Phil: Okay. I'm feeling interested in talking just of the subject of integration in itself. One of the reasons is that clearly this is one of your main focuses, something you staked out for yourself, actually. I was talking with someone about the idea of integration. I said that many Gestalt people look at Gestalt as a large enough theory to facilitate integration, bringing in strains from this and that place under the banner of these three pillars, mostly field, dialogue, and the phenomenological, and I guess you would add experimental, but he said that he didn't think there was a need for integration, that in fact that was a dangerous thing, because we needed to have diversity of therapeutic approach. How would you respond to that?

Leslie: Well, the basic argument is that knowledge progresses in a dialectical fashion in which you need the synthesis and the antithesis in order for there to be tension, and that's why integration isn't good. Again, I think that these are all so very abstract things that people say, but they don't really deal with concrete notions, and I think there'll always be differences, be it under integration or under anything, so I think it's a sort of straw man, that argument. It's a way of people protecting territory. I think integration has a lot to do with social politics of psychotherapy. And then, I think the era of school wars is unproductive.

Phil: You mean academic territory?

Leslie: Yes, academic territory, but also even more pernicious is economic territory. I think that's where it's really at. People make their livings out of doing psychotherapy and what they call themselves. It would be much better for us to have an integrated profession of psychotherapy in which we all knew as much as we could about how to help people. The other one is more of a religious schools, as I see it. One could argue that that's what we need because they each are a different value system, and the people can then choose which religion is right for them, but my faith lies in that there is something real about psychotherapy; I hesitate to say it's a science, but there's something we could all learn and know about helping people and helping to facilitate them. There are basic principles, and they could be taught as a generic set of rules or set of principles and that that would make us, then, psychotherapists.

Now, there were three basic ideas about integration in the first instance, and one was that you could have a grand theoretical integration. Another is that you could get a synthesis; you know, like systems and Gestalt, or Client-Centered and Gestalt. Add two things together, and I guess the third was a kind of technical eclecticism. You could just patch together different interventions from different schools.

Phil: In thinking of integration, what is the difference between integration and eclecticism?

Leslie: The big difference is that it's regarded as systematic eclecticism as opposed to seat-of-the-pants eclecticism. What makes it integrative is that you would know what you were doing, why, and you would do it similarly on different occasions for the same conditions. Systematic eclecticism is viewed as an empirically-based eclecticism. We learn that for panic attacks particular forms of exposure are the best way of treating them, and then we do that.

Phil: That opens up another thing. In terms of these protocols, so to speak, the best procedure in treating a certain condition or disorder - do you see the formation of protocols, or this empirically informed eclecticism, as cutting off advances or limiting the expansion of knowledge or alternatives? I ask this question because people dealing with HMO's are worried about the limiting of their options in terms of providing service.

Leslie: I think there is an enormous danger. You have an advanced notion of it, using the term "empirically informed" rather than "empirically validated." I think that's quite a big distinction in my mind. The idea of empirically validated treatment stinks, and it's a political attempt to control, ultimately. I think it has real dangers. I think empirically informed treatments are a good idea, because I think it's good to empirically study things, but, yes, I'm very worried about its usage. We don't have HMO's in Canada, but in academia it's the same thing. Now, you have to teach empirically informed treatments.

Phil: And so that limits further exploration, which might reveal further empirically informed treatments.

Leslie: Right, right; however, it's the political usage of this that's the problem. Empirically informed is good, but it shouldn't be used to limit. I do think more empirical study of psychoanalysis and of Gestalt would be a good thing, and I think encouraging that is good. The people who move the empirically validated movement, I think, are more closed-minded than open-minded, and that's the danger.

Phil: Well, you offered these three approaches to integration...

Leslie: Well, there's a fourth one that's come up that I prefer. That's called assimilative integration. The idea is that one has to make a distinction between integrative in theory versus integrative in practice. I don't really think you can have integrative theories, because often the theories have different tenets. Now you might at some stage be able to develop a grand, unified theory, and I think that would be good, but currently you can't integrate psychoanalysis and behaviorism or psychoanalysis and Gestalt, because they have different theoretical tenets. You can, working from within your own theory, assimilate things from other people's practice into your practice so that you end up with an expanded practice.

Phil: Wouldn't that be detached from theory?

Leslie: No. Because you assimilate it into your theory. So you see, I do systematic desensitization, but I assimilate it into a Gestalt theory.

Phil: How do you do that? What's the connection there?

Leslie: I just help people to be more aware. You know, Perls was doing systematic desensitization; he just wasn't calling it that. When you ask people to be aware, to be aware of their breathing, and to make contact with the feared stimulus, or object, or image, and to check what you're feeling, and regulate your breathing, and do it again, and feel your feet on the ground - I mean, anything like that; it's actually not dissimilar to systematic desensitization. It's the same basic exposure principle. Gestalt is an integration of a lot of things.

Phil: Well, as you were describing that, I could relate to a process I go through where I will see something from another theory, another perspective or clinical orientation, and say to myself, "In Gestalt, that would be like this. That would be doing this kind of thing." In one way it's semantic - in that theory you call it this, but in Gestalt we call it...

Leslie: Yes, yes, that's the translational phenomena. You can translate one thing from one theory into the language of another, and I agree, but I think there's also a way of expanding what you do, but still seeing it in your own theory terms.

Phil: Allowing another theory to inform the basic Gestalt commitment.

Leslie: Right, especially the Gestalt practice. I'll give you an example. You see, Gestalt is very integrative; this is the important thing, so it serves as a good basis for integration. Linking things to the past comes from psychoanalysis. In-session process comes from the phenomenological therapies, and there's extra-therapy tasks, or homework, which comes from behavior therapy. Now, if you're a Client-Centered therapist, you think only of responding empathically in the moment, but you never think of giving homework. There are ways of incorporating homework within your own theoretical framework, which involve, not that you are modifying people's behavior, but you're actually helping them to choose to do things that are in line with their own tendencies, and then practice is not necessarily incompatible, let's say, with an actualizing tendency.

Phil: I want to clarify something for myself. I can understand the connection between the present and the past, if the past is present in the session so to speak, but I'm having a difficult time making the integrative link in Gestalt to doing homework. How do you see that?

Leslie: I see that as awareness work outside of the session. Early on in Gestalt it used to be, "Be aware." And when you're outside, be aware of your critic, be aware of your top dog, be aware of when you drop your eyes - but somehow carrying it outside of the session. I think there's a lot of assertiveness training, actually, that was built into Gestalt therapy. Assertiveness training actually implies practicing, but in Gestalt it's done in terms of polarities - how do you bring your strength into enhancing your weakness, or how do you ask for what you want? And then, actually try this. We usually do trying it in the session, or in the group, but there's no incompatibility with trying it outside of the group. The implication is to try it outside.

Phil: Another aspect of Gestalt is the paradoxical theory of change. Aren't we encroaching upon that hallowed ground?

Leslie: That was one of the big dilemmas to me, because Client-Centered has also very much the equivalent of the paradoxical theory of change, but when I first came into Gestalt there were a number of things that I was being exposed to which seemed to me to be encouraging people to change. I think there's always been a tension in Gestalt between "is-ness" and doing, but I think that's actually a polarity within Gestalt - that there's both being and doing in Gestalt therapy, and it's important to make the distinction between is-ness being experience related - you know, "Accept your experience" - but that the experiment has, as a part of it, a doing component, you know, "Do this, to see what you experience." Not do this in order to change.

Phil: And to me, the self, getting back to that, is defined at the point of contact in the doing.

Leslie: Right, right. Where Gestalt sort of blew my mind, having just done one year of Client-Centered work, there was this sort of doing as a way of being. It opened new vistas. The basic experiment was sort of, "Look up, and then look down, and see what it's like." That would be a basic experiment. What you experience when you look up, what you experience when you look at me, what you experience when you look down. That's the self forming at the boundary.

Phil: Which, it suddenly occurs to me, is very existential, isn't it, taking a leap out there and seeing what's going to happen?

Leslie: Yes, yes. It's sort of a risk-taking, existential component. There were so many gestalts, you see, that was the problem. In the Gestalt in which I grew up there was a lot of that in the training. There was a risk-taking component. Try something new; when you have the support for it. So, I always saw Gestalt as including a behavioral component, which was not articulated as such. There are, then, ways of assimilating into one's own Gestalt theory different kinds of interventions from other schools and expanding, actually, what you do. It actually expands your practice.

Phil: Yes. I am really picking up on a difference between holding something in an academic sense, like you called it a paper game, and encountering, in a relational sense, in the therapy. It seems to me what you're saying is that a person can be integrative in the sense of being eclectic, appropriating this or that intervention, relating it to his or her Gestalt theory.

Leslie: Right, but I'm calling it assimilative rather than eclectic, because you truly are assimilating it into your theory. You're not doing a little bit of behavioral therapy; you're actually doing something and viewing it through the eyes of how you understand.

Phil: And so at some point, though, maybe a person would say, "I can't do this, because that won't assimilate."

Leslie: Exactly.

Phil: Not just because someone found some sort of outcomes that would support it.

Leslie: Right, right. That could happen. Definitely, it would violate something in the way you understand people functioning, and then you wouldn't be able to assimilate it.

Phil: Well, are you encouraged in your work for providing empirically supported research on integration?

Leslie: I see myself as not doing research on integration, basically, but on humanistic, experiential psychotherapy, incorporating Gestalt and Client-Centered. They're broader and narrower arena's of integration, I guess.
I'm not very highly encouraged by my research - I feel very lonely and isolated in my efforts to try to empirically validate the experiential therapies, and I find it hard in academic circles, because I constantly get beaten down by cognitive and dynamic competitors and their points of view. So, it's difficult, and I'm not highly encouraged. On the other hand, I'm not totally discouraged. About integration, which I see as a higher level kind of issue, I think there's some hope still for integration, but it's reached a kind of plateau. The Society of Psychotherapy Integration has been around for about 11 years now. I went to a conference to stimulate research on integration, and this was funded or support by NIMH, and I expected that we would come out with, "These are the studies that should be done." And the three recommendations that came out were all social-politic recommendations. They were promotion of desegregation - how do we get behaviorists, and analysts, and humanists to talk to each other and to attend the same conference. And that's what SEPI, the society for integration's conference is all about, trying to bring people together. The other was a recommendation of getting rid of x-rated language. That was the idea that we all see the jargon of other schools as dirty words, and just turn off. So, how do we try not to use x-rated language to turn other people off? You know words like "contact" in Gestalt, and even worse in the humanistic, "get in touch with your feelings." People just turn off when they hear these words. Or if you hear, "partial reinforcement schedule," or if somebody hears "counter-cathexis" or "projective identification" the behaviorist just turns off immediately. Some of the ideas on promoting integration were on somehow getting people to actually converse with each other from the different schools. I think some of that has taken place now, but it hasn't really succeeded, because there are still all the schools doing their own thing, and I think they're very socially and politically based. I mean, people make their living this way.

Phil: It sounds like you're discouraged about that.

Leslie: Yes. It's a big political issue. I think in academia there's been a softening of the boundaries, but in institute world there isn't. There can't really be, because they make their living out of being X's or Y's. I think this is very real. If you're cognitive-behaviorist now, you get a lot of goodies out of being cognitive-behaviorist. In Germany there's been a big fight trying to get Client-Centered and Gestalt people recognized to go on a register, and they currently only recognize cognitive-behavioral and dynamic. One of the current things is that they will not prohibit from practice the humanists, but they have to retrain or re-certify as either dynamic or cognitive. A similar thing happened in Holland where Client-Centered was recognized, and all the Gestalt therapists got certified as Client-Centered.

Phil: What do they have to do to get certified? Do they have to go through a whole...

Leslie: Well, you see one of the things I think that they're doing is that they're making it easy for the generation that's already trained to re-certify under another label. It's a terrible political corruption process, you know. You obliterate certain schools. There's a lot of politics involved.

Phil: You bring up another issue for me through the geographical connection. I know people in Germany and different parts of Europe who are involved in a different kind of Gestalt that goes back to the Wertheimer and Kohler, perceptual line. Historically, they were estranged or in conflict with the Perls' development, but now they're not so interested in perpetuating that rift; now they're interested in dialogue and talking about the application of this "classic" Gestalt theory. Are you familiar with any of that?

Leslie: No, no I'm not. It's interesting.

Phil: It is interesting, because they take from the perceptual end of things, which seems to me at this point to be an emphasis on the phenomenological, but they make the same applications that we would make to psychotherapy, to organizational development - they're doing the same kinds of application of their theory. I think that's interesting that there might be a renewed dialogue between these two groups.

Leslie: Somehow it seems that in psychology cognitive sciences have developed, and then cognitive therapy, which is like a poor cousin of cognitive science. Actually, cognitive science is a development from Gestalt psychology. Gestalt psychology was the original perceptual psychology, then out of this grew cognitive science. I've gotten into cognition and emotion, and I work a lot as well writing now theoretically about what is emotion and what's the relationship between emotion and cognition, and its application to psychotherapy. And I think that's all important in the notion of integration. I think Gestalt is primarily about emotion and cognition from a sophisticated perspective, not like a simple cognitive perspective, and this is where the whole constructivist thing comes in.

I think integration is interested in basic cognition and emotion and meaning as a way of integrating all the therapies, and I think Gestalt has something important to say about that, but the language of Gestalt is not the same as the language of academic psychology, and somehow bringing those two together seems very important.

Phil: Well, I think it is important. I see something of a constructivist thought, but think of it in terms of a Gestalt framework. Some of the things that you've said about the integration of emotion and cognition seem to fit. People are talking about these things; they may not understand, or they may not use the term "Gestalt," but they're doing Gestalt kinds of things.

Leslie: Yes, I think so, and I think Gestalt therapists know a lot about working with meaning creation at the formation stage, at the boundary so to speak, so with that forming process they've actually been working with it for a long time, but the only language that used to be available was, "Follow the process." I can remember one of my co-trainees saying, "Yeah, but which fucking process?!"

Both: (laughter)

Leslie: She was also with me at school and training at the Gestalt institute, and we used to sit around and say, "Yeah, follow the process - GREAT. But it's more complicated than that!" So, Gestalt has a lot to contribute, and it has something to learn by sophisticating and updating its theory and the language that it uses.

Choose... Beginning of Greenberg Interview 1. Personal 2. Gestalt 3. Integration 4. Conclusion

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	Gestalt! (ISSN 1091-1766) a chronicle of the developing application of Gestalt principles, Vol.1, No.1, 1997 Published by Gestalt Global Corporation. Last updated 11/13/03	Index | Masthead