What Is Schema Therapy?

Schema therapy treats personality disorders and other treatment-resistant mental health conditions through the framework of schemas. Schemas are patterns or themes developed in childhood that affect how you relate to yourself and others.

Schema Therapy Basics

Schema therapy is based on four main concepts:

• Core needs: People have a series of basic emotional needs in childhood, including security, affection, connection, autonomy, play, self-expression, nurturing, and identity. Everyone has the same core needs.
• Early maladaptive schemas: Schemas are patterns or themes about yourself and your relationships with others. We develop schemas during childhood when our core needs are unmet. Schemas are considered maladaptive because they are at least somewhat dysfunctional.
• Coping styles: In response to your schemas, you will develop certain behaviors known as coping styles. These styles can be maladaptive as well. Often, they end up reinforcing the original schema.
• Schema modes: Schema modes encompass our schemas, coping styles, and current emotional state. They are ways of responding to emotional stimuli. Many schema modes are unhealthy or maladaptive, while others are healthy.

What Is Schema Therapy Good for?

Schema therapy is particularly effective for people struggling with:

• Borderline personality disorder (BPD)
• Anxiety 
• Depression 
• Posttraumatic stress disorder (PTSD) 

18 Early Maladaptive Schemas

Dr. Jeffrey Young, founder of schema therapy, discovered 18 early maladaptive schemas that can be separated into five distinct categories, also known as schema domains.

1. Disconnection/Rejection Schemas

1. Abandonment/instability (AB) schema: Inability to trust others to provide support or protection
2. Mistrust/abuse (MA) schema: The belief that others will intentionally harm you
3. Emotional deprivation (ED) schema: Inability to trust others to provide a basic level of emotional support or care (listening, showing affection, offering guidance, etc.)
4. Defectiveness/shame (DS) schema: The belief that, at your core, something is wrong with you, making you unlovable
5. Social isolation/alienation (SI) schema: The belief that you are alone and separate from others in the world

2. Impaired Autonomy/Performance Schemas

6. Dependence/incompetence (DI) schema: Lack of faith in your own ability to take care of yourself without the help of others
7. Vulnerability to harm or illness (VH) schema: Overwhelming preoccupation with imminent danger or catastrophe, such as the diagnosis of a deadly disease
8. Enmeshment/underdeveloped self (EM) schema: Overinvolvement with another person, usually a parent or guardian, to the point that your individual self is severely stifled or completely suppressed
9. Failure to achieve (FA) schema: Overwhelming preoccupation with past and future failures, often identifying as a failure of a person in general

3. Impaired Limits Schemas

10. Entitlement/grandiosity (ET) schema: The belief that you are inherently better than everyone else and should therefore have power and control over others
11. Insufficient self-control/self-discipline (IS) schema: Inability to control your emotions and impulses to achieve your desired goals

4. Other-Directed Schemas

12. Subjugation (SB) schema: Suppressing your needs, feelings, and opinions as a way of protecting yourself
13. Self-sacrifice (SS) schema: Meeting others’ needs at the expense of your own
14. Approval-seeking/recognition-seeking (AS) schema: Overwhelming preoccupation with receiving praise and attention at the expense of expressing your true self

5. Over-Vigilance/Inhibition Schemas

15. Negativity/pessimism (NP) schema: Overwhelming preoccupation with the negative aspects of life at the expense of the positive
16. Emotional inhibition (EI) schema: Suppressing your emotions and overly relying on logic and analysis as a way of protecting yourself
17. Unrelenting standards/hypercriticalness (US) schema: Overwhelming preoccupation with perfection, rules, and efficiency
18. Punitiveness (PU) schema: The belief that punishment is the only acceptable response to mistakes, at the expense of forgiveness or empathy

What Causes Early Maladaptive Schemas?

When our core needs go unmet, we develop early maladaptive schemas. Common causes of schemas include:

• Instability at home 
• Abuse or neglect
• Trauma
• Overprotective or overindulgent parenting 
• Lack of age-appropriate boundaries
• Controlling or demanding parenting
• Overidentification with a parent or influential adult

Coping Styles

Although there are 18 different schemas, how we cope with our schemas also varies. This means that two people with the same schema may behave in different ways. The three main coping styles for schemas are:

• Surrender: Doing as the schema dictates
• Avoidance: Trying to find a way around doing what the schema dictates
• Overcompensation: Doing the opposite of what the schema dictates

For example, if you were a student living with the unrelenting standards/hypercriticalness (US) schema, you may cope in one of the following ways:

• Surrender: Try to live to the highest level of perfection possible. You might pull all-nighters and neglect your social life just to be the valedictorian of your class.
• Avoidance: Look for ways to satisfy the need for perfection without actually being perfect. Instead of trying to be valedictorian, you might justify your average grades by changing the definition of perfection to mean being well-rounded and not hyper-focused on academics.
• Overcompensation: Actively rebel against perfection. You might skip school, fail your classes, and fall into the wrong crowd, trying to escape the feeling that you’re not good enough.

Schema Modes

Schema modes are sort of like scripts. They combine our schemas with our preferred coping styles to create a ready response to anything that triggers our past trauma or threatens our sense of safety. Our schema modes are part of us, but they are also a bit disconnected from our true sense of self, like playing a role.

Multiple schema modes can be at play in one person. Dr. Young discovered ten possible schema modes that can be separated into four distinct categories:

1. Innate Child Schema Modes

1. Vulnerable child mode: The vulnerable child feels helpless, needy, weak, and misunderstood. They have needs but don’t know how to meet them.
2. Angry child mode: The angry child feels frustrated and impatient that the vulnerable child’s needs are not being met.
3. Impulsive/undisciplined child mode: The impulsive child insists on getting their wants met instead of their needs. This can lead to selfish or risky behavior.
4. Contented child mode: The contented child feels loved and supported. Their needs have been met.

2. Maladaptive Coping Schema Modes

5. Compliant surrenderer mode: The surrenderer tolerates poor treatment or abuse. They struggle with boundaries because they fear rejection.
6. Detached protector mode: The protector cuts themselves off from others as a way to protect themselves. They may feel detached from the world to the point of dissociation.
7. Overcompensator mode: The overcompensator becomes a large, overbearing presence in an attempt to assert control. They become aggressive and domineering to get their needs met.

3. Maladaptive Parent Schema Modes

8. Punitive parent mode: The punitive parent actively punishes themselves and others when mistakes are made. This may take the form of abuse or self-harm.
9. Demanding or critical parent mode: The demanding parent insists on perfection at the expense of the individual self.

4. Healthy Adult Mode

10. Healthy adult mode: The healthy adult validates, limits, supports, and/or moderates the other schema modes as necessary. This allows the healthy adult to experience life in a healthy, functional way.

How Does Schema Therapy Work?

Much of schema therapy focuses on identifying the unmet core needs, early maladaptive schemas, coping styles, and schema modes currently at work in an individual. Once these basics have been identified, your schema therapist will employ a variety of techniques to challenge and change your schemas, including:

• Limited reparenting: Your schema therapist can, at an appropriate level, offer the validation and support of your core needs that you needed from your parents when you were a child.
• Empathetic confrontation: Your therapist will help you confront your maladaptive schemas in a nonjudgmental way so you can commit to change.
• Cognitive strategies: You may be encouraged to use your cognitive skills to question the story your schema is proposing. For example, if you have the vulnerability to harm or illness (VH) schema, you may be asked to list the pros and cons of living under the constant assumption that you’re on the brink of catastrophe.
• Emotional strategies: Techniques that focus on emotional expression and closure can be effective in schema therapy.
• Behavioral strategies: Your therapist may assign you certain habits or activities as homework to challenge your schemas.

Visit our directory to find a schema therapist near you today.

Related Therapies

Schema therapy integrates principles from a variety of other therapies and psychological theories, including:

• Attachment theory: Like schema therapy, attachment theory is based on the concept that early childhood experiences create patterns in how we build relationships. These are known as attachment styles. In attachment theory, these critical experiences take place during infancy. In schema therapy, these experiences take place throughout childhood and into adolescence.
• Cognitive behavioral therapy (CBT): CBT helps people identify unhelpful or negative thought patterns that affect their emotions and behaviors. Schema therapy uses cognitive, emotional, and behavioral techniques to help people identify their maladaptive schemas and adopt healthier behaviors.
• Emotionally focused therapy (EFT): EFT helps people restructure their emotional responses to help strengthen their relationships. Schema therapy also focuses on the emotional and relational impacts of our patterns of behavior.
• Gestalt therapy: Gestalt therapy techniques involving re-enactment, such as the empty chair technique, are often used in schema therapy.