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Theory
Early Maladaptive Schemas develop when core childhood needs are not met
Schema Therapy
The four main concepts in the Schema Therapy model are: Early Maladaptive Schemas (18)
*Lifetraps Schema Domains (5)
Schema Domain
5 broad developmental categories Represents an important component of a child's core needs Schemas interfere with the child's attempts to get the core needs met within each domain
EMS Characteristics
A theme, not just a belief Adaptive versus maladaptive schemas Many develop in the pre-verbal period Deeply entrenched patterns, central to ones sense of self Usually self-perpetuating Erupt when triggered by everyday events relevant to specific schema
Impaired Limits
-Entitlement
-Insufficient Self-Control
Other Directedness
-Subjugation -Self-sacrifice -Approval Seeking
Coping Styles
Surrender
Giving in to our schemas and repeating them over and over Freeze
Avoidance
Finding ways to escape or block out our schemas Flight
Overcompensation
Doing the opposite of what our schemas makes us feel Fight
Compulsive Stimulation-seeking:
Seeks excitement or distraction through compulsive shopping, sex, gambling, risk-taking, physical activity, novelty, etc.
Addictive Self-Soothing:
Avoids through addictions involving the body, such as alcohol, drugs, overeating, excessive masturbation, etc.
Psychological Withdrawal:
Copes through dissociation, numbness, denial, fantasy, or other internal forms of psychological escape
Recognition-seeking, Status-seeking:
Overcompensates through impressing, high achievement, status, attention-seeking, etc.
Manipulation, Exploitation:
Meets own needs through covert manipulation, seduction, dishonesty, or conning
Passive-aggressiveness, Rebellion:
Appears overtly compliant while punishing others or rebelling covertly through procrastination, pouting, backstabbing, lateness, complaining, rebellion, non-performance, etc.
Schema Modes
Represents "those schemas, coping responses, or healthy behaviors that are currently active for an individual". A schema mode is activated when particular schemas or coping responses have erupted into strong emotions or rigid coping styles that take over and control an individual's functioning. An individual may shift from one schema mode into another; as that shift occurs, different schemas or coping responses, previously dormant, become active.
Schema Modes
CHILD MODES
Vulnerable Child Angry Child Impulsive/Undisciplined Child Happy Child
Schema Operations
Schema Perpetuation
Cognitive distortions Self-defeating life patterns Schema coping styles and responses
Schema healing
Angry Child
feels intensely angry, enraged, infuriated, frustrated, impatient because the core emotional (or physical) needs of the vulnerable child are not being met
Impulsive/Undisciplined Child
acts on non-core desires or impulses in a selfish or uncontrolled manner to get his or her own way and often has difficulty delaying short-term gratification; often feels intensely angry, enraged, infuriated, frustrated, impatient when these non-core desires or impulses cannot be met.; may appear spoiled
Happy Child
feels loved, contented, connected, satisfied, fulfilled, protected, accepted, praised, worthwhile, nurtured, guided, understood, validated, self-confident, competent, appropriately autonomous or self-reliant, safe, resilient, strong, in control, adaptable, included, optimistic, spontaneous
Detached Protector
Cuts off needs and feelings; detaches emotionally from people and rejects their help; feels withdrawn, spacey, distracted, disconnected, depersonalized, empty or bored; pursues distracting, self-soothing, or self-stimulating activities in a compulsive way or to excess; may adopt a cynical, aloof or pessimistic stance to avoid investing in people or activities
Overcompensator
Feels and behaves in an inordinately grandiose, aggressive, dominant, competitive, arrogant, haughty, condescending, devaluing, overcontrolled, controlling, rebellious, manipulative, exploitative, attention-seeking, or status-seeking way. These feelings or behaviors must originally have developed to compensate for or gratify unmet core needs
Demanding Parent
Feels that the right way to be is to be perfect or achieve at a very high level, to keep everything in order, to strive for high status, to be humble, to puts others needs before one's own or to be efficient or avoid wasting time; or the person feels that it is wrong to express feelings or to act spontaneously. This mode refer to the nature of the internalized high standards and strict rules, rather than the style with which these rules are enforced; these rules are not compensatory in their function.
Treatment
Strategies
Pattern identification Educate patient about schemas Reinventing your life Review schema inventories Trigger schemas through imagery, dialogue, exercises Observe patterns in the therapy relationship Integrate with schema conceptualization form
The Tools
Young Schema Questionnaire (YSQ)
assesses which of the Early Maladaptive Schemas a patient probably has
Experiential
Practice experiential exercises to vent anger, grieve for early pain and to empower the patient
Therapy Relationship
Provide limited reparenting Heal schemas and coping styles triggered in sessions
Behavioral Pattern-Breaking
Assign and rehearse behavioral and interpersonal changes related to presenting problem Break dysfunctional life patterns
Cognitive Techniques
Self help assignments
Therapist dictates flashcards using template Write separate flashcards for all recurring life situations or schemas Later in therapy, assign Schema Diary
Eye Charts
FAILURE (FA)
SELF-SACRIFICE (SS)
PUNITIVENESS (PU)