Deepening Trauma Practice: A Gestalt Approach to Ecology and Ethics

Abstract

Miriam Taylor’s latest book was published during a time of global pandemic, climate emergency, cultural conflict, and resource inequality, so it is both timely and apposite. It is best read as a follow-up to her previous volume (2014), although readers new to the concepts discussed are provided with succinct summaries of the ideas underpinning the Gestalt approach and the neurobiological perspective on trauma. As Taylor readily acknowledges, many of her arguments are ones that have already been well-rehearsed in both Gestalt and non-Gestalt literature. The list of writers advocating an embodied, relational approach and a move away from an anthropocentric approach to an ecocentric one is long and distinguished. Yet, Taylor argues that psychotherapy practice and the structure of its provision frequently remain rooted in a Western, capitalist, individualist model.Adding her voice to those challenging this paradigm, Taylor urges us to make an “ecological turn” (4) and widen our understanding of not just the concept of trauma, but the embodied experience of it in our own lives. Foreground for her in this volume, she says, is the cultivation of “an embodied, almost second-nature felt sense” (9), in which theory is important but not necessarily figure. Complex and wide-ranging theoretical arguments calling for cognitive processing sit side by side with a demand to stop thinking and turn one’s focus to exploring embodied process. Accepting her invitation to leave temporarily the intellectual argument and prioritize embodied feelings rather than thoughts can be uncomfortable. Taylor’s metaphor of the Trickster aptly encapsulates the disorientation that ensues when habitual ways of thinking/seeing are disrupted, when everything is turned upside down and boundaries move. Trickster stories (Hyde 1983), retold at the beginning of each of the book’s three parts, speak to the way the disruptive intelligence of the Trickster expands the field and illuminates new perspectives. The image of a Möbius strip is used to illustrate the flow and connection between the shifting perspectives and experiences that we will be introduced to. In all three parts (Situating Trauma, The Space Between, and Ecological Perspectives), clinical examples and spaces for reflection encourage the reader to move from certainty to uncertainty, from cognitive understanding to felt experience. To facilitate the shift, the author continually moves among theoretical arguments, clinical examples, and practical experiments in a sequence described by Laura Perls (Rosenfeld 1988) thus: “First comes the awareness and then the de-automatizing and bringing it more into the foreground. . . and out of that develops experimentation in different directions” (22).In Part One (Situating Trauma), the focus is on raising awareness by contextualizing and exploring ways in which our society is organized around trauma. The evidence is all around us: migrant boats full of refugees, polarized and often violent political discourse, burgeoning numbers of people presenting with mental health issues, relentless destruction of precious natural habitats. Taylor argues that because we are enmeshed in Western capitalist culture, it is almost impossible to avoid imbibing the “something in the air” (Harris 2011, 21) that shapes us. The result she says is, despite the evidence, we frequently fail to register what is “hiding in plain sight” (11). Taylor argues that if we fail to make the shift in awareness necessary to transcend this dynamic (Parlett 2015), “what remains in the dark can continue to do its toxic work unabated” (22). She challenges herself and the psychotherapy profession about complicity in maintaining the oppressive structures that Hosemans (2020) refers to, but acknowledges that separating ourselves from the context we are inevitably embedded in is far from straightforward. She considers the proposition that trauma is part of a culturally acceptable symptom pool and describes the evolution of “a whole industry” (73) around the topic. Pointing out that our livelihoods depend on this “industry,” and we are therefore compelled to compromise with it to some degree, she includes herself as “very much a part of this system” and asks “who profits from trauma?” (73). Criticism of mental health services and psychiatry often strike a chord with psychotherapists, but questioning our own profession’s complicity might sit less comfortably. Nevertheless, the question is a pertinent one and raises the issue of how much compromising is possible and permissible if we are to remain true to our philosophical and theoretical approach.At times, the range of information and number of complex concepts offered for consideration seemed overwhelming. I could identify with Taylor’s revelation that thinking and writing about situating trauma was very challenging, took many months, and left her with a feeling that she had “barely scratched the surface” (40). My image was of a sheepdog trying to collect a herd of lively sheep into a confined pen, as multiple concepts from a wide variety of Gestalt and non-Gestalt sources were gathered together with some left hanging with a promise to return to the themes later. I sometimes found myself echoing Bednarek’s (2018) question, “How Wide Is the Field?” and identifying with the latter author when she asks “whether working on a client’s feelings is not more or less therapeutic than working on cleaning a local riverbank” (12). As long ago as the 1990s, Hillman and Ventura (1992) were posing the same kinds of questions and criticizing the assumption that more psychotherapy, situated in the same individualist paradigm, would automatically lead to a better world.Taylor asks similar questions, but for me, her most important contribution to the debate lies, not so much in the conveying of ideas and information, detailed and well-researched as these are, but in her invitation to become actively involved in responding to the important issues she raises. She intersperses complex discussion with clinical examples and regular “dropping in” spaces where readers are invited to stop thinking, ground themselves in breath, and register embodied sensation. I chose to accept the invitation. With journal to hand I allowed myself to feel, record, and reflect on my embodied responses as I explored the impact of colonialism, slavery, racism, power, class, resource distribution, and ecocide on my attitudes, thoughts, and therapeutic interventions. It was tempting to engage with the argument on a cognitive level and move forward quickly to think about the next theoretical concept rather than stop to allow feeling. The Trickster had many opportunities to do his work (Taylor uses the male pronoun), as a complex and dynamic intersection of the personal, historical, social, political, and economic was animated. Many of the common threads Taylor identifies as human responses to trauma were evoked in this process; an impulse to disconnect, the presence of shame, a tendency toward “othering” in the service of self-preservation, and a retreat into role. At times I was aware of the potential for overwhelm, exacerbated no doubt by the precariousness of the current global situation. The offering of the “SOS model” (Denham-Vaughan and Chidiac 2013) as a tool to assist reflection and navigate through confusion was useful, but it was Taylor’s own crystal clear commitment to personal transparency that enabled this reader to feel accompanied when attempting to embrace a potentially infinite field.In Part Two (The Space Between), the focus narrows to explore the dynamics of the therapeutic dyad. Expanding some of the issues raised in a recent article, Taylor (2019) reminds us that when thinking inserts itself into the intersection between Denham-Vaughan and Chidiac’s (2013) “Self and Other (SOS)” model, the possibility of presence is reduced. Taylor encourages us to stay with the tension of both knowing and not-knowing as we commit to feeling our way toward the “unthought known” (Bollas 1987, xviii). Describing the potentiality of this space, the German theologian Bonhoeffer (1995) said: “[T]o the extent the emptiness truly remains unfilled one remains connected to the other person” (41). In this place of “cultivated uncertainty” (Staemmler 1997, 40), an opportunity for connection and intimacy resides cheek by jowl with the threat of fear and pain. It is here that the opportunity for the kind of transformation Francesetti (2012) describes is present. This is, however, also a place where unaware prejudice, personal history, and enduring relational themes (Jacobs 2017) can intrude with the potential for desensitization, distortion, and flight into premature sense making. To explore the former, we are invited to log into Harvard University’s (2011) Project Implicit, which this reader did do with some personally revealing results.Taylor adds two new dimensions to Lichtenburg’s (2001) four corners of contact model: “You are and I want to tell you who I am, what I want and how I react to you” (94, emphasis added). With courage and almost breathtaking honesty, Taylor takes up her own challenge and tells us something of who she is by sharing her own trauma history, remarking that seasoned therapists will recognize her story as “grindingly common” (100). Grindingly common or not, the impact of suffering is always visceral if we allow ourselves to be open to it. My own initial response was a complex mixture of shock, horror, anger, and admiration. My breath and body tightened and then, as I grounded myself and allowed my exhalation, my body softened and my heart began to ache.Like Perlman (1999), Kepner (2003), and Cozolino (2004), Taylor considers that resonating with, and being activated by, another’s trauma is evidence of connection and not of failure or inadequacy on the part of the therapist. She quotes Geller and Greenberg (2012), who argue that the response of the client is strongly influenced by the inner state of the therapist, and pays attention to therapist activation in a revised window of tolerance model, which includes the need for co-regulation when trauma is present. The need compassionately to include ourselves, our personal history, and our embodied responses is not presented as a merely cerebral concept. Taylor challenges herself and her readers to feel viscerally the impact of staying with another’s suffering while simultaneously being present to their own. Agreeing with Denham’s (2006) positioning of authenticity as a clear requirement of deep contact, she acknowledges that the process of becoming authentic is not straightforward or pain free. I was reminded of Williams’s (1922) children’s book, The Velveteen Rabbit. Rabbit wants to be real but asks, “Does it hurt?” (8). The Skin Horse, who has been through the experience and, as his name suggests, has “skin in the game,” replies “Sometimes . . . for he was always truthful” (9). Like the Skin Horse, Taylor is truthful; sharing her own hurts, describing how she resources herself, and encouraging us to do the same. To respond to this book only on a cognitive level would be to miss the major point that Taylor is making: that it is including ourselves, acknowledging our role in the maintenance of the traumatic field both personally and professionally, and being appropriately vulnerable that enables us to be truly in relationship. As Margherita Spagnuolo-Lobb and Donna Orange respectively comment in reviews included in the book: Taylor “gets to the heart of the therapist” and “teaches us to inhabit our personal trauma so that we can accompany the Other” (praise page).Part Three (Ecological Perspectives) reprises some of the content of Taylor and Duff’s 2018 article. Themes of inclusion, connection, shared ground, and therapist authenticity are drawn together into what Taylor describes as new territory, which involves seeing and responding to the natural world “not as a resource but as a relationship” (150). That this is not really new territory for Gestalt practice, as pointed out by Bednarek (2018). The concept is foundational in our theoretical framework. Perls, Hefferline, and Goodman (1994) say that “it makes no sense to speak . . . of an animal that breathes without considering air and oxygen . . . or to speak of eating without mentioning food, or of seeing without light or locomotion without gravity and supporting ground” (228). This concept can easily get neglected or forgotten as we imbibe the “something in the air” (Harris 2011, 21) of an acquisitive, Western capitalist culture and are encouraged to focus on doing about rather than being with. It is the reestablishment of that connection, that location-in rather than dominance-over, which Taylor is arguing for.She is not alone in making this argument; the call is global, it crosses disciplines, and it is getting louder all the time. The recent pandemic, rapid escalation of the pace of climate change, and mass migration of populations from areas of famine, war, or economic deprivation all highlight the interconnectedness of our planet and the need for us to focus on relationship rather than alienation if we, and the world we inhabit, are to survive. Speaking of her own experience of Gestalt training, Bednarek (2018) says: “Sociopolitical issues were not part of what was deemed to be a relevant focus for the aspiring psychotherapist” (9). Taylor makes a powerful call for these issues to be not simply a relevant focus but an absolutely essential one for training organizations, individual practitioners, supervisors, and service providers. She points out that the vast majority of psychotherapy students are self-funding, men are generally underrepresented, and most students are white. Those particular demographics can mean that the collective lens is narrowed unless active and experiential steps are taken to locate Gestalt training and practice firmly in a sociopolitical field.There is no easy solution to these issues. Taylor’s insistence that we not only think about them but commit to making the time to feel their embodied impact, both personally and professionally, offers a possible pathway to moving forward. Heightening embodied awareness of the wider field in which trauma is situated, and taking “an ecological turn” (4) in thinking and practice, prepares the ground for the kind of action needed. The issues raised by Taylor will not be resolved by words alone. For this reader, the impact of the book resides not so much in words and argument but in the felt experience provided. In 1991, James Hillman said, “Personal growth doesn’t automatically lead to political results” (Hillman and Ventura 1992, 6); and with Margherita Spagnuolo-Lobb (2014), we might well ask what is the “Now for Next”? What needs to change in practice, pedagogy, training curricula, and student recruitment if we are to work together to really make a comprehensive ecological turn? Laura Perls, referring to Paul Goodman’s contribution in Perls, Hefferline, and Goodman (1994), remarked: “You don’t get it by just reading through it quickly” (Rosenfeld 1988, 21). The same can be said of Taylor’s current volume.