Martin & Young (2010) explores the concept of schema therapy, a complementary psychotherapy approach that combines the theory and techniques from formerly existing treatments such as cognitive therapy, Gestalt therapy, behavioral therapy, and constructivism, attachment, and psychoanalytic object relation models. Schema therapy and theoretic framework treat patients with personality disorders, some chronic Axis I diagnoses, characterological problems, and several other challenging emotional, behavior, and psychological issues faced by individuals and couples (Martin & Young 2010). The therapy, according to the handbook, focuses on the characterological and chronic aspects of a disorder as opposed to severe psychiatric symptoms.
The development of schema therapy came as a result of the failure of traditional treatments, including behavioral and cognitive therapies, to benefits clients with personality disorder (PD) and other intricate and chronic disorders. From his clinical experience, Jeffrey Young noted that an intensive cure approach was necessary to help the PD patients and those with other chronic and complex disorders become cognizant of their cognitions and emotions—prompting an integrative form of psychotherapy. Schema therapy operates on the assumption that personality pathology results from adverse childhood experiences and unsatisfied emotional needs. The experiences cause the development of early maladaptive schemas (EMS) (Martin & Young 2010). The primary goal of schema therapy is, therefore, to decrease the influence of the presence of early maladaptive schemas, reduce the impact of maladaptive coping styles, and promote the development of healthy adaptive response.
Early maladaptive schemas (EMSs), as described by the authors, refers to a broad range of self-defeating that develop during the childhood stage and keeps repeating themselves throughout an individual’s life. The EMSs comprise of emotions, cognitions, memories, and bodily sensations, and defines how one sees oneself and the relationships with others. The early maladaptive schemas developed during childhood and adolescence but can pose a significant degree of dysfunctional effects throughout an individual’s life. Maladaptive or dysfunctional schemas are the primary emphasis of schema therapy since cognitive-behavioral therapy has proven ineffective in some cases for the treatment of dysfunctional schemas (Martin & Young 2010).
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EMSs are multifaceted and vary in the degree of pervasiveness, intensity, and frequency of activation. They can generate high levels of disruptive impact, enormously self-defeating consequences, and even substantial harm to others. Schema therapy centers on the early EMSs. The early schemas primarily result from a nuclear family. Other factors such as peers, community groups, school, and culture also become major influencing factors for schema development as the child matures. These toxic repetitive experiences accumulate, translating to the development of schemas, with the most damaging facets, including the child’s feeling of abuse, neglect, abandonment, and rejection (Martin & Young 2010). The impact may be beyond cognitive-behavioral therapy (CBT) treatment.
The authors argue that even though cognitive-behavioral therapy (CBT) is present-focused and brief, some clients have characterological features, chronic and persistent dysfunctions, complicating, and expanding the scope of the therapy. They noted that about 40% of depressed patients do not respond effectively to treatment and about 30% of those who respond experience degeneration in a period of one year or less (Martin & Young 2010). A 40% non-response to treatment is such a worrying figure, which explained the development of schema therapy to comprehensive personality disorders. Different strategies have been proposed to manage schemas and grouped them as coping styles.
Martin & Young (2010) identified three coping styles for maladaptive schemas and included avoidance, surrender, and overcompensation. When one surrenders or submits to a schema, the schema is considered as valid. The individual consents to the schema, not trying to fight the associated feelings. The person directly experiences the emotional impact of the schema. The schema-related configurations are repeated, and the childhood experiences that led to the schema are relieved, and to an extent, strengthened as one transition to adulthood. (Martin & Young 2010). Surrender coping styles of comprising submission and dependence.
Other people may adopt avoidance as a coping style, positioning their lives to discourage schema activation. Any feeling, thought, behavior that relates to the schema is evaded. Such might include work stress, intimate relationships, and to some extent, the whole facet of life that the person perceives vulnerable. Avoidance could be too costly, which is true. You can imagine forfeiting your intimate relationship or quitting your job to evade a schema. The process emphasizes on psychological and social withdrawal, addictive self-soothing, and even drug use, which can generate new problems such as substance addiction. Overcompensation as a coping style, on the one hand, entails doing on the extreme contrasting end of the schema inducing factors, for instance, differentiating oneself with the childhood personalities who developed the schema. However, this can also translate to unproductive behaviors such as aggression, excessive self-assertion, status, and recognition seeking (Martin & Young 2010).
Schema significantly influences our thinking, feelings, behaviors, and social interactions, and outcomes can result in undesirable behaviors. Schema therapy as a treatment to schema-induced personal disorders combines the theory and traditional approaches to cognitive and behavior therapy. Three coping styles for maladaptive schemas include avoidance, surrender, and overcompensation and depend on an individual’s coping capability.
Martin, R., & Young, J. (2010). Schema therapy. Handbook of cognitive-behavioral therapies, 317.