MY THEORETICAL APPROACH: SCHEMA FOCUSED THERAPY

The central idea in my work is that mental health is more than the absence of disease or dysfunction. True mental health is the state of high-level wellness which generates your energy and zest for life and enables you to maximize your potential.

I practice Schema Therapy because it works! Schema therapy was developed by Dr. Jeffrey E. Young.  It integrates elements of cognitive-behaviour therapy, psychodynamic, object relations, attachment, gestalt/experiential and emotion focused therapies into one unified, systemic approach to psychotherapy.

Shema psychotherapy combines the theoretical and the therapeutic methods previously assigned to each school. In this model, the therapist emphasizes a progressive examination from behaviour to automatic thoughts (which govern these behaviours) to enduring attitudes, beliefs, and self-concepts which underlie the person's behaviour. It follows that a person's emotional and behavioural responses can be altered by changing his/her cognitions; therefore, satisfying my conviction that thought and action in psychotherapy are critical. While behaviourists emphasize action (Meichenbam, Skinner, Wolpe) cognitivists (Beck) focus on insight and reflection. However, no therapy is complete without the humanist approach (Maslow, Rogers) which emphasizes emotional experience and expression.

PSYCHOLOGICAL PRINCIPALS

Schema psychotherapy’s basic principle is that the way we feel and the way we behave are primarily determined by the way we structure our world. Our feelings, behavior, and thoughts all influence each other, which means that we all have the tools to heal ourselves.

In Schema therapy a schema is a pattern of thought and/or behaviors, a filter through which an individual perceives the world. In schema therapy, a schema is considered to be an early maladaptive coping mechanism, a pattern that develops as a result of needs not being met in childhood or adolescence. These patterns can continue to affect individuals into adulthood and cause emotional distress and relational issues. Early maladaptive schemas may take the form of emotional memories; they can also include physical sensations.

Dr Jeffrey E. Young denotes 18 maladaptive schemas which he categorizes into five different domains.

Domain 1: Disconnection and rejection

This domain includes schemas that inhibit the formation of healthy relationships, including:

1. Abandonment/Instability – the belief that others will leave you and loss is inevitable
2. Mistrust/Abuse – the belief that others are not to be trusted
3. Emotional deprivation – believing that your needs will never be met 
4. Defectiveness/Shame – the belief that you are flawed and will be rejected
5. Social Isolation/Alienation – a pervasive sense of aloneness

 

Domain 2: Impaired autonomy and performance

This domain includes schemas that make it difficult to maintain a strong sense of self and function appropriately in the world, including:

1. Dependence/Incompetence – believing that you are not able to make your own decisions and you have to rely on others 
2. Vulnerability – a sense that the world is a dangerous place and that you will be overwhelmed by challenges
3. Enmeshment/Undeveloped Self – the sense that you do not have a defined sense of self, separate to others
4. Failure – the expectation that you will fail

 

Domain 3: Impaired limits

This domain includes schemas that affect self-control, boundaries, and limits, including:

1. Entitlement/Grandiosity – having a strong sense that you are special and better than others
2. Insufficient Self-Control and/or Self-Discipline – believing that you cannot engage with boring, repetitive, or frustrating activities in the process of achieving your goals; impulsive behaviours

 

Domain 4: Other-directedness

This domain includes schemas that prompt people to put others' needs before their own, including:

1. Subjugation – the belief that you must submit to others out of fear of rejection or punishment
2. Self-Sacrifice – believing you should give up your own needs for those of others
3. Approval-Seeking/Recognition-Seeking – the belief that approval and recognition are far more important than being true to yourself

 

Domain 5: Over vigilance and inhibition

This domain includes schemas that prioritize avoiding failure and encouraging alertness and following the rules, disregarding desires or emotions, including:

1. Negativity/Pessimism – the belief that negatives outweigh positives and having little hope for the future
2. Emotional Inhibition – believing that you must control your emotional expression or others may reject you 
3. Unrelenting Standards – the belief that you must always be the best, perfectionistic behavior
4. Punitiveness – the belief that people must be harshly punished for their mistakes 

Consequently, my sessions focus on cognition, affect, or behavior. I employ procedures such as monitoring automatic thoughts, skills training, and mirroring with intent to identify conditions of client's worth and dysfunctional assumptions. In addition, I also examine the client's developmental ante­cedents in an attempt to increase the client's resources upon which the client self-redefines him/herself in the therapy.

The goal of my psychotherapy is to reverse the client's self-destructive thought processes by enabling the individual to recognize both the antecedents and consequences of self-distortions. The client's self-destructive thoughts are corrected resulting in the prevention of further distortions of reality and/or self-fragmentation. As the person redefines him/herself, he/she obtains a new, different, or richer level of self-understanding, unity, and resilience.

Using Schema therapy model, I will teach you how to become self-reliant, and able to examine and change your own perceptions, thoughts, and beliefs and consequently change your behaviors. Once you master the process, you will discover a new way of viewing the world and you will become your own therapist.

In our sessions, I will teach you how to examine your thoughts (which govern these behaviors) as well as the enduring attitudes and beliefs which underlie your behavior. I will show you how emotional and behavioral responses can be altered by changing your thoughts.

With respect to any theoretical approach, I assert that the actual selection of a particular theory is not as important as the process of the therapist's investigating, evaluating, and choosing the best theoretical approach that is most congruent with a client's unique needs of growing, learning, and healing.

These postulates are consistent with the research's findings. The critical components to any successful therapy consist of (a) therapeutic relationship which balances the rights of the client with the responsibilities of the therapist, (b) client's active participation of novel experiences, and (c) client's self-examination and changes in self-system within a safe and caring client-therapist relationship.