MODULE 3 : HUMANISTIC THERAPIES.

UNIT 1: CLIENT-CENTERED THERAPY: VIEWS

ABOUT HUMAN NATURE, GOALS OF
PSYCHOTHERAPY, THERAPEUTIC
RELATIONSHIP
Person centered therapy
The person-centred approach was developed from the concepts of
humanistic psychology. The humanistic approach “views people
as capable and autonomous, with the ability to resolve their
difficulties, realize their potential, and change their lives in
positive ways” (Seligman, 2006). Carl Rogers (a major
contributor of the client-centred approach) emphasized the
humanistic perspective as well as ensuring therapeutic
relationships with clients promote self-esteem, authenticity and
actualisation in their life, and help them to use their strengths
(Seligman, 2006).
The person-centred approach was originally focused on the client
being in charge of the therapy which led to the client developing a
greater understanding of self, self-exploration, and improved self-
concepts. The focus then shifted to the client’s frame of reference
and the core conditions required for successful therapy such as
ensuring the therapist demonstrates empathic understanding in a
non-judgemental way.
Currently, the person-centred approach focuses on the client
being able to develop a greater understanding of self in an
environment which allows the client to resolve his or her own
problems without direct intervention by the therapist. The
therapist should keep a questioning stance which is open to
change as well as demonstrating courage to face the unknown.
Rogers also emphasized the attitudes and personal characteristics
of the therapist and the quality of the client-therapist relationship
as being the determinants for a successful therapeutic process.

Contribution of Maslow : Many of Carl Rogers’s ideas,

especially on the positive aspects of being human and the
fully functioning person, are built on Maslow’s basic
philosophy.
Criticized Freudian psychology for what he saw as its
preoccupation with the sick and negative side of human
nature.

Too much research was being conducted on anxiety,

hostility, and neuroses and too little into joy, creativity, and
self-fulfillment.
Self-actualization was the central theme of the work of
Abraham Maslow (1968, 1970, 1971).
Maslow studied what he called “self-actualizing people
The core characteristics of self-actualizing people are self-
awareness, freedom, basic honesty and caring, and trust
and autonomy
Other characteristics of self-actualizing individuals include:
A capacity to welcome uncertainty in their lives
Acceptance of themselves and others
Spontaneity and creativity
A need for privacy and solitude, autonomy,
A capacity for deep and intense interpersonal relationships,
A genuine caring for others,
An inner-directedness (as opposed to the tendency to live by
others’ expectations)
The absence of artificial dichotomies within themselves
(such as work/ play, love/hate, and weak/strong),
A sense of humor.

All of these personal characteristics have been identified by

Rogers as being central to the person-centered philosophy.
View about Human nature
People are trustworthy, resourceful, capable of self-
understanding and self-direction, able to make constructive
changes, and able to live effective and productive lives.
When therapists are able to experience and communicate
their realness, support, caring, and non-judgmental
 understanding, significant changes in the client are most
likely to occur.
Three therapist attributes create a growth-promoting climate
in which individuals can move forward and become what
they are capable of becoming:
Congruence (genuineness, or realness)
Unconditional positive regard (acceptance and caring)
Accurate empathic understanding (an ability to deeply grasp
the subjective world of another person).
According to Rogers, if therapists communicate these attitudes,
those being helped will become less defensive and more open to
themselves and their world, and they will behave in prosocial and
constructive ways.
Actualizing tendency
A directional process of striving toward realization,
fulfillment, autonomy, and self-determination.

This growth force within us provides an internal source of

healing, but it does not imply a movement away from
relationships, interdependence, connection, or socialization.
The person-centered approach rejects the role of the therapist
as the authority who knows best and of the passive client
who merely follows the beliefs of the therapist.
Therapy is rooted in the client’s capacity for awareness and
self-directed change in attitudes and behavior
 By promoting self-awareness and self-reflection, clients
learn to exercise choice.
Humanistic therapists emphasize a discovery-oriented approach in
which clients are the experts on their own inner experience and
they encourage clients to make changes that will lead to living
fully and authentically, with the realization that this kind of
existence demands a continuing struggle.
Goal of therapeutic process
The goal is to assist clients in their growth process so clients
can better cope with problems as they identify them.
The underlying aim of therapy is to provide a climate
conducive to helping the individual strive toward self-
actualization.
Before clients are able to work toward that goal, they must
first get behind the masks they wear, which they develop
through the process of socialization.
Clients come to recognize that they have lost contact with
themselves by using facades.
In a climate of safety in the therapeutic session, they also
come to realize that there are more authentic ways of being.
The cornerstone of person-centered theory is the view that
clients in a relationship with a facilitating therapist have the
capacity to define and clarify their own goals.
Person-centered therapists are in agreement on the matter of
not setting goals for what clients need to change, yet they
 differ on the matter of how to best help clients achieve their
own goals and to find their own answers.
Relationship Between Therapist and Client
Necessary and sufficient conditions for therapeutic
personality change” on the quality of the relationship
Rogers (1967) hypothesized further that “significant positive
personality change does not occur except in a relationship”
Hypothesis of Roger:
Two persons are in psychological contact.
The first, whom we shall term the client, is in a state of
incongruence, being vulnerable or anxious.
The second person, whom we term the therapist, is
congruent (real or genuine) in the relationship.
The therapist experiences unconditional positive regard for
the client..
The therapist experiences an empathic understanding of the
client’s internal frame of reference and endeavors to
communicate this experience to the client.
The communication to the client of the therapist’s empathic
understanding and unconditional positive regard is to a
minimal degree achieved
If the therapeutic core conditions exist over some period of
time, constructive personality change will occur.
The core conditions do not vary according to client type.
Further, they are both necessary and sufficient for
 therapeutic change to occur.

UNIT 2: TECHNIQUES OF CLIENT-CENTERED

THERAPY – EMPATHY, UNCONDITIONAL
POSITIVE REGARD,

Person-centered therapy, or client-centered therapy, places an emphasis on

the client as an expert. Originally founded by psychologist Carl Rogers, it
posits that people strive toward a state of self-actualization and therapy can
help a client reach self-awareness. A therapist’s job is to offer support
rather than any form of judgment or advice. Ultimately, it is the
responsibility of the therapist to create the proper surroundings for a client
to become a “fully functioning person”.
Therapist does not use techniques as much as they develop a therapeutic
atmosphere, there are certain behaviors a therapist must perform to create
the optimal environment. Let’s look at some techniques a therapist uses in
person-centered therapy.

EMPATHY

It is essential that a therapist exhibit empathy while applying person-

centered therapy techniques. Empathy is the ability to put yourself in
someone else’s shoes and relate to their experience. It should be noted that
empathy is different from sympathy. Empathy is showing understanding for
a person while sympathy is feeling bad for them. If a client does not feel
understood they will not feel safe with the therapist and will be unable to
be genuine and exhibit their true self.
To be empathic is to enter another’s world without being influenced by
one’s own views and values. To do so, individuals must have sufficient
separateness so that they do not get lost in the perceptual world of the other
person. Rogers has eloquently described the process of empathy.

Accurate empathy is the therapeutic condition professionals most directly

linked to Carl Rogers and PCT. Based on what he initially learned from
Elizabeth Davis, Rogers became more and more capable of noticing and
reflecting his clients’ feelings. At times, when listening to audiotapes of his
work, he seems to slip completely into the client’s world, seeing and
experiencing exactly what the client sees and experiences.
Of the three core conditions, empathy has been most widely discussed and
researched . Many theorists from many different theoretical orientations
acknowledge the importance of empathy to psychotherapy.

Empathy is a multidimensional concept. In 1964, Rogers identified three

ways of empathic knowing. Clark (2010a) described these:

Subjective empathy : enables a counselor to momentarily identify with a

client through intuitive reactions and fleetingly imagine and experience
what it is like to be a client.
Interpersonal empathy : the counselor attempts to grasp [and feedback]
the phenomenological experiencing of a client from an immediate or
extended perspective.

Objective empathy : features a counselor’s use of theoretically informed

observational data and reputable sources in the service of understanding a
client.

UNCONDITIONAL POSITIVE REGARD OR ACCEPTANCE.

One of the most important aspects of the person-centered therapy technique
is that the therapist must exhibit unconditional positive regard for the
client. In short, this means that they accept and care for the client as they
are. This does not mean that the therapist always has to agree with the
client but it does mean that they refrain from judgment. It is essential that
the client feels valued by the therapist.

The therapist must have no conditions of acceptance but must accept and
appreciate the client as is. Hurtful, painful, bizarre, and unusual feelings,
as well as good feelings, are to be accepted by the therapist. Even when the
client lies, the therapist acceptance , and eventually the client is likely to
confront his own lies and admit them to the therapist . Acceptance does not
mean agreement with the client but rather refers to caring for the person as
a separate individual. By accepting but not agreeing with the client, the
therapist is not likely to be manipulated. Clearly, therapists do not always
feel unconditional positive regard for their clients, but it is a goal toward
which they strive. By appreciating clients for being themselves, the
therapist makes no judgment of people’s positive or negative qualities.
Conditions of worth imposed on the client by others are not fostered by the
therapist. As the client values the unconditional positive regard of the
therapist, there is an increase of positive self- regard within the client.
Bozarth (2007) views unconditional positive regard as the primary
condition of therapeutic change.
CONGRUENCE OR GENUINENESS

In the therapeutic relationship, the therapist must genuinely be herself and

not “phony.” Congruence includes being fully aware of one’s body, one’s
communication with others, being spontaneous, and being open in
relationships with others. In addition, congruence incorporates being able
to be empathic and to offer unconditional positive regard to the client.
Rogers (1966) defines genuineness (similar to congruence) as follows.

Genuineness in therapy means that the therapist is his actual self in his
encounter with his client. Without facade, he openly has the feelings and
attitudes that are flowing in him at the moment. This involves self-
awareness; that is, the therapist’s feelings are available to him to his
awareness and he is able to live them, to experience them in the
relationship and to communicate them if they persist. The therapist
encounters his client directly, meeting him person to person. He is being
himself, not denying himself.
As Rogers clarifies, genuineness does not mean that the therapist discloses
all of her feelings to the client. Rather, the therapist has access to her
feelings and makes them available, where appropriate, to further the
therapeutic relationship. Genuineness by itself is not a sufficient condition;
a murderer may be genuine but not meet other conditions.

Congruence is defined as authenticity and sometimes referred to as

transparency. The congruent therapist is real, open, and honest. Rogers
claimed, “The more that I can be genuine in the relationship, the more
helpful it will be’’. Rogers was very specific about why therapist
congruence is essential. He stated, ‘‘It is only by providing the genuine
reality which is in me, that the other person can successfully seek the
reality in him’’. Counselor congruence provides a sort of grounding or
reality so that clients’ real selves have something to interact with.
Congruence implies that therapists should acknowledge and express both
positive and negative feelings within the context of the therapy
relationship.
NON-DIRECTIVENESS
A cornerstone of client-centered therapy, non-directiveness refers to the
method of allowing the client to drive the therapy session; therapists should
refrain from giving advice or planning activities for their sessions.

Nondirective psychotherapy, also called client-centred or person-centred

psychotherapy, an approach to the treatment of mental disorders that aims
primarily toward fostering personality growth by helping individuals gain
insight into and acceptance of their feelings, values, and behaviour. The
function of the therapist is to extend consistent, warm, “unconditional
positive regard” toward “clients” (avoiding the negative connotations of
“patients”) and, by reflecting the clients’ own verbalized concerns, to
enable them to see themselves more clearly and react more openly with the
therapist and others. Pace, direction, and termination of therapy are
controlled by the client; the therapist acts as a facilitator. The nondirective
approach was originated by the American counseling psychologist Carl
Rogers in the 1940s and influenced other individual and group
psychotherapeutic methods.

ACTIVE LISTENING

The goal in active listening is to clarify what is being said so you know you
are hearing what they want you to hear. One way of doing this is to
paraphrase their comments to ensure you are understanding their meaning.
Tone – Your tone of voice is an important consideration in person-centered
therapy.

Active listening is a bit of a misnomer. Yes, you are listening to the client.
In fact, truly listening to the client without exhibiting judgment is a
fundamental part of person-centered therapy. But, active listening is not
just listening. It is listening in such a way as to let the client know that you
understand what is being said. Here are some critical aspects of active
listening:

Body Language – One way to show a client you are paying attention is
through body language. You want to maintain eye contact, lean slightly
forward, and keep an open style of communication (e.g., arms and legs
uncrossed).
Reflection – Another part of active listening is verbally responding to what
is being said. In many therapies, the therapist is trying to interpret what the
client means and see it through their own lens. In person-centered therapy,
you do not try and change the meaning but rather simply reflect the client
in an effort to further understanding.

Paraphrase – It is quite easy to misunderstand a client’s meaning. The goal

in active listening is to clarify what is being said so you know you are
hearing what they want you to hear. One way of doing this is to paraphrase
their comments to ensure you are understanding their meaning.

Tone – Your tone of voice is an important consideration in person-centered

therapy. Your tone should remain even and supportive. Large inflections
may be interpreted by the client as a judgment or a lack of empathy.

Open-Ended Questions – When you ask a client a question you have a

choice: direct them toward a certain answer or leave it open-ended. In
person-centered psychotherapy, open-ended questions are superior. They
are not leading, allowing the client to remain in control of their session. In
addition, open-ended questions tend to elicit more information.
Affirmations – Affirmations can be both verbal and non-verbal. “I
appreciate what you are telling me” is an example of a verbal affirmation.
Even a small phrase like “go on” tells a client you are interested in what
they have to say. A non-verbal affirmation can be something as simple as a
head nod.

CONCRETENESS

Concreteness is the ability not only to see the incomplete picture that
clients paint with their words but also to communicate to clients the
figures, images, and structures that will complete the picture. In the process
of exploring problems or issues, clients often present a somewhat distorted
view of the actual situation. Concreteness enables the counselor or therapist
to help clients identify the distortions in the situation and fit them together
in such a way that clients are able to view the situation in a more realistic
fashion. The concreteness helps clients clarify vague issues, focus on
specific topics, reduce degrees of ambiguity, and channel their energies into
more productive avenues of problem solution.

Personal characteristics and behaviors that enhance a counselor’s or

therapist’s ability to provide degrees of concreteness include, but are not
limited to, the following:
The capacity for abstract thinking and the ability to “read between the
lines.”
The willingness to risk being incorrect as one attempts to fill in the
empty spaces.
The belief in one’s own competence in analyzing and sorting through
the truths and partial truths in clients’ statements.
 The ability to be objective while working with clients in arriving at
the reality of clients’ situations.

REFLECTION OF FEELINGS
Reflecting feelings is determining the feelings and emotions in a person’s
verbal and body language and stating (or reflecting) those feelings back to
the person or client. When a counselor reflects their client’s feelings, it is
almost as if the counselor is acting as a mirror, or reflection, of the client’s
emotional state. Just reflecting feelings alone can make a client feel
validated, understood, and listened to, and it can even bring awareness to
hidden secondary emotions.

Reflecting feelings validates a person’s feelings. Validating, or ‘okaying,’

someone’s feelings through reflecting their feelings is a way to tell that
person that you are accepting of their feelings. This can be a relief to a
person or client who is struggling with some difficult feelings.

There are three broad types of reflection: Reflections of content,

reflections of emotion, & reflections of meaning.
Counselors can strengthen their reflections by constructing a reflection that
integrates content, process, affect, and meaning. For example, “While
talking about the loss of your dog (content) I experience you as alternating
between anger and sadness (affect). That makes a lot of sense to me (self-
disclosure), since you told me that seeing your dog at the end of a stressful
day kept you grounded (meaning)”.
Types of Reflections

Counselors can reflect a wide range of information, but reflections

typically include one or more of the following:

Content
Reflecting content involves repeating back to clients a version of what they
just told you. Reflecting content shows the client you understand and are
listening to them. Typically, reflecting content alone is not as powerful as
reflecting content with emotions and/or meaning.

Emotions

Reflecting a client’s emotions is often useful for heightening the client’s

awareness of and ability to label their own emotions. It is important that
counselors have a wide emotional vocabulary, so they can tailor their word
choice to match a level of emotional intensity that is congruent with a
client’s experience. Feeling word charts are useful for reviewing a wide
range of feeling words.
Meaning

As existential theorists observe, humans are meaning making creatures.

Reflecting a client’s meaning can increase the client’s self-awareness while
encouraging emotional depth in the session.

Therapist uses reflection of feeling to restate and explore the client’s

affective (feeling) messages. The response may capture both feeling and
content, but the emphasis is on feelings. You validate the client by
conveying accurately an understanding of the client’s feelings. This process
leads to the establishment of rapport and the beginning of a therapeutic
relationship.

Helps to:
Convey understanding
Gain insight into client’s emotional responses to life
Validate client’s emotional response
Manage the emotions of the client
Identify feelings and sort out multiple meanings
Discriminate among various feelings
You want to mirror or match client’s affective message/response in
intensity

Appropriate to use when:

Exploring the extent and depth of a problem;

There is a need to normalize the client’s feelings;
Be sure to attending to the client’s non-verbal reactions because
sometime they may not match verbal message
Inappropriate to use:

In premature exploration of feelings

Overanalyzing client’s reactions
To minimize client’s problem

UNIT 3: GESTALT PSYCHOTHERAPY: VIEWS ABOUT

HUMAN NATURE, KEY CONCEPTS, GOALS OF
PSYCHOTHERAPY, THERAPEUTIC RELATIONSHIP
GESTALT PSYCHOTHERAPY
Basic goal of gestalt psychotherapy is the development of
growth and personal integration through awareness.
This is done through the establishment of a good therapeutic
relationship.

Emphasis on the present and utilization of aware-ness. In

gestalt therapy, much assessment is through the therapist’s
moment-to-moment observation of the patient.

Many observations provide a useful overview of the

problem for both patient and therapist.

Resulting from this assessment are procedures to enhance

the patient’s awareness, both verbal and nonverbal.
Integrating approaches to awareness takes creativity and
experience.

GOALS OF THERAPY
Therapy should assist patients in seeing that they can do
much more than they think they can. Thus, patients become
more self-aware and move toward self-actualization.
Implicit in the goal of maturity and growth is that of
achieving integration. Integration implies that a person’s
feelings, perceptions, thoughts, and body processes are part
of a larger whole.
 When a person is not fully integrated there are voids and the
individual is likely to experience contact boundary
disturbances. Perls believed that the integration of previously
alienated parts was an extremely important goal of
psychotherapy.
Basic to maturity, growth, and integration is the development
of awareness .

Perls believed that with full awareness the organism or

individual would regulate itself and function optimally. Fully
aware individuals are aware of their environment, are
responsible for their choices, and accept themselves .
Gestalt therapy helps individuals become more fully aware
of themselves and their environment.

THE GESTALT APPROACH

Pulls the long-dead but still influential past into the
Living present. Because everything is happening now,
We watch the client’s personal issues and neuroses
Unfold in the therapy session.

[Link]
Meaning form or shape. Gestalten means to shape, to form,
to organize and to structure.
Humans do not perceive things in isolation but organize
them through their perceptual processes into meaningful
 wholes.
Visual fields are structured in terms of figure and ground
and they are in dynamic interplay.

[Link] holistic doctrine

Human organism is a unified whole.
There exist a close relationship between mental and physical
activity and so between the self and the external world.

[Link] Boundary and contact

It is the boundary between organism and environment and it
is at this boundary that psychological events take place.

[Link] and organismic self-regulation

Homeostasis is the process by which the organism satisfies
its needs by restoring balance when faced with a demand or
need which upsets its equilibrium.
Figure means the salient experience of the client and ground
is the aspects that are often out of awareness.
Cues to the ground may come to surface: tone of voice,
physical gestures, other non-verbal content
When figures surface out of background through awareness,
the process of contact leads to integration

[Link] Self and Self actualization

 The self exists where there are boundaries of contact. Its
activity is that of forming figures and grounds: (experience
and context)
The self consists of identifications and alienations at the
contact boundary. Self actualization may be viewed as the
expression of appropriate identifications and alienations.
(What I’m, I want Vs What I’m not, and don’t want).

When a person gets into contact all aspects of self and

accepts without judging, it leads to self-actualization.
[Link]
It is the energy we create, the life force or the élan vital is at
the heart of gestalt approach.
Excitement varies according to the task on the basis of
hormonal differentiation

KEY CONCEPTS UNDER GESTALT PSYCHOTHERAPY

[Link]
Perls says you can understand an individual’s behavior by
taking the person whole in all aspects.
You should not judge somebody by one occasion but we
should be aware of all our human dimensions, that is client’s
total participation-physical, emotional, intellectual and
spiritual throughout therapy. E
 Essentially this means that no aspect of the client is neglected
in counseling.
The counselor has to pay attention to the appearance body
language tone of voice and mannerisms.
[Link] and ground
The figure is what your mind is focusing at that time, it is the
present need somebody has what you are aware of at that
minute and the others are at the background.
We behave the way we behave because of what is in the
figure. .
Therefore you work with the client on her
phenomenological point of view.
The process whereby each need or figure emerges and is
dealt with is referred to as the formation and destruction of
Gestalts.
The figure-formation process tracks how the individual
organizes experience from moment to moment as some
aspect of the environmental field emerges from the
background and becomes the focal point of the individual’s
attention and interest.

[Link] and now

We deal with a behavior at the present moment, because
focusing on the here and now is the principle.
Gestalt therapy is dealing with what is happening when the
client is there not her past or future.
 You bring the past and the future into the here and now and
check on the non verbal.
According to Gestalt theory, life and change take place in the
present.
It follows therefore that the focus of this particular model of
counseling is on what the client feels, thinks and does at this
particular moment of his existence.
An example of keeping a client present might include
something like asking about a client’s facial expression or
body language as they process a particular event or
experience.
[Link] inquiry:
Paying attention to what is occurring now.
To promote “now” awareness, the therapist encourages a
dialogue in the present tense by asking questions like these:
“What is happening now?”
“What is going on now?”
“What are you experiencing as you sit there and attempt to
talk?”
“What is your awareness at this moment?”
“How are you experiencing your fear?”
“How are you attempting to withdraw at this moment?”
“How is it for you to be with me in this room now?”
Phenomenological inquiry also involves suspending any
preconceived ideas, assumptions, or interpretations concerning
the meaning of a client’s experience.
Gestalt therapists recognize that the past will make regular
appearances in the present moment, usually because of some
lack of completion of that past experience.
When the past seems to have a significant bearing on clients’
present attitudes or behavior, it is dealt with by bringing it
into the present as much as possible.
When clients speak about their past, the therapist may ask
them to reenact it as though they were living it now.
For example, rather than talking about a past childhood trauma
with her father, a client becomes the hurt child and talks directly
to her father in fantasy, or by imagining him being present in the
room in an empty chair

[Link] business:
The Gestalt approach pulls the long-dead but still influential
past into the living present. Because everything is happening
now, we watch the client’s personal issues and neuroses
unfold in the therapy session.
“These incomplete directions do seek completion and when
they get powerful enough, the individual is beset with
preoccupation, compulsive behavior, wariness, oppressive
energy and much self defeating behavior” (Polster & Polster,
1973, p. 36).
 Unfinished business persists until the individual faces and
deals with the unexpressed feelings.
The effects of unfinished business often show up in some
blockage within the body, and the therapist’s task is to assist
clients in exploring these bodily expressions.
Gestalt therapists emphasize paying attention to the bodily
experience on the assumption that if feelings are
unexpressed they tend to result in some physical sensations
or problems.
The impasse, or stuck point, occurs when external support is
not available or the customary way of being does not work.
The therapist’s task is to accompany clients in experiencing
the impasse without rescuing or frustrating them.
The counselor assists clients by providing situations that
encourage them to fully experience their condition of being
stuck.
6. Energy and block to energy
When energy is blocked, in may result in unfinished
business
Blocked energy is another form of defensive behavior.
It can be manifested by tension in some part of the body, by
posture, by keeping one’s body tight and closed, by not
breathing deeply, by looking away from people when
speaking to avoid contact, by choking off sensations, by
 numbing feelings, and by speaking with a restricted voice, to
mention only a few.
Clients may not be aware of their energy or where it is
located, and they may experience it in a negative way.
One of the tasks of the therapist is to help clients find the
focus of interrupted energy, identify the ways in which they
are blocking energy, and transform this blocked energy into
more adaptive behaviors.
Clients can be encouraged to recognize how their resistance
is being expressed in their body.
Rather than trying to rid themselves of certain bodily
symptoms, clients can be encouraged to delve fully into
tension states and bodily symptoms.
For example, by allowing themselves to exaggerate their tight
mouth and shaking legs, they can discover for themselves how
they are diverting energy and keeping themselves from a full
expression of aliveness
[Link] and resistance to contact
Contact is necessary if change and growth are to occur,
effective contact means interacting with nature and with
other people without losing one’s sense of individuality. i.e.
clear awareness, full energy and the ability to express
oneself.
Miriam Polster (1987) claimed that contact is the lifeblood of
growth.
 It is the continually renewed creative adjustment of
individuals to their environment.
It entails zest, imagination, and creativity.
After a contact experience, there is typically a withdrawal to
integrate what has been learned.
Gestalt therapists talk about the two functions of boundaries:
to connect and to separate.
Both contact and withdrawal are necessary and important to
healthy functioning
Gestalt therapists also focus on interruptions, disturbances,
and resistances to contact, which were developed as coping
processes but often end up preventing us from experiencing
the present in a full and real way.
Resistances are typically adopted out of our awareness and,
when they function in a chronic way, can contribute to
dysfunctional behavior.
Because resistances are developed as a means of coping with
life situations, they possess positive qualities as well as
problematic ones, and many contemporary Gestalt therapists
refer to them as “contact boundary phenomena.”
Polster and Polster (1973) describe five different kinds of contact
boundary disturbances: introjection, projection, retroflection,
deflection, and confluence
Introjections: Refers to the internalized rules governing our
thoughts, feelings, and behavior which we absorb from
 parental and other influences from childhood onwards.
Projection: Is a process of attributing aspects of ourselves to
other people, as a result of which we disown them e.g. father
falling in love with their daughter then they blame the
daughter.
Retroflection: Is a process whereby we do to ourselves what
we would like to do to someone else. This process seriously
restricts engagement between the person and his or her
environment.
Deflection: Means that contact with other people is
diminished through a process of distraction. Through the use
of humor, generalization, etc.
Beating around the bush.
People who deflect speak through and for others.
(5)Confluence: Describes a style of relating to other people
which is based on
absence of conflict and a conviction that everyone should
be in agreement.
Being a yes person or okay person.
It is a way of staying safe by going along with others and
not expressing one’s true feelings and opinions.
LAYERS OF NEUROSIS
Perls (1970) likens the unfolding of adult personality to the
peeling of an onion.
He referred to the ways in which people avoid awareness of
self as having five layers of neurosis.
In Perls view these layers of neurosis need to be stripped
away if clients are to achieve psychological growth and
maturity.
The five layers comprises of;-
The phony layer-
This refers to inauthentic way in which we often relate to
others, this is the level where we play games and get lost in
roles.
We are trying to live up to a fantasy that we or others have
created.
Once one becomes aware of the phoniness of game he/she is
playing and become more honest then we experience
unpleasantness and pain. (Brownell et al, 2009)
The phobic layer-
It is the point at which we resist seeing aspects of ourselves
which might cause emotional disturbance or pain.
We have catastrophic fears that if we recognize who we
really are and present that side of ourselves to others they
will surely reject us.
For example when a man cries he will be regarded as weak.
(Doubrawa, 2006)
The impasse layer-
This is the point we are stuck in our own maturation.
 We feel we have no resources within ourselves to move
beyond the stuck point.
We often feel a sense of deadness and feel that we are
nothing or we are empty. People seek to manipulate the
environment.
According to Perls view it is impossible to overcome
difficulties by resisting them and regarded impasse layer as a
source of many problems in therapy.
If we allow ourselves to fully experience denying and
running away then we move to the next layer.
The implosive layer-
Perls (1970) writes that it is necessary to go through this
implosive layer in order to get to the authentic self (real
you).
By getting into contact with our deadness and inauthentic
ways we expose our defenses and begin to make contact
with our genuine self.
Clients who access this layer of awareness often experience
catharsis.
The explosive layer-
It is when you experience yourself fully in pain or joy.
You become alive and authentic.
We let go of all phony roles and pretenses and become alive
and authentic.

RELATIONSHIP BETWEEN THERAPIST AND CLIENT

Therapists are responsible for the quality of their presence,
for knowing themselves and the client, and for remaining
open to the client.
They are also responsible for establishing and maintaining a
therapeutic atmosphere that will foster a spirit of work on the
client’s part.
It is important that therapists allow themselves to be affected
by their clients and that they actively share their own present
perceptions and experiences as they encounter clients in the
here and now.
However, therapists need to be thoughtful about when and
what to share.
Therapists are expected to encounter clients with honest and
immediate reactions, and therapists share their personal
experience and stories in relevant and appropriate ways.
Further, they give feedback that allows clients to develop an
awareness of what they are actually doing.
Brown (2007) suggests that therapists share their reactions
with clients, yet she also stresses the importance of
demonstrating an attitude of respect, acceptance, present-
centeredness, and presence.
Many contemporary Gestalt therapists place increasing
emphasis on factors such as presence, authentic dialogue,
gentleness, more direct self-expression by the therapist,
decreased use of stereotypic exercises, and greater trust in
the client’s experiencing.
 Laura Perls (1976) stressed the notion that the person of the
therapist is more important than using techniques.
A current trend in Gestalt practice is toward greater emphasis
on the client–therapist relationship, and therapists who
operate from this orientation are able to establish a present-
centered, nonjudgmental dialogue that allows clients to
deepen their awareness and to make contact with another
person.
Polster and Polster (1973) emphasize the importance of
therapists knowing themselves and being therapeutic
instruments.
According to them, therapists are more than mere responders
or catalysts. If they are to make effective contact with clients,
therapists must be in tune with both their clients and
themselves.
Therapy is a two-way engagement that changes both the
client and the therapist.
If therapists are not sensitively tuned to their own qualities
of tenderness, toughness, and compassion and to their
reactions to the client, they become technicians.

UNIT 4: TECHNIQUES OF GESTALT THERAPY –

FOCUSING ON THE HERE AND NOW, DREAM WORK,
ROLE PLAY, EMPTY CHAIR, RULES AND GAMES
Gestalt therapy is a humanistic, holistic, person-centered form of
psychotherapy that is focused on a person's present life and challenges
rather than delving into past experiences. This approach stresses the
importance of understanding the context of a person’s life and taking
responsibility rather than placing blame.

Gestalt, by definition, refers to the form or shape of something and

suggests that the whole is greater than the sum of its parts. There is an
emphasis on perception in this particular theory of counselling. Gestalt
therapy gives attention to how we place meaning and make sense of our
world and our experiences.
Some therapy approaches tend to focus on the therapist as an expert on
distress and symptoms. The client has more of a learning role, as the
therapist shares their knowledge about what they are experiencing and how
to heal. Within gestalt therapy, the client has space to safely explore their
experiences without fear of judgment. In fact, the client is encouraged to
not simply talk about their emotions or experiences, but to bring them into
the room so they can be processed in real-time with the therapist
WORDS AND LANGUAGE

Attention to language and tone is important in gestalt therapy. As clients

learn to accept responsibility, they learn to use language that reflects a
sense of personal ownership rather than focusing on others. For example,
rather than saying, "If he didn't do that I wouldn't get so mad!" a client
might be encouraged to say, "I feel mad when he does that because it makes
me feel insignificant and I don't like that." The use of "I" statements is
important in gestalt therapy.

EMPTY CHAIR
This is a role-playing exercise that allows a client to imagine and
participate in a conversation with another person or another part of
themselves. Sitting across from the empty chair, the client enters into a
dialogue as if they were speaking with that other person or that other part
of themselves.

The empty chair exercise can be very helpful in drawing out important
perceptions, meanings, and other information that can help clients become
more aware of their emotional experience and how to start healing.
ROLE PLAY
Another example of role-playing might be what is referred to as "top dog
and underdog." In this, it is recognized that a client has different parts of
self. Similar to the empty chair, the client speaks as both the top dog, which
is the more demanding side of their personality and the underdog, which is
the more submissive and obedient side of their personality.

The key is to become aware of inner conflicts so that the person can better
learn how to integrate these parts of self into a more complete whole.

BODY LANGUAGE
During a session, a gestalt therapist will observe the client's body language
and movement such as tapping their foot, wringing their hands, or making a
certain facial expression. The therapist is likely to mention their
observation of this and ask what is happening for the person at that
moment. Incorporating language, the gestalt therapist may even ask the
client to give their foot, hands, or facial expression a voice and speak from
that place.
EXAGGERATION
In addition to giving body language a voice, a gestalt therapist may inquire
about the client's body language. If it is difficult for the client to find words
to put to what is happening, they may be asked to exaggerate that motion or
repeat it several times in a row for a period of time during the session to
draw out some of their experience at that moment.
The client and the therapist get a chance to process emotions and how the
person might have learned to disconnect their emotional experiences with
their physical experiences.

DREAM WORK
Gestalt therapists believe that dreams are existential messages we send to
ourselves. These messages are actively explored to bring dream content
into a person's actual life. A major technique used in Gestalt dream
analysis is the “Take the Part of” technique. The dream-work is the
unconscious ciphering that transforms the latent content into the manifest
content. As such, the work of interpreting the dream follows the dream-
work in reverse, from the manifest content to the latent content. The
dream-work is what allows the dream wishes to get past censorship.

UNIT 5: APPLICATION AND EVALUATION OF

HUMANISTIC THERAPIES
The founders of humanistic psychology believed that, while it is possible
for personality development to occur in most interpersonal contexts, it is
likely to occur most directly by way of a therapeutic encounter. Humanistic
therapy is a phenomenologically-oriented approach intended to assist
clients in living authentically in accordance with their values, aspirations,
and limitations and in assuming an active role in their growth. Therapeutic
Principles Humanistic therapy assumes that clients are holistic/irreducible
(i.e., not determined by their past or conditioning, capable of agentic
change) and that they are experts on their own experiences, their potentials
within themselves, and the social, community, and cultural contexts within
which they forge their identities and senses of control, responsibility, and
teleological purpose. Thus, clients are granted an autonomous role in the
therapy process, with therapists respecting their freedom and potential to
make choices about whether and how to change. Contemporary humanistic
psychotherapies share several therapeutic evidence-based principles of
practice, many of which are rooted in Rogers’ (1961/1995) person-centered
therapy:

An authentic therapeutic relationship is central to effective practice.

Therapists attempt to enter empathetically into clients’ subjective
experience – deemed an essential aspect of their humanity in a way that
provides them with a new, emotionally-validating interpersonal experience.

Tacit experiencing is an important guide to conscious adaptive experience.

An attuned, supportive therapeutic relationship serves to help clients
develop comfort looking inward and therefore to render emotional pain
more bearable.

Therapists’ responses/interventions are intended to stimulate and deepen

the process of clients’ immediate experiencing and ongoing awareness
throughout the course of therapy. This includes clients’ perceiving, sensing,
feeling, thinking, and wanting/intending.
Emphasis is given to clients’ integrative, formative tendencies toward
survival, growth, personal agency, and the creation of meaning through
symbolization. The collaborative nature of the therapeutic relationship is
key to the unfolding process of therapy and to clients’ disclosure of
narratives/personal stories which further develops/maintains a shared
understanding and trust.

Clients are seen as unique individuals with complex arrays of emotions,

behaviors, stories, and capacities that can, at times, be viewed as
representative of a particular clinical diagnostic category but never reduced
to one. Instead of viewing clients through the lens of pathology/deficits,
humanistic therapists understand them from the stance of thwarted
potential and truncated development and emphasize their strengths. (Angus
et al. 2014)

TRANSFORMATION VERSUS TENSION REDUCTION

Rather than focus on first-order change processes (i.e., symptom reduction
and adjustment) that offer temporary relief to clients but leave
underlying/root problems relatively unaddressed and prone to eventual
return, humanistic therapists focus on second-order (transformative)
change processes. These involve a deep restructuring of self that results in
long-term, core-level shifts in and expansions of clients’ perspectives of
their presenting concerns, of their world, and of themselves, as they create
and maintain new ways of being. Humanistic therapists rely less on
prescriptive techniques that uphold their role as expert and instead employ
their presence and reflexive capacities as instruments for understanding
clients’ unique patterns of lived experience.

FORGING A NEW SELF-NARRATIVE

Humanistic therapists attend to clients’ narratives, metaphors, nonverbal
behaviors, responses to feedback, and other interaction patterns in order to
help them explore how these may point toward attachment histories and
other relational patterns that contribute to defensive interpersonal/behavior
patterns in an effort to uphold a false sense of self. Therapists “reflect back
aspects that are evident but unnoticed – in effect, holding a mirror up to the
client” (Schneider and Krug 2010, p. 2/37). Accordingly, clients’ resistance
to growth becomes exposed and challenged to promote disidentification –
i.e., surrendering the need to defend their current position, having confused
it for their greater self-identity. Rather than cling to past knowledge and
expectations of themselves, others, and situations, clients become better
able to realize and act on a sense of personal meaning in all their
experience. The therapeutic relationship offers a safe emergency that
stimulates neural plasticity and therefore new learning. When the process
goes well, “clients reclaim and re-own their lives” (Schneider and Krug
2010, p. 1), developing a worldview and behavior that authentically express
their core values. The therapeutic encounter serves to present clients with
the choice between (a) becoming consumed by suffering to the point that
they attempt to evade it (experiential avoidance) and thereby create even
more suffering for themselves or others and (b) suffering well – i.e.,
accepting the aspects of their lives over which they have no control and
committing their attention and energy to those which they do. This sense of
intentionality enables a person to set goals and move forward instead of
becoming mired in the face of adversity. Accordingly, therapists employ
role play, rehearsal, visualization, mindfulness-based techniques, etc. to
help clients try out new experiences in the interest of incorporating them
outside the therapy relationship and thereby maintaining their progress.

OUTCOMES OF THERAPY
The humanistic approach to therapy – specifically Rogers’ (1961/1995)
facilitative conditions in conjunction with the principles espoused by other
founding humanistic therapists (e.g., Frankl 1978; May 1983) – anticipated
the contemporary outcome literature on common relational/experiential
factors which account for the most substantial sustainable change (as
opposed to isolated techniques). Moreover, Angus et al.’s (2014) meta-
analysis of empirical studies conducted during the last quarter century
suggests that humanistic approaches to therapy result in large effects in
pre-post client change and longitudinal maintenance (suggesting that
clients continue to develop on their own after termination), as well as in
demonstrated effectiveness in addressing interpersonal/relational issues,
depression, psychosis, and chronic medical issues.

INFLUENCE
The humanistic approach stimulated a relationally oriented revision of
psychoanalysis and the advent of applied behavior analysis as an extension
of behavior modification with increased focus on individualized
interventions that address the underlying functions of behavior (vs. mere
behaviors). In addition, humanistic approaches to therapy have been
influential in the development of third-wave cognitive-behavioral (CBT)
approaches (e.g., acceptance and commitment therapy and dialectical
behavior therapy with their emphases on mindfulness and developing
openness to experience), motivational interviewing (with its emphasis on
promoting agency), and narrative therapies (with their emphasis on
meaning-making).

EVALUATION

The humanistic perspective began as an alternative to the limitations of and

disparities between experimentalism/behavioursm and psychoanalysis. It
both subsumed the strengths and transcended the limitations of those
traditions by using intersubjective methods to develop a growth-/process-
oriented conceptualization of personality that had been inadequately
available in the field. It drew from classical and contemporary literature,
existential-phenomenological philosophy, Eastern wisdom, systems theory,
Gestalt psychology, Goldstein’s organismic theory, James’ radical
empiricism, and personality and post-Freudian psychodynamic
psychologies to develop a predominantly phenomenological approach to
the science of personality. Following its establishment as the Third Force in
American psychology at the mid-twentieth century, it further evolved by
way of elaborations on its principles by the existential, transpersonal, and
constructivist movements in psychology. Today, the humanistic perspective
has become further refined based on an integration of these ontologies in
conjunction with dialogue with parallel constructs in conventional
psychology. The humanistic approach to therapy involves a collaborative
relationship between therapist and client designed to promote
transformative change by cutting through clients’ defenses and helping
them forge a new worldview and behaviors that authentically express their
core values. This approach has been influential in its contribution of
relational factors and experiential techniques that are now considered the
core ingredients of effective and sustainable therapy and of principles of
change and case conceptualization that have influenced other systems of
therapy (e.g., relational psychoanalysis, applied behavior analysis, third-
wave CBT, narrative therapy, etc.). The humanistic approach to research
draws from existential-phenomenological philosophy as its basis for
descriptive qualitative methods that supplement the quantitative methods
valued by the natural science model of psychology in order to broaden the
foundation for psychology as a human science faithful to its subject matter.
Humanistic psychology has been influential in introducing and legitimizing
qualitative methods and the study of creativity and consciousness in
psychology. This approach to research also forms the basis of a humanistic
approach to personality assessment. In general, the strengths of humanistic
psychology include its innovativeness and its degree of influence on
psychology and society. Its limitations involve its focus on individuality,
which renders it incompatible with the natural science model valued by
conventional psychologists as well as prone to associations with its
problematic popular implementation by the 1960s–1970s counterculture
and to accusations of Western bias. However, these criticisms tend to
reflect incomplete and/or inaccurate readings of primary humanistic texts
as well as an antiquated view of the humanistic perspective. The
humanistic perspective emphasizes the individualized qualities of optimal
well-being and the use of creative potential to benefit others, as well as the
relational conditions that promote those qualities as the outcomes of
healthy development. Rather than conceptualize personality as a fixed
structure, set of quantifiable traits, or self-concept, it
holistically/systemically portrays the person qua self as continually
evolving and as uniquely situated in sociocultural and ecopsycho-spiritual
contexts. It assumes that optimally functioning people are consciously
aware, responsibly free to make choices in accordance with their values,
goal-directed, meaning-making, and creative in relation to their experience.

MODULE 4: EXISTENTIAL PSYCHOTHERAPY

UNIT 1: OVERVIEW OF THE EXISTENTIAL VIEWPOINT,
EXISTENTIAL

PHILOSOPHY

Existential psychotherapy deals with attitudes and thematic concerns, goals

focus on issues such as finding a purpose or meaning in life and fully
experiencing one’s existence. Although assessment instruments are
occasionally used , it is primarily the therapeutic relationship that allows
for the assessment of important existential tasks and themes. In helping
their clients, existential therapists deal with resistance and transference
issues that may interfere with the development of a real relationship with
the client. In working with clients, existential therapists may take a variety
of approaches to important existential themes, such as dealing with the
death of others or with one’s own mortality. Also, clients struggle with
being responsible for choices and decisions that come from their freedom