Schema Therapy

This page describes the main principles of Schema Therapy and how it can help with more difficult issues.

Although Paul is not a member of the Schema Therapists Association, he has adapted many of the core principles into his everyday therapeutic work.

Schema Therapy was developed by Jeffrey Young, Janet Klosko and Marjorie Weishaar to address a fundamental limitation (from their point of view) with “conventional” Cognitive Behavioural Therapy (CBT); that of providing better and more consistent results for patients suffering from “Characterological” or “Personality” disorders that do not seem to respond particularly well to “Directive” therapies.

In their own words:

Schema Therapy is an innovative Psychotherapy developed by Dr. Jeffrey Young for personality disorders, chronic depression, and other difficult individual and couples problems.

Schema Therapy integrates elements of Psychoanalysis, Cognitive Therapy, Behavioural Therapy, Object Relations, and Gestalt Therapy into one unified, systematic approach to treatment.

They recognised that people suffering from these long term, habitual problems tended to derive some (usually short-term) benefits from Cognitive Therapies but did not necessarily develop an effective and lasting “emotional” sense of resolution.

What is a Schema?

Within the world of Cognitive Psychology a Schema is: “an abstract cognitive plan that serves as a guide for interpreting information and solving problems.”

We might think of a Schema as a “Belief System”, a set or rules and filters that we use to understand what any external experience “means” to us.

Schema Therapy is interested in what are known as “Maladaptive Schemas”, or belief systems that results in negative experiences for us.

We would also call these “Limiting Beliefs.”

As with Belief Systems, Maladaptive Schemas may lie below the level of consciousness and so seem beyond any conscious control.

Schemas as Un-met Core Emotional Needs

Young et al, believe that these “Maladaptive Schemas” are the direct result of having one or more “Core Emotional Needs” not met in childhood, and therefore become integrated into the Personality of the individual.

These Core Emotional Needs are:

1. Secure attachments to others (these attachments include; Safety, Stability, Nurturance & Acceptance)
2. Autonomy, competence & a sense of identity
3. Freedom to express valid needs & emotions
4. Spontaneity & Play
5. Realistic Limits & Self Control

It is believed that these core needs are universal and that a psychologically “healthy” individual can adapt to meet these needs.

If these core emotional needs are un-met then a schema (a maladaptive scheme in fact) is likely to develop to “compensate” for this loss.

Once a schema is adopted, the individual then copes with the associated “loss” by developing a set of “Coping Mechanisms”, or “Behavioural Adaptations” designed to minimise the loss. These coping mechanisms and behaviours are sometimes known as “safety behaviours”.

Schema Coping Mechanisms

These “coping mechanisms” are believed to fall into one of three main arenas directly associated with the primal survival instincts of “Freeze”, “Flight” or “Fight.”

The Schema Therapy creators labelled these as:

• Surrender (Freeze)
• Avoidance (Flight)
• Overcompensation (Fight)

So, whenever faced with a situation that “triggers” a particular schema, people will use a “coping response” in line with one of these “styles.”

As an example, consider a person who has a “Mistrust/Abuse” schema.

People with this Schema have an expectation that other people will:

• Hurt them
• Abuse them
• Humiliate them
• Cheat on them
• Lie to them
• Manipulate them
• Take Advantage of them

and so behave in one the following ways, depending on their particular personality pre-dispositions:

Surrender

Selects abusive partners and permits abuse

Avoidance

Avoids becoming vulnerable and trusting anyone

Overcompensation

Uses & Abuses others (“Get them before they get you.”)

Behavioural Adaptations Can Be Automatic

Cognitive Science claims that we cannot have a (negative) emotional response without there first being a “thought” or cognition, however, neuro-science research carried out in the mid *1990’s seems to clearly demonstrate that an emotional response can be “hard-wired” in a part of the brain known as the Amygdala that is able to “respond” to a “triggering event” without the need for the brains “cortex” to create a “cognition” in the first place.

This is a critical point as what it means is that a person can experience a negative emotional experience without needing to have any conscious thought at all.

In such cases Cognitive Behavioural Therapy is unlikely to have any impact on these problems!

*LeDoux 1996 – (Click To Review Joseph LeDoux on Wikipedia).

Schema Therapy Methodology

Following a course of Schema Therapy normally involves the following;

Phase 1: Assessment & Educational Phase

• Establish a life history
• Identify relevant Schemas & Limiting Beliefs created by unmet core emotional needs
• Link the Schemas to childhood or adolescent experiences
• Identify the associated maladaptive coping responses (Surrender/Avoid/Overcompensate)
• Establish a conscious link between the current problems and child-related problems
• Identify issues of confirmation bias

Phase 2: Change

• Build a cognitive case against the validity of the Schemas
• Develop Emotional and Experiential tools to de-construct Schemas
• Utilise behavioural pattern-breaking tools and techniques
• Therapist-client psychodynamic support mechanisms (Empathic Confrontation & Limited Re-parenting models)