What is Schema Therapy?
Updated: Oct 28, 2022
I love Schema Therapy! Out of all the different models I've come across, this is the one that makes the most sense to me, when I think about the personal struggles I've faced, and the different people I've worked with along the way. But I realise that it's a less well-known model than many others, so I thought I'd write something about it, for those who want to know more, or who are thinking "Is this for me?"
Schema Therapy was developed by Jeff Young, who found that traditional CBT was just not working for many patients, particularly those with painful childhood experiences. The model has since evolved over the years, and it draws from several different therapy approaches, including CBT, Psychodynamic Therapy and Gestalt Therapy. Originally it was a long-term therapy model, yet it can be adapted and used in shorter-term interventions, depending on the severity of the problem.
Schema Therapy is based on the premise that all children have crucial emotional needs. Those needs include nurture, safety, autonomy/individuality, freedom of expression, spontaneity/play, and to have realistic limits set on their behaviour so they can learn self-control. However, painful early childhood experiences often result in those emotional needs going unmet. As a result of these unmet needs, the child may form negative, unhelpful schemas (beliefs) about themselves and others. For example, common schemas include "Defectiveness" (I'm not good enough), "Emotional Deprivation" (I'll never get the love I need) and "Unrelenting Standards" (perfectionism).
The child may also internalise the negative messages they receive from caregivers and peers (through criticism, rejection etc) and develop their own "inner critic" which endures as they grow older, resulting in a stream of self-critical thoughts. Finally, in an attempt to survive the pain of unmet needs, the child may develop particular ways of coping. These "coping modes" are initially helpful, but as the child grows into an adult, the behaviours often lead to problems in relationships. For example, typical coping modes include people-pleasing, trying to control situations, and putting up protective "walls" in order to pull away from others.
Schema Therapy helps you to understand how your past experiences have led to current difficulties. It aims to help you develop healthier beliefs (schemas), silence your inner critic, identify your unhelpful coping modes and break unhelpful patterns linked with them. Most importantly, it aims to help you to learn to recognise and meet your emotional needs.
Schema Therapy is a collaborative model, tackling deep-rooted difficulties as well as here-and-now patterns, but without the apparent secrecy and sense of mystery that can shroud some therapy approaches (where the therapist can seem like a silent, distant expert). In Schema Therapy, the therapist is very much a real person: a warm, human, compassionate presence: a secure attachment figure, who strives to help you meet the needs that were not met in childhood.
Schema Therapy uses many different techniques depending on the stage of the therapy. It might involve talking, exploring, and problem-solving; it might involve working with imagery and memories; it might involve being creative; it might involve using movement/changing position: all to make the therapy come alive and be "felt" - so that it is not "just words".
Above all, Schema Therapy aims to help you understand your story and develop compassion for yourself. It helps your head to understand why your heart has been hurting - while also helping your heart begin to heal.