Tag Archives: Language

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CAT Across Cultures: Challenge & Encouragement in Equal Measure

Are you using Cognitive Analytic Therapy across languages? With culturally diverse communities? Do you supervise or support such work by other therapists? Do you use CAT consultation in teams where staff get stuck around cultural or religious issues? Have you struggled to incorporate the impact of race and racism in formulations? Does your own heritage and identity figure strongly in how clients engage with you? Has your CAT training sufficiently addressed issues of power?

These can be emotive topics and can evoke powerful responses in us. How do we manage such responses and where can we take these within our CAT practice? 

CAT practitioner Rhona Brown shares some background to Jessie Emilion’s forthcoming training day and why it may be of interest.

We at Catalyse are delighted that Jessie Emilion took up the invitation to lead a day “Exploring Issues of ‘Race’, Culture and Language within a CAT Framework” on 20 July in Liverpool.

Cognitive analytic therapy is of course a radically social model which is explicit about how issues of cultural and subcultural difference are procedurally enacted in therapy. It offers us a way to make the political personal and create shared meaning across cultural divides. Establishing CAT training in Bangalore in India over the last six years, Jessie’s had ample first hand experience of adapting CAT in response to the cultural context in which it’s practised. She also articulates how CAT concepts are shaped by such international experience. Along with Hilary Brown, she published a chapter in Deborah Pickvance’s book, on CAT supervision in the Indian context which brought to life ways in which CAT theory is extending in order to more explicitly realise its radically social basis.

“…through our case discussions, we came to think about dilemmas, traps and snags as being held in the culture rather than exclusively in the individual….. A snag might actually be a prohibition, a dilemma a threat of exile as the punishment for non-conformity and a trap a vicious cycle created by poverty and disadvantage …..The metaphor of the ‘dance’ [in CAT theory] in which each individual seeks reciprocation from others, fails to acknowledge the power dynamics at work in a society. ….The dance does not happen in a vacuum but is structured on the basis of positioned roles, selectively occupied on the basis of class, race, age or gender.”

The Catalyse practitioner training has long included space within its twenty training days to consider what has become known as the “SCOPE of CAT” – social, community, organisation, political and economic aspects. It was a privilege to be able to contribute to these training days for a few years, thinking together with successive trainee cohorts on how to engage with such issues, alongside Deborah Pickvance.

The diversity of perspectives held within CAT’s interdisciplinary community felt like a resource to be mined on these days. We all bring with us our own personal identities, our pre-course experiences, and a range of core trainings with their own professional cultures. We each have our own baseline with regards to culturally competent practice. However to acknowledge areas where we may feel less competent and skilled, or feel perhaps more personally invested, can be a challenge. Starting to unpick some of these issues on SCOPE days always felt like an enriching dialogue, although as a white British facilitator I always felt limited in my capacity to authentically represent the lived and living experience of people of colour.

Diversity in groups we work, supervise and train within gives us all daily opportunities to engage with life experience that’s unfamiliar, but do we have places to take what this can evoke? Uncomfortable reciprocal roles and enactments might arise around ‘silencing-to-silenced’ or ‘privileged and well-resourced to exploited, neglected and marginalised’. Experiencing, or simply witnessing ‘hostile and attacking to harmed’ along racial lines can throw up intense emotions which might be difficult for client and therapist to name if a sense of safety within the alliance is uncertain. Such themes, ever-present for many communities, may more frequently be on the cusp of entering conversations within our consulting rooms in recent times where Trump, Brexit, austerity, #MeToo and Windrush have thrown the impact of power and social positioning into stark relief.

Insidious or more frank psychological sequelae of world affairs impact on all of our lives, illuminating multiple aspects and intersections of identity for both client and therapist. How we as therapists respond when such conversations arise can be crucial to the success or otherwise of a psychological therapy.  CAT gives us various ways to “name it, name it, and name it again”, and experimenting with ways to weave such themes  into formulations, diagrams and letters in authentic ways can be important.  At last year’s international conference in Nottingham, Jessie touched helpfully on putting CAT tools such as mapping to good use by helping to name & navigate ‘gut feelings’ felt by both client and therapist around racism & discrimination.

As team consultants or supervisors, when staff and supervisees share what’s come up in their work around social power and difference, do we feel equipped to respond? At her presentation in Nottingham, Jessie also made the gentle provocation:

“….if issues around race and culture have never come up in your supervisory practice, what’s being missed?”

So, have we had enough in our trainings to feel confident and competent as therapists and supervisors able to engage authentically with such issues, with sensitivity, respect, empathy where possible, and a lack of defensiveness? Perhaps it’s most useful to think about engaging in SCOPE issues as an ongoing learning journey for us all, rather than a certain destination we arrive at by the time we complete practitioner, psychotherapy or supervisor training. As the world and society changes, we and those we work with change, and hence the SCOPE in CAT is never finalised.

In my experience there’s nothing quite like a contained face-to-face dialogue with peers where we can feel safe enough to share both difficult procedures, and also approaches that we’ve found helpful.  Jessie, as a solid ‘more knowledgeable other’ can help take us into an area of more stretch and challenge, also providing an opportunity to develop and take away skills to apply in day-to-day work.  Her experience as psychotherapist, trainer and supervisor lend her many practical tools and resources to share with those attending.  Her training and experience as an interpreter offers an uncommon perspective on language and mothertongue in the nuances of emotional expression and intimacy in therapy. For those considering or already working with interpreters, this specific angle, merged with her CAT lense, may aid in understanding and managing the complexity of triadic relationships.

I expect she will bring to the day equal measures of challenge and encouragement. She herself hopes:

“…we could have an open dialogue about these difficult and complex issues without feeling blamed, frightened or persecuted and that we could use CAT’s mapping and positioning to understand and learn from the discussion”.

The event is open to therapists of all persuasions who are familiar with CAT concepts, plus all within the CAT community, including trainees, supervisors, and those applying CAT skills in case management and indirect work. We hope you’ll join us there.

For more information and to book on to ‘Exploring Issues of ‘Race’, Culture and Language within a CAT Framework’ click on this link.

Saying Things Simply: Up-goer Five Challenge


Rhona Brown looks after the Catalyse website and its Twitter activity.  She offers some thoughts here on how we might convey complex ideas in straightforward ways.

The new Catalyse website is very nearly up and running. Spending time in virtual environments and thinking about how to get CAT out into them led me to recall that a year or so ago I set myself a challenge using a little website called Up-goer Five. This is basically a simple text editor which uses only the first one thousand most common English language words. It doesn’t provide readability metrics but sets a limit on allowable words.  This forces the writer to describe complex terms and ideas using more straightforward language. Its invitation goes like this:-

Can you explain a hard idea using only the ten hundred most used words? It’s not very easy. Type in the box to try it out.

Up-goer Five has been used playfully by the science community in particular, to run contests comparing the most straightforward ways of expressing complicated concepts. You can see some of the results posted up on the site, and many an entertaining hour can be spent absorbing them and making guesses at the concepts being described.  Try the Ten Hundred Words of Science collection.

As someone interested in notions of speech genres, accessibility of information, and how CAT ideas can be conveyed without the jargon that can so easily become a barrier to engagement, this was a challenge that grabbed me. Doing this sort of exercise immediately invokes an awareness of one’s addressee, much like the process of writing a reformulation or goodbye letter. In this case I wanted to experiment with conveying something which was straightforward but not couched in such simple language that it seemed patronising.

An early tweet to whoever was listening (we had perhaps a mere 60 followers at the time!) suggested we all had a go and that Catalyse could maintain a ‘gallery’ of efforts. This could act as an alternative glossary of CAT terms and could be added to, whether by those in role of therapist or of person making use of a CAT therapy.

I’m not sure if this tempted anyone to have a go with Up-goer Five.  But my invitation stands.   How would you describe CAT, or concepts within it, in as straightforward a way as possible?

Here’s my attempt at explaining Reciprocal Role Procedures using only the first thousand most common words. My addressee is someone naive to CAT who may experience significant difficulties borne of complex trauma, perhaps attracting a diagnosis of ‘personality disorder’.

When you have grown up with people or things going on in your life that made you feel scared, confused, cross, hurt, or sad, this can lead to conversations inside yourself, and ways of acting in the world, that continue into your grown up life and cause you problems. These can keep you feeling very bad, tire you out, make you lose hope, and can seem very hard to change on your own.

These ways of being can carry on in three ways:-

1) “Others do it to me”
You might still be in situations where people act in ways that scare you, hurt you or put you down. You might notice these things happening in small ways more than others would. You may feel it more than others when bad things happen again. You might feel very worn down and it may be hard to expect that things can ever be different. Sometimes you might think people are being cross or hard on you, even when that’s not what they mean to do. You might live your life as if the things that hurt you long ago are still happening, or about to happen, even when they’re not. This can keep you feeling scared. To keep yourself safe you might avoid doing things, or having much to do with other people, just in case. Your world can become very small and you may also feel very alone. Both of these can make you feel worse.

2) “I do it to myself”
You might end up being cross and hard towards yourself. You might expect too much of yourself. You might say things to yourself inside that make you feel bad, using words that are not kind. You might not take care of yourself very well, especially if you don’t really know how to because no-one looked after you well in the past. You might do things to hurt your body, like taking in too many things that are bad for you, or perhaps eating in ways that make you feel better for a short time but worse as time goes on. You might cut yourself or do other things which cause pain in your body. You might even try to end your life. Even if it doesn’t get as bad as that, you might not keep yourself very safe. You might carry on being around people who hurt you, instead of getting away from them and and staying away. If people are good and kind to you, you might not notice it. Or you might see it, but not allow yourself to accept care or to have any good things. You might not ask for help, or take it when it’s offered. This may stop other people stepping in and helping to keep you safe.

3) “I do it to others”
Sometimes you might find yourself doing things that make other people feel scared, confused, cross, hurt or sad. This can sometimes come as a shock. Seeing yourself acting in those ways can make you feel even worse. It can also make others respond to you in ways that hurt you more. Or others may stay away from you, leaving you feeling more alone. It can feel very hard to change.

Some people feel it’s easier if you meet with someone trained to help you understand how these things came about, and to spot exactly what they look like in your situation. Once you can see them better you can change them more easily, but this will take time. It might help to stay in touch with someone like this for a while in order to make changes that last. Not everyone feels helped by this though. It would be no surprise if the things in 1), 2) and 3) start to happen in a helping relationship. It’s important for you and the person helping you to be open with each other so that you can make sense of things together and sort out any problems that might come up between you.