Understanding the Power of Schemas
We all have patterns of thinking and behavior that shape our lives. Some of these patterns serve us well, while others can lead to recurring problems in relationships, work, or personal growth. Schema Therapy, developed by Dr. Jeffrey Young in the 1980s, is an innovative and integrative approach that addresses these deeply ingrained patterns, known as schemas, to promote lasting psychological change1.
What is Schema Therapy?
Schema Therapy is a comprehensive approach to treatment that combines elements of cognitive-behavioural therapy (CBT), attachment theory, psychodynamic concepts, and emotion-focused therapy. It was originally developed to treat personality disorders and chronic psychological issues that were not responding well to traditional therapies2.
The core idea behind Schema Therapy is that many psychological problems stem from unmet emotional needs in childhood, leading to the development of maladaptive schemas – deeply held beliefs about oneself, others, and the world3.
Key Concepts in Schema Therapy
1. The 18 Early Maladaptive Schemas
Schemas are broad, pervasive themes that develop during childhood and are elaborated throughout an individual’s lifetime. They are comprised of memories, emotions, cognitions, and bodily sensations.
Early Maladaptive Schemas are organised into five domains. Here’s a breakdown of each schema with brief descriptions:
| Domain | Schema | Description |
|---|---|---|
| I. Disconnection & Rejection | 1. Abandonment | Fear that close relationships will end imminently |
| 2. Mistrust/Abuse | Expectation that others will hurt, abuse, or take advantage | |
| 3. Emotional Deprivation | Belief that one’s emotional needs will not be met by others | |
| 4. Defectiveness/Shame | Feeling that one is defective, bad, or inferior | |
| 5. Social Isolation | Feeling that one is isolated from the rest of the world | |
| II. Impaired Autonomy and Performance | 6. Dependence/Incompetence | Belief that one is unable to handle everyday responsibilities competently |
| 7. Vulnerability to Harm/Illness | Exaggerated fear that catastrophe will strike at any time | |
| 8. Enmeshment/Undeveloped Self | Excessive emotional involvement with others, often at the expense of full individuation | |
| 9. Failure | Belief that one has failed, will fail, or is fundamentally inadequate | |
| III. Impaired Limits | 10. Entitlement/Grandiosity | Belief that one is superior to others and entitled to special rights |
| 11. Insufficient Self-Control/Self-Discipline | Difficulty exercising self-control and tolerance of frustration | |
| IV. Other-Directedness | 12. Subjugation | Excessive surrendering of control to others |
| 13. Self-Sacrifice | Excessive focus on meeting the needs of others at the expense of one’s own gratification | |
| 14. Approval/Recognition-Seeking | Excessive emphasis on gaining approval or recognition from others | |
| V. Overvigilance & Inhibition | 15. Negativity/Pessimism | Pervasive focus on the negative aspects of life |
| 16. Emotional Inhibition | Excessive inhibition of spontaneous action, feeling, or communication | |
| 17. Unrelenting Standards | The belief that one must strive to meet very high internalized standards of behavior and performance | |
| 18. Punitiveness | Belief that people should be harshly punished for making mistakes |
Understanding these schemas is crucial in Schema Therapy as it helps identify the core patterns that may be causing distress or dysfunctional behaviors. Therapists work with clients to recognise these schemas and develop strategies to challenge and modify them.
These schemas often operate on an unconscious level and can significantly influence how a person interprets and responds to situations4.
2. Coping Styles
In response to schemas, individuals develop coping styles. These are ways of managing the emotional pain associated with schemas. The three primary coping styles are:
- Surrender: Accepting the schema as truth and acting in ways that confirm it.
- Avoidance: Trying to avoid situations that might trigger the schema.
- Overcompensation: Behaving in a manner opposite to the schema.
While these coping styles may provide short-term relief, they often reinforce the underlying schema in the long run5.
3. Schema Modes
Schema modes are moment-to-moment emotional states and coping responses. They can be thought of as facets of the self that have been shaped by schemas and coping styles. Some common modes include:
- Vulnerable Child Mode
- Angry Child Mode
- Punitive Parent Mode
- Detached Protector Mode
- Healthy Adult Mode
The goal of therapy is often to strengthen the Healthy Adult Mode, which can nurture the Vulnerable Child Mode and set appropriate limits6.
The Process of Schema Therapy
Schema Therapy typically involves several phases:
- Assessment and Education: The therapist helps the client identify their schemas and understand how they developed.
- Emotional Awareness: Clients learn to connect with their emotions and recognize when schemas are activated.
- Cognitive Restructuring: This involves challenging the validity of schemas and developing more balanced views.
- Behavioral Pattern-Breaking: Clients learn new ways of coping and behaving that don’t reinforce their schemas.
- Relationship Repair: The therapy relationship is used to provide corrective emotional experiences.
Throughout these phases, the therapist employs a range of techniques, including cognitive, experiential, and behavioral interventions7.
Techniques Used in Schema Therapy
1. Imagery Rescripting
This powerful technique involves revisiting painful childhood memories and imaginally changing the outcome to meet the child’s unmet needs. This can help heal emotional wounds and challenge long-held beliefs8.
2. Chair Work
In this technique, the client dialogues with different aspects of themselves or significant others, often by moving between different chairs. This can help integrate different schema modes and resolve internal conflicts9.
3. Limited Reparenting
The therapist provides a corrective emotional experience by partially meeting the client’s unmet childhood needs within appropriate professional boundaries. This helps the client internalize a healthier parent figure10.
The Effectiveness of Schema Therapy
Research has shown Schema Therapy to be effective for a range of psychological issues, particularly personality disorders. A landmark study found that Schema Therapy was more effective than traditional psychodynamic therapy for Borderline Personality Disorder, with a lower dropout rate11.
Other studies have demonstrated its effectiveness for chronic depression, anxiety disorders, eating disorders, and complex trauma12.
The Power of Understanding Our Patterns
One of the most empowering aspects of Schema Therapy is the insight it provides into our own patterns of thinking, feeling, and behaving. By understanding the origins of our schemas and how they influence our lives, we gain the power to make conscious choices rather than react automatically based on old patterns.
Conclusion: A Path to Deep and Lasting Change
Schema Therapy offers a comprehensive framework for understanding and treating a wide range of psychological issues. By addressing deep-rooted patterns and unmet emotional needs, it provides a path to lasting change that goes beyond symptom management.
While it was originally developed for more severe psychological disorders, many of its principles and techniques can be beneficial for anyone seeking to understand themselves better and create positive change in their lives.
Take some time to reflect on recurring patterns in your life. Are there themes that seem to repeat in your relationships or work life? These patterns might point to underlying schemas. Awareness is the first step towards change!
→ Click here for more information about Schema Therapy services at Mind Health
References
Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy: A practitioner’s guide. Guilford Press. Link to book ↩
Rafaeli, E., Bernstein, D. P., & Young, J. (2011). Schema therapy: Distinctive features. Routledge. Link to book ↩
Young, J. E., & Klosko, J. S. (1993). Reinventing your life: The breakthrough program to end negative behavior and feel great again. Plume. Link to book ↩
Thimm, J. C. (2010). Personality and early maladaptive schemas: A five-factor model perspective. Journal of Behavior Therapy and Experimental Psychiatry, 41(4), 373-380. Link to paper ↩
Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy: A practitioner’s guide. Guilford Press. Link to book ↩
Arntz, A., & Jacob, G. (2013). Schema therapy in practice: An introductory guide to the schema mode approach. Wiley-Blackwell. Link to book ↩
Farrell, J. M., Reiss, N., & Shaw, I. A. (2014). The schema therapy clinician’s guide: A complete resource for building and delivering individual, group and integrated schema mode treatment programs. John Wiley & Sons. Link to book ↩
Arntz, A. (2011). Imagery rescripting for personality disorders. Cognitive and Behavioral Practice, 18(4), 466-481. Link to paper ↩
Kellogg, S. (2004). Dialogical encounters: Contemporary perspectives on “chairwork” in psychotherapy. Psychotherapy: Theory, Research, Practice, Training, 41(3), 310. Link to paper ↩
Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy: A practitioner’s guide. Guilford Press. Link to book ↩
Giesen-Bloo, J., Van Dyck, R., Spinhoven, P., Van Tilburg, W., Dirksen, C., Van Asselt, T., … & Arntz, A. (2006). Outpatient psychotherapy for borderline personality disorder: randomized trial of schema-focused therapy vs transference-focused psychotherapy. Archives of general psychiatry, 63(6), 649-658. Link to paper ↩
Masley, S. A., Gillanders, D. T., Simpson, S. G., & Taylor, M. A. (2012). A systematic review of the evidence base for schema therapy. Cognitive behaviour therapy, 41(3), 185-202. Link to paper ↩
