Schema Therapy

Schema therapy combines elements of cognitive, behavioural, attachment, psychodynamic and gestalt models, making it truly integrative. This page discusses what schemas are and what schema therapy is, who is best suited to access it and how it differs from Cognitive Behavioural Therapy. Please see my therapy FAQ page for answers to common questions about how talking therapies work.

I am an accredited schema therapist with the International Society of Schema Therapy (ISST). If you have any questions about the information on this page or would like to find out more about how schema therapy can help please contact me. I can offer schema therapy sessions face to face from my Market Harborough therapy office, or try online video therapy via zoom.

What is a Schema?

Do you ever feel like you fall into the same unhelpful patterns of thinking and acting even though you know you don’t want to but can’t stop yourself?

A schema is a self-defeating life pattern involving thinking, emotion, and physical sensations and include our memories and how we view the world. Schemas are developed from our childhood experiences and lead us to play out the same patterns of behaviour with other people again and again. These patterns are developed as a way of keeping ourselves safe from scary or problematic situations as a child, however, as we become an adult they are unhelpful and hard to cope with.

Schema therapy can be of benefit if you:

• Have relationships with people who end up hurting you in some way, even when they start out well. You might know that you should end the relationship, but fear how you would cope alone. 
• Put so much pressure on yourself to do things well that it leads to high levels of stress and feeling exhausted. 
• Are someone who will help others out, often to a point that you lose out or your needs aren’t met, which can lead to you feeling upset or sad. 
• Are highly anxious about what other people will think of you that it stops you from doing things, socialising or being the ‘real you’. It may be that you hide this well from others, but deep down you feel lonely. 
• Have a belief that you are unworthy, inferior, or unlovable, which leads to a cycle of self-blame and excessive fear of criticism.

Schema Examples

Jeffry Young identified 18 maladaptive schemas.  A full list of schemas can be found here. These schemas include:

Emotional Deprivation:

An expectation that the need for emotional support will not be met adequately by others.  People can feel this in three different ways.  They may have a deprivation of nurturance, where they feel people do not offer them affection, attention or warmth.  Deprivation of empathy is where they feel a lack of understanding, listening, or sharing of feelings from others.  Deprivation of protection is where the person feels a lack of guidance and support from others.   Individuals with this schema will often have not had their core emotional needs met as a child.  They may have suffered from neglect, abuse, or significant criticism from the caregiver.   As adults, the individual may find themselves drawn to relationships where the other person cannot meet their emotional needs.  They may have people in their lives that do meet these needs, however they still have a sense that they are being deprived emotionally.

Defectiveness/ Shame:

The feeling that the person is defective, bad, unwanted or inferior.  This can come with a sense that they are ‘not good enough’.  The person may submit to a defectiveness schema, feeling long term depression and low self esteem, and doubting their abilities in relationships, work, and life.  More often, individuals with a defectiveness schema will overcompensate.  They will be successful, will set high standards for themselves or will do a lot for others.  These are all mechanisms to try and hide an underlying sense that if people knew the ‘real them’ they would see their flaws, and that they were defective.  Individuals with this schema may have grown up with a strong critical or demanding caregiver.  They may have directly been told ‘you are not good enough’, or may have felt like they were never able to meet the expectations of their parents. 

Unrelenting Standards:

With unrelenting standards, the person believes that they must meet excessively high personal standards. This is usually as a means to avoid criticism, but may also be to gain positive feedback. People who have this schema present with high levels of stress, feelings of pressure, and difficulty in slowing down. They can get stuck in a cycle of setting unrealistic goals. When they inevitably don’t meet these it leads them to feel bad about themselves. On occasions when they do meet their goal, they do not allow themselves time to enjoy this before seeking the next opportunity. They can be perfectionists, or hold a lot of rigid rules about how they (or others) should live life. Unrelenting standards is often seen with the defectiveness schema.

Social isolation/ alienation:

The social isolation (also referred to as social exclusion) schema is a lifelong pattern of feeling like the person does not fit in. They might surrender to this, finding themselves in an endless stream of situations which make they feel different. Others may avoid it by steering clear of social situations. Other times, people will come across as being very sociable, with lots of friends, as a means to overcompensate for feeling different. Learn more about this schema here.

The Mode Model

Schema modes are defined as “the moment to moment emotional states and coping responses that we all experience”. Schemas are the underlying, unconscious patterns of thoughts, emotions, and memories which guide our behaviour. Modes are the reactions and responses to these that we see and are aware of. A full list of modes can be found here. There are four broad categories:

Child modes: These are the underlying part of us that hold our vulnerable feelings and needs. It holds our feelings of sadness, fear, embarrassment, loneliness, fragility and loss. Imagine your seven year old self when they were feeling upset. This mode will be triggered at times when your vulnerabilities or sensitivities are activated. However, the coping modes will kick in pretty quickly, so you often will not be aware of this.

Parent modes: These represent the negative messages received from your caregivers, that you have internalised as true. They may be direct words that you were told – “you are stupid” “you are never going to be good enough”. They can also come from the experience of parenting – being ignored, shouted at, laughed at. All these experiences lead you to create a negative view of yourself. This mode will repeat critical or demanding messages, especially in difficult situations.

Coping modes: These can be seen as the coping strategies that you learnt as a child to protect yourself. At the time, they kept you safe in some way. However, as you become an adult and develop your own life, they can start to have downsides. For example:

• As a child you found it easiest to ignore arguments by your parents. You learnt to ‘switch off’ from this, so it didn’t upset you. As an adult, you find yourself doing this with a partner when they are trying to talk to you. This is an example of the ‘detached protector’.
• In childhood, you learnt to snap back and shout at your siblings so that they would not pick on you and hurt you. As an adult, you find yourself having an urge to shout or say something nasty to colleagues when you don’t understand something. This is an example of the ‘bully/ attack’ mode.
• As the oldest child, you were expected to look after your siblings when you were younger. Your parents would be critical if you did not do this correct. As an adult you find yourself doing tasks for other people, putting them before yourself. Often you don’t want to do this and feel like they take advantage. This is an example of a ‘compliant surrenderer’ mode.

Healthy adult modes: This is the part of you that can respond to the vulnerable child in a healthy way. When you feel a strong emotion, it allows you to acknowledge it, set boundaries, and find positive ways to respond. It stops the parent modes from putting yourself down, and is focused on goals.

Schema Therapy techniques

Schema Therapy aims to help individuals to understand where their patterns of behaviour come from, and offer strategies to change these. It starts with assessment and education around what schemas are, and developing a personal formulation of your schemas, why these are triggered and how you manage them. The therapy then focuses on helping you to make changes to your patterns by exploring how these developed in your childhood. Schema therapy uses a mixture of techniques which include:

• Imagery: Using guided imagery exercises to connect current difficult emotions and situations from your childhood experiences. It may also be used to practise coping with upcoming situations, or imagining yourself coping with difficult emotions. 
• Chair work: This technique involves using different chairs to explore the different sides of you and understand how these may affect your behaviour. You may have ‘dialogues’ between these sides (i.e. an angry part of you, and a critical voice) to try and understand how they help or hinder you in your life. 
• Schema Therapy diaries: You may be asked to keep a weekly diary of times when your schemas have been triggered, to help to understand these better. 
• Behavioural experiments: Identifying situations where you want to do things differently and trying this out to prove to yourself that you are able to cope. For example, someone who finds it hard to socialise may set themselves a behavioural experiment to spend some time talking to someone they haven’t done at work before. These experiments are then discussed during therapy sessions. 
• Challenging your thinking: you may complete some exercises where you explore your thinking patterns linked to schemas, and start to challenge these – looking at the evidence that they are true; finding more positive statements about yourself.​

Who is Schema Therapy for?

Schema therapy can help people in the following areas:

• Those who have ongoing problems in their relationships
• Recurring issues around anxiety or depression
• People who have experienced problems in the childhood that they wish to understand
• Problems with anger management and control
• Personality disorders 

How is Schema therapy different from CBT (Cognitive Behavioural Therapy)?

Cognitive Behavioural Therapy – CBT is usually used to help with specific mental health problems, such as a period of feeling very anxious or depressed. It focuses on the ‘here and now’ and ways to change your thinking and behaviour in the present.

Schema Therapy works with people who may show these mental health problems, but who find themselves experiencing them over and over again. Schema Therapy takes the view that to understand the problem it is important to explore where it came from, and why it keeps returning. It is more experiential therapy. It is designed to be able to process any possible trauma or negative experiences we have had and understand how these may impact on our present behaviour.

A useful book to consider is ‘Reinventing your life‘ by Jeffrey Young.  It gives a great introduction to schemas (called ‘Lifetraps’ in the book) and ideas on how to manage these.  

Interested in trying schema therapy? Please contact me for more details