The holistic and positive aspects of Gestalt therapy makes it ideal for the treatment of any addiction related problem.  It allows for the greatest possible treatment variables in approaching individual differences, stresses the uniqueness of each person, admires the resiliency of the human spirit, and appreciates the integrity and spirituality of any individual.

Gestalt therapy sees the whole as greater than the sum of its parts.  It bridges the gap between cognitive and behavioral therapies by including the body, emotions, senses, and the phenomenological field of the individual as a context for the decision making processes and their behavioral execution.  One of Gestalt’s major premises is that all our coping mechanisms are creative adjustments to the stresses of life depending on the developmental readiness of the individual: Creative, because they are chosen among several alternatives; and adjustments, because they alter the experience in some way.  Gestalt therapy presumes that the individual organism attempts to self-regulate, and all coping mechanisms are considered positive until they no longer serve well their intended purpose.

The Gestalt awareness/experience/contact cycle can be demonstrated as follows:

When healthy individuals are thirsty, they allow the emergence of their need for water to become figural:

through the awareness of sensations (dry throat)

through identification of need (I am thirsty)

to activation of energy (go to the water faucet)

to action (pouring water and drinking it)

to contact (cool water feels good)

to enjoying the process of need satisfaction and withdrawal, leading to organismic homeostasis (no longer thirsty).

When this natural completion of the cycle becomes blocked, dysfunction occurs and the individual becomes stuck in habitual behavior patterns.  Considering the chaotic histories of most substance abusers, a clear figure (need) cannot emerge.  Thus, the awareness-contact-withdrawal cycle is interrupted through misidentification of sensations and inappropriate need fulfillment.  Eventually behaviors become rigid, then they become addictive patters that do not allow self-regulation and homeostasis to occur.

Examining the interruptions

In addiction treatment it is imperative that this cycle and its interruptions be examined in the context of the individuals’ problems, relationships, and environmental field.

The Gestalt 10-Step Program for Addiction and Trauma Recovery organizes the evaluation of the client’s lifestyle in the context of the awareness-experience cycle and the recovery stages from addictions or related problems (See table 1).  They also serve to make individuals co-responsible for their lives, stress decisions and choices, relationships, and the person’s phenomenological world.

The first three steps stress the personal decision/choice processes by examining our contribution to our problems, and work toward an examination of our lifestyle and the re-discovery of our long-abandoned internal and external supports.  Steps four and five allow us to examine our problem development as part of a process in connection with others at a particular time and place.  In addition, it stresses that we should examine our coping skills as strengths that help us to survive.

Steps five and six encourage individuals to look at how they keep unfinished business from the past alive and how it interferes with healthy living.  Relationships become particularly important here as sources of information and strength, because most of our unfinished business is lived out in relationships.

Accepting ourselves

In steps seven and eight, we accept our own and others’ inherent strengths and weaknesses and a healthy interdependency results.  The phenomenological world of individuals becomes enlarged with steps nine and ten, as we fully accept our strengths as weaknesses, pains and joys, as part of the human condition.

Source: Helga M. Matzko, MA, CAGS, CCMHC, ACDP, Gestalt Institute, www.gestaltri.com.

The Addiction Letter: A Resource Exchange for Professionals on Preventing and Treating Alcoholism and Drug Abuse

Vol. 9, No. 11

November 1993

ISSN 8756 405X