Schema Therapy
If you hold beliefs about yourself that impact your decisions, the way you view the world, and how interact with other people, Schema Therapy may be for you.
Schemas… what are they?
A ‘schema’ in the context of Schema Therapy is an extremely stable, enduring negative pattern of behaviour that develops during childhood or adolescence in response to your core needs not being met. They determine your beliefs about yourself, and are often accepted without question. For instance, children who develop a schema that they are incompetent may respond to that schema throughout their life by not challenging themselves - for example in a career, or putting in their best effort at work, or being the best partner that they can be in a relationship - and so never thrive, and may in fact perform poorly. These actions reinforce the belief that they are incompetent.
Schemas can lead to low self-esteem, lack of connection to others, problems expressing feelings and emotions and excessive worrying about basic safety issues. The beliefs can also create strong attractions to inappropriate partners and lead to dissatisfying careers. (Schema Therapy Institute)
Twenty specific schemas have been identified, where most clients have at least two or three of these schemas (and often more). Here’s a list of the 20 schemas, with brief explanations:
Emotional Deprivation: the belief that your primary emotional needs will never be met by others.
Abandonment/Instability: the expectation that you will soon lose anyone with whom an emotional attachment is formed.
Mistrust/Abuse: the expectation that others will intentionally take advantage of you in some way.
Defectiveness/Shame: the belief that you are internally flawed, and that others will realize this and withdraw from you.
Social Isolation/Alienation: the belief that you are isolated from the world and different from other people.
Dependence/Incompetence: the belief that you are not capable of handling day-to-day responsibilities competently and independently.
Vulnerability to Harm and Illness: the belief that you are always on the verge of experiencing a major catastrophe (financial, natural, medical, criminal, etc.).
Enmeshment/Undeveloped Self: a pattern in which you experience too much emotional involvement with others – usually parents or romantic partners.
Failure: the belief that you are incapable of performing as well as others.
Subjugation: the belief that you must submit to the control of others in order to avoid negative consequences.
Self-Sacrifice: the excessive sacrifice of your own needs in order to help others.
Fear of Losing Control: the excessive inhibition or disconnection of spontaneous emotion due to a fear of losing control of one’s impulses leading to dire consequences.
Emotional Constriction: the excessive inhibition or disconnection of spontaneous emotion due to underlying embarrassment or shame.
Approval-Seeking/Recognition-Seeking: the placing of too much emphasis on gaining the approval and recognition of others at the expense of your genuine needs and sense of self.
Unrelenting Standards/Hypercriticalness: the belief that whatever you do is not good enough, that you must always strive harder.
Entitlement/Grandiosity: the belief that you should be able to do, say, or have whatever you want regardless of whether that hurts others or seems reasonable to them.
Insufficient Self-Control/Self-Discipline: the inability to restrain expression of your impulses or feelings.
Negativity/Pessimism: a pervasive pattern of focusing on the negative aspects of life while minimizing the positive aspects.
Punitiveness (self): the belief that one should be punished for making mistakes or not meeting expectations.
Punitiveness (other): the belief that others should be punished for their indiscretions.
People respond to their schemas differently (referred to as coping styles), where they may surrender to them (e.g., do not set goals due to a belief that they will fail), overcompensate in response to them (e.g., try really hard in studies to overcompensate for a failure schema), or avoid them (e.g., not completing assessments on time to avoid the fear of failure). At any given time a schema may be activated, which triggers a temporary way of responding (referred to as a mode). A number of modes have been identified. For example, there may be a part of you that at times feels lonely, isolated, and sad - this part of you could be described as the vulnerable child. (Schema Therapy Institute; Yalcin et al., 2022)
Schema Therapy
Dr. Jeffrey Young (PhD) developed Schema Therapy in response to noticing that some clients did not benefit as much from the standard cognitive approach to therapy. These clients typically had long-standing, self-defeating ways of thinking and feeling (and consequently in behaving or coping) that required a different means of intervention. Dr. Young’s attention turned to ways of helping his clients to address and modify these deeper patterns or themes. (Schema Therapy Institute)
Schema Therapy is an integrating approach that combines aspects of cognitive behavioural therapy, psychodynamic therapy, and attachment-focused therapy. Schema Therapy begins with a series of assessments to identify your schemas, ways of coping, and modes, as well as an exploration of the origin of your schemas. We work together to recognise self-defeating patterns of behaviour that have perpetuated your schemas over your life. Therapy uses cognitive strategies to identify when your unhealthy patterns of behaviour are repeating, and we challenge these patterns together. In addition, there is a focus on experiential techniques including imagery rescripting and chair work. Through these exercises we work together to process difficult memories and aim to change the meaning of these memories and give you the opportunity to express your feelings and needs. We work to identify and implement healthy ways of responding, for lasting change. As the therapist, I provide a partial antidote to meeting some of your needs that may not have been met in your childhood. (Schema Therapy Institute)
Schema Therapy is typically a longer term therapy, requiring weekly sessions. The duration of therapy depends on the individual’s unique presentation and engagement with the therapy, which may be six months in duration, through to a number of years.
Who is Schema Therapy appropriate for?
Schema therapy may be a treatment option if you have been struggling with negative beliefs about yourself over a long period of time, and these beliefs have led you to engage in unhelpful patterns of behaviour. If you have struggled with mental health difficulties for a long period of time and other shorter-term treatment options have not been effective in resolving your difficulties, Schema Therapy may be a viable option for you. Because Schema Therapy explores early maladaptive schemas, it is a good treatment option when early life experiences play a large role in your current difficulties. Schema Therapy has been shown to be effective in increasing adaptive ways of functioning (Peeters et al., 2021) and reducing early maladaptive schemas (Taylor et al., 2017).
Research has shown that early maladaptive schemas are associated with childhood abuse and neglect (Pilkington et al., 2020), and so may be a relevant form of therapy for those who present with complex trauma. Schema Therapy is effective in the treatment of personality difficulties, including borderline personality disorder (Taylor et al., 2017) and antisocial personality disorder (Gibbon et al., 2020). It has also been shown to be effective in treating chronic anxiety, obsessive compulsive disorder, and post-traumatic stress disorder (Peeters, Passel et al., 2021), and may be indicated for those with eating disorders due to the presence of early maladaptive schemas (Maher et al., 2022).
Schema Therapy is a form of therapy that I use with my clients, where appropriate based on your needs and goals for therapy. Please contact me to find out more.
Resources
Reinventing Your Life, by Jeffrey E Young and Janet S Klosko
Breaking Negative Thinking Patterns, by Gitta Jacob, Hannie van Genderen, and Laura Seebauer
