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Thursday, August 22, 2024

Gestalt therapy

From Wikipedia, the free encyclopedia
https://en.wikipedia.org/wiki/Gestalt_therapy

Gestalt therapy is a form of psychotherapy that emphasizes personal responsibility and focuses on the individual's experience in the present moment, the therapist–client relationship, the environmental and social contexts of a person's life, and the self-regulating adjustments people make as a result of their overall situation. It was developed by Fritz Perls, Laura Perls and Paul Goodman in the 1940s and 1950s, and was first described in the 1951 book Gestalt Therapy.

Overview

Edwin Nevis, co-founder of the Gestalt Institute of Cleveland, founder of the Gestalt International Study Center, and faculty member at the MIT Sloan School of Management, described Gestalt therapy as "a conceptual and methodological base from which helping professionals can craft their practice". In the same volume, Joel Latner stated that Gestalt therapy is built upon two central ideas:

  1. that the most helpful focus of psychotherapy is the experiential present moment, and that everyone is caught in webs of relationships;
  2. thus, it is only possible to know ourselves against the background of our relationships to others.

The historical development of Gestalt therapy (described below) discloses the influences that generated these two ideas. Expanded, they support the four chief theoretical constructs (explained in the theory and practice section) that comprise Gestalt theory, and that guide the practice and application of Gestalt therapy.

Gestalt therapy was forged from various influences upon the lives of its founders during the times in which they lived, including the new physics, Eastern religion, existential phenomenology, Gestalt psychology, psychoanalysis, experimental theatre, systems theory, and field theory. Gestalt therapy rose from its beginnings in the middle of the 20th century to rapid and widespread popularity during the decade of the 1960s and early 1970s. During the 1970s and 80s Gestalt therapy training centers spread globally; but they were, for the most part, not aligned with formal academic settings. As the cognitive revolution eclipsed Gestalt theory in psychology, many came to believe Gestalt was an anachronism. Because Gestalt therapists disdained the positivism underlying what they perceived to be the concern of research, they largely ignored the need to use research to further develop Gestalt theory and Gestalt therapy practice (with a few exceptions like Les Greenberg; see the interview "Validating Gestalt"). However, the new century has seen a sea change in attitudes toward research and Gestalt practice. In March 2020, Vikram Kolmannskog became the world's first Professor of Gestalt Therapy at the Norwegian Gestalt Institute, where he has been teaching and researching since 2015.

Gestalt therapy is not identical to Gestalt psychology, but Gestalt psychology influenced the development of Gestalt therapy to a large extent.

Gestalt therapy focuses on process (what is actually happening) over content (what is being talked about). The emphasis is on what is being done, thought, and felt at the present moment (the phenomenality of both client and therapist), rather than on what was, might be, could be, or should have been. Gestalt therapy is a method of awareness practice (also called "mindfulness" in other clinical domains), by which perceiving, feeling, and acting are understood to be conducive to interpreting, explaining, and conceptualizing (the hermeneutics of experience). This distinction between direct experience versus indirect or secondary interpretation is developed in the process of therapy. The client learns to become aware of what they are doing and that triggers the ability to risk a shift or change.

The objective of Gestalt therapy is to enable the client to become more fully and creatively alive and to become free from the blocks and unfinished business that may diminish satisfaction, fulfillment, and growth, and to experiment with new ways of being. For this reason Gestalt therapy falls within the category of humanistic psychotherapies. As Gestalt therapy includes perception and the meaning-making processes by which experience forms, it can also be considered a cognitive approach. Also, because Gestalt therapy relies on the contact between therapist and client, and because a relationship can be considered to be contact over time, Gestalt therapy can be considered a relational or interpersonal approach. As it appreciates the larger picture which is the complex situation involving multiple influences in a complex situation, it can also be considered a multi-systemic approach. In addition, the processes of Gestalt therapy are experimental, involving action, Gestalt therapy can be considered both a paradoxical and an experiential/experimental approach.

When Gestalt therapy is compared to other clinical domains, a person can find many matches, or points of similarity. "Probably the clearest case of consilience is between gestalt therapy's field perspective and the various organismic and field theories that proliferated in neuroscience, medicine, and physics in the early and mid-20th century. Within social science there is a consilience between gestalt field theory and systems or ecological psychotherapy; between the concept of dialogical relationship and object relations, attachment theory, client-centered therapy and the transference-oriented approaches; between the existential, phenomenological, and hermeneutical aspects of gestalt therapy and the constructivist aspects of cognitive therapy; and between gestalt therapy's commitment to awareness and the natural processes of healing and mindfulness, acceptance and Buddhist techniques adopted by cognitive behavioral therapy."

Contemporary theory and practice

The theoretical foundations of Gestalt therapy essentially rests atop four "load-bearing walls": phenomenological method, dialogical relationship, field-theoretical strategies, and experimental freedom. Although all these tenets were present in the early formulation and practice of Gestalt therapy, as described in Ego, Hunger and Aggression (Perls, 1947) and in Gestalt Therapy, Excitement and Growth in the Human Personality (Perls, Hefferline, & Goodman, 1951), the early development of Gestalt therapy theory emphasized personal experience and the experiential episodes understood as "safe emergencies" or experiments. Indeed, half of the Perls, Hefferline, and Goodman book consists of such experiments. Later, through the influence of such people as Erving and Miriam Polster, a second theoretical emphasis emerged: namely, contact between self and other, and ultimately the dialogical relationship between therapist and client. Later still, field theory emerged as an emphasis. At various times over the decades, since Gestalt therapy first emerged, one or more of these tenets and the associated constructs that go with them have captured the imagination of those who have continued developing the contemporary theory of Gestalt therapy. Since 1990 the literature focused upon Gestalt therapy has flourished, including the development of several professional Gestalt journals. Along the way, Gestalt therapy theory has also been applied in Organizational Development and coaching work. And, more recently, Gestalt methods have been combined with meditation practices into a unified program of human development called Gestalt Practice, which is used by some practitioners.

Richard G. Erskine, the originator of Integrative Psychotherapy (Developmentally Based, Relationally Focused), has written about the treatment of shame and self-righteousness in "A Gestalt therapy approach to shame and self-righteousness: theory and methods“ from his book Relational Patterns, Therapeutic Presence: Concepts and Practice of Integrative Psychotherapy (2015).

Phenomenological method

The goal of a phenomenological exploration is awareness. This exploration works systematically to reduce the effects of bias through repeated observations and inquiry.

The phenomenological method comprises three steps:

  1. Applying the rule of epoché - one sets aside one's initial biases and prejudices in order to suspend expectations and assumptions.
  2. Applying the rule of description - one occupies oneself with describing instead of explaining.
  3. Applying the rule of horizontalization - one treats each item of description as having equal value or significance.

The rule of epoché sets aside any initial theories with regard to what is presented in the meeting between therapist and client. The rule of description implies immediate and specific observations, abstaining from interpretations or explanations, especially those formed from the application of a clinical theory superimposed over the circumstances of experience. The rule of horizontalization avoids any hierarchical assignment of importance such that the data of experience become prioritized and categorized as they are received. A Gestalt therapist using the phenomenological method might say something like, "I notice a slight tension at the corners of your mouth when I say that, and I see you shifting on the couch and folding your arms across your chest ... and now I see you rolling your eyes back". Of course, the therapist may make a clinically relevant evaluation, but when applying the phenomenological method, temporarily suspends the need to express it.

Dialogical relationship

To create the conditions under which a dialogic moment might occur, the therapist attends to their own presence, creates the space for the client to enter in and become present as well (called inclusion), and commits themself to the dialogic process, surrendering to what takes place, as opposed to attempting to control it. With presence, the therapist judiciously "shows up" as a whole and authentic person, instead of assuming a role, false self or persona. To be judicious, the therapist takes into account the specific strengths, weaknesses and values of the client. The only good client is a live client, so driving a client away by injudicious exposure of intolerable [to this client] experience of the therapist is obviously counter-productive. For example, for an atheistic therapist to tell a devout client that religion is myth would not be useful, especially in the early stages of the relationship. To practice inclusion is to accept however the client chooses to be present, whether in a defensive and obnoxious stance or a superficially cooperative one. To practice inclusion is to support the presence of the client, including their resistance, not as a gimmick but in full realization that this is how the client is actually present and is the best this client can do at this time. Finally, the Gestalt therapist is committed to the process, trusts in that process, and does not attempt to save themself from it.

Field-theoretical strategies

Field theory is a concept borrowed from physics in which people and events are no longer considered discrete units but as parts of something larger, which are influenced by everything including the past, and observation itself. "The field" can be considered in two ways. There are ontological dimensions and there are phenomenological dimensions to one's field. The ontological dimensions are all those physical and environmental contexts in which we live and move. They might be the office in which one works, the house in which one lives, the city and country of which one is a citizen, and so forth. The ontological field is the objective reality that supports our physical existence. The phenomenological dimensions are all mental and physical dynamics that contribute to a person's sense of self, one's subjective experience—not merely elements of the environmental context. These might be the memory of an uncle's inappropriate affection, one's color blindness, one's sense of the social matrix in operation at the office in which one works, and so forth. The way that Gestalt therapists choose to work with field dynamics makes what they do strategic. Gestalt therapy focuses upon character structure; according to Gestalt theory, the character structure is dynamic rather than fixed in nature. To become aware of one's character structure, the focus is upon the phenomenological dimensions in the context of the ontological dimensions.

Experimental freedom

Gestalt therapy is distinct because it moves toward action, away from mere talk therapy, and for this reason is considered an experiential approach. Through experiments, the therapist supports the client's direct experience of something new, instead of merely talking about the possibility of something new. Indeed, the entire therapeutic relationship may be considered experimental, because at one level it is a corrective, relational experience for many clients, and it is a "safe emergency" that is free to turn out however it will. An experiment can also be conceived as a teaching method that creates an experience in which a client might learn something as part of their growth. Examples might include:

  • Rather than talking about the client's critical parent, a Gestalt therapist might ask the client to imagine the parent is present, or that the therapist is the parent, and talk to that parent directly
  • If a client is struggling with how to be assertive, a Gestalt therapist could either:
    • have the client say some assertive things to the therapist or members of a therapy group
    • give a talk about how one should never be assertive
  • A Gestalt therapist might notice something about the non-verbal behavior or tone of voice of the client; then the therapist might have the client exaggerate the non-verbal behavior and pay attention to that experience
  • A Gestalt therapist might work with the breathing or posture of the client, and direct awareness to changes that might happen when the client talks about different content.

With all these experiments the Gestalt therapist is working with process rather than content, the how rather than the what.

Noteworthy issues

Self

In field theory, self is a phenomenological concept, existing in comparison with other. Without the other there is no self, and how one experiences the other is inseparable from how one experiences oneself. The continuity of selfhood (functioning personality) is something that is achieved in relationship, rather than something inherently "inside" the person. This can have its advantages and disadvantages. At one end of the spectrum, someone may not have enough self-continuity to be able to make meaningful relationships, or to have a workable sense of who they are. In the middle, their personality is a loose set of ways of being that work for them, including commitments to relationships, work, culture and outlook, always open to change where they need to adapt to new circumstances or just want to try something new. At the other end, their personality is a rigid defensive denial of the new and spontaneous. They act in stereotyped ways, and either induce other people to act in particular and fixed ways towards them, or they redefine their actions to fit with fixed stereotypes.

In Gestalt therapy, the process is not about the self of the client being helped or healed by the fixed self of the therapist; rather it is an exploration of the co-creation of self and other in the here-and-now of the therapy. There is no assumption that the client will act in all other circumstances as they do in the therapy situation. However, the areas that cause problems will be either the lack of self-definition leading to chaotic or psychotic behaviour, or the rigid self-definition in some area of functioning that denies spontaneity and makes dealing with particular situations impossible. Both of these conditions show up very clearly in the therapy, and can be worked with in the relationship with the therapist.

The experience of the therapist is also very much part of the therapy. Since we co-create our self-other experiences, the way a therapist experiences being with a client is significant information about how the client experiences themselves. The proviso here is that a therapist is not operating from their own fixed responses. This is why Gestalt therapists are required to undertake significant therapy of their own during training.

From the perspective of this theory of self, neurosis can be seen as fixed predictability—a fixed Gestalt—and the process of therapy can be seen as facilitating the client to become unpredictable: more responsive to what is in the client's present environment, rather than responding in a stuck way to past introjects or other learning. If the therapist has expectations of how the client should end up, this defeats the aim of therapy.

Change

In what has now become a classic of Gestalt therapy literature, Arnold R. Beisser described Gestalt's paradoxical theory of change. The paradox is that the more one attempts to be who one is not, the more one remains the same. Conversely, when people identify with their current experience, the conditions of wholeness and growth support change. Put another way, change comes about as a result of "full acceptance of what is, rather than a striving to be different."

The empty chair technique

Empty chair technique or chairwork is typically used in Gestalt therapy when a patient might have deep-rooted emotional problems from someone or something in their life, such as relationships with themselves, with aspects of their personality, their concepts, ideas, feelings, etc., or other people in their lives. The purpose of this technique is to get the patient to think about their emotions and attitudes. Common things the patient addresses in the empty chair are another person, aspects of their own personality, a certain feeling, etc., as if that thing were in that chair. They may also move between chairs and act out two or more sides of a discussion, typically involving the patient and persons significant to them. It uses a passive approach to opening up the patient's emotions and pent-up feelings so they can let go of what they have been holding back. A form of role-playing, the technique focuses on exploration of self and is used by therapists to help patients self-adjust. Gestalt techniques were originally a form of psychotherapy, but are now often used in counseling, for instance, by encouraging clients to act out their feelings helping them prepare for a new job. The purpose of the technique is so the patient will become more in touch with their feelings and have an emotional conversation that clears up any long-held feelings or reaction to the person or object in the chair.

Historical development

Fritz Perls was a German-Jewish psychoanalyst who fled Europe with his wife Laura Perls to South Africa in order to escape Nazi oppression in 1933. After World War II, the couple emigrated to New York City, which had become a center of intellectual, artistic and political experimentation by the late 1940s and early 1950s.

Early influences

Perls grew up on the bohemian scene in Berlin, participated in Expressionism and Dadaism, and experienced the turning of the artistic avant-garde toward the revolutionary left. Deployment to the front line, the trauma of war, anti-Semitism, intimidation, escape, and the Holocaust are further key sources of biographical influence.

Perls served in the German Army during World War I, and was wounded in the conflict. After the war he was educated as a medical doctor. He became an assistant to Kurt Goldstein, who worked with brain-injured soldiers. Perls went through a psychoanalysis with Wilhelm Reich and became a psychiatrist. Perls assisted Goldstein at Frankfurt University where he met his wife Lore (Laura) Posner, who had earned a doctorate in Gestalt psychology. They fled Nazi Germany in 1933 and settled in South Africa. Perls established a psychoanalytic training institute and joined the South African armed forces, serving as a military psychiatrist. During these years in South Africa, Perls was influenced by Jan Smuts and his ideas about "holism".

In 1936 Fritz Perls attended a psychoanalysts' conference in Marienbad, Czechoslovakia, where he presented a paper on oral resistances, mainly based on Laura Perls's notes on breastfeeding their children. Perls's paper was turned down. Perls did present his paper in 1936, but according to him, it met with "deep disapproval." Perls wrote his first book, Ego, Hunger and Aggression (1942, 1947), in South Africa, based in part on the rejected paper. It was later re-published in the United States. Laura Perls wrote two chapters of this book, but she was not given adequate recognition for her work.

The seminal book

Perls's seminal work was Gestalt Therapy: Excitement and Growth in the Human Personality, published in 1951, co-authored by Fritz Perls, Paul Goodman, and Ralph Hefferline (a university psychology professor and sometimes-patient of Fritz Perls). Most of Part II of the book was written by Paul Goodman from Perls's notes, and it contains the core of Gestalt theory. This part was supposed to appear first, but the publishers decided that Part I, written by Hefferline, fit into the nascent self-help ethos of the day, and they made it an introduction to the theory. Isadore From, a leading early theorist of Gestalt therapy, taught Goodman's Part II for an entire year to his students, going through it phrase by phrase.

First instances of Gestalt therapy

Fritz and Laura founded the first Gestalt Institute in 1952, running it out of their Manhattan apartment. Isadore From became a patient, first of Fritz, and then of Laura. Fritz soon made From a trainer, and also gave him some patients. From lived in New York until his death, at age seventy-five, in 1993. He was known worldwide for his philosophical and intellectually rigorous take on Gestalt therapy. Acknowledged as a supremely gifted clinician, he was indisposed to writing, so what remains of his work is merely transcripts of interviews.

Of great importance to understanding the development of Gestalt therapy is the early training which took place in experiential groups in the Perls's apartment, led by both Fritz and Laura before Fritz left for the West Coast, and after by Laura alone. These "trainings" were unstructured, with little didactic input from the leaders, although many of the principles were discussed in the monthly meetings of the institute, as well as at local bars after the sessions. Many notable Gestalt therapists emerged from these crucibles in addition to Isadore From, e.g., Richard Kitzler, Dan Bloom, Bud Feder, Carl Hodges, and Ruth Ronall. In these sessions, both Fritz and Laura used some variation of the "hot seat" method, in which the leader essentially works with one individual in front of an audience with little or no attention to group dynamics. In reaction to this omission emerged a more interactive approach in which Gestalt-therapy principles were blended with group dynamics; in 1980, the book Beyond the Hot Seat, edited by Feder and Ronall, was published, with contributions from members of both the New York and Cleveland Institutes, as well as others.

Fritz left Laura and New York in 1960, briefly lived in Miami, and ended up in California. Jim Simkin was a psychotherapist who became a client of Perls in New York and then a co-therapist with Perls in Los Angeles. Simkin was responsible for Perls's going to California, where Perls began a psychotherapy practice. Ultimately, the life of a peripatetic trainer and workshop leader was better suited to Fritz's personality—starting in 1963, Simkin and Perls co-led some of the early Gestalt workshops and training groups at Esalen Institute in Big Sur, California, where Perls eventually settled and built a home. Jim Simkin then purchased property next to Esalen and started his own training center, which he ran until his death in 1984. Simkin refined his precise version of Gestalt therapy, training psychologists, psychiatrists, counselors and social workers within a very rigorous, residential training model.

The schism

In the 1960s, Perls became infamous among the professional elite for his public workshops at Esalen Institute. Isadore From referred to some of Fritz's brief workshops as "hit-and-run" therapy, because of Perls's alleged emphasis on showmanship with little or no follow-through—but Perls never considered these workshops to be complete therapy; rather, he felt he was giving demonstrations of key points for a largely professional audience. Unfortunately, some films and tapes of his work were all that most graduate students were exposed to, along with the misperception that these represented the entirety of Perls's work.

When Fritz Perls left New York for California, there began to be a split with those who saw Gestalt therapy as a therapeutic approach similar to psychoanalysis. This view was represented by Isadore From, who practiced and taught mainly in New York, as well as by the members of the Cleveland Institute, which was co-founded by From. An entirely different approach was taken, primarily in California, by those who saw Gestalt therapy not just as a therapeutic modality, but as a way of life. The East Coast, New York–Cleveland axis was often appalled by the notion of Gestalt therapy leaving the consulting room and becoming a way of life on the West Coast in the 1960s (see the "Gestalt prayer").

An alternative view of this split saw Perls in his last years continuing to develop his a-theoretical and phenomenological methodology, while others, inspired by From, were inclined to theoretical rigor which verged on replacing experience with ideas.

The split continues between what has been called "East Coast Gestalt" and "West Coast Gestalt," at least from an Amerocentric point of view. While the communitarian form of Gestalt continues to flourish, Gestalt therapy was largely replaced in the United States by Cognitive Behavioral Therapy, and many Gestalt therapists in the U.S. drifted toward organizational management and coaching. At the same time, contemporary Gestalt Practice (to a large extent based upon Gestalt therapy theory and practice) was developed by Dick Price, the co-founder of Esalen Institute. Price was one of Perls's students at Esalen.

Post-Perls

In 1969, Fritz Perls left the United States to start a Gestalt community at Lake Cowichan on Vancouver Island, Canada. He died almost one year later, on 14 March 1970, in Chicago. One member of the Gestalt community was Barry Stevens. Her book about that phase of her life, Don't Push the River, became very popular. She developed her own form of Gestalt therapy body work, which is essentially a concentration on the awareness of body processes.

The Polsters

Erving and Miriam Polster started a training center in La Jolla, California, and published a book, Gestalt Therapy Integrated, in the 1970s.

They were influential in advancing the idea of contact boundary phenomena, which is a key part of Gestalt theory. The standard contact boundary resistances were confluence, introjection, projection, and retroflection, but the Polsters added "deflection" as a way of avoiding contact. Boundary phenomena can have good or bad effects, depending on the situation. For example, it's normal for a baby and mother to merge, but not for a therapist and client. If the therapist and client become too merged, then there can be no progress because there is no boundary for them to connect with. The client will not be able to learn anything new because the therapist will just become a part of them. 

Influences upon Gestalt therapy

Some examples

There were a variety of psychological and philosophical influences upon the development of Gestalt therapy, not the least of which were the social forces at the time and place of its inception. Gestalt therapy is an approach that is holistic (including mind, body, and culture). It is present-centered and related to existential therapy in its emphasis on personal responsibility for action, and on the value of "I–thou" relationship in therapy. In fact, Perls considered calling Gestalt therapy existential-phenomenological therapy. "The I and thou in the Here and Now" was a semi-humorous shorthand mantra for Gestalt therapy, referring to the substantial influence of the work of Martin Buber—in particular his notion of the I–Thou relationship—on Perls and Gestalt. Buber's work emphasized immediacy, and required that any method or theory answer to the therapeutic situation, seen as a meeting between two people. Any process or method that turns the patient into an object (the I–It) must be strictly secondary to the intimate, and spontaneous, I–Thou relation. This concept became important in much of Gestalt theory and practice.

Both Fritz and Laura Perls were students and admirers of the neuropsychiatrist Kurt Goldstein. Gestalt therapy was based in part on Goldstein's concept called Organismic theory. Goldstein viewed a person in terms of a holistic and unified experience; he encouraged a "big picture" perspective, taking into account the whole context of a person's experience. The word Gestalt means whole, or configuration. Laura Perls, in an interview, denotes the Organismic theory as the base of Gestalt therapy.

There were additional influences on Gestalt therapy from existentialism, particularly the emphasis upon personal choice and responsibility.

The late 1950s–1960s movement toward personal growth and the human potential movement in California fed into, and was itself influenced by, Gestalt therapy. In this process Gestalt therapy somehow became a coherent Gestalt, which is the Gestalt psychology term for a perceptual unit that holds together and forms a unified whole.

Psychoanalysis

Fritz Perls trained as a neurologist at major medical institutions and as a Freudian psychoanalyst in Berlin and Vienna, the most important international centers of the discipline in his day. He worked as a training analyst for several years with the official recognition of the International Psychoanalytic Association (IPA), and must be considered an experienced clinician. Gestalt therapy was influenced by psychoanalysis: it was part of a continuum moving from the early work of Freud, to the later Freudian ego analysis, to Wilhelm Reich and his character analysis and notion of character armor, with attention to nonverbal behavior; this was consonant with Laura Perls's background in dance and movement therapy. To this was added the insights of academic Gestalt psychology, including perception, Gestalt formation, and the tendency of organisms to complete an incomplete Gestalt and to form "wholes" in experience.

Central to Fritz and Laura Perls's modifications of psychoanalysis was the concept of dental or oral aggression. In Ego, Hunger and Aggression (1947), Fritz Perls's first book, to which Laura Perls contributed (ultimately without recognition), Perls suggested that when the infant develops teeth, he or she has the capacity to chew, to break food apart, and, by analogy, to experience, taste, accept, reject, or assimilate. This was opposed to Freud's notion that only introjection takes place in early experience. Thus Perls made assimilation, as opposed to introjection, a focal theme in his work, and the prime means by which growth occurs in therapy.

In contrast to the psychoanalytic stance, in which the "patient" introjects the (presumably more healthy) interpretations of the analyst, in Gestalt therapy the client must "taste" his or her own experience and either accept or reject it—but not introject or "swallow whole." Hence, the emphasis is on avoiding interpretation, and instead encouraging discovery. This is the key point in the divergence of Gestalt therapy from traditional psychoanalysis: growth occurs through gradual assimilation of experience in a natural way, rather than by accepting the interpretations of the analyst; thus, the therapist should not interpret, but lead the client to discover for him- or herself.

The Gestalt therapist contrives experiments that lead the client to greater awareness and fuller experience of his or her possibilities. Experiments can be focused on undoing projections or retroflections. The therapist can work to help the client with closure of unfinished Gestalts ("unfinished business" such as unexpressed emotions towards somebody in the client's life). There are many kinds of experiments that might be therapeutic, but the essence of the work is that it is experiential rather than interpretive, and in this way, Gestalt therapy distinguishes itself from psychoanalysis.

Principal influences: a summary list

Therapies influenced by Gestalt therapy

Psychotherapies influenced by Gestalt therapy include:

Current status

Gestalt therapy reached a zenith in the United States in the late 1970s and early 1980s. Since then, it has influenced other fields like organizational development, coaching, and teaching. Many of its contributions have become assimilated into other schools of therapy. In recent years, it has seen a resurgence in popularity as an active, psychodynamic form of therapy which has also incorporated some elements of recent developments in attachment theory. There are, for example, four Gestalt training institutes in the New York City metropolitan area alone, in addition to dozens of others worldwide.

Gestalt therapy continues to thrive as a widespread form of psychotherapy, especially throughout Europe, where there are many practitioners and training institutions. Dan Rosenblatt led Gestalt therapy training groups and public workshops at the Tokyo Psychotherapy Academy for seven years. Stewart Kiritz continued in this role from 1997 to 2006.

Training of Gestalt therapists

Pedagogical approach

Many Gestalt therapy training organizations exist worldwide. Ansel Woldt asserted that Gestalt teaching and training are built upon the belief that people are, by nature, health-seeking. Thus, such commitments as authenticity, optimism, holism, health, and trust become important principles to consider when engaged in the activity of teaching and learning—especially Gestalt therapy theory and practice.

Associations

The Association for the Advancement of Gestalt Therapy holds a biennial international conference in various locations—the first was in New Orleans, in 1995. Subsequent conferences have been held in San Francisco, Cleveland, New York, Dallas, St. Pete's Beach, Vancouver (British Columbia), Manchester (England), and Philadelphia. In addition, the it holds regional conferences, and its regional network has spawned regional conferences in Amsterdam, the Southwest and the Southeast of the United States, England, and Australia. Its Research Task Force generates and nurtures active research projects and an international conference on research.

The European Association for Gestalt Therapy, founded in 1985 to gather European individual Gestalt therapists, training institutes, and national associations from more than twenty European nations.

Gestalt Australia and New Zealand was formally established at the first Gestalt Therapy Conference held in Perth in September 1998.

Limitations

it has been shown that Gestalt Therapy is neither designed nor intended for treatment of young adolescents, especially those who manifest severe psychiatric or behavioral disorders.

Social semiotics

From Wikipedia, the free encyclopedia

Social semiotics (also social semantics) is a branch of the field of semiotics which investigates human signifying practices in specific social and cultural circumstances, and which tries to explain meaning-making as a social practice. Semiotics, as originally defined by Ferdinand de Saussure, is "the science of the life of signs in society". Social semiotics expands on Saussure's founding insights by exploring the implications of the fact that the "codes" of language and communication are formed by social processes. The crucial implication here is that meanings and semiotic systems are shaped by relations of power, and that as power shifts in society, our languages and other systems of socially accepted meanings can and do change.

Overview

Social semiotics is the study of the social dimensions of meaning, and of the power of human processes of signification and interpretation (known as semiosis) in shaping individuals and societies. Social semiotics focuses on social meaning-making practices of all types, whether visual, verbal or aural in nature. These different systems for meaning-making, or possible "channels" (e.g. speech, writing, images) are known as semiotic modes (or semiotic registers). Semiotic modes can include visual, verbal, written, gestural and musical resources for communication. They also include various "multimodal" ensembles of any of these modes 

Social semiotics can include the study of how people design and interpret meanings, the study of texts, and the study of how semiotic systems are shaped by social interests and ideologies, and how they are adapted as society changes (Hodge and Kress, 1988). Structuralist semiotics in the tradition of Ferdinand de Saussure focused primarily on theorising semiotic systems or structures (termed langue by de Saussure, which change diachronically, i.e. over longer periods of time). In contrast, social semiotics tries to account for the variability of semiotic practices termed parole by Saussure. This altered focus shows how individual creativity, changing historical circumstances, and new social identities and projects can all change patterns of usage and design (Hodge and Kress, 1988). From a social semiotic perspective, rather than being fixed into unchanging "codes", signs are considered to be resources which people use and adapt (or "design") to make meaning. In these respects, social semiotics was influenced by, and shares many of the preoccupations of pragmatics (Charles W. Morris) and sociolinguistics and has much in common with cultural studies and critical discourse analysis.

The main task of social semiotics is to develop analytical and theoretical frameworks which can explain meaning-making in a social context.

Halliday and the social semiotic in language

Linguistic theorist, Michael Halliday, introduced the term ‘social semiotics’ into linguistics, when he used the phrase in the title of his book, Language as Social Semiotic. This work argues against the traditional separation between language and society, and exemplifies the start of a 'semiotic' approach, which broadens the narrow focus on written language in linguistics (1978). For Halliday, languages evolve as systems of "meaning potential" (Halliday, 1978:39) or as sets of resources which influence what the speaker can do with language, in a particular social context. For example, for Halliday, the grammar of the English language is a system organised for the following three purposes (areas or "metafunctions"):

  • Facilitating certain kinds of social and interpersonal interactions (interpersonal),
  • Representing ideas about the world (ideational), and
  • Connecting these ideas and interactions into meaningful texts and making them relevant to their context (textual) (1978:112).

Any sentence in English is composed like a musical composition, with one strand of its meaning coming from each of the three semiotic areas or metafunctions. Bob Hodge generalises Halliday’s essays on social semiotics into five premises:

  1. ‘Language is a social fact’ (1978:1)
  2. ‘We shall not come to understand the nature of language if we pursue only the kinds of question about language that are formulated by linguists’ (1978:3)
  3. ‘Language is as it is because of the functions it has evolved to serve in people’s lives’ (1978:4).
  4. Language has ‘metafunctions’, which in English are: ideational (‘about something’), interpersonal (’doing something’) and textual (‘the speaker’s text-forming potential’) (1978:112).
  5. Language is constituted as ‘a discrete network of options’ (1978:113)

Social semiotics and critical linguistics

Robert Hodge and Gunther Kress's Social Semiotics (1988) focused on the uses of semiotic systems in social practice. They explain that the social power of texts in society depends on interpretation: "Each producer of a message relies on its recipients for it to function as intended." (1988:4) This process of interpretation (semiosis) situates individual texts within discourses, the exchanges of interpretative communities. The work of interpretation can contest the power of hegemonic discourses. Hodge and Kress give the example of feminist activists defacing a sexist advertising billboard, and spray-painting it with a new, feminist message.

"Text is only a trace of discourses, frozen and preserved, more or less reliable or misleading. Yet discourse disappears too rapidly, surrounding a flow of texts." (1988:8)

Hodge and Kress built on a range of traditions from linguistics (including Noam Chomsky, Michael Halliday, Benjamin Lee Whorf and sociolinguistics), but the major impetus for their work is the critical perspective on ideology and society that originates with Marx.

Hodge and Kress build a notion of semiosis as a dynamic process, where meaning is not determined by rigid structures, or predefined cultural codes. They argue that Ferdinand de Saussure's structuralist semiotics avoided addressing questions about creativity, movement, and change in language, possibly in reaction to the diachronic linguistic traditions of his time (the focus on the historical development from Indo-European). This created a "problematic" legacy, with linguistic change relegated to the "contents of Saussure’s rubbish bin" (1988:16-17).

Instead, Hodge and Kress propose to account for change in semiosis through the work of Charles Sanders Peirce. Meaning is a process, in their interpretation of Peirce. They refer to Peirce's triadic model of semiosis, which depicts the "action" of a sign as a limitless process of infinite semiosis, where one "interpretant" (or idea linked to a sign) generates another. The flow of these infinite processes of interpretation are constrained in Peirce's model, they claim, by the material world (the "object"), and cultural rules of thought, or "habit". (1988:20)

Social semiotics revisits De Saussure's doctrine of the "arbitrariness of the linguistic sign". This notion rests on the argument that the signifier only has an arbitrary relationship to the signified) — in other words, that there is nothing about the sound or appearance of (verbal) signifiers (as, for example, the words "dog" or "chien") — to suggest what they signify. Hodge and Kress point out that questions of the referent become more complicated when semiotics moves beyond verbal language. On the one hand, there is the need to account for the continuum of relationships between the referent and the representation. Here, they draw on Pierce's differentiation between iconic signification (e.g. a colour photograph of smoke, where the signifier recreates the perceptual experience of the signified), indexical signification (e.g. a column of smoke, where there is a causal relationship between the physical signifier and the fire it might signify), and symbolic signification (e.g. the word "smoke", where the arbitrary link between signifier and signified is maintained by social convention).

Social semiotics also addresses the question of how societies and cultures maintain or shift these conventional bonds between signifier and signified. De Saussure was unwilling to answer this question, Hodge and Kress claim. This leaves the socially determinist implication that meanings and interpretations are dictated from above, by "the whims of an inscrutably powerful collective being, Society." For Hodge and Kress, social semiotics must respond to the question and explain how the social shaping of meanings works in practice (1988:22).

Social semiotics and multimodality

Social semiotics is currently extending this general framework beyond its linguistic origins to account for the growing importance of sound and visual images, and how modes of communication are combined in both traditional and digital media (semiotics of social networking) (see, for example, Kress and van Leeuwen, 1996), thus approaching semiotics of culture (Randviir 2004). Theorists such as Gunther Kress and Theo van Leeuwen have built on Halliday's framework by providing new "grammars" for other semiotic modes. Like language, these grammars are seen as socially formed and changeable sets of available "resources" for making meaning, which are also shaped by the semiotic metafunctions originally identified by Halliday. The visual and aural modes have received particular attention. Accounting for multimodality (communication in and across a range of semiotic modes - verbal, visual, and aural) is considered a particularly important ongoing project, given the importance of the visual mode in contemporary communication.

In the field of graphic design, the multimodal and social semiotic viewpoint can be perceived as an illustration that connects our sensory abilities together opening up new opportunities for deeper visual interaction. Utilizing this design process, the graphic designers create content which helps improvise the act of meaningful visual communication between the content creators and their audiences.

Viktor Frankl

From Wikipedia, the free encyclopedia
 
Viktor Frankl
Frankl in 1965
Born
Viktor Emil Frankl

26 March 1905
Died2 September 1997 (aged 92)
Vienna, Austria
Resting placeVienna Central Cemetery
Alma materUniversity of Vienna (MD, 1930; PhD, 1948)
Occupation(s)neurologist, psychologist, philosopher, and author
Known forLogotherapy
Existential analysis
Spouse(s)Tilly Grosser, m. 1941 – c. 1944–1945 (her death)
Eleonore Katharina Schwindt, m. 1947
Children1 daughter

Viktor Emil Frankl (26 March 1905 – 2 September 1997) was an Austrian neurologist, psychologist, philosopher, and Holocaust survivor, who founded logotherapy, a school of psychotherapy that describes a search for a life's meaning as the central human motivational force. Logotherapy is part of existential and humanistic psychology theories.

Logotherapy was promoted as the third school of Viennese Psychotherapy, after those established by Sigmund Freud, and Alfred Adler.

Frankl published 39 books. The autobiographical Man's Search for Meaning, a best-selling book, is based on his experiences in various Nazi concentration camps.

Early life

Frankl was born the middle of three children to Gabriel Frankl, a civil servant in the Ministry of Social Service, and Elsa (née Lion), a Jewish family, in Vienna, in what was then the Austro-Hungarian Empire. His interest in psychology and the role of meaning developed when he began taking night classes on applied psychology while in junior high school. As a teenager, he began a correspondence with Sigmund Freud upon asking for permission to publish one of his papers. After graduation from high school in 1923, he studied medicine at the University of Vienna.

In 1924, Frankl's first scientific paper was published in the Internationale Zeitschrift für Psychoanalyse. In the same year, he was president of the Sozialistische Mittelschüler Österreich, the Social Democratic Party of Austria's youth movement for high school students. Frankl's father was a socialist who named him after Viktor Adler, the founder of the party. During this time, Frankl began questioning the Freudian approach to psychoanalysis. He joined Alfred Adler's circle of students and published his second academic paper, "Psychotherapy and Worldview" ("Psychotherapie und Weltanschauung"), in Adler's International Journal of Individual Psychology in 1925. Frankl was expelled from Adler's circle when he insisted that meaning was the central motivational force in human beings. From 1926, he began refining his theory, which he termed logotherapy.

Career

Psychiatry

Between 1928 and 1930, while still a medical student, he organized youth counselling centers to address the high number of teen suicides occurring around the time of end-of-the-year report cards. The program was sponsored by the city of Vienna and free of charge to the students. Frankl recruited other psychologists for the center, including Charlotte Bühler, Erwin Wexberg, and Rudolf Dreikurs. In 1931, not a single Viennese student died by suicide.

After earning his M.D. in 1930, Frankl gained extensive experience at Steinhof Psychiatric Hospital, where he was responsible for the treatment of suicidal women. In 1937, he began a private practice, but the Nazi annexation of Austria in 1938 limited his opportunity to treat patients. In 1940, he joined Rothschild Hospital, the only hospital in Vienna still admitting Jews, as head of the neurology department. Prior to his deportation to the concentration camps, he helped numerous patients avoid the Nazi euthanasia program that targeted the mentally disabled.

In 1942, just nine months after his marriage, Frankl and his family were sent to the Theresienstadt concentration camp. His father died there of starvation and pneumonia. In 1944, Frankl and his surviving relatives were transported to Auschwitz, where his mother and brother were murdered in the gas chambers. His wife Tilly died later of typhus in Bergen-Belsen. Frankl spent three years in four concentration camps.

Following the war, he became head of the neurology department of the General Polyclinic Vienna hospital, and established a private practice in his home. He worked with patients until his retirement in 1970.

In 1948, Frankl earned a PhD in philosophy from the University of Vienna. His dissertation, The Unconscious God, examines the relationship between psychology and religion, and advocates for the use of the Socratic dialogue (self-discovery discourse) for clients to get in touch with their spiritual unconscious.

Grave of Viktor Frankl in Vienna

In 1955, Frankl was awarded a professorship of neurology and psychiatry at the University of Vienna, and, as visiting professor, lectured at Harvard University (1961), Southern Methodist University, Dallas (1966), and Duquesne University, Pittsburgh (1972).

Throughout his career, Frankl argued that the reductionist tendencies of early psychotherapeutic approaches dehumanised the patient, and advocated for a rehumanisation of psychotherapy.

The American Psychiatric Association awarded Frankl the 1985 Oskar Pfister Award for his contributions to religion and psychiatry.

Man's Search for Meaning

While head of the Neurological Department at the general Polyclinic Hospital, Frankl wrote Man's Search for Meaning over a nine-day period. The book, originally titled A Psychologist Experiences the Concentration Camp, was released in German in 1946. The English translation of Man's Search for Meaning was published in 1959, and became an international bestseller. Frankl saw this success as a symptom of the "mass neurosis of modern times," since the title promised to deal with the question of life's meaningfulness. Millions of copies were sold in dozens of languages. In a 1991 survey conducted for the Library of Congress and the Book of the Month Club, Man's Search for Meaning was named one of the ten most influential books in the US.

Logotherapy and existential analysis

Frankl developed logotherapy and existential analysis, which are based on philosophical and psychological concepts, particularly the desire to find a meaning in life and free will. Frankl identified three main ways of realizing meaning in life: by making a difference in the world, by having particular experiences, or by adopting particular attitudes.

The primary techniques offered by logotherapy and existential analysis are:

  • Paradoxical intention: clients learn to overcome obsessions or anxieties by self-distancing and humorous exaggeration.
  • Dereflection: drawing the client's attention away from their symptoms, as hyper-reflection can lead to inaction.
  • Socratic dialogue and attitude modification: asking questions designed to help a client find and pursue self-defined meaning in life.

His acknowledgement of meaning as a central motivational force and factor in mental health is his lasting contribution to the field of psychology. It provided the foundational principles for the emerging field of positive psychology. Frankl's work has also been endorsed in the Chabad philosophy of Hasidic Judaism.

Statue of Responsibility

In Man's Search for Meaning, Frankl states:

Freedom, however, is not the last word. Freedom is only part of the story and half of the truth. Freedom is but the negative aspect of the whole phenomenon whose positive aspect is responsibleness. In fact, freedom is in danger of degenerating into mere arbitrariness unless it is lived in terms of responsibleness. That is why I recommend that the Statue of Liberty on the East Coast be supplemented by a Statue of Responsibility on the West Coast.

Frankl's concept for the statue grew in popularity, and drew the affection of Stephen Covey, author of The 7 Habits of Highly Effective People. Covey teamed up with Kevin Hall to push the idea of the statue forward in the 1990s, and eventually commissioned the sculptor Gary Lee Price who came up with the concept of two hands clasped together. The design was approved by Frankl's widow, and they began looking for a location to construct it. Their first choice was California, to have it in a Pacific Ocean harbour to complement the Statue of Liberty's position in the Atlantic harbour of New York. However, the state regulations proved difficult to navigate, and the governor of Utah, Spencer Cox, suggested a location in his state for the project, which was approved in 2023. Construction has not yet started.

Controversy

"Auschwitz survivor" testimony

In The Missing Pieces of the Puzzle: A Reflection on the Odd Career of Viktor Frankl, Professor of history Timothy Pytell of California State University, San Bernardino, conveys the numerous discrepancies and omissions in Frankl's "Auschwitz survivor" account and later autobiography, which many of his contemporaries, such as Thomas Szasz, similarly have raised. In Frankl's Man's Search for Meaning, the book devotes approximately half of its contents to describing Auschwitz and the psychology of its prisoners, suggesting a long stay at the death camp. However his wording is contradictory and, according to Pytell, "profoundly deceptive", as contrary to the impression Frankl gives of staying at Auschwitz for months, he was held close to the train, in the "depot prisoner" area of Auschwitz, and for no more than a few days. Frankl was neither registered at Auschwitz nor assigned a number there before being sent on to a subsidiary work camp of Dachau, known as Kaufering III, that (together with Terezín) is the true setting of much of what is described in his book.

Origins and implications of logotherapy

Frankl's doctrine was that one must instill meaning in the events in one's life, and that work and suffering can lead to finding meaning, with this ultimately what would lead to fulfillment and happiness. In 1982 the scholar and Holocaust analyst Lawrence L. Langer, critical of what he called Frankl's distortions of the true experience of those at Auschwitz, and of Frankl's amoral focus on "meaning", that in Langer's assessment could just as equally be applied to Nazis "finding meaning in making the world free from Jews", went on to write that "if this [logotherapy] doctrine had been more succinctly worded, the Nazis might have substituted it for the cruel mockery of Arbeit Macht Frei" ["work sets free", read by those entering Auschwitz]. In Pytell's view, Langer also penetrated through Frankl's disturbing subtext that Holocaust "survival [was] a matter of mental health." Langer criticized Frankl's tone as self-congratulatory and promotional throughout, so that "it comes as no surprise to the reader, as he closes the volume, that the real hero of Man's Search for Meaning is not man, but Viktor Frankl" by the continuation of the same fantasy of world-view meaning-making, which is precisely what had perturbed civilization into the holocaust-genocide of this era and others.

Pytell later would remark on the particularly sharp insight of Langer's reading of Frankl's Holocaust testimony, stating that with Langer's criticism published in 1982 before Pytell's biography, the former had thus drawn the controversial parallels, or accommodations in ideology without the knowledge that Victor Frankl was an advocate/"embraced" the key ideas of the Nazi psychotherapy movement ("will and responsibility") as a form of therapy in the late 1930s. When at that time Frankl would submit a paper and contributed to the Göring institute in Vienna 1937 and again in early 1938 connecting the logotherapy focus on "world-view" to the "work of some of the leading Nazi psychotherapists", both at a time before Austria was annexed by Nazi Germany in 1938. Frankl's founding logotherapy paper, was submitted to and published in the Zentrallblatt fuer Psychotherapie [sic] the journal of the Goering Institute, a psychotherapy movement, with the "proclaimed agenda of building psychotherapy that affirmed a Nazi-oriented worldview".

The origins of logotherapy, as described by Frankl, were therefore a major issue of continuity that Pytell argues were potentially problematic for Frankl because he had laid out the main elements of logotherapy while working for/contributing to the Nazi-affiliated Göring Institute. Principally Frankl's 1937 paper, that was published by the institute. This association, as a source of controversy, that logotherapy was palatable to Nazism is the reason Pytell suggests, Frankl took two different stances on how the concentration-camp experience affected the course of his psychotherapy theory. Namely, that within the original English edition of Frankl's most well known book, Man's Search for Meaning, the suggestion is made and still largely held that logotherapy was itself derived from his camp experience, with the claim as it appears in the original edition, that this form of psychotherapy was "not concocted in the philosopher's armchair nor at the analyst's couch; it took shape in the hard school of air-raid shelters and bomb craters; in concentration camps and prisoner of war camps." Frankl's statements however to this effect would be deleted from later editions, though in the 1963 edition, a similar statement again appeared on the back of the book jacket of Man's Search for Meaning.

Frankl over the years would with these widely read statements and others, switch between the idea that logotherapy took shape in the camps to the claim that the camps merely were a testing ground of his already preconceived theories. An uncovering of the matter would occur in 1977 with Frankl revealing on this controversy, though compounding another, stating "People think I came out of Auschwitz with a brand-new psychotherapy. This is not the case."

Jewish relations and experiments on the resistance

In the post war years, Frankl's attitude towards not pursuing justice nor assigning collective guilt to the Austrian people for collaborating with or acquiescing in the face of Nazism, led to "frayed" relationships between Frankl, many Viennese and the larger American Jewish community, such that in 1978 when attempting to give a lecture at the institute of Adult Jewish Studies in New York, Frankl was confronted with an outburst of boos from the audience and was called a "nazi pig". Frankl supported forgiveness and held that many in Germany and Austria were powerless to do anything about the atrocities which occurred and could not be collectively blamed.

In 1988 Frankl would further "stir up sentiment against him" by being photographed next to and in accepting the Great Silver Medal with Star for Services to the Republic of Austria as a Holocaust survivor, from President Waldheim, a controversial president of Austria who concurrent with the medal ceremony, was gripped by revelations that he had lied about his WWII military record and was under investigation for complicity in Nazi War crimes. It was later concluded that he was not involved in war crimes but had knowledge of them. Frankl's acceptance of the medal was viewed by many in the international Jewish community as a betrayal.

In his "Gutachten" Gestapo profile, Frankl is described as "politically perfect" by the Nazi secret police, with Frankl's membership in the Austro-fascist "Fatherland Front" in 1934, similarly stated in isolation. It has been suggested that as a state employee in a hospital he was likely automatically signed up to the party regardless of whether he wanted to or not. Frankl was interviewed twice by the secret police during the war, yet nothing of the expected contents, the subject of discussion or any further information on these interviews, is contained in Frankl's file, suggesting to biographers that Frankl's file was "cleansed" sometime after the war.

None of Frankl's obituaries mention the unqualified and unskilled brain lobotomy and trepanation medical experiments approved by the Nazis that Frankl performed on Jews who had committed suicide with an overdose of sedatives, in resistance to their impending arrest, imprisonment and enforced labour in the concentration camp system. The goal of these experiments were to try and revive those who had killed themselves, Frankl justified this by saying that he was trying to find ways to save the lives of Jews. Operating without any training as a surgeon, Frankl would voluntarily request of the Nazis to perform the experiments on those who had killed themselves, and once approved – published some of the details on his experiments, the methods of insertion of his chosen amphetamine drugs into the brains of these individuals, resulting in, at times, an alleged partial resuscitation, mainly in 1942 (prior to his own internment at Theresienstadt ghetto in September, later in that year). Historian Günter Bischof of Harvard University, suggests Frankl's approaching and requesting to perform lobotomy experiments could be seen as a way to "ingratiate" himself amongst the Nazis, as the latter were not, at that time, appreciative of the international scrutiny that these suicides were beginning to create, nor "suicide" being listed on arrest records.

Response to Timothy Pytell

Timothy Pytell's critique towards Viktor Frankl was used by Holocaust denier Theodore O'Keefe, according to Alexander Batthyány. Batthyány was a researcher and member of staff of the Viktor Frankl Archive in Vienna. Throughout the first chapter of his book Viktor Frankl and the Shoah, he reflects on Pytell's work about Frankl, and the flaws in it. Batthyány points out that Pytell never visited the archive to consult primary sources from the person about whom he was writing. Batthyány also critiques Pytell for not interviewing Viktor Frankl while Frankl was still alive. Pytell wrote in his book on Frankl that he had the opportunity to meet him – as a friend offered it – yet he decided that he could not meet Frankl.

Decorations and awards

Personal life

In 1941, Frankl married Tilly Grosser, who was a station nurse at Rothschild Hospital. Soon after they were married she became pregnant, but they were forced to abort the child. Tilly died in the Bergen Belsen concentration camp.

Frankl's father, Gabriel, originally from Pohořelice, Moravia, died in the Theresienstadt Ghetto concentration camp on 13 February 1943, aged 81, from starvation and pneumonia. His mother and brother, Walter, were both killed in Auschwitz. His sister, Stella, escaped to Australia.

In 1947, Frankl married Eleonore "Elly" Katharina Schwindt. She was a practicing Catholic. The couple respected each other's religious backgrounds, both attending church and synagogue, and celebrating Christmas and Hanukkah. They had one daughter, Gabriele, who went on to become a child psychologist. Although it was not known for 50 years, his wife and son-in-law reported after his death that he prayed every day and had memorized the words of daily Jewish prayers and psalms.

Frankl died of heart failure in Vienna on 2 September 1997. He is buried in the Jewish section of the Vienna Central Cemetery.

Existential psychotherapy

From Wikipedia, the free encyclopedia
https://en.wikipedia.org/wiki/Existential_therapy

Existential psychotherapy is a form of psychotherapy based on the model of human nature and experience developed by the existential tradition of European philosophy. It focuses on concepts that are universally applicable to human existence including death, freedom, responsibility, and the meaning of life. Instead of regarding human experiences such as anxiety, alienation and depression as implying the presence of mental illness, existential psychotherapy sees these experiences as natural stages in a normal process of human development and maturation. In facilitating this process of development and maturation existential psychotherapy involves a philosophical exploration of an individual's experiences while stressing the individual's freedom and responsibility to facilitate a higher degree of meaning and well-being in his or her life.

Background

The philosophers who are especially pertinent to the development of existential psychotherapy are those whose works were directly aimed at making sense of human existence. For example, the fields of phenomenology and existential philosophy are especially and directly responsible for the generation of existential therapy.

The starting point of existential philosophy (see Warnock 1970; Macquarrie 1972; Mace 1999; van Deurzen and Kenward 2005) can be traced back to the nineteenth century and the works of Søren Kierkegaard and Friedrich Nietzsche. Their works conflicted with the predominant ideologies of their time and committed to the exploration of reality as it can be experienced in a passionate and personal manner.

Søren Kierkegaard (1813–1855)

Soren Kierkegaard (1813–1855) protested vehemently against popular misunderstanding and abuse of Christian dogma and the so-called 'objectivity' of science (Kierkegaard, 1841, 1844). He thought that both were ways of avoiding the anxiety inherent in human existence. He had great contempt for the way life was lived by those around him and believed truth could only be discovered subjectively by the individual in action. He felt people lacked the courage to take a leap of faith and live with passion and commitment from the inward depth of existence. This involved a constant struggle between the finite and infinite aspects of our nature as part of the difficult task of creating a self and finding meaning. As Kierkegaard lived by his word, he was lonely and much ridiculed during his lifetime.

Friedrich Nietzsche (1844–1900)

Friedrich Nietzsche (1844–1900) took this philosophy of life a step further. His starting point was the notion that God is dead, that is, the idea of God was outmoded and limiting (Nietzsche, 1861, 1874, 1886). Furthermore, the Enlightenment—with the newfound faith in reason and rationality—had killed or replaced God with a new Truth that was perhaps more pernicious than the one it replaced. Science and rationality were the new "God," but instead took the form of a deity that was colder and less comforting than before. Nietzsche exerted a significant impact upon the development of psychology in general, but he specifically influenced an approach which emphasized an understanding of life from a personal perspective. In exploring the various needs of the individual about the ontological conditions of being, Nietzsche asserted that all things are in a state of "ontological privation," in which they long to become more than they are. This state of deprivation has major implications for the physiological and psychological needs of the individual.

Edmund Husserl (1859–1938)

While Kierkegaard and Nietzsche drew attention to the human issues that needed to be addressed, Edmund Husserl's phenomenology (Husserl, 1960, 1962; Moran, 2000) provided the method to address them rigorously. He contended that natural sciences assume the separateness of subject and object and that this kind of dualism can only lead to error. He proposed a whole new mode of investigation and understanding of the world and our experience of it. He said that prejudice has to be put aside or 'bracketed,' for us to meet the world afresh and discover what is absolutely fundamental, and only directly available to us through intuition. If people want to grasp the essence of things, instead of explaining and analyzing them, they have to learn to describe and understand them.

Max Scheler (1874-1928)

Max Scheler (1874-1928) developed philosophical anthropology from a material ethic of values ("Materielle Wertethik") that opposed Immanuel Kant's ethics of duty ("Pflichtethik"). He described a hierarchical system of values that further developed phenomenological philosophy. Scheler described the human psyche as being composed of four layers analogous to the layers of organic nature. However, in his description, the human psyche is opposed by the principle of the human spirit. Scheler's philosophy forms the basis of Viktor Frankl's logotherapy and existential analysis.

Martin Heidegger (1889–1976)

Martin Heidegger (1889–1976) applied the phenomenological method to understanding the meaning of being (Heidegger, 1962, 1968). He argued that poetry and deep philosophical thinking could bring greater insight into what it means to be in the world than what can be achieved through scientific knowledge. He explored human beings in the world in a manner that revolutionized classical ideas about the self and psychology. He recognized the importance of time, space, death, and human relatedness. He also favored hermeneutics, an old philosophical method of investigation, which is the art of interpretation.

Unlike interpretation as practiced in psychoanalysis (which consists of referring a person's experience to a pre-established theoretical framework), this kind of interpretation seeks to understand how the person himself/herself subjectively experiences something.

Jean-Paul Sartre (1905–1980)

Jean-Paul Sartre (1905–1980) contributed many other strands of existential exploration, particularly regarding emotions, imagination, and the person's insertion into a social and political world.

The philosophy of existence, on the contrary, is carried by a wide-ranging literature, which includes many authors, such as Karl Jaspers (1951, 1963), Paul Tillich, Martin Buber, and Hans-Georg Gadamer within the Germanic tradition and Albert Camus, Gabriel Marcel, Paul Ricoeur, Maurice Merleau-Ponty, Simone de Beauvoir and Emmanuel Lévinas within the French tradition (see for instance Spiegelberg, 1972, Kearney, 1986 or van Deurzen-Smith, 1997).

Others

From the start of the 20th century, some psychotherapists were, however, inspired by phenomenology and its possibilities for working with people.

  • Otto Rank (1884–1939), an Austrian psychoanalyst who broke with Freud in the mid-1920s, was the first existential therapist.
  • Ludwig Binswanger, in Switzerland, also attempted to bring existential insights to his work with patients, in the Kreuzlingen sanatorium where he was a psychiatrist.
    • Much of his work was translated into English during the 1940s and 1950s and, together with the immigration to the USA of Paul Tillich (1886–1965) (Tillich, 1952) and others, this had a considerable effect on the popularization of existential ideas as a basis for therapy (Valle and King, 1978; Cooper, 2003).
  • Rollo May (1909–1994) played an important role in this, and his writing (1969, 1983; May et al., 1958) kept the existential influence alive in America, leading eventually to a specific formulation of therapy (Bugental, 1981; May and Yalom, 1985; Yalom, 1980).
  • Viktor Frankl (1905–1997) was possibly the individual most responsible for spreading existential psychology throughout the world. He was invited by over 200 universities worldwide and accomplished over 80 journeys to North America alone, first invited by Gordon Allport at Harvard University.
  • In Europe, after Otto Rank, existential ideas were combined with some psychoanalytic principles and a method of existential analysis was developed by Medard Boss (1903–1990) (1957a, 1957b, 1979) in close co-operation with Heidegger.
  • In France, the ideas of Sartre (1956, 1962) and Merleau-Ponty (1962) and of some practitioners (Minkowski, 1970) were important and influential, but no specific therapeutic method was developed from them.

Development

Development in Europe

The European School of existential analysis is dominated by two forms of therapy: Logotherapy, and Daseinsanalysis. Logotherapy was developed by psychiatrist Viktor E. Frankl. Frankl was heavily influenced by existential philosophy, as well as his own experience in the Nazi concentration camps of World War II. The three main components to Logotherapy are Freedom of Will, which is the ability to change one's life to the degree that such change is possible, Will to Meaning, which places meaning at the center of well-being, and Meaning in Life, which asserts the objectivity of meaning. The primary techniques of Logotherapy involve helping the clients to identify and remove any barriers to the pursuit of meaning in their own lives, to determine what is personally meaningful, and to then help patients effectively pursue related goals.

Daseinsanalysis is a psychotherapeutic system developed upon the ideas of Martin Heidegger, as well as the psychoanalytic theories of Sigmund Freud, that seeks to help the individual find autonomy and meaning in their "being in the world" (a rough translation of "Dasein").

Development in Britain

Britain became a fertile ground for further development of the existential approach when R. D. Laing and David Cooper, often associated with the anti-psychiatry movement, took Sartre's existential ideas as the basis for their work (Laing, 1960, 1961; Cooper, 1967; Laing and Cooper, 1964). Without developing a concrete method of therapy, they critically reconsidered the notion of mental illness and its treatment. In the late 1960s, they established an experimental therapeutic community at Kingsley Hall in the East End of London, where people could come to live through their 'madness' without the usual medical treatment. They also founded the Philadelphia Association, an organization providing an alternative living, therapy, and therapeutic training from this perspective. The Philadelphia Association is still in existence today and is now committed to the exploration of the works of philosophers such as Ludwig Wittgenstein, Jacques Derrida, Levinas, and Michel Foucault as well as the work of the French psychoanalyst Jacques Lacan. It also runs some small therapeutic households along these lines. The Arbours Association is another group that grew out of the Kingsley Hall experiment. Founded by Joseph Berke and Schatzman in the 1970s, it now runs a training program in psychotherapy, a crisis center, and several therapeutic communities. The existential input in the Arbours has gradually been replaced with a more neo-Kleinian emphasis.

The impetus for further development of the existential approach in Britain has primarily come from the development of some existentially based courses in academic institutions. This started with the programs created by Emmy van Deurzen, initially at Antioch University in London and subsequently at Regent's College, London and since then at the New School of Psychotherapy and Counseling, also located in London. The latter is a purely existentially based training institute, which offers postgraduate degrees validated by the University of Sheffield and Middlesex University. In the past few decades, the existential approach has spread rapidly and has become a welcome alternative to established methods. There are now many other, mostly academic, centers in Britain that provide training in existential counseling and psychotherapy and a rapidly growing interest in the approach in the voluntary sector and the National Health Service.

British publications dealing with existential therapy include contributions by these authors: Jenner (de Koning and Jenner, 1982), Heaton (1988, 1994), Cohn (1994, 1997), Spinelli (1997), Cooper (1989, 2002), Eleftheriadou (1994), Lemma-Wright (1994), Du Plock (1997), Strasser and Strasser (1997), van Deurzen (1997, 1998, 2002), van Deurzen and Arnold-Baker (2005), and van Deurzen and Kenward (2005). Other writers such as Lomas (1981) and Smail (1978, 1987, 1993) have published work relevant to the approach, although not explicitly 'existential' in orientation. The journal of the British Society for Phenomenology regularly publishes work on existential and phenomenological psychotherapy. The Society for Existential Analysis was founded in 1988, initiated by van Deurzen. This society brings together psychotherapists, psychologists, psychiatrists, counselors, and philosophers working from an existential perspective. It offers regular fora for discussion and debate as well as significant annual conferences. It publishes the Journal of the Society for Existential Analysis twice a year. It is also a member of the International Federation of Daseinsanalysis, which stimulates international exchange between representatives of the approach from around the world. An International Society for Existential Therapists also exists. It was founded in 2006 by Emmy van Deurzen and Digby Tantam and is called the International Community of Existential Counsellors and Therapists (ICECAP).

Development in Canada

New developments in existential therapy in the last 20 years include existential positive psychology and meaning therapy. Different from the traditional approach to existential therapy, these new developments incorporate research findings from contemporary positive psychology.

Existential positive psychology can reframe the traditional issues of existential concerns into positive psychology questions that can be subjected to empirical research. It also focuses on personal growth and transformation as much as on existential anxiety. Later, existential positive psychology was incorporated into the second wave of positive psychology.

Meaning therapy (MT) is an extension of Frankl's logotherapy and America's humanistic-existential tradition; it is also pluralistic because it incorporates elements of cognitive-behavioral therapy, narrative therapy, and positive psychotherapy, with meaning as its central organizing construct. MT not only appeals to people's natural desires for happiness and significance but also makes skillful use of their innate capacity for meaning-seeking and meaning-making. MT strikes a balance between a person-centered approach and a psycho-educational approach. At the outset of therapy, clients are informed of the use of meaning-centered interventions appropriate for their predicaments because of the empirical evidence for the vital role of meaning in healing and thriving. MT is a comprehensive and pluralistic way to address all aspects of clients' existential concerns. Clients can benefit from MT in two ways: (1) a custom-tailored treatment to solve their presenting problems, and (2) a collaborative journey to create a preferred better future.

View of the human mind

Existential therapy (of the American, existential-humanistic tradition) starts with the belief that although humans are essentially alone in the world, they long to be connected to others. People want to have meaning in one another's lives, but ultimately they must come to realize that they cannot depend on others for validation, and with that realization, they finally acknowledge and understand that they are fundamentally alone. The result of this revelation is anxiety in the knowledge that our validation must come from within and not from others.

Existential therapy is based on a theory of mind, and of psychology. In existentialism, personality is based on choosing to be, authentically, the real you, given an understanding based on a philosophical idea of what a person is. Therefore, practical therapeutic applications can be derived given a theory of personality, emotion, and “the good life.”

This leads to practical therapeutic applications like dealing with personal choices in life that lead to personal happiness. Personal happiness based on a concept of yourself as having the freedom of directing your life and making necessary changes (so to speak, a radical freedom). So, a full philosophical understanding of existentialism is basic to methods implemented for emotional and life changes. That is, a background in philosophy is basic to existential therapy.

Philosophical issues of the self, personality, philosophy of mind, meaning of life, personal development are all fundamentally relevant to any practical therapeutic expectations.

Psychological dysfunction

Because there is no single existential view, opinions about psychological dysfunction vary.

For theorists aligned with Yalom, psychological dysfunction results from the individual's refusal or inability to deal with the normal existential anxiety that comes from confronting life's "givens": death, freedom, isolation, and meaninglessness.

For other theorists, there is no such thing as psychological dysfunction or mental illness. Every way of being is merely an expression of how one chooses to live one's life. However, one may feel unable to come to terms with the anxiety of being alone in the world. If so, an existential psychotherapist can assist one in accepting these feelings rather than trying to change them as if there is something wrong. Everyone has the freedom to choose how they are going to exist in life; however, this freedom may go unpracticed. It may appear easier and safer not to make decisions that one will be responsible for. Many people will remain unaware of alternative choices in life for various societal reasons.

The good life

Existentialism suggests that it is possible for individuals to face the anxieties of life head on, embrace the human condition of aloneness and to revel in the freedom to choose and take full responsibility for their choices. They can aim to take control of their lives and steer themselves in any direction they choose. There is no need to halt feelings of meaninglessness but instead to choose and focus on new meanings for the living. By building, loving and creating, life can be lived as one's own adventure. One can accept one's own mortality and overcome the fear of death. Although the French author Albert Camus denied the specific label of existentialist in his novel, L'Etranger, the novel's main character, Meursault, ends the novel by doing just this. He accepts his mortality and rejects the constrictions of society he previously placed on himself, leaving him unencumbered and free to live his life with an unclouded mind. Also, Gerd B. Achenbach has refreshed the Socratic tradition with his own blend of philosophical counseling, as has Michel Weber with his Chromatiques Center in Belgium.

The strictly Sartrean perspective of existential psychotherapy is generally unconcerned with the client's past, but instead, the emphasis is on the choices to be made in the present and future. The counselor and the client may reflect upon how the client has answered life's questions in the past, but attention ultimately shifts to searching for a new and increased awareness in the present and enabling a new freedom and responsibility to act. The patient can then accept that they are not special and that their existence is simply coincidental, or without destiny or fate. By accepting this, they can overcome their anxieties and instead view life as moments in which they are fundamentally free.

Four worlds

Existential thinkers seek to avoid restrictive models that categorize or label people. Instead, they look for the universals that can be observed cross-culturally. There is no existential personality theory which divides humanity into types or reduces people to part components. Instead, there is a description of the different levels of experience and existence with which people are inevitably confronted. The way in which a person is in the world at a particular stage can be charted on this general map of human existence (Binswanger, 1963; Yalom, 1980; van Deurzen, 1984).

In line with the view taken by van Deurzen, one can distinguish four basic dimensions of human existence: the physical, the social, the psychological, and the spiritual.

On each of these dimensions, people encounter the world and shape their attitude out of their particular take on their experience. Their orientation towards the world defines their reality. The four dimensions are interwoven and provide a complex four-dimensional force field for their existence. Individuals are stretched between a positive pole of what they aspire to on each dimension and a negative pole of what they fear. Binswanger proposed the first three of these dimensions from Heidegger's description of Umwelt and Mitwelt and his further notion of Eigenwelt. The fourth dimension was added by van Deurzen from Heidegger's description of a spiritual world (Überwelt) in Heidegger's later work.

Physical dimension

On the physical dimension (Umwelt), individuals relate to their environment and the givens of the natural world around them. This includes their attitude to the body they have, to the concrete surroundings they find themselves in, to the climate and the weather, to objects and material possessions, to the bodies of other people, their own bodily needs, to health and illness and their mortality. The struggle on this dimension is, in general terms, between the search for domination over the elements and natural law (as in technology, or in sports) and the need to accept the limitations of natural boundaries (as in ecology or old age). While people generally aim for security on this dimension (through health and wealth), much of life brings a gradual disillusionment and realization that such security can only be temporary. Recognizing limitations can deliver a significant release of tension.

Social dimension

On the social dimension (Mitwelt), individuals relate to others as they interact with the public world around them. This dimension includes their response to the culture they live in, as well as to the class and race they belong to (and also those they do not belong to). Attitudes here range from love to hate and from cooperation to competition. The dynamic contradictions can be understood concerning acceptance versus rejection or belonging versus isolation. Some people prefer to withdraw from the world of others as much as possible. Others blindly chase public acceptance by going along with the rules and fashions of the moment. Otherwise, they try to rise above these by becoming trendsetters themselves. By acquiring fame or other forms of power, individuals can attain dominance over others temporarily. Sooner or later, however, everyone is confronted with both failure and aloneness.

Psychological dimension

On the psychological dimension (Eigenwelt), individuals relate to themselves and in this way create a personal world. This dimension includes views about their character, their past experience and their future possibilities. Contradictions here are often experienced regarding personal strengths and weaknesses. People search for a sense of identity, a feeling of being substantial and having a self.

But inevitably many events will confront them with evidence to the contrary and plunge them into a state of confusion or disintegration. Activity and passivity are an important polarity here. Self-affirmation and resolution go with the former and surrender and yielding with the latter. Facing the final dissolution of self that comes with personal loss and the facing of death might bring anxiety and confusion to many who have not yet given up their sense of self-importance.

Spiritual dimension

On the spiritual dimension (Überwelt) (van Deurzen, 1984), individuals relate to the unknown and thus create a sense of an ideal world, an ideology, and a philosophical outlook. It is there that they find meaning by putting all the pieces of the puzzle together for themselves. For some people, this is done by adhering to a religion or other prescriptive worldview; for others, it is about discovering or attributing meaning in a more secular or personal way. The contradictions that must be faced on this dimension are often related to the tension between purpose and absurdity, hope and despair. People create their values in search of something that matters enough to live or die for, something that may even have ultimate and universal validity. Usually, the aim is the conquest of a soul or something that will substantially surpass mortality (as in having contributed something valuable to humankind). Facing the void and the possibility of nothingness are the indispensable counterparts of this quest for the eternal.

Research support

There has not been a tremendous amount of research on existential therapy. Much of the research focuses on people receiving therapy who also have medical concerns such as cancer. Despite this, some studies have indicated positive efficacy for existential therapies with certain populations. Overall, however, more research is needed before definitive scientific claims can be made.

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