Written by Child & Family Therapist Holly Gilbert, MA, LPC

This Spring, I performed the dreaded task of weeding my garden. With my gloves on, I dug into the dirt, determined to pull the entire root up from the ground. There were several times that I was unsuccessful and would only grab the stem. I noticed that after some time, the weeds that were not fully uprooted grew back. This got me thinking about superficial care—when we only treat the surface layer of issues and expect long term results: when we confuse convenience with a cure.

I realized that in most areas of our life we are encouraged to address underlying issues; however, when it comes to mental health, we simply focus on symptoms. Why is this? If we knew we had a termite problem, we wouldn’t solely patch the holes. And we certainly would never prescribed surface level treatment to our landscaping. Yet, when it comes to our mental health we often are seeking to treat issues with skills, techniques, and easy fixes.  So, what exactly is the price we pay for this surface level approach?

• We fail to go deeper into the therapeutic process and, therefore, focus on the breadth of solutions rather than the depth of the hurt. Superficial care is often more concerned with the outcome than the onset of issues. However, in Gestalt therapy, we recognize that instrumental change can only take place when personal insight is met with an awareness to present experiences.

For example, let’s say Mark comes into my office and shares that he is struggling with social anxiety. During our interactions, I notice that he breaks eye contact whenever I initiate a conversation. I begin to gently point this out to him in order to facilitate some awareness. Eventually, we explore his upbringing and the more volatile messages he heard in his home. As a result of his upbringing, he learned that to withdraw from social interactions—through means such as avoiding eye contact—was self-protective.

This past exploration deeply informed Mark’s present experience and will help produce more sustainable, long-term change. From the onset, I could have prescribed skills to address Mark’s anxiety or improve his level of intimacy. However, I believe that when we get to a person’s “truth” three things happen: 1) they develop a deeper layer of awareness to their hurt; 2) they encounter a greater sense of power over their experiences; and 3) they experience an increased level of investment in their change process. All of these things lead to a more sustainable and deeper process of healing.

• We begin to view the person as a problem to be fixed. In our modern era, therapy has become less about the root and more about the results and this is detrimental to both how we view the healing process as well as how we view the person in general. In a conversation I had earlier this week about superficial care, I came to the realization that when we assume that people can be “fixed” through a series of tools, there is a level of dehumanization that takes place. To an individual who has already experienced a loss of power—whether through trauma, anxiety, or “normal” life transitions—this is unhelpful and can be detrimental to their sense of self.

In Gestalt therapy, we focus on the entire person being present to themselves as well as the therapeutic relationship and encounter. We expect and encourage the person to grow deeper in their awareness and rely on them to share their insight into their experience. I firmly believe that if therapy is not used as a platform that strengthens a person’s sense of empowerment rather than diminish it, we will not only impact their sense of self but also compromise their ability to encounter past, present and future experiences.

As someone who has experienced both the superficial care as well as the long term, sustainable care that promotes awareness, insight, and investment in the change process, I advocate for the latter. It is a privilege to spend my days sitting across from young men and women who have chosen to dive deeper than their surface level issues and invest in a longer but more sustainable therapeutic process. After all, don’t we owe it to ourselves to benefit from the same depth of healing that we offer our wood floors and our garden beds?