Schema Therapy

[David Baxter PhD]

Schema Therapy
Urban Monk
February 20, 2011

Overview:
One of the modalities I love is Schema Therapy. This approach builds on traditional cognitive therapy, and focuses a lot more on identifying and healing schemas. Schemas are long-standing patterns of negative thoughts, emotions, and behaviours. They are underneath and cause a lot of our more surface problems, and the ST researchers have identified a list of the most common schemas that many of us have. Even better, they incorporate a lot of techniques from other systems such as psychoanalysis. In my experience, these techniques add so much more to the method and their inclusion is the main reason I enjoy it so much.

My experiences:
ST stands out from the other approaches as a ?bottom-up? approach; in other words, they start by identifying and healing the underlying cause instead of the surface problem. Although healing the underlying cause might be slower, once it changes, so does all our surface problems.
For example, one of my old problems was the tendency to give too much and then feel hurt if the other person didn?t reciprocate enough (and even if they do I still felt it wasn?t enough). Now this was a surface problem. However, this problem had an underlying root, the schema of emotional deprivation. If I fixed this problem but not the underlying schema, it leaves my deprivation active in other parts of my life. Further, it makes me vulnerable to restart my surface problem, the selfish giving. (This is not to say the ?top-down? approaches are worthless, most problems are not so long-standing or hard to change.) Identifying my schemas showed me all the other unhealthy behaviours I was doing but was unaware of ? very eye-opening and powerful.

One possible danger, though, is going through the list and finding out more schemas than you bargained for, therefore giving yourself more reason to hate yourself. Take note if you?re prone to beating yourself up or are feeling very down.

To find out more:
When I used ST, I found two major books on it. Re-inventing Your Life is the ?self-help? version of the book, and it provides information on the schemas, how to identify if it is something you suffer from, and practical self-applicable advice on recognizing how it negatively affects you and how to overcome them. There is an emphasis on taking action, which is something many of us need.

The Schema Therapy: Practitioner?s Guide was the other book I found. This was the book I really fell in love with, mostly because it contained some very powerful techniques that aren?t available in Re-inventing Your Life. However, this is with good reason, as you would need a professional in order to apply these additional techniques. If you are experienced in such techniques, try the Practitioner?s Guide. I?ve used these additional techniques on myself, and even though I?m not a Schema Therapy professional, I got a lot of benefit from them. This is not to say that Re-inventing Your Life is not good though, as it is fantastic.

You can find information on the official website and on Wikipedia, but they don?t present the best parts of Schema Therapy, in my opinion.

 

[Daniel E.]

Also:

A Client’s Guide to Schema Therapy

When I used ST, I found two major books on it. Re-inventing Your Life is the “self-help” version of the book, and it provides information on the schemas, how to identify if it is something you suffer from, and practical self-applicable advice on recognizing how it negatively affects you and how to overcome them. There is an emphasis on taking action, which is something many of us need.

That book, Re-inventing Your Life, is certainly the best way to understand what they are talking about, especially since there is not a ton of articles on the subject. The book reminds me of the "tough love" approach in DBT.

 

[Daniel E.]

 

[Daniel E.]

List of maladaptive schemas - Wikipedia

en.wikipedia.org

This is a list of maladaptive schemas, often called early maladaptive schemas, in schema therapy, a theory and method of psychotherapy. An early maladaptive schema is a pervasive self-defeating or dysfunctional theme or pattern of memories, emotions, and physical sensations, developed during childhood or adolescence and elaborated throughout one's lifetime, that often has the form of a belief about the self or the world.

Disconnection and rejection​

Abandonment/instability The belief system involving the sense that significant others will not be able to continue providing support, connection, strength, or protection because they are unstable, unpredictable, unreliable; because they will eventually die; or because they found someone better.

Mistrust/abuse The belief system involving the sense that others will intentionally hurt, abuse, humiliate, cheat, lie, manipulate, take advantage, or neglect.

Emotional deprivation The belief that one's standard for emotional support will not be met by others.

Defectiveness/shame The belief that one is defective, bad, unwanted, inferior, or unworthy. This includes the fear of insecurities being exposed to significant others, accompanied by hypersensitivity to criticism, rejection, and blame.

Social Isolation/alienation The belief that one is isolated from other people; the feeling of not being a part of any groups.

Impaired autonomy and performance​

Dependence/incompetence The belief that one cannot handle daily responsibilities without the help of others.

Vulnerability to harm or illness The belief system involving the exaggeration of fear that catastrophe will strike at any time; the catastrophes may be medical, emotional, or external.

Enmeshment/underdeveloped self The belief system that one must please others at the expense of self or social development.

Failure The belief that one will fail in everything.

Impaired limits​

Entitlement/grandiosity The belief that one is superior to others, which allows one to have special rights and privileges.

Insufficient self-control/self-discipline The conflict between life goals and low self control, perhaps seeking comfort instead of trying to perform daily responsibilities.

Other-directedness​

Subjugation The belief that one should surrender control to others, suppressing desires in order to avoid anger, retaliation, or abandonment.

Self-sacrifice The belief system involving excessive selflessness, focused on meeting the needs of others at the expense of one's own desire.

Approval-seeking/recognition-seeking The desire to gain approval, recognition, or attention from other people at the expense of developing a secure and true sense of self.

Overvigilance and inhibition​

Negativity/pessimism The belief system involving the overemphasis on the negative aspects of life including pain, death, loss, disappointment, conflict, guilt, resentment, unsolved problems, potential mistakes, betrayal, or things that could go wrong; neglecting positive aspects of life.

Overcontrol/emotional inhibition The belief system involving the inhibition of actions, feelings, or communications to avoid negative consequences.

Unrelenting standards/hypercriticalness The belief that one must strive to meet very high personal standards, usually to avoid criticism, leading to hypercriticalness toward self and/or others.

Punitiveness The belief that people should face consequences for their mistakes.

 

[Daniel E.]

Schema Modes Therapy Exercises & Worksheets | Psychology Tools

Schema therapy combines cognitive, behavioral, psychodynamic and gestalt ideas. Download schema therapy worksheets from Psychology Tools.

www.psychologytools.com

Schema therapy (ST) is an integrative approach that brings together elements from cognitive behavioral therapy, attachment and object relations theories, and Gestalt and experiential therapies. It was introduced by Jeff Young in 1990 and has been developed and refined since then. Schema therapy is considered an effective way of conceptualizing and treating personality disorders. Rafaeli, Bernstein, and Young (2011) and Jacob and Arntz (2013) describe some of the distinguishing features of schema therapy.

• ST places more emphasis than traditional CBT upon the development of current symptoms.
• ST emphasizes the therapist–patient relationship and its potential for corrective influence.
• ST aims to help patients understand their core emotional needs and to learn ways of meeting those needs adaptively.
• ST focuses extensively on the processing of memories of aversive childhood experiences, making use of experiential techniques to change negative emotions related to such memories.

 

[Daniel E.]

Schema Therapy Society e.V. (ISST) - Limited Reparenting

LIMITED REPARENTING​

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The Heart of Schema Therapy​

The process of limited reparenting is the heart of the treatment in schema therapy and is one of its most unique and defining elements. Its centrality and power has been gaining strong empirical support through the results of two randomized control trials of schema therapy. These outcome studies have found that a large percentage of patients with Borderline Personality Disorder can achieve full recovery across the complete range or symptoms. The drop out rate in these studies was extremely low. The patients in these studies attributed a great deal of the effectiveness of the treatment and the low drop out rate to limited reparenting.

Meeting Needs and Establishing a Secure Attachment​

Limited reparenting flows directly from schema therapies assumption that early maladaptive schemas and modes arise when core needs are not met. Schema therapy’s aim is to meet these needs by helping the patient find the experiences that were missed in early childhood that will serve as an antidote to the damaging experiences that led to maladaptive schemas and modes. Limited reparenting, paralleling healthy parenting, involves the establishment of a secure attachment through the therapist, within the bounds of a professional relationship, doing what she can to meet these needs. Research spanning a wide range of disciplines supports the notion that secure attachment is at the root of adaptive functioning, well-being and flourishing.

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The Broad Range of Limited Reparenting​

The focus of limited reparenting spans a broad range of needs including early connection, joy, adequate limits, and autonomy. Just as the process of parenting takes widely different forms, limited reparenting may involve warmth and nurturance, firmness, self-disclosure, confrontation, playfulness, and setting limits amongst other things. It takes the form of simultaneous tenderness and firmness through what is called “empathic confrontation”. It will also vary depending upon the phase of treatment. For this reason, schema therapy cannot be typified by a particular stance such as neutrality, firmness or nurturance. It is best typified by the broad range of responses and inclinations on the part of the therapist it incorporates, its flexibility, and the organization of these responses around the core needs of the patient.

Limited Reparenting and Trusting Needs​

The limited reparenting approach to early needs for connection sets schema therapy apart from most other approaches to psychotherapy. The prevailing view is that autonomy is most effectively promoted by teaching patients to regulate their affect through teaching skills or remaining therapeutically neutral and thus keeping the patient from becoming dependent upon the therapist for this regulation. The process of limited reparenting involves welcoming and encouraging this dependency. The therapist’s regulation of the patient’s affect becomes internalized by the patient and forms a healthy adult mode modeled on the therapist’s. This healthy adult mode becomes a strong foundation for the establishment of autonomy. In this way limited reparenting is based upon more trust of these early dependency needs and a belief that is more effective to gratify than fight them.

The Key steps in Limited Reparenting​

Limited reparenting involves reaching the Vulnerable Child Mode and reassuring, being firm with or setting limits on the avoidant and compensatory modes or coping styles that block access to the Vulnerable Child Modes or schemas. In the midst of this, the therapist helps to provide constructive outlets for what is called the Angry Child Mode. In addition, it often requires that the therapist help the patient fight punitive, demanding, or subjugating parent modes or schemas. These steps are usually facilitated by the use of guided imagery; an experiential technique that allows the therapist to establish more direct contact with the various modes and schemas.

(by George Lockwood, Posted on Dec 27, 2008)

 

[Daniel E.]

Regarding "empathic confrontation":

2. Empathic Confrontation - STUCKNESS: describes the opposite of intentionality, or a lack of - StuDocu

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