Schema therapy is a modern form of therapy that uses an integrative approach, combining elements of cognitive-behavioural therapy (CBT), psychoanalysis, attachment theory and more.
Schema therapy is based on a belief that all humans are striving towards connection, understanding and growth, but that certain things stand in the way. It is designed to identify and address the client’s unmet needs to help them break negative patterns of behaviour or thought.
Schema therapy is helpful in treating chronic depression, anxiety and relationship difficulties and is shown to prevent relapse in those struggling with substance abuse. Schema Therapy is an evidence-based approach that has shown to be particularly effective in the treatment of people with personality disorders such as borderline personality disorder (BPD).
What Is a Schema?
Schemas are unhelpful patterns of thoughts or behaviours that can develop if a person’s emotional needs aren’t met as a child. These schemas can impact you throughout life and lead to the development of problematic or damaging coping methods or behaviours if they aren’t identified and addressed.
These schemas often consist of dysfunctional thought patterns and feelings and pose significant barriers to achieving your desires or goals and ultimately having your needs met as an adult, especially the need for love and belonging.
Some examples of schema beliefs are:
“I will never be good enough,”
“I’m a failure,”
“I will never have my needs met,”
“People don’t care about me,”
“I’m not important,”
“Something bad is going to happen,”
The development of these schemas is directly linked to not having your needs met as a child, and dysfunctional coping modes often stem from an unstable childhood where an individual didn’t have their needs met. Emotional memories of past hurt, fear, abuse, neglect, unmet safety needs and abandonment are all commonly linked to the development of schemas.
What Are a Child’s Needs?
A child’s core needs include:
- a sense of safety and secure attachment to others
- a sense of self-identity and autonomy
- the freedom of self-expression, to share how you feel and ask for what you need
- the ability to engage in various forms of play and be spontaneous
- safe, age-appropriate limits and boundaries
Some children’s basic needs are not met repeatedly and chronically over time, reaching a point in which their health and development is seriously affected. This is when early maladaptive schemas can form in response.
People develop different kinds of coping styles or reactions to their schemas. These vary from person to person, and two people with the same schema could develop two completely different coping styles. This can be compared to stress or trauma – two people who experience the same traumatic event could have completely different reactions at the time of the event, and following the event. For example, in the case of a violent assault, one person may freeze, and another may fight or run away (flight). Similarly, one person may experience PTSD following the event, and another may not. Mental health professionals have not yet concluded the exact reason for this.
Your own coping style may change over time, even though you’re still dealing with the same schema. There are three coping styles:
This generally means accepting a schema and ‘giving in’ or surrendering to it. This can cause a ‘self-fulfilling prophecy’ where a person engages in behaviour that reinforces the schema pattern.
An example of surrender is accepting emotional neglect in a relationship as an adult as a result of a schema that formed as a child due to parental emotional neglect.
This is not destined to happen and does not happen in all situations. Schema therapy aims to address the root of a schema such as this and identify what emotional needs may not have been met as a child, helping you avoid the negative aspects of a schema coping style and address self defeating patterns of behaviour that can result in low self-esteem.
Schema avoidance is when an individual attempts to live their life without triggering the schema. This may include avoiding activities or situations that could make you feel vulnerable or triggered.
This can lead to risky or compulsive behaviours, eating disorders, psychological problems and substance use.
Overcompensation is when a person acts in complete opposition to a schema, this can often become extreme or go too far. Behaviour can become aggressive, intense or seemingly excessive. It may give the illusion of being in control to begin with, but lead to emotional dysregulation and stress and take a toll on your mental health and relationships in the long run.
Schema focused therapy aims to provide healthier alternatives to these coping mechanisms, addressing mental health concerns through finding the core emotional needs that you may not have had met as a child. Schema therapy or schema-focused cognitive therapy focuses on the unhelpful schemas that form and offers a way of helping individuals restructure thinking patterns related to their struggles.
What Are Schema Modes?
In schema therapy, a mode is a temporary mindset that includes both your present emotional state and the way that you are dealing with it. Modes can be helpful (adaptive) or unhelpful (maladaptive).
Schema modes help therapists categorise schemas and group them together in order to address them as a single state of mind, rather than individual traits.
Schema modes are divided into four categories:
- Child modes are characterised by childlike feelings and behaviours. The vulnerable child mode is often the focus of schema therapy.
- Dysfunctional coping modes (maladaptive coping modes) can be helpful in childhood, but in adulthood, they can reinforce schemas.
- Dysfunctional parent modes are internalisations of external, often parental voices that were critical, demanding, or harsh.
- Healthy adult mode represents your healthy, functional self. This helps you regulate the other modes.
Early Maladaptive Schemas
Early maladaptive schemas are cognitive and emotional patterns that are most often self-defeating and negative that are established in childhood and repeated throughout life. The more severe the schema, the more intense the negative feeling or emotion will be when the schema is triggered and generally, the longer it will last. Moreover, more pervasive schemas will be triggered by a greater number of situations.
Schema therapy is all about overturning negative thought patterns and behaviours. During therapy sessions, you’ll work with a therapist to unpick these schemas and link them back to specific childhood events and experiences. You will then go through a process of letting go of unhealthy schemas that may have developed as a result of adverse childhood experiences and develop healthy ways of processing emotions. Schema therapists help you find the root of schemas by tracing past unmet core emotional needs and subsequently learning to construct healthier behaviour patterns and relationships. This can help people reframe their core beliefs about themselves and the world around them. Schema therapy work can help you begin to build feelings of self-worth and adequacy.
Early maladaptive schemas lead to unhelpful coping styles or beliefs about yourself and the world. These may have protected you as a vulnerable child, but emotional deprivation in the early years can lead to self sacrifice, approval-seeking, pessimism and emotional inhibition in adulthood. It can lead to the belief that your emotional needs will never be met.
Schema Therapy Sessions
Schema therapists may use several techniques over the course of therapy. Certain techniques that work well for some, may not work for others so it is important to let your therapist know what is and is not working for you. The therapeutic relationship is incredibly important in schema therapy.
Whether it is to treat mental health conditions, address relationship problems or for treating personality disorders, schema therapy has shown remarkable results in helping people to change patterns that they have lived with for years. Schema therapy is shown to help even when other methods and efforts that individuals have tried before have been unsuccessful.
At Addcounsel, we offer a multi-pronged approach to treatment that makes use of a wide range of therapy options to help you become the best version of yourself. Contact us today to hear more about how schema therapy can help you overcome and restructure unhelpful thoughts and behaviour patterns and maintain healthy relationships.