Schema Therapy was developed by Jeffrey Young. In the early 1980’s Young was working with Aaron Beck, the “father” of Cognitive Therapy, when he began to take a particular interest in the patients who did not respond to cognitive therapy, and those who would make gains only to relapse.
What are Schemas?
By examining the work that he and others were doing with these patients, he discovered that they all had in common a series of constructs (schemas) about the self, others, and the future that were particularly detrimental to healthy functioning. He labelled these Early Maladaptive Schemas: “early”, because Young believed they develop when a child’s core needs (including security, autonomy, competence, freedom of expression, identity, spontaneity, realistic limits, and self-control) are not met.
The schemas may reflect experiences people had as children (for example the schema of mistrust/abuse), or reflect the survival mechanisms that they used to adapt to difficult situations as children (for example the schema of self-sacrifice or approval seeking). However irrational these schemas may appear to the individual on close logical examination, they are believed to be, and are treated as accurate and highly emotionally charged.
Young has identified 18 early maladaptive schemas which fall under five schema domains. These schema domains are:
- Disconnection and Rejection: The expectation that one’s need for security, safety, stability, nurturance, empathy, sharing of feelings, acceptance, and respect will not be met in a predictable manner.
Includes the schemas of: Abandonment/Instability, Mistrust/Abuse, Emotional Deprivation, Defectiveness/Shame and Social Isolation/Alienation.
- Impaired Autonomy and Performance: Expectations about oneself and the environment that interfere with one’s perceived ability to separate, survive, function independently, or perform successfully.
Includes the schemas of: Dependence/Incompetence, Vulnerability to Harm or Illness, Enmeshment/Undeveloped Self and Failure.
- Impaired Limits: Deficiency in internal limits, responsibility to others, or long-term goal orientation.
Includes the schemas of: Entitlement/Grandiosity and Insufficient Self-Control/Self-Discipline.
- Other-Directedness: An excessive focus on the desires, feelings, and responses of others, at the expense of one’s own needs in order to gain love and approval, maintain one’s own sense of connection, or avoid retaliation.
Includes the schemas of: Subjugation, Self-Sacrifice and Approval-Seeking/Recognition-Seeking.
- Over-Vigilance and Inhibition: Excessive emphasis on suppressing one’s spontaneous feelings, impulses and choices or on meeting rigid, internalised rules and expectations about performance and ethical behaviour, often at the expense of happiness, self-expression, relaxation, close relationships or health.
Includes the schemas of: Negativity/Pessimism, Emotional Inhibition, Unrelenting Standards/Hypercriticalness and Punitiveness.
As maladaptive schemas represent the self, others and the future in harsh and upsetting ways, and they are believed by the individual to be absolutely true, people develop ways to cope with the emotional impact of the schema.
Essentially an individual has three ways of coping with a schema:
1. Surrender: The schema is accepted as true and the individual feels the emotional pain of the schema directly. They act in ways that confirm the schema, thus without realising it they repeat schema-driven patterns and often find themselves reliving the childhood experiences that created the schema.
Example – someone with the mistrust/abuse schema selects abusive partners and permits abuse.
- Avoidance: To avoid a problematic schema, individuals will try to arrange their lives so that the schema is never activated. They pretend the schema doesn’t exist, block thoughts and images that might trigger it or distract themselves. If feelings start to surface they reflexively push them down, and if this does not work they may drink excessively, take drugs, have promiscuous sex, overeat, compulsively clean, seek stimulation, or become workaholics. They may get to the point where they avoid whole areas of their life in which they feel vulnerable.
Example – someone with the mistrust/abuse schema avoids becoming vulnerable and trusting anyone; keeps secrets.
- Overcompensation: The schema is fought by thinking, feeling, behaving and relating as though the opposite of the schema were true. Effort is applied to being as different as possible from the children they were when the schema was acquired. The problem with overcompensating is that individuals tend to get locked into counter-attacking the schema aggressively. To avoid the vulnerability and emotional pain of the schema, the behaviour of overcompensators is usually excessive, insensitive or unproductive.
Example – someone with the mistrust/abuse schema uses and abuses others (“get others before they get you”).
Treatment using Schema Therapy
The initial goal in schema therapy is to make a connection between the presenting problem and the individual’s problematic core beliefs. Schema therapy is a collaborative therapy, and the client and therapist will work together to identify maladaptive schemas and challenge the validity of them.
The final stage is behavioural pattern-breaking. This involves identifying behaviours that are a problem (coping modes), finding and practicing alternatives, and implementing these alternatives effectively in the client’s daily life.
Greta Neilsen is a Loganholme psychologist utilising schema therapy in her integrative approach to therapy. She endeavours to provide her clients with a safe space to understand the challenges they face, as they develop ways to overcome their difficulties.
To make an appointment with Loganholme Psychologist Greta Neilsen, please call (07) 3067 9129 or you can book online today.
- Young, J. E., Klosko, J., & Weishaar, M. (2003). Schema therapy. New York: Guilford Press.