‘The BRITISH GESTALT JOURNAL is independently published for the Gestalt community in Britain and throughout the world. ISSN 0961 - 771X, LUMI ny MARGHERITA SPAGNUOLO Lops: Addressing Psychosis PevER PuiLipPson: Gestalt and Transference FRANK-M, STAEMMLER: The Here and Now Git Carapoc-Davigs interviewed by Malcolm Parlett CLARE CROMBIE profiles Richard Harris working with Cancer NEIL Harris reviews ‘The Search for a Secure Base’ by Jeremy Holmes JosePH ZINKER reviews ‘Gestalt Therapy’ by Claudio Naranjo Doxorry SimiNovitcH reviews ‘Skills in Gestalt Counselling and Psychotherapy’ by Phil Joyce and Charlotte Sills RoBerT RESNICK on Otherness Letters to the Editor: GorDon WHEELER replies to his Crities PETER SHACKLETON on Evidence for Gestalt DAN RosENBLATT on The Other Jubilee PRICE £13.50BRITISH GESTALT JOURNAL MALCOLM PARLETT MARGHERITA SPAGNUOLO LOBB PETER PHILIPPSON FRANK-M. STAEMMLER GILL CARADOC-DAVIES Letters to the Editor: GORDON WHEELER PETER SHACKLETON DANIEL ROSENBLATT Out in the Field: CLARE CROMBIE, Book Reviews: NEIL HARRIS JOSEPH ZINKER DOROTHY SIMINOVITCH Opinion ROBERT RESNICK, Notices Volume 11 Number 1 June 2002 pp1-72 ISSN 0961 -771X CONTENTS Editorial 2 A Gestalt Therapy Model forAddressing 5 Psychosis A Gestalt Therapy Approach to 16 ‘Transference ‘The Here and Now: A Critical Analysis 2m Interviewed by MALCOLM PARLETT - The 33 Excitement Point and Other Matters Up from Individualism: A Response to 44 Malcolm Parlett, Peter Philippson, and Des Kennedy ‘The Facts are Friendly: A Response to 47 Stephen George The Other Jubilee 48 Richard Harris: Working with Clients with 50 Serious Physical Iliness ‘The Search for a Secure Base — Attachment 53 ‘Theory and Psychotherapy by Jeremy Holmes (Book Review Essay) Gestalt Therapy: The Attitude and Practice 59 of an Atheoretical Experientialism by Claudio Naranjo Skills in Gestalt Counselling and a Psychotherapy by Phil Joyce and Charlotte Sills When ‘Other’ is Less Than... 64 67 GESTALT KNIIZNICAEDITORIAL Miriam Polster, 1924 - 2001 ‘The death of Miriam Polster, on 19th December, 2001, is a significant oss to the Gestalt community world-wide. She was one of the most renowned, talented, and beloved trainers in the world of Gestalt therapy. As staff members, of the Journal, and on behalf of our readership, we extend ‘our sympathies to her husband, life partner, fellow trainer, and sometime co-author, Erving Polster. We mourn the loss of Miriam Polster, celebrate her life, and appreciate het important contribution to Gestalt therapy. Miriam was born on 7th July, 1924 in Cleveland, Onio into a family that was loving, Jewish, devoted to learning, and supportive of her love of singing, to which she remained passionately devoted all her life. She took her bachelor’s degree in music and then went on to study vocal performance at the Cleveland Institute of Music. Soon after, in 1949, she met Erving Polster and they ‘married in the same year. This was before Gestalt therapy appeared, (with the publication of the founding text by Petls, Hefferline and Goodman in 1951) and before the Gestalt Institute of Cleveland began in 1953. Erving became one of the founding members of the Institute. Miriam, with two school age children, returned to University to study psychology in 1962, received her Ph.D from Case Western Reserve University in 1967, the year that also marked her joining the faculty of the Cleveland Institute. In 1973, the Polsters published their book, Gestalt Therapy Integrated, a result of a powerful collaboration of talents. For many students, including myself, this was an intelligent, accessible, and useful introduction to working as a Gestalt therapist. It is believed to be the Gestalt therapy book that has been most widely read. 1973 was the year, too, when Erv and Miriam Polster moved to San Diego. When asked what had prompted their move from Cleveland, Ohio to southem California, Miriam's answer was a single word: ‘November! However, there were other factors, including that they wanted (in Erv's words) ‘to start something on our own in a new setting’. In Cleveland, too, Miriam was always likely to be thought of as ‘Erv's wife’. This changed in San Diego, where they set up and co-directed the Gestalt Training Center in La Jolla on a completely equal footing. Miriam, in Erv's words, was now ‘totally her own person’ and an ‘immediate hit? with ‘people recognising her excellence very quickly’. As Eva Gold and Steve Zahm have written (for Gestalt Review): ‘Women students, trainees and patients, hungry for a female model, saw in Miriam a woman who was comfortable with her power, who could be tender and tough, refined and boisterous. She never took a back seat to men.’ In 1992, she published Eve's Daughters: The Forbidden Heroism of Women, in which she encouraged women to find their ‘own heroic myths. Miriam’s and Erv's centre in San Diego became the focus and venue for their joint training activities for the next quarter of a century (and it continues today). They attracted psychologists, psychiatrists, and other helping professionals from all over the world, who travelled to take part in summer programmes. These gained a formidable and favourable reputation. They also travelled abroad a lot, including regularly to a several European countries. For a number of years in the 1990s they taught course annually at the Metanoia Institute in London. In the workshops they ran, Erv and Miriam worked both, together and apart, but were always regarded as a very close team, with complementary styles of working, an amazing rapport, clearly shared values, and much good humour shared between them, Their devotion to each other was very obvious. John Reis has written about Miriam in the following terms: ‘She was superbly able to access and make available, to her patients and students...and her friends, her extraordinarily rich background in literature, art, and clinical theory, in poignant, hilarious, provocative, subtle ways. She was never pretentious; she never patronised. She showed how to make technique invisible, She showed how it was possible for a therapist to be personable, elegant, precise, subtle, and bawdy ~ with discipline and humour. She made it look easy. Miriam never sought disciples. She wanted her patients and students to be impressed with themselves, rather than with her, and proud of their work. Miriam was generous. She embodied clinical grace. She had class. We are all larger for knowing her.’(From an obituary in the San Diego Psychological Association Bulletin.) Tributes to her work ~ both The Gestalt Journal and Gestalt Review are publishing excellent accounts of het life as well ~ make frequent reference to her artistry, love of life, natural gracefulness, poise, depth of understanding, and her humout. She touched so many. In the words of a colleague, she ‘was friendly, trusting, and changed the climate of Gestalt I had previously experienced’. Another remarked: ‘She was so gentle, in German we would say “fine”; I was so impressed ~ her presence and attention were just obvious.’ She did not shame clients but at the same time did not avoid giving clear feedback — she just did it with such finesse and sensitivity that the message could be taken in without defensiveness or loss of dignity. Another theme in the many appreciations of Miriam Polster relates to her ‘ordinariness’ — in that she loved cooking and gardening, collecting kaleidoscopes and entertaining, going to the opera and singing around the house, reading a good book and showing photographs of her grandchildren. The last few years of her life, as she ‘coped with cancer, also revealed her fortitude, lack of self0 find their ecame the ities for the bday) ‘They her helping travelled to e gained a so travelled European hey taught London, In orked both as a very jorking, an mach good jon to each fe following, and make her friends, me, art, and tive, subtle patronised, he showed sonable, scipline and ver sought ents to be th her, and embodied larger for ‘an Diego fourmal and ots of her sty, love depth of bo many. In hing, and breviously jin without lof Miriam F she loved q feopes and nnd the graphs of life, as She ick of self- pity, and grace under pressure. These became obvious, along with her customary ability to laugh and make others augh, Natasha Josephowitz, writing in the San Diego Jewish Times, wrote that at her ‘last visit with her doctor, when told she may have just weeks to live, Miriam replied: “Does that mean I should cancel my New Yorker subscription?” ‘The next issue of the British Gestalt Journal (Volume 11, No, 2) will contain some further personal reminiscences and memories of Miriam Polster. If you would like to add a brief anecdote or memory of your ‘own, please let us have it atthe following Email address: editor @britishgestaltjoumal.com Professionalism in Gestalt Therapy ‘What does it mean to be ‘professional?" Sociologists describe the process by which groups of people fight to acquire the higher status of ‘a profession’. Such a process is continuing in Britain for psychotherapists, and many Gestalt psychotherapists are part of this movement. However, there are other more attractive and inspiring meanings and connotations of what it means to be professional. These include a commitment to ‘best practice’, to high levels of competence within the boundaries of a discipline, and to ‘walking one’s talk’. Miriam Polster was, for us, someone who exemplified a truly professional approach. She was dedicated to skilful practice, lived well and not just for therapy, made a lasting contribution to her field, was grounded in profound understanding of Gestalt fundamentals, and brought courage and dedication to what she undertook. It is a “wider vision of being professional that the British Gestalt Journal recognises and seeks to emulate and encourage. ‘A professional journal should foster the exchange of ideas, promote new thinking, report fresh applications serve the professional community, and inspire readers. AS such it does not have to be excessively academically proper, let alone solely interested in theory and abstract ideas. Other threads need to be woven into each issue, and preferably into each article. In the present issue we are fortunate to have sor rate writing from some very experienced pract who combine thoughtfulness with addressing practical questions. The leading articles are backed up by letters, book reviews, Out in the Field, and an Opinion, all of which make the issue, in our view, one which will satisfy ‘our readership, as well as meeting our own high standards regarding what it means to create a professional journal Volume 11, No. 1 We begin with an important article about working with psychosis, by Margherita Spagnuolo Lobb. Gestalt therapists who work in psychiatric settings will relish this thoughtful and ground-breaking discussion, and it will interest other psychotherapists too. This is followed by Peter Philippson’s paper on Gestalt thinking in relation to the psychoanalytical concept of transference. It echoes the preceding article in that its arguments have not been articulated elsewhere before (somewhat surprisingly). The third article is another major contribution, (2s well as being the first German article for which the BGJ commissioned and funded a translation). It is by Frank-M, Staemmler, and reviews the central idea and often unthinking Gestalt endorsement of the Here and Now. As a review article, covering a wide spectrum of issues, it is, ‘an important contribution to our collective understanding. We are very pleased to have it. (Other translations of foreign language articles will follow.) In our view, all three of the papers mentioned are destined to become ‘classic’ articles, much referred to for many years to ‘An interview with Gill Caradoc-Davies also captures some of that wide vision of professionalism that was ‘mentioned earlier It is a very accessible interview, and reveals the outlook and priorities of an experienced Gestalt teacher with psychiatric credentials, imagination, an expansive vision, and a big heart. ‘As usual, we are glad to be able to publish some lively letters — in this issue from Gordon Wheeler, Peter Shackleton and Dan Rosenblatt, covering a wide range of topics. The Out in the Field profile is of Richard Harts, a consultant oncologist and Gestalt therapist. He and Clare Crombie explore working with cancer sufferers. Book Reviews include a magisterial contribution by Joseph Zinker and one written by Dorothy Siminovitch, a newcomer to the BGJ. Our gratitude to them both for two helpful perspectives. ‘Also included is an ‘essay review’ by Neil Harris on the subject of ‘attachment’. Occasionally we invite (or press) someone to write at greater length about a seminal book which deserves special notice or overlaps a particular interest of the reviewer / essayist. It is our intention to include this feature more regularly and also not to confine the choice of books solely to those written by Gestalt specialists. The rationale is that many important books are published each year that link with, or could add to understanding of, issues of concem to Gestalt therapists; and these should not be automatically ineligible for discussion within the BGJ just because they are not written by Gestaltists. This represents a shift in poli keeping with our constant refreshment of what the Journal represents. (If you have a particular book that you wish to ‘rite about for possible publication, please let us know.) We conclude with an Opinion from Robert Resnick, ‘hich has both topical and enduring resonance. It brings a substantial and high quality issue to an apt conclusion.Omissions and Corrections In the last issue of the BGJ (Vol.10, No.2) we published a Letter to the Editor from Stephen George. ‘Unfortunately, because the decision to publish it was very last minute, information about Stephen was unavailable and was not included. We are pleased to rectify the omission here. Stephen George writes: ‘I am a UKCP registered Gestalt psychotherapist who graduated from the Sherwood Institute in 1998.1 currently work as a psychological therapist in the psychology and counselling department of Wirral and West Cheshire community NHS Trust. I have a background in mental health social work.” Stephen’s address for correspondence is: Flat 1, 8 Charlesville Prenton, Merseyside CH43 ITP (Email: stegeodragon@hotmail.com). (Stephen George's letter was in the form of a request for help and assistance in putting the case for Gestalt therapy within the National Health Service. It has provoked an interesting response from Peter Shackleton, which appears in the Letters section of this issue, Other responses are welcome ~ it is an important question and we shall return to it in later issues if we can.) The atticle ‘Psyche and Culture’ by Lolita Sapriel and Dennis Palumbo, published in Vol.10, No.2, should have contained an acknowledgement that the article was based on a chapter written for a book, Making a Difference, edited by Talia Levine Bar-Yoseph and Gordon Wheeler, to be published by the Analytic Press / Gestalt Press in 2003. We are grateful to the editors, publishers, and authors for agreeing to the publication of the article in the last issue of the British Gestalt Journal and regret that this acknowledgement was overlooked. The Editorial Advisory Board ‘The BGJ's Editorial Advisory Board has been reconstructed, in line with searching for further economies and in making the group smaller, more manageable, and more involved in the editorial process than has been the case in the past. ‘A number of those who were previously on the Board — several having served for the full ten years of our existence —have left, and three new members have joined the Board. We welcome Sally Denham-Vaughan, Arthur Roberts, and Karen Rookwood, the new arrivals. And we thank those who have served us generously with a variety of kinds of support in the past, and who have now retired: Dolores Bate, Hunter Beaumont, Gill Caradoc-Davies, Petruska Clarkson, Gilles Delisle, Talia Levine Bar- Yoseph, Helen McLean, Jennifer Mackewn, Flora Meadows, and Eleanor O'Leary. Inthe early days of the BGJ, in particular, those involved in producing the Joumal felt very supported by having the Advisory Board Ealtorial in the background — available for advice, refereeing, publicising, and feedback about how we were doing, Again, thank you, all those who are either currently serving or have served on the Editorial Advisory Board, for your continuing or past support ‘The Friends of the British Gestalt Journal Once again we should like to thank readers who have become Friends of the British Gestalt Journal for their ‘generosity, commitment to the BGJ’s future, and support (Gnancial and otherwise). We would like to encourage others to consider becoming a Friend. When they came into existence it was ata time of near insolvency. People’s ‘generosity enabled us to continue publication. Though the need is now less acute, the financial input from Friends is still of critical importance. This may not be understood. The shared experience of publishers is that no Gestalt therapy journal can exist without some level of ongoing subsidy or sponsorship. Small specialist journals are not alone in this, as we know. Most orchestras, theatre companies, amateur sports clubs, and poetry magazines require regular financial topping up of one kind or another. So it is for the BGJ. As a result of prudent management and holding back on several projects, we are in a better financial shape than for several years, but we would still be on a knife-edge without an injection of } Friends money each year. To be able uninterruptedly to | focus our attention on producing a constantly improving | Joumal with an ever wider global readership, we need to be in a stronger financial position than we enjoy at the moment. Everyone in the Gestalt field would like to see more recognition in other professions and specialities, of the quality of Gestalt thinking and therapeutic practice. The British Gestalt Journal could serve as a flagship publication ~ marketed to particular groups and advertised to different kinds of psychotherapists and other mental health professionals. Books of reprinted articles on particular themes could also be produced with an eye to communicating Gestalt to a wider audience. However, 0 embark on any of these projects — all desirable forthe Gestalt community as a whole — would be unwise when our reserves are still so low. So, please, do give seriow consideration to joining the Friends of the British Gestalt Journal, getting the benefits to Friends that there are, ani becoming eligible to attend the Annual Meeting of Friends, which this year will be held on Sunday 24th November, 2002. Malcolm ParlettEaitorial refereeing, ere doing. r currently ry Board, yrnal who have al for their ed snpot encourage they came People’s Though the Friends is std. no Gestalt f ongoing als are not s, theatre magazines kind or pe prudent #5, we ae but We jection of rupedly to improving Je need to njoy at the see more es, of the tice. The flagship advertised per mental ticles on an eye to owerer, to efor the wise when ve serious sh Gestalt are, and eeting of day 24th Parlett A GESTALT THERAPY MODEL FOR ADDRESSING PSYCHOSIS Margherita Spagnuolo Lobb Received 6 January 2002 Abstract: This article first reviews historical influences within psychiatry in the UK and Italy, before considering the plight of profoundly disturbed patients within psychiatric institutional settings. Through consideration of the differing needs of neurotic aind psychotic clients, and the specific environmental needs of profoundly disturbed individuals, the author reveals a Gestalt therapy approach to treatment which honours, both field theory and the unique figure-ground balance and needs of an individual suffering a psychotic reaction. Examples from practice are illuminated throughout the ‘ext, and a Gestalt model is suggested for future development. Key words: psychoses, Gestalt, relationship, residential care, psychotherapy, profound disturbance. How Might a Psychotherapeutic Model be Applied to Psychiatric Institutions? Given forty or more years of international endeavour to include knowledge from psychotherapy in our work with patients in psychiatric settings, mental health professionals still need to ask themselves the above question, First, the question retums because the answers framed by previous experiences have left parts of the question unaddressed (especially regarding a more individualised treatment able to cure the different needs, of psychiatric patients). Second, because each and every experience is linked to a particular cultural moment, we continually need to find new solutions applicable to our ‘own unique situation, Historically, the UK has hosted some of the most interesting and passionate experiences in the field of community care. During the Second World War, a few psychiatrists of the British Army adopted a new perspective to working with patients, which addressed not so much individual discomfort, as the health of the whole community. This approach, the, Therapeutic Community (TC) movement as it later came to be called, was greatly influenced by Lewin’s field theory and other Gestalt related notions (Rayner, 1991, p 228). ‘Tom Main and Maxwell Jones, the most charismatic representatives of this movement, though coming from different cultural backgrounds (psychodynamic the former, and psychosocial the latter), based their treatment on the way that work was conducted in the hospital, rather than focusing on symptoms and the dyadic relationship of patient and psychiatrist. The experiments of these enthusiastic practitioners, not only influenced the Mental Health Act of 1959 into giving psychiatric communities an official role in treatment, but did much to ferment the anti-psychiatric movement in the UK. While Main and Jones were attempting to solve concrete problems of hospitals, from the inside, the anti- psychiatric movement (Laing, Cooper, Esterson and the historical group of Kingsley Hall), starting from an ideological point of view linked to the anti-authoritarian historical movement, made the case that the power structures of traditional psychiatry perpetuated human suffering. These two movements, more than any other, caused mental health practitioners to consider the reality of the objective situation (including its previous failures) and to search for new methodological definitions. The iain results of this evolutionary process (of some fifty ‘years or more duration in the UK) are still to be seen in the attention paid to the working team, plus the change