Schema therapy developed from cognitive-based therapies to better treat personality disorders. The goal is to identify and change negative schema a person holds so they can function better in society.
Personality disorders are enduring personality traits. They develop in youth and cause significant stress and impairment to the individual. These disorders express themselves in interpersonal relationships.
Personality disorders can often be difficult to treat by other cognitive therapies. The reasons vary depending on the personality disorder but stem from non-participation.
This has caused the development of specific treatment plans. Dialectical behavioural therapy is a modified therapy used to treat borderline personality disorder.
A key difference between these therapies is the focus on personal acceptance and validation. This is important for borderline patients as they can have an emotional reliance on their therapist.
Schema therapy attempts to capture the positives of these other cognitive therapies. It also uses aspects of other theories to better treat personality disorders.
We all create schema as it is an important aspect of what makes us who we are. Understanding what schemas are and therapeutic techniques can help everyone.
Schemas are patterns of thoughts and behaviours based on our experiences. They act as a frame so that in future we can move through our world without every experience being novel.
We develop schema through our early years and these continue to grow and change through life.
While being dynamic and able to change, because schemas shape how we act, they tend to be enduring. Schemas self-reinforce because that’s how we experience our world.
If you order a piece of Ikea furniture, it comes in a flat-pack box with a set of instructions on how to build it. The instructions are the schema, the furniture is the situation you are experiencing.
You don’t think about how to build this furniture, you don’t question the instructions, you follow them. You take out the pieces and put them together in the order it says.
In the same sense, if you are meeting a friend in public. You have developed a certain set of rules that you will follow without thinking about it. You might show up five minutes early, you may hug each other, you’ll follow some basic small talk.
You don’t think about these behaviours, they are repetitions. They are a set of instructions on how to act, how to behave in that situation that you follow. As with the furniture, by the end, you have something that looks like a successful interaction.
Our schemas do not cover everything. We do experience novel situations and have different cognitive functions to handle these.
Our schemas are specific but can be very elaborate or related to a generalised group.
We will have a schema that shapes how we act around a close friend. It will be specific to them and no one else. We will also have a schema that shapes how we interact with strangers as a whole.
Let’s say that halfway through building your piece of furniture you realise that a piece is missing. Or there’s a mistake in the instructions and you’ve put something in the wrong place. Even worse, you opened the box and there weren’t any instructions included.
All these things are going to cause you stress. Trying to push through anyway will generally cause more problems. You might even end up breaking something when trying to solve the problems.
The same issue can happen to us. While developing our schema, we may get things wrong or miss crucial information. We may not even get the chance to develop them at all.
This leaves us without good instructions for social interactions. One key component to schema therapy is attachment theory. Children need relationships for good social and emotional development.
If someone experiences neglect in those formative years, they will develop poor social schemas. They will have poor instructions on how to interact with others.
With poor instructions on how to interact with others, people often make ‘social mistakes,’ and struggle to connect. As this starts in childhood, negative reactions often reinforce the original schemas.
When people find their set of instructions on how to act don’t work, they have to come up with solutions to the problems. If you have a flawed core understanding of how to interact with others, it can be difficult to change.
If you do okay building that Ikea chair, it might only be wobbly. It might be that the legs are in the wrong place and the whole thing collapses. In either case, you don’t have the real instructions so it’s the best you can do.
Again, the same thing happens with people. They make up their own coping styles to deal with these situations.
For example, someone develops an avoidant style of coping with social situations. As the name implies, they find ways to distract themselves and avoid the schema.
Often they will be prone to substance abuse as a way to distract themselves and escape. These also offer an excuse for poor behaviour that they can use.
They tend to try and find ways to avoid triggering those experiences altogether. This might be isolating themselves or stopping people getting ‘too close’ to them.
We develop different coping styles based on our personal experiences and schemas. Negative coping styles tend to fall into the following three groups.
Surrender, where they have learned to accept whatever happens to them. Avoidant, as stated earlier avoids the issue.
Overcompensation, where they try to counteract the schema by opposing it. Without learning the metrics of social interaction, they go too far.
There are many different schemas but they tend to result in these three main coping styles.
Schema therapy attempts to help you understand your coping styles. This comes from the psychoanalytic approach and looks at your childhood experiences. The goal to understand the schema that shapes your coping style.
You would try to understand what coping styles you are using and their triggers. From there, you would look to why they triggered at those times and what the actual schemas are.
Your early relationships reflect later behaviour. Looking at the patterns which formed your schema can help change later behaviour.
A therapist will use empathic confrontation where they acknowledge and validate your schemas. They also try to help you understand how important it is to change them.
Limited parenting is another technique. The therapist offers security, emotional stability and general comfort. They act in a pseudo parental role to help modify schema.
They will also use other cognitive-based practices. Recording negative thoughts, visualising stressors and confronting negative beliefs are common practices.
If you are struggling with these types of relationships, you should seek out a therapist.
If you know someone who might be, it’s worth encouraging them to seek a therapist, though be careful when doing this. Personality disorders develop at a young age and are very difficult to treat.
We can learn from these practices even if we don’t have a personality disorder. Of course, not everyone is capable of seeing a therapist as well. In which case, some of these might help.
Researching coping styles is a good start. Reflecting on your own life, you can look at how you interact with others. It’s important to look inward and see how you feel. Often your coping style hides your feelings to the outside world.
Keeping a journal of interactions and how they made you feel can help with this process. These are cognitive practices that let you establish how you interact with the world. The focus is on how those interactions make you feel.
Another task is to put yourself in other people’s shoes in different scenarios. For example, someone invited you out for dinner and you turned them down. You can flip the scenario and try to imagine how you would feel in the scenario.
If you’re playing out these different scenarios, swap between the positive and negative. You have to be careful not to slip into a negative pattern and get trapped.
Writing them down will help and if you start by saying you will imagine it being positive, this can also help.
The reason for this is to show that there isn’t one way of doing things and you are capable of doing others.
The next step is to go deeper into why these coping styles develop. Consider your previous relationships, what they meant, how they affected you. It’s common for someone to reinforce poor schema with bad relationships later in life.
Again, writing about this can help while keeping you from going into a negative spiral. Taking regular breaks from this is also important. You should make sure your frame of mind is in a good place before doing these kinds of activities.
This is not going to be a quick fix, these kinds of changes take a long time. Don’t rush it and don’t push yourself beyond where you are comfortable.
Another benefit of a therapist is they can help guide and support these changes. If you can’t see one, be careful that you take care of yourself while making these changes.
You can also simulate ‘limited parenting.’ It’s important to be careful about how you do this. If you are dealing with these issues, it is unlikely you will have a friend or relation suitable to act as support.
Using support groups, whether online or not can be useful. I would recommend groups that have either a leader or mentors that have some training. Support groups also don’t have to be specific to your problems. It’s the ‘support’ part that is important here.
Having a level of anonymity online can help with this. Make sure the group you join is about being supportive. Validation is one of the most important parts of this relationship. The group should never make you feel invalidated.
Be prepared to try different groups. This can be difficult and it’s easy to convince yourself that you’re the problem. It’s important to realise that it’s not about right or wrong, that it’s about finding the right fit for you. You might have to try a few different groups before you find the right people to help you.
You can change your schema, you can change your life. It won’t be easy, it won’t be quick, but it can happen and it will be worth it.
Further recommended reading:
Arntz, A., & Jacob, G. (2017). Schema therapy in practice: An introductory guide to the schema mode approach. John Wiley & Sons.