Theoretical underpinnings of CAT

Abstract

Abstract This chapter describes the development of cognitive analytic therapy (CAT) from its early origins in Anthony Ryle’s efforts to create a common language for the psychotherapies, through the provision of a solid object relations base to more cognitive aspects of the model. CAT is an integrative and relational model of therapy, which also draws on the ideas of Lev Vygotsky and Mikhail Bakhtin on the continuous social and dialogic formation of mind and the self—‘we interact and communicate, therefore I become’. CAT views participants in therapy as whole human beings within their interpersonal context, and focuses on how we construe the world around us and choose to interact in it. CAT is time-limited and in the early stages of therapy sequences of problem procedures are jointly identified, which become the main focus throughout the work. Ryle’s interest in why we don’t revise these procedures, even though they come at high personal cost, lead to the development of the core CAT concept of reciprocal roles and their resultant reciprocal role procedures. The chapter describes the development of these interpersonal roles and procedures, both from a theoretical perspective, and through their demonstration in observational studies. CAT uses written and diagrammatic tools to describe these patterns, and the diagram in particular, the sequential diagrammatic reformulation, is a powerful aid for addressing these as they emerge within the therapy relationship. The chapter gives clinical illustrations and examples of diagrams.