Schema Therapy

Schema therapy is an integrative therapy which can be used to treat many different mental health challenges. It is particularly effective for treating personality disorders, depression, anxiety, and relationship difficulties. It combines elements from cognitive behavioural therapy, psychodynamic therapy, attachment theory, and experiential therapy.

Schema therapy has the goal of identifying and healing deep-seated patterns of thinking and behaviour called ‘schemas’. These are themes or beliefs about oneself, others or the world- developed early in life, often as a result of unmet emotional needs. Schema therapy supports the development of healthier coping strategies, leading to improved emotional well-being and healthier relationships.

There are five broad categories of schemas which correspond to important childhood needs which were unmet.

• Disconnection and rejection: Belief that one’s needs for safety, stability, nurturance, empathy or acceptance won’t be met.
• Impaired autonomy and achievement: In this domain there is a diminish sense of competency. There is a belief that one’s ability to function independently or perform successfully is undermined.
• Impaired limits: In this domain, there are deficiencies in one’s internal limits. This may show as difficulty cooperating with others, taking responsibility for actions, making decisions or following through on goals.
• Other-directedness: An excessive focus on the needs of others at the expense of one’s own in order to maintain connection with others.
• Overvigilance and inhibition: There is a heightened alertness and anxiety, where individuals are constantly on guard to dangers, often of criticism, or disapproval. In this domain, there is a tendency for adherence to rigid rules or expectations and excessive control. There is often a suppressing or ignoring of emotions.

Schema therapy uses a variety of techniques to address and heal these schemas, including:

• Cognitive Restructuring: Challenging and reframing maladaptive beliefs.
• Experiential Techniques: Using imagery, role-playing, or chair work to re-experience emotional memories and reframe them with new meaning.
• Limited Reparenting: The therapeutic relationship as a key tool for healing, encouraging clients to experience corrective emotional experiences through their work with the therapist.
• Behavioural Interventions: Encouraging new, healthier behaviours that contradict the old schemas.