Schema therapy was developed as a way to treat patients with longstanding problems that hadn’t responded to other therapeutic methods.
Designed to help people with deeply-rooted personality disorders, schema therapy uses a mixture of:
- Cognitive-behavioural therapy
- Psychodynamic therapy
- Attachment theory
- Gestalt therapy
“Schema therapy thus developed into a modality that sees clients understand why they behave in the ways that they do (psychodynamic/attachment), get in touch with their feelings and attain emotional relief (gestalt), and benefit from learning practical, active ways to make better choices for themselves in the future (cognitive).”
US psychologist Dr. Jeffrey E. Young devised schema therapy after finding that some patients with lifelong problems were not responding to cognitive therapy. Furthermore, he realised that for them to change their negative present-day behaviours, they had to recognise what was in the past that was holding them back.
In other words, whatever was holding them back was blocking them from moving forward. Dr. Young believed that the thing holding them back was rooted in their childhood. Consequently, he realised that this is the self-defeating patterns started.
However, the problem is that for many people with longstanding problems, the traumatic event in their childhood is hidden deep within their subconscious. Before we move on, it’s important to discuss schemas; what they are and how they impact our lives.
What are schemas and how do they work within schema therapy?
A schema is a mental concept that allows us to make sense of our experiences. In addition, it’s based on the information we’ve collected from previous experiences. This information has been categorised to help us quickly understand the world around us. We have schemas for everything in life.
For instance, if we hear something above us in the air and it has a flapping sound, our previous schemas of birds (flying, wings, in the air, above us) will lead us to conclude that this is very likely to be another bird. We have schemas for gender, people, foreigners, food, animals, events and even our self.
There are four main concepts in Schema Therapy:
- Coping styles
- Basic emotional needs
1. Schemas in Schema Therapy
The type of schemas we are interested in is the negative schemas that develop during childhood. These early maladaptive schemas are extremely enduring, self-defeating thought patterns we have about ourselves. We have learnt to accept these schemas without question.
Additionally, they are particularly resistant to change and very difficult to shake off without help. Established in our childhood, we repeat them throughout our lives.
2. Coping Styles
We deal with maladaptive schemas by using various coping styles. As well as helping us deal with schemas they are also behavioural responses to the schemas.
Examples of coping styles:
- A person who had experienced a schema involving a childhood trauma might avoid similar situations which lead to a phobia.
- Someone who has experienced neglect may start using drugs or alcohol to ease the painful memories.
- An adult who had a loveless relationship with their own parents may isolate themselves from their own children.
When a person suffers from a maladaptive schema and then uses a coping style, they fall into a temporary state of mind called a mode.
There are 4 categories of modes which include child, adult and parent:
- Child (Vulnerable Child, Angry Child, Impulsive/Undisciplined Child, and Happy Child)
- Dysfunctional Coping (Compliant Surrenderer, Detached Protector, and Overcompensator)
- Dysfunctional Parent (Punitive Parent and Demanding Parent)
- Healthy Adult
So take the adult in our example above who had a loveless relationship with their own parents. They could use a coping style of isolation from their children and fall into the detached protector mode (where they detach emotionally from people).
4. Basic emotional needs
A child’s basic emotional needs are:
- To be safe and secure
- To feel loved and liked
- To have a connection
- To be listened to and understood
- To feel valued and encouraged
- To be able to express their feelings
If a child’s basic emotional needs are not met during childhood, then schemas, coping styles and modes can develop.
Schema therapy helps patients recognise these schemas or negative patterns. They learn to spot them in their daily lives and replace them with more positive and healthy thoughts.
The end goal of schema therapy is to:
Help a person to strengthen their healthy adult mode by:
- Weakening any maladaptive coping styles.
- Breaking the self-repeating schemas.
- Getting core emotional needs met.
The problem is because schemas often form in early childhood, many people have difficulty remembering or identifying the events that caused them. The actual perception of an event from a child’s point of view can form the schema.
Children often recall the emotion of the event but not what actually happened. As adults, they have the memory of the pain, anger, fear or trauma. But as a child, they do not have the mental capacity to deal with what actually happened.
Schema therapy takes the adult back to that childhood memory and dissects it as an adult would. Now, through an older and wiser person’s eyes, that fearful event is completely changed. As a result, the person can now acknowledge the schemas that have been holding them back and change their behaviour.
Now, I’d like to give you an example of my own negative schemas that have affected me throughout my life.
My schema therapy
When I was around 6 or 7, I was learning to swim in a public swimming pool with the rest of my classmates. I loved the water so much and was getting really confident with my armbands on. So much so that my swimming instructor picked me out of the whole class. He told me to take my armbands off and show everyone how far I could swim.
Maybe I was being a little cocky but I took them off, went swimming and then sank like a stone. I remember seeing the blue water above me and thought I was going to drown. Despite the fact I was swallowing water and struggling, no one came to my aid.
Eventually, I managed to surface, but instead of the instructor rushing to my side, he and everyone else were laughing. Consequently, I’ve never been in another swimming pool after that. At age 53, I still haven’t learned to swim.
After that experience, I always had a fear of being trapped and claustrophobic when in small spaces. Likewise, I don’t go in lifts as I feel I can’t breathe.
When I was 22, I was on holiday to Greece and it was extremely hot. I went out in the evening to a restaurant and when I arrived, I was led down into a basement area as upstairs was busy. There were no windows and it was stiflingly hot. No air, I couldn’t breathe and felt faint and panicky. For this reason, I had to get out immediately.
Later as we went to board the plane to leave, I had another panic attack on the plane. I felt trapped and that I could not breathe again. Since then, I had always had terrible anxiety with travelling.
How my schema formed
My schema therapist took me back to that day at the swimming pool. She explained that my fear and unresolved feelings after my near-drowning experience had started a maladaptive schema. This schema was connected to a fear of not being able to breathe.
When I entered the depths of the restaurant, it was as if I was underwater again. Again, on the plane, the airless feeling of the cabin reminded me, subconsciously, of drowning.
My schema was perpetuated because my needs were not being satisfied during my childhood. This led to the formation of my travel phobia in later life. Using schema therapy, I learnt that my fear of travelling had nothing to do with the incident on the plane. It all began with that first experience in the swimming pool.
Now I am taking steps to rid myself of the blockage caused by that drowning trauma and learning new coping styles.
If you’ve had schema therapy, why not let us know how you got on? We’d love to hear from you.
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