Acceptance and commitment therapy (ACT) recognizes that pain is inherent in human existence. From the ACT point of view, schema-related pain isn’t pathological; nor is it something that can be overcome. Because schema-related pain has its origins in early childhood, it is an enduring part of the individual’s experience. No matter what age we are or how long we have been in therapy, we are unlikely to fully emancipate ourselves from schemas or schema-related affect. For example, the abandonment and instability schema is likely to be triggered by any relevant interpersonal event for those who had early abandonment experiences and learned to expect them. The criticism, withdrawal, and anger of others will activate the schema and the fear that goes with it.
The focus of ACT for interpersonal problems is not to eliminate schemas and schema-related pain; rather it is to learn to respond differently when schemas are triggered. ACT makes a clear distinction between the primary pain that is part of the human condition and the secondary pain, or suffering, that results from the struggle to avoid the unavoidable. From the ACT point of view, schema affect is primary pain—an unavoidable by-product of living. Therefore, the target of the treatment protocol used in The Interpersonal Problems Workbook is not to stop or block the primary pain related to schema activation, but rather to ease the secondary pain: the suffering generated by attempts to avoid schema affect.
Schema coping behaviors (SCBs) lie at the root of interpersonal problems. Whenever people try to avoid or block primary pain due to schemas, relationships are damaged. Therefore, the focus of this treatment is on clients’ schema coping behaviors. SCBs correspond to the ACT concept of experiential avoidance, which involves maladaptive strategies to suppress, numb, manage, and control pain. From an ACT point of view, the problem isn’t the schemas or the emotions they generate; the problem is trying to avoid schema-related pain with a variety of strategies that damage or destroy relationships.
Although schema coping behaviors are highly individualized, they do tend to follow similar patterns. The SCBs most damaging to interpersonal relationships can be broadly classified into ten types, which were outlined in a previous post. The first five schema coping behaviors all involve overcompensation. The easiest way to understand this type of SCB is to think of it as a more aggressive response to a schema-triggering event. When people engage in one of these coping responses, they are fighting the schema. This is akin to the “fight” part of the fight, flight, or freeze reaction.
The sixth schema coping behavior involves surrender. It can best be described as a more passive response to a schema-triggering event. Think of it as the “freeze” aspect of the fight, flight, or freeze reaction.
The last four schema coping behaviors involve avoidance. These responses to schema-triggering events are attempts to avoid the pain associated with those events. Think of them as the “flight” component of the fight, flight, or freeze response.
Below we’ve listed the ten common schema coping behaviors that clients are likely to use in response to a schema-triggering event, categorized by the three patterns listed above.
Aggression or hostility: The client may find herself counterattacking by blaming, criticizing, challenging, or being resistant.
Dominance or excessive self-assertion: The client may find herself trying to control others in order to accomplish her goals.
Recognition seeking or status seeking: The client may find herself overcompensating by trying to impress others and get attention through high achievement and status.
Manipulation or exploitation: The client may find herself trying to meet her own needs without letting others know what she’s doing. This may involve the use of seduction or not being completely truthful to others.
Passive aggressiveness or rebellion: The client may appear to be compliant but will rebel by procrastinating, complaining, being tardy, pouting, or performing poorly.
Compliance or dependence: The client may find herself relying on others, giving in, being dependent, behaving passively, avoiding conflict, and trying to please others.
Social withdrawal or excessive autonomy: The client may find herself isolating socially, disconnecting, and withdrawing from others. She may appear to be excessively independent and self-reliant, or she may engage in solitary activities such as reading, watching TV, computer use, or solitary work.
Compulsive stimulation seeking: The client may find herself seeking excitement or distraction through compulsive shopping, sex, gambling, risk taking, or physical activity.
Addictive self-soothing: The client may find herself seeking excitement with drugs, alcohol, food, or excessive self-stimulation.
Psychological withdrawal: The client may find herself escaping through dissociation, denial, fantasy, or other internal forms of withdrawal.
It’s important to keep in mind that clients may have different coping behaviors for different schemas, or even different coping behaviors for the same schema. A client with an emotional deprivation schema may sometimes demand that her needs be met, and at other times give in or surrender. It is critical to work with clients to identify all of the coping strategies they use to avoid schema-related pain.
Once you’ve introduced the concept of schema coping behaviors and clients have had a chance to identify their schemas and associated coping behaviors, you’ll need to help them link SCBs with particular relational triggers. For more information on the complete protocol for treating interpersonal problems with schema therapy and ACT, check out The Interpersonal Problems Workbook, or ACT for Interpersonal Problems.