simply not understood by a white
community that is predominantly agnostic in its focus. The result has
been a complete failure of any attempt at dialogue. When a dialogue is
attempted, it is based on the false assumption that differences can be
ignored. An example of this was an advertisement for a public employee,
which stated that the post was open to gays and lesbians. The result
was that no Muslim applied. Another example is that no attempt is
made in community mental health centers to recognize that at certain
times of the day certain religious practices are seen to be essential (Bhui,
et al, 1995). No facilities are provided, and the environment is not con-
ducive to any form of religious practice (Fernando, 1995).
Over the past 15 years, I have been searching for a psychological
system that incorporates the whole of a person’s life. It was only in the
researching and writing of a report exploring the mental health needs
of different faith communities that such a framework began to emerge.
My early training in psychological thought was psychodynamic.
However, I was always searching for something further. Somehow, the
predominant focus on insight left me feeling incomplete. This approach
was too individualistic and I seemed cut off from the wider context
which was the world in which I lived. At the same time, I was also
seeking to hold together the importance of the faith community to which
I belonged with my psychological journey. The very rigid boundaries
of the psychodynamic system seemed to isolate me from that reality. In
such a model, there is no true dialogue of intimacy. I could not see any
hope of change unless the therapist was fully willing to join the field.
It was a revelation to me when I discovered a theory (field theory)
that took the whole of a person’s life seriously. It was also very risky! A
combination of a phenomenological approach, a dialogic relationship, and
field theory challenged me to reexamine the assumptions underlying the
therapies to which I had been hitherto exposed. Even the majority of
humanistic therapies have been practiced around the introjected norms
of the context in which they have emerged. Hence, the practice is heavily
bounded by those norms. A simple example of this would be the use of
language and the accepted norm of the therapeutic hour. How many
humanistic therapists start from the assumption that the culture is the
field that might teach them how to form a dialogic relationship? The
language of therapy, for example, counseling, therapy, awareness, cli-
ent, all contain many assumptions. In many cases, humanistic introjects
AN EXPERIMENT IN COMMUNITY PSYCHOTHERAPY 293


have replaced psychoanalytical ones. I was not (and never have been)
working with people in a one-to-one individual and private setting.
My work has always led me to be with people suffering from mental
health problems in their own context. This was the challenge to me as I
embarked on this research. Here I was, a white Christian minister, com-
mitted to psychological and spiritual change, seeking to learn from the
many diverse faith communities in inner London.
The phenomenological approach (Husserl, 1931) stressed the importance
of “bracketing off” my own assumptions as I sought to understand how
people from other backgrounds saw and understood their world. I very
quickly realized how difficult this was. Especially with faith communi-
ties that were predominantly white, I realized that the assumptions I
internalized were often far removed from their reality. One very good
example came when I was approached by a white Christian religious
group in the docklands area to provide a support group for those who
needed help with the many mental health problems in their lives. This
was a group that was very different from the traditional church. They
met in a house. Each person had lived in that area of East London all
their lives. This group had a large number of men which is unusual for
this area. The area has an unemployment rate of 22% and has one of the
highest levels of deprivation and crime in London. Alcohol and drug
abuse are a way of life to many who live in this area. Adopting a phe-
nomenological approach, I quickly realized that I had assumed I knew
what it was like to live in such an environment (after all, I had lived in
the area for 15 years!). However, the reality was that I had no under-
standing of what it was like for some of the group members to live in
that context. I had projected onto them my understanding of their con-
text. In supervision, I was able to see my process. I returned with a
renewed desire to listen and learn. This phenomenological investiga-
tion enabled me to discover what this particular group needed. One
introject I carried was the size of the group. After all, four was not a
group! Another was a belief that everyone should attend every time. I
had to discover that what was required was a much less rigid system. I
had to keep on asking lots of questions in order to be able to engage in a
true dialogue with them concerning their experience.
With the white religious group I began with an assumption (albeit
wrongly!) that I fully understood the culture. When I began to approach
the Asian, African, and African-Caribbean communities, I realized at
the outset that I had to adopt a phenomenological approach. I quickly
realized that Western interventions use a language containing many
assumptions. For example, the very notion of counseling has little or
no meaning to an Asian elder. In the first place there is no equivalent
word in their language. My Asian colleague and I spent a morning
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

seeking to draw up a list of words that we use as psychologists but that

have no equivalent in the language of the Asian communities. In addi-
tion, there is often an association that is unhelpful. For example, the
terms counseling and client have associations with the science of the
mind, which in turn is associated with madness and being cut off. The
implication is that everyone has given up on you. Even the word helper
implies that a person is unable to help himself. If a professional from
the statutory services is involved with a family, then there is a deep
sense of shame since it is perceived that such a person will only be
involved when there is a failure in the family. The structure of the fam-
ily is very important to an Asian family. This very simple example il-
lustrates how anyone seeking to intervene needs first of all to discover
(by joining the field and enquiring) how he or she will be perceived.
Even the use of introjected language could prevent true contact. I
approached one Hindu group to ask them what problems they faced,
only to be told they didn’t have problems. This very obvious word im-
mediately met with resistance because it did not communicate what I
was attempting to convey. In a subsequent meeting I was able to reframe
my question. I asked what it was like living in London. The response
was immediate. Underpinning all these examples is the assumption that
at the contact boundary there is difference. (Perls, Hefferline, and
Goodman, 1979)
For me to be able to discover meaning for these different communi-
ties, I needed to adopt a dialogic approach (Hycner and Jacobs, 1995).
This was very important because the traditional method of working
has been to approach the new communities with a set of Western as-
sumptions and assume that those communities will adapt to a Western
model. This is true of both psychiatric and therapeutic services. A dia-
logic method assumes equality and a willingness to come alongside
others and learn together. I was surprised to discover how many people
from the Muslim and Hindu communities were visibly moved by the
fact that I was visiting them in their own setting (whether it was the
mosque or the temple) and was prepared to join with them in their
time of worship and then learn from them by respecting their faith and
culture. As a result of this approach, there are now a number of key
people willing to share with me in the next stage of the journey.
The Gestalt emphasis on field theory provided me with the neces-
sary framework to evolve a radical approach to mental health provi-
sion for members of the new communities. It is my contention that such
an approach is needed in order to have any impact on the effectiveness
of mental health provision for members of the new communities (Parlett,
1997). The first step is to recognize that religious belief systems are part
of the field. Instead of ignoring what is a crucial area of life for a large
AN EXPERIMENT IN COMMUNITY PSYCHOTHERAPY 295


proportion of the population, there is a need not only to recognize it,

but also to integrate it holistically with its mental health needs. It is
often this area that is most figural for large sections of the population.
Failure to recognize this means that anyone attempting a therapeutic
intervention will fail to be sensitive to how the field is organized.
The belief system of the faith community is inextricably connected
with both the culture and the extended family. This is very important
because most therapeutic interventions (with the notable exception of
systemic theory) take place with an individual and exclude the family.
While in recent years there has been a focus on the importance of the
cultures of the new communities, there has been a failure to recognize
that the traditional white East End population similarly has its own
culture, which has a very clear identity and, together with the new cul-
tures, is a part of the richness of the inner city. In many respects, indi-
vidual therapeutic work is just as alien to this culture as it is to Asian
and African-Caribbean culture. Traditional East End culture has always
placed a heavy emphasis on the mutual support of the extended fam-
ily. The very notion of confidential professional help has all the asso-
ciations connected with dependence and failure to cope with life.
Individual therapy by its very nature is experienced as a sign of weak-
ness and of being cut off from the reality of life as it exists. The reason
for this is that the majority of those working in therapeutic roles come
from a different social background to the community within which they
are working. There is an implicit assumption that, by working with
intrapsychic processes, an individual will cope better. The reality is far
more complicated. Within the field, social and political forces are often
far more powerful than any intrapsychic resolution. In many cases, there
needs to be a recreating of support systems. Any therapy that fails to
recognize the importance of support within the community will have
little or no effect. Hence, therapists are perceived as professionals along
with social workers and other statutory agents who are separate from
the world in which the client lives and struggles. There is a danger
within such a system that both clients and therapists co-create a depen-
dent culture of powerlessness.
It may be seen from the points noted above that East London pre-
sents a highly complex picture in which a whole range of different
influences form the field.

An Experiment in Community Psychotherapy

I set out first to find a trained Gestaltist living and working in this area
of London. I was also looking for someone who was working within
community rather than operating in a “counseling centre.” In addition,
296 NIGEL COPSEY AND TALIA LEVINE BAR-YOSEPH


I was looking for someone who came from one of the new communities
and saw religious belief as a part of his or her life. My reason for want-
ing to work with a Gestalt-trained therapist was because I needed some-
one who shared my commitment to moving into the field and who was
flexible enough to work with the phenomenological data. I also needed
a colleague who could quickly gain the confidence of those communi-
ties with whom I had only limited contact. This is particularly impor-
tant when considering the issue of language and the willingness of Asian
women to relate to another woman from their own cultural background.
The importance of their faith, which impinges on every aspect of their
lives, needed also to be both understood and empathized with fully. I
knew that it was simply not possible for me to become part of this sec-
tion of the community. I was unable to find any fully trained Asian
female Gestaltist! The reason for this is that therapeutic training is very
expensive and focused primarily within Western middle-class culture:
a culture that ignores the values of the new communities. Such trainings
expect trainees to conform to the values of the Western worldview
(Hellman, 1994). It can therefore be seen that for someone for whom
spirituality is a part of life, such a value system is experienced as alien.
After much searching, I found a coworker from within one of the Asian
voluntary organizations, who was in the process of completing her
master ’s degree in counseling psychology.
In order to discover how to proceed, I “moved into the field.” In one
mosque, both the President and the Imam said that they were willing
to engage with me in discovering how the mental health services and
their religious organization could explore ways of working together. A
Sai Baba group invited me to their worship as an honored guest and
was willing to explore future partnerships. In both cases I did not stipu-
late what the content of the dialogue should be. Instead, I was willing
to engage in a process in which we joined together in discovering a
relationship of trust. My willingness to join with what was already in
the field enabled us to embark on a dialogue. In both cases I started
from the assumption of difference. I have also established a working
relationship with an Asian mental health charity as a result of adopting
the same approach.
In addition to the group already referred to above (the white, East
End, Christian group), the most exciting development has been the es-
tablishment of a women’s Muslim group. In my two years of research,
I discovered a very special Muslim lady who had herself experienced
severe mental health problems, directly related to a number of factors
linked to living in East London. In our discussion, she realized that
there were many Muslim women who actively sought her out for help—
she is a natural listener and, because of her own journey of both suffer-
ing and survival, does not preach to those who come to her. I should
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

add that in my many discussions with faith community leaders, I was

repeatedly told that Asian men and women would not come together
in a large group and openly talk about difficulties. They would seek
help by using existing networks that were informal, normally in dyads.
From these discussions was born an idea.
I asked this wonderful lady if she would meet my coworker with a
view to establishing a small group of those with whom she has contact.
She was very enthusiastic and has become the coworker. My colleague
and she are in the process of establishing a small group in her home
where those who come can meet and share. Using the principle of avoid-
ing all language that could be misunderstood, they are simply estab-
lishing a morning together. The aim is very simple: to encourage those
who come to decide together how to proceed and to create a place of
safety where they can explore new possibilities. It is possible that what
will emerge as safe for them could be a time to chat. For many Asian
women there is a deep fear about discussing anything to do with their
faith in case they are told how to behave. It is also accepted that, be-
cause many Asian women retroflect their pain, they will only access
the mental health services when all other methods of coping fail. This
is also true of others from the new communities. One example is a group
of African men who told me that they would never refer to anything
religious within earshot of any mental health worker for fear of either
being sent into hospital or having an increase in medication prescribed!
This experiment is at a very early stage. One difficulty that we en-
countered almost immediately was that the Asian counselor wanted to
use her Western therapeutic introjects. One such was that the therapy
should have very strict boundaries. This proved to be a problem be-
cause the Asian women had a need to feel safe in order to share. Safety
for them was the sharing of practical concerns around the difficulties
of living in a Western culture. It was only by engaging with this issue
(creative adjustment) that it was possible to begin the process of allow-
ing the coworker to cocreate a shared figure with the women. The signs
are promising. The women are beginning to share at a very deep level.
I have learned from this process how difficult it is for Asian therapists
trained in the Western tradition to respond to the field.
I have also learned that, while I began with the assumption that only
an Asian therapist can effectively work within an Asian culture, I am
now discovering that it is possible for a white male Christian to sup-
port and work with an Asian Muslim woman. I am very much in the
background, but what I am embarking on with this Asian lady paral-
lels the journey with my supervisor. Differences become the source of
creativity. As I write, another Asian counsellor has joined me in this
journey. I do believe that the outcome could have important implica-
tions in how to engage in community psychotherapy. I imagine that
298 NIGEL COPSEY AND TALIA LEVINE BAR-YOSEPH
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what could become could be very different to that which we have hith-
erto defined as psychotherapy.
I would like to pause at this point and refer to the role of supervision
in this process. My supervisor, Talia, joined me in this venture as I was
bringing together many of the findings from my research. It is very
significant that she comes from a different culture (she’s Israeli and I
am English) and from a different spiritual background (Judaism and
Christianity). From the ground of our relationship has emerged a mu-
tual respect that is held together by differences. It is as if we mirror the
process that I am undertaking with my Asian colleagues. I hope that
my Asian colleagues and I will also be able to model this. They are
Asian, Muslim, and Hindu. I am English and Christian. Both in my
supervision and in the work setting, true dialogue is only possible by
recognizing the differences. This is also a basic assumption in Gestalt
theory. Tali’s role for me has been similar to that of a consultant. I have
been able to ask lots of questions and to be clear about what I need
from her. In turn, she has challenged me in many areas, not least about
my own introjected assumptions. She has also enabled me to keep a
very clear focus on the phenomenology. I see such a role as crucial, for
she is separate enough from the situation to be able to avoid fusion. I
would sum up her role as providing me with the challenge to remain
focused on what is figure in the field and to concentrate on the phe-
nomenological data rather than on interpreting the content.
A very good example of this was with the white Christian group. It
was not the policy of the group to be totally white, but because it meets
in a district that is predominantly white, it draws solely from that com-
munity. I quickly discovered that the members of this group had adopted
the introject of the wider community, which resulted in their believing
that they could not influence the structures of society. The structures
do, in fact, reinforce this perception. The co-created reality is one of
powerlessness. The main task has been to help them to draw on the
very strong resources of their faith to begin the process of creating a
different environment for themselves. My goal has been to encourage
them to co-create an environment of mutual support in order to em-
power one another to effect change in their daily living. Although my
work has been to support the system to effect change, I am willing, if
necessary, to become part of the wider field in order to enable this to
happen. In this setting, the “field” involves major inequalities that are
both social and political.
I am convinced from the early experience of these two groups that
working in groups is the only way to work with the reality that groups
are an essential part of the community. People need the support of a
family-sized group. Again, I have been willing to adjust the size of the
group according to the needs of the participants. It seems that a total of
AN EXPERIMENT IN COMMUNITY PSYCHOTHERAPY 299


five is an ideal number. This fits with the cultural norm where people
only share personal details with a chosen few.
I also realize that small groups have an important place in all faith
communities in this area of London. Both these groups come from a
tradition that is not based on individualism. The extended family is
essential as a way of life for them. This is in stark contrast to suburban
London where there are high levels of mobility and where people live
in very unsupported environments. However, a further common de-
nominator of the groups is that there is a shame connected with the
sharing of mental health problems. By forming an alliance with the
supportive structure of a faith community, it is hoped that we will be
able to evolve a safe group in which to explore such problems. It is
early, but the signs are encouraging.

Conclusion

A new chapter is beginning in East London. The National Health Ser-

vice has funded the establishment of a Department of Religious, Spiri-
tual and Cultural Care. This is a recognition that faith communities
form an essential part of the community and that religious/spiritual
belief is part of the normal life of nearly the majority of the population.
With the establishing of this Department and the desire to create
supportive groups within the faith communities themselves, I believe
there is the possibility of creating a culture of mutual support that is
neither Western nor clinical. I also hope that such groups will be able to
respond to the needs of the community. Some important work has al-
ready been achieved by voluntary groups in the area, most notably by
an Asian Elders group called Subco, which has pioneered counselling
provision. This provision has primarily been based on a one-to-one
therapeutic model. I am convinced that a model that moves away from
traditional methods of therapy is essential if psychological help is to
become available to the majority who do not want to be identified with
receiving professional help.
This approach is within the tradition of Action Research: it is the
combining of Gestalt methods with research resulting in social action.
In these highly complex settings it is necessary to adopt a phenomeno-
logical approach. I am optimistic because I believe that Gestalt theory
has at its core a willingness to wait and discover what emerges from
the field and to join with what emerges to co-create something new. It
is the beginning of this journey that I have sought to convey in this
article. In a few years’ time, I hope to be able to record the next stage.
What is exciting is that I do not know how this will take place, but the
richness of the different cultures combined with a dialogue that respects
those differences will form the foundation of this journey.
300 NIGEL COPSEY AND TALIA LEVINE BAR-YOSEPH


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Copsey, N. (1997), Keeping Faith: The Provision of Community Mental Health Ser-
vices Within a Multi-faith Context. London: The Sainsbury Centre for Mental
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Fernando, S. (1995), Mental Health in a Multi-Ethnic Society. London: Routledge.
Goodman, P. (1960), Growing Up Absurd. New York: Vintage Books.
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Husserl, E. (1931), Ideas: General Introduction to Pure Phenomenology. New York:
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Parlett, M. (1997), The unified field in practice. Gestalt Rev. 1:16–33.
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Slemenson, M. (1998), Gestalt therapy in Argentina: Revolution, evolution,
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135 Bletchingley Road

Merstham
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Gestalt Review, 3(4):301–304, 1999

Comments on Copsey and

Levine Bar-Yoseph
“An Experiment in
Community Psychotherapy”


MY R I A M M U Ñ O Z P O L IT

What I Most Appreciate and Value of the Paper

such as this in what you name Com-

I
T IS ESSENTIAL THAT EXPERIENCES
munity Psychotherapy, be presented, shared, and reported since
there has been little written on this important subject. I consider it
valuable particularly for psychotherapists, such as ourselves, living in
countries where individual psychotherapy does not properly respond
to the needs of the people due to our less individualistic culture and
much smaller communities.
I very much appreciate the thorough style in describing and explic-
itly stating the vicissitudes of your work: I found it easy to follow the
process and gradually learn from the experience described. It also
helped me to sequentially make comparisons with my own experience.
Some of the time I felt I could perfectly understand your experience
because it is quite similar to those we have had in Mexico. Other times
I found myself learning, for you describe things I would not have
thought of. Your article opened doors by helping me to reflect on my
work and generating what could turn out to be new specific applica-
tions to my professional practice.
I am in agreement with the authors that the phenomenological
approach helps us Gestaltists to break from our biased ideas, thus
allowing us to understand people within their own context. This phe-
nomenological approach to culture is the essence of community
psychotherapy.
I am reminded of interventions that I was witness to some years ago,
that involved psychotherapists working with peasants near Guadalajara
city. In one particular instance, the psychotherapist called himself
301  1999 The Analytic Press
302 MYRIAM MUÑOZ POLIT


“facilitator” because the word psychotherapist was not part of the

everday language and had no meaning for them. The facilitator par-
ticipated as part of the natural meeting groups of these peasants. When
a visitor asked them what was the issue of these meetings, one of them
answered, taking off his hat, and speaking most seriously: “The issue is
we, ourselves.”

Community Psychotherapy: A New Area

of Application for Gestalt Psychotherapy

As I continued reading, I confirmed within myself that “community

psychotherapy” is an inventive and truly respectful way of interven-
ing in the field. In order to practice a community psychotherapy, it is
imperative that, among other things, professionals must live in the same
geographical area or come from similar areas as those in which they
intend to work. In Latin America, these places are populated by low-
resource classes. It is very unusual for there to be professionals in such
environments. This is mainly because professional services are prohibi-
tively expensive for these low-source individuals, and psychologists
rarely choose to practice there.
Until recently, this had been the case in Mexico. However, beginning
roughly 15 years ago, some of us academicians, involved in the task of
training psychotherapists, have been struggling to change the profile
of those we train for this type of profession. We have helped to gener-
ate institutions where training can be relatively cheap, and increased
the availability of scholarships. I will not expand on this subject here,
for this is not the focus of my commentary. I simply wish to point out
that we have trained, despite great reluctance from the academic side,
individuals from diverse professions and even some who, though not
having a formal professional background, have, instead, a rich life ex-
perience and have been seriously committed to their own personal
growth. We have also advocated for training to be available to various
social classes and for the possibility of scholarships for them.

With Latin American eyes

It is a pleasure to read an article where the importance of respecting

the “field” is expressed. Unfortunately, we Mexicans have experienced
our colleagues from overseas or across the border (for instance, Gestalt
Therapy in particular, and Humanistic Psychology, in general) as intro-
ducing “conquest” plans, to teach us “poor underdeveloped ones” how
therapy must be done.
COMMENTS ON COPSEY AND LEVINE BAR-YOSEPH 303


We Mexicans have been clever enough to defend our culture from

all external violent influences, beginning centuries ago (Spain and
France), and even at present (USA). This has been possible thanks to
our peculiar communal and familial ways of support, which have helped
preserve our traditions, our world vision and our sense of belonging.
All this is especially true for our native peoples who have safeguarded
their values and life style from the “civilized society” produced by a
competitive and aggressive, individualistic, capitalistic ideology. In
recent times, the speed of social changes imposed by ”modernization”
and “globalization” make this communal way of life appear as one of
the few viable means left to preserve our differences and uniqueness in
a world whose leadership seems determined to unify people at all costs.
But, in spite of all the resistance our country has shown, this influence
is taking its toll. It is leaving many a person disoriented, alone, worn
out, and without a meaningful vital sense. As a result, it has increased
the need for effective interventions in the area of mental health that
surpass the mere individual space and rely on the group and commu-
nity aspect. This is historically the natural way of socially relating in
Mexico.

Some Concerns

The authors of this article seem to imply that not having a particular
religious belief is a hindrance, and that belonging to any religion is,
“per se,” something good for the development of the individual. This
seems to me like a projection of their own beliefs which may limit the
vision of their investigation and analysis. Be that as it may, I would like
to comment on what is happening in Mexico in this regard. Since the
Spanish conquest, Catholicism, and recently the various types of Prot-
estantism resulting from the close proximity to the United States, have
influenced their members to generate a culture where conscience devel-
opment is deeply limited, due to the basic idea that it is necessary to
obey the religious authority mandates. They dictate what is right and
wrong. Any attempt at autonomous reflection is deemed as “diabolic.”
This is illustrated by the satanization of all that implies conscience de-
velopment, specifically all humanistic psychotherapies. They are ranked
by the official Catholic Church (dominated by the “Opus Dei” and
“Christ Legionaries”) as part of what they affirm to be a “demonic sect”
called “New Age” and prohibited to their followers.
One result has been the arrival of different types of Christian Protes-
tantism. It has generated, especially in native communities like those
in the state of Chiapas, a real “religious war” where Catholics and Prot-
estants have been part of armed confrontations, and families and
304 MYRIAM MUÑOZ POLIT


communities have been divided, since each side proclaims itself as

owner of “The Truth.”
I think that when we speak of Latin American countries it is
undeniable that religious faith has seriously limited the progress of both
individual and collective conscience. There remains to be seen whether
this has also been so in the communities investigated by the authors of
this article.
In closing, I would like to summarize what I believe to be the prime
underpinnings of Community Psychotherapy:

1. The importance of the belief system on the mental health of indi-

viduals has to be acknowledged, respected and taken into account.
2. The use of the community language is an important element in or-
der to have a communication that facilitates intervention.
3. The importance of environmental support for individual change has
to be acknowledged.
4. The best community psychotherapists are those who come from simi-
lar communities or are inserted into them in a steady and enduring
way.
5. The psychotherapist has to question the learning obtained in his
formation, in order to be free and open in whatever area he may be
working.
6. The community psychotherapy supervisor must have sufficient dis-
tance regarding the situation and, at the same time, the proper em-
pathy to understand it.
7. Group work is the natural and appropriate way of doing commu-
nity psychotherapy.
Gestalt Review, 3(4):305–307, 1999

Response to Myriam Muñoz Polit



N I G E L C O P S E Y, MSC
T A L I A L E V I N E B A R-Y O S E P H, MA

HANK YOU , MYRIAM, FOR YOUR RESPONSE to our article. You were so

T encouraging with your comments. So often when exploring new

ideas it is easy to feel isolated and to be regarded as a heretic!
Your situation in Mexico sounds so similar to the one we described in
East London.
Thank you in particular for the following reflections, which will be
helpful to develop in the future.

1. You focused on the contrast between the individualized culture of

the West, in particular that of psychology, and the focus on commu-
nity in Mexico. Traditionally there has been a strong sense of com-
munity in East London, particularly among the indigenous
population. However, over the last decade, this has been slowly
disintegrating because of the movement of populations from the
inner-city areas out to the suburbs. Thus, the natural focus of com-
munity in East London is now under threat. At this time, it is, in
fact, the new Faith Communities that are now providing the focus
for community. That is the very reason it is necessary to encourage
a true dialogue between those communities and the mental health
services.
2. You rightly drew attention to the dangers of unhealthy religion. This
is also a danger in London because the extreme fundamentalists of
all religions are very autocratic and tend to view anything psycho-
logical as dangerous. The work that is being pioneered in East Lon-
don is among those groups that are able to hold the middle ground
and be open to dialogue between the worlds of faith and psychol-
ogy. There exists in East London not only all the major religions of
the world but also the whole spectrum of expression from within
each religion. It is only possible to be creative with those who are
willing to engage in dialogue. It is also very important to be able to
support those who have found their religious community to be

305  1999 The Analytic Press

306 NIGEL COPSEY AND TALIA LEVINE BAR-YOSEPH


unhelpful resulting in ill health. By providing a style of community

psychotherapy that is neutral yet at the same time able to work with
the belief systems of these faith communities, it will be possible to
help people work through this negative experience.
3. Your focus on the importance of community psychotherapy is a great
help. Your own experience in Mexico and the exciting ways in which
you have opened the doors to those who are excluded from tradi-
tional trainings is a great encouragement. Psychotherapy training
has become very elitist. One of the major goals of the new Depart-
ment in Newham is to establish a training program based on Ge-
stalt principles that will be available to those who could not, by
virtue of cost, enroll in mainstream training programs. The experi-
ence of the Faith Communities will become the ground from which
to draw the material necessary for the training. It is good to know
that similar experiments are taking place in areas like East London.
Because the course will be grounded in and emerge from the East
End, we hope that it will avoid containing many of the Western
middle-class introjects. One of the main problems will be that ini-
tially the trainers will be those who were trained by the Western
oriented-institutes; hence, there will be a need to find ways to change
the current training paradigm.
You rightly pointed out the need for practitioners to originate from
the communities in which they work. However, there is value in
cross-cultural meeting and for practitioners to appreciate, learn
from, and respect differences in each other. All the communities we
address are culture in their own right within the British culture. In
England, training is very expensive, with the result that few from
poorer areas can undertake the training. Also, few see the need to!
A training that offers psychotherapy to such groups will help to
break through the barrier. As in Mexico, there is also a need for
practitioners to be drawn from the communities that they serve. As
you observe, this is so important when seeking to understand the
nuances of language and complexities of culture.
A focus on community-based psychotherapy will enable the com-
munity itself to be the network of support for those receiving help.
Such a focus will enable psychotherapy to move away from the in-
dividualistic paradigm and move into the communities themselves
and use the natural support systems. We believe that psychotherapy
needs to be involved in social change. This is an area of great im-
portance in community mental health.
4. Your observation that the supervisor needs to keep enough distance
from the situation in order to be supportive is very important. We
found this to be the case when we began the experiment. Clearly
RESPONSE TO MYRIAM MUÑOZ POLIT 307


there is a real danger that when working in such systems it is pos-

sible to become confluent with the community. Talia was able to
support Nigel because she was sufficiently separate from the com-
munity. It is also interesting that, despite being part of the white
indigenous community and also one step removed from all the com-
munities, Nigel was able to create this entire project and carry
through the work of supervising and establishing the work.

In conclusion, your comments have encouraged us to pursue the

experiment with even greater enthusiasm. Thank you.
Gestalt Review, 3(4):308–320, 1999

Narrative Formation and Gestalt Closure:

Helping Clients Make Sense of
“Disequilibrium” Through Stories
in the Therapeutic Setting


P E T E R M O R T O L A, Ph.D.

between Gestalt theory and the narrat-

T
HERE IS AN IMPORTANT LINK
ive theory. Gestalt theorists (Perls, Hefferline, and Goodman, 1951;
Latner, 1973) describe how individuals are constantly engaged in
an ongoing process of losing and then reestablishing organismic equi-
librium. In a parallel way, narrative theorists (Labov, 1982; Bruner, 1990;
Linde, 1993) describe how we tell stories about troubling events in our
everyday experience in order to regain some sense of equilibrium in
our lives. The important shared concept at the heart of both Gestalt
theory and narrative theory is that we are constantly addressing and
attempting to make sense of “disequilibrium” in our experience.
In this article I will make visible how individuals work to reestab-
lish a sense of equilibrium in their lives through the stories they tell. I
will also show how these efforts parallel what Gestalt theorists have
described as the process of Gestalt formation and closure. Through this
analysis, I hope to show how a working knowledge and awareness of
narrative theory can help Gestalt practitioners in their work with cli-
ents in the therapeutic context.
In Part One of this article, I present a case example in the form of a
transcript of therapeutic work between Dr. Violet Oaklander (“Dr. O”
hereafter) and a 14-year-old girl named Elisa. In Part Two, I elaborate
on the theoretical links between Gestalt therapy theory and narrative
theory before analyzing, in Part Three, the exchange between Dr. O and


Peter Mortola, Ph.D. is an Assistant Professor of School and Counseling Psychology
at Lewis and Clarke College in Portland, Oregon. For the past five years, he has worked
closely with Dr. Violet Oaklander in her training workshops that provide adults with a
Gestalt approach to doing therapy with children.

308  1999 The Analytic Press

NARRATIVE FORMATION AND GESTALT CLOSURE 309


Elisa. In Part Four, I outline implications of this study for Gestalt prac-
titioners.

Part One: A Case Example

In this section, I present a transcript from a therapeutic demonstration

that took place during a 1997 summer training given by Dr. O on the
“Gestalt therapy approach with children” (Oaklander, workshop ma-
terials, 1997). In the transcript Dr. O is working with Elisa, a “child
guest” in the workshop who had also been in therapy with Dr. O over
the previous year. A significant issue for Elisa at that time in her life
had been the separation from her two brothers, Matthew and Jason,
both of whom were being held in juvenile detention centers. (All names
and identifying information in the transcript have been changed for
purposes of privacy and confidentiality.)
The 24-minute demonstration in the workshop between Dr. O and
Elisa was meant to show participants how Dr. O worked with children
in the therapeutic context. Dr. O and Elisa both sat on the floor in front
of the 25 workshop participants. While working with Dr. O, Elisa used
pastels and large sheets of paper that were spread out on the floor to
draw. In the transcript presented below, italics are used to denote words
that were spoken with emphasis, and hyphens are used to denote a
brief pause in speech. Additional descriptive information, when neces-
sary, is provided in parentheses.

Transcript of Dr. O and Elisa

Dr. O: Because you’ve mentioned your brothers, Matthew and Jason,
I’d like you to maybe draw a picture of that feeling you have
missing them. You know, like colors, lines, and shapes. . . .
Elisa: Okay—With Jason . . .
Dr. O: You know, how you feel about not having your brothers around
anymore. . . .
Elisa: With Jason, I lived with him longer and so—it feels like some-
times, when you’re just sitting there . . .
Dr. O: Hm, mmm.
Elisa: . . . There’s just like this really big, dark tunnel. I never really
told anybody before, but there’s a big chunk missing. Because
Jason had, he was a lot of me. People don’t really understand
sometimes why I miss him that much. But in life he was—he
was a really big part of me. It was like, he was part of me and,
when he’d leave, I kinda—fall down. Like if I was like a table?
He’d be one of the legs. . . .
310 PETER MORTOLA


Dr. O: Wow. . . .
Elisa: . . . And he’d go and I’d be sitting there going all crooked. . . .
Dr. O: Wow . . . Yeah. . . .
Elisa: . . . And it’d be really hard to live my life without him because
he was always something that when I made decisions—it was
his part too. And so, ummm (crying, wiping nose)—it was just
like all my life depended on him too. Even though he had his
own feelings too. But, I never really told him that either, that he
was a lot of me . . . but . . .
Dr. O: Hm, mmm . . .
Elisa: So when I think of him, it’s like . . .
Dr. O: Now, how old is he now?
Elisa: He’s going to be 16 in September. So, he’s going up (she draws
a line going up) and I’m staying down (she draws a descending
line). So he’s kinda like living his life—he just keeps going, but
I’m still down here trying to figure out what to do, so . . .
Dr. O: Hm, mmm—If he were here, how would it be different for you?
Elisa: Actually, it’d probably still be the same. I’d have to get adjusted
to having him back. And it’d be awhile before he started being
part of me again? See, because I’ve lived—now I’ve lived like—
a year I think, or two years—without him, and so, I’ve gotten
used to sort of being on my own. I’ve gotten used to making
decisions, without me asking “Jason, what do you think?” A lot
of the reasons I got my answers was from him ‘cause he helped
me. So if he did come back, I’d get used to—having him there.
But I don’t think I’d be so much with him anymore.
Dr. O: And maybe you’ve learned—you’ve had to learn a lot of how to
do that yourself.
Elisa: Yeah. . . . That’s happening a lot where—I live my life on my
own, without having Jason there. . . .

Part Two: Bridging Gestalt Theory and Narrative Theory

Before analyzing the transcript above, I will first elaborate on the im-
portant connections between Gestalt and narrative theory. Although
the concepts within Gestalt theory and narrative theory are divergent
in many ways, both sets of theories hold at least one thing in common.
That is, the concept of a central, three-part, or “triadic” process involv-
ing a movement through equilibrium, disequilibrium, and modified
equilibrium. In Gestalt theory, this movement is described as being cen-
tral to the ongoing process of Gestalt formation and closure. In narra-
tive theory, this three-part movement is described as being central to
the process of telling a story and “making sense” of human experience.
In the following sections, I briefly outline how both Gestalt theory and
NARRATIVE FORMATION AND GESTALT CLOSURE 311


narrative theory address this centrally important three-part process

involving disequilibrium. In Part Three, I then use these theoretical
frameworks to analyze the trancript provided above from the work of
Dr. O with Elisa.

The Triadic Process in Gestalt Therapy

Perls (1947) makes it clear that the concept of “disequilibrium” is at the
core of Gestalt theory by stating: “The organism is striving for the main-
tenance of an equilibrium which is continuously disturbed by its needs
and regained through their gratification” (p. 7). Perls et al. (1951) de-
scribe this ongoing process as including the “destruction of previous
partial equilibria, and the assimilation of something new” (p. 373). The
constantly revisited process of establishing equilibrium, losing equi-
librium, and establishing a modified equilibrium is, in the view of
Gestalt therapy theorists, nothing less than the healthy ongoing pro-
cess of being alive.
Latner (1973) describes an individual in need of water as an example
of the creation of a need—or Gestalt formation—and the destruction of
a partial equilibria. When the individual finds water, there is Gestalt
closure—the fulfilling of a need and the organismic assimilation of
something new. The individual is able to move on and address his or
her next need as it arises. Latner argues that the process of being alive
is the process of addressing needs and being changed by these encoun-
ters with the environment as one does so. In other words, one is con-
stantly moving through the process of equilibrium, disequilibrium, and
modified equilibrium as one grows and changes.
In Table 1, the Gestalt theorists discussed in this section are listed in
the left-hand column. Across the horizontal rows, their particular de-

Table 1 Triadic elements of Gestalt therapy theory


Modified
Theorist Equilibrium Disequilibrium Equilibrium

Perls “equilibrium” “disturbed” “regained”
(1947) equilibrium equilibrium
Perls et al. “attempt of the “destruction of “assimilation
(1951) organism to previous partial of something
remain as it equilibria” new”
has been”
Latner, “organism . . . “organismic “organism
(1973) striving to imbalance will rebalances
regulate itself” occur” itself”

312 PETER MORTOLA


scriptions of the “triadic” process of moving through equilibrium, dis-

equilibrium, and modified equilibrium are listed.

The Triadic Process in Narrative Theory

Narrative is a universal, verbal, and nonverbal phenomena found in
most, if not all, cultures across time and place (Heath, 1986; Goodwin,
1990; Ervin-Tripp and Küntay, 1996). Narrative appears in many forms
including myth, history, cinema, comic book, and news item (Barthes,
1988) and has been defined in many different ways from varying theo-
retical perspectives (Spence, 1982; Ricouer, 1985; Leitch, 1986). For the
purposes of this paper, the definition of narrative provided by Scholes
(1982) will be used. In this definition, narration “rests upon the pres-
ence of a narrator or narrative medium (actors, books, film, etc.) and
the absence of the events narrated” (p. 58). Thus, with narrative there
is always a “teller” and “told.”
Regarding the form of a story, narrative theorists have in the great
majority agreed upon at least three consistent elements that make up a
narrative. Whether such stories are written for the dramatic stage, told
to children in fairy tales, or spoken to a counselor in the therapeutic
context, stories contain the same elements of triadic structure as de-
scribed by Gestalt theorists above. That is, stories tend to include a
“scene setting” description of some kind of normative reality (i.e. equi-
librium), a description of a “troubling” breach of those norms (i.e. dis-
equilibrium), and some effort at “sense-making,” wherein a new
understanding of reality is constructed (i.e. modified equilibrium).
In the Poetics (Aristotle, trans. by Janko, 1987), Aristotle highlighted
these three essential elements within Greek tragedy, describing not only
the natural human act of “representing” reality in narrative form, but
also the common act of portraying both “complication” and “resolu-
tion” as a necessary part of dramatic structure. Using slightly different
terms than Aristotle in his seminal work on the analysis of Russian folk
tales, Propp (1968) also identified a similar three-part structure of folk
narratives nestled among other narrative elements. Beginning with a
description of a protagonist’s “initial state,” these folktales next invari-
ably described some “villainy,” or “lack,” that is the focus of the reso-
lution in the denouement of the story.
It is interesting to note that both Gestalt therapy theory and Propp’s
narrative analysis of folktales describe a central role for an unmet need
or a “lack” that must be fulfilled in some way for there to be some kind
of resolution. In the same way that Latner (1973) used the example of
an individual in need of water to describe the process of Gestalt forma-
tion, the protagonists represented in Russian folktales are also propelled
by a need that must be met. Russian folktales about kidnapping, drag-
NARRATIVE FORMATION AND GESTALT CLOSURE 313


ons, or the pursuit of a mate, argues Propp, unfold as the protagonist

addresses a need that “creates an insufficiency and provokes a quest”
(p. 35).
Cognitive psychologists Bruner and Lucariello (1989) also address
this issue of unmet needs as the “trouble” that lies at the heart of most
narratives. In their research on the development of narrative in early
childhood, the authors describe that the “engine of a narrative is a vio-
lation of the expectable” (p. 77) in our lives. Thus, Bruner and Lucariello
also outline a three-part structure of narrative where a “normative”
scene is set and where a “violation” of those norms creates “trouble”
that somehow must be addressed. They state: “The narrative is a ve-
hicle for characterizing, exploring, preventing, brooding about, redress-
ing, or recounting the consequences of ‘trouble’ ” (p. 77).
In linguistic research, Labov (1982) also emphasizes how people use
narratives to make sense of troubling experience. In what has become
known as a “classic,” or “standard,” form of a narrative (Ervin-Tripp
and Küntay, 1996), Labov (1982) outlines six elements of a narrative
which include:

1) Abstract: what is the upcoming story about?

2) Orientation: the time, the place, the participants?
3) Complicating Action: then what (crucially) happened?
4) Resolution: how did these actions come to a closure?
5) Evaluation: so what?
6) Coda: what is the relevance to the present context?

Table 2 Triadic elements of narrative


Theorist/ Modified
Theory Equilibrium Disequilibrium Equilibrium

Propp (1928); “initial state” “villainy or lack” “liquidation of
Literary misfortune or
theory transfiguration”
Bruner and “the legitimate” “violation of “legitimacy
Lucariello the legitimate” redefined”
(1989),
Cognitive
theory
Labov (1982), “orientation” “complicating “evaluation and
Linguistics action” resolution”
theory

314 PETER MORTOLA


Although Labov identifies six elements of a narrative, an essential

three-part structure of narrative similar to that described by Bruner
and others above provides the foundation for his analysis: The “orien-
tational” aspects of a narrative describe some kind of “equilibrium”;
the “complicating actions” describe the “disequilibrium” or “trouble”
at the heart of the narrative; and the narrative elements of both “reso-
lution” and “evaluation” are used to come to some degree of “closure”
and make sense of that troubling experience.
The narrative theorists discussed in this section and their descrip-
tions of the triadic aspects of narrative are detailed in Table 2.

Summary of Part Two

In Part Two, I have drawn connections between narrative theory and
Gestalt therapy theory. I have described how both Gestalt and narra-
tive theories have identified a similar three-part process that includes
movement through “equilibrium,” “disequilibrium,” and “modified
equilibrium” The essential conceptual bridge that is articulated in both
narrative theory and Gestalt therapy theory is that “disequilibrium” is
an integral part of human experience. This disequilibrium comes as a
result of being in constant negotiation with, as Perls et al. (1951) de-
scribe, a constantly “novel environment” in which we must work to get
our needs met. As Bruner (1990) has argued, the process of addressing
those experiences that do not meet our expectations is a primary human
need that is, in part, worked out through the construction of narratives.
In Part Three, I present an analysis of the narrative data provided
above to show how Elisa used a story about her own life to make sense
of “disequilibrium” that she had experienced. Furthermore, I make vis-
ible the way in which Dr. O, as a skillful Gestalt therapist, helps to
facilitate and “co-construct” this process of narrative formation and
Gestalt closure.

Part Three: Narrative Analysis of Elisa’s Story

In the following paragraphs, the three-part structure of Elisa’s narra-

tive—that is, “equilibrium,” “disequilibrium,” and “modified equilib-
rium”—will be made visible using the frames of narrative analysis
discussed thus far in this paper. Dr. O’s role in the collaborative con-
struction of Elisa’s sense-making narrative will also be made visible.
As Capps and Ochs (1995) state, “Co-participants . . . contribute infor-
mation that is critical to interpreting the significance of the events un-
der consideration” (p. 117). Such co-construction of narratives is
especially relevant in regard to the counseling context for those profes-
NARRATIVE FORMATION AND GESTALT CLOSURE 315


sionals wishing to help clients “make sense” of difficulties they have

faced.

Narrative “Equilibrium”
In the transcript presented in Part One above, Elisa opens with a state-
ment about her older brother Jason: “With Jason, I lived with him
longer.” Elisa then elaborates on this statement by describing what had
been “normative” (Bruner, 1990) in her young life with a series of
phrases that captures the importance of her brother ’s presence:

• “He was a lot of me.”

• “He was a really big part of me.”
• “He was part of me.”
• “My life depended on . . . him.”
• “He was lot of me.”

Elisa highlights these references to the norms that once existed in

her life by use of repetition—“he was a lot of me”—and by emphatic
stress—“he was a really big part of me.” She next uses a series of graphic
images to highlight the pain she felt losing her brothers and having her
“norms” disrupted.

Narrative “Disequilibrium”
Tannen (1989) states that instances of repetition in a story “underline a
key phrase or idea” that the narrator is emphasizing. In Elisa’s case,
repetition of the idea that “something is missing” underlines the dis-
equilibrium that she has experienced in the process of losing her broth-
ers. To emphasize her feelings of missing her brother Jason, Elisa uses
multiple metaphors in her first lengthy passage to portray her trou-
bling feelings in clear images:

• “There’s this really big, dark . . . tunnel.”

• “There’s a big chunk missing.”
• “When he’d leave I’d kinda fall down.”
• “If I was a table, he’d be one of the legs and he’d go and I’d be
sitting there . . . going all crooked.”

Capps and Ochs (1995) note that storytellers emphasize their mean-
ing within a spoken text through the use of “intensifying” adverbs and
adjectives as in Elisa’s emphasis placed on her descriptions of trouble
through her repeated use of “really” (e.g., “really big, dark . . . tunnel,”
“he was a really big part of me,” “it’d be really hard to live my life with-
316 PETER MORTOLA


out him”). Thus, through both repetition and emphasis, Elisa makes
clear that losing her brothers was a significantly troubling event in her
young life. In Gestalt terminology, Elisa brings into “figure” a verbal
portrait that clearly articulates her foregrounded disequilibrium. By
having encouraged Elisa to express herself through the images of “col-
ors, lines and shapes,” Dr. O can be seen as facilitating both narrative
construction as well as Gestalt formation with her client: “The figure
(Gestalt) in awareness,” state Perls et al. (1951), “is a clear, vivid per-
ception, image, or insight” (p. 231). What Elisa has done thus far through
her image-laden words is to articulate a “vivid perception” of the trouble
in her story, which she next works to make sense of in collaboration
with Dr. O.

Narrative “Modified Equilibrium”

Elisa’s story about missing her brothers in the transcript is not over
once she has described the images that so clearly articulate the “dis-
equilibrium” that losing her brothers has caused her. Instead, Elisa
moves quickly into the “sense making” part of her story with the use of
what Labov and Fanshel (1977) has identified as the evaluative con-
junction “so” (i.e., “for that reason, therefore”). Elisa repeats the use of
“so” four separate times within three sentences, thereby highlighting
the point she wants to make in summing up this story of loss:

• “So when I think about him, he’s like—”

• “So he’s—going up and I’m staying down.”
• “So he’s kinda like living his life—he keeps going, but I’m still down
here trying to figure out what to do, so.”

In these lines, Elisa’s grammatical use of present progressive verb forms

(“I’m staying down,” “he keeps going,” “I’m still down here trying”)
describe her perception of a continuing action or a state of being that is
still in progress. Thus, in both aspect and tense, Elisa is highlighting a
residual negative effect of her brothers having left, an effect that still
affects her. Her repeated use of directional adverbs (Lakoff and Johnson,
1980), which put her in a “down” position, also emphasize this ongo-
ing negative state: “He’s going up, and I’m staying down,” “he keeps
going, but I’m still down here.” Together, these evaluative adjectives
and adverbs are used by Elisa to cast her present state as one of being
idled, stuck, and unchanging since her brothers left.
Importantly, Dr. O—in her “co-constructive” role in eliciting and
helping to make sense of Elisa’s narrative—does not allow Elisa to end
the story after Elisa concludes in line 24: “So he’s kinda like living his
life—he just keeps going, but I’m still down here trying to figure out
what to do” Instead, Dr. O poses a question regarding how Elisa’s life
NARRATIVE FORMATION AND GESTALT CLOSURE 317


might be different if her missing brother returned. Dr. O asks, “If he

were here, how would it be different for you?” With this question, Dr.
O asks Elisa to imagine her missing brother as if he were “here,” that is,
with her in the present moment.
In considering this question about the “here and now,” Elisa sur-
prisingly reevaluates and makes sense of her story in a way that almost
diametrically opposes her first set of evaluative statements described
above. In responding to Dr. O’s question, Elisa again introduces the
evaluative marker “so” and again employs repetition (e.g., “used to”)
to make a second series of evaluative comments to describe that she
has in fact changed, in some ways for the better, in the absence of her
brothers:

• “So, I’ve gotten used to—sort of being on my own.”

• “I’ve gotten used to making decisions.”
• “So if he did come back, I’d get used to—having him there. But I
don’t think I’d be so much with him anymore.”
• “So . . . I live my life on my own, with having —Justin there.”

In this second set of evaluative comments, Elisa gives a “particular

evaluative hue” (Capps and Ochs, 1995) to herself in the narrative as
someone who has not only been changed by her experience, but also
grown from it. With the use of present perfect verb forms, Elisa describes
a process that was started in the past but has been completed by this
present time: “I’ve gotten used to—sort of being on my own.” “I’ve
gotten used to making decisions.” These statements stand in stark con-
trast to her use of the present progressive verb forms in her first attempt
at evaluation: “I’m staying down”; “I’m still down here trying to figure
out what to do.”
Moreover, Elisa’s use of the phrase “I’ve gotten used to” signals that
she has developed through habit or custom a “new norm” in her life
since her brothers have left. Such habituation signals not only a kind of
“modified equilibrium” that was described by narrative theorists above,
but also a kind of “regained equilibrium” that was described by the
Gestalt theorists as well. To highlight this change of state, Elisa closes
this second series of evaluative comments by again returning to the use
of the present tense to describe her present state, in spite of not having
her brother with her:

“I’ve had to learn a lot of where—I live my life on my own, with-

out having—Justin there”

Peterson and McCabe (1983) discuss how tellers of a story achieve

some kind of “resolution” after they have addressed the trouble that
was described in the “high point” of the story. The authors state that
318 PETER MORTOLA


“such later events resolve the high point action in some sense, clearing
the stage or capping off the experience” (p. 31). Reflecting this notion
of resolution, Elisa ends the transcript with a statement that works to
resolve or, in Gestalt terminology, bring closure to the conflicts she has
been describing. Additionally, it can be argued from the Gestalt per-
spective that such phrasing is evidence of what Perls et al. (1951) have
described as “the destruction of previous equilibria, and the assimila-
tion of something new” (p. 373). At the end of the transcript, Elisa pre-
sents herself not simply as “down” about losing her brothers, but as
someone who has incorporated that difficult loss into a larger perspec-
tive of herself, gaining some closure on it in the process.
It is important to highlight the fact that this example of narrative
formation and Gestalt closure was not accomplished by Elisa in isola-
tion, but within the particular context of a therapeutic relationship es-
tablished over time with Dr. O. Thus, Elisa’s sense making can be seen
as being both verbally and nonverbally “co-constructed” with the able
assistance of a caring adult in the form Dr. O. In the following section,
I discuss the implications of this study.

Part Four: Stories Are Not Just “Stories”

This study has important implications for Gestalt therapy practitioners,

especially in relation to working therapeutically with children. First,
the theoretical linkages that exist between Gestalt theory and narrative
theory can be used by Gestalt therapists to inform the moment-to-mo-
ment verbal interactions between the therapist and the client in the
context of therapy in the Gestalt tradition.
Specifically, this study asserts the need to pay close attention to the
role that words—and particularly narratives—play in the process of
Gestalt formation and closure. Narratives, I have argued, carry with
them powerful constellated images of troubling experience that the cli-
ent is attempting to work through in the “sense-making” process of
talk. Moreover, the formation of a complete narrative—that is, one con-
taining each of the three elements of “equilibrium,” “disequilibrium,”
and “modified equilibrium”—enables the client to fully “bring into fig-
ure” not only images, but also feelings, responses, thoughts and evalu-
ations of their experience. In this way, narrative formation can be seen
as related to the process of Gestalt closure in that both processes in-
volve “the assimilation of something new” (Perls et al., 1951).
This study also raises important implications regarding the interac-
tions of adults and children in the therapeutic context. For example,
from a developmental perspective, children’s narratives need to be
understood by adult therapists as more than just a child “telling sto-
ries.” As Bruner and Lucariello (1989) state:
NARRATIVE FORMATION AND GESTALT CLOSURE 319


There is compelling evidence to indicate that narrative compre-

hension is among the earliest powers of mind to appear in the
young child and among the most widely used forms of organiz-
ing human experience. [p. 75].

Furthermore, as the data in this study demonstrate, Dr. Oaklander

had a vital role in helping Elisa to better “organize her experience”
through story in their work together. Specifically, Dr. Oaklander helped
Elisa to move through a process of narrative formation and Gestalt clo-
sure in two important ways. First, Dr. Oaklander prompted Elisa to tell
her story (“I’d like you to maybe draw a picture of that feeling you
have missing them”) in a way that helped Elisa fully bring into figure
the trouble she was facing. Importantly, this prompt included the non-
verbal use of drawn images to facilitate the child’s storytelling. Sec-
ond, Dr. Oaklander helped Elisa to “reevaluate” the story she told by
bringing her more fully into the present (“If he were here, how would
it be different for you?”). In this way, Elisa was able to see that she had
changed over time and that her old version of the story, her old at-
tempts at “closure,” no longer fit her present life. Through these ex-
amples, it is clear that therapists who work out of a Gestalt orientation
can act in important ways not only to facilitate the process of narrative
formation, but also of Gestalt closure.

References

Aristotle (trans. by Janko, 1987), Poetics. Indianapolis, IN: Hackett Publishing Co.
Barthes, R. (1988), The Semiotic Challenge. New York: Hill and Wang.
Bruner, J. (1990), Acts of Meaning. Cambridge, MA: Harvard University Press.
 & Lucariello, J. (1989), Monologues as narrative representation of real-
ity. In: Narratives from the Crib, ed. K. Nelson. Cambridge, MA: Harvard
University Press, pp. 73–79.
Capps, L. & Ochs, E., (1995), Constructing Panic: The Discourse of Agoraphobia.
Cambridge, MA: Harvard University Press.
Ervin-Tripp, S. M. & Kuntay, A. (1996), Conversational narratives of children:
Occasions and structures. Paper presented at the VIIth IASCL, Istanbul,
July 14–20.
Goodwin, M. H. (1990), Tactical uses of stories: Participation frameworks with
girls’ and boys’ disputes. Discourse Processes, 13:33–71.
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Labov, W. (1982), Speech actions and reactions in personal narrative. In:
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 & Fanshel, D. (1977), Therapeutic discourse: Psychotherapy as Conversa-
tion. New York: Academic Press.
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Lakoff, G. & Johnson, M. (1980), The Metaphors We Live By. Chicago: Univer-
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 (1973), The Gestalt Approach and Eye Witness to Therapy. Ben Lomond,
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 , Hefferline, R. & Goodman, P. (1951), Gestalt Therapy: Excitement and
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Lewis & Clark College

Campus Box 86
Portland, OR 97219-7899
Gestalt Review, 3(4):321–324, 1999

Building Bridges:
A Response to Peter Mortola


S T E P H A N I E B A C K M A N, MSSA

ATS OFF TO P ETER M ORTOLA for bringing specific ways in which

H narrative theory connects to Gestalt therapy. Many practi-

tioners who have written about and practiced narrative therapy
have profoundly influenced the therapeutic field. However, the flot-
sam and jetsam of trendiness float through the narrative approach, leav-
ing fuzziness and confusion about exactly how one would have a clear
narrative lens. For example, the words postmodern, social construction-
ism, poststructuralism, languaging, and the like are often bandied about
in ways that have restricted narrative therapy to abstractions. Mortola
has not only brought clarity by looking at a session with an eye to nar-
rative theory, but he has also heightened our awareness of the marvel-
ous contribution of Labov and others in their research on human
conversation.
I would like to briefly continue Mortola’s attempt at bridging the
two approaches by first describing a few additional shared intentions
of both narrative theory and Gestalt therapy theory. I will then describe
two additional bridges, and finally, I will articulate one major distinction.
Prior to beginning, I would like to highlight one cornerstone of nar-
rative work: change comes about by a shift in the narrative (or the story)
told by the client. Carlos Sluzki (1992) argued that the most important
element in bringing about change is “the ability of one or more family
members to describe current problems as emanating from (or embed-
ded in) interpersonal, relational or systemic issues” (pp. 217–230). What
he and other narrative therapists refer to as the “dominant story” is
often that a problem is described as existing solely inside of self or in
another person. Narrative therapists are interested in getting the story
to shift in the way Sluzki describes. They call it “re-storying” or “re-
authoring,” which is shifting the interpretation of the life-organizing

Stephanie Backman, MSSA is on the faculty of the Cleveland Gestalt Institute/Cen-
ter for the Study of Intimate Systems, and is in private practice in Portland, Maine.

321  1999 The Analytic Press

322 STEPHANIE BACKMAN


problem significantly. They have a variety of methods of getting the

client(s) to change the dominant story. One is through the use of the
reflecting team; another is the use of a collaborative process in the
therapy session.

Bridge Number One:

Well-Formed Narrative Is Basic to Both Approaches

Most of the narrative therapists have in their repertoire the use of the
reflecting team. (The team consists of a group of therapists seated to-
gether with each member “reflecting” back to the client an invariably
positive musing about what has just been said in session; the client
discusses whatever was of interest out of that reflecting. The team re-
flects again; the client discusses whatever was of interest in that reflec-
tion. That sequencing continues throughout the session. Most of the
time the team members speak only to each other, and the client ad-
dresses only the therapist.) The reflecting team, with its rhythmic back
and forth of the reflections and responses to the reflections, to the de-
gree that some focus is maintained, can fit the elements Mortola has
described as the “well-formed” narrative. He describes the six elements
of a well-formed narrative from a linguistic perspective, abstract, orien-
tation, complicating, action, resolution, evaluation, and coda. In fact, he is
describing what is one of the basic supports for change in the Gestalt
theoretical framework: The co-creation of good form. The template of
the cycle of experience (see Zinker, 1977), the good form, the Gestalt, or
unit of the work can all be synonymous with the linguistic perspective
of the well-formed narrative. An honoring of form can be applied to
the use of the Gestalt session or to the use of the reflecting team. How-
ever, many times the team does not follow a well-formed narrative.
What is adhered to, instead, is a rule that nothing needs to (or even
should) stand out, and no coda is necessary. As a result, the focus shifts
continually and the ending is ragged. Continuous shifting of figures
leaves an “unformed” narrative.
One more bridge, then, between narrative and Gestalt therapists is
that the reflecting team and a Gestalt therapy interview both have the
potential for the creation of a well-formed narrative. Most Gestalt thera-
pists value a therapy session that adheres to a theme and a clear devel-
opment of one issue. The value of the good form exists for the Gestalt
therapist as an important ingredient of the change process. Among many
other uses in the process of change, good form helps the client retain
the new meaning that was created during the session. Practically speak-
ing, neither the Gestalt therapist nor the narrative therapist always suc-
ceeds in orchestrating a well-formed narrative, but both share this value.
To use Mortola’s words, they share a theoretical linguistic perspective.
BUILDING BRIDGES: A RESPONSE TO PETER MORTOLA 323


Bridge Number Two:

Collaboration as a Hallmark of Narrative and Gestalt Therapy

Many narrative methods, such as the “not-knowing” of Anderson and

Goolishian (1992), the Socratic questions of Michael White (1990), and
the “kitchen table” of Lynn Hoffman (1992), are used with the inten-
tion of a phobic push away from the “modern” schools, which empha-
size and acknowledge hierarchy. Instead, the narrative approaches want
the therapist to become collaborative with the clients. (What is meant
by collaborative is the belief that the therapist and the client have equal
expertise.) This view of collaboration has been heavily influenced by
the writings of Michael White (1990). His interest in Foucault’s ideas of
power has led him to the idea that the dominant discourse (the semi-
aware linguistic behavior that keeps the majority opinion unchanged
and the other opinions inaudible), includes the therapist, leading to
overt and covert influencing and determining of clients’ lives. Narra-
tive therapists are so eager that no one in the position of hierarchy (that
is, the therapist) slips unaware into the dominant discourse, that they
and the reflecting teams have stayed with the rules of conjecture and
positive reflection. The vow of not having a therapist-driven sequence
has paradoxically trapped the team and the therapist into a reified,
static, and structured stance. What gives promise of a true collabora-
tive stance becomes a technique, a matter of political awareness.
The collaborative stance has long been a value of the Gestalt thera-
pist. It fits hand and glove with the notion of experiment (see Zinker,
1977). For example, the therapist’s clear interest in the client’s contactful
agreement to proceed in trying something new and the careful laying
out of the purpose of trying what is being proposed exemplify a col-
laborative value. The therapists’ focused attending, grading, checking
and more attending, transparency, and use of self all show that the con-
tinuous collaboration is sewn into the nervous system of the seasoned
Gestalt therapist.
Again, practically speaking, staying process oriented and not pas-
sionately wedded to a theory or idea becomes a difficult disciplined
act for any therapy theory. However, valuing a continuous collabora-
tive stance that shows interest in the process of the client(s) is a true
bridge between both approaches.

The Difference That Makes the Difference

A major difference between narrative theory and Gestalt therapy is in

the pursuit of process. Each is a method of inquiry, gaining data about
how change can be possible and how sameness is maintained. How-
ever, the distinction is in how the data are obtained about the process
324 STEPHANIE BACKMAN


of the couple, family, and so on. The data that the Gestalt approach
values regarding the patterns and sequences that are transpiring dur-
ing a session are now not being used by narrative therapists in a way
that makes those patterns visible to the client. In an attempt to stay
away from the “therapist-driven” sessions, they have substituted a cha-
otic, unformed format. This results in a loss of novel and compelling
data for both the therapist and the client, and the narrative approach
risks limiting itself to intrapsychic work. Out goes a baby with the bath
water.
Mortola’s interesting article suggests the building of the above-men-
tioned bridge. Further linguistic awareness can always be a shared driv-
ing force of both the narrative and the Gestalt approach, as he suggests.
In that way, narrative-based work can become more integrated into
Gestalt therapy. In turn, the Gestalt therapy theory can return to the
narrative world a commitment to phenomenological observations between
and among people. I hope the ideas in my response will add to the devel-
oping of connections between narrative theory and Gestalt therapy theory.
Thank you to Peter Mortola for bringing it to our awareness.

References

Andersen, T. (1987), The reflecting team: Dialogue and meta-dialogue in clini-

cal work. Family Proc., 26:415–428.
Anderson, H. (1999), Re-imagining family therapy: Reflections on Minuchin’s
invisible family. J. Marital & Family Ther., 25:1–8.
Goolishian, H. A. & Anderson, H. (1992), Strategy and intervention versus
nonintervention: A matter of theory? J. Marital & Family Ther., 18:12–13.
Resnick, R. W. (1996), Differences that separate, differences that connect: A
reply to Wheway and to Cantwell. Brit. Gestalt J. 5: 48–53.
Sluzki, C. E. (1992), Transformations: A blueprint for narrative changes in
therapy. Family Proc., 31:217–230.
White, M. & Epston, D. (1990), Narrative Means to the Therapeutic Ends. New
York: Norton.
Zinker, J. (1977), Creative Process. New York: Brunner/Mazel.

32 Pleasant St.
Portland, Maine 04101
Gestalt Review, 3(4):325–334, 1999

Gestalt Therapy as Narrative

A Commentary on Peter Mortola’s Paper
“Narrative Formation and Gestalt Closure”


M A R G H E R IT A S P A G N U O L O L O B B

Speech is good contact when it draws energy from and makes a

structure of the three grammatical persons, I, Thou and It; the
speaker, the one spoken to, and the matter spoken about; when
there is a need to communicate something [Perls, Hefferline, and
Goodman, 1951, ch. 7, sec. 2].

on an article that reflects a contempo-

I
HAVE BEEN ASKED TO COMMENT
rary trend in the field of both psychotherapy and literary narrative.
As a participant in this discussion, I feel most interested in the nov-
elty of the theme “narrative in psychotherapy.” Perhaps I am caught
up by a narrative process too. What is the disequilibrium that provokes
me to read this article? What modified equilibrium do I find in writing
this reply? More important, in which relationship of mine does this new
construction of meaning happen?
What follows is my narrative of my process of regaining some sense
of equilibrium, in the here-and-now of the relationship with you the
readers (author included). It springs from the encounter between what
I have read in the article and my previous experience of the interface
between narrative and Gestalt therapy (disequilibrium). My narrative
is a new, always momentary, equilibrium—already surprising and un-
foreseeable as it emerges—of my making contact with you, who the
reader.
Narrative is therapeutic in the extent to which it implies an active
restructuring on the part of the narrator, whose previous balance has
been thrown into crisis by an experience that overturns the preceding
Gestalt. This is what Mortola’s article affirms, underlining how the pro-

Margherita Spagnuolo Lobb is Director Istituto di Gestalt, H.C.C., Italy and Presi-
dent European Association for Gestalt Therapy.
Translated from the Italian by Bruno G. Just.

325  1999 The Analytic Press

326 MARGHERITA SPAGNUOLO LOBB


cess that supports the act of narration on the part of the client high-
lights a parallel between Gestalt therapy and narrative theory.
My commentary consists of four parts. I begin with a brief descrip-
tion of therapy as narrative in order to situate Mortola’s contribution in
this field of literature. I then would offer a definition of the narrative,
which, in my opinion, is more harmonious with Gestalt therapy theory.
I list what I consider to be useful and stimulating points of reference
between narrative theories and Gestalt therapy. In so doing, I can then
specify the usefulness of this approach for Gestalt clinical practice.

Narrative and Psychotherapy: Today’s Field of Interest

It seems to me that Mortola’s article derives from cognitive and pro-

cess-oriented perspectives, certainly not from relational and, less so,
hermeneutic perspectives. What follows will demonstrate this.
The connection between narrative and psychotherapy has had
various permutations (Salonia, 1987). First, the emphasis was placed
on the client, who tells the story, while the therapist notices the gaps of
the account, with the goal of evoking the negated memories and
experiences.1
Second, the interest shifted to the therapist, who recounts metaphors
(Bechert, 1987), fables (Peseschkian, 1979), or a “strategy story” from
unconscious to unconscious like that of Milton Erikson (1983). A third
revolutionary moment of the theories occurs when the telling of the story
itself is seen as a therapeutic space. Narrative is no longer seen as a
methodological instrument, but a hermeneutic key2 to the therapeutic
process (Salonia, 1987). The contribution by Spence (1982) indicates this
turnaround. He questions the concept of the psychoanalyst as the “ar-
chaeologist of the psyche” and confronts the connection between his-
torical truth and narrative truth. Psychotherapy, he affirms, is located
in the context of narrative truth. The task in psychotherapy is not so
much to discover the existing significances, but to create and produce
fresh significances (Salonia, 1987). Hillman (1983) pushes us further
still. He looks at the relational aspect of narration and maintains that
psychotherapy is the place where the therapist as a storyteller, offers a

1
It is interesting to remember that the second volume of Gestalt Therapy includes a
chapter in which the authors criticize the use that society and psychoanalysis had for
the client’s narrative: “Know Thyself, is a humane ethics . . . something one does for
oneself as a human. . . . It does not follow for the analyst to reveal all his interpreta-
tions; rather, to interpret very little, but to give the patient the tools of the analyst”
[Perls et al., 1951, ch. 7, sec. 5].
2
The key concept, which allows us to understand a specific reality at an epistemo-
logical level.
GESTALT THERAPY AS NARRATIVE 327


tale to the client or, better still, a thread capable of allowing the client
to discover the lost plot in his story.
In this last decade, the literature of psychotherapy has been enriched
by the many contributions to this stimulating relationship between nar-
rative and psychotherapy. Among the most original contributions are
those of Gestalt therapist Erving Polster (1987). Within a literary and,
therefore, aesthetic code, he presents Gestalt therapy’s attention to pro-
cess as a mirror of life’s spontaneity, from which no therapist should
escape. Narrative theory in psychotherapy thus becomes a develop-
ment of the Buberian concept of “betweeness” (Zwischenheit). It also
illustrates our concept of contact as the phenomenology of a boundary’s
event and the discourse by Goodman on verbalizing and poetry (Perls
et al., 1951, vol. II, ch. 7).
Current thought on narrative in psychotherapy moves in the field of
hermeneutics (Gadamer, 1960; Salonia, 1992b, Sichera, 1998). Narra-
tive significance of interest to the therapist is that which develops at
the contact boundary (the escaping point, Gadamer would say) between
the therapist and client, between the horizon (precomprehension) of
the therapist and that of the client.
Even in the field of the developmental theory, the narrative aspect is
of great moment. The child’s capacity to tell a story about himself is,
indeed, defined as a fundamental milestone in self-development (Stern,
1985; Wilber, 1986). This is consistent with Gestalt therapy. Perls et al.
(1951, vol. II, ch. 7, sec. 1) affirmed that the acquisition of language is
tightly bound to the development of the personality. They considered
it a creative act of the second or third year of age. We can, therefore, say
that the ability to tell about one’s self indicates the ability to integrate
the various experiences into one experiential, holistic unity that is well
differentiated from what is not-self. This evolutionary jump, which oc-
curs around three years of age, allows the child to experience contact
making with the environment in a differentiated, integrated way with
a clear sense of personal beingness (Salonia, 1992a).

What Is Narrative Process for Gestalt Therapy?

The phrase quoted by Perls et al., in epigraphs is evidence of a funda-

mental difference with Mortola’s manner of thinking about narrative.
His definition of narrative is at the beginning of the paragraph: “The
triadic process in narrative theory” and includes simply the narrator
and the narrated event. I understand that the author does this to stay
in a context as generic as possible, thus leaving space for the inclusion
of other elements. Nonetheless, I believe that a fundamental parameter
of Gestalt therapy has been forgotten. Narrating, insofar as it is an act
328 MARGHERITA SPAGNUOLO LOBB


of contact, can never, either in its coming to pass (as action of the ego)
or in its signification, disregard “who” the story is being told to. There
are necessarily three elements that define narrative for the Gestalt thera-
pist: the narrator, the narrated, and the person(s) to whom the narrative
is addressed.
In Gestalt therapy, the self—the hinge of all therapeutic approaches—
is conceived as an experiential event that happens in the phenomeno-
logical actuality (Perls et al., 1951, ch. 10, sec. 4). Narration, as expression
of the self-in-contact, is necessarily a relational act inserted in a field
(the self is the experience of the field). The other, “the who” to whom
the story is addressed is neither secondary nor background: he is an
element that determines the narrative. Indeed, the self, with its voli-
tional aspect decides how to tell the story, according to whom it is ad-
dressed. There doesn’t exist a fact in itself, for itself: since narrative is
as an event of contact, there exists then only “a fact told to.”
Narrative that occurs in therapy (a process described by the author
as (equilibrium, disequilibrium, modified equilibrium) cannot be sepa-
rated, in its contents as well as in its modes, from the fact that the nar-
rative is addressed to the therapist. Narration is a creative adjustment
that occurs in the here-and-now; it is a product of the experience of the
field. The therapist is a fundamental part of the field; s/he is the envi-
ronment with which the client’s self is in contact. For a Gestalt thera-
pist, the three phases of the process described by Mortola cannot be an
exception to this reading. If one observes them from a relational and
experiential perspective (What is Elisa’s experience in relationship to
Oaklander?), then one sees that the client’s manner of being in the pres-
ence of the therapist is centered on feelings of discouragement and pain.
It is as if the client is asking the therapist: “Will I dare to live without
my brothers?” When Oaklander asks: “If he were here, how would it
be different for you?” she gives the client the key to redo the story with
another truth: “It’d probably still be the same.” When both Oaklander
and Elisa concur: “And maybe you’ve learned—you’ve had to learn a
lot of how to do that yourself,” they discover in that mutual contact a
narrative truth, which fits beyond the historical truth and which is the
proper locus of psychotherapy.

Bridging Gestalt Therapy and Narrative Theories

Certainly, a Gestalt therapist who reads Mortola’s article feels stimu-

lated to enter this fascinating discussion. Who better than a Gestalt
therapist can fully taste the fascination of the narration: with the body,
the intellect, and the spirit fused in one experience, without falling into
devitalizing pondering? There is no one better fitted to respond to the
GESTALT THERAPY AS NARRATIVE 329


cry that issues from the very blood of the founders of our approach.
Despite the dichotomy, which Sartré pointed out, between living and
narrating, they rose to the challenge of forming a theory that could stand
with what marks the spontaneity of human living: the phenomenology
of its being-in-the-world.
Perls et al. (1951, vol. II, ch. 7) analyzed language in such a way as to
allow the evolution of our theory toward the narrative aspect of therapy.
They define language as the bridge between individual and society.
“People . . . find confronted within themselves their ‘personal’ wishes
and their societal roles” (Perls et al., 1951, ch. 7, sec. 1). Thus, they allow
us to define narrative, not as a wish to hide, but as a wish to reveal.
Narrative reveals then, not only some preexisting meaning, but also,
and more important, the meaning of the here-and-now relationship, a
meaning that is always between “personal” wishes and societal roles.
Furthermore, in line with Mortola’s thesis, they affirm, in speaking
of poetry, “and most important of all, a poem has a beginning, a middle
and an end; it finishes the situation” (Perls et al., 1951, ch. 7, sec. 2).
Also, “the present situation is taken as an adequate possible field for
solving an unfinished situation” (Perls et al., 1951, ch. 7, sec. 2).3
The parallel between narrative theories and Gestalt therapy offered
by Mortola leaves at least two important aspects not covered: the rela-
tional aspect (to whom is the story addressed?) and the aspect of se-
quence within the process (sequentiality) which carries the closure of
the Gestalt (what to do to foster it?)

Narrative as a Contact Experience

I recall a dream that I told Isadore From, during the years that I was in
therapy with him. He and I both knew that he had cancer. (Here, I wish
to consider the dream as a narrative act.) Totally unaware of the reason
why I felt an urge to tell him that dream, I said to him, “Last night, I
dreamed that I was driving my car on a paved road. All of a sudden, I
see, stuck to the asphalt, a death notice with my name on it, as if I’d
died. [This is a practice in southern Italy; death notices are stuck to the
city walls.] I drive over the notice and something seems strange” He
very quickly said to me: “I believe that the name on the death notice
should have been mine.” I felt profoundly moved, and my feeling of
pain at his imminent death could be freed. I felt a deep contact with
Isadore; it was true that, since he was still alive, I had not admitted to


3
Kitzler [1999] connects this process aspect of narrative to Miller ’s analysis [1981]
of the roles of conflict and resolution and wonders which one of the two is more influ-
ential in final narrative creation.
330 MARGHERITA SPAGNUOLO LOBB


myself, much less to him, the pain of his foreshadowed loss. In one
instant this dream acquired its narrative truth: the possibility of ex-
pressing my love to Isadore and the pain of his approaching death.
Every account finds its deepest significance, its most pregnant be-
ing, in the relationship within which it is created. Isadore From’s dream-
work theory exemplifies this central theme in Gestalt therapy. The mode
in which the client narrates his story to the therapist has to do with the
therapist and has the goal of undoing a retroflection that, unaware,
maintains a relational hold on the client vis-à-vis the therapist.
As an example, I cite an excerpt from Salonia (1992b):

The client says: “I feel confused.” The therapist can ask: “In what
way do I confuse you?” After the first: “This doesn’t concern you”
. . . the client can hint at the fact that, perhaps, the therapist has
talked too much or has said something different in this session
than in the previous ones [p. 10].

The client’s narrative includes a relational deliberateness, a way in

which the client tries to overcome, in the relationship with the therapist,
relational blocks learned in previous relationships (the gestalt closure
discussed by Mortola). It includes useful information on the client’s
cognitive-perceptive abilities (e.g., cf. Bandler and Grinder, 1975; Perls
et al., 1951, vol. II, ch. 7) that must also orient the language of the thera-
pist. Mortola describes the narrative process as coinciding with a clo-
sure of the gestalt. To that I would add that it also gives meaning to the
here-and-now of a relationship.
I now discuss the second aspect that connects Gestalt therapy to nar-
rative theories.

The Sequentiality of the Story: The Transition Between

Now and Next
I recall another dream that I had and told during my training with
Erving and Miriam Polster. I dreamt about a great ship that sailed the
sea, and afterward I felt a great weight. Erv asked me to be the ship. I
entered the part, and little by little, what was, at first, a large, heavy
ship metamorphosed into a fast motorboat that went in a jolly way from
one group member to another, saying: “I won’t ever use those tissues [I
shall never cry].” Erv let me go on, letting my story develop by itself. I
travelled without obstacles from one step to another of my awareness,
always surprised about what was befalling me, like a writer who al-
lows herself to be carried along by her characters who seem to take on
a life of their own in the plot of the novel. In the end, I was satisfied to
understand that I might not be such a “large and heavy ship” in that
GESTALT THERAPY AS NARRATIVE 331


group and also in my life as a therapist. I regained my lightness of be-

ing and a new sense of identity.
The sequence that binds one phase of the process to another (Polster ’s
sequentiality) has to do with the spontaneity of life, with being fully in
the experience of contact. Coining the concept of “transition between
now and next,” Polster (1987) explains well, perhaps better than does
the term “here-and-now,” the organism’s deliberateness, that our theory
identifies as the spontaneity of being: “The present is a passage out of
the past towards the future” (Perls et al., 1951, vol. II, ch. 10, sec. 3).
Erving Polster identifies this spontaneous aspect of the present as “in-
terest”: being interested/interesting is an expression of human vitality
(Spagnuolo Lobb, 1988). Interest expresses a need that is born in a rela-
tionship. This is why it is located in a fully Gestaltist perspective, as
opposed to an intrapsychic one.
The therapist, like the novelist, is expert in catching the fascination
of human lives. Salonia (1987, p. 125) finds a great affinity between the
task that Polster assigns to the therapist and that which Milan Kundera
(1988) assigns the novelist: “Great novels are always a little more intel-
ligent than their authors. . . . [The novel] is the territory in which no
one possesses the truth . . . but in which everyone has the right to be
understood” (p. 218).
The narrative is a holistic entity that goes beyond the sum of its parts;
no one knows beforehand the truth of the story, neither the therapist
nor the patient. It is the spontaneous and unforeseen process of the
making of the story that contains the truth.

Implications for Gestalt Therapists’ Practice

The narrative has to do with the process; this is why it is of interest to

Gestalt therapists. The narrator constructs his own story and thus re-
makes anew the meaning of preceding perceptions. In other words, he
closes a Gestalt. The therapist accompanies and facilitates this process,
which remains the creation of the client. Who could not agree with this
parallelism described by Mortola who, in effect, underlines a clinical
implication that is not new for Gestalt therapists? Instead, I would like
to make evident three aspects, related to what I have said before, that
seem new to Gestalt clinical practice.

Reading the Client’s Story in a Hermeneutic Key

This entails thinking of the client’s story as a creation that assumes its
meaning more properly in the relationship in which it is inserted
(Salonia, 1992b). Basing himself on the phenomenology of the narra-
tive process, the therapist can ask himself questions of this nature: “How
332 MARGHERITA SPAGNUOLO LOBB


have I contributed to the creation of this story?” “What role do I have

in the creation of this story?” “In what way can this story reveal to me
how the client wants to resolve his relational block with me?” In the
manner of self-inquiry of Karen Humphrey (1999): “How does the nar-
rative become when I contribute what I see?” When the therapist com-
ments on the relational aspect of the account, he allows the client to
openly carry into the here-and-now of the therapeutic relationship those
feelings that the relational block keeps repressed. When the client is
able to express these feelings, he experiences overcoming the relational
block.

An Instrument With Which to Work With Seriously Disturbed

Clients and with Children
As I said above, Perls et al. (1951) anticipated contemporary develop-
mental theories when they mentioned the about face of the self at about
three years of age. The clinical usefulness of this concept for the heal-
ing of severe disturbances is apparent (Spagnuolo Lobb, 1996; Salonia,
1999): the parallelism already revealed (Mahler, Pine, and Bergman,
1989) between the prepersonal experience of the child and the experi-
ence of the seriously disturbed client allows us to attune our therapist’s
language to the experiential categories of the prepersonal period when
we work with these clients. They are experiences that are qualitatively
different from the personal or “neurotic” ones. The prepersonal experi-
ential categories of the child, as well as those of the seriously disturbed
client, pertain to existential themes bound to one’s existence: being–
not being, devouring–being devoured, destroying–being destroyed, and
so on. Meanwhile, the neurotic categories, presupposing a self that has
the capacity to perceive the boundaries in an integrated and differenti-
ated manner, have to do with self-esteem, “I am worthy–I am not wor-
thy,” “I am accepted by the group or not,” and the like. It follows that it
is important for the therapist to receive the seriously disturbed client’s
(or the child’s) account and to adjust his language to the prepersonal
experiential categories. For example: “You feel overwhelmed by your
mother ’s voice,” instead of “Your mother ’s voice annoys you.”

Sequentiality and Interest as Narrative Qualities

“The verbalizer bores because he means to bore, to be let alone” (Perls
et al., 1951, ch. 7, sec. 3). I do not know how much this sentence in-
spired Erving Polster in the creation of his contribution to narrative as
therapy—or as the art of returning to the client the ability to recount
himself. The client’s being interesting/interested is a category that helps
the therapist both to identify the resources to support in the client’s
GESTALT THERAPY AS NARRATIVE 333


story (in the creation of his self in contact), and to update himself,
moment to moment, on the quality of his being there as a therapist. The
therapist’s lack of interest, as in the case of the client, indicates a verbal-
izing, the silencing of a conflict, thus a central point for therapy.
I hope that this narrative will stimulate reflections useful to our cli-
ents and for whoever tells us his story.

References

Bandler, R. & Grindler, J. (1975), The Structure of Magic. Santa Clara, CA: Sci-
ence and Behavior Books.
Bechert, Ph. (1987), L’uso della Metafora in Psicoterapia. Roma: Astrolabio.
Erikson, M. H. (1983), La mia Voce ti Accompagnerà. Racconti Didattici. Roma:
Astrolabio.
Gadamer, H. G. (1960), Verità e Metodo. Milano: Bompiani.
Hillman, J. (1983), Le Storie che Curano. Milano: Cortina.
Humphrey, K. (1999), Theater as field. Implications for Gestalt therapy. In:
Studies in Gestalt Therapy, 1999, No. 8 (dedicated to the 6th European Con-
ference of Gestalt Therapy).
Kitzler, R. (1999), Developmental theory in the light of pragmatism and Iiter-
ruptions of contact: An integration. In: Studies in Gestalt Therapy, 1999, No.
8 (dedicated to the 6th European Conference of Gestalt Therapy).
Kundera, M. (1988), L’arte del Romanzo. Milano: Adelphi.
Mahler, M., Pine, F. & Bergman, A. (1989), The Psychological Birth of the Human
Infant. London: Karnac.
Miller, D. A. (1981), Narrative and Its Discontents. Princeton: Princeton Univer-
sity Press.
Perls, F. S., Hefferline, R. & Goodman, P. (1951), Gestalt Therapy. Excitement
and Growth in the Human Personality. New York: Julian Press.
Peseschkian, N. (1979), Der Kaufmann und der Papagei orientalischen Geschichten
als Medien in der Psychotherapie. Frankfurt: a. M.
Polster, E. (1987), Every Person’s Life Is Worth a Novel. New York: Norton.
Ricoeur, P. (1985), Time and Narrative. London: University of Chicago Press.
Salonia, G. (1987), Quando raccontarsi è terapia. Quaderni di Gestalt. 5:119–
134.
Salonia, G. (1992a), From we to I–thou. A contribution to an evolutive theory
of contact. Studies in Gestalt Therapy. 1:31–41.
 (1992b), Time and relation. Relational deliberateness as hermeneutic
horizon in Gestalt therapy. Studies in Gestalt Therapy. No. 1:7–19.
 (1999), Working with seriously disturbed patients in Gestalt therapy.
In: Psicoterapia della Gestalt. Ermeneutica e Clinica, ed. M. Spagnuolo Lobb &
G. Salonia.
Sichera, A. (1998), Comparison with Gadamer. Towards a hermeneutic episte-
mology of Gestalt therapy. Studies in Gestalt Therapy, 6/7:9–30.
Spagnuolo Lobb, M. (1988), Introduzione all’edizione italiana. In: Ogni Vita
Merita un Romanzo, ed. E. Polster. Roma: Astrolabio.
334 MARGHERITA SPAGNUOLO LOBB


 (1996), Developmental theory and seriously disturbed patients. The

perspective of Gestalt therapy. Workshop for skilled therapists given at the
20th anniversary of the Swedish Gestalt Academy, Stockholm.
 (1999), The theory of self in Gestalt therapy. In: Psicoterapia della Ge-
stalt. Ermeneutica e clinica, ed. M. Spagnuolo Lobb, & G. Salonia.
Spence, D. P. (1982), Narrative Truth and Historical Truth. New York: Norton.
Stern, D. (1985), The Interpersonal World of the Infant. New York: Basic Books.
Wilber, K. (1986), Lo spettro dello sviluppo. In: Le Trasformazioni della Coscienza,
ed. K. Wilber, J. Engler & D. Brown. Roma: Astrolabio, pp. 58–94.

via San Sebastiano, 38

96100 Siracusa, Italy
Gestalt Review, 3(4):335–336, 1999

Response to Backman’s and Spagnuolo

Lobb’s Commentaries


P E T E R M O R T O L A, Ph.D.

T HAS BEEN AN HONOR to be in dialogue with my colleagues, Stephanie

I Backman and Margherita Spagnuolo Lobb, regarding the conver-

gence and divergence of Gestalt and narrative theory in therapeu-
tic practice. Having read Backman and Spagnuolo Lobb’s responses to
my original piece, I now think that the topic has been more broadly
addressed than it could have been in one piece on its own. In this way,
our work together represents a kind of co-constructed sense making, a
central concern of all our pieces.
In particular, I appreciate how both authors broadened the context
and background of narrative practice, both within and outside of
Gestalt circles. This kind of attention to the “field” helps to bring the
figure of narrative practice into clearer focus.
I was also glad to see Ms. Spagnuolo Lobb highlight the fact that,
when a client tells us a story, we are a “fundamental part of that field.”
Perhaps the importance I had placed on this idea did not come through
in my original article. I wanted to highlight its importance by showing
how Elisa “reevaluated” her own story through her dialogue with Dr.
Oaklander. In her initial “solo” attempt to gain closure on her story
and her unfinished business with her brothers, Elisa was not hopeful
(“he just keeps going and I’m still down here trying to figure out what
to do”). With this first attempt at sense making, Elisa seems unable to
approach Spagnuolo Lobb’s poignantly phrased question: “Will I dare
live without my brothers?”
What is so fascinating about her narrative reevaluation that soon
follows as a result of her dialogue with Dr. Oaklander is watching Elisa
come more fully into the “here-and-now” and, in the process, how she
sheds an old closure like a snake sheds a skin. This is fascinating to me
because, without the co-construction of a new closure with Dr.
Oaklander, Elisa may have continued to live in a present that was de-
fined by an outmoded evaluation of herself. In other words, Elisa may

335  1999 The Analytic Press

RESPONSE TO COMMENTARIES 336


have simply accepted living with a narrative closure that reflected the
way things were for her sometime in the past without being able to
acknowledge the way things are for her now in the present. I think this
reflects what Backman aptly points out as change coming about by a
shift in the narrative told by the client.
Dr. Oaklander ’s question that encourages Elisa’s reevaluation (“If
he were here, how would it be different for you?”) somehow allows
Elisa to glimpse and articulate an awareness of herself in the present
that she had not been able to see just seconds prior! The reversal is
dizzying. Instead of accepting that “he’s going up and I’m staying
down,” Elisa now clearly asserts that “I live life on my own, without
having Jason there.” All this results from, as Spagnuolo Lobb points
out, the centrally important fact that Elisa is telling a story to and with
someone.
For me, seeing the power of micro-interactional moments like these
clarifies what Backman has described as the fuzziness of words like
“social constructionism.” When I think about the kind of influence “we
who hear stories” have in the therapeutic context, I feel both exhila-
rated and laden with incredible responsibility.
A last point that I would like to clarify is subtle and perhaps a bit
dangerous. In writing my original piece, I was not starting from the
assumption that Gestalt theory and narrative theory were two reified
things in themselves that I was trying to join. Rather, my assumption
was that both the Gestalt process and the narrative process were part
of the same human/organismic move to make sense of ourselves and
the world. I didn’t view them as two separate processes that I was try-
ing to link theoretically. Instead, I was trying to describe how they are
really part of the same fundamentally important phenomena of human
meaning making. I am thankful to Joseph Melnick and all the others
who have made this opportunity possible.
Gestalt Review, 3(4):337–340, 1999

Clinical Films as Training Tools:

A Comparison of REBT and Gestalt
Therapy with Children


S H E I L A Y. A S P I N A L L, Psy.D.
I R I S G. F O D O R, Ph.D.

was to compare and contrast

T
HE PURPOSE OF THIS EVALUATIVE PILOT
two videos, one with Violet Oaklander, using Gestalt therapy and
the other with Ray DiGiuseppe, using Rational–Emotive Behav-
ior therapy (REBT), to explore their utility as training tapes for gradu-
ate students.
For decades, therapy films with adults, which compare various theo-
retical perspectives, have been produced and used as training tools for
mental health practitioners. The most famous training film was the
“Gloria” tape, which featured a Gestalt (Perls), Rogerian (Rogers), and
a Rational–Emotive Behavior (Ellis) therapist. Each clinician worked
with the same client “Gloria” from their respective theoretical orienta-
tions. Despite the criticisms and limitations (Stoten and Goos,1974;
Kiesler and Goldston,1988; Weinrach,1990) of the “Gloria” tapes, they
have been used as the model for training films for clinicians who work
with adult clients (Weinrach, 1986).
While numerous films have been produced, most recently a series
by the American Psychological Association, there is a scarcity of clini-
cal films featuring therapeutic work with children and particularly from
a Gestalt approach. Futhermore, minimal research has been carried out
in evaluating the utility of training films by student therapists.

Sheila Aspinall is a School Psychologist with the New York City Board of Educa-
tion, Division of Special Education. She also has her own consulting agency. This paper
was submitted in partial fulfillment of the requirements for the doctorate in Profes-
sional Child/School Psychology at New York University.
Iris Fodor, Professor of Applied Psychology and Director of the School Psychology
Program at New York University is interested in the integration of Gestalt and Cogni-
tive therapies. Recent work features a Gestalt approach to emotional education in the
schools.

337  1999 The Analytic Press

338 SHEILA Y. ASPINALL AND IRIS G. FODOR


After reviewing a handful of films, we selected two videos, from

two different therapy orientations, both of which addressed anger is-
sues with adolescent males. One film was selected from tapes made by
Ray DiGiuseppe using the rational–emotive behavior approach and the
other by Violet Oaklander from a Gestalt series. Each therapist reported
that they hoped to demonstrate the practical application of their theo-
retical constructs on these training tapes.
In “A Boy and His Anger” Oaklander (1987) sees Abram, a 12-year-
old boy, who is having difficulty controlling his temper and dealing
with his anger about his cousin Sarah, whose recent move into his
family’s household leaves Abram feeling misunderstood and disre-
spected. Oaklander suggests Abram work with clay as a means of ex-
pressing his anger and to foster talking about his probems of coping
with these intense feelings.
In the REBT tape (“Ray and Erwin”), DiGiuseppe (in press) works
with Erwin, an 8th grader who is having problems with his teachers.
Erwin reports he is frequently in trouble for talking excessively in class.
He expresses his anger and feels he is being picked on by the adults.
Throughout the film, DiGiuseppe explores with Erwin his belief sys-
tem about the anger and uses role playing to experiment with Erwin
about alternative beliefs and behaviors.
Participants in this study were 15 first-year doctoral students in a
child psychotherapy practicum course in an urban university. All the
subjects had been exposed to REBT and Gestalt theory through didac-
tic seminars and course reading. The student raters had not seen either
film as part of their coursework.
A 43-item self-report measure was developed to rate and evaluate
the videos for this pilot project. Based on relevant criteria for therapy
process research (Goodman and Dooley, 1976), the items reflected im-
portant theoretical constructs of Gestalt and REBT, emphasized pro-
cess, presented identifiable units of measure, and had multisetting
applicability. After each tape, the subjects were asked independently
to complete the questionnaire.
In evaluation of the students’ responses to those tapes, we found
that the graduate students had a positive perception on the usefulness
of these tapes for training. The participants were able to distinguish
key features of the Gestalt and REBT approaches. These findings were
consistent with the Agin and Fodor (1996) research where the key dif-
ferences between the treatment approaches of Oaklander (Gestalt) and
DiGiuseppe (REBT) were identified, using Luborsky’s (1977) Core
Conflictual Relationship Theme (CCRT) methodology to analyze these
same films.
The graduate students reported that they perceived the Gestalt tape
as featuring the use of nonverbal material, analysis of feelings, explo-
CLINICAL TRAINING FILMS 339


ration of the cultural impact of behavior, utilization of fantasy exer-

cises, and the augmenation of sensory awareness.
The distinguishing features of the REBT treatment, according to the
graduate students, were exploring the adaptiveness of anger, examin-
ing negative self-concepts, exposing irrational beliefs, and exploring
alternative ways of managing behavior, as well as using self-instruc-
tional coachings.
The research participants had differing evaluations of the therapies’
efficacy with children. Most subjects felt that Gestalt therapy would be
useful with a wide range of children. REBT was seen as being more
suitable for older children and for brief therapy.
Despite the theoretical differences betwen REBT and Gestalt, both
therapists were seen by the graduate students as interactive and direc-
tive. They also were both viewed as assessing the child’s goal to change
and reviewing alternative behavior strategies, as well as providing the
child the opportunity to practice them.
Additionally, the clinicians’ personal characteristics were noted by
the students. The majority of participants perceived Dr. Oaklander as
“nurturing,” “child-centered,” and “flexible.” Dr. DiGiuseppe was de-
scribed as “humorous,” “focused,” and “distant,” with his interven-
tions being “future oriented.”
The graduate students indicated ways in which they believed the
tapes’ effectiveness could be increased. Most respondents felt that for
the REBT film a summary analysis and the inclusion of topics for dis-
cussion would have been a worthwhile improvement. For the Oaklander
Gestalt tape, they reported that a presentation of the theoretical frame-
work would have enhanced its efficacy.
Results from this pilot study of graduate students’ reactions to the
tapes cannot be generalized because of the small sample size.
Futhermore the subjects were not randomly selected. However, these
preliminary findings do point to the need for further research, particu-
larly on identifying generic therapeutic variables for working with chil-
dren and examining the practitioners’ personal characteristics and their
relationship to the therapeutic orientation.

References

Agin, S. & Fodor, I. (1996), The use of the core conflictual relationship theme
method in describing and comparing Gestalt and rational emotive behav-
ior therapy with adolescents. J. Rational–Emotive & Cog. Behav. Ther., 14:173–
186.
DiGiuseppe, R. (in press.),Rational emotive behavior therapy with a depressed
adolescent. [Videotape]. New York: The Institute for Rational Emotive
Therapy.
340 SHEILA Y. ASPINALL AND IRIS G. FODOR


Goodman, G. & Dooley, D. (1976), A framework for help-intended communi-

cation. Psychother.: Theory, Res. & Prac.,13:106–117.
Kiesler, D. & Goldston, C. (988.), Client–therapist complementarity: An analy-
sis of the gloria films. J. Couns. Psychol., 35:127–133.
Luborsky, L. (1977), Measuring a pervasive psychic structure in psychotherapy:
The core conflictual relationship theme. In: Communicative Structures and
Psychic Structures ed. N. Freedman & S. S. Grand. New York: Plenum Press,
pp. 367–395.
Oaklander, V. (1987), A boy and his anger [Videotape]. Seattle, Washington:
Max Sound.
Stoten, J. & Goos, W. (1974), Three psychotherapies examined: Ellis, Rogers,
Perls. Alberta J. Educ. Res., 20:103–115.
Weinrach, S. (1986), Ellis and Gloria: Positive or negative model? Psychotherapy,
23:642–647.
 Weinrach, S. 1990. Rogers and Gloria: The controversial film and the
enduring relationship. Psychotherapy, 27:282–290.

Sheila Aspinall, Psy.D.

340 Stratton Road
New Rochelle, N.Y. 10804

Iris Fodor, Ph.D.

Department of Applied Psychology
239 Green St., Fifth Floor
New York University
New York, NY 10003
Gestalt Review, 3(4):341–352, 1999

Back Pages: Topics and Reviews

Touch in Therapy: Review and Comments


J A M E S I. K E P N E R, Ph.D.

Touch in Psychotherapy: Theory, Research, and Practice. (1998). Edited by

Edward W. L. Smith, Pauline Rose Clance, and Suzanne Imes. The
Guilford Press: New York and London.
Psychotherapy has always reflected the social and political limita-
tions of the society in which it comes into existence. Psychoanalysis,
growing as it did in the formal and repressed Victorian era, reflected
the formality and distance in its stylistic approach, even while its ideas
about sexuality as the hidden cause of neurosis were a radical chal-
lenge to the accepted view. Similarly, Gestalt therapy, coming as it did
as a reaction to the limitations and formalism of psychoanalysis and its
era, reflected the stance of the liberal social movement of the late 1950s
and 1960s. Early Gestalt therapy was subject both to the innovation
that comes with the release of retroflection in conservative restraint
and to the unfortunate excesses typical of a swinging pendulum.
One of the results of these limitations for practitioners such as my-
self is that, while therapeutic taboos such as those around touch were
broken, there were few guidelines for its use. Gestalt practitioners, in
the context of experiment, used touch as part of awareness building,
emphasizing resistance, or as part of authentic contact, but it was done
mostly from an intuitive ground. As Isadore From used to say, Intuition
is a marvelous thing, informed intuition is a better thing. When I wrote
Body Process (Kepner, 1987), there was almost nothing in the thera-
peutic literature on the use of touch and nothing at all in Gestalt litera-
ture, which discussed it directly rather than in passing as an implicit
part of some experiment. My chapter on touch, limited as I now feel it
was, was at least an attempt to present a direct discussion of use of
touch in psychotherapy.
This limit has hobbled us in training programs in body-oriented
therapy as well as in facing the rest of the therapeutic profession to
support the use of touch as legitimate and helpful. It is even more timely,
in the swing of the pendulum back to very conservative times in psy-
341  1999 The Analytic Press
342 BACK PAGES: TOPICS AND REVIEWS


chotherapy in Europe and the United States, that this edited collection
on the use of touch in psychotherapy should appear. It is the first over-
view volume on the topic and, as such, warrants review by Gestalt and
body-oriented therapy programs.

The Book and Its Orientation

The book is divided into three sections. The first section, “Theoretical
and Ethical Considerations,” is geared at outlining the history, issues
and concerns, context, and rationale for the ethical use of touch in psy-
chotherapy. The second section, entitled “Research Perspectives,”
reports on some specific research on touch in psychotherapy, hoping to
illuminate its use. The final section, “Insights From Practice,” presents
a number of thoughtful and sometimes brave descriptions of the use of
touch with clients, along with the authors’ guidelines in its usefulness,
problems, and possible proscription in certain clinical situations.
The section is started off by editor Ed Smith’s orienting discussion
on “Traditions of Touch in Psychotherapy.” Smith’s approach is histori-
cal in emphasis, suggesting that the bias against touch in mainstream
psychotherapy stems from a Western cultural bias against the body, as
well as Freud’s historical, we might even say hysterical, taboo against
any forms of touch in psychoanalysis. Despite this, Smith notes the
importance of touch in human development and ego formation, the
use of touch by Ferenczi and later by Reich within the analytic tradi-
tion, and the modern use of touch by some analysts, by body-oriented
psychotherapists, and by humanistic therapists, all of whom use touch
in different ways and for different purposes.
The chapter by Kertay and Reviere is, to my mind, a crucial one for
the discussion of the use of touch because it defines touch, its mean-
ings, and its usefulness, as contextual. In Gestalt terms, it is a field prob-
lem. Its complexity, therefore, is not amenable to simplistic taboos or
rigid guidelines. They note that both the decision to touch and the de-
cision not to touch will have meanings which are interpreted by the
client and that the real issue is how to understand the context in which
meaning is made. Their most important point is that the use of touch
requires careful consideration and thoughtfulness by the therapist with
ample attention to the impact on the particular client, on the therapeu-
tic relationship, and with much self-searching and clarity about one’s
motives and countertransference issues. They offer some initial guide-
lines which are better elaborated elsewhere in the book.
Smith returns with a chapter on “Taxonomy and Ethics of Touch in
Psychotherapy.” His taxonomy is an attempt to break down the dual-
ism of touch/no touch and note the forms of touch that are taboo in
BACK PAGES: TOPICS AND REVIEWS 343
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therapy, such as aggressive or sexual touch, and those that are not, such
as conversational markers, technical touch in body therapy, expressive
touch, and so on. I found his use of the chakra model awkward and
distracting here, marring an otherwise useful theoretical discussion. I
appreciated his mention of informed consent for touch as part of the
contracting process within Gestalt experiments utilizing touch. This
ongoing informed consent model is what we have used in Body Pro-
cess training as well.
The final chapter in this section by Bar-Levav is a brief but powerful
appeal for the importance of touch in healing deep psychic wounds.
He grounds his rationale in the fundamental developmental language
of touch for infants, noting that verbal reassurance is simply inadequate
in the face of terrible or painful inner experience. Gestaltists would say
that words alone are simply inadequate relational support for the mag-
nitude of the phenomenological experience in many situations. While
he mentions the importance of permission each time touch is used, this
chapter is more of an impassioned plea for the relevance of touch for
healing in therapy, and readers must look to other chapters for clinical
guidance.
The section on research is started off by Fagen and Silverthorn, who
report their research on touch and emotional communication. Their main
findings suggest that the interpretation of touch by clients tends to be
more skewed and inaccurate as the degree of psychopathology increases,
a not surprising finding, and that more care must be taken therapeuti-
cally to understand and interpret touch with such clients.
The chapter by Milakovich looks at variables which distinguish thera-
pists who touch versus those who do not. Most of this, like the prior
chapter, is fairly obvious. For example, touch users were more likely to
be humanistic, to value touch, to have experienced body-oriented thera-
pies themselves, to have had more training in touch. A few findings,
such as that touch users are more likely to be female and to have been
sexually abused (a confounding variable here?), seem against stereo-
type. I found this chapter dry and not rich enough to raise much in the
way of questions.
The next chapter, by Clance and Petras, investigates therapists’ de-
cision-making processes regarding the use of touch. What I found so
helpful here is their use of detailed excerpts from therapist interviews,
which describe their thoughtfulness about how, when, and why they
use touch. This reveals much about the way in which they see the clini-
cal issues of touching and not touching, regardless of whether you agree
with their specific rationale.
The chapter by Geib on the client’s experience of nonerotic touch in
therapy was of the most interest to me in this whole section. Her small
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

sample interviews of clients, which she usefully excerpts in the clients’

own words, have much to say about what was useful and what was
problematic from the client’s perspective. Factors associated with a posi-
tive experience of touch included the client being in control of the pro-
cess, therapists’ encouragement of open discussion about the experience,
and the sense that they were touched for their own benefit and not the
therapists’. The most crucial negative factor to me was that clients may
not report negative experiences of touch because of the risk of under-
mining of other, positive, feelings regarding touch. This particular situ-
ation emphasized one of the most consistent points regarding touch
throughout the book, which I have likewise found crucial in my own
clinical work: we must be very sensitive to signs of the negative impact
of touch, even if they are not brought up verbally by clients, and that
the impact of touch must be carefully monitored and discussed.
This is reiterated in findings by Horton, who again notes that nega-
tive experiences of touch are often not brought up by clients; the re-
sponsibility to explore such feelings rests with the therapist. This
highlights the realities of the power relationship in therapy and the
potential for abuse of such power. The therapist is the one with the
greatest power, no matter how authentic or democratic we might think
we are being, and the use of touch puts the onus firmly on us to use our
power carefully and responsibly.
As we move into the “practice” section of the book, Fagen returns
with a sage discussion by a mature and seasoned grand dame of Ge-
stalt therapy. She makes a plea for parameters of touch being included
in all therapists’ training and for therapists to explore their own fears
and avoidances in relation to touch.
Glickhauf-Hughes and Clance continue with an object relations view-
point, which I found very relevant to the nitty-gritty of clinical deci-
sion making on the use of touch. Although some Gestalt practitioners
may find their use of diagnostic labels off-putting, I see them as short-
hand for modes of contact by clients. They note the usefulness of touch
with schizoid (detached) clients in forming attachments, with obses-
sive clients to increase spontaneity and affect, with masochistic clients’
to soothe them and for supporting empathy. Their overall requirement
is that the client have sufficient ego development so that the regression
promoted by touch is “benign” and the client can bond to it. They use-
fully discuss the contraindications of touch with borderline clients be-
cause touch opens primitive longings and engulfment issues which can
spin therapy out of control. This meets my own clinical experience, and
I agree that one should be extremely guarded in using touch with such
clients. The authors are notable, for analytically oriented therapists, in
seeing touch as a therapeutically legitimate and useful tool for healing.
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Imes’s chapter on the use of touch with long-term clients in Gestalt

therapy is one of my favorites in the book. Because Imes is a body-
oriented Gestalt therapist, her discussion of the use of touch covers the
range from no or little use of touch, to moderate use of touch, to the
extensive use of touch through the use of body release techniques, in
addition to the kinds of techniques most referred to in the book such as
hugs, holding, or touching a client’s hand. This chapter was most re-
flective of the kind of practice that I do as a body-oriented psycho-
therapist. I very much appreciated how her use of touch is a very
considered process and her willingness to discuss her own mistakes
and errors in its use, as well as its value to her work. She also describes
how touch can mitigate effects of sexual abuse, touch deprivation, and
neglect, while being mindful that all of this is in the context of long-
term therapy where deep relationship and consistency over time helps
build the framework where touch can be experienced as healthy and
safe in such otherwise fragile and wounded clients.
The chapter by Lawry on touch with clients who have been sexually
abused poses a set of questions which, it seems to me, therapists should
ask themselves in all use of touch, not just with abused clients. For the
therapist, “How do I feel about touch personally?” “Am I attracted sexu-
ally to this client?” And about your client: “What client need is being
met by touch?” “Is that the only way to meet that need?” “Does my
client have sufficient ego strength?” “What level of dissociation/dep-
ersonalization is the client currently experiencing?” “Is my client seek-
ing sexual gratification from me?” My only disagreement with her
discussion is her recommendation against the use of touch with disso-
ciative clients. I have found touch quite useful in grounding dissocia-
tive clients, although this rests on my considerable experience both with
use of touch and with dissociative clients. I also would have liked a
more extensive discussion by her about the importance of touch in heal-
ing survivors of abuse: why it is so important to healing the embodied
self, the wounded and often lost bodily self. Although many survivors
will not be able to negotiate touch until the middle phases of healing
(see Kepner,1993), experiencing safe touch with well-bounded care giv-
ers, such as massage therapists, chiropractors, and energy healers, is
often essential to the reclamation and healing of the violated bodily
self. She does point out that, if the therapist is uncomfortable with using
touch, a good referral for work of this kind is useful.
Mandelbaum’s chapter on touch in professional development de-
scribes his exposure to the use of touch and body-oriented therapy in
the course of his personal therapy and training experiences. Gestalt
readers will find it familiar for the kind of evocative and intense work
often promulgated in workshop settings. I would have found this chap-
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ter more useful if the author had taken an evaluative look at his train-
ing and practice in regard to touch. Mandelbaum’s approach is mostly
descriptive, and I found myself asking for more substance and critique,
more chewing. What of his training was problematic in regard to touch,
and why? How does he evaluate with whom he uses touch, what kind
of touch, and who he does not use it with? His discussion was not com-
plex enough for so complex a topic.
Torraco presents a set of descriptions of using physical touch, mostly
holding, with clients in transferential long-term therapy to fill in de-
velopmental deficits. The discussion of client dynamics and the com-
plexity of relationship here stands in contrast to the previous chapter.
Her first case presentation is laudable in that she describes how the use
of such holding failed with an intensely disturbed client, flooding the
transference with more than the client could contain. She thoughtfully
discusses what she did wrong and what she learned from this. She then
contrasts two clients, one who had not been well cared for as a child,
with whom she gently used touch over time, and another who was over-
indulged and whose self-supports were consequently underdeveloped,
with whom she did not use touch because it would have undermined
her growing independence. By the end of the chapter, after other cases
are discussed, she presents useful guidelines for the use and non-use
of such holding touch in long-term therapy. What stands out to me most
is that to use holding in this way requires ample experience and clini-
cal, discernment and is thus not anything new therapists can do. The
evaluation of the therapeutic field requires great clinical acuity and
ample experience to avoid the kind of problems she describes in her
first case when she was a younger and less experienced therapist.
The book ends abruptly here and glaringly lacks an afterword, sum-
mary, or discussion chapter by the editors. The reader could use an
overview that extracts some of the salient points and principles in the
use of touch, as well as suggestions for further research and clinical
consideration. I would have liked to hear, also, what their experience
was in putting together a book of this nature. What did they learn?
What are their new questions? What do they recommend to the field in
terms of developing training, supervision, or practice guidelines?

Final Comments

Although I am very glad to have this book available for my students

and for verbal-oriented therapists who have questions about the use of
touch, there are some limitations to it. The overall problem with the
book is that it is too narrowly drawn on a number of fronts.
First, as a body-oriented psychotherapist, I found its emphasis too
narrowly focused on using touch in verbally oriented therapy. Although
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body-oriented therapy was referred to in a number of places as back-

ground to legitimize use of touch as a psychotherapeutic intervention,
it was really only described at all in two of the chapters. The differ-
ences in the use of specific body-oriented touch techniques and prac-
tices in therapy has a whole different flavor than the use of touch within
a regular therapy, and the differences are illuminating. For instance,
why is it that the regular use of touch in body-oriented therapy does
not arouse the same kind of transference problems that its use often
does in verbal therapy? What does this tell us about the way a client’s
expectations shape the way touch is received? How are boundaries and
consent managed within body-oriented therapy that allows such a broad
range of touch to be used? What is the difference between making touch
the figure of the work (as it often is when used within a verbal therapy)
versus using touch as a ground condition to facilitate another figural
process (such as release of emotion or developing body awareness as
in body approaches)? There is something different about the context of
body-oriented therapy which makes it possible for the use of touch to
be organized differently in the client’s experience, and this is little men-
tioned here.
Another limit of the book is how culture-bound it is. It is basically a
white, North American–oriented viewpoint. There are no chapters on
cultural and subcultural views of touch, which is crucial since mean-
ings of touch and body contact are profoundly culture-bound. The only
mention of this in the book, which stands out specifically because of its
difference in basic assumptions from the hyper-cautious view of touch
held elsewhere, is from an interview with a Latino therapist who notes
that not to touch a Latino client would be perceived by the client as
“cold, distant and uncaring” (p. 102).
Similarly, issues relating to gender, cross-gender, cross-ethnic, and
cross-racial touch usage are virtually unmentioned—despite the pres-
ence of so many female authors. These are crucial boundaries in the
use of touch, which all clinicians must negotiate and understand. The
dynamics of power, sexuality, and personal space are laden here with
historical and social factors which are well beyond the particular thera-
peutic intention we bring to touch. They are the deeper ground for the
experience of touch by the client and therapist. Unless these deep
ground conditions are held with some awareness by the therapist, the
use of touch can founder on many hidden rocks.
Some other limitations of perspective include the predominantly
humanistic and psychodynamic orientation of the authors. Another is
that 12 of the 17 authors are based in or trained in the Atlanta area,
which may have some bias in terms of training, community standards,
and other limitations on viewpoint.
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Despite these limitations, I recommend this book to Gestalt thera-

pists and others interested in having an informed understanding of
touch in psychotherapy. It is an important first effort which I hope will
encourage wider explorations in future volumes.

References

Kepner, J. (1993), Body Process: Working with the Body in Psychotherapy. San Fran-
cisco: Jossey-Bass.

Prose and Poetry

A few years ago I saw the results of a study which tallied the number of
times people touched each other in public places, in two dozen coun-
tries. I had supposed the United States would be toward the bottom of
such a list, but I was more than a little surprised to find that the land of
the free was dead last: less physical contact than any other of the coun-
tries measured, the study reported, below Japan, below the Scandina-
vians (my guess for the low men on that particular totem pole).
More than 15 years ago, we had the beginnings of the national cho-
rus of outrage about the 4 million children or 10 million abducted in
America, or one child in four, the sad faces on milk cartons and the
courses in every elementary school, teaching children to be wary of
adults, not only strangers but also their own parents. The Time reporter
who tried to double-check on the figures advanced by organizations
created by parents of abducted children did a sampling of police de-
partments and arrived at a figure of 1,000 a year. When he went to his
editor, he was told to bury it because it was so low that it would cause
too much controversy.
Since then, we’ve had child abuse and its attendant hysteria (and
real injury) piled onto the stolen children wagon. Now, camp counse-
lors get courses in when they can touch children and where (in public,
on the arms and back, sometimes, maybe). And added to this is the
formulaic, religious fever of public and “professional” attitudes toward
drinking and smoking. Therapy of course has not escaped the influ-
ence of this polluted atmosphere of righteousness. This is surely a ver-
sion of the neurosis of normalcy about which our Gestalt
predecessors—who were, some of them, refugees from Nazi Germany
and homosexuals (in much less tolerant times than we enjoy)—spoke
and wrote. In Gestalt therapy and elsewhere they were eloquent about
the importance of discerning what constitutes heath in a “sick” society.
Unfortunately, no mention of any of this is made in the present book.
In discussing the reputation of touch in therapy, they say the fears of
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therapists (about what will happen if they touch their patients) is at-
tributable to “lack of accurate information” (p. xi) about what touch is
and how it is used, an Alice in Wonderland perspective for sure. The
tone of most articles is academic good manners as the ship goes down.
To give the reader a flavor of this, here is the first sentence of the early
chapter, “Touch in Context”: “Touch is a fundamental, multilayered,
and powerful form of communication thought to be essential to nor-
mative human development” (p. 16). All of this—the cautious note,
being tentative about that about which there is no doubt, and the ab-
sence of any recognition of sensuality or pleasure for its own sake (much
less any approval or encouragement of it)—is remarkable and bizarre.
I would not for a moment underestimate the devastating conse-
quences of this American way of no-touch. What is the cost to us as a
nation, not to mention our patients, of this don’t-touch culture? It’s
immeasurably large, I think. I can’t recall any occasion when this im-
portant iatrogenic effect of the current tenor of things has been men-
tioned.
In the sphere it has marked out for itself, Touch in Psychotherapy is a
sensible book. I’d rather have my own actions judged by the panel of
authors of Touch in Psychotherapy than any other grouping I can think
of—but perhaps that’s why both book and the situation in which it ex-
ists seems pathetic and tragic.
I touch my patients, nearly all of them at one time or another. There’s
a lot of back patting as we leave together, mostly that, unless there’s
something up. In the course of sessions, I take hands, pat arms, some-
times hug, touch knees, the works. But I’m not immune to the effects of
the social climate, whether because I’m more restrained than I was or
because the people I see are. (It’s a contact boundary phenomenon as
well as a field phenomenon, isn’t it?) There’s less hugging in my office
than there used to be and less simple, sweet off-hand touching. My
daughter-in-law is Italian, Venetian, and she is always touching me. I
love it. And I remember when I was first teaching in France, in Bor-
deaux in the late 1980s, how fascinated I was with the round of two-
cheek kisses in the morning and at the end of the day, how eager I was
to be included, wondering how I’d stand the warmth and the body
smells, the relief and pleasure of it.
I wonder sometimes, in bewilderment at the current state of things,
if the residue of sixties attitudes combined with the reaction against
them accounts for some important part of the present problem. The
1960s virtually eliminated the common handshake in this country, in
favor of a “Hi, I’m Karen” or “Have a nice day” and a wave or a nod of
the head. (I still tend to try to insist on shaking hands, but I know it’s
not the current rhythm of things and probably seems a little oddball or
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overly formal.) The current ubiquitous use of first names and the re-
cent establishment of “How are you?” “I’m great, just great; how are
you?’” does little, I believe, to relieve the don’t-touch chill in the social
climate, although it has the appearance of friendliness. It seems to say,
“We’re so casual and friendly we even use first names right off the bat,”
but we hardly touch each other. No wonder we’re so desperate to know
how everyone feels.
Joel Latner

Recommendations

Spring: A Journal of Archetype and Culture publishes two theme issues a

year. Titles of recent topic-centered issues have included “Marriage”
(#60), “Haiti, or, The Psychology of Black” (#61), “American Soul” (#62),
and “Mom and the Kids” (#63). The insistently psychological perspec-
tive is a dissenting and revisionist Jungian one, and the contributions
are nearly always provocative, thoughtful, sophisticated, and intelli-
gent (Box 583, Putnam, Connecticut 06281).
The Journal of Polymorphous Perversity is a wide-ranging general per-
versity journal, published twice a year over the past 15 years. Signifi-
cant topic areas first explored here include Smoller’s 1985 “The Etiology
and Treatment of Childhood,” an early discussion of this widespread
and disabling syndrome characterized by “congenital onset, dwarfism,
emotional lability and immaturity, knowledge deficits and legume an-
orexia,” and the recent (Fall/Winter 1998) “Understanding Communi-
cation in Managed Care: Therapists Are From Mercury, Case Managers
Are From Uranus” (www.psychhumor.com).

*****

A Separate Pathway Slowly Carries a Caress

To the Brain’s Attention

A separate pathway slowly carries a caress to the brain’s attention

in nerves not enclosed by a fatty sheath
A slow pathway
Slower than pain’s fast pathway

Most animals have fast and slow pathways for touch

and for pain
Thus, if you spill hot water on your foot
you will feel the water ’s touch
faster than my caress
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

and then a pain sensation

from your slow pain pathway.
These slow pathways are an ancient
development in the evolution of the nervous system
I have always been able to touch you
more slowly than hot water.

For scientists it was a complete surprise.

Though the nerves for touch
are arrayed through the muscles and skin
and transmit a message to the brain when stimulated,
Some fibers are much slower to respond
to touch than they expected
One third of my nerve fibers respond at low velocity
Only a yard a second instead of seventy yards.
But I could have told them
had they thought to ask
that indeed I am slow to respond
to pain and to gentle stroking.

Most animals have fast and slow pathways

for responding to touch,
The slow one for gentle stroking,
But scientists had long believed that humans
in the course of evolution
had retained a slow pathway for pain
but lost the slow pathway for touch
Homo fabriken, the forsaken species.

Researchers have recently investigated

in order to find out the purpose of
this slow pathway for touch,
Blocking out the fast acting fibers surgically.
The result is no pain altogether although
slow acting fibers are transmitting signals to the brain
When slow touch paths are blocked surgically
and the investigated subject is gently stroked
He or she feels an uncomfortable
burning and itching sensation
It appears that blocking slow touch pathways
leads to a distorted touch sensation
An unpleasant feeling, said the researchers
I have found this true also
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Blocking slow touch pathways

(and also avoiding them altogether)
leads to an unpleasant feeling.

Slow and fast fibers must work together

to produce pleasurable sensations
undistorted touch sensations
such as caresses, said one investigator
He said this slow touch system must somehow
also promote positive emotions
Though further research is required
to clarify the mechanisms which promote them.
These conclusions are tentative
pending experiments which are under way
to further explore the fast- and slow-acting fibers
involved in touch

He said also, according to the newspaper report

that a huge mystery remains:
How these signals are interpreted by the brain
as feelings of pleasure or pain.
While a chasm of non-investigable dimension
exists between me and this scientific method
I feel more than comradely warmth
- relief -
in the wake of these conclusions
Perhaps it could be my contribution to science
to attest that I have seen and furthermore
stepped inside this huge mystery
only to find the step is off a cliff
and the journey endless so far.

Joel Latner

Joel Latner
jlatner1@rochester.rr.com
716 385 6180 fax 716-385-0021
One Durham Way
Pittsford, New York 14534-2309 USA