Living With BPD
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Schemas and Schema Therapy: The Basics

What are Schemas?

A schema is a mental concept that informs a person about what to expect from a variety of experiences and situations. Schemas are developed based on information provided by life experiences and are then stored in memory. People use schemes to organize current knowledge, provide a framework for future understanding, and evaluate cause and effect.

Schemas often dictate how we interact and predict social situations and interactions. They allow us to develop expectations about other people based on the social role they occupy. We develop expectations about other people’s behavior based on their personality traits and our past experience. We use schemas to develop “scripts” or ways of speaking, behaving, and responding to social interactions.

Schema themselves are not bad. They are necessary to create and maintain a stable worldview. Schemas can become negative when they develop under maladaptive or negative situations.

Maladaptive Schemas

Early Maladaptive Schemas are our negative automatic thoughts or “life traps” we don’t consciously know exist. They are incredibly deeply rooted in us, are broad and complex, and seep into every aspect of our lives.

Maladaptive Schema development comes from disruptions in our 5 core emotional needs:

  • Secure attachment to others
  • Freedom to express valid needs and feelings
  • Realistic limits and self control
  • Autonomy, competence, and sense of identity
  • Spontaneity and play

Maladaptive Schemas mostly come about through 4 types of toxic early childhood experiences:

  • Toxic frustration of needs
  • Tramuatization or victimization
  • No limits or regulation
  • Selective internalization or identification with significant others

Types of Schemas:

There are 5 categories of unmet needs called Domains:

  • Disconnection and Rejection: expectation that one’s needs for security, safety, stability, nurturance, empathy, sharing of feelings, acceptance, and respect will not be met in a predictable manner. (Includes Abandonment/Instability and Mistrust/Abuse schemas, Emotional Deprivation, Defectiveness/Shame, and Social Isolation/Alienation schemas.)
  • Impaired Autonomy and Performance: expectations about oneself and the environment that interfere with one’s perceived ability to survive, function independently, or perform successfully. (Includes Dependence/Incompetence, Vulnerability to Harm or Illness, Enmeshment, and Failure schemas.)
  • Impaired Limits: deficiency in internal limits, responsibility to others, or long-term goal-orientation. Leads to difficulty respecting the rights of others, cooperating with others, making commitments, or setting and meeting realistic personal goals. (Includes Entitlement/Grandiosity and Insufficient Self Control/Self Discipline schemas.)
  • Other-Directedness: an excessive focus on the desires, feelings, and responses of others, at the expense of one’s own needs—in order to gain love or approval, maintain one’s sense of connection, or avoid retaliation. Usually involves suppression and lack of awareness of one’s own anger and natural inclinations. (Includes Subjugation, Self Sacrifice, and Approval Seeking/Recognition Seeking schemas.)
  • Hypervigilance and Inhibition: excessive emphasis on suppressing one’s spontaneous feelings, impulses, and choices OR on meeting rigid, internalized rules and expectations about performance and behavior—often at the expense of happiness, self-expression, relaxation, close relationships, or health. (Includes Negativity/Pessimism, Emotional Inhibition, Unrelenting Standards/Hypercriticalness, and Punitiveness schemas.)

Family of Origin

Family of origin means the environment you were raised in. Almost 100% of maladaptive schemas are born through family of origin issues.

Disconnection and Rejection: family of origin is detached, cold, rejecting, withholding, lonely, explosive, unpredictable, or abusive.

Impaired Autonomy and Performance: family of origin is enmeshed (when people become one another or fuse together), undermining of child’s confidence, overprotective, or failing to reinforce child for performing competently outside of the family.

Impaired Limits: family of origin is permissive, overindulgent, lacking direction, or a sense of superiority—rather than appropriate confrontation, discipline, and limits in relation to taking responsibility, cooperating in a reciprocal manner, and setting goals. In some cases, the child may not have been pushed to tolerate normal levels of discomfort, or may not have been given adequate supervision, direction, or guidance.

Other-Directedness: family of origin is based on conditional acceptance: children must suppress important aspects of themselves in order to gain love, attention, and approval. In many families, the parents’ emotional needs and desires—or social status—are valued more than the unique needs and feelings of each child.

Hypervigilance and Inhibition: family of origin is grim, demanding, and sometimes punitive: performance, duty, perfectionism, following rules, hiding emotions, and avoiding mistakes predominate over pleasure, joy, and relaxation. There is usually an undercurrent of pessimism and worry—that things could fall apart if one fails to be vigilant and careful at all times.

Modes and Coping Styles

Schema modes are the moment-to-moment emotional states and coping responses that we all experience.  Our schema modes are triggered when particular schemas or coping responses have erupted into strong emotions or rigid coping styles life situations that we are oversensitive to (our “emotional buttons”).

Currently, there are 10 identified schema modes.  These modes can then be grouped into four general categories:

  1. Child modes: vulnerable child, angry child, impulsive child, and happy child
  2. Dysfunctional coping modes: compliant surrender, detached protector, and overcompensator.
  3. Dysfunctional parent modes: demanding parent and punitive parent.
  4. Healthy adult mode: balanced and integrated thoughts and actions.

There are three types of coping styles:

  1. Surrender
  2. Avoidance
  3. Overcompensation

Examples of each for the Abandonment/Instability schema are:

  • Surrender: dates partners who can’t commit and stays with them.
  • Avoidance: avoiding intimate relationships altogether and possibly drinking when alone.
  • Overcompensation: becomes overly attached to the point of pushing partners away, sometimes verbally attacking partners at the slightest separation.

Examples of each for Failure would be:

  • Surrender: does tasks in a half hearted manner.
  • Avoidance: avoids work challenges completely; procrastinates on tasks.
  • Overcompensation: pushes self to the point of compulsive overachievement.

 

What is Schema Therapy?

Schema Therapy is a combination of:

  • Cognitive Behavioral Therapy (CBT)
  • Attachment Theory
  • Gestalt Therapy
  • Object Relations
  • Psychoanalytic counseling.

These therapies, when used in combination, are especially helpful with chronic conditions that haven’t responded to other types of treatment, such as BPD and other disorders resulting from early childhood trauma.

Where did it come from?

Schema Therapy evolved from CBT. Sometimes CBT itself isn’t enough but can help when paired with other types of counseling. CBT is good for clinical depression and general anxiety but doesn’t quite go deep enough to address the roots of the issues. The people who came up with CBT (Aaron Beck started it with Rational Emotive Behavioral Therapy) designed Schema Therapy to reach those deep feelings.

How does it work?

Schema therapy works to educate the person on their schemas and challenge and fight the schemas to “defeat” them for good.

There are two phases:

  1. Assessment
  2. Change

The assessment phase involves figuring out which schemas are present and in what way. It’s a combination of a life history review, several schema questionnaires, self-monitoring assignments, imagery exercises, and making emotional links between what’s troubling the person now and what happened during their childhood.

The change phase combines elements of different styles of counseling. Things that deal with the cognitive side include building a case against the schema often by creating schema flashcards for each particular schema to use when said schema comes up. For things that would be considered experiential the person would fight the schema on an emotional level using imagery and dialogues, meaning they put words to their feelings and tear the schema down bit by bit with self talk of change and soothing affirmations. There are also behavioral homework assignments that help replace the old schema with new, healthy ways to cope. The homework can also include rehearsing new behaviors.

The relationship between the person and their counselor is empathetic yet not afraid to confront the person. The counselor also backs off of a parent-type role that you would see in other types of counseling.

We all have mental schemas. Acknowledging when they are productive or maladaptive is necessary to having a balanced life.

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