The Thinking Mind Podcast: Psychiatry & Psychotherapy

E77 - Gestalt Psychotherapy & Training as a Therapist (with Sarah Paul)

Gestalt Psychotherapy is an often under-discussed, yet widely practiced form of therapy that was developed in the 40s and 50s by a psychoanalyst Fritz Perls, his wife Laura Perls and Paul Goodman. Gestalt therapy came to prominence during the counterculture movement of the 60s and focused on an individual's experience of the present moment, their relationship with their therapist, and the psychological adjustments people make in response to their environmental and social context.

Today, on the podcast to discuss Gestalt psychotherapy is Sarah Paul. Sarah is a tutor of humanistic psychotherapy at the Metanoia institute in London, a UKCP registered gestalt psychotherapist and a certified couples counsellor. She has been working with people therapeutically for more than 15 years and aside from her psychotherapy experience, she is also experienced in working with individuals with severe mental health difficulties, homelessness and substance misuse problems.

In today’s episode we discuss Gestalt psychotherapy, its historical origins, some of the core principles of the Gestalt approach, its strengths and weaknesses, the barriers people have to changing, Sarah’s own approach to psychotherapy, some of the challenges of training as a therapist, and much more.

Interviewed by Dr. Alex Curmi, a consultant psychiatrist and UKCP registered trainee psychotherapist - Give feedback here - thinkingmindpodcast@gmail.com

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This is the Thinking Mind Podcast, a podcast all about psychiatry, psychotherapy, psychology and related topics. Gestalt psychotherapy is an often under discussed yet widely practiced form of therapy that was developed in the 40s and 50s by a psychoanalyst, Fritz Peretz, his wife Laura Paz, and Paul Goodman. Gestalt therapy came to prominence during the counterculture movement of the 60s, and focused on an individual's experience of the present moment, their relationship with their therapist, and the psychological adjustments people make in response to their environmental and social contexts. Today in conversation with me to discuss Gestalt psychotherapy is Sarah Paul. Sarah is a tutor of humanistic psychotherapy at the Metanoia Institute in London, a UCP registered Gestalt psychotherapist and a certified couples counsellor. She has been working with people therapeutically for more than 15 years, and aside from her psychotherapy experience, she also has a background in working with individuals with severe mental health difficulties, homelessness, and substance misuse problems. In today's episode, we discuss Gestalt psychotherapy, its historical origins, some of the core principles of the Gestalt approach, its strengths and weaknesses, the barriers people have to changing their own approach to therapy. Some of the challenges of training as a therapist, and much more. As always, if you value the podcast, there's a few ways you can support it. You can share it with a friend. Give us a rating, follow us on Apple, Spotify, or wherever you listen or follow us on social media. If you want to support us further, you can also check out the Buy Me a Coffee link in the description. Thanks for listening. And now here's today's conversation with Sarah Paul. 12s Thank you so much for coming on the podcast. Thank you for having me. I've wanted to make a podcast about the gestalt approach for a long time, so I'm really keen to explore that with you today, and also just to explore your approach to therapy in general. But the first question I might ask is what's what originally brought you to psychotherapy? My understanding is it wasn't sort of your first career. It was a choice you made later on. How did you decide on that? What's what influenced that choice for you? Sure. So, I mean, I think the idea of something therapeutic had been around for me since I was very young. So when I was like 14, I wanted to be a music therapist originally because I played piano and flute, played in lots of orchestras, really, really loved that. And I also always knew I wanted to do something involving people. So initially, music therapy seemed like the kind of the fit for me. Um, so I went off to university to study music, and um, whilst I was there, there were a sequence of very difficult, um, incidents in my own life. My dad died very suddenly in a plane crash in my first year. My mum moved to the States to remarry a year later, and as a result of those sort of a sequence of events, I went into therapy myself in my third year with a therapist, um, that my cousin, who's also a therapist, passed me onto, um, which I think was the first time I'd really found therapy useful. I'd had a few little bits of therapy and counselling whilst I was at secondary school for one reason or another, but hadn't ever found it that helpful. Um, but this particular period of therapy I found really, really useful, um, in terms of the particular kind of more relational approach I suppose she took with me. Um, and I think at the same sort of time. So I then sort of left university, having had that experience, went off to, um, sort of gather some other work experience, I suppose, worked in homelessness and mental health and dual diagnosis, mental health and substance misuse for quite a long time. Um, and the more I thought about it, the more I thought I wanted more tools than just music that I could use to work with people. I think music is a wonderful tool, um, for helping people for whom speech is not a natural way of coming at difficulties. Um, but the thing that particularly took me to Gestalt was the fact that I could use music, as well as other creative ways of helping to find somebody needed helping to meet somebody. Um, so Gestalt and psychotherapy just seemed to me at that time to be like a broader approach, something that I could do, um, that would encapsulate music rather than kind of just being that one narrow, um, way of doing things, I suppose. So that's kind of the broad picture, I suppose, of how I got there. 2s You mentioned the relational approach helped you. And for those that don't know, you know, not every psychotherapeutic approach involves a relational approach like cognitive behavior therapy typically wouldn't involve a relational approach. What does it mean to adopt a relational approach in therapy? 1s Oh, that's a big question. Um, I suppose I can tell you what it means to me. Um, what it means to me is that the relationship between the client and the therapist is a fundamental aspect of the healing that would take place. So it would be using my understanding of how my client relates to me, or how I relate to my therapist as a way of illuminating how things might be going on in that person's world in general. Um, so I might be able to get a better idea of of why this person keeps running into the sorts of difficulties that they do. But I think from a client's perspective, um, if I stay with what we were speaking about just now, for me, it just felt like it just felt much easier to talk to somebody about things that were really painful and really difficult and really vulnerable. If I really had the sense that somebody was really in the boat with me, um, feeling it and helping me see that they were feeling that so that I didn't feel so alone with it. I think. So, I guess to me, that's kind of the nub of it, that sense of two humans on a feeling based, empathic journey together, um, trying to help each other through something. I suppose that's its base. 1s Mhm. That's interesting. So you mentioned two things there. The second thing you mentioned was really developing a therapeutic rapport, a feeling of collaboration, of emotional attunement that helps you feel understood, less isolated and therefore you can confront. Your vulnerability is the really difficult material. But then the first thing you mentioned was. 1s Daring to examine the relationship between a client and their therapist can help them understand, oh my God, what are these patterns I'm running into in my regular life and all my other relationships? If I feel abandoned, for example, with my therapist, is this relevant? If I also feel abandoned with my romantic partner, with my friends sometimes. So these seem to be two facets to what you are saying though. Yes. Yeah. I mean, and for me, the one can't happen without the other because how am I, as clients, supposed to talk about these things that might be full of pain or full of shame or full of vulnerability? And if I don't get the sense that somebody is keen to be gentle with and loving with me in that space, um, you know, and willing to really enter into what that might feel like. Um, it's going to make me much more willing to do that, I suppose. Mhm. And the other thing that this leads to is the idea that. Really part of the therapy. Is for the therapist to be kind of a flawed person, to make mistakes, because those mistakes are can. What creates those mistakes can create useful material to be discussed in the client therapist relationship. And I think a lot of people, whether they're therapists or just working in mental health more generally, we often want to portray ourselves as being very perfect and sensible and wise, and hopefully we are to a degree. But it's also important that that we have flaws, and that's when our flaws crop up and influence the therapy that it's acknowledged on the part of the therapist, because then that can help. Really move the relationship to a deeper level of maturity, because a relationship that's like, I'm super wise, I'm a super knowledgeable expert and I'm not really fluid and you're super slow. There's not a very mature relationship, whereas a relationship between two flawed individuals has a much, which is much more likely to be real, has a greater capacity for like that intimacy you mentioned. Absolutely. And and also it just isn't. It's kind of almost like gaslighting in some way to sort of assume that I'm sitting there and I've got all the answers and let me kind of pontificate to you and show you how you should do things, and the client's like, but that doesn't feel quite right for me. That doesn't quite fit for me. But I must do it because you're the therapist and you're the wise one. And I think I'd much rather help somebody to find their own resources and learn to trust it themselves. Um, which might include sometimes pointing out how I've got it wrong. And I think it's Yellen that says this, but there's a lovely Yellen quote that I always remember that my view of what ever it is that, that the client is struggling with will always be less profound and less deep and less nuanced and meaningful than the client's view on it. So if I can kind of be patient and, um, attentive to really understanding what it's like for that person to be in their world, then and then they see me get it and we get it together. I just think there's so much more richness and use in that place. 1s Yeah. People would get a lot more, uh, insights out of insights that they generate themselves. Whereas the often insights I find insights that other people tell them can be correct, but they just don't land with the same degree of impact for whatever reason. Absolutely. Yeah. Like it's not even if it's just not in my own language. Even if I haven't language it myself, then it will make a bit less sense or it won't kind of clunk in that way that things do when I suddenly get hold of what I'm doing, I'm like, oh dear. Okay, yeah. And now I get it. Um, like, there's something like you need to have the entire receptive experience of like, oh, God. Yeah. No, that's it, isn't it? Ah. 1s Then, um, I think even Perl says this. He says it's the difference between, um, shining a flashlight on something to illuminate it, and the internal combustion of a of a coal that glows from the inside because it just gets it. Like that's how he describes the difference between awareness. There's I see that and oh my gosh, I feel that, you know, so going specifically more into the gestalt approach, I think to people who haven't studied it, Gestalt is probably either very mysterious or maybe a little bit stereotyped. They might think of the empty chair technique and not a whole lot as what do you think are the fundamentals of the Gestalt approach and what distinguishes it from other forms of psychotherapy? Well, I mean, the thing that I think is most exciting about Gestalt is the real willingness and ability to lean into what's happening in the here and now as a way of understanding the whole picture, and to have that real sort of immediacy of approach so that I would be paying just as much attention to what I'm feeling, thinking and noticing in our dialogue right now as I am to what you're telling me about what happened back then. And I'm going to be using the one to illuminate the other so that that really, in my view, kind of puts awareness on speed in a way. Um, because if we can not only think about what was happening, but what still is happening, and right here, right now between the two of us, then we've got a chance of really making something quite live in a way that we can then really work with. So for me, that immediacy, that here and now approach is generally sets us apart. Um, as in, if you were to watch a set of different practitioners in a room, I would expect the gestalt person to be working in that much more immediate way. I mean, the sort of three pillars of gestalt, if we think theoretically, we would say would be field theory, dialogue and phenomenology. Um, as in like, these are the three things that we hold as key to sort of holding the approach together. So working in a phenomenological way, in an experience near way, um, so that we help somebody really to get the feel, the embodied feel of their experience of something. But also including that within a dialogic approach, by which I mean what Martin Buber called I thou. So the my who I am holding who you are, and seeing you as a human being, and all your depth and complexity as we work through this experience and helping you feel me, feel that just a few things to do at the same time. Um, and field theory being the idea that, um, everything is present all at the same time, it just depends on what's coming into figure. So, you know, my past historical field, my current field, they're all present, all at the same time. It just depends what is coming forward for my attention. So I would be encouraged to pay attention to that current figure, whilst also holding the whole of the rest of somebody's life experience around the outside of it. So not just working in isolation with one issue, but holding it in context of the whole space. I will definitely dive into more, but commenting on those three pillars. So the first pillar phenomenology that is. Awareness of what's happening for a person here and now. And that will presumably include their thoughts, their emotions, how they feel in their body, perhaps an awareness of how they're holding their body in space as well. And also the therapist being quite candid about what they're thinking, what their emotional reactions might be, what their somatic reactions might be. So there's a big awareness of the here and now. And then the second pillar, you mentioned the dialogic approach. Keeping in mind both people are complex. As we said earlier, both people have flaws and it's kind of almost an exchange of experience. And then the the third pillar that you mentioned, field theory, is the thing that helps a person reconcile what's happening now. With the sort of summation of their past experiences. Is that a good way to summarize it, do you think? Yeah, I think it's I think as a way of thinking about it. And really, when you're thinking field theory or thinking figure and ground, that our whole experience forms the ground of our experience and what comes into and out of figure will be interesting at different times, but all forms out of the same ground, if you like. And I think this is a very important point because we're really talking about perception. And of course, Gestalt by its name relates to, you know, old theories about psychological perception which hold which are very valid. And something I've been thinking about a lot is the difference between sensation and perception. Sensation is the raw data we take in, and then perception is what do we make of that raw data in light of, for example, our past experiences. So to make this more concrete so people can understand it, imagine two people walking into a party. One of them's socially anxious, one of them's not particularly. And they both see a group of people laughing as soon as they walk into the party. The group of people laughing is the data. There's a group of people laughing. That's kind of the raw facts of the situation. But the perception, because of their fields and the field of the socially anxious person is one of, you know, social interaction can be a bit dangerous and a bit threatening. The field means that what stands out to that, that the socially anxious person is, maybe those people aren't just laughing, maybe they're laughing at me. And that's a perception rather than a sensation. So is that kind of how field theory can help us understand how we interact with our world? Yeah. Yeah, absolutely. That the what becomes figural to you as is informed by your experiences to this point in your life? Absolutely. So somebody who never had to worry about whether or not somebody was laughing at them, quite possibly just wouldn't have even noticed that I would have just sort of it would have been part of the background hum of people having a great time at a party. Of course, somebody who's been heavily bullied and used to feeling humiliated, um, is likely to tune in to that sound more sharply and more quickly and make different meaning of it based on their experiences to date. And obviously that can be really complex as well. So that doesn't have to include sort of really. Uh. Big T triggers. If you like things like, you know, bullying or big experiences that I could put my finger on and say, this happened to me and therefore I still worry about that. It can also be much more subtle things as well. It could be, um, a difficulty in early attachment. That means that you tend to find new environments more threatening than inviting, you know, perhaps an early experience of a caregiver who, for whatever reason, didn't particularly look up or even notice when you came in the room, um, is going to leave somebody with a different set of expectations as they walk into new spaces than somebody who was delighted and simply because they walked in the door and said, I am here. Um, some of these things can be can be quite subtle and also differences in temperament and differences in life experiences that just help to highlight what we do or don't make important. And that's one of the things therapy can get quite interested in is, um, how somebody can come to make the meaning that they do. You know how is it that the thing that this client, first of all, noticed is that, um, I look a bit stern, you know, for example. And whereas if I sit with thinking about that and I think, oh, do I feel stern, perhaps I just feel tired and a bit thoughtful. Um, but their reality is that I look stern, and it doesn't mean that their reality is is wrong. It just means that that's their reality that I need to then get interested in. How did my face read as stern in this instance? What meaning did you make that? How did that then change how you interacted with me? Exactly. So someone's face being stern would be the sensation. And then deciding as a result of that. Stern is. Perhaps my therapist is upset with me, or my therapist doesn't like me or whatever. The narrative that spins out as a result of that, that's the perception. And then that can, if it's examined, that can help the client understand, okay, this is my pattern because I had these experiences before. 2s Absolutely. Yeah. Or even just to notice. Even just to put in a bit of a pause and think, you know, I might have noticed that that face looked a bit stern, but I, you know, just to put in a bit of a pause before the assumption is that therefore they don't like me, therefore I'm going to stay quiet, you know, because so far that's an assumption. It's not necessarily one that's been checked out. So even if we never understood where that assumption emerged from, even if the client can be encouraged to just put in a bit of a pause and think, well, hang on, what are the other possibilities we've got going on here? You know, I've just literally walked in the room. I don't think I've said anything yet. That's going to have annoyed the person that much that their face looks really stern. So let's just keep on going here. You know, even that just can improve somebody's self-support a little bit to tolerate situations that previously they would have just withdrawn or shut down from. 1s We've already talked a bit about some theory, and already the complexity of some of the ideas is the complexity of some of the ideas are starting to stand out. How do you manage it when you're sitting down? So you're sitting down for the first time with a new client. What's your approach? Is what are you thinking? Is there anything in your head? Do you have a clear head? How do you approach that kind of situation? For me, the first. Um, order of business, I suppose, is just to create a space in which somebody can settle into the space and start to talk about what brings them, because people usually come with some sort of idea about what's been causing them difficulty. So I try not to reconfigure it too much at all, really, that we might have had some contact by email or by phone or something, that I would have some sort of idea about what they were hoping for. Um, but I would try generally to create a bit of a space in which somebody felt able to just start talking, just start talking about what had been bringing them. And then as they're doing that, I'm attending on lots of different levels. So I'll be hearing the content, because that's going to be important for most people. They want to know that you've understood why they're coming and what they want. Um, but I'm also going to be attending to things like how they're telling me, um, are they discounting themselves? Are they dismissing themselves or are they cutting themselves short? Or maybe they're being very good and telling me all of what they should be doing and what they what they think I think they should be doing. They're doing the work for me. Then I start noticing sort of patterns and nuances in the way that they're communicating with me. That might give me some early idea of what's going on for somebody. So, you know, perhaps they're coming because they're feeling very dissatisfied at work. You know, they are capable of much more, but they never seem to be the one who gets the promotion. And what I start to notice in the session is how much the client is talking and talking and talking and talking and doing the work for me, telling me, well, you know, it's because of this and it's because of that that happened. And therefore I have to do this. And I'm sitting there thinking, gosh, you're working so hard over there on your own. I guess it's quite easy to just leave you to get on with it. And now I'm starting to get a picture of how this client might get missed in the world. So then I suppose I might start building on those ideas to think about how I could offer something useful to the client. So I might even just offer something as simple as maybe we could pause and see how you're feeling as you're starting to tell me about this. If nothing else, just to put a bit of a a pause in the flow so that the client can start to actually track their emotions as they speak. And remember that I'm in the room with them and therefore they're to help. I'm not necessarily going to dive in straight away with my diagnosis of the situation, because I don't think that's going to be particularly helpful, but just to help somebody to start to. Slow down and notice their emotional experience as well as their content, so that we can start to knit the two together. Does that make some sense? Yes, and obviously all of this. 1s Involve some degree of change, change in the way that you choose to interpret events. You know, once you start to get the awareness and then do you think changing how a person acts in the world in between therapy sessions is, is quite important? Or do you find that doing the work in therapy is sufficient for most people? How do you think that works for your clients in general? 2s Do you know what I. I think I'm probably a bit unusual for a twist on this one, because I think that's heavily client led. I have some clients for whom they will just really lean heavily into the therapy. Um, and the working through that we do in the sessions kind of makes the change on its own. And they'll come to a session one day and say, do you know what I, I went to do that thing where I just get on with it at work. And I suddenly thought, why am I doing this? Maybe so-and-so could do it today, you know, and they'll they'll have noticed a shift that's happened as a result of the work that we've done. Um, and for some clients, that's enough. And that feels satisfying. Um, but there are other clients where the work doesn't integrate itself quite so naturally. Um, and there's a frustration build up of, like, how can I start putting these things into place in my life? And then I think there is a function of some sort of homework. If you like. Like even if it's something as simple as asking somebody to pay attention to. 1s Uh, you know, I suppose in the session you've been talking about, um, 1s uh, drinking too much, for example. Um, and what that might be, um. Avoiding what? Drinking too much might be avoiding. You might set somebody something really simple, like, you know, maybe during this week when you notice that you want to have a drink, just put in a five minute pause and get your phone out and make a note of what you are noticing, what feelings you might be having that you, you know, maybe wouldn't listen to if you went straight away to get that drink. And then we can talk about it, we can bring it back together. And for some clients, that gives them a link between sessions so they don't lose touch with the therapy or lose touch with the inner journey that they're on. And I think that's quite variable from clients clients. Some really like it. Some are doing the work quite naturally already. Yeah, yeah. I'm a and is this what she was calling? Start an experiment or an experiment? Must be something you do in the session and serve. Absolutely. Yeah. And, um, experiments are one of the most wonderful things about Gestalt, I think, because, um, I remember my first year reading this little quote that said, in Gestalt, you can do whatever you like, as long as it's ethical and aimed at raising awareness. And I really liked that quote, because it sort of gives permission for a bit of craziness from time to time just to actively try something out, you know, like instead of just talking about it. I used to call that about ism, and he had lots of rude ways of talking about it. Um, but one of the ways that we can work is just to actually try something out in the space. So, yeah, it could be, um, something that you could do in the therapy room itself. People, a lot of people have heard of empty chair or two chair experiments where you take a dilemma and you put one half of the dilemma on one chair and one half of the dilemma on another chair, and they have a conversation with each other. That's a really great experiment. It helps the therapist to notice the differences between each part of the dilemma that the client maybe isn't naturally noticing, and bring forward the feelings attached to both halves of a dilemma that somebody might be trying to squash, rather than pay attention to that. So you can do all of these experiments in the therapy room itself, or, yes, like you were just saying, you can ask somebody to try something out at home and get the experimental attitude. 2s And that technique, also with dilemmas, helps people to understand that dilemmas. 1s Are often reflective of inner conflict. So the reason why people get into dilemmas, why they find certain choices hard to make, is because each choice. Is reflective of a different part of themselves. For example, if someone has a dilemma about starting a PhD because they would prefer to start a family. Starting the PhD might reflect the part of themselves that academic that wants to perform. Perhaps one that wants to please their parents. And the other 1s side of the dilemma might reflect the part of themselves that wants relationship, that wants connection, that wants to nurture people. And people don't generally think of dilemmas in those terms. They don't. We don't tend to think of ourselves as composed of lots of different parts of ourselves. And I guess it was the psychoanalyst that first. 1s Uh, woke us up to this idea that we're not kind of one unit, but we have all these little conflicts within us, and a lot of the work in psychotherapy, I think, kind of regardless of the approach, is how can we get some degree of reconciliation between all these different parts of ourselves, get things kind of rowing in the same direction, if you like? Absolutely. And perhaps there's a way that they can be more integrated so that you can, uh, feel connected and, um, in relationship with others whilst pursuing your academic, um, dreams. You know, maybe they can happen at the same time, or maybe even if they can't, we can get some more clarity on what it is that really, really matters here so that a difficult choice can afford to be made because the best choice out of a difficult set of choices was clear. For people who don't know how to get started starts. What was its origins? Gestalt originally was kind of Fritz Pearl's, um, baby, I suppose so. Fritz Perls was an analyst originally, and I do think you can see that in his work later on, his psychoanalytic beginnings, um, find their way through the approach. Um, but what I think Fritz Pearls fell out with in terms of the psychoanalytic school was the idea of so much kind of, um, long talking about and the therapist being a heavily kind of blank screen, um, that it took a very long time. And, um, the client quite often didn't come out of it with a sense of personal responsibility or personal agency or personal efficacy. They would just spend a long time in the presence of a blank screen, uh, talking over the same and same things and nothing really kind of moving. So I think he took issue with that. And he said, well, why can't we make things more potent, more present, more immediate, more now? And of course, what he was building on was, excuse me, was the zeitgeist of the 60s in the 50s and 60s. We'd just come out of two awful world wars. We'd just come through the Holocaust for its pearls, of course, was Jewish himself, so we'd seen some real horrors. Um, and I think there was an element of that kind of energy to make change happen that really inspired him to kind of create this approach. Now, obviously he didn't do it on his own. He worked with Ralph Heflin and Paul Goodman and actually his wife, Laura Perls, um, had a had a lot to do with the original development of Gestalt theory, where he used this kind of psychoanalytic idea that talking is what works, but then really built in the Gestalt psychology idea of like, well, let's consider the fact that people are created within contexts and we can't ignore context. And let's build in the ideas from like Reiki and body armor. That embodied experience matters as well, and further build in some psychodrama and say, well, let's actually bring this to the here and now, to the experiential here and now, so that we can actually kind of work something through in the experimental moment. So this was kind of all the and existentialism and Zen Buddhism, there's all these different routes that take place that hold the approach together. And in some ways, I think you still see that now these varying different approaches, um, that that formed a kind of. 1s Uh, sort of were collected together and called gestalt. But there are still so many different practitioners with so many different views on what Gestalt looks like and should be and is and isn't properly informed by the fact that the early collection of ideas was, um, 1s I don't say loose because that's the wrong word, but were brought together from so many different places perhaps. Yeah, yeah. One of the things I liked the most about Gestalt is the emphasis on the importance of spontaneity in how a person lives their life, and that it's so important that the person has access to spontaneity. And often when we talk about spontaneity, we kind of talk about it in a frivolous way, like it would be a bit more spontaneous, should be a bit more fun, make a plan spontaneously. But I think the importance of spontaneity is much deeper than that. And I see people having quite deep psychological problems. And and one of those problems is a lack of access and a lack of ability to rely on spontaneity. Can you comment on the importance of spontaneity for us psychologically and how? Psychotherapy can help us get. Get that back. 1s Absolutely. I think for me, one of the. Main difficulties people can get into is is simply overthinking, um, spending too much time trying to weigh the pros, the cons, the do I do this? The do I do that? What if I do this? What if I do that? And none of it. All of that keeps us really firmly in one place. And it keeps us in a really heavily cognitive plane in which we're trying to weigh complex equations on our own, in isolation, in a very thought based way. And I just think that's quite limiting in terms of how am I supposed to really think through something that is a real visceral, gut based experience that also involves other people? I can't work it all out quietly, on my own, in my head, and come to the absolute right conclusion, because it's either going to be dead end, because I've made the right choice and it feels awful, or it's something that I've done out of relationship with other people. I've I've forgotten that there are other people involved in this situation, whereas. You know, if I can actually try on some different ways of doing things, while I'm going to get much more immediate feedback if I can try on, um, something, you know, I don't know. I suppose I want to take a risk about being bolder in my interactions with people. I can think through exactly how I might like to do it and, um, get feel ever so passionate internally about it and then never actually kind of do it. Or I can actually just take a risk and see how that felt. Now that's much more overwhelming. Obviously, it's much more immediate, much more visceral, but I'm going to know much more quickly, um, what what what's right for me, what I need, what I need to do. Yeah, that's kind of going back to your point that you mentioned previously that. For early psychoanalysis. It was all talk. Whereas we'd get started, what we're saying is, yes, let's talk about it. Let's gain some awareness through different means. Having got some awareness, let's try something out. In the real world, you learn a lot more than just by like sitting at home and thinking about it. You get real feedback from the world, but also. I think going even deeper with this. 2s You're a person's value system isn't just in their thoughts. It's not just what they think is important to them or important in general. Uh, again, I'll give a concrete example. If you want to find the job that you really like, it's you're not going to do it by thinking you're going to find a job you really like, by trying out different forms of work. And then eventually you'll find a form of work where kind of in your gut, it feels like the thing you ought to be doing. So there's a felt sense of meaning, a felt sense of fascination, which obviously can be accompanied by thoughts and emotions. But it's not just thoughts and emotions. Kind of feel it in our bodies. A large part of the time. But if we're all in our thoughts, we just remain very can remain very disconnected from our values, I think. 2s Yeah. I mean, if, for example, I think this is often why things like dating websites don't work, because if I think, for example, if I think through my my friendship groups, at the moment there are very few friends where I would say the mutual connection was about enjoying the same things, enjoying doing the same things. But if I look at the connections that I have, that's much more about people that can talk in a way that I find appealing, you know, that can hold a conversation at depth and at length and with passion. You know, those sorts of things are much more, um, obviously, for me, much more important than the stuff I might do together. So whereas it's quite easy to stay quite surface and say, well, what sort of things do you enjoy doing? I enjoy long walks and, you know, evenings in the pub or something like that, but I'm not going to enjoy any of that unless I'm enjoying the, the, the particular way that somebody wants to converse with me, you know, or unless I'm feeling inspired by the company or the contacts and that stuff is much more difficult to quantify. It's it's much more felt, isn't it? You've got to do it in relationship and you've got to know it. Um, and it's not until you try these things out loud or actually feel them, that you're actually going to know what it is that you need and what it is that you feel that you need the experiential data to support your suspicion, if you like. Yeah. A lot of what we're talking about is circling around the idea that. 2s Everyone has a nature, and it's really helpful to get to know what your nature is. And psychotherapy is a powerful way of getting to know your nature. Do you feel? 1s Inclines that you see that this kind of I seen in the zeitgeist. One of the trends of our zeitgeist is. I kind of sense that we should all. Be whoever we want, that in some ways we can invent our identity, invent our nature, rather than discover it. Is that something that you see much in your clients work? I kind of. A desire to be anything except who we actually are, and a resistance to discovering who we are. Is that something you see as well? 2s I think a lot of the time people fundamentally get in their own way. You know, either with feelings about how the world should be and isn't or how they should be and aren't. Um, you know, a lot of avoidance of just coming to terms with the reality of who you are and the situation that you find yourself in. Um, but in some ways, this is what makes Gestalt most exciting to me is, is that it doesn't, um, that who you are is absolutely available for fluidity. If I am sick and tired of things going a certain way for me, I have absolute agency. Mhm. Uh, it's a little bit strong. Most of the time I can make decisions to make that be different. I can allow myself to change what I'm going to have to come across as I do. That is all the reasons why I don't, or the things that I don't want to feel or the grief that I don't want to feel. All of the anger or anxiety that I don't want to have to feel. But, you know, on the other hand, the freedom that comes with that is is immense. Um, I don't have to remain in a box that I have designed or that somebody else has designed for me. I mean, I want to I feel like I don't want to get too carried away and forget that systemic systems do exist, that do keep people locked in place. Um. 1s And we still have some choice and freedom about what we do with that. Yeah, it's easy to overemphasize the amount of control a system has on us, and under emphasize what possibilities we have for change, especially, you know, historically, you can argue that in the West, people have more choice than most people have had throughout most of human history. Like if you're in the Middle Ages and you were born into the peasant class, you were born in the peasant class, and there's not a huge amount you can do to change that. Social mobility wasn't the phrase they used at that time. So I think it's easy to fall into that trap of thinking nothing's ever going to change. I can't change my circumstances, but I think the mistake people tend to make with this is they think I can change everything right now, kind of immediately. Therefore I can change. Whereas actually, if you plan out over a 5 to 10 year period and you make changes incrementally and consistently, there's a huge people have a huge, uh, bandwidth to change, in my experience. And even if you can't change the situation you're in, you can always reconsider your way of being within it, your attitude towards it. You're thinking about it. The way you are currently handling that situation is always open for reconsideration, which is more of an eastern way of thinking about it. Don't change the circumstances. Change the change your relationship to the circumstances. Yes. Yeah. And that's where that probably that Zen Buddhism, um, angle starts to make itself more obvious or the existential base of Gestalt. Um, well, one thing I, I'd like to talk about more on the podcast, I haven't talked about it enough, is really how difficult psychotherapy training is for a lot of reasons. It's, uh, it's a real lifestyle choice in a big way. I kind of liken it to joining the priesthood. You know, if you join a rigorous. Multi-year training program that has a certain level of expectation and commitment, which usually they would. If you're going to get accredited with boards in the UK like Bacup or UCP, that can be quite rigorous training programs. What do you think potential trainee therapists should be aware of in terms of the difficulties of training as a therapist? I think the biggest thing to be aware of is that you won't necessarily see it coming until you're in the middle of it. I think you're absolutely spot on. Training is a really difficult journey, and the thing is, it's almost impossible to completely prepare for what that's going to look like. I mean, there are some very practical things you can get ready for. Like, it's probably going to cost a lot more money than you'd ever expected it costing, which you're going to have to continue earning during training, which is then going to demand more of your time as well, because you have to give so much time to build and clinical hours and things like that, but also just the internal emotional journey you're going to go on, even if you've done plenty of therapy already and you're feeling in a good place in yourself, that's a great place to start training from. But it it requires you to really go into much more depth than your personal therapy might. Your personal therapy might be about making yourself more comfortable in the world, but then training is going to ask you to put another layer on top of that of but why is that how you have to be to be comfortable in the world? And what impact does that way of being comfortable in the world have for your clients who are going to come and see you, and it requires you to put a different lens on it again, and that can be quite, quite challenging. I remember one of my early trainers saying to me, oh, don't go into therapy, go into training and get much more bang for your buck, because I think that was exactly what she was talking about. You kind of see it on several, you know, it's not just you're not just holding what you need, but you're holding what you need and how you do things and what impact that then has for the people that then come to see you. It's not about becoming a different person, it's just about understanding the impact of the person that you are. Yes, you're learning more about yourself, but it's all now in training. It's been within the context of responsibility, responsibility to other people and the burden of making ethical decisions, which can be much more complicated than people anticipate. And I say that because. 2s A lot of people who go into studying therapy are the kind of people who really want to help their compassionate. They're agreeable, so they think unconsciously. Ethics is easy. I like to help people, and helping people is good. What's the problem? But a lot of the ethical problems you run into with therapies helping people too much. Rescuing people. A common problem people might encounter. Training as a therapist is. Without knowing it. Sacrificing yourself for your client, sometimes in small, medium or large ways, and having to learn to hold yourself back is a huge problem. I think for a lot of training therapists to let the client, it's hard for the client to take that responsibility. If if the attitude of the therapist isn't to hold, to stand back and let them take that responsibility for their issues. 2s Absolutely. And also within that, to see what impact your excessive stepping in is having for that client. Um, in some ways that that can be quite, um, alarming when people first sort of see it that although they had intended well and they meant well by, um, overworking for this person, when you look at it through the light of how you are, then disabling somebody who has never had anybody really championed their own ability to do what they need to do for themselves. Um, it can be quite confronting, you know, to realize that although you thought you were trying to be a nice person, actually, in many ways, all you've done is just repeat the thing that that client knew their whole life long, um, and resulted in the client incompetent rather than empowered. 1s We've talked about some of the strengths of the Gestalt approach. It's concentrated in the here and now, maybe can be a bit more immediate. It can allow people to experiment with their lives in a way that they can get real feedback from their therapist, but from the world, from interacting with people differently. What are some of the weaknesses of the Gestalt approach, and are there any other? Pieces of theory you pull from that really helps sort of round out your practice. 2s Yeah. Of course. Um. Well, I mean, so I think one of the potential difficulties of Gestalt, if you're applying it to pure purely to pure purist is not a word puritanical, puritanical, that's the word. Thank you. If you're applying it to puritanical, one of the issues, um, is that gestalt can be very potent, very to the point, um, but also forget the importance of, bizarrely, forget the importance of context and the importance of, um. 2s People needing time to get comfortable with new emotional states and with new emotional and sensory data. They need time to kind of integrate that. If you're to sort of, um, fast to help somebody to to point out where somebody is, um, tripping themselves up or creating patterns that they're doing over and over and over again. If you're too sharp and too potent and too quick, that can be quite overwhelming for a client, I think. Um, also setting I see this more in training. Um, people who are learning to adopt a phenomenological approach can can almost get a bit like the Spanish Inquisition after a while, where they're trying to help the client really drill down to an experience, but the client's just feeling a bit drilled into the wall. Um, so for me, the part that really that still needs to be at its best is the sort of relational theory holding that comes underneath it. So things like, um, 1s so I would always hold a developmental lens on it. I think about people like Daniel Stern and the importance of people's early developmental learning in the world. Um, I think that can provide a real support for clients to face very difficult material. If they've got a sense that you, as a therapist, know how they need to be held. So as much as I'm thinking about what my client needs from me and here and now, I'm also thinking about how they need me to hold them to face that. So if I have. Um, a client who had a heavily emotionally neglectful early experience. I'm going to put quite a lot of attention into making sure that they really know that I understood and heard what they're feeling, and that I'm going to be quite inclusive and quite careful, so that they can really feel that I'm holding the importance of their experience before I try and then offer something more challenging, because I think it's going to shore up the ground for them to move from. Um. 1s So for me, that developmental lens is always very important and also the relational lens. So I would think about people like Martha Stark who talk about the importance of using myself both authentically, so both using my authentic reactions, which is heavily in line with Gestalt theory, to help somebody understand themselves. But also at times I'm going to use myself more as a reparative object, which is much more person centered and style. And so if I have somebody who's feeling a great deal of shame, for example, about some experience that they're talking about, you know, maybe they're talking for the first time about how much they resented their grandmother and having to care for them. I might put myself in a much more. I'm going to maybe hold my authentic reactions back a little more, but bring forward the part of me that wants to hold the space of it's okay to have these difficult feelings, you know? And you can lean into my support here and know that that's okay as a way of providing. Support for what they're doing. So this is my view of the weakness of capital is that it can be too sharp. So you're balancing out a lot of the quick, kind of brutal insights you can get with Gestalt, with with an ear out and an eye out for is this too much? Because ultimately, insights that are too challenging for a client in any given moment of time will not only be not helpful, but can actually be harmful like they're. I think Carl Jung said, beware of the danger of unearned insight. Something like this. Oh yeah, that's such a great quote. Yeah, absolutely. Not only not helpful at best, but possibly harmful at worst. Um, and I just think you have to be aware of what ground you're treading on. Yeah, yeah. One question I was curious about. I'm not sure if you'd, uh, want to comment on it, but there's more talk of the involvement of psychedelics in mental health and mental health treatments, and. You know, guest stars really came to prominence during the counterculture movement. And as a as a set of theories seems to complement the way psychedelics, the way we think psychedelics work quite well in that psychedelics chemically help us open up a. 1s An opportunity for change, they induce a certain amount of neuroplasticity. So they give people a window where new insights perhaps can be taken in more easily, adopted more easily, internalized more easily. Do you think? 1s In terms of having a therapy that would work alongside the psychedelics. Do you think Gestalt and its theories could complement it well? And in the future, when these therapies are more available, they could work well together. 2s Urban. It certainly sounds that way, doesn't it? My hunch is that if Fritz Perls were alive today, he would be absolutely very interested in pursuing, you know, a different aspect of experience, I guess, is what I think about when I think about psychedelics opening to a different aspect of experience. And that is probably one of the things that Gestalt does quite well. It just stays really experienced, near and focused and interested and curious about what is happening right now. And to apply that with this kind of extra layer of the psychedelic treatment could be really quite interesting. I mean, it's not something I know much about, but I can feel interest, particularly in the sessions, I think, before and after the actual psychedelics themselves. Could you you know, the way a psychedelic therapy would work typically is you have a few sessions to kind of prepare, probably establish an intention of what you want to work on then. 1s I'm not sure if it's possible to have a really a coherent therapeutic approach. While the person is on the psychedelics. Although an expert might correct me on this and then after to reintegrate. Those experiences and try to figure out how what they've learned on that trip can help them move forward again and internalize those insights. Yes, make sense of them, I suppose. Like, yeah, I suppose it makes real sense because sometimes you have people that come to therapy because they've had some experience or another one when drunk or something like that, that suddenly made them go, oh God, you know, I really need to figure out what's going on with me here. You know, why is it that I can only do x, Y, or z when I've had a drink? You know, people are already in some ways kind of aware that if they get themselves into an altered state, other things become available. Yeah, it's amazing how just getting your brain to work at a different level of consciousness, even if it's just being drunk, can help us to gain some altitude in our situation and realize, okay, maybe there's some changes worth making here. If I could only, for example, socialize when I'm drunk and feel not anxious, then maybe. Maybe. What's wrong with me? Yeah, if I could, I if I could mobilize that part of myself that's usually mobile. You know, when I've had a couple of drinks. If I could do that without alcohol. Unstoppable. Sort of. 1s Um, in all of your sort of client work, your own personal therapy, your experience training therapists. What do you think you've learnt about human nature, which has kind of surprised you the most? 1s It's a big question. 2s I mean, ultimately how resilient people are, I suppose, which sounds silly, but people can go through the most incredible things and not only survive, but thrive. You know, and also the the variety within that always puzzles me as well, that you'll have people that will have gone through huge amounts and come out of it somehow unscathed or apparently unscathed. And others who will have had one very small incident happened that completely destroys them for many years. That always kind of puzzles me as well. Like, what is it that makes some people so incredibly resilient? Um, and others find it so much more difficult? That's that's the bit that. Continues to kind of. Puzzle me is how do we how can we ever imagine the this. A way of doing things that would safeguard everybody from trauma, because there probably isn't. Some people seem more susceptible than others. But mainly, the thing that always stands out to me is, is the desire for things to be better, for things to be different. You know, that real kind of reaching for the sun, reaching for the lights, the what's that? Carl Rogers told that potato story, didn't he? Where the potato always reaches for the light. And I feel like I see that over and over again, even in the darkest spaces. The yearning is to find a way through, a way to be together, a way to connect, a way, you know. 1s And people are intensely resilient. You know, we can all cope with a lot more than I think we think we can. Yeah, I think that's true. And I think not leaning on your resilience is a big reason why. People retreat from life and end up engaging with life a lot less and ultimately having a a less rich experience. But the other thing I was thinking about what he said was, you know, there's people who are more resilient and more sensitive, and we kind of know this from personality studies that emotional sensitivity is a trait partly genetic, partly environmental. 1s Did the resilient people. Also, on some level, if you're hyper resilient, do you also miss out on some of the rich experience of life because you lack a certain sensitivity? Because emotional sensitivity, although it has its drawbacks, it exists for a reason. It helps us maintain better relationships. We can pick things up and other people better would probably make a better therapist if we're emotionally sensitive. So the other question, which I'm not expecting necessarily to answer, is does the resilience naturally resilient people do they miss out on some of the vibrancy of life as a result? Is there a trade off there? I suppose you're right. I mean, what I was thinking is you were speaking was that this must all be I mean, we're primates. This must all be about functioning in society on some level that we need a combination of. I think I read something recently that, um. You must be able to correct me on this if I'm wrong, Alex, that there's some evidence that people who are diagnosed psychopaths contain this warrior gene, and this warrior gene creates this emotional blunting on purpose to enable somebody to go out and be a warrior in the very bloody sense of the word, you know, to tolerate battle over and over again and not feel it too intensely, whereas somebody who's much more emotionally sensitive just wouldn't cope. Um, whereas but that emotionally sensitive person will maybe be the one who's at home helping everybody make the recovery as they return from war. I mean, it must be sociologically important to have a mix of people that are able to, you know, and wouldn't it be great if as a society, we got out of each other's way and stop judging each other for having these different levels of sensitivity and allowed it to be the strength that it is, you know? Yeah, that we don't all have to be good at the same. Yeah. No, absolutely. The last question I ask is, you know, if. If someone's thinking about training as a therapist. Maybe they've just started out. What kind of advice do you have? You know, people often very nervous before their first client sessions and they don't know what to do. And how do I metabolize all the theory? How do I manage the soul? How how am I supposed to come off as this wise person if I haven't yet gone through the process? Well, what advice would you give to someone in that situation? Well to sound like a terrible cliché. Rome was not built in a day, and so don't expect yourself to, you know, really, you have to you have to allow for the fact that this is going to take the entire period of your training and some time beyond that, to feel really confident and comfortable in what you're doing. There's a huge journey to go on. And the best advice I could give is just to really enjoy and honor that journey and what you're good at and what you find easy and what you find difficult will shift as you go. Um, and you'll notice those shifts so much more profoundly when you're earlier on in your practice and your training. They become more subtle later on the line. So that can be really enjoyable as well. You know, suddenly noticing that you understand something that you didn't understand before or that you get something that you didn't get before can be quite exciting. So I would just as much as I can encourage it, it's a difficult and rewarding and wonderful process. So just to enjoy it at the pace it's meant to be enjoyed at, you know, rather than expecting brilliance of yourself. Thank you for, uh, spending some time with us today teaching us about Gestalt. Whether training is just training as a therapist or you're just curious, I'd encourage everyone to read a little bit about the this this piece of theory, because I think they can be really helpful for anyone. Are there any books you could recommend so people could learn more? Yeah, I mean, the The big Gestalt Bible has always Perls, Heflin and Goodman excitement and growth in the human personality, which is 1951. It's a bit of a tome. So if you wanted something that was more gradual, you could go with something really simple, like Dave Mann's 100, um, key techniques, I think it's called or something like that. Um, which is a really nice one for just, uh, pulling out the odd bit here and there when you've got ten minutes, you know, it's a bit more digestible. Perfect. Thank you very much for speaking with me, Sarah. Thank you for having me on this. 11s Thanks so much for listening this week. If you've got any feedback, as always, do get in touch. If you enjoyed the episode, why not give us a rating on Spotify or Apple Podcasts? Because it really helps other people to find us. If you want to get in touch, you can find us on Instagram or Twitter, or you can drop us an email. And if you value the show more generally, why not bias coffee? Thanks so much.