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Beard, H., 2003. Discovery consists of seeing what everybody has seen and thinking what nobody has thought. Reformulation, Spring, pp.11-12.
“Discovery consists of seeing what everybody has seen and thinking what nobody has thought”
Long before the days of Vygotsky and Bakhtin, Reciprocal Roles, SDR’s and self-states, four year CAT Training Courses, UKCP and ACAT, a Consultant Psychotherapist called Anthony Ryle crossed the threshold and entered the medical territory of St. Thomas’ and Guy’s Hospital.
At St. Thomas’ basic survival against the elements proved an early preoccupation. With a bucket as a favoured “tool” to tackle the leaking roofs the challenge began to establish a small territory in which to work free from climatic change. Many battles were fought before there was an assurance of freedom from the wet and cold.
A parallel challenge lay in gathering the few to try to meet the needs of the many. As word spread of a new arrival and new possibilities individual people found their way to establish contact and all were warmly welcomed. Interest, enthusiasm and time seemed the only requirements.
I cannot recall when the first CAT Introductory Workshop was held but I have a vivid recollection of the first one I attended. I had already known Anthony Ryle for some time as he played a major supervisory role in several teams in which I worked. However at that time I was unfamiliar with the world of Psychotherapy and was unaware of the pioneering nature of his work.
On the day of the Introductory Workshop I met with what seemed like over 100 others from all sorts of backgrounds and locations. We were introduced to a very young version of what was to become CAT. My experience was of recognising the familiarity of much of what was being said, yet of surprise, relief and excitement that these ideas were being woven together in a way that offered a new model of conceptual understanding and application which made sense to me. It was like rediscovering something that was already known or which was at least recognised, but meeting it in a new form which promised all sorts of possibilities.
Excited and enthused I returned to my team and asked Anthony Ryle if he would supervise me in working in this way, and so my first formal contact with CAT began.
Over the years I have met many others who have described the unusual mix of meeting both the familiar and unfamiliar in CAT. Perhaps this is one of the magnets which draws NHS Professionals and others interested in Brief Psychotherapy.
The months that followed were filled with an intoxicating fusion of enthusiasm and excitement, anxiety and terror. I rapidly and intensely experienced the difference between what I felt myself capable of, and what Anthony Ryle deemed me able to accomplish, yet this was I think well before the days of the Zone of Proximal Development. Having learned a little myself, I, like many others, was drawn into a small, steadily growing network of people who tried to teach others, whether at Introductory Days in London or equivalent workshops elsewhere. In this way the network of interested people grew, fuelled by interest, and enthusiasm and a fair amount of perspiration!
Concurrently CAT theory and practice steadily transformed and reformulated itself. Training consisted of attending “Nuts and Bolts” days or “Advanced” days, at conventions of “CAT kittens” and “Golden Oldies”. There was no formal training programme, but if you missed a meeting you missed a theoretical development!
Looking back so many of these developments emanated from dialogue in supervision, or derived from the challenge to understand and conceptualise the needs of particular patients. Perhaps it is important to acknowledge the important influence that patients themselves have had on the development of CAT.
Anthony Ryle initiated the theoretical transformations – from core pain to reciprocal roles, to SDR’s, to Activity Theory, to SSDR’s. This process was also profoundly influenced by the dialogical exchange between Mikael Leiman and Anthony Ryle.
There was also a sense of personal discovery in this process. The constant challenge of accommodating the new, as interpreted by a number of people, bred much diversity, and the clumsy application of partial understanding in turn led sometimes to further developments as well as crude understandings, rapidly abandoned! This was an exciting process and fuelled motivation as there was the possibility of participating in generating theoretical and clinical understanding. Less pleasant was the persistent anxiety about lack of conformity, getting it wrong, and the fear of exposure. Dual tensions which resonate within CAT teaching and training to this day.
The steady increase in demands for Training generated the first CAT Basic Training at Guy’s Hospital, and the publication of CAT papers and texts consolidated and formalised the evolving theory. Meanwhile Anthony Ryle invited dialogue with psychoanalysis and other psychological theories. Rumours of a Ryleian Therapy produced a characteristic swift reaction from the originator and CAT was named in recognition of its collaborative and integrative nature. Eventually in 1992 ACAT was founded.
This is my memory of how CAT spread. The interest and motivation in being part of the development of CAT is in my view infectious. Colleagues become interested in what is going on. They seek a teaching session, consult now and then about a patient, and if they find supervision helpful seek more training and supervision. The CAT Practitioner’s role becomes transformed and they become a specialist resource within the team. If they are very lucky status, resources, and service provision follows, and more people become interested, and so it goes on ….
However very often this process also involves many battles, similar to the battles Anthony Ryle fought when he first arrived. Offering a ‘free’ CAT service to a tiny number of people within another role is where it begins, but the subsequent changes are more of a challenge. Battles for physical space, recognition, for posts, for professional development, for adequate supervision, for service provision for further training and for research are hard fought and often very long struggles. Anthony Ryle was the original pioneering force, but many others, in many diverse places, have fought similar hard pressed battles with considerable fortitude.
The harvest from this endeavour is that CAT is recognised and securely established in many places. In other areas this process is just beginning with a new and renewed generation of CAT people.
However the battle for resources continues needing all the skills of collaboration, dialogical exchange and respect for diversity that CAT can gather. Perhaps the difference is that it is no longer the few trying to meet the needs of the many, but more than a few trying to meet the needs of the many.
So ends a brief personal account of the early days, one version of the many versions of how it all began ….
Hilary Beard