Developed by Jeffrey Young, Schema therapy is an integrative approach, bringing together elements from cognitive therapy, attachment and object relations theories and experiential therapies. Schema therapy can help people understand and change long-term life patterns. It provides a clear map that guides and informs therapy and can be used in conjunction with other therapies.
Schemas are stable, enduring patterns that develop during childhood or adolescence and are elaborated throughout an individual’s life. We view the world through our schemas. Schemas are important beliefs and feelings about oneself and the environment which we accept without question. They are self-perpetuating, and are very resistant to change.
Core emotional needs for safety, stability, nurturance, acceptance, autonomy, competence, a sense of identity, the freedom to express our needs and emotions, spontaneity and play and for realistic limits which foster the emergence of self-control are universal. Psychological health is the ability to get our needs met in an adaptive manner.
Maladaptive schemas are formed when needs are not met during childhood and then the schema prevents similar needs from being fulfilled in adulthood. Even though schemas persist once they are formed, they are not always in our awareness. However, when a schema is triggered by events, our thoughts and feelings are dominated by these schemas. It is at these moments that we tend to experience negative emotions and have dysfunctional thoughts.
Coping Styles are normal attempts on the part of the child to survive in a difficult environment. We tend to cope with our schemas in ways that reinforce them. Unfortunately, we keep repeating our coping styles throughout adulthood, even when we no longer need them. There are three general ways that we adapt to our schemas:
Surrender - giving in to our schemas and repeating them over and over
Avoidance - finding ways to escape or block out our schemas
Overcompensation - doing the opposite of what our schemas makes us feel
Research has found eighteen specific schemas. Most clients have at least two or three of these schemas, and often more. The first step in therapy is to do an assessment to identify our early maladaptive schemas and coping styles.
The primary goal of treatment is to engage in schema healing processes to help adults get their own needs met, even though these needs may not have been met in the past. There are many techniques that the therapist can use to help clients weaken their schemas. These techniques can be broken down into four categories:
Emotive techniques encourage clients to experience and express the emotional aspects of their problem. Together, we work towards creating new emotional experiences that heal the old patterns.
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 with the therapist. This may lead to a useful exploration of other instances in which the client perpetuates their schemas and how they might better cope at those times.
Cognitive techniques are those in which the schema-driven cognitive distortions are challenged. The dysfunctional thoughts are identified and the evidence for and against them is considered. Then new thoughts and beliefs are substituted.
Behavioural techniques are those in which the therapist assists the client in changing long-term behaviour patterns, so that healthy coping responses are strengthened.