The 5-layer model

To recapitulate how I understand the theory, in working through a specific neurotic fixation, the following layers need to be worked with:

• Cliché layer: social chat, avoiding what is significant. The therapist needs to avoid joining in this level.
• Role-playing layer: the client plays a habitual and polarised role, and requires the therapist to play the complementary role, e.g. nurturer/nurtured. Any solution to the client’s dilemmas will be seen in relation to maintaining this limited role. The therapist needs to avoid just tak-ing up the role that is offered to him/her. Experiments can be useful here to explore the boundaries of the role, and what lies beyond the confines of the role that is important for the client.
• Impasse/phobic layer: The client is no longer engaged in deflective chat, nor wishes to stay within a fixed role, but what now? Remember, this is a theory of neurosis, not of contact. The client has adopted the fixed role not as an assistance in contacting, but as a defensive ma-noeuvre to avoid risking precisely this point. Therefore the client becomes phobic, usually tries to sidestep into something more known. The task of the therapist is to encourage the client to stay with the unknown, to acknowledge that this is a ‘safe emergency’ rather than an intolerable one as it may have been when the client first withdrew into the role.
• Implosion: Themes of paralysis and death arise, but this is not Freud’s ‘death instinct’ but the existentialist’s ‘vertigo of possibility’. The client is called on to choose a way forward that is his/her own, something s/he has avoided doing. There are no signposts, and it is im-portant here that the therapist is not pulled into providing them to make it easier (Goodman called this ‘premature pacification’). Notice that this is not a retroflection of an action, but the tension of being caught between many possible actions.
• Explosion: Not strictly a ‘layer’, but the release of energy in action and emotion as the client makes his/her own authentic choice of path. The task of the therapist is to witness, acknowl-edge and engage with this choosing.

Goodman’s model

I now want to compare Perls’ 5-layer model with the way Goodman (based, he says, on an original draft by Perls) describes the Gestalt therapeutic process (p. 64 in PHG, my own re-statement). I want to note in describing this how unfamiliar this way of describing the proc-ess is to many Gestaltists in my experience.

1. The client concentrates on the actual situation: what s/he is feeling, thinking, doing and saying, what attracts his/her attention.
2. The therapist gets a sense of where the ‘resistance’ is: where the client is avoiding going, and encourages the client towards noticing this area.
3. The client becomes more aware of the self-imposed barrier as this is focused on.
4. Therapist and client ‘play’ with this point, using imagination and exaggeration or reversal of the client’s fixed attitude, both in relation to the therapist and in visualising behaviour in the client’s ordinary life.
5. As the client focuses more closely on the situation and the resistance, s/he experiences anxiety, but also knows that there is no actual danger in the present context: this is the ‘safe emergency’.
6. In the safe emergency, the ‘underlying (repressed) intention - action, attitude, present-day object, memory - will become dominant and re-form the figure’.
7. The client takes ownership of this new figure.

For me, this is very close to the 5-layer model, with 1. and 2. being in the role-playing layer, 3. and 4. being the use of experiment to show the limits of the role, 5. being the impasse, 6. and 7. being the explosion. The extra for me in the 5-layer model is the implosion, the con-traction in facing the freedom of possibilities. However, they are clearly the same model. But what is it that makes both the 5-layer model and this discussion of therapeutic methodology unpopular in Gestalt circles? I would like to suggest two aspects of this.

Medical model

There is something in the way of describing the methodology that inherently says that the therapist is working with a specific pathological situation, according to a specific therapeutic theory, in order to produce change. The description of the psychotherapeutic process in PHG does not avoid this, saying ‘The context [for focusing attention] may be chosen by the therapist ... according to his scientific conception of where the resistance is’. (p. 64). This sits uneasily with the current dislike of the ‘medical model’, with an expert asking a patient to put him/herself into his/her hands. How does it fit with the paradoxical theory of change (Beisser, 1970)?

I would say that Gestalt Therapy operates a significantly modified medical model. There is a theory of health and a theory of neurosis, together with a methodology for working with the neurosis. The modification is that neither the theory of health nor the theory of neurosis is based on a particular way of behaving, which the therapist can see and interpret as healthy or unhealthy. Compare medicine, where a raised temperature shows illness, or classical psycho-analysis, where homosexuality is linked to the regressive anal phase, and therefore neurotic for adults. Rather, the question for everything is: how does the person get to do what s/he does? Is the action choiceful, based on good contact with the environment, and sensory con-nection to the person’s own body experience and emotions; or, conversely, is it based on ha-bitually restricted contact and awareness, which avoids facing the possibilities of the actual situation? If the latter, the theory says that the point of restriction, the ‘resistance’, is ob-servable: the immediacy of contact is lost, there is diminished awareness, the lively energy is dulled (the ‘autonomous criterion’: ‘autonomous’ because it is a usable criterion, but not based on a picture of what healthy people do). This alerts the therapist, who stays focused on the area of resistance, and encourages the client to do the same. This is not to say that re-sistance is wrong, but that the habitual resistance points to the area of loss of ego function.

The ‘paradoxical theory’ is precisely that therapist and client stay at the point of resistance, rather than seeing it as somewhere to get beyond and ‘fix’. Once again, the paradox of the paradox is that, if the impasse of the paradox does not lead to the explosion of the newly choiceful behaviour, I would be taking people’s money under false pretences, foisting an ide-ology or a metaphysics onto them rather than working with them in a way which has proven results. I am happy to base my therapy on this theory, since it fits well with my philoso-phy, and, equally importantly, it is observably clinically effective in a way which therapy based on, say, ‘discharging emotion’ does not (in my experience).

Flow and singularity

A second way in which this form of Gestalt Therapy is countercultural is that there is a strong emphasis these days on continuing therapy, with slow accretion of change, surrender-ing of old habits and building up of new and more contactful behaviours. The dominant pic-ture is of a smooth cycle (whether drawn as a circle or a wave). It is easy to see how this pic-ture arose in reaction to the episodic therapy Fritz Perls conducted at Esalen. However, something is missing both theoretically and clinically. If the image of change in Gestalt Ther-apy, the ‘a-ha’, is the gestalt shift, a realigning of figure and ground, then it cannot be smooth. Remember the vase and the faces: the shift from one to the other is instantaneous. (There are many parallels in this between the ‘punctuated evolution’ theories of the late Stephen Jay Gould, and the ‘continuous evolution’ theories of Richard Dawkins.)

So, does this mean a return to short-term Gestalt Therapy? In some cases, the answer must be ‘yes’: quite a lot of clients can achieve satisfying results in a very brief period, do not want to engage in longer-term exploration, and it would be unethical to try to pull them into some-thing expensive, unwanted, and unnecessary. Erv Polster, among others, has written and pre-sented about Gestalt Therapy as a form of brief therapy, and the British Gestalt Journal, 8, 1 (1999) has a series of articles on the theme, including one by myself.

Yet, long-term ongoing therapy is important as well. There are some clients, and some kinds of work, which do not work within a brief therapy timescale. For example, work with clients with borderline, narcissistic or schizoid process will not be able to move away from this process in brief therapy. However, reflecting on my work with such clients, the model I am using is still one of punctuated evolution. What the therapeutic approach of PHG and the ‘five layers’ provides me with here is a more clearly defined understanding of what takes the time. Firstly, ‘the patient [is] an active partner in the experiment’: building such a relation-ship proceeds very slowly with clients who have learned not to trust others, or to wait for others to tell them what to do. Secondly, ‘It is something of lively interest to himself, so he need not deliberately attend to it, but it attracts his attention.’ This cannot happen when the client habitually avoids the ‘lively interest’ of the novel. Similarly, ‘the patient is encouraged to follow his bent, to imagine and exaggerate freely, for it is safe play’. Building up the sense safety in the play is slow with many clients, who do not play (schizoid), or do not play safely (borderline), or do not play as partners (narcissistic). Finally, ‘the emergency is safe and controllable and known to be so by both partners’. This also takes time where trust is absent, or perception is heavily distorted by projection.

The changes in client experience, in their self-reported being in the world, and in my experi-ence of being with clients are not continuous however. The words which, for me, best encap-sulate the experience are ‘I found myself (for example) telling someone what I want from him - I don’t do that!’

Existentialism and behaviourism

The final difficulty with the five layers theory, and the similar therapeutic approach outlined in PHG, is that it faces therapist, as well as client, with the existential uncertainty of the impasse, a place where there is no right answer, no expertise. This is often a difficult place for professionals to face, and it is much easier to act in a more linear fashion to produce a behavioural response: and it must be faced that attunement to increase the client’s sense of safety and reduce the feelings of shame is a behavioural activity aiming to produce a particular result (and simultaneously helps the therapist feel stronger and more certain in relation to the client). Frank-M. Staemmler has written beautifully about ‘cultivating uncertainty’ as a thera-peutic tool (Staemmler, 1997).

References

Beisser, A. (1970). The Paradoxical Theory of Change. In Gestalt Therapy Now, ed. J. Fagan & I.L. Shepherd, Harper & Row, New York.

Perls, F.S. (1969) Gestalt Therapy Verbatim. Real People Press, Moab.

Perls, F., Hefferline, R., Goodman, P. (1994/1951) Gestalt Therapy: Excitement and Growth in the Human Personality. Gestalt Journal Press, New York.

Philippson, P.A. (1999). Process, Not Solutions. British Gestalt Journal, 8, 1.

Staemmler, F.-M. (1997). Cultivating Uncertainty: An Attitude for Gestalt Therapists. British Gestalt Journal, 6, 1.

Peter Philippson, 25th May, 2002.

Peter Philippson, M.Sc. (Gestalt Psychotherapy) is a UKCP Registered Gestalt psychotherapist and trainer, a Teaching and Supervising Member of the Gestalt Psychotherapy Training Institute UK, a founder member of Manchester Gestalt Centre, Full Member of the New York Institute for Gestalt Therapy, faculty member of Gestalt Therapy International Network (GTin), and a guest trainer for many training programmes internationally. He is co-author with his GTin colleagues of Contact and Relationship in a Field Perspective, pub. l'Exprimerie, editor of 'The Nature of Pain' and (with John Harris) co-author of 'Gestalt: Working with Groups' and co-editor of 'Topics in Gestalt Therapy', all published by Manchester Gestalt Centre, and author of many papers on Gestalt therapy in British, French, Ameican, Australian, Canadian and Spanish Gestalt Journals. His book, Self in Relation, will be published by the Gestalt Journal Press, and will be available in September 2002.