How is Schema Therapy used?
Schema Therapy evolved out of cognitive behavioral therapy, Gestalt therapy, and psychoanalysis and shares some features with these approaches. The goal is to become conscious of underlying patterns of thought and behavior and to gain insight into how these patterns have been helpful for us in our lives, as well as how they might be hurting us now.
Schema Therapy is most often used as an individual, longer-term form of therapy, due to the importance of forming a secure bond of trust between the therapist and the client. However, there are brief therapy applications as well, such as in substance abuse treatment programs.
Schema Therapy is one of the most effective forms of treatment for people who have been diagnosed with a personality disorder, such as Borderline Personality Disorder or Narcissistic Personality Disorder. This may be because a disordered personality is the result of maladaptive schemas. Some pioneers in the field of trauma treatment, such as Dr. Janina Fisher, have suggested that the so-called “personality disorders” are actually caused by extreme fragmentation, representing survival states that were once necessary to make it through severely overwhelming circumstances.
Through Schema Therapy, we are gently supported to become conscious of our schemas. With recognition of schemas filtering our experience, we restore our native ability to have choice about how to think of ourselves, other people, and the world at large.
Schema Therapy is used successfully with people who have behavioral disorders (such as substance abuse, self-harm, and eating disorders), and for mental health disorders like anxiety and depression. Schema Therapy has been effective with many “treatment-resistant” forms of mental health symptoms, meaning that where some other types of therapy have failed to work, Schema Therapy has worked well.
What to expect in Schema Therapy?
Schema Therapy will guide you to identify your core schemas, as well as your behavioral reactions to your own schemas.
Although each person is unique, and sometimes more than one schema is at play, there are roughly five main categories of schemas and three primary ways that we tend to react to schemas. Through Schema Therapy we become conscious of these and gradually regain control over how we relate and behave.
The five categories of schemas are:
- Impaired Autonomy and Performance. The belief that I am doomed to failure and that I do not have what it takes to meet the requirements of daily life
- Other-directedness. The belief that other people’s needs and points of view are more important than my own, and/or that I must give up control to others
- Overvigilance and Inhibition. The belief that expressing my emotions leads to negative outcomes, and/or that overall, life is more negative than positive
- Disconnection and rejection. The belief that I cannot rely on other people for emotional support, or that I am essentially alone or disconnected from others
- Impaired limits. The belief that I am entitled to special treatment and that I am superior to others
The three main coping styles that people use when reacting to an activated schema are:
- Fighting the Schema: Overcompensation
In this coping style, we try to disprove a core schema by behaving in the opposite way or garnering evidence that the opposite is true.
For example, to counteract a painful schema that we are doomed to failure, we may develop a workaholic pattern, pursuing markers of success to the point of burnout. We might pursue a promotion at work, even though we don’t really want the job change, just because it disproves our core schema.
- Fleeing the Schema: Avoidance
In this coping style, we try to avoid triggering a painful schema, shutting down areas of our lives if necessary.
For example, to avoid the painful schema that we are doomed to failure, we may avoid trying anything outside our comfort zone, so that we do not have an opportunity to fail. We might not even try for a promotion at work, even though we would have liked to have the job change.
- Submitting to the Schema: Surrender
In this coping style, we give up and give in to the painful schema. Giving into a painful schema often leads to self-destructive behavior.
For example, to surrender to a painful schema that we are doomed to failure, we might unconsciously sabotage ourselves, to make the schema come true. We might try out for a promotion at work, then get drunk the night before the interview, as a way of fulfilling the schema.
Coping styles can be fluid, and we may try different coping styles in response to the same core schema.
Once the Schema Therapist has helped us to identify our schemas and our main coping styles, we will be guided to learn techniques for replacing negative schemas and coping styles with better ways of thinking about ourselves and the world.
Some techniques used by Schema Therapists are cognitive and might involve homework between sessions, or suggestions to keep a diary that tracks changes and experiences. A common Schema Therapy homework assignment is to look for evidence for and against our core schema and to use the evidence to challenge the truth of the schema.
The Schema Therapist may also use Gestalt therapy exercises, like role-playing, enactments, and practicing adaptive responses in session. These are behavioral exercises that can help us rehearse for life.
How does Schema Therapy work?
The person who developed Schema Therapy is the psychologist, Jeffrey Young. Young’s theory is that maladaptive schemas formed in childhood can explain the presence of severe mental health symptoms, behavioral disorders, and even personality disorders. He discovered that a therapy that targeted schemas specifically could empower clients to overcome chronic negative feelings and behave differently in the world.
Schema Therapy works in part because the client is supported in the therapeutic relationship to learn to relate in ways that do not require the schemas for protection. As the therapist provides an environment of unconditional acceptance, empathy, and curiosity rather than condemnation or coercion, the client experiences relational safety. This helps the client meet some attachment needs and learn less distorted ways of relating without fear.
Although Schema Therapy rests on positive attitudes toward the client, and honoring the client’s coping styles and core schemas as important survival strategies at one point in the client’s life, it also includes an element of empathic confrontation, which means that the therapist will help the client to see the reality of their schemas’ negative impacts. This reality-orientation is necessary for developing motivation to extract the negative schema and replace it with something that is more life-positive and friendly.
What to look for in a schema therapist?
When looking for a therapist, it’s important to check your felt-sensed, bodily awareness for a personal feeling of resonance and safety with the therapist you’re considering working with, especially if you have a background of complex post-traumatic stress. For any kind of therapy to work, we will need to feel accepted and understood by the therapist, so that we can relax and share our burdens with them without undue discomfort.
Training and experience are also important, and when you are looking for a Schema Therapist you should look for one who has been certified in the Schema Therapy method. The Schema Therapy Society has a therapist finder section on its site.
Villa Kali Ma offers Schema Therapy for women
At Villa Kali Ma, we offer Schema Therapy as a part of our holistic programs for women. We incorporate the empowering, liberating method into our multidisciplinary approach to helping women recover from substance addiction, mental health disorders, and trauma.
