¶ Psychotherapy Approaches
Hello and welcome to our special Halloween episode here at licensure exams .
My name is Stacy Frost and , though I usually play the role of myself , today I'm donning the robes of Victor Frankel , an Austrian existential therapist and founder of Logotherapy , and my co-host , dr Linton Hutchinson , is imbuing the spirit of Fritz Perls , a German psychiatrist and co-founder of Gestalt Therapy , along with his wife Laura , and we're going to have what
promises to be a lively discussion about our different approaches to psychotherapy , so that we have some disagreements . I think there is much we can learn from each other , right , fritz ?
Certainly so there . I believe that there's value in both of our approaches . After all , there's more than one path to healing and wholeness . Where do you want to start , Victor ?
Wir willen von einen Wissenhaber-isch einen .
Wait a minute , Victor . Ich spreche nicht Deutsch .
That's strange , aren't you from Germany ?
Well , I moved to New York in the 1940s and lived in California later in the 60s . Even though I have German roots , I dream in English nowadays .
Okay , well , I'll practice my American accent then and continue in English , shall I ? Alright ? As you know , my theory is an existential approach to therapy , and there were several of us existentialists in Europe in the 1940s and 50s .
We tried to help clients who felt isolated , alienated and lacked interest in the world or an initiative to make positive changes in the world . Like many , I was a student of Sigmund Freud , but I disagreed with his obsession with the unconscious and the idea that we are not in control of our lives .
No matter what happened in the past , I believe that we have the freedom to choose who we want to be .
Victor , at least we have something in common from the beginning . You know , I too met with Freud , but found his form of analysis to be really too intellectual and removed from seeing the whole person , and don't even get me started on his approach to the dream work , layton and manifest content , come on . Sometimes a cigar is just a cigar , sigmund .
I'm much more interested in the emotions attached to the drama of the dream .
Very , very interesting .
Care to share an example , okay , let's say a client dreams of being chased by a growling wolf . I would have them play out both of those roles the dreamer and the threatening wolf . This helps to explore any suppressed emotions or inner conflicts that the dream may represent .
I may ask what does a growling wolf mean to you , or what would the wolf say if it could speak ? By dialoguing with dream elements , clients can integrate disowned parts of themselves and achieve greater self-awareness .
Ah , I understand now , fritz . So in your Gestalt view , dreams aren't just abstract symbols to decode , like our friend Freud thought , but rather opportunities for meaningful experiential work .
Precisely . So tell me , Victor , what was the idea behind logotherapy that you developed ?
Well , logotherapy or I think of it as healing through meaning focuses on finding meaning and purpose in life . I've come to believe that even in the darkest of circumstances , human beings have the capacity to find meaning and move forward .
My experiences in the Nazi concentration camps during World War II , where I witnessed profound suffering yet also incredible displays of courage and dignity , helped to confirm and solidify my view of life .
Hmm , I see where you're coming from , victor . As a Gestalt therapist , I focus on how we can become fully aware of the present moment by noticing what we're avoiding and taking responsibility for our choices . A client can integrate the fragmented parts of themselves and become whole .
Hmm , you make a fair point , Fritz . You can't move forward without taking responsibility for your choices .
Exactly . What's your take on the reason behind psychological disturbance ?
Ah , yes , good question . So I see what contemporary therapists call mental illness as stemming from an existential vacuum , a lack of meaning and purpose . In these modern times , many clients see themselves as victims who are trapped and helpless . They lack the awareness of the extraordinary freedom that they have .
My role as a therapist is to help clients see that they must take personal responsibility for their lives . Doing so is the only way they can grow and lead a meaningful life . So what about you , fritz ? What's your view of human nature and the problems they manifest , like resentment , anxiety , guilt , depression ?
Hmm , I believe that individuals with psychological disturbances become stuck because they deny and repress aspects of themselves . By becoming aware of what they are avoiding , they can accept all the parts of themselves and become fully integrated individuals . Mental illness results from a lack of self-awareness and a voidance of what is not confronted .
It's a lack of owning all aspects of who you are .
Well , you raise an interesting perspective , Fritz . While I believe meaning comes through using our gifts and talents , I can see how avoidance and this lack of awareness can hinder that process .
Exactly . I think our theories have more in common than we realize , Victor . While awareness is critical and gestalt , the goal is choice and integration . With awareness comes responsibility . I must choose whether I accept every part of myself or deny unpleasant aspects .
Depression , anxiety and rage come from when we avoid and fixate on what we're missing , versus realizing we have everything already within us .
You make an excellent point , my friend . Perhaps integrating existential meaning with gestalt awareness is the healthiest path . We must become fully aware in order to make authentic choices that fulfill our potential , and when we inevitably encounter unchangeable suffering , we remember that we always , always have the power to choose .
Our response align with our values and find meaning , regardless of circumstances .
Right . So when a client avoids pain , they also numb joy With radical self-awareness . A client is open to all of life , the agony and the ecstasy . They discover their inner wholeness and from that centered place a client can discern their gifts and callings without avoidance or illusion and they can fully live their purpose .
You know , fritz , though we come from different orientations , I'm really struck by how much overlap we have in wanting to help clients . While we may use different language and techniques , our overall shared goal is really alleviating suffering by empowering clients to find truth , meaning and their highest selves .
You took the words right out of my mouth , Victor . Here we've been debating , yet we both only want clients to experience the freedom that comes through self-realization and living passionately from their essence . When we fully inhabit each moment , we can break free of the past and face the future with courage .
My method utilizes certain techniques to help clients become more self-aware and integrated . How do you help clients uncover meaning and purpose ?
Well , that's an important question . In Logo Therapy , I implore several core concepts . First , there is freedom of will . We always have some freedom to respond to life circumstances , even in great adversity . Then there is will to meaning , the search for purpose , which I believe is the primary motivational force .
Finally , there's meaning in life , values we can fulfill and purposes we can serve outside of ourselves , and my therapeutic work Helps clients to reflect on these three areas , to discern their uniqueness and their purpose .
Interesting . You know , gestalt also empowers clients to guide their own lives , Using the framework that many of our troubles stem from disowning aspects of ourselves . For instance , one technique I often use is the internal dialogue experience , where a client dialogues between two opposing parts of themselves to increase their awareness and integration .
The overall point of this exercise is to help the client learn to Accept these polarity and live with them . How might you work with the client experiencing inner conflict ?
Well , first , what a great exercise for its . In Logo Therapy , I would explore with the client areas where they may be lacking self transcendence , in other words , lacking pursuits outside of themselves . Inner conflicts often arise when we become self-focused and detached from meaningful values and purposes .
My aim in using Logo Therapy is to guide them back to more altruistic goals and actions . After all , we only have meaning in relation to something or someone outside of ourselves . A purpose to fulfill , a person to love , work of value to do , arbiten , unlieben . What do you see as the benefits and limits of focusing primarily on this self in Gestalt therapy ?
Gestalt therapy isn't solely focused on the self in a narrow sense . The goal is full integration with one's environment and relationships . However , I believe that the emphasis in therapy should be on self-awareness and responsibility first . We can't show up fully for others if we still are in conflict with aspects of our self .
When the cabin pressure drops during an air flight , it's best to put on your oxygen mask first . The experiential , active involvement of the client used in Gestalt therapy creates the new ah ha Insight that talk therapy alone cannot . But then again , victor , you make a fair point that connecting to a larger purpose beyond oneself is vital .
How do you work with clients who lack self-awareness ?
This is a challenge I face all the time . Clients who lack self-awareness may benefit from Logo Therapy techniques like Socratic dialogue , where through questioning they gain more objective clarity about their lives . I also suggest meaningful Experiments to help them discover sources of their purpose , perhaps volunteering , creating art or expressing gratitude .
To discover one's true meaning , one must interact with others . You mentioned some experiential techniques used in Gestalt . Can you elaborate ?
Mm-hmm . Well , I know you probably heard of the empty chair , so I won't bore you with details of that one , but perhaps you haven't heard of a more paradoxical technique I use from time to time . Ah , such as Staying with the feeling , that's one that's when the client has the urge to flee from an unpleasant feeling .
I encourage them to not only confront this feeling , but experience it to the fullness .
This sounds rather counterintuitive .
Well , yeah , on the surface perhaps , but Enduring the uncomfortable feeling breaks the control that the feeling has over the client . For example , let's say someone says something about you that annoys or makes you angry .
Rather than react into what they've said , mentally , count down from five to one and then agree with what they said Regarding their perception of what is occurring . The feeling is instantaneously released and its hold over you is broken .
¶ Exaggeration Technique in Therapy
Another technique is exaggeration . I asked the client to exaggerate a nonverbal behavior that I observed them engaging in . Perhaps they're clenching their fists or bouncing their leg up and down . I Draw attention to this behavior and have them purposely intensify the movement , which then helps the client to discover the meaning behind their behavior .
Very interesting . Well , fritz , this has been such an enlightening dialogue . Although we approach therapy from different perspectives , I'm struck by how our core aims are similar to help clients live more fully , purposefully and responsibly .
Yes , victor , this has been a pleasure .
And thank you , listeners , for joining us on this special episode today . May it spark insightful reflections on how to live with meaning , purpose and compassion this season . Good luck to all of you as you prepare for your exam and remember .
It's in there .