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A New Concept of Understanding CAT and Hermeneutics

Bobvos-Bekefi, M., 2014. A New Concept of Understanding CAT and Hermeneutics. Reformulation, Winter, pp.22-32.

In this article, I analyse whether the hermeneutic approach could enrich the theory and practice of CAT, since in my experience, CAT is based on a relatively new hermeneutical concept of understanding.
I will:
-Briefly discuss the directions of the hermeneutical approaches to psychotherapy in the professional literature. I will also explain my own motivations behind my focus on the matter of understanding, including the relationship between CAT and hermeneutics.
-Outline the meaning of philosophical hermeneutics, primarily based on the work of Hans-Georg Gadamer.
Write about the development of dialogue with Gadamer, the overlapping theories between him and Mikhail Bakhtin and finally, the theoretical and practical possibilities of a hermeneutical approach to CAT.

Hermeneutics and Psychotherapy
Philosophical hermeneutics constitute a meta-theory of knowledge, based on the description and analysis of the understanding process in every field of existence, including human communication – both verbal and non-verbal – as well as science and art. The hermeneutic approach features a relatively broad literature in the theory of psychotherapy, thus offering considerable potential for further research, including within the field of CAT.

When I was learning CAT, as a trained philosopher, from the very beginning I studied the method through “hermeneutical eyes”. This continuous hermeneutical reflection has not limited me in gaining a better understanding of CAT; to the contrary, it even assisted me. Furthermore, I was increasingly looking at CAT as a hermeneutical practice.

A large part of the literature on the subject underlines the historical, sociological, political and moral determination of both the client and the therapist and the need to pay necessary attention to this during the process of the therapy. The client and the therapist are not isolated subjects in the process of therapy but rather, in the course of the open dialogue, among those who enlarge the borders of understanding and self-understanding. (Martin, J. and Thompson, J., 2003).

We also find examples in the professional literature, where the theoretical and practical application of the hermeneutical model of understanding is a precondition for the competency and professionalism of the psychotherapist and the assessment of the therapy is based on the method and success of the hermeneutical approach (Rory Owen, I., 2006). The writings related to the practice of psychotherapy consider the notion of understanding to be an “open-ended process of interpretation”, stating the importance of hermeneutical conceptualisation in the process of the dialogue (Prall, W., 2000).

I also have to acknowledge some of the literature on Gadamer and relational psychoanalysis. Gadamer’s approach to psychoanalysis is critical. He accepts that psychoanalysis is a hermeneutical situation, but criticizes the asymmetrical relationship and the authoritarian communication between the analyst and the patient (Gadamer, 1996). The patient’s voluntary submission is a preliminary argument and the analysis is a play of language from which there is no escape: the patient has to communicate everything (Di Cesare, D., 2013). Through the critical dimension of understanding, Gadamer demystifies the analyst’s role and this leads to a regained balance between the therapist and the patient (Orange, D. M., 2009). Reinforcing the critical reflexive knowledge of the analyst by using hermeneutics gives a chance to reform psychoanalysis (Orange, D. M., 2011).

In my opinion, CAT is a type of reformed psychoanalysis. Of course, in reality, CAT is much more complex – since psychoanalysis is just one of its sources. In CAT, we focus on the RRP “understanding-understood”, instead of the RRP “analyzing-analysed”.

Why the Subject of Understanding?
My experience as a philosopher has also led to my consideration of why CAT theory and practice does not more explicitly acknowledge its hermeneutic aspect, particularly as it is CAT’s goal to base its general theory on an integrated model of psychotherapy and “it does not represent solely a new package of techniques” (Ryle, A. and Kerr, I. B., 2002).

I was interested in why CAT draws on the ideas of two Soviet-Russian - “Eastern” - philosophers and psychologists : Vygotsky and Bakhtin. Having studied these Marxist theoreticians and psychologists at length, my concern lies with why CAT “neglects” Western theories of inter-subjectivity, such as Schleiermacher, Heidegger, Habermas, Barthes, Riceur, Foucault, Derrida and especially Gadamer, because of the similarities between some of his ideas and those of Bakhtin.

Could it be because of the “freshness” of the Marxist theory? Or because of the “exotic” nature of the Russian thinkers, who tend to echo Western thoughts with a more vivid, colorful and original approach? Or is it due to the interest in the English translations of the Russian authors and the reception in the mostly left-wing oriented intellectual and scientific circles in the West? These are exciting questions indeed, themselves deserving another hermeneutical analysis…

The overlaps between the Western and Eastern traditions could well originate from the common philosophical tradition, which will be explained later on in detail.

While studying CAT, it also became clear to me that it combines two different forms of obtaining and interpreting knowledge: “a posteriori” and “a priori”.

“A posteriori” knowledge is created by gaining experience in practical life and then explaining this with the theory created afterwards. The “a priori” knowledge first creates a theory, usually of ontological character (ontology is the philosophical study of existence), and then tries to verify it in practice. These two approaches have developed in parallel in the history of science and philosophy. The scientific and philosophical traditions used by CAT are not homogenous in this respect.

Figure I shows how hermeneutics may unify the two approaches.
The Scientific & Philosophical Traditions used by CAT & Hermeneutics

“a priori” / “a posteriori” classification

Hermeneutics

Theory of Understanding as a Meta-theory of Knowledge that Unifies Both Above Approaches

In the course of my therapeutic work, it has become clear that the CAT method is based on what could be thought of as a new relational model of understanding. This became evident in the following areas: the identification of the patient’s target problems procedures (TPPs) and reciprocal role procedures (RRPs), the practice of diagram building, the reformulation, and the co-operative and time-limited nature of the therapeutic process itself.

I have found this new model is especially useful in the interpretation and handling of cultural differences in the therapeutic procedure and supervision, by reinforcing the critical reflexive approach.

Being Hungarian, I felt slightly “culturally challenged” in the course of studying CAT in the UK, despite a lot of cultural similarities between the UK and Hungary.

The “understanding-being understood” RRP is extremely important for me personally and has been of great influence in my career path and in satisfaction with work.

Philosophical Hermeneutics
The word “hermeneutics” comes from the Greek verb “hermeneuen”, meaning “to interpret”, “to translate”. This could include: a search for the hidden or complex meanings, or to express the unspoken, translation, and explanation of a difficult text. Hermeneutics is also related to the Greek god Hermes, the messenger, who also symbolizes any mediated communication. In the history of philosophy, it is also connected to the analysis and interpretation of Sacred Scripture in the 19th century in the works of Schleiermacher, who described the circulatory movement of textual interpretation between the entire text and its components (Schleiermacher, F., 1998).

Gadamer goes back to the Greek tradition of the Socratic dialogue: to the method of interpretation as a technique of understanding and the search for the truth.

All of the highlighted terms below are derived from Gadamer’s own set of terminology. In his Magnum Opus, “Truth and Method” (1960, German original edition; Gadamer, H.-G., 1975), Gadamer explains the foundation of his philosophical hermeneutics: Understanding is not just an existential act, but also a historical, linguistic and dialectical one. Unlike Descartes’ method of pure, rational enquiry that in Gadamer’s view does not fulfill the understanding process and the search for the truth, philosophical hermeneutics is not only analytic and descriptive, but dialectical and dynamic as well. Gadamer, drawing on Heidegger, introduces a new phrase: the fusion of horizons. This refers to a shared understanding of the participants in the discussion, or the “dialogue”.

Obviously, this cannot be a perfect understanding, but rather an approximation, derived from the explanation of the dialogue and dialectics as a method in Gadamer’s philosophy. The consciousness of the participants in the discussion is embedded in time, space and culture; it is a historical consciousness, because the understanding is embedded in history. The tradition constitutes the historical horizons of consciousness.

In the understanding process, the interpreter uses preliminary hypotheses, expectations and presuppositions. These are determined by the effective historical consciousness which shows how the historical consciousness is affected by tradition. In a dialectic process and through repeated comparison, the interpreter continually revises the correctness of interpretations. This systematically open process is the hermeneutic circle that echoes the process of understanding in CAT, in which interpretation and revised understanding is a collaborative process.

The basis of all this is the generalization of the concept of dialogue, which explains the central role of the language in Gadamer’s hermeneutics. Gadamer differentiates three steps in the experience: understanding, explication and application. Ideally, explication is at the same time an application. Application is the practical side of understanding so ideal explication shows how we use knowledge, how we apply and incorporate it in practice (e.g. studying CAT).

The Development of Dialogue with Gadamer
In the works of Gadamer, dialogism (dialogism means the use of different viewpoints in a text; discussion which leads to a deduction), as the reflection of dialectics (dialectic is a method of argument for resolving disagreement) in practice, is of key importance. The real goal of philosophy, according to Gadamer, is to show how understanding can happen and why language is the medium in which understanding takes place. In his early works, Gadamer shows the connections and continuity between the philosophies of Socrates, Plato and Aristotle. These three are all connected by dialectics and dialogism (Gadamer, H-G., 1975).

Gadamer, in “How Discussion and Conjunction Occur?” (1992), defines the dialectics of Plato as a dialogical conjunction, as a co-operation with the other party (in : Sullivan, Robert R., 1989).

The role of the dialogue is taken over by “techne”, the Greek scientific ideal, which, as an experience (“episteme”), is a totality of latent dialogues. It is a “knowledge” based on assumption, which, due to its predictive nature, is aimed at the possession of the security of the world. Moreover, Gadamer deducts the process from “techne” (techne is the implication of knowledge of principles; it is concrete, variable and context dependent) to “logos” (logos is a principal of order, knowledge, reasoned discourse, argument, and word). These cumulate upon each other, from Plato to Aristotle, and he builds up his differentiated language-philosophy by the classification of the execution forms of “logos” (in this instance, referring to speech).

Classifications

The classifications are as follows:

The original form of speech is speaking to each other, understanding the other party (as the “other”); it is the search for theoretical speech, namely knowledge and the reasons behind it.

The subject-defining, dialectical discussion: the common ability and joint will for questioning; the conversation, which is a manifestation of “logos”, targets cognition and knowing
The degradation form of the scientific conversation:
“Phtonos”: i.e. envy, being afraid of losing in the conversation, attention paid to ourselves, vanity
“Competitive logos”: sophism, showing the illusion of knowledge. Two sub-categories of it are contradiction and seduction (flattery), both blocking the free responses.
“The all-knowledgeable logos”: undeniable arrogance, manipulation and total exclusion of the other party.

In Plato’s interpretation, Socrates’ dialogue arose from the tension between real scientific conversation and its forms of degradation. It looks for the knowledge of “good”, and is not satisfied with merely the illusion of knowledge. The participants in the dialogue first determine and agree what is false knowledge, which is a condition for finding real knowledge.

Presenting the truth-experience in the dialogue is a very important turn towards the “ethos” of the theory, which unifies knowledge and morality. The “theoretical logos” of Aristotle is based on predicative statements, and therefore has a monologic aspect (i.e. magisterial voice, editor’s note). However, as this apodictic (apodictic means beyond dispute, categorically true or certain) scientific method latently takes for granted the agreement of the other party so it also has a dialogical aspect. It means that the methods used by Aristotle and Socrates/Plato are united, since the predicative statements have a dialogical character as well.

The “logos” analysis shows the central role of language in the tradition of Socrates, Plato and Aristotle. It is precisely using the proof of this continuum that hermeneutics could solve the conflict between “a priori” and “a posteriori” knowledge, by utilizing the meta-theory of understanding. So understanding and dialogism are deeply interconnected in Gadamer’s hermeneutics.
The historical dimension of dialogism is the historically effected consciousness itself: the fusion of time-horizons.
The human experience of the World has a dialectic character. Therefore, the structure of “being” is dialectic. This means that, although human thinking, including scientific thought, is dialectic, the adequate method of thinking is dialogic.

The Bakhtin-Gadamer Parallels

At the beginning of his professional career, Bakhtin was influenced by German philosophy, particularly by Neo-Kantianism and phenomenology (Hermann Cohen, Ernst Cassirer, Max Scheler, Nicolai Hartmann). Gadamer himself, along with Nicolai Hartmann, was the student of Paul Natorp, whose professor, in turn, was Hermann Cohen.

In his early works, Bakhtin already underlines the significance of the experience of over theory, based on Neo-Kantianism (Bakthin, M. M., 1981).

Gadamer, in his hermeneutics, merges the Hegelian (historical, primarily theoretical) tradition into the Kantian one (based on the critique of practical reason) by reaching back to the dialectics of Socrates and Plato.

All of the highlighted terms below are derived from Bakhtin’s own set of terminology. In his study on Dostoevsky (-1984) and in his earlier four essays (-1981), Bakhtin introduces three important concepts that can also be found in Gadamer’s hermeneutics:

Unfinalisability: it is not possible to define and understand the individual self completely and definitely. Understanding could only be completed partially, in personal intimacy. The borders of understanding are not rigid ones. In the case of Gadamer, the process of understanding is executed in the fusion of horizons of the participants, but it is never fully completed – neither in space, nor in time.

The importance of relations to others: because selves are not isolated, but determined by time, space and culture. This is comparable to Gadamer, first in the concept of “Bildung” (the evolution or development of the self) and later-on in the concept of the historically effected consciousness.

Polyphony: the unfinalizability of selves creates the polyphony of selves or voices, so the truth is polyphonic, born in the dialogues of selves/voices. In the case of Bakhtin, the most prominent form of polyphony is the carnival, when uncompleted individual selves act together, in a genuine dialogue. The carnival is a challenge to authority and hierarchy, giving rise to a new scaffolding of human relations.

With Gadamer, understanding is also born in the dialogue, and like Bakthin, he introduces polyphony as a feature of the narrative which includes a diversity of voices and points of view. He also introduces “festivity”, which is the equivalent of the carnival, as the prominent form of polyphony.

For both Gadamer and Bakhtin, it is the dialogue between subjects, in which language is paramount, that stands in the centre as an ontological and political principle (Bakhtin, M. M., 1981, Gadamer, H.-G., 1976). Both in the cases of Bakhtin and Gadamer, language plays a central role, based on the dialogue-theory.

Both Bakhtin and Gadamer see the act of understanding as an ethical and aesthetical principle (Bakhtin, M. M., 1981 and 1984, Gadamer, H.-G., 1975 and 1976).

These are just the main similarities between Bakhtin and Gadamer, which need further research. However, in my opinion, Gadamer’s hermeneutical approach and philosophical analysis of the understanding process is more elaborate and more focused on how understanding happens. Based on Gadamer’s work, we could better understand that CAT is a hermeneutic practice and so CAT’s theory and practice could be enhanced.

Hermeneutics in CAT

In CAT practice hermeneutics, a conceptualised understanding, based on inter-subjectivity, would be exemplified in the therapist’s approach characterised by empathy, dialogue, interpretation and exploration (coexisting in different variations). The therapist becomes an involved participant “hermeneutist”, not a “detached scientist”. The hermeneutic analysis of CAT practice is illustrated in the diagrams below.

Figure II/a represents the basic RRP of understanding in CAT.

Figure II/b represents, by the expanding outer circles, the development of understanding in CAT. Thanks to the hermeneutic approach, the therapist is conscious about how the understanding occurs in the therapy, and the awareness of it is thereby strengthened. The understanding of the entire therapeutic situation expands and develops continually, revisiting each part as new understandings are reached.

Figure II/c represents the process of understanding from the supervisor’s point of view.

Figure III/a and b show the “detached scientist’s” method in psychotherapy as well as the epistemological model of it.

The process of understanding in CAT could be described by the hermeneutic circle: first presuppositions and then insights, recognizing problems, targeting problems, and collaborative identification of RRPs. In the dialogue, as understanding between therapist and client develops, the therapeutic alliance becomes stronger (horizons are closer), and the patient’s self-understanding and capacity for self-reflection develops, assisted by the use of diagrams, the reformulation letter and rating sheets. As the process of understanding develops, previously repressed memories come to light in the secure frame of the therapeutic alliance.

New, positive patterns and outcomes occur because understanding is a creative, open-ended process that produces and reproduces creativity in human behaviour as well. The hermeneutic horizons of the therapist, the patient and their relations would suitably interpret the transference and the counter-transference as well, as shown in Figure II/a, b and c. Moreover, the Zone of Proximal Development (ZPD) (Vygotsky, 1978) of the patient assumes inter-subjectivity, since it can only be interpreted in relation to “the other” and, by the principle of the hermeneutic horizons, it could be understood more clearly and deeply.

Hermeneutic horizon is one’s complex perspective on the world which is constantly changing by interactions with others. It accumulates experience and involves future processes, e.g. developments. The ZPD implies the perspectives of developments by presuppositions, which is future-oriented and does not assume that current performance is determined by a fixed capacity. Understanding in CAT is a fusion of horizons of the therapist and the patient, including the measurement of the patient’s ZPD, as well as an awareness of the therapist’s own limitations.

Recognizing one’s limits could lead to the therapist being more human and accessible and this, indirectly, creates a stronger alliance.

In this approach, it is a big plus to accept that the therapist is not able to be totally detached from his/her own cultural horizon, despite all their efforts, and the therapist also has developmental potential. However, by using the hermeneutical approach, being aware of this fact might assist in the openness, creativity, respect, humility, self-reflection, ability to correct and so forth.

“Therapist and patient roles are not symmetrical, but they are of equal value and the aim should be to base them on openness and mutual respect” (Ryle, A., Kerr, I.B., 2002).

“The hermeneutic research-approach is underestimated in psychology” (Kinsella, E.A., 2006) – in general, however, the awareness of the therapist’s role, the realistic goals and limits in therapy, the perception of a patient, acceptance and understanding transference and counter-transference, as well as handling cultural differences and disabilities (Psaila, C. L., Crowley, V., 2006) would be more intense.

Hermeneutic approach enhances the fact that transference and counter-transference are not side-effects of the therapeutic procedure, but an inherent part of understanding.

The hermeneutical approach to CAT also explains how the New Concept of Understanding (NCU) appears in the different phases and special tools of the therapy.

In my opinion, and based on my personal experience during the therapy, the awareness and undertaking of this hermeneutical approach clearly enriches the CAT-practice.

In the Assessment phase, instead of the “investigating – investigated” model (Figure III/a), introducing the “understanding – understood” model (Figure II/a) helps in avoiding the diagnosis-oriented approach and encourages an open and cooperative attitude towards the patient.

Identification of TPs and TPPs is more rapid and easier because NCU supports focusing on the essentials.
In the Reformulation phase, the identification of RRs and RRPs is the consequence of the cooperative understanding process, which, at the same time, maintains and further motivates the understanding. This can well be explained by the hermeneutical model.

A new, deeper level of understanding makes it necessary for the patient to accept how RRs that date back to an earlier time in their life do define and narrow down the repertoire of behaviour and also how they lead to current problems.

The Reformulation Letter (RL) could be seen as the document of “being understood” for the patient.

“…a lasting document of the therapy to reread, to help assimilate a new understanding of self, over time” (Hamill, M., Reid, M., Reynolds, S., 2008). The personal character of the letter touches the emotional side as well but, at the same time, helps the patient in distancing themselves from the problems.

By changing the framework of understanding, the RL further motivates and reinforces the process of understanding, while also preparing for the further active phases of the therapy.

The Sequential Diagrammatic Reformulation is the imprint, jointly created with the therapist, of the ever deeper and many-fold process of understanding.

In the main course of the therapy, in recognition and revision of unhelpful, repetitive and dysfunctional procedures, the understanding gets deeper. This is supplemented by understanding why, in a given situation, old patterns appear and why new patterns are successful. The usage of Diagrams, the Diary and the Rating Sheet all support this active and focused process of understanding, by providing permanent and many-fold feedbacks. All these further support the self-reflection, self-understanding and, at the end, self-acceptance.

In CAT, the active and cooperative process of understanding is getting more and more complete, and, as a result, a new repertoire of behaviour is created (see Gadamer’s ideas). The maintenance of this is guaranteed by the internalization of the new framework of understanding.

In the Ending phase, the time pressure and the emotional pressure (being cut from the therapist, the person who “understands”) usually speeds up these above-mentioned processes.

The Good-bye Letter (GL) is not only the document of the patient’s understanding, but an imprint of the overall process of joint understanding and the development of the patient’s self-understanding. By rereading the GL, both the process of “understanding” and “being understood”, as well as the road that leads to these, could be reproduced.
Active understanding could be maintained by the usage of the Diary, further use of RS, and the Follow-up Interview.
Finally, the patient acquires a new model of understanding, over time and in the course of the therapy.
She/he sees her/him-self, more and more, as a complex being, harmonizing better within the social matrix and in a new way – this is exactly how the therapist approaches the patient in CAT.

This new form of self-understanding is realised through a new repertoire of behaviour, maintained and re-built by a new, internalised model of understanding.

In addition, the hermeneutic approach (Christopher, J.C, Smith, A.J., 2006) to cultural differences in CAT yields to a brand new perspective; for example, by increasing the awareness and attention to the interpretation of cultural meanings and their specific manifestations in psychotherapy. In a global world, it is of great importance to have psychotherapeutic theories and practices that could adequately bridge out the differences between cultures.

Figure IV represents the overlaps between an abstract hermeneutic model of therapeutic procedure and the CAT phases, focusing on the importance of understanding. My thoughts are presented by using – to a certain degree, but with modifications – the theory of Ian Rory Owen (“Hermeneutics in Psychotherapy”, 2006).

This model in Figure IV can be the explanation as to why CAT could be utilised to incorporate other therapeutic techniques – based on my experience, especially the creative ones. This comes from the new hermeneutic concept of understanding and the creative character of the process of understanding:

“A hermeneutic outlook is consistent with methodological pluralism”. (Christopher, J. C., Christopher, S. E., Richardson, F. C., 2000; page 15).

Practising CAT is highly challenging: it has the potential to increase understanding and self-understanding, since CAT has dialogical, relational and hermeneutic qualities.

In conclusion, CAT could be fittingly interpreted as a new therapeutic model of the hermeneutic approach and, through the course of the therapy, the patient obtains a new model of understanding.

If CAT is intended for the purposes “[of finding] a common language for the psychotherapies” (Ryle, A., Kerr, I.B., 2002), hermeneutics would be the grammar of this common language.

Acknowledgements
Special thanks go to my CAT Skills Training Course Leaders, Dr. Karen Shannon and Dr. Marisol Cavieres, because I felt at home and benefitted from the openness, creativity and the real, lively dialogue with them and the entire Team during the workshops.

I also owe much to the Co-editor of Reformulation, Dr. Rachel Pollard, for her valuable comments and suggestions, and for the chance to present this publication.

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Marianna Bobvos-Bekefi is a consultant psychologist working at a Medical Center. She is the first Hungarian professional who has completed the CAT Skills Training in the UK. Marianna is a psychotherapist trained at the Medical University in Budapest. Her training included, among others, analytic, cognitive and group therapy and she also holds a Master’s Degree in Philosophy. Her main research area is in the border territory of psychotherapy and philosophy.
mariannabobvos@hotmail.com.

Full Reference

Bobvos-Bekefi, M., 2014. A New Concept of Understanding CAT and Hermeneutics. Reformulation, Winter, pp.22-32.

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Who was Bakhtin? Marxist Materialist, Christian Mystic, or rampant plagiarist? - Does the 'Crisis' in Bakhtin Studies have any implications for Cognitive Analytic Theory?
Pollard, R., 2003. Who was Bakhtin? Marxist Materialist, Christian Mystic, or rampant plagiarist? - Does the 'Crisis' in Bakhtin Studies have any implications for Cognitive Analytic Theory?. Reformulation, ACAT News Spring, p.x.

Are there Limitations to the Dialogical Approach to Psychotherapy?
Pollard, R., 2004. Are there Limitations to the Dialogical Approach to Psychotherapy?. Reformulation, Summer, pp.8-14.

A Dialogue About the Dialogical Approach
Pollard, R., Hepple, J. and Elia, I., 2005. A Dialogue About the Dialogical Approach. Reformulation, Autumn, pp.18-24.

Book Review: 'Language for those who have nothing. Mikhail Bakhtin and the Landscape of Psychiatry' Peter Good (2001)
Pollard, R., 2003. Book Review: 'Language for those who have nothing. Mikhail Bakhtin and the Landscape of Psychiatry' Peter Good (2001). Reformulation, Summer, pp.40-43.

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.

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