Free Research Papers Gestalt Psychology
This essay will explore the nature of learning from different approaches in psychology. Furthermore, the ways in which learning might affect health and well-being will be investigated. This will be carried out by examining different treatments, in an attempt to reveal the use of learning as part of these treatments.
Initially, key terms will be defined. Subsequently, learning will be discussed from the perspectives of the behavioural approach, the social approach and the biological approach, all of which represent different psychology perspectives. Following this, Gestalt therapy, psychoanalytical psychodynamic psychotherapy (PPP) and naturopathy will be considered as treatments, in which learning plays an essential part. Finally, there will be a reflection on what has preceded, followed by a conclusion.
The terms `learning', `health' and `well-being' require definition. Smith et al define `learning' as `relatively permanent change in behaviour that occurs as the result of experience' (2003, p.233). Gross states that `learning is a hypothetical construct: it cannot be directly observed, but only inferred from observable behaviour' (2005, p.171). There are several definitions of the term `health'. In this essay the World Health Organisation definition will be used. `Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity' (WHO, 2006, p.1). Whereas, `well-being refers to how good, desirable and enjoyable life as a whole is felt by the person in question. In this sense, it is a subjective feeling, something felt or experienced' (Chatterji, S. et al, 2002, p.15).
Having defined key terms, the first point of discussion will be to view learning from different perspectives of psychology. Firstly, learning will be explored from the behavioural perspective. According to this approach, behaviour is influenced by the environment (Gross, 2005). The key idea is that the human brain is `a tabular rasa at birth - a blank slate, waiting to be written on by its experiences' (Hayes, 1994, p.249). There are different mechanisms and processes influencing learning within the behavioural approach, such as, classical conditioning and operant (or instrumental) conditioning, which will be discussed.
Classical conditioning is based on Pavlov's experiments on dogs and Watson's studies of the behaviour of animals and infants (Smith et al, 2003). The fundamental principle is `the idea of learning through association' (Hayes, 1994, p.846). An association is `a learned link (…) between a stimulus and a response' and it `could be forged simply by repeating the two together often enough' (Hayes, 1994, p.846). Thus, when the same stimulus repeatedly creates the same response, one will create an association between the two and eventually will learn that this stimulus creates this specific response.
Skinner developed operant conditioning (Smith et al, 2003). According to this, learning happens because it is reinforced (Hayes, 1994). There are two types of reinforcement, positive and negative. `Positive reinforcement describes a behaviour that produces an appetitive stimulus, and negative reinforcement occurs when behaviour prevents an aversive stimulus' (Smith et al, 2003, p.243). In other words, behaviour that is followed by positive outcomes is strengthened and it will probably be repeated, whereas behaviour that is followed by negative outcomes will probably not be repeated (Hogg & Vaughan, 2008).
The social learning theory derives from the behavioural approach and was developed by Bandura (Smith et al, 2003). According to Bandura there are three factors that influence one's behaviour. These factors are the `internal cognitive processes', `observation of the behaviours of others and the environment in which behaviour occurs' (Smith et al, 2003, p.472). One can learn behaviour through the processes of `imitation and modelling' (Hayes, 1994, p.308). This requires observation of the outcomes of others' responses and learning these responses (Hogg & Vaughan, 2008). Thus, one observes others, learns to imitate their behaviour and thus they become a model for behaviour.
The biological perspective in psychology identifies the neurobiological processes that cause behaviour (Smith et al, 2003). The nervous tissue consists of neurones and neuroglia (Tortora and Derrickson, 2009). Neurones transmit nerve impulses from their origins to their destinations (Waugh & Grant, 2007). The point at which the nerve impulse passes from one neurone to another is called a synapse (Waugh & Grant, 2007). According to the biological approach, learning is viewed as a transformation in the synapse. The effect of this transformation is to make the synapse more or less effective (Smith et al, 2003).
Having viewed learning from different psychological perspectives, this section will review therapies in which learning plays an essential role. These therapies are the Gestalt therapy, psychodynamic psychoanalytical psychotherapy (PPP) and naturopathy. It is important to consider alternative methods in promoting and preserving health and well-being to the current prevailing medical model. It is essential because many support that the current medical model has an increasingly narrow, linear and reductionist view of health and well-being (Kielhofner, 1997; Lim and Iwama, 2006, citing Masi 1992; Pauli et al, 2000; Wilcock, 2006).
Initially, Gestalt therapy will be explored and the use of learning within this therapy will be highlighted. In the early 1900s the school of Gestalt psychology (Gross, 2005) was developed in Germany (Hayes, 2000). Gestalt psychologists believe that human beings have the tendency to complete patterns or find meaning in any form (Mackewn, 1997). This led them to argue that `the whole is different from the sum of its parts, because the whole depends on the relationships among the parts' (Smith et al, 2003, p.8). As a result, human beings can only be comprehended as a whole and within a context (Mackewn, 1997).
According to Gestalt psychologists, humans arrange their experiences and ideas into meaningful wholes (Mackewn, 1997). Thus, humans have an inherent desire to complete or seek meaning from their emotional life. Subsequently, when one cannot experience closure and feels unable to make sense out of his or her experiences or ideas, there is anxiety (Mackewn, 1997), which interferes with the formation of new experiences or ideas (Hayes, 2000). This uneasiness is to be addressed and resolved in Gestalt therapy.
The main goal in Gestalt therapy is to bring awareness to the client (Hayes, 2000). The therapist guides the service user towards the formation of meaningful, organised, whole ideas and perceptions (Hayes, 2000). Thus, the client is supported in regaining a sense of who they are and what is important in their life and therefore the service user becomes aware (Hayes, 2000). The client is taught mechanisms in order to preserve this newly found awareness, which are the same mechanisms that are used by the therapist to bring awareness. For example, the therapist could offer to the service user new ways of experiencing situations, in order to help the client grow to understand and experience things directly (Hayes, 2000). The therapist could also educate the service user on how to experience things fully by concentrating on forming and completing just one experience at a time (Hayes, 2000). Overall, the Gestalt therapist aims to `complete or resolve people's unfinished business and free them up to move on with their life' (Mackewn, 1997, p.17).
However, depending on the severity of the case, it could be argued that bringing awareness of one's actions might not be an adequate treatment. As a result, Gestalt therapy would not have the same therapeutic outcomes for everyone. Whereas, it could be suggested that taking a pill is faster, cheaper, painless and more reliable. Therefore, why should one attend Gestalt therapy, if there are no guarantees of the outcome? Pestello and Davis-Berman (2008) support in a study they conducted with people who are prescribed antidepressant medication, that the ease and speed with which the physicians prescribe psychiatric medication is disproportionate to the support that physicians offer to the clients once on medication. This leaves the clients by themselves to deal with negative side effects, such as loss of sense of self and sexual side-effects (Pestello and Davis-Berman, 2008). Thus, the use of a pill might not be as implication-free as one might initially think. Whereas, it could be argued that although Gestalt therapy will take longer, might be harder and more costly, the teachings which the client has gained will not only help in dealing with the current situation, but will also provide valuable tools in dealing with any future situation that might arise. Thus, Gestalt therapy could be viewed not only as a cure for the present situation, but also as an investment in preserving health and well-being.
Having discussed Gestalt therapy, how it operates and the role of learning within it, the next therapy to consider is psychodynamic psychoanalytical psychotherapy (PPP). PPP will be viewed and the use of learning within this therapy will be underlined. Freud developed psychoanalysis in the late 1890s and early 1900s (Gabbard, 2005). Psychoanalysis is an intense therapy, whereby the client attends sessions four to five times per week, often for numerous years (Brown and Pedder, 1991). As this form of therapy is not feasible for most, nowadays analytic psychotherapy tends to start with one to three appointments per week and the service user can decide on the future frequency of sessions (Brown and Pedder, 1991). The psychodynamic theory also stems from Freud and it focuses on the unconscious forces that motivate one's behaviour (Gross, 2005) and affect one's thinking and well-being (Hayes, 2000).
The core of Freud's theory is the idea of the unconscious, which influences behaviour (Smith et al, 2003). The unconscious contains `the thoughts, attitudes, impulses, wishes, motivations and emotions' (Smith et al, 2003, p.8) of which one is not aware. Thus, the main notion in PPP is that for the client's present issues to be thoroughly worked out, the service user needs to fully understand the unconscious source of the problems, which stem from the early relationships within the family (Smith et al, 2003). Essentially, in PPP the therapist helps the client understand his or her past, in order to be able to deal with the present and future in a better way.
There are several techniques that an analyst can employ in order to address these issues and to reach the unconscious. Freud initially used the method of hypnosis in order to access his patient's unconscious (Brown and Pedder, 1991). He then developed the method of free association, whereby the service user was invited to say whatever came into their mind (Brown and Pedder, 1991). Moreover, Freud developed the study of dreams, which he considered to provide a valuable inside to one's unconscious (Gabbard, 2005). Another technique is the investigation of minor slips of the tongue, which let unconscious anxieties emerge (Hayes, 2000).
Freud also identified essential features of any psychoanalytic approach, such as transference, resistance and countertransference (Brown and Pedder, 1991; Gabbard, 2005). The therapist forms a therapeutic alliance with the client, whereby both focus on understanding the child within the service user (Gross, 2005). As this relationship develops, the client experiences transference phenomena, which are encouraged and explored (Brown and Pedder, 1991). Transference takes place when the service user unconsciously associates the analyst with someone from their past (Gabbard, 2005). With the help of the therapist, transference becomes conscious to the client (Gabbard, 2005). Thus, the service user can be free from the past's continuing effects, by making the unconscious conscious (Brown and Pedder, 1991). The client may display resistance in the form of silence, avoidance of difficult topics, forgetting appointments or even falling asleep during the sessions (Gabbard, 2005). This resistance should be viewed as a revelation of the patient's internal world (Gabbard, 2005). Countertransference is the therapist's transference to the service user (Gabbard, 2005). Countertransference was viewed by Freud as a difficulty in treating the client, which originates from the analyst (Gabbard, 2005). However, nowadays it is viewed as a valuable feature of PPP because although it originates from the therapist's past, it can also provide the analyst with an understanding of how other people feel in relationships with the service user (Gabbard, 2005). As long as the analyst contains the countertransference, it can be used as a therapeutic tool (Brown and Pedder, 1991).
Overall, with PPP the service user reconstructs and re-evaluates emotions and desires which were repressed during childhood (Gross, 2005). The client is able to articulate them, as an adult, in an appropriate way and in a safe environment and is also able to experience a different ending to these emotions and desires from what he or she may have expected (Gross, 2005). Therefore, the client not only learns the benefits of being analytical and reflective, but also learns how one's unconscious mind can affect their life (Hayes, 2000). All in all, the service user learns new ways of looking at problems by understanding their roots (Smith et al, 2003). With these teachings the client is able to experience himself or herself and his or her relationships in full (Brown and Pedder, 1991). Furthermore, there is less conflict and alienation of parts within the service user, thus the client is able to develop and grow (Brown and Pedder, 1991).
It has been supported by Eysenck (1985, cited by Hayes, 2000) that there is little evidence that PPP is successful, because the amount of people who made progress with the help of psychoanalysis was not very different from the percentages to be expected from improving just as a result of time, without treatment. As it has been argued already for Gestalt therapy, results might be uncertain and each person's experience of PPP might vary. However, as Pestello and Davis-Berman's (2008) study indicates, even with modern medicine the results might be unclear and differ between various people. In spite of PPP not being fast or cost-effective, it is a therapy that has the potential of relieving the client of current symptoms and also providing him or her with the tools to deal with problems that might arise. After all, understanding the past may be the key to dealing with the present and the future (Brown and Pedder, 1991).
Having discussed the therapeutic process of PPP and the function of learning within it, the next therapy to contemplate is naturopathy and the use of learning within this therapy will be pointed out. During the 18th and 19th centuries, nature's healing potential became a subject of interest with the work of the Germans Priessnietz and Kneipp, who used hydrotherapy as a treatment for illnesses (Ernst et al, 2007). Lust, who was a student of Kneipp, moved to the US where he established hydrotherapy and coined the term naturopathy for the method he was using (Ernst et al, 2007). Initially, naturopathy was strongly related to hydrotherapy and was known for its opposition to mainstream medicine (Uehleke, 2007). Nowadays, naturopathy has evolved in `an eclectic system of health care that uses elements of complementary and conventional medicine to support and enhance self-healing processes' (Ernst et al, 2007, p.146).
`The aim of naturopathy is to educate patients on how to prevent illness and, if they are sick, to support the body's capacity to heal itself' (Center for Integrative Medicine, 2006, p.443). Thus, one of the main goals of naturopathy is for the client to learn a different and more beneficial lifestyle. A naturopath may use several treatments, such as counselling, electrical stimulation, acupuncture, hydrotherapy, nutrition, herbal medicine, mind-body connection, exercise and use of the physical environment (Center for Integrative Medicine, 2006). In this essay only the treatments that use learning will be examined.
Naturopaths use mainly cognitive behaviour therapy as part of their counselling sessions (Center for Integrative Medicine, 2006). Cognitive behaviour therapy endeavors to assist people to recognize what types of stressful circumstances create their physiological or emotional symptoms (Smith et al, 2003). Furthermore, the therapist helps the client to change the methods with which they handle these circumstances (Smith et al, 2003). Thus, the service user is trained to deal with stressful or unpleasant situations in a different way from what they normally would.
A naturopath aims to improve the client's health and well-being by examining his or her history and current lifestyle (Ernst et al, 2007) and making modifications as necessary (Center for Integrative Medicine, 2006). Nutrition is believed to be essential to health and well-being because the human body will only achieve and preserve good health if it obtains sufficient amounts of food, which will provide adequate quantities of energy and nutrients (Fox and Cameron, 1990). The naturopath, by eliminating certain foods, constructs a diet that is addressed to the needs of each individual service user (Center for Integrative Medicine, 2006). The client is also taught the benefits of a diet high in fresh fruit and vegetables (Ernst et al, 2007). Furthermore, the service user learns of the benefits of regular physical exercise (Ernst et al, 2007). Moreover, a naturopath might use light therapy as part of the treatment, during which the client learns the benefits of light and the impact of the physical environment on his or her health and well-being (Center for Integrative Medicine, 2006).
Guided imagery or visualization of one's health condition is a technique used by naturopaths to improve and maintain good health (Center for Integrative Medicine, 2006). Visualization can direct the mind's power to influence the body (Whorton, 2002) and it can also develop one's awareness, by constructing images and investigating their meaning (Center for Integrative Medicine, 2006). The exploration of these images offers the client opportunities to learn valuable information about themselves and their condition (Center for Integrative Medicine, 2006).
It could be supported that naturopathy as a therapy embraces virtually any alternative therapy, with no specific focus (Whorton, 2002; Uehleke, 2007). On the other hand, naturopathy should be viewed as a philosophy of life and not as set of inflexible prescriptions (Trattler, 1985), embracing inclusivity in an attempt to be truly holistic. Furthermore, similarly as in the cases of Gestalt therapy and PPP it could be claimed that results are not guaranteed. But then again, there does not seem to be a medical model that offers guarantees, as previously discussed. Finally, it could be argued that naturopathy is not based on a specific scientific system and there is no systematic academic proof of its effectiveness (Center for Integrative Medicine, 2006; Uehleke, 2007). Nonetheless, there is evidence of the effectiveness of the different treatments used within naturopathy (Center for Integrative Medicine, 2006).
It has been illustrated throughout this essay that learning can be of great contribution in improving and maintaining health and well-being. As discussed in Gestalt therapy, the client learns mechanisms, which help him or her gain and maintain awareness of what is important in their life. In turn, awareness brings the freedom to change and make responsible choices (Clarkson, 2004). Furthermore, with PPP the service user is taught to analytically explore the past and to understand it. The benefit of this exploration is to better understand one's self in the present, which assists in being able to deal with difficulties in the future (Brown and Pedder, 1991). Finally, naturopathy's main goal is to teach the client how to sustain good health and avoid ailment (Center for Integrative Medicine, 2006).
Learning can be empowering and rewarding as it can make a difference to one's behaviour, attitude, personality and future choices to be made (Rogers, 1996), all of which impact health and well-being. It could also be argued that without learning humans would not be as successful species as they are, because they would not be able to learn new skills and to develop (Smith et al, 2003). Finally, according to Rogers and Freiberg learning is a holistic experience as it `combines the logical and intuitive, the intellect and the feelings, the concept and the experience, the idea and the meaning' (1994, p.37).