Schema therapy is a modern psychotherapeutic technique that belongs to the methods of the third wave of cognitive behavioral therapy. Its focus is human emotions. Schema therapy was developed by Dr. Jeffrey Young to treat post-traumatic stress disorder, personality disorders, depression, and the effects of childhood trauma. Young noted that conventional psychotherapeutic techniques do not work for patients with these disorders. In addition, as practice has shown, schema therapy copes well with maladaptive behavior in healthy people: it helps to identify the causes of such behavior, work through them and make their lives more harmonious. How does schema therapy work?
An important term in schema therapy is the concept of early maladaptive schema. This is a pattern of perception of reality that was formed in childhood as a result of traumatic circumstances. There are 18 such patterns in total. And already in adulthood, in certain situations, this scheme of perception and behavior is activated. Maladaptive patterns are formed if the child did not receive satisfaction of 5 basic needs:
• Need for security
• Need for acceptance
• Need for boundaries, self-control
• The need to freely express your feelings and emotions
• Need for connection with others (play, conversation, spontaneity)
A child’s perception is formed based on his experience of communicating with parents, significant adults, brothers, sisters, and other children. What happens if a child's basic needs are not met? They are not satisfied even in adulthood. A person experiences situations that cause quite strong negative emotions in a certain way; he uses styles of behavior called coping. There are three main copings:
• Surrender
• Avoidance
• Overcompensation
As we mentioned earlier, there are 18 main maladaptive schemas that are formed in situations in which the child's basic needs are not met.
Abandonment. A person is sure that he can lose someone important with whom an emotional attachment has been established. Such a pattern can develop if adults left the child alone, if they threatened that they would leave him or send him to an orphanage, if the child experienced a parental divorce or one of the parents died.
Emotional deprivation. The person is sure that he is not understood. This pattern of behavior is formed if the parents did not try to understand the child, were emotionally distant, and did not show due care and attention to the child’s emotions.
Mistrust, expectation of abuse. A person with such a pattern of behavior is confident that other people will cause him harm and pain and take advantage of their position. They often act out of revenge, with the goal of launching a preemptive strike.
Insulation. A person believes that he is different from other people, that he is different, he cannot be part of society. This pattern is formed in children who often had to change their place of residence and school, and whose families differed from the families of other children.
Defectiveness. The person is sure that if the other person gets to know them better, he will see that he is internally flawed and will refuse the relationship. This belief is formed in children whose parents were demanding (good grades, achievements in sports), and they did not feel unconditional love and support.
Failure, helplessness. Develops in those adults whose parents did not give freedom of action and did not encourage independence in childhood. Such people cannot make decisions and prefer to rely on other people if they need to take the initiative.
Expectation of disaster or illness. With this scheme, a person is in constant anticipation of illness, financial collapse, natural disaster, robbery, or attack. As a result, a person tries to play it safe and take measures to protect himself. This pattern develops in children whose parents instilled the idea that the world is hostile and had an authoritarian parenting style.
Undeveloped self. A person with such a scheme does not feel his own identity; he constantly “merges” with his parents and partner. Often this pattern is formed in children whose parents overly cared for them, protected them, and controlled them.
Doomed to fail. A person has the belief that he is incompetent, has no talents and abilities. As a result of such beliefs, a person does not strive for any achievements or career. The parents of such children did not provide such children with support in case of failure, did not encourage them in success, and did not develop their talents.
Subordination. This pattern is formed in children whose parents controlled them, told them that they needed to obey and ignored the child’s wishes. The behavior of people with this schema is that they submit to the control of others in order to avoid negative consequences and avoid rejection. Since childhood, they have become accustomed to ignoring their desires and feelings.
Self-sacrifice. People sacrifice their own wants and needs to help others. If they pay attention to their needs, they feel guilty. By sacrificing themselves, they feel their own importance. This pattern is formed if the child feels responsible for the parent.
Seeking approval. As the name suggests, this pattern involves behavior in which a person seeks approval and recognition from other people. He may pay excessive attention to his status and attributes. As a rule, such people were deprived of unconditional love in childhood.
Negativism. A person is focused on negative events, he is pessimistic, and pays little attention to the positive aspects in life. They worry about the future, imagining negative scenarios. The childhood of such people was fraught with anxiety, which was broadcast by anxious parents.
Suppression of emotions. Children whose parents forbade them to express anger, disappointment, strong emotions, and feelings are afraid to express these feelings as adults. They are convinced that negative emotions, especially anger, should not be shown, as this will lead to rejection and harm to others.
Punishment. People do not allow themselves and others to make mistakes; they are sure that any mistake entails punishment. They are dissatisfied with people's behavior, which is far from perfect. In such children, one of the parents was overly absorbed in work and had a punitive parenting style.
Strict standards. People with this pattern believe that they are not trying hard enough and have very strict demands on themselves. Such people usually have low self-esteem; they are unable to enjoy a situation if, in their opinion, it is not ideal enough. The parents of such children were not satisfied with their successes and grades; the condition for praise and love was only very high achievements.
Grandiosity. The belief is that a person is obliged to say what he thinks and feels here and now. It doesn't matter whether it hurts the other person or whether it's appropriate. A person does not think about the feelings of another person, about the fact that by his behavior he can alienate another person from himself. This behavior is typical of those who were spoiled by their parents in childhood, allowed a lot and did not set boundaries. It often happens the other way around, such a scheme appears as compensation for feelings of inferiority or feelings of emotional deprivation.
Lack of self-control. If it is not enough to discipline a child, not to give him the idea of self-control, then in adulthood such a person demonstrates an inability to limit his impulses, a lack of self-control. Such people often get involved in criminal stories and become dependent on alcohol and drugs.
Why are children's basic needs not being met? Often the reason lies in the personal characteristics of parents, who act based on their own traumatic experiences, habits or values. Sometimes the reason is the child himself - his characteristics, temperament. And the third reason is external: circumstances, environment.
Absolutely everyone has early maladaptive patterns. No one grew up in ideal conditions where all basic needs were met. But these patterns can be expressed to a greater or lesser extent. The more pronounced the pattern, the more pain and suffering it brings.
Since schemas are formed in close connection with emotions, appealing to the logic on which cognitive behavioral therapy is built is useless. Schemes are very stable and require a lot of work: patterns of behavior formed in childhood are not questioned in adulthood.
Coping is a strategy of behavior and emotional response to a stressful situation or difficulties that bring psychological discomfort. This term was first used in 1962 by L. Murphy, when he studied how children overcome developmental crises. In 1966, the same term appeared in the book of R. Lazarus. He described coping as a strategy for coping with the unpleasant effects of stress. In other words, these are the actions that a person takes to cope with stress. The choice of strategy for such action depends on several factors:
• Personal characteristics (self-esteem, level of anxiety, locus of control)
• Gender, age
• Experience gained in society, family, belonging to a certain social group
Coping can be either productive or dysfunctional and maladaptive. If productive coping is aimed at coping with a problem, dysfunctional coping is aimed at avoiding solving problems in various ways. Main scenarios of dysfunctional coping:
• Avoidance. A person seeks to avoid activating a scheme that causes him psychological discomfort. Basic avoidance methods:
• Cognitive avoidance. People do everything they can to avoid thinking about the stressful situation that activates the schema. This may be a conscious refusal to concentrate thoughts on some part of the personality or some specific events, or it happens unconsciously (for example, children who have experienced a traumatic situation “forget” about it).
• Emotional avoidance. If we are talking about events that activate emotional experience, people try to abstract themselves from this event, as if “drowning out” emotions. People often use alcohol or drugs to turn off their emotions.
• Behavioral avoidance. People make attempts to avoid the situations themselves. For example, a woman with a pattern of failure and helplessness will avoid situations where she needs to take the initiative. For example, at work.
• Surrender. The person passively accepts the pattern and unconsciously acts in ways that reinforce it. For example, a woman with a self-sacrificing pattern will sacrifice her own interests again and again to help others. At the same time, she can choose a partner with whom she will reinforce her scheme.
• Overcompensation. In response to the scheme, the person tries to protect himself and acts in the opposite way. Very often this behavior crosses boundaries. From the outside it seems like a healthy reaction, but ultimately the consequences of this behavior reinforce the pattern even more. For example, a man with an approval-seeking pattern may, on the contrary, behave in such a way that he is not interested in other people’s opinions and approval, and may do this in a rather aggressive manner. As a result, this behavior can lead to people, on the contrary, criticizing him, which will lead to even greater dependence and an attempt to gain this approval.
The main goal of schema therapy is to reduce the influence of early maladaptive schemas. The therapist and patient identify such patterns and styles of responding to them. This happens during a conversation, the patient’s story about recent events in life, and a discussion of his childhood. Questionnaires may be used.
There are four methods that help weaken circuits.
• Interpersonal techniques. The therapist and the patient explore his interactions with other people. Sometimes mother, husband, child can also be included in therapy.
• Cognitive techniques. They help identify cognitive distortions, track dysfunctional thoughts and replace them with new ones.
• Emotional techniques. Based on the patient expressing emotions associated with the schema. This could be a mental dialogue with a parent, writing a letter to him, or taking on his role in an imaginary dialogue.
• Behavioral techniques. They consist of teaching other skills of communication, relaxation, and helping to choose a partner.
It is very important that a trusting and warm relationship develops between the psychotherapist and the patient. This fact is the key to successful therapy and overcoming established patterns.