Gestalt Therapy: What It Is, Techniques, & How It Works

What Is Gestalt Therapy?

Gestalt therapy is a type of psychotherapy that contains elements of many other counseling theories, including person-centered therapy, humanistic therapy, as well as aspects of psychodynamic therapy. It also has elements of systems theories, emphasizing that a person can’t be understood without looking at the context of their life and relationships.^1,3,4,5

Gestalt therapy was also influenced by Eastern philosophies that highlight the importance of here-and-now practices like mindfulness and acceptance. While Gestalt therapists consider the relevance of certain unresolved issues from the past, they tend to address these issues in the present using experiential techniques.^1,5 The Gestalt approach was first developed in the 40s and has some followers, but it’s still a relatively uncommon therapeutic approach.

What Does Gestalt Mean?

A term coined in 1890 by philosopher Christian von Ehrenfels, Gestalt doesn’t have an exact English translation. However, the word Gestalt can be used interchangeably to refer to shape or form, and implies that the whole of something is greater than the sum of its parts. The basic assumption underlying Gestalt theory views human beings as a mixture of their mind, body, emotions, and spirit with distinctive realities and experiences.⁶

What Is the Therapist’s Role in Gestalt Therapy?

A gestalt therapist approaches therapy without any preconceived ideas, allowing the client to tell their own story while also paying close attention to the person’s feelings and self-awareness. The gestalt therapist aims to develop a strong partnership with a client to guide them throughout the therapeutic process. The clinician values process over content and their role is not to change the client but rather support them in becoming more aware of their experiences, perceptions, and how they respond to situations in the here-and-now. This paves the way for the individual to overcome existing obstacles and resolve the issues impacting their life.⁶

Main Components of the Gestalt Approach to Therapy

There are four focal points of Gestalt therapy that help to summarize the main components: The phenomenological method, dialogical relationship, field theoretical strategy, and experimental freedom.

Here are the four components of the Gestalt approach:^1,3,5

1. Phenomenological method: Phenomenological methods in Gestalt therapy involve the use of non-judgmental and unbiased perspectives to help people gain new insight into themselves and their lives. Phenomenology is particularly focused on understanding how clients make sense and meaning from their experiences.
2. Dialogical relationship: The dialogical relationship in Gestalt describes the importance of the client-therapist relationship. Similar to person-centered therapy, Gestalt therapists are trained to develop strong therapeutic relationships and alliances with each client. Gestalt therapists are encouraged to be more open, authentic, and transparent with their clients to form this bond.
3. Field theoretical strategy: The “field theory” is constructed on the basic belief that humans can only be understood in the context of their lives. This includes their current and past relationships, experiences, situations, and settings, which all work to help shape the individual and their patterns of response.
4. Experimental freedom: Experimental freedom is the use of creative, experiential, and interactive activities in therapy, in addition to traditional talk therapy models. These methods can help clients conduct “experiments” in sessions to help them become more aware of themselves and their patterns. Gestalt therapy exercises and experiments are designed to help clients identify, interrupt, and change certain patterns contributing to their problem.

What Can Gestalt Therapy Help With?

There hasn’t been enough scientific research to determine which issues the Gestalt approach can treat and how effective Gestalt therapy is overall. However, three studies comparing Gestalt to other proven treatments (cognitive behavioral therapy (CBT), person-centeredness, and psychodynamic therapy) found it just as effective.⁷

Gestalt therapy has been used to treat issues like:⁴

• Depression or mood disorders like bipolar disorder
• Anxiety disorders or general stress and anxiety
• Relationship problems or interpersonal conflicts
• Behavioral problems like gambling disorder
• Self-esteem issues or a lack of confidence
• Negative self-talk
• Identity crisis
• Improving self-awareness

Gestalt Therapy Techniques

Depending on the concerns they are trying to target, Gestalt therapists have developed a range of different techniques. Some of the most widely used and well-known Gestalt therapy exercises include the empty chair technique, role play, experimentation, dream work, and present moment awareness.

The Empty Chair

The empty chair technique is one of the best-known Gestalt techniques. It involves having the client talk to an empty chair in order to resolve old issues and conflicts. Contrary to popular belief, the empty chair technique isn’t just used for the client to create dialogue with an imaginary person from their past or current life; it can also be used for situations, dilemmas, or personal traits or habits.^2,5

Here are examples of when the empty chair may be used:⁵

• To help a client “talk” with a deceased or absent loved one from the past to resolve old issues or unresolved traumas
• To allow a client to dialogue with a certain “part” of themselves they dislike (including a trait like shyness or laziness)
• To provide an opportunity to problem solve by placing a dilemma or problem in the empty chair to allow the client to talk through possible origins, options, and solutions

Role Plays & Re-enactments

Role plays and re-enactments are another common Gestalt therapy technique that involves helping clients practice certain skills in the present moment during a session. Role plays and re-enactments always involve constructing a “scenario” that the client (and sometimes also the therapist) acts out in the therapy session.^1,2,5 These interventions can be used to resolve unfinished business, address root issues, and identify and change patterns.¹

Here are examples of when role plays and re-enactments may be used:⁵

• To help a client practice assertive communication skills in a dialogue, role-play, or re-enactment with the therapist
• To have a client use different voice volume, inflection, and tone to notice changes in how they feel
• To create a “safe emergency” where a client is able to practice certain regulation or conflict management skills in a therapeutic role play

Dream Work

Dream work is an element of Gestalt therapy that involves re-enacting a client’s dreams inside the therapy session. Because Gestalt is primarily a present-focused therapy, the goal is always to bring memories, thoughts, and even dreams from the past into the here-and-now. Unlike other forms of psychotherapy and analysis, Gestalt therapists do not interpret dreams, but instead use them to help clients build awareness and work through blockages.^5,8

Here are examples of when dream work may be used:⁸

• A client experiencing vivid dreams may be asked to re-enact or role-play these dreams to bring up emotions, underlying thoughts, and associated issues
• A client may be asked to identify the main conflict within the dream and then act this conflict out in therapy using the therapist or the empty chair technique
• The therapist may use questions like, “What did you want to happen next?” or “How should this end?” in order to help the client resolve unfinished business or conflicts

Focus on the Here and Now

Gestalt therapists are always working in the present moment to help track clients’ body language and notice subtle changes that indicate what they’re thinking, feeling, and experiencing. Many Gestalt methods are aimed at helping clients develop this kind of self-awareness during therapy sessions by asking them to notice, track, and describe changes in their body, thoughts, and feelings.^1,2,5

Here are examples of when present moment awareness may be used:^2,5

• A therapist may notice a client shut down, cross their arms, or look down and use this as a cue to ask the client what they’re thinking or feeling
• A client may be asked to track sensations in their body when they think about a certain past traumatic event in order to build awareness of how this still affects them now
• While discussing certain problems or issues, a client may be asked to describe the emotions they’re having, process them, and allow them to pass

Paradoxical Change

The concept of paradoxical change centers around the inherent human desire for self-acceptance which can assist a person to foster an improved sense of self-awareness. Using this philosophy, the therapist encourages the individual to bring forth and explore polar conflicts that exist within the self so they can directly deal with aspects that have caused discomfort and thus have been repressed. Once someone comes to terms with who they really are, change can occur and then the client can experience positive emotions and live fully in the moment.

Exaggeration Technique

Sometimes people have difficulty putting into words what they’re feeling or what is affecting them. So, during this intervention the therapist might request that the client repetitively exaggerate some aspect of an emotion or behavior (like a gesture, posture, or voice). This technique focuses on assisting someone become attentive to the subtle cues or signals related to core problems that may be linked to their distress and how they might have learned to detach from their emotions and channel these in a physical manner.

Use of “I” Statements

Attention to language and tone is paramount in Gestalt therapy. Learning to use “I” statements can help clients to recognize their feelings and actions and employ language to convey self-responsibility rather than projecting it onto others. For example, instead of saying, “If my friend hadn’t said that then I wouldn’t have gotten so angry!” Instead, a client might be prompted to say, “I feel upset when they talk about me that way because it makes me feel humiliated.”

Tracking Body Language

During a session, a Gestalt therapist will observe a client’s bodily movements or gestures like fidgeting with their hands, tapping their foot, etc. Then the clinician will bring attention to this and ask the client to verbalize or elaborate in detail about what is affecting them at that moment. The clinician may ask something like, “If your tears could talk, what would they say?” This enables the person to give a voice to a nonverbal expression and internally experience what has only been observed on the outside.

Inclusion of Creative Arts

Another intervention that can be incorporated into treatment is creative arts activities such as drawing, painting, or sculpting. These creative exercises can assist people to increase awareness of their surroundings, stay present, and acquire skills to make sense of the moment as it occurs. In the same way, any method that is provided to a client other than traditional talk therapy methods can be beneficial in granting them the opportunity to become more conscious of themselves, their experiences, and the recovery process.

Benefits of Gestalt Therapy

Some of the benefits of Gestalt therapy are related to the foundational principles and techniques, which are also found in other types of therapy.^1,2,5 For example, mindfulness has many therapeutic benefits, and role-plays can help people develop and practice new communication and coping skills. Additionally, the focus on a strong client-therapist alliance has been proven to improve outcomes in therapy.⁹

Here are some of the potential benefits of Gestalt therapy:^1,2,3,5,6

• Ability to interrupt patterns and replace them with more adaptive responses
• Opportunity to practice mindfulness or communication skills in sessions
• The ability to track changes in thoughts, feelings, and bodily sensations
• Improving self-awareness and insight into problems, origins, and patterns
• Building a strong, warm, authentic relationship with a therapist
• Improving stress management or coping skills and breaking negative behavior patterns
• The ability to work through past traumas or “unfinished business” from the past
• Exploring life meaning and purpose or working through existential anxiety
• Improving relationships and situations that impact mental health and stress

Gestalt Therapy Examples

Gestalt therapy can help people in a variety of settings, like dealing with stress or coping with the symptoms of anxiety, depression, and grief.

Here are some examples of how Gestalt therapy techniques may actually be used during sessions:

Empty Chair

Melisa’s father passed away in a car accident a few months ago. As she grieves, she’s overwhelmingly conflicted with guilt because she had an argument with him a few days before and they weren’t talking when he died. The therapist suggests the empty chair technique. Melisa faces an empty chair and imagines her father sitting in it, and she starts describing her feelings. She apologizes and tells him she loves him. This may help her start to give closure to what occurred before the car crash and assist her to better cope with the loss.

Exaggeration and Tracking Body Language

John keeps tapping his feet in sessions. The therapist tells him to exaggerate that motion and to stomp his feet harder and louder. The therapist says, ‘‘Make that motion again, only make it bigger. What are you aware of now?” John eventually divulges that he is feeling particularly nervous because he’s failing his classes in school and doesn’t know if he’ll even pass the semester. Thus, through this intervention the therapist helped John become aware of what was at the core of his body language during the therapy.

Is Gestalt Therapy Effective?

Because of the lack of research, it’s hard to list the issues and conditions that Gestalt therapy effectively treats. Limited data may explain why Gestalt therapy is not more mainstream, and also why it is not listed as an approved “evidence-based practice” by major associations like the American Psychological Association (APA).^1,2,6

Gestalt therapy is not as well-researched or common as other kinds of psychotherapy, but the Gestalt approach focuses on developing a profound respect and connection with each client. This matters because research has consistently proven the therapeutic relationship to be the single most important factor that determines whether a person will benefit from therapy or not.⁹

Limited data suggests Gestalt therapy can be effective in these situations:⁶

• In group therapy settings improve their social and emotional wellbeing and conduct
• With children who are struggling with depressive symptoms or mood problems
• With recently divorced women who are trying to move on and become more confident
• With anxious moms to reduce anxiety, improve self compassion, and increase self awareness

Cost of Gestalt Therapy

Factors that can affect pricing of Gestalt therapy sessions include where you live, what kind of provider you see, and the rates the provider sets. As of 2018, the average cost per session was between $100 and $200. In bigger cities, that might be closer to $300. There isn’t a set number of sessions required for Gestalt therapy, although some studies have found positive results in about 12 sessions.⁷

Therapy is often covered by mental health insurance, but the specific copay or deductible on your plan will determine your out-of-pocket cost. For those without insurance or who are self-paying, the cost of therapy varies considerably depending on a number of factors.

How to Find a Gestalt Therapist

It can be difficult to find a Gestalt therapist, as not many contemporary therapists use this approach. Some seek out informal training while others choose to get certified by one of the many national or international Gestalt therapy training institutes and may list this certification in their bio.

When looking for a therapist, many people begin online by using a free therapist directory that allows them to filter their search by location, insurance type, and specialty areas of practice. One of the most important aspects of choosing a therapist is to find a good fit, meaning you select someone with a style and approach that you think is a good match for your needs.⁹ Most therapists offer a free consultation call to help clients make this decision.