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The Italian Margherita Spagnuolo Lobb is one of the Gestalt Psychotherapists with best knowledge of the international history of Gestalt Therapy. 

Interviewed by Ann Kunish and Per Terje Naalsund

Welcome! We’re glad you agreed to be interviewed for Gestaltterapeuten’s yearbook.

– I’m glad to be here.

This issue is about Gestalt Therapy by Perls, Hefferline, and Goodman and contemporary approaches to it. I’d like to start by asking about your history with the book, then a bit about your own work in the context of this book.

PHG isn’t the easiest to read and was written 70 years ago. What would you say are the gifts and problems of having this book as our foundational text?

– I came to this book via Isadore From, one of the founders of Gestalt therapy. He was my therapist. My first training was with the Polsters, Erving and Miriam Polster. They had their own book, which they referred to, referring occasionally to the founding book. There I met Isadore and invited him to Sicily, he introduced me and the colleagues with whom I founded my institute to this book. He explained to us how the book had been written and how they used it, both at the New York Institute for Gestalt Therapy and to train other groups, like in Cleveland. We started to read the book in a similar way, the so-called hermeneutic way. 

This is a fantastic book because it creates ideas. It’s not easy to understand in a logical, structured way. But it’s wonderful because it stimulates ideas. We suggest that our students read this book like the Bible, you know? Half joking and half seriously I suggest them to keep it on their bedside tables and read it before going to sleep. They just open it and read any bit their eyes land on. Every time you read a sentence or read it again, it means something new, like a living entity that makes you think and generate ideas. I think this is a very special quality of the book. The fact that it is written in a non-introjectable way, in such a style that you cannot introject it, you have to create new ideas when you read it. This is why it’s called the Bible. There’s always yet another meaning in the Bible; there are seventy structured meanings, and then the seventy-first: your own meaning, your personal meaning. 

«Unfortunately it was written quickly, so it was not developed enough—the paradigm of relationality.»

– On the other hand, the book was written quickly, as we know, especially chapter 15, the most important for clinicians. It was written quickly because they had to publish it. In the first part of the book there is a deep passage from the individualistic point of view to the relational point of view. In that chapter, it seems they go backwards. They come back to an individualistic point of view. I very much appreciate the criticism people like Georges Wollants and Gordon Wheeler have about the book. In Wollants’ book, he emphasises how Gestalt Therapy would have been if it had been faithful to this relational paradigm. I think the negative aspect of the book is that it is so sophisticated that it was difficult to develop the method with the book as a point of departure — it’s a very complex approach to human relations and clinical practice. I like to say that, as Gestalt therapists, we need to become therapists of complexity, to develop the book.

Unfortunately it was written quickly, so it was not developed enough—the paradigm of relationality. In that last chapter of the first volume, it seems that the individual is seen not as emerging from an organism-environment field, but as an individual who makes contact with an environment. Our paradigm of relationality is something we should develop, and is what we have done in my institute with a very recent book that is going to be published by Routledge, Psychopathology of the Situation. There, we approach various sufferings from a field perspective. 

 

«If I have to write, I refer to PHG for the basic things they say about vitality and supporting what already works in human relationships and how this can be seen in contact-making between therapist and client: to stay with what works, with the positive aspect of human relationships and with what vibrates.»

 

We seem destined to reread and rewrite this book, quote it, digest it. How has this process been for you?

– Very inspiring, very rich. I don’t know the degree to which it was the book or Isadore From or my belonging to the New York Institute that contributed to what I feel in my blood as a Gestalt psychotherapist. I feel the vitality that this approach underlines. In any situation, I look for the vitality that is in that situation. Then, if I have to write, I refer to PHG for the basic things they say about vitality and supporting what already works in human relationships and how this can be seen in contact-making between therapist and client: to stay with what works, with the positive aspect of human relationships and with what vibrates. When we speak of vitality, we are speaking of aesthetics. Vitality is something that touches our senses. We vibrate in the presence of what we see of the vitality and appreciate the creativity, the way the client creates forms with us, in a unique way. This is our way of knowing the other, knowing our clients, knowing their situations and their integrative capacity. Our vibration is the way we diagnose and choose how to intervene. This is the way I developed PHG.

I wanted to ask about vibrating in the presence of our clients and their suffering. Can you say something about how this is different from simple awareness?

– Awareness is a more general term, I think. It comes from being awake, from our own senses. Awareness is having our senses open. Using the aesthetic tools with our awareness, to shape our awareness—we use it in a more detailed way. This is what I did when I described the construct of Aesthetic Relational Knowledge. I also want to mention Erving and Miriam Polster, because I learned a lot from them about aesthetics. They worked—and he works—with aesthetics a great deal. When we vibrate in front of something we see, we are like the ripples when a stone falls into the water. So we are moving, we are the environment of the person before us, the environment that reacts with waves to what is happening. These waves are the way in which the environment adjusts to the individual’s act, to what is happening. So we react somehow in a way that is similar to the meaningful other’s reaction. 

Like a parallel process?

– Yes, but I think it’s a whole process in this case. As a therapist, I focus my senses on the client and let myself be impacted by any vibration that I feel. The symptom is a work of art—we can say that the client is a work of art. We react to the client as we would react to a work of art. We just let ourselves be impacted by this person. 

When I look at you now, Ann, I see nice glasses, such short hair, interesting earrings (laughter). So we let ourselves go into this and try to understand the client’s past and present, how the client has shaped his or her own life with meaningful others. And now the client is before us, asking for help. The function of asking for help is something very impressive. Every one of us asks for help in a different way. So we react in a synchronic way that is somehow complementary to what the client feels. We were speaking of parallel processes, and actually this can be a parallel process with what happens in other meaningful relationships. But honestly when I’m with a patient, I’m interested in the here and now, how we co-create our being-with.

Is this the origin of therapy as a form of dance?

– Yes. It comes from the paradigm of reciprocity. The client is there and the therapist is here (holds out her hands) and they’re not separate—they are an organism-environment field. So when the client moves, the therapist reacts. Without this reaction, the client doesn’t feel seen or recognised by the therapist. And the client reacts—they are reacting to each other. They are also repairing derailments in their dance. They are adjusting to each other, creating something together, a dance. In 2011, in The Now-for-Next in Psychotherapy: Gestalt Therapy Recounted in Post-Modern Society, I described the concept of Aesthetic Relational Knowledge, and in an article published in the British Gestalt Journal in 2017 I described this dance in a series of eight steps. 

As a therapist, you have to have aesthetic tools that you refine in the presence of the client as a work of art. Could you say a bit more about how you train yourself to be able to relate aesthetically?

– I think that the concept of movement is important here. Recent research in neuroscience, especially from the group that discovered mirror neurons at the university in Parma with Rizzolatti and Gallese, refer to the movement as a basic act of being. Even thinking is a sort of movement. So when I explain this concept to my students, I ask them to think about a client they want to understand better and recognise a movement that is typical of the client—something that would enable them to be able to recognise this client from among thousands of people—and draw this movement. I then ask them to feel what kind of movement they would make in response. Usually it’s very useful, because the movement is a way to recognise the aesthetics of the other. Movement includes perception, feelings, actions, and being open to the other. It’s good to practice the therapeutic aesthetic tools.

When I lead physical workshops about my model of reciprocity, I ask the trainees to work in pairs. One of them enacts the movement of the client, but without words. The other is the therapist and reacts only with movement. They create unique, beautiful dances.

«The ground experience is what creates the experience of being in the here and now, of safety, of sureness. (…) It’s in the reciprocity between therapist and client that we can build the safe ground.»

I wanted to ask you a bit about the ground. For me, you are a theoretician of the ground. You speak of the aesthetics of the ground and the importance of tools for dealing with matters of the ground. You have interpreted the contemporary situation as a situation in which people are missing ground.

– I started to be interested in the ground experience after the 80s, when the symptoms and suffering of people became more serious. When the borderline client came and said for instance, “I don’t know if you will be able to treat me, to cure me,” and the therapist could react with anger — if he receives the client’s words as a challenge, and this challenge becomes figural to the therapist’s intervention and he wants to make their boundaries clear. We understand that the ground experience of the client is suffering a kind of unsureness of his or her identity. S/he doesn’t know if s/he is able to be treated or can trust this therapist. It’s a ground experience of not feeling sure of his or her own identity. So the answer should be focused on the suffering of this client rather than the challenge. 

When I began to study this type of serious disturbance, I started to appreciate the experience of the ground. I think Gordon Wheeler did something similar at that time. I connect this with the needs of society. Society hasn’t provided a sense of safety for children and young people during the past decades. Primary relationships are somehow missing the sense of sureness, the sense that the other is there for the child, is stable. The adult is not stable, is busy, is worried, not aware of his or her body, is not fully present. The child doesn’t receive a message of safety. Safety needs ground, needs the adult. So the ground experience is what creates the experience of being in the here and now, of safety, of sureness. It’s close to what Stephen Porges calls neuroception. I think this is part of the ground, not all. But this is a basic aspect of the ground. The body reacts differently when we feel secure, safe, or are in danger. We stop breathing, our muscles tense, we are unfocused on the contact boundary and more focused on our basic sense of safety. 

It’s a ground condition that is quite different from that of safety, of being able to focus on the contact boundary with the other. If I feel secure, safe, I can be completely myself and present in the moment with the other. If I’m not safe, I have to fly around, be very careful about something that could happen. I think that most clients we treat today are like this. For instance, a client can say that s/he doesn’t feel good going out and prefers not to leave home. If we follow the traditional Gestalt method that works with the figure, we’ll ask this client what do you feel when you’re about to leave your home, what are your thoughts, your resistances? But if we work on the ground, we say look at me, breathe—what do you feel in this moment when you tell me that you don’t want to leave your home? It’s in the reciprocity between therapist and client that we can build the safe ground.

So we are not supposed to help the client to have full contact with a figure, but with another person.

– Yes, because in contact-making we can create a safe ground. 

And safe ground has to be there before figure-making makes sense, because the figure is influenced by the lack of safety?

– There is a balance between figure and ground. If the ground is not safe, not calm, the figure will not be clear. If the ground is insecure, our condition is different, because we activate emergency functions. We are alert to what can happen and are not calm and breathing when looking at the other, we don’t let ourselves go into the contact.

I’m confused about the balance between figure and ground when we speak of working on the ground. When our attention goes to the ground, doesn’t the ground then become the figure?

– As a therapist, what you see is the way the client breathes and looks at you, his or her resilience in the body. You have a feeling that there is anxiety and can see that work on the ground is needed. Then of course you see also the figure formation that comes from that kind of ground, but the figure formation happens spontaneously when the ground is calm, safe, clear, and you just have to enjoy how this happens.

You write about the losses of ego-functions as a polyphonic development of domains, Aesthetic Relational Knowledge, and reciprocity between client and therapist. In which way are those three themes connected to the theories in PHG? 

– The story of the polyphonic development of domains is a story about my faithfulness to PHG because the so-called losses of ego-functions, such as introjecting, projecting, etc. in chapter 15, is something that has been very much criticised by the Gestalt community because they are not phenomenological terms, they are more psychoanalytical terms. They don’t express the movement of the field. 

What I tried to do was reread the losses of ego functions—introjection, projection, etc.—as competencies for contact that the organism has acquired in previous contacts. So they are part of the ground experience of the client. They become available ways of interacting with the world, thousands of possibilities to create new figures. If I’m taking a walk, I decide moment by moment what I want to do, drawing on what I have learned—how I have learned to introject, retroflect, project, to be confluent. 

If I speak to my therapists, every moment I draw on what I have learned about contacting. I present my case, my episode to the therapist by creating a symphony of all this, of the functions that I have learned, competencies that I have learned. For the therapist it’s interesting for example to know how the client introjects, because this helps the therapist to be able to use the right language for the client. If I see the client has learned to introject with anxiety, I will use introjection in a positive way that doesn’t create anxiety, that gives a better experience. 

«For us it’s not a matter of implicit or explicit, since we are not interested in verbal or non-verbal, conscious or unconscious; we are more interested in the knowledge that comes through the senses as Gestalt therapists.»

Dancing through the contact functions.

– Yes, there is always reciprocity. I consider the polyphonic development of domains as being faithful to chapter 15, but in a more phenomenological way.

Aesthetic Relational Knowledge is a way to describe the therapist’s awareness in a way that includes the notion of field. I took this on a practical level from the Polsters, as I’ve mentioned, and the language from Daniel Stern. He spoke of implicit relational knowledge, which is how the child’s non-verbal knowledge of the mother and also how the mother knows the child. We cooperated with Stern for nine years, he is very influential in my approach. When he talked about this, I was thinking that we can say the same thing at an aesthetic level. Because for us it’s not a matter of implicit or explicit, since we are not interested in verbal or non-verbal, conscious or unconscious; we are more interested in the knowledge that comes through the senses as Gestalt therapists. So I used the term Aesthetic Relational Knowledge, and I spoke with Daniel Stern about this. The crucial connection that I feel with PHG is to consider therapeutic process as support to vitality that, in spite of suffering, is still present in the client and in his or her situation. 

Reciprocity is a way to stay close to their intuition, their brilliant intuition about the organism-environment field and how everything can be understood in the dynamic between organism and environment. Reciprocity is a way of describing in more detail the movement inside the organism-environment field. 

Thank you, Margherita, for sharing your thoughts about the connection between your work and PHG!

 

This interview was first published in Norwegian translation in Gestaltterapeuten. Årbok for Norske gestaltterapeuter 2021. 

Further reading: 
You can read more about the above-mentioned concepts in these works: 

Spagnuolo Lobb M., & Cavaleri, P. A. (2021). Psychopathology of the Situation. Gestalt Psychotherapy in the Emergent Clinical Fields. Routledge/Gestalt Therapy Book Series (in press).

Spagnuolo Lobb, M. (2013). The Now-for-Next in Psychotherapy. Gestalt Therapy Recounted in Post-Modern Society. Siracuse: Istituto di Gestalt HCC Italy Publ. Co., www.gestaltitaly.com

Spagnuolo Lobb, M. (2017). Psychotherapy in Post Modern Society. Gestalt Today Malta, 1(2), 45–55. ISSN 2519-0547

Spagnuolo Lobb M. (2017). From Losses of Ego Functions to the Dance Steps Between Psychotherapist and Client. Phenomenology and Aesthetics of Contact in the Psychotherapeutic Field. British Gestalt Journal, 26(1), 28–37.

Spagnuolo Lobb, M. (2018). Aesthetic Relational Knowledge of the Field: A Revised Concept of Awareness in Gestalt Therapy and Contemporary Psychiatry. Gestalt Review, 22(1), 50–68.

Spagnuolo Lobb, M. (2018). Figure and Ground Experiences of the Self. Integrating Development and Psychopathology in Research and Clinical Practice. In M. Spagnuolo Lobb, D. Bloom, J. Roubal, J. Zeleskov Djoric, M. Cannavò, R. La Rosa, S. Tosi, V. Pinna (Eds.), The Aesthetic of Otherness: Meeting at the Boundary in a Desensitized World, Proceedings. Siracusa (Italy): Istituto di Gestalt HCC ItalyPubl. Co. (www.gestaltitaly.com), 423–439.

Spagnuolo Lobb, M. (2019). The Paradigm of Reciprocity: How to Radically Respect Spontaneity in Clinical Practice. Gestalt Review, 23(3), 234–254.

Spagnuolo Lobb, M. (2019). To become a Gestalt psychotherapist within a group: Ethics of a teaching/learning community. New Gestalt Voices, 5, 31–40.

Spagnuolo Lobb, M. (2020). Gestalt Therapy During Coronavirus: Sensing the Experiential Ground and “Dancing” with Reciprocity. The Humanistic Psychologist 48(4), 397–409. DOI: 10.1037/hum0000228