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Ethics of Context and Field: The Practices of Care, Inclusion and Openness to Dialogue
Abstract
"Editor’s Note: In this article, which will be published in a collection of writing on relational issues applied to ethics, Lynne Jacobs, prominent Gestalt therapist and writer, develops a model of ethics which arises from examination of the field and context in which therapy takes place. She uses vivid examples from her own experience and clinical practice to show how therapists might focus their awareness on the ethics of their practice, primarily by attending to the issues of care, inclusion and openness to dialogue. She describes how this stance can be challenged by circumstance both distal and proximal, by events both in the consulting room and in the wider world; and she illustrates how these are inevitably linked. By attending to ourselves and to our work with this in mind, she suggests, an ethical practice that develops authentically from the therapeutic dialogue can inform and guide us, perhaps more helpfully than one imposed somewhat arbitrarily from the outside. Key words: Gestalt therapy, ethics, care, inclusion, dialogue, context, therapeutic task."
... At the same time, he and others have acknowledged that there are a variety of fields that can be classified and observed (Francis, 2005;Yontef, 2002). Some of the fields identified and discussed have included the embodied field (Kepner, 2003), the erotic field (O'Shea, 2003), the phenomenal field (Kennedy, 2003), and the oft-examined phenomenological field (e.g., Jacobs, 2003;Wheeler, 2000;Yontef, 1993). Here, the specific purpose of the field being considered defines and shapes the field itself (Parlett, 2005). ...
... Retention of the term I-Thou relationship (or I-Thou process) in early Gestalt therapy literature (e.g., Jacobs, 1989;Yontef, 1993), apart from Hycner's writings, appears to be in service of the adaptation of this specific way of contacting to the therapy situation. Still, it seems that Hycner's early concerns have been fully integrated into general Gestalt therapy literature, as most authors refer to dialogue or the dialogic instead of I-Thou (e.g., Jacobs, 2003;Yontef, 1998Yontef, , 2002Yontef, , 2005. ...
In the assessment of the utility of theoretical orientations for cultural appropriateness and sensitivity, examination of the foundational theory of these orientations is often overlooked in place of an emphasis on the efficacy and effectiveness of interventions and techniques. However, as interventions are ideally borne out of strong theoretical foundations, the importance of examining the implicit values of theoretical orientations is important. Gestalt therapy was examined as an example of a theoretical approach. Gestalt therapy is described by many of its practitioners as being highly sensitive and adaptable to culturally diverse clients due to the openness and inclusiveness found in the philosophical, theoretical, and methodological expression of the orientation. The implicit values embedded within the grounding principle of organismic self-regulation were reviewed to determine if the principle exemplifies a universal process of functioning or merely a culture-bound heuristic. Exploration of the ways Gestalt therapy’s philosophical foundations, theoretical attitude, and methodological style impact the implementation of organismic self-regulation in work with culturally diverse clients was also conducted. Organismic self-regulation was found to have two interconnected levels, one of which can be easily adapted to diverse clients due to the flexibility to different cultural norms and traditions that the level provides, allowing for Gestalt therapists to be able to work with theoretical consistency with culturally different clients.
... Self is here understood to be more verb than noun, more event than singular form; a moment-to-moment reformation of subjectivity dependently arisen from a context. This processformation of self is what makes possible structural or ground change, as distinct from shorter-term cognitive or behavioral change (Jacobs, 2003;Parlett, 2005;Yontef, 1993). Here, change can be taken as code for optimal responsiveness, at times a therapeutic end in itself. ...
... This philosophical influence has generated a capacity for therapists to maintain competence and steadiness in the face of the genuine uncertainties of working inter-subjectively with other human beings. The influence is most evidently present where a therapist works intentionally and skillfully with the therapeutic relationship, attuned to the present reality -to the 'in-between' -of the exchange flowing between them and their client (Yontef, 1993;Jacobs, 2003;Parlett, 2005). ...
A clearly articulated disciplinary base could significantly bolster the still emergent profession of psychotherapy and counselling. As the profession sharpens its profile it is important that the implications of the common factors research be fully integrated into disciplinary frameworks. The predominance of the therapeutic relationship as a factor in therapeutic effectiveness calls for greater rigour in the understanding of how that relationship works. Within an already crowded mental health space, it is timely that the profession foreground how its disciplinary bases provide that rigour.
This article considers where the profession sits within a spectrum of models of health and presents an argument for deeper consideration to be given to the philosophical and relational roots of the disciplines of psychotherapy and counselling.
... My judgmental retreat is a signal to myself engage in the process of asking myself what, in my perspective, limits my capacity to find the sense, the truth, in the patient's perspective. This has become a daily practice (Jacobs, 2004). ...
This article addresses the issues of white-centeredness and racialization that are inherent in contemporary American society and culture. The aim is to develop a conceptual framework by which dominant culture therapists and analysts might sensitize themselves to the implications of their dominance in the therapeutic process. While racialization is my fulcrum, the ideas I present could as easily be applied to heterosexism and to any situation in which a so-called normative standard regarding experience and behavior reigns. The article addresses the major difficulty in recognizing white-centeredness and challenges the common wisdom that white shame and white guilt need to be removed as barriers to the progress toward racial justice. The author addresses inherent power imbalances in the therapeutic setting and offers ideas for managing white guilt and shame productively.
... Self is here understood to be more verb than noun, more event than singular form; a moment-to-moment reformation of subjectivity dependently arisen from a context. This processformation of self is what makes possible structural or ground change, as distinct from shorter-term cognitive or behavioral change (Jacobs, 2003;Parlett, 2005;Yontef, 1993). Here, change can be taken as code for optimal responsiveness, at times a therapeutic end in itself. ...
This article addresses the basis for the centrality of the therapeutic relationship in effective therapeutic outcomes, especially as distinct from technique, which prevails in the 21st-century Australian mental health context as a focus in determining what constitutes evidence-based practice. Presence-oriented therapeutic approaches infer an intersubjective field within which transformative enquiry can occur. This forms the basis of the article’s exploration of the function of the phenomenon of the “field” for intersubjective therapeutic relationship and its relationship to Levinas’ “third” as the basis for transformative, ethical, therapeutic practice. Work on “fields,” in different disciplinary domains that share a focus on understanding underlying processes and patterns of physical and social organization, yields sufficient common ground to speak of a field as a substantive principle on which to base practice. Relational Gestalt psychotherapy has developed the concept of field sufficiently to have evolved principles for working with the felt effects of the field, without firm resolve yet as to the ontological status of relational fields. Paradigmatically the work remains emergent in most disciplines. Further transdisciplinary research into field theory may yield more nuanced analysis of how to work intentionally with field conditions.
... A number of Gestalt theorists, all working primarily with individuals and families, are pointing to the power of more fully embodying in our practice the deeply relational, field-embedded nature of human experience that is at the radical core of Gestalt theory. These writer-practitioners in the therapeutic domain have been demonstrating how to work with their clients while embracing field theory in a more thoroughgoing way (Hycner and Jacobs, 1995;Jacobs, 2001;Jacobs, 2003;Lee, 2004;Wheeler, 2000;Wheeler, 2005;Yontef, 1993;Yontef, 2001). In the parallel universe where the authors of this article live-consulting to large systems--we have been exploring how we might embody a field-relational, dialogic way of working in more complex settings. ...
There is a growing literature describing what a field-relational Gestalt practice looks like in the therapist's office, but little about how to embody a relational stance in non-therapeutic contexts--working with groups, organizations and larger systems. This article attempts to fill that gap. Our focus is aligning our practice with our theory—how do we as consultants incorporate in our moment-to-moment experience and way of relating and intervening the core insights about human nature that makes Gestalt theory so powerful.
ABSTRACT Obesity is a poorly understood growing epidemic. Public perceptions continue to locate the problem with the individual, who is stigmatized, marginalized, and shamed. This article argues that assumptions, namely that psychological issues are causal, are unhelpful therapeutic responses that risk further shame and self-loathing. It proposes a psychotherapeutic approach to obesity with an open, curious therapeutic stance interested in the embodied experience of the client and includes contextual factors shaping the client/therapist field. This dialogical stance has the therapist as a nonjudgmental present other, who is able to hold the client's wants and needs at the center of the work.
Gestalt therapy's ethics and reading of human nature are discussed in this article. While early Gestalt therapy placed an emphasis on the liberation of the individual and was critical towards the prevailing morals of the society of the time, in recent years, this early individualism has been challenged. Critics have focused on the interdependence among human beings and tried to articulate the ethics inherent in field theory. The relationship between the individual and the field can be observed as a polarity within Gestalt. Behind this polarity lie differing basic assumptions about (wo)men. This article discusses three different interpretations of this polarity: antagonism, harmony, and paradox. The author argues that those who advocate an ethics of the field actually are formulating a utopian approach to human nature. This utopian character is illustrated by using Gulliver's Travels and George Orwell.
Dr. Lynne Jacobs’ “On Dignity, a Sense of Dignity, and Inspirational Shame” is an interdisciplinary integration of a priori ethics and a phenomenology of dignity. She contends that the human person’s engagement with other people—writ large in the therapeutic encounter—is inherently ethically situated. Moreover, she avers an inherent content to this ethics, namely, mutual respect for distinctively human value—dignity—between and among people. Her ethics of dignity informs her psychoanalytic exploration of experiences of dignity, indignity, and her notion of inspirational shame, among others. I join in Jacobs’ advocacy for therapeutic facilitation of a person’s sense of inherent worth, as well as her opposition to relational contexts of devaluation and degradation. However, the primordiality Jacobs grants to her ethics of dignity often obscures the constitutively cultural, familial, and personal contextuality of, first, her—and in my view, any—ethical conviction; second, what she describes as the experience of being human; third, the alleged indignity of human vulnerability; and finally, the claim that shame is the natural reaction to one’s failure to live up to personal ideals. In the end, and subject to certain clinical concerns, Jacobs’ article integrates into psychoanalysis primordial ethical duties that she and others claim inhere in us as human beings.
Group therapy, including Gestalt group work, is deeply rooted in group development theories as a principal way of orienting to groups. The author argues that a primarily developmental frame will limit therapists' ability to experience a fuller range of available phenomena. He suggests that therapists broaden their perspective through a grounding in phenomenological field theory. This emphasis on field theory is consistent with the tenets of Gestalt therapy and allows therapists to work in a more relational and experience-near manner.
"COMMENTARY: The following is an edited version of a plenary lecture given at the 4"" British Gestalt Conference in Nottingham in July 1990. I introduce the basic features and history of field theory and suggest that it provides a foundation for Gestalt therapy theory and practice. Five basic principles of field theory are explored. I then argue that the models of knowledge and knowing embodied in field theory form part of the emerging epistemology that characterizes many new areas of inquiry - e.g., holistic medicine and ecology. In the second half of the lecture I apply field theory thinking to a discussion of the ""Self' in Gestalt therapy and to the mutual effects on one another of two (or more) persons relating together. I focus on some new ways to think about the psychotherapy ""field"" of therapist and patient and end by discussing the importance of ""presence."" Keywords: Field theory, Gestalt therapy, new epistemology, psychotherapy relationship, the Self, presence."
Gestalt therapy has long acknowledged its indebtedness to phenomenological philosophy in general and to Edmund Husserl in particular, but ironically in a fashion that disregards the organic context of this work. The result is too often exemplified by discussions of phenomenology that either misrepresent its contribution to Gestalt therapy or apply its insights in stilted or inappropriate fashion. The literal translation of Husserl's reduction as psychotherapeutic method is a case in point. This article asks Gestalt therapy to assess Husserl's method in its own context and to appreciate his real contribution, which was no less than providing a philosophical foundation and justification for Gestalt therapy's reverence for human experience.
This article is a distillation of Maurice Friedman's book The Healing Dialogue in Psychotherapy (1985). With almost no reference to the first, historical part of the book, the article brings together the second, topical part into a compact whole, which isn't done in the book itself. The first section of the article makes explicit the link between philosophy and psychotherapy through a section on "Philosophical Anthropology and the Ontology of the Between." The ontology of the between is the groundwork for that "healing through meeting" (second section) that arises when the meeting between therapist and client is seen as central rather than ancillary. In the third section ("The Unconscious and Dreams"), the unconscious is seen as that personal wholeness that underlies the ever-new elaboration into physical and psychic, outer and inner. Dreams, in consequence, are not raw material of the unconscious but a product of the mixture of unconscious and conscious and of the meeting of the therapist and patient. Existential or real guilt (fourth section), similarly, is a reality of relationship that must be addressed within healing through meeting, and confirmation (fifth section) becomes the decisive key to the development of the person, the origin of psychopathology, and such healing as therapy makes possible. Confirmation in therapy is made possible through what Martin Buber calls "inclusion," or imagining the real, and "making the other present," which induces the inmost growth of the self. Inclusion is different from both empathy and identification in that it is bipolar, remaining on one's own ground while swinging toward the other. The last section of the article expands confirmation into that "dialogue of touchstones" in which the therapist helps the client overcome the impossible choice between alienating everyone through expressing his touchstones of reality and pseudo belonging to the community through suppressing his touchstones. This can be accomplished only in an atmosphere of trust, which includes the confirmation of the otherness and uniqueness of the client.
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