Time in the work of a Gestalt therapist

Moscow,
Moscow Institute for Gestalt Therapy and Consulting, pp. 232 – 243, 2018

Back to the future

Part 1
Working with time in gestalt therapy.

Like a bird in the sky, like a fish in the ocean,
Like a slippery worm in damp earth's layers,
Like a salamander in flames—so is a person
In time... (V. Khodasevich, 1920)

Time is like air. We may not notice it, but as long as we are alive, we cannot escape our relationship with time.

Because, as the Queen from "Alice" rightly pointed out, if you're out of sync with time, "you have to run as fast as you can to stay where you are, and to get somewhere, you have to run at least twice as fast."

Andrei Tarkovsky in his article "Sculpted Time" says that the viewer goes to the cinema for time — "for what has been lost or not yet found." "A person goes there (to the cinema) for life experience." [18]

In this sense, it seems to me, the motivation of a client in therapy resembles Tarkovsky's view of a viewer's motivation in cinema. The client goes to the therapist "in search of lost time," to capture something in the past (a moment that didn't happen, was interrupted, or went in the wrong direction) or to catch up with something that happened in our lives, something we weren't prepared for and couldn't face, feel, or experience.
As a result of "quarrels with time," which happened for various reasons (we lose the ability to fully be present in our lives.
In order for this presence to be possible, a person must be in touch with themselves (aware of their own feelings and desires) and with the surrounding world, including other people (be able to hear and feel them). When this contact is interrupted, there is (sometimes barely noticeable) stoppage, a shift in time.

A man shifts from his time line, and it doesn't matter whether he's drinking endless tea in languor and irritation, like the Hatter and the March Hare, or singing "Hakuna Matata" like the future Lion King. Either way, something has gone wrong, he's lost. To be fair, if the client has already come to the therapist, it means that he or she is already very tired of the taste of tea, and the words have become confused, and "hakuna matata" has imperceptibly turned into "fuck it all to..." Most likely, the client has already made more than one attempt to sit down at the table in search of clean dishes and has already found that all the cups are dirty, that is, he has exhausted his own resources to make peace with time.

The therapist's job is to try to help the client make peace with time, to find presence in his or her own life.

Gestalt therapy is based on the idea that movement through time occurs as a result of a person's interaction with the surrounding world. F. Perls believed that psychotherapeutic work should take place in the present, and extrapolation into the past and future leads to neurotic experiences [11].
However, the past, present, and future are intertwined in the present. "The present moment contains everything" (Robin, 2008) [13]. Turning to the past and future happens precisely "here and now" and is directly related to this "here and now". The past not only influences the present but also exists within it. "Memory is a way to speak about the actual state..." (Spagnuolo Lobb, 2015) [17].
The future is also present in the now. Ideas, fears, and dreams about myself at eighty affect me now. Our future (more precisely, our perception of it) gives meaning to our present and influences it, including the therapeutic process. We cannot change the past, but we can, in therapy, here and now, in direct contact with the surrounding world, meet those moments in the past when we deviated from the path of time, unfold the halted experience to be able to move into our future (Spagnuolo Lobb, 2015) [16].
When a client comes to a psychotherapist, a remarkable juggling of "there and then" and "here and now" begins, where both the present and the past become alive and existent. In this dance of the client's temporal contexts interacting with the therapist, it becomes possible to restore the client's connection to their own time, the ability to align with their own life. This becomes possible through the restoration of the capacity to experience. And this dance happens in the present. Because experiencing is the process of current interaction with the world. It is a "holistic ongoing experience... a holistic process of experiencing the current interaction with the world" (Nemerinsky, 2017) [10]. Experiencing is the thread that ensures the integrity of our time, defining the connection between our past, present, and future. The past, present, and future are, on the one hand, separate, but on the other hand, connected through our present experience of past events and future perspectives.

Time perception changes in a number of conditions, including psychopathological conditions, schizophrenia, depression, burnout syndrome, and stressful situations. Time perception changes after trauma and in the process of experiencing grief. (Vasilyuk, 2000 [3]; Vazquez-Bandin 2017 [4]; Vidakovic, 2017 [5]; Polster I., Polster M., 1997 [12]). If the situation is not experienced and therefore not accepted, the person wants to recover the lost past. Time is frozen. It is impossible to move forward. The person returns to the past and cannot look to the future. And if the person faces a retraumatizing situation, the past catches up with the person in the present in a fullness of bodily sensations that may be totally incongruent with the situation. The therapeutic goal of at least "the first few sessions" with a client experiencing grief is "to synchronize subjective and objective, social time." [4]

In session, the client is often replaying what is happening to them in their lives. Attention to how the client lives in the session time, how they feel and experience themselves, including how they are bodily aware at any given time, provides a great deal of insight into experiences, meanings and needs and helps to find ways to meet them.

Client Boris, 54 years old, applied at the insistence of his daughter, who "does not understand why she is worried", "she does not like it, you see, that I do not go anywhere and do not want to go to the dacha".

I'll provide a small excerpt from the 6th session:

B: I think it's all hopeless (Boris sits slightly hunched over, glancing at me from under his brow), it's only going to get worse. I'm just tired of her (his daughter). And in general, my time has passed. "No Country for Old Men."
T: Do you feel out of place here too?
B: I feel out of place in life... and here too. Maybe if I had come twenty years ago (smirking)...
T: How does it feel for you to be out of place now?
Boris covers his face with his hand, peeking through his fingers. His shoulders slump forward, as if he’s curling up. I notice his posture and ask what he would prefer I not notice. Boris struggles to articulate this, so I suggest he start a sentence with, "I don't want you to see that..." After some breathing and grounding work, Boris says:
— I don't want you to see that I'm old. These bags under my eyes... it's not about them... everything passed so quickly... now others are at the helm... my time is over...
T: We still have a whole 35 minutes.
B: 35 minutes...
T: Well, yeah, this time isn't over yet. Already 34.
Boris looks at me in astonishment. Suddenly, we have time that can be used somehow. I look at Boris, he seems very intriguing to me. A beautiful face. In his eyes, I sense tiredness and confusion. I like him. And (horror) he seems to be looking at me. Now he'll see my wrinkles and, in general, my age.
B: Am I funny? (Boris interprets my smile, meant to hide my awkwardness.)
T: No, I thought you might notice my wrinkles and that I'm not 30...
We look at each other. It's warm and embarrassing. The remaining part of the session and several subsequent ones were about the possibility of experiencing embarrassment, the losses and gains of past experiences, the desire and risk of being seen.
When a client brings up various "time issues" as a topic for work, the session time can be metaphorically used by the therapist for awareness and seeking ways of creative adaptation.

The treatment of time in therapy is the client's message to the world and to the therapist as part of that world. It can vary. From a plea for sympathy to passive aggression. In any case, it is useful to decipher this message, legalize it and understand how the therapist responds to this message.

It is not uncommon at the beginning of therapy for a client to be regularly late for a session. This can be:

• a problem characteristic of the client's life: "I am late everywhere, I don't have time for everything", "I can't calculate time", "I take on too much";
• is related to therapy or to a stage of therapy: "I don't understand how it turns out, I seem to have gone out in advance", "actually I don't like to be late and I'm not late, only here".

Here's an example:
Client Nina, 28 years old, sought help due to difficult relationships at work. More precisely, at different jobs. After graduating from university (which was a year and a half before she came to see me), the client had already changed her job four times. Each time, she found herself in some kind of conflict. Nina gave the impression of being soft and compliant. She lived with her parents and younger sister. In Nina's family (which was large: grandparents, two sisters, an aunt, two uncles, and their children), relationships were friendly, mutual assistance was highly valued, and it was customary to help and generally be involved in each other's lives. Nina never had time to be bored: "Yesterday, there was a concert at the music school for my favorite niece, today I need to visit my grandmother — she is sick, and then drop by my sister's — she is doing renovations, I need to help choose the tiles; tomorrow, it’s my mom’s friend's anniversary — we'll be coming up with a greeting from the whole family." Everything was fine in the family. But at work... The client seemed very nice to me. I tried to understand the essence of her conflicts with colleagues, which, to be honest, eluded me. My attempts to find out from Nina how she saw the reasons for the disagreements were also unsuccessful. At her last job, which Nina "really liked," everything was fine, and there was a senior employee, K., whom Nina was assigned to. K. looked after Nina, was attentive, and Nina "managed to quarrel with her so much that she had to quit." Nina started being late for sessions when a mother figure (caring, nurturing, and expecting reciprocal care) appeared in her work. During one of the sessions, Nina said she could see that I cared for her, and it caused her panic. The meaning of this panic remained unknown, and we agreed to discuss it in the next session. But at the next session, Nina was half an hour late. "Oops, it didn't work out earlier," she cheerfully stated. And then Nina started being late regularly for several sessions, each time explaining her lateness jokingly. "Well, I just couldn't, I couldn't..." "Another F," Nina rejoiced. I asked why it was so funny. "It's not funny at all," she retorted, smiling broadly and tapping her foot slightly. I felt confused and experienced both irritation and curiosity. Nina, sitting in front of me, was barely noticeably dancing. I suggested she follow the small movements of her body, try breathing, and slowly increase the amplitude of the movements. She really started dancing, shaking her head, and sticking out her tongue. I suggested Nina clearly show me her tongue and asked about words that could reach me with the tip of her tongue. "I can have my own business and my own plans too," Nina said. "Even if I care about you?" my irritation turned into warmth. Nina hid her face in her hands. "Yes," she whispered. "You have your own business and plans, and I'm sure that's important." Nina cried, "I want her to respect that."
In addition to the client's relationship with time, it's also worth looking at how the therapist handles time in the context of working with a specific client. Is the therapist able to adhere to the setting with this client? There are clients with whom sessions cannot end on time, or vice versa, with whom the therapist ends the session a little earlier. If this happens regularly, the therapist should pay attention to this phenomenon in their relationship with the client. And if the meaning of this phenomenon eludes them, it is undoubtedly a reason to consult a supervisor.

What can different perceptions of time in a therapy session tell us? Sometimes we are able to touch a tiny episode, and sometimes a whole period of half a client's life. Sometimes the session seems to have gone by without a second thought, and sometimes it seems to drag on for ages.
I will try to look at this issue from the point of view of the predominant way of interrupting contact.

Interruptions (or modalities) of contact - a mode of behavior that was once a creative adaptation to the situation for the client, but then lost its adaptive meaning and began to lead to a drift from their time line. This can be stretching: we freeze, stop breathing, stop, not daring to move forward, as in retroflexion. Or, on the contrary, compression: we rush prematurely towards something without realizing if we really want it, as in confluence, getting out of the flow of our own life. We can also move in the wrong direction because we've been told the road is here, but we haven't had time to realize whether that road is relevant to our lives, as in introjection. Or we can endow others with our experiences without recognizing them as our own, and act (or not act) accordingly, missing the turns of our own lives, as in projection.

It is likely that if the therapist feels like the session is going on indefinitely, we are failing to be fully present with the client. Probably the predominant way of interrupting therapist-client contact (or the modality of their contact) in this situation is retroflexion. Time feels like it is slowing down. One wants to speed up, for something to start happening or for this session to finally end. If the therapist is able to understand and express what is so painfully held back (boredom, anger, excitement), time will go faster. More precisely, time will feel faster.

Confluence feels the opposite. Everything happens too fast. The client is talking fast, speaking fast, moving fast. The therapist may have the urge to slow down. If the therapist misses this urge and finds himself or herself prematurely very close to the client, there is the possibility of feeling that the session has flown by and nothing has happened. And this close proximity can cause feelings of awkwardness or inappropriateness. Missed experiences do not allow the fullness of time to be felt.

The appearance of egotism in a session causes a feeling of wasted time. "And happiness was so possible..." And frustration. Similar feelings, I think, occur in deflexion. Something seems to have happened, but it's not the same. And it feels like time has been wasted.

In introjection, time is felt, so to speak, according to an external clock. We are not going our own way because someone has told us that it is our way. And at the beginning of the path, it may seem as if time takes its own course. But if it is not our way, there is inevitably a feeling of "lost time" ("I am not living my life", "I am lost") and a sense of confusion and sadness. When the client gets to the therapist, they are no longer so sure of the right path and are themselves somewhat slower, so there may be a slight slowing of pace in the session. Even though there is no sense of time change or some slowing down in the session, in order to get the client to choose, the therapist slows the session down even more, facilitating the client's awareness of the possibility of choice and encouraging the choice to be made. And if this happens, the sense of time is restored.

In projection, the pace of the session may not change, or time may feel both slightly faster (not as pronounced as in confluence, but still slightly faster) and slightly slower (not as pronounced as in retroflexion, but the pace may be reduced). This depends on the content of the experiences being projected. When the client endows the therapist with his or her own experiences or with the properties of significant figures from his or her own life, there is a ground for too rapid and too obvious rapprochement or, on the contrary, a ground for excessive apprehension or fear. In both cases, the therapist pauses the client, paying attention to where the contact is interrupted.

The therapist seems to slow down the flow of the session in all contact modalities except retroflexion. In retroflexion, the therapist uses both slowing down (paying attention to the client's and his own breathing and bodily phenomena) and speeding up (offering to amplify the client's bodily manifestations, realizing his own bodily phenomena, and daring to express his retroflexed experiences to the client) the processes occurring in the session.

Thus, the relationship to the client's and the therapist's time can have both therapeutic and diagnostic meaning. Attention to the phenomenon of time contributes to understanding the meaning of the client's relationship with time in therapy, to the therapist's sense of how time flows in the session, to realizing whether there is enough time for resonance between the client and the therapist, and to finding the right moment for intervention. In addition to the sense of time speeding up or slowing down being a diagnostic sign, dealing with time can be a therapeutic technique.

The techniques used by the therapist to influence the experience of time in the session: slowing down (we often ask the client to say a slower phrase, make a slower gesture), speeding up, repetition (we can ask the client to repeat again (or several times) what he said), amplification (suggesting to the client to make more explicit or simply intensify different manifestations: tone, loudness or, on the contrary, softness of voice, amplitude of movements, posture), retardation (in some situations we can ask the client to dwell on the events and related experiences and bodily phenomena that precede what the client sees as the main (possibly traumatic) event), storyboarding (we can ask the client to tell his/her story, stopping at episodes if it seems to the therapist that the client does not realize how his/her experiences are changing and what is influencing them), etc. д..

At first glance it may seem that the therapist is only slowing down time. Referring to bodily phenomena, inviting the client to be in touch with his or her breath, asking the client to repeat or slow down a movement. I believe this notion may be due to the fact that it simply takes time for resonance to emerge between client and therapist, to build a field in which client change is possible. It also takes time to restore a disturbed sense of time (which can be the case with many of the situations with which clients come to psychotherapy: grief, trauma, depression). "Only the client's slow progress through the assimilation process, together with the development of their ability to face difficult experiences, will allow them to recognize and express them" (Vidakovic, 2017, [5]). However, this does not necessarily mean that the therapist's interventions "slow down" time in the session. Slow or frozen movement comes to life, and something that has been lingering and has not happened in any way can happen right here and now.

And if the therapist can be that way to help the client discover their role in the movie they brought to therapy, maybe the client will be able to remember who they are as Simba from The Lion King.

And according to Arnold Beisser's theory of paradoxical change, the client will be able to move along the time line into their future, enter into and be present in the flow of their own life.

List of literature:
Bolotova A. K. Psychology of Time Organization. Moscow, 2006.
Vasilyuk F. E. Model of the Chronotope of Psychotherapy. // Moscow Psychotherapeutic Journal. 2009, No. 4.
Vasilyuk F. E. Surviving Grief. // Psychology. 2000.
Vazquez-Bandin C. Loss and Grief. When the Death of One Person Makes All Existence Meaningless. Gestalt Therapy in Clinical Practice. Moscow, 2017. pp. 269–285.
Vidakovich I. The Ability to "Move On." Gestalt Approach in the Therapy of Traumatic Experience. Gestalt Therapy in Clinical Practice. Moscow, 2017. pp. 287–299.
Zimina S. V. Perception of Time by Humans. Medical and Biological Aspects.
Mikhalsky A. V. Psychology of Time. Moscow, 2016.
Nimirinsky O. V. Reflections on the Theory of Gestalt Therapy.
Nimirinsky O. V. Gestalt Therapy in Clinical Practice. Moscow, 2017. Foreword to the Russian Edition.
Perls F. Inside and Outside the Garbage Pail. 1995.
Polster I., Polster M. Integrated Gestalt Therapy: Contours of Theory and Practice. Moscow: Klass, 1997.
Robin J.-M. Being in the Presence of Another. Essays on Psychotherapy. 2008.
Robin J.-M. Social Changes Begin with Two. 2016.
Sartre J.-P. Being and Nothingness. 2000.
Spagnuolo-Lobb M. Now for Next. 2015.
Spagnuolo-Lobb M. Basics and Development of Gestalt Therapy in Modern Society. Gestalt Therapy in Clinical Practice. Moscow, 2017. pp. 26–51.
Tarkovsky A. Sculpting in Time. // Questions of Cinema Art. 1967, No. 10.