2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43
Gestalt therapy refers to the medium-term types of psychotherapy, and on average lasts from 10 to 50 sessions, in some cases lasting up to 60-120 hours. Why can't it be faster?
Stable and qualitative changes require stable and strong neural (synaptic) connections. Relatively speaking, our psyche is arranged in such a way that the more often we use a certain neural connection, the stronger and more developed this connection becomes - this is how a skill is formed and developed. And those neural connections that we do not regularly operate on - on the contrary, weaken. Psychotherapy works the same way as any learning - it is the formation and consolidation of skills.
The difference between knowledge and skills is physiologically determined. To better understand what this difference is, let us turn to the neurobiology of memory: according to the degree of participation of awareness in the process of memorization, scientists distinguish two types of memory: declarative (explicit, semantic) memory and implicit (procedural) memory.
Declarative memory is associated with our consciousness - this is information, facts, knowledge - everything that we can reproduce consciously and that lends itself to verbal description (for example, the names of notes or traffic rules).
Implicit memory is our skills, reflexes, "automatisms" in behavior - everything that usually defies verbal description and is formed on the basis of experience (the ability to play a musical instrument, driving a car) - everything that we can reproduce without the participation of awareness. That is, declarative memory is what we know, and implicit memory is what we can do. You can know the notes, but not be able to play musical instruments. You may not know traffic rules, but be able to drive a car.
Psychotherapy mainly works with implicit memory - gaining new experience in client-therapeutic relationships, changes in a person's life and relationships occur as a result of mastering new, effective skills to replace maladaptive ones - through changes in character and behavior. And in order for the skill to gain a foothold, it is necessary to create a strong neural connection, which requires experience and regular practice (including the skill of receiving psychotherapy).
Thus, it is impossible to achieve qualitative and stable changes in a couple of sessions (we also call such changes structural changes, implying structural formations in the psyche), just as it is impossible to professionally master playing musical instruments in a couple of lessons.
The neural networks of the brain begin to form even during intrauterine development and continue to develop after birth, passing through critical stages of their development. The task of psychodynamically oriented psychotherapy, which is gestalt therapy, is to identify a conflict that arose at one of these stages and disrupted the development of certain skills.
Therefore, the duration of psychotherapy is determined not only by the peculiarities of the request, but also by the duration of the existence of difficulties with which the client addresses, and the stage of their occurrence in the process of development of the psyche. The "fresh" difficulties that have arisen as a result of recent and perceived events can be dealt with much more quickly than the discomforting personality and behavior characteristics that were formed in childhood and have been used throughout life.
What duration should you focus on and who determines it?
Conventionally, the following forms of psychotherapeutic intervention in gestalt therapy can be distinguished:
1. Crisis intervention or gestalt counseling. Lasts from 5 to 7 sessions. Suitable as support in an acute crisis situation. The task of crisis counseling is rather in preventing the negative consequences of the event for the psyche, and not in resolving already existing "symptoms" (in character, behavior, reactions, etc.), and, therefore, is not psychotherapy.
2. Short-term gestalt therapy. Lasts from 10 to 50 sessions. Suitable for the treatment of lingering conditions and symptoms that have arisen as a result of recent and well-recognized events and psychogenic causes. Requires a client-therapeutic relationship (and a psychotherapeutic contract that regulates the boundaries of this relationship) and is associated with learning and mastering skills (including mastering the skill of receiving psychotherapy). It lasts on average as long as the condition or symptom lasted before treatment.
3. Long-term gestalt therapy. 50 to 120 sessions. Suitable for the treatment of personality disorders and involves working with stable structures, symptoms and behavior (emotional, behavioral, clinical) that have existed for more than 5 years.
These are the recommended forms of gestalt therapy intervention, taking into account the conditions of occurrence, nature and duration of the client's difficulties. At the same time, the client himself determines the duration and depth of the intervention, depending on the goals of his therapy, therefore, the duration of gestalt therapy is selected individually and is prescribed or spelled out in the psychotherapeutic contract - taking into account the recommendations of the therapist and the goals of the client.
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