Should I have Schema Therapy?

Understanding Schema Therapy: Unpacking the Different Schemas and Coping Modes

Schema Therapy (ST) is a relatively recent development in the world of psychotherapy, designed to help individuals break free from deep-seated, negative patterns of thinking, feeling, and behaving that can trace their roots back to early childhood experiences.

When we examine the research out there, Schema Therapy is one of the four gold standard treatments regarding personality disorders, and in common with the other 3, it requires a longer therapy duration, sometimes up to 2 years and also a strong therapeutic alliance.

What is a Schema?

A schema, in the context of Schema Therapy, refers to a broad, enduring, and pervasive pattern of thoughts, feelings, and behaviours that individuals develop based on early experiences—particularly those related to their caregivers, family environment, and key relationships. Schemas influence how a person perceives themselves, others, and the world. These early maladaptive schemas (EMS) often emerge when basic emotional needs aren't met during childhood, leading to dysfunctional coping strategies and negative core beliefs that persist into adulthood.

Schemas can affect our relationships, self-esteem, and emotional well-being, and even our physical health. Recognising and addressing these patterns in therapy can help individuals break free from self-destructive cycles and form healthier ways of thinking and interacting.

Schema’s can often lay dormant for a number of years, so to speak. A failure schema may be fairly inactive through someone’s 20’s but may be triggered later on by parenthood or issues at work such as redundancy. One way of seeing a schema, is like those glasses you wear at the opticians for eye exams. They put in different lenses to test your vision and that is like the schema being activated, what you see is influenced by that particular schema.

The Different Types of Schemas

Dr. Young identified 18 core schemas, which he categorised into five broad domains. Each schema represents a way of interpreting and responding to the world based on unmet needs from early childhood.

As children we have core needs which are summarised below, and when these are impacted or not met, then this can lead to the formation of schema’s.

Core unmet needs:

• Safety

• Stability/predictability

• Love/nurturance

• Empathy/warmth

• Acceptance/praise

• Autonomy

• Guidance/protection

• Belonging to/identification to a group

• Validation of needs and emotions

• Spontaneity and play

• Realistic limits/boundaries

These 18 schemas can be grouped into five overarching domains:

1. Disconnection and Rejection

These schemas reflect a core belief that others will reject, abandon, or fail to meet one’s emotional needs. Individuals with these schemas may feel unworthy of love or support. Examples include:

- Abandonment/Instability: Fear that others will abandon or be unreliable.

- Mistrust/Abuse: The belief that others will hurt, manipulate, or deceive.

- Emotional Deprivation: A belief that one’s emotional needs (for affection, empathy, or nurturance) will not be met.

- Defectiveness/Shame: A feeling that there is something inherently wrong with oneself and that one is unworthy of love or respect.

- Social Isolation/Alienation: A feeling of being different from others, leading to a sense of isolation or loneliness.

2. Impaired Autonomy and Performance

This category is characterised by a belief that one is incapable of functioning independently or successfully. Individuals with these schemas often struggle with self-efficacy and self-reliance. Examples include:

- Dependence/Incompetence: Belief that one is unable to function independently or effectively.

- Vulnerability to Harm or Illness: A heightened sense of danger from physical harm, illness, or disaster.

- Enmeshment/Undeveloped Self: An inability to differentiate from family or significant others, resulting in an unclear sense of self.

- Failure: The belief that one is destined to fail and cannot achieve success or mastery in life.

3. Impaired Limits

Schemas in this domain involve difficulties with setting boundaries, self-control, and respect for others’ rights. These issues can lead to impulsivity, irresponsibility, and lack of discipline. Examples include:

- Entitlement/Grandiosity: A belief that one deserves special treatment and has the right to do whatever they want.

- Insufficient Self-Control/Self-Discipline: Difficulty managing impulses or behaving in a disciplined, responsible way.

4. Other-Directedness

Schemas in this category revolve around prioritising others’ needs and emotions over one’s own. This often leads to self-sacrifice, neglect of personal desires, and difficulty asserting oneself. Examples include:

- Subjugation: The belief that one must surrender to others’ needs or desires, often out of fear of anger or rejection.

- Self-Sacrifice: A tendency to focus excessively on others’ needs at the expense of one's own needs.

- Approval-Seeking/Recognition-Seeking: A preoccupation with gaining approval, validation, and recognition from others.

5. Overvigilance and Inhibition

These schemas are rooted in the fear that negative outcomes will occur unless one remains overly cautious, vigilant, or emotionally restrained. This category often leads to perfectionism, anxiety, and emotional suppression. Examples include:

- Emotional Inhibition: The belief that expressing emotions leads to negative consequences, so one suppresses them.

- Unrelenting Standards/Hypercriticalness: A belief that one must meet excessively high standards in order to be worthy or avoid failure.

• Punitiveness: The tendency to be overly critical of oneself or others when mistakes are made.

Arntz (2021) has proposed three new schemas as a result of the core emotional needs of:

• The need for self-coherence

• The need for fairness

Arntz believes that this leads to the schemas of:

• Lack of a coherent identify

• Lack of a meaningful world

• Unfairness

Schemas can often exist on an implicit memory level, which means that they are often an unconscious emotional and physical response to triggers in life. This can be different from explicit memory which is why often CBT can be unsuccessful in targeting these schemas as this is something that can not be “talked” through and processing may need to be on an emotional and somatic level.

This is how Schema Therapy was supposedly developed, as Jefferey Young was a CBT Therapist who was trying to understand why a lot of his private clients were not improving. When he looked further into it, he discovered that many of them had difficult histories which meant there were often deeply rooted schemas at play.

How we respond when these schemas are triggered and activated is discussed below.

Coping Modes in Schema Therapy

In response to these early maladaptive schemas, individuals develop various coping strategies or "modes" to manage emotional distress or avoid confronting painful feelings. These coping modes are adaptive in the short term but often perpetuate the negative schemas and interfere with emotional healing in the long term.

Schema Therapy identifies several key coping modes, including:

1. Child Modes

These modes reflect the emotional responses of the child within us, reacting to perceived abandonment, criticism, or other painful experiences. Common child modes include:

• Vulnerable Child: Feeling helpless, alone, or unworthy of care and attention.

• Angry Child: A reaction to being mistreated, where anger or frustration is expressed.

• Impulsive/Undisciplined Child: Behaving impulsively or without restraint in response to unmet needs.

- Happy Child: A mode where an individual feels carefree, joyful, and at peace—often a reflection of a well-nurtured inner self.

2. Parent Modes

These modes reflect the critical or nurturing voices of significant figures in one’s life (e.g., parents). They often stem from early experiences of criticism or neglect. Examples include:

• Critical Parent: An internalised voice that criticises or punishes oneself, echoing parental or societal standards.

- Nurturing Parent: A more compassionate, caring voice that offers support and encouragement, usually arising in more healing, self-compassionate modes.

3. Adult Modes

These modes reflect an individual's ability to process experiences in a mature, balanced way. The Healthy Adult mode is able to evaluate situations objectively and make decisions based on logic and self-compassion, without the distortions caused by unresolved schemas.

4. Coping Modes

These modes are survival mechanisms that individuals use to deal with distressing emotions. Some common coping modes include:

• Avoidance: Avoiding situations or emotions that trigger painful schemas, often leading to emotional numbness or withdrawal.

• Surrender: Giving in to the schema's demands, such as engaging in self-destructive behaviours, being passive, or not asserting one's needs.

• Overcompensation: Trying to "undo" the effects of the schema by engaging in behaviours that are extreme in the opposite direction (e.g., perfectionism to counteract feelings of worthlessness).

Due to the complexity of our brains, it will often take the path of “least resistance in situations. It is like having to walk to school across a field, you will often take the well trodden path instead of striding through the long grass simply because it is easier. This means we can be drawn to life situations that are familiar and safe but ultimately may trigger our own schema’s.

We may be drawn to others in life such as partners due to schema attraction or chemistry. Someone who is feeling dependent and incompetent could be drawn to someone who is a rescuer. Or someone with a strong surrender mode may be attracted to someone who is a bully/aggrandiser. Being aware of our schema’s and modes can help us to step back from situations with a different awareness.

Healing Through Schema Therapy

The goal of Schema Therapy is not just to identify and challenge these schemas but also to foster emotional healing by changing the way individuals interact with their own feelings and experiences. Over time, through therapeutic work, individuals learn to:

• Recognise and validate their schemas and coping modes

• Replace negative coping patterns with healthier, more adaptive    responses.

• Develop a more compassionate and realistic relationship with themselves.

• Develop their healthy adult and to get their core needs met in more positive ways.

Therapists often use a combination of cognitive, experiential, and behavioural techniques to help clients reframe their schemas, process painful emotions, and create new ways of interacting with the world. This process helps individuals develop a stronger, more resilient sense of self, heal emotional wounds from the past, and lead more fulfilling lives.

Schema therapy requires an effective therapeutic relationship and this uses limited reparenting and empathic confrontation to help change older ways of coping which are ultimately survival focused.

Schema therapy can be made even more effective through the integration of EMDR and its ability to process emotional and physical responses.

Final Thoughts

Schema Therapy provides a powerful framework for understanding the deep-rooted patterns that influence behaviour, thoughts, and emotions. By recognising these patterns and the coping mechanisms that reinforce them, individuals can embark on a transformative journey toward healing. It’s a process that requires self-compassion, patience, and commitment but offers the promise of a more integrated and balanced self.

If you are interested in exploring Schema Therapy please contact philpbrucetherapy.co.uk for more information.