Schema Therapy: How it differs from CBT

CBT

Standard Cognitive-Behavioural Therapy (CBT) is considered the gold standard for depression and anxiety and adjustment conditions. It is a talk therapy that involves helping people to recognize their triggers for mood disturbance and exploring unhelpful thoughts that may be adding to their suffering or unhelpful behaviours that are holding them back in life. The therapy provides a practical tool kit to assist people to question unhelpful thinking to gain perspective and find ways of coping that help people adapt to stressful situations in their life. CBT is like a gardening tool that allows people to cut the weeds from their garden (unhelpful thoughts and behaviour) in order to make way for more flowers (insight and coping).

Schema Therapy

For some people, if weeds are cut down, they may keep growing back. The reason for this is that there may be deeper core beliefs and unresolved wounds in the root system that have not been addressed such as trauma or unmet needs. Additionally, the soil may not have enough nutrients to allow for growth (unmet basic needs). Schema therapy allows for the weeds to be uprooted and new seeds to be planted for the garden to thrive. Schema therapy is a talk therapy that helps people uncover core beliefs that are holding them back and the origins in terms of wounds from past painful events. Children can absorb messages like sponges if traumatic or negative life events occurred, and people can hold onto these internalized messages in later life. Schema therapy allows people to adopt a healthier adult perspective of past events that may allow them to see a more balanced picture of themselves and their life. Schema therapy also allows people to identify unmet childhood needs and learn how to re-parent those needs for themselves. The aim is to create the ingredients necessary for growth and thriving.

Can you relate to any of these schemas under stress?

Fear of failure – persistent self-doubt in the face of new tasks or goals and anticipating failure to achieve positive outcomes. This may be in the form of self-criticism or undermining yourself with procrastination or ending tasks prematurely to avoid possible disappointment. People with this schema may stay in their comfort zones of familiarity which can lead to feeling restricted and over-protecting themselves.

Fear of abandonment – feeling insecure in relationships that are healthy. This may come in the form of anticipating that people will let you down or leave. A common fear is that if you reveal their true self, others will not stick around. This can lead to masking their true self, testing the relationship unnecessarily, or prematurely ending a relationship unnecessarily.

Mistrust – a sense of hypervigilance in terms of anticipating danger or harm from others, when there is not firm evidence for this. This may come in the form of fear of being hurt or ridiculed if you show vulnerability or there is true intimacy, or fear of letting your guard down in case you are taken advantage of. This mistrust may get in the way of forming closer relationships or taking healthy risks.

Self-sacrifice – this is similar to people pleasing. Self-sacrifice is a tendency to be hyper-focused on the needs of others and not feel like your needs are important. It involves excessively caring for others in a way that compromises your own wellbeing. For example, over-extending yourself at work or in your personal life until you have no energy left to care for yourself. Self-sacrifice can lead to feeling resentful or burnout in the long run.

Unrelenting standards – having perfectionistic standards of yourself or others in terms of constantly striving for better, and never feeling like it is quite good enough. This can involve expecting too much of yourself or others in a way that creates unnecessary pressure. This may interfere with the ability to relax or feel joy due to achievement being consuming.

Defectiveness – when a person has a strong inner critic this can often be a reflection of low self-esteem. This may come in the form of not feeling worthy or deserving of good things or feeling unlovable, bad, or useless. This may lead to feeling inadequate and having difficulty with self-acceptance or self-compassion.

If you can relate to any of the above schemas and think that you may benefit from Schema Therapy, or think CBT has been ineffective in the past, feel free to contact Katherine or Tim Bonaldi at In Bloom Psychology.

Written by Katherine and Tim Bonaldi, In Bloom Psychology.

References:

Greenberger, D & Padesky, C. (2015). Mind Over Mood. Change How You Feel by Changing the Way You Think.

Young, J. & Klosko, J. (2019). Re-inventing your life.