schema therapy
TRANSCRIPT
Schema
Therapy
Schema Therapy
Background Notes
Schema Therapy
Schema Therapy and Life Traps
Human beings are born vulnerable and completely unable to help themselves. This helpless condition forces the intelligence in us to quickly learn how to get what we need.
To come through childhood is a very difficult, very complex and an extremely vulnerable experience. Many things go wrong that are not healed. The relationship with the parents and specially the mother is fundamental in shaping the sense of identity a child forms.
Emotional wounds accumulate as parents and children interact in a way that is inadequate to fulfill the childs emotional needs.
These interactions are interpreted into painful beliefs and feelings the child has about itself which it accepts without question
Schema Therapy
Schema Therapy and Life Traps
Unhealthy behaviors develop as a reaction to false beliefs and
form a lifetrap into adulthood, unhealthy life-strategies that
keep you dependent on others for fulfilling your core emotional
needs.
When a schema erupts or is triggered by events, our thoughts
and feelings are dominated by these schemas. It is at these
moments that people tend to experience extreme negative
emotions and have dysfunctional thoughts.
The result of being stuck in a life trap is that you maintain parts
of you emotionally functioning as a child.
Schema Therapy
Lifetraps Conitued A life trap is created when a child puts together a set of memories,
emotions, bodily sensations and cognitions as a plan for adapting to a familiar condition. This is a reaction to the experience of abuse, abandonment, neglect or rejection by one or both parents.
Once this plan has been created it goes on automatic. Whenever a person encounters situations that the unconscious mind perceives as similar to what is known the trap gets activated
A life trap includes everything a person does internally and externally that keeps the plan for survival going.
This includes all the thoughts, feelings and behaviors that reinforce the false beliefs. The person’s self and world view becomes a self fulfilling prophecy.
Schema Therapy
Lifetraps Conitued Life traps are perpetuated by three primary mechanisms:
Cognitive (the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses) distortions: the person unconsciously misperceives situations. They
exaggerate information that confirms the trap and minimize or delete information that contradicts the trap.
Self-defeating life patterns: the person unconsciously chooses and continues to participate in
situations and relationships that trigger and perpetuate the trap.
Coping style: The trap is painful so the ego develops another plan to adapt. This
is a coping mechanism that when acted upon reinforces the trap.
Schema Therapy
Definition of a Schema
A broad, pervasive theme or pattern
Comprised of memories, bodily sensations,
emotions & cognitions
Regarding oneself and one's relationships with
others
Developed during childhood or adolescence,
and elaborated throughout one's lifetime
Dysfunctional to a significant degree
Schema Therapy
Definition of a Schema
A theme, not just a belief
Deeply entrenched patterns, central to one's
sense of self. Usually self-perpetuating.
Erupt when triggered by everyday events
relevant to the schema
Created by Toxic frustration of needs
Traumatization, victimization, mistreatment
Schema Therapy
Core Needs of the Child Schemas are formed when core emotional needs are not met during childhood and then
the schema prevents similar needs from being fulfilled in adulthood
The level of fulfillment of these core needs in your early childhood is the foundation for how you function in life now.
Core emotional needs
Safety
Predictability
Warmth
Affection
Playfulness and spontaneity
Understanding, protection and guidance
Acceptance and praise
Sense of belonging to a group or community
Needs for independence or freedom
Boundaries and limits
Reasonable expectations
Schema Therapy
Core Needs of the Child
A mature and healthy individual is one
who can adaptively meet their core
emotional needs in themselves.
The interaction with parents frustrates the
child temperament when these basic
needs are not gratifying to him. The child
adapts and a trap is created.
Schema Therapy
Parents & Lifetraps Critical > Defectiveness
Overprotective > Dependence
Cold > Emotional Deprivation
Controlling > Subjugation
Indulgent > Entitlement
Schema Therapy
We have highest chemistry
toward...
Partners who trigger our lifetraps
Partners who fill in the gaps in our own
self-esteem
Schema Therapy
5 Schema Domains
Schema Therapy
Early maladaptive schemas EMS serve as templates for the processing of data
experiences and have certain core characteristics:
They have unconditional rigid beliefs and feelings about oneself, and the world that the individual never challenges.
They form the core of the individual's sense of self.
They are self perpetuating and resistant to change.
They operate outside individual's conscious awareness.
Schema Therapy
Early maladaptive schemas
They are triggered by events relevant to the particular schema, and associated with extreme negative emotions.
Behaviours in do not form part of the schema; instead the schema drives the behaviour.
Schemas can be positive or negative, can develop early or late in life, vary in degrees of severity.
Schema Therapy
Early maladaptive schemas
18 EMS Identified and grouped under five
domains
Five domains:
1. Disconnection and rejection: the lack of
secure attachment.
2. Impaired autonomy and performance:
the lack of competence or a sense of
identity.
Schema Therapy
Early maladaptive schemas 3. Impaired limits: the lack of freedom to express valid needs
and emotions.
4. Other – Directedness: the loss of spontaneity and play.
5. Over vigilance and inhibition: the loss of realistic limits and self control.
EMS vary in severity and progressiveness; can be unconditional formed in the early as part of life and conditional schemas which are set to develop later.
Schema perpetuation refers to all thoughts, feelings and behaviours which reinforce and perpetuate the schema resulting in the maladaptive behaviour patterns seen.
Schema Therapy
5 Schema Domains Disconnection and rejection
Abandonment/instability Mistrust/abuse Emotional deprivation Defectiveness/shame Social isolation/alienation
Impaired autonomy and achievement Dependency/incompetency Vulnerability to harm and illness Enmeshment/undeveloped self Failure
Impaired limits Entitlement/grandiosity Lack of self-control/self-discipline
Othcr-directcdness Subjugation Self-sacrifice Approval-seeking
Hypervigilance and inhibition Negativity/pessimism Emotional inhibition Unrelenting standards Punitiveness
Schema Therapy
1. Disconnection and Rejection This schema domain is characterized by attachment difficulties.
All schemas of this domain are in some way associated with a
lack of safety and reliability in interpersonal relationships.
The quality of the associated feelings and emotions differs
depending on the schema—for example, the schema
“abandonment/instability” is connected to a feeling of
abandonment by significant others, due to previous
abandonment in childhood.
Individuals with the schema “social isolation/alienation,” on the
other hand, lack a sense of belonging, as they have
experienced exclusion from peer groups in the past.
Patients with the schema “mistrust/abuse” mainly feel
threatened by others, having been harmed by people during
their childhood.
Schema Therapy
2. Impaired Autonomy and
Performance #1
People with these schemas perceive themselves as
dependent, feel insecure, and suffer from a lack of self-
determination.
They are afraid that autonomous decisions might
damage important relationships and they expect to fail
in demanding situations.
People with the schema “vulnerability to harm and
illness” may even be afraid that challenging and
changing their fate through autonomous decisions will
lead to harm to themselves and others.
These schemas can be acquired by social learning
through models, for example from parent figures who
constantly warned against danger or illnesses, or who
suffered from an obsessive–compulsive disorder (OCD)
Schema Therapy
2. Impaired Autonomy and
Performance #2 The schema “dependency/incompetency” may develop
when parents are not confident that their child has age-
appropriate skills to cope with normal developmental
challenges.
Schemas Can also develop when a child is confronted with
demands which are too high, when they have to become
autonomous too early and do not receive enough support to
achieve it. Thus patients with childhood neglect, who felt
extremely overstressed as children, may develop dependent
behavior patterns in order to ensure that somebody will provide
them the support they lacked earlier in life, and thus do not
learn a healthy autonomy.
Schema Therapy
3. Impaired Limits People with impaired limits schemas have difficulty accepting normal
limits.
It is hard for them to remain calm and not cross the line,
They often lack the self-discipline to manage their day-to-day lives, studies, or
jobs appropriately.
People with the schema “entitlement/grandiosity” mainly feel entitled and tend
to self-aggrandize.
The schema “lack of self-control/self-discipline” is principally associated with
impaired discipline and delay of gratification.
These schemas are learnt by direct modeling and social learning. Often
patients were spoiled as children, or their parents were themselves spoiled in
their childhoods and/or had problems accepting normal limits.
These schemas can also develop when parents are too strict, when they inflict
too much discipline, and when limits are too narrow. In such situations, these
schemas develop as a kind of a rebellion against limits and discipline in
general.
Schema Therapy
4. Other-Directedness #1 People with other-directedness schemas typically put the
needs, wishes, and desires of others before their own. Most of
their efforts are directed towards meeting the needs of others.
Individuals with a strong “subjugation” schema always try to
adapt their behavior in a way which best accommodates the
ideas and needs of others.
In the schema “self-sacrifice,” the focus is more on an extreme
feeling of responsibility for solving everyone else’s problems;
typically feel that it is their job to make everybody feel good.
Schema “approval-seeking” have as a sole purpose pleasing
others; thus all their actions and efforts reflect that desire, rather
than their own wishes.
Schema Therapy
4. Other-Directedness #2 With regard to the biographical background and development
during childhood, these schemas are often secondary.
The primary schemas are often those from the domain
“disconnection and rejection”. I.e., schemas in the domain
“other-directedness” may have developed to cope with
schemas of disconnection and rejection..
Schema Therapy
5. Overvigilance and Inhibition
#1 People with Overvigilance and Inhibition schemas avoid the experience and
expression of spontaneous emotions and needs.
People with the schema “emotional inhibition” devalue inner experiences
such as emotions, spontaneous fun, and childlike needs as stupid,
unnecessary, or immature.
The schema “negativity/pessimism” corresponds with a very negative view of
the world; people with this schema are always preoccupied with the negative
side of things.
Schema “unrelenting standards” constantly feel high pressure to achieve;
they do not feel satisfied even when they achieve a lot, as their standards are
extremely high.
The “punitiveness” schema incorporates moral codes and attitudes that are
very punitive whenever a mistake is made, regardless of reason.
Schema Therapy
5. Overvigilance and Inhibition #2 These schemas are acquired by reinforcement and social modeling,
for example when parent figures mocked the spontaneous
expression of feelings, thus teaching their children to be ashamed of
being emotional.
This can also take place indirectly, for example when parents
reinforce only achievement and success, and devalue or ignore
other important aspects of life such as fun and spontaneity.
Some patients with these schemas report mainly negative
experiences regarding intense emotions in their childhood. They
started to avoid intense emotional experiences in order to protect
themselves against these aversive stimuli.
Schema Therapy
18 SCHEMAS
Schema Therapy
18 SCHEMAS1. ABANDONMENT / INSTABILITY (AB)
The perceived instability or unreliability of those available for support and connection. Involves the sense that significant others will not be able to continue providing emotional support, connection, strength, or practical protection because they are emotionally unstable and unpredictable (e.g., angry outbursts), unreliable, or erratically present; because they will die imminently; or because they will abandon the patient in favor of someone better.
2. MISTRUST / ABUSE (MA)
The expectation that others will hurt, abuse, humiliate, cheat, lie, manipulate, or take advantage. Usually involves the perception that the harm is intentional or the result of unjustified and extreme negligence. May include the sense that one always ends up being cheated relative to others or "getting the short end of the stick.“
Disconnection and rejection
Schema Therapy
18 SCHEMAS3. EMOTIONAL DEPRIVATION (ED)
Expectation that one's desire for a normal degree of
emotional support will not be adequately met by
others. The three major forms of deprivation are:
A. Deprivation of Nurturance: Absence of
attention, affection, warmth, or companionship.
B. Deprivation of Empathy: Absence of
understanding, listening, self-disclosure, or
mutual sharing of feelings from others.
C. Deprivation of Protection: Absence of strength, direction, or guidance from others.
Disconnection and rejection
Schema Therapy
18 SCHEMAS4. DEFECTIVENESS / SHAME (DS)
The feeling that one is defective, bad, unwanted, inferior, or invalid in important
respects; or that one would be unlovable to significant others if exposed. May involve
hypersensitivity to criticism, rejection, and blame; self-consciousness, comparisons, and
insecurity around others; or a sense of shame regarding one's perceived flaws. These
flaws may be private (e.g., selfishness, angry impulses, unacceptable sexual desires) or
public (e.g., undesirable physical appearance, social awkwardness).
5. SOCIAL ISOLATION / ALIENATION (SI)
The feeling that one is isolated from the rest of the world, different from other people,
and/or not part of any group or community.
Disconnection and rejection
Schema Therapy
18 SCHEMAS6. DEPENDENCE / INCOMPETENCE (DI)
Belief that one is unable to handle one's everyday responsibilities in a competent
manner, without considerable help from others (e.g., take care of oneself, solve daily
problems, exercise good judgment, tackle new tasks, make good decisions). Often
presents as helplessness.
7. VULNERABILITY TO HARM OR ILLNESS (VH)
Exaggerated fear that imminent catastrophe will strike at any time and that one will be
unable to prevent it. Fears focus on one or more of the following:
(A) Medical Catastrophes: e.g., heart attacks, AIDS;
(B) (B) Emotional Catastrophes: e.g., going crazy;
(C) (C): External Catastrophes: e.g., elevators collapsing, victimized by criminals,
airplane crashes, earthquakes.
Impaired autonomy and achievement
Schema Therapy
18 SCHEMAS8. ENMESHMENT / UNDEVELOPED SELF (EM)
Excessive emotional involvement and closeness with one or more significant others (often parents), at the expense of full individuation or normal social development. Often involves the belief that at least one of the enmeshed individuals cannot survive or be happy without the constant support of the other. May also include feelings of being smothered by, or fused with, others OR insufficient individual identity. Often experienced as a feeling of emptiness and floundering, having no direction, or in extreme cases questioning one's existence.
Impaired autonomy and achievement
Schema Therapy
18 SCHEMAS9. FAILURE TO ACHIEVE (FA)
The belief that one has failed, will inevitably fail, or is fundamentally inadequate
relative to one's peers, in areas of achievement (school, career, sports, etc.).
Often involves beliefs that one is stupid, inept, untalented, ignorant, lower in
status, less successful than others, etc.
Impaired autonomy and achievement
Schema Therapy
18 SCHEMAS10. ENTITLEMENT / GRANDIOSITY (ET)
The belief that one is superior to other people; entitled to special
rights and privileges; or not bound by the rules of reciprocity that
guide normal social interaction. Often involves insistence that one
should be able to do or have whatever one wants, regardless of
what is realistic, what others consider reasonable, or the cost to
others; OR an exaggerated focus on superiority (e.g., being
among the most successful, famous, wealthy) -- in order to
achieve power or control (not primarily for attention or approval).
Sometimes includes excessive competitiveness toward, or
domination of, others: asserting one's power, forcing one's point of
view, or controlling the behavior of others in line with one's own
desires---without empathy or concern for others' needs or feelings.
Impaired limits
Schema Therapy
18 SCHEMAS11. INSUFFICIENT SELF-CONTROL / SELF-DISCIPLINE (IS)
Pervasive difficulty or refusal to exercise sufficient
self-control and frustration tolerance to achieve
one's personal goals, or to restrain the excessive
expression of one's emotions and impulses. In its
milder form, patient presents with an exaggerated
emphasis on discomfort-avoidance: avoiding pain,
conflict, confrontation, responsibility, or overexertion-
--at the expense of personal fulfillment, commitment,
or integrity.
Impaired limits
Schema Therapy
18 SCHEMAS12. SUBJUGATION (SB)
Excessive surrendering of control to others because one feels coerced - -usually to avoid anger, retaliation, or abandonment. The two major forms of subjugation are:
A. Subjugation of Needs: Suppression of one's preferences, decisions, and desires.
B. Subjugation of Emotions: Suppression of emotional expression, especially anger.
Usually involves the perception that one's own desires, opinions, and feelings are not valid or important to others. Frequently presents as excessive compliance, combined with hypersensitivity to feeling trapped. Generally leads to a build up of anger, manifested in maladaptive symptoms (e.g., passive-aggressive behavior, uncontrolled outbursts of temper, psychosomatic symptoms, withdrawal of affection, "acting out", substance abuse).
Othcr-directcdness
Schema Therapy
18 SCHEMAS13. SELF-SACRIFICE (SS)
Excessive focus on voluntarily meeting the needs of others in daily situations, at the expense of one's own gratification. The most common reasons are: to prevent causing pain to others; to avoid guilt from feeling selfish; or to maintain the connection with others perceived as needy . Often results from an acute sensitivity to the pain of others. Sometimes leads to a sense that one's own needs are not being adequately met and to resentment of those who are taken care of. (Overlaps with concept of codependency.)
Othcr-directcdness
Schema Therapy
18 SCHEMAS14. APPROVAL-SEEKING / RECOGNITION-SEEKING (AS)
Excessive emphasis on gaining approval, recognition, or attention
from other people, or fitting in, at the expense of developing a
secure and true sense of self. One's sense of esteem is dependent
primarily on the reactions of others rather than on one's own
natural inclinations. Sometimes includes an overemphasis on
status, appearance, social acceptance, money, or achievement
-- as means of gaining approval, admiration, or attention (not
primarily for power or control). Frequently results in major life
decisions that are inauthentic or unsatisfying; or in hypersensitivity
to rejection.
Othcr-directcdness
Schema Therapy
18 SCHEMAS15. NEGATIVITY / PESSIMISM (NP)
A pervasive, lifelong focus on the negative aspects of life (pain,
death, loss, disappointment, conflict, guilt, resentment, unsolved
problems, potential mistakes, betrayal, things that could go
wrong, etc.) while minimizing or neglecting the positive or
optimistic aspects. Usually includes an exaggerated expectation--
in a wide range of work, financial, or interpersonal situations -- that
things will eventually go seriously wrong, or that aspects of one's
life that seem to be going well will ultimately fall apart. Usually
involves an inordinate fear of making mistakes that might lead to:
financial collapse, loss, humiliation, or being trapped in a bad
situation. Because potential negative outcomes are exaggerated,
these patients are frequently characterized by chronic worry,
vigilance, complaining, or indecision.
Hypervigilance and inhibition
Schema Therapy
18 SCHEMAS17. UNRELENTING STANDARDS / HYPERCRITICALNESS (US)
The underlying belief that one must strive to meet very high internalized standards of behavior and performance, usually to avoid criticism. Typically results in feelings of pressure or difficulty slowing down; and in hypercriticalness toward oneself and others. Must involve significant impairment in: pleasure, relaxation, health, self-esteem, sense of accomplishment, or satisfying relationships.
Unrelenting standards typically present as: (a) perfectionism, inordinate attention to detail, or an underestimate of how good one's own performance is relative to the norm; (b) rigid rules and “shoulds” in many areas of life, including unrealistically high moral, ethical, cultural, or religious precepts; or (c) preoccupation with time and efficiency, so that more can be accomplished.
Hypervigilance and inhibition
Schema Therapy
18 SCHEMAS16. EMOTIONAL INHIBITION (EI)
The excessive inhibition of spontaneous action, feeling, or communication --usually to avoid disapproval by others, feelings of shame, or losing control of one's impulses. The most common areas of inhibition involve: (a) inhibition of anger & aggression; (b) inhibition of positive impulses (e.g., joy, affection, sexual excitement, play); (c) difficulty expressing vulnerability or communicating freely about one's feelings, needs, etc.; or (d) excessive emphasis on rationality while disregarding emotions.
Hypervigilance and inhibition
Schema Therapy
18 SCHEMAS18. PUNITIVENESS (PU)
The belief that people should be harshly punished for making mistakes. Involves the tendency to be angry, intolerant, punitive, and impatient with those people (including oneself) who do not meet one's expectations or standards.
Usually includes difficulty forgiving mistakes in oneself or others, because of a reluctance to consider extenuating circumstances, allow for human imperfection, or empathize with feelings.
Hypervigilance and inhibition
Schema Therapy
Coping Styles
Schema Therapy
Lifetrap Coping Styles In order to get out of your life traps you need to identify the trap, become
familiar with your stile of attention so you can realize when you are using cognitive distortions, are engaged in an unhealthy pattern and what copying style you are engaged in.
The coping style of each child depends on their unique temperament and the life trap it is reacting to.
A coping style is developed to avoid experiencing the more intense, overwhelming and painful life trap. It consists of emotions, cognitions and behaviors that while distracting attention from the deeper pain they end up reinforcing it.
For example, the life trap that you are inherently defective can have three different coping mechanisms for different situations at different stages of life. You can look for critical partners and friends, you can avoid getting close to others or you can have a superior attitude towards others. All these coping mechanism help suppress the more painful belief of being defective
Schema Therapy
Schema Coping Styles
Broad maladaptive schema coping styles
1. Surrender
2. Avoidance
3. Overcompensation
Schema Therapy
Common Coping Responses Aggression
Hostility
Manipulation
Exploitation
Dominance
Overcompensation
Recognition-Seeking
Stimulation-Seeking
Impulsivity
Substance abuse.
Compliance
Dependence
Excessive Self-Reliance
Compulsivity, Inhibition
Psychological Withdrawal
Social isolation
Avoidance
Schema Therapy
Surrender Coping Style Schema surrender refers to ways in which people passively
give in to the schema. They accept the schema as truth and then act in ways that confirm the schema
For instance, a young man with an Abandonment/Instability schema might choose partners who are unable to commit to long-term relationships.
He might then react to even minor signs\indications of abandonment, such as spending short times without his partner, in an exaggerated way and feel excessive negative emotion.
Despite the emotional pain of the situation, he might also passively remain in the relationship because he sees no other possible way to connect with women.
Schema Therapy
Compliant Surrenderer: Acts in a passive, subservient, submissive,
reassurance-seeking, or self-deprecating way towards others out of fear of conflict or rejection.
Passively allows him/herself To be mistreated, or does not take steps to get healthy needs met. Selects people or engages in other behaviour that directly maintains the self-defeating schema-driven pattern.
Surrender to damaged child modes: In these modes individuals behave as if they are like the
child, with the same beliefs, emotions and behaviours as when the childhood pattern was set up.
Schema Therapy
Avoidance Coping Style Schema avoidance refers to the ways in which people avoid activating schemas,
when schemas are activated, they cause extreme negative emotion and pain.
There are three types of schema avoidance: cognitive, emotional and behavioral.
Cognitive avoidance refers to efforts that people make not to think about upsetting events. These efforts may be either voluntary or automatic. People may voluntarily choose not to focus on an aspect of their personality or an event, which they find disturbing. There are also unconscious processes which help people to shut out information which would be too upsetting to confront. People often forget particularly painful events.
Emotional avoidance refers to automatic or voluntary attempts to block painful emotion. Often when people have painful emotional experiences, they numb themselves to the feelings in order to minimize the pain. Some people drink or abuse drugs to numb feelings generated by schemas. Ways of avoiding the trap include having promiscuous sex, over eat, compulsively clean, seek stimulation or become workaholics.
Behavioral avoidance. People often act in such a way as to avoid situations that trigger schemas, and thus avoid psychological pain. For instance, a woman with a Failure schema might avoid taking a difficult new job which would be very good for her. By avoiding the challenging situation, she avoids any pain, such as intense anxiety, which could be generated by the schema.
Schema Therapy
Avoidance:-Detached protector
Withdraws psychologically from the pain of
the schemas by emotionally detaching. The
patient shuts off all emotions, disconnects
from others and rejects their help, and
functions in an almost robotic manner. May
remain quite functional
Schema Therapy
Shuts off emotions by going numb or
spacing out. Can give rise to an Experience
of being foggy or even unreal and gives rise
to states of depersonalization and cognitive
slowing which are dysfunctional.
Avoidance:-Spaced out protector
Schema Therapy
Shut off their emotions by engaging in activities that will somehow soothe,stimulate or distract them from feeling.
These behaviours are usually undertaken in an addictive or compulsive way,and can include workaholism, gambling, dangerous sports, promiscuous sex, or drug abuse.
Another group of patients compulsively engages in solitary interests that are more self-soothing than self-stimulating, such as playing computer games, overeating, watching television, or fantasizing.
Avoidance:-Detached Self Soother
Schema Therapy
Avoidance:- Avoidant protector & Angry
protector
Avoidant protector: Avoids triggering by
behavioural avoidance - keeps away
from situations of cue that my trigger
distress.
Angry protector: Uses a ‘wall of anger' to
protect him/herself from others who are
perceived as threatening. Displays of
anger serve to keep others at a safe
distance to protect against being hurt.
Schema Therapy
Overcompensation Coping
Style Schema overcompensation. The individual behaves in a
manner which appears to be the opposite of what the
schema suggests in order to avoid triggering the schema. On
the surface, it may appear that the overcompensators are
behaving in a healthy manner, by standing up for
themselves.
But when they overshoot the mark they cause more
problem patterns, which then perpetuate the schema. For
instance, a young man with a Defectiveness schema
might overcompensate by presenting himself as perfect
and being critical of others. This would likely lead others to
criticize him in turn, thereby confirming his belief that he is
defective.
Schema Therapy
Overcompensation:-Attention
and approval seeker
Tries to get other people's attention and
approval by extravagant, inappropriate
and exaggerated behaviour. Usually
compensates for underlying loneliness.
Schema Therapy
Overcompensation:- Self-aggrandiser
Behaves in an entitled, competitive, grandiose, abusive, or status-seeking way in order to have whatever they want. They are almost completely self-absorbed, and show little empathy for the needs or feelings of others.
They demonstrate superiority and expect to be treated as special and do not believe they should have to follow the rules that apply to every one else. They crave for admiration and frequently brag or behave in a self-aggrandizing manner to inflate their sense of self.
Schema Therapy
Overcompensation:- Overcontroller:
Attempts to protect self from a perceived or real threat by focusing attention, ruminating, and exercising extreme control.
• Perfectionistic Overcontroller: Focuses on perfectionism to attain control and prevent misfortune and criticism.
• Suspicious Overcontroller: Focuses on vigilance, scanning other people for signs of malevolence, and controls others' behaviour out of suspiciousness.
• Scolding Overcontroller: Controls the behaviour of others by blaming, criticizing, and telling them how to do things in a dictatorial and scolding manner.
Schema Therapy
Schema Modes
Schema Therapy
Schema Modes A “schema mode” is defined as a current
emotional state which is associated with a given schema.
Schema modes can either change frequently or be very persistent.
In patients with many different schemas and intense schema modes, it is often much easier to address these modes than to refer to the schemas behind them.
Schema modes are divided into modes associated with mostly negative emotions and modes used to cope with these emotions.
Schema Therapy
Schema Modes
“Those schemas, coping responses, or
healthy reactions that are currently active
for an individual”
The predominant state that we’re in at a
given point in time
Schema Therapy
Schema Modes
There are 4 broad Mode Domain
1. Child Mode
2. Dysfunctional Coping Modes
3. Dysfunctional Parent Modes
4. Healthy Adult Modes
Schema Therapy
1. Child Modes Child modes are associated with intense
negative emotions such as rage, sadness, and
abandonment.
They resemble the concept of the “inner child,”
which is used in many therapies
A patient with a mistrust/abuse schema, for
example, may feel threatened and at the
mercy of others when they are in the abused
child mode
Schema Therapy
2. Dysfunctional Coping modes
Dysfunctional coping modes are related to avoidant, surrendering, or overcompensating schema coping.
In avoidant coping modes, people avoid emotions and other inner experiences, or avoid social contact altogether.
In overcompensating coping modes, people stimulate or aggrandize themselves in order to experience the opposite of the actual schema-associated emotions.
Schema Therapy
3. Dysfunctional Parent Modes
The other category of highly emotional modes is the dysfunctional parent modes.
they are viewed as internalizations of dysfunctional parental responses to the child.
In dysfunctional parent modes, people keep putting pressure on themselves or hate themselves.
Patients with a mistrust/abuse schema, de-value and hate themselves when they are in the punitive parent mode.
Schema Therapy
4. Healthy Adult Modes Healthy modes are the modes of the healthy adult
and the happy child.
In the healthy adult mode, patients are able to view their life and their self in a realistic way.
They are able to fulfill their obligations, but at the same
time can care for their own needs and well-being.
This mode has conceptual overlap with the psychodynamic concept of “healthy ego functioning.”
The mode of the happy child is particularly related to fun, joy, and play.
Don’t we all want to be like this!
Schema Therapy
Child Modes
Schema Therapy
Vulnerable child modes Lonely Child
Feels like a lonely child that is valued only
in so far as (s)he can aggrandise his/her
parents. Because the most important
emotional needs of the child have
generally not been met, the patient
usually feels empty, alone, socially
unacceptable, undeserving of love,
unloved and unlovable
Child Modes
Schema Therapy
Vulnerable child modes Abandoned
and Abused Child
Feels the enormous emotional pain and fear of abandonment, which has a direct link with the abuse history. Has the affect of a lost child: sad, frightened, vulnerable, defenceless, hopeless, needy,victimised, worthless and lost. Patients appear fragile and childlike.
They feel helpless and utterly alone and are obsessed with finding a parent figure who will take care of them. Humiliated/Inferior Child. A subtype of the Abandoned and Abused Child mode, in which patients experience humiliation and inferiority related to childhood experiences within and outside the family.
Child Modes
Schema Therapy
Vulnerable child modes
Dependent Child
Feels incapable and overwhelmed by
adult responsibilities. Shows strong
regressive tendencies and wants to be
taken care of. Related to the lack of
development of autonomy and self-
reliance, often caused by authoritarian
upbringing.
Child Modes
Schema Therapy
Angry/unsocialized child modes
Angry child
Angry child: Feels intensely angry,
enraged, infuriated, frustrated or
inpatient, because the core emotional (or
physical)needs of the vulnerable child are
not being met.
They vent their suppressed anger in in
appropriate ways. May make demands
that seem entitled or spoiled and that
alienate others.
Child Modes
Schema Therapy
Angry/unsocialized child modes
Enraged child
Experiences intense feelings of anger that results in hurting or damaging people or objects.
The displayed anger is out of control, and has the goal of destroying the aggressor, sometimes literally.
Has the affect of an enraged or uncontrollable child, screaming or acting out impulsively to an (alleged)perpetrator
Child Modes
Schema Therapy
Angry/unsocialized child modes
Impulsive Child
Acts on non-core desires or impulses from
moment to moment in a selfish or
uncontrolled manner to get his or her own
way, with out regard to possible
consequences for the self
Or others. Often has difficulty delaying
short-time gratification and may appear
`spoiled`.
Child Modes
Schema Therapy
Angry/unsocialized child modes
Undisciplined child
Cannot force him/herself to finish routine
or boring tasks, gets quickly frustrated and
gives up soon.
Child Modes
Schema Therapy
Happy/Contented Child Mode
Feels at peace because core emotional
needs are currently met. Feels loved,
contented, connected, satisfied, fulfilled,
protected, praised, worthwhile, nurtured,
guided, understood, validated,
self-confident, competent, appropriately
autonomous or self-reliant, safe, resilient,
strong, in control, adaptable, optimistic
and spontaneous.
Child Modes
Schema Therapy
Dysfunctional Parent
Modes
Schema Therapy
Punitive Parent: The internalized voice of the parent, criticizing
and punishing the patient. They become angry with themselves and feel that they deserve punishment for having or showing normal
Needs that their parents did not allow them to express. The tone of this mode is harsh, critical, and unforgiving. Sings and symptoms include self-loathing, self-criticism, self-denial, self-mutilation, suicidal fantasies, and self-destructive behaviour.
Parent Modes
Schema Therapy
Demanding Parent
Continually pushes and pressures the child to
meet excessively high standards.
Feels that the`right` way to be is to be perfect
or achieve at a very high level, to keep
everything in order, to strive for high status, to
be humble, to put other needs before one's
own or to be efficient Or avoid wasting time.
The person feels that it is wrong to express
feelings or to act spontaneously
Parent Modes
Schema Therapy
Healthy Adult Modes
Schema Therapy
Healthy Adult This mode performs appropriate adult
functions such as obtaining information, evaluating, problem-solving, working, parenting. Takes responsibility for choices and actions, and makes and
keeps to commitments. In a balanced way, pursues activities that are likely to be fulfilling in work,
intimate and social relationships, sporting, cultural and service-related activities.
Healthy Modes
Schema Therapy
Schema Triggers
Schema Therapy
Schema Triggering Schemas may lie dormant until triggered by
particular events or situations. For example, in relationships, a critical or dismissive remark from a friend or intimate partner may trigger schemas associated with rejection, abandonment, or abuse. Hearing about an accident or misfortune may trigger a schema associated with lack of safety or security.
A disappointment or lack of achievement may trigger schemas associated with defectiveness, failure, or pessimism. A schema can be triggeredbywatching a scene from movie or reading a story in a magazine that is thematically related to the schema.
Schema Therapy
Schema Triggering Activation of a schema that is usually dormant can trigger
a sudden rush of intense and confusing feelings. Other schemas present themselves less intensely. However, once a schema is active, it strongly shapes our patterns of perception, interpretation, feeling and behaviour. When faced with a threat, there are three characteristic patterns of response which are found in humans and animals.
These are the three Fs: flight, fight and freeze. Thus, if an animal is attacked by a predator it can try to escape (flight), try to fight back (fight), or go limp and play dead (freeze). These three kinds of response can be seen in the way people respond to cope with the triggering of schemas.
Schema Therapy
Schema Therapy
Therapists\Clients
Schema Therapy
Healing the Vulnerable Child Most EMSs are embedded in childhood experiences which
were emotionally painful. These patterns continue into the future, driven by memories of critical experiences from long ago.
As EMSs are activated, they allow us to get in touch with the memories from the past events that hurt us, and seemed to be impossible to resolve. It can be helpful to see how present-day feelings are actually memories of what happened in the past. In addition, the painful memories can, themselves, be addressed by way of rescripting them.
This involves working with the Vulnerable Child, empathizing with him/her, and symbolically providing ways in which he/she can have these needs met that were not met at in the past.
Schema Therapy
Reducing the power of dysfunctional
coping and parent modes
Coping modes prevent access to the child modes which are the source of spontaneity, authenticity and the capacity for meaningful interpersonal contact. They also create additional problems by gMng rise to self-limiting, self-defeating, and self-destructive behaviors.
These modes need to be identified and replaced with more effective and non-harmful ways of coping. Schema therapists help their clients to challenge avoidances. This will involve exposing yourself to situations, thoughts and feelings that you normally and automatically avoid. Your therapist will help you to plan this in a graded manner so that you can learn to tolerate uncomfortable feelings that might be evoked. Often these are feelings from childhood that can be worked with in therapy.
Schema Therapy
Reducing the power of dysfunctional
coping and parent modes
They also help clients to relinquish over compensatory behaviours because, although these may be adaptive to some extent, they also have the negative effect of distancing us from our genuine experience, and this can have a negative impact on interpersonal relationships. By giving up compensations, we will expose ourselves to EMSs which we have not wanted to experience.
As these EMSs come into focus, they can be worked on and resolved in therapy (see Healing the Vulnerable child above). This can lead to learning to interact in a more authentic and satisfying way.
Schema Therapy
Reducing the power of
dysfunctional coping Dysfunctional parent modes are also problematic. At the outset,
they might appear to help to motivate you to get things done. But, on closer inspection, they have the opposite effect. A critical voice that constantly repeats demeaning messages and undermines your self-esteem makes it difficult to enjoy everyday activities and relationships.
A demanding voice that keeps imposing rigid standards in the form of rules and “shoulds” creates chronic tension and dissatisfaction. Both these voices can activate an angry or rebellious child mode that refuses to be pushed around, resulting in procrastination or alack of motivation. To identify these parent modes, the messages they give need to be closely scrutinized, and where deemed unhelpful, need to be stopped and banished.
Schema Therapy
Reducing the power of
dysfunctional coping Often the effect of vulnerable child states and the
avoidances and compensations that are adopted to hide them is that individuals find it difficult to remain in a balanced state.
But we need to be in a balanced state where we can exercise good judgment and have an accurate perception of our own and others’ behavior if we are to engage in relationships that are mutually respectful and effectively solve every day problems. Building this balanced Healthy Adult state can be an important focus of therapy. This might involve:
Schema Therapy
Building the healthy adult Building self-awareness and cultivating mindfulness:
to stay balanced we need to have an ongoing awareness of our emotional states and how they are activated in different situations. At the same time we need to be able to distance from these states like an observer who can see and not what they are without getting caught up in them and carried away.
Building an understanding of how EMSs and schema modes work: This will help you step back and see clearly what you need to do to break out of the patterns, and how the various aspects of schema therapy can contribute to empowering you to do this.
Schema Therapy
Building the healthy adult Addressing cognitive distortions: involves identifying beliefs,
assumptions, and every day thoughts that are inaccurate and serve to maintain the schema. You can actively challenging the distortions on the basis of reason and examination of evidence in real-life situations.L]
Behavioural experiments/behavioural pattern-breaking: involves experimenting with new ways of behaving to replace your current self-defeating behaviours. In behavioural experiments, you will learn what works for you by trying out new behaviours which are likely to be more effective, and by examining the effects of these new behaviours. Through pattern-breaking, we work to break the power of self-defeating patterns, and replace them with new ones that will help you to lead a more satisfying life.
Schema Therapy
Building the healthy adult:-
Assessment and Education
Identify and educate patient about
central life schemas
Link schemas to presenting problems & life
history; explore origins of schemas
Bring patient in touch with emotions
surrounding schemas
Identify dysfunctional coping styles
Schema Therapy
Building the healthy adult:-
Assessment and Education
Pattern identification: Link presenting problems with life history and early origins
Educate patients about schemas: “Reinventing Your Life”
Review schema inventories
Trigger schemas through imagery, dialogues, and inner child exercises
Observe patterns in the therapy relationship
Integrate with Schema Conceptualization Form
Schema Therapy
Building the healthy adult:-
Assessment and Education Cognitive: Restructure thinking related to schemas;
develop healthy voice to create distance.
Experiential: Practice experiential exercises to vent anger &grieve for early pain, to empower patient.
Therapy Relationship: Focus on therapy relationship to provide limited reparenting, and to heal schemas & coping styles triggered in sessions.
Behavioral Pattern-Breaking: Assign and rehearse behavioral and interpersonal changes related to presenting problem break dysfunctional life patterns
Schema Therapy
Aim for Emotional Maturity Autonomy (the ability of the person to make his or her own
decisions ) is a sign of emotional maturity.
When a person has healed enough of their past they are able to access their latent (capable of becoming active)potentials.
For example, learning to focus your awareness inwardly to access the capacity to become what you need emotionally and beyond.
When you mature you become loving towards you and others, you learn to focus your attention in the here and now and you are confident in your capacity to function
Schema Therapy
Pattern-Identification
Focused Life History Interview
Link presenting problems to life pattern
Find emotional links
Discuss patient’s memories from
childhood
Link to current problems when possible
Link parenting behaviors with specific
schemas
Schema Therapy
Experiential Techniques for Assessment
Get upsetting childhood images of
mother, father & other significant people
Set up dialogues
Ask patients what they need in the image
Link emotions from childhood images with
current life circumstances
Schema Therapy
Techniques
Techniques for tackling Schemas can be
broken down into four categories:
Emotive,
Interpersonal
Cognitive
Behavioral
Schema Therapy
Emotive Technique Emotive techniques encourage clients to experience and express the
emotional aspects of their problem. One way this is done is by having clients close their eyes and imagine they are having a conversation with the person to whom the emotion is directed. They are then encouraged to express the emotions as completely as possible in the imaginary dialogue.
One woman whose core schema was Emotional Deprivation had several such sessions in which she had an opportunity to express her anger at her parents for not being there enough for her emotionally.
Each time she expressed these feelings, she was able to distance herself further from the schema. She was able to see that her parents had their own problems which kept them from providing her with adequate nurturance, and that she was not always destined to be deprived.
Or they may write a letter to the other person, which they have no intention of mailing, so that they can express their feelings without inhibition.
Schema Therapy
Interpersonal Technique Interpersonal techniques highlight the client’s interactions with other people
so that the role of the schemas can be exposed. One way is by focusing on the relationship withthe therapist.
Frequently, clients with a Subjugation schema go along with everything the therapist wants, even when they do not consider the assignment or activity relevant.
They then feel resentment towards the therapist which they display indirectly.
This pattern of compliance and indirect expression of resentment can then be explored to the client’s benefit.
This may lead to a useful exploration of other instances in which the client complies with others and later resents it, and how they might better cope atthose times.
Schema Therapy
Cognitive Technique Cognitive techniques are those in which the schema-driven
cognitive distortions are challenged. As in short-term cognitive therapy, the dysfunctional thoughts are identified and the evidence for and against them is considered. Then new thoughts and beliefs are substituted. These techniques help the client see alternative ways to view situations.
The first step in dealing with schemas cognitively is to examine the evidence for and against the specific schema which is being examined.
This involves looking at the client’s life and experiences and considering all the evidence which appears to support or refute the schema. The evidence ¡s then examined critically to see if it does, in fact, provide support for the schema. Usually the evidence produced will be shown to be in error, and not really supportive of the schema.
Schema Therapy
Cognitive technique After having several of these dialogues the client and therapist can
then construct a flashcard for the client, which contains a concise statement of the evidence against theschema.
A typical flashcard for a client with a Defectiveness/Shame schema reads: “I know that I feel that there is something wrong with me but the healthy side of me knows that I’m OK. There have been several people who have known me very well and stayed with me for a long time. I know that I can pursue friendships with many people in whom I have an interest.”
The client is instructed to keep the flashcard available at all times and to read it whenever the relevant problem starts to occur. By persistent practice at this, and other cognitive techniques, the client’s belief in the schema will gradually weaken.
Schema Therapy
Behavioral Technique Behavioral techniques are those in which the therapist assists the client in changing
long-term behavior patterns, so that schema surrender behaviors are reduced and healthy coping responses are strengthened.
One behavioral strategy is to help clients choose partners who are appropriate for them and capable of engaging in healthy relationships. Clients with the Emotional Deprivation schema tend to choose partners who are not emotionally giving. A therapist working with such clients would help them through the process of evaluating and selecting new partners.
Another behavioral technique consists of teaching clients better communication skills. For instance, a woman with a Subjugation schema believes that she deserves a raise at work but does not know how to ask for it. One technique her therapist uses to teach her how to speak to her supervisor is role-playing. First, the therapist takes the role of the client and the client takes the role of the supervisor. This allows the therapist to demonstrate how to make the request appropriately.
Then the client gets an opportunity to practice the new behaviors, and to get feedback from the therapist before changing the behavior in real life situations.
Schema Therapy
SUMMARY
Schema Therapy
Summary Life traps are unhealthy beliefs that served as adaptations to early painful circumstances in
childhood. These mental traps were created when emotional core needs were not met appropriately.
A life trap consists of memories, emotions, cognitions and bodily sensations.
These are formed so early in life that they are taken as accurate and truthful ways of seeing one self and the world.
They consist of broad themes, repeating patterns regarding yourself and your relationship to life, these are dysfunctional in nature and they keep repeating.
When a person chooses and commits to become increasingly more self aware they realize their traps and that they arefalse. People notice that they are not inherently defective, worthless, incompetent failures etc.
As long as a person keeps their life traps as true and accurate representations of themselves and the world they will not be able to change, heal and become a greater potential of themselves. This is understandable since the trap was taught to the child through a long process of indoctrination. (set of beliefs)
Schema Therapy
Summary 2 Once a trap is formed a coping style is also created to avoid experiencing the emotional
pain inside the trap.
The coping styles are many and eventually they group into the familiar sense of self a person identifies with.
These include all familiar thoughts, emotions, behaviors, kinds of people and circumstances that they know how to deal with.
The aim of therapy is first of all to introduce psychological awareness of the traps and the coping styles.
Then add an elaborate understanding of the history that created the trap and the development of attention and observation skills.
These are necessary to interrupt the automatic trap- the automatic adaptation and the automatic behavior.
The work to free your awareness from life traps demands committed discipline, skillful support and an unwavering love for life in its fullest potential