Tag Archives: Symbols

Working Creatively with Complexity: a thoroughly dialogical act

In our third blog, Rhona Brown tells the tale of how our November event on “Working Creatively in CAT with Dreams and Stories” came about, with more details of co-presenters Sophie Rushbrook & Nicola Coulter and what they plan to share on the day.

Our forthcoming CPD event on “Working Creatively in CAT with Dreams and Stories” has garnered much interest, not least for the striking image of an SDR embedded within an artwork of a ship which has accompanied information about the day on the website and Twitter.  We were delighted when co-presenter Nicola Coulter offered this as a promotional image, with the consent of one of her clients who had produced the artwork during a CAT therapy.

The day is an extension of workshops previously presented by Nicola and her colleague Dr Sophie Rushbrook at the Malaga ICATA conference in 2013, and the 2014 Liverpool ACAT annual conference.  Karen Shannon, Catalyse’s CPD lead, attended the Liverpool workshop and was struck by how clinically relevant it was and how it helped her think “on a different level, out of awareness”.  Catalyse invited Sophie and Nicola to present a day event in order to bring their refreshing approach back up to the north from their work setting in Dorset.

Nicola and Sophie work together in the Intensive Psychological Therapies Service (IPTS), a Beacon service in Poole, Dorset. The service provides CAT, DBT and Radically Open DBT to people attracting a diagnosis of personality disorder, often with a background of complex trauma.  They have worked together for many years, blending their respective skills as occupational therapist and clinical psychologist, underpinned by their shared practitioner training in cognitive analytic therapy.  Throughout this, their independent clinical work, and supervisory and other roles with the Jersey Practitioner Training Course, is a seam of creativity and playfulness in the way they approach complex difficulties.

Their 2010 Reformulation article on “Playfulness in CAT” outlined their position regarding the thoughtful use of play, risk-taking, humour and use of the therapist’s self in order to engage more authentically and productively in therapy with people with complex presentations.  “When we use playfulness, particularly higher order playfulness, the function may be either to create a break by offering a moment of relief from the distress or to engage in exploration, by creating some distance”.

Their subsequent 2012 publication “Sleep Tight: Working Creatively with Dreams in CAT” described how they have adapted Fritz Perls’ approach to working with dream material. Contrary to a more psychoanalytic approach to dreams, they describe how their techniques help to make use of this material via “a thoroughly dialogical act” between therapist and client.  The training day will elaborate on ideas presented in this paper, and will also incorporate Sophie and Nicola’s more recent work applying the same techniques to stories generated through the Six Part Story Method.  In addition there will be an emphasis on using these techniques in therapy to further explore and develop jointly derived metaphors.  The training will demonstrate how this approach elegantly fits with the CAT model and CAT tasks.

Participants can expect a day of lively experiential work in addition to theory and practical examples.  As Nicola explained, playfulness “is a cornerstone in the way we work clinically and in presentations, hand in glove with the creativity of the embodiment techniques presented”.

Sophie noted how pleased she is to have another opportunity to share their thoughts and experience to help CAT and other therapists in the north build confidence in working more creatively with complexity.  She explained “through experience this is an excellent technique to use with complex clients, particularly when talking directly seems ‘stuck’ in some way.  I have found it useful in looking at how clients relate self to self and in particular accessing how they can be in the top roles to themselves (and then ultimately others).  It facilitates a discussion that might not otherwise have been possible by more direct means.  It has alleviated PTSD symptoms, and certainly psychological distress, sometimes quite dramatically.”

Sarah Littlejohn, one of the lead trainers within the Catalyse Practitioner training course, and supervision lead for Catalyse, welcomes the event.  She sees benefits for practitioners, supervisors and trainees in developing a broader repertoire of clinical approaches, noting how use of creative techniques forms part of the trainee appraisal within practitioner training.  She emphasised “both supervisors and current trainees, particularly those in their second year of training, might find it really helpful as they integrate the different aspects of their practice”.

Ultimately the benefit lies with the experience of the person in therapy. CAT uses a range of active and collaborative techniques alongside talking, most notably collaborative mapping and use of letters between therapist and client.  However these may remain overly reliant on the spoken or written word.  Speech and writing within CAT can be a rich source of metaphor and provide many opportunities to develop jointly elaborated signs but are not easy or accessible for all.  Story and dream material offer more indirect yet potent sources of sign, symbol and metaphor through which to collaboratively explore and develop shared language to articulate emotional experience.  This may be of particular value where therapy has either run aground in the “shallow waters” of direct talking, or become lost in choppy therapeutic seas.

If you’re keen to increase the adaptability and creative potential of your practice through these techniques, then join us for this event.  It takes place on Wednesday 30th November 2016 in Manchester.  It is open to trainee and qualified CAT practitioners and psychotherapists, and other therapists who have some knowledge of CAT concepts.  Places are limited and booking can be made via this link.

Rhona Brown, CAT Practitioner
Rhona tweets for Catalyse @CatalyseC