Ryle, A., 2001. CAT's Dialogic Perspective on the Self. Reformulation, ACAT News Autumn, p.x.
The word "Self" is more often used than defined. It is a reification and is often best seen as an abbreviation for self processes, but the word also and importantly carries the implication of sameness, identity, continuity and of distinctness from other. Self may be defined as narrative or by role and context, it may be seen as continuous and coherent or as discontinuous and incoherent and variously as a unity, a confederation or a loose assembly of component sub-selves. In the psychological literature it most frequently appears as hyphenated, for example in self-esteem, self-regard, self-doubt, a fact which raises the question as to who is esteeming, regarding or doubting what. William James answered the question by proposing that the self can be understood only as a relation between two parts "a stream of thought each part of which as ‘I’ can remember those that went before and can emphasise and care paramountly for certain ones among them such as ‘me’." A man’s "me" he described as an empirical aggregate of things objectively known, in otherwise this sense the "sum total of all that he can call his" and incorporating the material, social and spiritual selves and "pure ego".
James's I-Me distinction supposes a divided self but does not describe the parts as being in dialogue. Mead (1965), however, was one of the early writers to propose both the central importance of internal dialogue and its origin in external relations, stating that, "The self, as that which can be an object to itself, is essentially a social structure, and it arises in social experience..." and suggesting that the essence of self, "lies in the internalised conversation of gestures which constitutes thinking or in terms of which thought or reflection proceeds". This view is close to the ideas incorporated in the current, still developing CAT model, the evolution of which will now be described.
In common with most psychotherapy theories the idea of self was incompletely explored in the early CAT literature. The initial model was based on the integration of the new cognitive psychology with a translation and partial revision of object relations ideas. The resulting Procedural Sequence Model (Ryle, 1982) was an essentially cognitive model but it was not cognitivist in the sense that it did not regard individual psychological processes as being generators of behaviour. Thus the procedural sequence describes experience and activity in terms of continuing sequences involving context, individual perceptions, conditions, affects and judgements, plans of action and enactments and consequences (with particular emphasis on the responses of others). The model emphasised the way in which the procedural learning of the child takes place without conscious reflection but, in the adults, is not inaccessible to it. The effects attributed to the dynamic unconscious by traditional psychoanalysis were described in terms of the avoidant or restrictive procedures which, in CAT clinical practice, are described in the reformulation. The subsequent development of the Procedural Sequence Object Relations Model involved a rejection of many psychoanalytic assumptions about the dynamic unconscious but included an appreciation of Ogden's proposal that both poles of early object relationships are learned, an understanding re-stated in the concept of the reciprocal role procedure which became a fundamental element in the CAT model of early development and in the transformed accounts of transference, counter transference and projective identification (Ryle, 1985).
These developments were accompanied by the attempt to derive a theory compatible with the rapidly expanding observational research on early development, notably through the work of Stern (1985). The issue of how to conceptualise the self remained incompletely addressed, however; individuals were conceived of as essentially the sum of their reciprocal role procedures.
Over the past decade, influence of Leiman's introduction of the ideas of Vygotsky and Bakhtin (Leiman, 1994) and further developments examining the interplay of biological and social influences on development have established a dialogical perspective on the self. The nature-nurture controversy has been largely resolved by an understanding of the way in which human biological evolution, occurring in an evolving social context has resulted in our extreme openness to social formation; in the words of Aitken and Trevarthen (1997), "the dependence of the child on co-operative understanding and cultural learning is part of human genetic inheritance" and this is "firmly grounded in the developmental neurobiology of the infant." This work provides support for Leiman’s transfer of Vygotsky’s account of the older child's intellectual learning to the earliest phases of the development of self and for the relevance of Vygotskian ideas to psychotherapy.
Three linked ideas of relevance to therapy as well as to early development may be summarised.
defined as the gap between what a child can do unaided and what it can do with the provision of appropriate help from a more experienced other. The more experienced other provides a "scaffolding" of support, sequencing planning and pacing as well as tools and concepts which are handed over as the child acquires them. How this scaffolding is provided will have important implications; an authoritarian structure will inhibit the child's capacity for discovery and trust in the self, and an incomprehensible, incoherent structure will leave exploration undirected (Cheyne & Tarulli, 1999). Similar considerations apply to therapy - it is not difficult to locate different models by this distinction. Ideally, the scaffolding should be adjusted to the child or patient’s current capacity and should encourage increasing autonomy, questioning and debate.
"What the child does with an adult to date she will do on her own tomorrow" - more generally, learning takes place on a two planes, the first external and the second internal.
Internalisation by means of science is crucially different to the concept of representation as used by both cognitive and psychoanalytic writers. I can perhaps illustrate the difference by an example. A quarter of a century ago I sailed across the Channel three or four times. I was not guided by photographs (representations) of the Channel or of the French coast, nor did I rely on the information store of a marine encyclopaedia. I used culturally provided tools (compass, echo sounder, radio direction finder) and I had acquired enough culturally shared knowledge to interpret the conventional signs on Admiralty charts concerning depths, hazards and navigational aids, to make sense of the patterns of lights on ships and boys, to obey the rules for avoiding a collision at sea, to calculate tidal flows from tide charts, and much more. I was, in these ways, to a very modest degree, a member of the navigational culture. Navigating through life requires in the same way the internalisation of culturally appropriate skills and understandings through sign mediation.
Whereas intersubjectivity is now granted a central place in most developmental accounts and while most theories grant that self processes are best described in terms of some interaction between parts or aspects, derived in the case of object relations theories from early parent-child interactions, they are not dialogical in the way now proposed. Dialogue implies two participants and the use of shared language. An individual’s reciprocal role procedures evolve from internalising outer experience and this involves infants and mothers in using increasingly developed signs. These signs are elaborated, for example, from joint action sequences, imitation, amplification, taking turns, reciprocation, mutual gestures, social referencing and the mother’s attributions of meaning to the child’s gestures, expressions and activity.
In early development the psychological unit is the baby-mother; as Winnicott said, "there is no such thing as an infant" and in his description of the transitional object, standing for the mother in her absence, he provided an example of a mutually developed interpsychological sign. Such signs acquired during biological maturation are crucial determinants of individual development. According to Vygotsky, "mastery of a psychological tool and through it of a natural psychological function raises the particular function to a higher level", a fact which more recently has been shown it to be reflected not only in the procedural repertoire but also in the shaping of neurological tracts (see, for example, Eisenberg, 1995).
This dialogical account of early development stands in stark contrast to the Kleinian view, summarised by Segal’s statement, "The immature ego of the infant is exposed from birth to the anxiety stirred up by the inborn polarity of instincts … the life instinct and the death instinct" (Segal, 1988). It is expressed poetically by Bakhtin (1986): "just as the body is formed initially in the mother’s body (womb), a person’s consciousness awakens wrapped in another’s consciousness". It is distinguished from monadic understandings which local the source of self functions in the individual and from the Cartesian explanation of this, replacing, "I think therefore I am" with, "We engage and communicate, therefore I become". Dialogue continues through life, both external dialogue with others and the internal dialogue representing the transformed conversations of early development. Our ability to keep these internal conversations private, combined with the intensely individualistic ideology accompanying the development of capitalism in Western Europe during the last few centuries, supports an intense conviction in the centrality of the "I" which, for many people, is as hard to abandon as was the belief that the world was the centre of the cosmos. In the dialogic view, however, the self remains permeable throughout life, generating and responding to other selves directly and through accumulated words and other artefacts.
Some other psychotherapy theories propose models of the self, for example Kohut’s attempt to introduce the notion into psychoanalysis which, in my view, remains entangled in classical theory. In cognitive therapy Guidano has struggled with the problem but remains limited by his monadic cognitivist assumptions whereby individuals "actively construct" a uniquely private view from within" (Guidano, 1987). In discussing how infants acquire a "theory of mind" Fonagy and Target (1997) reject the cognitive view of the child as an "isolated processor of information" but their description of how a mother mirrors and contains a child’s anxiety is somewhat contorted: "The mother’s representation of the infant’s affect is represented by the child and is mapped onto the representation of his self-state." This "two cartographers" account could be labelled as monadic intersubjectivity, a position which, to varying degrees, still colours much observational research where, as in attachment theory, there is no concept of the role of signs. The dialogic view of the self proposed here offers a way of many conceptual problems and a basis for the critical examination of a wide range of therapies and theories.
CAT theory could be called a semiotic object relations theory. As regard practice, the dialogic perspective reminds us of the importance of our jointly elaborated reformulation procedures, which produce the focused signs which assist internalisation of the reparative dialogue of therapy. And it reminds us that we are always in the patient’s field seen as reciprocating or failing to reciprocate their role procedures or as imposing ours, not only in what we say, but in how, and in what context we say it.
The CAT model evolved largely from modifications of Object Relations theories and from the introduction of Vygotskian and Bakhtinian ideas, but always attempted to be compatible with observational research. Such research has expanded enormously since CAT emerged and it is encouraging to find that a recent comprehensive review by Trevarthen and Aitken (2001) offers a mass of detailed support for the proposition that human infants are uniquely equipped biologically to be formed socially. The authors note the usual preoccupations of psychologists with object awareness as opposed to person awareness and argue for the general and clinical importance of the latter, whereby children learn, ‘how to mean’ through, "dialogic exchanges of emotive and referential narratives in body mimesis ... language and learning ... a cultural accumulation of well-reasoned knowledge and strategic technical skills" (p.4). Densely (but not always elegantly) written, this paper is likely to be a key text on infant development and an important challenge to "individualist, constructivist and cognitive theory". For the academic CAT person there are 15 pages of references, mostly from the 1970s to the 1990s.
Aitken, K.J. & Trevarthen, C. (1997) "Self/Other Organisation in Human Psychological Development." Development and Psychopathology, 9, 653-677.
Bakhtin, M. (1986) "Speech Genres and Other Late Essays." Austin, University of Texas Press.
Cheyne, J.A. & Tarulli, D. (1999) "Dialogue, Difference and Voice in the Zone of Proximal Development." Theory and Psychology, 9, 5-28.
Eisenberg, L. (1995) "The Social Construction of the Human Brain." American Journal of Psychiatry, 152, 1563-1575.
Fonagy, P. & Target, M. (1997) "Attachment and Reflective Function: Their Role in Self-psychopathology and Therapy." Development and psychopathology, 9, 679-700.
Guidano, V.F. (1987) "Complexity of the Self; a Developmental Approach to Psychopathology and Therapy." New York, Guilford Press.
Leiman, M. (1984) "The Concept of Sign in the Work of Vygotsky, Winnicott and Bakhtin; further integration of object relations theory and activity theory." British Journal of Medical Psychology, 65, 209-221.
Mead, G.H. (1934) "Mind, Self and Society." Chicago, University of Chicago Press.
Ryle, A. (1982) "Psychotherapy; a Cognitive Integration of Theory and Practice." London, Academic Press.
Ryle, A. (1985) "Cognitive Theory, Object Relations and the Self." British Journal of Medical Psychology, 58, 1-7
Segal, H. (1988) "Introduction to the work of Melanie Klein." London, Karnac.
Stern, D.N. (1985) "The Interpersonal World of the Infant: A View from Psychoanalysis and Developmental Psychology." New York, Basic Books.
Trevarthen, C. and Aitken, K.J. (2001) "Infant Intersubjectivity: Research, Theory, and Clinical Applications." Journal of Child Psychology and Psychiatry, 42, 1, 3-48.
The issues discussed here are more fully considered in the forthcoming Introducing Cognitive Analytic Therapy; principles and practice. This is co-authored with Ian Kerr and our discussion, plus and ongoing dialogue with Mikael Leiman, played a large part in these later attempts at clarifying CAT theory.
The following books deal with related topics. Social selves; theories of the social formation of personality by Ian Burkitt (Sage paperback) Sociogenetic perspectives on internalisation. Mahwah, New Jersey. L. Erlbaum Associates.
Some reflections on the Malaga International CAT Conference "Mental health in a changing world"
Maria-Anne Bernard-Arbuz, 2013. Some reflections on the Malaga International CAT Conference "Mental health in a changing world". Reformulation, Winter, p.50.
What's it like to have Cognitive Analytic Therapy?
Sloper, J., 2002. What's it like to have Cognitive Analytic Therapy?. Reformulation, ACAT News Spring, p.x.
A Randomised Controlled Trial of the Efficacy of CAT for the Treatment of Personality Disorder
Clarke, S., 2001. A Randomised Controlled Trial of the Efficacy of CAT for the Treatment of Personality Disorder. Reformulation, ACAT News Autumn, p.x.
Borderline Traits and Dissociated States in Later Life
Hepple, J., 2001. Borderline Traits and Dissociated States in Later Life. Reformulation, ACAT News Autumn, p.x.
Reconstructing the Infant : Review of 'The Interpersonal World of The Infant' by Daniel Stern
Scott Stewart, M., 2001. Reconstructing the Infant : Review of 'The Interpersonal World of The Infant' by Daniel Stern. Reformulation, ACAT News Autumn, p.x.
Research and Cognitive Analytic Therapy: What do we need to know?
Pollard, R., 2001. Research and Cognitive Analytic Therapy: What do we need to know?. Reformulation, ACAT News Autumn, p.x.
Some of the Historical and Cultural Background to the Self
Pollard, R., 2001. Some of the Historical and Cultural Background to the Self. Reformulation, ACAT News Autumn, p.x.
The Development of Self in Early Experience: Borderline Mothers and Their Infants
Danon, G., Rosenblum, O. and LeNestour, A., 2001. The Development of Self in Early Experience: Borderline Mothers and Their Infants. Reformulation, ACAT News Autumn, p.x.
The impact of illness on the therapist's self and the handling and use of this in therapy
Wilton, A., 2001. The impact of illness on the therapist's self and the handling and use of this in therapy. Reformulation, ACAT News Autumn, p.x.
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