C.A.T.

[Randomman]

I mentioned something in a previous post about C.A.T. (Cognitive Analytic Therapy). At the back end of 2013 i was in a very bad place. I have never cried so much, so often. i cried over anything and everything and nothing. i was seeing both my GP and the practice's Link Worker on a very regular basis. My Link Worker knew i had a number of different issues, some of which went back to when i was in my early teens. She mentioned C.A.T. as a form of talking therapy. i was, to say the least reluctant at this time due to heightened anxiety but we talked about it some more and i accepted that it might be a way forward.

As i understand it, and please correct me if you know differently, but C.A.T. is very often conducted in groups. Well, my Link Worker knew i would never be able to do that, so she arranged for me to have individual sessions with a therapist. I feel very lucky by the way that where i live the people i have seen have been nothing but brilliant and inexhaustibly supportive.

So, i have to drive to this place, and i'm feeling grim. really anxious and scared. The thought of finally, after many years of hiding my thoughts and feelings away from all those i knew, to finally open up to someone i have never met was both a relief and totally terrifying.

Now, i have a problem with men. i know i am one, but i have never felt comfortable in an all male situation. but guess what. Yes, he was a man. 

Ok, now I'm going to flash through, as I'm getting a bit emotional thinking about the detail. Suffice to say i spent the first 4 or 5 sessions in pieces. crying at any little mention of my troubles. And this you should know. C.A.T. goes deep. I would like to be confident in saying that we left no stone unturned, but in all honesty there are things i cannot barely think about myself, let alone share them with anyone else.

C.A.T. usually lasts for 8 sessions. Mine lasted 12. Such were the concerns of said therapist and his manager. As these went along i spent less time crying and more time trying to work through my problems. The therapist was very good, great in fact. he listened and reflected back to me. He never pressured me. If there was pressure it was coming from within, you know, like the old pressure cooker analogy. He provided me with mini reports that documented what we had discussed. (I can't read them, they're are still too painful). And at the end, for it had to end, he voiced his concerns, as we had not found solutions to all things we had discussed. Don't get me wrong, he challenged my thoughts and on occasions made me think hard about what i had said. Made me question my beliefs. It wasn't all bad.

I want to say a few things to anyone out there who has thought about talking therapies. Personally, I think they work. I am now mid way through C.B.T. and as you might know, C.B.T.'s aim is to deal with the here and now. The problems and difficulties you might be experiencing right now that are impeding your progression to a better place. And to be quite honest its having some good effects. I've begun to see how my opinions of myself can change. I don't have to hate who I am. Hell, i don't even have to change who I am. i just need to accept who I am.

So, to conclude. Please, anyone of you who have dismissed the idea of talking therapies for what ever reason, Don't. You might not be in the right place right now, but there might come a time when you can be more accepting of this kind of intervention. Medication?, well medication for me has played an important role in enabling me to peek over the 20ft high wall. But the rest is up to me. And yes, i still go way down. Still have thoughts i'd rather not have. But the opportunity I've had to exorcise some of those demons that have weighed me down for so long has been invaluable.

*Here are my words of caution*
Please make sure you are ready, truly ready for the likes of C.A.T. You need to be emotionally and mentally resilient and robust. I was not....But that's another story.

[Pip]

I've never been through C.A.T. and to be quite honest I don't know if I ever could.  I have suffered with depression since I was 12 or 13 which became severe when I was 19 years old.  For the next 23 years I didn't speak of the circumstances which led to me being severely depressed as that what was expected of me.  I also emotionally shut down as we which wasn't healthy.  The fear of being a pressure cooker exploding is enough to put me off.  I have had some counselling but the counsellor learned more from me as to how to help others and I got my real support online.  Back in 2012 I did CBT but you have put it perfectly ~ it helped with the here and now but not the root core of my depression. 

[SteveW]

CAT is an interesting form of therapy. Anthony Ryle who formulated it about 35 years ago was a qualified psychoanalyst but also an NHS GP.  His project was to formulate a therapy that drew on psychoanalysis but was feasible within the context of a resource constrained NHS.  Classical analysis, 5 sessions a week possibly for a number of years, was never a possibility for large scale use on the NHS. I'm not sure who can afford £300 + a week for 4 or 5 years. It would be interesting to know if the psychoanalytic elements have survived up to 2015.

I don't particularly associate CAT with group work. For a while CAT therapists published a bit on the subject of Personality Disorders in general and Borderline Personality Disorder in particular. That is the only specialism that I ever picked up on. But I never bothered reading what they produced so I could be wrong. I was using Dialectical Behaviour Therapy with that group with good results so I didn't feel the need for any additions.

I am a little surprised at the 8 sessions extended to 12 length of therapy. I read some CAT case reports in the 80's and 20-24 seemed to be pretty much the standard number of sessions. But that was way back and they could have pruned the number of sessions they offer now. But I wouldn't think that 12 sessions indicated anything problematic.

There is evidence for the effectiveness of CAT. Compared to the massive research base of CBT it is relatively small but CAT never took off in quite the way CBT did. But if offered I would say CAT is worth a try.

There is an Association of Cognitive Analytic Therapists and they have a website. Maybe a little too geared to therapists.

     http://www.acat.me.uk/page/home
   
The Wikipedia page on CAT is rather more informative on the theory and techniques of the perspective.

     http://en.wikipedia.org/wiki/Cognitive_analytic_therapy   

I am glad that CAT was a help to you.   

[Randomman]

Hello SteveW. Thank you for your insight. I attended C.A.T. through my region's Wellbeing Service. Their' standard course of sessions is set at 8. This is possibly due to NHS funding. I guess if you seek C.A.T. privately you might find sessions that are longer. and this is my point really about my not being ready. Just two months after my sessions finished I was faced with hospitalisation or home treatment, on account of my ramblings about harming myself at the GP surgery. In my experience, and I can only speak from that perspective, C.A.T. left me with many issues opened up but not resolved. It is the opinion of a number of professionals I have since seen that at least part of the reason for my second breakdown was more than likely due to that. I personally cannot verify, certainly as, at the time I was in no fit state to analyse anything. I am an advocate for talking therapies, as I think I've said. But I do think C.A.T. is not to be undertaken unless it is understood as to what is involved.

I've re-read what I've just written to try to make sure it doesn't read caustic. No offence is intended. I've had a rubbish day. Apologies in advance.

[SteveW]

I often think that the explanation offered to prospective consumers of therapy is inadequate. For examples Google Cognitive Analytic Therapy NHS and you will get links to some Patient Information Leaflets from various health authorities. They say very little really.

On the number of sessions look at Dorset. They appear to offer 16-32 sessions. For a depth therapy that is more like it than 8. Opening things up and not dealing with them is a danger with all short term therapies. I hope you have made significant progress since.