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Schema Therapy – A new psychotherapy

Schema Therapy was founded by Dr Jeffrey Young. Dr Young originally worked with Dr Aaron Beck, founder of Cognitive Behavioural Therapy (CBT), as a therapist. Whilst working with CBT clients, Dr Young found that some individuals with specific characteristics in common only gained marginal benefit from the standard CBT approach. These clients typically had repeated, self-defeating patterns or themes in thinking and feeling (and consequently in behaving or coping) and they required a different therapeutic approach – an approach that really took into account how earlier life experiences can shape life patterns.

Dr. Young found he could help his patients make meaningful change when they took the time to explore, understand, address and redirect these life pattern. He began to refer to the life patterns as “Schemas.” Schemas consist of maladaptive negative/critical thoughts and feelings which develop earlier on in life as a result of certain needs not being met, or only being partially met. Schemas can get in the way of your life goals and getting your needs met in relationships.

Some examples of Schema beliefs are: “I’m unlovable,” “I’m a failure,” “People don’t care about me,” “I’m not important,” “Something bad is going to happen,” “People will leave me,” “I will never get my needs met,” “I will never be good enough,” etc…

Schema Therapy aims to deeply understand how your earlier experiences have led to your Schemas and how your Schemas are impacting on your life. Using a variety of methods and techniques, Schema Therapy can help you to feel more grounded and connected to healthier parts of yourself enabling you to move away from restricting and maladaptive Schema patterns.

When reading this, bear in mind that everyone will have Schemas (including your friends, family, work colleagues and even therapist) – they’re part of the human condition. The temperament we’re born with and the environment we grow up in can interact, meaning some individuals are more likely to have certain Schema than others. Some people have 4 or 5, some people have all 18. Once we are aware of our Schemas we can begin to address them and lessen their pull and effect.

Research in the Schema Therapy field has highlighted 18 distinctive Schemas and they’re separated into 5 domains described below:

The Schemas listed below, 1-5, are characterised by Disconnection & Rejection.

The essence of this Schema domain is about a general expectation that your basic needs will be met by others in an unpredictable or inconsistent way. People who identify with Schema within this domain may come from families perceived as cold, detached, explosive, lonely, abusive, or rejecting. Or they may have spent a large proportion of their childhood in a harsh and uncaring environment.

(1) Abandonment/Instability: This Schema involves the experience of real or perceived unreliability and instability of others for basic connection and support. There is often an accompanying belief that others are unwilling or incapable of meeting your needs due to their own emotional instability and inconsistent presence. There may be an underlying fear of being abandoned for someone “better.”

(2) Mistrust/Abuse: This is a basic belief that others will inevitably hurt, take advantage, manipulate, or lie to you in some way. There is often a belief that these harmful behaviours are intentional or the result of negligence. As an adult, there may be a belief of always feeling that you get the “short end of the stick” in comparison to others.

(3) Emotional Deprivation: This Schema includes a general expectation for basic emotional needs to go unmet or unnoticed. Three major forms of emotional deprivation include deprivation of nurturance, protection, and empathy.

(4) Defectiveness/Shame: This involves a core feeling of a sense of defectiveness or inherent “badness.” There is often a belief that if you were actually exposed to others as your true self, you would discover that you were actually unlovable. This Schema may manifest itself through heightened sensitivity to criticism and blame, intense self-consciousness, insecurity, and comparisons around others

(5) Social Alienation/Rejection: This Schema involves a deep sense of feeling isolated from the world, disconnected from other people, and not feeling a sense of social belonging to any group or community.

The Schemas listed below, 6-9, are characterised by Impaired Autonomy & Performance.

This Schema domain is typified by expectations about yourself and your personal environment interfering with your belief in your ability to survive, function on your own, or demonstrate success. Typical early family dynamics associated with these Schema are enmeshment, overprotection, or a failure to reinforce your ability (as a child) to show independent competence (perhaps by doing things for you rather than teaching you how to do things for yourself).

(6) Dependence/Incompetence: This Schema is associated with a belief that you are not capable of dealing with everyday responsibilities without significant help from others. These beliefs may become evident through failure to take care of yourself, make healthy decisions, or solve daily problems without seeking excessive outside assistance – a general sense of helplessness.

(7) Vulnerability to Harm/Illness: This Schema may be experienced as a pronounced fear of looming or imminent disaster, coupled with the belief that it cannot be avoided/prevented. These fears are generally associated with medical, emotional, or external catastrophes.

(8) Enmeshment/Undeveloped Self: This may be experienced as intense emotional closeness and involvement with significant others (other parents); the cost of which is often forgoing healthy social development or building a sense of a personal identity. This Schema often includes feelings of being smothered by or overly attached (fused) to others, while also experiencing a lack of personal direction or emptiness.

(9) Failure: This Schema is generally rooted in the sense that you have failed, will fail, or are fundamentally inadequate in comparison to others in areas of achievement. There are associated core beliefs of being stupid, ignorant, untalented, or inferior.

The Schemas listed below, 10-11, are characterised by Impaired Limits.

This domain is related to a general lack of responsibility to others, internal limits, and/or future goals. Schema’s categorised within this schema domain tend to result in difficulty cooperating with others, respecting their rights, and making commitments. People who identify with the following Schemas may come from families characterised by a permissive parenting style, overindulgence, lack of guidance/direction, or a sense of superiority, accompanied by parental failure to set limits related to taking responsibility or healthy confrontation. As a child, you may not have been pushed to learn to tolerate normal levels of discomfort or given appropriate guidance or direction (and thus did not learn how to do these things).

(10) Entitlement/Grandiosity: This Schema is related to a belief in your superiority to others or a general belief in being entitled to special privileges, rights, or exceptions. These is often a belief that “normal” rules of social interactions don’t apply to you and that you should be able to do as you please without concern for the impact on others or an exaggerated focus on/need to be the “best” in some way to achieve power/control (not primarily related to attention/approval). There may be a tendency toward exerting power over others, forcing viewpoints upon others, or generally trying to control others’ behaviours in self-serving ways.

(11) Insufficient Self-Control/Self-Discipline: This schema involves significant difficulty or refusal to demonstrate adequate self-control and to tolerate frustration/discomfort in the service of achieving goals. There may be a focus on avoiding discomfort (pain, conflict, overexertion, responsibility, or confrontation) with the potential cost of personal fulfilment of goals or relationships.

The Schemas listed below, 12-14, are characterised Other-Directedness.

This domain tends to present itself with an excessive focus on the wants, needs, desires, and reactions of others (at the cost of your own needs). Sacrifices tend to be made in hopes of gaining love and approval or maintaining relational ties to others. Many children who develop the following Schema’s come from families who show conditional acceptance, which can result in denying or over-representing parts of yourself in hopes of gaining love/acceptance. Many parents within these families tend to place their own emotional needs/desires or social status/acceptance above the needs of their children (consciously or otherwise).

(12) Subjugation: This involves a tendency to surrender control to others in attempts to avoid abandonment, anger, or conflict. You may identify with this Schema through a pattern of subjugating your needs/emotions coupled with a perception that your own needs, feelings, wants, or beliefs are unimportant or invalid to others. As a result of this Schema, your current experience may include excessive compliance to the needs/wishes of others while simultaneously feeling trapped.

(13) Self-Sacrifice: There may be excessive focus on going “above and beyond” to meet the (real or imagined) needs of others, while sacrificing your own gratification/needs in the process. There may be internal motivations related to desires to avoid causing pain to others or guilt from feeling selfish in some way. This Schema may develop into an underlying sense that your own needs are going unmet (and are possibly unvocalised to others), followed by increased resentment toward the recipients of your self-sacrifices.

(14) Approval-Seeking/Recognition-Seeking: This schema is related to placing an excessive amount of importance on recognition, attention, or approval from others (at the expense of development a mature and authentic self). Self-esteem may be rigidly tied to the (actual or perceived) reactions from other people, as opposed to trusting your own intuition or inclinations. For some, this Schema manifests itself through attempting to meet these deep needs by overly emphasising money, appearance, status, power, or prestige. The focus here is basically about the earnest need for approval and recognition, as opposed to seeking power or control.

The Schemas listed below, 15-18 are characterised Over-vigilance & Inhibition.

This domain includes Schema that share common themes of suppressing spontaneous emotions/decisions/impulses or focusing on a deep desire to adhere to rigid rules and expectations regarding ethical behaviour and performance. The basic cost is authentic happiness, inner peace, overall relaxation, and meaningful relationships. This Schema may develop within families who are demanding (perhaps punitive), hide/avoid emotions, require perfection/high achievement, and place emphasis on avoiding mistakes over happiness and relaxation. There may be a basic fear that without strict adherence to these rigid rules/standards, things may “fall apart.”

(15) Negativity/Pessimism: This Schema relates to a consistent underlying focus on the perceived negative parts of life (death, pain, suffering, betrayal, etc.) with a simultaneous effort to minimise or avoid the positive or optimistic sides of life. There may be an exaggerated expectation that things will ultimately go horribly wrong and that any parts of your life that “seem” to be going well will end up falling apart. Because negative possibilities are exaggerated, there is often a tendency to worry excessively or complain.

(16) Emotional Inhibition: This involves overly suppressing forms of spontaneous emotional expression, action, or communication out of fear that these expressions of emotion will result in shame, disapproval, rejection, or loss of impulse control. Commonly, attempts may be made to inhibit: anger/aggression, positive impulses (spontaneous expressions of joy/happiness), and vulnerability/open communication about feelings or needs. There may also be a proclivity toward an overemphasis on rationality with a disregard for emotions.

(17) Unrelenting Standards/Hyper-criticalness: This is a Schema characterised by a deep belief that you must meet incredibly high standards (performance/behaviour) in order to avoid criticism. You may experience feelings of pressure, notice difficulty slowing down, and hyper-criticalness/unrealistically high standards of yourself and others. This Schema may present itself outwardly as perfectionism, excessive attention to detail, rigidity toward behavioural, moral, or ethical rules/standards, or a preoccupation with time and efficiency (in hopes of getting more accomplished).

(18) Punitiveness: This Schema may be experienced as a belief that people should be punished or judged harshly for their mistakes. People who identify with this schema may feel intolerant, angry, impatient, and punitive toward themselves and others who don’t meet certain high expectations or standards. There may be an accompanying difficulty in forgiveness toward oneself and others due to a general reluctance to consider the impact of external factors. Individuals with this Schema may share an inner sense of reluctance to accept natural human imperfection and empathise with others.

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