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Letter from the Editors

Hepple, J., Lloyd, J. and Shea, C., 2011. Letter from the Editors. Reformulation, Summer, p.3.

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This issue comes out at a difficult time for public services faced with draconian and often arbitrary cuts on a scale not seen before since the inception of the NHS in 1948. As CAT at its heart is relational, it is hardly surprising that a number of the contributions offered by the CAT community in this edition are of a political nature. This political and social discussion is also timely as several articles hitting the press in this edition respond to Tony’s recent political paper and to Rhona Brown’s development of his themes.

Rhona Brown’s powerful and moving fictional account of a CAT with a female Kurdish refugee brings to us what it is like to be disposed, powerless and at the mercy of blind political forces which neither care nor even acknowledge. Jessie Emilon’s paper describes actual cases, exploring what working with an interpreter brings to the RRs enacted in the room. Working with interpreters raises many complex issues especially around the interpreter’s influence (helpful or unhelpful) on transference and counter transference within the therapeutic relationship. Josephine Ahmadi’s paper is also feminist and political; dealing with the structures of dominance and a way of applying these insights intra- and interpersonally. Ahmadi describes how structures of dominance are maintained by being internalised in the form of blaming ↔ blamed. She makes clear that whether we blame the victim who has been so deeply imprinted by trauma that he cannot help but replicate it, or whether we blame ourselves, this is the inner operation of the dominant-dominated culture and it is also what ensures its perpetuation. Her paper lifts us all up to the polyvalent perspective of an observing eye.

Yvonne Waft’s paper on the constraints and limitations of a NICE approach to evidence is again political, although perhaps this time with a small ‘p’ because her paper describes how NICE attempts to sculpture psychological therapy services. The irony about “evidence-based CBT” is that commissioners, GPs, and the lay public have the idea that “CBT is evidence-based” - for everything, owing to their flawed interpretation of the evidence. Because of the diagnostic approach of NICE (hereby betraying its medical origins), CBT colleagues may end up with referrals for people with complex transdiagnostic relational issues that they are ill-equipped to cope with. Waft explores possible RRs between NICE and CAT practitioners and wonders about how to achieve a more constructive dialogue.

Rachel Pollard’s extended review of Parker’s book is a way into both Lacan and a critique of psychotherapy and psychoanalysis. Rachel gives treble value, situating these alongside CAT, both philosophically and practically. From a different angle, Rose Hughes’ personal letter is a generous gift to us, describing her father’s death and her observations of what Reciprocal Roles were surrounding him. This letter is another example of how the personal and political are merged.

A second theme to emerge from current submissions explores CAT’s use of imagery, story and expression. Steve Jefferis describes how films offer therapeutically useful insights, and Kim Dent-Brown distils his extensive experience of using the Six Part Story Technique as an assessment tool in CAT. James Turner has here the first of two papers on his use of visual metaphor to enrich dialogue in therapy. This first paper describes his research and in the next edition, we will publish some of his clinical usage of visual metaphor. Liz Wilde McCormick write a review from a CAT perspective on a new book on Mindfulness.

Continuing the CAT Community’s aim of improving CAT practice, Catherine McCombie and Aoife Pettit describe an imaginatively designed audit of Goodbye letters written by clients to their therapists in an NHS trust, aiming at seeing whether these letters describe experiences of therapy consistent with both CAT and local NHS stated values. Alison Jenaway offers an idea on deepening the sequential diagrammatic reformulation through drawing out what infant’s experience thereby inviting a connection between the needs and frustrations of babies and relational patterns the adult contends with nowadays. This third theme of developing CAT practice is also described in an audit and account of offering standard CAT to three adults with acquired brain injury who presented with roadblocks in utilising normal rehabilitation processes owing to their pre-existing Reciprocal Role Procedures.

Last, but not least, we again have some fun with the 16+1 interview with a willing victim; Mark Westacott in his new position as ex-chair of ACAT….look out Jason Hepple who interviewed Mark; the tide may turn…..

We are delighted that Catherine Shea has joined us as a third Editor. She has the ability to look not just at the detail of a paper, but to look at it really dialogically. She also has the sensitivity to “voice” within the text, and to how authors switch voices, which she is able to describe to them. We are enjoying working with her, as she adds to the perceptiveness, kindness, open mindedness and honesty in the team. Catherine works at the Well Spring Centre for Psychotherapy and the Crossreach Postnatal Depression Service, both in Edinburgh.

We would like to thank Annie Nehmad for helping with editing and proof-reading.

We continue to be in a steep learning curve, working out how to edit, and we are grateful for your patience!
Jason Hepple, Julie Lloyd and Catherine Shea
reformulation@acat.me.uk

Full Reference

Hepple, J., Lloyd, J. and Shea, C., 2011. Letter from the Editors. Reformulation, Summer, p.3.

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