Schema therapy (ST) can be conceptualized as an extension of cognitive-behavioral therapy (CBT) with which it shares many principles, but it also differs from CBT in several important ways. ST works well where CBT often fails, often due to relational difficulties between patient and therapist. Schema therapy is also meant to serve people with personality (Axis II) disorders.
In a nutshell, ST can be called an extension of cognitive-behavioral therapy. It originates from CBT, while combining elements of Gestalt therapy, attachment, constructivism, object relations and psychoanalysis. Schema therapy is a relatively new therapeutic method developed by American psychologist Jeffrey E. Young in the 1990s.
Among the most important tenets of schema therapy is its focus on helping people with chronic personality problems. The creator of the method noticed that the classic version, i.e. CBT, was not fully successful in treating people with personality disorders. This group of patients can be difficult to work with, as they often have little psychological flexibility, and exhibit cognitive difficulties. The fact that patients are often unable to precisely identify the reasons why they came to see a specialist also does not make therapy any easier. To be effective, schema therapy must go beyond CBT. For this reason, it takes longer than the standard CBT process. The length of therapy depends on the needs of the individual patient – if necessary, treatment can last several years.
The concept of schemas was popularized by the Swiss psychologist and biologist Jean Piaget. The scientist became famous primarily for his theory of cognitive development, which says that a child’s mind goes through four stages of development. According to the scientist, a schema concerns both knowledge itself and the process of its expansion. Schemas categorize knowledge, making it easier to understand and interpret reality. As a person develops, the number of his or her experiences increases, which translates into a change of the pre-existing schemata. Schemas are subject to constant modification in the course of learning. For example, a child surrounded by young people may think that everyone is young. The moment he sees an older person, he will update his knowledge and change his schema.
Young expanded the definition of a schema, calling it a general pattern composed of memories, emotions, or beliefs. A schema is an overall theme that is built up over years, affecting relationships with other people. A pattern can form in childhood as well as in adulthood. Unfortunately, it is very often dysfunctional, making it difficult for the person to establish lasting, proper relationships, or pushing them into toxic ones.
The therapeutic process realized in ST focuses on recognizing the so-called modes. This name is given to the emotional states experienced by the patient and his reactions in the moments when one of the so far dormant maladaptive patterns is activated. They may be “awakened” by a memory, an event, or someone else’s behavior. Any factor can become an activator. The therapist’s task is to support the patient in overcoming these patterns. During the therapy, the patient learns to recognize them and to release them from their influence. He discovers the source of his problems and works on them.
Jeffrey E. Young has identified 18 maladaptive schemas that usually form during the earliest stages of life. These include distrust (as a result of being hurt), pessimism, self-sacrifice, alienation, and emotional inhibition. Currently, researchers are trying to identify further maladaptive schemas. Psychology today also focuses on analyzing new emotional needs of patients, such as justice or self-coherence.
Schema therapy is being practiced by more and more psychotherapists. It can be found not only in cities like Warsaw or Krakow, but also in smaller towns. It is provided to people who have noticed that they keep finding themselves in similar problematic situations, e.g., choosing the same toxic type of partner. Schema therapy can be a solution for people experiencing strong emotions that they do not understand, discouraging their surroundings and loved ones. Schema theory has shown effectiveness in those who have gone through other types of therapy, but without reaching their desired results.
People who have problems with assertiveness, low self-esteem, comparing themselves to others (to their own disadvantage) may consider undergoing schema therapy. ST can be helpful for people who are stuck in a particular situation and cannot move forward with their lives.
Those interested in treatment can find help in Mokotów, Warsaw. Meetings take place once a week for about an hour. The therapy is considered long-term because of its duration (usually between one and two years).