What Is Schema Therapy?
Schema-focused therapy aims to help patients move from maladaptive schemas to healthy, adult schemas. Changing schemas can help clients change life patterns and behaviors that have been driven by maladaptive schemas that can be problematic or related to mental illness.
Schema therapy is a combination of cognitive behavioral therapies, attachment theory and other psychological concepts that inform how people think and behave. To help people connect with others and meet their emotional needs, schema therapy aims to strengthen healthy schemas and unlearn or weaken maladaptive schemas.
What Is Schema Therapy Used For?
Schemas are usually deeply ingrained and can be hard to change. Because of this difficulty, schema therapy is often used for difficult-to-treat mental health conditions. These can include personality disorders, childhood maltreatment, post-traumatic stress disorder, eating disorders and substance use disorders.
Schema therapy is used to break down, weaken or heal unhelpful schemas and encourage clients to develop new and healthy schemas. This therapy is also used to reduce the use of maladaptive coping skills and teach healthy coping strategies to encourage schema change.
Schema therapy was developed by Dr. Jeffrey Young in the 1990s after noticing that traditional therapies failed to help some patients. Usually, these patients had long-held beliefs or characteristics that were hard to change with the therapy frameworks available at the time.
To address this, Dr. Young identified what he called “schemas” or “life traps” that contributed to the problems his patients were having. Schema therapy was developed to help his patients address and change these schemas.
18 Maladaptive Schemas
Early maladaptive schemas are developed as a result of early life challenges or environments. These maladaptive schemas can lead to mistrust and problematic thinking and often impact adult behavior.
There are 18 maladaptive schemas, many of which involve underlying beliefs and perceptions that can increase the risk for substance use:
- 18 Maladaptive Schemas
Abandonment/Instability: Others will not be able to continue providing emotional support or connection. People with this schema believe that people will leave or abandon them for someone better.
Mistrust/Abuse: Others will hurt, cheat, humiliate, lie to or take advantage of them. This level of mistrust is the result of the belief that others will intentionally or willingly hurt the individual.
Emotional Deprivation: A person’s normal emotional needs will not be met by others. Schema therapy for emotional needs can help alter this belief.
Defectiveness/Shame: One is bad, unwanted or defective. This schema involves intense feelings of shame and insecurity.
Social Isolation/Alienation: The belief that a person is not a part of any group, community or doesn’t belong.
Dependence/Incompetence: Often presenting as helplessness, this schema involves the belief that a person is unable to meet their own needs or take care of themselves without significant help from others.
Vulnerability to Harm or Illness: The belief that danger or catastrophe can happen at any moment, and there is nothing a person can do to prevent it.
Enmeshment/Undeveloped Self: This includes extreme emotional involvement with others in a person’s life, often their parents or a partner. This closeness comes at the cost of developing one’s own independent and fulfilling relationships.
Failure to Achieve: The belief that one is a failure and will continue to fail. A person with this schema may believe that they are inadequate compared to those around them.
Entitlement/Grandiosity: The belief that one is special, superior or has special powers that make them better than other people. People with this schema often believe that rules don’t apply to them and that they should get what they want. These individuals often lack empathy.
Insufficient Self-Control/Self-Discipline: An inability or unwillingness to exert control over one’s behavior or impulses. People with this schema tend to avoid discomfort and responsibility.
Subjugation: Persistent surrender to others due to perceived coercion or avoidance of feelings of hurt or anger. This schema can include a person feeling the need to subjugate their own desires based on the belief that their beliefs or wants are not as important as other people’s.
Self-Sacrifice: Extreme focus on putting other people’s needs ahead of one’s own, often to avoid feeling unneeded or guilty.
Approval-Seeking/Recognition-Seeking: Driven by the need and desire to be noticed and recognized. This schema may include an overemphasis on the importance of status and achievement and may cause an individual to put recognition above their own needs or desires.
Negativity/Pessimism: A persistent focus on the negative aspects of life, like disappointment, death and helplessness about the future. The potential positives in life are often ignored or overlooked.
Emotional Inhibition: Suppressing spontaneous actions and feelings, often to avoid disappointing others or losing control of oneself.
Unrelenting Standards/Hypercriticalness: A person must meet high internal and external standards that they set for themselves. Individuals with this schema are often unable to slow down or relax and may forgo pleasure and healthy relationships.
Punitiveness: Others should be harshly punished for their beliefs. As a result, individuals with this schema can be intolerant, unforgiving and unwilling to consider external circumstances.