Anxiety Treatment: Gestalt Therapy Theory
I treat anxiety in its many forms. We have different names for it: social anxiety, generalized anxiety, performance anxiety (also click here for more on my work treating people with performance anxiety), and panic attacks, for example. I’m often asked for tips on how to manage anxiety and there are many tips online as well as some good book recommendations for books on self help for anxiety, and if you suffer from anxiety it is worth exploring some of these coping strategies.
In this article I want to explore how I work with anxiety and stress, based in gestalt therapy theory. In the article that follows I will look at typical ways I might work with anxiety in therapy. Then I will address some of the results that my clients have had in working with their anxious symptoms.
What is anxiety?
How does gestalt therapy think about anxiety? Let us start by unpacking a definition of anxiety found early on in Perls, Hefferline & Goodman, Gestalt Therapy: Excitement and Growth in the Human Personality (Gestalt Journal Press Edition, 1994)
We shall, for instance, consider anxiety, the pervasive factor in neurosis, as the result of the interruption of the excitement of creative growth (with accompanying breathlessness)… (p. 7)
First of all, anxiety is “the pervasive factor in neurosis”. The dictionary definition of neurosis today is a mild mental illness characterized by stress that can express itself in depression, anxiety, obsessive behavior, hypochondria, but not a break from reality in the form of hallucinations or delusions.
When we talk of neurosis we are also taking into account how the world is not always a healthy place that welcomes us in our most healthy state. We can see neurosis as a series of habitual adjustments, our best attempt to survive and thrive.
Gestalt therapy deals with how we form and shape ourselves and our world and particularly pays attention to the threshold between self and world. How do we adjust ourselves and how to we respond to what we encounter as we also make and mold our world? One could argue that our situation now is not all that healthy, and a neurotic adjustment to the world is completely natural and helps protect us from the stressors we encounter. Certainly in the people I see living in a major urban center stress and anxiety are rampant and seem to be inevitable. However, I would argue that many of us can work with and know better the adjustments that we are making so that we can meet the world more fluidly.
Anxiety as the interruption of the excitement of growth
“…as the result of the interruption…”: we stop ourselves, we interrupt the energy and send it off in a different way. We might discharge it by overeating, overdrinking, overindulging or by having a panic attack. We might stop it in one of the classic ways that gestalt therapy theory talks about interruption: projecting it onto someone else, taking it in as if it was our own when it is not, turning the energy we want to send out into the world back on ourselves (angry at our partner, without enough support for that anger, we feel anxious and then criticize ourself),
“…of the excitement…” Anxiety and excitement are closely linked—here anxiety is an interruption of excitement. Elsewhere in the book Goodman talks about the close connection between anxiety and excitement. Think of the performer waiting to go on stage. The symptoms of anxiety are practically the same as the excitement of waiting to begin: energetic, physically in a ready mode, anticipating. The only difference is the story we tell ourselves, the imagined ending: it is going to be embarrassing, vs. I’m going to go out there and have fun.
“… of creative growth…” Creative growth (as stated elsewhere in Gestalt Therapy) is the experience of ourselves forming something new, our next experience. If we can move into and experience something new, such as speaking what felt forbidden, we tolerate the anxiety on the way to the novel. If not, if either our fear overtakes us or we dull it out into a chronic, low-grade situation when we cannot find our way to the new experience. We repeat, we stop ourselves, we erase our differences to be like others.
We interrupt with breathlessness
“…(with accompanying breathlessness).” When we are growing creatively we need healthy support, and breathlessness is the body’s experience of cutting off the support of healthy give and take from the environment. Hold your breath for a few seconds and see what happens. How much of the world seems there for you? Do you withdraw inwards? Do you begin to feel stressed or restless?
Breath is both metaphor and lived experience of support, one of the reasons why almost every discussion of coping methods for anxiety tells you to breathe, or to pay attention to your breath. Because it is hard to find yourself without that support.
Exploring Support
Our breathlessness, and the other ways we constrict ourselves in anxiety, do not just happen to us. We are restricting ourselves. For example, we restrict our breathing and the tensing of those muscles in a more chronic, habitual way leads to a more pervasive tension.
Part of the work of therapy is to feel how we do this. In the process we learn about how we can do or not do, that is, we begin to understand why it has been important for us and to take a fresh look at whether we need to tense and constrict now.
Working with anxiety: the therapy process
I’ll have more to say about anxiety treatment in the next article in this series of three (Anxiety and Gestalt Therapy Theory, Anxiety and Gestalt Therapy Interventions, and Anxiety and Gestalt Therapy Results). However a few hints here.
We explore the adjustment that produces the anxiety; it may be producing this unwanted symptom, but it is there for a reason. Few people will willingly throw away what seems to be working. We will look at how it works AND how it does not work.
We look at the process of how you do it, so you can get more ideas and feelings about how you might experiment with something different.
And we look at the world, and grow your ability to see what is there for you and use it for support to experiment.
Gestalt therapy is a lively, creative, powerful modality and if you are interested in trying this kind of work for acute or chronic anxiety feel free to be in touch. You can email me, call, or use my client portal to schedule a complimentary consultation.
