Schema Therapy and Schema Coaching

What Is Schema Therapy?

schema therapy

Schema Therapy, developed by psychologist Jeffrey young, is an innovative and comprehensive approach that combines aspects of cognitive-behavioral therapy (CBT), Gestalt experiential therapy, and psychoanalytic thinking into one process. It is specifically designed to help people to change some of the longstanding patterns of thinking and acting.

The ‘Schemas’ that we aim to change refers to those self-defeating core themes that you keep repeating throughout your lives. These deep-rooted patterns are associated with not only thoughts but also feelings and even physical sensations. Some examples of schema beliefs are: “I’m unlovable,” “I’m a failure,” “People don’t care about me,” “I’m not important,” “Something bad is going to happen,” “People will leave me,” “I will never get my needs met,” “I will never be good enough”.

Schemas, as defined by the system of Schema Therapy, are developed when childhood needs are not met. One metaphor I like to use is that they are like old shoes that no longer fit – because they tend to begin early in life, schemas become familiar and comfortable, even though they are ultimately not good for us. Because they are so powerful, we may even distort our view of events in our current lives in order to keep these schemas going.

You may find schema work helpful if any of the following apply to you:

  • You find yourself over-reacting to certain situations (which may lead to impulsive behaviors that you later regret).

  • You are drawn to the same type of partner over and over, even your emotional needs are not met in these relationships.

  • You feel stuck in habitual patterns or addictive behaviors that you can’t seem to change.

  • You struggle to say no, or with the thought of others disliking you.

  • You have low self-esteem or confidence, which holds you back from fulfilling your potential.

What Is Schema Coaching?

Liberating from the enduring and self-defeating patterns

Like Schema Therapy, Schema Coaching will involve exploring maladaptive schemas that are keeping you stuck in life. However, the process will be more solution-focused, less pathologizing, and problem-oriented. We will still explore your past and how your past impact you, but the goal is to move past your past wounds through a series of experiential strategies, behavioral experiments, and cognitive insights. 

Due to the nature of remote working, we may not be able to execute the whole Schema Therapy protocol. Certain activities, such as Chair Work, may not be feasible. However, based on my original training as a Schema Therapist, I incorporate some of the principles and techniques in this highly effective system in our online work.

Firstly, we start by identifying some of your enduring and self-defeating patterns that typically begin early in life. Next, we use a combination of talking and experiential exercises to raise your emotional awareness; during this phase, you may get in touch with some of the early experiences and learn how to spot emotional triggers in your daily life. Thirdly, we focus on behavioral change. Structured assignments may be given so you can continue to work outside of sessions. You can actively practice replacing some of the negative, habitual schemas with a fresh perspective.

Many people who come for schema work have spent years in other types of therapies such as psychoanalysis or traditional CBT and were frustrated with the lack of progress. This is a very collaborative and empowering process that truly aims to help you turn insights into real changes.    Schema work has also recently been blended with mindfulness meditation and elements of neuroscience for those who can further benefit from them.

 

Schema Therapy and Emotional Regulation

schema therapy

Although the use of Schema Therapy is not restricted to treating personality disorders and emotional regulation problems, it has produced impressive results when it comes to treating treatment-resistant personality disorders, emotional dysregulations, relationship issues, and other complex difficulties.

As reported in a recent news article on Science Daily, a large-scale trial released in the American Journal of Psychiatry has shown Schema Therapy to be significantly more effective than two major alternative approaches to the treatment of personality disorders. It resulted in a higher rate of recovery, greater declines in depression, and greater increases in general and social functioning. The results also suggest Schema Therapy is more cost-effective, achieving these results with fewer sessions.

More On Schema

In the Schema model, there are 18 different schemas- They are ways of thinking and feeling, as well as bodily sensations, that get triggered by certain people or situations that remind you of upsetting experiences from your childhood. Unlike ‘core beliefs’ or ‘negative thoughts’ in CBT, schemas are deeply held structures that form a part of our identity.

We all have schemas, and they are ways that we have developed in order to survive difficulties in life. The 18-schema model is simply a convenient way of reflecting on survival strategies that no longer work for us, and give us an idea of how to move forward.

Reading the following may give you some ideas of where you have been wounded, your primary coping mechanisms, and where you are likely to get triggered.

The following is adapted and edited from the work of Jeffrey Young (2016), taken from the Schema Therapy website.

1. Abandonment

This schema concerns not believing others can offer you consistent emotional support, love and connection . Perhaps because in your early years your parents were emotionally unstable and unpredictable (eg angry outbursts), unreliable, or erratic in the way they are. You may fear they will suddenly leave this world, walk away or abandon you at any time.

2. Mistrust/abuse

Perhaps because you have been hurt before, you don’t feel you can trust others. This schema involves the expectation that others will hurt, abuse, manipulate, or take advantage of you. It includes the sense that we always end up being cheated relative to others or ‘getting the short end of the stick.’

3. Emotional deprivation

In Jeffrey Young’s conceptualization, this Schema has three components:

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.

4. Defectiveness/shame

This schema gives us the feeling that we are defective, inferior, or invalid in some way. It makes us feel we may be ‘found’ to be a fake even if we have achieved things on the outside (Imposter Syndrome). This may lead to hypersensitivity to criticism, rejection, and blame; self-consciousness, comparisons, and insecurity around others; or a sense of shame regarding our perceived flaws.

(also look at Brene Brown’s work on shame)

5. Social isolation/alienation

This is the belief or feeling that you are isolated from the rest of the world, different from other people, and/or not part of any group or community. In my experience, this is a schema common to many neuro-atypical people, such as those who are innately sensitive, intense, and gifted.

6. Dependence/incompetence

With this schema, we lack the confidence that we can do things for ourselves. It may make us an ‘under-functioning’ person in relationships. This is also related to Dependent Personality Disorder. We feel we could not take care of ourselves, make good decisions, solve practical problems, try new things, go places on our own, etc. With this, you may experience multiple ‘collapses’ during the day when faced with seemingly trivial difficulties such as the train running late, administrative errors and etc.

7. Vulnerability to harm or illness

With this schema, you live with a constant fear that imminent catastrophe is just around the corner. Fears focus on one or more of the following: (a) Medical Catastrophes: eg heart attacks, AIDS; (b) Emotional Catastrophes: eg going into psychotic crisis, losing oneself; (c): External Catastrophes: eg. accidents or natural disasters. In my experience, this schema is common to people who identify as Enneagram Type 6, and is related to health anxiety.

8. Enmeshment/undeveloped self

Enmeshment entails too much involvement with one or more significant others (often parents), at the expense of full individuation or normal social development. In other words, you remain ‘undifferentiated’ from others. You may feel that you cannot survive or be happy without the constant support of the other. On the other hand, you may also feel smothered, engulfed, and fused with others. Because of the lack of a solid sense of self, you may feel emptiness and flounder, having no direction, or in extreme cases questioning your existence.

9. Failure to achieve

The belief that one has failed, will fail, or is just incompetent to achieve anything. Often involves beliefs that one is stupid, inept, lower in status, less successful than others, etc.

10. Entitlement/grandiosity

This involves the belief that we are somehow not bound by the rules that apply to others. This is related to Narcissism, though a healthy degree of narcissism can be functional. Sometimes this schema includes excessive competitiveness toward, or domination of, others.

11. Insufficient self-control/self-discipline

With this schema, we have difficulties in the arena of self-control. We may find ourselves resorting to procrastination, addictions, or compulsive behaviors in order to cope.

12. Subjugation

Subjugation involves the perception that our needs are not valid or important. It makes us a people pleasure, or deprive us of a solid sense of self.

a. Subjugation of Needs: Suppression of our decisions and desires.

b. Subjugation of Emotions: Suppression of our emotional expression, especially anger.

13. Self-sacrifice

Excessive focus on meeting the needs of others, even if it costs a lot for you. The most common reasons are: to prevent causing pain to others; to avoid guilt from feeling selfish; or to maintain the connection with others.

14. Approval-seeking/recognition-seeking

Excessive emphasis on gaining approval, recognition, or attention from other people. With this schema over-activated, our sense of esteem is dependent primarily on the reactions of others rather than on our own natural inclinations. This may also look like an over-emphasis on staus and external recognition. Can lead to hypersensitivity towards rejection.

15. Negativity/pessimism

A pervasive focus on negative things, constantly worried about mistakes and failures, and not be able to relax.

16. Emotional inhibition

This schema concerns a lack of expressiveness and spontaneity. There may be a lack of emotional expression and playfulness. You constantly feel the need to hold yourself back or to control your impulses. You always let rationality override feelings. This schama is related to the trait of overcontrol.

17. Unrelenting standards/hypercriticalness

The underlying belief is that one must strive to meet very high internalized standards of behavior and performance, usually to avoid criticism. You may find it hard to slow down, relax, put work aside, etc.

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; or (c) preoccupation with time and efficiency.

18. Punitiveness

You have a tendency to punish yourself or treat yourself harshly when something goes wrong. This may extend to how you treat others and find it hard to not find faults or let mistakes go.

(The above description is a mixture of my personal edits and the original texts from “List of schemas © Jeffrey Young” 2016, taken from www.schematherapy.com)