What is Schema Therapy?
Each of us is born with an innate desire for connection, understanding, and growth. Our desire for connection includes our desire to be known, heard, seen, valued, and affirmed by those around us. If our stories include emotional deprivation, neglect, trauma, abuse, and/or loss, our innate desires will become encompassed with sorrow, grief, and pain.
A schema is our cognitive structure that provides the foundation for understanding people, places, objects, and events; they enable us to organize our knowledge of the world and process new information. Schemas come with pros and cons: on the one hand, our schemas allow us to process and understand the world around us, on the other hand, our schemas can cause us to have narrow thinking, which can also result in stereotypes. If undealt with, our maladaptive schemas can result in low self-esteem, disconnection in relationships, barriers in communicating our needs and emotions with others, and anxiety. They may also play a role in being attracted to unhealthy relationships and career discontentment. Your counselor will work with you to explore past and/or present unmet emotional needs and how they have affected your schemas. You and your therapist will discuss your current schemas, both positive and negative, how your schemas developed, how maladaptive coping styles may be feeding into your unhealthy schemas, and how to make changes in your schemas. Schema therapy will help you to grow in self-confidence, improve your ability to create and enjoy nurturing relationships, and provide guidance as you develop and achieve your goals for a healthy and wholesome life.
How was Schema Therapy Developed?
In the 1980s, Dr. Jeffrey Young began to develop schema therapy after finding cognitive behavioral therapy to be ineffective for some of the patients, particularly patients with chronic illnesses. The creation of schema therapy included combining an eclectic mix of concepts and techniques from other therapeutic modalities, such as attachment theory, object relations, cognitive behavioral therapy, constructivist, Gestalt, and psychoanalytical approaches. Recently, mindfulness meditations have been incorporated into schema therapy, allowing for a more holistic spiritual approach.
Schema therapy understands that neurophysiology plays a critical role in its approach. Neuroscientists (who study the nervous system, the brain, and its effects on behaviors and cognitions) discuss how each of us is born with the ability to grow and heal from painful situations. Healing occurs within the context of safe, positive, and responsive relationships - when we experience these healthy relationships, our brains produce chemicals and hormones that enhance emotional regulation, stress regulation, and neural rewiring. Throughout the therapeutic process, as the brain heals and rewires, we can begin to experience decreases in depression, anxiety, and loneliness, providing us with more peace.
What are Schemas?
Schemas are our frameworks through how we view the world and organize and interpret information around us. Our schemas are created based on our life experiences and how we process them. Here are a few examples of some different schemas:
Emotional deprivation schema: the belief that your needs will never be met, as there is no one who will nurture you, care for you, protect you, or show you compassion
Mistrust/abuse schema: the belief that everyone around you is abusive, manipulative, narcissistic, out to hurt you, and never to be trusted
Vulnerability schema: the belief that the world around you is dangerous and something bad could happen at any moment
Other examples of schemas include thoughts such as “No one will ever love me”, “I’m a failure”, and “No one cares about me”.
Schemas develop early in life, often resulting from unmet needs for connection, autonomy, play, spontaneity, limits, and assertion. These schemas are then repeated and built on over the course of a person's life, potentially hindering their ability to attain their life goals and have their needs met.
How we deal with our schemas results in different schema coping modes, which are triggered by sensitive situations we find ourselves in. Examples of schema modes include:
Child Modes
Vulnerable child: tends to be lonely, isolated, unsupported, anxious, overwhelmed
Angry child: tends to experience intense anger, frustration, and impatience
Happy child: tends to be loved by and connected with those around them, fulfilled, protected, accepted
Maladaptive Coping Modes
Compliant surrenderer: tends to be passive, submissive, and a people-pleaser
Detached protector: tends to cut off their own needs and feelings, emotionally isolates from those around them
Maladaptive Parent Modes
Punitive parent: tends to be very punishing of their child, blameful, rigid rules
Demanding parent: tends to have unrealistic high standards which their children must meet to be loved and cared for
How Does Schema Therapy Work?
In schema therapy, you will explore some of your schemas that involve negative life beliefs. Your therapist will work with you to identify your maladaptive schemas and modify them to be more balanced and healthy. Through this process, you will grow in self-worth and self-confidence, learning how to have your needs honored and met. Different techniques you and your therapist will do include:
Imagery exercises, where you explore difficult childhood memories and identify the sights, sounds, and other sensations associated with the memory. You then process through the memory and rewrite it in a way that ends with your needs being met. Many clients find that after doing this, they are able to identify current situations that trigger their maladaptive schema modes and handle the situation in a way that ends with their needs being met.
Flashcards, in which you will create messages to your caregivers who did not meet your needs as a child. This helps you learn to effectively articulate your needs in the present moment.
Chair work, in which you move between two chairs having conversations. This may be a mock conversation between you and your caregiver or between the present you and you as a child. You will practice discussing the moments in which your needs were discarded and unmet.
Who Could Benefit From Schema Therapy?
Schema therapy is effective in treating a range of mental health concerns, including PTSD, eating disorders, anxiety, substance use, depression, and personality disorders, including narcissism. It can also be helpful in reducing criminal behavior.
Sources
About Schema Therapy. (2022). About Schema Therapy. SCHEMA therapy institute.
Schema Therapy. (2016). Schema Therapy. GoodTherapy. https://www.goodtherapy.org/learn-about-therapy/types/schema-therapy
What Is a Schema in Psychology? (2022). What Is a Schema in Psychology? Verywellmind. https://www.verywellmind.com/what-is-a-schema-2795873