Unlike other therapeutic approaches that may primarily target surface-level symptoms, Schema Therapy delves into the root causes of emotional and psychological difficulties. It emphasises understanding the origins of maladaptive schemas, often rooted in unmet core emotional needs and early negative experiences. The therapy aims to foster a therapeutic relationship that provides the emotional support and corrective experiences necessary for individuals to restructure these maladaptive schemas and develop healthier coping mechanisms.

One distinguishing feature of Schema Therapy is the use of experiential and emotion-focused techniques. These techniques help individuals connect with their emotions, challenge ingrained beliefs, and build new, adaptive schemas. The therapeutic process involves not only cognitive exploration but also emotional and behavioural components, creating a comprehensive framework for personal transformation.

This article provides a brief overview of Schema Therapy, setting the stage for a deeper exploration of its principles, techniques, and applications in the context of counselling.

What is a ‘Schema?’

Schemas are patterns of beliefs and behaviours that come about as a result of our environment and genes.

Are all Schemas bad?

A schema is a lens through which we see the world and as such is not necessarily bad or ‘maladaptive’ the point being that in therapy it is these maladaptive (unhelpful) schemas which are the focus of work to help clients move forward.

In their text, Young and Klosko (1994) ask the following key questions relating to ‘Lifetraps’:

  • Are you repeatedly drawn to people who are cold and selfish?
  • Do you feel at your core you are defective and that no one who truly knows you could love you?
  • Do you put the needs of others above your own, so your own needs never get met- and so you do not know what your real needs are?
  • Do you feel that something bad will happen to you, so that even a mild sore throat sets of dread of a more dire disease?
  • Do you feel that regardless of how much public acclaim or social standing you receive, you still feel unhappy, unfulfilled or undeserving?

The authors also identify the following 11 most common lifetraps:

  • Abandonment
  • Mistrust
  • Emotional depravation
  • Social Exclusion
  • Dependence
  • Vulnerability
  • Defectiveness
  • Failure
  • Subjugation
  • Unrelenting standards
  • Entitlement

If we look at abandonment as an example, we get a feel for the horrible quandary individuals find themselves in when they are enmeshed within such a schema. Very often what happens is that a person’s schema, developed in childhood, relates to parents/caregivers and despite the pain experienced by them as a child, that person actively seeks to recreate the issues. They actively seek to recreate what they felt and continued to feel as familiar, so a partner who cheats and is inconsistent, for example, may be attractive to someone with an abandonment lifetrap/schema. In practice, many clients with relationship difficulties will discover that the person/people they are attracted to (who is/are often doing them significant harm) is the broken parent or caregiver from their childhood. They actively seek out that which is familiar, despite the pain, suffering and harm they are likely to suffer, including further abandonment.

Young and Klosko’s work sees ST as an extension of cognitive behavioural therapy (CBT) by combining cognitive behavioural approaches with psychoanalytic and experiential techniques.

Below are five of the eleven lifetraps commonly found by Young and Klosko, as well as ideas for possible origins for each one:

Abandonment
People you love will leave you and abandon you for someone else. Because of this belief, you may cling too much to people and end up pushing them away.

Mistrust and abuse
The mistrust and abuse lifetrap is the expectation that people cannot be trusted, and you must not let them get too close. You expect people that you love to let you down.

Dependence
If you are stuck with dependence lifetrap, then you feel unable to cope alone. As a child, you may well have been made to feel that you were incompetent or unable to find your own way.

Vulnerability
If you suffer with this one, you may well have had over-protective parents and have been given the strong impression that the world is a dangerous place, and you need to be constantly vigilant in it to survive.

Emotional Depravation
You feel no one truly cares for you or understands how you feel. You may be cold and ungiving, or attracted to people who are cold and ungiving, meaning the relationships you form are unsatisfying.

Now to some of the detail around how to potentially change these schemas. The argument here is that to change a life-long pattern you really do have to understand it. Some steps in the process are covered below:

  • Carry out a questionnaire, such as Young’s schema questionnaire, to identify any clear schema. By naming it, you are able to understand it better and identify how the schema manifests itself in your adult life.
  • The second step is about insight. To understand what the childhood origins for your clients’ schema are can be difficult, but is about identifying and connecting with what is the wounded child within them. Often imagery and imagery rescripting are used. Memories which are painful and are clearly connected to the origins of the schema (e.g., remembering sitting in the drive waiting for the parent who never came). In imagery rescripting, the therapist will go into the memory and put a supportive arm around the child to tell them this is not right/fair and someone should have taken care of them.
  • Step three relates to arguing against (and finding evidence against) the schema/lifetrap. For example, your client may feel defective, so in this step you would need to list all the evidence that suggests they are defective and all the evidence that suggests they are not.

Finally, there is what Young and Kosko call a ‘flashcard’ (which the client writes with the help of the counsellor), which is kept near and accessible and preferably as a habit to be read every day. For example:

I feel that when people get close to me, they will abandon me. It is not part of my logical brain but a ‘feeling’ to some extent I can’t help it arising, but it is not true. I was left at an early age by my mother and this in all probability gives rise to my feeling towards relationships. I don’t need to cling to people to make them like me, I can give them space and those who like me will stay with me, those who don’t will not, but we don’t always like each other and it’s ok. On many occasions I have been attracted to men who are cold and indifferent towards me but I know this relates to the way my father has been with me- I am attracted to men who have difficulty in making commitments and this eventually leads to me being abandoned, I am working on this by focussing on the qualities I really want in a partner and catching myself when I feel sexual chemistry with some who is aloof which is not he path I wish to continue going down.

Clients are also encouraged to write letters to the transgressing person/s in their life, to the absent parent or to all the other people who hurt the client. The letter may not actually get sent, of course; it is about the process of clearly expressing emotion rather than giving it to someone else.

What is the evidence base for Schema Therapy?

In a study on anxiety, OCD and PTSD, Peeters and colleagues (2022) found that schema therapy showed promising results for these disorders, despite a need for more robust research.  D’Rozario and Pilkington (2022) reported the increased likelihood of anxious avoidant attachment styles in adults whose parents had separated/divorced and the likelihood that Schema therapy would serve as a front-line approach to treating the problems these adults then had in forming healthy relationships.  Taylor and colleagues (2017) conducted a systematic review of evidence around schema therapy and although they point out further studies are needed; they also conclude that there is significant evidence for both early maladaptive schemas and the symptoms clients experience from schema are both improved by schema therapy. 

References

D’Rozario, A. B., & Pilkington, P. D. (2022). Parental separation or divorce and adulthood attachment: The mediating role of the Abandonment schema. Clinical Psychology & Psychotherapy, 29(2), 664-675.

Peeters, N., van Passel, B., & Krans, J. (2022). The effectiveness of schema therapy for patients with anxiety disorders, OCD, or PTSD: A systematic review and research agenda. British Journal of Clinical Psychology, 61(3), 579-597.

Taylor, C. D., Bee, P., & Haddock, G. (2017). Does schema therapy change schemas and symptoms? A systematic review across mental health disorders. Psychology and Psychotherapy: Theory, Research and Practice, 90(3), 456-479.

Young, J. E., & Klosko, J. S. (1994). Reinventing your life: The breakthough program to end negative behavior… and feel great again. Penguin.