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Enhancing Your Therapy with Gestalt Approaches
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Section 26
Using the Gestalt Empty Chair Technique to
Detriangulate an Absent Father

CEU Question 26 | CEU Test | 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.

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 Test.

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Table of Contents

The article above contains foundational information. Articles below contain optional updates.
Innovative approaches to exploring processes of change in counseling psychology: Insights and principles for future research. - July 02, 2020
In recent years, innovative approaches have been implemented in counseling and psychotherapy research, creating new and exciting interdisciplinary subfields. The findings that emerged from the implementation of these approaches demonstrate their potential to deepen our understanding of therapeutic change. This article serves as an introduction to the “Innovative Approaches to Exploring Processes of Change in Counseling Psychology” special issue. The special issue includes articles representing several of the most promising approaches. Each article seeks to serve as a sourcebook for implementing a given approach in counseling research, in such areas as the assessment of coregulation processes, language processing, physiology, motion synchrony, event-related potentials, hormonal measures, and sociometric signals captured by a badge. The studies included in this special issue represent some of the most promising pathways for future studies and provide valuable resources for researchers, as well as clinicians interested in implementing such approaches and/or being educated consumers of empirical findings based on such approaches. This introduction synthesizes the articles in the special issue and proposes a list of guidelines for conducting and consuming research that implements new approaches for studying the process of therapeutic change. We believe that we are not far from the day when these approaches will be instrumental in everyday counseling practice, where they can assist therapists and patients in their collaborative efforts to reduce suffering and increase thriving. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Physiological synchronization in the clinical process: A research primer. - July 02, 2020
Physiological synchronization is the study of how individuals in interaction coregulate their physiology. The topic has sparked increasing interest in counseling and psychotherapy research, where it has been found to be associated with the therapeutic alliance, clinicians’ empathy and patients’ outcome. Physiological synchronization allows researcher to investigate subtle but fundamental aspects of the clinical process through objective measures. In this article, we aim to offer a guide to researchers and clinicians to explore this growing field of study. We begin by reviewing the existing literature of physiological synchronization in clinical relationships, and then we provide practical guidelines for research. We discuss the various aspects involved in synchronization studies: study design, selection of physiological signals, data analytic approaches, and interpretation of results. To better illustrate how to implement these types of design, we provide a running example describing the data collection and analysis of a single-case study. In the example we discuss both how to conduct a longitudinal nomothetic analysis, as well as a moment-to-moment idiographic exploration of the clinical content. In this latter analysis, in particular, we show how physiological synchronization can be used in combination with 2 transcripts analysis tools, the Patient Attachment Coding System, and the Therapist Attunement Scales to reach a deeper understanding of the ongoing processes. We conclude by arguing that research in counseling and psychotherapy has much to gain from and contribute to the overall development of our understanding of physiological synchronization in human interaction. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Machine learning and natural language processing in psychotherapy research: Alliance as example use case. - July 02, 2020
Artificial intelligence generally and machine learning specifically have become deeply woven into the lives and technologies of modern life. Machine learning is dramatically changing scientific research and industry and may also hold promise for addressing limitations encountered in mental health care and psychotherapy. The current paper introduces machine learning and natural language processing as related methodologies that may prove valuable for automating the assessment of meaningful aspects of treatment. Prediction of therapeutic alliance from session recordings is used as a case in point. Recordings from 1,235 sessions of 386 clients seen by 40 therapists at a university counseling center were processed using automatic speech recognition software. Machine learning algorithms learned associations between client ratings of therapeutic alliance exclusively from session linguistic content. Using a portion of the data to train the model, machine learning algorithms modestly predicted alliance ratings from session content in an independent test set (Spearman’s ρ = .15, p < .001). These results highlight the potential to harness natural language processing and machine learning to predict a key psychotherapy process variable that is relatively distal from linguistic content. Six practical suggestions for conducting psychotherapy research using machine learning are presented along with several directions for future research. Questions of dissemination and implementation may be particularly important to explore as machine learning improves in its ability to automate assessment of psychotherapy process and outcome. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Patterns of early change in interpersonal problems and their relationship to nonverbal synchrony and multidimensional outcome. - July 02, 2020
Early change is an increasing area of investigation in psychotherapy research. In this study, we analyzed patterns of early change in interpersonal problems and their relationship to nonverbal synchrony and multiple outcome measures for the first time. We used growth mixture modeling to identify different latent classes of early change in interpersonal problems with 212 patients who underwent cognitive–behavioral treatment including interpersonal and emotion-focused elements. Furthermore, videotaped sessions were analyzed using motion energy analysis, providing values for the calculation of nonverbal synchrony to predict early change in interpersonal problems. The relationship between early change patterns and symptoms as well as overall change in interpersonal problems was also investigated. Three latent subgroups were identified: 1 class with slow improvement (n = 145), 1 class with fast improvement (n = 12), and 1 early deterioration class (n = 55). Lower levels of early nonverbal synchrony were significantly related to fast improvement in interpersonal change patterns. Furthermore, such patterns predicted treatment outcome in symptoms and interpersonal problems. The results suggest that nonverbal synchrony is associated with early change patterns in interpersonal problems, which are also predictive of treatment outcome. Limitations of the applied methods as well as possible applications in routine care are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Feasibility and acceptability of a novel tool for the study of interpersonal processes in psychotherapy. - July 02, 2020
Psychotherapy process research methods often require extensive time and resources. Technology innovations, such as wearable sensors, have the potential to increase the efficiency of process data collection and processing. One such tool is the Sociometric Badge (SB), which is a portable, palm-sized device that can simultaneously record raw audio and data on social signals (e.g., speech patterns, body movement) in real-time and in varied contexts. In addition to describing the nature and implications of wearable sensing devices for psychotherapy research, this article reports results from a pilot study that examined the feasibility and acceptance of these assessment devices in comparison with traditional audio recording equipment. Undergraduate students (N = 306; Mage = 19.16 years, SD = 1.44; 50.3% female) were randomly placed into 153 dyads to mimic a psychotherapy dyad. Each dyad was randomly assigned to either a SB condition (n = 75 dyads) or a standard recording device condition (n = 78 dyads), and engaged in a conversation task. Participants completed self-report items assessing perceived relationship quality and experience with the respective recording device. Between-condition tests showed that perceived relationship quality did not differ between conditions. Participants in the audio recorder (vs. SB) condition reported more awareness of the device in the room. These findings reveal comparable acceptability and feasibility of SBs to traditional audio recorders in a simulated dyad, suggesting that wearable sensing devices may be suitable for research and practice in routine psychotherapy contexts. (PsycInfo Database Record (c) 2020 APA, all rights reserved)

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