A Client’s Guide to Schema Therapy
作者: Jeffrey E. Young / 6310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

Kc/A C DI"y0A Client’s Guide to Schema Therapy
3q$jZo7U L0David C. Bricker, Ph.D. and Jeffrey E. Young, Ph.D.
*H4q}5H7f!oC6{0Schema Therapy Institute
? }9t Ur3B n ~}y0HARRY is a 45-year old middle-level manager. He has been married for 16 years, but his心理学空间6l'y(_-m _ ~8m#Mzj
marriage has been very troubled. He and his wife are often resentful of each other, they
n#ln:cK}e]0rarely communicate on an intimate level, and they have few moments of real pleasure.
{9nOe:OztcY j0Other aspects of Harry’s life have been equally unsatisfying. He doesn’t enjoy his work,心理学空间zd2au#W2\
primarily because he doesn’t get along with his co-workers. He is often intimidated by
g)Y'S8N8Nb)U.o0his boss and other people at the office. He has a few friends outside of work, but none心理学空间/rg2P4G'juGRJ
that he considers close.心理学空间&d"V,Gn;i8]XgM{
During the past year Harry’s mood became increasingly negative. He was getting more心理学空间~6m|*w0]I4Bn u-V
irritable, he had trouble sleeping and he began to have difficulty concentrating at work.心理学空间8pxxW5G so
As he became more and more depressed, he began to eat more and gained 15 pounds.
+]T6`~$z0When he found himself thinking about taking his own life, he decided it was time to get心理学空间q,sY[:oF5pV
help. He consulted a psychologist who practices cognitive therapy.心理学空间 h?&i%H"h3~N
As a result of short-term cognitive therapy techniques, Harry improved rapidly. His mood
k!`cBoe0lifted, his appetite returned to normal, and he no longer thought about suicide. In心理学空间 a cEoB ^
addition he was able to concentrate well again and was much less irritable. He also心理学空间3u U'u1h,e;g6}I
began to feel more in control of his life as he learned how to control his emotions for
&O;X?s Jhf \5e0the first time.心理学空间:F4Y&T C^ F$_
But, in some ways, the short-term techniques were not enough. His relationships with
7b.T0`7B1mT4o0his wife and others, while they no longer depressed him as much as they had, still failed
V!MY$dC0to give him much pleasure. He still could not ask to have his needs met, and he had few心理学空间"]ap8] M
experiences he considered truly enjoyable. The therapist then began schema therapy to心理学空间LJJxw:h;P:D
help Harry change his long-term life patterns.
9K&Bu$X4| x1@(`5o0This guide will present the schema therapy approach, developed by Dr. Jeffrey Young to
O8l6PX.z!v]+{%K0expand cognitive therapy for clients with more difficult long-term problems. Schema心理学空间p@.em)r R!X3PC t
therapy can help people change long-term patterns, including the ways in which they心理学空间,b%Q ~%n/Zio0F
interact with other people. This overview of schema therapy consists of six parts:心理学空间 M0UNFz(o-lS
1) A brief explanation of short-term cognitive therapy心理学空间ux%Ps4S.Po
2) An explanation of what a schema is and examples of schemas;
A3U-_L5Ia4B03) An explanation of the processes by which schemas function;心理学空间rs!V"Zu#e;F3q+n(e
4) An explanation of modes and how they function within schema therapy;心理学空间$^y8KH-x;t-I"b
5) Several case examples; and心理学空间VF0H8R\
6) A brief description of the therapeutic process心理学空间s h9N S\8q _ws
Short-Term Cognitive Therapy
n}_j Di0Cognitive therapy is a system of psychotherapy developed by Aaron Beck and his
.w_%@Y3w l0colleagues to help people overcome emotional problems. This system emphasizes
lAd9o)W zU(JIB0changing the ways in which people think in order to improve their moods, such as
] b*w6^Y!M0depression, anxiety and anger.
WKTEX T6pK0Emotional disturbance is influenced by the cognitive distortions that people make in
wn m.~WA0dealing with their life experiences. These distortions take the form of negative
zq.w-WSg0interpretations and predictions of everyday events. For instance, a male college student心理学空间)S.g[_1j`g@+|
preparing for a test might make himself feel discouraged by thinking: “This material is
2|4] ?!?S9r_@0impossible” (Negative Interpretation) and “I’ll never pass this test” (Negative Prediction).心理学空间&zNM:IKi
The therapy consists of helping clients to restructure their thinking. An important step in
|Fs3{"}n]sm0this process is examining the evidence concerning the maladaptive thoughts. In the
A4q$B8b8x;d(r0_0example above, the therapist would help the student to look at his past experiences and
.V-n2Q(s h~1lc0determine if the material was in fact impossible to learn, and if he knew for sure that he心理学空间l`yL'ke
couldn’t pass the test. In all probability, the student would decide that these two
*b"Ec3j6@,}]0thoughts lacked validity.
2`jb\{c W0More accurate alternative thoughts are then substituted. For instance, the student might心理学空间 JP*Id^
be encouraged to think: “This material is difficult, but not impossible. I’ve learned
+]z$Q`:}S0difficult material before” and “I’ve never failed a test before, so long as I’ve done
{!Tey]6_0enough preparation.” These thoughts would probably lead him to feel better and cope心理学空间:l7V(K v c|8a#B
better.心理学空间K(J0R&Z-y.\+S8_
Often short-term cognitive therapy is enough to help people overcome emotional
s2TP&Y b*V"t0problems, especially depression and anxiety. Recent research has shown this to be so.
$m`Lg(|F!U0However, sometimes this approach is not enough. Some clients in short-term cognitive
"w*szNt%jXH0therapy find that they don’t get all the benefits they want. This has led us, as well as心理学空间UH$r:iM tq$}R4k
various other researchers (Beck, xxxx) to look at deeper and more permanent cognitive
a``Nk7k0structures as a means to understand and treat problem moods and behaviors. Schema心理学空间}CW%?gt5@BR)q
therapy was created as a result of these efforts.心理学空间*Y2p0H/Z:V0b/}
Schemas - What They Are
Q G X5[k-e5YI{0A schema is an extremely stable, enduring negative pattern that develops during
#VO e2@)vfvi0childhood or adolescence and is elaborated throughout an individual’s life. We view the心理学空间+IL*O9ou#T }@7]
world through our schemas.
X I*Ww9?\GF0Schemas are important beliefs and feelings about oneself and the environment which心理学空间5j,Y_UutR!TF6M P
the individual accepts without question. They are self -perpetuating, and are very
'Z3q!s.KI`\T0resistant to change. For instance, children who develop a schema that they are
| YP;C/?R b0incompetent rarely challenge this belief, even as adults. The schema usually does not go心理学空间 pG'g%dx"h?,{
away without therapy. Overwhelming success in people’s lives is often still not enough
/mEXs4q J G0to change the schema. The schema fights for its own survival, and, usually, quite心理学空间 DZ@-JT$s:K'G/O
successfully.
Ikdw*^,b"zrg \0It’s also important to mention the importance of needs in schema formation and心理学空间zi(GAI}Vm,[
perpetuation. Schemas are formed when needs are not met during childhood and then
H,X;NOH9h6A1I'z0the schema prevents similar needs from being fulfilled in adulthood. For instance a child
:i&oE*cNM|jbz9pF6_0whose need for secure attachments is not fulfilled by his parents may go for many years
7W&F DPh+|^0in later life without secure relationships.心理学空间+I Q9_ a(p Z&p#CF
Even though schemas persist once they are formed, they are not always in our心理学空间w _9i,v fX0G
awareness. Usually they operate in subtle ways, out of our awareness. However, when a心理学空间g)LT.~!jU.qp
schema erupts or is triggered by events, our thoughts and feelings are dominated by心理学空间)\?5Y7Mb:]\z-|
these schemas. It is at these moments that people tend to experience extreme negative
!r(wi7jq7r ty0emotions and have dysfunctional thoughts.
!AN2?-v]&b q)Q0In our work with many patients, we have found eighteen specific schemas. Most clients
*g?&QmX.u0have at least two or three of these schemas, and often more. A brief description of each
@){,r({g0of these schemas is provided below.心理学空间E!u:DS]r'{6@
Emotional Deprivation心理学空间Fy sS H.n4mQ
This schema refers to the belief that one’s primary emotional needs will never be met by
/i;e*Ue df6V G0others. These needs can be described in three categories: Nurturance – needs for
(@#I,ep W~$xI0affection, closeness and love; Empathy – needs to be listened to and understood;心理学空间([[/d*K2h9[
Protection – needs for advice, guidance and direction. Generally parents are cold or
#[&kSBq0removed and don’t adequately care for the child in ways that would adequately meet心理学空间r%bI v9px
the above needs.
%eM1U,q-Vgb_f0Abandonment/Instability心理学空间V.OrB1ytT8r ^
This schema refers to the expectation that one will soon lose anyone with whom an心理学空间\e8N3]6x
emotional attachment is formed. The person believes that, one way or another, close心理学空间&Nn7B0O!nV
relationships will end imminently. As children, these clients may have experienced the心理学空间-N {3R'JM(Ra
divorce or death of parents. This schema can also arise when parents have been心理学空间q!rYs,cn O/bk
inconsistent in attending to the child’s needs; for instance, there may have been心理学空间(l)~+n(g:oW8w2VT
frequent occasions on which the child was left alone or unattended to for extended心理学空间-c4A#H\3{(Q!A#G
periods.
2I1o's F&b'm0Mistrust/Abuse
5C^F.o [{ q/Rd(I0This schema refers to the expectation that others will intentionally take advantage in
S{ s.S:N9e1m0some way. People with this schema expect others to hurt, cheat, or put them down.
Y F$l5QnR V"}#M%o3|D0They often think in terms of attacking first or getting revenge afterwards. In childhood,
|4fEi FZ&eY0these clients were often abused or treated unfairly by parents, siblings, or peers.心理学空间dKG`$@
Defectiveness/Shame
'qIa1J'Oze0This schema refers to the belief that one is internally flawed, and that, if others get心理学空间-gY3|8Q7?4?$]5Y!g%gI
close, they will realize this and withdraw from the relationship. This feeling of being心理学空间T J+}g&l i/q
flawed and inadequate often leads to a strong sens e of shame. Generally parents were心理学空间&P@oEu.r ^$l
very critical of their children and made them feel as if they were not worthy of being
[0t zoA-} P0loved.心理学空间u j'z-B r7lDC
Social Isolation/Alienation心理学空间ZzJ+I)B*UQrf ]
This schema refers to the belief that one is isolated from the world, different from other
;Oe*s{^ ry0people, and/or not part of any community. This belief is usually caused by early心理学空间e~*x8T~F
experiences in which children see that either they, or their families, are different from
t3KV%F.M J'A,Q0other people.心理学空间0@_hh1d2| V
Dependence/Incompetence
*i(Y+en T0This schema refers to the belief that one is not capable of handling day-to-day心理学空间*{xp#c:e I,S;hh
responsibilities competently and independently. People with this schema often rely on心理学空间 L4y^V"^G
others excessively for help in areas such as decision-making and initiating new tasks.心理学空间o"AT i6x
Generally, parents did not encourage these children to act independently and develop心理学空间9L2f t:`#T
confidence in their ability to take care of themselves.
L mE|(F$z!r;v#[0Vulnerability to Harm and Illness
#m^f'gx-a0This schema refers to the belief that one is always on the verge of experiencing a major
)e e?c.r#M0catastrophe (financial, natural, medical, criminal, etc.). It may lead to taking excessive
.x` ?{]F/k2~0precautions to protect oneself. Usually there was an extremely fearful parent who心理学空间:JfD*J N~qn
passed on the idea that the world is a dangerous place.心理学空间 O+z y6St:D'md
Enmeshment/Undeveloped Self
.vi4fb$x%g ]l0This schema refers to a pattern in which you experience too much emotional心理学空间,L.}3a$yG,p
involvement with others – usually parents or romantic partners. It may also include the心理学空间~aZ{Bp#{9FxG
sense that one has too little individual identity or inner direction, causing a feeling of心理学空间5xm a*B k
emptiness or of floundering. This schema is often brought on by parents who are so
APl*bu u.z0controlling, abusive, or overprotective that the child is discouraged from developing a心理学空间 DY{&j bJh
separate sense of self.
ee,b)O5X#x8?+e0Failure心理学空间 U#V.\t QQ8tT8_#nR
This schema refers to the belief that one is incapable of performing as well as one’s
b$HCKs/m4G*K3@7p7X0peers in areas such as career, school or sports. These clients may feel stupid, inept or
4Ke4eT&k%g`0untalented. People with this schema often do not try to achieve because they believe
1]c:j H@T2}/u T0that they will fail. This schema may develop if children are put down and treated as if心理学空间*F`O,r)uiz5O;s
they are a failure in school and other spheres of accomplishment. Usually the parents
d h#k2t-~GW:A9l5m0did not give enough support, discipline, and encouragement for the child to persist and
AT0tPA a H0succeed in areas of achievement, such as schoolwork or sport心理学空间!L |"pM tv3}o
Subjugation心理学空间E;?/w\s
This schema refers to the belief that one must submit to the control of others in order to心理学空间5{#@|#G]3[ d
avoid negative consequences. Often these clients fear that, unless they submit, others心理学空间 D$[&\IO1A7I,u
will get angry or reject them. Clients who subjugate ignore their own desires and心理学空间[6x#WJ4IP S/G0p
feelings. In childhood there was generally a very controlling parent.心理学空间%g`m.h}D
Self-Sacrifice心理学空间A$Mb4?S$bBJF&{h
This schema refers to the excessive sacrifice of one’s own needs in order to help others.心理学空间&mGD1p/W
When these clients pay attention to their own needs, they often feel guilty. To avoid this
1c ml.V:R9?](z0guilt, they put others’ needs ahead of their own. Often clients who self -sacrifice gain a
_Mix*tV!}Q}0feeling of increased self -esteem or a sense of meaning from helping others. In childhood心理学空间Ix9@V tAj V
the person may have been made to feel overly responsible for the well being of one or
T1R1G@6b4k0both parents.心理学空间4ZTd}$Z2p[
Emotional Inhibition心理学空间wu)`|A!v
This schema refers to the belief that you must suppress spontaneous emotions and心理学空间5Pu\ mp#}
impulses, especially anger, because any expression of feelings would harm others or心理学空间(uQ"Us E O;Z:u?MA
lead to loss of self -esteem, embarrassment, retaliation or abandonment. You may lack心理学空间z?:Vs0S6E
spontaneity, or be viewed as uptight. This schema is often brought on by parents who心理学空间p+@8g;D7jh
discourage the expression of feelings.
1E4NT W'vs!Y y)\0Approval-Seeking/Recognition-Seeking
3~R!k~4z2XW#|0This schema refers to the placing of too much emphasis on gaining the approval and
m#f#a\P!X\0recognition of others at the expense of one’s genuine needs and sense of self. It can心理学空间.e'[%}5@p
also include excessive emphasis on status and appearance as a means of gaining
q}Bwa)~5N s9h*A0recognition and approval. Clients with this schema are generally extremely sensitive to
o6rhh!N!o:L z%~0rejections by others and try hard to fit in. Usually they did not have their needs for心理学空间6j(V1hs R#A}
unconditional love and acceptance met by their parents in their early years.心理学空间A7gPkZ1p PM` ]
Unrelenting Standards/Hypercriticalness
z$`3L l"H8M hT0This schema refers to the belief that whatever you do is not good enough, that you心理学空间9h TAY _!@9Nu`+f
must always strive harder. The motivation for this belief is the desire to meet extremely
|&y0go,G4i `_0F0high internal demands for competence, usually to avoid internal criticism. People with心理学空间i"E7pGVWFk;dyr!F h
this schema show impairments in important life areas, such as health, pleasure or self -心理学空间]8P0W#aW
esteem. Usually these clients’ parents were never satisfied and gave their children love
q&\ pGZF)Ti0that was conditional on outstanding achievement.心理学空间:i6}(\4cQvr
Entitlement/Grandiosity心理学空间3P0Ima#S&R-c#?
This schema refers to the belief that you should be able to do, say, or have whatever心理学空间O P cWT
you want immediately regardless of whether that hurts others or seems reasonable to心理学空间/R f'c6_ A)n)d$evd
them. You are not interested in what other people need, nor are you aware of the longterm
8x_7a({] L\0costs to you of alienating others. Parents who overindulge their children and who
e6Q'tmh5|0do not set limits about what is socially appropriate may foster the development of this
G| ]:J d0schema. Alternatively, some children develop this schema to compensate for feelings of心理学空间#@N@6}@TQ/}
emotional deprivation or defectiveness.心理学空间*i+L3T/h}^&NY3{r5s4L q
Insufficient Self-Control/Self-Discipline心理学空间_i:b;Z6v,mR!T)C
This schema refers to the inability to tolerate any frustration in reaching one’s goals, as
lB*PCU*UX]@0well as an inability to restrain expression of one’s impulses or feelings. When lack of心理学空间2^8X^;v^N9H+v
self-control is extreme, criminal or addictive behavior rule your life. Parents who did not
2p!}g.OG0model self-control, or who did not adequately discipline their children, may predispose
PWEXX*D0]0them to have this schema as adults.心理学空间%s:\B o5V/[YW*E
Negativity/Pessimism
WA k Uq%f@ k0This schema refers to a pervasive pattern of focusing on the negative aspects of life
{:rP"R-A0while minimizing the positive aspects. Clients with this schema are unable to enjoy心理学空间6hU E*]\7X[k
things that are going well in their lives because they are so concerned with negative心理学空间 aq4]5JGy_2aIX-G
details or potential future problems. They worry about possible failures no matter how心理学空间$g4V/k a-sQ-@
well things are going for them. Usually these clients had a parent who worried心理学空间LN B J5ZGT
excessively.心理学空间qZ~-l'H5j0T
Punitiveness
&n&t/Gg$U G M0This schema refers to the belief that people deserve to be harshly punished for making心理学空间wk8J q-EC)G(S
mistakes. People with this schema are critical and unforgiving of both themselves and心理学空间\8uD|2h%p5s!U8e2h
others. They tend to be angry about imperfect behaviors much of the time. In心理学空间:?.C pn8w!kJw;Z
childhood these clients usually had at least one parent who put too much emphasis on
Z.I0u.LZfF'Nw0performance and had a punitive style of controlling behavior.心理学空间B V Umcv Nd'R.Y
How Schemas Work心理学空间)?(zG3^rhs
There are two primary schema operations: Schema healing and schema perpetuation.心理学空间7`5Gp3]buiN1C(xdi
All thoughts, behaviors and feelings may be seen as being part of one of these心理学空间wY bX*D%]#D E(B-z
operations. Either they perpetuate the schema or they heal the schema. In a later心理学空间p Gl4cjBqpu
section on the therapy process we will explain more about schema healing.心理学空间;b rcb4u0Y1}#O c
Schema perpetuation refers to the routine processes by which schemas function and心理学空间!E_+^^ n5K;m
perpetuate themselves. This is accomplished by cognitive distortions, self -defeating心理学空间2{.Gc0zn Y
behavior patterns and schema coping styles.心理学空间9S MrTk#P
Earlier we mentioned that cognitive distortions are a central part of cognitive therapy.心理学空间9SW(R+??'?$[d
These distortions consist of negative interpretations and predictions of life events. The
2]4eM o o$XTd)F0schema will highlight or exaggerate information that confirms the schema and will
f b WCo"~-EG y*f(k0minimize or deny information that contradicts it. Likewise, unhealthy behavior patterns
st_7Oko0will perpetuate the schema’s existence. Someone who was abused in childhood and
l9v"Ks)F]'J!VM%P0developed a Mistrust/Abuse schema may seek out abusive relationships in adulthood
;p*RW0`n9d3V&E,U0and remain in them, providing a constant stream of evidence for the schema.心理学空间7UALR+qD6U7`P&A
In order to understand how schemas work, there are three schema coping styles that
FJAClV]ip0must be defined. These styles are schema surrender, schema avoidance, and schema
\.d_.w(m[ vK.x1l0overcompensation. It is through these three styles that schemas exert their influence on心理学空间z"z/l },zN4h
our behavior and work to insure their own survival.心理学空间U:P|^c Q
Schema surrender refers to ways in which people passively give in to the schema.心理学空间$moJM(| Oq%\"_
They accept the schema as truth and then act in ways that confirm the schema. For
Vig(r0q zs0instance, a young man with an Abandonment/Instability schema might choose
N;E6y/e0Y+j XC0partners who are unable to commit to long-term relationships. He might then react to
%C&[4y:g3})@c0even minor signs indications of abandonment, such as spending short times without his
%LAp(uTj0gh v0partner, in an exaggerated way and feel excessive negative emotion. Despite the
W1?fAZ`0emotional pain of the situation, he might also passively remain in the relationship
[(L.C2m3q%w#qNR0because he sees no other possible way to connect with women.心理学空间tq0[Ez5?#x'{#V.p
Schema avoidance refers to the ways in which people avoid activating schemas. As心理学空间?M-Gjf9m,aJ
mentioned earlier, when schemas are activated, this causes extreme negative emotion.
Ai Ys3U|0People develop ways to avoid triggering schemas in order not to feel this pain. There are
`6tjy.m:[RL(~1Y0three types of schema avoidance: cognitive, emotional and behavioral.心理学空间I:w _!@A\3q
Cognitive avoidance refers to efforts that people make not to think about upsetting
a]_+Zb d0events. These efforts may be either voluntary or automatic. People may voluntarily心理学空间1G7`)?)Gt No6jwVA8r
choose not to focus on an aspect of their personality or an event, which they find心理学空间%a ^3y)`2?n
disturbing. There are also unconscious processes which help people to shut out心理学空间+Ol ?3b"k
information which would be too upsetting to confront. People often forget particularly
q6] V9l c$g Xa+F0painful events. For instance, children who have been abused sexually often forget the
W0e Qi bn'WT-a0memory completely.心理学空间c#ID'v4k1B7l"^
Emotional or affective avoidance refers to automatic or voluntary attempts to block
(B8j9c|#Rnz0painful emotion. Often when people have painful emotional experiences, they numb
W-xM#@7iU0themselves to the feelings in order to minimize the pain. For instance, a man might talk心理学空间c+i*v$Ap
about how his wife has been acting in an abusive manner toward him and say that he
@v%J.^^J0feels no anger towards her, only a little annoyance. Some people drink or abuse drugs心理学空间 Y6ylL![2AI*]
to numb feelings generated by schemas.心理学空间'U,B `EE(F'H:L5D2d
The third type of avoidance is behavioral avoidance. People often act in such a way as
sl9}(\2aFl*mU0to avoid situations that trigger schemas, and thus avoid psychological pain. For instance,心理学空间'b p+\g0j8u4NF
a woman with a Failure schema might avoid taking a difficult new job which would be心理学空间 `f/p'j+`y
very good for her. By avoiding the challenging situation, she avoids any pain, such as
kQ+a,?.XS+TG;u0intense anxiety, which could be generated by the schema.
-A6U/U$_+IcGJ0The third schema process is Schema overcompensation. The individual behaves in a
wPE*b.p Ae0manner which appears to be the opposite of what the schema suggests in order to avoid心理学空间7hu ah0{(vzR
triggering the schema. On the surface, it may appear that the overcompensators are
E _KRrF:d8aZ0behaving in a healthy manner, by standing up for themselves. But when they overshoot心理学空间 vQz X1O1o o
the mark they cause more problem patterns, which then perpetuate the schema. For
t j-i H3Y0instance, a young man with a Defectiveness schema might overcompensate by心理学空间]xk^$V+Y+o(fh
presenting himself as perfect and being critical of others. This would likely lead others
M'GM(~4z0to criticize him in turn, thereby confirming his belief that he is defective.心理学空间,_,ti'\ E&ac~ H
Working With Modes心理学空间)cj*N2W1c
When treating clients with schema therapy one of the most important innovations is the心理学空间i Lt2Jc
concept of mode. For our purposes we will define a mode as the set of schemas or心理学空间!MF[ gWc
schema operations that are currently active for an individual. Or you might think of a
] Y q;J1E+B NJ{0mode simply as a mindset or state that you might be in temporarily. Most people can
RyxN`w4U+v0Q0relate to the idea that we all have these different parts of ourselves and we go in and心理学空间]6\0EV J4{!s/dQf
out of them all the time. For instance, if a friend tells you she had a bad day because
k x'v:d9t)XKT0GD{0her boss (or her toddler) was in his raging bull mode, you’d know exactly what she心理学空间&A(i%\"Z2|#I9S"@
means.
D,OuEg0`&u\0There are often occasions when a therapist will choose to work with a client’s modes in心理学空间J3r'ULCq
therapy. If a client is extremely upset at the beginning of a session, the therapist may心理学空间+eX%]E nB@2V
inquire about what part of the person is feeling the emotional pain and attempt to心理学空间}a3AC9jK"G5X
recognize it and deal with it directly. For instance, for several sessions, Myra was very心理学空间p#G"gq ^7R:w
sad and hurt because she was unable to talk out some problems with her husband. In
wv wE+z0talking with her therapist they focused on a mode, or part of her, that she called Lonely心理学空间!D/mdaYq7M
Myra, that seemed to be active after these failed attempts. By engaging this part of
](}(Ld"Uv H gZ+r0Myra in this manner the therapist was able to give her an opportunity to express the心理学空间+n`"I(fHT
feelings and thoughts connected with her pattern of loneliness.心理学空间 s-\T }PL
The exact pattern of work with modes will vary from session to session. But some of
y'op^,m;v0the more common activities in mode work can be described. The history of the mode is
4u@N-R4Buv i9u0often discussed; the client will speak about when the mode started and what was going心理学空间a(r0O} P Qz-@]V
on at the time. Connections are made between modes and current problems.心理学空间f(`(S }+\J
Dialogues can be conducted between different modes when there is a conflict. For
X%HaN'b4J/l^j0instance, a miser mode and a playboy mode might have it out over what type of car to
.|5g9t+m S T]{0buy. And there is always an effort to link mode work with other aspects of the therapy.
jY'\4| j!yhR0Case Examples心理学空间F+^J2~ ^z
In this section six case examples are presented. In each one, the schema coping styles
#UqVAaU_tb!XyE0are demonstrated. By reading through this section, you will get a better feel for how心理学空间1w`)~ T7M P
these processes can operate in real life situations.心理学空间3VJknV oS
Abby is a young woman whose main schema is Subjugation. She tends to see people心理学空间JGvur8Gg+F/j
as very controlling even when they are being appropriately assertive. She has thoughts
T eA? n%sRC0such 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I`*~1E&B&ntx*B
others (Schema surrender). At other times she decides that no one will get the better心理学空间"iy/[(|M9Tn)hF
of her and becomes very controlling (Schema overcompensation). Sometimes when心理学空间$l-tx \0rv*sDp*T
people make unreasonable demands on her she minimizes the importance of her own
9fL,n4g2t v~#v"I0feelings and has thoughts like “It’s not that important to me what happens.’ At other心理学空间5D4v,P:j6E8U%q+CeG
times she avoids acquaintances with whom she has trouble standing up for herself心理学空间)fDY*G*]Pve)r_;}
(Schema avoidance).心理学空间,^$Dy/]0G'X3I&I._X
Stewart’s main schema is Failure. Whenever he is faced with a possible challenge, he
IG'p.SS(B0tends to think that he is not capable. Often he tries half -heartedly, guaranteeing that he
q^S%gI5_0will fail, and strengthening the belief that he is not capable (Schema surrender). At
y"pC Hc%HDLkj0times, he makes great efforts to present himself in an unrealistically positive light by心理学空间xN)B+E*E `
spending excessive amounts of money on items such as clothing and automobiles
)r(S)W*yP0(Schema overcompensation). Often he avoids triggering his schema by staying away
$hU&uL"\0from challenges altogether and convinces himself that the challenge was not worth
|"g4DDy@5W0taking (Schema avoidance).心理学空间,R5m-e0}'JV
Rebecca’s core schema is Defectiveness/Shame. She believes that there is
hm9B4v^` ?2i,M0something basically wrong with her and that if anyone gets too close, they will reject
3@*|!\&K{ `y"f?0her. She chooses partners who are extremely critical of her and confirm her view that心理学空间pc:r,S s
she is defective (Schema surrender). Sometimes she has an excessive defensive心理学空间]w2n4B H$G}b
reaction and counterattacks when confronted with even mild criticism (Schema心理学空间!Q^{ ?F
overcompensation). She also makes sure that none of her partners get too close, so心理学空间~%C l5?p6^
that she can avoid their seeing her defectiveness and rejecting her (Schema
-f Q#CC ]B[ A0avoidance).心理学空间#iIo#Rmr-f
Michael is a middle-aged man whose main schema is Dependence/Incompetence.心理学空间,\Mw.P:Am
He sees himself as being incapable of doing daily tasks on his own and generally seeks
*Qsx]'k:@0the support of others. Whenever he can, he chooses to work with people who help him
X4KH`oi7Zc#H0out to an excessive degree. This keeps him from developing skills needed to work alone
RK,{_~ L0and confirms his view of himself as someone who needs others to help him out
u U8P~"\Dh"C0(Schema surrender). At times, when he would be best off taking advice from other
,O@-r'n7J$^:e"OUx0people, he refuses to do so (Schema overcompensation). He reduces his anxiety by
w @ \C\;MT0procrastinating as much as he can get away with (Schema avoidance).心理学空间Kk5`B*V
Ann’s core schema is Social Isolation/Alienation. She sees herself as being different
1Z%@&{ k)x9?]6^0from other people and not fitting in. When she does things as part of a group she does心理学空间/@#I i oc&zh2F
not get really involved (Schema surrender). At times she gets very hostile towards
3I:o]xkb0group members and can be very critical of the group as a whole (Schema心理学空间.Lm I,ac8?
overcompensation). At other times she chooses to avoid group activities altogether
uVe:D-A5XM0(Schema avoidance).
s X$T Ue6Yf1XB'[f0Sam’s central schema is Emotional Deprivation. He chooses partners who are not
ZeK"Y8xR0very capable of giving to other people and then acts in a manner which makes it even心理学空间O@["W:}(\y/l?
more difficult for them to give to him (Schema surrender). At times he will act in a
Nn7N1q`Ni0very demanding, belligerent manner and provoke fights with his partners (Schema心理学空间3? e:yN}.dT N:CG6[
overcompensation). Sam avoids getting too close to women, yet denies that he has心理学空间_,S:fx3@S}{~+k Y
any problems in this area (Schema avoidance).
(?y9zR(t!J4~!Vf]2L*J n#?0Therapeutic Process - Changing Schemas
9yGQ yVQ?3e0In schema therapy the goal of the treatment is to engage in schema healing processes.心理学空间HU5u$kIQ-m
These processes are intended to weaken the early maladaptive schemas and coping心理学空间zQD#J]'~+nx7gz
styles as much as possible, and build up the person’s healthy side. An alliance is formed心理学空间5M}wk5D7T Z1sC
between the therapist and the healthy part of the client against the schemas. Any of
8dB0l%_;be"\B0the therapy activities described below may be seen as examples of schema healing.心理学空间.rbGk G$L`Dg
The first step in therapy is to do a comprehensive assessment of the client. The main
Px cH(zQ%G0v4B-M0goal of this assessment is to identify the schemas and coping styles that are most心理学空间 _8rPu8w&fwE.tV
important in the client’s psychological makeup. There are several steps to this process.心理学空间F/b f%X|$W)W
The therapist generally will first want to know about recent events or circumstances in心理学空间-F1C;t9s9a)h;D9G%uS
the clients’ lives which have led them to come for help. The therapist will then discuss心理学空间xY x[v |
the client’s life history and look for patterns which may be related to schemas.心理学空间c1haD#D1f
There are several other steps the therapist will take in assessing schemas. We use the心理学空间0CJ WE'zmr,Y+C
Young Schema Questionnaire, which the client fills out, listing many of the thoughts,心理学空间!n%SP"Z"[P/h&qIR5b
feeling and behaviors related to the different schemas; items on this questionnaire can
+x$e*`k{5D.P0be rated as to how relevant to the client’s life they are.
3BuCF~v7^U JaP0There are also various imagery techniques which the therapist can use to assess
7m3dz/b/y%U%z0schemas. One specific technique involves asking clients to close their eyes and create an
9x7m9^2_Nk0image of themselves as children with their parents. Often the images that appear will心理学空间,KUZ&vhix
lead to the core schemas.心理学空间p0K0H6]fK7E)ba-V
Jonathan is a 28 year old executive whose core schema is Mistrust/Abuse. He came
*I$M;l d1]a"fS0_3@5e x0to therapy because he was having bouts of intense anxiety at work, during which he
MH3ZA8uO0would be overly suspicious and resentful of his co-workers. When asked to create an心理学空间?6Idh:p D"\n~
image of himself with his family, he had two different images. In the first he saw himself
st,L+hb6P'C0being terrorized by his older brother. In the second he saw his alcoholic father coming心理学空间]p$UJqJ ?
home and beating his mother, while he cowered in fear.
@;aD?iF0Q0There are many techniques that the therapist can use to help clients weaken their
/gHBxgFnx/M+~0schemas. These techniques can be broken down into four categories: emotive,
5GJ.l}C0interpersonal, cognitive and behavioral. Each of these categories will be briefly心理学空间4?u#h@0m
discussed, along with a few examples.心理学空间U@W)p+]
Emotive techniques encourage clients to experience and express the emotional aspects
8E'Kj8NSK8|#p,X'T0of their problem. One way this is done is by having clients close their eyes and imagine心理学空间/w*J p7cUbV:f\M
they are having a conversation with the person to whom the emotion is directed. They心理学空间Rju`T-e/W.c){
are then encouraged to express the emotions as completely as possible in the imaginary
9{"h GNm$t0dialogue. One woman whose core schema was Emotional Deprivation had several心理学空间-F*o1~ qT(cp
such sessions in which she had an opportunity to express her anger at her parents for心理学空间|C1~)Bg^-B1v s)P1h
not being there enough for her emotionally. Each time she expressed these feelings, she心理学空间An#f pKK q
was able to distance herself further from the schema. She was able to see that her
Yw'y1Tt3m%lEP0parents had their own problems which kept them from providing her with adequate心理学空间f!YTg LF&X%A"f:H
nurturance, and that she was not always destined to be deprived.
!}H8D/s{ WX g6p0There are many variations on the above technique. Clients may take on the role of the心理学空间(N+t5o)Cb7t
other person in these dialogues, and express what they imagine their feelings to be. Or心理学空间|P$P0Mg4`
they may write a letter to the other person, which they have no intention of mailing, so心理学空间&a"Eb3R)|d
that they can express their feelings without inhibition.
,Y`.]iu8i8Cb%g0Mode work can be invaluable as an emotive technique. A client may be feeling a vague
DFa2XK|1y)ir1Q.l0sense of sadness which he can’t clarify. By looking at modes with his therapist he may心理学空间d s8q k7i}
connect with a mode that he labels as Unimportant. By dialoging with the therapist心理学空间WxN*Y,A j
from the mode’s point of view many feelings can come out which can be worked on心理学空间2wc'wy3llqm
further. In this case the client might get in touch not only with the sadness, but also心理学空间!i/uBh@cWT+S
with anger at being ignored.
3Dg*Rk [9N.B3o%]`0Interpersonal techniques highlight the client’s interactions with other people so that the心理学空间 rC$q0E)p,^ K@.c
role of the schemas can be exposed. One way is by focusing on the relationship with the心理学空间q}"Dzv
therapist. Frequently, clients with a Subjugation schema go along with everything the心理学空间3n/w @d}T(b kQ3d
therapist wants, even when they do not consider the assignment or activity relevant.心理学空间fU1x LW4EC7IO,~
They then feel resentment towards the therapist which they display indirectly. This心理学空间oz(e1d)s.\2B K
pattern of compliance and indirect expression of resentment can then be explored to the
6E-KqND3CX}0client’s benefit. This may lead to a useful exploration of other instances in which the
/nZ(L*W?*@b7IN)eHf0client complies with others and later resents it, and how they might better cope at those
2e/B!?Oi/j0WZ\*B0times.心理学空间-p.B"T,@&oI+MS
Another type of interpersonal technique involves including a client’s spouse in therapy. A
XdvQ(w7QC_0man with a Self-Sacrifice schema might choose a wife who tends to ignore his wishes.
4e(U6_G?'f#As4Y0The therapist may wish to involve the wife in the treatment in order to help the two of心理学空间m#n3KB5kM
them to explore the patterns in their relationship and change the ways in which they
.Mw7WMa Ft0interact.
n!bC-b$B:Q0Cognitive techniques are those in which the schema-driven cognitive distortions are心理学空间bnl X4CjK.suD
challenged. As in short-term cognitive therapy, the dysfunctional thoughts are identified心理学空间+F{,wA.?2v
and the evidence for and against them is considered. Then new thoughts and beliefs are心理学空间 r(pZ?jC$`t Z'~d
substituted. These techniques help the client see alternative ways to view situations.心理学空间5C1tG+^:D1gw"O
The first step in dealing with schemas cognitively is to examine the evidence for and心理学空间~8lvo3p4`
against the specific schema which is being examined. This involves looking at the client’s
D.[NU Yt K)H7w0life and experiences and considering all the evidence which appears to support or refute心理学空间Y!B+AJ1im8d#R
the schema. The evidence is then examined critically to see if it does, in fact, provide
uEN:Y\N)W0support for the schema. Usually the evidence produced will be shown to be in error, and
F)I8{ B8n1|;L0not really supportive of the schema.心理学空间&B4Ul e y'X&X n
For instance, let’s consider a young man with an Emotional Deprivation schema.
+P&`o _&nw0When asked for evidence that his emotional needs will never be met, he brings up心理学空间6`2@^,Ox
instances in which past girlfriends have not met his needs. However, when these past
x~n,m2k0relationships are looked at carefully, he finds that, as part of the schema surrender心理学空间G4f8MC`V}
process, he has chosen women who are not capable of giving emotionally. This心理学空间2uxCM&pu
understanding gives him a sense of optimism; if he starts selecting his partners心理学空间 wo5],g u#Lo:sO
differently, his needs can probably be met心理学空间K+G W`x+JZ$b
Another cognitive technique is to have a structured dialogue between the client and心理学空间2](rMtcnN
therapist. First, the client takes the side of the schema, and the therapist presents a心理学空间z1~6Z0C2C
more constructive view. Then the two switch sides, giving the client a chance to
}}\ sr6BL d0verbalize the alternative point of view.
\B3dX R H"~0~LC A0N0After having several of these dialogues the client and therapist can then construct a
*Xhj_ S7gV0flashcard for the client, which contains a concise statement of the evidence against the
KN6w$KM&V6e0schema.心理学空间 pnk R nO;a
A typical flashcard for a client with a Defectiveness/Shame schema reads: “I know
;E8Z` F s`SAO0that I feel that there is something wrong with me but the healthy side of me knows that心理学空间['KWQ||.J$Z o
I’m OK. There have been several people who have known me very well and stayed with心理学空间m:k:Z@)m%hmR
me for a long time. I know that I can pursue friendships with many people in whom I心理学空间 ] VK,c+P#lnK
have an interest.”
F*m ym;w.u5i0The client is instructed to keep the flashcard available at all times and to read it
-Y'\2r Guo"rJ0whenever the relevant problem starts to occur. By persistent practice at this, and other心理学空间\oSR[8Gr
cognitive techniques, the client’s belief in the schema will gradually weaken.
\'k%y%btbeo0Behavioral techniques are those in which the therapist assists the client in changing心理学空间&|y2zhY?O
long-term behavior patterns, so that schema surrender behaviors are reduced and心理学空间?5n"p%gl9fg
healthy coping responses are strengthened.
5A\S8krD0One behavioral strategy is to help clients choose partners who are appropriate for them心理学空间%eP ly6]
and capable of engaging in healthy relationships. Clients with the Emotional
[Q+Xr ? W.^0Deprivation schema tend to choose partners who are not emotionally giving. A心理学空间o0c9I4E jf)b5Hs
therapist working with such clients would help them through the process of evaluating
~ I7d;k^3_0and selecting new partners.
:V S k$n!u7bZ`w0Another behavioral technique consists of teaching clients better communication skills.
'tKR A;C(m;i0For instance, a woman with a Subjugation schema believes that she deserves a raise
B/Y3e2JuP0at work but does not know how to ask for it. One technique her therapist uses to teach
.~Q uV.]cA?7t0her how to speak to her supervisor is role -playing. First, the therapist takes the role of
Y!z5lx*Y)^ x0the client and the client takes the role of the supervisor. This allows the therapist to心理学空间sch0{5B U/_(?(~]
demonstrate how to make the request appropriately. Then the client gets an opportunity心理学空间{_-t_vr
to practice the new behaviors, and to get feedback from the therapist before changing
] HW TKR0the behavior in real life situations.心理学空间3A7w6i2P6V[O
IN SUMMARY, schema therapy can help people understand and change long-term life心理学空间eI$t/G dF-GC f F#^
patterns. The therapy consists of identifying early maladaptive schemas, coping styles
^D}/a%csg0and modes, and systematically confronting and challenging them.
"w8Y[s4M%p0References:心理学空间+ug8|?c
Young, J.E., and Klosko, J.S. (1993). Reinventing your life. New York:心理学空间g}` Q D
Dutton, 1993.
RZ7C| r@.\!A"T k8i0Young, J.E., Klosko, J.S., and Weishaar, M.E. Schema therapy: A心理学空间-}SnY#s
practitioner’s guide. New York: Guilford, 2003.
(^D:H9r3o n0Copyright 2004, Cognitive Therapy Center of New York心理学空间{\x*?_^ a
For more information contact:
~M&tp3`RXQ0David Bricker, Ph.D.
We2S)O1a5\0160 Broadway
dc,C,?P@\0New York, NY 10038心理学空间P-QQ)Mq1BT7z
(212) 406-3520

qb&E0t1o+[:U+_0www.psychspace.com心理学空间网
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