Fritz Perls - The Founder of Gestalt Therapy

Fritz Perls was born in Germany in 1893 (died 1970) and is famous for promulgating Gestalt psychotherapy. He immigrated to South Africa to escape Nazi persecution (he was Jewish) and ultimately immigrated to the United States. Gestalt therapy was developed by Perls in the 1950s.

Establishing himself in New York, in 1952 Perls founded the Gestalt Institute of New York. Largely influenced by research concepts derived from studies performed by psychologists working on human perception, Perls used self-perception as a fundamental building block. Gestalt theory uses the maxim, "The whole is different from the sum of its parts", which helps to explain not only how we perceive ourselves in terms of basic functionality, but how this affects our whole psychic system in a generalized way.

A practical example is in shape perception. For instance, consider a square which as a geometric figure comprises four straight and equal lines bounded by four right angles; however we do not see this. What we see is a square. Though the square must comprise the straight lines and angles, it is the complete shape we see ? in other words the square is very different spatially from the component parts. In this respect Gestalt theory is therefore a holistic way of approaching psychology, wherein the individual psychological components, whilst important, are very different from the gestalt complex which is formed and which will have very different function. In other words, Gestalt theory does not rely on study of underlying psychological components but on what the completed psychological 'shape' is and does. Human beings are viewed as a complicated, interacting system of psychological components acting as a complete body and places less reliance on individual features such as imagination, IQ, empathy and ability to move.

The Gestalt view of a person is as a fully integrated being functioning through time and space where an individual's psychological components do not operate in isolation.

This has ramifications for patient treatment. In Gestalt theory a patient cannot expect to be successfully treated if individual symptoms and psychological components are only addressed. For treatment to be successful, the entire psychological being must be examined and assessed, with treatment aimed at the entire spectrum of the patient's psychological profile. In particular, Gestalt theory places great reliance on what is known as homeostasis. Homeostasis deals with the natural, internal equilibrium of a living organism expressed in basic organic terms. This provides the ability to directly express patient health in terms of how the patient's needs are satisfied in a variety of environmental circumstances.

Medical and biological indicators may be blood sugar levels, blood pressure, muscle function and eyesight ability or what may be described as physiological functionality. Psychological functionality is expressed in homeostatic capacity, or how a patient uses adaptive mechanisms to achieve internal equilibrium. Underlying Gestalt theory is that physiological and homeostatic functionality is interlinked and that mental health cannot be distinguished from physical health in terms of assessment and treatment for a successful outcome.

Organisms are subject to an array of environmental variables under normal circumstances; however they are only effectively able to adapt using one mechanism at a time. Accordingly, organisms develop a hierarchical process for employing adaptive mechanisms to be applied to themselves to maintain equilibrium based upon what is most readily apparent to the individual. Most urgent needs are treated first and an organism's categories urgency in a very short term scope, creating what is known as a "figure in the background". Gestalt theory utilizes this figure in the background analogy to see the organism as a viable reflection of the true self, and that mental health issues arise when the homeostatic process is unable to adequately operate. A failure in the homeostatic process means there is a failure to properly identify their urgent needs in proper alignment with the existing environment, typically because of rigidity in how the patient views and interacts with their environment.

Mobility is the major differentiating factor between healthy and neurotic patients. A healthy subject will actively interact with their environment in a dynamic fashion as they respond to change and either adapt their own posture or seek to change the environment around them. This requires a high degree of self-awareness, and Gestalt theory seeks to reactivate that self-awareness through whatever underlying psychological disorder is present. By re-establishing environmental connections between the patient and changing environment, the patient is able to achieve a personal sense of achievement and avoid the sense of inadequacy or frustration which frequently results otherwise.

Increasing the patient's self-awareness and understanding of the wider world is a prime gestalt technique. Gestalt therapists will typically employ the Five Questions which are:

• What do you do?
• What do you feel?
• What do you want?
• What do you expect?
• What do you avoid?

Perls himself came up with the analogy of patients being like onions which had layers to be carefully peeled away until the true inner-self was revealed. Thus, examination may start with the physically observable as expressed in the initial question on what you do, progressing to indistinct emotions and sensory feelings, such as how a patient feels. Ultimately, examination progresses through to cognitive and volitional issues as evinced in patient questions in respect of what they want and what do they wish to avoid. Aside from patient responses, the Gestalt therapist will also look for non-verbal language and cues to assess the truthfulness of patient responses and what defensive strategies or self-manipulation is being utilized by the patient.