HUMANISTIC AND EXIESTENTIAL THERAPY

MODULE-4
Gestalt psychology was first developed by Max Wertheimer and later by Wolfgang Kohler and
Kurt Koffka. Essentially, gestalt psychology is based on the view that psychological phenomena
are organized wholes rather than specific parts. Gestalt psychologists principally studied visual
and auditory perception and viewed learning as a perceptual problem in which individuals
attempt to discover a correct response in their perceptual field (Shane, 2003). In doing so,
individuals experience the “Aha!” response, or “Now I see it” or “Now, I understand it; it’s all
come together for me!” Some properties of a phenomenon cannot be observed by looking at its
parts but occur only when individuals view the entirety. For example, a student learning algebra
may know formulas, but only when these formulas are brought together is she able to arrive at
the solution to the problem. In gestalt psychology, the “field” can be viewed in terms of “figure”
and “ground.” The figure is what stands out, and the ground is the background.
Gestalt psychology is a school of thought that looks at the human mind and behavior as a whole.
When trying to make sense of the world around us, Gestalt psychology suggests that we do not
simply focus on every small component. Instead, our minds tend to perceive objects as elements
of more complex systems. A core belief in Gestalt psychology is holism, or that the whole is
greater than the sum of its parts.1 This school of psychology has played a major role in the
modern development of the study of human sensation and perception.

Principles of Gestalt Psychology

Gestalt psychology helped introduce the idea that human perception is not just about seeing what
is actually present in the world around us. It is also heavily influenced by
our motivations and expectations.

Wertheimer created principles to explain how Gestalt perception functions. Some of the most
important principles of Gestalt theory are:26

 Prägnanz: This foundational principle states that we naturally perceive things in their
simplest form or organization.
 Similarity: This Gestalt principle suggests that we naturally group similar items together
based on elements like color, size, and orientation. An example would be grouping dogs
based on whether they are small or large, or if they are big or small.
 Proximity: The principle of proximity states that objects near each other tend to be
viewed as a group.
 Continuity: According to this Gestalt principle, we perceive elements arranged on a line
or curve as related to each other, while elements that are not on the line or curve are seen
as separate.
 Closure: This suggests that elements that form a closed object will be perceived as a
group. We will even fill in missing information to create closure and make sense of an
object. An example of this Gestalt psychology principle is using negative space to give
the illusion that a particular shape exists when it doesn't.
  Common region: This Gestalt psychology principle states that we tend to group objects
together if they're located in the same bounded area. (For example, objects inside a box
tend to be considered a group.)

History of Gestalt Psychology

Originating in the work of Max Wertheimer, Gestalt psychology formed in part as a response to
the structuralism of Wilhelm Wundt.2
While followers of structuralism were interested in breaking down psychological matters into
their smallest possible parts, Gestalt psychologists wanted instead to look at the totality of the
mind and behavior. Guided by the principle of holism, Wertheimer and his followers identified
instances where perception was based on seeing things as a complete whole, not as separate
components.

Wertheimer developed Gestalt psychology after observing what he called the phi phenomenon
while watching alternating lights on a railway signal. 4 The phi phenomenon is an optical
illusion where two stationary objects seem to move if they are shown appearing and disappearing
in rapid succession. In other words, we perceive movement where there is none.

Based on his observations of the phi phenomenon, Wertheimer concluded that we perceive
things by seeing the whole perception, not by understanding individual parts. In the example of
blinking lights at a train station, the whole we perceive is that one light appears to move quickly
between two points. The reality is that two separate lights are blinking rapidly without moving at
all.

Gestalt Therapy
Gestalt therapy is based on the idea that overall perception depends on the interaction between
many factors. Among these factors are our past experiences, current environment, thoughts,
feelings, and needs. Gestalt therapy involves key concepts such as awareness, unfinished
business, and personal responsibility.7
The main goal of Gestalt therapy is to help us focus on the present. While past context is
important for viewing yourself as a whole, a Gestalt therapist will encourage you to keep your
focus on your present experience.
Research suggests that Gestalt therapy is effective at treating symptoms
of depression and anxiety, and it may help people gain confidence and increase feelings of self-
efficacy and self-kindness.8 It is often a helpful way to structure group therapy.

Concepts of Gestalt therapy

Below are some of the main concepts of Gestalt therapy:

1. Self-awareness
Perls suggests that many people develop mental health symptoms because they weren’t aware of
their senses, emotions, didn’t have good recognition of their bodily sensations, and had poor
awareness of their environment.
Perls explained that ‘awareness in itself is healing’. Thus, Gestalt therapy sessions focus on
helping people learn to become more self-aware and to accept and trust in their feelings and
experiences to alleviate their distress.
During therapy, there may be some experiential exercises which are used to help increase
awareness of the client. By building self-awareness, Gestalt therapy helps clients to better
understand themselves and how the choices they make affects their health and their relationships.
With this understanding, clients can begin to comprehend how their emotional and physical
selves are connected, and not separate parts. Through this, they can develop more self-
confidence to start living a fuller life and more effectively deal with problems.

2. ‘Here and now’

The focus of Gestalt therapy is on the present moment rather than on past experiences or future
possibilities. Focusing on the present doesn’t negate the past or future, in fact, the past is
intricately linked to one’s present experience.
The idea is to avoid swelling on the past or anxiously anticipating the future. The idea is that if
it’s a current problem it can be dealt with. If it is in the past, it has already happened and cannot
always be resolved.
Clients are urged to discuss their memories and concerns in the present tense. Experiences of the
past that are brought up can be explored as to what factors made a particular memory come up in
that moment, or how the present moment is impacted by experiences of the past.
Once clients have become aware of the present, they can then confront past conflicts or
unfinished business – what Perls refers to as incomplete Gestalts.

3. Context is important
It is understood that context is important when the therapist learns about the experience of their
clients.
Therapists can use techniques to help the client become more aware of their experiences,
perceptions, and their responses to events in the here and now.
It is thought that a person cannot be fully understood without understanding their context.
Gestalt therapists are taught to accept the validity and truth of their client’s experiences since
they recognise that no one can be purely objective, including the therapist whose experiences and
perspective are also influenced by their own contexts.

4. Experiences can influence perception

The therapist recognises that the experiences of a client can influence their perceptions,
understanding that in this way, no one can be fully objective.
The therapist allows a space for clients to share their truth without imposing their own
judgements, which are also influenced by their own experiences.
At the core, Gestalt therapy is the holistic view that people are intricately linked to and
influenced by their environments and that all people strive towards growth and balance.
It has emphasis on the therapist’s use of empathy, understanding and unconditional acceptance of
the client’s experiences to enhance therapeutic outcomes.

5. Dealing with painful experiences

Often, the easiest course of action for many people is to push down painful memories to avoid
having to deal with them. In Gestalt therapy, this offers a space where clients do not have to shut
these memories down anymore.
This does not mean that memories will be readily available at the start of therapy, but they may
do eventually.
A Gestalt therapist will understand that painful experiences will come into awareness when the
client is ready for healing in that area.

GOALS OF GESTALT

1. 3Maintaining present
A goal of Gestalt therapy is to teach clients to stay in the present moment and be aware of what
is going on around them and their emotions in the here and now. The therapy is focused on what
is happening in the moment and finding solutions in the present time. Dwelling on the past and
being anxious about future events is thought to not be useful as they cannot be worked on, only
the present can.

2. Increasing self-awareness
Often, people can create roadblocks or push things out of awareness, especially if they are
painful.
Although this can help in the short-term, in the long-term this can create troubles as we will then
have more incomplete Gestalts and block self-awareness and growth.
Increasing client’s awareness allows for these roadblocks to be identified, properly challenged
and moved out of the way so that the person can heal.
The goal of Gestalt therapy is to collaborate with the therapist to increase personal awareness
and actively challenge the roadblocks that have been getting in the way.
Teaching people to become aware of significant sensations within themselves and their
environment can help them fully respond and reasonably to situations.
 3. Adopting personal responsibility
As clients of Gestalt therapy become more aware of themselves and their senses, the goal is that
they will take more responsibility for themselves, accept the consequences of their behaviour,
and learn to satisfy their own needs while respecting the needs of others.
When blaming others, people often lose a sense of control and become victims of other people or
the event.
Learning how to accept personal responsibility allows clients to gain a greater sense of control in
their experiences and they can learn how to better regulate their emotions and interactions with
others.

4. Increasing self-regulation
Gestalt therapists believe that all people want to achieve self-regulation but sometimes
individuals can use maladaptive techniques to cope with unpleasant experiences.
While these may feel beneficial in the short-term, in the long-term it can make people unable to
regulate their emotions and feel unable to express themselves. they may find it harder to interact
with others and be less able to achieve a sense of wholeness.
However, through the techniques used in Gestalt therapy, clients are taught ways to increase their
self-regulation and thus to drop the maladaptive techniques they previously used.

Techniques of Gestalt therapy

Gestalt therapy is practised in the form of exercises and experiments either in individual or group
settings. Exercises in general are practices designed to bring about action, emotion, or goals from
the client.
The therapist and the client can then examine the result of the exercise to increase their
awareness and help the client understand the here and now of the experience.
Below are some of the main techniques which are utilised in Gestalt therapy:

1. 2Empty chair
The empty chair technique is a popularly used roleplaying exercise which allows the client to
imagine and participate in a dialogue with another person or another part of themselves.
This technique involves the client sitting in front of an empty chair while the therapist
encourages them to imagine that either another person or a part of themselves (such as an angry,
critical, or past part) is sitting in the chair.
The client will then engage in a dialogue with whoever they imagine is in the empty chair.
This exercise is thought to engage the person’s thoughts, emotions, and behaviours and can be
helpful for helping people to become more mindful of the whole situation and forgotten or
disengaged pieces of their own self.
This self-dialogue is a very popular technique and can be used by a lot of therapists outside of
Gestalt therapy.

2. Two-chair
The two-chair technique is similar to the empty chair technique in that the client is encouraged to
have a dialogue with an empty chair positioned next to them.
However, after speaking to the metaphorical person or part of self, the client has the chance to
respond to themselves by taking up the role of the other person or self.
The client will physically sit on the other chair and have a dialogue with themselves as if they are
the other person or part. The client can go back and forth between the two chairs while the
therapist makes observations and encourages meaningful dialogue.
This can be useful for gaining perspective and awareness of other people’s experiences. It can
also help someone to come to decisions that were previously hard to make, as well as helping
them to have better interpersonal conversations with the person they may have experienced
conflict with.
Both the empty chair and the two-chair techniques can be helpful in drawing out important
perceptions, meanings, and other information that can help the client be more aware of their
emotional experience and how they can start healing.

3. ‘I’ statements
The language a client uses, and their tone are important in Gestalt therapy. As clients are
encouraged to, and learn to accept responsibility, they learn to use language that reflects personal
ownership rather than focusing on others and outside experiences.
Clients are encouraged to use ‘I’ statements to learn personal responsibility. For instance, instead
of saying ‘It made me feel angry’, they could say ‘I feel angry’.
Labelling an emotion as an ‘it’ makes it seem that the emotion is a separate entity to the
individual. However, taking ownership and recognising the emotion is a part of the self improves
awareness.
The more the client uses the word ‘I’, the more their awareness will increase, according to
Gestalt therapy.

4. Confrontation
Confrontation was a key technique in the early days of Gestalt therapy but is not used as much in
recent times. When something comes up that the therapist believes requires confrontations, such
as when some sort of change is apparent, but the person cannot quite get there, the therapist
would become confrontational.
While this can be effective for some, others may find this technique too aggressive. Clients may
be put off by the confrontational manner of the therapist and so it is not used as often nowadays.

5. Body language
During therapy sessions, the therapist will pay close attention to the client’s body language and
movements such as hand gestures, their posture, and facial expressions.
The therapist will likely mention their observations to the client and ask them what is happening
for the person at that moment. They could say ‘I notice you put your hand on your chest when
speaking. Why do you think you did that?’
Incorporating language, the Gestalt therapist may even ask the client to give their body parts of
facial expression a voice and speak from that place.
The technique of noticing body language helps to make the client more aware of what they are
doing and what it means.

6. Exaggeration
Alongside giving body language a voice, the therapist may ask the client to exaggerate the
motion they made or repeat it several times during the session.
This can be especially useful if the client finds it difficult to find the words to put to what is
happening in that moment.
This makes them more aware of the emotions attached to the behaviour and increases their
awareness of immediate experiences.

7. Locating emotions
Often, a lot of emotions can be brought up during Gestalt therapy. When a client talks about an
emotion, the therapist may ask them where they feel that emotion in their body.
For example, they may represent the emotion as a heavy or tight feeling in the chest, a lump in
the throat, or tension in the shoulders.
Being able to do this brings awareness to emotions and helps the client to stay present and
process their emotions effectively.
Through Gestalt therapy, clients learn to discover emotions that may have been pushed down or
masked by other feelings. Through bringing them to the surface, the client can learn to accept
and trust their emotions.

8. Creative activities
Other activities such as painting, drawing, and sculpting can also be used to help clients gain
awareness, stay present and learn how to process the moment.
Essentially, any method that can be offered to the client other than traditionally sitting still and
talking can prove helpful in increasing self-awareness, awareness of experiences, and being the
process of healing.

Concerns and limitations of Gestalt Therapy

While Gestalt practice can be applied to various problems, it is also essential to consider the
limitations of Gestalt therapy. As experts have explained, much research is with Gestalt group
therapy activities rather than individual counseling sessions. The therapy may be effective for
individual people, but more studies are needed to confirm that this therapy model is effective.
Furthermore, some research shows that Gestalt techniques are not effective for prison inmates
suffering from psychopathology, so the approach may not be useful for severe psychological
problems. There is a place for Gestalt theory in counseling. Still, until more research is
conducted, it is difficult to say with certainty that this method is as effective as other, highly-
researched therapies

APPLICATION OF GESTALT THERAPY:

1. Anxiety disorder: Gestalt therapy helps people focus on the present. This allows
individuals to discover what immediate thoughts, feelings, or behavior may make them
feel anxious.

 People with anxiety disorders frequently have intense, excessive and persistent worry and
fear about everyday situations. Often, anxiety disorders involve repeated episodes of
sudden feelings of intense anxiety and fear or terror that reach a peak within minutes
(panic attacks).
 These feelings of anxiety and panic interfere with daily activities, are difficult to control,
are out of proportion to the actual danger and can last a long time. You may avoid places
or situations to prevent these feelings. Symptoms may start during childhood or the teen
years and continue into adulthood.
  Agoraphobia (ag-uh-ruh-FOE-be-uh) is a type of anxiety disorder in which you fear and
often avoid places or situations that might cause you to panic and make you feel trapped,
helpless or embarrassed.

 Generalized anxiety disorder includes persistent and excessive anxiety and worry about
activities or events — even ordinary, routine issues. The worry is out of proportion to the
actual circumstance, is difficult to control and affects how you feel physically. It often
occurs along with other anxiety disorders or depression.

 Panic disorder involves repeated episodes of sudden feelings of intense anxiety and fear
or terror that reach a peak within minutes (panic attacks). You may have feelings of
impending doom, shortness of breath, chest pain, or a rapid, fluttering or pounding heart
(heart palpitations). These panic attacks may lead to worrying about them happening
again or avoiding situations in which they've occurred.

 Separation anxiety disorder is a childhood disorder characterized by anxiety that's

excessive for the child's developmental level and related to separation from parents or
others who have parental roles.

 Social anxiety disorder (social phobia) involves high levels of anxiety, fear and
avoidance of social situations due to feelings of embarrassment, self-consciousness and
concern about being judged or viewed negatively by others.

 Specific phobias are characterized by major anxiety when you're exposed to a specific
object or situation and a desire to avoid it. Phobias provoke panic attacks in some people.

 Substance-induced anxiety disorder is characterized by symptoms of intense anxiety or

panic that are a direct result of misusing drugs, taking medications, being exposed to a
toxic substance or withdrawal from drugs.

Symptoms

Common anxiety signs and symptoms include:

 Feeling nervous, restless or tense

 Having a sense of impending danger, panic or doom

 Having an increased heart rate

 Breathing rapidly (hyperventilation)

 Sweating
  Trembling

 Feeling weak or tired

 Trouble concentrating or thinking about anything other than the present worry

 Having trouble sleeping

 Experiencing gastrointestinal (GI) problems

 Having difficulty controlling worry

 Having the urge to avoid things that trigger anxiety

 Several types of anxiety disorders exist:

 Causes

The causes of anxiety disorders aren't fully understood. Life experiences such as traumatic events
appear to trigger anxiety disorders in people who are already prone to anxiety. Inherited traits
also can be a factor.

 Medical causes

For some people, anxiety may be linked to an underlying health issue. In some cases, anxiety
signs and symptoms are the first indicators of a medical illness. If your doctor suspects your
anxiety may have a medical cause, he or she may order tests to look for signs of a problem.

Examples of medical problems that can be linked to anxiety include:

 Heart disease

 Diabetes

 Thyroid problems, such as hyperthyroidism

 Respiratory disorders, such as chronic obstructive pulmonary disease (COPD) and

asthma

 Drug misuse or withdrawal

 Withdrawal from alcohol, anti-anxiety medications (benzodiazepines) or other

medications
  Chronic pain or irritable bowel syndrome

 Rare tumors that produce certain fight-or-flight hormones

 Sometimes anxiety can be a side effect of certain medications.

 It's possible that your anxiety may be due to an underlying medical condition if:
 You don't have any blood relatives (such as a parent or sibling) with an anxiety disorder

 You didn't have an anxiety disorder as a child

 You don't avoid certain things or situations because of anxiety

 You have a sudden occurrence of anxiety that seems unrelated to life events and you
didn't have a previous history of anxiety

 Risk factors

These factors may increase your risk of developing an anxiety disorder:

 Trauma. Children who endured abuse or trauma or witnessed traumatic events are at
higher risk of developing an anxiety disorder at some point in life. Adults who experience
a traumatic event also can develop anxiety disorders.

 Stress due to an illness. Having a health condition or serious illness can cause
significant worry about issues such as your treatment and your future.

 Stress buildup. A big event or a buildup of smaller stressful life situations may trigger
excessive anxiety — for example, a death in the family, work stress or ongoing worry
about finances.

 Personality. People with certain personality types are more prone to anxiety disorders
than others are.

 Other mental health disorders. People with other mental health disorders, such as
depression, often also have an anxiety disorder.

 Having blood relatives with an anxiety disorder. Anxiety disorders can run in families.

 Drugs or alcohol. Drug or alcohol use or misuse or withdrawal can cause or worsen
anxiety.
 2. Behavioral health issues: Gestalt therapy can help people with behavioral conditions
like bipolar disorder. It's also an effective therapeutic method for treating substance abuse,
compulsive gambling, and PTSD. People struggling with these conditions may develop a
new view on life through gestalt therapy and may see a positive change in their lifestyles.

A. Bipolar disorder, formerly called manic depression, is a mental health condition

that causes extreme mood swings that include emotional highs (mania or
hypomania) and lows (depression).

Symptoms

There are several types of bipolar and related disorders. They may include mania or hypomania
and depression. Symptoms can cause unpredictable changes in mood and behavior, resulting in
significant distress and difficulty in life.

 Bipolar I disorder. You've had at least one manic episode that may be preceded or
followed by hypomanic or major depressive episodes. In some cases, mania may
trigger a break from reality (psychosis).

 Bipolar II disorder. You've had at least one major depressive episode and at least
one hypomanic episode, but you've never had a manic episode.

 Cyclothymic disorder. You've had at least two years — or one year in children and
teenagers — of many periods of hypomania symptoms and periods of depressive
symptoms (though less severe than major depression).
Mania and hypomania

Mania and hypomania are two distinct types of episodes, but they have the same symptoms.
Mania is more severe than hypomania and causes more noticeable problems at work, school and
social activities, as well as relationship difficulties. Mania may also trigger a break from reality
(psychosis) and require hospitalization.

Both a manic and a hypomanic episode include three or more of these symptoms:

 Abnormally upbeat, jumpy or wired

  Increased activity, energy or agitation

 Exaggerated sense of well-being and self-confidence (euphoria)

 Decreased need for sleep

 Unusual talkativeness

 Racing thoughts

 Distractibility

 Poor decision-making — for example, going on buying sprees, taking sexual risks
or making foolish investments
Major depressive episode

A major depressive episode includes symptoms that are severe enough to cause noticeable
difficulty in day-to-day activities, such as work, school, social activities or relationships. An
episode includes five or more of these symptoms:

 Depressed mood, such as feeling sad, empty, hopeless or tearful (in children and
teens, depressed mood can appear as irritability)

 Marked loss of interest or feeling no pleasure in all — or almost all — activities

 Significant weight loss when not dieting, weight gain, or decrease or increase in
appetite (in children, failure to gain weight as expected can be a sign of depression)

 Either insomnia or sleeping too much

 Either restlessness or slowed behavior

 Fatigue or loss of energy

 Feelings of worthlessness or excessive or inappropriate guilt

 Decreased ability to think or concentrate, or indecisiveness

 Thinking about, planning or attempting suicide

Causes

The exact cause of bipolar disorder is unknown, but several factors may be involved, such as:
  Biological differences. People with bipolar disorder appear to have physical
changes in their brains. The significance of these changes is still uncertain but may
eventually help pinpoint causes.

 Genetics. Bipolar disorder is more common in people who have a first-degree

relative, such as a sibling or parent, with the condition. Researchers are trying to
find genes that may be involved in causing bipolar disorder.

B. SUBSTANCE USE:

Drug addiction, also called substance use disorder, is a disease that affects a person's
brain and behavior and leads to an inability to control the use of a legal or illegal drug or
medicine. Substances such as alcohol, marijuana and nicotine also are considered
drugs. When you're addicted, you may continue using the drug despite the harm it
causes.

Symptoms

Drug addiction symptoms or behaviors include, among others:

 Feeling that you have to use the drug regularly — daily or even several times a day

 Having intense urges for the drug that block out any other thoughts

 Over time, needing more of the drug to get the same effect

 Taking larger amounts of the drug over a longer period of time than you intended

 Making certain that you maintain a supply of the drug

 Spending money on the drug, even though you can't afford it

 Not meeting obligations and work responsibilities, or cutting back on social or

recreational activities because of drug use

 Continuing to use the drug, even though you know it's causing problems in your life
or causing you physical or psychological harm
  Doing things to get the drug that you normally wouldn't do, such as stealing

 Driving or doing other risky activities when you're under the influence of the drug

 Spending a good deal of time getting the drug, using the drug or recovering from
the effects of the drug

 Failing in your attempts to stop using the drug

 Experiencing withdrawal symptoms when you attempt to stop taking the drug

Causes

Like many mental health disorders, several factors may contribute to development of drug
addiction. The main factors are:

 Environment. Environmental factors, including your family's beliefs and attitudes

and exposure to a peer group that encourages drug use, seem to play a role in initial
drug use.

 Genetics. Once you've started using a drug, the development into addiction may be
influenced by inherited (genetic) traits, which may delay or speed up the disease
progression.

Changes in the brain

Physical addiction appears to occur when repeated use of a drug changes the way your brain
feels pleasure. The addicting drug causes physical changes to some nerve cells (neurons) in your
brain. Neurons use chemicals called neurotransmitters to communicate. These changes can
remain long after you stop using the drug.

Risk factors

People of any age, sex or economic status can become addicted to a drug. Certain factors can
affect the likelihood and speed of developing an addiction:

 Family history of addiction. Drug addiction is more common in some families and
likely involves an increased risk based on genes. If you have a blood relative, such
as a parent or sibling, with alcohol or drug addiction, you're at greater risk of
developing a drug addiction.
  Mental health disorder. If you have a mental health disorder such as depression,
attention-deficit/hyperactivity disorder (ADHD) or post-traumatic stress disorder,
you're more likely to become addicted to drugs. Using drugs can become a way of
coping with painful feelings, such as anxiety, depression and loneliness, and can
make these problems even worse.

 Peer pressure. Peer pressure is a strong factor in starting to use and misuse drugs,
particularly for young people.

 Lack of family involvement. Difficult family situations or lack of a bond with your
parents or siblings may increase the risk of addiction, as can a lack of parental
supervision.

 Early use. Using drugs at an early age can cause changes in the developing brain
and increase the likelihood of progressing to drug addiction.

 Taking a highly addictive drug. Some drugs, such as stimulants, cocaine or opioid
painkillers, may result in faster development of addiction than other drugs. Smoking
or injecting drugs can increase the potential for addiction. Taking drugs considered
less addicting — so-called "light drugs" — can start you on a pathway of drug use
and addiction.

C. COMPULSIVE GAMBLING:

Compulsive gambling, also called gambling disorder, is the uncontrollable urge to keep
gambling despite the toll it takes on your life. Gambling means that you're willing to risk
something you value in the hope of getting something of even greater value.

Symptoms

Signs and symptoms of compulsive gambling (gambling disorder) can include:

 Being preoccupied with gambling, such as constantly planning gambling activities

and how to get more gambling money

 Needing to gamble with increasing amounts of money to get the same thrill

 Trying to control, cut back or stop gambling, without success

 Feeling restless or irritable when you try to cut down on gambling

  Gambling to escape problems or relieve feelings of helplessness, guilt, anxiety or
depression

 Trying to get back lost money by gambling more (chasing losses)

 Lying to family members or others to hide the extent of your gambling

 Risking or losing important relationships, a job, or school or work opportunities

because of gambling

 Asking others to bail you out of financial trouble because you gambled money away

Causes

Exactly what causes someone to gamble compulsively isn't well understood. Like many
problems, compulsive gambling may result from a combination of biological, genetic and
environmental factors.

Risk factors

Although most people who play cards or wager never develop a gambling problem, certain
factors are more often associated with compulsive gambling:

 Mental health issues. People who gamble compulsively often have substance
misuse problems, personality disorders, depression or anxiety. Compulsive
gambling may also be associated with bipolar disorder, obsessive-compulsive
disorder (OCD) or attention-deficit/hyperactivity disorder (ADHD).

 Age. Compulsive gambling is more common in younger and middle-aged people.

Gambling during childhood or the teenage years increases the risk of developing
compulsive gambling. But compulsive gambling in the older adult population can
also be a problem.

 Sex. Compulsive gambling is more common in men than women. Women who
gamble typically start later in life and may become addicted more quickly. But
gambling patterns among men and women have become increasingly similar.

 Family or friend influence. If your family members or friends have a gambling

problem, the chances are greater that you will, too.
  Medications used to treat Parkinson's disease and restless legs
syndrome. Drugs called dopamine agonists have a rare side effect that may result
in compulsive behaviors, including gambling, in some people.

 Certain personality characteristics. Being highly competitive, a workaholic,

impulsive, restless or easily bored may increase your risk of compulsive gambling.

D. PTSD:
Post-traumatic stress disorder (PTSD) is a mental health condition that's triggered by a terrifying
event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares
and severe anxiety, as well as uncontrollable thoughts about the event.

Symptoms

Post-traumatic stress disorder symptoms may start within one month of a traumatic event, but
sometimes symptoms may not appear until years after the event. These symptoms cause
significant problems in social or work situations and in relationships. They can also interfere
with your ability to go about your normal daily tasks.

PTSD symptoms are generally grouped into four types: intrusive memories, avoidance, negative
changes in thinking and mood, and changes in physical and emotional reactions. Symptoms can
vary over time or vary from person to person.

Intrusive memories

Symptoms of intrusive memories may include:

 Recurrent, unwanted distressing memories of the traumatic event

 Reliving the traumatic event as if it were happening again (flashbacks)

 Upsetting dreams or nightmares about the traumatic event

 Severe emotional distress or physical reactions to something that reminds you of the
traumatic event

Avoidance

Symptoms of avoidance may include:

  Trying to avoid thinking or talking about the traumatic event

 Avoiding places, activities or people that remind you of the traumatic event

Negative changes in thinking and mood

Symptoms of negative changes in thinking and mood may include:

 Negative thoughts about yourself, other people or the world

 Hopelessness about the future

 Memory problems, including not remembering important aspects of the traumatic

event

 Difficulty maintaining close relationships

 Feeling detached from family and friends

 Lack of interest in activities you once enjoyed

 Difficulty experiencing positive emotions

 Feeling emotionally numb

Changes in physical and emotional reactions

Symptoms of changes in physical and emotional reactions (also called arousal symptoms) may
include:

 Being easily startled or frightened

 Always being on guard for danger

 Self-destructive behavior, such as drinking too much or driving too fast

 Trouble sleeping

 Trouble concentrating

 Irritability, angry outbursts or aggressive behavior

 Overwhelming guilt or shame

For children 6 years old and younger, signs and symptoms may also include:
  Re-enacting the traumatic event or aspects of the traumatic event through play

 Frightening dreams that may or may not include aspects of the traumatic event

Causes

You can develop post-traumatic stress disorder when you go through, see or learn about an event
involving actual or threatened death, serious injury or sexual violation.

Doctors aren't sure why some people get PTSD. As with most mental health problems, PTSD is
probably caused by a complex mix of:

 Stressful experiences, including the amount and severity of trauma you've gone
through in your life

 Inherited mental health risks, such as a family history of anxiety and depression

 Inherited features of your personality — often called your temperament

 The way your brain regulates the chemicals and hormones your body releases in
response to stress

3. DEPRESSION (REFER BIPOLAR)

4. Relationship difficulties:
Gestalt therapy can help couples recognize underlying destructive behaviors that may be negatively
impacting their relationships. This can help them work toward making positive changes in their
relationship and individual lifestyles.
1. Communication

If people in a relationship can master communication, you’ll be far less likely to experience other
common relationship problems.

Effective, honest communication is essential to relationship success.

Different people communicate differently. You may be quiet while your partner is talkative.
Regardless of your communication styles, relationships need effective, regular communication to
thrive as a unit.

2. Staying Close
With time, every long term relationship will change. Some of what used to seem most important
might begin to not even phase you anymore. Additionally, as things in the relationship change,
you and your romantic partner may also be changing in different ways, evolving as individuals.

4. Sex & Intimacy

Many relationship problems are sex-based. Ask yourself what you want sexually. Be honest and
open with yourself. Encourage your partner to do the same. Then, get together and discuss what
you both want.

5. Infidelity

If your partner cheated on you, you’ll have to decide for yourself if you can forgive them, or if
you’ll need to move on without them in your life.

Most affairs don’t typically happen spontaneously. Infidelity can also come in the form of
emotional cheating, too. If you want the relationship to survive post-affair, you’ll both need to be
honest about what happened, and then work together to solve any underlying issues.

6. Money

The simple fact is life requires money and couples argue about finances. Financial pressures can
lead to catastrophic relationship issues when not addressed properly. Research shows that more
than half of all couples enter a marriage already in debt.

7. Trauma

External pressures from traumatic life events can stress any relationship. The death of a loved
one, financial strain, disease diagnosis, chronic stress, past abuse, or anything else that you or
your partner has endured can affect emotional and physical health. Don’t shut your partner out.
You’re a team. Be there for each other, even through the rough times.

9. Children

Parenting can be very difficult if you haven’t developed a cohesive plan and a firm commitment
to stick to. This is especially true in the case of step-parenting. If you’re raising children from
previous relationships together, definitive house rules are necessary. Talk with your partner in
private about any parenting issues, and always present a unified front.

10.Trust

Trust is one of the most important aspects of any relationship. If you’re questioning whether or
not you can trust your partner, calmly yet firmly ask them if there’s reason for concern. If your
partner is the one who has trust issues, reassure them they have nothing to worry about.
 5. Self-esteem issues:
 Self-esteem refers to a person's overall sense of self-value. It is essentially your opinion
about yourself. Your self-esteem can encompass a range of factors, such as your sense of
identity, self-confidence, feelings of competence, and feelings of belonging.
 Self-esteem is about more than just generally liking yourself—it also means believing
that you deserve love and valuing your own thoughts, feelings, opinions, interests, and
goals. It can also play a role in how you allow others to treat you.

Signs of Low Self-Esteem

 While not a mental illness, poor self-esteem can still affect a person’s thoughts, emotions,
and patterns of behavior. Sometimes its signs can be fairly apparent. Other times, low
self-esteem symptoms are much more subtle.

Poor Confidence
People with low self-confidence tend to have low self-esteem, and vice versa.1
Low self-esteem can play a role in causing a lack of confidence, but poor confidence can also
contribute to or worsen poor self-esteem.
Lack of Control
People who have low self-esteem often feel that they have little control over their lives or what
happens to them. This can be due to the feeling that they have little ability to create changes in
themselves or in the world. Because they have an external locus of control, they feel powerless to
do anything to fix their problems.
Negative Social Comparison
Social comparison can sometimes serve a positive function and enhance a person's sense of self.
But comparing yourself to others can also damage self-esteem. People with low self-esteem may
be more likely to engage in what is known as upward social comparison, or comparing
themselves to people who they think are better than themselves
Problems Asking for What You Need
When a person has low self-esteem, they may struggle to ask for what they need. Trouble asking
for what you need can be caused by feeling embarrassed. Or you may feel that a need for
assistance and support is a sign that you are incompetent.
Worry and Self-Doubt

Even after making a decision, people who have low self-worth often worry that they’ve made the
wrong choice. They doubt their own opinions and may defer to what others think instead of
sticking to their choices.

Trouble Accepting Positive Feedback

A 2017 study published in the Journal of Experimental Social Psychology found that low self-
esteem is directly correlated to not being able to accept or capitalize on compliments from others.
Negative Self-Talk
Low self-esteem causes people to focus on their flaws rather than their strengths. Rather than
build themselves up with positive self-talk, they always seem to have something negative to say
about themselves, engaging in negative self-talk instead.
Fear of Failure

Because they lack confidence in their abilities, people with low self-esteem doubt their ability to
achieve success. Because they fear failure, they tend to either avoid challenges or give up
quickly without really trying.

Poor Outlook

Low self-worth can cause people to feel that there is little chance that the future will be any
better than the present. These feelings of hopelessness can make it hard for people with low self-
esteem to engage in behaviors that will bring about positive changes in their lives.

Lack of Boundaries
The ability to set boundaries is often established early in life. Children with caregivers who show
them that they are respected and valued are better able to create good boundaries in adult
relationships. They are also more likely to have a more positive view of themselves in general.
Trying to Please Others
People-pleasing is another common symptom of low self-esteem. In order to gain external
validation, people who don't feel good about themselves may go above and beyond to make sure
that others are comfortable and happy.

HOW GESTALT THERAPY IS USED TODAY:

Today, Gestalt is a well established, well known therapeutic approach and is increasingly
popular with people looking for a practical, positive way to address problems and effect change
in their lives. The Gestalt Centre has been operating in London for more than 30 years and is a
recognised centre of expertise for training in Gestalt therapy.