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By Christine Lister-Ford

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Gestalt therapy was originated by Fritz Perls and his wife Laura. Perls became a neuropsychiatrist, and briefly had analysis with Karen Horney, following which he trained as a psychoanalyst himself and worked in Berlin. During the 1920s he came into contact with gestalt psychology and existentialism. In 1933 he fled from fascism in Germany and moved to South Africa, where he founded the psychoanalytic society (1936). He began to develop his own ideas, departing from traditional psychoanalytic theory, but they were not well received.

Holmes and Bateman (2002), however, consider the case for the existence of ‘common factors’ to be convincing, especially regarding the ‘therapeutic alliance’. , 1993; Wolfe, 1995). Holmes and Bateman (2002) critique the impact of evidence-based practice on the development of psychotherapy integration. They recognise that much integration occurs through flexible clinical practice by experienced and skilled psychotherapists faced with the particular needs of a specific client. The need for consistent ‘manualised’ psychotherapy approaches that lend themselves to replicable research studies precludes the exploration of flexible, integration strategies, resulting in a very limited evidence base for the integrative psychotherapies.

A psychodynamic approach proposes a basic structure of the mind within which the management of these conflicts occur. This structure was described by Freud as the ego, id and superego. Essentially the id contains unconscious material and the ego and superego contain conscious and preconscious material. A key concept here is the idea of the unconscious – processes that influence us outside of awareness. A principle arising from this concept is the movement of unconscious material into consciousness or awareness leading to greater freedom and authenticity (see Chapter 1).

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