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Enhancing Your Therapy with Gestalt Approaches
Gestalt Therapy continuing education psychologist CEUs

Section 16
A Case Study Example of Gestalt Art Therapy

CEU Question 16 | CEU Answer Booklet | Table of Contents | Gestalt
Psychologist CEs, Counselor CEUs, Social Worker CEUs, MFT CEUs

Sharon is living on many levels all at once; I marvel that she can move about in the everyday world practically and effectively while carrying on such a lot of symbolic activity in her inner life. Tiny and delicate physically, she is inclined to be quiet and still. Only her shining, expressive eyes move about quickly, and she tilts her head from side to side as if she wants to see things from many angles. When she feels shy and fearful, Sharon's whole bearing becomes that of a little girl, on the verge of but never quite giving up her held-back tears. When she has that look I see the child who learned to go into her closet and be alone rather than ask for any sort of open emotional expression with her parents. Her mother says that Sharon was an obnoxious child whom she has never understood; her father, a quiet, bookish man, dramatically taught Sharon that the best thing to do with bad feelings was to bury them underground: in a planned ceremony the two went out one evening, dug a hole in the ground, and six-year-old Sharon was told to bury her temper and never let it show again. Sharon learned her lesson well; her conscious suppression gradually became habitual and her outward behavior fit into the family's pattern of keeping out of sight anything that might be disturbing.

Sharon went to college, painted, went to a New York art school on a scholarship, and worked for the New York State Council of the Arts. Her inventive techniques for three-dimensional print-making brought her success but not much happiness. She tried psychotherapy; that didn't seem to help. Her prints were in galleries, and she was in limbo. She took LSD and was shocked out of lethargy; on the drug she felt transported beyond all individuality and felt ecstasy in belonging with all-beingness. She saw joys in non-ego-involvement and envisioned wondrous release in non-being. But she was frightened, too; when she saw herself in a mirror, Sharon saw only translucency. Was that what she wanted--to lose her identity in cosmic unity before she'd ever lived here on this earth? Sharon didn't know. She and a new husband, who was little more than another body in lostness, began wandering. John drove the car; Sharon sat and passively watched the world go by. "It" was "out there, fascinating" but none of "it" was here.

Back in San Francisco, Sharon functioned on a sort of minimal level, limiting herself to superficial involvements. But when her father developed terminal cancer, she chose to be with him during the long months of his dying. At his request, Sharon and her father together did what they could to help him express his buried feelings; he grieved that he had repressed so much of himself and hoped that Sharon would live more freely. After her father died, though, she felt more deadened than ever and could not involve herself deeply in art or anything else.

Sharon realized how much she had cut off her creativity when she saw in a stranger's home a three-dimensional print that she'd made two years before and now could not recognize or remember as her own creation. Shortly afterwards she began coming to art therapy groups and then to weekly private sessions with me.

For the first year, Sharon resisted expressing herself with art forms; given a large sheet of paper, she would draw tiny, delicate decorations in one corner and was inarticulate about them. Six months ago Sharon told me that she was "making little things" at home; she "enjoyed tinkering," she said. She made gifts for people, grew potted plants, decorated her apartment for Christmas--small things, but all of her own creation. She brought small, neat, black and white collages to our sessions, discussing how she was beginning to discover elements in them that related to her individuality. A month ago she brought in four forms.

About six inches high, made from plastic, glass, cotton, and metal, they are very personally Sharon's. At my suggestion, she began expressing her thoughts and feelings by writing. At first this was difficult for her, but now she pours out words, pages and pages of them. In her own way, she describes her self-trait figures:

"Aspect I"
I am obscure, unclear, non-functional, split, non-directional. I am soft and dream-like, with sharp tangents of reality and discomfort. I neither radiate nor direct. I feel helpless and static. My movement is dependent--I can be picked up, placed, and given meaning by an "other." I can also be ignored, passed over, unseen. I can be loved or unloved, unhappy or happy, observant but indecisive, a willing object. I am between a dream and a reality. Life becomes an echo.

"Aspect II"
I am definite, definitive, directed. My movement starts slowly with a spiraling to conclusions. I am unreasonable, brilliant, angry, rash, permanent, stubborn, and purposeful. I am right, tall, and impenetrable. I have no feeling, but I have logical progressions of a third sense. I reach an end, lose connections with the spiral or process or why, and I become implacable, dreamless, determined, and compassionless. I am not here to be loved or loving. I am here to do and to be. There is no echo, I am the voice and the conception. Brittle and breakable.

"Aspect III"
I am in balance, shorter but functioning. I can both feel and be at the same time. I combine softness with balance and brittle receptivity. I am open to change that I can maintain in various positions. I can be delighted and graceful, useful and willing. I have a synthesis of dream and reality. I am non-linear; I can be absurd but not dismissed. I do not alarm, nor do I feel alarmed or vulnerable to breakage. I am perhaps content with the image I am.

"Aspect IV"
I must combine my dream-observer with real-life situations. Softness can combine with sharpness and still give a pleasing feeling. I can joke about my situation because I am self-willed and not an object of a stranger's needs. I can work with my own needs and experiment with combinations of feelings. I can destroy myself when I feel I need to destroy an unworkable aspect of me. If I do it it's okay; I need the time to reach my own conclusions. I can laugh and give my experience to others 'cause I did it myself.

Sharon is now exploring her own experiences through art, with her own intelligence and imagination; recently she wrote: "I have developed a real feel for edges. I can sense an edge, or a limit, or a closing off of space and time and sound when I am in an uncomfortable situation .... I am trying to learn the process of expanding this space without the fear of edges, without the tendency to get lost in another, and without the need to scrap the whole picture if I can't find my place."

Sharon is finding her place: she is working for a public-service agency part time and is also acquiring a clientele for her free-lance services as a designer. She feels that she will have an agency in a few years and is excited about her possibilities. More important, Sharon is increasingly self-determining; she is realistically expanding to fit recognized spaces in her own potential.

This brief vignette is an unenclosed, open-ended image of the here-and-now awareness of a person in process. More eloquent than any words I can say are Sharon's own self-perceptions, both graphic and verbal.
- Rhyne, Janie; The Gestalt Approach To Experience, Art, And Art Therapy; American Journal of Art Therapy; Aug2001, Vol. 40 Issue 1
The article above contains foundational information. Articles below contain optional updates.

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Personal Reflection Exercise #2
The preceding section contained information about a case study example of Gestalt Art Therapy.  Write three case study examples regarding how you might use the content of this section in your practice.

Online Continuing Education QUESTION 16
What two statements did Sharon make that indicated her increased receptiveness to expressing herself through art? 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.
Intersectionality research in counseling psychology. - October 19, 2017
This article introduces the special section on intersectionality research in counseling psychology. Across the 4 manuscripts that constitute this special section, a clear theme emerges: a need to return to the roots and politics of intersectionality. Importantly, the 2 empirical articles in this special section (Jerald, Cole, Ward, & Avery, 2017; Lewis, Williams, Peppers, & Gadson, 2017) are studies of Black women’s experiences: a return, so to speak, to the subject positions and social locations from which intersectionality emanates. Shin et al. (2017) explore why this focus on Black feminist thought and social justice is so important by highlighting the persistent weaknesses in how much research published in leading counseling psychology journals has tended to use intersectionality as a way to talk about multiple identities, rather than as a framework for critiquing systemic, intersecting forms of oppression and privilege. Shin and colleagues also point to the possibilities intersectionality affords us when scholars realize the transformative potential of this critical framework. Answers to this call for transformative practices are foregrounded in Moradi and Grzanka’s (2017) contribution, which surveys the interdisciplinary literature on intersectionality and presents a series of guidelines for using intersectionality responsibly. We close with a discussion of issues concerning the applications of intersectionality to counseling psychology research that spans beyond the contributions of each manuscript in this special section. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
The intersectionality framework and identity intersections in the Journal of Counseling Psychology and The Counseling Psychologist: A content analysis. - October 19, 2017
The framework of intersectionality is a powerful analytical tool for making sense of how interlocking systems of privilege and oppression are experienced by individuals and groups. Despite the long history of the concept, intersectionality has only recently gained attention in psychology. We conducted a content analysis to assess counseling psychology’s engagement with an intersectional perspective. All articles published in the Journal of Counseling Psychology (n = 4,800) and The Counseling Psychologist (n = 1,915) from their first issues until July 2016 were reviewed to identify conceptual and empirical work focused on intersectionality. A total of 40 articles were identified and examined for themes. Limitations and future directions are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Applying intersectionality to explore the relations between gendered racism and health among Black women. - October 19, 2017
The purpose of this study was to apply an intersectionality framework to explore the influence of gendered racism (i.e., intersection of racism and sexism) on health outcomes. Specifically, we applied intersectionality to extend a biopsychosocial model of racism to highlight the psychosocial variables that mediate and moderate the influence of gendered racial microaggressions (i.e., subtle gendered racism) on health outcomes. In addition, we tested aspects of this conceptual model by exploring the influence of gendered racial microaggressions on the mental and physical health of Black women. In addition, we explored the mediating role of coping strategies and the moderating role of gendered racial identity centrality. Participants were 231 Black women who completed an online survey. Results from regression analyses indicated that gendered racial microaggressions significantly predicted both self-reported mental and physical health outcomes. In addition, results from mediation analyses indicated that disengagement coping significantly mediated the link between gendered racial microaggressions and negative mental and physical health. In addition, a moderated mediation effect was found, such that individuals who reported a greater frequency of gendered racial microaggressions and reported lower levels of gendered racial identity centrality tended to use greater disengagement coping, which in turn, was negatively associated with mental and physical health outcomes. Findings of this study suggest that gendered racial identity centrality can serve a buffering role against the negative mental and physical health effects of gendered racism for Black women. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Controlling images: How awareness of group stereotypes affects Black women’s well-being. - October 19, 2017
This paper presents research exploring how stereotypes that are simultaneously racialized and gendered affect Black women. We investigated the mental and physical health consequences of Black women’s awareness that others hold these stereotypes and tested whether this association was moderated by the centrality of racial identity. A structural equation model tested among 609 young Black women revealed that metastereotype awareness (i.e., being aware that others hold negative stereotypes of one’s group) predicted negative mental health outcomes (e.g., depression, anxiety, hostility), which, in turn, predicted diminished self-care behaviors and greater drug and alcohol use for coping. High racial centrality exacerbated the negative association between metastereotype awareness and self-care. We discuss implications of the findings for clinical practice and for approaches to research using intersectionality frameworks. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Using intersectionality responsibly: Toward critical epistemology, structural analysis, and social justice activism. - October 19, 2017
The increasing popularity of the concept of intersectionality in the social sciences, including in psychology, represents an opportunity to reflect on the state of stewardship of this concept, its roots, and its promise. In this context, the authors aim to promote responsible stewardship of intersectionality and to tip the momentum of intersectionality’s flourishing toward fuller use and engagement of its roots and promise for understanding and challenging dynamics of power, privilege, and oppression. To this end, this article provides a set of guidelines for reflection and action. The authors organize these guidelines along 3 major formulations of intersectionality: intersectionality as a field of study, as analytic strategy or disposition, and as critical praxis for social justice. Ultimately, the authors call for expanding the use of intersectionality toward fuller engagement with its roots in Black feminist thought, its current interdisciplinary richness and potential, and its central aims to challenge and transform structures and systems of power, privilege, and oppression. (PsycINFO Database Record (c) 2017 APA, all rights reserved)

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