A Client’s Guide to Schema Therapy
作者: Jeffrey E. Young / 6288次阅读 时间: 2010年11月20日
来源: Schema Therapy Institute 标签: SchemaTherapy
www.psychspace.com心理学空间网心理学空间,nPmc[~oF

A Client’s Guide to Schema Therapy心理学空间3J:vi:w%u\-qj*R/W
David C. Bricker, Ph.D. and Jeffrey E. Young, Ph.D.
'EJR.`&r/x/Q)X0Schema Therapy Institute心理学空间 j;e$QM4CV&F9W
HARRY is a 45-year old middle-level manager. He has been married for 16 years, but his心理学空间X'I/j6H/K3^
marriage has been very troubled. He and his wife are often resentful of each other, they
7k;pQj)vQ D|+q0rarely communicate on an intimate level, and they have few moments of real pleasure.心理学空间?R9g:w0epKd d
Other aspects of Harry’s life have been equally unsatisfying. He doesn’t enjoy his work,心理学空间Al6S#qH })v/{}
primarily because he doesn’t get along with his co-workers. He is often intimidated by
!?k-PDl3G)JRTW0his boss and other people at the office. He has a few friends outside of work, but none心理学空间U!c'ac{h;P
that he considers close.
8nkxIg;F+X;B B!i(T0During the past year Harry’s mood became increasingly negative. He was getting more心理学空间+Rfikq0Q{ZI1T
irritable, he had trouble sleeping and he began to have difficulty concentrating at work.心理学空间0x!ZmQI&o^'M3~J
As he became more and more depressed, he began to eat more and gained 15 pounds.
/I;Sf8Fj)RX lA0When he found himself thinking about taking his own life, he decided it was time to get心理学空间5? LJ N nquSw
help. He consulted a psychologist who practices cognitive therapy.
fE;oZt[0As a result of short-term cognitive therapy techniques, Harry improved rapidly. His mood
8e%Ad-Q)?0lifted, his appetite returned to normal, and he no longer thought about suicide. In
]9X,GS)yq0addition he was able to concentrate well again and was much less irritable. He also心理学空间m}6r0nU ]
began to feel more in control of his life as he learned how to control his emotions for心理学空间YTL h6h3a H
the first time.
l&H8B&Fw;f){SW n0But, in some ways, the short-term techniques were not enough. His relationships with心理学空间b p2W)wJMc1N.^
his wife and others, while they no longer depressed him as much as they had, still failed
"O2H%U)dT b8x3p)]M*n0to give him much pleasure. He still could not ask to have his needs met, and he had few
}0[^%u G:m'^7g0experiences he considered truly enjoyable. The therapist then began schema therapy to心理学空间J(CZ(a1IR0j
help Harry change his long-term life patterns.心理学空间AqT{$_+b
This guide will present the schema therapy approach, developed by Dr. Jeffrey Young to
%M/J$CXV0expand cognitive therapy for clients with more difficult long-term problems. Schema
|MeD4X6_r HP0therapy can help people change long-term patterns, including the ways in which they心理学空间0O+k9[t|9Z^
interact with other people. This overview of schema therapy consists of six parts:心理学空间Ph*D+q}n \
1) A brief explanation of short-term cognitive therapy
9o7r#|-\s7K4{6kO02) An explanation of what a schema is and examples of schemas;心理学空间[%HRv7is0^2P
3) An explanation of the processes by which schemas function;
\4P G^i&FE04) An explanation of modes and how they function within schema therapy;
A)Z[$L'x,ex8pDM05) Several case examples; and
k"o*h a;Q4T-`06) A brief description of the therapeutic process心理学空间;x+K\&t"X
Short-Term Cognitive Therapy心理学空间 w gOA~
Cognitive therapy is a system of psychotherapy developed by Aaron Beck and his心理学空间V-s[sr
colleagues to help people overcome emotional problems. This system emphasizes心理学空间 dPBv,x
changing the ways in which people think in order to improve their moods, such as
'r-X0| u tq,I/qzC0depression, anxiety and anger.
JE!\[6\3j^ A liG0Emotional disturbance is influenced by the cognitive distortions that people make in
6P T0np]m.F0dealing with their life experiences. These distortions take the form of negative
S7@+bk.M[:k0interpretations and predictions of everyday events. For instance, a male college student
4L,F3TW-j8Io;x3W:I0preparing for a test might make himself feel discouraged by thinking: “This material is
S0U;CQm0\bvF!X&_0impossible” (Negative Interpretation) and “I’ll never pass this test” (Negative Prediction).
v3`*D,ik7uX0The therapy consists of helping clients to restructure their thinking. An important step in心理学空间-l7X] uq,T
this process is examining the evidence concerning the maladaptive thoughts. In the心理学空间.b%|,p ?+u8ns[-e
example above, the therapist would help the student to look at his past experiences and心理学空间 R.U~:X-} jF'wGd {
determine if the material was in fact impossible to learn, and if he knew for sure that he
g1jzl.i0couldn’t pass the test. In all probability, the student would decide that these two
t#T#] V!?i8W%d7? Y0thoughts lacked validity.心理学空间kf` {UjLMoOW
More accurate alternative thoughts are then substituted. For instance, the student might心理学空间 P(E6|#V_E
be encouraged to think: “This material is difficult, but not impossible. I’ve learned
Ssat~\1D B0difficult material before” and “I’ve never failed a test before, so long as I’ve done心理学空间o1U6zoYA
enough preparation.” These thoughts would probably lead him to feel better and cope心理学空间"]7CGxm8r_zC
better.心理学空间&y.P7o#?z:kO
Often short-term cognitive therapy is enough to help people overcome emotional
k?vc$X4aS0problems, especially depression and anxiety. Recent research has shown this to be so.
H` NcD8t$h/A|0However, sometimes this approach is not enough. Some clients in short-term cognitive心理学空间Wqb+r7L
therapy find that they don’t get all the benefits they want. This has led us, as well as
)_ Gg2BB0various other researchers (Beck, xxxx) to look at deeper and more permanent cognitive
:~c}d@*W9KA&k0structures as a means to understand and treat problem moods and behaviors. Schema
!`p'E[v&g*H0therapy was created as a result of these efforts.
%L"O/W,V3e2E q7Gf0Schemas - What They Are
8MsDS6u(s7u0A schema is an extremely stable, enduring negative pattern that develops during心理学空间'Pr8T8[fM%~
childhood or adolescence and is elaborated throughout an individual’s life. We view the心理学空间jz2E#y$j~f$z#e:W
world through our schemas.心理学空间)Ev(~9BD jJU(F-[l,S
Schemas are important beliefs and feelings about oneself and the environment which
/zN#w"Q6r#S3_/v} b2R0the individual accepts without question. They are self -perpetuating, and are very心理学空间 J}\t[ I2Q
resistant to change. For instance, children who develop a schema that they are心理学空间 A ^.Z?6A'V
incompetent rarely challenge this belief, even as adults. The schema usually does not go
i9IZ5sk9DQ]`0away without therapy. Overwhelming success in people’s lives is often still not enough心理学空间 FHtgFJ\
to change the schema. The schema fights for its own survival, and, usually, quite心理学空间CQkKkK$v/w)h
successfully.心理学空间 o?K2nJ C6@
It’s also important to mention the importance of needs in schema formation and
,zd`Pm'sj0perpetuation. Schemas are formed when needs are not met during childhood and then
}_ ZPX^A0the schema prevents similar needs from being fulfilled in adulthood. For instance a child心理学空间E3?b(X?4j
whose need for secure attachments is not fulfilled by his parents may go for many years心理学空间;_~Yzs;Q
in later life without secure relationships.心理学空间BA#Vy!K{h"^k
Even though schemas persist once they are formed, they are not always in our心理学空间+l7p\6eu*F h|
awareness. Usually they operate in subtle ways, out of our awareness. However, when a
l.jMz1d%S;O)]$c:l"v0schema erupts or is triggered by events, our thoughts and feelings are dominated by
D C[k |"i8w0these schemas. It is at these moments that people tend to experience extreme negative心理学空间 D D:GJp.P
emotions and have dysfunctional thoughts.
YG k_*b ^0In our work with many patients, we have found eighteen specific schemas. Most clients
sFB1` u%X ]2pij0have at least two or three of these schemas, and often more. A brief description of each心理学空间c2g6Q{LCU$m]k
of these schemas is provided below.心理学空间N_ W4t!H#feE
Emotional Deprivation
5BP0z|@ ^6g0This schema refers to the belief that one’s primary emotional needs will never be met by心理学空间w"r ]8m'G0@H
others. These needs can be described in three categories: Nurturance – needs for
T]%mD&ca0affection, closeness and love; Empathy – needs to be listened to and understood;心理学空间:p'Plq-{ d
Protection – needs for advice, guidance and direction. Generally parents are cold or心理学空间 A6~aL)kz M!\
removed and don’t adequately care for the child in ways that would adequately meet
Mw@[r,N xa4]0the above needs.
gT&I"g/X7g-mt0Abandonment/Instability
_"o,XA3j ~ nX0This schema refers to the expectation that one will soon lose anyone with whom an
7[ D']e'f'l.rMBL0emotional attachment is formed. The person believes that, one way or another, close
UMI%n!v p3|V.o0relationships will end imminently. As children, these clients may have experienced the心理学空间#?0h$~T3oy4F*Tr
divorce or death of parents. This schema can also arise when parents have been
7K qR#t?-]0inconsistent in attending to the child’s needs; for instance, there may have been心理学空间 `3B7\ ^ ?x4]
frequent occasions on which the child was left alone or unattended to for extended
!K5@&LSw%B u0periods.
H ff |`*wBl'A$FU4g0Mistrust/Abuse心理学空间M4p%\3l.R8m u/R-E+W
This schema refers to the expectation that others will intentionally take advantage in心理学空间zW]&N8}"[7_
some way. People with this schema expect others to hurt, cheat, or put them down.心理学空间 JWb}T6o8qw
They often think in terms of attacking first or getting revenge afterwards. In childhood,心理学空间;r0cKI }~.Ja
these clients were often abused or treated unfairly by parents, siblings, or peers.心理学空间8}j%C&Y*UR
Defectiveness/Shame
7_(x K$Me"n6JXEZ0This schema refers to the belief that one is internally flawed, and that, if others get
?~([-y}K0close, they will realize this and withdraw from the relationship. This feeling of being心理学空间1~ aX5m!i)h3g+PE
flawed and inadequate often leads to a strong sens e of shame. Generally parents were心理学空间5D3j'Cv2u4?#v2v
very critical of their children and made them feel as if they were not worthy of being
m | P6` h2F&S+w!u0loved.
$d-H)y&]~ c/I RT1}0Social Isolation/Alienation心理学空间2q f|J9Dc/p?7e9f
This schema refers to the belief that one is isolated from the world, different from other心理学空间4X K8iu#^V7iw4~^t
people, and/or not part of any community. This belief is usually caused by early心理学空间 m3cR w1w`
experiences in which children see that either they, or their families, are different from心理学空间 HcY4UT9@ `%^)\4h/J
other people.心理学空间&V:I Y$vc$?%F
Dependence/Incompetence
N;l1p'hb:^(L m S7_q0This schema refers to the belief that one is not capable of handling day-to-day
\wwC"u0responsibilities competently and independently. People with this schema often rely on心理学空间hk5\@^!V-N \
others excessively for help in areas such as decision-making and initiating new tasks.心理学空间N K9OL3b/^9A)`
Generally, parents did not encourage these children to act independently and develop心理学空间#P5zw0b6o:[
confidence in their ability to take care of themselves.
(A3bv$U*dK:`0Vulnerability to Harm and Illness心理学空间5C j4Wm ~t(sF
This schema refers to the belief that one is always on the verge of experiencing a major心理学空间jQ)Y4E]6j h z7s d_n
catastrophe (financial, natural, medical, criminal, etc.). It may lead to taking excessive
tR2dAmP.K0precautions to protect oneself. Usually there was an extremely fearful parent who心理学空间(Y5\BqE!Fv
passed on the idea that the world is a dangerous place.
&v xH~'kW!O n4wC0Enmeshment/Undeveloped Self心理学空间O#Z!N0V$S5?0m^
This schema refers to a pattern in which you experience too much emotional心理学空间Y7?}D,z
involvement with others – usually parents or romantic partners. It may also include the心理学空间k6Vx.iJq$?X(k
sense that one has too little individual identity or inner direction, causing a feeling of心理学空间4} h@)e9zGDg(k
emptiness or of floundering. This schema is often brought on by parents who are so
3L'}!E O3uV0controlling, abusive, or overprotective that the child is discouraged from developing a
(w5MZ#f&Y X0separate sense of self.
v&@2o s:b R;|0Failure心理学空间2]QgXSb%p%Z
This schema refers to the belief that one is incapable of performing as well as one’s心理学空间}(U,t/o!gA A,W
peers in areas such as career, school or sports. These clients may feel stupid, inept or
u%O GB#SJ0untalented. People with this schema often do not try to achieve because they believe心理学空间$]"n7gqcw6c$d$Ey)g
that they will fail. This schema may develop if children are put down and treated as if
[%XWb!Q!ZZ(Sf[V0they are a failure in school and other spheres of accomplishment. Usually the parents
[0D^~ A6B&?rM0did not give enough support, discipline, and encouragement for the child to persist and
#^.JT/TG.N8\0succeed in areas of achievement, such as schoolwork or sport心理学空间"g,g(fWQ"w'dAje
Subjugation心理学空间u.P,C3W)U}h2fF
This schema refers to the belief that one must submit to the control of others in order to心理学空间E)KVD)Y8}4e9U;^
avoid negative consequences. Often these clients fear that, unless they submit, others
-q X qd;_0will get angry or reject them. Clients who subjugate ignore their own desires and
"KL{2s&w0feelings. In childhood there was generally a very controlling parent.
7?Hz\{~A'W0Self-Sacrifice
/BgA6U8b:^_x0This schema refers to the excessive sacrifice of one’s own needs in order to help others.心理学空间l,e8q%K _.N
When these clients pay attention to their own needs, they often feel guilty. To avoid this
'C/|Z] s/s|+~.b1pS0guilt, they put others’ needs ahead of their own. Often clients who self -sacrifice gain a
Ro6M NP z0feeling of increased self -esteem or a sense of meaning from helping others. In childhood心理学空间(|4n2t{(] T:DJ
the person may have been made to feel overly responsible for the well being of one or心理学空间qaA7W9U3A9O
both parents.
A9YLA xu-{-RSV!x0Emotional Inhibition心理学空间X;|syY"Gi
This schema refers to the belief that you must suppress spontaneous emotions and
IE*Zy+ST(D0impulses, especially anger, because any expression of feelings would harm others or心理学空间(o-ka8IZ*QZ3o&o
lead to loss of self -esteem, embarrassment, retaliation or abandonment. You may lack
6L!ey;zk;V~0spontaneity, or be viewed as uptight. This schema is often brought on by parents who
n*d rV0])|.?0discourage the expression of feelings.
Jm&O/b;bfa&dK[#L ^0Approval-Seeking/Recognition-Seeking心理学空间!J)i`h N)Pl
This schema refers to the placing of too much emphasis on gaining the approval and
5V0p9bK%Z5qV1j0recognition of others at the expense of one’s genuine needs and sense of self. It can
C0~0Em Bz3D4S0also include excessive emphasis on status and appearance as a means of gaining
;rc!W*k QIR i0] E0recognition and approval. Clients with this schema are generally extremely sensitive to心理学空间6V3at-s[(D @#d
rejections by others and try hard to fit in. Usually they did not have their needs for心理学空间?M\0E2P2Hr
unconditional love and acceptance met by their parents in their early years.心理学空间C6FESC%r
Unrelenting Standards/Hypercriticalness心理学空间K.`,R @Vy1J6E5Cw
This schema refers to the belief that whatever you do is not good enough, that you
;D({4c"U9V2U0must always strive harder. The motivation for this belief is the desire to meet extremely心理学空间DF;J W B
high internal demands for competence, usually to avoid internal criticism. People with
:S,a)j0{!Xb1O0this schema show impairments in important life areas, such as health, pleasure or self -心理学空间H2_2e:VU$H[T|
esteem. Usually these clients’ parents were never satisfied and gave their children love心理学空间nj v0n3t$c YB'?1x
that was conditional on outstanding achievement.心理学空间d"QbzwLH
Entitlement/Grandiosity心理学空间gCRs-|s$|-v
This schema refers to the belief that you should be able to do, say, or have whatever
J/K"l5?Qb0you want immediately regardless of whether that hurts others or seems reasonable to
L {v#Z?b"H0them. You are not interested in what other people need, nor are you aware of the longterm心理学空间d:H+\;O Z/MPiiY m:l
costs to you of alienating others. Parents who overindulge their children and who心理学空间;k_L0]V&KezX
do not set limits about what is socially appropriate may foster the development of this心理学空间m Q+La8L2x
schema. Alternatively, some children develop this schema to compensate for feelings of
B6s q;M s\#fg ?V0emotional deprivation or defectiveness.心理学空间8a,W(AIpb}l2w
Insufficient Self-Control/Self-Discipline心理学空间 ~aA}`
This schema refers to the inability to tolerate any frustration in reaching one’s goals, as心理学空间L7] s![[Has
well as an inability to restrain expression of one’s impulses or feelings. When lack of
O.YcKh0self-control is extreme, criminal or addictive behavior rule your life. Parents who did not心理学空间'c:e3I VkP D:P\
model self-control, or who did not adequately discipline their children, may predispose
a&aW.?k-y0them to have this schema as adults.心理学空间^&^t2aO&p
Negativity/Pessimism心理学空间S.M4{CnX
This schema refers to a pervasive pattern of focusing on the negative aspects of life
Iwwq;Ri0while minimizing the positive aspects. Clients with this schema are unable to enjoy
aopyT0things that are going well in their lives because they are so concerned with negative心理学空间y6F|+K G5g2p`
details or potential future problems. They worry about possible failures no matter how心理学空间t,hX'^])] aMr
well things are going for them. Usually these clients had a parent who worried
6U M0|D4XJP*H/`:Z0excessively.
G$m)s)j ^4@ HH0Punitiveness心理学空间`&V:g^v)MZ
This schema refers to the belief that people deserve to be harshly punished for making
p6R*uw L:P,l:V^0mistakes. People with this schema are critical and unforgiving of both themselves and
;r&U&A9m|/sXAL0others. They tend to be angry about imperfect behaviors much of the time. In心理学空间FWoj[]E!A&xZ
childhood these clients usually had at least one parent who put too much emphasis on
4aHkd2SG0performance and had a punitive style of controlling behavior.心理学空间vC/{K*b8W;eB r
How Schemas Work
[dr!\ b:g0There are two primary schema operations: Schema healing and schema perpetuation.
3i"f |x9mw0All thoughts, behaviors and feelings may be seen as being part of one of these
MS+iX$[KeI0operations. Either they perpetuate the schema or they heal the schema. In a later
j,l-W9Q)Q!^0section on the therapy process we will explain more about schema healing.
1?o/zc y{?_@0Schema perpetuation refers to the routine processes by which schemas function and
2y5V4_@I0A$@B8q6O0perpetuate themselves. This is accomplished by cognitive distortions, self -defeating
.p)@N P0E)`a0behavior patterns and schema coping styles.心理学空间*P`cnzG
Earlier we mentioned that cognitive distortions are a central part of cognitive therapy.心理学空间D%z+CoI+{/l
These distortions consist of negative interpretations and predictions of life events. The心理学空间p`I/V3?K
schema will highlight or exaggerate information that confirms the schema and will
8l.jb]D$L0minimize or deny information that contradicts it. Likewise, unhealthy behavior patterns心理学空间7A[kK6x&X$E
will perpetuate the schema’s existence. Someone who was abused in childhood and心理学空间$\X!e)RJ
developed a Mistrust/Abuse schema may seek out abusive relationships in adulthood
b+~{ R9gX0and remain in them, providing a constant stream of evidence for the schema.
o9Q;REz1gao0In order to understand how schemas work, there are three schema coping styles that心理学空间:fW7xGB-[V e
must be defined. These styles are schema surrender, schema avoidance, and schema心理学空间@;J!IX&vq W }`
overcompensation. It is through these three styles that schemas exert their influence on心理学空间\'x[G+z
our behavior and work to insure their own survival.
IN5q JPR0Schema surrender refers to ways in which people passively give in to the schema.
"X-H&Y't&A A"|q0}0They accept the schema as truth and then act in ways that confirm the schema. For
]-@.xj!ge2Z0instance, a young man with an Abandonment/Instability schema might choose
7V?'dg3R#D;V%]0partners who are unable to commit to long-term relationships. He might then react to心理学空间s-HR{d
even minor signs indications of abandonment, such as spending short times without his
G U(hNwPD;d0partner, in an exaggerated way and feel excessive negative emotion. Despite the心理学空间O5g8O0a,G;l$P\^r
emotional pain of the situation, he might also passively remain in the relationship心理学空间7WH5W/uXa5c9k [Y
because he sees no other possible way to connect with women.
vX[m,v|;W9g0Schema avoidance refers to the ways in which people avoid activating schemas. As心理学空间c@`q'J8S
mentioned earlier, when schemas are activated, this causes extreme negative emotion.
1Sl$iL#Q4zlZ$F0People develop ways to avoid triggering schemas in order not to feel this pain. There are
$z^!mbs7^5Be4@0three types of schema avoidance: cognitive, emotional and behavioral.心理学空间:fOG'Tu wN'O![,j.k
Cognitive avoidance refers to efforts that people make not to think about upsetting
ld:Ov:FJ6k?D0events. These efforts may be either voluntary or automatic. People may voluntarily
L A$V ce_){0W0choose not to focus on an aspect of their personality or an event, which they find心理学空间 tA1o c/x X p#S
disturbing. There are also unconscious processes which help people to shut out心理学空间;My-Qxh0B3}
information which would be too upsetting to confront. People often forget particularly心理学空间I FV4Xa"Oh$G] N|"P
painful events. For instance, children who have been abused sexually often forget the心理学空间4v.P6yw8r}(B
memory completely.
9~)X(f)T.hgw-`CO0Emotional or affective avoidance refers to automatic or voluntary attempts to block
"i"kJH;q/C0painful emotion. Often when people have painful emotional experiences, they numb心理学空间+ODVw6G^M8^
themselves to the feelings in order to minimize the pain. For instance, a man might talk心理学空间O1o{`.N:^Lw%J+R}
about how his wife has been acting in an abusive manner toward him and say that he心理学空间/J]pZ%f%gB
feels no anger towards her, only a little annoyance. Some people drink or abuse drugs心理学空间P7L,o+?8x6qz Th
to numb feelings generated by schemas.心理学空间]"Y;S{ L*z*WJ g,\
The third type of avoidance is behavioral avoidance. People often act in such a way as心理学空间 }?Re L9P/[9vA!J#i
to avoid situations that trigger schemas, and thus avoid psychological pain. For instance,心理学空间2O1P[6YJ!q` T0}
a woman with a Failure schema might avoid taking a difficult new job which would be心理学空间F;C!R.n'L;|;bY`%T
very good for her. By avoiding the challenging situation, she avoids any pain, such as心理学空间4Z6V mV1qd@
intense anxiety, which could be generated by the schema.心理学空间8J ]\1h DhUp
The third schema process is Schema overcompensation. The individual behaves in a心理学空间$} f5bS7z8U(h0XR.@!PO
manner which appears to be the opposite of what the schema suggests in order to avoid
f7D`A.?gin0triggering the schema. On the surface, it may appear that the overcompensators are心理学空间y`n7S:vpN*~ \]7M
behaving in a healthy manner, by standing up for themselves. But when they overshoot心理学空间P4V2U(gJ;s nOr
the mark they cause more problem patterns, which then perpetuate the schema. For
N,Vkh,N$b+h&@.i0instance, a young man with a Defectiveness schema might overcompensate by心理学空间{ X.G1_ P:E R
presenting himself as perfect and being critical of others. This would likely lead others
]Gl"W#|e2z"\1h0to criticize him in turn, thereby confirming his belief that he is defective.
zA#sh\(R\"y,Y;` m0Working With Modes
E:`'n3WUKH1y9\:B0When treating clients with schema therapy one of the most important innovations is the
-l0g}"Y PP.ns0concept of mode. For our purposes we will define a mode as the set of schemas or
UTr/\Y x0schema operations that are currently active for an individual. Or you might think of a心理学空间%{iIp}@[
mode simply as a mindset or state that you might be in temporarily. Most people can
9R5r&I4z"N\lh0relate to the idea that we all have these different parts of ourselves and we go in and
uti:I)]5H0out of them all the time. For instance, if a friend tells you she had a bad day because
z n$\Z-ul2]#~0her boss (or her toddler) was in his raging bull mode, you’d know exactly what she
,M Yd:Z A Q%Y!]/rF"N}0means.
2SB/zc1pz0There are often occasions when a therapist will choose to work with a client’s modes in心理学空间y5^/hxt.Bw
therapy. If a client is extremely upset at the beginning of a session, the therapist may
.Rl1f:FAh0inquire about what part of the person is feeling the emotional pain and attempt to
v(Z%n*lp#b0Kf1K @.fp8Q0recognize it and deal with it directly. For instance, for several sessions, Myra was very
8dn2H @9ab^0sad and hurt because she was unable to talk out some problems with her husband. In
U.|4x,c%p/c^ `0talking with her therapist they focused on a mode, or part of her, that she called Lonely
S F7\el } m0Myra, that seemed to be active after these failed attempts. By engaging this part of心理学空间 N E%X'[W Hv6Y%M#Ud
Myra in this manner the therapist was able to give her an opportunity to express the心理学空间2`1_$co5_2t
feelings and thoughts connected with her pattern of loneliness.
[?P,F7Gr5o0The exact pattern of work with modes will vary from session to session. But some of心理学空间iJ[9ji
the more common activities in mode work can be described. The history of the mode is
J;v+gE2cCJ0often discussed; the client will speak about when the mode started and what was going
,Ai pa.I(F0on at the time. Connections are made between modes and current problems.心理学空间"bN9c'jD#B$g+L
Dialogues can be conducted between different modes when there is a conflict. For心理学空间 Z P&FW]!I k&W7u
instance, a miser mode and a playboy mode might have it out over what type of car to
l-yM&v*S1[#J8u;O[0buy. And there is always an effort to link mode work with other aspects of the therapy.心理学空间5P5n uu!t3hDg
Case Examples心理学空间sq}^lL/m
In this section six case examples are presented. In each one, the schema coping styles
q xd#b*N#FcJ*D0are demonstrated. By reading through this section, you will get a better feel for how心理学空间1VT$y8Y"fF3\
these processes can operate in real life situations.
$s(B {3Ud iq0Abby is a young woman whose main schema is Subjugation. She tends to see people
#PK,N/Zml/|/@9y~H3F0as very controlling even when they are being appropriately assertive. She has thoughts心理学空间6UdG)YT;y g9S'WR
such as “I can’t stand up for myself or they won’t like me’ and is likely to give in to心理学空间t~NFeb;L3];F2T
others (Schema surrender). At other times she decides that no one will get the better
~I!GKS-V0of her and becomes very controlling (Schema overcompensation). Sometimes when
\Yl6]"M&c0people make unreasonable demands on her she minimizes the importance of her own心理学空间/Zm0C+} A Wp
feelings and has thoughts like “It’s not that important to me what happens.’ At other心理学空间&C&B"_w J)E;l
times she avoids acquaintances with whom she has trouble standing up for herself
4X'rM,v~1U0(Schema avoidance).心理学空间?|gU0{ CI#en
Stewart’s main schema is Failure. Whenever he is faced with a possible challenge, he心理学空间;X3N ev @.]a7l
tends to think that he is not capable. Often he tries half -heartedly, guaranteeing that he心理学空间 D%vP0{Y'k2m
will fail, and strengthening the belief that he is not capable (Schema surrender). At
't;p$i L*B%p'c/ws7V0times, he makes great efforts to present himself in an unrealistically positive light by
;bH'\I^0E0spending excessive amounts of money on items such as clothing and automobiles
^#h"rx_c T0(Schema overcompensation). Often he avoids triggering his schema by staying away
E2j~ v7PaFe`0from challenges altogether and convinces himself that the challenge was not worth
:p9u1W4z!mjn4wC;}0taking (Schema avoidance).心理学空间q7T)kV4k#S2?!l
Rebecca’s core schema is Defectiveness/Shame. She believes that there is心理学空间V"V+an(I'N.Zs/}
something basically wrong with her and that if anyone gets too close, they will reject
2Gz$z5AB7o0her. She chooses partners who are extremely critical of her and confirm her view that心理学空间 HCj1V[Qv
she is defective (Schema surrender). Sometimes she has an excessive defensive
g$q ]4V/s0reaction and counterattacks when confronted with even mild criticism (Schema
L!l+b8? m6TB7Z0overcompensation). She also makes sure that none of her partners get too close, so
.}rW I!U!B0that she can avoid their seeing her defectiveness and rejecting her (Schema
e)xp \[Mv:u0avoidance).心理学空间 g!],a2y9Ci#LJ;GK
Michael is a middle-aged man whose main schema is Dependence/Incompetence.
3o#a;eO^1XR v.g8k0He sees himself as being incapable of doing daily tasks on his own and generally seeks
;Q3a"of j0the support of others. Whenever he can, he chooses to work with people who help him
1H i s|.|t8RI(V0out to an excessive degree. This keeps him from developing skills needed to work alone心理学空间7\ il{C&xAI L| b
and confirms his view of himself as someone who needs others to help him out
;DFsy e@0(Schema surrender). At times, when he would be best off taking advice from other
[%o4N/[0M@*J3e+K(n0people, he refuses to do so (Schema overcompensation). He reduces his anxiety by心理学空间7pT)eZ*bx
procrastinating as much as he can get away with (Schema avoidance).心理学空间w}t2MII
Ann’s core schema is Social Isolation/Alienation. She sees herself as being different心理学空间 P6V QmpAW)p
from other people and not fitting in. When she does things as part of a group she does心理学空间? t"ls+u5H;v0Ja
not get really involved (Schema surrender). At times she gets very hostile towards
2{q8P(g1S2M#z0group members and can be very critical of the group as a whole (Schema心理学空间._6gE*I4}+h$w
overcompensation). At other times she chooses to avoid group activities altogether
q v/qG8^_0(Schema avoidance).
)S5YMS8]Tu2k\0Sam’s central schema is Emotional Deprivation. He chooses partners who are not心理学空间n1~S!|0~%B*qQx!e
very capable of giving to other people and then acts in a manner which makes it even
0Ea}c$[6f G0more difficult for them to give to him (Schema surrender). At times he will act in a心理学空间5Ni5^et JR
very demanding, belligerent manner and provoke fights with his partners (Schema心理学空间%iB ^"Y'` s[3A1[
overcompensation). Sam avoids getting too close to women, yet denies that he has
9^uB~/NA+ii;H0any problems in this area (Schema avoidance).心理学空间?q*hv2XAD$[
Therapeutic Process - Changing Schemas心理学空间2e V |o ^#r,Nt
In schema therapy the goal of the treatment is to engage in schema healing processes.
&lkvo*g0These processes are intended to weaken the early maladaptive schemas and coping心理学空间(d NRi1B8qtG&@)S
styles as much as possible, and build up the person’s healthy side. An alliance is formed心理学空间7t,~R^,QaN^5C
between the therapist and the healthy part of the client against the schemas. Any of心理学空间dm\Qr/eb F[
the therapy activities described below may be seen as examples of schema healing.
_)d4LOr Q$V0The first step in therapy is to do a comprehensive assessment of the client. The main
LWG3?X9Zl)D/A0goal of this assessment is to identify the schemas and coping styles that are most
6Y"k k~ U&{+V0important in the client’s psychological makeup. There are several steps to this process.
| Rb O`(w?0The therapist generally will first want to know about recent events or circumstances in心理学空间$TCX |3s
the clients’ lives which have led them to come for help. The therapist will then discuss
x9tfd?#`0the client’s life history and look for patterns which may be related to schemas.
v/b Xx5K0J9EJo^/O;N0There are several other steps the therapist will take in assessing schemas. We use the
DxS0}JWb0Young Schema Questionnaire, which the client fills out, listing many of the thoughts,
~_+xJF0feeling and behaviors related to the different schemas; items on this questionnaire can心理学空间 a$M;wY%? j)R-Y"eV
be rated as to how relevant to the client’s life they are.
cu,f^*bL!L(M5Q4C0There are also various imagery techniques which the therapist can use to assess心理学空间fHX-aP
schemas. One specific technique involves asking clients to close their eyes and create an
9IL n+dh_0image of themselves as children with their parents. Often the images that appear will
G/e#Q8s Syw5k0lead to the core schemas.
|z(ls2})t \+_0Jonathan is a 28 year old executive whose core schema is Mistrust/Abuse. He came
u*v `6f(w0to therapy because he was having bouts of intense anxiety at work, during which he
j5H dAi0would be overly suspicious and resentful of his co-workers. When asked to create an心理学空间+EK$Zgp6K$mkZ
image of himself with his family, he had two different images. In the first he saw himself心理学空间 M n A-j;hpz
being terrorized by his older brother. In the second he saw his alcoholic father coming心理学空间7Q[M9ltF
home and beating his mother, while he cowered in fear.
S&dA EF0There are many techniques that the therapist can use to help clients weaken their心理学空间-PZFlS\a8K9E
schemas. These techniques can be broken down into four categories: emotive,心理学空间"L{W }.S+Pv be
interpersonal, cognitive and behavioral. Each of these categories will be briefly
3PS1Li6u'jn N0discussed, along with a few examples.
%rLTVQ0X4H"a0udM0Emotive techniques encourage clients to experience and express the emotional aspects心理学空间z'v'e5re1aP:YH
of their problem. One way this is done is by having clients close their eyes and imagine
mY`/\5L-L"y][0they are having a conversation with the person to whom the emotion is directed. They
I8t+b(suu\ l0are then encouraged to express the emotions as completely as possible in the imaginary
b#iv/J0S%F0dialogue. One woman whose core schema was Emotional Deprivation had several
6]Q2Od%lE$[0such sessions in which she had an opportunity to express her anger at her parents for心理学空间tK#u%HK9`n"^"z
not being there enough for her emotionally. Each time she expressed these feelings, she
$U/yf%T&T|*GWh"D0was able to distance herself further from the schema. She was able to see that her心理学空间Y*~;W2lbh(J$CA
parents had their own problems which kept them from providing her with adequate心理学空间;VJ;Bwx
nurturance, and that she was not always destined to be deprived.
Y4Ga5YPn4H0There are many variations on the above technique. Clients may take on the role of the
:VJ K L7Wy0other person in these dialogues, and express what they imagine their feelings to be. Or心理学空间"UX.C mQ+l$q'q:E
they may write a letter to the other person, which they have no intention of mailing, so
LD'eRr'^0that they can express their feelings without inhibition.心理学空间6|Fy9^0`D qi
Mode work can be invaluable as an emotive technique. A client may be feeling a vague
3vu8nht \_{%u0sense of sadness which he can’t clarify. By looking at modes with his therapist he may
"[5[K;J5D0]N0connect with a mode that he labels as Unimportant. By dialoging with the therapist心理学空间o'OZ-Fgo f"B
from the mode’s point of view many feelings can come out which can be worked on心理学空间2`F?}8z#q'L/C
further. In this case the client might get in touch not only with the sadness, but also心理学空间"S4g cUd
with anger at being ignored.
FDV-M2hO#e a0Interpersonal techniques highlight the client’s interactions with other people so that the心理学空间B8a/vSrh7?;h
role of the schemas can be exposed. One way is by focusing on the relationship with the
%r9S~;Da-Fg U0therapist. Frequently, clients with a Subjugation schema go along with everything the
WRu ~$A"dD&u0therapist wants, even when they do not consider the assignment or activity relevant.心理学空间;D]!`:gzN2B
They then feel resentment towards the therapist which they display indirectly. This心理学空间h wn%u])o,yN
pattern of compliance and indirect expression of resentment can then be explored to the心理学空间F7nmE-Xi&^X P:rJ
client’s benefit. This may lead to a useful exploration of other instances in which the心理学空间C ?5o`:^ ~9KEM?"B
client complies with others and later resents it, and how they might better cope at those
R4iiB o[1p+W'tO0times.心理学空间9tCFX)jq
Another type of interpersonal technique involves including a client’s spouse in therapy. A心理学空间q"`&bY7@G~ F
man with a Self-Sacrifice schema might choose a wife who tends to ignore his wishes.
5pF6B(y6oOo0The therapist may wish to involve the wife in the treatment in order to help the two of
2{,UCDv/?9K0them to explore the patterns in their relationship and change the ways in which they
D9GSX_4`0interact.心理学空间:qzxc0f
Cognitive techniques are those in which the schema-driven cognitive distortions are心理学空间m#a9NoFJ o7P0]_i
challenged. As in short-term cognitive therapy, the dysfunctional thoughts are identified
6qcP } U |v4X0and the evidence for and against them is considered. Then new thoughts and beliefs are
s0qt$~0r$h)i0substituted. These techniques help the client see alternative ways to view situations.心理学空间%dDA4b!g)I
The first step in dealing with schemas cognitively is to examine the evidence for and
bY5k\[aA0against the specific schema which is being examined. This involves looking at the client’s
"Um5@ ]d+c"j??Y-n0life and experiences and considering all the evidence which appears to support or refute心理学空间N5X%?Ji*D4T#X
the schema. The evidence is then examined critically to see if it does, in fact, provide
S;F:tQ9|T#~U0support for the schema. Usually the evidence produced will be shown to be in error, and
:Tw'|\O*_0not really supportive of the schema.心理学空间1\i+nJ%C G R&Ju5b8R
For instance, let’s consider a young man with an Emotional Deprivation schema.
VfoeO+k0When asked for evidence that his emotional needs will never be met, he brings up
@R$U1X|HK0instances in which past girlfriends have not met his needs. However, when these past心理学空间!} pV8YSsvV `
relationships are looked at carefully, he finds that, as part of the schema surrender心理学空间2]thN@
process, he has chosen women who are not capable of giving emotionally. This心理学空间1@,P:ztz/|n7se
understanding gives him a sense of optimism; if he starts selecting his partners
,ix+Pg4U$S8D+Gn0differently, his needs can probably be met
,}9Nj/[ j1C)v&P"{.X0Another cognitive technique is to have a structured dialogue between the client and
;IT i5i?3q"j0therapist. First, the client takes the side of the schema, and the therapist presents a
`i*c9Z,Z0PKX,o-X-j0more constructive view. Then the two switch sides, giving the client a chance to
q3w%h0e"Y K9Y6\*T0verbalize the alternative point of view.心理学空间 }`Gr.L2r,xV
After having several of these dialogues the client and therapist can then construct a心理学空间b M(m:S][tA8o
flashcard for the client, which contains a concise statement of the evidence against the心理学空间 DY!Q.b:iC
schema.心理学空间f`0C {f L!H
A typical flashcard for a client with a Defectiveness/Shame schema reads: “I know心理学空间[ ?'~+J2dd:?*mw
that I feel that there is something wrong with me but the healthy side of me knows that心理学空间;Z9lU*{%a4F*n
I’m OK. There have been several people who have known me very well and stayed with心理学空间!n!@(q FI'e W
me for a long time. I know that I can pursue friendships with many people in whom I心理学空间]s(P%H P2U _
have an interest.”心理学空间#} o,` ?0Mxe
The client is instructed to keep the flashcard available at all times and to read it心理学空间9|xr*o%RF
whenever the relevant problem starts to occur. By persistent practice at this, and other
f$l2u x)A4? X2t s0cognitive techniques, the client’s belief in the schema will gradually weaken.心理学空间4C5q%se'VQ{&pUU j
Behavioral techniques are those in which the therapist assists the client in changing
V S l E Q*J0long-term behavior patterns, so that schema surrender behaviors are reduced and
B1MFw+RLn;b0healthy coping responses are strengthened.
Xz oV,XN0One behavioral strategy is to help clients choose partners who are appropriate for them心理学空间"mCw!r uZf7X,Y8?
and capable of engaging in healthy relationships. Clients with the Emotional
r;z9s-GCOa0Deprivation schema tend to choose partners who are not emotionally giving. A心理学空间Y(e+RN7E d~
therapist working with such clients would help them through the process of evaluating
{JB!C H {4W\WSA8j^&x0and selecting new partners.心理学空间J`!jNf _(l(j
Another behavioral technique consists of teaching clients better communication skills.心理学空间hM]mo jFv
For instance, a woman with a Subjugation schema believes that she deserves a raise心理学空间 e}/S;t%xVc!Rl
at work but does not know how to ask for it. One technique her therapist uses to teach
/JZCd)hu0her how to speak to her supervisor is role -playing. First, the therapist takes the role of心理学空间%~G r;S ~*d*s.~
the client and the client takes the role of the supervisor. This allows the therapist to心理学空间#{7s$r^&T
demonstrate how to make the request appropriately. Then the client gets an opportunity
x*{|,@$C%Ej0M~Q0to practice the new behaviors, and to get feedback from the therapist before changing心理学空间 r\? j%O
the behavior in real life situations.
&I3S!g0{5LX0IN SUMMARY, schema therapy can help people understand and change long-term life心理学空间/co5^zm)b6qS_
patterns. The therapy consists of identifying early maladaptive schemas, coping styles心理学空间QG+kY&~y j
and modes, and systematically confronting and challenging them.心理学空间2Rf7J{@2b_
References:心理学空间3Da%a'A3yQ8N0Q
Young, J.E., and Klosko, J.S. (1993). Reinventing your life. New York:心理学空间,yT&_*J8`;W#Vm(J%c
Dutton, 1993.
xos4y)Cg/r6O0Young, J.E., Klosko, J.S., and Weishaar, M.E. Schema therapy: A心理学空间9v(p)?W1G/J
practitioner’s guide. New York: Guilford, 2003.心理学空间9~Q)`;QfCR)`
Copyright 2004, Cognitive Therapy Center of New York
j n(Y,z2D&XU0For more information contact:
#|,c7A$` a0g0David Bricker, Ph.D.
!yv `!H!jhq.Qo0160 Broadway心理学空间`q/m"_0mIHp
New York, NY 10038
3y+|)R${b6}.F6j0(212) 406-3520

1HxHr/Etg)i0www.psychspace.com心理学空间网
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