What is Schema Therapy, and Can It Help You Break Your Patterns?
by Andrea M. Darcy
Schema therapy was originally designed to help those who had personality disorders or found that other forms of psychotherapy just weren’t working for them.
But its focus on understanding what drives our ways of being has also been found to help with depression, relationship problems, and general self-awareness.
What is schema therapy?
Schema therapy thus developed into a modality that sees clients understand why they behave in the ways that they do (psychodynamic/attachment), get in touch with their feelings and attain emotional relief (gestalt), and benefit from learning practical, active ways to make better choices for themselves in the future (cognitive).
The history of schema therapy
American psychologist Dr. Jeffrey E. Young is the creator of schema therapy. He first began experimenting with its concepts in the 1980s. Trained in cognitive therapy, he was finding that using what he had been taught helped clients with depression. But not necessarily those with lifelong problems such as personality disorders.
So he began to add other elements to his work, including elements of psychodynamic therapy and attachment theory. So while cognitive techniques saw his clients work to change the way they were making choices in the present, they were also now looking at their childhood, to get an idea of where their tendency towards self-defeating patterns stemmed from in the first place. The combination seemed to work.
He then integrated elements of Gestalt therapy. It focuses on moving a client beyond logic, to a state where they can provoke and process emotions that are buried in the unconscious. This is accomplished with a series of techniques such as visualising and ‘chair work’ (talking to another part of your ‘self’ that you imagine is sitting on another chair across from you).
How is schema therapy different from integrative therapy?
On first look schema therapy can sound no different from working with an integrative therapist – someone who is trained in many different psychotherapy modalities that they draw from during sessions depending on what they feel their clients need and could benefit from.
But schema therapy is more systematic. While an integrative therapist is in some ways using a ‘hit and miss’ approach, schema therapy has a distinct overall model, with the different techniques it uses blended in an order and process that has been researched and tested to be effective.
What are ‘schemas’?
At the core of schema therapy is the idea that we all have certain ‘life themes’. These are patterns we live out that tend to develop in childhood, then repeat themselves throughout our lives. Unless we become conscious of them and work to change them. These are known as ‘schemas’, or by their more colloquial name of ‘life traps’.
Schemas are in a way coping mechanisms. They exist because our basic emotional needs were not met as children, so we create these schemas to help ourselves get by.
In fact each schema represents an unmet need. An abandonment schema, for example, could be seen as the unmet need of feeling safe and cared for.
Understanding schemas or ‘life traps’ means that you cannot only understand your own patterns of being and perceiving? But can develop an understanding and compassion for those around you act as well.
Examples of schemas
For example, you might be living out the ‘abandonment schema’. If this is your life trap, it will manifest as ongoing anxiety that everyone you get close to will leave you at some point or another. You might constantly overreact and illogically assume the worse if, say, your partner talks to someone you don’t know, or is late getting home. Or perhaps you sabotage every relationship you are in rather quickly, convincing yourself they ‘aren’t for you’ when deep down you are just scared they might break up with you so leave them first. This schema would trace back to one of your parents abandoning or neglecting you as a child, either leaving completely or not giving you necessary attention.
A ‘self-sacrifice schema’ would mean you constantly ignore your own needs or wants in order to meet others’ needs. You can’t stand the idea of others experiencing pain, or you feel that they are weak and need you. If you don’t take care of needy people you would just suffer from too much guilt. Perhaps the only time you let yourself stop taking care of others is when you are sick, meaning you might then manifest sickness for yourself more than an average person as the only way to give yourself a break. Looking back to your childhood you might trace this schema to a parent who you had to take care of, who was often ill or depressed, or had a weak character that meant they relied heavily on you.
There are 18 such life traps that schema therapy has identified and works with, and your schema therapist will go through the list with you to help you discover what ones you struggle with.
Limited reparenting – a core technique of schema therapy
Schema therapy believes that even as not having our needs met as a child lead to self-defeating patterns as adults, having an experience of those needs finally being met as an adult can help heal and stop dysfuntional ways of being.
This is achieved by using a technique called ‘limited parenting’, where your therapist essentially stands in (within limits) as the reliable parent you never had.
This means that your therapist encourages you to have a secure ‘attachment’ with them – relying on them to be there for you no matter what you do, think, or say, just as a healthy parent would be there for a child no matter the child’s behaviour. This can include things like warmth, playfulness, and nurturing between you and your therapist, but also things like firmness and confrontation.
It doesn’t mean that your therapist will ever be unkind to you of overstep the boundaries of professionalism. It just means that with schema therapy, your therapist might develop a stronger bond with you than other, more traditional forms of psychotherapy where therapists might aim to stay neutral and not encourage dependency.
What sorts of issues can schema therapy help with?
Schema therapy was originally designed to help with personality disorders that did not respond well to other therapies, such as borderline personality disorder. An American study on schema therapy and borderline personality disorder found that after eight months of schema therapy, an impressive 94% of participants no longer had the symptoms of borderline personality disorder, as opposed to only 16% who received the regular treatment proposed for the disorder.
Other personality disorders that schema therapy has been found effective for include avoidant personality disorder, paranoid personality disorder, histrionic personality disorder, dependent personality disorder, obsessive compulsive personality disorder, and narcissistic personality disorder.
But schema therapy is also helpful for any issue that is ongoing and originating in childhood, such as:
- depression
- anger management issues
- low self-esteem
- relationship problems
- fear of intimacy
- codependency
Schema therapy is now also being used to work with couples, as a form of couples counselling, helping each partner recognise their life traps and see how this causes clashes.
Schema therapy – a better way forward?
While traditional therapy can slap you with the label of a personality disorder in a way that for some feels limiting and condemning, schema therapy instead presents a list of clear and useful patterns of being we can all relate to and empathise with. In this way it opens the door for understanding and real change.
Working with a schema therapist to recognise the dysfunctional ways of seeing and being that are running your life means you can finally change long held patterns. You can get back in touch with your true feelings, learn healthier ways of acting other than your schemas, and work to get your emotional needs met in healthier, present-focused ways.
Do you have a question about schema therapy we haven’t answered here? Ask below. We love hearing from you.
How do you know if schema therapy is working successfully for you/if you are responding well to treatment? Are there some patients who are too difficult/more difficult to treat? Also, regarding the ‘Gestalt’ element of schema therapy, does chair work and imagery work with everyone being treated with this type of therapy? Are there any reports I can read anywhere which provide an analysis of the effectiveness of schema therapy? Would be grateful for any help you can provide with answering the above questions.
All very good questions – but very big ones! Therapy is a personal experience, and whether you are responding ‘well’ to a therapy depends on you and your definition of ‘doing well’ as well as your own goals you have set for your experience of therapy. If you are very interested in schema therapy, it would be a better idea to book a first ‘discovery’ session with an experienced, professional and accredited schema therapist who can answer these questions in depth. They would then be able to also get a sense of you personally, and your main goals for therapy and whether or not schema therapy is suitable for you or not. Each person is unique, and naturally not all kinds of therapy work for every issue or every person. If schema therapy was not suitable for you, the therapist could then recommend other modalities that could work for you.
How often should you meet your therapist for effective progression. Once a week or once a fortnight. My schemas are being triggered very often leaving me in bits
Most therapists meet clients at least once a week. Schema therapy in particular is about forming a strong relationship with your therapist so it would be surprising to be offered only once a fortnight.
Thank you for the subject.
Would you please recommend a self-help book on schema therapy, an easy one. I tried to read Schema Therapy by Jeffrey Young and found it difficult (I find the book meant for therapist more than individuals).
Thank you
We can’t think of one of the top, but will pass it on to see if any of our therapists have a suggestion.
Eden, it sounds as if you may have picked up Jeffrey Young’s practioner’s guide to Schema Therapy. I would recommend Jeffrey Young’s ‘Reinventing Your Life’. It is a superb introduction to Schema Therapy and written for the lay person in mind.
Hi Eden,
I would also recommend breaking negative thinking patterns by Gitta Jacob. It is a self-help guide using the schema mode approach and is an excellent book!
Tina, thank you for this contribution!
Hello-
I find the quotes you provide very inspiring. Are they original to you, or are you quoting from some book or article, and if so, what book or article.
Thank you.
Hi Doug, any quote you find that is from someone else would be attributed to them, otherwise what we post is all original content! Hope that helps, and thank you for enjoying our work, it means a lot to us.
Can we do self therapy
Hi Ravi, you can do whatever helps you! But if you have deep-rooted childhood patterns and trauma it’s unlikely to achieve results quickly without support.
Hi Doug, can Schematic Therapy help my son OCD. I’m at my wits end. He’s 30 years old and for the last 5 years has been crippled by this condition. I just what my fun loving boy back living he’s life again.
Thank you
Hi Mary, therapy can really help OCD but schema therapy would not be the one unless his OCD results from attachment issues or childhood trauma and he struggles to trust others. Schema therapy is more recommended for personality disorders. Is your son actually diagnosed with the condition or is it just what you think he has? We’d highly recommend not diagnosing him yourself. A proper diagnosis can see if it’s actually OCD, a related condition, or several things occurring together. The therapies most recommended for OCD are cognitive behavioural therapy (CBT) or in some cases exposure therapy. Also note that it’s your son himself who has to decide to seek help as he’s an adult. The decision has to his.
“This means that your therapist encourages you to have a secure ‘attachment’ with them – relying on them to be there for you ”
How does this attachment work out as therapy ends? Especially if part of the issues are abandonment.
Hi Mario, Schema therapy creates a relationship that helps you work through abandonment issues. When the therapy ends the point is you would be in a place where you see an adult relationship ending in an honest way as an adult relationship ending in an honest way… not abandonment.
Do you think that schema therapy could be of use to my daughter who suffers constantly with psychosomatic pain….going three times weekly to emergency room, doing countless medical tests etc.this has been her story for about six years. If not schemic , which kind of therapy could help her? Many thanks
Hello, schema therapy is not known for psychosomatic pain. CBT therapy has been researched for pain, and psychodynamic therapy could help her get to the root of things. Hypnotherapy is also something to consider. Good luck!
How long do you think Schema therapy would take to treat abandonment issues with borderline personality disorder?
Hi Kim, there is no direct answer. It entirely depends on you, your issues, how you respond to therapy. Therapy is in no way a magic want. It is hard work, commitment, and has ups and downs. But it is affective and can change your life. We’d also say, is this the right question to even be asking? or is it more, how much do I want to move beyond these issues that are holding me back? Am I willing to do whatever it takes? Good luck.
I am currently having psychodynamic psychotherapy but remain confused with the specific type of therapy I’m actually receiving. I am not aware of any therapy goals and feel that my therapist is seeking greater trust from me. I’m not very good at feeling feelings or talking about them and wonder if this sounds like a prerequisite for schema therapy. My ACE score is 8/10.
Hi Jae, schema therapy is not psychodynamic therapy. It can use a few elements similar to psychodynamic, but is quite different. (Use the search bar to read our different articles on psychodynamic therapy, we have a few that might be helpful). Trust is the basis of therapy, so that is something any good therapist will work to grow with you. Most if not all people who end up in therapy are not good at feeling feelings, but have long repressed, one of the points of therapy is to help with that. So no, it is not a prerequisite for any kind of therapy. You can actually talk about your experience of therapy with the therapist. So you can tell your therapist in your next session that you are confused about the type of therapy and ask that it is explained. You can also say that you worry you aren’t good at feelings or talking about feelings. And you can look at that together, it might be very helpful. As for your ACE score, if you had a lot of childhood trauma you might want to read this article on types of therapy that work for trauma (schema therapy is one, psychodynamic not always) http://bit.ly/therapyfortrauma. Finally, therapy is a process. It takes time. So don’t feel stressed if you don’t see instant changes, just keep going. All the best, HT
Hello Harley,
During a Schema Therapy session, will the therapist get physical? I’m wondering due to the therapy focusing on people with abandonment issues along with those who have personality disorders, will the therapist willingly get physical? If someone was not held or hugged enough growing up and they really want to be hugged and caressed, how would the therapist respond to this?
Hi Janine, there are holistic ‘therapists’ using a kind of physical ‘reparenting’ which is not connected to schema therapy’s reparenting. Or carried out by licensed registered psychotherapists just people calling themselves therapists. Schema therapists wouldn’t be holding or hugging clients due to the fact that clear boundaries are required for good therapy and that would be very poor client/therapist boundaries which could confuse a client. And also due to protocol required to be a registered therapist in the UK.The reparenting involved is strictly relational. If you asked to be hugged or held your therapist would discuss that with you and how you could find that in your life from relationships outside the therapy room. Hope that helps.