A Client’s Guide to Schema Therapy
作者: Jeffrey E. Young / 6320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

D;Io+?+Na0A Client’s Guide to Schema Therapy心理学空间aTr+O*XnA.u9E"y_
David C. Bricker, Ph.D. and Jeffrey E. Young, Ph.D.心理学空间J`ZE(@4v#Z5HU
Schema Therapy Institute
L+Sc2h'|0HARRY is a 45-year old middle-level manager. He has been married for 16 years, but his心理学空间9ilK{ X;d)h
marriage has been very troubled. He and his wife are often resentful of each other, they心理学空间| \*Z*e [V$n
rarely communicate on an intimate level, and they have few moments of real pleasure.
j R"B[)Un)b0Other aspects of Harry’s life have been equally unsatisfying. He doesn’t enjoy his work,
xb7bXE;e8c K0primarily because he doesn’t get along with his co-workers. He is often intimidated by心理学空间8Lh)n8x.d6X:bJ8T
his boss and other people at the office. He has a few friends outside of work, but none
9Yss-Ip0that he considers close.心理学空间d\/z4@2j
During the past year Harry’s mood became increasingly negative. He was getting more心理学空间1Rk2Kfwte X
irritable, he had trouble sleeping and he began to have difficulty concentrating at work.心理学空间Ur q;PE+?7sj
As he became more and more depressed, he began to eat more and gained 15 pounds.
X8DeQ QAy)q3qe0When he found himself thinking about taking his own life, he decided it was time to get心理学空间 io0M;m/s2N @;c
help. He consulted a psychologist who practices cognitive therapy.
!F_yC,D5_(_zk+R0As a result of short-term cognitive therapy techniques, Harry improved rapidly. His mood
4m1dcI_K0lifted, his appetite returned to normal, and he no longer thought about suicide. In
o7r L,pW un~y%B0addition he was able to concentrate well again and was much less irritable. He also心理学空间 g7mqU4u s)t
began to feel more in control of his life as he learned how to control his emotions for
z#@#|cEX A9Zg0the first time.心理学空间)XL`2]"H f_9N+]
But, in some ways, the short-term techniques were not enough. His relationships with心理学空间Q.O \j-k8WO
his wife and others, while they no longer depressed him as much as they had, still failed心理学空间}"}Tmi8jk
to give him much pleasure. He still could not ask to have his needs met, and he had few心理学空间g-d3Jx&xJy|-p
experiences he considered truly enjoyable. The therapist then began schema therapy to心理学空间(}TZ1i%q:R
help Harry change his long-term life patterns.心理学空间(yK p m V'TvN
This guide will present the schema therapy approach, developed by Dr. Jeffrey Young to
5u;V-G3\in;uG0expand cognitive therapy for clients with more difficult long-term problems. Schema
M(z^3m ~mW0therapy can help people change long-term patterns, including the ways in which they
sh+~ N H R)l0interact with other people. This overview of schema therapy consists of six parts:
0uNJRS2c2{d+i01) A brief explanation of short-term cognitive therapy
/x9AsJ[5o02) An explanation of what a schema is and examples of schemas;心理学空间(df/?*O~6q
3) An explanation of the processes by which schemas function;心理学空间7N_5kt:c1dr
4) An explanation of modes and how they function within schema therapy;心理学空间us8t PB!`,m
5) Several case examples; and心理学空间 q-v2@"bE
6) A brief description of the therapeutic process心理学空间K6~U5RK6Gk6@8zk
Short-Term Cognitive Therapy心理学空间vgUrj q)vl
Cognitive therapy is a system of psychotherapy developed by Aaron Beck and his心理学空间@s!D#n2w5N c4^ z;b
colleagues to help people overcome emotional problems. This system emphasizes心理学空间N:S:a_1[ l^.`p
changing the ways in which people think in order to improve their moods, such as心理学空间7k@Kdj&k,B5j
depression, anxiety and anger.
pP/Xx+A/S0Emotional disturbance is influenced by the cognitive distortions that people make in心理学空间 ~mTM7IiN)Rr
dealing with their life experiences. These distortions take the form of negative
2zM;D,g+tL0interpretations and predictions of everyday events. For instance, a male college student
y];O8nJBX0preparing for a test might make himself feel discouraged by thinking: “This material is
*rBN#]&oCtM$P1C0impossible” (Negative Interpretation) and “I’ll never pass this test” (Negative Prediction).心理学空间sK9^dgu|"W{K+]
The therapy consists of helping clients to restructure their thinking. An important step in心理学空间D-LA-W Q^u
this process is examining the evidence concerning the maladaptive thoughts. In the
$y%v(o5Tu'?P0example above, the therapist would help the student to look at his past experiences and
8ox)c\/TV@0determine if the material was in fact impossible to learn, and if he knew for sure that he心理学空间8m8oF6M'tn:S*{$r E
couldn’t pass the test. In all probability, the student would decide that these two
]1tX.d2G0G[0thoughts lacked validity.心理学空间6L PbzJ.B
More accurate alternative thoughts are then substituted. For instance, the student might
lK&E-Mf;p0be encouraged to think: “This material is difficult, but not impossible. I’ve learned心理学空间[F!O dLr6KM#L
difficult material before” and “I’ve never failed a test before, so long as I’ve done心理学空间4?Cny*xY
enough preparation.” These thoughts would probably lead him to feel better and cope
x$r^YJ4h4Wm9oC7C,Tx0better.
*E2hsW ?#d(Tj0Often short-term cognitive therapy is enough to help people overcome emotional
#PO _f*w/hc3d}0problems, especially depression and anxiety. Recent research has shown this to be so.
y L7Yi9hm`]0However, sometimes this approach is not enough. Some clients in short-term cognitive心理学空间4a G&M3@J!C
therapy find that they don’t get all the benefits they want. This has led us, as well as
]3?#]u;e0various other researchers (Beck, xxxx) to look at deeper and more permanent cognitive心理学空间 AQ `.x1O i?
structures as a means to understand and treat problem moods and behaviors. Schema心理学空间5Z(C:R pR
therapy was created as a result of these efforts.
h0F3Z}7s5Q7|0Schemas - What They Are
2{/Q#q#@3a|Q0@$m6Bbk0A schema is an extremely stable, enduring negative pattern that develops during
o#LD l'K Y,c0childhood or adolescence and is elaborated throughout an individual’s life. We view the心理学空间1FW*r(Wdy9]7_A
world through our schemas.
;^u$o2{Poe4|0Schemas are important beliefs and feelings about oneself and the environment which心理学空间:dY lk3Lw'{)y
the individual accepts without question. They are self -perpetuating, and are very
7M7J!Dv _e+QJ-O0resistant to change. For instance, children who develop a schema that they are心理学空间@_X*r(s0Y4c
incompetent rarely challenge this belief, even as adults. The schema usually does not go
g$]2RRjjC0away without therapy. Overwhelming success in people’s lives is often still not enough心理学空间@ P$s-Q;trmv)Pmr
to change the schema. The schema fights for its own survival, and, usually, quite心理学空间.z{^ h*x#I
successfully.心理学空间5_E0f/M9I N_{
It’s also important to mention the importance of needs in schema formation and心理学空间 cZV"d ^e:tj
perpetuation. Schemas are formed when needs are not met during childhood and then
)qY4h|-kN0the schema prevents similar needs from being fulfilled in adulthood. For instance a child
)IVSJM} ~3I {:g0whose need for secure attachments is not fulfilled by his parents may go for many years心理学空间1Z9l0\ep$|z-}:o
in later life without secure relationships.心理学空间u"_ wF Q
Even though schemas persist once they are formed, they are not always in our心理学空间3G}e*HV&j3j2cl%^
awareness. Usually they operate in subtle ways, out of our awareness. However, when a
R}ppS0schema erupts or is triggered by events, our thoughts and feelings are dominated by心理学空间x+|'P UN5ZZ t
these schemas. It is at these moments that people tend to experience extreme negative
P5{Z7GU'?UM2~#mR0emotions and have dysfunctional thoughts.心理学空间Mw1DU%xr r+? T
In our work with many patients, we have found eighteen specific schemas. Most clients心理学空间} RDp\
have at least two or three of these schemas, and often more. A brief description of each心理学空间6B(n t#|T6n:X,z
of these schemas is provided below.心理学空间p)XA\,}Ckh.D
Emotional Deprivation
%c^*_3yN%w]0This schema refers to the belief that one’s primary emotional needs will never be met by
DW's+m)h/OKG0others. These needs can be described in three categories: Nurturance – needs for心理学空间:r'ux |(PrK.n
affection, closeness and love; Empathy – needs to be listened to and understood;
4H1[a5kiv0Protection – needs for advice, guidance and direction. Generally parents are cold or心理学空间 ~%N uUiMu7Lk
removed and don’t adequately care for the child in ways that would adequately meet
Y2nK,a4V5@'z0p0the above needs.
H ?y3w%}}a0Abandonment/Instability心理学空间:|1l-B4]+M6E.mz&gWo
This schema refers to the expectation that one will soon lose anyone with whom an
Eq0jdC!_M:\0emotional attachment is formed. The person believes that, one way or another, close
1Qw0t8] l_t4H0relationships will end imminently. As children, these clients may have experienced the
,o*pE}` [0divorce or death of parents. This schema can also arise when parents have been
F2yi7q*a;I^(`g/pc-H*Y0inconsistent in attending to the child’s needs; for instance, there may have been
Jg/M#o@0od0frequent occasions on which the child was left alone or unattended to for extended
e/hZBu u8l0periods.心理学空间N6[+P)rk+s8fI
Mistrust/Abuse心理学空间9V!N0{ {+t9F9x.s
This schema refers to the expectation that others will intentionally take advantage in心理学空间m(wT1ce"I-_j
some way. People with this schema expect others to hurt, cheat, or put them down.心理学空间 ] t4y5n;z&[ A
They often think in terms of attacking first or getting revenge afterwards. In childhood,
$V#C1]wx3\0these clients were often abused or treated unfairly by parents, siblings, or peers.
,[-h8z~ei0Defectiveness/Shame
$jI)e`5QL0This schema refers to the belief that one is internally flawed, and that, if others get心理学空间n f8WMgFm
close, they will realize this and withdraw from the relationship. This feeling of being
`i#n"YK2C.f0flawed and inadequate often leads to a strong sens e of shame. Generally parents were心理学空间&mA'f(DMBD
very critical of their children and made them feel as if they were not worthy of being心理学空间 wJS|.i`+G ~
loved.
8l*tso!c[0Social Isolation/Alienation
O6v$pY+m#Vl0This schema refers to the belief that one is isolated from the world, different from other
#R"j\:B"O4h"J\+?0people, and/or not part of any community. This belief is usually caused by early心理学空间 `K!Iz%V|+Y
experiences in which children see that either they, or their families, are different from心理学空间lg \Pdv
other people.心理学空间5f4zs*[$Q8cq/W
Dependence/Incompetence
#FZo1?4`hE0This schema refers to the belief that one is not capable of handling day-to-day
cC8e@ E0responsibilities competently and independently. People with this schema often rely on心理学空间)d-@*f?m8};gkO
others excessively for help in areas such as decision-making and initiating new tasks.心理学空间j7y"E}8V(WT K+Q
Generally, parents did not encourage these children to act independently and develop
0Wp hi8cP8Eh?/X0confidence in their ability to take care of themselves.心理学空间6\(Z'ATTZr/\+d+T
Vulnerability to Harm and Illness心理学空间J3^iXDZ9Pz
This schema refers to the belief that one is always on the verge of experiencing a major心理学空间%[6F.@4b(^
catastrophe (financial, natural, medical, criminal, etc.). It may lead to taking excessive
}W b&u.Uw fa0precautions to protect oneself. Usually there was an extremely fearful parent who
:e!Zm^f8D!u;i0passed on the idea that the world is a dangerous place.
\)Fi9VD0Enmeshment/Undeveloped Self
_[6nk#m8n e.^0This schema refers to a pattern in which you experience too much emotional心理学空间_j DnAI)m k
involvement with others – usually parents or romantic partners. It may also include the心理学空间8{-M_j1SpJ`m
sense that one has too little individual identity or inner direction, causing a feeling of
hBQ:d3tu0emptiness or of floundering. This schema is often brought on by parents who are so
5qI`"Bit5d0controlling, abusive, or overprotective that the child is discouraged from developing a
&@@H;ZIVr+kd*w0separate sense of self.心理学空间'Y?G`;_YVN"c
Failure
S&W'TJ[D ~0b `$n0This schema refers to the belief that one is incapable of performing as well as one’s
2TOH9d;o2IMs0peers in areas such as career, school or sports. These clients may feel stupid, inept or
W%A Zx;h F0untalented. People with this schema often do not try to achieve because they believe心理学空间-e2o+X7h6~ @o
that they will fail. This schema may develop if children are put down and treated as if
c M"@S5Z dw0they are a failure in school and other spheres of accomplishment. Usually the parents
{` z.r2P)xH0did not give enough support, discipline, and encouragement for the child to persist and心理学空间0R p IVu#R"C^*rvE'j
succeed in areas of achievement, such as schoolwork or sport心理学空间3U2ud2UQ*S
Subjugation心理学空间8V1Q(gd6m%n
This schema refers to the belief that one must submit to the control of others in order to心理学空间 IZ#mf#p*sm
avoid negative consequences. Often these clients fear that, unless they submit, others心理学空间-^m'hld yv,H4o
will get angry or reject them. Clients who subjugate ignore their own desires and
1_4HH]$XC1h.Z&z6{0feelings. In childhood there was generally a very controlling parent.
^'FSt-cAI$w'i*z0Self-Sacrifice心理学空间wDy!L-|]Y:g
This schema refers to the excessive sacrifice of one’s own needs in order to help others.
HXw||/s!e%w0When these clients pay attention to their own needs, they often feel guilty. To avoid this心理学空间;e k(O5mtO
guilt, they put others’ needs ahead of their own. Often clients who self -sacrifice gain a心理学空间o9p;{$[6`7s9Q n-m
feeling of increased self -esteem or a sense of meaning from helping others. In childhood
'~"h1|u^ O1u0the person may have been made to feel overly responsible for the well being of one or
6l7a#BEWZ0g-QUkH0both parents.
O*n#kF H~0Emotional Inhibition心理学空间#lqE^G:wxw
This schema refers to the belief that you must suppress spontaneous emotions and心理学空间/_;[jnt
impulses, especially anger, because any expression of feelings would harm others or
8VY$uUsi{]0lead to loss of self -esteem, embarrassment, retaliation or abandonment. You may lack心理学空间3si/X6D7{F ?#}
spontaneity, or be viewed as uptight. This schema is often brought on by parents who
+| ttL9F0discourage the expression of feelings.
+I^E#dA P;c9@(d(^4M0Approval-Seeking/Recognition-Seeking
(_3d Ou | n0This schema refers to the placing of too much emphasis on gaining the approval and心理学空间$C'oUv(\] qR
recognition of others at the expense of one’s genuine needs and sense of self. It can心理学空间*Y$V.ve ]4~)h ^4_%eUW
also include excessive emphasis on status and appearance as a means of gaining
q Y Q7Z bv0recognition and approval. Clients with this schema are generally extremely sensitive to
]x6p+B)D i7\$f'uN'``0rejections by others and try hard to fit in. Usually they did not have their needs for
u&x.l?)b k~kN0unconditional love and acceptance met by their parents in their early years.心理学空间2eGi'by0YH
Unrelenting Standards/Hypercriticalness心理学空间 IY9A1XYiK
This schema refers to the belief that whatever you do is not good enough, that you
YEnpL1d3o0must always strive harder. The motivation for this belief is the desire to meet extremely
\P)xH@:p m ?(y~ g0high internal demands for competence, usually to avoid internal criticism. People with
Q"T ^|3v#AE#Z_0this schema show impairments in important life areas, such as health, pleasure or self -心理学空间lb]5d9N.`tE h%y
esteem. Usually these clients’ parents were never satisfied and gave their children love
L;N8PdA8Qle"i,WX6[0that was conditional on outstanding achievement.心理学空间 S"s Y$V6u mXL ~
Entitlement/Grandiosity
n6]zb$} J0This schema refers to the belief that you should be able to do, say, or have whatever心理学空间 A@!Vp)hW4v\
you want immediately regardless of whether that hurts others or seems reasonable to心理学空间;T*[CX vB
them. You are not interested in what other people need, nor are you aware of the longterm
Siy)HSY{)BwL X1v.J0costs to you of alienating others. Parents who overindulge their children and who心理学空间;_C&m_} f3Z*t j.?
do not set limits about what is socially appropriate may foster the development of this心理学空间n:j'cKMAc_(I#h+e
schema. Alternatively, some children develop this schema to compensate for feelings of
R^0p"z6Z9}0emotional deprivation or defectiveness.
%c7ky!Bvw,P0Insufficient Self-Control/Self-Discipline心理学空间H+U0cj d
This schema refers to the inability to tolerate any frustration in reaching one’s goals, as心理学空间m:X X+T?u1wzwY!T
well as an inability to restrain expression of one’s impulses or feelings. When lack of心理学空间 b%NQ/iL:O
self-control is extreme, criminal or addictive behavior rule your life. Parents who did not心理学空间*n h1K#nP
model self-control, or who did not adequately discipline their children, may predispose
a%nRK&s&a l0them to have this schema as adults.
z)f8\D?0Negativity/Pessimism心理学空间&P c+f4ml9cXs;ti
This schema refers to a pervasive pattern of focusing on the negative aspects of life心理学空间Bap$hXQ
while minimizing the positive aspects. Clients with this schema are unable to enjoy心理学空间 s7}8]:d5?r*u
things that are going well in their lives because they are so concerned with negative心理学空间iKs)Ruw
details or potential future problems. They worry about possible failures no matter how
2R {1K eT,~A"Ty0well things are going for them. Usually these clients had a parent who worried
#V'_:AJ.[7R0excessively.心理学空间c:u-bA6n q:f
Punitiveness
zyy+Z)W3O1_:C!F0This schema refers to the belief that people deserve to be harshly punished for making心理学空间q1E~?C.N!@h"G&oxV
mistakes. People with this schema are critical and unforgiving of both themselves and
$N#IJ en7T.{0others. They tend to be angry about imperfect behaviors much of the time. In
Cm#]5],m3N([u0childhood these clients usually had at least one parent who put too much emphasis on
8q3Z@8ts)D~Q0performance and had a punitive style of controlling behavior.
3a o2J%fSv0How Schemas Work
Sl!~/lb(DC5M0There are two primary schema operations: Schema healing and schema perpetuation.
y]&?i;Y_i-fOl0All thoughts, behaviors and feelings may be seen as being part of one of these心理学空间g*{mj,b Z
operations. Either they perpetuate the schema or they heal the schema. In a later
6jCR!G%cs_i0section on the therapy process we will explain more about schema healing.
K m!H;r-zf0Schema perpetuation refers to the routine processes by which schemas function and
/W XA+V)H]Z2v9s0perpetuate themselves. This is accomplished by cognitive distortions, self -defeating心理学空间$A6r _v$vY
behavior patterns and schema coping styles.心理学空间#h/g e7TJ:zt
Earlier we mentioned that cognitive distortions are a central part of cognitive therapy.
oY([4i'U7T _dQ0These distortions consist of negative interpretations and predictions of life events. The
6~'WV&g|gZ#f0schema will highlight or exaggerate information that confirms the schema and will
7Ah7uD!A3TV8Y|!rLd0minimize or deny information that contradicts it. Likewise, unhealthy behavior patterns
0D,E9T2kp0will perpetuate the schema’s existence. Someone who was abused in childhood and
P[*e9Rv \;ow0developed a Mistrust/Abuse schema may seek out abusive relationships in adulthood心理学空间U.|jU,r7g5Mnv Xh
and remain in them, providing a constant stream of evidence for the schema.心理学空间 RwI&z2Dtt
In order to understand how schemas work, there are three schema coping styles that心理学空间V3hx'[CQ` X
must be defined. These styles are schema surrender, schema avoidance, and schema
|x ^Qp0overcompensation. It is through these three styles that schemas exert their influence on
G#wL~ a#T0our behavior and work to insure their own survival.
x6Pi,cDz#T0Schema surrender refers to ways in which people passively give in to the schema.心理学空间n3o2W8L-u0?#v%b.UD
They accept the schema as truth and then act in ways that confirm the schema. For
9acW!`5Z` n'a0instance, a young man with an Abandonment/Instability schema might choose心理学空间h$Px\ fm/w
partners who are unable to commit to long-term relationships. He might then react to
R3v1[KO:{4k0even minor signs indications of abandonment, such as spending short times without his
s}I ARi8D0partner, in an exaggerated way and feel excessive negative emotion. Despite the心理学空间 rzY$TS Y
emotional pain of the situation, he might also passively remain in the relationship心理学空间TbqV,M g\
because he sees no other possible way to connect with women.心理学空间:Ag ^1QG-_}9`3q w
Schema avoidance refers to the ways in which people avoid activating schemas. As
(|`8\0P"z+M:i\0mentioned earlier, when schemas are activated, this causes extreme negative emotion.
)fR7r](d+cq9I F0People develop ways to avoid triggering schemas in order not to feel this pain. There are
g@3\x.gQ0three types of schema avoidance: cognitive, emotional and behavioral.
&R7? aj3qB5u3c0Cognitive avoidance refers to efforts that people make not to think about upsetting
j4^#PG&K SS0events. These efforts may be either voluntary or automatic. People may voluntarily
Rt3dD;`0P8F.bS0choose not to focus on an aspect of their personality or an event, which they find
5~H"w#W9kjrV0S0disturbing. There are also unconscious processes which help people to shut out
:FzC,R3g$s0information which would be too upsetting to confront. People often forget particularly
KU&lcv KZ0painful events. For instance, children who have been abused sexually often forget the心理学空间G0T'?b#G7M*y
memory completely.
m%R:atg @:{0Emotional or affective avoidance refers to automatic or voluntary attempts to block
~(|^Tz,J-p0painful emotion. Often when people have painful emotional experiences, they numb
'rxHQ8?Z0themselves to the feelings in order to minimize the pain. For instance, a man might talk心理学空间&^TP+U,J%t4Rw
about how his wife has been acting in an abusive manner toward him and say that he心理学空间 W zp NDg)}{0n
feels no anger towards her, only a little annoyance. Some people drink or abuse drugs
` F"Ktu(fE0to numb feelings generated by schemas.心理学空间d8cG0U'fj
The third type of avoidance is behavioral avoidance. People often act in such a way as心理学空间%u o6l jIy;P/bh!Zw5z4?
to avoid situations that trigger schemas, and thus avoid psychological pain. For instance,
@7vrT}0a woman with a Failure schema might avoid taking a difficult new job which would be
p6Qn ~OMO3a"S0very good for her. By avoiding the challenging situation, she avoids any pain, such as心理学空间9cz&Sk2t S} x
intense anxiety, which could be generated by the schema.心理学空间 pL@RauS%a _
The third schema process is Schema overcompensation. The individual behaves in a
Am K)NUtC0manner which appears to be the opposite of what the schema suggests in order to avoid心理学空间P? ^H^v'S6Q
triggering the schema. On the surface, it may appear that the overcompensators are
Kyh dL0behaving in a healthy manner, by standing up for themselves. But when they overshoot
'J\#SosB7_\0the mark they cause more problem patterns, which then perpetuate the schema. For心理学空间0C+a!q`:hj&_ U,r
instance, a young man with a Defectiveness schema might overcompensate by心理学空间\[hh4b![ }
presenting himself as perfect and being critical of others. This would likely lead others
Guw9f/D!U0q P0to criticize him in turn, thereby confirming his belief that he is defective.
,I(RV!Ly'E6qN0Working With Modes
2s1L6^"\b7`}#^,H0When treating clients with schema therapy one of the most important innovations is the心理学空间kSSg7ZU
concept of mode. For our purposes we will define a mode as the set of schemas or
~5^J)m&B2S ?jJ b0schema operations that are currently active for an individual. Or you might think of a
A}f%_)h0mode simply as a mindset or state that you might be in temporarily. Most people can
#w[:a'h0r1^6d0relate to the idea that we all have these different parts of ourselves and we go in and
&Rj'_^1m}&I;q0out of them all the time. For instance, if a friend tells you she had a bad day because心理学空间 d9g7|~!l.sz
her boss (or her toddler) was in his raging bull mode, you’d know exactly what she
&xztI*cy7r [0means.心理学空间^.Wy-A7LIZG
There are often occasions when a therapist will choose to work with a client’s modes in
6mt/OR;P&I0therapy. If a client is extremely upset at the beginning of a session, the therapist may
J(k&XZ)Hy0inquire about what part of the person is feeling the emotional pain and attempt to心理学空间.l:_!m)N.s
recognize it and deal with it directly. For instance, for several sessions, Myra was very
:s y?6s}{m~"wK o P0sad and hurt because she was unable to talk out some problems with her husband. In
:i6Ve@#O |"E,bN7[0talking with her therapist they focused on a mode, or part of her, that she called Lonely
,r5U)U Vy^k2Ni!S _0Myra, that seemed to be active after these failed attempts. By engaging this part of心理学空间6dAaM%q
Myra in this manner the therapist was able to give her an opportunity to express the心理学空间Dt4Gi*O
feelings and thoughts connected with her pattern of loneliness.心理学空间i7C&y+^8c4Kg8|
The exact pattern of work with modes will vary from session to session. But some of心理学空间"s0Q&w)Cd
the more common activities in mode work can be described. The history of the mode is心理学空间4h&zMW,}-y
often discussed; the client will speak about when the mode started and what was going心理学空间Z*_+Z(l/e
on at the time. Connections are made between modes and current problems.心理学空间Pe5ko"fVkI
Dialogues can be conducted between different modes when there is a conflict. For心理学空间bU$qz+\^b-K
instance, a miser mode and a playboy mode might have it out over what type of car to
9n ]7q,kN0buy. And there is always an effort to link mode work with other aspects of the therapy.
IiZ C'l @A!Wd0Case Examples
Mpsu A%VQc)o5B!g0In this section six case examples are presented. In each one, the schema coping styles心理学空间;?%_ m9N*fg-k2r;u
are demonstrated. By reading through this section, you will get a better feel for how
d!qO~(~6g4v V0these processes can operate in real life situations.心理学空间*G wC6oy q2~4j
Abby is a young woman whose main schema is Subjugation. She tends to see people
.Z#[d9Z*RU7f0as very controlling even when they are being appropriately assertive. She has thoughts
r_s~2xu}-RM0such as “I can’t stand up for myself or they won’t like me’ and is likely to give in to
/v#S_$}?0others (Schema surrender). At other times she decides that no one will get the better心理学空间"@z`4M6e QUZ"]
of her and becomes very controlling (Schema overcompensation). Sometimes when心理学空间-v8go+d)wVi9_
people make unreasonable demands on her she minimizes the importance of her own
Cl aX1y2qO0feelings and has thoughts like “It’s not that important to me what happens.’ At other心理学空间WRL2dw)h
times she avoids acquaintances with whom she has trouble standing up for herself心理学空间/e-u(k%Z;\.F]aE#~,I&y
(Schema avoidance).
8Lx\ TR'\]5CV0Stewart’s main schema is Failure. Whenever he is faced with a possible challenge, he心理学空间H[8^-Q`B
tends to think that he is not capable. Often he tries half -heartedly, guaranteeing that he
,\t a"p1xTr4w0will fail, and strengthening the belief that he is not capable (Schema surrender). At
"a(Ewcu0times, he makes great efforts to present himself in an unrealistically positive light by心理学空间C@9dX{/};V
spending excessive amounts of money on items such as clothing and automobiles
9t3T_+vdNT3H0(Schema overcompensation). Often he avoids triggering his schema by staying away心理学空间~F{/}%?O
from challenges altogether and convinces himself that the challenge was not worth心理学空间j f-ken1|$Y x'x
taking (Schema avoidance).
%CI(Ew"Q8f'i0Rebecca’s core schema is Defectiveness/Shame. She believes that there is心理学空间At3g}H|a'T
something basically wrong with her and that if anyone gets too close, they will reject
It |!Ry0her. She chooses partners who are extremely critical of her and confirm her view that心理学空间sG8fUjw4f*|
she is defective (Schema surrender). Sometimes she has an excessive defensive
N&d0lh~!V6u;l(?0reaction and counterattacks when confronted with even mild criticism (Schema
-uLn4Ylv0overcompensation). She also makes sure that none of her partners get too close, so
r0_(t+] B0that she can avoid their seeing her defectiveness and rejecting her (Schema心理学空间-x6]+uP3@1aB
avoidance).
?7??-\&l] S0Michael is a middle-aged man whose main schema is Dependence/Incompetence.心理学空间rd_e}`x\)h
He sees himself as being incapable of doing daily tasks on his own and generally seeks心理学空间s|1A[d"G9?C
the support of others. Whenever he can, he chooses to work with people who help him心理学空间L'W'Y~4aPQ
out to an excessive degree. This keeps him from developing skills needed to work alone心理学空间0f[ \0LrJ'CL7o
and confirms his view of himself as someone who needs others to help him out
U/nhD-u'Le;@ hz0(Schema surrender). At times, when he would be best off taking advice from other心理学空间+{5f`wW"Ic1J Y
people, he refuses to do so (Schema overcompensation). He reduces his anxiety by心理学空间3o plCy;z \'CZ
procrastinating as much as he can get away with (Schema avoidance).
"G pnVnG E&m0Ann’s core schema is Social Isolation/Alienation. She sees herself as being different心理学空间P\b? F k%L5a
from other people and not fitting in. When she does things as part of a group she does心理学空间~)Hf o)a.Q)b
not get really involved (Schema surrender). At times she gets very hostile towards心理学空间| t-rZ*H.}&C
group members and can be very critical of the group as a whole (Schema心理学空间I+| SD"CXc
overcompensation). At other times she chooses to avoid group activities altogether
@2A/gE_2Jl0(Schema avoidance).心理学空间CO-@4g8I.O*t8d4]
Sam’s central schema is Emotional Deprivation. He chooses partners who are not
$RG;f`wi0very capable of giving to other people and then acts in a manner which makes it even
Q f"kR)J~S0more difficult for them to give to him (Schema surrender). At times he will act in a心理学空间9f9^m;wc5v,h }w
very demanding, belligerent manner and provoke fights with his partners (Schema
7v l,t vt#d!`0overcompensation). Sam avoids getting too close to women, yet denies that he has心理学空间$Yuh}h"m9px/C
any problems in this area (Schema avoidance).
7d(a:bn ynj#m0Therapeutic Process - Changing Schemas
6DAX8Z6sH/K(R0In schema therapy the goal of the treatment is to engage in schema healing processes.
~N|UKqy0B'c-d T0These processes are intended to weaken the early maladaptive schemas and coping
#C_7U$C~{rBE'_0styles as much as possible, and build up the person’s healthy side. An alliance is formed心理学空间,f ])Aa6hh#aD
between the therapist and the healthy part of the client against the schemas. Any of
kFhs6@)^`*H(]0the therapy activities described below may be seen as examples of schema healing.心理学空间 nl8ciF3Mh#e
The first step in therapy is to do a comprehensive assessment of the client. The main心理学空间:]jIG*}*X3V%x-x
goal of this assessment is to identify the schemas and coping styles that are most
-hp;DS-e5Cc!hW0important in the client’s psychological makeup. There are several steps to this process.
D0Y%ZC#A4R0The therapist generally will first want to know about recent events or circumstances in
4x^8^Cq m0the clients’ lives which have led them to come for help. The therapist will then discuss
3P]v&Z9vE0the client’s life history and look for patterns which may be related to schemas.心理学空间aye*Ofq:l6m$j
There are several other steps the therapist will take in assessing schemas. We use the心理学空间@ ~@o&P$s
Young Schema Questionnaire, which the client fills out, listing many of the thoughts,心理学空间_f7Q@le$`VJ
feeling and behaviors related to the different schemas; items on this questionnaire can心理学空间 n@cKN5@8MH2i
be rated as to how relevant to the client’s life they are.
$xShkce0There are also various imagery techniques which the therapist can use to assess心理学空间V$dJb udg
schemas. One specific technique involves asking clients to close their eyes and create an心理学空间AnUh9IQ
image of themselves as children with their parents. Often the images that appear will
,[F&Nx K8GE/w)`;h0lead to the core schemas.心理学空间3LV D+GI9N/[
Jonathan is a 28 year old executive whose core schema is Mistrust/Abuse. He came心理学空间HLKb ^ k1b
to therapy because he was having bouts of intense anxiety at work, during which he
_~?-g~ | GGo0would be overly suspicious and resentful of his co-workers. When asked to create an心理学空间Dvx*HO
image of himself with his family, he had two different images. In the first he saw himself心理学空间n^f2a/v~)qA5r
being terrorized by his older brother. In the second he saw his alcoholic father coming心理学空间.fJ\3Lk'p`/`ce
home and beating his mother, while he cowered in fear.
C;S'O-NX:pl0There are many techniques that the therapist can use to help clients weaken their心理学空间 O3du)~:fK.s
schemas. These techniques can be broken down into four categories: emotive,
5~-e/b!s](c:sv0interpersonal, cognitive and behavioral. Each of these categories will be briefly心理学空间 m9A8S~)pp f
discussed, along with a few examples.
V Q"c7T8{#U)QO0Emotive techniques encourage clients to experience and express the emotional aspects心理学空间$sC?]1HrT
of their problem. One way this is done is by having clients close their eyes and imagine心理学空间)j!pW,n*SnD8V
they are having a conversation with the person to whom the emotion is directed. They心理学空间*yxjY)h]w+V+OH/wN }
are then encouraged to express the emotions as completely as possible in the imaginary心理学空间g0R:hux Q+r/j_:J
dialogue. One woman whose core schema was Emotional Deprivation had several
x&i~M ks NS0such sessions in which she had an opportunity to express her anger at her parents for
pHM p \0not being there enough for her emotionally. Each time she expressed these feelings, she心理学空间0aMM4|%pJ*W0L D
was able to distance herself further from the schema. She was able to see that her心理学空间,P%w?4{$}c*ZcP8b
parents had their own problems which kept them from providing her with adequate
hL|] w k6i0nurturance, and that she was not always destined to be deprived.心理学空间&d!V7?,o3hai
There are many variations on the above technique. Clients may take on the role of the
KL Ab(?~S'}5Y5M0other person in these dialogues, and express what they imagine their feelings to be. Or心理学空间;~#n;uc p
they may write a letter to the other person, which they have no intention of mailing, so
c!G9Y"Q3Q&Bn2m3c tnA{3a0that they can express their feelings without inhibition.心理学空间6v}O+n]5B(X&c3A q
Mode work can be invaluable as an emotive technique. A client may be feeling a vague心理学空间O"\.wys~U7z
sense of sadness which he can’t clarify. By looking at modes with his therapist he may
|"DH b0C E%P#c0connect with a mode that he labels as Unimportant. By dialoging with the therapist
M L#V(t,|r)b)O0from the mode’s point of view many feelings can come out which can be worked on
j/KLm5I.`my0further. In this case the client might get in touch not only with the sadness, but also
cx-}YM;`@0with anger at being ignored.
ko0BhX;Hy0Interpersonal techniques highlight the client’s interactions with other people so that the
YxE? g q![0role of the schemas can be exposed. One way is by focusing on the relationship with the心理学空间1p-aXzHHxc
therapist. Frequently, clients with a Subjugation schema go along with everything the心理学空间$c{y$G-?HV cB
therapist wants, even when they do not consider the assignment or activity relevant.心理学空间:]0H'@6woU:X
They then feel resentment towards the therapist which they display indirectly. This
0g-Xh U"G;i0pattern of compliance and indirect expression of resentment can then be explored to the心理学空间]$l9s2{/g'Jh R
client’s benefit. This may lead to a useful exploration of other instances in which the心理学空间7s8d M3Fu+?H/P T
client complies with others and later resents it, and how they might better cope at those心理学空间)Y%{0v$a4]6Cn
times.
aU%v0P4G:z`,]0Another type of interpersonal technique involves including a client’s spouse in therapy. A心理学空间q v DCdGc3B
man with a Self-Sacrifice schema might choose a wife who tends to ignore his wishes.
9za W_*w$Y ~0c0The therapist may wish to involve the wife in the treatment in order to help the two of
+z-MG7Q8o0them to explore the patterns in their relationship and change the ways in which they心理学空间%ie)XsQf9y.b
interact.
~ u E!vAD8a0Cognitive techniques are those in which the schema-driven cognitive distortions are
sHyew#~(]0challenged. As in short-term cognitive therapy, the dysfunctional thoughts are identified
3j B:g,_&W0and the evidence for and against them is considered. Then new thoughts and beliefs are心理学空间3c2[;|c](v%~5s
substituted. These techniques help the client see alternative ways to view situations.
7K Euw.w0The first step in dealing with schemas cognitively is to examine the evidence for and心理学空间;h6D ~/BR,}S2T,J
against the specific schema which is being examined. This involves looking at the client’s心理学空间m G5T/t,x1R
life and experiences and considering all the evidence which appears to support or refute心理学空间:Fl FMF:F-HrR
the schema. The evidence is then examined critically to see if it does, in fact, provide
]kI(W]0support for the schema. Usually the evidence produced will be shown to be in error, and
j$`7u+lcc"A1[!JE:dF0not really supportive of the schema.心理学空间T6sS@z;h;_
For instance, let’s consider a young man with an Emotional Deprivation schema.
"|.M3Ns:edc0When asked for evidence that his emotional needs will never be met, he brings up
qm)d"k&W \*o(U0instances in which past girlfriends have not met his needs. However, when these past
QG.ul*k4v1_bt0relationships are looked at carefully, he finds that, as part of the schema surrender心理学空间D|[?R4O#J9P
process, he has chosen women who are not capable of giving emotionally. This心理学空间H$b6@!`O
understanding gives him a sense of optimism; if he starts selecting his partners
tK+M Wl Zl0differently, his needs can probably be met
W |Std1a~0Another cognitive technique is to have a structured dialogue between the client and
)L H,xEY9M&w ^@tH0therapist. First, the client takes the side of the schema, and the therapist presents a
a!C?gm/G-}0more constructive view. Then the two switch sides, giving the client a chance to
yFh*o(u'[pO0verbalize the alternative point of view.
EtU\Xp~'LY(l0After having several of these dialogues the client and therapist can then construct a心理学空间K@0s/dxT-Y$Y
flashcard for the client, which contains a concise statement of the evidence against the
'z:acW l;[:M5O0schema.心理学空间0L x[v{JM
A typical flashcard for a client with a Defectiveness/Shame schema reads: “I know
-F*M:i4R3v5W'I*s0that I feel that there is something wrong with me but the healthy side of me knows that心理学空间D)u6q4H$[a Y%ja
I’m OK. There have been several people who have known me very well and stayed with
0a#FAXB_qzqY*kE6`0me for a long time. I know that I can pursue friendships with many people in whom I心理学空间0QK0VuTA
have an interest.”心理学空间Y(b aR;y'B
The client is instructed to keep the flashcard available at all times and to read it心理学空间s])S7@!@ C5`{
whenever the relevant problem starts to occur. By persistent practice at this, and other
;A5K"u-u%v'_g?0cognitive techniques, the client’s belief in the schema will gradually weaken.心理学空间p ^#|7JM^
Behavioral techniques are those in which the therapist assists the client in changing
']R5|f U:\*O a~Z0long-term behavior patterns, so that schema surrender behaviors are reduced and心理学空间KO$MHUd
healthy coping responses are strengthened.
&xLc3g!}0One behavioral strategy is to help clients choose partners who are appropriate for them
`)e#N;n8w6a Ex0and capable of engaging in healthy relationships. Clients with the Emotional心理学空间uP'l2h1Ej
Deprivation schema tend to choose partners who are not emotionally giving. A心理学空间*V2` eG/r#cM"FA
therapist working with such clients would help them through the process of evaluating
4W ^;f7V(Mp0and selecting new partners.
"\%] l.Y9s"b0Another behavioral technique consists of teaching clients better communication skills.
@-]RR2b7pD0For instance, a woman with a Subjugation schema believes that she deserves a raise心理学空间:_;J3]SpD.k^'g {
at work but does not know how to ask for it. One technique her therapist uses to teach心理学空间^ u x6a;dPI*S
her how to speak to her supervisor is role -playing. First, the therapist takes the role of心理学空间$khCX:A HB
the client and the client takes the role of the supervisor. This allows the therapist to心理学空间:]w J.?)w!hfa6i,L
demonstrate how to make the request appropriately. Then the client gets an opportunity心理学空间 v/Y)t(Q DR8\
to practice the new behaviors, and to get feedback from the therapist before changing心理学空间#I!LtPTJ ~O}
the behavior in real life situations.心理学空间;A:UVi o"`]R
IN SUMMARY, schema therapy can help people understand and change long-term life心理学空间3VYQ2N U/h&_K\
patterns. The therapy consists of identifying early maladaptive schemas, coping styles
Bi-@'I,K w0and modes, and systematically confronting and challenging them.
7\-b&G r%|{q S7j[0References:心理学空间j4k(F qh$V
Young, J.E., and Klosko, J.S. (1993). Reinventing your life. New York:心理学空间-vq%A5i6O
Dutton, 1993.心理学空间8nax\Brm
Young, J.E., Klosko, J.S., and Weishaar, M.E. Schema therapy: A
rt @U&[\!G3s8s p _~0practitioner’s guide. New York: Guilford, 2003.
*SMhKs0Copyright 2004, Cognitive Therapy Center of New York
P a~k#@0U0For more information contact:
u"| j&T&{0David Bricker, Ph.D.心理学空间1Y/qdV_
160 Broadway
[qxO(A7q0New York, NY 10038
/Qt.|2W _8n0(212) 406-3520心理学空间 M^s.h@ kS

www.psychspace.com心理学空间网
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