Introducing Cognitive Analytic Therapy. Anthony Ryle

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СКАЧАТЬ Bowlby offered a more acceptable biological basis in ethology, suggesting in particular that experiences and behaviors related to attachment and loss could be seen as examples of complex innate behavior patterns found throughout much of the animal kingdom. This revision, easily linked with some versions of object‐relations theory and in Bowlby's view constituting a version of it (Bowlby, 1988), drew attention to the profound importance of the quality of real experience and of the infant's bond with the mother. This constituted a radical and humane revision of contemporary psychoanalytic theory despite its being received with much hostility and misrepresentation at the time (Schwartz, 1999). The theory was developed using cognitive psychology concepts to describe the early formation of internal “working models of relationships” responsible for the subsequent shaping of relationship patterns. Workers in the AT tradition have also carried out important research describing how the form and content of parents' recollections of childhood are linked to the patterns of attachment displayed by their own children. From a CAT perspective, Jellema has offered a series of thought‐provoking papers on the importance of an AT perspective particularly in considering personality‐type disorders (Jellema, 1999, 2000, 2002). However, in its initial form a least, in seeking a respectable scientific base in biology, AT largely ignored what is essentially human, namely the formative role of culture and its meanings and values, and from Bowlby's “working models of relationships” on, has largely adopted restricted, cognitivist assumptions. The creation and maintenance of other self processes and the transmission of social values in the mother–child relationship were not explicitly considered. It appears that AT was enthusiastically over‐extended in an attempt to account for all aspects of development (including the generation of “theory of mind”) and psychopathology. In our view, and that of many others (Aitken & Trevarthen, 1997; Brown & Zinkin, 1994; Gilbert, 1992; Leiman, 1995), this theory, although important, described only some of the factors involved in healthy growth and development. Although the issues that attachment theorists stress are important, in particular loss and attachment throughout the life cycle (Bowlby, 1988), AT does not, in itself, at least in its earlier formulations, appear to offer an adequate account of the complexity and subtlety of development or of psychopathology. However, in recent years, the scope of AT has itself broadened very considerably with the result that its field of study appears now almost synonymous with, and to include, most other domains of developmental psychology (for overviews see Cassidy & Shaver, 2016; Mooney, 2010).

The Contribution of Vygotsky's Ideas

Many of the criticisms made of classical psychoanalytic theory and practice during the evolution of the CAT model, and many features of the specific methods employed, were grounded in a wider perspective with the incorporation of a Vygotskian perspective into CAT theory (Leiman, 1992, 1994b, 1997; Ryle, 1991). Useful reviews of these ideas are given in Volosinov (1973), Burkitt (1991), Wertsch and Tulviste, (1992), Wertsch, (1985), and Stevens (1996); and see Vygotsky (1978). This involved the application of ideas originally concerned with intellectual development to the formation of the self. Four distinctive aspects of Vygotsky's thought have been important for the development of CAT theory.

      The Social Formation of Mind

      Individuals are not self‐generated or self‐maintained. Born with a unique genetic endowment, their individuality is shaped and maintained through their relationships with others. This rejection of the monadic view of personality is shared with Mead (1934) and many others (see Burkitt (1991) for a useful survey of the field, and see Ormay (2012) for a group analytic perspective). It emphasizes that the activities of learning and becoming a person take place essentially in relation to others. In this process our activity and the acquisition of facts and of their meanings are inseparable. We do not store representations to which we apply a mayonnaise of meaning. “Representations” become a fundamental part of emerging psychological structures. They are inextricably imbued with the meanings acquired in the course of our activity in an intersubjective universe, through our relation to others, notably parents, whose own meanings in turn will reflect those of the wider society. Child‐rearing practices are guided by deliberate educational intent to a small extent only and their impact on the growth of the self is registered without conscious reflection on the part of the child.

      Just as the realization that the world was not the center of the cosmos was resisted for a long time, so to think of the individual self as being formed and maintained in this social, interpersonal way, rather than as being the central source of thought and action, does seem to present major conceptual difficulties to many members of our contemporary professional culture. This point is returned to at the end of this chapter.

      Sign Mediation

      Long before language is acquired, children are active in the presence of others who, by gesture, expression, movement, rhythms, mimicry, sounds, and by jointly created rituals and symbols, communicate wishes, intentions, and meanings. Repeated parental responses which reflect, amplify, control, or ignore the child's actions and expressions offer a commentary on the child's activity, whether its object is a part of its own or its mother's body or a pattern of light or a spoon or a toy. These responses shape the child's understanding of the world and also constitute a defining example of the parent–child relationship and are hence a source of the sense of self.

      From a Vygotksian viewpoint, signs are created and used between people or within cultures. A well‐known example of the creation of meaning and intention is provided by Clark's (1978) extension of Vygotsky's account of what happens when a child attempts to reach an object beyond its range. Whether it elicits from the caretaker assistance, encouragement, or removal from possible harm, the fact of the response transforms the attempt into a gesture which, with repetition, can come to serve as a statement of intent and as a means of influencing the caretaker, that is to say it becomes a jointly elaborated interpsychological sign (see Leiman, 1992).

Within psychoanalysis, Winnicott's understanding of the transitional object as standing for the mother in her absence was an example of such an interpsychological sign and was related to his insistence that the mother–baby dyad was the proper focus of attention for developmental psychology. Language is a shared system of signs which is “de‐contextualized” and hence flexible, allowing more abstract and theoretical forms of thought. It creates for the individual (as it did, in the course of evolution, for the species) the possibility of conscious self‐knowledge and it represents an important human way of making sense of the world. However, as noted previously, important formative, early, relational experience also occurs pre‐verbally in the first couple of years of life. As such this remains beyond the reach of conscious linguistic memory or recall although its effects may be incorporated at a deeper bodily level and be profound.

      Internalization

      One of Vygotsky's well‐known statements was: “What the child does with an adult today she will do on her own tomorrow.” In this he was proposing a two‐stage learning process whereby interpersonal activity, involving the development and use of skills and the acquisition of concepts which convey meaning, always precedes internalization. In this way, speech, which is first acquired in conversation with others, is practiced in conversation with the self (the instructions and commentaries and judgments of their own actions of young children bearing witness to this) before finally “going underground” as the internal speech which is a main component of conscious thought. It is important to recognize that the “protoconversations” between mother and infant (see Braten, 1988, 1998; Trevarthen, 1993, 2017), and the RR relationships they embody, which are major determinants of the development of personality, involve pre‐linguistic mediating tools and are, as a result, largely unavailable to conscious reflection. It will be clear from this account that internalization of external interpersonal activities takes place by way of signs conveying meanings (see also Boyes, Guidano, & Pool, 1997; Cox & Lightfoot, 1997) and is quite distinct from representation. An important feature of Vygotsky's concept of internalization is that the process is also understood to transform the psychological structures СКАЧАТЬ