Gestalt psychotherapy was developed in the early 1950s by the physician Fritz Perls (1893-1970), who emigrated to South Africa in order to escape persecution during Nazi rule in Germany and later on went to The United States.

On becoming established in New York, he founded the Gestalt Institute of New York in 1952. The Gestalt approach to psychotherapy was to a large extent influenced by concepts derived from research conducted by a group of psychologists working in the field of human perception. These concepts show that humans do not perceive objects as distinct or disconnected elements but organise them into meaningful wholes through the process of perception. One of the basic concepts of the Gestalt approach, ‘The whole is different from the sum of its parts’, explains a basic functional modality not only of the process of perception but also of the psychic apparatus in general.

Fritz PerlsWhen we observe a geometric figure - for example, a square – we do not see it as four lines and four angles but as a single object. The object in question, formed by all of its component parts is perceived as a whole in which the  final result is something different from the sum of its parts. Gestalt psychology is thus a holistic field of study, i.e, based on the idea that the properties of a system cannot be explained exclusively by means of its components alone, but these should be analysed in their entirety. This conception is applied to human beings, thereby producing a vision of the individual as a whole, greater and more complex than the parts with which he/she is composed, which include the body, mind, thought, feelings, the imagination and movement. A person can thus be viewed as a being formed by the integrated functioning in time and space of the various components and aspects of the whole.

From this point of view, to exclusively treat one aspect of a person or to identify a part as the cause of a problem means effecting an artificial fragmentation of what is in actual fact something that works as a single unit. Gestalt psychotherapy focuses particular attention also on what is known as the process of homeostasis. In the sphere of physiology, this process governs the basic functions of life and has the purpose of preserving the internal equilibrium of the organism in fundamental organic terms, thus ensuring its health and appropriate functioning in variable conditions. Coherent and adequate behaviour aimed at satisfying multiple needs are a consequence of this process. While medical and biological science are interested in and study physiological needs (e.g., the physiological regulation of sugar levels in the blood), psychology deals with the individual’s needs of a psychic nature and the ‘homeostatic’ or adaptive mechanisms by which they can be satisfied, and in any case recognising that the two processes (biological-physiological and psychological) are always interconnected.

Under normal circumstances, the organism copes with various needs which manifest simultaneously, but as it can adequately cope with only one function at a time, it has to make choices according to a hierarchic scale of values, following a scheme which allots priority to the need in the ‘foreground’ (the ‘figure’ which we see in front us) - the need which is the most urgent and requires satisfaction in the very short term - temporarily leaving aside other needs in the ‘background’. Gestalt psychotherapy sees the functioning of the organism as an organisation reflecting this ‘principle figure’/’background’ dynamic. If, however, the  homeostatic process fails, on account of the fact the individual has not been able to identify his/her real needs or because he/she has failed to establish adequate contact with the environment, the gestalt (a German word meaning ‘form’) remains ‘open’ and incomplete. A non-concluded gestalt will then constantly interfere with the flow of exchanges between the individual and the environment, determining a certain rigidity in the ways in which he/she manipulates and interacts with the environment.

The element which most of all differentiates a healthy individual from a neurotic subject is the mobility factor. A healthy model of functioning provides for a constant, harmonious and rhythmic process of ‘opening’ and ‘closing’ with respect to the environment. One of the main objectives of Gestalt therapy is thus that of restoring the self-awareness which is lost when a psychological disorder becomes manifest, and this can be done by re-establishing the individual’s capacity to discriminate, helping him or her to discover what is and what not is himself or herself, and what gives the person a sense of self-realization and achievement and what leads to frustration. The person is guided towards a sense of integration, in the search for an appropriate balance in terms of the limit or frontier between the self and the rest of the world.

One of the main techniques adopted by this approach, aimed at increasing the patient’s self knowledge and knowledge of the outer world in every sense, is the so-called ‘awareness’ technique. There are five classical questions a Gestalt therapist will put to his patients so as to facilitate the process of becoming more aware of reality. These are: "What do you do?", "What do you feel?", "What do you want?", "What do you avoid?", and, "What do you expect?" The work on a subjects’ awareness involves various levels of examination, and, in fact, in this regard Perls ‘peeling-an-onion’ metaphor is quite apt". The work starts at the surface and then one begins to peel off the various layers, passing from more easily observable behaviour (cfr. What do you do?) to the sensations and emotions (cfr. What do you feel?) and finally the cognitive and volitional processes (cfr. What do you want?; What are you avoiding?; What do you expect from life?). The therapist also places importance on non-verbal responses of the subject as, while language is potentially insincere, the body is not, and will often reveal when and how a patient implements his or her self-manipulative and defensive strategies.

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