Developed by Jeff Young in the 90s, Schema Therapy is an integrative approach incorporating powerful elements from several therapeutic frameworks, including Cognitive Behavioural Therapy, Psychoanalytic Therapy, and Gestalt Therapy. In simple terms, Schema Therapy examines core themes within a person’s life to help them break negative, rigid and unhelpful patterns of thinking, feeling and behaving. Let’s explore how it works and who it’s for together…
Unmet Core Emotional Needs
Schema Therapy links current patterns of symptoms and problems back to unmet core emotional needs in childhood. A child’s core needs can be divided into two categories – practical and emotional.
For many people, their practical needs were met as a child. They had shelter and clothes and were fed regularly. However, their core emotional needs may not have been met consistently enough. This includes things like feeling safe and loved, having boundaries and realistic limits, and being able to express their own needs and feelings without being shamed or punished.
Failure to adequately meet these needs may be a generational thing. Parenting styles were once completely different because society hadn’t fully grasped what children need to thrive and flourish. For example, it may have been acceptable to hit a child, or shame them for having big feelings. We now know it can be very traumatic for a child to be treated in this way. It can impact the way they see themselves, other people and the world around them.
Childhood needs can be actively unfulfilled, such as through trauma and abuse of the child, however, other more passive ways, such as withholding love and care, can also result in unmet childhood needs. Spoiling or idealising in the child (e.g. giving too much of something) can also count towards unmet childhood needs.
What Is a Schema?
Within the Schema Model, unmet childhood needs can lead to the formation of ‘early maladaptive schemas’. This is defined as a broad, pervasive theme or pattern, comprised of memories, body sensations, emotions, and thoughts/beliefs. Essentially, a schema is our internal view of the world that is created in childhood, based on our experiences.
We all have schemas. Some may be adaptive (or healthy) schemas. Schema Therapy is designed to work on the maladaptive schemas as these are the ones that cause the most distress and can impact our daily lives and ability to function. These maladaptive schemas are often unhelpful to a significant degree and can be activated in the present by everyday events relevant to the schema.
One example of an early maladaptive schema is ‘defectiveness and shame’. Individuals affected by this will often report being hyper-sensitive to criticism and rejection from others. Many people who identify with this schema often come from a family perceived as cold, detached, explosive, lonely, abusive and/or rejecting. Home life for someone with this schema may have been unstable and chaotic, with a lack of warmth and affection, leading to intense emotions, such as sadness, anxiety, loneliness, rejection and anger.
Early maladaptive schemas can be triggered in our adult life, meaning the past memories, emotions, body sensations and negative beliefs can also be activated alongside it. For example, someone with a defectiveness schema may notice that being (or perceiving to be) on the end of criticism in adulthood can activate the schema. This experience can be extremely emotionally distressing for the individual and can lead them to engage in behaviours that are unhelpful.
How Do Early Maladaptive Schemas Affect Behaviour?
Humans are all born with innate survival strategies – fight, flight, and freeze. As children, we automatically develop ways of coping with schemas and how they make us feel. In Schema Therapy, we call these ‘coping modes’.
A ‘fight’ coping mode may lead you to overcompensate for the schema. For example, if you have a defectiveness schema, this might look like trying to be the best in everything you do. A ‘flight’ coping mode could mean you try and avoid the feelings linked to the schema when it’s triggered. A ‘freeze’ coping mode is when you can’t fight or flee, so you essentially give up. You become submissive to others and allow them to have the upper hand.
These coping modes were how you survived in childhood. However, in adulthood, these coping modes can reinforce your schemas and keep you stuck in dysfunctional patterns of thinking, feeling, and behaving.
How Can Schema Therapy Help Me?
To help a person break these unhelpful patterns, Schema Therapy uses a combination of cognitive, experiential (e.g. Imagery Rescripting, Chair-Work) and behavioural strategies. The main goal is to help you get your core needs met in an adaptive manner (e.g. not through unhelpful coping styles such as emotional avoidance), and to help you develop and maintain healthy and functional behaviours and relationships with yourself and others.
Within Schema Therapy, there is a greater emphasis on the therapeutic relationship. The idea is your therapist provides a corrective emotional experience to combat what you may have experienced growing up. The model has a much longer treatment focus than other psychological modalities, often because clients with complex presentations have more rigid patterns of thinking and behaviour with origins in childhood.
Schema Therapy is particularly helpful if you have not responded to other psychological interventions (such as counselling or Cognitive Behavioural Therapy), and if your current symptoms and problems are significantly complex, such as with PTSD, severe depression, eating disorders and ‘personality disorders’.
What Should I Expect?
Schema Therapy is very intensive and goes into significantly more depth and detail than many other therapies. It is not a first line treatment and is normally offered if someone hasn’t benefitted from other psychological therapies. Treatment sessions last up to an hour and are conducted in person or remotely via Microsoft Teams. Appointments are offered on a weekly basis and will continue for at least a year.
We will begin by conducting a full history of your life, focusing on your own childhood experiences and unmet core needs. We’ll also explore the coping modes you developed in your early life to keep you safe, and the impact these modes are having in your life and relationships now. Based on this, we’ll establish some treatment goals.
A key component to the initial stages of Schema Therapy is for you to develop a positive and safe therapeutic relationship with me as your therapist. We will also work on emotion regulation strategies to enable you to adequately self-soothe in and outside of your therapy sessions.
The second phase of Schema Therapy is focused on using experiential exercises, such as imagery work, to identify situations and memories from childhood that led to the formation of the maladaptive schemas. We’ll then re-script these memories to what should have happened (i.e. having your needs met by your care-giver). Doing this work eventually leads to the healing of the schema. It also gives you an opportunity to experience what it feels like to have your needs met, providing a corrective emotional experience.
The third and final stage of Schema Therapy is about making behavioural changes and testing these out in the real world. This could be things like trying to connect with your feelings rather than distracting yourself from them or being more assertive instead of not expressing your needs and feelings to others.
Towards the end of therapy, we would work together at your pace to manage any feelings associated with reaching the end of your therapy journey.
Find Out More
If you’re interested in working with me, you can book a free consultation here. I also share lots of tips and advice via Instagram.
Useful Links
What is Cognitive Behavioural Therapy?
All You Need to Know About EMDR Therapy
What to Do If Therapy Isn’t Working
