Do you need help with long-term negative patterns of thinking? Try Schema therapy.
Schemas are mental frameworks that we use to help organise and process large amounts of information quickly. They contribute to our stereotypes and affect the way we think and behave.
Schema therapy is a process that helps individuals identify unhealthy schemas so as to change them into healthier patterns of thought, feelings and behaviours.
It is helpful in treating long-standing mental health conditions such as chronic anxiety and depression, and is usually effective in treating borderline personality disorders.
Our Core Emotional Needs
All of us are born with the necessity to meet 5 core emotional needs while growing up.
How our schemas and modes are developed depends on how our caregivers provide for these needs. If our emotional needs are unmet, an unhealthy schema may form.
Here are the 5 core emotional needs:
The Need for Secure Attachment
Secure attachment includes safety, stability, nurturance, and acceptance.
It is developed when caregivers ensure children are safe, protected and loved.
With secure attachment, one will be able to build better relationships and get along better with people.
Freedom to Express Valid Needs and Feelings
This is the ability to express oneself without being afraid of criticism.
If a child is not given the environment to express himself and regulate his emotions, maladaptive schemas may develop.
Eventually, this may cause challenges in expressing emotions.
Autonomy, Competence and A Sense of Identity
This core need is met when children are given the ability to carry out individualised tasks and make decisions that are age-appropriate.
If condemning feedback is given by caregivers or if children are given too much responsibility for their age, this core need may not be met.
A healthy sense of identity can only be developed when the core need of autonomy and competence is met.
Learning and Expressing Yourself Through Spontaneity and Play
By allowing play, one is provided with opportunities for self-expression, imagination and fun.
Without learning how to play or being encouraged to be spontaneous, one may face difficulties in mental health and relationships.
Realistic Limits and Self-Control
Building healthy boundaries and limits for children is important for their development of self-control and discipline.
If children are neglected by their caregivers, they may feel entitled and have no sense of limits and self-control. On the flipside, controlling caregivers set too many limits for children, preventing them from developing their own sense of self-control.
Both situations affect a child’s ability to meet this core need, and hence may cause them to be disciplined by others and have feelings of being socially defective.
The 5 Schema Domains
Schemas are formed when one or more of our core human needs are not met. There are 18 early maladaptive schemas that represent specific emotional needs that were not met during childhood and left unmanaged.
These 18 schemas can be categorised into 5 domains.
I: Disconnection and rejection
Schemas in this domain are typically associated with childhood trauma. They include abandonment, mistrust, shame, social isolation and emotional deprivation. These schemas make it difficult to form healthy relationships.
II: Impaired autonomy and performance
This domain includes schemas that relate with a lack of self. They are formed when one grows up in a family with overprotective parents, undermining one’s confidence.
Schemas may include incompetence, vulnerability, enmeshment, failure and dependence, affecting one’s ability to function independently.
III: Impaired limits
Schemas in this domain include entitlement and insufficient self-control. They are developed when one was spoiled by their parents or was not encouraged to build discipline. With these schemas, one’s abilities to respect boundaries and limits and self-control will be affected.
IV: Other-directedness
Schemas under this domain include subjugation, recognition seeking and self-sacrifice. People who have these schemas suppress their emotions and needs and focus on others’ reactions and opinions. They believe that people will love them only if they satisfy others’ needs.
V: Over vigilance and inhibition
This last domain includes schemas that emphasise on strict rules and moral values — people who develop them avoid failures as their top priority. Schemas include pessimism, emotional inhibition, unrelenting standards and punitiveness, as they were often brought up in demanding families.
How Does Schema Therapy Work
What it is used for
All schema therapies will focus on identifying and changing schemas. Schema therapy is typically separated into 2 phases:
- Assessment and education phase
During the assessment and education phase, the therapist will identify your schemas and schema mode. The therapist will help you to notice unhealthy coping styles and you will learn how to meet your emotional needs healthily.
- Change phase
The change phase will aim to challenge your schemas. With the help of the therapist, you will learn how to feel and react when your schema is found to be untrue.
With the completion of these processes, you may start to develop a strong and healthy schema mode that can help to regulate your emotions better.
Techniques used
There are 4 categories for techniques used, and they revolve around 2 concepts.
- Empathic confrontation: Your therapist acknowledges your schemas, and encourages you while you begin to realise that change is necessary
- Limited reparenting: Your therapist offers you security, respect and compassion and fulfils your unmet childhood emotional needs
These 2 concepts are used with techniques under these 4 categories:
- Emotive
Emotive technique involves guided imagery and role-play activities. These will help to engage you emotionally and to express them in a safe environment.
- Interpersonal
This technique requires you to scrutinise your relationships while identifying the schemas that are responsible for affecting them. You may even need to bring a friend or a partner to assist in the session.
- Cognitive
Your therapist will identify and confront your unhealthy thinking patterns that are caused by your schemas. You may be required to evaluate your life experiences to find reinforcements or evidence that refutes your schema.
- Behavioural
You’ll be guided to make fine choices by changing the patterns you’ve attained from your coping style. Your therapist will guide you in improving your communication skills through exercise and role-play activities.
Limitations
Schema therapy is helpful in treating chronic conditions such as personality disorders, depression and anxiety. Thus, it requires a long-term commitment which can get expensive.
Additionally, this is a relatively new type of therapy that was created in the 1980s with only 30 years of track record. However, according to Taylor et. al. (2017), there is evidence of early effectiveness in improving symptoms of personality disorders.
What Schema Therapy Can Help With
Schema therapy aims to help clients create healthy schemas and modes for a better life. It can help with the conditions below:
- Post-traumatic stress disorder (PTSD)
- Eating disorders
- Substance abuse
- Chronic depression
- Agraphobia
- Criminal behaviour
- Anxiety
- Relationship issues
- Personality disorder
- Personality-related conditions
- Post-traumatic stress disorder (PTSD)
- Eating disorders
- Substance abuse
- Chronic depression
- Agraphobia
- Criminal behaviour
- Anxiety
- Relationship issues
- Personality disorder
- Personality-related conditions
Our Psychotherapist Trained in Schema Therapy: Alexandra Bohnen
Alexandra has worked with adults on relationships, sexuality, low self-esteem, depression, anxiety, stress management and other mental health issues.
She believes in empathic techniques and will cultivate a safe space for you to share your woes.
Why Choose Sofia Wellness Clinic?
Evidence-based approaches
Our psychotherapists apply evidence-based approaches to improve our clients’ mental well-being.
Our approaches include schema therapy, cognitive behavioural therapy, acceptance and commitment therapy and dialectical behavioural therapy.
Qualified psychotherapists
At Sofia Wellness Clinic, our psychotherapists are equipped with extensive experience in counselling to provide the best outcomes for our clients.
Each of our psychotherapists has their own area of expertise to serve the varying needs of our clients.
Frequently Asked Questions
What are the different types of schemas?
There are 4 different types of schemas:
- Person schema focuses on details of different individuals, such as one’s appearance, likes, dislikes and personality
- Social schema represents how people behave under social circumstances. For example, one might feel that sneezing aloud is a rude gesture, whereas someone else may not
- Self schema centres around you and includes knowledge about your current and future selves
- Event schema guides you about how you should act in any situation. An example would be crossing the road only when the pedestrian light turns green
What are schema modes?
Schema modes affect the way one feels and copes at any one moment and they are constantly evolving. One can have dormant schema modes and active schema modes at the same time. One can also switch between helpful and unhelpful schema modes during the day.
Schema modes are mainly categorised into 4 categories:
- Child modes, such as the vulnerable, angry, undisciplined or happy child mode
- Dysfunctional coping modes, where one may tend to become passive, detach oneself emotionally or end up mistreating others
- Dysfunctional parent modes including the punitive or demanding parent
- Healthy adult mode represents a healthy and functional self
What are some ways that people cope with schemas?
There are 3 main ways that people usually cope with schemas:
- Surrender
You tend to accept the way you were treated and give in to the beliefs of the schema. By surrendering, you reinforce the schema as if it were true. You may find yourself often relying on others, avoiding conflict and being dependent on others.
- Avoidance
You tend to avoid triggering the schema by avoiding people who mistreat you and disconnecting from your own emotions. This avoidance can lead you to becoming excessively self-reliant and may leave you more vulnerable to risky behaviours.
- Overcompensation
You tend to fight a schema by acting in a complete opposite manner. Overcompensating will lead to actions that seem aggressive and excessive. Some examples include manipulating others to achieve your goals or focusing on perfectionism so that you will not be criticised.
What is the difference between schema therapy and CBT?
CBT is an active intervention psychotherapy that examines the relationships between thoughts, feelings, and behaviours. It is to help people change the ways they think so that they can overcome their emotional problems.
Whereas schema therapy combines a few techniques that help to rebuild people’s schemas and coping styles for healthy living. It places more emphasis on one’s unmet needs and toxic experiences.
