Recent posts
Yorke, L, 2024, Looking for the Observing Eye-I?, Reformulation 57, p.6-9
The observing eye: key to the model
Along with tools such as the psychotherapy file, maps, reformulation and goodbye letters and concepts such as zone of proximal development and dialogism, the observing eye is a key element of CAT. It is described as such in both the original and current edition of the Handbook of Cognitive Analytic Therapy (Ryle and Kerr, 2002 2020), ‘CAT therapists often include in the diagram [SDR or map] an image of an “observing eye” of the patient which is outside the system: the eye which becomes an ‘I’. Fawkes and Fretten (2017) expand on this definition in their reflection on the developmental disruption of personality and change, ‘In CAT the task is seen as developing an ‘observing eye’ …which links the self-reflective capacity with a more stable sense of self, a larger range of responses within relationships and an expanded reciprocal role repertoire’.
Eye / I am lost
The observing eye was both a taught and applied element of CAT Practitioner training. However, over the years, at conferences and in articles on CAT the observing eye is often missing with the consequent loss of associated discourse. In the search for the observing eye, at the time of writing, only two drawn eyes could be found in two key CAT texts and guidelines (Varella and Franks in Lloyd and Pollard (eds.), Freshwater in Ryle and Kerr 2020, as well as featuring only twice in recent issues of Reformulation (Jefferis, 2023; White and Hepple, 2020).
Recently a compressed text on the observing eye has been written for the Oxford Handbook of Cognitive Analytic Therapy (Yorke in Brummer et al. in press). The question is necessarily asked, “Why was the section in the Handbook written?” Firstly, to ensure an explicit focus on the observing eye in the Handbook given the observation that this element of the CAT model is often missing from key texts and, through lack of use, may be in danger of being lost to the model and CAT practice; and secondly, because of the significant utility it has to clinical practice and therapeutic change.
Finding ourselves
The observing eye was present from the inception of the model, enabling the ‘eye/I’ as the observed self, to be internalised as the better understood self; the reformulated, recognised and revised self / I. The observing eye, just as the healthy observing parent, carer or society, enables us to recognise and understand key elements of ourselves and our lives. As Ryle (1975), states in his seminal article Self to Self and Self to Other, “Like the man who discovered that he had been talking prose all his life.” In this way the observing eye, helps us to understand parts of ourselves that we may already have a sense of but which, by being out-of-sight or beyond our zone of proximal development, (Vygotsky, 1978), have become ‘out of mind’.
Containing CAT
From experience in training, practice and supervision, clients and therapists alike typically find the observing eye helpful to the therapy process and outcomes. The eye, as a non-judgemental observing element of the therapy, just as a healthy observing care giver or supervisor, can have a containing and supportive role for the client and therapist, particularly when its non-judgemental element is described. In this context of safety, time can be given, words can be spoken, thoughts and feelings can be explored, and meaning developed.
Developing the capacity to change
Some years ago, a pivotal article, Untying the knots: relational states of mind in Cognitive Analytic Therapy? appeared in Reformulation (Potter, 2004). The article made several helpful reflections, with the proposition that the self has complexity beyond the observing self; ‘CAT tends to focus on the self-observing or mindful sense of self, but I suggest ‘sense of self’ comprises four capacities:
- Self-reflection, mindfulness or self-observation
- Self-assertion, action and agency
- Self-orchestration, management or an executive sense of self-involving a co-ordination and synchronisation among roles, states, social identities and allegiances.
- Self-identity, narration and lineage and coherence.’
The multiplicity that is described perhaps requires a primary orchestrating observing self to achieve full recognition and expression of the four capacities, as described in the clinical vignette in the article:
“In one case we mapped the client’s five different states out on the back of what he called his five beer mats and moved them about the table like playing cards until we had some sense of how they linked to each other. I always add a self-reflecting state or the observing eye noting “well, is this state a bit like what we are doing now?” (Potter, 2004).
Seeing ourselves in the map - me, myself, eye
In the same article, there is recognition of the importance of the client developing a familiarity with their map with the process described as taking ‘a short walk around the…diagrams’ in order to observe and internalise understanding and change in therapy. The article suggests that the practice, ‘also models the self-observing reflective process both as a joint activity and an internalising activity of the client’s – an aspect of therapy which cannot be re-enforced enough.’ Similarly, in her chapter describing the CAT model in the book Cognitive Analytic Supervision: A Relational Approach, Burns-Lundgren (2017), describes how central the concept of the observing eye is to the process of change in therapy as part of the CAT map, ‘It [the map] is a unique and non-blaming tool, highly valued by most patients, and plays a unique and powerful role in the creation of a perspective or an ‘observing eye (I)’ on the patient’s habitual ways of relating.’
Perhaps best drawn in the form of a human eye given the developmental nature of our experience, the use of a single forward-facing eye on the map with its multiplicity of seeing, looking directly and fully at the client, therapist and therapy can be seen as a necessary simplification. Eva Burns-Lundgren (2017b) writes of this process, ‘This becomes a powerful means of developing the ‘observing eye/I, a position of growing self- awareness or observation, often represented on the diagram via the drawing of an actual eye’. Despite the frequent use of the eye icon while mapping, it should be noted there are many ways of placing the concept of observation on the map to reflect the reciprocal nature that it has been said that the single eye can lack (Potter, 2017). To this aim a person or two people or the reciprocal role ‘noticing to noticed’ can be drawn on the map (Akande, 2007).
An essential element throughout therapy.
The process of mapping and noticing reciprocation can lead to change in therapy. Change happens with or without an observing eye on the map, just as there is human growth without observing parents or caregivers. However, do we develop as well as we might without healthy caregivers and does therapy progress as well as it might without an observing eye? It has been my experience of clinical work and feedback from supervisions, that the presence of the observing eye can aid and amplify change in therapy. The proposition that the observing eye supports vital change in therapy is perhaps understood in relation to the analogy of the Reformulation Letter, which once written enables therapy to start in earnest, but if delayed or omitted is known to slow or negatively affect the process of therapy.
CAT is a short-term therapy with associated theory and tools underpinning its efficacy. The observing eye is often linked to post-Reformulation mindfulness and recognition (Bennett and Parry, 2004; Corbridge, Brummer and Coid, 2018; Parry et al. 2020). However, it can be argued that the observing eye can be most helpful to CAT as a constant from the start of therapy, just as it is in the healthy care-giver’s gaze from birth. In this way, the observing eye becomes a means to explore and notice during the reformulation sessions. During these first four sessions, there is an understandable focus on problematic reciprocal roles, which means that discussions have potential to be challenging. When the observing eye is on the map from the first moments of therapy, the therapeutic dyad can have an encouraging and dynamic experience of change; noticing and naming, recognition and mapping of their experiences with non-judgemental dialogue rather than repeating, neglecting or avoidant ways of relating that have led to therapy. From the first meeting with the observing eye on the map, the client has an opportunity to be seen in ways that may not have been possible in childhood. The client and therapist also have the opportunity to manage enactments and to notice strengths as well as difficulties. By these means exits can be identified and written on the map from the start of therapy, which can start the change process and thereby motivate the client and encourage attendance (Jenaway: All About CAT website).
Implicit and explicit mechanisms of change
The observing eye is discussed in therapy and thereby can have an explicit effect on change. Observing can trigger therapeutic exit-generating processes such as ‘noticing and naming and negotiating how we respond to what we feel and do,’ (Potter 2016). The eye can be used as ‘a compassionate way to enable the development of a curious, interested, kind observer, as opposed to an internal critic’. This stance, modelled initially by the therapist and thereafter between the therapeutic dyad, is increasingly internalised by the client who thereby develops their own therapeutic capacity (Corbridge, Brummer and Coid, 2018). In this way, as therapy progresses, it is not unusual to hear clients, having internalised the concept of ‘non-judgemental observing’ start sessions, with the phrase, “this week I noticed….”.
In all probability, due to its presence on the map, the eye is also likely to implicitly affect the process of change, enabling understanding and meaning to develop as the therapy process ‘shimmers between conscious and unconscious cognitive processes and procedures” both during and between therapy sessions (Potter, 2016). Consistent with these thoughts, Hepple (2017), has also reflected on the logical and imaginal qualities and potential of observing, “In CAT we use the metaphor of the ‘observing eye’ to describe, particularly, a reflective capacity that can take an overview of a range of dissociated self-states. This is quite a thinking eye that sees and describes. Perhaps to be aware of more of ‘what is going on’, we need to develop a ‘dreaming eye’ as well?”.
Managing enactments
The observing eye can also be used as a helpful means to reflect on and manage enactments that inevitably occur during therapy. Enactments are acknowledged as difficult to navigate with potential to damage relationships and the therapy. As such it is important to resolve enactments before they become problematic. The use of the observing eye in this context is particularly valuable, benefiting clients and therapists alike given the deft and non-blaming way that enactments can be explored and resolved through the observing eye on the map. The question “What does the observing eye notice?” or “Where are we on the map?” focuses the therapeutic dyad upon the shared nature of the relationship and experience rather than the polarizing impact of the enactment. As noticing and recognition of the shared experience occurs, so reciprocal compassion and understanding can develop, leading to relational exits and change.
Seeing the circle of life
Ryle and Kerr’s description of the observing eye finds its parallel in TS Eliot’s poem Little Gidding (1943) which describes how life involves a search for meaning. In CAT terms this involves recognition of the circumstances, often from childhood, which initiate unhelpful reciprocal roles that shape the behaviours we come to therapy to change, but have remained unrevised because they are unknown, not actively looked for or seen.
We shall not cease from exploration
And the end of all our exploring
Will be to arrive where we started
And know the place for the first time.
Through the unknown, unremembered gate
When the last of earth left to discover
Is that which was the beginning;
At the source of the longest river
The voice of the hidden waterfall
And the children in the apple-tree.
The eye in supervision
In supervision and training therapies, it can be helpful for us to reflect on how as therapists we relate to the observing eye; how we experience our therapy and ourselves being seen. Stevens (2017) notes the importance of self-reflection and how the observing eye can facilitate clinicians’ “awareness of their own internal dialogues which may be inspiring but also restricting or undermining of their development as a CAT therapist”. Casement (1985) describes ‘the island of intellectual contemplation’, the capacity for self-reflection we achieve using the observing eye in CAT. Fawkes and Fretten (2017) describe how in early sessions the supervisor’s role is to ‘slow things down’ in support of the process of reformulation, “With their ‘excess of seeing’ (Bakhtin, 1990), it is often the supervisor’s observing eye which facilitates the process of beginning to sequence patterns of selves and others.” In part the rationale for this article has been the number of supervisees who report clinical progress of the kind Corbridge, Brummer and Coid,(2018) describe after adding the observing eye to maps.
It is a tenet of CAT that without healthy dialogue and supervision, our therapies and the self that we bring to our work can founder. Such consideration is often presented in guidelines from professional bodies where the requirement is for healthy clinicians to be delivering effective therapies. In supervision, the observing eye is often the means to re-establish the mutual ‘excess of seeing’ of the supervisor and supervisee, just as it is in therapy when enactments occur. Without the ability to notice judgement, to play, to be creative and also to see and search for understanding of our whole therapeutic self, supervision has diminishing returns and we can lose our way in therapy and our practice. Aware of its core purpose, intention and contribution to the success of CAT supervision groups, Darongkamas, John and Walker (2014) have proposed the observing function as an “eighth mode”, the “observing us”, to Hawkins and Shohet’s (2012) Seven-Eyed Model supervisory model. With its multiple functions therefore, the observing eye can be a gift to supervision, reflective practice, individual and group therapies and organizational culture (Yorke, 2021) for our clients during therapy and when therapy ends, and for the therapist life within and beyond therapeutic work.
The client’s view
The following is a description from a client who has given permission to share their written feedback of how CAT, including the observing eye, helped with their change process and continues to inform their day-to-day relationships with self and other:
“Mapping has helped me to find out things about my behaviour, which I didn’t understand previously. It has made me aware of my reactions and how they affect my behaviour and relationships. The observing eye helps to identify and observe these reactions, and the thoughts, feelings and relationship patterns. It felt rewarding to be able to see how far I came in mapping and talking in therapy. I now look at things from a totally different perspective. I no longer look at things with tunnel vision; instead, I see things with panoramic views, as the pieces have come together. Therapy helped me to observe myself and other people to identify Exits. I am still me but with improved wellbeing and understanding of my relationship with myself and of my relationships with other people. I would recommend CAT to people in hospital and the community”.
An invitation
Whichever way we see it and whatever our focus, fifty years after he developed the model, Tony Ryle’s invitation to use the observing eye is there, with the other elements of the CAT model, for us to consider if, when, how and why we use it in cognitive analytic therapy.
References:
Akande, R. (2007) A sign for the therapeutic relationship, Reformulation Winter,pp 6-7.
Bakhtin, M.M. (1990) ‘Author and hero in aesthetic activity’. In M.M Bakhtin, M. Holquist and V. Liapunov (eds.) Art and Answerability: Early Philosophical Essays (No. 9). Austin: University of Texas.
Bennett, D. and Parry G. (2004) A measure of Cognitive Analytic Therapy (CAT) competence CCAT. Association for Cognitive Analytic Therapy.
Burns-Lundgren, E. (2017) ‘The CAT model and practice of supervision’. In D. Pickvance (ed.) Cognitive Analytic Supervision: A Relational Approach pp. 40(a), 48(b). Oxon: Routledge.
Casement, P. (1985) On learning from the patient. London: Routledge.
Corbridge, C., Brummer, L. and Coid, P. (2018) Cognitive analytic therapy distinctive features. London: Routledge.
Darongkamas J., John C. and Walker M.J. (2014) An eight-eyed version of the Hawkins and Shohet’s clinical supervision model: the addition of the Cognitive Analytic Therapy concept of the “observing eye/I” as the “observing us”. British Journal of Guidance and Counselling 42 (3) pp. 261-270.
Elliot, T.S. (1943) Little Gidding, four quartets. London: Gardners Books.
Fawkes, L. and Fretten, V. (2017) ‘The use of the CAT model in the supervision of CAT therapists working with borderline personality disorder’ pp. 89(a) and 86(b). In D. Pickvance (ed.) Cognitive Analytic Supervision: A Relational Approach. Oxon: Routledge,
Freshwater, K. (2020) ‘Case History: Sam’. In A. Ryle and I.B. Kerr Introducing Cognitive Analytic Therapy Principles and Practice of a Relational Approach to Mental Health p. 253. West Sussex: John Wiley and Sons Ltd
Hawkins, P. and Shohet, R. (2012) Supervision in the helping professions (4th edition). Maidenhead: Open University Press.
Hepple, J. (2017) ‘The microcosm in CAT Supervision’. In D. Pickvance (ed.) Cognitive Analytic Supervision: A Relational Approach p. 179. Oxon: Routledge.
Jefferis, S. (2023) A CAT view of social innovation and capabilities: Hilary Cottam’s “radical help”. Reformulation 56 pp. 12-17.
Jenaway, A. ‘The observing eye in CAT’ All About Cognitive Analytic Therapy. https://www.engage.acat.org.uk/observing-eye-in-cat/
Lloyd. J. and Pollard. R. (2019) Cognitive Analytic Therapy and the Politics of Mental Health. New York: Routledge
Parry G., Bennett D., Roth A.D. and Kellett, S. (2020) Developing a competence framework for cognitive analytic therapy. Psychology and Psychotherapy: Theory, Research and Practice 94 (51) pp. 151-170.
Potter, S. (2004) Untying the knots: relational states of mind in Cognitive Analytic Therapy?, Reformulation Spring pp. 14-21.
Potter, S. (2016) Negotiator’s Mind. Reformulation Summer 29-32.
Potter, S. (2017) ‘Using CAT mapping in relational supervision’. In D. Pickvance (ed.) Cognitive Analytic Supervision: A Relational Approach pp. 138. Oxon: Routledge.
Potter, S. (2020) Therapy with a map: a cognitive analytic approach to helping relationships. West Sussex: Pavillion Publishing.
Ryle, A. (1975) Self to self and self to other. New Psychiatry pp.12-13.
Ryle, A and Kerr, I. (2002) Introducing Cognitive Analytic Therapy, principles and practice. West Sussex: John Wiley & Sons.
Ryle, A. and Kerr, I. (2020) Introducing Cognitive Analytic Therapy, principles and practice of a relational approach to mental health. West Sussex: John Wiley & Sons.
Stevens, Y. (2017) ‘Supervision in a training context’. In D. Pickvance (ed.) Cognitive Analytic Supervision: A Relational Approach pp. 188. Oxon: Routledge.
Varela, J and Franks, L. ‘Responding not reacting to challenging behaviour: a reformulation approach’. In J. Pollard and Pollard, R (eds.) Cognitive Analytic Therapy and the Politics of Mental Health p.136. Oxon: Routledge.
Vygotsky, L. S. (1978) Mind and society: The development of higher psychological processes. Massachusetts: Harvard University Press.
White, S. and Hepple, J. (2020) Eight session Cognitive Analytic Therapy (CAT) improving access to psychological therapy (IAPT) service – description of a model and method Reformulation Summer pp. 16-20.
Yorke, L. (2021) ‘Relational Discovery.’ In J. Kirkland and J. Marshall (eds.) Reflective Practice in Forensic Settings: A Cognitive Analytic Approach to Developing Shared Thinking. West Sussex: Pavillion Publishing.
Yorke, L. (in press). ‘ The Observing Eye’. In L. Brummer., M. Cavieres, M. and R, Tan (eds.) The Oxford Handbook of Cognitive Analytic Therapy. Oxford: Oxford University Press.
I have an interest in organizational culture and additional training and practice in Forensic Psychology, DBT, EMDR and CAT. I have worked as a therapist, supervisor, trainer on the CAT Foundation at Exeter University and as editor for the Journal of Cognitive Analytic Therapy. My interest in the Observing eye arose initially during training; it’s importance has become evident the more I train and supervise. I present the related topics here for consideration.