Wilde McCormick, E., 2008. How to Enjoy Writing a Prose Reformulation. Reformulation, Summer, pp.16-17.
This presentation took the form of an hour experiential workshop with participants spending time first in inner dialogue with their inner writer, then working individually with cards, sharing in pairs, and finally writing a paragraph as part of a reformulation and reading aloud within the group.
There are often fears expressed around having to write a prose reformulation, known colloquially by many CAT students as ‘the letter’. Writing is a form of intimate conversation and the CAT reformulation offers us a way of communicating with our patients that lives on in black and white. But many of us experience negative feelings or blocks. In writing we are putting ourselves in there, putting ourselves and our way of expression on the line. So the first step in the workshop was to explore the inner dialogue around writing.
Just sit quietly with eyes closed or at a half glance and ponder on what you notice when you have to write a reformulation. Notice any obstacles in your thinking such as:
“I can’t write”
“I just go blank.”
“I won’t get it right”
Whatever it is, just allow all the statements to arise.
Notice how your body feels when one of these statements arises and see if you can describe the reciprocal role that underpins the statement:
Critical judging in relation to judged. Dismissing in relation to dismissed. Punishingly idealising (I MUST get it perfectly right) in relation to rubbishingly dismissive and given up.
Now imagine ring fencing these reciprocal roles. Use a red cord to make a fence around them and tie a knot in it. These reciprocal roles that act as blocks to creativity are, for the next hour, ring fenced safely so that you can experiment with the space without them. They are not to break that red cord. If they do, make sure to get them back in there.
Now turn and face the other way. The way facing you is your own voice. It’s whatever you want to say. It’s the voice you share with your patient. It draws on all you say in the room and all you think when you are looking through the notes and when you think about the person. Just let all these things you take for granted now have full space. Thank them, value them for you are now going to let them out to play and allow them to have a proper voice.
We are not actually going to write anything yet, we are just preparing the ground in the same way we would till the soil and nourish it before planting seed. The seeds today are the seeds of your own awareness and recognition about your patient. So just spend a few minutes imagining sitting down wherever you would like to sit to write your letter. It might be by computer, by hand, you might be composing whilst walking around the garden, sitting in a cafe, driving your car, at your desk…
This is a basic exercise I have learned to practice over the years I have been attending writing workshops. It helps to free up our imagination and our flow of words, metaphor and poetry. It helps to move us away from the demands of the left brain and into the more reflective right brain, and it helps link us to our creative capacity.
I keep a box of old cards – from Christmas, birthday, and postcards of all kinds. Using a picture can be a useful device to help stimulate the imagination. In this exercise, I poured the box of mixed cards into the centre of the floor and invited the participants to contemplate in the following way before choosing a card:
Spend a few moments thinking about the person you want to write about. If you had an image for them, and for the two of you in the dance of therapy, what would it be?
If you could choose a colour, shape or image what would it be?
What main reciprocal roles are being danced between you?
Merging in relation to merged
Confusing in relation to confused
Critical judging in relation to judged/criticised
Listening respectfully to listened to and heard
Now spend time choosing a card and take it back to your seat and examine it. Pick out aspects that have drawn you to the card AND ALLOW THE IMAGES ON THE CARD TO EXPAND INTO A STORY. So place your concentration now on the card you have chosen, not on the person you are to write about. Let yourself go. Be a bit fanciful now …
Using free-floating stream of consciousness, just write whatever comes to you on the A4 white sheet. (five minutes for this)
Then group the themes – the traps, dilemmas, snags, the reciprocal roles, the procedures by ring-fencing them on the white sheet.
Now take each theme or procedure and use the coloured stickers or cards, one for each theme.
The idea is when you have found the metaphor or theme around the procedure and separated it; you have more time to think about it and how you want to write it. It also allows us to write in small steps, rather than become overwhelmed by thinking of the whole letter.
I offered an example by preparing the white A4 sheet and coloured stickers in advance and offered this as a way forward.
I did the exercise and thought about the person I might write about - not a patient in fact. I was drawn to a card showing a barn owl flying over a snowy winter scene.
When I studied it I was drawn into the drama of the picture and I wrote the following: ‘Loner’. ‘Wintry feeling.’ ‘Beautiful.’ There was a coldness and aloofness in the picture as well as beauty, and a sense of things being hidden, perhaps waiting for spring.
I happen to really like owls and spend time listening for them and watching them so I was curious about the mixture of feelings the picture invited. Not dissimilar from the person in my mind.
Then I pondered on the reciprocal role of the owl flying past over the silent frozen earth and I got a glimpse of a dilemma ‘If I don’t keep flying, they will get me; if I keep on flying I can get anything.’
This was also not dissimilar to the experience I have in relation to the person where the reciprocal role of controlling in relation to controlled is a dance between us. There is also the image of the loner: ‘ I’m in control, I can be on my own and fly where I like.’ And then pondering on the other end of the role – controlled but frozen and alone.
I thought about the healthy island, and for an owl this has to be the ability to fly and to prey and to come alive at night, to watch and wait and develop wisdom. And so my imagination kept informing me of possibles…
I looked at the shadow in the distance, the sense of a storm coming and I wondered what might be hidden. I had the image of a frozen heart, and of something predatory in relation to preyed upon and I remembered this person once telling me of an uncle who spied upon her when she was a little girl and was always waiting to touch her body.
I thought also of the beauty of the picture and the sense of so much waiting to come to life. If this were a therapy situation with a presenting problem and permission to work, the therapeutic work might be in finding an appropriate connection in relationships whilst keeping the original owl nature.
So the cards are a stimulus and help to loosen the soil around our creativity.
I invited the workshop participants to make a story about their card and read it to another participant and then feed back to the whole group. This seemed to be taken up enthusiastically.
And then we settled upon the (more serious maybe) more focussed work of writing a paragraph for a reformulation from the card, the stickers and the conversation. After ten minutes, we had enough time for five people to read their sentence or paragraph.
KEEP IT SIMPLE!
USE AS MANY OF THE PATIENT’S OWN WORDS AND METAPHORS AS POSSIBLE
PUT YOURSELF INTO IT – DON’T BE AFRAID TO BE IMAGINATIVE
A REFORMULATION, LIKE ANY PIECE OF WRITING WILL HAVE A BEGINNING, MIDDLE AND END.
THE BEGINNING needs to give an overview of the meeting and purpose of the sessions. For example:
“You have sought this short term therapy because of…the incident with the…”
“After feeling for some time that…you would never get over the death of your… “
“We are meeting together to explore the difficult relationship with…”
THE MIDDLE needs to explore the history and roots of the problems and the traps, dilemmas, snags and unstable states that have been the means to cope with chronically endured pain but which actually reinforce the false beliefs and the pain itself.
THE END needs to make reference to what might be possible in the therapy in relation to the procedures and their revision and this might be very modest. Included will be the possible transference invitations through reference to the reciprocal roles. So if naming merging in relation to merged as a reciprocal role stating how this might be invited in the work so that it is already out there and can be referred to if things get sticky.
A credit-card sized SDR and its use with a patient with limited language skills.
Fitzsimmons, M, 2000. A credit-card sized SDR and its use with a patient with limited language skills.. Reformulation, ACAT News Autumn, p.x.
“Playing” with CAT - Using a CAT Informed Approach with Young Children and their Families
Jo Varela, 2016. “Playing” with CAT - Using a CAT Informed Approach with Young Children and their Families. Reformulation, Summer, pp.6-10.
Clinical Implications for the Pregnant CAT Therapist
Knight, A., 2008. Clinical Implications for the Pregnant CAT Therapist. Reformulation, Summer, pp.38-41.
Integration of Cognitive Analytic Therapy Understandings
Ruppert, M., Birchnall, Z., Bruton, C., Christianson, S., 2008. Integration of Cognitive Analytic Therapy Understandings. Reformulation, Summer, pp.20-22.
Metaprocedures in Normal Development and in Therapy
Hayward, M., McCurrie, C., 2008. Metaprocedures in Normal Development and in Therapy. Reformulation, Summer, pp.42-45.
The â€˜Human Givensâ€™ Fast Trauma and Phobia Cure
Jenaway, A., 2008. The â€˜Human Givensâ€™ Fast Trauma and Phobia Cure. Reformulation, Summer, pp.14-15.
The Development of the Sequential Diagrammatic Reformulation
Parkinson, R., 2008. The Development of the Sequential Diagrammatic Reformulation. Reformulation, Summer, pp.33-37.
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