Introducing Cognitive Analytic Therapy. Principles and Practice By Anthony Ryle & Ian B. Kerr

Introducing Cognitive Analytic Therapy. Principles and Practice

By Anthony Ryle & Ian B. Kerr

 

Leningradで ‘Pavlovian’ psychotherapyなんて余計なことを書いたものだから
Ryleさんも、いったいなんだってーの、何も関係ないでしょ、と食いついた

どういう評価であれCATということばをこれだけ反復して使いまくってくれているのは
書評を依頼された人としてある種、誠実なのかもしれない
たいてい、中身なんか読まない
CATという文字だけ頭に残る

 

Reading this book brought to mind a sobering experience from my youth.

 In 1966, I visited a psychotherapy institute in Leningrad (now St 

Petersburg). Its doctors said they used ‘Pavlovian’ psychotherapy. 

How did they do this? They admitted patients, took a detailed history 

of their upbringing and showed them how current maladaptive behaviours

 grew out of earlier forms of interaction with family and others which

 needed revision to become more appropriate to current circumstances. 

Western psychotherapists using a similar approach might have been 

surprised to hear that Pavlov was its progenitor. Now Ryle & Kerr see 

it as part of cognitive analytic therapy (CAT), which takes about 16 

sessions. Together with the patient, the therapist writes a 

パブロフを持ち出しても持ち出さなくても
過去に形成された行動思考パターンが繰り返される
意識化されないものは反復して行動化される
というだけの話で
まったく平明な話である

問題を探り出す部分では精神分析的な手法が役に立つし
それを訂正するなりする場合には認知療法の手法が役に立つ

これも全く平明な話 

 

治療目標を決めて
日記を書き
問題に焦点を当て
だんだん良くなって
最後にお手紙を書きましょうというのだそうだ

書くことが好きな人には向いていると思う 

 

Case examples show how CAT assessment is done and reformulation 

letters and diagrams are constructed. Its use of a goal-oriented 

approach, diary-keeping, self-ratings and collaboration with the 

patient overlaps with the practice of behavioural and cognitive 

therapists. However, a case history of CAT in a patient with 

obsessive?compulsive rituals (pp. 138-144) highlights how CAT differs 

from behaviour therapy by exposure and ritual prevention: the ‘ 

target problem’ procedures did not mention the rituals, the 

post-treatment rating of improvement did not say whether or not 

rituals reduced, and a mean of 16 sessions of ‘brief’ CAT exceeds 

the 9 sessions usual with face-to-face behavioural therapy, let alone 

the single hour of clinician contact needed with computer-aided 

behavioural therapy. The authors acknowledge the paucity of controlled

 trials of CAT. The aim of CAT in early dementia seemed unclear (p. 

156).

The authors say that CAT derives its ideas from evolutionary 

psychology, genetics, developmental neurobiology and psychology, and 

uses a ‘ Vygotskian perspective’ regarding ‘sign mediation’, ‘ 

Bakhtinian concepts of the dialogic self’ and ‘Kellyian personal 

construct therapy, cognitive therapy and psychoanalytic object 

relations theory’. These supposed roots remind one of the historian's

 warning of ‘idols of origin’.

A would-be practitioner might learn more from the book's case 

illustrations than its turgid theoretical digressions, replete with 

redundant argot. We need not have heard of Vygotsky to know about 

meaning, intention and signs, or of Bakhtin to know that we are social

 beings.

The case histories give an idea of what CAT is about, but the book 

testifies to the long journey ahead before psychotherapy can reach the

 authors' laudable goal of a lucid language, method and evidence-base 

shared by all practitioners.