Episode Transcript
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Speaker 1 (00:05):
All right, let's
really get into this.
So you're a therapist in thisnarrative and your client,
rachel, is having pretty majoranxiety as she prepares for her
licensure exam.
Honestly, a lot of you canprobably relate to this.
Right, it can be nerve-wracking.
She's pretty much convincedthere's no way she'll pass.
Oh, and let's not forget,rachel is the first in her
(00:27):
family to go to college, sothere's a ton of pressure riding
on those shoulders.
We're talking sleepless nights,upset stomach, constant
ruminating the wholerollercoaster of feelings.
First point, let's just call itout Anxiety around big exams is
, um, super common.
But for Rachel it's not justabout nerves before an exam.
(00:48):
She was diagnosed withgeneralized anxiety disorder
back when she was a teen andeven though, yes, she's had
therapy before, that anxietyseems to creep back in,
especially now that the stakesfeel sky high.
I mean, wow, who wouldn't feelthe weight of all those
expectations, especially whenfamily pride is on the line?
(01:09):
So what do you look for on theexam and how do you, as a
therapist, help someone likeRachel?
That's where you're going towant to understand how different
theories work in practice, notjust on paper or for the exam.
And today we're leaning intogestalt therapy because it's
really designed to help clientswho are stuck in worry about the
(01:30):
past or future and can't seemto enjoy the here and now.
Let's talk about gestalt for asecond.
It's all about being in themoment.
You're not time traveling backto that failed high school
algebra test or forward to acatastrophic fantasy where you
bomb the license exam and yourfuture is ruined.
Nope, the focus is right nowwhat's going on in your body,
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mind and emotions at this exactminute.
The thing is.
Here's a big point for yourexam you're not ignoring past
situations entirely.
Gestalt therapy does touch onunfinished business.
Think about it.
Lingering feelings or eventsfrom the past that still haunt
your client in the present.
For Rachel, maybe, there's someold stuff about needing to
(02:15):
prove herself or fear of lettingher family down.
That's showing up as testanxiety.
Now in Gestalt you're aiming forawareness, like radical
self-awareness, because, let'sface it, you can't change what
you don't notice.
So how would you actually getRachel started?
First?
You use those classic Gestaltwhat and how questions.
(02:37):
It's not.
Why are you anxious?
That's too abstract.
Instead, ask things like whatare you feeling in your body
right now as you think aboutyour exam?
Or how does your anxiety showup.
It's not about solving thefeeling but getting her to tune
into it.
Let's use an example like anarrative that will crop up on
(02:58):
the licensing exam.
You notice Rachel's hands aretrembling as she talks about her
upcoming test date.
You don't ignore it.
Instead, you use theexaggeration technique.
You notice Rachel's hands aretrembling as she talks about her
upcoming test date.
You don't ignore it.
Instead, you use theexaggeration technique.
You might say let's trysomething together.
Can you exaggerate that shakingfor a second?
Rachel might at first be like,uh, why?
But trust the process.
(03:19):
You ask her to reallyaccentuate the tremor, get aware
of it and maybe even say outloud what's happening.
Why bother?
No-transcript.
Helping clients notice them isoften the first step to well
unblocking it, and this istextbook gestalt.
The goal isn't to make theshaking stop, but to help Rachel
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notice it, experience it in themoment and, surprisingly, start
to release some of that pent-upanxiety.
Second point language ispowerful.
Gestalt therapists pay closeattention to how clients phrase
things.
Language is powerful.
Gestalt therapists pay closeattention to how clients phrase
things.
Rachel keeps saying I should bestudying more or I have to pass
(04:05):
this exam.
Those shoulds are everywherewith your client.
They're sneaky.
They're often borrowed fromoutside, perhaps from family or
society, instead of what theclient actually wants.
So as a therapist, you help herpay attention to her words.
Maybe ask her to swap I shouldwith I choose, instead of I
should study more.
Rachel says I choose to studymore.
And wow, that really shiftsthings Suddenly.
(04:30):
She's not a helpless bystanderin her own life, she's making
choices.
It's subtle, but I promise it'simportant.
Let's continue this narrative.
Imagine Rachel says I have tostudy three more hours tonight
or I'll fail.
You nudge her politely butpersistently.
Can you try saying I choose tostudy three more hours tonight?
(04:51):
She might feel kind of silly atfirst or even protest, but
eventually the shift fromfeeling forced to feeling in
control is noticeable.
That personal responsibilitypiece Huge.
In Gestalt You're helpingclients realize they're not
victims.
Here's a big one.
You know how clients sometimeswant to run away from their
tough feelings.
Rachel says I just want toleave when I get anxious Totally
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understandable, right?
Who wants to sit in discomfort?
Well, gestalt therapy flipsthat on its head.
It's all about staying with thefeeling.
So when Rachel wants to bolt,you ask her to pause, breathe
and sit with that anxiety, evenif it's only for a minute, she
might say, uh, this is too much.
But you're supporting her asshe faces that uncomfortable
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emotion rather than alwaysrunning from it.
The key to using gestalt withclients is not to make the bad
feeling vanish.
If Rachel can stay with heranxiety, she might find it gets
a tiny bit more bearable.
That's the start of buildingtolerance and real awareness.
That's the start of buildingtolerance and real awareness.
Let's go even further withanother classic technique the
empty chair.
(06:00):
Now, this one might show up onyour exam and, to be honest, in
real life all the time.
If Rachel's has unspoken stuffgoing on with, say, her parents,
the pressure, the unspokenexpectations, you might
literally put an empty chair inthe room and have her imagine
her mom or dad sitting there.
It's kind of like hey, rachel,what would you say to your mom
(06:23):
right now if she were here?
Or just as often, you can haveher talk to a part of herself in
that empty chair, maybe thesuper critical voice or the
scared little kid part that'safraid to fail.
Here's what might happen.
Through the empty chairdialogue, all those tangled
feelings can get spoken out loud.
Rachel might say things she'snever been able to say to her
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parents or even to herself.
That's another importantgestalt concept giving a voice
to the parts of your client thatusually silence and bringing
hidden conflicts into the open.
Now you as the therapist, youaren't there to interpret
everything she says.
Gestalt puts a huge emphasis onletting your client make sense
of their own words.
(07:06):
You might reflect back whatyou're seeing or hearing, but
you're not there to tell Rachelwhat her dream about failing
actually means.
That's her job.
But at the same time you don'tjust sit back and do nothing.
You're active, attentive,present.
The relationship you build, theI-Thou connection, as Fritz
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Perls and even Martin Bubertalked about, is where so much
of the work happens.
Speaking of for your exam,fritz Perls is the big Gestalt
name you want to remember.
Other names Irvin Polster andMiriam Polster, made significant
contributions too.
The approach is experientialand, honestly, some clients
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really respond to that hands-on,present-focused style.
Here's a quick mnemonic forsome contact boundary
disturbances.
In Gestalt I pray daily forrelief from class that stands
for introjection, projection,deflection, retroflexion and
confluence For the exam.
Don't forget these terms.
Here's a rundown with examples.
(08:10):
Cause you never know what willbe throw at you.
Introjection this is acceptingother people's ideas whole
without deciding for yourself ifyou believe them.
Like if Rachel says my familysays the only way to succeed is
to pass this exam, so I have to.
She's not stopping to wonderwhat she believes, she's just
(08:31):
internalized their standards.
Projection this is when you pinyour own pathologies on other
folks or circumstances.
Rachel might say my professorsare disappointed in me already,
when in fact she's feelingdisappointed in herself.
Deflection this is dodgingdirect contact.
Maybe Rachel answers yourquestions with jokes or changes
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the subject whenever her anxietycomes up, kind of like swerving
around the tough stuff.
Retroflexion Turning things youwant to do to someone else back
onto yourself.
Like if Rachel wants to shoutat the world for pressuring her
but instead she just beatsherself up inside Confluence,
losing track of where she endsand her family begins.
(09:15):
That blurred boundary where shecan't tell if her anxiety is
her own or just absorbed fromothers' expectations.
Make sure you know these terms.
Licensing exam writers love totoss them into narratives.
The philosophy behind gestalttherapy it's existential at its
core.
The focus is on mind-body unity, direct experience and, above
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all, personal responsibility.
You are always looking at howclients can support themselves
from within, not just rely onoutside crutches.
Here's an exam tip.
Gestalt therapy really aims tomove clients from environmental
support towards self-support.
For rachel, that might meanmoving away from only relying on
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external validation to buildingher own sense of hey, I, I've
got this.
Don't trip up on how this mightlook on a multiple choice
question.
You're not interpreting dreamsin gestalt the way
psychoanalysts would.
Instead, you focus on thepresent experience, even if you
might use dream content as a wayfor the client to access
(10:18):
different parts of herself.
For instance, asking Rachelwhat it's like to be the monster
chasing her in her anxietynightmare, rather's like to be
the monster chasing her in heranxiety nightmare, rather than
what she thinks the monstersymbolizes.
Another prime point gestaltinterventions are best when they
happen organically.
You're not forcing a client touse an empty chair just because
it's on your techniques list forthe week.
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You're sensing what fits themoment.
Therapy in Gestalt is meant tounfold through the client's
experience, not through achecklist.
Now applications a big exampoint.
Gestalt works well withindividuals, groups, even
families and couples.
But, heads up, it might not bethe go-to modality for, say,
clients with pretty severemental health issues like active
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psychosis.
The here-and-nowexperience-focused approach can
be overwhelming unless theperson has a fairly stable sense
of reality.
So let's continue with thenarrative.
Say Rachel gets stuck becauseshe keeps looping between I'm
going to fail and I have tosucceed for my family.
You notice she gets teary orangry, but she doesn't say much
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about it.
That's a cue for you to gentlyconfront her.
Like Rachel, I notice you'reclenching your jaw and looking
away as you talk about yourparents' expectations.
What's happening for you rightnow?
Confrontation here isn't aboutbeing aggressive.
It's really just inviting yourclient to notice discrepancies
between what they're saying andwhat their body is showing.
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And watch out for clients whoget really stuck in their heads.
Intellectualizing everything.
Gestalt can sometimes, uh, feela little too anti-intellectual
for them because it doesn'tspend a ton of time analyzing or
debating ideas.
It's about the raw, unfilteredexperience.
If you're thinking about usingthis approach in schools or
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classrooms, gestalt methods canactually slot in pretty well for
helping students get more tunedin to their feelings or even
for conflict resolution.
Just don't expect it to be thefix for every setting or every
client.
Honestly, all right, here's aquick list of terms to burn into
your brain before exam dayExamples so you'll remember them
.
(12:25):
Awareness, rachel.
What sensations are you awareof in your body as you talk
about the test.
She might notice her tightchest or sweaty palms.
Confrontation I hear you sayyou're confident, but I see your
hands shaking.
What's that about Dichotomy?
Rachel's stuck between totalsuccess and total failure, like
there's no in-betweenRetroflexion.
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She turns her frustrationinward rather than expressing it
to others, so she feelsself-blame instead of honest
anger.
Unfinished business all thoseshoulds left over from growing
up still running the show Forthe exam and for real life.
The main Gestalt goals are buildyour clients' awareness of
their actual experience rightnow.
(13:08):
Help them deal with lingeringold issues that block them in
the present.
Encourage personalresponsibility through real,
felt choices, not shoulds.
Use in-the-moment techniques.
Exaggerate sensations, staywith tough feelings, swap out
powerless language, play outdialogues in the empty chair and
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boom.
Watch your client become morepresent, self-supporting and
less controlled by automaticfluff from the past.
All right, last tip Don'tforget that, as the therapist,
the most important technique isactually being real with your
client Present, attentive, nothiding behind a therapy mask or
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textbook script.
It sounds cliche, but Gestaltis about you, the therapist,
showing up as your real self andinviting your client to do the
same.
Good luck with that licensingexam.
Stay present, focus onawareness, don't shy away from
using active techniques if theyfit, and trust your gut as much
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as your theory, and rememberit's in there.