Gestalt Therapy Around the World, First Edition. Edited by Eleanor O’Leary. © 2013 John Wiley & Sons, Ltd. Published 2013 by John Wiley & Sons, Ltd.

Gestalt Therapy in Chile

Francisco Huneeus

Brief History

Gestalt therapy first became known in Chile in the later part of the 1960s, when Claudio Naranjo started a gestalt therapy group with some of the staff of the Psychiatric Clinic of the University de Chile in 1968. Naranjo had read the classic Gestalt Therapy by Perls, Hefferline, and Goodman (1951) when an uncle of his (one of the founding representative members of the UN) handed this book and many others (received as courtesy at the UN) to his nephew, who had a medical degree and was at the time interested in psychiatry, psychology, and anthropology. Following this, Naranjo studied gestalt therapy with Fritz Perls at Esalen, California (1967–1969), before returning to Chile and starting the first gestalt therapy group. In 1970, Adriana Schnake’s (Professor of Psychiatry Medical School of the Universidad de Chile) previous clinical training under Professor Ignacio Matte, psychoanalyst, had led her to adopt an existential and phenome-nological approach towards psychotherapy. Her introduction and training in gestalt was basically with Claudio Naranjo in the group which was composed of several professors and psychiatrists in training. From those activities the first gestalt psychotherapists emerged.

As a result of the efforts of Franz Hoffmann and Claudio Naranjo (who had set up the Instituto de Antropología Médica within the Medical School of the Universidad de Chile) there was considerable interest and experimentation in the use of psychedelic drugs such as harmaline, ibogaine, LSD, and substituted amphetamines as an adjunct to psychotherapy and a powerful means of self exploration. All of this was based on the tradition of the shamanic procedures of Native American medicine men. It soon became apparent that the altered states of consciousness achieved with these adjuncts were somewhat compatible and easily

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dealt with the gestalt therapy style of working with clients. Their use enhanced the therapeutic process and promised to be a powerful tool for their patients and therapists alike. Such experimentation was terminated abruptly in 1973 with the advent of the military dictatorship.

In 1972, Barry Stevens, who had worked with Fritz Perls in Esalen and later in Cowichan, spent five months in Chile, invited by Schnake. She brought with her several documentary films of Perls working with clients in the Esalen setting. These films were seen by a large number of psychology students, therapists. and psychiatrists from the two big universities (Universidad de Chile and Universidad Catolica), none of whom had ever heard of gestalt therapy. The films were accompanied by the comments of Barry Stevens and were very influential in show-ing the power and effectiveness of gestalt therapy in the hands of a master. During her stay, Barry was also very active in leading and supervising therapy groups. She also provided books on gestalt therapy from her publishing house Real People Press, which she owned conjointly with her son John Stevens – with the outcome that some of them were translated into Spanish and published in Chile from 1974 onwards. After the abominable military coup of Pinochet (aided by the US Government under Nixon and Kissinger), Chile was very much isolated, and also morally and intellectually devastated. The opening of the publishing house Cuatro Vientos Editorial was important. From its beginning in 1974, its efforts were entirely devoted to the translation and publication of basic gestalt therapy ideas stemming from Fritz Perls’ influence on the West Coast of the USA. At that time, there was no contact with gestalt therapy practitioners on the East Coast.

It merits mentioning that Barry and John set up a lifeline of books, tapes, and letters – having waived the payment of copyright due to them from Cuatro Vientos for many years. It was a luminous and endearing signal from a segment of the people from the USA, telling us that humanism and generosity still existed. The ideas contained in gestalt therapy were spread through the availability of books and through the establishment of groups and by word of mouth. The ideas that were published stemming from this joint venture were very important for the mor-als of the many Chileans, and also for the Argentineans and Uruguayans who were undergoing very analogous vicissitudes that are part of fascist military dictatorships. In the dark ages of military fascism, these ideas came as a breath of fresh air.

The first and most important book was Fritz Perls’ (1974) Gestalt Therapy Verbatim (translated in 1974 into Spanish: Sueños y Existencia). In fact, it could not have been more adequate reading for the oppressed democratic citizens since most people had progressive ideas about human and social issues. This book was an instant best seller among psychological and psychiatric readers and less so with the rather scarce general reading public, as its message was clear and prophetic. Taking into account that, in general, there was a closedown of book shops together with public and private libraries plus occasional book burnings, the arrival of this book was a rare and salutary event. Perls in his self exile at Cowichan in British Columbia, Canada, had sniffed another fascist wave expanding in the USA with Nixon and Kissinger. The wave hit a significant part of Latin America: Brazil, Uruguay, Argentina, and Chile.

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A few months after the military coup, the authorities, miraculously did not ban the book. But they did censor a few lines from the foreword – which, in fact, made it even more anti-fascist. It was obvious the censors did not understand the real message of what they were reading. People could see that the basic tenets of gestalt therapy were totally anti-fascist and that it was entirely grounded in self- determination and humanistic values. This socio-political aspect of gestalt was better appreciated in Argentina owing to that country’s long tradition in social psychology in the school of Pichón Rivière and others.

In 1972, Schnake and I visited Buenos Aires (Argentina) periodically in order to offer weekend workshops on gestalt therapy to the more progressive psycho-analytical community there. We had been invited by Martha Atienza, a young Argentinean psychiatrist who had interned in the University Psychiatric Clinic under the supervision of Schnake. At first it was the psychoanalytic therapists who sent their patients to the workshops; then, somewhat surprised by the results, they themselves started to attend. In 1976, the first training groups in Buenos Aires began, and the Asociación Gestáltica de Buenos Aires (Gestalt Association of Buenos Aires) followed four years later. This was to become the first gestalt-therapy-centered professional association in the Spanish-speaking world. Gestalt therapy had a much better foundation in Argentina than in Chile, possibly due to the former’s long tradition in psychotherapy with a strong Freudian psychoanalytical orientation.

In 1978, Schnake and I went for two weeks to Peru, Brazil, and Spain for the purpose of introducing gestalt therapy and promoting its use. We now had another book that turned out to be of great appeal, Awareness by John Stevens, published in Spanish in 1976 as El Darse Cuenta. It contained a very thoughtful listing of  sensory awareness and imagination exercises that allowed people to start experimenting by themselves. This was followed by the publication in Spanish of In and Out of the Garbage Pail (Perls, 1978), the very appealing, eye opening, and informative autobiography of Perls. With the aid of the books, study groups were started in most of the places we visited; a few of these developed into training and treatment institutes.

In this very brief and personal view of the history of gestalt therapy in Chile, it is worth mentioning that, from the beginning, it is has been very much related to people with strong bonds to the medical profession, hence its focus on personal and body work. In Argentina, where it has been more widely spread and shared with psychologists, social workers, and psychotherapists, it has evolved partly in a community/social-based form of therapy and social action.

One of the most prolific teachers of gestalt therapy to psychology students as well as the initiator of Gestalt Organizational Development in 2002 has been Héctor Calás. In 1995, Rolando Pihan in Concepción instituted Gestalt Diplomas given at the Medical School of the Universidad de Concepción. At the same time at the educational level, Patricio Varas, a school teacher who had spent time at Esalen, had devoted his career to training teachers in basic gestalt therapy techniques and theory together with other humanistic approaches as a method of personal growth. In general, gestalt therapy is known by the psychotherapeutic

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community, and its techniques are known to many therapists in view of the availability of books on gestalt therapy. In 2010, the Asociación Gremial de Psicoterapeutas Gestálticos de Chile (Chilean Association of Gestalt Therapists) was founded. Its president is José Gengler (psychiatrist and psychotherapist) and its manager is Tatiana Mechasqui.

At present, there is one formal gestalt training institute in Santiago – Centro de Psicoterapia Gestalt de Santiago (Santiago Centre of Gestalt Psychotherapy) – founded in 2005 and directed by Antonio Martínez Ribes.

Theoretical Contributions

An important theoretical contribution to gestalt therapy has been the body/ symptom/character method called Enfoque Holístico de la Salud y la Enfermedad (Holistic Approach to Health and Disease) developed by Schnake and her associ-ates, Marina Varas and Antonio Martínez, in 1985. As a specialty within gestalt therapy, it is being applied by therapists, psychologists, and physicians in Chile as well as in Argentina, Mexico, Brazil, and Spain.

Most dualistic approaches in dealing with organic symptoms and disease are based on the premise that there is a cause that can be found and treated in isolation. Modern medicine, for the most part, is based on this presupposition, as if symptoms and disease are “the enemy,” objects apart from the person that have to be “beaten” or removed without consideration of or intervention by the subject. The holistic approach, in contrast, is based on the conviction that organismic self-regulation is the prime source of knowledge of our bodies.

The essential aspect of Schnake’s approach is the advantage obtained when exploring personality traits and behaviors guided by the diseased organ in the body. Each organ of our body, as well as each system in our body, has a special and peculiar way of being in the world which has made itself figural either through a symptom or a disease. In this way, the organ provides a message regarding ongoing difficulties related to the denial or suppression of undesirable character traits. When these traits are acknowledged and accepted, they can be resolved and can retreat into the background. The process of understanding the  message of the organ allows for affected individuals to become aware of the nature of conflict sustained within these organs and the avoidance of some characteristics or personality traits that until now were outside the reach of their awareness. They can actively work to overcome the difficulty. The technique used is basically a gestalt dialogue in which clients are asked not only to center their attention on the organ (for which they have been provided with sufficient anatomical and physiological information), but also that they become that organ in the most realistic possible way, using inner visualization, kinesthetic awareness, and dialogue.

Of great importance are the relationships uncovered with other organs, their functioning, and the conflict-producing traits. It has been found that almost everybody has certain exploitative or negligent attitudes with respect to parts

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of  their body, not limited to the symptomatic and diseased organs. Especially noticeable are the omnipotent characteristics in patients with or prone to develop cancerous tumors.

To date, four books have been published by Schnake, all in Spanish. The first (Schnake, 1987), Sonia, Te envío los cuadernos café (Sonia, I sent you the brown notebooks), is written in a personal and inviting style. It is a descriptive and theoretical confrontation of the ideas of Freud and those of Perls. She explains her reasons for her departure from psychoanalysis and existential psychiatry and her encounter with Perls. She became a gestalt therapist when the results obtained by  her using gestalt techniques proved to be highly productive and effective in a group context, as compared with the psychoanalytical approach in group therapy.

The second book (Schnake, 1995), Los diálogos del cuerpo (The dialogues of the body), explains an approach that is a unique and original way of addressing the symptoms of all kinds of ailments. Through gestalt dialogues and conversations with patients and trainees, she reveals the wisdom she has gleaned in her many years dealing with and treating disease. The patient listens and talks to the afflicted organ, and ultimately reclaims the organ, resolves the conflict, and allows healing to begin. The method reveals symptoms to be messages from our bodies, for which the sick organ has become the only spokesperson. In the dramatized dialogues, the paradigmatic characteristics of that organ inevitably emerge as character traits of the patient in question. (There is a partial English translation in 2009 of this book, published for promotional purposes only, which is available at Editorial Cuatro Vientos.)

The third book (Schnake, 2001), La Voz del Síntoma (The Voice of the Symptom), is similar to her previous book, but provides many more clinical cases. There is an Italian translation of this book published in 2006. Her last book (Schnake, 2007) depicts all the organs in color plates together with their attributes and possible failings and character traits. It is based on the work of a group of students who for years have been testing and describing cases.

Research

There has been no empirical research in gestalt therapy in Chile to date.

Future Challenges

Even though gestalt therapy has been applied in Chile for more than thirty years, at present there are few training institutions. Since 2008, a Masters degree has been offered in Santiago at the Universidad Mayor directed by Antonio Martínez and Marina Varas (both clinical psychologists and gestalt therapists) in collaboration with the staff of the Centro de Psicoterapia Gestalt de Santiago. The degree requires 1873 hours of lectures and training activities

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plus a thesis. Since 2006 in Valparaíso (the second largest city in Chile), a training course directed by Paula Ascorra and Patricio Medina, a clinical psychologist and an anthropologist respectively, has been avalable. They have worked with approximately twenty students on a two-year basis. They are currently on their third course. Since 1995, a training course and Diploma granted by the Medical School of the University of Concepción has been led by Rolando Pihán. Yearly courses conducted by Adriana Schnake starting in 2006 take place on the Island of Chiloé in her Centre Anchimalén, and with staff made up of former students – all of whom have professional degrees plus the Diplomate obtained at her center. Prior to that course in 1990, she started dictating short courses (five to ten days) on the Holistic Approach to Disease which slowly evolved toward the Diplomate.

In at least five universities where degrees in psychology are conferred, there are elective courses in gestalt therapy at an introductory level. The attendance is of the order of fifteen students per course and the duration is approximately eighty hours. Until now, all these courses have had their own curricula and are not standardized since there is no available information on them. With the very recent inauguration of the Chilean Association of Gestalt Therapists, there will soon be a clear picture of all the training institutions and courses, and their curricula. This is an endemic problem in all Latin American countries. As gestalt becomes more popular owing to its efficiency and relative low cost, the need for some standardi-zation of requirements for practice has become very urgent.

Perhaps the greatest challenge facing gestalt therapy in Chile is one of organiza-tion and communication. There is not a single gestalt therapy journal in general circulation in Chile, nor in the whole of the Spanish-speaking world. There are no seminars or conventions of any sort where many people who have come in contact and studied gestalt therapy can convene.

Unfortunately, the lack of academic activities and publications by the gestalt community, both locally and in most countries of the Spanish-speaking world, has resulted in strong leaders who teach orally through lectures and demonstrations. The result is that there is great loyalty to a particular leader but little or no contact between different groups; yet, it leads to loyalty and vitality among the trainees. Unfortunately, it does not promote professional or scientific communication, which of course hampers the expansion and evolution of the discipline. Precisely due to this lack of experience in academic activities, with no publications to speak of, and hence no acquaintance with the frontiers of development of the discipline, strong leaders look upon the training groups of the “others” and institutions with suspicion, if not disdain.

Owing to the lack of professional publications in gestalt therapy, most gestalt practitioners are dependent on books for their continued education and progress. But books in general are not peer reviewed, and publishers, needless to say, neces-sarily do not have rigor and veracity as their main agenda. Together with the lack of access to the literature, its counterpart – research, qualitative or quantitative and its concomitant writing – is not encouraged, all of which has resulted in a relative conceptual stagnation.

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This, together with the oral teaching administered by the training groups, gives rise to a special type of clustering of a very personalized fanatical style that revolves around a strong leader, and is impervious to outside influences. Although this happens in all Spanish-speaking countries, it is most noticeable of all in Mexico, where there are at least four clusters around their respective leaders with little or no interaction among them. It is also true that oral experiential training and the continued presence of the teacher or supervisor is probably the best pedagogy available, which is one of the reasons why gestalt therapy has remained so vital and well received in the Spanish-speaking world. However, it has also fostered the migration of the more intellectually or academically prone to other schools. Just recently, a few leaders and their institutes are becoming aware of the social/organizational and political potential of gestalt therapy.

References1

Perls, F. (1974). Sueños y existencia [Gestalt therapy verbatim]. Santiago de Chile: Editorial Cuatro Vientos.

Perls, F. (1978). Dentro y fuera del tarro de la basura [In and out of the garbage pail]. Santiago, Chile: Editorial Cuatro Vientos.

Perls, F., Hefferline, J., & Goodman, P. (1951). Gestalt therapy: Excitement and growth in the human personality. New York, NY: Julian Press.

Schnake, A. (1987). Sonia, Te envío los cuadernos café [Sonia, I send you the brown notebooks]. Buenos Aires: Editorial Estaciones.

Schnake, A. (1995). Los diálogos del cuerpo [The dialogues of the body]. Santiago, Chile: Cuatro Vientos.

Schnake, A. (2001). La voz del síntoma [The voice of the symptom]. Santiago, Chile: Cuatro Vientos. (Translated in 2006 by Elizabetha Muracca into Italian. I dialoghi del corpo. Un apprecio holístico alla salute e alla malatttia. Rome: Editorial Borla.)

Schnake, A. (2007). Enfermedad, síntoma y carácter [Character, symptoms and disease]. Buenos Aires: Del Nuevo Extremo/Cuatro Vientos.

Stevens, J. (1976). El darse cuenta. Sentir, imaginar, vivenciar [Awareness: exploring, experimenting, experiencing]. Santiago, Chile: Editorial Cuatro Vientos.

1 Books are published by Cuatro Vientos Editorial in Spanish and made available to the Spanish-speaking world: www.cuatrovientos.cl.