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Introducing Schema Therapy for Treating Interpersonal Disorders

Introducing Schema Therapy for Treating Interpersonal Disorders

If you have clients who suffer with interpersonal problems, treatment begins with defining early maladaptive schemas and helping clients identify which schemas are relevant to them and contribute to their problematic relationships. Once you are able to identify which schemas are relevant to your client, you can move on to helping clients identify common schema triggers so they can bring more mindful awareness to these situations as they occur. Behavioral change will be more likely to occur once clients are aware of how schema-driven thoughts, emotions and behaviors are impacting their interpersonal interactions.   

What is a Schema?

A schema is a core belief that’s generated in early childhood as a result of an individual’s experiences with parents, caregivers, siblings, and peers. Schemas are deeply rooted cognitive structures and beliefs that help define a person’s identity in relationship to others. As such, schemas exert a huge influence over interpersonal behavior and are the driving force behind interpersonal problems.

Early maladaptive schemas are very powerful for a number of reasons (Young and Klosko, 1993):

  • They include unconditional beliefs about who we are and what we can expect in a relationship to others and the world. They are experienced as a priori truths and are taken for granted.
  • They are self-perpetuating and resistant to change because they develop in early childhood and adolescence. They can be experienced in the first few years of life and can therefore be preverbal.
  • They are derived from early trauma, neglect, and repeated negative messages about the self. As a result, they form the core of self-concept. They are tied to high levels of distressing emotion, or schema affect. Typically, schema affect includes fear, shame, loneliness, a sense of emotional hunger or yearning, anger, or a combination of these.
  • They are activated by relevant events. For example, a failure schema is often activated by criticism or confronting a challenging task.
  • They attempt to predict the future. Schemas help organize people’s knowledge about interactions between themselves and the world. At root, schemas are efforts to identify what will happen in ever circumstance of every relationship. Because these beliefs offer the illusion that one can peer into the future and prepare for it, they are extremely hard to give up.

The Role of Unmet Early Childhood Needs in Schema Development

Maladaptive schemas are created when early childhood core needs aren’t met. According to Jeffrey Young (2004), six needs must be met for children to thrive. If neglected, these needs create schemas that are problematic for people and their interpersonal relationships.

  • Basic safety. Essential at birth, this need involves how children are treated by their family or caregivers. When infants or small children aren’t provided with a stable and safe environment, they may develop an abandonment and instability schema, a mistrust and abuse schema, or both.
  • Connection to others. When Children don’t receive love, affection, empathy, understanding, and guidance from family members or peers, they may develop an emotional deprivation schema, a social isolation and alienation schema, or both.
  • Automomy. Essential for childhood development, autonomy allows for healthy independence and separation from parents. When children aren’t taught self-reliance, responsibility, and good judgment, they are likely to develop a dependence and incompetence schema. 
  • Self-esteem. When children are loved, accepted, and respected, they develop self-esteem. When family and peer support are absent, children may develop a defectiveness and shame schema, a failure schema, or both.
  • Self-expression. In a nurturing environment, children are encouraged to express their needs and desires. When this self-expression is discouraged, children are made to feel that their needs and feelings matter less than those of their parents. Often these children are punished and made to feel “less than.” When self-expression isn’t encouraged and supported, children may develop a subjugation schema or an unrelenting standards and hypercriticalness schema.
  • Realistic limits. When children are raised in an environment that encourages responsibility, self-control, discipline, and respect for others, they learn to operate within realistic limits. When parents are permissive and overly indulgent, children grow up without understanding the need to consider other people before acting. In the absence of realistic limits, children may develop an entitlement schema.

Next week, we’ll go further into identifying the various types of maladaptive schemas, and we’ll identify the common coping behaviors associated with each. Meanwhile, check out the Interpersonal Problems Workbook: ACT to End Painful Relationship Patterns, an evidence-based protocol for treating interpersonal problems with acceptance and commitment therapy.

References

Young, J., Klosko, J., & Weishaar, M. (2003). Schema therapy: A practitioner’s guide. New York: Guilford Press.