Impressive results: Schema therapy for complex issues

Schema Therapy is an innovative and comprehensive therapy approach that combines the best aspects of cognitive behavioural therapy (CBT), Gestalt experiential therapy and psychoanalytic thinking into one process. It is specifically designed to help people to change some of the longstanding patterns of thinking and acting.  

The ‘Schemas’ that we aim to change refers to those self-defeating core themes that we keep repeating throughout our lives. These deep-rooted patterns are associated with not only thoughts but also feelings and even physical sensations. Some examples of schema beliefs are: "I'm unlovable," "I'm a failure," "People don't care about me," "I'm not important," "Something bad is going to happen," "People will leave me," "I will never get my needs met," "I will never be good enough”.  

Schemas are developed when childhood needs are not met. One metaphor I like to use is that they are like old shoes that no longer fit - because they tend to begin early in life, schemas become familiar and comfortable, even though they are ultimately not good for us. Because they are so powerful, we may even distort our view of events in our current lives in order to keep these schemas going. 

You may find Schema therapy helpful if any of the following apply to you: 

  • You find yourself over-reacting to certain situations (which may lead to impulsive behaviours that you later regret).
  • You are drawn to the same type of partner over and over, even your emotional needs are not met in these relationships.
  • You feel stuck in habitual patterns or addictive behaviours that you can’t seem to change.
  • You struggle to say no, or with the thought of others disliking you.
  • You have low self-esteem or confidence, which holds you back from fulfilling your potential.

The process of schema therapy 

Firstly, we identify some of your enduring and self-defeating patterns that typically begin early in life. Questionnaires may be used as well to get a clear picture of the various patterns involved. Next, we use a combination of talking and experiential exercises to raise your emotional awareness; during this phase you may get in touch with some of the early experiences and learn how to spot them when they are being triggered in your daily life. Thirdly, we focus on behavioural change. Structured assignments maybe given so you can continue to work outside of sessions. You can actively practise to replace some of the negative, habitual schemas with a fresh perspective. 

Many clients who come for schema therapy have spent years in other types of therapies such as psychoanalysis or traditional CBT, and were frustrated with the lack of progress. Schema therapy is a very collaborative and empowering process that truly aims to help you turn insights into real changes.    Schema therapy has also recently been blended with mindfulness meditation and elements of neuroscience for clients who can further benefits from them.

Significant effectiveness in treating borderline personality disorder  

Although the use of Schema Therapy is not restricted to treating personality disorder, it has produced impressive results when it comes to treating treatment-resistant personality disorders, chronic depression, relationship issues and other complex difficulties. 

As reported in a recent news article on Science Daily, a large scale trial released in the American Journal of Psychiatry has shown Schema Therapy to be significantly more effective than two major alternative approaches to the treatment of personality disorders. It resulted in a higher rate of recovery, greater declines in depression, and greater increases in general and social functioning. The results also suggest Schema Therapy is more cost-effective, achieving these results with less number of sessions.

This is an important and unprecedented outcomes in the treatment of borderline personality disorder.  What sets Schema Therapy apart from all the other major treatments for personality disorders, including treatments like dialectical behavioural therapy, is its use of a warm and safe relationship between client and therapist. In this way of working, the therapist will try to actively and directly meet the early core emotional needs of the client. 

Schema Therapy empowers you to heal the early dysfunctional schemas and to break negative life patterns. The ultimate goal, however, is to strengthen your own inner healthy adult, so that you can get back in touch with your own feelings and needs, and to effectively meet them in a healthy way in your everyday life.

Reference: Lotte L.M. Bamelis, Silvia M.A.A. Evers, Philip Spinhoven, Arnoud Arntz.Results of a Multicenter Randomized Controlled Trial of the Clinical Effectiveness of Schema Therapy for Personality Disorders. American Journal of Psychiatry, 2013

Link to Science Daily article:

This article was written by Imi Lo.

Counselling Directory is not responsible for the articles published by members. The views expressed are those of the member who wrote the article.

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