Finding the type of therapy that is right for you can feel like a minefield. It isn’t helped by therapeutic world’s love on an acronym e.g CBT, CAT, ACT etc. 

Here is some clarity.

CBT or Cognitive Behavioural Therapy is considered to be one of the most popular therapeutic modalities, particularly within the NHS. CBT thinks about how your thoughts, feelings and behaviours are interconnected and proposes that you can break unhelpful patterns and feel differently by challenging your thoughts and undertaking different behaviours. It focuses on the ‘here and now’ and is generally very structured and goal orientated. It is utilised within the NHS because it is time limited, it can be relatively easily manualised and (because it is goal based), easy to measure benefit. It has a strong evidence base as is seen as effective, particularly when there is a clear identifiable problem for a person.

Sometimes things aren’t so clear however. The human psyche being a complicated thing! Sometimes a person might just have the sense that they are overwhelmed, resentful, burnt-out, a feeling that their relationships aren’t working or a feeling like they aren’t enough, perhaps striving but never being satisfied. Maybe they need to get things perfectly right all time, or they feel unlovable or are unhappy with their body. Sometimes these things can be wrapped up within a diagnosable mental illness e.g depression, anxiety, anorexia, sometimes not, but it is generally helpful to have an understanding of why we feel like that – where your needs come from and why they are there, before we can make change. When this is the case it is helpful to think about a therapy that explores your past and thinks about how you relate to others as well as yourself.

This is what is great about CAT – it takes some of the cognitive behavioural elements of CBT (after a period of time in therapy you will be encouraged to find exits to your unhelpful patterns), but it also helps you think about understanding why you do or feel what you do. It can be a lot easier to be compassionate and caring to yourself if you understand what need you are trying to address when you do or feel something that you don’t like. Your brain might tell you that you are hopeless/useless/a failure but it is important to understand that not only are you not, but there will be a reason why you are not. CAT recognises that part of what makes us human is that we are relational beings who are striving to feel physically and emotionally safe. We have learnt from our caregivers as we have grown up how to get our survival and safety needs met. Sometimes, however, what we learned when we were infants doesn’t serve us so well as we grow up

Psychodynamic therapy recognises that are minds are so much more than our conscious thought and it is tapping into what sits in our unconsciousness that often drives our thoughts and feelings without us being aware. CAT is heavily influenced by this and together with your therapist you will be working to become more aware and make the unconscious conscious. One of the ways of doing this is to map things out to make sense of connections and to develop what we call an ‘Observing Eye/I’. Having this awareness makes it much easier to have choices and having choices makes it easier to make change.

Not all therapies e.g psychodynamic/psychoanalytic have clear endings. CAT recognises that for many people endings are important. Not just because you don’t want to pay a therapist forever (!) but it is important in creating goals, motivating you to make change and often, more importantly, to be able to have the experience of good, safe relational end (without feeling rejected). Hence why CAT,  like CBT, is time limited and has a start, middle and end.

So what about all the many other types of therapy (all it seems with three letter acronyms) – e.g. Compassion Focused Therapy (CFT), Acceptance and Commitment Therapy (ACT), Dialectical Behaviour Therapy (DBT), Internal Family Systems (IFS) therapy. Again these are different ways to conceptualise our internal worlds and workings. I see them as tools that can be helpful within a CAT framework.

Whilst we are here, lets acknowledge that making change and the process by which you do this, does have some risks. Sometimes looking into your past, or facing your difficulties head on can stir things up and elicit lots of feelings that can be hard to tolerate. It is important that you feel safe and contained by your therapist to support you whilst you work through the hard stuff. We should also recognise the influence you have on others, so if you change that can impact your relationships. For example, if people think of you as someone they can rely on and perhaps take advantage of (consciously or unconsciously) and you work on having limits and saying no, then that is likely to be hard for some of those around you to tolerate initially. However long term, it might mean that the relationships you have are healthier and more sustainable.

For completion, it probably worth thinking about the different between counselling and psychotherapy. Sometimes people mean the same things and use them interchangeably but there are some significant differences – how your counsellor or therapist thinks about your difficulties (counselling generally is more directive whilst therapy more explorative), the time frame they will take (therapy generally lasts longer), the problems dealt with (counselling being particularly day to day problem focused and dealing with one issue at a time, psychotherapy looking with greater depth and what underlies difficulties).

And finally, we should acknowledge that the term ‘therapist’ is not protected and just about anyone can call themselves a therapist of a counsellor. Its important to check someone’s credentials. Personally as well as being an accredited CAT therapist (member of ACAT), I am a GMC registered psychiatrist.

I hope you have found this honest, helpful, respectful, compassionate? Sounds almost like the beginning of a therapeutic relationship! If interested in thinking more about making change then make a free booking today.