Cognitive analytic therapy: a sympathetic critique

Abstract

Cognitive analytic therapy (CAT) is an increasingly popular form of time‐limited therapeutic intervention in the UK, which claims success with a variety of psychological problems such as depression, trauma, eating disorders, anxiety related disorders, borderline personality disorder and histrionic personality disorder. This paper begins by outlining the theoretical origins of CAT as well as its main conceptual tools. Cognitive analytic therapy has its roots in the synthesis of cognitive psychology, personal construct theory and psychoanalytic object relations. However, I would suggest what is most promising in CAT is the (relatively) recent import of Vygotskian and Bakhtinian ideas such as the ‘zone of proximal development’ (ZPD) and ‘dialogic interaction’. Further ideas from critical psychology/psychotherapy are used to interrogate some of the limitations of CAT. I will be asking if CAT is a genuine gain for the contemporary worker who has to deal with greater psychic tension than before under a crisis‐ridden capitalist regime. The paper ends with an assessment of CAT's future influence and the two principle trajectories available to it: ‘therapy as an expert system’ or ‘therapy as social critique’ (Totton, 2005, 86).