Physiological Foundations Of Gestalt Therapy In Accordance With The Doctrine Of The Dominant A.A. Ukhtomsky

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

Introduction

The current position of gestalt therapy speaks of the need to search for its physiological justification. Most of the representatives of the direction go further and further into speculative constructions, which of course cannot be devalued. However, such constructions lead the specialist away from understanding the material processes underlying traumatization, the formation of neuroses and, more serious diseases, and, of course, underlying the therapy and restoration of the client's health. Development in a philosophical key is reduced to walking in circles and interpreting the personal observations of consultants and therapists, rather than developing certain recommendations on the basis of a common materialistic base.

Purpose of the study

In this article, we will try to find the physiological basis of Gesttelt therapy, based on the concept of the dominant A. A. Ukhtomsky. For our research, we will consider only those provisions that will be significant from the point of view of material description. We will omit a number of provisions concerning a purely philosophical orientation.

The functioning of the body from the standpoint of gestalt therapy theory

The principle of homeostasis. The functioning of the body is based on its desire for homeostasis. This principle has a fairly strict physiological and empirical justification. An individual, in the event of a violation of homeostasis (for example, a decrease in glucose levels), begins to experience a state of need, this forces the body to act in the direction of satisfying this need.

Figure and background. The need determines the focus of our attention. For example, if the nutritional need is relevant, then our attention is focused on food, and all other objects become the background.

Completed and unfinished gestalt. While the need is not satisfied, it is an unfinished gestalt, and, conversely, as soon as the need is satisfied the gestalt is completed.

Contact. The body is not self-sufficient, it cannot exist without the external environment. He enters into interaction with the external environment in order to find an object in it that can satisfy a need. This interaction is called contact.

Contact boundary. This is the border that separates the individual from the external environment.

The holistic principle. This principle assumes that the body is whole and indivisible. It is based on the ability of the psyche to self-regulation with the unity of all functions of the human body and psyche. That is, the organism, in its healthy state, comes into contact with the environment as an integral unit, just as every interaction with the environment also acts as a whole.

Contact cycle

We will separately discuss the theory of the contact cycle. Gestalt experts noted that the interaction of the body with the environment (contact) goes through a number of stages (contact cycle), which can also be called stages of satisfying a need. We will try to describe each of the stages of the model in a more specific language than is given in the original presentation by Paul Goodman [2].

1. Precontact. The stage is characterized by a violation of the body's homeostasis and the perception of this violation (if a person does not perceive and does not realize it, he will not try to satisfy his need). This stage is actualized under the influence of external and internal physiological stimuli. Even under the influence of an external stimulus, an individual perceives an actual need through a bodily response to this stimulus.
2. Contact. The perceived need moves from internal variables to an external one. There is a search for an object to satisfy the need. For example, when an external threat appears, the individual feels tension in the muscles, his heart rate rises, this makes him look for a source of influence and a way to avoid the threat.
3. Final contact. The stage is characterized by the implementation of the target action. A whole action is carried out, taking place here and now, perception, emotion and movement are inextricably linked. For example, an individual may begin to flee from danger.
4. Post-contact. This is the phase of assimilation, comprehension of the completed cycle of contact, the fading of excitement and activity. If at the phase of final contact the individual, as it were, was inside the action (was associated), then here he is already looking at the situation from the outside, from the position of evaluation (dissociated).

Neurosis concept

We have already determined with you that the normal functioning of an individual is characterized by the process of the emergence and satisfaction of needs (the completion of gestalts, a change in figure and background). To satisfy a need, an individual must go through a series of stages described above. If all these conditions are met, then this organism can be considered healthy. He knows how to differentiate external stimuli and adaptively respond to them.

However, interruptions are also possible at different stages of satisfying the need. They lead to the fact that the need is not satisfied. Moreover, it does not disappear, i.e. it continues to affect the body. Any need for Gestalt therapy stems from bodily changes. It is logical to conclude that when the need is interrupted, the bodily reaction is also interrupted, i.e. it is not realized, it is imprinted in the body and physiology. Hence, for example, psychosomatic diseases (the hormone aimed at performing an action did not find its realization in this action, it was not exhausted, and accordingly worked in vain, leading to negative chemical reactions in the body). Therefore, it becomes clear that muscle clamps, various tics (this is a healthier option in relation to psychosomatic diseases, since this or that bodily tension still finds its way out). Based on this concept, many (if not all) neurotic and sometimes psychotic disorders can also be interpreted.

Gestalt therapists have tried to identify the types of interruptions that occur at different stages of satisfying a need. Again, in different sources you can find different variations of interrupts and their number, but we will not need more than four basic interrupts [1; fifty].

1. Confluence (merger). Confluence is described as the perceived continuity of the boundaries of the organism and the external environment. With this abstract understanding, we will finish our discussion of this interruption for now.
2. Introjection is a process in which something external (rules, values, standards of behavior, concepts, etc.) are accepted by the body without critical processing and verification.
3. Projection is the process in which the individual attributes of a subject are attributed to other people or objects.
4. Retroflection is a process in which the focus of actions to satisfy a need is shifted from the external environment to oneself. For example. instead of striking another person out of anger, the individual knocks himself on the leg.
5. Deflection is a diffusion of activity. This spraying occurs in order to relieve the tension caused by the frustration of need. For example, in anticipation of a significant event, a person may begin to walk back and forth around the room.

All these interruptions occur at different stages of the contact cycle: confluence - precontact, postcontact; projection and introjection - contact; retroflection and deflection - the final contact.

Each of the types of interruptions has both a positive meaning, an adaptive meaning, and a negative meaning, a painful one.

Modern physiological basic gestalt therapy

At the present stage of development of gestalt therapy, its physiological mechanisms should be considered insufficiently studied. Among the major works, such can be recognized as "Gestalt: the art of contact" by Serge Ginger. In it, the author explains the physiological mechanisms of therapeutic action. Let us dwell on a number of its main provisions.

1. Gestalt therapy "rehabilitates the all-embracing, generalizing functions of the right hemisphere" [1; nineteen]. Gestalt is supposed to use a generalization function, where the therapist helps the client integrate bodily, emotional, cognitive and behavioral responses into a coherent whole, while other approaches often use only the left hemisphere.
2. Gestalt therapy aims to increase the interconnection of different layers of the brain. “Therapeutic action connects the following functions: medulla oblongata (needs); limbic (emotions and memory); corticofrontal (awareness, experimentation, decision)”[1; 76]. “Gestalt therapy mobilizes the hypothalamic zones (excitement of desires“here and now”) and the frontal regions (holistic and integrative approach, responsibility). Gestalt therapy maintains these weak areas of the brain in an active state.”[1; 70]. Gestalt is focused on connecting hemispheres compared to approaches, mainly verbal. Verbalization occurs after bodily or emotional movement, whereas in other therapies, utterance is preceded by emotion. [1; 78] Gestalt “could be qualified as“right brain therapy”rehabilitating the functions of intuitive synthesis and non-verbal languages (facial expression and body expression)” [1; 66].
3. Neurosis arises from a discrepancy - a poor connection between the above functions and departments or its absence (which follows from the situation itself).
4. Gestalt therapy is aimed at teaching the client. “During therapy, the limbic system responsible for emotions is activated. Memorization is possible only if sufficient emotion has arisen”[1; 66]. Thus, Gestalt therapy, through intense emotional experiences, allows you to accelerate learning. The Gestalt strategy is aimed at mobilizing the deepest emotions of the client so that the work being done is sure to “enroll in the engram” [1; 67].
5. Learning in gestalt therapy also involves the correction of the biochemical processes of the brain. “Psychotherapy directly affects cerebral processes, changing the internal biochemistry of the brain, ie. production of hormones and neurotransmitters (dopamine, serotonin, adrenaline, testosterone, etc.)”[1; 64].
6. Gestalt therapy not only corrects hormone production, but also exploits their relationship to behavior. “Thus, testosterone controls both aggression and sexual desire. These two impulses coexist in the hypothalamus. In gestalt therapy, this "closeness" is sometimes used - for example, they develop weakened sexuality through play aggression. Neurotransmitters function in antagonistic pairs. For example, the effect of dopamine, the hormone of awareness, contact and desire, is opposed by the effect of serotonin, the hormone of satiety, orderliness and regulation of mood. The psychotherapeutic action will help balance these two foods. Interactions are cyclical: for example, vigilance will stimulate the production of dopamine, which in turn will maintain or increase vigilance.”[1; 73-74]
7. The bodily symptom is often viewed as a channel that allows direct contact with the deep subcortical regions of the brain [1; sixteen]. To do this, it can be strengthened in the course of therapy.

These provisions can be treated in different ways. However, now we will dwell only on the point that these data do not reflect the qualitative specifics of Gestalt therapy. Basically, the process is about learning, just like in behavioral therapy. The difference is the involvement of emotions and their primacy in relation to logic, as well as their influence on the speed of learning. The mechanism of trauma formation and the role of catharsis and insight in its elimination are overlooked.

Next, we will try to supplement these physiological positions from a new side.

Gestalt therapy from the position of the doctrine of the dominant A. A. Ukhtomsky

In accordance with the objectives of this article, we will consider the basic provisions of the concept of dominant. To begin with, let's reveal the concept of dominant.

The dominant is a stable focus of increased excitability of the nerve centers, in which excitations coming to the center serve to increase excitation in the focus, while in the rest of the nervous system inhibition phenomena are widely observed [4]. This concept, while unclear, will be revealed further in separate provisions of the theory of A. A. Ukhtomsky.

A number of the provisions of A. A. Ukhtomsky can be immediately compared with the provisions adopted in gestalt therapy.

The principle of activity. This scientist considered an active, not a passive organism that lives in interaction with the external environment. He discovered that the reaction of the body is not predetermined, that a given stimulus can cause different reactions, and, conversely, this reaction can be produced in different nerve centers.

Integrity principle. The dominant appears to us as a set of various symptoms manifested in the muscles, the work of the endocrine system and other systems of the whole organism. It does not appear as a point of excitation in the nervous system, but as a specific configuration of centers of increased excitability at different levels of the nervous system. In fact, the dominant directs the entire organism to the implementation of one or another activity.

The principle of target determinism. In every unit of time, there is a center whose work has the greatest significance. The dominant is determined by the task that the organism performs at a given unit of time.

The principle of homeostasis. The principle of homeostasis is not so easy to define in the doctrine of the dominant, however, the very functioning of the dominant presupposes it. After all, the dominant arises under the influence of external or internal stimulation, creates tension aimed at solving the problem and ultimately leads to a release of tension in action and a change in the external environment.

Figure and background. The dominant focus of excitement tends to pull off excitement from other areas and at the same time inhibit them. This leads to such a phenomenon of our attention as selectivity. It is the dominant that directs our attention to certain objects in the external environment, thereby determining the ratio of figure and background.

Completed and unfinished gestalt. An active dominant creates tension that prompts us to act (unfinished gestalt). When a dominant gets its realization in action, this leads to its inhibition and switching to another dominant (completion of the gestalt).

Contact. A contact can be called a situation when an individual, under the influence of one or another dominant, enters into interaction with the external environment (begins to select objects to satisfy needs in it and in one way or another realize his intentions).

Contact boundary. Here we will slightly change the classical understanding of the boundary of contact in Gestalt therapy, in order to make it more objective. We will understand the border of contact quite simply - it is the border that separates the content of the individual's consciousness from the external environment, his representation from reality. In this case, the dominant from the inside will act as an idea, and from the outside, as behavior.

Striking similarities are found between the cycle of contact and the cycle of functioning of the dominant. The scientist identified a number of stages in the functioning of the dominant.

Stimulation - precontact. The appearance of a dominant is due to the presence of an irritant. Stimulation leads to excitement in the nerve centers, it creates a dominant. Obviously, for the appearance of a dominant, stimulation must be significant for the organism

Further, the stage of contact is divided into two stages of the functioning of the dominant.

1. Conditioned reflex - contact. This stage is characterized by the formation of a conditioned reflex, when the dominant selects the most significant group from the incoming excitations. Like the stage of contact, it is characterized by the selection of external stimuli associated with the satisfaction of a need.
2. Objectification - contact. This stage is characterized by the creation of a strong connection between the dominant and the stimulus. Now this stimulus will evoke and reinforce it. At this stage, the entire external environment is divided into various objects to which the dominant will react and to which it will not. This moment in gestalt therapy is seen as the end of the contact phase, when the client first, under the influence of an emotional state, touches certain figures, and then clearly defines the so-called basic figure, establishes a direct connection between the need and the way of its satisfaction.

These stages are related to the development of the dominant. We will designate further stages proceeding from other comments of A. A. Ukhtomsky.

1. Dominant Resolution - Final Contact. Any reflex as its final link presupposes a behavioral act. In the same way, the dominant is realized in certain actions. This is the main mechanism for resolving the dominant. Realized in behavior, excitement turns into inhibition due to reinforcement mechanisms.
2. Switching / creating a new dominant - postcontact. This stage is characterized by the beginning of a new cycle of dominant functioning. In gestalt therapy, this stage is characterized by awareness of the experience. In this case, for the client, the figure becomes not the object to which the action was directed, but the action itself. In the language of physiology, the same dominant change occurs as in any other case.

The concept of gestalt therapy disease from the standpoint of the doctrine of the dominant A. A. Ukhtomsky

At this stage, it is extremely important for us to note two provisions of A. A. Ukhtomsky.

1. Dominants, having formed, can exist for a long time, including the whole life.
2. Formed dominants can play a negative role, since they do not allow to adequately respond to the current situation.
3. A. A. Ukhtomsky speaks of such a method of inhibiting the dominant as a direct prohibition. The use of such a technique can lead to a conflict between desire ("want") and demand ("need"), i.e. to a phenomenon called a collision of nervous processes and, accordingly, to neuroses.

Thus, we will consider several options for neurotic processes and arrange them in accordance with the interruptions adopted in gestalt therapy.

The absence of a dominant is a confluence. The individual does not have a formed dominant that would be activated in response to external influences. For example, a mother pampered her child throughout childhood. He did not develop any usual adaptive skills, or motivation for certain actions. In this case, all work will be aimed at the formation of these skills and the ability to differentiate the stimuli of the external environment

Next are the options for the conflict. The cause of the conflict is introjection. It is introjection that creates the conflict between "want" and "need."

1. Fusion of nervous processes - projection, retroflection, deflection. The described interruptions are the result of a conflict between nervous processes. In this case, there are three such interruptions: projection - an action that we prohibit ourselves, we transfer to the external environment; retroflection - when we implement an action, but forbid ourselves to do it in relation to an external object, redirecting it to ourselves; deflection, when we still implement an action in relation to an external object, but this object is not the target. In all cases, we somehow temporarily relieve tension, but we do not destroy the dominant. You can also say that this classification of interrupts is not so fundamental. You can find its various variations, generalize or differentiate. It is most important for us to understand that there are essentially two options here, the dominant is either realized and achieves the goal, or not. If it is not realized, then a neurosis arises, and in completely different ways.
2. The maladaptive dominant is a confluence of the second type. This case is typical for situations when a problem pattern is automatically activated in a person. For example, this applies to phobias when a panic attack pattern is activated on a certain stimulus. Typically, these patterns are the result of a traumatic situation. The essence of the confluence here is the impossibility of completing the final contact. A person realizes his need, realizes it in actions, gets relief, but this method no longer corresponds to the new situation.

Psychotrauma and the role of childhood in the formation of the disease

Now we will try to answer the question why such an important role in gestalt therapy is given to childhood and how this is related to the doctrine of the dominant.

As we have already said, at certain periods, different dominants are formed in us, which are fixed in the psyche and, subsequently, influence us. Such dominants at the moment of their formation have a specific content (for example, an individual was frightened of a specific object and had a specific impulse to act). And, only later, this dominant begins to work as a filter of our perception, pulling other incoming excitements to itself. All other content in addition to the original is secondary to the dominant, all its activities are aimed at satisfying the primary content. It is logical that in order to achieve the realization of the dominant, we must bring to life the original object on which it was directed and implement the planned action. Only then will our brain receive a signal about the success of the action and give out reinforcement, which will lead to the successful inhibition of the dominant. Obviously, most of the main dominants are formed in childhood. It is they who determine our worldview.

Another question is the question of psychotrauma. How psychotrauma is formed and why in childhood. The answer lies in the peculiarities of the development of our brain in the process of ontogenesis. Our brains are only fully formed by school age. Childhood is characterized by the predominance of the first signal system, greater impressionability and less ability to reflect. Since the second signaling system is formed rather late, many events are experienced at the bodily and emotional level, at the same level they are remembered, i.e. in adulthood we see a repressed event. There is one more pattern - more effective memorization of emotionally colored events. As soon as a child gets into a stressful situation, his consciousness turns off, he is overwhelmed with emotions, and the reaction is imprinted. In adulthood, the individual no longer understands why he has a neurotic reaction. This is the result of the formation of an isolated focus of excitation. The dominant is activated when a stimulus appears, while it has no connection with the second signaling system, a person cannot control it.

Interrupts are generated in a different way. Introjection is formed by the type of suggestion, i.e. at a certain state of the psyche, under the influence of external influence, a new dominant arises, which comes into conflict with the old one. Another option is the formation of a conditioned reflex, when one or another action is interrupted. In this case, a maladaptive way of responding is fixed, which subsequently also leads to conflict and nervousness.

The case when the dominant is not formed probably does not make sense to discuss separately. Here, too, childhood has a huge influence, where the basic skills of interacting with the world are taught.

The structure of the psyche

Another point of gestalt therapy that should be transferred to the field of physiology is the structure of the psyche. In Gestalt therapy, it is customary to consider a single personality ("Self"), which is in one state or another at a time. There are three such states: "id", "persona", "ego". These states manifest themselves at different stages of the contact cycle: id on pre-contact, person at the stage of contact and final contact; ego on postkontakte.

1. "Id" is associated with inner impulses, vital needs and their bodily manifestation. Human functioning is manifested in the ability to perceive impulses coming from the body. The first stage in the emergence of a dominant can be observed - the perception of external stimulation. The ability to perceive a given irritation determines the ability to form a dominant.
2. "Person" is a function of adaptation to the environment and a set of patterns of such adaptation. This state determines how we will fulfill the created need. From the standpoint of the dominant, this is the functioning of the dominant at the stages of the conditioned reflex, objectification and resolution of the dominant.
3. "Ego" is a normative-volitional function. The ego determines the individual's ability to proceed not just from the impulses of his body, but from his own norms and beliefs when implementing certain actions. To realize this opportunity, a set of sufficiently strong dominants must already be formed.

Health concept

If in Gestalt therapy the disease is considered as the presence of an interruption on the way of satisfying a need, then health, obviously, as an opportunity to freely satisfy one's need (self-realization), while not entering into conflict not with oneself or with the external environment. This requires effective adaptation to the environment.

A person functions either adaptively, reacting to environmental influences, or maladaptively. In the latter case, a person cannot adequately respond to external influences due to the fact that he ignores the impulses that take place "here and now", he reacts stereotypically, based on previously formed interruptions.

Thus, an individual has two options for adapting to the environment: either directly transferring a situation from the past to a new situation (neurotic way), or reacting to a new situation based on the experience gained from a situation in the past (healthy way). A healthy way of responding is also called creative adaptation, as it allows an individual to always react in a new way to a new situation. Surprisingly, we find almost the same reflections in A. A. Ukhtomsky. He even introduces a similar term - "creative search".

Creative search is a mutual change in the external environment and personality in their general interaction. Recommendations for the development of creative search: the acquisition of many different dominants; awareness of their dominants, which allows them to control; replenishment of dominants associated with the creative process.

Methods and process of therapy

The task of the therapist is to achieve a state of creative adaptation or search. However, as A. A. Ukhtomsky: “before realizing a creative search, it is necessary to correct the previous dominants”. This necessitates the search and study of trauma and the impossibility of instantaneous switching to solving new problems. This distinguishes modern Gestalt therapy from other directions, as it covers both work with trauma and the formation of new skills.

It is also important that A. A. Ukhtomsky insisted on the impossibility of complete inhibition of the old dominants. He considered natural resolution of the dominant to be the most effective method of inhibition. Other methods: direct prohibition (leads to neuroses), automation of actions (skill formation), replacement of a dominant with a new one. Replacing a dominant with a new one is often used in various coaching directions, as well as in cognitive-behavioral therapy.

The work of the gestalt therapist is aimed at going through the stages of the contact cycle, and, accordingly, at finding the primary problem and working it out, and then at the formation of a new skill.

The main tools in the work of the gestalt therapist are methods aimed at resolving the dominant, which is possible in three versions:

1. Verbalization - when, the individual brings internal dialogue and his problem to the external plane, thereby realizing the dominant in speech.
2. Catharsis is the realization of a repressed emotion in expressive behavior.
3. Behavioral realization is a mechanism similar to catharsis, when a person resolves his dominant in a specific action.

The main task is to achieve complete resolution of the dominant. For this person, they try to immerse themselves as much as possible in the initial situation and cause the maximum depth of emotions. Separate methods of gestalt therapy are aimed at achieving this goal, or the goal of awareness. The method of active listening and creating empathy allows you to immerse a person in his emotion, to find a dominant. The empty chair method allows you to recreate a particular situation. The differentiation method helps the client to verbalize everything that has accumulated about the problem.

These methods are aimed primarily at finding a traumatic situation. But they can also be used to form new patterns.

The basic therapeutic principle is the here and now principle. In practice, it manifests itself in the fact that the therapist constantly sees the client's reactions, including neurotic ones, and draws the client's attention to them, which leads him to their awareness and further realization.

To summarize, let's say the following. As obvious as it may sound, Gestalt therapy aims to form Gestalt in a therapeutic situation. The client is assembled piece by piece into a single whole. First, he notices the fragmentation of his reactions (incongruence), then he distinguishes the main dominant in his reaction, allowing it to be realized in the external environment. After the old dominant has received its realization, the process of forming the ability to adapt to the external environment begins on the basis of awareness of one's impulses and reactions.

Conclusion

This article should not be taken as a clear physiological description of the processes taking place in Gestalt therapy. Rather, it should be seen as a general message to transfer Gestalt therapeutic theory and practice to a physiological and empirical basis and to reject abstract philosophical and sometimes contradictory judgments. This problem is very clearly manifested, for example, in the concept of "field" in Gestalt therapy. A number of authors borrow the scientifically recognized concept of Kurt Lewin, and a number try to use the abstract concept of the field of existentialists [3].

The main value of the work may consist in understanding the processes of psychotrauma and its healing. Realization of how catharsis helps to rid a person of a problem.

Bibliographic list:

1. Ginger S. Gestalt: the art of contact. - M.: Academic Project; Culture, 2010.-- 191 p.

2. Perls F. Theory of gestalt therapy. - M.: Institute of General Humanitarian Research. 2004. S. 278

3. Robin J. M. Gestalt therapy. - M.: Institute of General Humanitarian Research. 2007. S. 7

4. Ukhtomsky A. A. Dominant. - SPb.: Peter, 2002.-- 448 p.