by Dr.Moira Borg MD Gestalt Psychotherapist
No living organism can survive without contact with its environment in some form or the other. Human beings need air, water, food and shelter for their physical well-being and one another for the psychological and social one. In fact, the phrase ‘no man is an island’ has become more than a cliche, it is actually a reality we all wish and hope for especially nowadays where loneliness has become one of the most common and painful scourges of mankind.
In psychotherapy, particularly Gestalt therapy, the therapeutic relationship between the therapist and the client is one of the main pillars of its ideology. Founder Laura Perls describes it as the true essence of Gestalt therapy which can, in and of itself, be powerfully therapeutic. As a result, the creation of a good therapeutic relationship not only influences the effectiveness of the therapy process but can, within itself be therapeutic to the client.
Research has in fact shown that the therapeutic relationship is the second most important variable that influences therapeutic outcomes in general. The type of alliance forged depends on various factors including the unique personality, life experiences and present realities of the client and therapist which can also be influenced by culture, race and social backgrounds. The client’s awareness/insight and his/her previous knowledge of therapy are also important.
Four qualities in the therapist are necessary in ensuring positive outcomes in therapy.
These include:
- The therapist’s relational qualities – especially his/her acceptance or inclusion of the client. This enhances both self-acceptance and awareness of the client supporting him/her to contain and process experiences which he/she was either not aware of or was finding it hard to assimilate or understand. A satisfactory life outside therapy supports the therapist to keep a good working alliance even in challenging situations.
- The therapist’s theoretical background and knowledge – especially the therapist’s responsibility and commitment to have the necessary skills and theoretical awareness garnered through regular professional development and supervision. In the latter, the therapist attends regular sessions with another therapist specialised in supervision and processes with him/her any challenges presented by clients during therapy. This avoids the therapist unnecessarily affecting the client with unresolved issues of his/her own. For example if the therapist has unresolved issues with sexual abuse, this could hinder his/her work with clients coming up with similar issues unless he/she works on them.
- A consistent commitment to the personal development of the therapist – that is his/her commitment to his/her own self-awareness through regular therapy, where the therapist can process his/her own personal issues, especially if these hinder therapy with clients, and/or supervision where particular issues that surface during work with clients can be dealt with.
- This commitment to the theoretic and personal development of the therapist sets the ethical framework for the therapist to reflect on his/her impact on the therapeutic relationship and the ability to engage in reflective practice – that is reflect on the work being done in therapy with the client. The ethical position of Gestalt therapy has in fact shifted from the moralistic one of how one should be to the ethics of responsibility of how the therapist is toward the client in psychotherapy – that is focusing on inclusion or the respect of the client and dialogue and genuine presence and avoiding imposing his/her views.
In such a space where the client is accepted for who he/she is, where there is a focus on the otherness of the other, true contact results from this appreciation of difference. Such creation of a genuine relationship where, as in other relationships, both the therapist and the client contribute, the latter can find the safety and the right support to explore and process painful issues both within and outside his/her awareness. Poster (1987) describes this genuine appreciation by the therapist as a search for the hidden fascination of the client which in turn revitalizes his/her ability to be interested/interesting and thus spontaneous. Such “healing love” for the client is a “sort of spotlight, illuminating the other’s beauty. Gelso et al. (2014) assert that this love of the therapist for the client “is likely to have an impact in helping the patient change how he or she perceives, behaves, and interprets in relationships in general, and in how he or she feels about him/herself.” (p125).
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