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Enhancing Your Therapy with Gestalt Approaches
Gestalt Therapy continuing education addiction counselor CEUs

Section 26
Using the Gestalt Empty Chair Technique to
Detriangulate an Absent Father

CEU Question 26 | CEU Answer Booklet | Table of Contents | Gestalt
Psychologist CEs, Social Worker CEUs, Counselor CEUs, MFT CEUs

The projection of the mother's unresolved feelings about an absent father onto one or more of her children--often the eldest son expected to assume the role of parental child--is an obstacle frequently encountered in therapy with single-parent Black families. Acknowledgment and resolution of these feelings by the mother is an important step toward reestablishing generational boundaries and improving communication between mother and children. It is suggested that the empty chair procedure and the use of family photographs are two interventions that can be used within the context of structural and/or transgenerational family therapies to help the mother separate her feelings about the absent father from her feelings about her children. Models for the use of both approaches and the potential benefits of each is presented. The successful outcome of either technique may depend, however, on variables in the family's history and the stage of therapy during which the techniques are introduced.

The Triangling Of Absent Fathers
One way to look at the effect of a mother's projection of her feelings about an absent father onto his son is in terms of triangling, a term coined by Minuchin (1974) to describe the method by which communication between two members of a family subsystem is diverted through their interactions with a third member. The classic example is the husband and wife who use one of their children as a "go-between" or scapegoat for unresolved conflicts between themselves.

By projecting her feelings about the absent father onto her son, the mother has, in effect, created a triangle composed of absent lather, son, and herself. Were the father alive and living with the family, or even in contact with the family, we would say that the mother was triangling the son into her relationship with the father, because the son would be the third party onto whom the parents' issues were being diverted. With the father absent, and the son perhaps being needed to assume a parental-child role in the family, however, it is the issues in the relationship between the mother and her son that are being confused with, and obfuscated by, the mother's feelings about the absent lather.

Among the issues most likely to arise between a single mother and a parental child is the conflict between the son or daughter's "age-appropriate thrust toward interaction with his or her peer group" (Boyd-Franklin, 1989), and the mother's reliance on him (or her) to take on parenting responsibilities. The parental child's thrust toward differentiation (Bowen, 1976) is both natural, appropriate, and psychologically healthy, yet his assumption of various executive functions of the household--often necessary for the well-being of the entire family system--may in his mother's eyes, as well as his own, seem in direct contradiction to that thrust to differentiate. As Minuchin (1974) pointed out, the therapeutic goal, then, is to "realign the family in such a way that the parental child can still help the mother," without blurring of generational boundaries. In other words, the son should be able to help his mother, without foregoing the developmental tasks appropriate to adolescence. These issues are best addressed directly between mother and son, with the therapist acting to support both in their respective roles. When, however, the absent father is triangled into the mother-son relationship, it becomes easier for the mother to view her son's thrust toward differentiation as evidence of irresponsibility or uncaringness by virtue of his resemblance to his father whom she might resent for having been (in her eyes) irresponsible or uncaring.

The Use of the Empty Chair: The rationale underlying the Empty Chair technique (popularized by Fritz Perls in his book, Gestalt Therapy, 1951) is well described by Sherman and Fredman (1986): "The process is based on the assumption that the parents' internalized object relations are played out with their children. The parents' internalized relational difficulties result in boundary and contact problems for the members of the family, such as scapegoating, enmeshment, and projective identification by the child. This technique affords the members of the family an opportunity to carry on dialogues with significant individuals who are not present ... the goal is to stimulate the person to those feelings and beliefs that he projects onto other members. The projections create a distortion of reality in the system. The family is organized around those distortions. By integrating the feelings into the self, a more realistic pattern of interaction can emerge (pp. 64-65)."

The Empty Chair is particularly useful in instances such as the one under discussion, as Sherman and Fredman (1986) explain: "The Gestalt technique of the Empty Chair is a useful strategy for working with projection. To interrupt the process of projection this technique may assist the parent in reowning and assimilating the disowned part of himself. By reidentifying the disowned side of the dialogue, the parent is better able to see and relate to the child without projecting his disowned fantasy... In those clinical situations in which a parent projects onto a child, the therapist may interrupt the process of projection by having the parent use the Empty Chair technique. In this instance, it is recommended typically to have the parent work on his projections separate from the children as the intensity and intimacy of the work may weaken generational boundaries (pp. 66-67)."

Bauer (1979) has given a detailed description of the Empty Chair procedure as it is commonly used. Two chairs are set facing each other, and the therapist has the parent sit in one chair and speak to her child as though he were sitting in the empty chair opposite her. Then the therapist instructs the parent to move to the facing chair and speak for the child to herself in the chair she just left. With periodic guidance and interpretive comments from the therapist, the parent continues to conduct both sides of the dialogue until "the parent begins to reown some of the projected parts" (Bauer, 1979).

Eventually the focus will shift from the parent and child dialogue to dialogue within the parent himself or possibly between the parent and his own imagined parent in the empty chair. In this way, the experience is located historically within the family of origin (Bauer, 1979).
It is worth noting that Bauer refers to the Empty Chair technique possibly leading to a dialogue between the parent and his or her own imagined parent, and particularly relevant when working with single-parent Black mothers. Since the times of slavery, American society has either overtly or covertly undermined the nuclear Black family, and the welfare system, in particular, has rewarded the lack of involvement of Black fathers with their children and the mothers of their children. First, welfare laws prohibit the father (or another man) from living in the home of a mother receiving welfare assistance. In addition,

Procedure with Black Single-Parent Mothers: The first stage of the procedure will begin with the mother conducting both sides of a dialogue between herself and her eldest (parental-child) son. At any point in the dialogue, where the therapist notices the mother's projections of her son's absent father coming into the conversation, he will encourage the mother to conduct both sides of a dialogue between herself and her son's absent father. That would be the second stage. As the dialogue between the mother and her son's absent father progresses, the therapist will be alert to evidence of the projection of the mother's feelings about her own absent father onto the son's absent father, and in this way guide the mother toward assimilating her feelings about both absent fathers (hers and her son's) and separating those feelings from the way she sees her son. This is the third stage. In most cases where the mother's father was either present in her home during her childhood, or sufficiently involved with her and her family that she didn't feel abandoned by him, the procedure can end during the second stage (her dialogue between her son's absent father and herself). On the other hand, if the mother's father was present in her home during her childhood but was abusive to her or other members of the family, the therapist should encourage and guide the mother toward the third stage of dialogue.
- Lowe Jr., Walter; Detriangulation of Absent Fathers in Single-Parent Black Families: Techniques of Imagery; American Journal of Family Therapy, Jan-Mar2000, Vol. 28 Issue 1
The article above contains foundational information. Articles below contain optional updates.

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Personal Reflection Exercise #12
The preceding section contained information about using the Gestalt Empty Chair technique to detriangulate an absent father.  Write three case study examples regarding how you might use the content of this section in your practice.

Online Continuing Education QUESTION 26
What is triangling? Record the letter of the correct answer the CEU Answer Booklet.

 
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The article above contains foundational information. Articles below contain optional updates.
Enhancing psychotherapy process with common factors feedback: A randomized, clinical trial.
In this study, we developed and tested a common factors feedback (CFF) system. The CFF system was designed to provide ongoing feedback to clients and therapists about client ratings of three common factors: (a) outcome expectations, (b) empathy, and (c) the therapeutic alliance. We evaluated the CFF system using randomized, clinical trial (RCT) methodology. Participants: Clients were 79 undergraduates who reported mild, moderate, or severe depressive symptoms at screening and pretreatment assessments. These clients were randomized to either: (a) treatment as usual (TAU) or (b) treatment as usual plus the CFF system (TAU + CFF). Both conditions entailed 5 weekly sessions of evidence-based therapy delivered by doctoral students in clinical psychology. Clients completed measures of common factors (i.e., outcome expectations, empathy, therapeutic alliance) and outcome at each session. Clients and therapists in TAU + CFF received feedback on client ratings of common factors at the beginning of Sessions 2 through 5. When surveyed, clients and therapists indicated that that they were satisfied with the CFF system and found it useful. Multilevel modeling revealed that TAU + CFF clients reported larger gains in perceived empathy and alliance over the course of treatment compared with TAU clients. No between-groups effects were found for outcome expectations or treatment outcome. These results imply that our CFF system was well received and has the potential to improve therapy process for clients with depressive symptoms. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Can reflecting on personal values online increase positive beliefs about counseling?
This research developed and tested an online values-affirmation exercise to attenuate threat and enhance positive beliefs about counseling among individuals struggling with mental health concerns. There is evidence that reflecting on personal values (values-affirmation) is an effective approach to eliciting self-affirmation—a psychological process that temporarily bolsters self-worth in order to forestall maladaptive, self-protective responses to counseling information. The present study utilized a randomized 2-group between-subjects design to test the effectiveness of a values-affirmation exercise with an online sample (N = 186) of adults who reported struggling with a mental health concern. It was predicted that values-affirmation would reduce threat related to reading mental health information and increase positive beliefs about counseling. Results indicated that those in the values-affirmation condition reported fewer negative emotions such as feeling upset, irritable, hostile, and scared after reading mental health information, indicating that the information was perceived as less threatening. There was also evidence that engaging in values-affirmation was associated with greater anticipated growth in counseling and greater intent to seek counseling, reflecting greater positive beliefs about counseling. Overall, the results suggest that reflecting on personal values may have the potential to enhance the positive effects of online psychoeducation. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Depression symptoms moderate the association between emotion and communal behavior.
Depression is associated with emotion regulation deficits which manifest as elevated negative affect and greater continuation of negative affect over time. The present study examined a possible emotion regulatory deficit, whether depression symptoms attenuate the association between communal (i.e., agreeable, quarrelsome) behavior and affect. A community sample reported on depression and anxiety symptoms before recording their affect and behavior following naturally occurring interpersonal interactions over 21 days. Participants’ behaviors were measured using items selected to represent the Interpersonal Circumplex Model of behavior. Results indicated an association between affect and communal behavior, which was stronger for negative than positive affect. Depression symptoms moderated this association; elevated depression symptoms were associated with decreased association of affect and interpersonal behavior. Comorbid anxiety symptoms did not moderate this association. Results suggest that elevated depression symptoms are associated with a diminished ability to adapt communal behavior to emotion cues. Given prior evidence of elevated overall quarrelsome behavior among individuals with elevated depression symptoms, this may demonstrate an interpersonal mechanism by which emotion regulation deficits impact the generation of interpersonal problems. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Thwarted belongingness, perceived burdensomeness, and depression among asian americans: A longitudinal study of interpersonal shame as a mediator and perfectionistic family discrepancy as a moderator.
This short-term longitudinal study applied Joiner’s (2005) Interpersonal-Psychological Theory of Suicide to Asian Americans’ experiences with depression. Interpersonal shame (i.e., the experience of inadequacy arising from interpersonal concerns) was hypothesized to mediate the effects of (a) thwarted belongingness and (b) perceived burdensomeness on future depression. Furthermore, the positive associations between (a) thwarted belongingness and (b) perceived burdensomeness on future depression were hypothesized to vary depending on students’ experiences with perfectionistic family discrepancy (PFD; their perceived gap between their actual performance and what their parents expect of them). A total of 605 Asian Americans attending predominantly White, Midwestern universities completed 3 online surveys. Conditional process modeling via Hayes’s (2013) PROCESS was used to analyze the data. Results demonstrated that (a) thwarted belongingness and (b) perceived burdensomeness contributed to higher interpersonal shame, which influenced students’ future depression. Furthermore, the effect of thwarted belongingness on future depression was significantly positive for those with PFD levels greater than the 12th percentile, after taking into account students’ initial level of depression. The effect of perceived burdensomeness on future depression was not significant for those with PFD levels greater than the 3.5th percentile. This study identified that students with perfectionistic family discrepancy may be at higher risk for depression while experiencing thwarted belongingness. Overall, findings supported using Joiner’s (2005) theory to understand Asian American students’ risk for future depression. Future studies may gather data across Asian American students’ years in college. Counselors can apply these findings to increase students’ awareness about possible risk factors for depression. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Distress disclosure and psychological functioning among Taiwanese nationals and European Americans: The moderating roles of mindfulness and nationality.
Research using Western samples shows that talking about unpleasant emotions—distress disclosure—is associated with fewer psychological symptoms and higher well-being. These benefits of distress disclosure may or may not be observed in East Asia where emotional control is valued. Instead, mindfulness may be more relevant to emotion regulation in East Asia (e.g., Taiwan). In the present study, cultural context (Taiwanese nationals vs. European Americans) and mindfulness were examined as moderators of the relation between distress disclosure and both depression symptoms and life satisfaction. A sample of 256 Taiwanese college students and a sample of 209 European American college students completed self-report measures in their native language. Moderated multiple regression analyses revealed significant interaction effects of mindfulness and distress disclosure on both depression symptoms and life satisfaction for Taiwanese participants but not for European Americans. Specifically, distress disclosure was negatively associated with depression symptoms and positively associated with life satisfaction for Taiwanese low in mindfulness but not for Taiwanese high in mindfulness. For European Americans, distress disclosure was not associated with depression symptoms but was associated with higher life satisfaction, regardless of one’s level of mindfulness. These findings suggest that the potential benefits of disclosing distress are a function of one’s cultural context as well as, for those from Taiwan, one’s mindfulness. (PsycINFO Database Record (c) 2017 APA, all rights reserved)

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