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CAT Concepts — MRCPsych Paper B MCQ

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HardPsychotherapyCAT ConceptsMRCPsych Paper B

During cognitive analytic therapy, a patient and therapist identify a recurring pattern described as ‘controlling–controlled’. The patient may occupy either position with other people and may also relate to the self in these terms. Which statement most accurately defines the reciprocal role represented by this formulation?

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Correct answer: C — A paired self–other pattern internalised from early relationships and re-enacted with others or toward the self

The correct answer is C. In CAT, reciprocal roles are internalised, paired patterns of relating, such as controlling–controlled or criticising–criticised, usually shaped by early interpersonal experience. A person may enact either pole with other people, experience others as occupying the reciprocal pole, or reproduce the relationship internally—for example, by criticising the self. They are collaboratively identified rather than assigned unilaterally by the therapist, so A is incorrect. C describes a CAT trap: coping responses unintentionally maintain the problem. D describes a dilemma, in which choices are restricted to polarised alternatives. E describes a snag, where change is inhibited because improvement is expected to have adverse consequences.

Reference: Ryle A, Fawkes L. Multiplicity of selves and others: cognitive analytic therapy. Journal of Clinical Psychology. 2007;63(2):165–174. https://pubmed.ncbi.nlm.nih.gov/17173319/