What is Schema Therapy

Schemas operate as blueprints to help us understand the world.  They influence how we see, feel and behave in the world. We learn about ourselves and the world from our early experiences hence schemas develop in childhood or adolescence and are elaborated throughout our lives. If we mostly get our needs met then we can feel safe, loved and important. However, if we have negative experiences and our needs are not met, we can feel unloved, unsafe and unwanted.  

Maladaptive schemas are maintained by coping styles (modes) that we adopt. When schemas are triggered, we experience a threat. Therefore, our reaction can be to freeze, flight or fight. The coping styles we adopt can take the form of schema surrender (freeze), schema avoidance (flight) or schema overcompensation (fight). To give some examples of this: if you have an emotional deprivation schema, you may feel lonely and unlovable. If you surrender to this schema, you may discount any warm behaviour directed towards you and you may come across as withdrawn, which reinforces the schema. If you have an abandonment schema you may avoid going on dating apps as you fear the emotions that a separation may cause (avoidant coping style). This keeps abandonment fears going and does not meet your need for a relationship. If you have a defectiveness schema and you adopt an overcompensation coping style, then you may adopt narcissistic behaviours. Overcompensation can lead you to function more effectively in the world than surrendering or freezing in response to a schema, but ultimately core needs do not get met due to self-defeating behaviours.     

Different people cope with their schemas in different ways. Our ways of coping can be influenced by our temperaments at birth (e.g., anxious, outgoing) and we may unconsciously choose different caregivers to copy or model from. Coping styles are normal attempts by a child to survive in a challenging environment. The coping styles may have had an important function in childhood, but we often repeat our coping styles in adulthood, even though we no longer need them. Often these coping styles in adulthood act in ways that block our development.

The goals of Schema Therapy

The main goal is to help strengthen the healthy adult mode. In doing this, the aim is to reduce the power of your maladaptive coping modes so that you are in touch with your core needs and feelings. You will learn to validate and support your vulnerable child mode and set limits on your angry/impulsive child mode.  You will learn how to reduce the power of your critic and demanding modes. The aim is to heal early schemas and to break schema driven behavior patterns. Ultimately the aim is to help you to be able to get your emotional needs met as much as you can, in your life.

What are children’s core needs?

1. Safety and stability

2. A secure, loving and reliable bond with one or more caregivers.

3. Autonomy, competence and a sense of identity

4. To express and regulate emotions

5.  To be playful and spontaneous

6.  Having realistic limits from caregivers.

The main goal is to help strengthen the healthy adult mode. In doing this, the aim is to reduce the power of your maladaptive coping modes so that you are in touch with your core needs and feelings. You will learn to validate and support your vulnerable child mode and set limits on your angry/impulsive child mode.  You will learn how to reduce the power of your critic and demanding modes. The aim is to heal early schemas and to break schema driven behaviour patterns. Ultimately the aim is to help you to be able to get your emotional needs met as much as you can, in your life.

SCHEMAS

Emotional Deprivation: The expectation that your need for emotional support will not be met - no one will nurture, care for, guide, protect or empathise with you.

Abandonment: The belief and expectation that others are unreliable and will leave, that relationships are fragile, that you will be abandoned in favour for someone better and ultimately you will end up alone.

Mistrust/Abuse: The expectation that others are abusive, manipulative, selfish, will lie, and humiliate or hurt you and are not to be trusted.

Defectiveness: The belief that you are flawed, damaged, unlovable, inferior and you will therefore be rejected. It may involve a hypersensitivity to criticism and rejection. There is insecurity and a sense of shame about perceived flaws.

Social Isolation: A sense of aloneness, being different from others and not part of a community.

Vulnerability to Harm and Illness: The sense that the world is a dangerous place, that disaster can happen at any time and that you will be overwhelmed by future challenges. There are often fears about emotional, medical, and external catastrophes.

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. It can lead to feelings of helplessness.

Enmeshment/Undeveloped Self: Excessive closeness with one or more significant others (often parents). You may feel smothered and feel that you do not have your own identity or “individuated self”.

Failure: The expectation that you will fail or the belief that you cannot perform well enough. The belief that you have failed relative to peers. It can often involve beliefs that you are stupid/ less successful than others.

Subjugation: The belief that you must submit to the control of others to avoid anger, retaliation, or abandonment. It frequently presents as excessive compliance and feelings of being trapped. It can lead to a build-up of anger (e.g., passive aggressive behaviour, psychosomatic symptoms, substance abuse).

Self-Sacrifice: The belief that you should give up your own needs for the sake of others to a point which is excessive.

Approval-Seeking/Recognition-Seeking: The sense that approval, attention, and recognition are far more important than being true to yourself. It can include an overemphasis on status, appearance, money, or achievement.

Emotional Constriction: The belief that you must inhibit self-expression due to an underlying shame or embarrassment, with fears that others will reject or criticise you. It can include inhibiting: negative impulses (anger, sadness) positive feelings (joy, affection, play) and vulnerable feelings. There can be an excessive emphasis on rationality and logic whilst disregarding emotions. Involves beliefs “expressing emotions shows that I am weak”.

Fear of Losing Control: The excessive inhibition of spontaneous emotion, action, or expression, due to a fear that you would lose control of your impulses resulting in terrible consequences. For example, fears of being overwhelmed by emotions, fears of others responses/ damaging others, fears of ‘overindulging’ (e.g., losing control of spending, eating). There may be an excessive preoccupation with your internal state and how you appear to others.

Negativity/Pessimism: The pervasive belief that the negative aspects of life outweigh the positive, along with negative expectations for the future. It can involve the belief that things will always go wrong and a fear of making mistakes that will lead to catastrophe.

Unrelenting Standards: The belief that you need to be the best, always striving for perfection or that you must avoid mistakes.

Punitiveness to others: Hyper-critical towards others’ mistakes, suffering or imperfections. Involves a belief that people should be harshly punished for their mistakes or shortcomings. It can involve a pre-occupation with concepts of justice. There are often difficulties with empathising and forgiveness.

Punitiveness to self: Self-directed hyper-criticalness towards your own mistakes, suffering, or imperfections. Involves a belief that one should be punished or held accountable for failing to meet expectations. Involves an excessive sense of responsibility leading to self-blame, self-directed anger and difficulty forgiving yourself.

Entitlement/Grandiosity: The sense that you are special or more important than others. It involves the belief that you do not have to follow the rules like other people, even though it may have a negative effect on others. It 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 if the process contains boring, repetitive, or frustrating aspects. It involves a discomfort avoidance at the expense of fulfillment, commitment, or integrity. Also, that you cannot resist acting upon impulses even if they lead to negative consequences

MODES

When you experience an intense reaction (an emotional button has been pressed) or an overreaction to a situation, this is indicative that a schema has been activated and you may respond by going into a mode. Modes refer to our everyday, moment to moment emotional states and coping responses.


Here are some of the main modes: 

Child Modes

  • Vulnerable Child:  feels lonely, isolated, sad, misunderstood, unsupported, defective, deprived,
    overwhelmed, incompetent, self-doubting, needy, helpless, hopeless, anxious, worthless,
    unlovable, lost, weak, defeated, oppressed, powerless, left out, pessimistic.

  • Angry Child: feels intensely angry, enraged, infuriated, frustrated, impatient because the core emotional, psychological, or physical needs of the vulnerable child are not being met.

  • Impulsive Child: acts on impulses in an uncontrolled manner and has difficulty delaying short-term gratification; often feels intensely angry when these impulses cannot be met. They may appear “spoiled”.

  • Happy Child: feels loved, contented, connected, satisfied, fulfilled, protected, accepted, praised, worthwhile, nurtured, guided, understood, validated, self-confident, competent, appropriately autonomous, safe, resilient, strong, in control, adaptable, included, optimistic, spontaneous

Coping Modes

SURRENDER MODES

  • Compliant Surrenderer: acts in a passive, subservient or self-deprecating way around others out of fear of conflict or rejection; tolerates abuse and/or bad treatment; does not express healthy needs or desires to others; selects people or engages in other behaviour that maintains the self-defeating schema-driven pattern.

  • Victim mode/ Helpless surrenderer: experiences themselves as a victim. Feels helpless and passive, wanting to be rescued or given special treatment because they are a victim.  

 AVOIDANCE MODES

  • Detached Protector: detaches emotionally from people and rejects their help; feels withdrawn, spacey, distracted, disconnected, depersonalised, empty or bored. Can operate in a robotic way. Can remain functional.

  • Avoidant protector: Avoids situations that may trigger distress.

  • Detached self-soother: pursues distracting, self-soothing or self-stimulating activities in a compulsive way or to excess (e.g. workaholic, gambling, substance use, computer games).

  • Angry Protector: Uses a wall of anger to protect themselves from perceived threat, to protect from being hurt.

OVERCOMPENSATION MODES

  • Over-controller: Several modes that protect from (perceived or real) threat by focusing attention on details, ruminating, and exercising extreme control. A Perfectionistic over-controller focuses on perfectionism to attain control and prevent criticism. A Suspicious over-controller scans other people’s behaviours and controls others' behaviour out of suspiciousness. A Scolding over-controller tries to use orders and belittling remarks to control others behaviour. A Worrying over-controller has an inability to tolerate uncertainty so ruminates excessively on what that can go wrong and how to fix this. A Compulsive over-controller suppresses uncomfortable feelings by neutralizing them with repetitive ritualistic behaviours (overt of covert). A Rationalizing over-controller gives apparently rational but inaccurate explanations of their or others’ behaviour, to avoid accepting and dealing with their emotions or the emotions of others.

  • Attention and Approval Seeker:  Tries to get others’ attention and approval by extravagant, inappropriate, and exaggerated behaviour. It can be compensating for underlying loneliness.

  • Self-Aggrandiser:  Behaves in an entitled, competitive, grandiose, abusive, or status-seeking way to inflate their sense of self. Can be self-absorbed and shows little empathy for the needs or feelings of others. Expects to be treated as special and does not believe s/he should have to follow the rules that apply to everyone else.  

  • Bully and Attack: Harms other people in a sadistic, controlled and strategic way emotionally, physically, sexually, verbally, or through anti-social or criminal acts. The motivation may be to prevent abuse or humiliation.

  •  Conning and Manipulative:  Cons, lies, or manipulates in a manner designed to achieve a specific goal, which either involves victimising others or escaping punishment.

  • Predator:  Eliminates a threat, rival or enemy in a cold, ruthless, and calculating manner.

Parent Modes

  • Punitive Parent or Inner Critic:  internalised voice which could be from a caretaker/teacher that is harsh, critical and unforgiving of themselves e.g., tells them they are worthless.  Often acts on these feelings by being blaming, punishing, or abusive towards self or others.   

  • Demanding Mode:  feels that the “right” way to be is to be perfect or achieve at a very high level, continually pushes and pressures you. Importance is placed on keep everything in order, high status, to be efficient or avoid wasting time; or it can lead you to feels that it is wrong to express feelings or to act spontaneously.

  • Guilt Inducing mode:  Combines punitive and demanding aspects and induces guilt by telling them you should have acted in a certain way and you are “bad” for not having done so.

Healthy Adult Mode

  • Healthy Adult: nurtures, validates and affirms the vulnerable child mode; sets limits for the angry and impulsive child modes; promotes and supports the healthy child mode; combats and eventually replaces the maladaptive coping modes; moderates the maladaptive parent modes.  This mode also performs appropriate adult functions such as working, parenting, taking responsibility and pursuing pleasurable adult activities.

  

 

References

·        “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

·        Yalcin, O., Marais, I., Lee, C., & Correia, H. (2022). Revisions to the Young Schema Questionnaire using Rasch analysis: the YSQ-R. Australian Psychologist, 57(1), 1-13.

·        Lobbestael, J., van Vreeswijk, M., & Arntz, A. (2007). Shedding light on schema modes: a clarification of the mode concept and its current research status. Netherlands Journal of Psychology, 63, 76-85.

·        Simpson S. & Smith. E (2019) Schema Therapy for Eating Disorders

*There has been an increasing expansion of schema modes over the course of the development of schema therapy. To reduce overwhelm in the number of modes, the main ones that I use in therapy have been listed. These have been derived from the references above.

More information on schema therapy can be found at: ‘Reinventing Your Life’, by Jeffrey Young, Ph.D. and Janet Klosko, Ph.D. (1994).  More information on modes can be found at: ‘Breaking Negative Thinking Patterns’ by Jacob, G, van Genderen, H and Seebauer, L (2015)

 

Strategies Schema Therapy Uses

Schema therapy involves the use of experiential, cognitive and behavioural strategies. Experiential strategies include ‘empty chair’ work where the different parts of you (modes) are put onto chairs and they have a dialogue. Each part is explored further and this can bring powerful change. Imagery is used where memories from the past are relived and changed, to enable healing. The relationship between therapist and client is a key ingredient to the process of change in schema therapy. Many cognitive and behavioural techniques are used, for example, challenging thoughts, behaviour experiments and mode forms. At the end of therapy, you will have a tool kit to draw on when different modes are activated.