This is a shortened version of my published article on Academia - Read the full version here
Autism has seen a surge in diagnoses, leading to extensive research. The challenge lies in Autism’s broad spectrum, making it difficult to fit into traditional diagnostic criteria (Fitzgerald, 2018). Our current approach often uses a “tick-box” mentality from the DSM, categorizing disorders by symptoms. However, this method may not fully encompass Autism’s complexity.
Origins of Autism Spectrum Disorder in Psychotherapeutic Research
Hans Asperger first highlighted Autism in 1938. However, phenomenology, which focuses on individual experience, has waned, replaced by rigid diagnostic criteria (Andreason, 2006). This shift reflects a need to categorize disorders for better research and understanding. Gestalt Therapy, however, offers a phenomenological approach, aiming to understand rather than categorize Autism, recognizing its broader spectrum.
Initially linked to Asperger’s Syndrome, Autism’s symptoms varied, leading to its inclusion with Pervasive Developmental Disorder and Rett’s Disorder in DSM-IV. DSM-5 removed subcategories, reflecting inconsistency in diagnoses. Autism now encompasses Autistic Disorder, Asperger’s Disorder, and PDD-NOS, excluding Rett’s Disorder and CDD. Autism also shares symptoms with bipolar disorder and schizophrenia, complicating its understanding (Wilkinson, 2012).
Personal Experience with Autism
Professionally and personally, I’ve encountered the confusion surrounding Autism. As a Learning Support Educator and Gestalt Therapist, I’ve seen the struggles of children and their families. Diagnoses often lead to brief sessions and medication, ignoring deeper understanding.
However, working with Autistic children also brought positives. Building connections, even non-verbally, offered insights into their unique interactions with the world. One student’s constant drawing and imaginary conversations revealed his way of communicating and coping.
Delving into the Perspective of an Autistic Child’s Reality
Each child’s interaction with the world is unique. They struggle to connect because their reality differs. Imagine being sent to a doctor who barely communicates but prescribes medication, implying something is wrong with you. This is the experience for many Autistic children, facing scolding for behaviors that make them happy but deviate from “normal.”
Through creative communication, I learned how fragile and isolating their reality feels. Connecting through images, play, and imagination rather than words and discipline was enlightening.
So I started connecting through images rather than words, through play rather than work, through imagination rather than experiments, through love rather than discipline. And it was beautiful. However, it also made me question: What is their “here” right “now”? (Bonnici, J. 2020)
Broadening the Context of the “Here and Now”
Gestalt Therapy views individuals as organisms in an environment, where experience shapes reality, relationships, and well-being. But what if this reality differs from others? Autistic individuals may perceive the world as too loud, communicate differently, or see patterns instead of colors.
Field theory in Gestalt therapy considers all relevant aspects of a client’s experience. Everyone is an expert on their own story. This co-creation of reality between therapist and client makes Gestalt Therapy effective. It’s experiential, rooted in philosophy and history, guiding the perception and experience of reality.
Why Gestalt Therapy is Promising for Autism
Gestalt therapy’s relational, experiential, and dialogical nature allows therapists to enter and experience clients’ realities. This is invaluable for Autistic clients, offering qualitative insights into their unique experiences.
The relational aspect builds a tailored relationship, crucial for Autistic clients who struggle with emotional ambivalence and contradictory behavior. The experiential aspect creates a safe environment for clients to share their reality, fostering a co-created experience. This process aids in understanding and regulating their experiences.
Contact boundaries in Gestalt therapy, introduced by Perls et al. (1969), shape our experiences. For Autistic children, these boundaries can be rigid, blocking communication and growth. Guadalupe Amescua (1999) describes Autism as a toughening of contact boundaries, isolating the child and slowing development.
Understanding these boundaries helps therapists aid differentiation, allowing children to explore their introjections and make contact. For example, a child’s constant drawing may seem like disengagement but is a way to regulate overwhelming stimuli and invite contact.
Conclusion
Gestalt Therapy offers a unique lens for viewing Autism. Its phenomenological, experiential, and relational approach emphasizes contact and the merging of realities. This can provide critical insights into Autism and other disorders, particularly in children. By giving them a voice, we can better understand and translate their reality, fostering meaningful connections.
References
AMESCUA, G. (1999). Autism in Gestalt Theory Towards a Gestalt Theory of Personality. Gestalt Review, 3(3), 226-238. Retrieved June 2, 2020, from www.jstor.org/stable/44394127
Andreasen, N. (2006). DSM and the Death of Phenomenology in America: An Example of Unintended Consequences. Schizophrenia Bulletin, 33(1), 108-112. https://doi.org/10.1093/schbul/sbl054
Bonnici, J. (2020). Gestalt therapy and autism: A possible symbiotic relationship. Academia.edu. https://www.academia.edu/43325739/Gestalt_Therapy_and_Autism_A_Possible_Symbiotic_Relationship
Fitzgerald, M. (2012). Schizophrenia & autism – Overlap & difference. Neuropsychiatrie De L'enfance Et De L'adolescence, 60(5), S129. https://doi.org/10.1016/j.neurenf.2012.04.060
Michael, F. (2018). The broader autism phenotype: expanding the clinical gestalt of autism and broadening DSM V criteria of autism spectrum disorder. Journal Of Psychology & Clinical Psychiatry, 9(3). https://doi.org/10.15406/jpcpy.2018.09.00542
Perls, F. (1969). Ego, hunger, and aggression. Random House.
POLSTER, E., & POLSTER, M. (1973). Gestalt theory integrated. Contours of theory and practice. Brunner-Mazel.
Wilkinson, D. (2012). DSM-5: Rethinking Aspergers Disorder. Autism-Open Access, 02(04). https://doi.org/10.4172/2165-7890.1000e113
Comments