Passing your National Licensing Exam
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Passing your National Licensing Exam
Gestalt with Rachel
Facing license exam anxiety? You're far from alone. Today, we're diving deep into how Gestalt therapy offers powerful tools for navigating overwhelming test anxiety, using the story of Rachel – a first-generation college student whose pre-existing anxiety disorder intensifies as her licensure exam approaches.
Gestalt therapy stands apart from other approaches by anchoring clients firmly in the present moment. Rather than analyzing past experiences or catastrophizing future outcomes, we explore what's happening right now in the body, mind, and emotions. For clients like Rachel, this means turning toward physical sensations of anxiety – trembling hands, racing thoughts, upset stomach – rather than running from them. Through techniques like exaggeration (intentionally amplifying physical responses) and staying with uncomfortable feelings, clients begin building tolerance and awareness that transforms their relationship with anxiety.
Language matters enormously in the Gestalt approach. When Rachel says "I should study more" or "I have to pass," she's using disempowering language that removes her sense of choice. By shifting to "I choose to study more," she reclaims agency and responsibility. Similarly, the famous empty chair technique gives voice to unspoken feelings – allowing Rachel to address family expectations or dialogue with different parts of herself, like her inner critic. For your exam prep, remember the contact boundary disturbances with the mnemonic "I pray daily for relief from class" – Introjection, Projection, Retroflexion, Deflection, and Confluence. These patterns explain how clients interrupt natural contact between themselves and their environment, blocking authentic experience.
Whether you're preparing for your own licensure exam or working with anxious clients, Gestalt offers a pathway from environmental support to self-support, from avoidance to awareness, and from "shoulds" to choices. The beauty of this approach lies in its authenticity requirement – not just from clients but from therapists too. Ready to transform your understanding of anxiety and therapeutic presence? Listen now and discover why being real might be the most powerful technique of all.
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This podcast is not associated with the NBCC, AMFTRB, ASW, ANCC, NASP, NAADAC, CCMC, NCPG, CRCC, or any state or governmental agency responsible for licensure.
All right, let's really get into this. So you're a therapist in this narrative and your client, rachel, is having pretty major anxiety as she prepares for her licensure exam. Honestly, a lot of you can probably relate to this. Right, it can be nerve-wracking. She's pretty much convinced there's no way she'll pass. Oh, and let's not forget, rachel is the first in her family to go to college, so there's a ton of pressure riding on those shoulders. We're talking sleepless nights, upset stomach, constant ruminating the whole rollercoaster of feelings. First point, let's just call it out Anxiety around big exams is, um, super common. But for Rachel it's not just about nerves before an exam. She was diagnosed with generalized anxiety disorder back when she was a teen and even though, yes, she's had therapy before, that anxiety seems to creep back in, especially now that the stakes feel sky high. I mean, wow, who wouldn't feel the weight of all those expectations, especially when family pride is on the line? So what do you look for on the exam and how do you, as a therapist, help someone like Rachel? That's where you're going to want to understand how different theories work in practice, not just on paper or for the exam.
Speaker 1:And today we're leaning into gestalt therapy because it's really designed to help clients who are stuck in worry about the past or future and can't seem to enjoy the here and now. Let's talk about gestalt for a second. It's all about being in the moment. You're not time traveling back to that failed high school algebra test or forward to a catastrophic fantasy where you bomb the license exam and your future is ruined. Nope, the focus is right now what's going on in your body, mind and emotions at this exact minute. The thing is. Here's a big point for your exam you're not ignoring past situations entirely. Gestalt therapy does touch on unfinished business. Think about it. Lingering feelings or events from the past that still haunt your client in the present. For Rachel, maybe, there's some old stuff about needing to prove herself or fear of letting her family down. That's showing up as test anxiety.
Speaker 1:Now in Gestalt you're aiming for awareness, like radical self-awareness, because, let's face it, you can't change what you don't notice. So how would you actually get Rachel started? First? You use those classic Gestalt what and how questions. It's not. Why are you anxious? That's too abstract. Instead, ask things like what are you feeling in your body right now as you think about your exam? Or how does your anxiety show up. It's not about solving the feeling but getting her to tune into it. Let's use an example like a narrative that will crop up on the licensing exam.
Speaker 1:You notice Rachel's hands are trembling as she talks about her upcoming test date. You don't ignore it. Instead, you use the exaggeration technique. You notice Rachel's hands are trembling as she talks about her upcoming test date. You don't ignore it. Instead, you use the exaggeration technique. You might say let's try something together. Can you exaggerate that shaking for a second? Rachel might at first be like, uh, why? But trust the process. You ask her to really accentuate the tremor, get aware of it and maybe even say out loud what's happening. Why bother? No-transcript. Helping clients notice them is often the first step to well unblocking it, and this is textbook gestalt. The goal isn't to make the shaking stop, but to help Rachel notice it, experience it in the moment and, surprisingly, start to release some of that pent-up anxiety.
Speaker 1:Second point language is powerful. Gestalt therapists pay close attention to how clients phrase things. Language is powerful. Gestalt therapists pay close attention to how clients phrase things. Rachel keeps saying I should be studying more or I have to pass this exam. Those shoulds are everywhere with your client. They're sneaky. They're often borrowed from outside, perhaps from family or society, instead of what the client actually wants. So as a therapist, you help her pay attention to her words. Maybe ask her to swap I should with I choose, instead of I should study more. Rachel says I choose to study more. And wow, that really shifts things Suddenly. She's not a helpless bystander in her own life, she's making choices. It's subtle, but I promise it's important.
Speaker 1:Let's continue this narrative. Imagine Rachel says I have to study three more hours tonight or I'll fail. You nudge her politely but persistently. Can you try saying I choose to study three more hours tonight? She might feel kind of silly at first or even protest, but eventually the shift from feeling forced to feeling in control is noticeable. That personal responsibility piece Huge.
Speaker 1:In Gestalt You're helping clients realize they're not victims. Here's a big one. You know how clients sometimes want to run away from their tough feelings. Rachel says I just want to leave when I get anxious Totally understandable, right? Who wants to sit in discomfort? Well, gestalt therapy flips that on its head. It's all about staying with the feeling. So when Rachel wants to bolt, you ask her to pause, breathe and sit with that anxiety, even if it's only for a minute, she might say, uh, this is too much. But you're supporting her as she faces that uncomfortable emotion rather than always running from it. The key to using gestalt with clients is not to make the bad feeling vanish. If Rachel can stay with her anxiety, she might find it gets a tiny bit more bearable. That's the start of building tolerance and real awareness. That's the start of building tolerance and real awareness.
Speaker 1:Let's go even further with another classic technique the empty chair. Now, this one might show up on your exam and, to be honest, in real life all the time. If Rachel's has unspoken stuff going on with, say, her parents, the pressure, the unspoken expectations, you might literally put an empty chair in the room and have her imagine her mom or dad sitting there. It's kind of like hey, rachel, what would you say to your mom right now if she were here? Or just as often, you can have her talk to a part of herself in that empty chair, maybe the super critical voice or the scared little kid part that's afraid to fail. Here's what might happen. Through the empty chair dialogue, all those tangled feelings can get spoken out loud. Rachel might say things she's never been able to say to her parents or even to herself. That's another important gestalt concept giving a voice to the parts of your client that usually silence and bringing hidden conflicts into the open. Now you as the therapist, you aren't there to interpret everything she says.
Speaker 1:Gestalt puts a huge emphasis on letting your client make sense of their own words. You might reflect back what you're seeing or hearing, but you're not there to tell Rachel what her dream about failing actually means. That's her job. But at the same time you don't just sit back and do nothing. You're active, attentive, present. The relationship you build, the I-Thou connection, as Fritz Perls and even Martin Buber talked about, is where so much of the work happens. Speaking of for your exam, fritz Perls is the big Gestalt name you want to remember. Other names Irvin Polster and Miriam Polster, made significant contributions too. The approach is experiential and, honestly, some clients really respond to that hands-on, present-focused style. Here's a quick mnemonic for some contact boundary disturbances.
Speaker 1:In Gestalt I pray daily for relief from class that stands for introjection, projection, deflection, retroflexion and confluence For the exam. Don't forget these terms. Here's a rundown with examples. Cause you never know what will be throw at you. Introjection this is accepting other people's ideas whole without deciding for yourself if you believe them. Like if Rachel says my family says the only way to succeed is to pass this exam, so I have to. She's not stopping to wonder what she believes, she's just internalized their standards. Projection this is when you pin your own pathologies on other folks or circumstances. Rachel might say my professors are disappointed in me already, when in fact she's feeling disappointed in herself. Deflection this is dodging direct contact. Maybe Rachel answers your questions with jokes or changes the subject whenever her anxiety comes up, kind of like swerving around the tough stuff. Retroflexion Turning things you want to do to someone else back onto yourself. Like if Rachel wants to shout at the world for pressuring her but instead she just beats herself up inside Confluence, losing track of where she ends and her family begins. That blurred boundary where she can't tell if her anxiety is her own or just absorbed from others' expectations. Make sure you know these terms. Licensing exam writers love to toss them into narratives.
Speaker 1:The philosophy behind gestalt therapy it's existential at its core. The focus is on mind-body unity, direct experience and, above all, personal responsibility. You are always looking at how clients can support themselves from within, not just rely on outside crutches. Here's an exam tip. Gestalt therapy really aims to move clients from environmental support towards self-support. For rachel, that might mean moving away from only relying on external validation to building her own sense of hey, I, I've got this. Don't trip up on how this might look on a multiple choice question.
Speaker 1:You're not interpreting dreams in gestalt the way psychoanalysts would. Instead, you focus on the present experience, even if you might use dream content as a way for the client to access different parts of herself. For instance, asking Rachel what it's like to be the monster chasing her in her anxiety nightmare, rather's like to be the monster chasing her in her anxiety nightmare, rather than what she thinks the monster symbolizes. Another prime point gestalt interventions are best when they happen organically. You're not forcing a client to use an empty chair just because it's on your techniques list for the week. You're sensing what fits the moment. Therapy in Gestalt is meant to unfold through the client's experience, not through a checklist. Now applications a big exam point.
Speaker 1:Gestalt works well with individuals, groups, even families and couples. But, heads up, it might not be the go-to modality for, say, clients with pretty severe mental health issues like active psychosis. The here-and-now experience-focused approach can be overwhelming unless the person has a fairly stable sense of reality. So let's continue with the narrative. Say Rachel gets stuck because she keeps looping between I'm going to fail and I have to succeed for my family. You notice she gets teary or angry, but she doesn't say much about it. That's a cue for you to gently confront her. Like Rachel, I notice you're clenching your jaw and looking away as you talk about your parents' expectations. What's happening for you right now? Confrontation here isn't about being aggressive. It's really just inviting your client to notice discrepancies between what they're saying and what their body is showing. And watch out for clients who get really stuck in their heads.
Speaker 1:Intellectualizing everything. Gestalt can sometimes, uh, feel a little too anti-intellectual for them because it doesn't spend a ton of time analyzing or debating ideas. It's about the raw, unfiltered experience. If you're thinking about using this approach in schools or classrooms, gestalt methods can actually slot in pretty well for helping students get more tuned in to their feelings or even for conflict resolution. Just don't expect it to be the fix for every setting or every client. Honestly, all right, here's a quick list of terms to burn into your brain before exam day Examples so you'll remember them.
Speaker 1:Awareness, rachel. What sensations are you aware of in your body as you talk about the test. She might notice her tight chest or sweaty palms. Confrontation I hear you say you're confident, but I see your hands shaking. What's that about Dichotomy? Rachel's stuck between total success and total failure, like there's no in-between Retroflexion. She turns her frustration inward rather than expressing it to others, so she feels self-blame instead of honest anger. Unfinished business all those shoulds left over from growing up still running the show For the exam and for real life.
Speaker 1:The main Gestalt goals are build your clients' awareness of their actual experience right now. Help them deal with lingering old issues that block them in the present. Encourage personal responsibility through real, felt choices, not shoulds. Use in-the-moment techniques. Exaggerate sensations, stay with tough feelings, swap out powerless language, play out dialogues in the empty chair and boom. Watch your client become more present, self-supporting and less controlled by automatic fluff from the past. All right, last tip Don't forget that, as the therapist, the most important technique is actually being real with your client Present, attentive, not hiding behind a therapy mask or textbook script. It sounds cliche, but Gestalt is about you, the therapist, showing up as your real self and inviting your client to do the same. Good luck with that licensing exam. Stay present, focus on awareness, don't shy away from using active techniques if they fit, and trust your gut as much as your theory, and remember it's in there.
