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What is schema therapy?         

The schema therapy approach is designed to help people overcome complex longer standing psychological problems.  It builds upon traditional Cognitive Therapy to integrate Gestalt and Object Relation Therapies. This modality incorporates change through a detailed formulation process and uses an emotion-focused emphasis to enhance interpersonal connection.  This is facilitated by the therapeutic relationship which is seen as key in Schema Therapy uses a limited reparenting stance to understand and heal unmet needs from childhood. 

Schema therapy is an emotion -based form of psychological therapy developed for people who have chronic moderate to severe recurrent psychological problems e.g. recurrent depression or people who have been diagnosed with a personality disorder such as Borderline or Narcissistic PD.  Schemas are recurrent patterns of thoughts, memories, feelings and behaviour that have developed from childhood into adulthood.  The premise of the schema Therapy model is that all children require certain basic emotional needs to be met to develop into emotionally secure adults.  Conversely, schemas are likely to develop when basic emotional needs are not fulfilled. Core emotional needs common to all people, are as follows:   to feel connected and accepted, function autonomously, set realistic expectations and to live with reasonable rules and regulations. When any of these basic emotional needs are not met in childhood, a perpetuation of the unmet need is more likely to continue in adulthood leading to the development of schemas which comprise rigid negative memories and beliefs about the self.

Everyone has schemas to some extent, but some people have had childhood experiences characterised by not having their basic emotional needs met. This can lead to stronger maladaptive or unhelpful schemas that can impact significantly upon the individual’s quality of life. For example, a child growing up in an emotionally depriving environment, might learn to make choices in their adult life to perpetuate the schemas i.e. choosing a partner in later life that is cold and withdrawn. In this way, the person continues to experience the schema of emotional deprivation, by feeling unloved and unheard or acknowledged. Alternatively, the individual might grow up to fear emotional deprivation and avoid relationships; or feel angry at the lack of emotional care received in childhood and demand a lot of relationships in adult life by over-compensating for feeling deprived. The assessment stage of Schema Therapy is vital in enabling clients to understand how schemas have evolved.

Schema therapy has an expanding evidence base showing effectiveness for longstanding complex mental health issues including Personality Disorders, chronic depression, eating disorders and anxieties.  Due to the transdiagnostic nature of this therapy, it is versatile in working with a range of longstanding emotional difficulties to tackle long term destructive and repetitive life patterns.  Schema Therapy uses a range of interventions and enables individuals to work towards relational change via emotions and cognitively focused techniques which lead to a core level change.  

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