CHAPTER THREE1

ETHICS AND TRAINING PRACTICES: A CALL FOR DISCUSSION2

PHILIP BROWNELL, JAY LEVIN AND BRIAN O’NEILL

Introduction

This is an initial call for a public discussion of two issues affecting the practice of Gestalt therapy. The first concern is that of ethical guidelines for practice and the second area is an exploration of the models utilized for training in Gestalt therapy.

It seems to us that Gestalt therapy practice is associated with a variety of different values, ethics, and professional practices which find their origins in various forms of training and supervision, which are themselves derived from a number of different “schools” of thought. These have been likened to clans existing in the historical-cultural field. At times these differences may even give rise to conflicting ideas of what “is” Gestalt therapy, or what is “good” or “bad” Gestalt therapy. The lack of clarity and criteria regarding professional practice, ethical guidelines, and values inherent in Gestalt therapy make a coherent standard a seeming impossibility. This, however, is an attempt to open a discussion and clarify the wider field of professional practice and training.

1 In the effort to retain the “feel” of the original journal (which published rapidly the development of ideas in the field and encouraged growing writers to publish), the editors have chosen to retain the original articles as they appeared in the online venue. The errors are not a reflection of the publishing policy of Cambridge Scholars Publishing.

2 First published in Gestalt! 1(2), 1997.

Ethics, Values, and Professionalism

Should Gestalt organizations, such as the Association for the Advancement of Gestalt Therapy (AAGT) or the newly forming International Gestalt Therapy Association (IGTA), get into the business of defining ethical parameters for the practice of Gestalt therapy? If so, how should they proceed, for the process seems as crucial as the outcome? If Gestalt organizations choose not to define such guidelines, what might that say about the level of professionalism in Gestalt therapy and its relevance in today’s larger field of psychotherapy? Other questions also arise from this. For example, are the values and ethics which are nominally associated with professionalism relevant or appropriate for the practice of Gestalt therapy? Another way of putting that question is to ask if professionalization is the route to follow for Gestalt therapy – if the values and ethical standards of professionalism are actually antagonistic to Gestalt practice?

Some advocate that the AAGT, and other Gestalt therapy organizations, establish an ethical code of professional conduct. Others, more suspicious of the conventionality of mainstream psychotherapy, suspect that the thought police could not be far behind such a move. Reflected in these two reactions is a desire to join mainstream psychotherapy in the profession of Clinical Psychology, on the one hand, and to remain true to the values inherent in the history of Gestalt Therapy, on the other. Then there are those who maintain there is no such polarity between these two courses of action.

This is a conflict of values. It’s an issue that surfaces when one person notices that Gestalt therapy seems to be rising in popularity and another says that Gestalt therapy will be ruined by becoming conventional. Beyond these positions, furthermore, is the concern over the rightness for the AAGT, and other similarly constructed organizations, to adopt ethical guidelines at all, with the authority to make ethical judgments (if not sanctions) from time to time, when it is solely an association of like- minded people, created for the purpose of associating and not for the purpose of regulating the field of Gestalt therapy

We do not believe that the popularity of Gestalt therapy means that it is a conventional therapy. If it should so happen that Gestalt therapy becomes more popular, possibly that is because of the perception that it has something worthwhile to offer. After all, the unconventionality of Gestalt therapy in the 60’s was not necessarily the reason for its pervasive popularity at that time The AAGT, along with many other associations in the helping professions, gathers together its members in order to facilitate the growth and development of its theory and practice by nurturing the relationships among those interested in participating.

Unlike such organizations, however, it has not adopted ethical guidelines, which are nothing more than standards and utilitarian principles serving to set benchmarks for good practice.

Along with formalization of Gestalt professional community comes the responsibility to address such things as ethics, values, morality, community standards, and professionalism (Corey, Corey, and Calanan, p. 3). There is no acceptable reason for Gestalt organizations to avoid taking such positions.

What, after all, would be detrimental to a clarification of values that points the field in the direction of what it already implicitly holds to be good and desirable, or of ethics in the sense of what we feel to be correct? Is this anything more than, or different from, awareness work? People do this with regard to theory all the time; why not in terms of practice? We are quick to apply Gestalt principles to evaluate the values of our culture in books on social justice, so why can we not utilize the field to evaluate our own professional behavior? Community standards vary, but we understand that these field characteristics comprise the criteria from which judgments about conduct can be made. Our commitment to professionalism speaks to a level of clinical ability without necessarily identifying intent or motivation.

According to Corey, Corey, and Calanan (1993, p 9-10), such ethical decision making rests upon the concepts of autonomy, beneficence, nonmalficence, and justice or fairness.

  • Autonomy refers to the promotion of self-determination, or the freedom of clients to choose their own direction.
  • Beneficence refers to promoting good for others.
  • Nonmaleficence means avoiding doing harm, which includes refraining from actions that risk hurting clients.
  • Justice, or fairness, refers to providing equal treatment to all people.

These are the values and the processes we already hold dear; we have assimilated them into our field, so why not utilize them in making our ethical identities more explicit?

It may not be so simple. Gestalt practitioners may be in a bind with regard to this kind of decision-making. Many wish to update the base of theory undergirding Gestalt practice and join the rest of the contemporary field of psychotherapists. They would like to make membership in the larger field of psychotherapy as complete as possible, but they wish to do so with their Gestalt identities intact. Then there are those who have been in the diaspora since the sixties and have returned to Gestalt therapy having assimilated cognitive constructionist theories, attachment theory, object relations, and self-psychology. What is now in question by them is the sentiment of those who maintain that “The valid ethical stance in Gestalt therapy is based on the situation in which the interaction takes place. All persons are responsible for themselves in that interaction, and for the choices made in the existential moment” (Korb, Gorrel, and Van de Riet, p. 21).

Does our commitment to phenomenology make purely relative our values and ethical responsibilities? This question points to the suspicion that there may be theoretical requisites that preclude taking a set position on ethical standards.

Nevertheless, there is an unspoken sense of cognitive dissonance when Gestalt therapists put their other professional identities, and appropriated clinical theories and practices, alongside the Gestalt traditions they have been holding as well. There seems to be a contradiction when Gestalt therapists resist professionalism as a member of Gestalt associations but go along with it as members of other professional organizations (i.e. social workers, psychologists, group therapists, family therapists, etc.). How can we advocate Gestalt in the world as a viable and credible theory and practice, on the one hand, and still hold ourselves aloof from professional accountability, on the other?

These things need to be addressed. Whether the work be done on an organizational basis by groups like the AAGT, or it find some alternative initiative at a grassroots level, it is a discussion that needs to come above ground and get green in the full daylight sun.

Indeed, such may be occurring. In personal discussion on the AAGT email discussion list Jay Levin wrote:

Most – if not all – of the values, ethics and rules of professional conduct are derived from the implicit political stance that the therapist adheres to. I think that this includes issues around the role and purpose of confidentiality, the business of advertising, problems with colleagues (including the collegiate/political nature of “professionalism” which pervades much of psychotherapy practice), etc. I believe that these are unavoidable and necessary issues which need to be explored and clarified. The therapeutic relationship includes examining the very idea of psychotherapy as a human project. What is it that we think we are doing when we are “doing psychotherapy”?

These are important questions which, perhaps, have no definitive answer. Raising them is the issue. I see some parallel between the therapeutic relationship, in which a unique context of concern is explicated between therapist and another person (patient/client/customer/ consumer???), and the words of Marcel that “Life is a mystery to be lived, rather than a problem to be solved.” —Jay Levin, personal conversation, May 25, 1997.

Training Practices

All psychotherapies are influenced by a code of ethics and values; the same kind of thinking as that being advocated with regard to ethical guidelines needs to happen in the area of training and, by implication, supervision practices. What are the models of training that serve as heuristic metaphors that in turn determine an overall character of the training in question? Perhaps the discussion could best begin at that level.

Writing first to the AAGT discussion list, and then posting to Behavior OnLine’s forum on Gestalt therapy, Brian O’Neill identified the following training models, which effect individual training practices:

  • ACADEMIC: This metaphor focuses on the development of curriculum to teach core competencies. It rests on standards of accreditation and at its most basic is reduced to measuring competence by the number of hours in training.
  • THE GUILD: The guild model conjures up images of the Middle Ages in Europe and the pervasive monopoly of the guilds, where the Masters guarded the secrets of their trade (both for economic and quasi-religious reasons) and passed these secrets on to the appropriate apprentice.
  • THE MASTERS: The other image related to masters is a golfing metaphor. Golfers who have reached the pinnacle of the sport and are somewhat older than most, become the masters. They train by using coaches who are not as talented but who nonetheless offer feedback to improve the skills of the masters. The “master” metaphor highlights the importance of who you trained with, the establishment of societies, guilds or guardians of the tradition, and encourages an old boy (or girl ) network which determines competence.
  • FLIGHT TRAINING: A contrary image to the guild and masters metaphor, is that of flight training. Here the training involves specific measurable competencies and skills which are taught and evaluated. With this model of training, to maintain competence one must regularly practice and keep up flight hours. While experience is valued in this metaphor (flight hours) this model acknowledges historical progression, so that the kitty hawk pioneers are antiquated in comparison to the top guns of today. MARTIAL ARTS: Martial arts offers another metaphor. Here one progresses via training in micro skills until achieving a certain demonstrable competence and shifts from a neophyte to a black belt. This is akin to the academic model of a set training program with competencies and standards of achievement. This model also has the master metaphor of the guilds.
  • THE ARTS: Training in the arts combines the academic model and the guild models yet also highlights genius – the potential for the student to quickly move beyond the trainer in competence. This is less emphasized in the other models. Hence, not just who one trained with, but who one is determines outcome in this metaphor.
  • RELIGIOUS MYSTICISM: People who wish to learn and progress start from an ego perspective and realize they are part of a bigger field and ultimately this field is the Godhead/Tao/Buddhahood/Enlightenment. This is a process of unlearning (phenomenological method) as well as learning and has the field as the ultimate trainer, with the guru or master as assistants and temporary means of achieving a desired state of being. This model is represented in core Gestalt concepts such as the wisdom of the organism, yet is not well represented as yet in actual training opportunities.

Beyond this structure, however, one of the most fundamental influences on training has more to do with clans, for these models of training have emerged in the context of various traditions, and these traditions are associated with groups of people held together by various common histories. Writing to the AAGT discussion list, Ken Hutchinson noted:

“It is interesting that when I think of “clans” I think of groups with an underlying connectedness, family. This is also how I think of the Gestalt community, many of you being my (for lack of better words) spiritual cousins, aunts, uncles, grandparents etc. It doesn’t require that we think alike, or even that we may have to like Uncle Melvin who we may wish was hidden in a closet somewhere. There is an acknowledgement of something deeply experienced that connects us (even with Uncle Melvin).”

Bruce Barrett introduced the metaphor of clans in thinking about the various traditions in Gestalt therapy, and it has a particular attractiveness and utility. One can see, for instance, how the mentor system of training in which Gestalt originated has a clannish character to it. The Celtic clan style of social organization is personal. As Barrett stated ,”Loyalty and authority are living interactions, and center on the care and support of one’s followers. Leadership has a face, a voice, a touch, and a scent.” In Gestalt community one cites with whom he or she has trained, and often these people are spoken of with veneration, reflecting the debt that students realize is owed to their mentors. Unfortunately, the disadvantage to the clan system is that disputes, too, can become personal.

The presence in the field of historical conflict is evident in the observation made regarding an East/West split in North American Gestalt community. The very personal loyalties associated with the founding group of Gestalt trainers, in their various manifestations moving through time and space, from 50s through 60s and from East to West, gave rise to different traditions. Taken to another level, this idea of clans works when these personal differences foster divisions of theoretical commitment. Claudio Naranjo wrote:

“There is still another topic I want to mention, for without it, this retrospective on the history of ‘Gestalt after Fritz’ would be incomplete. In addition to being a story of remarkable geographic and intracultural diffusion… this has been a story of division – a division that originally reflected the distinctiveness of an East Coast and a West Coast network, but now permeates the world as the presence of two contrasting orientations.” (1993)

Perhaps contrasting would be too strong, suggesting some kind of true polarity; however, “distinctives” and “emphases” would be very appropriate to describe the different clans that exist in just the North American experience. Conflict persists among these groups. Some of it is tame, and some of it is malicious.

In spite of this, there are people who desire to leave behind the fixed positions and old wounds of the past and to avoid blood feuds. They hope to hold the middle, where loyalty to others within one’s own clan meets the desire to forge a larger community, one where the parochialism of local clans can be modified in the dialogue of an associating field – a global field made more aware of itself.

Different metaphors attract different needs, stimulate different methods, and convene different kinds of people. It makes sense that there would be a variety in the ethical considerations appropriate to each one, and it makes sense that this variety would channel the creative wisdom that could give birth to a whole new set of training practices more in tune with today’s field. Perhaps it would be good to utilize O’Neill’s taxonomy, build upon it, and think out loud with one another regarding what is smart and not so smart in each setting. Perhaps it would also be wise to acknowledge, and begin to talk out loud, about the differences that exist between our various clans. As such, it may be that our differences might become our strengths. Let each clan leave behind the desire to canonize its particular version of history and concentrate on what has become its theoretical and practical expertise. Let each clan contribute these things whenever the clans meet in conference, or write to one another in journals. Let these distincives stimulate the development of a whole new, and fully contemporary practice of Gestalt Therapy.

Conclusion

This has been an initial call for public discussion of the two issues of ethical guidelines for practice and the re-examination of our training methods. In the process, several observations have been made about the status of the field of Gestalt therapy. It would be possible to spin many different directions out of this call, but hopefully the Gestalt community will consider it an attractive offer to begin a dialogue and to see where that might lead.

Certainly, on an organizational basis, there are many regional Gestalt associations that may already have begun such a dialogue. We challenge each to make known what, if anything, is being done. This would mean that people write on these subjects. Let people write with passion from their hearts and with reason from their heads, let them express the real differences present in their communities as well as the agreements, but let us not just neglect to deal with these things, nor let us fail to utilize the great resources available to conduct such dialogue in a way that appreciates more of the entire field of Gestalt therapy.

References

Corey, G., Corey, M.S., and Callanan, P. (1993) Issues and ethics in the helping professions. Pacific Grove: Brooks/Cole Publishing Company.

Korb, M.P., Gorrell, J., Van De Riet, V. (1989) Gestalt therapy Practice and Theory. New York: Pergamon Press.

Naranjo, C. (1993) “Gestalt Therapy, The Attitude and Practice of an Atheoretical Experientialism” Part of an edited transcript of a talk given at the Fourth International Gestalt Conference, in Sienna, Italy, 1991. quoted on the AAGT discussion list by Anna Bernet, 30 Apr 1997.