Schema therapy can help individuals identify the thought and behavior patterns underlying and perpetuating mental health conditions. The treatment approach integrates elements from cognitive behavioral therapy, attachment theory, and a number of other approaches, expanding on CBT through exploration of emotions, maladaptive coping methods, and the origin of mental health concerns.
Mental health professionals work with those seeking treatment to discover the origins of any unmet emotional needs. Through schema therapy, people frequently become better able to develop a greater sense of self-worth and adequacy, explore methods of constructing nurturing relationships, and develop and achieve goals to work toward a healthy and happy life experience.
When emotional needs—one’s basic needs for affection, guidance, love, shelter, and safety—go unmet in childhood, individuals may enter adulthood with deficits in their abilities to find ways for these needs to be met, independently and through healthy relationships with others. Schema therapy is based on the belief that early maladaptive schemas form based on these adverse childhood experiences. These maladaptive schemas, which can be described as ways individuals interpret life events and the behavior of others, can later disrupt life: Individuals may make unhealthy choices, form toxic relationships, lack fully developed social skills, engage in destructive behavior patterns, have a poor sense of judgment, and experience feelings of worthlessness or self-doubt.
Identifying and modifying maladaptive schemas is central to schema therapy. Discovering the origins of one’s unmet emotional needs and learning to construct nurturing relationships through schema therapy can help people begin to build feelings of self-worth and adequacy.
Imagery: In this technique, people in therapy explore upsetting childhood memories in an attempt to understand the development of maladaptive schemas. Individuals are first asked to imagine the sights, sounds, and other sensations involved in these memories and then carry on imaginary dialogues with the caregivers involved in these memories and ask for their needs to be met. Following this process, individuals often become more able to identify the current situations eliciting similar emotions and may be more successful at getting needs met in healthy ways in future situations.
Flash cards: In schema therapy, therapists work to help those in therapy create messages designed for the caregivers who failed to meet their childhood emotional needs. These messages can take the form of simple statements, notes, or even complex poems. The person in treatment will typically look over the flash cards between sessions. This regular review is intended to help individuals learn how to make healthy, effective statements about their emotional needs to important people in their adult lives.
Chair work: This aspect of therapy attempts to help those in therapy identify variations in emotions and personality. In chair work, the person in therapy moves between two chairs, expressing different emotions and aspects of personality in each chair. Chair work can also be used to help a person in treatment imagine dialogues with family, friends, or significant others. In this type of chair work, a person might make statements regarding emotional needs while sitting in one chair and then move to another chair to play the role of a person who might meet these emotional needs. Imagery work is often conducted in conjunction with chair work.
Schema therapy was developed to more effectively treat mental health conditions affecting individuals across many periods and aspects of their lives after Dr. Young noticed not only were some concerns especially difficult to treat, but aspects of these conditions continued to cause problems for some individuals, even after generally effective treatment.
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