What is schema therapy?
As a Cognitive Therapist and Advanced Accredited Schema Therapist, I help people with a wide range of problems at my East Finchley practice. But what is schema therapy – and which kinds of problems can it help with? Developed by Jeffrey Young in the 1980s, schema therapy is an integrative approach that builds on traditional cognitive therapy by adding ideas and techniques from other approaches, such as psychodynamic and Gestalt therapies. It is a warm, compassionate approach that focuses as much on the healing relationship between therapist and client as it does on changing ways of thinking and behaving.
The central idea in schema therapy is that we all have unmet needs from childhood – such as the need to be loved, protected and valued as a unique human being. When these core needs are not met, for any reason, we develop a 'schema' – a pattern of thoughts, feelings, memories and body sensations that gets triggered throughout the rest of our lives. For example, we may have a Defectiveness schema, because our parents were overly harsh or critical, made us feel we were bad or worthless in some way. When we are harshly criticised as an adult, or are placed in a stressful situation that echoes childhood experiences, this schema gets triggered and we may feel extremely anxious, unconfident or upset; we might also remember all the times we have felt the same way before, or times when other people criticised or hurt us.
Most courses of cognitive therapy last for between 10 and 20 sessions, but schema therapy is a longer-term approach that lasts from 20 sessions to a year or more, depending on how serious and hard to treat your problems are. In the first stage of therapy, we will identify which are your core schemas and how they developed (usually in childhood, but sometimes in adolescence or early adulthood). We will also work out which 'modes' you have – different sides to your personality which help you cope with your problems, but often in an unhelpful way which serves to maintain, rather than solve those problems (drinking too much to cope with depression, for example; or avoiding groups of people if you are socially anxious).
We can then use all of the standard cognitive therapy techniques to help heal your schemas, as well as experiential techniques such as guided imagery, which can be incredibly healing and transformative. Over time, you will begin to feel less anxious, depressed and unhappy; and learn new ways of thinking and behaving which help you get your needs met. This will help you feel happier, stronger and more in control of your life.
Schema therapy can help with all sorts of problems, but especially ones which may have been resistant to standard CBT or other forms of therapy, such as long-term anxiety or depression, OCD, panic disorder, low self-esteem, eating disorders, addiction, difficulties in relationships and even personality problems such as Borderline or Narcissistic Personality Disorder.