What Is Schema Therapy?

By: Mary Elizabeth Dean

Updated March 18, 2021

Medically Reviewed By: Lauren Guilbeault

Have you ever met someone who seemed to go through the same thing over and over again? Whether it be entering into bad relationships, struggling with addiction, or crippling self-esteem issues, many of the negative situations in our lives seem like a broken record.

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Would you be surprised to learn that this isn't a coincidence, but a scientifically proven phenomenon that happens because of self-defeating core themes know as 'schemas'? These negative feelings and thoughts like "I'm not good enough" and "My needs will never be met" are developed in childhood and morph into deep-seated patterns that cycle on and on until something is done to change them.

One of the most beneficial ways to activate this change is schema therapy.

Schema Therapy: A Brief Overview

Schema therapy was started by Jeffrey Young. It is an integrative and comprehensive therapy that involves elements of many different treatment aspects including behavioral, attachment, cognitive, gestalt, and psychodynamic therapies.

When dealing with mental disorders, behavioral and cognitive techniques are the key modes of treatment. However, the schema therapy model gives equal importance to therapeutic relationships and the focus on the patient's emotion.

Jeffrey Young developed schema therapy for use with people whose mental health needs could not be solved using cognitive behavioral therapy. It focuses mainly on the premise that most personality disorders stem from unmet emotional needs during childhood. In the past, personality disorders such as Borderline Personality Disorder were thought of as 'unchangeable.' This caused many mental health professionals hesitant to work with patients suffering from BPD and in the like.

But success through Schema Therapy and other breakout techniques are giving new hope to people whose emotional problems were once thought 'untreatable.' Schema therapy is effective in treating other personality disorders such as paranoid personality disorder and narcissistic personality disorder among others. It is also effective in solving such problems as anxiety, chronic depression, eating disorders, posttraumatic stress, and substance abuse among others.

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What Is A 'Schema' And How Does Schema Therapy Work?

A schema is described as a continuing negative pattern that starts during childhood. Schemas are strengthened by actions, core beliefs, relationships, and thoughts throughout a person's life. Examples of negative trends that are schema beliefs are such as: "No one loves me," "I will never succeed," I'm ugly," "I'm a failure," among others. It is important to note that some schema beliefs can develop during adulthood and not necessarily during childhood, but those rooted in the early years can be especially powerful.

According to schema therapy, the maladaptive schemas starts to form because of bad childhood experiences. Maladaptive schemas can also be explained as the ways through which people interpret life occurrences and other people's behaviors, and their effect on life later. Maladaptive schemas can make people make the wrong choices in life such as engaging in toxic relationships, poor social skills, harmful behaviors, and having negative feelings of low self-esteem or worthlessness.

When emotional needs such as the need for safety, love, and affection are unmet during childhood, one goes into adulthood without the ability to come up with ways of making sure that their needs are met by having healthy relationships and meeting their emotional needs independently.

The main aim of therapists who use schema therapy is to assist people in addressing and fulfilling their unmet needs. It helps in modifying deep-rooted negative feelings or patterns.

Unlike cognitive behavioral therapy that shows the patient's how to get rid of the negative emotions, schema therapy uses various techniques to bring out the necessary change in a person with a focus on their feelings.

Techniques During Schema Therapy

Schema therapy incorporates CBT techniques and experiential and emotion-focused techniques during treatment. It dwells on the argument that one can experience meaningful change if higher levels of emotions are reached in the brain.

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During a typical Schema Therapy session, flashcards are created so that the individual can write messages intended for the people who failed in meeting the emotional needs during childhood. One can develop messages by composing simple poems or just writing a few sentences. During the schema therapy session, the person will continuously go through the flashcards. This helps them to come up with positive statements concerning their emotional needs to people who matter during their adult lives. The sentiments that the individual expresses on the flash card is then internalized, and this comes in handy in the development of healthy adult mode.

Schema diaries are also recommended to patients. They provide a guide for the patents to understand their experiences when the schemas are triggered by comparing it to what they are learning during the schema therapy. The patient can record their progress in comparison to the theoretical concepts that they are introduced to during treatment sessions.

For experiential and emotion-focused therapy, the techniques used are imagery, and chairwork are often used as they activate a higher level of emotional change in the individual.

Imagery gives people the chance to explore their unpleasant childhood events and better understand how their maladaptive schemas developed. During childhood, the right side of the brain is dominant, and it is through this that a child's experiences are created. Researchers believe that maladaptive schemas are stored in the right hemisphere which also is the place where strong feelings are centered.

During imagery, patients are asked to imagine anything that is involved with their bad memories or experiences and then have imaginary dialogues with the people who caused these bad experiences. They then imaginary ask the caregivers to meet their needs. Imagery is very useful in helping the individuals to grieve their losses and overcome traumatic events.

Other techniques are chair work and limited reparenting. According to schema therapy, if one's needs are not met during childhood can lead to negative patterns, therefore, having the needs met even as an adult can assist in healing and stopping the maladaptive schemas.

What Happens During Schema Therapy?

During a schema therapy session, the therapist does the following:

Assessing the patient to identify the maladaptive schemas. He/she will get to know you and understand your schemas and the effect that they have on you.

Second, the client is helped to develop emotional awareness and get in touch with the schemas. The emotional or experiential awareness helps in activating the schemas.

The next step is the behavior change where the maladaptive schemas are replaced with the correct ones. Check out the following schemas and see if you can relate to any of them in particular.

Definitions Of The 18 Schemas

Emotional deprivation: having the belief that other people will not give you protection or empathy or believing that adequate emotional support cannot be met by others.

Mistrust: believing that others will humiliate, use you, abuse or hurt you. One has the perception that every form of harm is intentional.

Dependence: believing that one cannot handle their responsibilities without getting assistance from others. For example, making the right decision and tacking new tasks, etc. The state of helplessness.

Defectiveness or shame: having feelings of being unwanted, invalid or inferior. As a result, one may become hypersensitive to criticism or rejection.

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Entitlement: It is also known as grandiosity. Often one has beliefs that one is superior to others and should get special rights. It may present with excessive competitiveness, controlling behavior, and lack of empathy.

Undeveloped self: having feelings of being intertwined to others especially the parents. It can compromise development. It has excessive emotional closeness with significant others, and this often leads to a lack of individualism.

Alienation or social isolation: having the belief that you are isolated from the world.

Abandonment: belief that others cannot be relied on to provide emotional support that is needed arising from their emotional instability,

Vulnerability to harm: having constant worries that bad things or catastrophes will happen.

Failure: belief that one is a failure or will eventually fail in terms of life achievements such as career,

Insufficient Self-control: refusing to exercise self-control. One presents as having an exaggerated emphasis on avoiding conflict, pain, and responsibilities.

Approval is seeking: the excessive desire of getting recognition, attention, and approval from others. In such a case self-esteem depends on the reactions of other people.

Punitiveness: believing that people should be punished for their mistakes. Involves difficulty forgiving others and one is often angry, punitive, and intolerant.

Unrelenting standards: belief that one must work hard towards meeting very high standards of performance to avoid criticism. Often present as perfectionism and having rigid rules.

Negativity or pessimism: having a consistent focus on life's negatives such as betrayal, death, and pain among others. At the same time, one is always reducing the positive aspects of life. People with such traits often present as having chronic worry, constant complaints, and indecisiveness.

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Self-sacrifice: it is the meeting of the needs of people at the expense of personal needs. The main reason for this is for connection maintenance and to avoid being labeled as selfish.

Subjugation: giving too much control to others to avoid being abandoned or angering the other party. Subjugation can be n terms of one's needs and emotions. Mostly manifests as being overly compliant and can lead to anger and maladaptive traits such as substance abuse or psychosomatic symptoms.

The Effectiveness Of Schema Therapy On BPD (Borderline Personality Disorder)

Studies have shown that Schema Therapy is very useful in treating BPD and the like, but you don't have to be diagnosed with a personality disorder to benefit. Initial goals during the therapy session are the identification of the client's relevant schemas and linking the schemas to the patient's past or current occurrences as well as their symptoms.

Schema Therapy is effective in helping patients with borderline personality disorders break free from damaging patterns. According to one study, participants who underwent Schema Therapy no longer experienced symptoms of BPD after eight months of treatment.

Final Thoughts On Schema Therapy

Schema therapy is a practical, evidence-based approach that is very effective in treating personality disorders. It helps in changing negative patterns or maladaptive schemas that individuals develop during childhood into positive behaviors. At betterhelp.com we have highly qualified therapists, counselors, and psychologists who are experts in conducting schema therapy and are ready to work with you today. All you have to do is reach out to be matched with a qualified mental health specialist in your area.


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