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https://doi.org/10.1177/00221678211000210
Journal of Humanistic Psychology
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DOI: 10.1177/00221678211000210
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Article
Participatory Sense-
Making in Therapeutic
Interventions
Enara García1
Abstract
Given the holistic and phenomenological character of Gestalt therapy, the
body has a primordial role in enhancing the here and now experience of
the client. In order to examine the role of embodiment in therapeutic
interventions more closely, this article applies Merleau-Ponty’s phenom-
enology of corporeality and its development in the embodied and enactive
cognitive sciences to the study of therapeutic interventions. Taking
Merleau-Ponty’s theory of Fundierung as starting point, the article describes
the enactive idea of sense-making as the movement from prereflective
to reflective consciousness, a movement that is driven by the primordial
valence of affectivity and e-motion. As a process of participatory sense-making,
mutual regulation between therapist and client can happen at different
levels of consciousness. Here, in addition to the well-known declarative
(reflective level) and resonance-based (prereflective level) interventions, I
will focus on interventions that operate between levels which constitute
a genuine modality of embodied therapeutic interventions. I introduce the
notion of cross-salience as the prefigurative participation of the therapist’s
reflective consciousness in the client’s sense-making process. I will illustrate
this idea by the analysis of an intervention extracted from Fritz Perls’ work
Gestalt Therapy Verbatim.
1Department of Philosophy, University of the Basque Country, San Sebastian, Gipuzkoa, Spain
Corresponding Author:
Enara García, Department of Philosophy, University of the Basque Country, Av. Tolosa 70,
San Sebastián, Gipuzkoa 20018, Spain.
Email: enara.garcia@ehu.eus
100021JHPXXX10.1177/00221678211000210Journal of Humanistic PsychologyGarcía
research-article2021
2 Journal of Humanistic Psychology 00(0)
Keywords
enactivism, phenomenology, empathy, intersubjectivity, Gestalt therapy
Introduction
Phenomenology is one of the core elements in humanistic/existential
approaches to psychotherapy, especially in Gestalt therapy, both at theoreti-
cal and methodological level (Bloom, 2009; Crocker, 2017; Müller-
Granzotto & Müller-Granzotto, 2009; Yontef, 1979). Examining and
enhancing individual experience of clients and shared and collective expe-
rience of the therapeutic dyad is one of the driving forces of therapeutic
interventions. Responding to the integrative character of humanistic
approaches, not only the dialogue but also the body should be considered to
have a primary role in therapeutic interventions since it mediates the con-
tact between client and therapist. Although there is no evidence that any of
the founders of Gestalt therapy studied the phenomenology of Merleau-
Ponty, there are plenty of resonances with his phenomenology of the body
in contemporary Gestalt theory. Many theorists have pointed to the influ-
ence of Merleau-Ponty’s intercorporeality and intersubjectivity in the rela-
tional approach to Gestalt therapy (Beja, 2016; Farrands, 2010; McConville,
2014), but a more thorough analysis of how intercorporeality operates in
the therapeutic dyad is missing in the literature.
The aim of this work is to apply the phenomenological analysis of inter-
subjectivity and intercorporeality to therapeutic interventions. Thus, I focus
on the “in-between” in embodied interpersonal interactions. By tracking the
traditional phenomenological literature and its influence in current embodied
cognitive science, in this article, I describe and articulate classical concepts
such as prereflective intentionality, affect, and intersubjectivity in order to
provide an embodied theoretical model of how clients and therapists partici-
pate in each other’s process of getting into consciousness. In this way, I
embed the gestaltic concept of contacting (i.e., the meeting with another per-
son or with the world; Perls et al., 1951) in a more general framework of
phenomenological tradition. At the same time, I elucidate to what extent and
in what sense we can talk about an intersubjective and embodied approach to
Gestalt therapy.
The analysis will be grounded on Merleau-Ponty’s theory of Fundierung
(Section 2) that describes the relation between prereflective and reflective
intentionalities, as it is shown in his canonical work Phenomenology of
Perception (Merleau-Ponty, 1945/2012). Furthermore, in Sections 3 and 4, I
will describe how this theory has been extended by Francisco Varela’s neuro-
phenomenology of time and affect (Varela, 1999; Varela & Depraz, 2005)
García 3
and the subsequent enactivist account of social interactions as participatory
sense-making (De Jaegher & Di Paolo, 2007). In Section 5, I will explain
how from this theoretical background, we can classify different modes of
embodied therapeutic interventions. As the main contribution, I will also
introduce the notion of cross-salience as a mode of intervention that aims to
enhance the prereflective intentionality of the client and to unfold their expe-
rience. As an example, in Section 6, I will analyze a piece of the work Gestalt
Therapy Verbatim of Fritz Perls (1972) in order to illustrate the different
modes of intervention and participatory sense-making in therapeutic con-
texts. By this, I aim to integrate contemporary insights on embodied phenom-
enology and cognition into the relational Gestalt therapy theory.
Embodiment and Intersubjectivity in Merleau-
Ponty
Merleau-Ponty’s (1945/2012) philosophy aims to perform an incarnated
phenomenological analysis in order to disentangle the embodied structure
of consciousness. The body for Merleau-Ponty is not an entity among enti-
ties, but provides access to every entity of the world, that is, it gives access
to external objects. Thus, being the condition of possibility of every sub-
jective experience, the body becomes a constitutive principle of conscious-
ness. Here, we should understand the body not as an objective body, but as
a lived body, that is, a body as it is experienced from the first-person point
of view.
The main contribution of Merleau-Ponty’s theory is to recognize that not
every intentionality is a reflective intentionality of a thinking ego, but there is
a prereflective and immediate intentionality anchored to our corporeality that
sets the foundation1 for every reflective consciousness. The distinction
between body schema and body image relies on this distinction between
reflective and prereflective intentionalities (Gallagher & Zahavi, 2013, p.
145). While body image corresponds to a reflective representation of our own
body, as in mentalizing, imaginary, or visualization practices, in body schema
the body is felt prereflectively. Body schema comprises two aspects: proprio-
ception, that is, the immediate consciousness of the body, and the regulation
of posture and movement which also regulates intentional actions. Although
these two ways of being aware of the body operate simultaneously, distin-
guishing them is crucial to understand different modalities of therapeutic
interventions on the body. In this section, following Merleau-Ponty’s stress
on the prereflective consciousness, I will focus on the features of body-sche-
matic processes.
4 Journal of Humanistic Psychology 00(0)
Prereflective consciousness is characterized by not having a determined
content, which implies that it is not consciousness of a concrete thing, and
it has not a linguistic structure either (Hutto & Myin, 2012). However, the
corporeal and prereflective intentionality responds to the solicitations of
the environment in terms of bodily posture, movement quality, rhythm, and
so on. Moreover, the lived body defines the environment (Von Uexkull’s
[2001] idea of Umwelt) in terms of affordances, that is, the range of possi-
bilities available that determine the field of meaningful situations and cir-
cumstances for action (Hirose, 2002). In perception and action, however,
the body hides behind the intentional object. This means that the content of
intentional acts are the objects in the world, not the body. For instance, in
opening a door, my consciousness is on the handle, not on the movement
itself. Nevertheless, this does not imply that movements are simply mechan-
ical, nonvoluntary or unconscious, but rather, they belong to the prereflec-
tive and immediate intentionality.
Prereflective consciousness is thus particularly evident in bodily move-
ments, which operate through the coupling between perception and action,
namely, “the intentional arc” (Dreyfus, 2002). To move the body is to point
toward things in the world, by letting the body respond to the solicitations
of the environment. This structural coupling between the organism and its
environment takes place without appealing to any mental representation.
Imagine, for instance, how movements are learnt: instead of drawing on
theoretical or declarative instructions, movements and bodily skills are
acquired by a bodily understanding that is primarily pragmatic. This pri-
marily pragmatic character of consciousness was already pointed by
Heidegger (1962, p. 98) in his formulation that the world is ready to hand2
for us. Hence, consciousness is not originally a declarative “I think that,”
but a pragmatic “I can.”
Building on the pragmatism of the body, for Merleau-Ponty, prereflective
consciousness is also primarily affective. This affective turn in Merleau-
Ponty’s phenomenology implies building an epistemology that is founded in
the emotional structure of perception. The world thus is what is relevant and
meaningful for the subject, being the primary relation with the environment
and others one of commitment and participation. Hence, there is no transfor-
mation or modification between what the body expresses externally by means
of bodily gestures and movements, and what is felt internally. In this way,
mental and affective states of others are neither completely transparent nor
completely opaque (Gallagher, 2008).
The double character of affectivity, internal and external, is the basis
for dialectic tension of being open to others, that is, of being exposed to
the possibility of being an object for the other. As Jessica Benjamin
García 5
(1988/2013) would say, this dialectics of “lord and slave” entails the
drama of intersubjectivity. Nevertheless, as we will see below, the open-
ness to the other does not only imply the risk of objectification and death
but also the possibility of significant participation of the other in one’s
own subjectivity, that is, the possibility of a genuine interpersonal contact
and joint action. In Hölderlin’s (1804/1998) words, “but where the danger
is, also grows the saving power.”
In summary, Merleau-Ponty’s thought puts forward a mode of conscious-
ness that is no longer mentalist by principle as the cartesian thinking ego was,
but it is based in the active, affective and incarnated participation in the
world. Consciousness is bi-intentional, reflective and prereflective, and it is
anchored in the body and the environment the subject is situated in.
Enactivism: Sense-Making, Affect, and Salience
While Merleau-Ponty provides a synchronic description of the embodied
structure of consciousness, which invites to attend to body-schematic pro-
cesses, latter philosophers will extend his theory to develop a diachronic
and genetic perspective on consciousness.3 This diachronic view departs
from the structure of consciousness towards its dynamics, and focuses on
the process by which the world gets to consciousness in a meaningful way,
i.e., the enactive concept of sense-making. Understanding consciousness
not only in its structure but also in its dynamics will contribute to distin-
guish more accurately the process triggered by different types of therapeu-
tic interventions.
Enactivism is a branch of embodied cognition theories that, drawing on
the insights from Merleau Ponty’s phenomenology of embodiment, aims to
bridge the gap of the mind–body dualism by providing a naturalized account
of consciousness (Varela et al., 1993/2017). Enactive cognition theories
define mental life as sense-making, which refers to the process of sedimen-
tation/precipitation of experience in consciousness. Sense-making, thus, is
a process of getting into consciousness. The difference between mental
states and sense-making is analogous to the Gestalt and Gestaltung distinc-
tion, in which the former refers to the static conformation and shape of
conscious experience while the latter refers to the process by which those
forms are brought about. In the phenomenological tradition, sense-making
is the process from which a figure/ground scheme emerges in conscious-
ness. In order to introduce this temporal aspect of sense-making, Francisco
Varela, who is considered a pioneer of the enactive approach, explored the
relation between temporality and affectivity of the lived body (Varela &
Depraz, 2005).
6 Journal of Humanistic Psychology 00(0)
Drawing on Husserl’s subjective temporality, Varela (1999; Varela &
Depraz, 2005) describes the trifold structure of the time present: the present
encompasses not only the actual present but also the openness to what is
becoming, named “protention”, and “retention” of the just lived present.4 The
authors described how affectivity is intrinsic to the experience of temporality
and manifests itself in the primordial asymmetry between protention and
retention. From this viewpoint, affectivity is what configures the protentive
field, being the condition of possibility for what is becoming. It plays a cru-
cial role in modulating the conscious flow, leading its folds and unfolds so as
it paves the way for the constitution of objects and acts of consciousness.
Recalling the prereflective/reflective distinction, the move from the for-
mer to the later implies a folding/unfolding movement. This movement
manifests as “salience,” that is, the emergence of prefigurative contours
that already possess certain fundamental orientation and eventually give
rise to a concrete configuration or a fulfilled Gestalt (Koffka, 2013; Köhler,
1967). Affectivity, in turn, is understood as the dynamic polarity of attrac-
tion–repulsion that drives salience, just like the Id function of Gestalt ther-
apy (Perls et al., 1951, p. 371). Emotions thus do not merely accompany
conscious states, but are immanent and constitutive of every conscious act
or mental state insofar as their valence prefigures the configuration of forms
in consciousness.
According to Varela and the enactivist tradition, however, affectivity not
only modulates the perceptual field, but this polarity or tension of affectivity
is what actually moves the organism. Since bodily movement manifests in
itself the affective force, we can talk about affectivity as the predisposition to
action, also named as e-motion. Affectivity and movement, thus, co-emerge
and co-determine each other.5 As an illustration, we can see in the primary
affective polarity of going/coming, approaching/distancing, contacting/with-
drawing, and so on in movement. Ruella Frank, for instance, has very aptly
described the development of the e-motive sensorimotor schemes and how
they lay the basis for the development of relational patterns in early life
(Frank & La Barre, 2011).
Sense-making thus happens in three conceptually distinguishable phases:
First, a tendency to move results from a tension in the primordial affective
polarity. Then, the tendency manifests as the emergence of a salience in
reflective consciousness. Finally, the actuality of movement elicits the sedi-
mentation and precipitation of a certain Gestalt—figure/ground configura-
tion—in the reflective consciousness. Notice that these phases do not always
happen sequentially, but they can be simultaneous.
Overall, the genetic analysis of experience revises the positivist/mentalist
paradigm of cognition, for which perception is elicited by means of primitive
García 7
sense data in a passive way that are latter organized by the reflective action of
the intellect. For phenomenology, on the contrary, affectivity has a primordial
active dimension—a predisposition for action (Colombetti, 2014). There are
no objective sense data independent from the inner tendency of the organism,
which implies that perception also has an intrinsic affective and active dimen-
sion. This approach, thus, challenges the traditional stimulus/cognition/action
schema.
In the therapeutic context, the concept of sense-making allows to under-
stand Perls’ notion of the therapeutic work as the construction of a clear and
defined Gestalt (Perls et al., 1951, p. 237). The idea behind this is that a
Gestalt is not only a perceptual state, but it also entails certain predispositions
to action. This is why the formation of a clear Gestalt is by itself healing. It is
not the case that clients grasp the solution to a given problem, nor that they
perceive the situation through a different lens, but they situate themselves in
a concrete and adaptive orientation toward the world. The ability to cope with
changes in environment and to reorient oneself has to do with the creative
adjustment that we pursue in therapeutic processes (Zinker, 1977).
Notwithstanding, this does not mean that experience becomes ready to action
after bringing it into the linguistic domain (Vanaerschot, 1997). On the con-
trary, not every experience needs to reach the linguistic domain to contribute
to the therapeutic change. Indeed, sometimes the therapeutic change consists
in incorporating implicit operational abilities that are adaptively adjusted to
the present situation (Lyons-Ruth et al., 1998).
Summarizing, we can understand the sense-making process as the move-
ment from the prereflective to reflective consciousness. According to phe-
nomenology and enactivism, this movement is primarily driven by
affectivity, understood as predisposition to action. At this point, some ques-
tions emerge: how does sense-making operate in dyadic interactions and,
particularly, in therapeutic relationships? How does the interaction with
another subject modulate our sense-making process? And what is the role
of empathy in the emergence of the Gestalt?
Intersubjectivity as Participatory Sense-Making
From the enactive approach, the therapeutic setting can be seen as a dyadic
system in which client and therapist modulate each other at, both, reflective
and prereflective levels (see Figure 1). As such, the therapeutic encounter can
be considered a particular case of social cognition. According to the enactive
theory, social interaction can be enabling and sometimes even constitutive of
social cognition (De Jaegher et al., 2010; De Jaegher et al., 2017). This
implies that in describing clinical empathy and interventions, we should
8 Journal of Humanistic Psychology 00(0)
focus on the interactive process between therapist and client as a process that
is extended in time and follows its own dynamics.
In the cognitivist approach, where only reflective consciousness is taken
into account, mental and emotional states are considered as individual and
opaque, and empathy is usually described as simulation and representation of
the other’s states6. However, the phenomenological and enactive approach,
by focusing on prereflective and schematic processes, consider affectivity as
the counterpart of bodily movement, being its condition of possibility and
co-extensive with it. In this way, we can perceive intentions and emotions of
others immediately through their bodily expression insofar as we act in a
shared and meaningful context, that is, in a unified relational field (Day,
2016; Parlett & Lee, 2005).
In this regard, phenomenological psychiatrist Thomas Fuchs (2017)
describes how empathy, in an embodied sense, is linked to bodily resonance or
intercorporeality in the interactions with others. This prereflective modulation
Figure 1. Movements of participatory sense-making in therapeutic relationships.
Note. Two levels of consciousness (prereflective and reflective) of two people interacting
(therapist and client) influence each other’s sense-making in different ways (horizontal/
vertical/diagonal arrows).
García 9
manifests in coordination patterns with others, such as synchronization, pitch
modulation, gaze, rhythm and so on. Indeed, several empirical studies show
the relation between bodily coordination and the outcome of therapeutic inter-
ventions (Kleinbub, 2017; Tschacher et al., 2014). Sensorimotor coordination
is modulated moment by moment, giving rise to an implicit and intuitive
empathic contact that lays the ground of the therapeutic alliance. This phe-
nomenon is called interaffectivity (Fuchs, 2016) and indicates the affective
resonance that operates in the relational field, giving rise to dyadic affective
states that modulate the mutual adjustment in interaction.
In vein with Varela’s analysis, the concept of interaffectivity reflects the
idea that affectivity is not located only within the individual, but it operates
in the intercorporeal space, in the interaction between two or more people.
Since affectivity’s primary polarity of attraction–repulsion has already a
directional force from the center of the subject outward, we can say that it is
directed toward alterity. This trademark of affectivity of being traversed by
alterity, constitutes the aperture where the primary intersubjectivity perme-
ates (Candiotto, 2016; Daly, 2016).
Notice that according to the enactive premises, intersubjectivity does not
encompass an abstract and generic alterity, but a concrete and particular other
that is involved in the dyadic interaction. Just like the enactive subject is a
situated, material and concrete subject, so is alterity. Here, alterity becomes
the concrete other that is interacting with the person. Hence, intersubjectivity
is not located in the individual psyche, but plays out in the concrete and situ-
ated interpersonal space in which a genuine contact becomes possible.
Intersubjectivity is interpersonal and interactive what means that intersubjec-
tivity exists insofar as it is activated or enacted between concrete subjects.
Sense-making, thus, is jointly created in the interactive process. Both par-
ticipants are actively involved and modulate each other’s experience in a pro-
cess called participatory sense-making (De Jaegher & Di Paolo, 2007). In its
dynamic aspect, participatory sense-making encompasses synchronization,
sensorimotor coordination, postural covariation, and vocal and bodily expres-
sions. Moreover, this interaction between subjects can occasionally acquire
certain autonomy (De Jaegher & Di Paolo, 2007), which means that a new
intersubjective domain emerges that is not reducible to activities of individ-
ual participants. Participants co-constitute the interaction, while the interac-
tion can modify participants in turn. Phenomenologically, participatory
sense-making is experienced as mutual incorporation, that is, the assembly
of the corporeality of the other as an extension of our own bodily experience
(Fuchs & De Jaegher, 2009).
From this point of view, clinical empathy does not take a declarative form
of “what they think/feel” but rather it is an implicit operational knowledge in
10 Journal of Humanistic Psychology 00(0)
the form of “how to respond to.” Eye movement is a clear example. I do not
need the declarative knowledge that an up-left gaze is related with retrieval
of visual memory, but in perceiving this behavior, I do feel the absence of the
other from the present situation and I know how to respond accordingly. Such
sensorimotor abilities emerge in the relational domain and are incorporated to
the repertoire of the therapist–client dyad. Indeed, the therapeutic work can
be seen as the incorporation of new operational abilities in response to a
changing environment that flexibilizes the relational habits of the client reor-
ganizing their existing patterns and fixations (Lyons-Ruth et al., 1998; Stern
et al., 1998). In this sense, the therapeutic change is a prolongation of the
developmental process by which the client acquires new relational capacities
in interaction with the therapist, relational abilities that can then be general-
ized to other contexts.
Cross-Salience
As stated in the previous section, the dyadic adjustment at prereflective
level, i.e., the interaffective resonance, modulates and determines indi-
vidual reflective conscious states. At the same time, the reflective dialogue
between therapist and client can also give rise to new insights in the client.
Although these horizontal modulations (see Figure 1, horizontal arrows)
have been extensively described in the phenomenological literature (Fuchs,
2016; Fuchs & Koch, 2014; Mehmel, 2019; Plant, 2018), the diagonal
modulations have not been thoroughly analyzed and described (see Figure
1, diagonal arrows). Not only prereflective and reflective modulations
operate in dyadic relationships, but both levels are intertwined in interac-
tions. A more fine-grained description of the role diagonal interactions
play in therapeutic relationships will be useful to complete the picture and
to highlight new forms of participatory sense-making in the clinical con-
text. In what follows, I will define the diagonal interventions as cross-
salience and I will describe their functioning particularly in Gestalt therapy
interventions.7
In Gestalt therapy, interventions pointing to bodily expressions of the cli-
ent are commonly used. Gestures such as rubbing hands, caressing legs or
shaking feet can be used as ways to unfold the experience of the client and to
reach a meaningful insight, that is, a clear and defined Gestalt in reflective
consciousness. Not only does affective resonance modulate the participatory
sense-making process as a bottom-up regulation, but the reflective conscious-
ness of the therapist can also elicit or modulate the sense-making process in
a nondeclarative way.
García 11
As an illustration, imagine an excited and agitated client. The therapist can
respond to the bodily expression of the client in three main ways:
A. In a declarative way. “You are nervous, why?”
B. By means of the bodily resonance; That is, breathing in a calmly to
slow down the client’s rhythm.
C. Reflecting what is obvious. “I am aware that your foot is trembling,
what does it mean to you?”
While A operates at the reflective level and B at the prereflective level, C
operates at the level of the prereflective-becoming-reflective. Let’s name this
latter operation (C type) a “cross-salience.” By addressing what is obvious,
the therapist indicates where to put the focus of the client’s attention, that is
to say, that the therapist highlights certain outlines from the background that
can be useful for the client to form a unified and coherent Gestalt. Notice that
the therapist’s indication in a C type intervention does not presuppose a con-
crete reflective state as an A type does. On the contrary, it points to something
that is nondeclarative and nonreflective, but still relevant to unfold the expe-
rience of the client.
Both intentionalities operate at the same time in the therapeutic relationship.
Reflective intentionality individuates the conscious intention of the client,
whereas prereflective intentionality is the one manifested by the corporeality in
interaction. Prereflective intentionality, remember, has no concrete content yet.
Consequently, given that prereflective intentionality is always richer in possi-
bilities and potentialities than reflective intentionality, the performance of the
therapist points to the realm of potentiality. Therapists operate over virtuality,
which implies that they must adopt a transitory and hypothetical attitude. In
other words, as a therapist, I can have a feeling of the wide range of possibilities
of the bodily intentionality (which may or may not be consistent with verbally
expressed intention) but it can be the case that none of these feelings is an actu-
ality for the client. Hence, my feeling of what is salient in the bodily intention-
ality of the client, is operating on the virtuality of the client’s experience. It can
even be that reflective intentions of the client are individuated retroactively by
the force of the interaction and are manifested before in the reflective con-
sciousness of the therapist (or vice versa; Di Paolo, 2015). For instance, imag-
ine that a client looks at the clock during a session and the therapist says, “Is it
enough for today?” The client can respond, “I was not aiming that, but now that
you said it, yes, I wanted to stop.”
One could think that cross-salience entails some kind of objectivity of
obviousness. However, what is obvious is fundamentally phenomenological
12 Journal of Humanistic Psychology 00(0)
and emerges from the interactive history. The salience manifested by the
therapist can also emerge from their prereflective resonance with the cli-
ent. Is in this regard that the therapist must be trained to identify their own
affective and bodily states in order to be present in the interaction and
disposed toward the client in an attitude of openness to co-construction.
Cross-salience, thus, is never determinant. The client may or may not con-
verge with the therapist’s particular salience, and may or may not incorporate
it into their process of sense-making. Cross-salience is, thus, an open and
non-conclusive operation that does not individuate the experience of the cli-
ent, but rather, it leads the relational dynamics in a certain direction and mod-
ulates the range of possibilities in the experience of the client. As a result,
cross-salience has a hypothetical and transitory character. Even if the thera-
pist points to a possible path for the interaction, they do not know the final
destination, just like a weathercock that indicates the direction of the wind
moment by moment.
The therapeutic process is a process of constant resignification. A gesture
or a movement quality can convey many meanings (Frank, 2013). Given that
prereflective phenomena are richer in potentialities than reflective ones, it
may be the case that no precise prereflective state is present in the client
before engaging in a participatory sense-making process. Instead, a wide
range of potentialities become individuated in interaction. These meanings
are established in interaction, a process which can sometimes acquire a cer-
tain autonomy on its own.8 This is why our acts are, to a certain extent,
dependent on how they are read by others, and they are always embedded
within emergent relational dynamics that are (sometimes, partly) indepen-
dent of the individual intentions.
In this sense, empathy is constituted only when the other perceives it as
such (Bohart & Greenberg, 1997). The same behavior can be perceived, as
an act of condescension, as indulgence or as empathetic, for instance. An
empathic act, thus, requires the complementarity of two partial acts as well
as the mutual co-regulation between them (Di Paolo et al., 2018). It is in this
sense that empathy, when it is originated in the prereflective resonance, can
have a therapeutic effect as facilitator and enhancer of the sense-making
process of the client. What matters in the therapeutic alliance is the synergy
between the cross-salience at the relational domain and the unfolding of the
sense-making of the client. In this way, empathy has to do with the fact that
the therapist is co-author of the experience of the client in a nontrivial sense,
that is, not only in a contextual or enabling way, but in a constitutive way
(De Jaegher et al., 2010). This participative movement is also the foundation
of the “we-experience” which sometimes emerges in therapeutic processes
(Jensen et al., 2019).
García 13
The therapeutic intervention, thus, permeates the level of temporality
of the client as it constitutes the condition of possibility for sense-making.
Since affectivity is what opens and closes the dynamic landscape and
precipitates protention, the therapeutic interaction and empathic reso-
nance push participants to open themselves to the phenomenological
present. This is why bringing the client to their bodily and prereflective
awareness also implies to bring them to the “here and now,” the phenom-
enological present that opens up the possibility of novelty. This idea of
the phenomenological presence has already been described as the fertile
void in Gestalt therapy or as lichtung in Heideggerian philosophy
(Heidegger, 1962), and refers to the phenomenological–existential open-
ness and clearing that allows things be brought into presence. In this
sense, coming to the phenomenological present is by itself a momentum
of the therapeutic change.
As a final remark, humanistic therapeutic schools, such as Gestalt ther-
apy, aim to empower clients as agents of their own personal development
and to learn to trust in their self-healing capacity. These schools deny the
directive model of therapy that sees the therapist as having a privileged
knowledge, whereas the client is needy and deficient. Humanistic schools,
instead, support an egalitarian view on clients and therapists. Nevertheless,
we should not confuse this predisposition for the client with the full accep-
tance promoted by the person-centered approach (Rogers, 2000). Sometimes,
cross-salience types of interventions can be very confrontative, in the sense
that they can show incongruities between what is said by the client and what
they express at the prereflective level.
Even if contemporary relational approaches stress the co-regulation and
co-construction of the therapeutic dynamics, it is important to keep an eye
on the asymmetry of therapeutic relationships. This structural asymmetry
emerges in the participatory sense-making process insofar as the attention
of the therapist is polarized toward the client. Generally, while therapist and
client pass through horizontal interactions both reflective and prereflective
ones (A and B types), cross-salience is usually (but not exclusively) unidi-
rectional, from the therapist to the client and not vice-versa. Although, this
structural asymmetry is analogous to the one in caregiver/child, teacher/
pupil, and most care relationships, we should keep in mind that these asym-
metries are not pregiven, but they are co-constructed through the interac-
tion. From this view, power dynamics that emerge in therapeutic encounters,
would also be transitory, hypothetical, and reversible. Future research on
embodied interactions might extend the explanations of how these power
dynamics emerge in therapeutic relationships, but such a discussion falls
beyond the scope of the present article.
14 Journal of Humanistic Psychology 00(0)
A Case Study
In order to provide a clearer picture of different therapeutic interventions on
the body, I will analyze a concrete therapeutic process. This is a piece of the
work Gestalt Therapy Verbatim (Perls, 1972) in which Fritz Perls works
with a client while being observed by a training group. The therapist works
individually with the client while sometimes addresses students to give them
some remarks on the ongoing intervention.
Jim: I have just a fragment of a dream. There’s no voices in the dream.
Fritz: Now, the first look is that Jim is open in his undercarriage, but
closed up here—he is covering his genitals with his hands. So this is
the first thing I see. Now, this is very important, which part is closed
up, whether the total personality, or the lower or the upper carriage.
The lower carriage is mostly for support, and the upper carriage for
contact. This is how we stand up on our own feet, and this is where
we reach toward the world, with our hands. So I see already a lot just
by Jim sitting there: his posture, the way he moves his head, and so
on and so on.
J: You already have me pretty well shook up. (laughter) This has nothing
to do with my dream, but that’s a heck of a comment to make, because—
F: You see the lack of ambidexterity in his gestures? He uses only the right
hand and it always points to himself; he is relating himself to himself.
That’s what Kierkegaard said in the beginning—the relation of the self
to the self. If you live like this, how much can you achieve?
J: I’m afraid to move.
F: That is exactly what I wanted to point out. (laughter)
J: Now I know why my dreams are short.
F: Would you enlighten me? I don’t know why your dreams are short.
J: I just have the typical recurring dream which I think a lot of people
might have if they have a background problem, and it isn’t of anything
that I think I can act out. It’s the distant wheel—I’m not sure what type
it is—it’s coming towards me, and ever-increasing in size, always
increasing in size. And then finally, it’s just above me and it’s no height
that I can determine, it’s so high. And that’s—[ . . . ]
F: Notice how much of your unsureness has left you? How much you have
already re-owned from the projection of the wheel?
J: Yeah. I think I—as large as it is, right now, I think I’d do whatever I
could. In other words, I’ve always had the feeling that—^what could I
do?—but now I know at least I’d do whatever I could—to stop the
wheel. . . . And, ah—on this thing here, I’m sterile, and that entered into
García 15
my marriage—that’s the very thing I was ashamed of, and you know
you said I covered my genitals.
F: The big wheel. Yah?
End of session
(Perls, 1972, p. 126-129)
In this fragment, Perls’ intervention consists mainly on showing what is
evident in Jim’s bodily posture by reflecting what is salient in his bodily dis-
position. Partially, this salience is interpreted by the therapist in the sense that
he fills the client’s experience with a concrete declarative content; for exam-
ple, utterances such as “The lower carriage is mostly for support, and the
upper carriage for contact.” This intervention would be of the dialogic kind
(A type in the previous classification). Initially, this interpretation is rejected
by the client: “This has nothing to do with my dream, but that’s a heck of a
comment to make, because . . . ” The therapist, in response, changes the focus
to another dimension of the corporeality of the client his lack of ambidexter-
ity and constant self-reference in his movements (C type intervention, cross-
salience). Here, phenomenological flexibility and the absence of fixation of
the therapist are necessary conditions for contacting with the ongoing experi-
ence of the client. This constant reference to the body, in turn, brings the cli-
ent to the phenomenological present. Instead of talking about his dream, the
client focuses on the here and now of his bodily experience. For instance,
“I’m afraid to move.” And from this bodily awareness, the dream of the client
makes sense: “Now I know why my dreams are short.” At this point, a Gestalt
has emerged, a meaningful understanding that is not merely mentalistic or
rational, but emerges from the prereflective experience of the here and now
of the client with the therapist being a coauthor of this experience.
There are also prereflective modulations (B type interventions), that is,
regulations of interaffectivity. This is evident in the use of laughter to release
the tension of high-intensity moments: “You already have me pretty well
shook up (laughter).” These regulatory acts are used to synchronize the affec-
tive states of client and therapist while they maintain an adequate level of
tension for the therapeutic work.
After a while of dialogue about the dream (A type intervention), the sense-
making process goes back to the initial salience, the client’s posture of cover-
ing his genitals, which now becomes meaningful and coherent in relation
with his marital issues, the feeling of general impotence, and sterility. This
episode evidences that corporeality contains the richness of potentialities in
prereflective consciousness that emerges along with bodily expression. The
return to the initial thematic shows also the lack of linearity of therapeutic
processes, which do not follow a consecutive temporal line of awareness, but
16 Journal of Humanistic Psychology 00(0)
the experience of the client unfolds as a prism, generating many thematic
lines that coexist in the corporeality of the client. This means that, since there
is no correct and objective answer to what is happening to the client in a
given moment, therapists’ interpretations are always possibilities that need to
be corroborated by the client. Here resides the core of relational therapies.
In this fragment, we could say that the confrontative and frustrating style
of Perls contrasts with the traditional idea of clinical empathy as a precondi-
tion for the success of an intervention. From this process, we can deduce that
there is no empathy or alliance that is prior to interaction and predicts whether
an intervention will be successful, but rather, the empathic act occurs, on the
one side, in the interaffective coregulation, and on the other, in the synergy
between the salience of the therapist with the sense-making process of the
client. For example, “That is exactly what I wanted to point out. (laughter).”
Conclusion
This article proposes a model of interaction between client and therapist that
builds on Merleau-Ponty’s phenomenological analysis of embodiment and its
subsequent development in the enactive theory. According to this model,
sense-making is understood as a movement from prereflective to reflective
consciousness that has different steps. From the primordial valence of affect
emerges a salience, that is, a prefigurative contour in reflective consciousness
that will, eventually, give rise to a figure-ground conformation (Gestalt) in
reflective consciousness.
In applying the schema of participatory sense-making to dyadic therapeu-
tic relationships different levels of mutual regulation can be identified that
give rise to different types of therapeutic interventions. At the prereflective
level, the mutual affective regulation, i.e., interaffectivity, takes place whereas
the main regulatory mechanism at the reflective level is of a declarative type.
Cross-salience, instead, operates as emerging in the reflective consciousness
of the therapist and directed towards generating a salience in the sense-mak-
ing process of the client. This type of intervention is transitory, hypothetical,
and it is directed to enhance the embodied experience of the client. The
dyadic relational model presented in this work thus provides a map that is
useful to clarify different types of interventions in relation to corporality in
therapeutic contexts, being particularly helpful for supervision sessions and
training, specially in deepening the therapeutic alliance.
As a final remark, it is worth mentioning that several therapeutic schools
use cross-salience-based interventions on the body. For instance, a commonly
used intervention in Feldenkrais’ (1972) method consists in the repetition and
enhancement of a concrete movement to achieve a meaningful understanding
García 17
of the bodily experience of the client. Nonetheless, an extended explanation
of how these types of interventions operate in the therapeutic dyad would be
useful to integrate different methodologies and approaches to the body.
Moreover, many of these methods work explicitly (and more or less
exclusively) on the body. In choosing a piece of Gestalt therapy, which,
despite its integrative character, is primarily dialogic, I aim to show that this
prereflective communication channel operates in psychotherapy at the
generic level, whether explicitly or implicitly. Indeed, by focusing on a ther-
apeutic intervention that works on dreams, which have traditionally been
understood as purely mental activity, I aim to overcome the idea that the
embodied approach can only be ascribed to low-level, bodily related, and
basic cognitive processes (de Bruin & de Haan, 2009). This phenomenologi-
cal work on self-embodiment is not only appropriate for body therapies but
also for dialogue-based approaches could be extended to problem-solving or
cognitive-behavioral psychotherapies.
Declaration of Conflicting Interests
The author declared no potential conflicts of interest with respect to the research,
authorship, and/or publication of this article.
Funding
The authors disclosed receipt of the following financial support for the research,
authorship, and/or publication of this article: EG was funded by the Basque
Government pre-doctoral training program PREDOC 2018. This work was supported
by project IT1228-19 funded by Basque Government and project Outonomy
(PID2019-104576GB-Ioo) by the Spanish Ministry of Science and Innovation.
ORCID iD
Enara García https://orcid.org/0000-0002-1163-1516
Notes
1. See the notion of Fundierung in Merleau-Ponty (1945/2012, p. 414), and repre-
sented in Figure 1.
2. The german distinction between Zuhanden and Vorhanden.
3. For a distinction between ontological, genetic, and genealogic phenomenologi-
cal analysis see Thompson, 2010.
4. Protention is a structure of experience that is fundamentally different from mem-
ory, which constitutes a different kind of mental act that takes place in the phe-
nomenological present.
5. This is a fundamental contribution that captures the enactivist thinking “we make
the path by walking” (Di Paolo, 2013).
18 Journal of Humanistic Psychology 00(0)
6. For a further description of different mentalist approaches and an introduction to
the social cognition debate see Gangopadhyay, 2014.
7. It is worth mentioning that these types of interventions are not specific to Gestalt
therapy, but they can be used by different therapeutic schools. However, to pin-
point the phenomenon, I focus on Gestalt therapy, where these type of interven-
tions are commonly recognized in its methodology.
8. The relational autonomy can even be in tension with individual inten-
tions (De Jaegher & Di Paolo, 2007). As examples of these tensions, see
the Drama Triangle (Karpman, 1968) or the fixation of helping/assistance
relationships.
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Author Biography
Enara García is a philosopher and cognitive scien-
tist with background in Gestalt therapy. Currently
she holds a predoctoral research possition at the
IAS-Research Group, University of the Basque
Country. She is also a member of the Spanish
Gestalt Therapy Association (AETG).
