What is Cognitive Emotive Narrative Therapy (CENT)?
 

Cognitive Emotive Narrative Therapy (CENT) is a new system of counselling, coaching and therapy which deals with the whole person, as a physical organism, as a social construction, and as an autobiographical story on legs.

CENT is an integration of systems of therapy originally developed by Dr Sigmund Freud, Drs Klein and Fairbairn, Dr Eric Berne, Dr Albert Ellis and others.  It is integrated and further developed by Dr Jim Byrne.

Dr Jim Byrne, January 2010

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CENT Paper No.2 (a):

What is Cognitive Emotive Narrative Therapy (CENT)?

By Dr Jim Byrne

Copyright (c) 2009-2013, Jim Byrne

(Updated 21st June, 2012; 22nd February 2013; and April 2013)

1. Introduction

"CENT sees humans as essentially story tellers, to ourselves and others, and storytellers who live in a world of narratives and scripts, which include reasonable and unreasonable elements, logical and illogical elements, and defensible and indefensible elements.  Humans often tend to push away (or repress) unpleasant experiences, to fail to process them, and to then become the (unconscious) victims of those repressed, undigested experiences.  CENT also sees adult relationships as being the acting out of childhood experiences with parents and siblings, because some part of those earlier relationships have not been properly digested and completed".  Extract from CENT Counselling: How to apply Cognitive Emotive Narrative Therapy in counselling and self-help, By Dr Jim Byrne.***

Cognitive Emotive Narrative Therapy (CENT) is a system of counselling and psychotherapy which helps clients to work on their brain-mind-body-and-relationships in order to reduce and control negative or painful emotions and behaviours, like anger, anxiety, depression, stress, self confidence and couple conflict.

DrJim_in-Scarboro_2010c.jpgCENT integrates Rational Emotive Behaviour Therapy (REBT), Transactional Analysis (TA), Attachment theory, Zen Buddhist philosophy, moral philosophy, and some other cognitive, narrative and dynamic therapies. And CENT goes beyond those systems, to create some original cognitive-emotive techniques, models and perspectives.

CENT is not an eclectic system which has merely bolted elements of different counselling systems together.  It is a truly integrative system which began by revisiting the basic model of the human personality developed by Sigmund Freud and asking: How does this model link up with the ABC model?  What are the necessary implications of assuming that there is substantial truth in both models?  The same process was conducted with Transactional Analysis and cognitive science.  The resulting model was then compared with the implications of the Object Relations School.  Moral philosophy and Zen Buddhism were also interrogated in this process of model building.  That work of model building is described in Papers No.1(a)[1] and No.9[2].

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In CENT counselling, we define ‘feeling’ as innate, and ‘emotion’ as a socio-cultural product of experience: “The terms ‘feeling’ and ‘emotion’, and ‘affect’ are used in many different senses in psychology.  A review of more than twenty theories of emotion reveals a plethora of widely diverging technical definitions.  These vary with the technique of investigation, the general theoretical framework, and the value-judgements of the psychologist.  Often, they are so diverse as to defy comparison let alone synthesis”.  Therefore, in CENT, we follow Sarbin in defining feeling as innate, and emotion as ‘narrative emplotment’ arising out of cumulative, interpretive, social experience.  Because emotion is narrativized, it can be changed in a therapeutic conversation.

Robert F. Hobson, Forms of Feeling: The heart of psychotherapy, Page 88. (10)

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Before that system of integration of models was begun, I had studied thirteen different systems of counselling and therapy, including: Freud and Jung, Rogers and Perles, Behaviour Therapy theory and practice, Cognitive Therapy and Rational Emotive Behaviour Therapy, Reality Therapy and Transactional Analysis, Existential Therapy and Logotherapy, Multimodal Therapy and Cognitive-Humanistic Therapy; and also committed myself to the proposition that all systems of counselling and therapy that are designed to be therapeutic are broadly equivalent in terms of the outcomes achieved for the client, as argued by Wampold (2001)[3], and Messer and Wampold (2000)[4].

CENT evolved in phases.  1968 to 1980 was a kind of incubation of some core ideas, triggered by a partial Freudian analysis, combined with art therapy, music therapy, relaxation therapy, group therapy, and some others.  And 1980 to 1998 involved active exploration of various systems of therapy and self development (including Gestalt and Psychosynthesis, and autogenic training).  Then, 1999 to 2007 saw an intensification of thinking and learning about the core elements of the thirteen systems mentioned above.  And finally, over the past six year period - of developing and applying the emerging CENT model - a basic theory of human personality and psychological disturbance emerged.

Viewer Comments:

1. "This is absolutely excellent!!! I would like to learn (this system) or read a book about this model". - Taski, via YouTube. 28th December 2011

2. "This dude's amazing (and I) totally love his work". - PsychologyLover93

3.  "Wow, Dr, Jim...  Maybe you'll finally be the one to create a unified theory of psychology, or at least progress the development of one. That's what the field needs". - Fritz - By Dr Fritz Hershey - Psychologists in Private Practice - LinkedIn, 4th March 2014

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This is the best book to begin to read on the foundations of CENT, and how it is applied in practice:

 

Cover.77.jpgCENT e-book No.2: CENT Counselling: How to apply Cognitive Emotive Narrative Therapy in Counselling and Self-help, by Dr Jim Byrne

This is a popular introduction to the theory and practice of Cognitive Emotive Narrative Therapy (CENT), which is a highly effective new philosophy of life, and psychological system of therapy.

This book was designed to answer the most common questions asked by counsellors, psychologists, psychotherapists, counselling and therapy students, counselling and therapy clients, and self-help enthusiasts, about the nature of CENT: how to learn it; and how to apply it in practice, to individual counselling, couple's therapy, and self management.

The main aim is to demonstrate CENT counselling in practice; and in the process you will learn something about how to integrate and apply CBT/REBT, Transactional Analysis (TA), Attachment Theory, Object Relations and Zen philosophy and Moral philosophy.

For further information on this book, please click here.

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2. The basic theory of CENT 

In a broader sense than that above, CENT was developed by this author over many years of study and application, in private practice with more than 720 clients. Here are some of the key features of CENT:

Firstly, we do not make the mistake of extrapolating from adult functioning in order to understand the psychology of human nature.  Instead, we begin with the baby in the mother's womb (where the mother may be more or less stressed, and more or less well nourished, depending upon the actual circumstances of her life).  We then move on to the baby post-birth, which is colonized by a carer (normally mother) who may be more or less sensitive to the baby's signals of comfort and discomfort; more or less responsive to the baby's needs; and more or less caring.  And we also take account of how stressed the mother was, by her life circumstances, even before the baby was conceived.  These are the foundations of human psychological functioning.

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There are currently nineteen core principles of CENT counselling and therapy, and they are listed on this page.  However, not long ago there were only eleven principles, and at that time I made a little video clip introducing those eleven principles.  This is it:

 

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Secondly, we accept the Attachment theory proposition, that the baby is born with an innate attachment drive, which causes it (after some period of weeks of development) to seek to attach itself to a main carer.  That attachment becomes either secure or insecure, depending upon whether the mother is "good enough" - meaning sensitive, responsive, and caring enough to soothe the affective states of the baby.  Later father and siblings become important attachment figures for the baby. And the baby forms a set of internal working model of relationship based upon those earliest relationships.

Third, the first five or six years of life are taken to be determinants of what kind of life the individual will live.  Very largely, the narratives, scripts and frames that the child learns and forms during this period - which manifests in the form of moods and emotional states, expectations, beliefs and habitual patterns of behaviour - will determine its trajectory through life, all other things being equal.  There is, of course, some degree of malleability of the human mind, and so what was once shaped badly (by relationship experiences) can to some extent be reshaped into a better form by subsequent ‘curative experiences', with a love partner, or with a counsellor or psychotherapist.

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My first book on Cognitive Emotive Narrative Therapy (CENT) was this: Therapy after Ellis, Berne, Freud and the Buddha:

Cover of e-book No.1CENT e-book No.1: The Theoretical Grounding of CENT 

This book - which was created after the death of Dr Albert Ellis - begins by enquiring into the case for integrating cognitive therapy and psychodynamic therapy.  It is a scholarly consideration and examination of the models that underlie the system of Rational Emotive Behaviour Therapy (REBT), and the ways this author gradually expanded that system by incorporating elements of Transactional Analysis, Gestalt Therapy, and, later, attachment theory and object relations theory.  That scholarly level of the book is underpinned by the personal and professional experience of the author.  This author uses his own difficult life history to investigate and explore models of the human mind and theories of counselling and psychotherapy which are at the growing edge of counselling psychology.  However, underneath this academic and theoretical level, there is a painful, personal narrative of childhood suffering.  What you will gain from this book is a huge infusion of creative ideas about how to rethink counselling and therapy practice post the narrative and the emotional revolutions.

Byrne, J. (2010) Therapy after Ellis, Berne, Freud and the Buddha: the birth of Cognitive Emotive Narrative Therapy (CENT). Hebden Bridge: The Institute for CENT.

For further information on this book, please click here.

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Fourth: With regard to the narratives, stories, schemas, scripts and frames that the individual learns and/or creates: these are, as Bruner said, enactive (or experiences of doing), iconic (or experiences of seeing) and semantic (or language based abstractions and interpretations of events and objects).  In cognitive psychology, the development of the child and later adult is mapped through studies of attention, perception, memory, language and thinking; and emotion only gets a brief mention at the end of standard textbooks - as an afterthought.  However, in CENT, we teach that it is an emotional being that pays attention; it is an emotional being that perceives; it is an emotional being that forms memories; it is an emotional being which uses language; it is an emotional being that thinks.  And even the most abstract of academic thinking cannot be totally separated from the emotionality of the person engaging in it.  In other words, the brain-mind is an emotional brain-mind.  Human beings are emotional beings, at their very foundations, and they can also think. They are not ‘cognitive beings', if by cognitive beings we mean ‘computer like'.  Computers do not have emotions.  And humans are not computers!  (This is why we developed cognitive-emotive therapy, because cognition and emotion cannot ever be separated!)  Indeed, we could say that human beings are not thinking beings at all.  They are actually perfinking beings: beings who perceive-feel-and-think all in one grasp of the mind.  And the feeling component never sleeps!  You cannot leave it at the door on your way into school or work.

Fifth: We accept that an individual may be born with a tendency towards introversion or extraversion; and that the new born baby may also be more emotionally disturbable, or less emotionally disturbable.  We accept that the innate nature of the baby will influence and impact the mother in how she relates to the baby; and the mother's personality and character and temperament will also influence and impact the baby.  This dialectical cross-influence between mother and baby will eventually settle down into a stable pattern of relating, which will be experienced by the baby (and the mother) as more, or less, satisfactory.

Sixth: Throughout the whole of the life of the individual, the external environment will continue to exert an impact on the moods and emotions of the individual. Only the most highly trained and committed Stoic or Zen practitioner could ever come close to ignoring (or being largely unaffected by) their external environment!  Indeed, only a rock, or lump of wood, or other inanimate object, ever achieves complete indifference to its environment.

Seventh, (1). CENT theory takes into account that we are bodies as well as minds, and so diet, exercise, sleep, relaxation/meditation, drugs and other physical inputs and stimuli are seen as important factors in determining the emotional state of the individual client.  That is to say we have needs

Seventh, (2). We have physical and emotional needs. 

Seventh, (3). For example, we need to be loved, liked and accepted by some significant others.  (This need is very strong when we are babies, and it continues to be strong throughout our lives.  However, it is not as strong as our need for oxygen or food.  If we fail to get oxygen, we will die in seconds; if we feel to get food, we will die within days; and if we fail to (give and) get love, we will wither and die more quickly than those individuals who do learn to give and get love.

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 CENT ebook No.6 is now available:

Creating Joy: How to be much happier, right now!  by Dr Jim Byrne

CreatingJoy2.jpgThe main aim of this book is to spread happiness.  Not just any old hedonistic happiness, excitement, or thrill seeking, which does not last; but rather pro-social, moral, sustainable happiness, in line with the insights of Positive psychology, Buddhist psychology, Stoic philosophy and various forms of Rational and Narrative therapy; as well as the two major systems of writing therapy: (the scientific and the artistic).

In this book you will find a twelve week program - involving just a few hours each week - which is designed to help you to manage your life in such a way that you can reduce your unhappiness and increase your happiness, pleasure, gratification and satisfaction.  You will learn simple techniques that can produce almost immediate improvements that will astound you.

Available here: Creating Joy: How to be much happier, right now! 

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Eighth: CENT starts from the assumption that we are primarily social animals, and not solitary individuals. We are social to our very roots, especially from the moment of parturition, when we are handed into the arms of our mothers. Everything that happens from that point onwards - and also including the original birth trauma - is significant for the development of the so-called 'individual' (who is really an amalgam of significant other 'individuals' with whom we are related from birth onwards, and who we 'internalize' as 'models').  In particular, our mothers and fathers are braided into the very foundations of our personality and character.

Ninth: From the Object Relations school, CENT takes the view that the first three phases of development of childhood can be disrupted, between birth and about the age of six years - or the first four subphases from birth to age three - resulting in specific forms of relationship dysfunction in later life. The solution to these problems tend to include a mixture of 'being with' the client in relationship; 'holding' the relationship in a suitable dialogue; helping them to make conscious and then process their un-experienced or resisted emotions; providing analysis and models as cognitive-emotive ways forward; and providing a ‘secure base' for the client, so they can learn how to have a secure relationship, perhaps for the first time.

Tenth: CENT theory represents the new born baby as containing two fundamental potentials: to develop pro-social and caring attitudes; and to develop anti-social and egotistical attitudes. Part of the process of socialization is to ensure that the new person mainly develops their 'good side' (or what the Native American Cherokee people called the 'good wolf') through the moral teachings of their parents, teachers and others; and that their 'bad wolf' is constrained and contained. (It cannot ever be totally or permanently eliminated. We each contain the capacity for significant levels of 'evil' to the ends of our days!) But the happy functioning of social animals depends upon the extent to which we develop our pro-social, moral virtues, and resist our anti-social, immoral or amoral vices. Some clients are clearly operating mainly from 'good wolf' and some are significantly operating from 'bad wolf'. That latter client group needs coaching in moral philosophy; and encouragement to operate mainly from 'good wolf', for both the sake of their community and the sake of their own happiness.


Eleventh: CENT sees humans as primary non-conscious beings, who operate tacitly, automatically, from layers of cumulative, interpretative experience, stored in the form of schemas and stories, in long-term memory, and permanently beyond direct conscious inspection. At least 95% of all of our daily actions are executed non-consciously and automatically. So change is not easy; delusion is our normal state (i.e. our perceptions of ourselves, others and the world are false to facts); and we project our own 'stories' onto our environments, and judge them accordingly. To wake up to a more accurate understanding of life - with our adult-functioning in the driving seat - is not easy, but it is possible.

Twelfth: We mainly operate from one of three so-called 'ego states', or 'ways of being' (as described in Transactional Analysis [TA]). These are:

(P) Parent ego state, when we think, feel and behave just like some parent figure from our past experience;

(A) Adult, which is the logical, reasonably cool and rational, computing part of the brain-mind. And:

(C) Child ego state, which is characterized by our thinking, feeling and behaving just like we once did as a young child.

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CENT book No.3: Chill Out: How to Control Your Stress Level, and to Have a Happier Life

Chill_Out_cover_1.jpgThird revised and expanded edition: 2012.  The purpose of this book is to teach the reader what stress is, and how to combat it. It contains eighteen techniques for reducing physical and mental strain, and to enhance environmental control.  It is written in the form of a self-help manual, with spaces for self-reflection exercises. However, it could also be used by counsellors, counselling students, and interested others, as a means to learn, understand and present the CENT approach to Stress Management in counselling, coaching and therapy contexts.  If you need to control your stress, or you want to help others to do so, then this book will help you.

For further information on this book, go to Chill Out: How to Control Your Stress Level...

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Thirteenth: We seem to be story tellers in a world of stories. (Language is the sea in which we swim, unknowingly; as fish swim in water without ever 'spotting' the water). And so our neurotic reactions often tend to be outgrowths of old, illogical, unreasonable and unhelpful narratives and stories, scripts, schemas, beliefs and attitudes.  (The exceptions tend to be when our neurotic feelings are a result of unprocessed experiences from the past).

Fourteenth: It may be that we each have a vulnerability towards angering, panicking or depressing ourselves when we are stressed by external events or objects; and CENT tries to help the client to work on curing those vulnerabilities, by changing elements of their beliefs, attitudes, schemas and stories; or by learning to reframe problematical activating stimuli.  Significant stories include: The story of origin, including birth and birth-family; The story of personal identity; The story of relationship; Stories of transitions; The story of career/wealth/success/poverty/failure; The story of present problems; The connections between the story of origin, the story of relationships, and the story of present problems; and so on.

Fifteenth: Our clients may be distressed because of their illogical, unreasonable, unrealistic or insupportable beliefs and attitudes about themselves, other people and the world, and we try to get them to reframe those beliefs and attitudes, using the Six Windows model. (See CENT Paper No.3)***.

Sixteenth: Our clients may be distressed because they have failed to process some earlier emotional experience, which is now stuck in the basement of their mind, causing neurotic symptoms to emerge in the form of distorted thoughts, feelings, behaviours, relationship conflict, or physical symptoms.  In this kind of situation, the CENT therapist's role is to help the client to dig up that part of their past, to process the unprocessed experience, which we call ‘completing your experience' of what happened, or did not happen.  In order to do this successfully, we have found that they need to be able, simultaneously, or concurrently, to reframe those previously unprocessed experiences, so they do not merely restimulate the distressing feelings which caused them to be denied, rejected and buried in the first instance, all those years ago.

Seventeenth: Our adult relationships (such as marriage and living together) are strongly coloured, shaped and driven by the original drama between our babyhood-self and our mother and father. We repeatedly re-enact our family drama, until we work on it and resolve it. We have to 'complete' our relationships with our parents before we can grow up and move on. And completing those relationships means allowing them to be, exactly as they were - accepting them, and getting over our judgemental attitudes about our parents, who were just 'blokes and birds doing their (highly imperfect) jobs'.

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CENT e-book No.5: How to Control Your Anxiety: A rational approach using REBT/CBT, by Dr Jim ByrneAnxiety.book.2.jpgIn this ebook, I want to do two things: (1) To present a basic understanding of the Rational-Emotive Behaviour Therapy (REBT/CBT) approach to dealing with anxiety’; and (2) To provide a set of exercises for you to do so that you can learn how to analyze your problems with anxiety; identify solutions; and implement those solutions so as to eliminate your anxiety. In that way, you can become your own “counsellor”, in the area of anxiety and fear, because you can learn to fix your own emotional and behavioural problems.For further information, please go to How to control your anxiety... 
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Eighteen:  When the relationship between the client and his/her parents is too damaged, CENT offers the client the option to engage in a ‘puberty rite', in which they ‘cut their ties' to their parents - divorce them, as it were - and in this way clean up their psychological baggage about their parents.  (This is a fourteen day process of visualization of cutting the ties with the parent(s) and allowing both to be free to live their won lives).  They then feel much freer to run their own lives from their Adult ego state, based on present time realities, instead of constantly wresting with the past.

Nineteenth: When the client is very distressed about their early childhood experiences, we deploy a process of ‘externalizing' the inner child, so the client can nurture and heal their own childhood self in the present.  This process gradually changes the perceptions-feelings-thoughts of the client, as the inner child ‘grows up' and becomes content with its lot.

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3. Therapy models used in CENT

CENT uses a number of different models to structure counselling and therapy sessions.  There are at least four used for relatively cognitive (or cooler, more surface level) work; and several others used for deeper, more emotive (or historical, and non-conscious) work - (although all counselling and therapy work involves cognitive-emotive processing).

Here are some of the main models we use:

(i) The S-O-R model, which stands for Stimulus-Organism-Response, which was created by the neo-behaviourists.  A stimulus (S) impacts an organism (O) causing it to output a particular response (R). (See below in the next section, on session structure).

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The next video clip presents some introductory ideas about the differences between CENT and REBT:

Jim-for-3Dists-vid.jpg

Please click the image above, or click the link that follows: Three Distinctions between REBT and CENT.*** 

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(ii) The A>B>C model revisited:

(A) Something - called the Activating Event - happens, which thwarts the client's goal-directed activities (or 'G'). This 'noxious Activating event' is called 'the A'. (Example: You are made redundant, and have problems getting a new job).

(B) The 'B' originally meant 'Belief', and the client is thought to trigger a particular belief, either 'rational' or 'irrational', upon encountering 'the A'. (Using the example above, the client might tell themselves: "I should not have been made redundant; it's awful that this has happened; and this proves what a worthless louse I am!") In other words, the client 'tells themselves', or 'signals themselves', something about 'the A', or noxious stimulus. And that piece of 'self talk', or 'languaging/imaging', or 'narrative interpretation', is either overly-distressing or reasonably-arousing.

(C) The client then feels either reasonably aroused about 'the A' - Activating event, or stimulus - or overly-upset.

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Here's a brief introduction to the ABC's of REBT:

Jim-for-Pt1-ABCs-vid.jpg

Click the image above, or click the link that follows: Part 1 of the ABCs of REBT.***

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(iii) The E>F>R model:

CENT therapists use a variation on the A>B>C model, called the EFR model, as follows:

E = Event or Experience. What happened, or what are you focussing upon?

F = Framing.  What kind of ‘frame' or ‘lens' are you looking through, in order to interpret this event, or to frame what are you are fixated upon?

R = Response.  What is the emotional and behavioural response generated by your body-mind?

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*Insert new video clip on three important models: the S>O>R; the A>B>C; and the E>F>R...*

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Returning to the ABC model:

After the A & B & C steps outlined above, then we have the Debating/Disputing (D) step in REBT:

(D) The aim of REBT therapy is to help the client to Debate and Dispute (D) their 'irrational beliefs'***, or unhelpful narratives; and to arrive at point 'E': a New Effective Philosophy***, or a more empowering 'story' or 'narrative'.

(E) The new effective philosophy, or 'E' has to be reviewed many times to get it into long-term memory, where it guides the tacit responses of the client when they meet that particular frustrating 'A' - or Activating stimulus - on a future occasion.

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In CENT, Disputing is replaced by the frame challenging step (FC):

FC = Frame challenging.  This is the essence of a frame challenge: How many different ways can you think of to frame the E (or event or fixation that is troubling you)?  If only one, then you really don't know how your mind works.  Let's use the Six Window Model*** to show you that there are at least six, and possibly 66 different ways to look at what happened to you.  Then we will consider which of those ways of looking at your situation is going to serve you best, and which you need to dump.  Once you have changed the F that is distressing you, you will get a new (emotional and behavioural) outcome at point R in the E>F>R model.  (Because it involves a good deal of detail in its own right, the Six Windows Model*** is described in a separate web page).

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(iv) The APET model:

Because of our automatic, tacit, non-conscious functioning, it may often be more realistic to use the APET model, from the Human Givens school of thought, rather than the A>B>C model; as follows:

A = Activating event (as before): Something frustrating, challenging or noxious in some way, happens to the client.

P = Pattern. Our 'organism as a whole' recognizes this activating event, because it can be assimilated to an existing 'schema' (or recognizable pattern) in long-term memory.

E = Emotion. Our organism as a whole then 'outputs' a standard, habitual, emotional response to this stimulus (at 'A' above).

T = Thoughts. Thinking follows on from consciously registering the fact that the emotional response has already occurred.

Whereas the ABC model tends to focus attention on the B (or belief system of the client), and what the client can do to change their beliefs/attitudes about the A (or activating stimulus), the APET model often focuses attention on the possibilities of changing the A, or activating stimulus.  This can be done by asking: what would be a solution to the problem posed by the Activating event (A)? What could you do to achieve that solution?

The APET model also can draw attention to the need to change the client's inappropriate patterns of response to particular stimuli.  This can be done by the therapist's telling relevant ‘educational stories', using metaphors, or using appropriate humorous images.  This material can be used by the client (non-consciously) to modify their current patterns that are stimulated by a particular Activating stimulus (A).

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And in CENT, the next element is:

NI = Narrative inquiry: What is going on 'in the basement' of your (the client's) mind? What is the story that produced this (R) response to this particular 'E' (or activating Event or Experience)? What is the narrative that is implied by this reaction? How helpful, logical or reasonable is this implicit narrative? What could the client change in the implicit narrative, or what more empowering narrative could they develop instead of the problematical one?

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In addition to the four models described above (including the Six Windows model), we also use the following models:

The WDEP model from Reality Therapy:  The WDEP model has four elements.  W = What do you want?  D = What are you doing to get it?  E = Let's hear your evaluation of how you are doing.  And: P = Plan (or re-plan): What would a better plan look like?

The Skilled Helper model: Originally called the Egan Model, after Gerard Egan who created it, this model asks three core questions.  Where are you now? Where are you trying to get to? And: What strategies could you use to get there?  Within each of those three stages, there are also sub-questions, regarding blindspots, leverage, viable agendas, choice and commitment, brainstorming strategies for action, choosing the best strategies, and: turning strategies into a plan.

The TA Ego State model: This model comes from Transactional analysis, and teaches that the client is always operating from either Parent (P), Adult (A) or Child (C) ego states, and that the most effective way to proceed is to learn how to put their Adult ego state in the executive position in their personality.  We use this model to identify the place the client is operating from.

The Gestalt Chair-Work model: This model posits splits in the personality (like the P, A, C ego states mentioned in the previous model; and also like the sub-personalities of Psychosynthesis), and provides a basis for healing those splits.

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The CENT session structure

The CENT approach to counselling and psychotherapy is much broader then the REBT approach.  This is how it goes:

Begin with the RCP model: Build Rapport; Establish a Contract; and then Process:  As follows:

(i) The RCP model - which is adapted from Impact Therapy - is used to open counselling sessions.  This is how it works:

R= Rapport.  Establish a warm, accepting and productive relationship with the client.

C = Contract. Identify the Contract, or what the client and counsellor will work on, to the benefit of the client. This could be quite broad, and open, and needs further exploration.

P = Process.  Having identified the contract, the counsellor must now begin the process of exploration:

Process = The process of CENT counselling can have formal and informal aspects; discussion and questions, or the use of questionnaires.  And the process tends to vary from one client to another, as each client is unique.  One approach could be to explain the S-O-R model, and then: Explore Diet, Exercise, Self-talk, Relaxation/Meditation (as first priorities).  Explore relationships (current and historic), as second priorities.  (This exploration sometimes involves the use of explicit questionnaires about: Diet and vitamin supplementation; Exercise routine; Sleep, relaxation and meditation practice.  To explore self-talk, we use an REBT inventory, and a TA questionnaire.  We then may use an Attachment Styles questionnaire, and the Keirsey Temperament Sorter).

Then select the appropriate model for the next step, from among the following:

The WDEP model: From Dr William Glasser's ‘Reality therapy', this model asks: What do you Want?  What are you Doing to get what you want?  How well is this going (the Evaluation stage)?  And: Let's re-Plan, or produce an explicit Plan linked to what you Want.

The ABC model: From Dr Albert Ellis's REBT, this model asks: What was the Activating event?  What is (or was) your Belief (rational or irrational) about that Activating event?  And what was the Consequent emotional and behavioural Response to thinking in that way about your Activating event?

The EFR model: This was one of the first CENT models.  It asks: What was the Event that disturbed you?  Do you have any idea how you Framed that Event (in order for it to show up so badly)?  And what was your Response to Framing it however you Framed it?  (In practice we expect the client to have no idea how they Framed their noxious Events.  That Framing process goes on non-consciously.  And so we have a strategy to get the client to rethink how they frame the problem, beginning with some conscious re-framing, which will become non-conscious with practice).

The Six Windows Model(s): Initially there was only one Six Windows Model, though we recognized that there were likely to be at least 66 different ways of looking at any problem, and possibly even 666.  (We are now working on two additional Six Windows Models, for dealing with Couple problems and Anger problems). But for most practical purposes, we wanted to develop a way of introducing the client to six different ways to re-frame their problem, which would hopefully break up their (non-conscious) mono-focal take on the problem.  The idea was to get them to re-story their approach to the presenting problem; to create a new narrative about it.  This has worked well in practice.  An example will be shown in the next section, below.

The APET model: From the ‘Human Givens' approach to counselling and therapy, this model suggests that: A, and Activating event occurs; then P, the individual matches that A to a pattern in long-term memory, and outputs an emotion (E) about it, automatically and non-consciously.  Subsequently, the individual may have some thoughts about the event and the consequent emotion.  This corresponds to Joseph Le Doux's ‘quick route' to emotion activation, while Dr Ellis's ABC model corresponds to the ‘slow (thinking first) route'.  You cannot do very much with the APET model apart from teaching the client about Joseph Le Doux's ‘quick route' to emotion activation; and to emphasize past patterns in the client's life as routes to current disturbances.

The PAC model (from Transactional Analysis [TA]): This model is used to teach clients how they move around between ego states; how those ego states can be managed; and how to grow the Adult ego state, and keep the Adult ego state in the Executive position in the personality.

The OK Corral (from TA): This model help the client to understand that the healthy life-position to operate from is this: I'm Ok and so are you (all).  It also helps the client to understand if they are operating from any not-OK life-positions (about self or others).

The Egan model: This is a more detailed exploration of the client's goals and resources for progress.

The Gestalt Chair-work model: We use this model to help clients to explore incomplete relationships (e.g. with mother or father, etc), by allowing the client to have previously unexplored conversations with the absent other.  This could be designed to help the client to heal psychological splits, or to become more fully self-expressed.

The attachment styles questionnaire: This questionnaire helps the client to learn whether they have a secure or insecure attachment style (to their original carers, and/or to their current partner). It also distinguishes between two types of insecure attachment, and I teach how differences in insecure attachment style plays havoc with some relational patterns.  The process involves the counsellor in providing a ‘secure base' for the client, so they can learn to be securely attached to the counsellor; which they can then transfer into the wider world.

The Keirsey Temperament Sorter: This can help some individuals more than others, especially those who have had a lot of negative programming from parents which has badly affected their self-concept.  Knowing their temperament style can help the individual to understand their potential to grow into a very different person from their parental scripting. It can also help individuals in relationships to become much more tolerant of individual differences within that relationship.

The emotional needs assessment questionnaire (adapted from the Human Givens approach): This allows the client to identify any unmet needs which may be affecting their equilibrium, and thus causing emotional disturbance.

A brief Depression inventory (from Dr David Burns): This is sometimes used to check the intensity of a client's depression; and sometimes to check on progress over time.

A brief Anxiety inventory (from Dr David Burns): Like the depression inventory, this is sometimes used to check the intensity of a client's anxiety; and sometimes to check on progress over time.

Other models: We also use some other models, to help the client to understand their marriage, or to help them to understand stress, or the handling of panic, etc.

Therapist style:  All of those models are taught and applied in a way that promotes a secure base for the client, and promotes both attachment to, and autonomy from, the counsellor/therapist.  That is to say, we work from an attitude of loving kindness, and sensitivity and caring for the client.  We do not normally ask the classic REBT questions (called, incorrectly, ‘Socratic Questioning').  We teach, and we explore.  In our explorations, we are guided by all of the theories and models outlined above, and more.  Our questions are designed to ask for information, to give information, to cause the client's thinking to start up, to cause the client to focus on a particular point, and to bring the client's thinking to a conclusion. 

We believe human communication is very difficult, and so we operate very skilfully with the client, in terms of what we ask and what we say.

And we relate to the client as a feeling being who can also (hopefully) think; rather than assuming the client is a fleshy computer.

CENT is, ultimately, as appropriate, a form of re-parenting therapy.

~~~

To reference this paper in a publication, please use the following citation:

Byrne, J. (2009/2013) What is cognitive emotive narrative therapy (CENT)?  CENT Paper No.2(a).  Updated June 2012 and February 2013. Hebden Bridge: The Institute for CENT.  Available online: http://www.abc-counselling.com/id75.html

~~~

Originaly posted in April 2009: (Updated: 13th April 2011, 21st June 2012; and 22nd February and 3rd May 2013).

Copyright (c) Dr Jim Byrne, 2009-2013, The Institute for CENT

http://www.abc-counselling.com/id112.html

May 2013

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[1] Byrne, J. (2009) Rethinking the psychological models underpinning Rational Emotive Behaviour Therapy (REBT).  Cent Paper No.1(a).  Hebden Bridge: The Institute for CENT.  Available online: http://www.abc-counselling.com/id184.html.

[2] Byrne, J. (2009) The ‘Individual' and its Social Relationships - The CENT Perspective.  CENT Paper No.9.  Hebden Bridge: The Institute for CENT.  Available online: http://www.abc-counselling.com/id185.html

[3] Wampold, B.E. (2001) The Great Psychotherapy Debate: Model, methods, and findings. Mahwah, NJ: Lawrence Erlbaum.

[4] Messer, S. and Wampold, B. (2002) Let's face facts: Common factors are more potent than specific therapy ingredients.  Clinical Psychology: Science and Practice. 9: 21-25.