Schema therapy is especially helpful in treating chronic depression and anxiety and relationship difficulties. Schema therapy enables changes in clients who feel hopeless about their self-destructive patterns, because these problematic behaviours may seem so entrenched that they appear to be part of their very identity. Schemas or ‘negative life beliefs’ can lead to low self-esteem, lack of connection to others, problems expressing feelings and emotions and excessive worrying about basic safety issues. The beliefs can also create strong attraction to inappropriate partners and lead to dissatisfying careers. Beginning with a series of assessments clients learn to recognise which schemas and problematic coping styles affect them the most, understand the origins and learn how to make lasting changes.
Structured assignments are worked on outside sessions that help clients to continually confront their negative beliefs. In each session, the client works with their therapist to identify when their unhealthy patterns are repeating, and are “empathically confronted” with the reasons for change.
Dr. Jeffrey Young, PhD, developed Schema Therapy and opened the first Schema Therapy Institute in New York out of his work at Columbia University. Dr Young originally worked with Dr Aaron Beck (founder of Cognitive therapy) as a Cognitive Therapist. While working with clients at the Centre for Cognitive Therapy at the University of Pennsylvania, Dr Young and his colleagues found that some clients with certain characteristics in common did not benefit as much from the standard approach. These clients typically had long-standing, self-defeating patterns or themes in thinking and feeling (and consequently in behaving or coping) that required a different means of intervention. Dr. Young’s attention turned to ways of helping his clients to address and modify these deeper patterns or themes, also known as “schemas” or “life traps”.
These Schemas or patterns consist of negative/dysfunctional thoughts and feelings which develop early in life as a result of the need for connection, autonomy, play and spontaneity, limits and assertion not being adequately met. The negative patterns are repeated and elaborated upon throughout a person’s life, and pose obstacles for accomplishing one’s goals and getting one’s needs met.
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,” etc.
Schema Therapy is designed to address unmet needs and to help clients break these patterns of thinking, feeling and behaving, which are often tenacious, and to develop healthier alternatives to replace them. Schema-Focused Therapy has shown good results in helping people to change patterns which they have lived with for a long time, even when other methods and efforts they have tried before have been unsuccessful.
List of Schemas:
- 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 empathise with you.
- Abandonment: The belief and expectation that others will leave, that others are unreliable, that relationships are fragile, that loss is inevitable and that you will ultimately end up alone.
- Mistrust/Abuse: The belief that others are abusive, manipulative, selfish, or looking to hurt or use you and are not to be trusted.
- Defectiveness: The belief that you are flawed, damaged or unlovable and you will therefore be rejected.
- Social Isolation: The pervasive sense of aloneness, coupled with a feeling of alienation.
- Vulnerability: The sense that the world is a dangerous place, that disaster can happen at any time and that you will be overwhelmed by the challenges that lie ahead.
- 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: The sense that you do not have an identity or “individuated self” that is separate from one or more significant others.
- 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.
- Self-Sacrifice: The belief that you should voluntarily give up your own needs for the sake of others, usually to a point which is excessive.
- 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 criticise 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 have a negative effect on others. Also can manifest in an exaggerated focus on superiority for the purpose of having 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, that you cannot resist acting upon impulses that lead to detrimental results.
Reference: “A Client’s Guide to Schema-Focused Cognitive Therapy” by David C. Bricker, Ph.D. and Jeffrey E. Young, Ph.D., Cognitive Therapy Center of New York. 1993