The Gestalt approach in Substance Abuse

• Gestalt Therapy and Mental Health Care: Part 1 by Brian O'Neill, 11/3/96
  • Substance Abuse Therapy in Community Mental Health Centers by J. Richard White, 11/24/96
    
    

Richard,

I've enjoyed your Haikus and now you are opening up a subject of great interest to me. I worked for many years as a psychologist in a community drug and alcohol counselling service (State run) and now I've just recently come back to be the director of the service. In both cases I am aware of the very valuable contribution that my background in Gestalt therapy provides. I'll mention a few brief points.

As a clinician I am focused on the immediate contact and relationship which develops when I meet someone, which I guess relates to what you have previously mentioned - that ethics is the starting point. I am not interested per se in fixing the problem that the person presents with, but in a more immediate unravelling and exploration of what is happening for the person and myself as we explore why they have come to see me. I also have found the Polsters' Contact Episode model useful to track the process of working with *wanting to use* and *not wanting to use*. I would argue that such process models in Gestalt are very similar in working with polarities or splits, as counselling models by Egan or Ivey, where the person is challenged or constructively confronted, however I believe the Gestalt approach is more fluid.

From both my grounding in Gestalt therapy and through working in the drug and alcohol area, I have come to perceive that a healthy maturity for any person (organism) is marked by our ability to tolerate and even rejoice in our paradoxical nature as human beings. I notice people begin work in this area of D&A by trying to hide or negate *I want to use/drink* and try to change themselves by focusing on *I don't want to use/drink*. I think there is a temptation for counsellors to support *I don't want to use/drink* and not attend to *I want to*. Having been with many people as they struggle with such strongly polarised and powerful aspects of their nature, I sense a maturity and turning point is reached when someone says *I would LOVE to drink or use drugs... AND I'm not going to.*

I sense the ethics and attitudes for counsellors that you speak of is in listening to the whole person and attending to what's next from them, as opposed to simply trying to change people for the better. I do not think such approaches are solely within the realm of Gestalt therapy as I've met some excellent case managers in mental health/psychiatry who, whatever words they use to describe themselves and their theoretical approach, are working from the same perspective. I believe there is a tremendous overlap in the literature on Case management, Therapeutic Alliance and Gestalt Therapy which has not been written about... perhaps more on this later.

• Ambivalence in Drug Users by J. Richard White, 12/5/96
  • Ambivalence in Human Beings by Brian O'Neill, 12/6/96
  • Drug users recover on the edge of forever.... by Dale R. Smith, 7/2/97
    • Reply to Dale by Brian O'Neill, 7/2/97
      • Forever is always in the NOW by Dale R. Smith, 7/3/97
        • Just doing some fishing ... by Dale R. Smith, 8/16/98
    • Dear Dale by Bob, 7/2/97
      • Dear Bob by Dale R. Smith, 7/3/97
        • Dear Dale by Bob Bock, 7/15/97
    • Drug users recover on the edge of forever... by ginger, 5/16/98
      • Reply to Ginger by Dale R. Smith, 5/16/98
• Little white lies... by Dale R. Smith, 7/19/97
  • Drugs, Lies and Email Groups by Brian O'Neill, 7/20/97
    • We have engaged the Borg... by Dale R. Smith, 7/23/97
      • In response... more of me by Brian O'Neill, 8/1/97
        • We is We... by Dale R. Smith, 8/2/97
          • DALE are you ALIVE... PRESENT? by Bob Bock, 3/17/98
            • Contact...how sweet it is Bob! by Dale R. Smith, 3/21/98
  • Little white lies emerge from the field! by Bob Bock, 7/25/97
    • Dear Bob by Dale R. Smith, 7/29/97
      • Who I am is What I am by Bob Bock, 7/31/97
        • Claiming by Brian O'Neill, 8/1/97
          • Looking to Claim by Bob Bock, 8/8/97
        • Hi ya Bob by Dale R. Smith, 8/20/97
          • Conditioned Responses: Head Games by Bob Bock, 8/20/97
  • Dear Dale by Bob Bock, 7/25/97
    • Contact...how sweet it is Bob! by Dale R. Smith, 3/21/98
      • Back Again by Bob Bock, 3/27/98
        • I hear ya... by Dale R. Smith, 4/3/98
• Graduate Student looking for Substance Abuse Info. by Kindra Threlkeld, 2/25/98
  • Reply by Brian, 2/26/98
• The Empty Chair Tecnique in the treatment of Substance Abuse by James T. Bouden M.Ed., CAGS, LPC ab0ge@train.missouri.org, 2/26/98
• GESTALT RESEARCH STUDIES by GRAD STUDENT, 10/21/98