Reflections on a Gestalt Therapy workshop:
"Getting below the Tip of the Iceberg"
by Isabel O'Leary, Speech and Language Therapist

I've been asked to give my comments on this day workshop run by Woody Starkweather and Jan Givens on 27th July 2001 possibly because I was perceived to have been fairly vocal on the day.

I write this as a speech and language therapist with no formal qualifications or training in counselling (which leaves me feeling vulnerable) but I do consider that I use some 'counselling skills' in my daily work in the N.H.S.

The day threw up quite a few issues for me, which have pushed me into considering aspects of my working life more deeply. That is a "Good Thing" and I am glad I attended the day for that.

The day started for me as I walked in a few minutes late as Woody and Jan were telling their "stories" about how they came to train as Gestalt Therapists. This engaged my interest immediately because I like hearing people's own life stories. Woody explained that his interest in Gestalt therapy came from a growing conviction (Van Riper was quoted here which inspires me to read more of his stuff again) that established stammering is intrinsically tied up with emotions, and cannot be separated out as just a behaviour. This was a useful reminder to me since I've been uncomfortable with how focussed on working on speech behaviour I've become in the last few years. (Training in the Lidcombe programme with young children and pressure of waiting lists and need to have "goals" and measurable outcomes will be familiar to many of my colleagues.)

The room was set up with about 60 people sitting in 3 long rows of chairs facing the speakers. The windows of the ground floor room were open since it was a hot sunny day and we could see and hear people passing by close outside. I was unsure whether I had missed some kind of introduction into what was planned for the day and some kind of explanation of the context of Gestalt Therapy in any other work they may do.

The next thing I knew we were being asked to stand up if we were a speech and language therapist (SLT), then to stay standing up if we considered ourselves to be a SLT and someone who stammers, and finally to stand up if we regarded ourselves as someone who stammers. The latter group of 6 people, all men, were asked to come to the front of the room and sit in a semi circle facing Woody and Jan whilst the rest of us continued to sit in long rows behind them. A "goldfish bowl" experience. The SLT's who had identified themselves as also people who stammer were invited to join those in the goldfish bowl but declined.

The six men at the front were then asked to close their eyes, imagine that they were good artists and to visualise a painting/picture of their stammer. They were then asked to describe their images out loud. I was surprised by the power of the images and how strikingly different they were. This highlighted for me again how differently people may experience and perceive their own stammer. It was clear that the described images had an impact on some of those listening as well as those speaking. I was also surprised by the apparent ease with which the men had come up with an image and their apparent willingness to share them with a bunch of strangers. Two of the men went on to do an exercise to explore their relationship with their stammer more fully. I found it a useful idea to consider someone having a relationship with a part of themselves which they may not like but need to come to some kind of terms with. This is one I would like to think more about.

So, we had witnessed two powerful exercises.

We then broke for lunch.

After lunch we were divided into groups of about 10 speech and language therapists in each with one of the people who stammers as a facilitator. They were asked to keep us to time and make sure no one dominated the discussion. A hefty task in dealing with a bunch of SLT's but one they accomplished. We were then led on a "guided journey" back to our own childhoods and were asked to have a written conversation between our adult and our child selves, using both hands for writing. After 10 minutes or so we were asked to share our experience of this activity in the group.

It was at this point that questions about the process of the day were raised. Some people were uncomfortable sharing experiences and feelings in a setting which had not been "made safe" and were aware of the power of the exercises which were being presented.

When Woody and Jan asked for a volunteer person who stammers and a volunteer SLT to come to the front to "do some therapy" in front of everyone there was a mini revolt! I was particularly vocal in my concern that the person who had "volunteered" to be the object of a therapist's attentions had in fact been coerced. It was suggested that I may be "projecting" my own anxiety onto this person, which is certainly a possibility.

Others raised concerns about the lack of safety and containment in the day so far, which Jan and Woody listened to and discussed with us. This gave us a living example of "staying in the moment" and listening to feelings. They didn't appear threatened by this "rebellion" but used it constructively without trying to have "all the answers".

We did go on to have 2 demonstrations of what I might call "therapeutic conversations" between a therapist and a person who stammers in front of the whole group, with Woody and Jan giving suggestions when needed to the 2 participants as to what to say. As one of the therapists who ended up volunteering (I'm not sure that I was projecting my own anxiety in my first objections) it felt unusual and comforting to have Woody by my shoulder offering reassurance and suggestions as to how to proceed in the conversation. I'm not sure whether that has reinforced or challenged my belief that "someone else would do it better than me". Because of the performance nature of the conversation I didn't get the chance to debrief with my conversational partner so don't really know "how it was for him".

Jan made the comment that therapy involves people pushing themselves to take risks and that she believes people can protect themselves.

The following issues were raised for me:

Issue 1: This kind of powerfully emotive work in groups needs preparation and follow up. Usually warming up activities are used to gain a sense of trust and safety. Also we usually establish basic rules such as confidentiality. It is important to allow for some follow up for those potentially left vulnerable by actively participating in or observing such exercises. It was ambitious to try to provide these conditions for a safe environment for those exploring and exposing their feelings (and speech) in a roomful of 60 or so strangers.

Issue 2: Being separated into "those who stammer" and "those who don't" made me question whether some of the principles of the therapy couldn't have been demonstrated with willing and prepared flawed humans who happen not to stammer. Such as speech and language therapists. Whilst we were there to get a "taster" of how Gestalt Therapy might be used in our work there was the danger of perpetuating the myth that people who stutter are somehow different from those who don't.

Issue 3: What is the boundary between "empathy" and "projection"?

Issue 4: How to encourage people to take the risks necessary for learning and development, without abusing the power that may be invested in the "helping professional"?. How to get the balance between risk and safety? This is presumably an issue for teachers in schools, since they may expose children to potentially positive or traumatic learning experiences in their everyday school routine. The examples of answering the register or reading out loud in class or participating in a school show seem memorable and significant to many (but not all) the people I have met who stammer.

I did find the day powerful, I think because of the emotion generated by our discomfort at times. I am aware that this has led to more reflection and active searching on my part for ways to work with people which do take emotions into account. It has crystallised my wish to look into more "action based" methods of therapy as well as the mainly verbal ways which I use currently.

Issue 5: What is the most appropriate form of training for me? How long will I need to commit to it? Who will pay for this training? If I start to use a "new form of therapy" within my work will my employers recognise it as a valid way of working with my clients and therefore insure me?

Woody and Jan said that they wanted to stimulate interest in Gestalt Therapy in work with people who stammer. My perception is that British Speech and Language Therapists are generally open to non-behavioural approaches and some are trained in approaches which take the psychological and emotional aspects of stammering as the focus. Woody and Jan recognised that a one day workshop did not equip people to go away and use the techniques demonstrated. I would like to thank them for giving me added impetus to look for suitable further training in order to integrate it into my current work.

Summer 2001