Schema therapy is an integrative approach to treatment that combines the best aspects of cognitive-behavioral, experiential, interpersonal, and psychoanalytic therapies into one unified model. It has shown remarkable results in helping people to change negative (“maladaptive”) patterns that they have lived with for a long time.
Schema therapy is a type of therapy that targets schemas, a term used clinically to describe maladaptive patterns of thinking that could cause someone to engage in unhealthy behavior, or to struggle in their important relationships. Schemas are thought to develop during the early years, particularly in children whose emotional and physical needs weren’t met; they may also develop in children who were overindulged or whose parents did not maintain proper boundaries. Schemas could also develop later, in adulthood when a traumatic event happens. In adulthood, these schemas influence an individual’s thoughts and actions in negative ways—leading to behaviors such as avoidance, overcompensation, or excessive self-sacrifice. These behaviors, in turn, can negatively affect relationships and emotional well-being.
Some examples of schema beliefs are: “I’m not lovable,” “I’m a failure,” “I will never be good enough,” “People don’t care about me,” “I’m not important,” „My needs aren’t important”, “Something bad is going to happen,” “People will eventually leave me,” and so on.
The Schema-Focused model was developed by Dr. Jeff Young, who originally worked closely with Dr. Aaron Beck, the founder of Cognitive Therapy.
Schema therapy is designed to help to break these negative cycles of thinking, feeling, and behaving, and to develop healthier alternatives to replace them.
Everyone has schemas (even positive ones), coping styles, and modes — they are just more extreme, pervasive, and rigid in some cases – when it’s good to have someone to help.
Three main stages of Schema Therapy:
Emotional Deprivation: The belief and expectation that your primary needs will never be met. The sense that no one will nurture, care for, guide, protect or empathize with you, so it doesn’t worth feeling your emotions.
Abandonment: The belief and expectation that others are unreliable and they will leave eventually, that relationships are fragile, that loss is inevitable and that you will ultimately end up alone.
Mistrust/Abuse: The belief that others are not to be trusted, because they are abusive, manipulative, selfish, or looking to hurt or use you.
Defectiveness: The belief that you are flawed, damaged, or unlovable and you will therefore be rejected.
Social Isolation: The feeling that one is isolated from the rest of the world, lonely, different from others, and/or not part of any group or community even if there are people around.
Vulnerability/ Illness: 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: I. Medical Catastrophes: e.g., heart attacks, AIDS; II. Emotional Catastrophes: e.g., going crazy; III.: External Catastrophes: e.g., elevators collapsing, victimized by criminals, airplane crashes, earthquakes.
Dependence/Incompetence: The belief that you are unable to make your own decisions, that your judgment is questionable, and that you need to rely on others to help get you through day-to-day responsibilities.
Enmeshment/Undeveloped Self: 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. Often experienced as a feeling of emptiness and floundering, having no direction, or in extreme cases questioning one’s existence.
Failure: The expectation that you will fail or the belief that you cannot perform well enough.
Subjugation: The belief that you must submit to the control of others or else punishment or rejection will be forthcoming. The two major forms of subjugation are:
I. Subjugation of Needs: Suppression of one’s preferences, decisions, and desires.
II. Subjugation of Emotions: Suppression of emotional expression, especially anger. Usually involves the perception that one’s desires, opinions, and feelings are not valid or important to others. Frequently presents as excessive compliance, combined with hypersensitivity to feeling trapped.
Self-Sacrifice: The belief that you should voluntarily give up your own needs for the sake of others, usually to an excessive point. 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 a sensitivity to the pain of others.
Approval-Seeking/Recognition-Seeking: The sense that approval, attention, and recognition are far more important than genuine self-expression and being true to oneself.
Emotional Inhibition: The belief that you must control your self-expression or others will reject or criticize you.
Negativity/Pessimism: The pervasive belief that the negative aspects of life outweigh the positive, along with negative expectations for the future.
Unrelenting Standards: The belief that you need to be the best, always striving for perfection, or that you must avoid mistakes.
Punitiveness: The belief that people should be harshly punished for their mistakes or shortcomings.
Entitlement/Grandiosity: The sense that you are special or more important than others, and that you do not have to follow the rules like other people even though it may hurt others. Also can manifest in an exaggerated focus on superiority to have power or control.
Insufficient Self-Control/Self-Discipline: The sense that you cannot accomplish your goals, especially if the process contains boring, repetitive, or frustrating aspects. Also, you cannot resist acting upon impulses that lead to detrimental results.
