Schema therapy is an approach that addresses the deeper held ‘unconditional beliefs that can maintain the suffering and despair experienced with depression.
The term, “schema” refers to a cognitive structure, and with schema theory of emotional disorders, it is the content of these structures, which are given most consideration. With schemas that are the source of a clients, cognitive (thinking, beliefs), emotional and behavioural maladaptive responses, because the content is taken as truths about the self and the world, it is hypothesised the schema are unconditional, rigid, inflexible and concrete and are associated with the maintenance of their emotional and psychological problems.
Schemas are deep cognitive structures that enable an individual to interpret his or her experiences in a meaningful way, or how to make sense of their world (Beck 1976). In Cognitive Theory, depressed clients have distorted negative schema, (e.g. “I am inept”), which, when activated by life events give rise to negative automatic thoughts, (e.g. “I can’t do this”), problematic moods, (e.g. depression, helplessness, hopelessness, and maladaptive behaviours, (e.g. procrastination).
Beck, (1976) described four types of schemas: Views of self, others, the world and the future. He proposed that depressed clients hold negative, distorted views of them selves, (e.g. worthless, useless, a loser, bad, defective, unlovable, second rate, a piece of garbage), others, (e.g. uncaring, attacking, critical, rejecting), the world, (e.g. burdensome, dark and unforgiving, bleak, ungratifying, punishing), and the future, (e.g. hopeless, unrewarding, futile).
A Core Belief or Schema (Defectiveness and Shame)
An example of Schema or unconditional beliefs that clients often present with in therapy reflects ‘Defectiveness and Shame’. Based on schema theory this indicates that the individual believes they are (without condition), defective, bad, unwanted, inferior or of no value to others, or they are unlovable to significant others in their lives. These clients are usually hypersensitive to criticism, rejection, and blame. They are self-conscious and insecure around others and may continually focus on their flaws and are ashamed of their fallibility. They often believe they don’t fit in their social group, because they perceive themselves as different in negative ways.
Defectiveness and shame at a schema level can also lead to the development of other schema as a way of compensating or an attempt at silencing or keeping the shameful beliefs buried. This can be an over emphasis on gaining approval and attention from others or trying to fit in at the cost of developing a true and real sense of self. The individual’s self-acceptance is reliant on the reactions of others and not on their own self-regard. Individuals who are influenced by their sense of defectiveness and shame can place great emphasis on, and are vigilant about status, appearance and money; this is not for power or control but as a way of gaining attention and social acceptance.
As you can imagine a core belief that maintains shame can lead to difficulty with coping in many domains of life, including intimate relationships, career, socialising and education, and affect decision making that may require a level of risk.
Where do Schemas or Core Beliefs come from?
We learn these negative schemas from our parents, siblings, peers and partners. Parents might contribute to these negative schemas by making you feel that you are not good enough unless you are superior to everyone. They may tell you that you are too fat or not attractive. They may compare you to other children who are “doing better”, telling you that you are selfish because you have needs. They may threaten to kill themselves or to abandon you.
There are many different ways that parents teach children these negative schemas about themselves and others.
For example, think about the following experiences that people recall about how their parents “taught” them their negative schemas:
- “You could do better – why did you get a B?” – this schema is about the need to be perfect or avoid inferiority.
- “Your thighs are too fat and your nose is ugly”: schema about fatness and ugliness.
- “Your cousin went to Auckland Boys – why can’t you be more like him?”: schema about inferiority and incompetence.
- “Why are you always complaining? Can’t you see that I have problems taking care of you kids?”: schema about the selfishness of needs.
- “Maybe I should just leave and let you kids take care of yourself “: schema about burden and abandonment.
Another source of schemas may be people other than your parents. Perhaps your brother or sister mistreated you, leading you to form schemas of being abused, unlovable, rejected, or controlled. Or perhaps your partner has told you you’re not good enough, leading to schemas of being unattractive, unworthy, and unlovable.
We even internalise schemas from popular culture, such as images of being thin and beautiful, having a perfect body, “what real men should be like”, perfect sex, lots of money and images that equate to having achieved enormous success. These unrealistic images reinforce schemas about perfection, superiority, inadequacy and defectiveness.
Schema therapy is an approach that addresses the deeper held ‘unconditional beliefs and can be implemented to great success.
