Enhancing Your Therapy with Gestalt Approaches

On the last track, we discussed four important factors to consider in addressing avoidance in Gestalt therapy.  These four factors were, contrasting avoidance and expression, avoidance is an ongoing self-regulatory process, avoidance is not a sign of weakness, and a vast majority of clients will engage in avoidance at some time. We also discussed the Rule Book technique.

On this track, we will discuss four concepts regarding acceptance of feelings.  These four concepts are, avoided feelings can be a source of difficulty, problems with beginning to accept feelings, building confidence, and confronting the idea of acceptance.

As you know, there are few feelings that are universally accepted or avoided by all clients.  In addition, avoided feelings are not always "negative", not are accepted feelings always "positive".  One client may accept the experience of grief, while another client may not.  On the other hand, one client may accept the feeling of affection, while another client may avoid feeling affection.

Four Concepts Regarding Acceptance

Concept #1 - Avoided Feelings a Source of Difficulties
A first concept regarding acceptance is that avoided feelings can be a source of difficulty.  My client Steven, age 32, put a high value on being "strong" and avoided feelings of weakness.  However, a recent job-related injury had threatened Steven's self-perception.  Steve stated, "I don't see how avoiding feelings is a bad thing.  Strong people can avoid feeling afraid, and that lets them succeed, right!?" 

I replied, "Well, sometimes avoided feelings, even 'negative' ones, can have purposes and messages which are to your advantage. Let's say I successfully avoid feelings of fear. One day, I am walking along, and a rabid dog charges at me to bite me. Not accepting feelings of fear increases my chances of being bitten, because I don't take precautions to remove myself from the situation. If I accepted my feelings of fear, I might look for a car, tree, or fence which I could climb to escape the dog."

Concept #2 - Beginning to Accept Feelings
A second concept regarding acceptance is problems with beginning to accept feelings. As you have experienced, to avoid experiencing negative feelings, a client may restrict his or her awareness of all feelings, even positive ones. As the client works on accepting his or her feeling, a negative feeling may be one of the first to emerge. 

Clearly, this is a critical moment for a client, especially considering that the negative feeling may be the one that led to the client's avoidance in the first place. In my experience, in this critical moment the client may be tempted to avoid the feeling again. This, of course, leaves the client right where he or she was.

Concept #3 - Building Confidence
In addition to the fact that avoided feelings can be a source of difficulty, and problems with beginning to accept feelings, a third concept regarding acceptance is building confidence. I have found that if a client can be supported in being aware of and accepting the avoided feeling, the client may find that the feeling is no longer as threatening as it was at the time he or she began avoiding it. 

As you know, learning that he or she can experience an avoided part of the self and survive can build a sense of confidence and strength. Additionally, by staying with an emergent feeling, a client may begin to experience positive feelings that have also been avoided. Steven stated, "If someone couldn't cope with feeling afraid a year ago, how is that going to be any different now?"  I stated, "Well, after time passes, this someone might find that his or her current situation is different.  He or she might now be able to do the things that their fear suggests might be constructive."

Concept #4 - Confronting the Idea of Acceptance
A fourth concept regarding acceptance is confronting the idea of acceptance.  Clearly, when a client has rejected or avoided a feeling for some time, the idea of accepting this feeling as part of him or herself may seem incomprehensible.  Steven had invested so much time and energy into avoiding his feelings of weakness that the suggestion of owning and accepting his feelings of weakness seemed very strange.  Steven found the idea of accepting his feelings of weakness especially strange, since he had initially entered counseling seeking better ways to avoid his feelings of weakness.

Technique: Staying With
To help Steven begin to accept his feelings of weakness, I implemented a variety of the Staying With technique, which we discussed on Track 3.  You might listen for how the Staying With technique was adapted to focus specifically on Steven's avoided feelings of weakness.

Steven stated, "Usually I feel very strong and capable.  But since I broke my hand, I can't fix my own damn breakfast.  You'd think I was some kind of baby, with as little as I can manage…"
-- I stated, "Do you hear yourself as you say this?"
-- "Yeah, a little."
-- "How do you sound?"
-- "Kind of quiet.  Sorta… soft."
-- "And what are you feeling?"
-- "I feel useless, and weak.  I fight it, try to ignore it… but it comes back."
-- I stated, "You are afraid to feel weakness."
-- "Yeah, because I'm a strong guy.  If I'm feeling weak, I feel like there's something wrong with me, more than just a busted hand."
-- "Can you allow yourself to feel some of your weakness now?"
-- "I don't want to… but I do feel that way."
-- "Just stay with what you feel.  What is feeling weak like for you?"
-- "I feel… old and useless.  I don't know what to do.  I'm not sure of myself."
-- "Just let yourself feel this."  After a few minutes of sitting quietly, I stated to Steven, "How do you experience your feelings of weakness now?"
-- Steven stated, "A little less afraid."
-- "No harm has come to you while you feel weak."
-- "Yeah."
-- "Can you accept this feeling of weakness as part of you?"
-- "I guess it's not as awful as I thought. I didn't, like, melt away, after all."
-- "Try saying, 'it's OK for me to feel weak.'"
-- "It's OK for me to feel weak."
-- "Again."
-- "It's OK for me to feel weak."
-- "Is this true?"
-- "Well, I still don't know. I still don't like feeling weak. But it's more true than before."

By allowing himself to experience a little of his weakness in the now, Steven found that he didn't 'melt away'.  As a result, he was able to feel less threatened by his weakness. I felt this was an important step in Steven's moving toward accepting his feelings of weakness.

Think of your Steven.  Would he or she benefit from trying the Staying With technique adapted to his or her own avoided feeling?

On this track, we have discussed four concepts regarding acceptance of feelings.  These four concepts are, avoided feelings can be a source of difficulty, problems with beginning to accept feelings, building confidence, and confronting the idea of acceptance.
Reviewed 2023

Peer-Reviewed Journal Article References:
Elliott, R. (2014). Review of Gestalt therapy in clinical practice: From psychopathology to the aesthetics of contact [Review of the book Gestalt therapy in clinical practice: From psychopathology to the aesthetics of contact, by G. Francesetti, M. Gecele & J. Roubal, Eds.]. Psychotherapy, 51(3), 462–463. 

Furley, P., Kohlhaas, S., Englert, C., Nieuwenhuys, A., & Bertrams, A. (2019). The expression of ego depletion: Thin slices of nonverbal behavior as cues to momentary self-control capacity. Social Psychology, 50(5-6), 305–321.

Gold, E., & Zahm, S. (2020). Buddhist psychology informed Gestalt therapy for challenging times. The Humanistic Psychologist, 48(4), 373–377.

Hallis, L., Cameli, L., Dionne, F., & Knäuper, B. (2016). Combining Cognitive Therapy with Acceptance and Commitment Therapy for depression: A manualized group therapy. Journal of Psychotherapy Integration, 26(2), 186–201.

Twohig, M. P., Ong, C. W., Krafft, J., Barney, J. L., & Levin, M. E. (2019). Starting off on the right foot in acceptance and commitment therapy. Psychotherapy, 56(1), 16–20. 

Online Continuing Education QUESTION 14
What is one benefit of accepting feelings? To select and enter your answer go to CEU Test.

This CD set has covered such topics as:  guidelines for Gestalt therapy, awareness and the now, techniques for enhancing client awareness, changing words, changing sentences, addressing nonverbal behaviors, identification and projection, fantasy, dialogues, helping the client presentize, responsibility, bipolarities, avoidance, and acceptance.

I hope you have found the information to be both practical and beneficial. We appreciate that you've chosen the Healthcare Training Institute at homestudycredit.com as a means for receiving your continuing education credit.

Other Home Study Courses we offer include: Treating Teen Self Mutilation; Treating Post Holiday Let-Down and Depression; Living with Secrets: Treating Childhood Sexual Trauma; Interventions for Anxiety Disorders with Children and Adults; and Balancing the Power Dynamic in the Therapeutic Relationship. 

I wish you the best of luck in your practice. Thank you.