Schema therapy is a form of integrative psychotherapy developed by Jeffrey E. Young for use in the treatment of personality disorders and other chronic conditions such as long-term depression, anxiety, and eating disorders. Its basic assumption is that invalid assumptions and mental representations (schemas) hinder one's psychological functioning. Schema therapy aims to challenge and adjust those assumptions.
Theoretical background Schema therapy is an integrative psychotherapy combining original theoretical concepts and techniques with those from pre-existing models, including cognitive behavioral therapy, attachment theory, Gestalt therapy, constructivism, and psychodynamic psychotherapy.
Four main theoretical concepts Four main theoretical concepts in schema therapy are early maladaptive schemas (or simply schemas), coping styles, modes, and core emotional needs:
Schema In cognitive psychology, a schema is an organized pattern of thought and behavior. It can also be described as a mental structure of preconceived ideas, a framework representing some aspect of the world, or a system of organizing and perceiving new information. In schema therapy, a schema specifically refers to an early maladaptive schema, defined as a pervasive self-defeating or dysfunctional theme or pattern of memories, emotions, and physical sensations, developed during childhood or adolescence and elaborated throughout one's lifetime. Often they have the form of beliefs about the self or the world. For instance, a person with an Abandonment schema could be hypersensitive (have an "emotional button" or "trigger") about their perceived value to others, which in turn could make them feel sad and panicky in their interpersonal relationships.
Coping style "Coping styles" are a person's behavioral responses to schemas. There are three potential coping styles:
In "avoidance" the person tries to avoid situations that activate the schema. In "surrender" the person gives into the schema, doesn't try to fight against it, and behaves passively in a manner consistent with an expectation that the feared outcome is inevitable. In "counterattack", also called "overcompensation", the person puts extra work into fighting back, hoping to prevent the schema's feared outcome from happening. These maladaptive coping styles (overcompensation, avoidance, or surrender) very often wind up reinforcing the schemas. Continuing the Abandonment example: having imagined a threat of abandonment in a relationship and feeling sad and panicky, a person using an avoidant coping style might then behave in ways to limit the closeness in the relationship to try to protect him/herself from being abandoned. The resulting loneliness or even actual loss of the relationship could easily reinforce the person's Abandonment schema. Another example can be given for the Defectiveness schema: A person using an avoidant coping style might avoid situations that make them feel defective, or might try to numb the feeling with addictions or distractions. People using a surrender coping style might tolerate unfair criticism without defending themselves. A person using the counterattack/overcompensation coping style might put extra effort into appearing superhuman.
Modes "Modes" are states of mind that cluster schemas and coping styles into a temporary "way of being" that a person can shift into occasionally or more frequently. For example, a Vulnerable Child mode might be a state of mind encompassing schemas of Abandonment, Defectiveness, Mistrust/Abuse and a coping style of surrendering (to the schemas).
Core emotional needs Some basic emotional needs that have been identified are connection, safety, validation, reciprocity, and autonomy. If a patient's core emotional needs are not met in childhood, then schemas, coping styles, and modes can develop. For example, a child with unmet needs around connection—perhaps due to parental loss to death, divorce, or addiction—might develop an Abandonment schema.
Early maladaptive schemas
"Early maladaptive schemas" are self-defeating emotional and cognitive patterns established from childhood and repeated throughout life. They may be made up of emotional memories of past hurt, tragedy, fear, abuse, neglect, unmet safety needs, abandonment, or lack of normal human affection in general. Early maladaptive schemas can also include bodily sensations associated with such emotional memories. Early maladaptive schemas can have different levels of severity and pervasiveness: the more severe the schema, the more intense the negative emotion when the schema is triggered and the longer it lasts; the more pervasive the schema, the greater the number of situations that trigger it.
Schema domains: groups of early maladaptive schemas "Schema domains" are broad categories of unmet needs into which are grouped 18 early maladaptive schemas identified by Young, Klosko & Weishaar (2003):
Disconnection/Rejection includes 5 schemas: Abandonment/Instability Mistrust/Abuse Emotional Deprivation Defectiveness/Shame Social Isolation/Alienation Impaired Autonomy and/or Performance includes 4 schemas: Dependence/Incompetence Vulnerability to Harm or Illness Enmeshment/Undeveloped Self Failure Impaired Limits includes 2 schemas: Entitlement/Grandiosity Insufficient Self-Control and/or Self-Discipline Other-Directedness includes 3 schemas: Subjugation Self-Sacrifice Approval-Seeking/Recognition-Seeking Overvigilance/Inhibition includes 4 schemas: Negativity/Pessimism Emotional Inhibition Unrelenting Standards/Hypercriticalness Punitiveness Yalcin, Lee & Correia (2020) did a primary and a higher-order factor analysis of data from a large clinical sample and smaller non-clinical population. The higher-order factor analysis indicated four schema domains—Emotional Dysregulation, Disconnection, Impaired Autonomy/Underdeveloped Self, and Excessive Responsibility/Overcontrol—that overlap with the five domains (listed above) proposed earlier by Young, Klosko & Weishaar (2003). The primary factor analysis indicated that the Emotional Inhibition schema could be split into Emotional Constriction and Fear of Losing Control, and the Punitiveness schema could be split into Punitiveness (Self) and Punitiveness (Other).
… excerpt ends here. Continue reading the full article.
