Relationships with partners, family members and carers can change when you go through a therapy like CAT which has a focus on relationships.  In this article, Alison Jenaway provides some information on why this might happen and what can be helpful to consider to help look after important relationships.

I tend to give what I call a “Marital Health Warning” when someone is starting cognitive analytic therapy (CAT) with me and they are in a long term relationship. This is a bit like the warning on cigarette packets – CAT can seriously damage your relationship.

Sadly, some people respond with a shrug, saying “well the relationship is pretty much over anyway so I don’t care”. Perhaps for those couples, therapy is a step on the way to end a relationship which is no longer working. However, for those who want to keep their relationship going, or perhaps improve it, things may get worse before they get better. Or at least a bit more complicated and confusing.

Here’s the thing.  CAT is about exploring your relationship patterns, those ones learnt early on in life.  You learned these through interactions with your family and others with influence while you were growing up. In CAT we call these Reciprocal Roles .

Couples generally pair up because there is some kind of complementary fit between your own relationship patterns and your partner’s. It’s a bit like going to a music festival and ending up in the same tent.  Together you are listening to the same style of music and dancing the same dance. You are likely to pair up with someone who is comfortable in the same kinds of relationship patterns as you.

This is not to say you’ll have exactly the same needs in a relationship. In fact you could be opposites or mirror images. For example, you might have grown up in a family where care was lacking. Parents or others around you may have been vulnerable in their own ways. You might have come to believe that your emotional needs were unimportant.  Perhaps you learned to care for others first. Looking after someone else might have been the only way to feel connected and stop being on your own and lonely.

Later in your life you might have met someone who has lots of needs and makes these very obvious. Perhaps they too grew up somewhere where their needs were overlooked.  In their own situation they might have learned that the only way to be noticed was to to be very upfront and vocal.

The two of you might fit together very well, as you meet each others’ expected patterns. You overlook your own needs, do lots for your partner and feel connected. Your partner makes their needs known, readily accepts your care and feels secure. As long as this is working for both of you, there’s no problem. It’s as if you are together in that tent, dancing away in time with each other, and both reasonably satisfied.

But then something might change in your life and that balance doesn’t work any more. You seek therapy, perhaps about something else altogether. Therapy, especially one like CAT, helps a person explore relationship patterns which might have gone unnoticed up till now. The therapist is interested in the kind of dance you do, and asks whether you’re still happy with that dance or want to learn some other steps. It’s as if the therapist turns up at the music festival, tells you there is a great dance band on the main stage and invites you to go and explore it with them.

Meanwhile, your partner is still stuck in the first tent doing the same old moves you always did together.  They might feel quite abandoned and alone, and confused about why you’re elsewhere. They might feel left out of something important. It might feel as though you are closer now to your therapist than you are to them. There might be worries about you and your therapist talking about them as part of your problem. They might feel confused about their own steps and what’s wrong with them. After all, this dance seemed to suit you both well enough for years. They might find that their own steps, which were so comfortable before, feel wrong or impossible without you opposite them.

It might be the case, of course, that you want to challenge your partner about the patterns you’re now questioning. But it might be that you want to preserve and protect the good things in your relationship, or improve things between you. Part of your task as the person having therapy is to invite them to come over to the main stage with you. At the very least you might try to explain what you like about this new music or dance steps, and why you want to try something different.

Going back to our example, you might have discovered that you can be healthier and happier if you give your own needs some more attention, and learn how to care for yourself better.  This might mean saying no to some of the things your partner expects.  You might need to sit down and relax after eating the meal you made, instead of washing up too.  Or you might be learning in therapy that it’s okay to ask for care from others.

This might be a surprise to your partner.  They might feel unprepared for these new ways, perhaps worried, disappointed or cross. This wasn’t the music festival they were expecting when they bought their ticket!  It might take them a while to see the benefits, but they might find they like it too.  In time it might become clear that you are more fun to be around in the evening if you’re less worn out.. You may have energy for other things you’ve not done together for a while.  They may discover new things about themselves.  It might feel good when they do something to help look after you, or to feel more confident when they do something on their own that they’d never had the chance to do before.

So your partner will need some courage to take a risk and try out this new dance with you.

In the second part of this article we outline another ‘Four C’s’ that can be helpful for both you and your partner to keep in mind while you’re having therapy: communication, curiosity, compassion and a little bit of challenge.

Dr Alison Jenaway is a Consultant Psychiatrist in Psychotherapy in the Liaison Psychiatry Service in Cambridge. She is a CAT therapist and supervisor and has been using CAT for over 20 years.  She is a former Chair of ACAT, the national Association for Cognitive Analytic Therapy.

How Might Having Therapy Affect My Relationship? by Alison Jenaway for ACAT
CC BY-SA 4.0