Overview of Schema Therapy Concepts1

195

To get the most out of the exercises in this book, trainees’ skill building should be inte-

grated with knowledge of schema therapy (ST) theory. ST is a comprehensive approach

in which therapists’ interventions are guided by a case conceptualization that rests on

several concepts. Therefore, knowledge of these concepts and their relationship to

each other is integral to providing effective ST. This appendix provides an overview of

some major ST concepts. We recommend that trainees study these and reﬂect on their

importance for clinical practice and, more speciﬁcally, their relationship to the skills

practiced in this book.

Association of Unmet Core Childhood Needs and Early Maladaptive

Schemas

The following is a list of unmet childhood needs, each of which corresponds with a set

of early maladaptive schemas.

Unmet Core Childhood Needs

1. Safe attachment: love, validation, protection, acceptance

2. Free expression of emotions and needs

3. Playfulness, spontaneity

4. Autonomy, competence, sense of identity

5. Realistic limits, self-control

Early Maladaptive Schemas

1. Disconnection and rejection

• Emotional deprivation

• Defectiveness/shame

• Mistrust/abuse

• Social isolation/alienation

• Abandonment/instability

Overview of Schema

Therapy Concepts

APPENDIX

1. Data from Farrell and Shaw (2018).

196 Appendix C

2. Other directedness

• Approval seeking/recognition seeking

• Subjugation

• Self-sacriﬁce

3. Overvigilance and inhibition

• Negativity/pessimism

• Emotional inhibition

• Unrelenting standards

• Punitiveness

4. Impaired autonomy and performance

• Enmeshment/undeveloped self

• Failure

• Vulnerability to harm/illness

• Dependence/incompetence

5. Impaired limits

• Insufﬁcient self-control/self-discipline

• Entitlement/grandiosity

Descriptions of Schema Modes

• Healthy modes: Adaptive functioning modes that are associated with a sense of

fulﬁllment and well-being

– Happy or contented child

– Healthy adult

• Demanding/punitive inner critic modes: Internalized negative aspects from early

caregivers. Includes punishing and harsh messages (punitive critic) and setting

unreachable expectations and standards (demanding critic)

– Punitive critic

– Demanding critic

• Maladaptive coping modes: Overused survival strategies that are triggered when

schemas related to trauma and unmet needs are activated. These include ﬂight

(avoidance), ﬁght (overcompensation), and freeze (surrender).

– Avoidant protector

– Overcompensator

– Compliant surrenderer

• Innate child modes: Schema-triggered reactions in adulthood related to childhood

unmet needs

– Vulnerable child

– Impulsive or undisciplined child

– Angry child

Appendix C 197

Unmet Core Childhood Needs and Their Associated Schema

Modes

• Lack of secure attachment

– Vulnerable child: The experience of intense loneliness, fear anxiety, sadness

• Lack of validation of feelings and needs, guidance, self-control, and realistic limits

– Angry child: Anger due to perceived unfair treatment or unmet needs

– Impulsive/undisciplined child: Reactively acts on personal desires, with no regard

to other’s needs or limits

• Rejection and suppression of any core need, in particular love, validation, praise,

acceptance, and guidance

– Punitive critic: Harshly punishes and rejects self

– Demanding critic: Pressures self to achieve unreasonably high expectations

• Any unmet childhood need can produce Maladaptive Coping Modes

– Avoidant protector: Breaks relational connections, isolates, physically avoids,

withdraws, dissociates

– Overcompensator: Does the opposite of the early maladaptive schema as a cop-

ing style to counterattack and control; may be somewhat adaptive at times (e.g.,

perfectionistic overcontroller at work)

– Compliant surrender: Acts as if the schema is true, surrendering to it. For example,

in the defectiveness/shame schema, gives up and accepts self as without worth

• Any unmet childhood need can lead to an underdeveloped healthy adult mode

– Healthy adult (underdeveloped): Meets one’s needs in a healthy and mature

manner, enjoying pleasures, maintaining healthy bonds, and fulﬁlling adult life

requirements