What Is Schema Therapy? A Newcomer’s Guide
Breaking Negative Life Patterns
As humans, we all have basic fundamental needs. The need for food, the need for shelter, for safety and for clothing. However, in order for a person to grow, develop and flourish, there are a number of core emotional needs which also must be met. These include the need for secure attachments with other people, the need for safety and predictability, for autonomy and a sense of identity, for acceptance and empathy, the need for freedom of expression and the need to have fun and play..
When some or all of these core emotional needs are not met throughout childhood (e.g. due to difficult childhood experiences or abuse), individuals can develop unhelpful and self-defeating emotional and cognitive patterns that are called schemas. Schemas encompass negative feelings and beliefs about oneself, others and the world, which develop during childhood and can continue into a person’s adult life. Schemas tend to develop in childhood when one or more core emotional needs are not met. Once developed, these schemas are often rigid; the individual accepts the beliefs and feelings without question. These can include themes such as “I’m not good enough”, “I’m unlovable” and “people will leave me”. Such beliefs and related feelings often result in maladaptive forms of coping, which can result in significant dysfunction in a person’s life, such as problematic relationships and difficulties regulating emotions.
How does Schema Therapy work?
Several controlled trials have demonstrated Schema Therapy and its components to be an evidence-based treatment for a large range of chronic problems including depression, PTSD, and personality disorders. Schema Therapy is an integrative therapy, incorporating powerful elements from a number of therapeutic frameworks, including Cognitive Behavioural Therapy, Psychoanalytic Therapy, and Gestalt Therapy. Schema Therapy looks at core themes within a person’s life to help them break negative, rigid and unhelpful patterns of thinking, feeling and behaving.
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, while also fully harnessing the therapeutic relationship to foster positive change. A person’s schemas and unhelpful patterns develop over the course of their lifetime and can be hard to change. For this reason, Schema Therapy often has a longer-term treatment focus, particularly with more severe or chronic issues with childhood origins. In schema Therapy, we focus on the disrupting the core dysfunctional themes and patterns in a person’s life in the service of helping people better connect to their core emotional needs.
Who might benefit from Schema Therapy?
Schema therapy is particularly well suited to patients with chronic problems regulating their emotions, and behaviour, and/ or those with long-standing problems with relationships. For this reason, schema therapy is particularly effective for people presenting with diagnoses or features of so called ‘personality disorders’ or more chronic cases of depression and anxiety. In particular, patients who have failed to respond to other therapies (e.g. CBT) may benefit from a Schema Therapy approach to target any barriers that may be hampering progress with standard treatment approaches (e.g. extreme avoidance, detachment). It can also be helpful for people with problems related to PTSD, including childhood trauma, eating disorders and addictions.