• Cognitive analytical therapy is a short-term treatment, helpful for feelings of anxiety

  • CAT looks at patterns of behaviour and relationships that may make anxiety worse

  • If you are struggling with anxious feelings, find a therapist here 

Anxiety comes in many shapes and sizes and it can affect us at any time. Some anxiety is contextual such as post-traumatic stress disorder (PTSD) or occupational burnout where is it an understandable response to the stressful situation we are in. Other forms of anxiety, for example generalised anxiety disorder, may be less attributable because an individual may feel anxious about a wide range of situations and events, rather than one specific circumstance. Anxiety can also be linked with another issue such as substance misuse, a medical condition or a history of mental health problems.

Being anxious is extremely distressing and for many people it can seriously affect their emotional and physical well-being as well as their ability to deal with day to day situations. Symptoms may include feeling restless or worried, having trouble concentrating or sleeping, dizziness or heart palpitations.  Chronic anxiety can result in an individual being so sensitive to their environment and to the criticism of others, that they may see anything or anyone as a potential threat.

Cognitive behavioural therapy (CBT) is often recommended as an appropriate approach for helping to cope with anxiety but cognitive analytical therapy (CAT) can also help by increasing an understanding of where the anxiety may have started. The CAT framework encourages you to take a step back and observe your patterns of interaction both with yourself and with others in order to challenge your intrusive and often incorrect thoughts.  

CAT is a time-limited therapy developed by Dr Antony Ryle and it is an integrative approach, which draws on cognitive, psychoanalytic and social learning theories. It differs from CBT in that it focuses on the importance of relationships in developing and maintaining anxiety. This includes the relationship you have with yourself as well as the relationships you have with others, including your therapist. By discussing your early childhood experiences and life story your CAT therapist will work alongside you to map out some of the patterns you have developed to deal with stressful situations.

For example, if you were brought up in an environment where adults were unpredictable in their responses to you as a child you may have developed coping mechanisms such as ‘pleasing others’ or ‘taking responsibility’ in order to reduce the uncertainty and gain control over the situation. As a child these ways of dealing with anxiety would be understandable but as an adult they may no longer serve a purpose and maintain the anxiety rather than helping to diminish it. Going through life always trying to please others can be stressful and anxiety provoking and it may leave you feeling put upon or uncared for if others don’t reciprocate. 

CAT looks at three types of procedures called traps, snags and dilemmas.

An example of an anxious ‘trying to please trap’ may be as follows:

- I feel anxious about a situation - I want other people to like me so I do what they want - They take advantage of me and I feel uncared for - I lose confidence and feel even more anxious - and around again to the beginning. This is a cycle. 

In this example, the procedure of trying to please others to feel less anxious is counter-productive and actually increases the anxiety.

By mapping out these behavioural and cognitive procedures CAT works to increase your self-awareness by exploring your patterns of relating both to yourself and to others. This compassionate understanding enables you to consider why you tend to cope in the way that you do and also identifies how you can choose to do things differently to increase your well being and reduce your anxiety in the future.

CAT is collaborative in its approach and the idea is that you work alongside your therapist to recognise how patterns, often developed in early childhood, could be adversely affecting your anxiety in your current relationships and situations. It is a short-term therapy that normally lasts for between 16 and 24 weekly sessions. 

Further reading

My experience of cognitive analytic therapy

My journey with anxiety, OCD, and depression

Anxiety: when does normal emotion become a problem

Learning your triggers to overcome anxiety

3 simple ways to beat anxiety