How Does Gestalt Therapy Work?

Medically Reviewed by Jabeen Begum, MD on April 19, 2024
Written by Stephanie Langmaid
7 min read

Gestalt therapy is a form of psychotherapy in which self-awareness and self-acceptance are considered keys to personal growth. It emphasizes creativity and collaboration in the interaction between you and your therapist and uses active techniques such as role-playing.

The word "gestalt" is a German term with no direct English translation. It generally means "whole" or "form." As a psychological concept, it's the idea every individual is a blend of mind, emotions, body, and soul with unique experiences and realities. No single life event, personality trait, or psychological diagnosis defines you.

History of gestalt therapy

Gestalt therapy was developed by German researchers Fritz and Laura Perls and American writer Paul Goodman as an alternative to traditional psychoanalysis. It has its roots in gestalt theory — a way of thinking about human perception that became popular in Europe in the early 20th century. It holds that our minds understand what we experience as a whole rather than individual parts. For example, instead of seeing individual brushstrokes or a series of still pictures, you see a painting or a movie.

Gestalt therapy emphasizes the whole person and focuses on the present rather than the past. In contrast, psychoanalysis digs into your subconscious to find buried memories that drive your psychological issues.

Perls published a book outlining the concept in 1951, and gestalt therapy became popular in the 1960s and 70s. Gestalt institutes continue to offer teaching and training all around the world. Many of its concepts and techniques are used in other kinds of therapy.

Gestalt therapy is considered a type of humanistic therapy. That means it starts with the belief that people are inherently good and have the ability and desire to move their lives in a positive direction. Problems happen when you aren't being your true self.

It's also a kind of experiential therapy. Experiential therapy goes beyond talking and uses activities such as art, music, or getting out into nature to help you identify and explore the emotions attached to your experiences.

Gestalt therapy includes several key concepts:

Self-awareness. According to gestalt therapy, you're held back by not understanding yourself, your motivations, and the ways you add to your own unhappiness. There's a lot of emphasis on being aware of your emotions, thought patterns, and even physical feelings so you can learn who you truly are and accept yourself fully.

Here and now. In gestalt therapy, what matters is who you are and how you feel in the present moment. The past is only important to the extent that it influences your present thoughts and behavior. You may be encouraged to "re-experience" a past event in a therapy session to explore how you feel about it now. It helps you to stop worrying about the future or potential problems and deal only with what's in front of you.

Paradoxical change. The theory behind this concept is that the best way to change is by not trying. Forcing yourself to be something you aren't only causes stress and anxiety. But understanding and accepting who you really are opens the way for personal growth to happen naturally.

Taking responsibility. This is acknowledging the role that your thoughts and behaviors play in your experiences and relationships. You're encouraged to accept the consequences of your actions and stop blaming others for your problems. Taking responsibility can help you interact with others in a more positive way. It also helps you understand that you have control in your life — you can take care of your own needs and you don't have to rely on someone else for fulfillment.

Closure. Gestalt therapy holds that problems can arise from unexpressed emotions and experiences in the past that you haven't fully processed. The ways that you choose to deal with pain may separate you from your true self. By dealing with this "unfinished business," you can let go of emotions you've been holding in and become whole again.

Mind-body connection. In gestalt therapy, your physical responses can give you insight into your emotions, so you're encouraged to pay attention to what your body may be telling you. For example, your therapist may ask you where in your body you may be feeling a certain emotion. Also, emotional issues can lead to physical problems, so dealing with one can help the other.

Gestalt therapy can be done one-on-one or in a group. It's also sometimes used in business, school, or other organizational settings to improve work relationships.

Therapists are encouraged to improvise and experiment, based on the patient's unique experiences and needs. While that makes sessions very individualized, certain techniques are commonly used.

Empty chair. This is the exercise probably most associated with gestalt therapy. It can help with relationship issues and also self-discovery. You sit with an empty chair and talk to it as if it's someone you have a problem with. The chair can also stand in for a part of yourself. The idea is that a self-dialogue may be more effective than talking about your issues with the therapist.

Exaggeration. This technique uses physical behavior to try to uncover thoughts and emotions you may not be aware of. The therapist pays close attention to your body language. If you have a physical reaction to something you're talking about, such as frowning or shifting in your seat, they'll have you repeat it in an exaggerated way. Then, you'll explore the emotion you're feeling and how it's connected to your experience.

Dramatization. Various kinds of acting are a part of gestalt therapy. You may do role-playing, where you act out both sides of a conversation between you and someone you're in conflict with. That's sometimes called the two-chair technique. Or your therapist may have you recreate a painful or traumatic moment from your past so you can re-experience the emotions in the present and process them.

"I" statements. This technique helps you focus on your own actions and feelings and take responsibility for them, rather than blaming others. For example, instead of saying something or someone makes you angry, your therapist will encourage you to say "I feel angry when.." 

Confrontation. If the therapist detects something that you're trying to avoid, they'll pursue it and challenge you to face it. This technique can seem too aggressive and is not as much a part of gestalt therapy as it was earlier.

Creative or physical activities. Rather than passive talking, gestalt therapy emphasizes movement and activity. It involves art activities, such as drawing, sculpting, or dancing, to help you learn to be mindful and focus on the present.

Dreams. The therapist may help you explore your dreams and find meaning in them, but they won't try to interpret them for you.

Topdog/underdog. This is a type of role-playing exercise, in which you act out two different aspects of your personality: the critical part of you that's trying to push you to be or act a certain way, and the part of you that feels weak and helpless and resists your internal demands to change. The idea is to create balance.

Gestalt therapy can be used to address several different mental and physical health conditions, including:

  • Anxiety
  • Behavioral health issues such as substance abuse or other addictions
  • Posttraumatic stress disorder (PTSD) or other trauma
  • Depression
  • Relationship problems
  • Self-esteem issues
  • Body image issues and eating disorders
  • Physical conditions that may have a psychological link, such as migraine or ulcerative colitis

Gestalt therapy concepts and techniques can also be used in combination with other kinds of therapy, such as cognitive-behavioral therapy (CBT), mindfulness, and psychodynamic therapy.

There isn't a lot of research to show how well gestalt therapy works compared to any other kind of therapy. That's partly because there's no standard training of therapists or set guidelines on how sessions should be conducted.

The benefits of gestalt therapy can include: 

  • Increased self-awareness
  • Improved self-confidence
  • Better understanding of how your past influences your present
  • Increased ability to deal with stressful situations
  • Better relationships
  • Better ability to regulate your emotions

Gestalt therapy isn't for everyone. You may not get a benefit from it if you:

  • Aren't comfortable with exercises such as acting or being closely observed by the therapist
  • Prefer structured therapy sessions
  • Want to examine your past

Gestalt therapy is a kind of psychotherapy that promotes self-awareness, personal responsibility, and good relationships. It focuses on the whole person, rather than an individual aspect of your personality or experience. There isn't a lot of scientific evidence to show whether it's more effective than any other kind of therapy.

What is an example of gestalt therapy?

An exercise often used in gestalt therapy is called the empty chair technique. You imagine someone you have an issue with -- or a certain aspect of yourself -- sitting across from you in an empty chair. Then you improvise a conversation with them.

What is the major goal of gestalt therapy?

The major goal of gestalt therapy is to help you understand and accept your true self so you can experience growth and positive change.

Is gestalt better than CBT?

There haven't been scientific studies showing how well gestalt therapy works compared to cognitive-behavioral therapy (CBT). It can be helpful for several different psychological issues, but not everyone will feel comfortable with its methods.