Schema Therapy

Schema Therapy was originally developed by a psychologist named Jeffery Young in the 1990’s and since then many other clinicians and researchers have contributed to its growth and modification.  A ‘schema’ is a fairly stable trait or aspect of our personality which develops in childhood through interactions with caregivers and other early experiences.  Such experiences, interactions or patterns of attachment are typically negative and tend to be repetitive in nature.  They can be obvious experiences of traumatic events or less obvious forms of emotional abuse or emotional neglect.  Examples include experiences of abandonment at a young age, or verbal messages from a parent that made you feel unworthy or defective.   In other words, these ‘Early Maladaptive Schemas’ developed when one or more of our core emotional childhood needs are not met or violated over time.  Many researchers have written about core emotional needs and Young et.al (2003) has grouped them into 5 categories: (1) safety and nurturance (2) autonomy, competence and a sense of identity (3) freedom to express needs, emotions and opinions (4) spontaneity and play and (5) realistic limits and self-control.  When these needs are not met, usually on a consistent basis over time (in early life), the child grows up developing unhelpful thinking styles, painful emotions and often dysfunctional ways of coping in life.  A child might develop a particular tendency to see themselves, the world and others in unhelpful ways and may grow up with rigid beliefs about themselves or other people – these beliefs feel very real to the person and will often dictate their behaviours.  So a ‘schema’, is akin to a very deeply held core belief or a ‘life script’.  Schemas tend to be very robust (ie, they want to survive and search for evidence to prove themselves right!).

It’s important to remember that everyone has schemas, and if a person is depressed they might even score more highly on the questionnaires used to measure schemas.  Our schemas (how many we have and how strong they are) will differ as a function of our early experiences in conjunction with the nature of our temperament (ie, the traits we were born with).  It is possible for a schema to develop very early in life, even at the pre-verbal (infant) level.  The abandonment schema – for example, can develop very early in life.  There are 18 identified maladaptive schemas and your therapist can provide you with a list and information about each schema.

A schema can be triggered by a situation or circumstance in a person’s life.  When the schema is triggered, a person will have feelings and thoughts which are tired up with the schema and which support the schema.  For example, someone with a strong abandonment schema may experience a relationship breakup as devastating, even if they only knew the person for a short time.  They might feel annihilated by the breakup and think that a reliable and stable relationship is unachievable for them.  They might believe that all future partners will leave them and this is just the way it is meant to be.  These thoughts and feelings will influence how they behave in relationships – often to their own detriment.  So, when a schema is triggered (or activated), people will have an urge to respond or act in a certain way.  These behavioural responses are referred to as ‘coping styles’.  Coping styles have been grouped into three categories: (1) Surrender (2) Avoidance and (3) Over-compensation.  This means that people can differ greatly in the way they respond to a schema being activated.  For example, a person with a strong ‘defectiveness’ schema might respond to criticism by getting very depressed and believing that they are worthless (ie, they are surrendering to the ‘idea’ that they are defective).  Or, they might also seek to avoid exposure to situations where they might be judged or criticised (ie, they are attempting to avoid the emotional pain of the schema).  Finally, a person might get annoyed and try to prove themselves right or act in a superior way in order to make themselves feel better (ie, they may over-compensate for their feelings of defectiveness or inadequacy by ‘fighting against the schema’ and blocking their true feelings).  Each and every schema has identifiable coping styles which can be grouped into these three categories.  None of these coping styles are very helpful in the long term because they only serve to keep the schema alive – they all supply fuel to the schema.  When we respond to being triggered in these ways, the schema gets reinforced over time and becomes more difficult to change.  It is very important for a person to identify their coping behaviours because one way to initiate change is at the behavioural level by altering how someone responds.  Your therapist can provide you with further information about coping styles and give you a table which illustrates some examples for each schema.

Schema therapy itself is an integrative therapy.  This means that different methods are used with the therapy to help people create change.  The different components of Schema Therapy include: (1) cognitive interventions – like cognitive therapy (2) behavioural pattern breaking – which includes resisting the urge to respond in the same old ways and to try new ways of responding; (3) experiential interventions (such as guided imagery for re-parenting and re-scripting and gestalt-like chair work) and (4) ‘here & now’ relational methods – which focus on the therapeutic relationship.  In this last one, the therapist can offer the client insights around how they might be perceived by others.  The therapist can also offer different ways of relating to others, which will help the client get their emotional needs met in a healthy way.  All these components are necessary for change to occur.  For change at a deeper level, which includes healing wounded child parts of the self (ie, vulnerable child modes), we find that experiential methods are an essential part of the therapy.

Schema therapy is usually a medium to long-term therapy (e.g, 6 months or more of regular or semi-regular sessions).  However, depending on your personal needs and situation, it is possible to get some change much earlier, just from understanding your own schemas and recognising what they feel like when triggered.   Schema therapy is a very hopeful, compassionate and practical therapy.  It doesn’t shy away from emotions and uses emotion-focused interventions to create real and lasting change.  One of the main goals of the therapy is to teach clients how to care and support themselves in a nurturing and helpful way, so that they can become their ‘own best parent’.  Being able to identify and get your emotional needs met (inside and outside of therapy) in a healthy and effective way is a key aim of schema therapy.  Schemas and modes (discussed later) can be modified and changed through therapy.  Therapy can help take the sting out of the schema/s and can greatly reduce the amount of emotional suffering and negative coping styles experienced by the client.  Success does also depend upon the client participating and trying new ways of responding when a schema is triggered.  It is not a passive therapy which seeks only to provide insight.  It requires that the client challenge themselves in ways that may feel uncomfortable.  It also requires the client to actually feel the pain of their schemas.  As the saying goes “you’ve got to feel it, to heal it!”  But this is a good thing ultimately and helps clients break free from old beliefs and life scripts which may have been holding them back for years or causing great emotional suffering.

Most people can benefit from Schema Therapy because we all have some degree of difficulty in our life which is linked to a schema.  Everyone has schemas.  Have you ever wondered why your emotional buttons get pushed, or why you seem to push other people’s buttons?  The answer is tied up in understanding your schemas, what they are, where they came from, and what or who triggers them.  So gaining some insight around your schemas at an intellectual level firstly is helpful so you can have a framework for understanding your issues or problems.

As well as identifying schemas, the therapy also looks at operational ‘personas’ or parts of the self.  These parts of self are called ‘modes’.  People can ‘flip’ in and out of these modes or may be in a default mode for most of the time.  There are core ‘child’ modes; learned ‘parent’ modes; and various non-helpful coping modes which can also be grouped into three types: (1) avoidant modes, (2) over-compensatory modes and (3) a general surrendering mode, called the ‘compliant surrender’.  There is also the ‘healthy adult’ mode – which therapy aims to strengthen and promote.  Modes are considered to be moment-to-moment cognitive-emotional states (or personas) which a person can ‘live in’ and ‘operate from’.  Each mode may have a specific behavioural response or set of responses when triggered and each mode will have a particular function or purpose.  As observers, we experience people as being in a mode or having a dominate mode.  Having an appreciation for modes, is a useful way to understand how and why a person might be behaving and to understand your own behaviours.  Your therapist can give you a list of modes and may ask you to complete a questionnaire which measures your modes.  When you complete any schema questionnaire, for best results, it is always important to complete it from an emotional place.  Don’t try to intellectualise the questions – just give your ‘gut’ responses.  This way, the results may actually be useful and you and your therapist will have a fairly reliable chart summary to discuss.  Questionnaires are only one aspect of the therapy.  They are never used to understand all of you, only to measure certain aspects of you.  You should always tell your therapist if you think the results don’t make sense, so you can work it out together.

When schemas and /or modes are very strong and go uncheck or unchanged for a long time they become factors which play a very real role in the cause of emotional/psychological health problems like depression.  By modifying your schemas, you can actually greatly reduce your vulnerability to future depression, clinical anxiety and other psychological disorders.  In particular, schema therapy is very useful for anyone with recurrent or long-standing mental health or psychological difficulties. Things like, multiple episodes or recurrent depression; depression which is difficult to shift; reoccurring negative events or persistent low self-esteem.  It’s also very helpful for people with problematic romantic or family relationships and for people whose own personality styles tends to interfere with their well-being, relationships and general functioning.  Good examples of problems which are driven by schemas include: being a self-sacrificer who can’t say “no” and becoming depressed or ill as a result; being attracted to ‘unavailable’ partners over and over again; expecting or anticipating that others will have control over you and carrying a lot of anger internally; expecting yourself to be perfect and not feeling good enough; feeling inferior to others; feeling inadequate and not able to stand on your own two feet; expecting loved ones to leave or disappoint you; being able to trust other people; having volatile or difficult relationships or avoiding romantic relationships all together .