This article is an excerpt from a chapter in, Clinical Activities in Child Therapy: Creative Applications in Therapeutic Practice. Jeff Chang, Editor. 2009 publication date
Felicia Carroll, M. Ed., MA
West Coast Institute for Gestalt Play Therapy Solvang, California USA
Frederick Perls, one of the primary founders of Gestalt Therapy wrote in an article (1948), “The criterion of a successful treatment is the achievement of that amount of integration that leads to its own development.” (pg. 52-53). Fundamental principles of Gestalt Therapy such as holism, organismic regulation, gestalt formation (organization of figure/ground), and the contacting process of awareness to closure support the assumption that a child will function in a way that meets the child’s physical, emotional, social, intellectual, and spiritual needs. The child strives to complete situations from moment to moment paving the way towards healthy growth and development. The child’s behavior is purposeful, balanced, flowing from one experience to another. That is, it is integrated.
However, when the child is unable to interact within his environment with ease because of lack of appropriate support or is overwhelmed with a circumstance in life and is unable to assimilate experience, the child’s sense of self becomes fragmented, lacking in cohesion. The energy that was used for on-going construction and development of the self becomes engaged with internal splits and conflicts. Such childhood experiences result in the child developing a sense that “something is wrong about me,” or “with me,” or even more fragmenting, “I am wrong.” In his efforts to maintain homeostasis or equilibrium in unsupportive life circumstances the child struggles with shame, unassimilated introjects, and a faulty sense of himself and his relationships with others. The child organizes his sense of who he is according these ideas and loses his spontaneous, cohesive involvement in life. The symptoms that bring a child into therapy are indicative of this disturbance of integration.
The Gestalt therapist asks, how can I assist this child to achieve healthy integration in order to restore his path of wholesome development? Violet Oaklander (1978, 2006), is a renowned Gestalt therapist who has written about the Gestalt approach to working with children and adolescents. Her model provides a way of working with children that strengthens their sense of self by utilizing many interventions that encourage the sharpening of the senses, learning direct and productive ways of getting needs met, understanding emotional expression, and becoming more accepting of the various aspects of being a whole person. These elements are experienced in therapy as the child and therapist utilize various creative modalities of expression in addressing the child’s difficulties in life.
In this article I want to tell about one method I have used with children as a part of their on- going therapy which also includes the objectives and activities presented by Oaklander and which is grounded in the principles of Gestalt therapy. The method discussed here involves collaborative telling, writing, and hearing of a story that captures the child’s lived experience, and much more. Engaging in this process allows the child to create a cohesive narrative that supports healthy integration and productive development.
The practice of psychotherapy in the 21st Century is greatly informed by the findings within the field of the neuroscience. This research into how the mind is formed and how it functions has clarified that the mind is an integrated manifestation of complex neurological operations. Daniel
Siegel (2007), one of the recognized researchers and teachers in how the findings from neuroscience can direct the clinical practice of child therapy, writes: “…mental well-being is created within the process of integration, the linkage of different components of a system into a functional whole.” (pg. 288) He uses words such as the following to describe qualities of mental well-being: flexible, adaptive, coherent, energized, and stable functioning. Siegel continues, “Personal transformation can be considered to involve three legs on a triangle of well-being: coherent mind, empathic relationships and neural integration.” (p. 289) Child therapy must incorporate each of these if the child’s mental well-being is to be restored. One of the major tools for such integration and personal transformation is the development of a life narrative that is cohesive and makes sense to the child.
Siegel (2007) speaks for many neuroscientists:
Healing in therapy involves sensing memory in a way in which we experience the textures of affect and somatic sensations in an integrated process as we move from the raw and intrusive natures of unresolved states to the open and mindful presence of resolution. Such a “making-sense” process is fully embodied, not just an intellectual exercise in using words to “explain away” things, but rather to create new insights that bring fresh meaning to old elements of memory. “Making sense” combined with discernment enables us to fully integrate memory into our life story so we can move more freely into the present. ( pp.310-311)
When a child is fully engaged in creating a cohesive narrative of his experiences within an empathic therapeutic relationship, he can move towards the neural integration of those experiences. The inner divisions can be resolved and he can become whole. Siegel poignantly observes that such a narrative can provide the person with a “bare understanding of a primary self beneath all the adaptation and struggle. Within the story of our lives is the essence of who we are.” ( pg. 311)
The title of this article is adapted from the fascinating book, Every Person’s Life is Worth a Novel (1987), by E. Polster. In the introduction to his book, Polster writes, “. . . the novelist and the therapist both invite us to open the covers of our own lives in order to find the marvels inside, painful or pleasurable. When we do, we move toward the satisfactions of a confirmed existence.” (pg. x) Each person, young and old alike, needs such confirmation of his existence which requires that his story be created and heard. A cohesive narrative provides a bridge that can be used in psychotherapy to create meaning in the lives of children. The meaning a child gives to the raw experience of life can influence greatly, if not determine, the trajectory of that life.
My approach to creating a child’s life story has been influenced by Jan Hindman (1989) and Joyce Mills (1989). Hindman’s work of creating trauma assessments for victims of sexual abuse helped me to appreciate the significance of facing the full sensory, relational, emotional, thinking details of trauma with children. The work of Mills (1989) on the use of metaphorical storytelling has provided me with invaluable tools for structuring life narratives and the use of sensory-emotional language for children. Even though the stories that I write are clearly the child’s story and not a metaphorical device, I have found the elements that go into structuring a therapeutic metaphor to be invaluable.
This process of capturing a life within a biographical story is very effective with children who have experienced acute or ambient trauma. In one case, two year old, Max, was severely traumatized by medical procedures during open heart surgery and recovery, even with the most supportive of circumstances. His parents were present, responsive, loving. The hospital staff was friendly, caring, and competent. However, Max’s embodied experience was overwhelmingly painful, terrifying, and shattering. Three years later when he came into therapy, he still struggled to find a way of engaging with this experience that would allow him to have a meaningful closure, to allow an integration of these memories so that his life could become more flexible, adaptive, coherent, energized, and stable.
Other children with whom I have written stories have experienced disruptions in their primary attachments . Children who are in foster care; who have been adopted; who have been
abused; or whose families have been destroyed due to divorce or death, benefit greatly by telling and hearing their experiences captured as a story that affirms their struggle and those strengths and courage that they had in facing these life circumstances. Some losses involve other kinds of relationships. I am currently writing a story for a girl whose beloved dog has been killed by a car in front of her house.
Children with other developmental disorders also respond well to this intervention. I have in my practice children diagnosed with Asperger’s Syndrome. These children manifested a vitality and focus through hearing their stories in which they felt they were deeply understood.
Every child’s life is full of struggle, disappointment, fear, uncertainty, as well as success, joy, reward, and accomplishment. These ordinary events become the makings of stories that help a child to recognize the remarkable person that he is. Finding the extraordinary is the stuff of great novels; and every novel is a case history (L. Perls, 1989). As the child hears her story she can recognize the person she is within the experiences of the story’s protagonist. She can find the gestalt, the meaning within her own lived life.
I am often asked what “gestalt” means. Simply answered, it is a German term that refers to a configuration that is so integrated that it is viewed as something different than the sum of its elements. A gestalt is characterized by coherence, boundedness, and meaningfulness. Once a gestalt is established, our minds lose interest in continuing to organize its structure. An unfinished experience becomes finished, and we move on to what comes next.
In writing and hearing the life narrative for the child, we provide him with a means of making sense of a previously chaotic, disorganized jumble of experiential events. These stories create for a child a clear configuration of a finished situation. Through the story the child and I can experience together the criterion of successful Gestalt therapy. He can come more fully into the present, achieve closure, and begin to assimilate and create meaning in his life. A cohesive life narrative will bring the child home to a stronger sense of self, instead of wandering away from the essence of who he is. We can achieve that amount of integration that leads to its own development so that the child goes forward into the never-ending adventure of living.
Carroll, F. (1997, 2009). Gestalt play therapy. In Play therapy: theory and practice: a comparative presentation. K. O’Connor and L. Braverman (Eds.) New York: John Wiley and Sons, Inc.
Carroll, F. (2002). The Pinocchio syndrome. In The heart of development: gestalt approaches to working with children, adolescents and their worlds, vol. I: Childhood. G. Wheeler and M. McConville, (Eds.) New Jersey: The Analytic Press.
Carroll, F. (2007). Every child’s life is worth a story. Workshop presentation. September, 2007. Koln Institut fur Kindertherapie. Koln, Germany.
Hindman, J. (1989). Just before dawn. Boise, Idaho: AlexAndria Associates.
Mills, J. and Crowley, R. (1986). Therapeutic metaphors for children and the child within. New York: Bruner/Mazel.
Oaklander, V. (1978) Windows to our children: A Gestalt approach to children and adolescents. Moab, UT: Real People Press. (New York: The Gestalt Journal Press, 1992).
Oaklander, V. (2006). Hidden treasure: A map to the child’s inner self. London: Karnac Books.
Perls, F. (1948). Theory and techniques of personality integration. In J. Stevens (Ed.) Gestalt is. … Moab, UT: Real People Press, 1975, 45-55. (Originally printed in The American Journal of
Psychotherapy. 2(4), October 1948: 565-586).
Perls, L. (1989). Every novel is a case history. Gestalt Journal. Vol. XII, No. 2, pp. 5-10.
Polster, E. (1987). Every person’s life is worth a novel. New York: W. W. Norton & Company, Inc.
Siegel, D. (2007). The mindful brain: reflection and attunement in the cultivation of well-being. New York: W. W. Norton & Company, Inc.