What is Schema Therapy?


Schema Therapy is a relatively new therapeutic technique, developed by the psychologist Jeffrey Young in the 1980s to the 1990s. Young theorised that sometimes, people may develop maladaptive thinking patterns in childhood, that interfere with healthy functioning in their adult life. This can lead to personality disorders, anxiety, depressive disorders, or other mental health issues.

According to Young, targeting these maladaptive patterns should form the core of therapy, which could lead to individuals combating persistent negative feelings and learning more adaptive behaviours in order to navigate through their lives. Schema therapy aims to replace maladaptive behaviours with healthier ones, helping clients regain their self-esteem, rebuild their interpersonal relationships, or general betterment of their daily functioning. It combines methodologies of Cognitive behavioural Therapy, Psychoanalytic Therapy, Gestalt Therapy and emotion-focused therapy. It is an integrative approach and also utilises concepts derived from attachment theory.

What are schemas?

In psychology, Schemas refer to the frameworks through which people understand themselves and the world around them. They begin forming in childhood, especially around family and immediate surroundings. Some people can develop maladaptive schemas, which are unrealistic and unbalanced. These schemas develop in children for a variety of reasons, described in further sections.

Negative schemas can negatively impact the adulthood of a person, resulting in behaviours or coping patterns such as excessive avoidance and self-sacrifice. These then lead to mental health issues like personality disorders and anxiety. For example, a child, due to neglect from their parents, may develop the belief that he/she does not deserve to be loved, which can cause a depressive disorder.

Read More: The Basics of Child Psychology

Why do schemas develop?

Every human has some basic emotional and physical needs that need to be met by their caregivers in order for them to develop into healthily functioning adults. These childhood requirements include a sense of safety and security, a sense of connection and attachment with others, freedom to express oneself, an ability to play and be spontaneous, age-appropriate boundaries, and more.

Maladaptive schemas usually develop because of one or more of the following reasons:

  • Unfulfilled needs: The lack of adequate care. If parents do not provide enough attention and affection to the child and neglect their needs, it can result in maladaptive patterns.
  • Traumatization or Victimisation: Experiences of abuse, trauma, or severe emotional distress can also cause unhealthy schemas.
  • Overindulgence: Overprotective and over-involved parenting and a lack of proper boundaries is also a reason.
  • Selective Identification and internalisation: This refers to the way some children absorb their parents’ or siblings’ attitudes and behaviours. For example, even a benign reason such as the perception of difference or competitiveness with siblings can also lead to maladaptive schemas.

Read More: Are you caring or over-caring for your child?: Parental Pressure

What are some of the common Schemas?

Schemas developed in childhood are resistant to change and can be very difficult to correct. Left unmanaged, they can cause negative patterns of behaviours that keep getting reinforced by negative interactions. Psychology researchers have identified as many as 18 different schemas, but they all fall under one of the following five domains:

1. Disconnection and Rejection:

These schemas usually result from a childhood environment that was cold, unstable and abusive. People with these schemas hold the belief that others are unreliable, caring, or safe to be around. It makes it difficult for them to develop healthy relationships. A few of the schemas under this domain are – abandonment (people have a fear that others will leave them), mistrust (people are always suspicious that others will hurt or humiliate them), and social isolation (people believe they do not fit in with others).

2. Impaired autonomy and performance:

Schemas in this domain usually stem from a home environment that was overprotective and did not let a child build their confidence. They impair their ability to develop a strong sense of self, to survive, or to perform. Some included schemas are – incompetence (people feel that they are incapable of handling challenges alone), vulnerability to harm (people constantly fear some catastrophic event will take place), and failure (people tend to think they have failed at life).

Read More: The Psychology Behind Confidence

3. Impaired limits:

These schemas result from a lack of boundaries and rules and an environment that lets children believe they are superior to those around them. They affect self-control and can cause people to repeatedly overstep boundaries. A few schemas in this domain are – entitlement (people believe they are special), and insufficiency of self-control (people have difficulties controlling their impulses).

4. Other-directedness:

These schemas lead a person to prioritise the needs of others over their own. They usually develop if a child has grown up in an environment that requires them to suppress their needs to gain the approval of elders and caregivers. A few of the schemas in this domain include – self-sacrifice (people exhibit an extreme need to please others at the cost of their own comfort or convenience) and approval-seeking (excessive emphasis on gaining approval and trying to fit in).

Read More: Self Care: What It Is And What It Isn’t

5. Vigilance and inhibition:

The schemas in this domain avoidance of failure or mistakes through alertness and strict internal rules. People with these schemas tend to disregard their own emotions and desires to adhere to rigid internal expectations. They stem from an overly critical, demanding, and punitive home environment during childhood. Some specific schemas are – pessimism (people focus only on negative aspects of life), emotional inhibition (people hide their emotions to avoid shame), and punitiveness (people believe they deserve to be punished harshly even for the tiniest errors).

What are schema modes?

Schema modes refer to the emotional states which describe how a person deals with their environment. In schema therapy terminology, there are three modes:

  1. Child Mode – It resembles how a person felt when they were a child. A person’s inner child may be vulnerable, angry, undisciplined, or happy.
  2. Parent mode – It resembles how a person was treated by their caregivers when they were a child. A person’s parent mode may be demanding or punitive.
  3. Adult mode – It resembles a person’s healthy, functional self.

In addition, there are also coping modes, which describe how a person responds to emotional distress. There are 3 coping modes – First, a person may be an overcompensator; they may compensate for their unfulfilled needs by exaggerating, manipulating, and rebelling. Second, they may be someone who engages in compliant surrender, wherein they surrender their needs to avoid rejection or distress. Third, a person may cope through avoidance and cut themselves off from their own emotions.

How does schema therapy help?

Schema therapy was initially developed to treat personality disorders. Research suggests that it is particularly helpful for clients with Borderline Personality Disorder and that clients who underwent schema therapy healed faster than those who underwent regular treatment. Other mental health concerns that can benefit from schema therapy are eating disorders, anxiety, and depression.

What does schema therapy involve?

After a person’s maladaptive schemas and coping styles have been determined, a therapist administering schema therapy utilises multiple techniques to treat the patient. The goal is to either correct and readjust the maladaptive schemas or to replace unhealthy coping behaviours with more adaptive ones. This can be achieved using a variety of approaches, including cognitive, emotional, and behavioural. For example, during schema therapy, a therapist may ask the client to provide evidence for or against a schema which can help prove that their negative beliefs are unfounded. Therapy may also include role-play, in which schema-triggering situations are recreated and adaptive responses are practised.

Two core elements of schema therapy include:

  1. Empathic Confrontation: Schema therapy emphasises a therapeutic relationship in which the client feels emotionally safe and comfortable. The therapist thus meets their maladaptive thinking patterns with unflinching empathy and understanding.
  2. Limited Reparenting: The therapist tries to meet some of the emotional needs of the client that went unfulfilled in their childhood. They take up a parental role and provide security, compassion, and respect. However, this is done within ethical bounds for mental health professionals.
Summing up

Schema therapy is a new therapeutic modality, and there is scope for extensive research on it. It is a promising talk therapy that uses a host of techniques to realign clients’ false beliefs. It can apply to numerous mental health issues and bring about a paradigm shift in the therapeutic domain of psychology.

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