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Chapter One - Fifty Years of Gestalt Therapy

Delisle, Gilles Karnac Books ePub

CHAPTER ONE

Fifty years of Gestalt therapy

After four editions of his book, Maddi (1989) finally includes Gestalt therapy in his comparative analysis of theories of the personality. Even then, he considers it a recent approach and cites only three references to Perls: (1) In and Out of the Garbage Pail (1969), considered by some to be a simple autobiographical essay (Clarckson & Mackewn, 1993; Stoehr, 1994); (2) Gestalt Therapy Verbatim (1969); and (3) Ego, Humor (sic!) and Aggression, which he cites as 1969, although Ego, Hunger and Aggression was published in 1942. One can only conclude that the theory of Gestalt therapy is relatively unknown, if a recognized specialist in the field of theories of the personality fails to cite the fundamental 1951 reference (Gestalt Ttherapy: Excitement and Growth in the Human Personality) and if other important authors (Drapela, 1987; Hall & Lindszey, 1957; Pervin, 1990) completely ignore the approach.

In spite of its limited visibility, Gestalt therapy has made important contributions to clinical thinking and practice (Bergin & Garfield, 1991). The major contribution of Gestalt is the holistic perspective, the idea that the interrelations between objects and persons are such that no situation can be reduced to the simple sum of its parts. Consequently, Gestalt defends the notion, relatively new at that time (Perls, 1942; 1947; Perls, Hefferline & Goodman, 1951) that the real, here-and-now relationship is as important as transference (Clarckson & MacKewn, 1993, p. 87). For Yontef (1993), psychoanalysis, in recent developments, has clearly integrated many elements borrowed from humanistic psychology and Gestalt therapy, including recognition of the importance of the real relationship. Certain ideas developed by Perls and by Perls et al. have certainly been assimilated, whether consciously or unconsciously, by thinkers in the psychodynamic tradition, sometimes even being announced as their own original discoveries (Burgalières, 1992; Miller, 1988, 1991).

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CHAPTER NINE: Treating eroticism issues

Delisle, Gilles Karnac Books ePub

In order to treat issues around love and sexuality we must first allow a theme to emerge through specific types of impasse that will appear in various experiential fields. Then, meaning must be clinically constructed in order to finally resolve the issue or fully achieve the task at hand. These themes are likely to emerge just as much in fields 1 and 2 as in field 3. As with developmental issues, these impasses are treated and meaning is constructed through cycles of reproduction, recognition, and reparation.

It would, though, be wrong to believe that all impasses in the areas of love and sexuality result from the developmental issues that we have been looking at here. Many people come into therapy because something is not quite right in their romantic relationships but it does not necessarily follow that every romantic impasse is the result of a developmental problem in the area of eroticism. Unresolved issues of attachment and self-esteem are just as likely to undermine the romantic sphere. In other words, pre-Oedipal issues often appear in the romantic sphere and it is important to recognize them for what they are. What particularly characterizes a romantic impasse linked to an unresolved developmental erotic issue is above all a relationship between desire and the forbidden, and other similar bipolar dynamics such as:

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CHAPTER ONE: Developmental issues in the etiology of personality disorders

Delisle, Gilles Karnac Books ePub

The definitions of personality disorders in the DSM help us to form a clinical picture of how enduring and ego-syntonic psy-chopathology arises. This multi-axial system is the basis of and framework for classification in American empirical psychiatry. This methodology has some disadvantages. In order to separate personality disorders from clinical syndromes, the American Psychiatric Association (APA) has had to opt for an empirical epistemol-ogy designed to allow communication between clinicians of varying disciplines. However, this has meant giving up a whole heritage of knowledge that has been constructed over the last century, that of traditional psychodynamic and developmental epistemology. The DSM may well allow us to diagnose from verifiable observation, but it is of no use when it comes to understanding the etiology and the psychic function of a personality disorder.

These pathologies seem to be sufficiently specific in character for us to be able to distinguish them from Axis I disorders, and place them on Axis II. Let us examine their characteristics: they are generally present from early adulthood, tend to be ego-syntonic, and appear in a variety of contexts. They are woven into the very identity of the person: hence their name of personality disorders. Since these are intimately connected with the identity of the individual, we must understand that the person is immersed in what both defines him and is also the source of his suffering. Nowadays we cannot approach these complex structures of identity in a one-dimensional manner. Personality disorders are the result of several etiological factors, of nature and of nurture, genetic and psychological, as well as risk and resilience factors, present in the person and in his developmental environment.

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CHAPTER THREE: Object relations development theories: an overview

Delisle, Gilles Karnac Books ePub

Psychoanalysis has sometimes been accused of having become a hermetically sealed system, unwilling to be open to the influence of other approaches. However, even though its history is one of violent theoretical and clinical disputes, such as the huge disagreements between Melanie Klein and Anna Freud, contemporary psychoanalysis is nevertheless pluralistic. Its practice has evolved so much that today one might be justified in asking whether classical analysis in its present form may be threatened with extinction. However, regardless of how it is practised, psychoanalytic theory is today part of our universal heritage. We can reasonably selectively employ certain of its more illuminating points without actually having to adopt the whole of its theoretical basis, framework, and techniques.

In this chapter the reader will be given a quick summary of key psychoanalytic theories of development that will be used to inform the analysis of the essential issues of development in the following chapters. In a notable piece of work in 1983, Greenberg and Michell proposed that these diverse theories could be seen through the lens of their respective strengths and weaknesses, and additionally from the angle of their similarities. These authors approach the plurality of psychoanalytic theory using a preliminary epistemological differentiating tool to answer the question: what came first and what has grown out of it? Greenberg and Mitchell classify psychoanalytical theories of development under three major ideological lines: instinct or drive theories, relational theories, and mixed theories. While this system of classification is not unanimously accepted by the psychoanalytic community, for our purpose it will serve to underline one of the seminal points of object relations developmental theory.

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CHAPTER FOUR: Attachment issues

Delisle, Gilles Karnac Books ePub

The most important developmental issue involved in attachment is the establishment of the basis of our affective security, which forms the basis of the quality and the solidity of our engagement with others. When the attachment process is correctly negotiated, the capacity and the desire for contact and intimacy are installed in the infant. Interdependence then seems natural and it is accepted calmly. Those who have successfully mastered this developmental phase are better able to experience the reality of separations, without developing excessive abandonment anxiety. They are capable of being alone, without their solitude seeming to deprive them of creativity and productivity. The Other is not essentially a menace nor does he seem like the ultimate, perfectly secure refuge. The integrated representation that organizes the personality function could be expressed as follows:

“I am safe. The Other can care for me and protect me. My needs are natural, acceptable and tolerable.” The Other remains there and is able to respond. This basic security, the consequence of a good metabolization of the attachment process, can be observed in adults in love. In 1987, Hazan and Shaver demonstrated how one can find, in the romantic experience, the same types of attachment organization as in children.

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