Abstract

Processual attention is the heart of Gestalt work: it is through the process of contact that the encounter between therapist and patient/client becomes an opportunity for growth.
It is not enough to listen, nor simply feel, nor even rely on mere theory: the co-construction of the therapeutic encounter is nourished by the intersection of different levels of experience—described here as levels of analysis—that collaborate in constructing meaning and revealing the complexity of the encounter with the other.
In this article I will try to illustrate, in sequence, a wide range of processes that are active in parallel as we sit face to face in therapeutic work.
It doesn’t propose a new idea of ​​the process, it just puts a lens on what happens when we are immersed in contact, rooted in the Gestalt perspective.

Historical premise and methodology

During my years of psychotherapy training, I was often told that, as a Gestalt therapist, I should only be interested in the “how,” the “process,” and not the “what” or the “why.” I really liked the idea that the focus of the work was the process, but I remember suffering from a lack of clarity, which I felt was present in other approaches. The need for a clear structure left me feeling lost, but also aware of the reality described by one of my clinical psychology teachers from Padua, Alessandro Salvini: “Psychotherapy is not solid ground, it’s a raft, and it’s useless to delude ourselves otherwise. Only through our ability to remain in uncertainty, facing the waves, can we weather the storm of encountering the other.”
Strengthened by this belief, I began my career as a psychotherapist, initially abandoning the idea that Gestalt therapy could be described systematically, that the contact process was difficult to explain, and that only experiencing it was the only possible choice.
However, my career led me to have to teach Gestalt psychotherapy, and when I met Massimo Biasin and we began to collaborate on various projects and to structure our own way of working, his increasingly pressing and in-depth questions about the “Passages” required an ever-increasing search for clarity in my exposition, as if, in the pressure of his questions, I always found myself too superficial and the need to know how to say, as well as know how to do, grew within me.
It is precisely from these exchanges, clashes, comparisons, and agreements that the Gestalt process analysis model that I am now going to describe in this article was born, making a fundamental premise, however: it is a schematization, and therefore, like any schema, it is in itself a reduction.
The things that happen with the person we meet in the therapy room don’t go exactly like this, because a map can never replace the territory: those steps that are described here as if they were sequential and distinct are in fact simultaneous and overlapping.
The four different levels are the result of the descriptive effort in a very complex situation.
This distinction can only be made for didactic purposes, to train the Gestalt therapist in training to focus, but in clinical practice the schematic boundary collapses and trying to use it distances one from the objective of contact.
This premise seems all the more necessary after having begun to talk about it to psychotherapy students and having seen how easy it is to fall into the error of using it as a behavioral pattern: it is not like that, it does not want to be and cannot be.
The aim of this framework is to highlight the mechanisms underlying procedural work, so that they can be clearly described and familiarity with them can be developed. This helps to bring some order to the enormous complexity that an inexperienced therapist faces when dealing with a patient, or when—even if more experienced—working in supervision to understand something that has not been so clear in previous experience.
The goal in therapeutic work will then be to completely abandon the pattern, to immerse oneself in the encounter with the other and come into contact with him.

The 4 levels of analysis

The analysis of the process starts from a theoretical assumption: what interests us as Gestalt therapists is not the content that a client/patient tells us, but rather the “How” they tell it and how, in being with us, it is possible to grasp elements of experience that speak to the client himself through his contact with us.
To be able to work therapeutically in this way, it is clear that our concentration must develop simultaneously on multiple levels, intertwining details of lived experience with theoretical knowledge that, from the background, guides our actions—asking questions, proposing experiments, focusing, etc.—and which represent but a part of that extraordinary encounter with novelty that for us therapists is contained in the patient’s world and his or her way of being in the world.

1) The first level: phenomenal analysis

The first level at which we are interested in encountering others is the phenomenal level, that is, the level of being attentive to what happens: not to the meaning we can attribute to it, but to the phenomenon itself.
The phenomenal world is what we are given to know through experience, through the senses, and which precedes any form of intellectualization (Kant I., 1894).
With the suspension of judgment, “Epoche” (Husserl, 1936), we allow ourselves to escape from the naive cognitive mechanisms that normally accompany our approach to reality, remaining in the experience of the encounter in an open and interested way in grasping what emerges from the co-construction (Spagnuolo 2013).
Quali sono i fenomeni rilevabili? Ciò che semplicemente accade, ovvero ciò che è possibile vedere e sentire in termini percettivi.
For example: “The person enters and sits on the edge of the chair, holding the purse between their legs and clutching it with two fingers,” rather than “The person enters showing obvious discomfort, sits without really leaning on anything and showing little trust in the environment, clutching the purse between their fingers on their knees” – which would already be an interpretative reading of the observed phenomena.
Or: “The boy is wearing a shirt with stains that look like grease, his hair is disheveled, he looks down as he walks in and greets me,” instead of: “The boy with a scruffy appearance walks in, avoiding my gaze, and greets me.”
By trying to eliminate all interpretations as much as possible, at the phenomenal level, we do not deny the subjectivity of observation: obviously, each of us might notice different things, so phenomenal analysis has no ambition to be objective, but rather to avoid the immediate attribution of our own meaning to what the other person manifests and, at the same time, to grasp important elements, which, when elaborated together with our patient, will help us increase the level of awareness.
It could be pointed out that at the phenomenal level we are not even “Observing”, because observation, unlike simple “Looking”, presupposes an underlying theory that orients the observing eye.
The invitation, at this stage, is to grasp the phenomena and leave the theories in the background, allowing perceptions to emerge.
At the “pure” phenomenal level we simply look, hear, smell, touch, detecting with our senses what strikes us and which becomes a “Figure” for us.
From a perspective as equal as possible, the approach is that of the Id, which grasps the surface elements that emerge as a perceptual figure, remaining aware that the very grasping of some elements rather than others is already the effect of our specific gaze.
The attempt to abandon interpretations is rooted in the awareness that the meaning we might attribute to that particular phenomenon is conditioned by our filter, while we are interested in the filter of the person we are working with.
Phenomenal analysis answers the question: “What did I perceive/notice?”

2) Emotional analysis

The set of phenomena we can grasp at the first level of analysis is not without an effect on us: the way a person presents himself and behaves has an effect on his interlocutor, and we are interested in this “effect.”
Detecting the emotional effect we capture is part of the emotional level of analysis, and involves all the emotions that:
– we feel with our patient—our emotions—;
– all those they say they feel with us;
– those they describe experiencing or having experienced in their environment outside the therapy room.
At the level of emotional analysis we are interested in capturing every emotion present in the field (Lewin K. 1936), as they are informative with respect to the situation that our client is experiencing and that we are experiencing together.
While it is certainly interesting to listen and appreciate how the client experiences each step of the story on an emotional level, it is equally important to focus on both the effect this has on us, on an emotional level, and on how the client feels about the situation with us as they tell us about themselves.
In emotional analysis we make use of what the patient tells us he feels – his emotional narrative –, as well as of what we are able to grasp of his way of feeling – empathy –, and of the effect that the patient and his story have on us – sympathy – (Perls. F. 2022).
Emotional analysis enriches phenomenal analysis and allows us to welcome the patient by paying attention not only to the effects that the content arouses in us, but also to the effects that the situation of the encounter itself creates.
At this level of analysis, it is important to also pay attention to all the elements present in the field, including non-verbal and paraverbal ones.
It is from the intertwining of this vast range of emotions that this level of analysis is nourished and which is particularly rich.
Emotional analysis answers the questions “What do I feel, what effect does it have on me?” and “What do you feel, what effect does it have on him/her?”
The use we can make of emotional analysis is not—contrary to what those with a superficial knowledge of Gestalt therapy might believe—simply sharing our feelings with the patient: the choice to share them, to “center” them, depends on the specific situation and the functional opportunity to do so. The naive use of emotional analysis can be counterproductive both if valuing one’s own feelings leads to the fundamental error of unilaterally attributing meaning to them, or if it translates into outright sharing, which can cause disorientation, introjection, rejection, even judgment. Within the therapeutic relationship, emotional experience becomes a fundamental element for understanding the process if it is inserted into a work of integrating the various levels and thus acquires relational depth.

3) Analisi processuale

Process analysis refers to a third level of analysis, namely the choice of a reference model, a lens, through which to analyze what happens. Given that, as we’ve said, every observation is based on a reference theory, in process analysis we identify it and interpret the process through this filter.
The analysis criteria can be very diverse and provide the lenses through which we observe and describe that reality.
It does not represent reality itself, but only the perspective we choose to adopt to observe or describe that reality.
In Gestalt terms, we could analyze the situation through:

1. Self-theory: We can ask ourselves whether the three functions of the self have been active and whether they function in an integrated and coherent manner. For example, how is the id function functioning in this session? Did the client rely on his own feelings? Does he recognize them? How does he use them? How was the personality function expressed in this situation? To what extent is the ego function active or not?
2. Contact disruptions: Have we detected disruptions? Which contact disruptions? What happened at the experience cycle level?
3. the organism-environment relationship in dimensional terms: were the organism and the environment equal, was there a small organism and a large environment or vice versa?
4. Relational diagnosis: What was the quality of presence during the session? What kind of suffering do we perceive in the experience?

Identifying a process analysis criterion can influence the type of intervention we deem most useful, what we might call the “Therapeutic Project.” As in supervision, process analysis provides a map that allows us to orient ourselves in therapeutic work, seeking not to reduce everything to a presumed “normality” of functioning, but rather to draw on other levels of analysis to enrich our perspective and grasp as much as possible about the functioning of the person we are working with.
The specific support we can offer our client is nourished by process analysis and allows the therapist to represent a sufficiently favorable environment in which to bring to fruition the intention for contact embedded in the symptom.
During the therapeutic session, the third level of analysis lies in the background, emerging like the plot of a film while it is still unfolding: if we linger to grasp it, we distract our attention from what is happening in the present moment, but at the same time, it is precisely thanks to what is happening in the here and now that the plot is constructed. In the spontaneity of the encounter it cannot be in figure, but it underlies every question: it is that theoretical trace that, although not visible, transforms simple looking into observation.

4) Sensory-functional analysis

The final level of analysis is the sensori-functional one, which investigates the meaning and function that a certain adaptation has for the person.
Starting from the theoretical assumption that the organism moves through the environment to satisfy its own needs (Perls F., Hefferline R.F., Goodman P. 1951), an important question concerns the meaning that a specific functioning has, or has had, for the person or the situation. If we assume that the symptom—at the moment it develops—is a creative adaptation, when the patient seeks support for a specific ailment, we are interested in making sense of it and understanding its possible function.
What purpose did or does that specific choice of the organism serve? Is it a choice—and therefore a creative adaptation—or is it a neurotic repetition of an old adaptation?
This question refers both to the choices or experiences the patient describes having made and lived through, and to those he or she enacts in the session with us.
Asking the patient about the meaning and function a symptom may seem paradoxical. If most people would immediately answer “Nothing” to the question, by dwelling on the question and exploring what seems like a void of meaning, something new can emerge. By dwelling on the paradox, embracing the possibility that it actually serves a function, a new awareness can emerge.
This approach leads us to avoid the medical idea of ​​treatment as a resolution of the symptom, and by providing a broader perspective that leads to the intentionality of contact, it highlights how every symptom can be the expression of this intentionality.
A symptom that becomes clear from a sensorial-functional perspective can be experienced completely differently by the person, and in some cases this can radically alter their suffering.
If, for example, I recognize that agoraphobia helps me avoid facing a job that scares me, it’s clear that the focus of the therapeutic work will not be on “treating the phobia,” but on the relational fear that generates it.
As long as symptoms perform an important function for the organism, they cannot be “cured,” because we would deprive the person of their creative adaptation. It is quite another matter if that symptom was a creative adaptation—then and then—and is no longer useful today—because the person has changed, or the environment has changed—but has crystallized. In that case, by recognizing its dysfunction, it is possible to overcome it through a new creative adaptation.
In clinical experience, it is important to recognize the function and meaning that a certain suffering has had for the patient, sometimes allowing for a narrative that is often reassuring and in any case fresh.

Conclusions

As underlined in the introduction, these four levels of analysis integrate and overlap, representing, in their complexity, the effort that a Gestalt therapist makes in the encounter with the other, not relying on pre-established models of interpretation, but rooting themselves in the experience of the here and now.
Process diagnosis is an intrinsic diagnosis, based on the experience of contact.
While avoiding objectifying the other, we cannot fail to recognize that what happens is not simply the result of their way of being, but rather their response to the field we co-construct together. This is a less than self-protective perspective, which can frighten those who prefer to remain safe in their role and not put themselves on the line, but it represents the heart of Gestalt work.
The authentic encounter is the goal of the therapeutic encounter, which allows the patient to experience assimilable newness within a protected situation. A level of “protection” sufficient to allow for safe experimentation, but not so high as to prevent the recognition of risk: the real encounter with the person we work with, in order to allow growth, requires leaving the comfort zone and temporarily abandoning taken-for-granted certainties, to arrive at the new.
Developing one’s senses and the ability to fully listen in encounters with others gives the Gestalt therapist the ability to immerse themselves fully in the process rather than observing it as if external. Process analysis, which integrates the various levels, is not a cognitive process, but rather an experience that occurs in the encounter with the other: it is in the present moment of the session that phenomena, emotions, processual evidence, and meaning take shape and can be recognized by the therapist as significant for the individual, the situation, and the desire for well-being that guides their seeking support.
It is in this desire to provide support that, as therapists, we abandon the mainland, riding together the uncertainty of the encounter to arrive at a new, co-constructed land.

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