Recent posts
Fawkes, L., 2002. In Celebration of Integration and Diversity. CAT in the West Country and Beyond. Reformulation, Autumn, p.5.
In Celebration of Integration and Diversity - CAT in the West Country and Beyond
Liz Fawkes
Ten years ago I was a mature student, part way through a psychology and counselling degree and I heard Annalee Curran speaking about CAT. I had been looking for a way of conceptualising my experiences of working with street homeless people in London, and I knew straight away that I had found it. There was something in the clarity of her thought and the warmth of her conviction that made me want to find out more about CAT. I am not sorry that I did, because now I make my living doing something that I believe in and that always leaves me with the feeling that there is more to learn. In terms of CAT I am as old as ACAT, which celebrates its tenth year this year, and I feel a sense of gratitude to those who have taught me. Mario Jacoby says in "The Analytic Encounter", 'I believe .. . that it is important for an analyst to consider himself [sic] each day 'a beginner' so that he continually questions what is happening between himself and his analysands'. For me, CAT offers the conceptual clarity and rigour that offers the therapist the opportunity to try and glimpse the world from the patient's point of view without getting hopelessly lost and without hiding uncertainty behind theoretical dogma.
East Dorset
Now I find myself thoroughly involved in the CAT endeavour, working mainly with people with complex difficulties (many with personality disorders) at the Intensive Psychological Therapies Service near Poole in Dorset. My main focus is individual clinical work, using CAT exclusively, in what is a specialist clinic. I am also supervising some of colleagues as part of the Randomised Controlled Trial researching the efficacy of CAT with certain personality disorders. Dr Sue Clarke leads this and we are currently in the second year. The third strand of my work there is running a CAT Group with my colleague, Val Fretten. We have 6 patients in a 40-week group, using a joint SDR and a joint Reformulation. It has been my first experience of working with a group and it has been truly astonishing. All of the group had had an individual CAT, usually reaching the stage of reformulation and recognition, and much of the group has focussed on the difficulties facing people with long standing and complex problems when they ae on the cusp of trying to change things for themselves. I know that there is a line of thought that argues that a therapy group should not contain too many 'borderline' patients, but in our experience in this group we have found people are really able to grapple with each others' difficulties because they truly understand the depth of each others' pain. It has not been easy for any of us, but it has been real and gritty and honest.
West Dorset
Outside my work at the Clinic I have been supervising two people from West Dorset and that has led to us putting on two Introductory Days, funded by the Trust there. Around 90 people attended and we are now looking at having a follow up day for those wishing to take things further.
Plymouth
For nearly two years I have been involved with the first CAT Training in Plymouth, set up by David Lobb and Sheila Cassidy. The second course will begin next March. My role has been to supervise weekly, and to back up Claire Tanner offering the training input. It is such a delight to be part of the process of learning and to be able to offer something of what other people have given me. I have watched people who have done no therapy before develop into fine therapists, and it reminds me again how strongly I feel that we must keep CAT open to all comers and not just to those with a core profession within the NHS. I believe (and yes, I am biased) that CAT and our patients would miss out if we start to exclude people who have come to this profession via the route of life outside the NHS!
Bits and Bobs
My supervisory role keeps me in contact with developments in CAT in Jersey, East Sussex, Hampshire, Dorset, Devon and Cornwall. Sometimes I worry that our lack of an RCT (which we are trying to remedy of course) will weaken CAT's position in the NHS but when I hear people's enthusiasm and the work that is going on with patients who, not very long ago, would not have been offered any therapy at all, I am reassured that at least at this point in time, CAT is alive and well and thriving and kicking!
October 2002
Liz Fawkes