What is the goal of schema therapy and what makes it an extraordinary therapy for personality disorders, depression, anxiety and other mental health disorders? Schema therapists help their clients identify their core emotional needs so they can learn to meet these needs without relying on others, substances like drugs or alcohol, or even resorting to dysfunctional behaviours. Find out how this integrative approach to various mental health conditions can help people love themselves unconditionally despite any negative feelings they may have about themselves.
What is Schema Therapy?
Developed by Dr Jeffrey Young in 1989, the schema therapy treatment is a form of psychotherapy that focuses on changing the way an individual thinks and feels about themselves. It aims to treat individuals with chronic schemas or early maladaptive schemas, which are defined as the organised collection or patterns of thoughts, feelings, memories and perceptions that give meaning to a person's experiences. Schemas develop in childhood and influence the way people view themselves, others around them and their future.
Source: PsychLearning.com
According to studies of schema therapy, individuals with negative schemas may ignore them for years and rely on dysfunctional coping modes before seeking help. When their schema becomes overly protective, schema therapy can be helpful in countering the negative impact it may have on their life.
Because schemas are stored in the unconscious mind, schema therapy interventions can help people become aware of them and work through them. Cognitive restructuring and experiential techniques are among the common therapeutic techniques used to address early maladaptive schema modes during a schema therapy session. It involves processing the schema with the therapist until new perspectives on old beliefs emerge. A therapist can help a person process the schema by asking questions such as, "What would you say to the child within if you saw him/her feeling sad?" or "How does the schema show up for you?"
How Does Schema Therapy Work?
A schema-focused therapy is primarily intended to target schema child modes causing distress and disrupting everyday life. Because of their emotional deprivation as children, people with negative schemas find it difficult to maintain healthy relationships and let go of their negative patterns resulting from their core needs not being met when they were children. Schema therapists address the 18 schemas grouped into five categories which are as follows:
Disconnection & Rejection
Schemas of neglect, abuse, mistrust and shame fall into this category. The schema domain makes us feel mistrusted, deceived or abused by others who we think don't have our best interests in mind. This schema often comes from times when people may not have acted the way you expected them to (e.g. a friend breaking your trust) and leads to feeling alienated and unsafe with other people, especially those who you do not know very well yet. You may also fear that no one is ever going to like you because of this schema and become overly guarded towards new relationships.
Impaired Autonomy & Performance
The maladaptive schema modes included in this category are vulnerability, self-doubt and incompetence, making it challenging for one to function independently as a healthy adult. This schema makes us feel vulnerable to being rejected, criticized or abandoned. It is rooted in childhood abandonment experiences and can lead to extreme anxiety when we start feeling like people do not want to be around us. We may also fear rejection from what others think of us or what they could say about us behind our backs. What's more, this schema makes us question our own abilities, capabilities or personal judgement.
Impaired Limits
Growing up without proper parental supervision, a person with negative schemas that influence self-control may feel entitled and not know how to respect the boundaries of others. A schema therapy for patients who received inadequate guidance during their childhood is aimed at providing them with limited reparenting. This will equip them with the ability to set realistic limits in their life and respect those of others.
Other-Directedness
The schema that makes us feel like we are deprived of love, support, caring, interest, attention or respect from others. This schema often comes from times when we were criticized, ignored or did not feel loved by our parents, and may lead to a fear of being alone. As a result of this schema, we may also feel afraid that others could easily leave us or forget about us if they find someone better, especially if we have experienced significant people leaving us.
Overvigilance and Inhibition
The schema that makes us feel ashamed for wanting things we desire, even bodily sensations that others may not agree with. This schema comes from feeling criticized or punished for having our own thoughts or feelings as a child, and leads us to avoid conflict or standing up for ourselves. As a result of this schema, we may also feel guilty expressing our feelings and needs to other people because we think we do not deserve them.
In an individual schema therapy, the therapist uses cognitive techniques, including narrative therapy, experiential techniques and transference-focused psychotherapy (TF-CBT), which focus on resolving the client's early maladaptive schemas so that they can achieve a healthy adult mode.
Schema therapy can help people to identify schema modes in their lives that are not adaptive or helpful. The schema therapist will work with the person in the treatment of their schema modes, developing an effective treatment plan to shift existing schema modes to schema modes that are more functional and can promote healthier relationships, cognition, emotions, behaviour and thoughts.
What are the Benefits of Schema Therapy?
The effectiveness of schema therapy has been demonstrated in the treatment of a wide range of mental health disorders. Schema therapists believe that negative life experiences, such as divorce, neglect or abuse, lead to the development of early maladaptive schemas in all areas of a person's life, such as schema about oneself or schema about others. These maladaptive schema modes influence how we think, feel and behave. And when these schemas are unhealthy, schema therapy can help provide relief.
Schema therapists employ a wide range of psychological therapy techniques, particularly cognitive therapy components, to process the schema, which leads to symptom reduction. Over time, many people who receive schema therapy find their schemas change for the better, hence making schema therapy a staple in their lives. Among the conditions that schema therapy can help with are:
- Borderline personality disorder (BPD)
- Post-traumatic stress disorder (PTSD)
- Agoraphobia symptoms
- Low self-esteem
- Mood swings
- Poor interpersonal skills due to memories of childhood abuse or neglect
- Depression
- Anxiety
Difference Between Cognitive Behavioral Therapy (CBT) and Schema Therapy
Schema therapists and CBT therapists share some similarities, but there are several key differences between schema therapy and CBT. A schema-focused therapy works on negative experiences, such as neglect or abuse, whereas cognitive therapists focus on the here and now.
A schema therapist's role is to provide support that can help people gain insight into the schema they might otherwise be unaware of, whereas CBT therapists are more active in helping their clients change the schema that has long been influencing their thought and behavioural patterns.
Schema-focused cognitive therapy appears to have lasting effects that enable people to use schema techniques even after treatment has ended. Many schema therapists say the schema-focused approach should be considered before recommending medication since many people who have attended outpatient schema therapy no longer needed medication after therapy ended.
In addition to being an effective therapy for personality disorders, agoraphobia symptoms and other mental health disorders, using cognitive-behavioral therapy techniques in a schema therapy session can lead to therapeutic relationships as well. You can find a qualified practitioner of schema therapy in your local area by visiting the Natural Therapy Pages' practitioner listing pages.
