This response examines the impact on the North American Gestalt community of Margherita Spagnuolo Lobb's extension of the field approach to include a “worldwide” suffering. I reflect on cultural variants in the understanding of suffering in Europe and North America and inquire what can be learned from the European model. Gestalt therapy's shift of attention from the rising figure to attention to the ground itself has enabled work with deeper forms of suffering such as psychopathology, depression, panic disorder, and trauma, as well as a diagnostic approach that describes the cocreated space between client and therapist. How much can this shift allow the Gestalt therapist to include the sense of an insecure world: changing boundaries, terrorism, inability to trust one's neighbor, lack of grounding? Although it may be difficult for the North American therapist to identify strongly with such matters, Spagnuolo Lobb asks us consider our youth's issues of desensitization, suicide, addictions, lack of containment and identity, to alert us to the need for change.

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