INTRODUCTION

This book began as a manuscript written by Frederick S. Peris. The material was developed and worked over by Paul Goodman (Volume II) and put to practical application by Ralph Hefferline (Volume I). However, as it stands now it is truly the result of the co-operative efforts of the three authors. What began as the work of one author ended up as that of three—each of us equally responsible.

We have had in common one purpose: to develop a theory and method that would extend the limits and applicability of psychotherapy. Our differences were many, but by bringing them forth rather than politely concealing them we many times arrived at solutions that none of us could have anticipated. Many of the ideas in the original manuscript have been retained in this book, but just as many have been added in the co-operative effort of the three authors in the writing of the book, and more importantly, they take on a new meaning in the context of the book as it has been completed.

The insights of Gestalt Psychology have been fruitful in the approach to art and education; and in academic psychology the work of Wertheimer, Koehler, Lewin, etc. is now fully recognized; however, following the interest in behaviorism, which is for the most part motorically oriented, academic circles now overemphasize the perceptual aspect of the Gestalt. The magnificent work of Goldstein in neuropsychiatry still has not found the place in modern science that it deserves. The full application of Gestaltism in psychotherapy as the only theory that adequately and consistently covers both normal and abnormal psychology has not yet been undertaken. The present work is an attempt to lay the foundation for that.

Indispensable—both for the writing and the thorough understanding of this book—is an attitude which as a theory actually permeates the content and method of the book. Thus the reader is apparently confronted with an impossible task: to understand the book he must have the “Gestaltist” mentality, and to acquire it he must understand the book. Fortunately, the difficulty is far from being insurmountable, for the authors have not invented such a mentality. On the contrary, we believe that the Gestalt outlook is the original, undistorted, natural approach to life; that is, to man’s thinking, acting, feeling. The average person, having been raised in an atmosphere full of splits, has lost his Wholeness, his Integrity. To come together again he has to heal the dualism of his person, of his thinking, and of his language. He is accustomed to thinking of contrasts—of infantile and mature, of body and mind, organism and environment, self and reality, as if they were opposing entities. The unitary outlook which can dissolve such a dualistic approach is buried but not destroyed and, as we intend to show, can be regained with wholesome advantage.

One of the themes of the book is assimilation. The organism grows by assimilating from the environment what it needs for its very growth. Though this is obvious to everyone in regard to the physiological proc-esses, the stages of mental assimilation have, for the most part, been overlooked. (An exception is Freud’s concept of introjection, which at least provides a partial account.) Only by thorough assimilation can heterogeneous substances be unified into a new Whole. We believe that by assimilating whatever valuable substance the psychological sciences of our time have to offer we are now in the position to put forward the basis for a consistent and practical psychotherapy.

Why, then, as the title suggests, do we give preference to the term “Gestalt” when we take equally into account Freudian and para- Freudian psychoanalysis, the Reichian armor theory, semantics and philosophy? To this we have to say: we were not benevolently eclectic; none of the disciplines mentioned have been swallowed wholesale and artificially synthesized. They have been critically examined and organized into a new whole, a comprehensive theory. In this process it emerged that we had to shift the concern of psychiatry from the fetish of the unknown, from the adoration of the "unconscious,” to the problems and phenomenology of awareness: what factors operate in awareness, and how do faculties which can operate successfully only in the state of awareness lose this property?

Awareness is characterized by contact, by sensing, by excitement and by Gestalt formation. Its adequate functioning is the realm of normal psychology; any disturbance comes under the heading of psychopathology.

Contact as such is possible without awareness, but for awareness contact is indispensable. The crucial question is: with what is one in contact? The spectator of a modem painting may believe that he is in contact with the picture while he is actually in contact with the art critic of his favorite journal.

Sensing determines the nature of awareness, whether distant (e.g., acoustic), close (e.g., tactile) or within the skin (proprioceptive). In the last term is included the sensing of one’s dreams and thoughts.

Excitement seems to be linguistically a good term. It covers the physiological excitation as well as the undifferentiated emotions. It includes the Freudian cathexis notion, Bergson’s elan vital, the psychological manifestations of the metabolism from Mongolism to Basedow, and it gives us the basis for a simple theory of anxiety.

Gestalt formation always accompanies awareness. We do not see three isolated points, we make a triangle out of them. The formation of complete and comprehensive Gestalten is the condition of mental health and growth. Only the completed Gestalt can be organized as an automatically functioning unit (reflex) in the total organism. Any incomplete Gestalt represents an “unfinished situation” that clamors for attention and interferes with the formation of any novel, vital Gestalt. Instead of growth and development we then find stagnation and regression.

Configuration, structure, theme, structural relationship (Korzybski) or meaningful organized whole most closely approximate the originally German word Gestalt, for which there is no exact English equivalent. As a linguistic example: pal and lap contain the same elements, but the meaning is dependent upon the order of the letters within their Gestalt. Again, bridge has the meaning of a game of cards or a structure joining two river banks. This time the meaning depends upon the context in which “bridge” appears. The color lilac looks bluish against a red back-ground, red against a blue background. The context in which an element appears is called in Gestalt psychology the “ground” against which the “figure” stands out.

In neurosis, and much more in psychosis, the elasticity of figure/ground formation is disturbed. We often find either a rigidity (fixation) or a lack of figure formation (repression). Both interfere with the habitual completion of an adequate Gestalt.

In health the relation between figure and ground is a process of permanent but meaningful emerging and receding. Thus the interplay of figure and background becomes the center of the theory as presented in this book: attention, concentration, interest, concern, excitement and grace are representative of healthy figure/ground formation, while confusion, boredom, compulsions, fixations, anxiety, amnesias, stagnation and self-consciousness are indicative of figure/ground formation which is disturbed.

Figure/ground, unfinished situation and Gestalt are the terms which we have borrowed from Gestalt psychology. Psychoanalytical terms such as super-ego, repression, introjection, projection, etc. are so commonly used in any contemporary psychiatric book that we shall not presently concern ourselves with them. They will be discussed in detail throughout the book. Semantic and philosophical terminology has been kept to a minimum. The cybernetic, dianetic and orgone theories will find little or no discussion in the text. We consider them to be at best half-truths as they deal with the organism in isolation and not in creative contact with the environment. A critical appreciation of dianetics, how-ever, will be found in the introduction to J. A. Winter’s book on this subject. Cybernetics has a unitary outlook in the all-or-nothing principle (first mentioned by Alfred Adler as a general neurotic attitude), in the yes/no attitude of the electronic tube (covered in this book in the discussion of the ego-function of identification/alienation) and in the optimum efficiency of balanced systems; but as long as Wiener’s robots do not grow and propagate by themselves, we prefer to explain his machines by human function rather than vice versa.

Reich’s orgone theory successfully extends ad absurdum the most doubtful part of Freud’s work, the libido theory. On the other hand, we are deeply indebted to Reich for having brought down to earth Freud’s rather abstract notion of repression. Reich’s idea of the motoric armor is doubtless the most important contribution to psychosomatic medicine since Freud. We are at variance with him (and Anna Freud) at one point. We regard the defensive function, of the armor as an ideological deception. Once an organismic need is condemned, the self turns its creative activity as aggression against the disowned impulse, subduing and controlling it. A person would have to engage in a lifelong nerve-wracking struggle with his own instincts (many nervous breakdowns bear witness to that) were it not for the organism’s ability to form automatically functioning cordons sanitaires. The ego is as defensive as Hitler’s Ministry for Defense in 1939.

However, in shifting the accent from the recovery of the “repressed” to re-organizing the “repressing” forces, we wholeheartedly follow Reich, though we find that in the recovery of the self there is much more involved than the mere dissolving of the character armor. When we try to make the patient aware of his "means whereby” he suppresses, we find an astounding inconsistency. We find that he is aware and proud of it when he uses many of his energies against himself, as in self-control, but we also notice—and this is the therapeutic dilemma—that he is for the most part unable to relinquish his self-control.

The Freudian tells his patient to relax and not to censor. But this is precisely what he cannot do. He has “forgotten” how he is doing the inhibiting. The inhibiting has become routine, a patterned behavior, just as in reading we have forgotten the spelling of the single word. Now we seem to be only slightly better off than Reich. First, we were unaware of what was repressed; now we are largely unaware of how we repress. The active therapist seems to be indispensable: he either has to interpret or to shake the patient.

Again a Gestaltist outlook comes to our rescue. In an earlier book (Perls: Ego, Hunger and Aggression) the following theory was put forward. In the struggle for survival the most relevant need becomes figure and organizes the behavior of an individual until this need is satisfied, whereupon it recedes into the background (temporary balance) and makes room for the next now most important need. In the healthy organism this change of dominance has the best survival chance. In our society such dominant needs, for example, morals, etc., often become chronic and interfere with the subtle self-regulating of the human organism.

Now we have again a unitary principle to work with. The neurotic’s survival outlook (even if it appears foolish to the outsider) requires that he become tense, that he censor, that he defeat the analyst, etc. This is his dominant need, but as he has forgotten how he organized it, it has become routine. His intentions not to censor are as efficient as an alcoholic’s New Year’s resolution. The routine has to become once more a fully aware, new, exciting need in order to regain the ability to cope with unfinished situations. Instead of pulling means out of the unconscious we work on the uppermost surface. The bother is that the patient (and too often the therapist himself) takes this surface for granted. The way the patient talks, breathes, moves, censors, scorns, looks for causes etc.—this to him is obvious, is constitution, is nature. But actually it is the expression of his dominant needs, e.g., to be victorious, good and impressive. It is precisely in the obvious that we find his unfinished personality; and only by tackling the obvious, by melting the petrified, by differentiating between blah-blah and real concern, between the obsolete and the creative, can the patient regain the liveliness of the elastic figure/ground relation. In this process, which is the process of growth and maturing, the patient experiences and develops his “self.” and we intend to show how he comes to this “self” via the means at his disposal: his available amount of awareness in experimental situations.

The greatest value in the Gestalt approach perhaps lies in the insight that the whole determines the parts, which contrasts with the previous assumption that the whole is merely the total sum of its elements. The therapeutic situation, for instance, is more than just a statistical event of a doctor plus a patient. It is a meeting of doctor and patient. If the doctor is rigid and insensitive to the specific requirements of the ever-changing therapeutic situation, he will not be a good therapist. He might be a bully or a businessman or a dogmatist; but he is not a therapist if he refuses to be a part of the on-going processes of the psychiatric situation. Like-wise, the patient’s behavior is dictated by many variables of the interview, and only the 100% rigid or the insane (oblivious of the context in which they operate) will behave in the consulting room as they do out-side.

Neither the full understanding of the organismic functions nor the best knowledge about the environment (society, etc.) covers the total situation. Only the interplay of organism and environment (a partial account of this is given in the theory of interpersonal relations of Harry Stack Sullivan) constitutes the psychological situation, not the organism and environment taken separately. The isolated organism and its abstractions—mind, soul and body—and the isolated environment are the subjects of many sciences; e.g., physiology, geography, etc.; they are not the concern of psychology.

The overlooking of this limitation has thus far prevented the creation of an adequate theory for both normal and abnormal psychology. As there is no doubt that associations and reflexes exist, most previous theories, even to a great extent Korzybski’s, concluded that the mind consists of a mass of associations or that behavior and thinking consist of reflexes. The creative activity of the organism is as little explained by associations, reflexes and other automatisms as the planning strategy and the organizing of war is explained by the automatism of the disciplined soldier.

Sensing and moving are both outgoing activities, not mechanical responses, whenever and wherever the organism meets novel situations. The sensoric system of orientation and the motoric system of manipulation work interdependently, but as reflexes only in the lower layers which are fully automatized and require no awareness. Manipulation is our (somewhat awkward) term for all muscular activity. Intelligence is adequate orientation, efficiency adequate manipulation. To regain these, the desensitized and immobilized neurotic has to recover his full awareness; i.e., his sensing, contacting, excitement and Gestalt formation.

In order to do this, we change our outlook toward the therapeutic situation by acknowledging that every non-dogmatic approach is based upon the trial and error method of nature. That way the clinical becomes an experimental situation. Instead of putting explicit or implicit demands upon the patient—pull yourself together, or: you must relax, or: do not censor, or: you are naughty, you have resistances, or: you are just dead—we realize that such demands would only increase his difficulties and make him more neurotic, even desperate. We suggest graded experiments which—and this is of the uppermost importance— are not tasks to be completed as such. We explicitly ask: what is going on if you repeatedly try this or that? With this method we bring to the surface the difficulties of the patient. Not the task, but what interferes with the successful completion of the task becomes the center of our work. In Freudian terms, we bring out and work through the resistances themselves.

This book has many functions. To those who work in the field of education, medicine and psychotherapy, we bring an opportunity to give up a sectarian attitude that their specific point of view is the only possible one. We hope to show that they can look at other approaches without going to pieces. To the layman we bring a systematic course for his personal development and integration. To derive the full benefit, however, the reader should tackle both parts of the book together, possibly in the following way: do the experiments as conscientiously as possible; a mere reading will achieve little. It might even leave you with a feeling of confronting a big and hopeless task; whereas, if you actually do what is suggested, you will soon feel that you begin to change. While you are working on the practical part, read the second part of the book once without bothering about how much you will understand. You may find the reading often exciting and stimulating, but as the total picture will be much at variance with the usual way of thinking, you cannot assimilate it at once unless you are well acquainted with Korzybski, L. L. Whyte, Kurt Goldstein and other Gestaltists. After a first reading you will have decided whether you have benefited enough from your first approach and you can start on a systematic chewing through of the theoretical part. Finally, if you are a patient or a trainee in psychoanalysis whose going to therapy is more than a mere dummy, you will find that the work here will not adversely interfere with your therapy but rather will stimulate it and help to overcome stagnation.