Cognitive Analytic Therapy is a collaborative method that brings together cognitive and analytic approaches. This means that CAT examines patterns of thoughts, feelings, behaviours and actions (cognitive approach), while also exploring events and relationships from earlier in life that underpin them (analytic approach). In essence, these patterns are understood to be coping strategies — they are how we learn to manage difficult situations and relationships with others when we are younger.
CAT is a time-limited therapy, usually lasting for 8, 16 or 24 sessions and often with follow up appointments. However, it can also be offered as a single session to help you to understand yourself better and have a framework to take away to work on yourself.
Essentially, Cognitive Analytic Therapy identifies any patterns in your life that might be causing you distress or holding you back. These patterns are placed into three categories:
— ‘Traps’ (vicious cycles)
— ‘Snags’ (I want to change this behaviour but…)
— ‘Dilemmas’ (false or narrow choices, such as either/or).
An example of a trap might be: ‘I feel worthless and that I can’t get what I want because others will reject or criticise me 🡪 so I believe it’s hopeless to try to change this 🡪 then I give up and don’t try 🡪 this confirms my belief that I’m worthless and can’t get what I want.’
An example of a snag might be: ‘I want to express my feelings 🡪 but I don’t for fear that others will reject me 🡪 so I end up feeling frustrated and miserable.’
An example of a dilemma might be: ‘When I feel upset I either 1) bottle up my feelings 🡪 then others don’t know how I’m feeling 🡪 so I feel alone and ignored 🡪 consequently my needs aren’t met or 2) I let all my feelings out explosively 🡪 then others don’t want to be around me or criticise me 🡪 so I feel rejected and ashamed 🡪 again my needs aren’t met.’
By exploring these patterns and their causes, CAT can help you to find a way out of any repeating situations and blocks in your life.
The early stages of CAT are spent identifying and noticing any patterns that you want to work on. This might involve completing a questionnaire or highlighting when any patterns are happening in session with your therapist. It could also involve completing between-session tasks to record when patterns are happening in your day-to-day life.
Your therapist will then share a ‘reformulation letter’ and diagram to summarise the patterns that impact your life now and how they developed. Following this, the sessions will focus on developing alternatives and ways of exiting these patterns, while noticing any obstacles to change. As your appointments come to a close, you will exchange ending letters with your therapist to reflect upon your progress and how this can be taken forward beyond therapy.
Depression, anxiety, low self-esteem, relationship difficulties, stress, eating issues, addictions.
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