Exploring Schema Therapy: A Path to Healing Deep-Rooted Emotional Wounds
Understanding Schema Therapy
Schema Therapy, developed by Jeffrey Young in the 1980s, emerged as a response to the persistent and recurrent mental health challenges faced by some people despite undergoing various forms of therapy. Young recognised that traditional therapies often failed to address deeply ingrained patterns, leading him to create a new approach. Schema Therapy integrates elements from Cognitive Behavioural Therapy, Internal Family Systems Therapy, Gestalt Therapy, Psychodynamic Therapy, and Attachment Theory. Unlike other therapies, Schema Therapy delves deeply into the childhood and adolescent roots of psychological issues, employing emotive techniques, focusing on the therapist-client relationship, and addressing maladaptive coping.
What is a Schema?
An Early Maladaptive Schema is a pervasive theme or pattern that encompasses memories, emotions, thoughts, and bodily sensations. It relates to how people view themselves and others. Schemas develop during childhood or adolescence and evolve throughout one’s life, often becoming significantly dysfunctional.
How Do Schemas Develop?
Humans have essential needs that must be met to feel safe and secure. Beyond physical necessities like food, water, and shelter, we also have emotional needs. These include:
Secure attachment to others
Autonomy, competence, and a sense of identity
Freedom to express valid needs and emotions
Spontaneity and play
Realistic limits
As children, we rely on caregivers to meet these emotional needs since we haven't yet developed the ability to fulfil them ourselves. There are various reasons why parents or caregivers might be unable or unwilling to meet their children's emotional needs, such as:
Substance dependency
Mental health issues
Grief or loss
Chronic illness or disability
Cultural norms
When our emotional needs aren’t met, we may develop Early Maladaptive Schemas. Jeffrey Young (2003) initially proposed 18 schemas but more recently 20 schemas have been identified (Yalcin et al., 2021). Below is a list of known schemas with brief descriptions:
Abandonment - The belief that significant others will ultimately leave.
Mistrust and Abuse - The belief that others will intentionally harm or deceive.
Emotional Deprivation - The belief that one's emotional needs for care and support will not be adequately met by others.
Defectiveness and Shame - The belief that one is inherently flawed, defective, or unlovable.
Social Isolation - The feeling of not belonging or fitting into society.
Dependence - The belief that one is entirely helpless, reliant on others, and incapable of making independent decisions.
Vulnerability to Harm - The belief that the world is dangerous and disaster can strike at any moment.
Enmeshment - Excessive emotional entanglement with others (usually parents), based on the belief that one cannot manage without them.
Failure - The belief that one will inevitably fail in their endeavours, especially related to performance (e.g., school or sport).
Entitlement - The belief that one is superior to others and deserves special privileges and rights.
Insufficient Self-Control - Difficulty in exercising self-control to achieve goals, with a low tolerance for frustration and trouble regulating impulses.
Subjugation - Excessive suppression of one's own needs to avoid punishment, abandonment, or rejection.
Self-Sacrifice - An exaggerated sense of duty to meet others' needs at the expense of one's own fulfilment.
Approval Seeking - An excessive focus on gaining validation, recognition, and approval from others, often compromising one's self-identity.
Negativity and Pessimism - A tendency to emphasise negative aspects of life while overlooking and undervaluing positive elements.
Unrelenting Standards - The belief that failure to meet very high, often self-imposed standards will lead to severe criticism.
Punitiveness towards self - Hyper-criticalness and punishment towards oneself for making mistakes or being imperfect.
Punitiveness towards others - The belief that others should face severe punishment and consequences for their mistakes and wrongdoings.
Emotional Constriction - Excessive control over emotions due to feelings of shame and embarrassment about expressing them.
Fear of Losing Control - The belief that failing to maintain emotional control will result in dire outcomes.
How Do Schemas Affect Day-to-Day Life?
Schemas are like emotional wounds that lie beneath the surface, becoming more apparent when triggered. They often relate to past experiences and impact how we think, feel, experience bodily sensations, and cope with situations. Below are some common schema presentations:
Abandonment Schema
Past Experiences: Death of a family member; sudden separation of parents; absent or estranged parent/s.
Common Triggers: Romantic partners or close friends distancing themselves or interpersonal conflict with significant others.
Thoughts: "My loved ones will die, leave me, or stop loving me."
Behaviours or Coping Responses:
Selecting emotionally unavailable partners.
Avoiding close, intimate relationships.
Becoming aggressive or critical if a partner seeks space.
Emotional neediness within relationships.
Defectiveness/Shame Schema
Past Experiences: Hypercritical or rejecting parents; being devalued or humiliated by parents or important adults.
Common Triggers: Criticism or perceived judgement.
Thoughts: "I am flawed, defective, and unlovable."
Behaviours or Coping Responses:
Regularly negatively comparing oneself to others.
Self-criticism.
Developing relationships with people who criticise them.
Becoming emotionally distant in relationships.
Being hypercritical of others.
Social Isolation Schema
Past Experiences: Bullying; exclusion by peers or family members; qualities that differ from others (e.g., cultural or ethnic background, disability, or neurodivergence).
Common Triggers: Social situations or situations involving comparison to others.
Thoughts: "I don't belong; I don't fit in; I am different from others."
Behaviours or Coping Responses:
Focusing heavily on differences between oneself and others and ignoring similarities.
Avoiding social situations.
Being very adaptable and blending into groups to fit in.
How Does Schema Therapy Work?
Schema Therapy involves several components to help individuals understand and heal their schemas:
Assessment: Through conversations, questionnaires, self-monitoring, and imagery.
Psychoeducation and Formulation: Learning about specific schemas, how they developed, how they affect daily life, and identifying maladaptive coping mechanisms.
Cognitive Challenging: Learning to change or manage unhelpful thoughts about oneself, others, and the world.
Behaviour Pattern Breaking: Establishing healthy coping mechanisms in response to triggers.
Experiential Techniques:
Imagery Rescripting: Using imagery to heal emotional wounds from past experiences.
Chair Work: Engaging in dialogues with different parts of oneself to facilitate emotional processing.
Therapist-Client Relationship: In Schema Therapy, the relationship between client and therapist serves as a model for healthy boundaries and caring interactions, while maintaining appropriate boundaries.
By addressing deeply rooted patterns and healing emotional wounds, Schema Therapy offers a powerful pathway to personal growth and improved mental health. If you resonate with any of the schemas discussed and are consider Schema Therapy, contact Bella Vida Psychology today. We offer a free, no obligation, 15 minute phone call. Your journey towards improved mental health starts here. Reach out to us now – we're here to help.
This blog utilised the following resources, in addition to my own clinical experience and knowledge.
Roediger, E., Stevens, B., & Brockman, R. (2018). Contextual schema therapy. Context Press.
Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy: A practitioner’s guide. Guilford Press.
Yalcin, O., Marais, I., & Lee, C., & Correia, H. (2021). Revisions to the Young Schema Questionnaire using Rasch analysis: The YSQ-R. Australian Psychologist, 57(1), 8–20. https://doi.org/10.1080/00050067.2021.1894857
Yalcin, O., Marais, I., Lee, C. W., & Correia, H. (2023). The YSQ-R: Predictive validity and comparison to the short and long form Young Schema Questionnaire. International Journal of Environmental Research and Public Health, 20(3), 1778. https://doi.org/10.3390/ijerph20031778
Trainings the author has attended:
Schema Therapy Training Australia - Workshop 1: The Model, Methods, and Techniques
Schema Therapy Training Australia - Workshop 2: Beyond the Basics
Schema Therapy Training Australia - Imagery Rescripting in Schema Therapy
Schema Therapy Training Australia - Schema Therapy in Adolescence and Emerging Adulthood.