A Client’s Guide to Schema Therapy
作者: Jeffrey E. Young / 6337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

}exin9q5dg B0A Client’s Guide to Schema Therapy心理学空间\F)g.Efg9?3k'|,`
David C. Bricker, Ph.D. and Jeffrey E. Young, Ph.D.心理学空间 |v Mx,c
Schema Therapy Institute心理学空间'Rc ws6~5n:E9\
HARRY is a 45-year old middle-level manager. He has been married for 16 years, but his心理学空间8M9v"G&vx s1b cJ
marriage has been very troubled. He and his wife are often resentful of each other, they
)I g/hnND4A"M#{q0rarely communicate on an intimate level, and they have few moments of real pleasure.
9v%`Sh7["I0Other aspects of Harry’s life have been equally unsatisfying. He doesn’t enjoy his work,
| ?D$Qv#R {&s0primarily because he doesn’t get along with his co-workers. He is often intimidated by心理学空间)\%R8LKl
his boss and other people at the office. He has a few friends outside of work, but none心理学空间_+O.u(K&x2\)p:{
that he considers close.心理学空间#eP.E-} [\*GL*`~
During the past year Harry’s mood became increasingly negative. He was getting more心理学空间.A&F"hn/q3a/aH(n d
irritable, he had trouble sleeping and he began to have difficulty concentrating at work.
/l;Dw5~~*A9O0As he became more and more depressed, he began to eat more and gained 15 pounds.心理学空间3oU.`*C UOV
When he found himself thinking about taking his own life, he decided it was time to get
!X!Z,u#? OA`0help. He consulted a psychologist who practices cognitive therapy.
0{Q.OM9T C T5P2k0As a result of short-term cognitive therapy techniques, Harry improved rapidly. His mood
R!ai,zk} cD0lifted, his appetite returned to normal, and he no longer thought about suicide. In
$nT0p\ r {-}0addition he was able to concentrate well again and was much less irritable. He also心理学空间:?hR+g%J^
began to feel more in control of his life as he learned how to control his emotions for
Q.vwH.tw0S0the first time.心理学空间 c"e+LUv }!Q O
But, in some ways, the short-term techniques were not enough. His relationships with
0n7_~2BtABc |d5i[0his wife and others, while they no longer depressed him as much as they had, still failed心理学空间6_ wZf]
to give him much pleasure. He still could not ask to have his needs met, and he had few心理学空间Nt4uj:nr
experiences he considered truly enjoyable. The therapist then began schema therapy to
g)\,l&gKK0help Harry change his long-term life patterns.心理学空间I1n |2L)Z!j#y
This guide will present the schema therapy approach, developed by Dr. Jeffrey Young to心理学空间1ll:mC+[*Nf8h
expand cognitive therapy for clients with more difficult long-term problems. Schema
+q7KR4l bf"m%n0therapy can help people change long-term patterns, including the ways in which they
%J't8U+_g6zN0interact with other people. This overview of schema therapy consists of six parts:心理学空间 [5Far7OK-S2R
1) A brief explanation of short-term cognitive therapy
p|.A!J E9lC q02) An explanation of what a schema is and examples of schemas;
:\6y'mBv03) An explanation of the processes by which schemas function;心理学空间_4I'L[]${\z^v{
4) An explanation of modes and how they function within schema therapy;心理学空间6Y qU"H+Z
5) Several case examples; and心理学空间edj9Hq
6) A brief description of the therapeutic process心理学空间n+e%XuH:g hA
Short-Term Cognitive Therapy心理学空间/f*k)c Q.u
Cognitive therapy is a system of psychotherapy developed by Aaron Beck and his心理学空间 e*U*i ba
colleagues to help people overcome emotional problems. This system emphasizes心理学空间vCi7@p!}W
changing the ways in which people think in order to improve their moods, such as心理学空间-]0N'vb1b
depression, anxiety and anger.
F!Toi8^W\z~ W0Emotional disturbance is influenced by the cognitive distortions that people make in心理学空间eC,Ah%`%T
dealing with their life experiences. These distortions take the form of negative
*j3JQ)OAO s t0interpretations and predictions of everyday events. For instance, a male college student心理学空间MCDD"{1hk4D
preparing for a test might make himself feel discouraged by thinking: “This material is
2p,Z-^pk8s0impossible” (Negative Interpretation) and “I’ll never pass this test” (Negative Prediction).
~J6p6bF4T\0The therapy consists of helping clients to restructure their thinking. An important step in
&I;GV;H s%N0this process is examining the evidence concerning the maladaptive thoughts. In the
%D+}fu+f0example above, the therapist would help the student to look at his past experiences and心理学空间(g*R!ZME
determine if the material was in fact impossible to learn, and if he knew for sure that he
d(yP S5l-|'N0couldn’t pass the test. In all probability, the student would decide that these two
I NJ%{z?0thoughts lacked validity.心理学空间_nY6?Eu [Xa}6X?
More accurate alternative thoughts are then substituted. For instance, the student might心理学空间O f.d+`M p&d
be encouraged to think: “This material is difficult, but not impossible. I’ve learned
-b"[)m0g.aPEJc%_*l0difficult material before” and “I’ve never failed a test before, so long as I’ve done
[)N6l*Vew%[0enough preparation.” These thoughts would probably lead him to feel better and cope
WC0gp2QR0better.心理学空间i`3Uyl4DA S
Often short-term cognitive therapy is enough to help people overcome emotional心理学空间8sCS+\?;yLVy
problems, especially depression and anxiety. Recent research has shown this to be so.
'~7xO Sn ik(f&CZ v0However, sometimes this approach is not enough. Some clients in short-term cognitive
&_qtV3A-y#KE;q0therapy find that they don’t get all the benefits they want. This has led us, as well as
^2h!l0?(^e3je/^f0various other researchers (Beck, xxxx) to look at deeper and more permanent cognitive
9g&u7lJ0N'UL0structures as a means to understand and treat problem moods and behaviors. Schema心理学空间h*@ }4u3Cn%\g
therapy was created as a result of these efforts.
.`N3E!iR9^1Q!q0f0Schemas - What They Are
2OPg/_7cu8B5?0A schema is an extremely stable, enduring negative pattern that develops during
9dU/n&YYj/E0childhood or adolescence and is elaborated throughout an individual’s life. We view the
)~+j{ snn0world through our schemas.
Nb`;F%I"r3~8^9W0Schemas are important beliefs and feelings about oneself and the environment which
}5K*S)Y\0the individual accepts without question. They are self -perpetuating, and are very心理学空间"Z?#t P'Kz(b
resistant to change. For instance, children who develop a schema that they are心理学空间w_,JI8aUg
incompetent rarely challenge this belief, even as adults. The schema usually does not go心理学空间4?z7n%o D;ls(o,v+G
away without therapy. Overwhelming success in people’s lives is often still not enough心理学空间,_ T@;Qy glB:W!R
to change the schema. The schema fights for its own survival, and, usually, quite心理学空间c D]cC*^
successfully.心理学空间f+xm\6M/?Sb
It’s also important to mention the importance of needs in schema formation and心理学空间0mm5\1L$Q:qQ`
perpetuation. Schemas are formed when needs are not met during childhood and then
`F:W6A,I&C0the schema prevents similar needs from being fulfilled in adulthood. For instance a child心理学空间2N F P hDR
whose need for secure attachments is not fulfilled by his parents may go for many years心理学空间6p(x f2Ot/[@
in later life without secure relationships.
"oc}Fcrn!I8tV0Even though schemas persist once they are formed, they are not always in our心理学空间}wZcVr5R
awareness. Usually they operate in subtle ways, out of our awareness. However, when a
u#gx-Z;Yl0schema erupts or is triggered by events, our thoughts and feelings are dominated by心理学空间C7aY dW!qc
these schemas. It is at these moments that people tend to experience extreme negative
A-OW"\_a*\0emotions and have dysfunctional thoughts.心理学空间4D I*~%uLys;F/d9H\K
In our work with many patients, we have found eighteen specific schemas. Most clients
H!]9H*rg0have at least two or three of these schemas, and often more. A brief description of each心理学空间v2^2Z*o K(T.x
of these schemas is provided below.心理学空间 c-~rWA?CI
Emotional Deprivation
A1gz%|#J c0This schema refers to the belief that one’s primary emotional needs will never be met by心理学空间8K-tk!qE2~!g
others. These needs can be described in three categories: Nurturance – needs for
L0lg*g:} _(A0affection, closeness and love; Empathy – needs to be listened to and understood;
K.@ucm1Sq)`5d0Protection – needs for advice, guidance and direction. Generally parents are cold or心理学空间 Pt;uW,B q u
removed and don’t adequately care for the child in ways that would adequately meet
`1zx,\ _Rx&b0the above needs.
"Wa1mpjpsm6S0Abandonment/Instability心理学空间N NX rs)^'c
This schema refers to the expectation that one will soon lose anyone with whom an心理学空间/r(t&GyN:WcH
emotional attachment is formed. The person believes that, one way or another, close心理学空间+W ^C$S,gf{lV;A$@
relationships will end imminently. As children, these clients may have experienced the
T&g%G~+^+^0divorce or death of parents. This schema can also arise when parents have been心理学空间!A*j YKaf8bn7@
inconsistent in attending to the child’s needs; for instance, there may have been
+Z]q#c"S!k6}/m-O0frequent occasions on which the child was left alone or unattended to for extended心理学空间h_)G3{ tl;z)wg}*fB
periods.心理学空间e#L2fwM8Qcwic
Mistrust/Abuse
/D0S-RA4iEx B,f0This schema refers to the expectation that others will intentionally take advantage in
3[b*Wxwwt\ w0some way. People with this schema expect others to hurt, cheat, or put them down.心理学空间A.ts1^6{R$v;`
They often think in terms of attacking first or getting revenge afterwards. In childhood,
,^%i5b4QR+p0these clients were often abused or treated unfairly by parents, siblings, or peers.
-P#f'V.lUU0Defectiveness/Shame心理学空间0qF]j7X2[ i Mw
This schema refers to the belief that one is internally flawed, and that, if others get心理学空间,{#C"^lH&oZ@m
close, they will realize this and withdraw from the relationship. This feeling of being心理学空间$W7M9tf;K#J
flawed and inadequate often leads to a strong sens e of shame. Generally parents were
%}!olJNQM7{0very critical of their children and made them feel as if they were not worthy of being
sb%kN&Z$Td hE0loved.心理学空间;f"|D8^w#r A%f
Social Isolation/Alienation心理学空间8J%sT ]6d bPhJ&tuj J
This schema refers to the belief that one is isolated from the world, different from other
/_8lb[,x)rzz N0people, and/or not part of any community. This belief is usually caused by early心理学空间:EBTy8Tu0s
experiences in which children see that either they, or their families, are different from心理学空间H+k$ErR"Lk&x)F)o
other people.心理学空间a(dXBY J6a
Dependence/Incompetence心理学空间1c&`Kz$_GfQ
This schema refers to the belief that one is not capable of handling day-to-day心理学空间$w2rb;J8_{
responsibilities competently and independently. People with this schema often rely on心理学空间8G0E+RQ|3nK,X(Or
others excessively for help in areas such as decision-making and initiating new tasks.心理学空间 uDc4B/i
Generally, parents did not encourage these children to act independently and develop心理学空间 Yi?$K%E$Z"_cn6Zh
confidence in their ability to take care of themselves.心理学空间J5M!D*^+gAp
Vulnerability to Harm and Illness心理学空间o.a Y8B t!c
This schema refers to the belief that one is always on the verge of experiencing a major
A@ F3P'd0catastrophe (financial, natural, medical, criminal, etc.). It may lead to taking excessive心理学空间C@#r#zl;^s
precautions to protect oneself. Usually there was an extremely fearful parent who
'MhzMs8is8`'I0passed on the idea that the world is a dangerous place.
`/` y!`t7i+W}aGp0Enmeshment/Undeveloped Self心理学空间.VTLt A(AT[f)K
This schema refers to a pattern in which you experience too much emotional心理学空间!W!I\6`\E1P F(BJ
involvement with others – usually parents or romantic partners. It may also include the
1gb"]h \3Xy0sense that one has too little individual identity or inner direction, causing a feeling of
#sgLC3XVs0emptiness or of floundering. This schema is often brought on by parents who are so
MV~,ur g0Y1e0controlling, abusive, or overprotective that the child is discouraged from developing a
6xr+Hxj/c+V-z ~W0separate sense of self.心理学空间(`$l}vu2KpUd\
Failure
0CS-Rvp7l v0This schema refers to the belief that one is incapable of performing as well as one’s心理学空间 Q sx(\ Ix0q
peers in areas such as career, school or sports. These clients may feel stupid, inept or
|o;E o.x6f2d-EP0untalented. People with this schema often do not try to achieve because they believe心理学空间&oH)r m J2o#@~;@
that they will fail. This schema may develop if children are put down and treated as if
|Q|UvN0they are a failure in school and other spheres of accomplishment. Usually the parents
(s)t{5[4q,z.?$mq0did not give enough support, discipline, and encouragement for the child to persist and
K\o(L,m1V8R0succeed in areas of achievement, such as schoolwork or sport心理学空间k+|0Hq6|
Subjugation
r(w*b`jL0This schema refers to the belief that one must submit to the control of others in order to心理学空间^1oim"M1p#xd/k V
avoid negative consequences. Often these clients fear that, unless they submit, others
%F;ln$W7u&Kp v)n7G0will get angry or reject them. Clients who subjugate ignore their own desires and心理学空间&@BY;g6~T
feelings. In childhood there was generally a very controlling parent.心理学空间BL1v }6G1_GoF
Self-Sacrifice心理学空间9BzEd~E+i I,kj
This schema refers to the excessive sacrifice of one’s own needs in order to help others.心理学空间]u|)fjFn6p ]
When these clients pay attention to their own needs, they often feel guilty. To avoid this心理学空间$[1uqV1R!@&D]/aQ
guilt, they put others’ needs ahead of their own. Often clients who self -sacrifice gain a
:N8q$f sqd/~^b0feeling of increased self -esteem or a sense of meaning from helping others. In childhood心理学空间8?#l5Dla%zEAg$_
the person may have been made to feel overly responsible for the well being of one or
b&RGp;f0both parents.心理学空间YZ qv$gKO
Emotional Inhibition心理学空间[7KU)gAt#k
This schema refers to the belief that you must suppress spontaneous emotions and心理学空间*|#_-A,Qh%F
impulses, especially anger, because any expression of feelings would harm others or
3u9y9~U"p(t0lead to loss of self -esteem, embarrassment, retaliation or abandonment. You may lack
eQKhVc.NR0spontaneity, or be viewed as uptight. This schema is often brought on by parents who
yv+J1NKX0discourage the expression of feelings.
P2C;cL:DG0Approval-Seeking/Recognition-Seeking
T)r[8m-gQkt0This schema refers to the placing of too much emphasis on gaining the approval and心理学空间7^EeSHKx$ab
recognition of others at the expense of one’s genuine needs and sense of self. It can心理学空间a0o6hnL f~ o a/xb
also include excessive emphasis on status and appearance as a means of gaining心理学空间/jz+KlD
recognition and approval. Clients with this schema are generally extremely sensitive to心理学空间.J$`7s,~ W!v @9x&T
rejections by others and try hard to fit in. Usually they did not have their needs for
yh)d9Cf0unconditional love and acceptance met by their parents in their early years.
y&t|"_*nN0Unrelenting Standards/Hypercriticalness心理学空间/cK?f [
This schema refers to the belief that whatever you do is not good enough, that you心理学空间-@p G5t Cx H_R
must always strive harder. The motivation for this belief is the desire to meet extremely心理学空间.s*E%?o j1Bxan
high internal demands for competence, usually to avoid internal criticism. People with心理学空间[\gf dub7UG%e:p
this schema show impairments in important life areas, such as health, pleasure or self -心理学空间6Y@-T-Xj`T
esteem. Usually these clients’ parents were never satisfied and gave their children love
\.C4{1I5hl0that was conditional on outstanding achievement.心理学空间^'d I n LX
Entitlement/Grandiosity心理学空间Kg8z8b k.z
This schema refers to the belief that you should be able to do, say, or have whatever心理学空间o&?9u Bc x
you want immediately regardless of whether that hurts others or seems reasonable to心理学空间+f9`V ` AS_ \ct
them. You are not interested in what other people need, nor are you aware of the longterm
qs2O3@ Bu0costs to you of alienating others. Parents who overindulge their children and who心理学空间!UQZsN*S R
do not set limits about what is socially appropriate may foster the development of this
3a-p0cAE0schema. Alternatively, some children develop this schema to compensate for feelings of心理学空间J0Lr;c ?!U;^t'^
emotional deprivation or defectiveness.心理学空间wS"d t_2G}Q
Insufficient Self-Control/Self-Discipline
Oe,h"r~;@0This schema refers to the inability to tolerate any frustration in reaching one’s goals, as
QNnw8hv0well as an inability to restrain expression of one’s impulses or feelings. When lack of心理学空间 VK2Yz5hp)UrZ
self-control is extreme, criminal or addictive behavior rule your life. Parents who did not
4FXp\ `,D ^0model self-control, or who did not adequately discipline their children, may predispose
}Pb&EdXl6vh0them to have this schema as adults.心理学空间(U,kW6{P!q)k oU
Negativity/Pessimism心理学空间d,B)ZG{2NqQ pY
This schema refers to a pervasive pattern of focusing on the negative aspects of life
#j uf%xj0while minimizing the positive aspects. Clients with this schema are unable to enjoy
H[_U ?!h0things that are going well in their lives because they are so concerned with negative心理学空间B&@Sc1l-H0uQ
details or potential future problems. They worry about possible failures no matter how心理学空间w"B*T%J%Z(U4l@V
well things are going for them. Usually these clients had a parent who worried
1Um'S-p/Z9N0excessively.
Ul?Lxj-F0Punitiveness
*l#lnoZh|d0This schema refers to the belief that people deserve to be harshly punished for making心理学空间c0|x9Af
mistakes. People with this schema are critical and unforgiving of both themselves and
T RC%ll2f;E0others. They tend to be angry about imperfect behaviors much of the time. In心理学空间!OW*kTH#aa
childhood these clients usually had at least one parent who put too much emphasis on心理学空间R/k9qI#?[4yA
performance and had a punitive style of controlling behavior.心理学空间-J7a0ZJBWX7[
How Schemas Work
/F+T OE~U(r$}0There are two primary schema operations: Schema healing and schema perpetuation.
rlEP*Q-i0All thoughts, behaviors and feelings may be seen as being part of one of these
-^%? e3R'Y~:q0operations. Either they perpetuate the schema or they heal the schema. In a later心理学空间aH`|3W`;d3N[e
section on the therapy process we will explain more about schema healing.心理学空间 qBOK+R%a
Schema perpetuation refers to the routine processes by which schemas function and
8v4aL r {!@P0perpetuate themselves. This is accomplished by cognitive distortions, self -defeating
)TuS#{e4gVJ7H6u0behavior patterns and schema coping styles.
&I(To z.MW0Earlier we mentioned that cognitive distortions are a central part of cognitive therapy.
wh,E b7ShR)W2i8D0These distortions consist of negative interpretations and predictions of life events. The心理学空间#m3aN|7{5sC%T
schema will highlight or exaggerate information that confirms the schema and will
%g0On Q)]X6J5l ue:p0minimize or deny information that contradicts it. Likewise, unhealthy behavior patterns
8UG8?{F-z G0will perpetuate the schema’s existence. Someone who was abused in childhood and心理学空间,NYV ~R5R`L5c
developed a Mistrust/Abuse schema may seek out abusive relationships in adulthood
jD@@;{q/M\0and remain in them, providing a constant stream of evidence for the schema.
BD2~-Wkf/qJ0In order to understand how schemas work, there are three schema coping styles that心理学空间-Fd7^qIp
must be defined. These styles are schema surrender, schema avoidance, and schema
wR6w!z{OW0overcompensation. It is through these three styles that schemas exert their influence on心理学空间*nf,i[J+`!c
our behavior and work to insure their own survival.
` M2O$o,ND!r6^0Schema surrender refers to ways in which people passively give in to the schema.
2JkZ(um0They accept the schema as truth and then act in ways that confirm the schema. For
R4fmy5eg,bR0instance, a young man with an Abandonment/Instability schema might choose心理学空间.~yR}:G:s`y}
partners who are unable to commit to long-term relationships. He might then react to
7zo wf1b&|^d1Y'?0even minor signs indications of abandonment, such as spending short times without his
PP#{u/_C:E0partner, in an exaggerated way and feel excessive negative emotion. Despite the心理学空间;I)wb#v H!E-CP(wh0m9^
emotional pain of the situation, he might also passively remain in the relationship
/AlE*X'{m@ r0because he sees no other possible way to connect with women.心理学空间-Z}%OYx6[ {F H.f
Schema avoidance refers to the ways in which people avoid activating schemas. As心理学空间(\x5?D_Q%p
mentioned earlier, when schemas are activated, this causes extreme negative emotion.
Ne7M9[.ayH0People develop ways to avoid triggering schemas in order not to feel this pain. There are心理学空间/AM$f,m,mb ]
three types of schema avoidance: cognitive, emotional and behavioral.
Ltk E(| Xrb0Cognitive avoidance refers to efforts that people make not to think about upsetting心理学空间N u A"Hz5IQ h
events. These efforts may be either voluntary or automatic. People may voluntarily
#rw:zM||\w@0choose not to focus on an aspect of their personality or an event, which they find心理学空间&i'BM Q2B$?
disturbing. There are also unconscious processes which help people to shut out
?*O:h&X/q\0information which would be too upsetting to confront. People often forget particularly心理学空间-Y$lJl BT'z%S
painful events. For instance, children who have been abused sexually often forget the心理学空间/mg,n'z5e8o$D'Z/o
memory completely.心理学空间6C4B!D'z`2x)H,a
Emotional or affective avoidance refers to automatic or voluntary attempts to block心理学空间B:iigz:W|
painful emotion. Often when people have painful emotional experiences, they numb
5zz+lmCb4k0themselves to the feelings in order to minimize the pain. For instance, a man might talk心理学空间-t5c,ju/\
about how his wife has been acting in an abusive manner toward him and say that he心理学空间K @kH+{ q2r M r V,C
feels no anger towards her, only a little annoyance. Some people drink or abuse drugs心理学空间(^Y N|M2i
to numb feelings generated by schemas.
"boM5je4lV2c0The third type of avoidance is behavioral avoidance. People often act in such a way as心理学空间,R'^-x;W([:y~(jt
to avoid situations that trigger schemas, and thus avoid psychological pain. For instance,
R {"k2G;|*P2J G }M0a woman with a Failure schema might avoid taking a difficult new job which would be
G`ol"D2M0very good for her. By avoiding the challenging situation, she avoids any pain, such as
\h3WI I/Cg-X0intense anxiety, which could be generated by the schema.
m"fg0D5z+MI jd0The third schema process is Schema overcompensation. The individual behaves in a
Uv | R1Pu?*n4a/l0manner which appears to be the opposite of what the schema suggests in order to avoid
,\,gM?/DM.p-|0triggering the schema. On the surface, it may appear that the overcompensators are心理学空间]`)oq{Mv(l:xV/g d,I
behaving in a healthy manner, by standing up for themselves. But when they overshoot心理学空间&Rt3`k d{\&]
the mark they cause more problem patterns, which then perpetuate the schema. For心理学空间W9W9k ~Ds7n/Y+G
instance, a young man with a Defectiveness schema might overcompensate by
Z3\)z\ Mf?,w;x0presenting himself as perfect and being critical of others. This would likely lead others心理学空间/~wl/J |*PT
to criticize him in turn, thereby confirming his belief that he is defective.
h0DJ.Wz#X0Working With Modes
|d/T8e:o b2Ax5w0When treating clients with schema therapy one of the most important innovations is the心理学空间^p)K/@ BE~ Tr\
concept of mode. For our purposes we will define a mode as the set of schemas or心理学空间@-Q+H%k|Z] alF?
schema operations that are currently active for an individual. Or you might think of a
Q Fk'@A&t.p"F7~0mode simply as a mindset or state that you might be in temporarily. Most people can心理学空间hash.y
relate to the idea that we all have these different parts of ourselves and we go in and心理学空间^?+v@ Q,`
out of them all the time. For instance, if a friend tells you she had a bad day because心理学空间w*IgffU9|8C P!d
her boss (or her toddler) was in his raging bull mode, you’d know exactly what she心理学空间0b$oyb5x x9H R
means.
6FY Yd3W V0There are often occasions when a therapist will choose to work with a client’s modes in心理学空间u8V b| OeQK3u'H [
therapy. If a client is extremely upset at the beginning of a session, the therapist may
0C k h9F7@0inquire about what part of the person is feeling the emotional pain and attempt to心理学空间 }Ov9V kh
recognize it and deal with it directly. For instance, for several sessions, Myra was very
7j y {&{a7l'D0sad and hurt because she was unable to talk out some problems with her husband. In
9l9H.gV uW?$PiT;X0talking with her therapist they focused on a mode, or part of her, that she called Lonely
5T&S,Y*Z$_J/T i0Myra, that seemed to be active after these failed attempts. By engaging this part of心理学空间HLB~ @6d e)E{g.V
Myra in this manner the therapist was able to give her an opportunity to express the
I mX*C:XI`0feelings and thoughts connected with her pattern of loneliness.心理学空间7bS2W,D9p&b
The exact pattern of work with modes will vary from session to session. But some of
,x,U;QO%I)E0the more common activities in mode work can be described. The history of the mode is
SSy)g&RE!Bqs0often discussed; the client will speak about when the mode started and what was going
,Ou-s}q6a i)q0on at the time. Connections are made between modes and current problems.心理学空间rJ&F%Im `ers0Nw&j
Dialogues can be conducted between different modes when there is a conflict. For心理学空间0p4Egp:i+S
instance, a miser mode and a playboy mode might have it out over what type of car to心理学空间 sqzYT V%@
buy. And there is always an effort to link mode work with other aspects of the therapy.
w6_cT/vqQ [&U0Case Examples心理学空间E7X:_3mcjBX1i}8q
In this section six case examples are presented. In each one, the schema coping styles
#rv^UG$q-p0are demonstrated. By reading through this section, you will get a better feel for how心理学空间 I.i#j Sx,is3fCL
these processes can operate in real life situations.心理学空间 @ j P(y;]izf
Abby is a young woman whose main schema is Subjugation. She tends to see people心理学空间T|d.b&c
as very controlling even when they are being appropriately assertive. She has thoughts
Sx&DWZ8s3Qzi0such as “I can’t stand up for myself or they won’t like me’ and is likely to give in to
|#^oL7~2m'~0others (Schema surrender). At other times she decides that no one will get the better心理学空间!yg9R"Ax p|(A0R
of her and becomes very controlling (Schema overcompensation). Sometimes when
`PA C mq$w0people make unreasonable demands on her she minimizes the importance of her own心理学空间T ~"z c3L
feelings and has thoughts like “It’s not that important to me what happens.’ At other
/d"Qlf+~.A)X0times she avoids acquaintances with whom she has trouble standing up for herself
/l"t{1L(R2hH/]ki*\0(Schema avoidance).
wGX(o:t:X0Stewart’s main schema is Failure. Whenever he is faced with a possible challenge, he心理学空间+\D2p&Prl!]
tends to think that he is not capable. Often he tries half -heartedly, guaranteeing that he心理学空间+?/B9uuf\,zfnP
will fail, and strengthening the belief that he is not capable (Schema surrender). At
tR _}(ZW8W7L d |0times, he makes great efforts to present himself in an unrealistically positive light by心理学空间5m6F Dx'a6XuL&GW
spending excessive amounts of money on items such as clothing and automobiles心理学空间7@i%D N(ffp-Sg
(Schema overcompensation). Often he avoids triggering his schema by staying away心理学空间;j"Kt&pi)lS3L
from challenges altogether and convinces himself that the challenge was not worth
!NhR1HG,P6cS fS0taking (Schema avoidance).心理学空间5F3vI)_ Z
Rebecca’s core schema is Defectiveness/Shame. She believes that there is
![#Z"y#x-{*@0OIv:hR0something basically wrong with her and that if anyone gets too close, they will reject心理学空间5kp~,R1Bk}j
her. She chooses partners who are extremely critical of her and confirm her view that
BWNs)c,f y%m0she is defective (Schema surrender). Sometimes she has an excessive defensive心理学空间!L7\2^t7cX$k,F}
reaction and counterattacks when confronted with even mild criticism (Schema
L!IZJ0a*em Z0overcompensation). She also makes sure that none of her partners get too close, so心理学空间8^-pZkH
that she can avoid their seeing her defectiveness and rejecting her (Schema
{:vUNB/v,_0avoidance).心理学空间0r.V} d$Q
Michael is a middle-aged man whose main schema is Dependence/Incompetence.心理学空间b!d2I|7e K+^m:`/v"a
He sees himself as being incapable of doing daily tasks on his own and generally seeks心理学空间|Ba*yu7Z
the support of others. Whenever he can, he chooses to work with people who help him
%k0WrE.I O0out to an excessive degree. This keeps him from developing skills needed to work alone
|6Ubrg0}%W0and confirms his view of himself as someone who needs others to help him out心理学空间,GCoSG6D1h8X5_
(Schema surrender). At times, when he would be best off taking advice from other
O t,c"ax[H^iP0people, he refuses to do so (Schema overcompensation). He reduces his anxiety by心理学空间BCgc H W i7m
procrastinating as much as he can get away with (Schema avoidance).
v'Y#p6@8Dv8QW0Ann’s core schema is Social Isolation/Alienation. She sees herself as being different
8Y)Rk }!}'US0from other people and not fitting in. When she does things as part of a group she does心理学空间 qQ ~6s wR*n7P"Z6cR
not get really involved (Schema surrender). At times she gets very hostile towards
,Z#h \+U$VMU0group members and can be very critical of the group as a whole (Schema心理学空间`^#q`(M8U{)oql
overcompensation). At other times she chooses to avoid group activities altogether心理学空间?x Vuk;[
(Schema avoidance).
+fi M,a0\L0Sam’s central schema is Emotional Deprivation. He chooses partners who are not心理学空间@9N@TLr'V
very capable of giving to other people and then acts in a manner which makes it even心理学空间8W$Q7vhP$Urm/QG
more difficult for them to give to him (Schema surrender). At times he will act in a心理学空间q#n$UP$YJ
very demanding, belligerent manner and provoke fights with his partners (Schema
,Sm#_8E [}v#L0bM0overcompensation). Sam avoids getting too close to women, yet denies that he has心理学空间$`)L:bF,vD2Pe,F
any problems in this area (Schema avoidance).
x-w5cvr8_6c0Therapeutic Process - Changing Schemas
x%r4Is9Jd.\0In schema therapy the goal of the treatment is to engage in schema healing processes.心理学空间0N8Bi8j%k3v!rY*x
These processes are intended to weaken the early maladaptive schemas and coping
hTN1p;X$i,v0styles as much as possible, and build up the person’s healthy side. An alliance is formed
8NjG-NEE0between the therapist and the healthy part of the client against the schemas. Any of心理学空间1T3dm(X[C
the therapy activities described below may be seen as examples of schema healing.
[n%Q+FxmJ8HO0The first step in therapy is to do a comprehensive assessment of the client. The main心理学空间+r,T1FwD:n4n'AnA`
goal of this assessment is to identify the schemas and coping styles that are most心理学空间T fj1zQ,r
important in the client’s psychological makeup. There are several steps to this process.
^s8Bo6D0The therapist generally will first want to know about recent events or circumstances in心理学空间 K%\o*tX%fZy{
the clients’ lives which have led them to come for help. The therapist will then discuss心理学空间Gi*R'Z;i'ub0Y s;h6jT z
the client’s life history and look for patterns which may be related to schemas.心理学空间 R_)V$`5q\"G xU*RR [ ?
There are several other steps the therapist will take in assessing schemas. We use the心理学空间G2~(B {t'iX
Young Schema Questionnaire, which the client fills out, listing many of the thoughts,心理学空间.[K(F8ml
feeling and behaviors related to the different schemas; items on this questionnaire can心理学空间xLJ[#J6m$?
be rated as to how relevant to the client’s life they are.心理学空间cDq-w,C}&b
There are also various imagery techniques which the therapist can use to assess
@pp,L$]H0schemas. One specific technique involves asking clients to close their eyes and create an
gxW;d9`/hCs_$Rc0image of themselves as children with their parents. Often the images that appear will心理学空间 I)G V,~ W)I
lead to the core schemas.心理学空间1My5w&P%JAA
Jonathan is a 28 year old executive whose core schema is Mistrust/Abuse. He came
Oaj~@4\7iY0to therapy because he was having bouts of intense anxiety at work, during which he
Vqir:Gw'K0would be overly suspicious and resentful of his co-workers. When asked to create an
8o_5L-O.[:P@(Vx\0image of himself with his family, he had two different images. In the first he saw himself
(f0|"\*Q k"d n0being terrorized by his older brother. In the second he saw his alcoholic father coming
"fI!Ro:s+JG0home and beating his mother, while he cowered in fear.心理学空间 If7GMq G
There are many techniques that the therapist can use to help clients weaken their
r~&Xiey9D0schemas. These techniques can be broken down into four categories: emotive,
y,H'g fK!~0interpersonal, cognitive and behavioral. Each of these categories will be briefly心理学空间k(J,?1xV:}z
discussed, along with a few examples.心理学空间:g(AS(z@ y
Emotive techniques encourage clients to experience and express the emotional aspects
S4r Z7B8P.{B0of their problem. One way this is done is by having clients close their eyes and imagine心理学空间k Q M(IY6U:@7p4\\]
they are having a conversation with the person to whom the emotion is directed. They
;i P6{F$k E.P0are then encouraged to express the emotions as completely as possible in the imaginary
/e$Y7FM&t0dialogue. One woman whose core schema was Emotional Deprivation had several心理学空间 zN0`Z^
such sessions in which she had an opportunity to express her anger at her parents for
j.?-JekAC]%H0not being there enough for her emotionally. Each time she expressed these feelings, she心理学空间S2A%f n ?_~s
was able to distance herself further from the schema. She was able to see that her
#a a ph)@0parents had their own problems which kept them from providing her with adequate
V j2Rb L0nurturance, and that she was not always destined to be deprived.心理学空间O|;WF(\s:gEL
There are many variations on the above technique. Clients may take on the role of the
3JcMhbgb-t0other person in these dialogues, and express what they imagine their feelings to be. Or心理学空间&e1d#PM!i!fBX
they may write a letter to the other person, which they have no intention of mailing, so心理学空间Ht$W5T4O"_`V
that they can express their feelings without inhibition.
$s$M(u3o3{|[s0Mode work can be invaluable as an emotive technique. A client may be feeling a vague心理学空间;f X"`Vh `)I;f
sense of sadness which he can’t clarify. By looking at modes with his therapist he may
JjQ6l#N0connect with a mode that he labels as Unimportant. By dialoging with the therapist
&X'VB sOj k#u*G0from the mode’s point of view many feelings can come out which can be worked on
`:r m0e}|o'[F0further. In this case the client might get in touch not only with the sadness, but also
wv9j\7bWk)k0with anger at being ignored.心理学空间:TH@0E,q nw?
Interpersonal techniques highlight the client’s interactions with other people so that the心理学空间A/t NZ2t%y
role of the schemas can be exposed. One way is by focusing on the relationship with the
{O U9M!w0therapist. Frequently, clients with a Subjugation schema go along with everything the
\"Z(|9y%~y-VT.[0therapist wants, even when they do not consider the assignment or activity relevant.
?oIX:{y,C]4S0They then feel resentment towards the therapist which they display indirectly. This心理学空间3[$]O U+r]o{'Dc?
pattern of compliance and indirect expression of resentment can then be explored to the心理学空间 j u5m1E?
client’s benefit. This may lead to a useful exploration of other instances in which the
cQ G#sS6M8gP0client complies with others and later resents it, and how they might better cope at those
x'c:HPn5z0times.心理学空间RKn+fJ+g h
Another type of interpersonal technique involves including a client’s spouse in therapy. A心理学空间$c}-|)Gs_\
man with a Self-Sacrifice schema might choose a wife who tends to ignore his wishes.心理学空间 c'|xGF M%@R
The therapist may wish to involve the wife in the treatment in order to help the two of
dukC5_}L0them to explore the patterns in their relationship and change the ways in which they
c"eQ:o(b I;kw0interact.
mz,n4Tt_?9Q*P0Cognitive techniques are those in which the schema-driven cognitive distortions are
j#C:swl H0challenged. As in short-term cognitive therapy, the dysfunctional thoughts are identified心理学空间8v5E'?;a]3I3P,_
and the evidence for and against them is considered. Then new thoughts and beliefs are
c,\QdQ5\8XwY0substituted. These techniques help the client see alternative ways to view situations.
3iDe2_ zg0The first step in dealing with schemas cognitively is to examine the evidence for and
b E(UGD9w hL aYuhY0against the specific schema which is being examined. This involves looking at the client’s心理学空间(hl_2V0ta'x$T
life and experiences and considering all the evidence which appears to support or refute
!Q2A)O O+L7}0the schema. The evidence is then examined critically to see if it does, in fact, provide心理学空间$J(` tW3e
support for the schema. Usually the evidence produced will be shown to be in error, and
p2y h3c7Rn9s4WB6sD0not really supportive of the schema.
3Pi_7fT elw#y`.z0For instance, let’s consider a young man with an Emotional Deprivation schema.心理学空间3R$dj1`u
When asked for evidence that his emotional needs will never be met, he brings up心理学空间Z?ZD'i9Ao|
instances in which past girlfriends have not met his needs. However, when these past
u"{-N O |&jd1T E0relationships are looked at carefully, he finds that, as part of the schema surrender心理学空间!P\L wK O$~Vzt
process, he has chosen women who are not capable of giving emotionally. This
(Gd%kb9~z!TQ0understanding gives him a sense of optimism; if he starts selecting his partners心理学空间2h)T/KmC4T3HIo
differently, his needs can probably be met心理学空间%VB9zJ3U6I!c3Mc`
Another cognitive technique is to have a structured dialogue between the client and
:k7Tr2SW0nYy%o0therapist. First, the client takes the side of the schema, and the therapist presents a
h5moCJ.}K0more constructive view. Then the two switch sides, giving the client a chance to
GiJ4E6Z,@&Ox6F4Y0verbalize the alternative point of view.
#z~C~"M{0After having several of these dialogues the client and therapist can then construct a
V5OJG6_H0flashcard for the client, which contains a concise statement of the evidence against the
X/`4Jy+_'bYtJq0schema.
l*@:eem0A typical flashcard for a client with a Defectiveness/Shame schema reads: “I know心理学空间9j8E7|vP;ofq
that I feel that there is something wrong with me but the healthy side of me knows that心理学空间;g Z2i L+v Q
I’m OK. There have been several people who have known me very well and stayed with
a$Uwjr`)eL0me for a long time. I know that I can pursue friendships with many people in whom I心理学空间bx V0C.H1o WB!n
have an interest.”
gSV,X&G|T%Cf2R0The client is instructed to keep the flashcard available at all times and to read it
M|"h7|/N?&]SS1S0whenever the relevant problem starts to occur. By persistent practice at this, and other
)yM"p)T)| E0cognitive techniques, the client’s belief in the schema will gradually weaken.心理学空间*{.z%s? Y A_Of
Behavioral techniques are those in which the therapist assists the client in changing
^n.|'p;L Kg0long-term behavior patterns, so that schema surrender behaviors are reduced and
d ? N-P+YRXV0healthy coping responses are strengthened.心理学空间5Vv^%aQ?"P
One behavioral strategy is to help clients choose partners who are appropriate for them
"F1Zx5Hh0J0and capable of engaging in healthy relationships. Clients with the Emotional
qy2T3qaC g4i0Deprivation schema tend to choose partners who are not emotionally giving. A心理学空间1EWt['Rd
therapist working with such clients would help them through the process of evaluating心理学空间4b n:P#` |,z M7c
and selecting new partners.
n,c`!S:nD6`c0Another behavioral technique consists of teaching clients better communication skills.心理学空间7K4W,Ee$np3W:Q_
For instance, a woman with a Subjugation schema believes that she deserves a raise心理学空间!p ml2@0Q&j*AGDk
at work but does not know how to ask for it. One technique her therapist uses to teach心理学空间D eB"sCX5A ng
her how to speak to her supervisor is role -playing. First, the therapist takes the role of心理学空间l7xd&q:b+K}
the client and the client takes the role of the supervisor. This allows the therapist to心理学空间P_(K KL8k v
demonstrate how to make the request appropriately. Then the client gets an opportunity
!m|m4c`M0to practice the new behaviors, and to get feedback from the therapist before changing心理学空间h1o5`0d o4~Td/e
the behavior in real life situations.心理学空间l9KK,]jHOq;H
IN SUMMARY, schema therapy can help people understand and change long-term life心理学空间&{@0Y ^7T!Qr$a| u(e
patterns. The therapy consists of identifying early maladaptive schemas, coping styles
/~rI LYA3e0and modes, and systematically confronting and challenging them.
)V c4jW-r|K!^0References:心理学空间e B/lb\
Young, J.E., and Klosko, J.S. (1993). Reinventing your life. New York:心理学空间,B5\ w5u fbt
Dutton, 1993.
8Da0gZ'EtU0Young, J.E., Klosko, J.S., and Weishaar, M.E. Schema therapy: A心理学空间v;M:d7Ir1r*\Ya-v
practitioner’s guide. New York: Guilford, 2003.心理学空间v)GeE9g!R
Copyright 2004, Cognitive Therapy Center of New York心理学空间.t0wY0~2P"H
For more information contact:心理学空间:F.~1c7~o]0uw3o
David Bricker, Ph.D.心理学空间 c O o~-x2W{%f
160 Broadway心理学空间n4e&ziKK
New York, NY 10038
7M*{:P3Mj[0(212) 406-3520心理学空间R dtiX gdgZ3K4J;X

www.psychspace.com心理学空间网
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