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Gestalt therapy is an approach to psychotherapy that helps clients focus on the present to understand what is actually happening in their lives at this moment, and how it makes them feel in the moment, rather than what they may assume to be happening based on past experience. Along with person-centered and existential therapy, it is one of the primary forms of humanistic therapy.

The term “gestalt” is derived from a German word that means “whole” or “put together.” Gestalt therapy was developed in the 1940s and 1950s by Fritz Perls, a psychiatrist and psychoanalyst, and his then-wife, psychotherapist Laura Perls, as an alternative to traditional, verbally-focused psychoanalysis. Their foundational premise is that people are best thought of as a whole entities consisting of body, mind, and emotions, and best understood when viewed through their own eyes.

The gestalt philosophy rejects the notion that any one particular trait, episode, or indeed a diagnosis could define a person. Instead, their total self must be explored, discovered, and confronted. As they encounter and gain awareness of other parts of themselves, individuals can take greater responsibility for themselves and hopefully gain a greater sense of what they can do for themselves and others.

Instead of simply talking, clients in gestalt therapy are often encouraged to engage in intellectual and physical experiences that can include role-playing, re-enactment, or artistic exercises like drawing and painting. In this way, clients can learn to become more aware of their thoughts and actions, of how negative thought patterns and behaviors may be blocking their self-awareness and making them unhappy, and how they can change.

When It's Used

Gestalt therapy can help clients with issues such as anxiety, depression, low self-esteem, relationship difficulties, and even some physical concerns such as migraines, ulcerative colitis, and back spasms. People who are interested in working on their self-awareness but may not understand the role they play in their own unhappiness and discomfort could be good candidates for gestalt therapy. Gestalt techniques are sometimes used in combination with dance, art, drama, body work, and other therapies.

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What to Expect

A gestalt therapist focuses on what is happening in the moment and finding solutions in the present. For example, rather than discuss why something happened to you in the past, the therapist might encourage you to re-enact the moment and discuss how it feels right now—in other words, actually to experience those feelings rather than just talking about them. The therapist may ask questions like, “What’s going on in this moment?” or “How does this make you feel now?”

A gestalt therapist may encourage you to try dream work, guided fantasy, role-playing, and other techniques to help bring past and current struggles to life in the therapeutic setting. As a client becomes more aware of themselves and their senses, they can begin to move past blame and take more responsibility for themselves, accept the consequences of their behavior, and learn to satisfy their own needs while still respecting the needs of others.

What is the therapist’s role in gestalt therapy?

As a humanistic therapist, a gestalt therapist strives to remain empathetic and non-judgmental and to be accessible to clients without exuding an air of superiority. While the therapist may not impose their own interpretations on their clients’ experiences, they will listen closely to their words, keenly observe their body language, and guide sessions based on what they hear and see.

For example, the therapist is likely to encourage clients to use “I” statements that focus on their own actions and feelings instead of those of others (“I feel anger when she ignores me” instead of “She makes me mad by ignoring me”) as a way of moving toward taking personal responsibility. And if a client begins dwelling on their past, or fixating on anxiety about the future, the therapist may urge them to come back into the present and explore their emotions in the moment.

What type of exercises can you expect to do in gestalt therapy?

Gestalt therapy does not have set guidelines for sessions; therapists are meant to be creative and find approaches that fit each client. But some gestalt exercises are fairly commonly used, including by other types of therapists:

The empty chair. In this exercise, the client sits across from an empty chair, representing a partner, relative, boss, or other person—or in some cases, a part of themselves—and, with the therapist’s encouragement, improvises a dialog with it. (Sometimes the client will go back and forth improvising the roles of both parties.) The goal is to address “unfinished business,” resolving past conflicts or encounters within their own selves by bringing the emotions raised into the present and working through them in the moment. Individuals may find that through this exercise they can access feelings and perceptions in a way that they could not by simply talking about a person, episode, or concern.

Exaggeration. A gestalt therapist will closely observe a client’s gestures and physical responses as they speak—for example, slouching, frowning, or bouncing their leg. In an exercise known as exaggeration, they may ask the client to repeat and exaggerate a given movement to explore the emotions attached to it in the moment and to help them gain a greater general understanding of the connection between their emotions and their bodies.

Through these exercises and other gestalt techniques, individuals may be able to reconnect with feelings they might otherwise ignore or deny, and reconnect those parts of themselves into their whole self.

How It Works

Gestalt therapy is based on the principle that to alleviate unresolved negative feelings like anger, pain, anxiety, and resentment, those emotions cannot just be discussed, but must be actively expressed in the present. Without that, psychological and physical symptoms can arise.

The Perlses believed that it is not our responsibility to live up to others' expectations, nor should we expect others to live up to ours. In building self-awareness, gestalt therapy aims to help clients better understand themselves and how the choices they make affect their health and their relationships. With this self-knowledge, clients can begin to understand how their emotional and physical selves are connected and develop the confidence to live a fuller life without holding themselves back, and to more effectively face problems when they arise.

What are the potential limitations of gestalt therapy?

Some people may struggle to adapt to the lack of formal structure typical of gestalt therapy sessions; clients may also find the emphasis on the present unhelpful if they feel strongly that they need to explore and resolve issues from their past. Some individuals may not be comfortable with a gestalt therapist’s observations of their body language and emotions, while others may not be able to commit to techniques that feel unnatural, like the empty chair exercise.

If a professional becomes convinced that a client cannot make further progress with gestalt therapy, they may recommend that the individual accept a referral to a therapist with different training or expertise.

What to Look for in a Gestalt Therapist

Look for a licensed, experienced psychotherapist with a stated gestalt approach toward therapy. There is no formal certification required to practice gestalt therapy but mental health professionals may take continuing education courses and training in gestalt therapy techniques. In addition to finding someone with gestalt experience, look for a therapist or counselor who is especially empathetic and with whom you can feel comfortable discussing personal issues.

References
American Psychological Association: Gestalt Therapy with Gordon Wheeler, PhD.  
Grant, Sheila K. California State University Northridge. Psychology 460: Counseling and Interviewing Presentation.