Gestalt therapy with profoundly disturbed persons

Gestalt therapy can be an integral part of the process of reorganization for a person stressed to the point of psychosis. Such a person has become confused about personal boundaries and consistently fails to make satisfying contact. Working with the person's present experience of interior and exterior is one way to lead to change, as well as clarifying boundaries, attending to contact functions, and respecting the rhythmic flow of contact and withdrawal. Only when awareness scrambling has decreased and ability to define boundaries has increased can work on resistances begin. Respect must be given to the survival value of resistances as well as to their self-destructive aspects. Modifications in method are suggested which help the psychotic person to experience safety, control, and wholeness of self.