vironment across a boundary that preserves the dialogue in ...gti.today/resources/jacobs.pdf ·...

-growth and development are dialectical events. They in-volve an integration of meetings between self and en-vironment across a boundary that preserves theparticipants' important differences. In such meetings,both are changed. Gestalt therapy can contribute farmore to the practice of psychotherapy as a whole throughretaining its originality and extending its theoreticalreach, compelling the other schools to grapple seriouslywith its implications. In the process both will be altered.But for this purpose we need to have all the historicalwritings on Gestalt therapy readily available, so that theycan be widely read, argued over, and tried out. GestaltTherapy Verbatim, in its curious tangle of one man'spredilections with a spirit of individualism and improvisa-tion, its theatrical daring combined with accommodationto its era, remains the most dramatic and influentialrecord of Perls's last few years.

DIALOGUE IN GESTALTTHEORY AND THERAPY

Lynne Jacobs

Hycner (1985), in a thoughtful and stimulating arti-cle on the concept of dialogue in Gestalt therapy, askedfor more public discussion to clarify the implications ofMartin Buber's philosophy of dialogue for Gestalt theoryand practice. His article is the impetus for me to contrib-ute my thoughts on the matter.** Hycner describedclearly and simply the basic premises of Buber's philoso-phy of dialogue. I shall elaborate on connections betweenthe philosophy of dialogue and the theory and practice ofGestalt therapy.

*This paper represents my early thoughts on a subject which is stillevolving. Although some of my thoughts have changed since I wrote thispaper, it become clear to me that if I wait to become current with myown thoughts I will never publish anything.I am deeply grateful to Richard Hycner, Ph.D., and GaryYontef, Ph.D., for their thoughtful and thorough criticisms of this paper.I am solely responsible for the content.

**The majority of this paper is taken from my doctoral dissertation,I-Thou Relation in Gestalt Therapy, California School of Profes-sional Psychology, Los Angeles, 1978. See also Enright, 1975;Friedman, 1985; Hycner, 1985; Kempler, 1973; Naranjo, 1975, Yontef,1975,1976; Zinker, 1975.

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The Gestalt Journal Vol. XII, No. The Gestalt Journal Vol. XII, No. 124

DIALOGUE IN GESTALT THEORY AND THERAPY JACOBS

There are two major foci when describing the na-ture of the relationship in any therapy: the role of the re-lationship in the overall therapy process (the impor-tance of the relationship as a curative factor vis-a-vis theother curative factors, as well as the extent to which therelationship per se is a focus of therapy), and the charac-teristics of the relationship in that therapy (the rangeof permissible and valued therapist behaviors, and thestructure of the patient-therapist relationship).

The relationship in Gestalt therapy is not clear cutand simple to describe; while there does seem to bewidespread agreement on the characteristics of the rela-tionship, full understanding of the role of the relationshipis still evolving. In keeping with existential values, thecharacteristics include a non-hierarchical structure andan emphasis on full and genuine engagement betweenpatient and therapist. But there has been little attentionto the role of the relationship in the literature, and rathera wide range of opinions on the subject in the oral tradi-tion. In the past there appears to have been two majoremphases: one, exemplified by Isadore From and thePolsters, which focused on contact; the other, representedby Perls, Hefferline and Goodman (and more widely pub-licized), which focused on awareness work. In my opinion,when the implications of the catch-phrase "I and Thou,Here and Now" are fully apprehended, one will find thatthe restoration of awareness of which Perls et. al. writecan only occur when the therapy operates from an I-Thoucontext in which the process that Buber describes as"dialogue" is encouraged and developed.

In the dialogue of which Buber writes, all living is ameeting. There is no "I" which stands alone, but only the"I" of "I-It" and the "I" of "I-Thou." There is an alternationbetween those two modes of existence. The I-It mode isvitally necessary for living, the I-Thou for the realizationof personhood. As Buber stated,

Without It a human being cannotlive. But whoever lives with onlythat is not human. (1970, p.85)

The I-It mode can be considered the "ego" mode (Farber,1966). It involves such functions as judgment, will,orientation and reflection (Farber, 1966). It also involvesself-consciousness and the awareness of separation(Friedman, 1976b). It is in the I-It mode that a person or-ders living in time and place. Importantly, ideas and feel-ings, and attempts to make oneself understood to others,all comprise the world of I-It.

In contrait to the necessary separation of I-It, the I-Thou relation is integrative, and affirms one's wholeness:

The basic word I-You can only bespoken with one's whole being.The basic word I-It can never bespoken with one's whole being.(Buber, 1970, p.54)

The I-Thou relation has the qualities of immediacyand directness, presentness, and mutuality (Farber, 1966).It is a full-bodied turning-toward-the-other, a surrenderto, and trust of, the "between." The I-Thou relation isseen :

...not as dimension of the self butas the existential and ontologicalreality in which the self comes intobeing and through which it fulfillsand authenticates itself.(Friedman, 1965a, p. xvii)

When two people surrender to the "between"called "existential trust" the possibility of I-Thou rela-tion emerges. But it will always be a temporary state.Both will return to the world of I-It, necessarily. Exis-tence in either mode is an evolving process in dynamic re-lation to the other mode. Each alternates as backgroundfor the other. The hallmark of creative and healthy livingis finding the proper balance between these modes inone's life (Hycner, 1985).

Before I describe the implications for the practiceof Gestalt therapy, I will describe how Buber's philosophyP) fL_XJ

of dialogue meshes with the concepts of contact, aware-ness, and the paradoxical theory of change.

I-Thou and the Theory of ContactingEssentially, the I-Thou relation, or dialogue can be

seen as a specific form of the contacting process. Con-tacting is a process common to all organisms and all typesof activity. I-Thou is a specific form of the contacting pro-cess between two people, through which each person real-izes most fully their distinct humanity. For one'shumanity is manifest only in dialogic relation to others. Itemerges from, and requires, self-awareness, a uniquelyhuman characteristic.

This specific form of contacting requires certain"elements of the interhuman" to be present for thedialogue to inhere (Buber, 1965b). These elements,presence, genuine and unreserved communication, inclu-sion and confirmation, will be described later in thepaper.

Buber says of the I-Thou relation that-it is lived inboth "actuality and latency" (1970, p. 69). This is impor-tant, because although most attention is given to themomentary experience of an I-Thou relation, I-Thourefers both to this special moment and to an underlyingprocess. This distinction, while relatively unimportant tounderstanding the phenomenon and significance of I-Thou, is of particular importance to the practice oftherapy, for milch therapy is conducted in an I-It mode,with I-Thou in the background. Thus, while Bubermakes no formal distinction between the two, I dis-tinguish between the I-Thou moment, and the dialogicpro cess.

Hycner (1985) prefers the term "dialogue" to de-scribe and differentiate I-Thou process from the I-Thoumoment. I worry that the term "dialogue" is used so com-monly in our language that Buber's specific meaning maybe ignored. But I agree with his need to differentiate thetwo uses of I-Thou, and his preference for de-emphasizingthe "peak moment" in favor of a discussion of on-goingprocess. So I too shall use the term dialogue.

In the prologue to I and Thou, Kaufmann assertsthat there are many modes of I-Thou (1970), p. 16). Thewriting in Buber's I and Thou focuses largely on themost intense and exalted moment of I-Thou (Kaufmann,1970). But some of his later writings, particularly on edu-cation, pay more attention to the process- to the varia-tions where It and Thou are intermingled (Buber, 1965a,1965b).

A teacher whose students are the means for gratifi-cation but who also cherishes the unique development ofeach pupil engages in I-Thou relation. One who asksdirections of another with the genuine courtesy that com-es from appreciation of personhood has permeated meanswith I-Thou relation (Kaufmann, 1970). When one is usedas a means, with full respect and appreciation that one isan end also, then there is I-Thou (Kaufmann, 1970).

I-Thou MomentThe I-Thou moment is a special moment of insight

or illumination wherein the participants confirm eachother in their unique being. Such moments occur at vari-ous times during genuine dialogue, and are often cul-minating points of the dialogic process. The I-Thou mo-ment is the most intense moment of what Polster andPolster (1973) call a contact episode. Any experience ofan I-Thou moment is a confirmation of the possibility ofintegration and wholeness, a confirmation of the healingprocess by which one can restore one's relation to theworld.

Sometimes this moment of illumination occurs be-tween a therapist and patient who engage so unreservedlywith each other that the essential being of both persons istouched. In Gestalt terms, such a completed contactepisode is the realization of the Gestalt formation processwithin the special context of what Buber calls an inter-human event. A clinical vignette from my own experiencewill illustrate this:

The patient was argumentative andcritical. She claimed to bedesperate for help, but disparagedmy attempts to understand her and


to be helpful. I tended to reactwith unaware defensiveness by tak-ing a particularly superior, au-thoritative stance toward her. Themeeting the momentary I-Thou

occurred after I realized that Iwas defensive, and decided to bemore attentive to my owndefensiveness.

The next hour, I found myself againreacting defensively. I began to"disclose" this to the patient, whilestill operating from my defensive,authoritative stance. Suddenly Irealized that at that moment Iwas still protecting myself by push-ing against the patient.brightened and exclaimed, "See!Oh my, I'm doing it right now!Damn it, E---, you are just toogood. I give up!" I began laughingat my own absurd attempts tocoerce the patient. The patient,surprised, also laughed heartily.She admitted she was very good atwhat she was doing, and enjoyed it,although she always left feeling bit-ter and dissatisfied. What ensuedwas our first authentically coopera-tive exchange of ideas. Both of ushad gained a renewed respect forthe anxieties that had driven usinto defensive styles at the expenseof presence with each other.

In the above example, the contact episode moved into anI-Thou moment. This was possible because in an instant

of immediate, spontaneous awareness, I experienced afull acceptance of our being-in-situation, that is, my ownand the patient's defensiveness. This acceptance, andthen the patients's willingness to be affected and torespond with her acceptance, allowed both of us to bewho we were, fully.

There is another way the I-Thou moment enterstherapy, and that is when the patient's saying "Thou" tothe therapist frees the therapist to enter I-Thou relation.The strand of Gestalt therapy which emphasizes en-counter between patient and therapist encourages suchmoments. For me, these moments often happen when Iam stuck in my own defensiveness or frustration, and thepatient recognizes this and points out what is happening,with the attitude of, "It's too bad we've gotten so messedup here. What can we do?"

Once recently a patient said to me, "I can tell whenyou are on your guard with me. You become sarcastic.Have I done something that pushed on you just now?"

I felt relieved to be able to pull back for a moment.I realized I had felt pressured by her conflicting messagesto me, and was trying to coerce her into being morestraightforward so that I would not feel pressured.

As Polster and Polster (1973) said when talking ofcontact episodes,these moments "endow the therapy withsubstance and drama." They are the critical moments thatbring the whole process together, render it meaningful,and release the possibilities for its participants.

Farber's idea that the I-It "ego functions" providegrounding for the I-Thou moment parallels the Gestalttherapy view that the directed and willful actions of themiddle state of contact are important for the successfulresolution of a contact episode (Farber, 1966; Perls et al.,1951, p. 402). This usage does some injustice to Buber'sconcept of I-Thou, in that not all contact episodes are dia-logic episodes. Dialogic episodes involve the further"becoming" of two people. Contact episodes which in-volve, say, realizing one's hunger and satisfying it ap-propriately, do not involve the development of one's per-son, and so are not dialogic processes. But the referencesto I-Thou can be seen as an attempt to capture the flavorof this particular moment of contact:


The lively goal is the figure and isin touch. All deliberateness isrelaxed and there is a unitary ac-tion of perception, motion andfeeling. The awareness is at itsbrightest, in the figure of the You.(Perls et al 1951, P. 402)

The I-Thou moment has some of the terrors of the im-passe. There is a danger of symbolic death. In the im-passe this occurs as one gives up one's self-image in orderto contact one's emergent sense of self. In the moment ofI-Thou, the danger is that one's boundaries willpermanently dissolve. There is a softening of one'sboundaries, and sometimes the intensity of the momentfeels explosive. But both Buber and Gestalt therapy as-sert the faith that surrender to the experience will takeone through symbolic death into symbolic rebirth (Brown,1977; Farber, 1966).

In Gestalt therapy, contact has the polarities ofisolation and of confluence. The danger in meeting isconfluence. The risk of moving toward contactful engage-ment is that one will become engulfed by union with theother. In addition to this fear of being entrapped in con-fluence is the fear that after the compelling, rending in-tensity is over, one's loneliness and isolation will be evengreater than before. A person who has settled for the"security" of isolation fears dialogue as a disruption of thisstate. For such a person,

The I-Thou relation is not an un-qualified good. In its lack ofmeasure, continuity and order itthreatens to be destructive of life.The moments of the Thou are"strange lyric and dramaticepisodes, seductive and magical,but tearing us away to dangerous

extremes, loosening the well-triedcontext, leaving more questionsthan satisfaction behind them shat-tering security." (Friedman, 1976b,p. 60)

Farber (1966) points out that the more alienatedone is, the less one can rejoice in either I-It or I-Thou (p.148). When split off from the I-Thou realm, the I-It worldis impoverished, lonely, and so divorced from its dynamicrelation to I-Thou that it provides no support for enteringinto dialogic relation. The danger becomes that a mo-ment's grace in dialogue will leave one all the moreprofoundly lonely when the moment is gone. Farberpoints to the most obvious and painful example of theschizophrenic, who has no continuity and order and can-not assimilate the "lyric and drama" of I-Thou. These in-tense moments tend to send such a patient into furtherretreat, further isolation, and further despair.

Thus, the two dangers of isolation and confluenceawait on either side of the I-Thou moment, the moment offullest contact of one being with another. The problem isthat contact cannot be made static. The boundaries ofself and other shift, and there is mutual influence whichcannot be predicted. If one wanders too far too long, oneis in danger of becoming so far removed as to lose sight ofthe way back. Or one's boundaries may disappear in themerging with the other, or may explode from intensity.One can never know the balance in advance, but followingit allows one to live fully in the present, and to come toknow one's own possibilities.

The importance of contacting for one's identity as ahuman being what makes it so compelling and also socomplex is the way it is different from contactingamong all organisms. The interhuman contacting.processis the process by which we come to know ourselves andothers,to apprehend our human existence and that ofothers. From Buber's perspective, contacting takes onimportance not only for organismic self-regulation, butalso for our specifically human ontology.All individuals have an urge toward growth. InGestalt therapy this is described, under holism, as the

DIALOGUE IN GESTALT THEORY AND THERAPYJACOBS

"press for closure" whenever Gestalten form. When acontact episode is begun, the individual is motivated tofinish the episode in the most growth-producing manner,given the current conditions of the organism-environmentfield (PerIs et al., 1951). I think this same principlemotivates the individual toward dialogue. The contactingthat occurs within the dialogic relation involves more ofthe being of the person than does any other kind of con-tact. The I-Thou moment is a moment in which we are to-tally absorbed with another, which paradoxically puts usprofoundly in contact with our humanity, with the knowl-edge of being; in this moment the meaning of human exis-tence is revealed.

Dialogue establishes the ontological significance ofcontacting. Contact is the means by which we feed our-selves, by which we understand, orient, and meet ourneeds, but cast in the light of I-Thou, contact alsostands at the ontic center of the psychological andspiritual development unique to our human exis-tence. For Buber stressed over and over again that onlythrough dialogical relation can one come to know theuniquely human aspects of one's self (Friedman, 1976a),and that genuine dialogue between persons is most cen-tral to realizing the full potential of the person(Friedman, 1976b, p.61).

I think that many Gestalt therapists operate froman appreciation of the ontic significance of contacting,and in fact most of the clinical as opposed to theoreti-cal literature on contacting focuses on contact as it oc-curs between persons (Latner, 1973; Polster andPolster, 1973, 1976). Compare the following quotationfrom Polster and Polster with Buber's statement that themoment of "meeting" in the dialogic process is "ontologi-cally complete" in simultaneously knowing and beingknown by the other, and that in such a moment the "in-most possibilities" of the person are released (1965b, p.71):

Contact is not just togetherness orjoining. It can only happen be-

tween separate beings, always re-quiring independence and alwaysrisking capture in the union. Atthe moment of union, one's fullestsense of his person is swept alonginto a new creation. I am no longeronly me, but me and thee make we.Although me and thee become wein name only, through this namingwe gamble with the dissolution ofeither me or thee. Unless I am ex-perienced in knowing full contact,when I meet you full-eyed, full-bodied, and full-minded, you maybecome irresistible and engulfing.In contacting you, I wager my inde-pendent existence, but onlythrough the contact function canthe realization of identities fullydevelop. (Polster and Polster, 1973,p. 99)*

The dialogue that Buber describes is also a trans-cendental process. Thus, when contacting is in the formof dialogue, the contacting process becomes itself anevolving, spiraling developmental process. For Buber thisdevelopment toward the higher reaches of existence was aproduct of his basic trust in the sphere of the "between."He had faith in the dialogic relation as it developed anddeepened. In the language of Gestalt therapy theory, asthe contact process unfolds, one must have faith in one's"coming solutions" if the contacting process is going toresolve itself well. In both cases there is a surrender to

* Both Erving and Miriam Polster are widely regarded as model "dialo-gical" therapists. But in their writings they refer to "contact" to describethe existential patient-therapist relationship. In fact, some of the surgeof interest in dialogue in Gestalt therapy can probably be traced mostdirectly to the influence of their book, Gestalt Therapy Integrated(1973) which deals extensively with contact issues. Interestingly, a laterarticle of theirs (1976) refers only to contact: awareness is not men-tioned at all.


DIALOGUE IN GESTALT THEORY AND THERAPY

the forming moment, rather than an attempt to controlwhat will happen next. When the contact episode is an in-terhuman event, then trust in one's "coming solutions"translates into trust in the between. Contact with anotherperson involves entering into dialogue without controllingthe other half of the dialogue.

In sum, in Gestalt theory, the ontic importance ofcontact is stressed by some authors, such as the Polsters.Buber emphasizes even more that the specific form ofcontact dialogue becomes the ground of self-realization. In Buber's view, contacting stands at the cen-ter of development, from psychological to spiritual. Andfor human beings, the raison d'etre of contact is that ittakes one beyond mere survival into the realm of one'shumanity.

I-Thou, Awareness, and the Paradox of ChangeBuber says that dialogic relation unifies one's soul

and makes one whole (Friedman, 1976b, p. 97), whereas inGestalt therapy, wholeness comes through awareness(Latner, 1973, p. 55). Actually, Perls, Hefferline andGoodman stress contact, with awareness as a subset, butfor many Gestalt practitioners awareness has become amajor focus, while contact has receded into the back-ground. For me, all three positions are intimately related.Contact, dialogue as a specific form of contacting, andawareness are all compatible aspects of a single wholewhen Gestalt therapy's phenomenological approach toawareness is taken into account.

Hycner (1985), believes that a dialogical Gestalttherapy would not take awareness as a goal, but rather therestoration of full dialogue. Yet he also admits that onecannot aim at dialogue. I agree one cannot aim. In fact,having the restoration of dialogue as the goal of therapygoes counter to the dialogic position that the patient isthe only one who can choose his or her existence. I hopeto show that a focus on dialogue does not change the Ges-talt therapy emphasis on awareness as the goal of therapywhen the ontic implications of awareness are fully un-

JACOBS

derstood. For the awareness process which Gestalttherapy posits is a full-bodied "turning-toward" existencewhich by implication is a precondition of dialogue.

For PerIs (1975b):

The criterion of a successful treat-ment is: the achievement of thatamount of integration which facili-tates its further development. (p.53)

Yontef (1976), defines integrative awareness inGestalt therapy:

(Awareness) is the process of beingin vigilant contact with the mostimportant element in the individu-al/environment field with fullsensorimotor, emotional, cogni-tive, and energetic support.

Awareness allows one to respondto a given situation in a fashion ap-propriate to one's needs and to thepossibilities of the situation.Awareness is integrative. Whenone is aware, one does not alienateaspects of one's existence; one iswhole. (p.67)

In order to experience this integration or whole-ness, one must not stand in judgment of one's experienc-ing process, must not discount or alienate aspects ofoneself. The phenomenological approach in Gestalttherapy provides the discipline for this kind of aware-ness(Yontef, 1976). In the phenomenological approachtherapists and patients bracket off, or put aside, theirpreconceptions about what experiences are relevant, andallow their sensory processes to discover whatever isrevealed by the self and the situation (Yontef, 1976).This phenomenological attitude implies accep-tance. Patients who can accept themselves will have no

need to judge and deny their experience. In the therapyrelationship, the therapist's acceptance seems to open forpatients the possibility of self-acceptance, and thispermits patients to deepen their own awareness.

Our deepest, most profound stir-rings of self-appreciation, self-loveand self-knowledge surface in thepresence of the person whom weexperience as totally accepting.(Zinker, 1975, p. 60)

From the stance of the phenomenological attitude, onemoves along the awareness continuum into the integrativemoment of awareness, much as I-It experience can spillover into an I-Thou moment.

Polster and Polster (1976) describe well the faithGestalt therapists have that integration evolves from theprocess of following the awareness continuum of bothpatient and therapist:

When the therapist is absorbedwith what is current, and brings thepatient's attention to current expe-rience, a resuscitative process isstarted which brings liveliness tovery simple events....

Amplification of experienceemerges organically when one paysattention to what is already hap-pening. One of the great recogni-tions of Gestalt therapy is that at-tending to one's own personal ex-perience from moment to momentmobilizes the individual into agrowth of sensation and an urgencyfor personal expression. As thismomentum gathers greateramplitude from each moment tothe next, it impels the person to sayor do what he must. This progres-sion leads to closure; to the com-pletion of a unit of experience.

With closure comes a sense ofclarity, as well as an absorption infresh developments without thepreoccupation which unfinishedsituations call forth. (p. 260)

When a person's awareness evolves from thisground of the phenomenological attitude, then the char-acteristics of dialogic process are present. The awarenesschanges and transcends itself (Yontef, 1976), just as thedialogic process does. More important, in the bracketingoff process, one allows for directness and mutuality in-herent in dialogue by not putting one's categories be-tween oneself and the situation. The situation can affectone however it will. And finally, one's whole person is in-volved; one is fully present. Thus it could be argued thatthe full awareness which Gestalt therapy values is an ex-pression of dialogic relation.

The acceptance of the phenomenological attitudeis not required of just the patient. In order to foster thepatient's awareness, the therapist must also share in thephenomenological attitude. Beisser's (1970) suggestionfor the therapist's stance in the "paradox of change" im-plies the acceptance inherent in the phenomenological at-titude. Beisser asserts that the therapist must take thepatient where the patient is. He expresses faith that if oneinvests oneself fully where one is, then one will changejust because all living is a process. The Polsters (1976)say that a therapist believes in two axioms: what is, is,and one moment flows into the next. The acceptancethat Buber describes in the I-Thou relation "ack-nowledgment" includes this faith in the process.

A true apprehension of the dialogic attitude advo-cated by Buber provides a grounding for therapists whowish to operate according to Beisser's paradigm. Iftherapists function from the perspective of I-Thou, thenthey have no desire to "change" patients, only to under-stand their existence and to "meet" them. They will not beseduced into becoming a coercive change agent con-fronted by a helpless patient. They will be free simply tobe with the patient as person-in-conflict. Dialogue pro-vides therapists with support for following Beisser'sparadigm of the paradoxical theory of change.

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In sum, change occurs with supported awareness ofwhat is. The awareness comes by investing oneself inone's present experience, with no demands to change andno judgments that it should not be as it is. The acceptanceof the I-Thou relation permits a deepening of awareness,and is itself an embodiment of the prerequisite forchange, which is acceptance of what is. In this way, aware-ness and the I-Thou relation are integrally related.

Dialogue in The Therapy ProcessI have suggested that the basic contact and aware-

ness processes are preconditions for dialogue; also, thatthe dialogue is a specific form of the contacting processconcerned with the illumination of interhuman becoming.The dialogic relation serves as an interpersonal model ofthe phenomenological approach to awareness valued inGestalt therapy. Now I shall attempt to integrate theseimplications into the practice of Gestalt therapy by dis-cussing dialogic relation (I-Thou process), and the dialog-ic attitude (I-Thou attitude) in the practice of Gestalttherapy.

Dialogic RelationAs I mentioned earlier, Buber asserts that for

dialogue to occur, certain "elements of the interhuman"must be present (Buber, 1965b). The elements of whatBuber calls "genuine dialogue" the I-Thou process as itoccurs between human beings are (1) presence, (2) gen-uine and unreserved communication, and (3) inclusion.In therapy, these conditions become the prerequisites fordialogic patient-therapist relationship. Each element willbe discussed below in terms of its application to Gestalttherapy.

PresenceThe most basic element, and the most difficult, is

presence, as opposed to seeming. One is present whenone does not try to influence the other to see oneself onlyaccording to one's self image. While no one is free ofpretense the desire to be seen in a certain way

presence must predominate in genuine dialogue. For in-stance, a therapist must give up, among other things, thedesire to be validated as a "good therapist" by the patient.When a therapist "heals" primarily in order to be ap-preciated as a healer, then the dialogic process is inter-rupted. The other has become an object, a means only,not an end also. Therapists' love for healing must be"uninvested," must not occur only to suit their needs for acertain self-image.

Presence cannot be legislated. But the resistanceto it can be examined. Buber and Gestalt therapy valueauthenticity and encourage both patient and therapist tobe in touch with each other's personhood.

In a therapy where contact is seenas a major organ of personality, thepersonhood of the therapist isgiven central importance in thecreation of behavioral change . . .

What is more crucial than [alisting] of desirable characteristicsis the unavoidable fact that, socialdesignations aside, the therapist is,after all, a human being. As one,he or she affects one. (Polster andPolster, 1976, pp. 267-268)

If "seeming" rather than presence predominates,then only poor-quality contact is possible. Wherepresence is difficult, many Gestalt therapists take thetime to explore what their difficulty is, in order to fostergreater ability to be present.

For instance, when I become defensive, I assume aself-protective posture of superiority. My therapy has im-proved as I have learned to recognize early my defensivefeelings, and at minimum I can make contact with mypatient around that issue.

Presence involves bringing the fullness of oneselfto the interaction. Therapists must be willing to allowthemselves to be touched and moved by the patient. TheGestalt therapist also tends to use the full range of emo-tions and behaviors. Eye contact, physical touching, andmovement all bespeak of one's presence.

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Being present also means being willing to be bothpowerf ul and power/ess. A therapist can be a powerfulhealing influence. At crucial times the loving attitude ofthe therapist seems to provide an experience of grace forthe patient. But ultimately the therapist is powerless tochange the patient, and sometimes the pain of wanting tomake the patient's life better but being powerless to do sois keenly felt. The therapist who is present brings thispain too to the meeting.

Genuine and Unreserved CommunicationA corollary of this principle of presence is the re-

quirement that one's participation in the dialogue be gen-uine and unreserved. By "unreserved," Buber did notmean to say that all that occurs to someone must be said.Words that are impulsively spoken but are not relevant tothe task at hand can serve to obscure genuine dialogue.What must be "unreserved" is the person's willingness tobe honestly involved, and to say what one believes willserve to create conditions for dialogue, or further the on-going dialogue, even if one is fearful of how they will bereceived. Unreserved communication does not precludesilence, but the silence must be a genuine responding andnot based on protecting oneself or the other from one'sself-expression. One must assume willing responsibilityfor the unreserved expression of that which occurs to onein the process of the dialogue.

In Gestalt therapy, unreserved communication,stemming from the therapist's authentic presence, con-forms to the special circumstances of the therapy rela-tionship. The need for unreserved communication is not alicense for impulsive behavior; communications must berelevant to the task at hand. For instance, Laura Perlsand Walter Kempler differ greatly in the respectiveweights they place on the existential encounter in therapy,but both agree that unreserved communication must berelated to the task of therapy. L. Perls states:

I share verbally only as much of myawareness as will enable thepatient to take the next step [inawareness] on his own, and lend

him support for taking a risk in thecontext of his actual present mal-function . . . I will describe someproblems and experiences from myown life or from other patients if Iexpect this to give support to thisparticular patient for a fullerrealization of his own position andpotentialities. In other words, onlyif it will help him take the nextstep. (L. Perls, 1970, p. 127)

The self-expression described by L. Perls is a kindof sharing of the contents of lives, a telling about oneself.Kempler uses another, more immediate kind of self-expression. He often responds to the patient with a directreaction based on how he feels with the client at the mo-ment. He and others refer to this as an "existential en-counter." He values spontaneity and immediacy of inter-action, but also within the context of the task:

Nor does full self-expression meansaying everything that comes intothe therapist's mind. Full personalexpression is not without judgment.The therapist is urged to say every-thing on his mind that he expectsto be of value or that woulddiminish his ability to partici-pate if he withheld it. (1973, p.271) (Italics mine)

The last part of Kempler's statement is crucial:Therapists must say those things which would diminishtheir participation were they to be withheld. Therapistscannot always know whether their expression will allowthe patient to take the next step. But they can know whatthey need to do in order to remain available for contact.That is a responsibility of anyone who engages in genuinedialogue, of anyone who presumes to take the other as aThou.

Kempler's statement is also a warning against theabuses of self-disclosure that have been common in the

3cr-

practice of Gestalt therapy. Therapists often tend to saywhatever comes to their minds, assuming that their streamof associations must have something to do with what istranspiring, and therefore must be valuable. What occursto one is related, if only peripherally, to what is transpir-ing. But the expression of it may or may not furtherthe dialogue or the therapeutic task. The self-disclosurewhich results from serving the task of therapy by eitherfurthering the dialogue (as Buber might say) or permit-ting the next step in awareness (as L. Perls might say)opens the way for a deepening of the experience of theparticipants.

With "presence" and with genuine and unreservedcommunication, the therapist's role becomes wide-ranging, limited only by creativity and personal style, andthe therapeutic task itself. Gestalt therapists do not con-fine themselves to a limited range of responses so that atransference can develop, as in the more traditionalpsychodynamic therapies. They are free to laugh and cry,to dance, yell, or sit quietly. They are free to be fully pres-ent with the patient in ways that suit their style, serve thedialogic relation, reflect the temper of the moment, andfurther the therapeutic task.

Gestalt therapy expects that by being present, andby communicating genuinely, the therapist will influencethe patient. T he artistry is in balancing one'spresence in relation to the needs of the patient.Standing back is as antithetical to "healing through meet-ing" as is being overbearing (Perls, 1973, p.105).

At some point in the interaction of patient andtherapist, even in traditional therapies, what is demandedof the therapist is to:

Step forth out of his protectedprofessional superiority into theelementary situation between onewho asks and one who is asked.The abyss in the patient calls to theabyss, the real, unprotected self, inthe doctor and not to his confident-ly functioning security of action.The analyst returns from this para-dox . .. as one for whom the neces-

sity has opened of a genuine per-sonal meeting between the one inneed of help and the helper.(Friedman, 1976b, p. 190)

This paradox, that healing through meeting exposeswhat is possibly unhealed in the self, is only one of manyparadoxes of therapy, but is a particularly anxiety-riddenone for therapist and patient alike. It is also crucial in ameeting which heals in genuine dialogic manner.Inclus ion and Confirmation

Buber defines "inclusion" in therapy in this way:

The therapist must feel the otherside, the patient's side of the rela-tionship, as a bodily touch to knowhow the patient feels it. (1967, p.173)

It is a concrete imagining of the reality of the other, inoneself, while still retaining one's own self-identity.

In dialogue, there is a special insight or illumina-tion in the personally experienced confirmation of oneselfby another. Confirmation means that one is apprehendedand acknowledged in one's whole being (Buber, 1965b).The act of confirmation requires that one enter into thephenomenological world of the other without judgment,while still knowing one's own being. In the peak I-Thoumoment, the underlying process culminates and spillsover into the peak moment, which:

...is ontologically complete onlywhen the other knows that he ismade present by me in his self andwhen this knowledge induces theprocess of his inmost self-becoming. For the inmost growthof the self is not accomplished, aspeople like to suppose today, inman's relation to himself, but inthe relation between the one and



the other, between men, that is,preeminently in the mutuality ofthe making present in themaking present of another self andin the knowledge that one is madepresent in his own self by the other

together with the mutuality ofacceptance, of affirmation andconfirmation. (Buber, 1965b, p. 71)

Both Buber and Maurice Friedman believed thatCarl Rogers exemplified the practice of inclusion in hisapproach to therapy (Buber, 1965b; Friedman, 1976a). Ina public dialogue with Buber, Rogers described whatmight be called inclusion:

I think that in those moments I amable to sense with a good deal ofclarity the way his experienceseems to him, really viewing it fromwithin him, and yet without losingmy own personhood or separate-ness in that. (quoted in Buber,1965b, p.170)

Both Buber and Rogers appear to focus on whatthe patient is experiencing, whereas Gestalt therapy tendsto focus on the experiencing process, or how one is ex-periencing. (This is especially evident to me in the oraltradition.) I think this difference stems from the Gestalttherapy emphasis on the awareness process. What Gestalttherapy has, which neither Rogers nor Buber had, is atechnology for increasing awareness. The assumption isthat patients can learn to deal with what they are experi-encing, if they can learn how they experience, and howthey interfere with their own experience. Erving Polster(1975) describes this emphasis:

The first step, therefore, is for thetherapist himself to meet thepatient in a face-to-face encounterwhere authenticity of expressionand communication are primary.

JACOBS

The basic psychological functioninvolved is for the individual tomeet otherness through his sensesand his actions, much as this func-tion is reflected in Buber's writingsabout I-Thou interaction. Second-ly, although for the therapist to beauthentic is basic, it is hardlyenough. The patient is really be-having in self-defeating ways, andthe therapist must give specific at-tention to the characteristic waysbarriers to contact are set up. (pp.156-157)

I think Buber was over-balanced on the side of in-clusion. He made occasional statements to the effect thata therapist could not operate without techniques (Buber,1967, p.164) or without attention to the patient's defensivestructure (Friedman, 1976b, p. 90), but he really did notseem to value that part of the healing process. His majorattention was of "healing through meeting" (Friedman,1976a). The necessary ground for meeting is inclusion.

But the capacity for dialogue and the healing ef-fects of dialogue are inaccessible to the patient whosedefensive structures prohibit entering into dialogue(Friedman, 1976a). The practice of inclusion, while an ab-solutely necessary starting point, may not be enough.Patients can be assisted in their attempts to enterdialogue by increasing awareness of their defensive struc-tures.

On the other hand, I also think that Gestalt therapyis over-balanced on the side of attention to the awarenessprocess. The experience of being "made present," or in-cluded, in the eyes of another, has powerful healingpotential in and of itself. Over the years I have noticed ashift in the practice of Gestalt therapists in relation to in-clusion. There is an increasing appreciation of the valueof the interpersonal event of inclusion as the startingpoint for dialogue in therapy. It is also an event which cancontribute powerfully to restoring a derailed self-regulating process.Buber (1970) says that the therapist: 3(,)

Must stand not only at his own poleof the bipolar relationship but alsoat the other pole, experiencing theeffects of his own actions. (p.179)

This part of inclusion is well respected in Gestalt therapy.In his later years Perls wrote:

If the therapist withholds himself,in empathy, he deprives the field ofits main instrument, his intuitionand sensitivity to the patient's on-going processes.... He must have arelational awareness of the totalsituation, he must have contactwith the total field both his ownneeds and his reactions to thepatient's manipulations and thepatient's needs and reactions tothe therapist. And he must feelfree to express them. (1973, p. 105)

Gestalt therapists tend to be highly attuned to theeffects of their actions on their patients, and to respondsensitively; this is particularly true of those therapists whostress contact. But even these therapists have tended toneglect the other part of inclusion: the willingness to en-ter into the patient's phenomenological world (ErvingPolster, personal communication). An example drawnfrom my experience as a patient:

One day I was painting a bleak pic-ture of humanity, and especially ofmyself. I felt that any "decent" im-pulse or deed was fraudulent, a liebecause I had also been "indecent,"and this betrayed my true self. Mytherapist attempted t odemonstrate to me how my think-ing/valuing process was confused,"double-binding." I finally said,"Hey,I just want to be heard. I

want you to practice inclusion."(He was also reading Buber at thetime.) I was both frustrated anddespairing. My therapist began tolisten, but in a half-hearted man-ner. I complained that he wasn'treally listening, and he blurted out,"I don't want to really practice in-clusion." His eyes brimmed withtears as he said, "It's a very sad andtormented experience." Seeing histears, knowing that he had tastedsome of my present existence,caused a felt shift of experience inme. I felt momentarily at peaceand whole, and was able to leavethe bleak picture behind and moveon.

The practice of inclusion in this case was almost like ahealing touch.

I do not advocate that Gestalt therapy reorient it-self altogether by focusing totally on inclusion (likeRogers used to do), but I do think that more attention toand practice of inclusion would be helpful. I think that alack of spontaneous inclusion is an interruption of the di-alogic relation and only attention to inclusion can restorethe dialogic relation in this case.

A word must be said about the relation between in-clusion and confirmation, and the confrontation and frus-tration that are so often a part of the Gestalt therapy pro-cess. Buber said that confrontation is not antithetical to adialogic relation, and that, in fact, sometimes a relationrequires confrontation (Buber, 1965a).

But some of Buber's ideas about confrontationstem from a view of human nature which is at odds withGestalt therapy's view of organismic self-regulation.Steeped in the Old Testament, he had a polar view ofgood and evil which does fit quite nicely with Gestalttherapy (Hycner, personal communication). But his viewof the dynamic relation between the two seems also tohave been informed by traditional drive theory of psycho-analysis, with which he was quite familiar. Buber talks of


the necessity to do battle with the patient's defenses, as ifdefenses are merely impediments to dialogue, as I havedescribed above. From the vantage point of holism,defenses are better seen as attempts to forge any kind ofrelationship under difficult field conditions. Thedefenses are a part of the whole, aspects of the patient'sself-regulating system to be contacted and revitalized, notcast aside.

I believe it is this same difference in views of hu-man nature that leads Buber and Friedman to distinguishso firmly between acceptance and confirmation.Friedman insists that the difference between mere accep-tance and confirmation is that confirmation emphasizesthat the patient is being affirmed for what he or shewill become, even if in there present state they engage inmyriad defensive, devitalizing behaviors.

Everything is changed in real meet-ing. Confirmation can be mis-understood as static. I meet an-other I accept and confirm himas he now is. But confirming a per-son as he is is only the first step.Confirmation does not mean that Itake his appearance at this momentas being the person I want to con-firm. I must take the person in hisdynamic existence, in his specificpotentiality. In the present lieshidden what can become.(1985,p.135)

Friedman later states that Rogers and Buber dis-agree about the difference between accepting and con-firming. Rogers equates the two, saying when one feelsaccepted, and through that lowers ones defensive bar-riers,

the forward-moving processes oflife take over. It is precisely thisassumption that the processes oflife will always be forward-moving

that Buber questions.

I believe that Gestalt therapy is much closer toRogers on this point than to Buber. There is no need toappeal to the ineffable "future becoming" of the patient.As you genuinely meet him or her now, you are meetingsomeone who is living/changing.

At any rate, Gestalt therapists do tend to confrontand frustrate those behaviors which turn the patient awayfrom experiencing the present moment. But when thetherapist is entering into the patient's world as fully as theact of inclusion requires, I think the style and the attitudeof confrontation is affected. For instance, the old notionof "bear-trapping" must be cast aside. That was a pejora-tive idea, most likely stemming from the therapist's frus-tration. When the therapist can see the patient's worldfrom the patient's perspective, then there is not somuch manipulation as there is a conflict between desireand fear.

Patients use manipulative behaviors when they donot have faith in their own processes of self-regulation.But "manipulation" is a term that arises when therapistsfocus on the way the patient's behavior is impacting them.Seen from the point of view of the patient, the behaviormight be described as a frightened attempt to get a needmet. Both points of view are valid. By practicing inclu-sion by entering the patient's world therapists mightfind themselves commenting on the need/fear dilemmathat is being enacted instead of confronting the behavioritself. Or the confrontation will be suffused with the un-derstanding acceptance one has gained through practicinginclusion.

For me, the notion of inclusion has made me lessconfrontive than before, despite Buber's insistence thatthe confirmation which emerges from inclusion some-times requires doing battle with the patient. His belief inthe necessity for battle is based on his erroneous I be-lieve view of human nature.

At times practicing inclusion while also confront-ing requires patience and confidence in the elasticity ofone's own boundaries. I may not like what a patient isdoing. I may even be angry. But I try to keep these feel-ings against the background of the overall dialogic atti-tude that I am maintaining. This dialogic attitude is often



not communicated in words, really; it develops over time,and is more often sustained by nonverbal behavior or bytone of voice than by any words spoken. In a few instancesrecently, when I confronted patients,I could really feel myability to be with the patients in my anger, and still beopen and receptive to them. The vibrancy of the meetingswas remarkable. This was very different from times whenI have set limits out of my own frustration, been psycho-logically cut off from the patients' experiences, andwanted them to do something to make me feel better.

Dialogic AttitudeBuber holds that the dialogic attitude is the requi-

site stance for anyone who would be an educator ortherapist (1970). The dialogic attitude of the therapist isdifferent from the dialogic relation of friendship: the dia-logic attitude is assumed by the one teacher ortherapist who is voluntarily engaged in furthering thelearning of the other; and while the friendship is definedby fully mutual confirmation, the dialogic attitude of thetherapist can be assumed independent of the inclinationsof the patient.

When both persons assume a dialogic attitude,thenthe fully mutual dialogic relation can accrue; but one canappreciate another in dialogue without mutuality. Oneperson, the therapist can be present and "imagine thereality" of the other. This is the dialogic attitude. The di-alogic attitude is an expression of the latency of I-Thou;thus, the I-It phase, within the context of a dialogic atti-tude, is embedded in the process that permits the pos-sibility of the I-Thou moment between the two people.

Buber is in agreement with most of the writing ofpsychotherapy that the position of the psychotherapist is aparadoxical one. A therapist must "live in confrontationyet be removed"; the therapist's responsibility is to genu-inely meet another person nor it is in the meeting thathealing occurs -- and yet the therapist cannot attempt tocoerce or require such meeting without violating theground of the meeting by demanding that the patientchange. For Buber, therapy is a change process, but thetherapist always confirms the existence of the individualas is, first. Our position is even more radical, I think.

JACOBS

For if the therapist is only starting where the patient is inan effort to move the patient, then the therapist is not tru-ly confirming the patient, the patient is not a Thou, andthe life affirming potentials of the patient cannot bereleased.

Whenever the apprehension of the patient by thetherapist moves from I-It to I-Thou, then the paradox be-comes irrelevant and there is only the genuine communi-cation of that moment. In Gestalt therapy, therapistsmaintain a dialogic attitude which allows them to attempt,as much as conditions will permit, to develop such a rela-tionship. It is a delicate dance. The therapist remains"aggressively in the I-Thou" (Yontef, 1976, p. 183), withsomeone who has only limited ability to allow for an I-Thou moment, much less a mutual dialogic relationship.

Gestalt therapists do not demand that patients en-ter into such a relationship. They can only be present andauthentic, and through the dialogic attitude refuse to for-sake either their own "I" or the potential "I" of the other,while maintaining respect for the actuality of the other.Recall Enright's statement:

... the strategy is always to keep asteady gentle pressure toward thedirect and responsible I-Thouorientation, keeping the focus ofawareness of the difficulties thepatients experience in doing thisand helping them find their ownway through these difficulties.(1975, p. 25)

Task as Thou

Buber points out that the dialogic attitude must bepresent within all therapists who work to "heal throughmeeting" and release the potentialities of the patient.Therapists serve not only the patients whom they meet,but also the task which brings the meeting about. Be ithealing, teaching, or developing, the task is crucial; itdefines the relationship, and the therapist must have faithin the invaluable importance of the task in order to meet

the patient without reservation in the context of thetherapy relationship.

In effect, the Gestalt therapist maintains a dialogicattitude toward the task. In the I-Thou moment there isno intention, the attitude is simply part of the moment.But the dialogue flows between the momentary mutualconfirmation and the period of I-It. In the period of I-It,the pressure of the paradoxical engagement tempts thetherapist to abandon the dialogical attitude for a morecoercive relationship.

The pressure comes from the need that arises inthe therapist (or anyone) during an encounter: the wish tobe confirmed by the other. To engage at the level of I-Thou without the demand that the other confirm one isthe essence of the therapist's dialogic attitude.

The goal of Gestalt therapy is awareness. To serveit is to participate in the patient's discovery of his or herown way. Awareness in Gestalt therapy emerges at theboundary of the meeting "between" therapist and patient.It occurs within the context of the I-Thou relation, in thecontext of the alternating rhythms of I-Thou and I-It. It isthe dilemma of the therapist that one encounters thepatient with the attitude and involvement ofdialogue, yet does not seek to be confirmed throughthe direct human encounter. The therapist's con-firmation comes through the expression of oneselfin the service of the task. Friedman has suggested, andI agree, that while therapists do not seek confirmationfrom patients, they must be open to the possibility as in-herent in the dialogical relation. In fact, the therapist isconfirmed when a patient allows him or herself to receivehelp (1985, p. 19). Yet ultimately, the therapist's ownself-acceptance, self-esteem, and faith in the "truth" of thetask, in the liberation of both people that the task will al-low, enables him or her to hold aside the wish to be con-firmed by the other, and instead to be confirmed throughknowing that the task is most creatively served in this way.

Taking the task as Thou requires this dialogic atti-tude: the therapist is confirmed by realizing the task,which includes the confirmation of the patient as Thouand the creativity of serving the task in relation to thisunique other of the patient.

To illustrate this point, examine an example which

Yontef presents:

Techniques arise out of thedialogue between I-Thou and the I-Thou sometimes requires a tech-nological intervention. Example:Patient talks without looking at thetherapist. The dialogue has beeninterrupted in that the patienttalks, but to no one in particular.A real dialogue now would requirea vigorous response by thetherapist. Possibilities: 1. "Youaren't looking at me," 2. "I feel leftout," 3. "I suggest an experiment:Stop talking and just look at meand see what happens." (1976, p.72)

Any number of responses to the situation are pos-sible, and therapists will respond according to their style,feelings, and intuitive appreciation of the other at thatmoment. It is important that the response arise out of adialogic attitude toward the patient, and that it attempt toserve the task of therapy.

For instance, the response,"I feel left out" herethe therapist directly confronts the client. But theresponse is stated with an entirely undemandingauthenticity, because the therapist offers the response asa creative involvement with the person and the task, anddoes not need for the patient to respond in any particularway, to take care of the therapist's "left out" feelings. Thetherapist need not and should not require I-Thoureciprocity from the client; instead, the therapist is con-firmed by having actively engaged with the patient inthe service of the task, which is the highest fulfillmentof his/her position as "helper," or one-who-is-asked.

The Place of Technique in Genuine DialogueExistential therapists typically frown on the use of

technique as a reduction or objectification of the patient'sbeing (Dublin, 1976). However, this attitude results in an


unfortunate limitation of the therapeutic practice. A dia-logic relationship is not limited to the interpersonal en-counters in which the figure of interest is the relationshipitself. Often, engagement with an external issue is thetruest dialogic relation of the moment, for dialogue, likeawareness, is grounded in the dominant interest ofthe person in that moment.

Buber appears not to have favored the use of tech-nique, perhaps because of the infancy of psychotherapy atthe time, he did not realize the implications for his ownassertion that "without It a man cannot live" (Buber, 1970,p. 85).

The ego functions are impaired in neurosis, just asthe peak moment of contact is impaired. The recovery ofego skills through awareness techniques makes the dialog-ic process a possibility in the patient's life. There are twotypes of awareness in Gestalt therapy: the integrative mo-ment, and the awareness continuum or "attention toawareness." It is through this attention to awareness thatcorrections to the contacting process are often initiated.

Thus, when working on contact functions or ondefenses, there is often a place for "I-It" in the therapyprocess. In a sense, when working on defenses thetherapist is merely taking the patient exactly where he orshe is in an I-It state and working to enable thepatient to use his/her own awareness process to reclaim amore integrated state. Dublin provides an example:

A young married male patient com-plains of "a deadened feeling . . .

hardly any sensation" upon ejacula-tion. He does not use "I"; he has nocomplaint of himself, or of his wife;he complains of his penis as an "it,"disclaiming any responsibility forits functioning . . . [The therapist]asks the patient to split off hispenis, and to dialogue with it. Ifthe patient protests that this is sil-ly, makes no sense, is not what hereally wants, etc., the therapistpoints out that he (the patient) isalready splitting it off, separating

it from the rest of his personhood,and that he (the therapist) is onlyasking him to do so more thorough-ly in order to experience more fullyhow he is doing so. As technique,this functional splitting off of thepenis takes the form of an experi-ential dialogue between theperson-minus-penis and the split-off penis, the patient taking bothroles experientially, verbally, andperhaps motorically. As is wellknown to experienced Gestalttherapists, the ultimate effect ... isnot a further experiential distanc-ing or alienation . . . but rather anexperiential reclaiming or owning.(1976, p. 132)

When working on contact functions the patient cangain skill in using It-mode functions to support deepeningthe dialogic process. A patient who can learn to allow histone of voice to express emotion rather than always speak-ing in a deadpan manner will be freer in dialogues withothers. The expressiveness may require practice and mayinitially even feel fraudulent; but by experimentation thepatient finds his own appropriately expressive style(Polster and Polster, 1973, p. 239).

The important thing is that the awareness techni-ques emerge organically from the ongoing dialogue.When the timing is right for a patient to explore just howhe interrupts himself, then an experiment based on whatis transpiring in the therapy process is appropriate. Sometechniques intensify and clarify current experience, suchas when the patient exaggerates the tightening of the jaw.Other techniques focus on the evolving awareness process

such as when the patient "brackets off" judgments, orallows body sensations to dictate body posture and move-ments. Still other techniques such as role-playingpolarities may experiment with blocks in awareness, oralienated awareness.

A major caution is that in order to be operatingfrom the context of the dialogic attitude, the therapist

(fl


cannot expect any results from the experimentation. Pos-sibly the most frequent misuse of techniques occurs be-cause therapists are tempted to use them whenever theyfeel stymied. A technique becomes a way to "make some-thing happen," or to push the patient in a certain direction

say, towards fuller expression in order to satisfy thetherapist's frustration.

The experiments must be offered without invest-ment in a particular result, but with investment in focus-ing on awareness, whatever the patient does. When ex-periments are offered with this attitude, the experimenta-tion process becomes a model of the phenomenologicalapproach to awareness. Goals and judgments are heldaside, and attention is directed simply to what is happen-ing.

In the therapy process there are times when the at-tention to awareness leads to evolving, transcendingawareness, moving to the "Aha!" of integration. The artfor the therapist is in knowing, by attending to and trust-ing what emerges, when to abandon directed, willful focuson awareness and simply be present for the patient. Theintegration that occurs is the existential trust (Buber,1967): faith in one's self- regulation and in the process ofdialogue. Much of the work in therapy is addressed tohow patients interrupt contact and awareness to such anextent that they lose this faith.

Therapy as a Special Case of Dialogue

Buber describes the healing relationship of psycho-therapy as a particular form of dialogic relation (1965b,1970). He considers it a necessary tragedy of helping rela-tionships that, unlike friendships, they cannot be fullymutual. (1965b, 1970). Buber contends that while atherapist may at certain moments experience fullmutuality with the patient, therapy, by the nature of itstask, involves a limited relationship. Returning to and ex-panding an earlier statement of Buber's:

The therapist must feel the otherside, the patient's side of the rela-tionship, as a bodily touch to know

how the patient feels it. If thepatient could do this, therewould be no need of therapyand no relationship. (1967, p.173) (Italics mine)

It is possible that in order to make his point clear-ly, Buber exaggerated the difference between therapy anda more fully mutual dialogue. Certainly, some patientsare capable of fully mutual inclusion with the therapist.But even these patients would not be serving their ownbest interests by engaging in a predominantly mutualtherapy relationship. The task of therapy requires thatthe focus be primarily on the patient, not on the therapist.

Because of the nature of the task, the therapy rela-tionship is limited. Buber describes the therapy rela-tionship as a "one-sided inclusion" rather than mutual in-clusion (1970). In one-sided inclusion, the helper strivesto imagine the reality of the other, but the reverse doesnot ordinarily happen and is not intended. If the rela-tionship is mutually inclusive, then it cannot be therapy.The essential difference between mutual inclusion andone-sided inclusion is not based on an assumption that theperson of the therapist is different from the person of thepatient. The difference comes from the fact that the tasksets the two people in different relations to each otherand to the task. The therapist has willingly set aside per-sonal investments in order to serve the learning of thepatient. Patients are invested in their own learning, notthat of the therapist. At moments of the I-Thou relation,such role definitions are irrelevant, but the alternationbetween the phases of I-It and I-Thou (or the phases of acontact episode) occurs within the context of the one-sided dialogic attitude. If a fully mutual dialogic rela-tionship develops, then although the relationship will betherapeutic for both participants, the therapy contract nolonger exists.

Buber's second point is that in therapy it is the re-sponsibility of the therapist to meet the patient, and notvice versa (Buber, 1967). In a more fully mutual dialogue,each participant may be expected to assume responsibilityfor meeting the other. In therapy there is no such ex-


pectation. The therapist's willingness and receptivity tothe sphere of "between" is the scaffolding against whichthe existential trust of the patient is formed.

Frederick and Laura Perls make similar assertionsabout the therapist's responsibility for the therapy itself.

In these cases of "failures" I eitherlack the ability to show them con-vincingly the need for change andreorientation, or else I myself aminsufficiently integrated to beaware of the crucial resistance. (F.Perls, 1975b, p. 59)

As far as I am aware, I want mypatients to get better. If theydon't, then I have to search forwhat I have failed to become awareof or to make them aware of in theon-going relationship. (L. Perls,1970, p.126)

Erving Polster (1975) suggests that it is up to thetherapist to establish an interactive climate whereingood-quality contact is a possibility for the patient.Therapists do not impose the model of I-Thou on theirpatients (Yontef, 1975), but they retain the dialogic atti-tude themselves out of the belief that such an attitude isthe means by which patients' potentialities are released.Because therapists are responsible for setting up the in-teractive climate for this release, sometimes they must attimes initiate contact, extending themselves to meet aseverely restricted patient where the patient is (Polsterand Polster, 1976, p.157).

This means that the requirements of the dialogue intherapy are different. The inclusion is one-sided, andconfirmation is largely one-sided as well. The therapistconfirms the patient, but not vice versa, except in rare mo-ments. In essence, it becomes the therapist's responsibili-ty to establish the conditions for dialogue (Friedman,1976a). The therapist must do everything possible to comefully to the relationship: be present, engage unreservedly

in the dialogue, and perhaps most important, practice in-clusion.

To this end, Hycner makes an interesting pointabout the personhood of the therapist. He asserts thattherapist individuality is important only insofar as itserves the task. As Hycner (1985) says:

In a genuine dialogical approach itseems to me that the therapist is a"steward of the dialogical." By thisI mean that in a very profoundsense, the individuality of thetherapist is subsumed (at leastmomentarily) in the service ofthe dialogical, which is the entiretherapeutic Gestalt and includesthe individuals in it.... It assumesthat genuine uniqueness arises outof genuine relations with othersand the world. Individuality is butone pole within an overall rhythmicalternation between our individualseparateness and our participationin something larger than us, i.e."Being." (p. 33)

A special requirement of the therapy relationship isthat the therapist must not only encourage the patient'sself-becoming through the dialogic relation inclusionin particular but must also put "before the patient theclaim of the world" (Friedman, 1976a, p. 201). This meansthat the therapist does not view the patient's individua-tion as something that can be achieved in isolation fromreal relationships in the real world.

The neurotic is one who has withdrawn fromdialogue, and healing involves resumption of the dialoguein one's concrete daily existence (Friedman, 1976a). I sug-gest that through awareness work done within a dialogiccontext, we restore the possibility of dialogue. Thepatient's involvement at that point, is based on an awarechoice to deepen dialogue or to turn away. I do not thinka therapist can restore a mutual dialogue with the patient.



A therapist can only work to meet the patient. Themutuality is a choice the patient must make.*

Finally, Buber's most important contribution topsychotherapy is his central tenet that in order to heal"the very roots of the patient's being," therapy must in-corporate a genuine meeting, for it is through the dialogicrelation that healing occurs (Buber, 1967, p.169).

The deciding reality is thetherapist, not the methods.Without methods one is a dilet-tante. I am for methods, but just inorder to use them, not to believe inthem. Although no doctor can dowithout a typology, he knows thatat a certain moment the in-comparable person of the patientstands before the incomparableperson of the doctor, he throwsaway as much of his typology as hecan and accepts this unforeseeablething that goes on betweentherapist and patient. (Buber, 1967,p.165)

In Gestalt therapy, the typology used is that of con-tact and awareness, with attention to the patient's inter-ference with these processes. We bring this typology andour intention toward a dialogic relationship when we be-gin to meet with the patient. At certain points thedemands of the dialogue require that we abandon thetypology, and it is at these moments, according to Buber,that the essential healing may occur (1970, p.179).

*1 am indebted here to a personal conversation with Maurice Friedmanwhere he suggested that on a continuum of means, ends, means andends, in sequential steps, perhaps the end of awareness in Gestalttherapy is a means to dialogue in the larger context of the person's life.

JACOBS

Summary and ImplicationsThis paper reflects a trend toward greater emphasis

on the patient-therapist relationship in the Gestalttherapy process. Gestalt therapy is increasingly aware notonly that the relationship is an important curative factor,but also that the relationship should be specifically thegenuine, loving meeting described by Buber as the dialog-ic relation. I have attempted to show that use of the I-Thou model is a fitting and logical extension of the Ges-talt therapy focus on the contacting process, and that thedialogic relation is itself a vehicle for the restoration ofawareness, which is the goal of Gestalt therapy.

The dialogic relation is a model of contacting livedout to its highest potential. The process of organismicself-regulation, as reflected in contacting and awareness,is itself involved in a developmental process: the develop-ment of one's uniquely human becoming. It is not enoughto say that contact and awareness serve our biological andemotional needs. There appears to be a kind of ontologi-cal imperative, an urge toward growth, so that these pro-cesses operate at increasingly finer levels of complexityand abstraction from biology. Contact and awareness arenot merely the processes that express the dynamic rela-tion between stasis and growth; they are themselvesspiraling developmental processes, always emerging andtranscending. The epitome of their development is livedthrough in the dialogic relation.

The dialogic relation is also a model for the kind oftherapeutic relationship that is consistent with the Ges-talt theory of change. A therapist who operates from a di-alogic orientation will establish a present-centered, non-judgmental dialogue that allows the patient both todeepen awareness and to find contact with another per-son. The therapy becomes a chance for the patient'sselfhood to unfold in the presence of another person.

In Gestalt therapy, awareness is used to restoreawareness, and this restoration can be facilitated by es-tablishing a dialogic context. In this context, contact canbe used to restore contact. The therapist's meeting thepatient in a dialogic relation becomes a model for therestoration of contact and awareness, and hence, the pos-sibility for growth. 4+

Gestalt therapy is considered a "growth discipline"(Latner, 1973; Polster and Polster, 1973). Healing andgrowth through the restoration of awareness are an ex-pression of the transcendental possibilities of human exis-tence. But the Gestalt therapy language of contact andawareness does not evoke Buber's sensitivity to the pos-sibilities of wholeness. Whereas the concept of contactserves to ground Gestalt therapy in the natural biologicalrhythms of all organisms, I-Thou transforms contact intothe realm of the uniquely human: the interhuman rela-tionship and the development of oneself.

The most important therapeutic implication isthat the therapy must take place within a dialogic relationif it is to be true to the ontic possibilities of contacting.Patients must be afforded the chance to meet another per-son if they are going to know themselves. Therapy com-posed solely of awareness techniques, without the con-tactful engagement of the therapist/person with thepatient/person, limits the awareness possibilities for thepatient and interrupts the becoming of both people.

This is not to say that techniques should not beused. I agree with Polster (1975) that contact is notenough. Without also increasing patients' awareness ofjust how they avoid contact, the therapy runs the risk ofbecoming a "Dance of Orpheus"; patients will be able torespond, to engage, only when the therapist is present toinitiate the contact. Awareness techniques teach patientshow to correct their interrupted contacting. They are apowerful methodology. But the techniques must evolveorganically from the dialogic process. In so doing theywill reflect the next step in the patient's becoming.

Buber's paradigm of the dialogic relation offers theGestalt therapist some concrete guideposts, as well as akind of vision, for establishing with the patient a rela-tionship that will be both conducive to the patient'sgrowth and gratifying to the therapist. When one entersinto dialogic relation, even in the sometimes unreciprocalrelationship of therapy, one experiences the release ofone's own potential as well as that of the patient. Thepractice of the art of therapy becomes not only an expres-sion of one's being, but a step in one's becoming.

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