Cognitive Analytic Therapy (CAT)

I am a Cognitive Analytic Therapy Practitioner and I have 15 years of experience using this approach across NHS and private settings.  I’ve genuinely seen people benefit hugely from the insights that this model can provide.  For people who have felt stuck in the same cycles despite previous therapy or their own efforts, CAT often offers a new way of understanding our problems.  It’s well suited to people who have tried other therapies and found them helpful but not quite enough, or who want a therapy that addresses the relational and historical roots of their difficulties within a clearly bounded timeframe.

What it is like to have Cognitive Analytic Therapy (CAT)? 

CAT is a talking therapy that is an integration of two types of therapy: cognitive therapy and analytic therapy.  It was developed for the NHS by Anthony Ryle in the 1980s and has been used across NHS settings, and in private practice, for over 45 years now.  CAT has a good evidence base in terms of helping people to change and it being an approach that people like and so don’t drop out from.  The approach is safe and widely applicable across a range of problems such as depression, anxiety, relationship difficulties and emotional difficulties.  CAT is a collaborative approach, so you will be fully involved in the process throughout.  

CAT is a relational therapy, so it’s focus is on the way in which you relate to yourself, how you relate to others and how they relate to you.  It assumes that your relational patterns were established in your childhood and through life experiences.  CAT views psychological difficulties as ways of trying to cope with difficulties in relationships, including the relationship you have with yourself.  It aims to make questions like “why do I always end up feeling like this?” become more answerable.  

You’ll end up with tools to take away including your own bespoke map of relational patterns in your life and how they link together and are maintained. We will work together to develop skills to break these cycles and develop new ways of relating to yourself and others. I write two letters over the course of therapy for you to take away which summarises the patterns that have developed in your life and perhaps have become problematic over the years.  People often find the map and letters really helpful for referring back to for support once our regular sessions have come to an end.  

CAT is a brief form of psychotherapy, typically 16-24 sessions which are usually weekly, lasting 50 minutes.  Because CAT is time-limited, there is a natural focus and energy to the work. The ending is known from the beginning, which often makes the relationship and the work feel particularly meaningful.  CAT is structured into three stages and these are described below: 

Stage One. This is where we will talk about the problems you are experiencing and try to understand where the problems come from and what maintains them.  You can expect to talk about your current and past relationships.  The early therapy sessions will be concerned with hearing your story and beginning to piece together the patterns which seem to be keeping you stuck.  I will start to draw out patterns which may repeat in your life and we start to make sense of this together within a safe and calm space.  I will then write you a letter summarising our discussions so far and what seems to be maintaining the current problems.  People have said that they find this letter particularly powerful and reading it with me has helped them to feel genuinely understood. 

Stage Two. This is where we will work together on trying to increase your awareness of the roles and patterns in your life that keep your problems going.  We develop a visual map of your key patterns, how they connect, and the patterns that keep you stuck. This map becomes a working tool throughout the rest of therapy.  Together we’ll start noticing when these patterns show up in everyday life and in the therapy itself, experimenting with different ways of responding, and building new relational and emotional responses.  

Stage 3. This is where we will work on trying to make effective changes.  These will be drawn onto the map so that you can see them clearly.  Change will be personal to you and I will work at your pace.  This phase will also end in me writing you another letter which summarises the work that has been done and is a helpful way of saying goodbye at the end of therapy. Normally, you will be offered a follow-up session to review how things have gone for you following the end of therapy. 

People often leave with a clearer sense of what will help to change these patterns and with a more caring and compassionate relationship with themselves.  

Where can I find out more?

The ACAT website – Home | ACAT

CAT self-help book: Wilde McCormick, E. (2008) Change for the Better.