Integrative Counseling: Gestalt, Reality, and Psychoanalytic Theory

Comparing Gestalt, Reality, and Psychoanalytic Theories

The theories compared and contrasted in this paper include gestalt theory, choice theory and its practical application in reality therapy, and psychoanalytic therapy. There are definite points of both similarity and variance among these theories. The natural starting point for comparison lies with an analysis of gestalt theory alongside choice theory and reality therapy.

Gestalt therapy was largely founded by Frederick Perls (Wagner-Moore, 2004, p. 180) and Miriam and Erving Polster (Jacobs, 2010, p. 25), whereas Glasser is widely credited with launching the notion of reality therapy (Bradley, 2014, p. 6). A critical point of similarity between these theories is that both are unequivocally focused on the present — the proverbial "here and now" of the patient and his or her cognitive, emotional, and physical states. Interestingly, these theories take different perspectives when addressing those present needs. The primary distinction is that gestalt theory acknowledges a direct correlation between the past and lingering emotions or events that affected an individual's history and his or her present state. Choice theory and reality therapy, on the other hand, deliberately forsake critical aspects of the past (Bradley, 2014, p. 6).

The true point of distinction regarding temporal causation is that reality therapy is far less willing to acknowledge the role the unconscious mind plays in an individual's difficulties. Gestalt theory, however, attributes considerable significance to the unconscious — which may or may not be related to the past — and attempts to explicate and work through it in order to best help the client.

The degree of emphasis on the unconscious greatly relates to psychoanalytic theory, which was most prominently popularized by Sigmund Freud (Bornstein, 2010, p. 133). Freud did pioneering work on the notion of the unconscious mind and its effects on people in the present, which he argued often stemmed from earlier events. Psychoanalytic theory is primarily concerned with personality. Counselors largely attempt to reconstruct the personality of an individual to help that person cope with the dominant events in his or her life (Bornstein, 2010, p. 134) — events this theory contends are rooted in unconscious tendencies. Still, there is a relative dearth of focus on present problems within this theory, which tends to prioritize the past and the unconscious. The underlying idea is that an understanding of the past and a reconstruction of personality will eventually impact present and future cognitive and emotional states — a point of distinction from the other two theories, which are adamantly focused on the present and whatever issues it presents to the client.

Compatibility and Integration of the Three Theories

The above points of comparison allude to the compatibility of these theories for the purpose of integration. It is quite clear that gestalt theory and choice theory/reality therapy are suitable for integration, since both focus on the present issues of the client. This shared focus on the present — and even on the future — plays a large role in the integration efforts advanced in this paper.

The principal point of distinction between these two theories is the importance each imputes to the past. There is something extremely pragmatic, and even a little romantic, about choice theory's concentration on the present and future to the exclusion of past issues (Bradley, 2014, p. 8), the unconscious, and the notion of transference. As healthy as such forward motion undeniably is, it can only be strengthened by a consideration of the past and an individual's unconscious proclivities. This focus on the past and the unconscious is drawn from both psychoanalytic and gestalt theory. Gestalt theory does so in a way that is highly congruent with the emphasis on present and future client wellbeing that forms the backbone of the integration advocated here. Although psychoanalytic theory addresses the unconscious and previous events more than it does present ones, its degree of personality analysis can help to determine the forward progress of a client (Bornstein, 2010, p. 136) when combined with the other two theories. Personality assessments are used across a wide range of professional contexts, and there is no reason that an individual's personality type could not help a troubled client determine which aspects of life to focus on going forward.

In fact, gestalt theory functions in many ways as the synthesis of psychoanalytic theory and reality therapy, since it incorporates the retrograde orientation and preoccupation with the unconscious characteristic of the former while remaining focused on the present and future needs of the patient as emphasized in the latter (Schulz, 2013, p. 24). This fact alone reinforces the degree of compatibility among these three theories. Gestalt theory also provides the foundation for the theoretical integration advanced in this paper, since it is predicated on analyzing the unconscious and the past as the very means by which a patient moves forward and builds new support systems to improve his or her life.

Specific Theoretical Components and Their Contributions

One of the specific components of reality therapy that is integral to its integration with the other two theories is that it is predicated on self-assertion and self-control — qualities the other two theories only hint at. Reality therapy is based on the notion that individuals can change their lives at any present moment, and that each subsequent moment is a consequence of choices made in the present. In particular, reality therapy posits that individuals are motivated by psychological needs for freedom, fun, belonging, and power (Bradley, 2014, p. 7). By helping clients to actualize these aspects of their lives, counselors can help them take control and find greater fulfillment with less emotional and cognitive burden than they would otherwise carry. These aspects of reality therapy will certainly play a considerable role in the amalgamation of these three theories into a cohesive model in which the strengths of certain approaches balance the limitations of others.

There are numerous aspects of gestalt theory that will inform the integrated model developed in this paper. Gestalt theory attempts to identify certain lingering elements of a person's past that are affecting that individual in the present. Moreover, this theory postulates that virtually all such lingering elements are negative — including, most prominently, resentment, as well as a host of other negative states such as anger, avoidance, and guilt — which serve to block positive attributes (Wagner-Moore, 2004, p. 182). This theory conceives that people are haunted in the present by issues that remain unresolved from their past, and that by addressing those issues they can move forward and enjoy a better present and future. Key concepts such as aboutism and confluence can produce a marked effect on clients and their tendency to allow the past to confound them in the present. Additionally, this theory takes an internal perspective in order to affect external outcomes in the present.

The way that psychoanalytic theory informs this integration is by helping counselors understand the specific past issues that may have impacted a client. Some of this theory's notions of the unconscious can yield considerable insight (Stoycheva et al., 2014, p. 100), and several of its techniques can assist practitioners who adopt this integrationist approach. Various aspects of free association, dream analysis, and psychological interpretation can help to illuminate factors of a person's unconscious that impact their present cognitive and emotional state — many of which are foundational concepts within psychoanalytic theory.

A Personalized Integrative Treatment Model

The personalized integrative theoretical model for the conceptualization and treatment of individuals, couples, and families advocated in this paper is grounded in the immediacy of reality therapy and choice theory. That immediacy is reflected in the core belief that people can take control of their lives and create far more impact in the present to shape their futures than whatever events occurred in the past are capable of doing. One of the key facets of treatment stemming from this theory is the role of the counselor, who functions somewhat as a life coach — encouraging, responsive, and nurturing toward the client while simultaneously empowering that client to pursue the life he or she wishes to live (Bradley, 2014, p. 8). From a conceptual standpoint, clinicians will strive to emphasize the four psychological needs of belonging, fun, freedom, and power that motivate most people, seeking to reinforce — if not outright instill — these attributes in the client.

While emphasizing the present and the client's ability to take control and transform his or her life, it is necessary to identify any impediments that might obstruct that progress. Many of the aims of gestalt theory accomplish this objective, primarily by helping individuals to replace dysfunctional external support systems — those facets of life that function as crutches enabling unhealthy behavior or emotions — with healthier internal self-support systems. The gestalt component of this model therefore centers on identifying areas of resentment, negativity, anger, and emotional baggage that are affecting the client's present and future (Wagner-Moore, 2004, pp. 181–182). Treatment will address the unconscious and its effects on cognitive, emotional, and behavioral states through the incorporation of gestalt concepts such as projection, retroflection, aboutism, and confluence. These techniques help the individual take inventory of the past and ultimately move beyond the things that obstruct present happiness. Despite the due emphasis on the past and the unconscious, these elements of treatment are utilized solely for the value they provide the client in the present and future — the core tenet of reality therapy is never lost.

Finally, selected notions from psychoanalytic theory — such as the importance ascribed to personality and personality types, as well as elements of free association and dream analysis — are incorporated as tools for inventorying and clearing obstacles in a person's past and unconscious mind.

References

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Bradley, E. L. (2014). Choice theory and reality theory: An overview. International Journal of Choice Theory and Reality Theory, 34(1), 6–13.

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Loyd, B. D. (2005). The effects of reality therapy/choice theory principles on high school students' perception of needs satisfaction and behavioral change. International Journal of Reality Therapy, 25(1), 5–9.

Polster, E., & Polster, M. (2010). From the radical center: The heart of gestalt therapy. Gestalt Review, 14(1), 8–23.

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Wagner-Moore, L. (2004). Gestalt therapy: Past, present, theory, and research. Psychotherapy: Theory, Research, Practice, Training, 41(2), 180–189. doi:10.1037/0033-3204.41.2.180