The boundary between self and environment must be kept permeable to allow exchanges, yet firm enough for autonomy. The environment includes toxins to be screened out. Even what is nourishing needs to be discriminated according to the dominant needs. Metabolic processes are governed by the laws of homeostasis. Ideally, the most urgent need energizes the organism until it is met or is superseded by a more vital need. Living is a progression of needs, met and unmet, achieving homeostatic balance and going on to the next moment and new need.
When the boundary between self and other becomes unclear, lost or impermeable, this results in a disturbance of the distinction between self and other, a disturbance of both contact and awareness see Perls, ; Polster and Polster, In good boundary functioning, people alternate between connecting and separating, between being in contact with the current environment and withdrawal of attention from the environment. The contact boundary is lost in polar opposite ways in confluence and isolation. In confluence fusion , the separation and distinction between self and other becomes so unclear that the boundary is lost.
In isolation , the boundary becomes so impermeable that connectedness is lost, i. Retroflection is a split within the self, a resisting of aspects of the self by the self. This substitutes self for environment, as in doing to self what one wants to do to someone else or doing for self what one wants someone else to do for self. This mechanism leads to isolation. The illusion of self-sufficiency is one example of retroflection as it substitutes self for environment.
Although one can do one's own breathing and chewing, the air and food must come from the environment. Introspection is a form of retroflection that can be pathological or healthy.
For example, resisting the impulse to express anger may serve to cope with a dangerous environment. In such a situation, biting one's lip may be more functional than saying something biting. Through introjection , foreign material is absorbed without discriminating or assimilating. Swallowing whole creates an "as if" personality and rigid character. Introjected values and behavior are imposed on self. As in all contact boundary disturbances, swallowing whole can be healthy or pathological, depending on the circumstances and degree of awareness. For example, students taking a lecture course may, with full awareness that they are doing so, copy, memorize and regurgitate material without full "digestion.
Projection is a confusion of self and other that results from attributing to the outside something that is truly self. An example of healthy projection is art. Pathological projection results from not being aware of and accepting responsibility for that which is projected. Deflection is the avoidance of contact or of awareness by turning aside, as when one is polite instead of direct.
Deflection can be accomplished by not expressing directly or by not receiving. In the latter case, the person usually feels "untouched"; in the former case, the person is often ineffective and baffled about not getting what is wanted. Deflection can be useful where, with awareness, it meets the needs of the situation e. Other examples of deflection include not looking at a person, verbosity, vagueness, understating and talking about rather than to Polster and Polster, , pp.
Human regulation is to varying degrees either a organismic, that is, based on a relatively full and accurate acknowledgment of what is , or b "shouldistic," based on the arbitrary imposition of what some controller thinks should or should not be. This applies to intrapsychic regulation, to the regulation of interpersonal relations and to the regulation of social groups. Perls explicated the above with an example of driving a car. Instead of a preplanned program, "I want to drive 65 miles per hour," a person cognizant of the situation will drive at different speed at night or differently when in traffic, or still differently when tired, and so on.
Here Perls makes it clear that "let the situation control" means regulating through awareness of the contemporary context, including one's wants, rather than through what was thought "should" happen. In organismic self-regulation, choosing and learning happen holistically, with a natural integration of mind and body, thought and feeling, spontaneity and deliberateness.
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In shouldistic regulation, cognition reigns and there is no felt, holistic sense. Obviously, everything relevant to boundary regulation cannot be in full awareness. Most transactions are handled by automatic, habitual modes, with minimal awareness. Organismic self-regulation requires that the habitual become fully aware as needed. Awareness and dialogue are the two primary therapeutic tools in Gestalt therapy. Awareness is a form of experience that may be loosely defined as being in touch with one's own existence, with what is.
Insight, a form of awareness, is an immediate grasp of the obvious unity of disparate elements in the field. Aware contact creates new, meaningful wholes and thus is in itself an integration of a problem. Effective awareness is grounded in and energized by the dominant present need of the organism. It involves not only self-knowledge, but a direct knowing of the current situation and how the self is in that situation. Any denial of the situation and its demands or of one's wants and chosen response is a disturbance of awareness. Meaningful awareness is of a self in the world, in dialogue with the world, and with awareness of Other -- it is not an inwardly focused introspection.
Awareness is accompanied by owning , that is, the process of knowing one's control over, choice of, and responsibility for one's own behavior and feelings. Without this, the person may be vigilant to experience and life space, but not to what power he or she has and does not have. Awareness is cognitive, sensory and affective. The person who verbally acknowledges his situation but does not really see it, know it, react to it and feel in response to it is not fully aware and is not in full contact.
The person who is aware knows what he does, how he does it, that he has alternatives and that he chooses to be as he is. The act of awareness is always here and now, although the content of awareness may be distant. The act of remembering is now; what is remembered is not now. When the situation calls for an awareness of the past or anticipation of the future, effective awareness takes this into account. For example:. P: I am glad to see you, but I'm tense about a meeting tonight with my boss.
I have rehearsed and prepared and I've tried to support myself as I wait. P: I thought of putting her in the empty chair and talking to her. But I am so tense I need to do something more physical. I need to move, breathe, make noise.
P: It's up to me, huh? Patient gets up, starts stretching, yawning. The movements and sounds become more vigorous. After a few minutes he sits down, looking more soft and alive. Self-rejection and full awareness are mutually exclusive. Rejection of self is a distortion of awareness because it is a denial of who one is. Self-rejection is simultaneously a confusion of who "I am" and a self-deception, or "bad faith" attitude of being above that which is ostensibly being acknowledged Sartre, Saying "I am" as if it were an observation of another person, or as if the "I" were not chosen, or without knowing how one creates and perpetuates that "I am" is bad faith rather than insightful awareness.
People, according to Gestalt therapy, are responsible response-able ; that is, they are the primary agents in determining their own behavior. When people confuse responsibility with blaming and shoulds, they pressure and manipulate themselves; they "try" and are not integrated and spontaneous. In such instances their true wants, needs and responses to the environment and choices in the situation are ignored and they overcomply or rebel against shoulds.
Gestalt therapists believe in the importance of a clear distinction between what one chooses and what is given. People are responsible for what they choose to do. For example, people are responsible for their actions on behalf of the environment. Blaming outside forces e. Taking responsibility for what one did not choose, a typical shame reaction, is also a deception. People are responsible for moral choices. Gestalt therapy helps patients discover what is moral according to their own choice and values.
Far from advocating "anything goes," Gestalt therapy places a most serious obligation on each person: choosing and valuing. Gestalt therapy personality theory has evolved primarily out of clinical experience. The focus has been a theory of personality that supports our task as psychotherapists rather than an overall theory of personality. The constructs of Gestalt therapy theory are field theoretical rather than genetic and phenomenological rather than conceptual.
Although Gestalt therapy is phenomenological, it also deals with the unconscious, that is, with what does not enter into awareness when needed. In Gestalt therapy, awareness is conceived of as being in touch and unawareness as being out of touch. Unawareness can be explained by a variety of phenomena, including learning what to attend to, repression, cognitive set, character and style.
Simkin compared personality to a floating ball -- at any given moment only a portion is exposed while the rest is submerged. Unawareness is the result of the organism's not being in touch with its external environment due to its being mostly submerged in its own internal environment or fantasies, or not being in touch with its inner life due to fixation on the external.
Children swallow whole introject ideas and behavior. This results in an enforced morality rather than an organismically compatible morality. As a result, people frequently feel guilt when they behave in accordance with their wants as opposed to their shoulds. Some people invest an enormous amount of energy in maintaining the split between shoulds and wants -- the resolution of which requires a recognition of their own morality as opposed to an introjected one. Shoulds sabotage such people, and the more they push to be what they are not, the more resistance is set up, and no change occurs.
Beisser advanced the theory that change does not happen through a "coercive attempt by the individual or by another person to change him," but does happen if the person puts in the time and effort to be "what he is," "to be fully in his current position" , p. When the therapist rejects the change agent role, change that is orderly and also meaningful is possible. The Gestalt therapy notion is that awareness including owning, choice, and responsibility and contact bring natural and spontaneous change. Forced change is an attempt to actualize an image rather than to actualize the self.
With awareness self-acceptance, and the right to exist as is , the organism can grow. Forced intervention retards this process. So, too, Gestalt therapists believe that people have an innate drive to health. This propensity is found in nature, and people are part of nature. Awareness of the obvious, the awareness continuum, is a tool that a person can deliberately use to channel this spontaneous drive for health.
Dichotomous thinking interferes with organismic self-regulation. Dichotomous thinking tends to be intolerant of diversity among persons and of paradoxical truths about a single person. Organismic self-regulation leads to integrating parts with each other and into a whole that encompasses the parts. The field is often differentiated into polarities : parts that are opposites that complement or explicate each other. The positive and negative poles of an electrical field are the prototypical mode for this differentiation in a field theoretical way. The concept of polarities treats opposites as part of one whole, as yin and yang.
With this polar view of the field, differences are accepted and integrated. Lack of genuine integration creates splits, such as body-mind, self-external, infantile-mature, biological-cultural, and unconscious-conscious. Through dialogue there can be an integration of parts, into a new whole in which there is a differentiated unity. Dichotomies such as the self-ideal and the needy self, thought and impulse, and social requirements and personal needs can be healed by integrating into a whole differentiated into natural polarities Perls, The good Gestalt describes a perceptual field organized with clarity and good form.
A well-formed figure clearly stands out against a broader and less distinct background. The relation between that which stands out figure and the context ground is meaning. In the good Gestalt the meaning is clear. The good Gestalt gives a content-free definition of health. In health, the figure changes as needed, that is, it shifts to another focus when the need is met or superseded by a more urgent need.
It does not change so rapidly as to prevent satisfaction as in hysteria or so slowly that new figures have no room to assume organismic dominance as in compulsivity. When figure and ground are dichotomized, one is left with a figure out of context or a context without focus F. Perls et al. In health, awareness accurately represents the dominant need of the whole field. Need is a function of external factors physical structure of the field, political activity, acts of nature, and so on and internal factors hunger, fatigue, interest, past experience, and so forth.
The Gestalt therapy concept of healthy functioning includes creative adjustment. A psychotherapy that only helps patients adjust creates conformity and stereotypy. A psychotherapy that only led people to impose themselves on the world without considering others would engender pathological narcissism and a world-denying realization of self isolated from the world. A person who shows creative interaction takes responsibility for the ecological balance between self and surroundings. This is the theoretical context F. The individual and environment form a polarity. The choice is not between the individual and society, but between organismic and arbitrary regulation.
Resistance is a part of a polarity consisting of an impulse and resistance to that impulse. Seen as a dichotomy, resistance is often treated as "bad" and, in such a context, often turns out to be nothing more than the patient's following personal dictates rather than the therapist's. Seen as a polarity, resistance is as integral to health as the trait's being resisted.
Gestalt therapists attend to both the working process of consciousness and the resistance process of consciousness.
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Many Gestalt therapists avoid the word resistance because of its pejorative dichotomized connotation, which frames the process as a power battle between therapist and patient rather than as the self-conflict of the patient that needs to be integrated into a harmoniously differentiated self. An impasse is a situation in which external support is not forthcoming and the person believes he cannot support himself.
The latter is due in large part to the person's strength being divided between impulse and resistance. The most frequent method of coping with this is to manipulate others. An organismically self-regulating person takes responsibility for what is done for self, what is done by others for self, and what is done for others by self. The person exchanges with the environment, but the basic support for regulation of one's existence is by self.
When the individual does not know this, external support becomes a replacement for self-support rather than a source of nourishment for the self. In most psychotherapy the impasse is circumvented by external support by the therapist, and the patient does not find that self-support is sufficient. In Gestalt therapy, patients can get through the impasse because of the emphasis on loving contact without doing the patient's work, that is, without rescuing or infantilizing. In Gestalt, the only goal is awareness. This includes greater awareness in a particular area and also greater ability for the patient to bring automatic habits into awareness as needed.
In the former sense awareness is a content, in the latter sense it is a process. Both awareness as content and awareness as process progress to deeper levels as the therapy proceeds. Awareness includes knowing the environment, responsibility for choices, self-knowledge, and self-acceptance, and the ability to contact. Beginning patients are chiefly concerned with the solution of problems. The issue for the Gestalt therapist is how patients support themselves in solving problems.
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Gestalt therapy facilitates problem solving through increased self-regulation and self-support by the patient. As therapy goes on, the patient and the therapist turn more attention to general personality issues. By the end of successful therapy the patient directs much of the work and is able to integrate problem solving, characterological themes, relationship issues with the therapist, and means of regulating his or her own awareness. Gestalt therapy is most useful for patients open to working on self-awareness and for those who want natural mastery of their awareness process.
Although some people claim they are interested in changing their behavior, most people seeking psychotherapy mainly want relief from discomfort.
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Their complaint may be generalized malaise, specific discomforts, or dissatisfaction in relationships. Patients often expect that relief will result from their therapist's doing the work rather than from their own efforts. Psychotherapy is most appropriate for persons who create anxiety, depression, and so forth by rejecting themselves, alienating aspects of themselves, and deceiving themselves. In short, people who do not know how they further their own unhappiness are prime candidates, providing they are open to awareness work, especially awareness of self-regulation.
Gestalt therapy is especially appropriate for those who know intellectually about themselves and yet don't grow. Those who want symptom relief without doing awareness work may be better candidates for behavior modification, medication, biofeedback, and so on.
The direct methods of Gestalt therapy facilitate patients' making this choice early in the therapy. However, patients' difficulty in doing the contact or awareness work should not automatically be interpreted as meaning that they do not want to work. Respect for the total person enables a Gestalt therapist to help the patients become clear about the differences between "can't" and "won't" and to know how internal barriers or resistance, such as prior learning, anxiety, shame and sensitivity to narcissistic injury, inhibit awareness work. There are no "shoulds" in Gestalt therapy.
In Gestalt therapy a higher value is placed on the autonomy and the self-determination for the patient than on other values. This is not a should, but a preference. The no-should ethic takes precedence over the therapist's goals for the patient and leaves the responsibility and sanctioning of the patient's behavior to the patient of course, the injunctions and requirements of society are not suspended just because the patient is in Gestalt therapy. Gestalt therapy is an exploration rather than a direct modification of behavior.
The goal is growth and autonomy through an increase in consciousness. Rather than maintaining distance and interpreting, the Gestalt therapist meets patients and guides active awareness work. The therapist's active presence is alive and excited hence warm , honest and direct. Patients can see, hear and be told how they are experienced, what is seen, how the therapist feels, what the therapist is like as a person.
Growth occurs from real contact between real people. Patients learn how they are seen and how their awareness process is limited, not primarily by talking about their problems, but by how they and the therapist engage each other.
- Gestalt Therapy: A Guide to Contemporary Practice.
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- Gestalt therapy a guide to contemporary practice.
Focusing runs the range from simple inclusions or empathy to exercises arising mostly from the therapist's phenomenology while with the patient. Everything is secondary to the direct experience of both participants. The general approach of Gestalt therapy is to facilitate exploring in ways that maximize what continues to develop after the session and without the therapist.
The patient is often left unfinished but thoughtful or "opened up," or with an assignment. This is like a roast that continues to cook after being removed from the oven. This is in part how Gestalt therapy can be so intensive on fewer sessions per week. We cooperate with growth occurring without us; we initiate where needed. We give the degree of facilitation necessary to foster patient self-improvement. We facilitate growth rather than complete a cure process.
Perls believed that the ultimate goal of psychotherapy was the achievement of "that amount of integration which facilitates its own development" An example of this kind of facilitation is the analogy of a small hole cut into an accumulation of snow. Once the draining process begins, the base that began as a small hole enlarges by itself. Successful psychotherapy achieves integration. Integration requires identification with all vital functions -- not with only some of the patient's ideas, emotions and actions.
Any rejection of one's own ideas, emotions or actions results in alienation. Reowning allows the person to be whole. The task, then, in therapy is to have the person become aware of previously alienated parts and taste them, consider them and assimilate them if they are ego-syntonic or reject them if they prove to be ego-alien.
Simkin has used the simile of a cake in encouraging patients to reown the parts of themselves that they have considered noxious or otherwise unacceptable: although the oil, or flour, or baking powder by themselves can be distasteful, they are indispensable to the success of the whole cake. Gestalt therapy focuses on the patient, as any therapy does. However, the relationship is horizontal, thus differing from the traditional therapy relationship.
In Gestalt therapy the therapist and patient speak the same language, the language of present centeredness, emphasizing direct experience of both participants. Therapists as well as patients in Gestalt therapy show their full presence. Since its beginning, Gestalt therapy has emphasized the patient's experience as well as the therapist's observation of what is not in the patient's awareness. This allows the patient to act as an equal who has full access to the data of his own experience so he can directly experience from inside what is observed by the therapist from outside.
In an interpretive system the patient is an amateur and does not have the theoretical foundation for the interpretation. It is assumed that the important internal data are unconscious and not experienced. An important aspect of the Gestalt therapy relationship is the question of responsibility. Gestalt therapy emphasizes that both the therapist and the patient are self-responsible. When therapists regard themselves as responsible for patients, they collude with patients' not feeling self-responsible and thereby reinforce the necessity for manipulation due to the belief that patients are unable to support and regulate themselves.
However, it is not enough for the therapist to be responsible for self and for the patient to be responsible for self -- there is also an alliance of patient and therapist that must be carefully constantly, and competently attended to. Therapists are responsible for the quality and quantity of their presence, for knowledge about themselves and the patient, for maintaining a nondefensive posture, and for keeping their awareness and contact processes clear and matched to the patient.
They are responsible for the consequences of their own behavior and for establishing and maintaining the therapeutic atmosphere. In Gestalt therapy there is a constant and careful emphasis on what the patient does and how it is done. What does the patient face? How does the patient make choices?
Does the patient self-support or resist? Direct experience is the tool, and it is expanded beyond what is at first experienced by continuing to focus deeper and broader. The techniques of Gestalt therapy are experimental tasks. They are the means of expanding direct experience. These are not designed to get the patient somewhere, to change the patient's feelings, to recondition, or to foster catharsis.
In a phenomenological therapy "now" starts with the present awareness of the patient. What happens first is not childhood, but what is experienced now. Awareness takes place now. Prior events may be the object of present awareness, but the awareness process e. Now I can contact the world around me, or now I can contact memories or expectations. Not knowing the present, not remembering, or not anticipating are all disturbances.
The present is an ever-moving transition between the past and future. Frequently patients do not know their current behavior In some cases patients live in the present as if they had no past. Most patients live in the future as if it were now. All these are disturbances of time awareness. In the therapy hour, when the patients refer to their lives out of the hour, or earlier in the hour, that is not now. In Gestalt therapy we orient more to the now than in any other form of psychotherapy.
Experiences of the past few minutes, days, years or decades that are of present importance are dealt with. We attempt to move from talking about to directly experiencing. For example, talking to a person who is not physically present rather than talking about that person mobilizes more direct experience of feelings. In Gestalt therapy this I and Thou, what and how, here and now methodology is frequently used to work on characterological and developmental psychodynamics.
For example, a year-old female patient is in group therapy. She is in the middle phase of therapy. She says she is very angry at a man in the group. One legitimate and frequent Gestalt approach is "Say it to him. T: [ the therapist's observations of her previous encounters with the man agree with that statement ] and you don't accept that. T: And there is an intensity to your rage that seems to be greater than the situation calls for. T: Like your father? The work proceeds into a reexperiencing the narcissistic injury from her father, who was never responsive to her ].
Gestalt therapy probably has a greater range of styles and modalities than any other system. It is practiced in individual therapy, groups, workshops, couples, families, and with children.
It is practiced in clinics, family service agencies, hospitals, private practices, growth centers, and so on. The styles in each modality vary drastically on many dimensions: degree and type of structure; quantity and quality of techniques used; frequency of sessions; abrasiveness-ease of relating; focus on body, cognition, feelings, interpersonal contact; knowledge of and work with psychodynamic themes; degree of personal encountering, and so forth. All styles and modalities of Gestalt therapy have in common the general principles we have been discussing: emphasis on direct experience and experimenting phenomenology , use of direct contact and personal presence dialogic existentialism , and emphasis on the field concepts of what and how and here and now.
Within these parameters, interventions are patterned according to the context and the personalities of the therapist and the patient. At the heart of the methodology is the emphasis on the difference between "work" and other activities, especially "talking about. First, it refers to a deliberate, voluntary and disciplined commitment to use phenomenologically focused awareness to increase the scope and clarity of one's life.
When one moves from talking about a problem or being with someone in a general way to studying what one is doing, especially being aware of how one is aware, one is working. Differences in techniques are not important, although the quality and type of therapeutic contact and a fit between the attitude and emphasis of the therapist and the patient's needs are important. Techniques are just techniques: the overall method, relationship, and attitude are the vital aspects. Nevertheless a discussion of some techniques or tactics might elucidate the overall methodology.
These are only illustrative of what is possible. All techniques of patient focusing are elaborations of the question, "What are you aware of experiencing now? P: [ tears well up. Then the patient tightens and looks away and starts to look thoughtful ]. T: Stay with the not wanting to. Put words to the not wanting to. The patient might respond: "I won't cry here -- I don't trust you," or "I am ashamed," or "I am angry and don't want to admit I miss him "]. Here the patient is asked to put feelings or thoughts into action.
For example, the therapist may encourage the patient to "say it to the person" if present or use some kind of role playing such as speaking to an empty chair if the person is not present. The patient with tears in his eyes might be asked to "put words to it. It is not a universal remedy. Exaggeration is a special form of enactment. A person is asked to exaggerate some feeling, thought, movement, etc. Enactment into movement, sound, art, poetry, etc.
For instance, a man who had been talking about his mother without showing any special emotion was asked to describe her. Out of his description came the suggestion to move like her. As the patient adopted her posture and movement, intense feelings came back into his awareness. Guided fantasy. Sometimes a patient can bring an experience into the here and now more efficiently by visualizing than by enacting:.
P: I was with my girlfriend last night. I don't know how it happened but I was impotent. T: Close your eyes. Imagine it is last night and you are with your girlfriend. Say out lout what you experience at each moment. T: Let's go through that again in slow motion, in more detail.
Be sensitive to every thought or sense impression. P: I am sitting on the couch. She comes over and sits next to me. She touches my neck. It feels so warm and soft, I get excited -- you know, hard. She strokes my arm, and I love it. This patient became aware of how he created his own anxiety and impotence. This fantasy was recreating an event that happened in order to get in better touch with it.
Subscribe to our newsletter. Register Log in My Order 0 Wishlist 0. You have no items in your order. Book Description This is a true second edition, so much so that it approaches being a different book. View Extract. ISBN Quantity :. Sessions tended to number into the hundreds over several years. Behaviorism developed in the s, and behavior modification as a therapy became popularized in the s and s. Watson and B. Skinner in the United States.
Behavioral therapy approaches relied on principles of operant conditioning, classical conditioning and social learning theory to bring about therapeutic change in observable symptoms. The approach became commonly used for phobias, as well as other disorders. Some therapeutic approaches developed out of the European school of existential philosophy. The uniqueness of the patient-therapist relationship thus also forms a vehicle for therapeutic enquiry.
A related body of thought in psychotherapy started in the s with Carl Rogers. Based on existentialism and the works of Abraham Maslow and his hierarchy of human needs, Rogers brought person-centered psychotherapy into mainstream focus. This type of interaction enables the client to fully experience and express themselves. Later these fields of psychotherapy would become what is known as humanistic psychotherapy today. Self-help groups and books became widespread. A few years later, psychiatrist Aaron T. Beck developed a form of psychotherapy known as cognitive therapy.
Cognitive and behavioral therapy approaches were combined and grouped under the heading and umbrella-term Cognitive behavioral therapy CBT in the s. These approaches gained widespread acceptance as a primary treatment for numerous disorders. Counseling methods developed, including solution-focused therapy and systemic coaching. Postmodern psychotherapies such as Narrative Therapy and coherence therapy did not impose definitions of mental health and illness, but rather saw the goal of therapy as something constructed by the client and therapist in a social context.
Systems Therapy also developed, which focuses on family and group dynamics—and Transpersonal psychology, which focuses on the spiritual facet of human experience.
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Other important orientations developed in the last three decades include Feminist therapy, Brief therapy, Somatic Psychology, Expressive therapy, applied Positive psychology and the Human Givens approach which is building on the best of what has gone before. A survey of over 2, US therapists in revealed the most utilized models of therapy and the ten most influential therapists of the previous quarter-century. Psychotherapy can be seen as an interpersonal invitation offered by often trained and regulated psychotherapists to aid clients in reaching their full potential or to cope better with problems of life.
Psychotherapists usually receive remuneration in some form in return for their time and skills. This is one way in which the relationship can be distinguished from an altruistic offer of assistance. Psychotherapists and counsellors often require to create a therapeutic environment referred to as the frame, which is characterised by a free yet secure climate that enables the client to open up. The degree to which client feels related to the therapist may well depend on the methods and approaches used by the therapist or counsellor.
Psychotherapy often includes techniques to increase awareness, for example, or to enable other choices of thought, feeling or action; to increase the sense of well-being and to better manage subjective discomfort or distress. Psychotherapy can be provided on a one-to-one basis or in group therapy. It can occur face to face, over the telephone, or, much less commonly, the Internet. Its time frame may be a matter of weeks or many years. Therapy may address specific forms of diagnosable mental illness, or everyday problems in managing or maintaining person relationships or meeting personal goals.
Psychotherapists employ a range of techniques to influence or persuade the client to adapt or change in the direction the client has chosen. These can be based on clear thinking about their options; experiential relationship building; dialogue, communication and adoption of behavior change strategies. Each is designed to improve the mental health of a client or patient, or to improve group relationships as in a family. Most forms of psychotherapy use only spoken conversation, though some also use other forms of communication such as the written word, artwork, drama, narrative story, or therapeutic touch.
Because sensitive topics are often discussed during psychotherapy, therapists are expected, and usually legally bound, to respect client or patient confidentiality. Psychotherapists are often trained, certified, and licensed, with a range of different certifications and licensing requirements depending on the jurisdiction.
Psychotherapy may be undertaken by clinical psychologists,counseling psychologists, social workers, marriage-family therapists, expressive therapists, trained nurses, psychiatrists, psychoanalysts, mental health counselors, school counselors, or professionals of other mental health disciplines. Psychiatrists have medical qualifications and may also administer prescription medication. The primary training of a psychiatrist focuses on the biological aspects of mental health conditions, with some training in psychotherapy.
Psychologists have more training in psychological assessment and research and, in addition, in-depth training in psychotherapy. Social workers have specialized training in linking patients to community and institutional resources, in addition to elements of psychological assessment and psychotherapy.
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