What is Schema Therapy?
Schema Therapy was originally developed by a psychologist named Jeffery Young in the late 1980’s and since then many other clinicians and researchers have contributed to its growth and modification. “watch Gemma Gladstone talk about schema therapy”.
In psychology a schema can be described as a mental structure of ideas and cognitions (a mental representations of how things are in the world) or a system of organizing and perceiving information. A ‘schema’ (or an early maladaptive schema) is a fairly stable trait or aspect of personality which develops in childhood through interactions with caregivers and other early experiences. Such experiences, interactions or patterns of attachment are negative and tend to be repetitive in nature. They can be obvious experiences of traumatic events or less obvious forms of trauma such as emotional abuse or 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 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.
The thing about ‘needs’ is that they are innate (ie, in-born). If they are not met by our caregivers during (early) childhood, then there are developmental consequences – that’s just the way it is.
There will always be individual differences in the way people cope with unmet or violated needs. When core emotional needs are not met, usually on a consistent basis over time (in early life), a 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 (the YSQ). 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, people will have an urge to act in a certain way. These behavioural responses are referred to as ‘coping styles’.
Coping styles have been grouped into three categories:
(1) Surrender – means to accept the schema without question
(2) Avoidance – means to avoid the pain of the schema by avoiding triggers
(3) Over-compensation – means to ‘fight’ against the schema to try and convince yourself otherwise
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 in the therapy to help people change or resolve vulnerabilities. The therapy has been informed by a number of different theoretical orientations including: psychoanalytic psychology (especially Object Relations Theory and Transactional Analysis); Gestalt Therapy and Cognitive-Behavioural Therapies
The different components of Schema Therapy include:
(1) cognitive interventions – like cognitive therapy
(2) behavioural pattern breaking – resisting the urge to respond in the same ways and to try new ways
(3) experiential interventions (such as guided imagery re-scripting and 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 – although it is possible to get some change 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 also depends 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.