Schema Therapy - getting to the root of your problems.

Jun 30, 2020

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? For example:

- 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.

- You put so much pressure on yourself to do things well that it leads to high levels of stress and feeling exhausted.

- You 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.

- You 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.

- You have a belief that you are unworthy, inferior, or unlovable, which leads to a cycle of self-blame and excessive fear of criticism.

A schema is a self-defeating life pattern involving thinking, emotion, and physical sensation. They include our memories and how we view the world. These patterns are long-standing and become more entrenched as we go through life. 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. A summary of different schemas is available here. Schema theory highlights the importance of understanding how core childhood needs were not met growing up, and how this may have led to the development of unhelpful coping strategies (schema).

What is Schema Therapy?

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.