Understanding Addiction With the Gestalt Concept of the Cycle of Experience

Michael Clemmons, a Gestalt therapist, has written a very  useful  description of the process the addicted person goes through in his book, Getting Beyond Sobriety:  Clinical approaches to long-term recovery.  It was published by the Gestalt Press in 1997 and updated in 2005.   Clemmons uses the Gestalt concept of the Cycle of Experience, developed by Joseph Zinker, a long-time member of  the Gestalt Institute of Cleveland, to explain the addictive person’s cognitive and emotional process when dealing with painful or frightening emotions.   He also contrasts it with  the non-addictive person’s way of dealing with painful emotions.

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Working With Addictions: Part I, The Pros and Cons Of 12-Step Approaches

A very popular idea in our society is that addictions are caused by diseases and are completely the result of genetic factors.  It does appear, from much research (e.g., Dick and Agrawal, 2008) that genetic makeup can contribute to alcohol and drug abuse.     But much addictive behavior, in my experience,  is partially caused by other factors:  underlying anxiety and depression from not having worked through the traumatic effects of childhood abuse and neglect; the negative example of having seen  parents and other adults solve their problems by the use of alcohol and drugs;  starting to drink or use drugs at an early age so that it becomes a habit by adulthood;  and finally, one’s social milieu.  For example, if a person’s  main social contacts are at bars or with friends and relatives who drink heavily, they are more apt to  become and stay addicted to alcohol.

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Working Through Loneliness: Part I

In my last posting, I discussed loneliness and how it feels.  In this one, I discuss what can be done to lessen the intensity of the feeling and healthy ways to deal with it.

Firstly, it is important  to identify the emotion of loneliness and allow oneself to feel it.  That may be a tall order since it is usually a very painful feeling, which many people avoid experiencing.   But like any negative emotion, you can only make a positive change in your loneliness by first allowing it to come to awareness.

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The Phenomenology of Loneliness

I recently went to a local farmers market and became aware of an  uncomfortable, vaguely depressed mood that I have experienced many times before when by myself in a public place:   a restaurant, a  shopping mall,  a movie theatre before the movie starts, or just walking down a busy city street.  I realized  at the market that I was feeling lonely and that I usually attempt to avoid  this painful affect by trying to escape it in various ways:  striking up a conversation with a stranger, leaving the public  scene as quickly as possible,  trying to vicariously enjoy  the interactions that I observed people having with each other.

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Working With the Helpless-presenting Client

Most therapists have had the experience of psychotherapy clients who feel helpless and depressed, and  lack the belief that they have the power to change their lives.  They implicitly or explicitly expect the therapist to “cure” them.  And many therapists, particularly those who are new to the profession,  try to take the responsibility of making these clients change.  This, in my experience, is usually doomed to failure.  Here are the reasons:

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Recognizing and Dealing With Countertranceference in Couples Therapy

I believe it was John Gottman  who has said that couples therapy is the most difficult type of therapy for therapists to do and the least successful in terms of percentage of positive outcomes.  Part of the reason for this, I think,  is that the therapist has the difficult task of needing to understand and be empathic to each partner’s individual  issues, while at the same time, understanding and addressing, dispassionately, the dynamics of the relationship.

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Exercise and Psychotherapy

One issue that is relatively neglected by most psychotherapists is the extent of their clients’ degree of physical activity.  This is partly understandable since psychotherapy is, at least as practiced by most therapists, a very sedentary activity and, my admittedly limited impression is that most therapists don’t  exercise themselves.   I recently handed out a questionnaire concerning personal exercise at a professional meeting of therapists and very few bothered to fill it out and return it.

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The Empty Chair Dialogue in Psychotherapy

This method was pioneered by Fritz and Laura Perls, the founders of Gestalt Therapy, but has been used  by therapists from numerous other theoretical orientations.  Research has shown it to be a powerful method for helping clients become more aware of and to express thoughts and feelings toward others that have been suppressed.

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Working With Emotion in Psychotherapy

Many therapy clients of mine through the years have come with very little awareness of the emotions they were experiencing.  This includes many who achieved much cognitive insight in prior treatment with previous therapists  but little awareness of the impact of unacknowledged and unexperienced emotion that were at the root of their problems.

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