Schema Therapy Quotes

Patients must be willing to give up their maladaptive coping styles in order to change. For example, patients who continue surrendering to the schema—by remaining in destructive relationships or by not setting limits in their personal or work lives -perpetuate the schema and are not able to make significant progress in therapy.

Object relations theorists are interested in understanding how formative interactions between parents and children become internalized by the child and, akin to cognitive schemas, serve as mental representations that shape or guide how children establish and carry out subsequent relationships with others.

When clients relinquish symptoms, succeed in achieving a personal goal, or make healthier choices for themselves, subsequently many will feel anxious, guilty, or depressed. That is, when clients make progress in treatment and get better, new therapists understandably are excited. But sometimes they will also be dismayed as they watch the client sabotage her success by gaining back unwanted weight or missing the next session after an important breakthrough and deep sharing with the therapist. Thus, loyalty and allegiance to symptoms—maladaptive behaviors originally developed to manage the “bad” or painfully frustrating aspects of parents—are not maladaptive to insecurely attached children. Such loyalty preserves “object ties,” or the connection to the “good” or loving aspects of the parent. Attachment fears of being left alone, helpless, or unwanted can be activated if clients disengage from the symptoms that represent these internalized “bad” objects (for example, if the client resolves an eating disorder or terminates a problematic relationship with a controlling/jealous partner). The goal of the interpersonal process approach is to help clients modify these early maladaptive schemas or internal working models by providing them with experiential or in vivo re-learning (that is, a “corrective emotional experience”). Through this real-life experience with the therapist, clients learn that, at least sometimes, some relationships can be different and do not have to follow the same familiar but problematic lines they have come to expect.

For example, in order to identify these schemas or clarify faulty relational expectations, therapists working from an object relations, attachment, or cognitive behavioral framework often ask themselves (and their clients) questions like these: 1. What does the client tend to want from me or others? (For example, clients who repeatedly were ignored, dismissed, or even rejected might wish to be responded to emotionally, reached out to when they have a problem, or to be taken seriously when they express a concern.) 2. What does the client usually expect from others? (Different clients might expect others to diminish or compete with them, to take advantage and try to exploit them, or to admire and idealize them as special.) 3. What is the client’s experience of self in relationship to others? (For example, they might think of themselves as being unimportant or unwanted, burdensome to others, or responsible for handling everything.) 4. What are the emotional reactions that keep recurring? (In relationships, the client may repeatedly find himself feeling insecure or worried, self-conscious or ashamed, or—for those who have enjoyed better developmental experiences—perhaps confident and appreciated.) 5. As a result of these core beliefs, what are the client’s interpersonal strategies for coping with his relational problems? (Common strategies include seeking approval or trying to please others, complying and going along with what others want them to do, emotionally disengaging or physically withdrawing from others, or trying to dominate others through intimidation or control others via criticism and disapproval.) 6. Finally, what kind of reactions do these interpersonal styles tend to elicit from the therapist and others? (For example, when interacting together, others often may feel boredom, disinterest, or irritation; a press to rescue or take care of them in some way; or a helpless feeling that no matter how hard we try, whatever we do to help disappoints them and fails to meet their need.)

Following Strupp (1980), clients change when they live through emotionally painful and long-ingrained relational experiences with the therapist, and the therapeutic relationship gives rise to new and better outcomes that are different from those anticipated and feared. That is, when the client re-experiences important aspects of her primary problem with the therapist, and the therapist’s response does not fit the old schemas or expectations, the client has the real-life experience that relationships can be another way. When clients experience this new or reparative response, a response that differs from previous relationships and that does not fit the client’s negative expectations or cognitive schemas, it is a powerful type of experiential re-learning that readily can be generalized to other relationships (Bandura, 1997).

What’s so interesting here is that through the course of development, these secure children increasingly “internalize” their parents’ emotional availability and responsiveness and come to hold the same constant or dependable loving feeling toward themselves that their parents originally held toward them (certainly, a beautiful developmental process to watch unfold in securely attached children). Said differently, cognitive development increasingly allows securely attached children to internally hold a mental representation of their emotionally responsive parents when the attachment figures are away and they can increasingly soothe themselves as their caregivers have done—facilitating the child’s own capacity for affect regulation and independent functioning. Thus, as these children grow older and mature cognitively and emotionally, they become increasingly able to soothe themselves when distressed, function for increasingly longer periods without emotional refueling, and effectively elicit appropriate help or support when necessary. In this way, object constancy and more independent functioning develops—facilitating their ability to comfort themselves and become the source of their own self-esteem and secure identity as capable, love-worthy persons. Furthermore, they possess the cognitive schemas or internal working models necessary to establish new relationships with others that hold this same affirming affective valence.

We have seen that when an emotional learning or schema is the underlying cause of a therapy client’s presenting symptom, the schema can be retrieved into direct, explicit experience and then profoundly unlearned and dissolved by the same sequence of experiences that neuroscientists identified in reconsolidation research

Schema therapy gives us a clear map of destructive habits. It details the emotional contours of, say, the fear of abandonment, with its constant apprehension that a partner will leave us; or of feelings of vulnerability, such as the irrational fear that a minor setback at work means you will end up jobless and homeless.

When therapy was successful, two kinds of changes showed up in person after person: the schemas’ grip on their lives loosened, and the script changed for the better its typical outcome.

schema therapy, which focuses on repairing maladaptive emotional habits.

One tenet of schema therapy, developed by Jeffrey Young (Young and Klosko 1993), is that the people we find most charismatic are subconsciously triggering us to fall back into old, negative family patterns.

I would like to think that objectivity maximizes fitness, but life in human groups demands patriotic loyalty to the in-group. Objective individuals are devalued and rejected. For sport fan groups this is not much of a problem, except for the unwary individual who suggests that the home team just isn’t any good. However, groups advancing neuroscience, psychoanalysis, behavior therapy, family therapy, and, yes, evolutionary psychiatry also tend to insist on loyalty to the core schema. Ideas and facts that don’t fit are ignored, opposed, and even repressed. Individuals who are excessively objective or sympathetic to other views are excluded. The tendency is deep and probably useful for our genes, but it can be poison for those searching for truth in the connections among different fields.

Social isolation. Some people lack the feeling of belonging to others. They feel isolated, as if they were cut off from the rest of the world. The

A schema is a set of beliefs and expectations about a person, thing, or scenario.

If you think poorly of yourself, you will be vulnerable to depression. A negative self-schema makes it hard to appreciate your achievements and enjoy relationships because you never quite believe you deserve them. Even when things are going well, you might find it hard to trust other people.

Adults with ADHD as a group have often experienced more than their fair share of disappointments and frustrations associated with the symptoms of ADHD, in many cases not realizing the impact of ADHD has had on them. When you reflect on a history of low grades, forgetting or not keeping promises made to others, repeated exhortations from others about your unfulfilled potential and the need to work harder, you may be left with a self-view that “I’m not good enough,” “I’m lazy,” or “I cannot expect much from myself and neither can anyone else.” The end result of these repeated frustrations can be the erosion of your sense of self, what is often called low self-esteem. These deep-seated, enduring self-views, or “core beliefs” about who you are can be thought of as a lens through which you see yourself, the world, and your place in the world. Adverse developmental experiences associated with ADHD may unfairly color your lens and result in a skewed pessimistic view of yourself, at least in some situations. When facing situations in the here-and-now that activate these negative beliefs, you experience strong emotions, negative thoughts, and a propensity to fall into self-defeating behaviors, most often resignation and escape. These core beliefs might only be activated in limited, specific situations for some people with ADHD; in other cases, these beliefs color one’s perception in most situations. It should be noted that many adults with ADHD, despite feeling flummoxed by their symptoms in many situations, possess a healthy self-view, though there may be many situations that briefly shake their confidence. These core beliefs or “schema” develop over the course of time from childhood through adulthood and reflect our efforts to figure out the “rules for life” (Beck, 1976; Young & Klosko, 1994). They can be thought of as mental categories that let us impose order on the world and make sense of it. Thus, as we grow up and face different situations, people, and challenges, we make sense of our situations and relationships and learn the rubrics for how the world works. The capacity to form schemas and to organize experience in this way is very adaptive. For the most part, these processes help us figure out, adapt to, and navigate through different situations encountered in life. In some cases, people develop beliefs and strategies that help them get through unusually difficult life circumstances, what are sometimes called survival strategies. These old strategies may be left behind as people settle into new, healthier settings and adopt and rely on “healthy rules.” In other cases, however, maladaptive beliefs persist, are not adjusted by later experiences (or difficult circumstances persist), and these schema interfere with efforts to thrive in adulthood. In our work with ADHD adults, particularly for those who were undiagnosed in childhood, we have heard accounts of negative labels or hurtful attributions affixed to past problems that become internalized, toughened, and have had a lasting impact. In many cases, however, many ADHD adults report that they arrived at negative conclusions about themselves based on their experiences (e.g., “None of my friends had to go to summer school.”). Negative schema may lay dormant, akin to a hibernating bear, but are easily reactivated in adulthood when facing similar gaffes or difficulties, including when there is even a hint of possible disappointment or failure. The function of these beliefs is self-protective—shock me once, shame on you; shock me twice, shame on me. However, these maladaptive beliefs insidiously trigger self-defeating behaviors that represent an attempt to cope with situations, but that end up worsening the problem and thereby strengthening the negative belief in a vicious, self-fulfilling cycle. Returning to the invisible fences metaphor, these beliefs keep you stuck in a yard that is too confining in order to avoid possible “shocks.