Suddenly, I became aware of my clinched jaws, my shoulders tensing up and my hands forming into fists. I remember being shocked when my therapist told me to try not to relax. Instead of giving into my urge to relax, she invited me to pay attention. I could then actually get a sense of my tension and there was space for it to develop into a sensation that I could register as a feeling. In other words, I became available to the information my tension was holding, which paradoxically led me to feel relaxed.
When we respond to our tension by trying to relax:
When we respond to others’ tension by telling them to relax:
What can we do with tension?
The idea that relaxation is good for us is not something that needs protesting against. We now know that being relaxed can soothe us when we are overwhelmed, that it can regulate our emotional responses, that it can support our breathing. What seems to get missed is that relaxation – a bit like joy – works more as a side effect rather than something we need to aim for by direct means.
Responding to our own or other’s emotional expression or tension by trying to relax ourselves or them can fuel alienation. Moments of connection, which we so desperately need, can be undermined by our attempts to relax one another. We would achieve just that, only if we stopped trying.
As published on welldoing.org
British Gestalt Journal © Copyright 2019 by Gestalt Publications Ltd. 2019, Vol. 28, No.1, 5–14
Codependency seems to capture a more specific, addict–addict’s partner dynamic, whilst confluence would simply refer to the process of merging with one another.
Suffering partners of people with addictions would be less stigmatised if therapists from other approaches and society were to understand and adapt the term ‘confluence’. The problem occurring between substance-misusing people and their partners could then move from a heavily localised and pathologised issue of codependency to a more general and normalised understanding of unaware merging in relationships.
As a practising Gestalt counsellor, I noticed that I had an increasing number of clients who are not misusing substances themselves but are partners of people who do. I was struck by how little dialogue there is around this generally in the field of counselling and psychotherapy. The main support available to partners of people with addictions is support groups, but there is little understanding or consensus on how they may be understood and best supported in the counselling room.
A UK-based research group contrasted six different perspectives on understanding the dynamic between partner and substance- misusing other, which were co-dependency, psychodynamic, systems, stress-coping, feminist, and community (Velleman, Copello and Maslin, 1998). Looking at this from a Gestalt therapy theory perspective has generally remained unexplored. This small-scale research paper is a result of dialogues I had with three Gestalt therapists who have had experience supporting a partner of a person who suffers with addiction.
An overarching image emerged out of these conversations which I will use to describe the process these Gestalt therapists have gone through with their clients, in the hope of initiating dialogue around this, in and outside of the Gestalt community.
Keywords: co-dependency, affected family members (AFMs), addiction, Gestalt therapy, Interpretative Phenomenological Analysis (IPA), confluence, creative indifference.
Implications for practice
Seeing the client with a substance-misusing loved one as someone who is not a victim seems pivotal. Holding the challenging position of creative indifference and noticing when one gets too invested in a certain focus as an ‘it’ needs to be recognised as a process, which needs ongoing attention from the therapist. Losing creative indifference seems to be strongly coupled with becoming confluent with a client. Even though this may be true to working with any person, as Gestalt therapists, being active agents of non-confluence seems especially important with partners of substance- misusing people. This study indicates that attending to this helps to establish a relationship where therapist and client are extensions of contact, where the client can be in touch with their sense of power, integrate their disowned parts and rediscover vulnerability as a relational possibility.
Implications for further research
This study revealed areas in which future research is necessary. As I was making sense of the dialogues with the three Gestalt therapists, I found it hard to attempt to understand the clients’ situations without having direct contact with them. I became aware of my power and the discomfort I felt being in that position. It seems to me that seeking positions of responsibility, and not letting them emerge out of a co-created dialogue with the person who is actually involved in their situation, could turn into blaming from a superior stance. Beyond theoretical papers and practitioners’ reflections, like this study, hearing people who are directly affected or have been affected would be crucial.
Furthermore, I was struck by how lively the exploration with the three Gestalt therapists felt. There certainly is a lot that we, as Gestalt therapists, could say about understanding and supporting partners of people who misuse substance. Future research could focus on developing a coherent Gestalt theoretical understanding on the subject that is beyond the scope of this paper.
Although previous research has demonstrated that ‘LGBT populations have the highest rates of alcohol use’, the literature review uncovered no existing research into the experiences of LGBTQ partners of addicts and/or practitioners who work with them (Kerr and Oglesby, 2017, p. 341). Papers and discussions seem to be centred around cisgender, heterosexual couples in monogamous relationship structures. Richard Velleman confirmed my findings when he stated, ‘virtually all of the literature is related to heterosexual partnerships and most literature is hetero-normative’ (private email exchange, 8 June 2018). All three participants in this study were reflecting on experiences with a client who was in a monogamous, heterosexual relationship. Future research should broaden the focus to people of diverse genders, sexualities and relationship structures.
Although Interpretative Phenomenological Analysis acknowledges the subjective role of the researcher, I am aware that a different person might have foregrounded different aspects of the data. The research participants brought their rich and diverse experiences to the dialogue and there was difference in terms of gender. However, all three therapists have trained at the same institute and therefore the sample was rather homogenous. Even though generalisability is not expected with qualitative studies, it is important to note that the findings here should only be considered as an in-depth conceptualisation of the dialogues I had with the participants.
Being attuned to the relational field of clients with substance-misusing partners transpired as an important part of the three therapists’ process. The confluence that emerged on the contact boundary between clients and their partners became a fixed gestalt, which only shifted through a tipping point, in which all three clients became aware of their vulnerabilities. As they entered into therapy this fixed gestalt could have gone on, repeating itself and being co-created again, if the therapists were not attending to the immediate space between them and their clients. Particularly, in the beginning phases of the work, they colluded with their client’s focus on the substance-misusing partner. The participants’ tracking of their creative indifference and attending to confluence supported their clients to relate to them as other, not just a means to an end. Seeing them as other who is not confluent with them but has their best interest at heart supported clients to integrate relational experiences they have been deprived of.
The more I engaged with the subject, the clearer it became to me that partners of substance-misusing people are often represented as just that, partners. It is then not hard to see how we would have a part in contributing to their sense of insignificance. In the interviews for this paper, the three clients emerged as fully rounded figures in their own right. Having them in the foreground of our exploration pointed to one of Gestalt therapy theory’s important contributions, which is that backgrounds are not a given context to figures but form simultaneously with them. Recognising this led me to a sense of responsibility and with it came a yearning for ongoing dialogue so that we, as the Gestalt community, are not colluding with holding fixed perceptions these clients are up against.
This article developed from a qualitative research project conducted at the University of East London.
Evans, V. (2012). Challenging Stigma. Available at: <https://adfam. org.uk/files/docs/adfam_challenging_stigma.pdf> (Accessed 10 February 2019).
Kerr, D.L. and Oglesby, W.H. (2017). LGBT Populations and Substance Abuse Research: An Overview. In J. VanGeest, T. Johnson, and S. Alemagno (eds), Research Methods in the Study of Substance Abuse. Cham, Switzerland: Springer. Available at: <http://www.readcube.com/ articles/10.1007/978-3-319-55980-3_16> (Accessed 12 December 2018).
Orford, J., Velleman, R., Natera, G., Templeton, L. and Copello A. (2013). Addiction in the family is a major but neglected contributor to the global burden of adult ill-health. Social Science and Medicine, 78, pp. 70–77.
Roubal, J. (2016) (ed). Towards a Research Tradition in GestaltTherapy. Newcastle upon Tyne: Cambridge Scholars Publishing.
Velleman, R., Copello, A. and Maslin, J. (1998). Living with Drink: Women who live with problem drinkers. Harlow: Longman. Reissued edition 2007, London: Pearson Education
British Gestalt Journal © Copyright 2019 by Gestalt Publications Ltd. 2019, Vol. 28, No.1, 5–14