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What is Schema Therapy?

Schema Therapy is an integrative approach that includes components of cognitive behavioral therapy (CBT), psychoanalysis, attachment theory, and emotion-focused therapy (EFT), among others. It intends to address mental health issues like personality disorders, relapse, and those that don't often respond to standard forms of treatment. It can be especially employed in treating Borderline Personality Disorder (BPD). Here, a schema therapist collaborates with you to identify and comprehend your early maladaptive schemas.

Early maladaptive schemas are persistent, lifelong, self-defeating emotional and cognitive tendencies that develop during childhood. They could be composed of painful emotional recollections of past suffering, tragedies, terror, abuse, neglect, unmet safety needs, abandonment, or a general lack of interpersonal attachment. They can also include bodily sensations associated with such emotional memories. These can have several degrees of severity and various impacts. The more severe the schema, the more negative emotions are experienced when activated, and the longer they persist. The more pervasive the schema, the more scenarios it is associated with.

The schema therapist begins by assessing the client's fundamental needs and schemas and how these connect to the client's present problems and the recurring themes throughout their lives. This therapeutic strategy's main goal is "schema healing." This process lowers maladaptive schemas by weakening the memories, feelings, physical sensations, and dysfunctional thought patterns linked to them. When the client has more control over them, activating the dysfunctional schemas becomes more challenging. To fulfill their needs and seek healthier connections, this approach also helps people liberate themselves from unhelpful coping styles and explore alternative, more adaptive behaviors.

The Different Types

There are 18 types of early maladaptive schemas. These are core themes or self-destructive patterns, and people keep repeating them throughout their lives.

• Abandonment: The persistent belief that people will leave you, relationships will end, the loss is inevitable, others are unreliable, all connections are fragile, and you will end up alone.
• Emotional Deprivation: The conviction and anticipation that your basic needs will never be satisfied. The firm belief that no one will support, advise, protect, or identify with you.
• Mistrust / Abuse: The belief that other people are unreliable, abusive, selfish, or out to harm or use you.
• Defectiveness: The idea that because of your flaws, harm, or lack of love, you will be rejected.
• Isolation: A pervasive sense of loneliness combined with alienation.
• Vulnerability: The impression that the world is unsafe, that disasters might happen at any time, and that the challenges ahead will overwhelm you.
• Incompetence / Dependence: The sense that you cannot make your judgments, that you have poor judgment, and that you depend on other people to help you with your day-to-day duties.
• Undeveloped Self: The perception that you don't have a separate identity or "individuated self" from one or more important people.
• Failure: The conviction that your performance will fall short or the belief that you will fail.
• Subjugation: The conviction that you must submit to the authority of others or else you will be punished or rejected.
• Self-Sacrifice: An excessive conviction that one must give up their own needs for the sake of gratifying others.
• Approval Seeking: The belief that seeking the approval and recognition of others is more important than remaining true to yourself.
• Emotional Inhibition: The idea that you must restrain your expression or else you face rejection or criticism.
• Pessimism: The conviction that life's unpleasant parts exceed its positive ones.
• Unrelenting Standards: The conviction that you should always strive for excellence, be perfect, or avoid faults.
• Punitiveness: The idea that people should suffer severely for their flaws or mistakes.
• Entitlement: The belief that you are special or more significant than others and that you are exempt from following the rules, even if that is harmful to others.
• Insufficient Self-Control: The feeling that you can't achieve your goals, particularly if the process has dull, tedious, or frustrating parts.

What are the Benefits?

ST may benefit people with maladaptive behavioral and cognitive patterns. Some advantages are:

• It helps in unlearning and relearning. Your therapist works with you to assimilate information. This acquired information can help you unlearn maladaptive thinking, associations, and linkings that you have formed.
• It helps one develop new and healthier coping mechanisms.
• It assists you in dealing with the environment more effectively. Schema Therapy equips you to rationalize things and see concepts for what they are.
• Provides trauma resolution as schemas get corrected, and one can come out of trauma by themself.
• It stops unhelpful patterns.
• It allows one to get in touch with one's authentic feelings.
• It helps determine and set realistic boundaries.
• It assists in developing the ability to withstand and confront self-critical and self-punishing habits.

Common Techniques

Listed below are some techniques to get a better overview of how emotional regulation works with Schema Therapy.

• Emotive: Emotional strategies involve using emotions to challenge schemas. They enable you to fully experience and express your feelings in the privacy of therapy. Using role-playing and guided imagery are two common emotional strategies.
• Interpersonal: Using interpersonal approaches, you can analyze your relationships to see how schemas affect them. While in therapy, you may find patterns in your life by observing how schemas and responses behave. This can include inviting a partner or close friend to join you in treatment.
• Cognitive: In cognitive approaches, destructive thought patterns that arise from schemas are recognized and challenged. You and your therapist will review your experiences to look for data that confirms or disproves the schema. Flashcards or planned conversations in which you will argue for and against a schema can be used to accomplish this.
• Behavioral: By altering the behavior patterns resulting from your coping style, behavioral approaches teach you how to make wise, constructive decisions. You could practice communication skills through role-playing or discussing an issue and a solution with your therapist to alter your behavioral patterns.

What Conditions Can it Help Treat?

ST was designed to address several issues that were not only very difficult to treat but also had aspects that some people still had issues with even after generally successful treatment. This treatment strategy is beneficial in treating the following mental health issues in different people:

• Post Traumatic Stress Disorder
• Eating Disorders
• Substance Abuse
• Relationship Issues
• Criminal Behavior
• Chronic Depression
• Personality Disorders
• Anxiety

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