Dr George Varvatsoulias

Early Maladaptive Schemas are our core patterns or behaviours

that we tend to repeatedly use throughout our lives. Schema Domains relate to the emotional needs of a child. If these needs were not met during our childhoods, unhealthy schemas develop, which then result in unhealthy patterns of behaviour. Coping Styles are the way we adapt to schemas and early life experiences. These are often unhealthy and tend to maintain or worsen the problems. Modes are emotional states that we all use from time to time. They can sometimes lie dormant for a long time, being activated by certain triggers. Whilst we can be in a dominant state or mode for some time, we can flip over into other modes. The different modes are listed below.

Schema Therapy is based upon CBT, but it is focused much more on early childhood experiences which have caused lifelong difficulties.

Maladaptive coping styles serve as elements in the schema perpetuation process

Schema is about memories, emotions, bodily sensations and cognitions, but not behaviours

Behaviour as part of the coping response, not of the schema

Coping styles are changeable; schemas are stable

MALADAPTIVE COPING MODES 1. Compliant Surrenderer: acts in a passive, subservient, submissive, approval-

seeking, or self-deprecating way around others out of fear of conflict or rejection; tolerates abuse and/or bad treatment; does not express healthy needs or desires to others; selects people or engages in other behaviour that directly maintains the self-defeating schema-driven pattern

2. Detached Protector: cuts off needs and feelings; detaches emotionally from people and rejects their help; feels withdrawn, spacey, distracted, disconnected, depersonalized, empty or bored; pursues distracting, self-soothing, or self-stimulating activities in a compulsive way or to excess; may adopt a cynical, aloof or pessimistic stance to avoid investing in people or activities

3. Over-compensator: feels and behaves in an inordinately grandiose,

aggressive, dominant, competitive, arrogant, haughty, condescending, devaluing, over-controlled, controlling, rebellious, manipulative, exploitative, attention-seeking, or status-seeking way. These feelings or behaviours must originally have developed to compensate for or gratify unmet core needs

Surrender: Avoidance:

Overcompensation:

Yielding (giving in) to schemas Schema-driven repetition patterns Passive and compliant so that experiences of

schemas to remain unaltered In therapy he/she adopts the role of the ‘child’

being subjugated to the ‘offending parent’

CHILD MODES 1. Vulnerable Child: feels lonely, isolated, sad, misunderstood, unsupported,

defective, deprived, overwhelmed, incompetent, doubts self, needy, helpless, hopeless, frightened, anxious, worried, victimized, worthless, unloved, unlovable, lost, directionless, fragile, weak, defeated, oppressed, powerless, left out, excluded, pessimistic

2. Angry Child: feels intensely angry, enraged, infuriated, frustrated, impatient because the core emotional (or physical) needs of the vulnerable child are not being met

3. Impulsive/Undisciplined Child : acts on non-core desires or impulses in a selfish or uncontrolled manner to get his or her own way and often has difficulty delaying short-term gratification; often feels intensely angry, enraged, infuriated, frustrated, impatient when these non-core desires or impulses cannot be met.; may appear “spoiled”

4. Happy Child: feels loved, contented, connected, satisfied, fulfilled, protected, accepted, praised, worthwhile, nurtured, guided, understood, validated, self-confident, competent, appropriately autonomous or self-reliant, safe, resilient, strong, in control, adaptable, included, optimistic, spontaneous.

MALADAPTIVE PARENT MODES 1. Punitive Parent: feels that oneself or others deserves

punishment or blame and often acts on these feelings by being blaming, punishing, or abusive towards self (e.g., self-mutilation) or others. This mode refers to the style with which rules are enforced rather than the nature of the rules

2. Demanding Parent: feels that the “right” way to be is to be perfect or achieve at a very high level, to keep everything in order, to strive for high status, to be humble, to puts others needs before one's own or to be efficient or avoid wasting time; or the person feels that it is wrong to express feelings or to act spontaneously. This mode refer to the nature of the internalized high standards and strict rules, rather than the style with which these rules are enforced; these rules are not compensatory in their function.

Healthy Adult: nurtures, validates and affirms the

vulnerable child mode; sets limits for the angry and impulsive child modes; promotes and supports the healthy child mode; combats and eventually replaces the maladaptive coping modes; neutralizes or moderates the maladaptive parent modes. This mode also performs appropriate adult functions such as working, parenting, taking responsibility, and committing; pursues pleasurable adult activities such as sex; intellectual, aesthetic, and cultural interests; health maintenance; and athletic activities.

Avoidance as a coping style towards non-activation of schemas

Reduced awareness as though the schema doesn’t exist

Distraction than concentration is what is chosen, so schemas ‘to be put out of mind’

Indications in the therapeutic relationship for such clients: ‘forgetful’ about homework assignments, emotion elicitation, jumping to irrelevant topics during therapy, come late or don’t come to sessions, terminate sessions without prior notice

Schema avoidance is avoiding the schema either by avoiding situations that trigger the schema or by psychologically removing oneself from the situation so one doesn’t have to feel the schema. An example of avoidance might be a person with a mistrust schema who avoids making friendships because of the fear of being hurt or taken advantage of. This action only tends to reinforce the belief when others pick up the coolness and distance themselves. One could respond to one’s “unrelenting standards” schema with more avoidance. One would avoid situations throughout one’s life that would call forth one’s high standards. Thus one would feel uncomfortable with them and would not want to face them or one’s potential inability to meet them.

Schema overcompensation means ‘fighting’ the schema by thinking, feeling, behaving like the opposite of the schema is true

In attempting to be ‘different’ schematists overdue, either by increasing of reducing behaviours of the past have found unhelpful to themselves

Schema compensation refers to counterattacking previous behaviour through replacement patterns of actions so to activate themselves in a positive way

Schema overcompensation can be viewed as a partially attempt to fight back against the schema, which however is perpetuated rather than healed

Schema overcompensation may lead to egotistic behaviours, i.e. one to fight back without taking into account the needs of others, their feelings or how they are placed in the life of the overcompensator concerned

Overcompensation and ‘entitlement’ Overcompensation and controlling and

domineering behaviours Overcompensation in emotionally deprived

clients Overcompensation and excessive,

insensitive, and/or unproductive (demanding) clients

It offers an alternative to the pain of schema It is a means of escape from the sense of

helplessness and vulnerability the clienet has grown with, e.g. narcissistic overcompensations so that clients to deal with core feelings of emotional deprivation and defectiveness

It brings about unhappiness, for they lose the ability to compensate with behaviours consciously helping to overcome problems, and instead fail to connect deeply with others

Responses of specific behaviours or strategies so surrender, avoidance and overcompensation to be satisfied

Coping responses refer to states, coping styles and can relate to traits, such as neuroticism, low agreeableness, low conscientiousness

Axis II diagnosis Antisocial Personality Disorder Avoidant Personality Disorder Borderline Personality Disorder Dependent Personality Disorder Histrionic Personality Disorder Mental Retardation Narcissistic Personality Disorder Obsessive-Compulsive Personality Disorder Paranoid Personality Disorder Personality Disorder Not Otherwise Specified Schizoid Personality Disorder Schizotypal Personality Disorder

Axis II diagnostic system in DSM-IV-TR is seriously flawed – issues of chronic disorders hard to treat haven’t been clearly considered

Axis I and Axis II disorders to be connected, their observable behaviours need to be distinguished in the elements that make them distinct from one another

Internal schemas lie at the core of personality disorders and the behavioural patterns in DSM-IV-TR are responses to the core schemas

Coping behaviours ARE personality disorders

Overcompensation 1. Aggression, Hostility: Counterattacks through defying, abusing,

blaming, attacking, or criticizing others 2. Dominance, Excessive Self-assertion: Controls others through

direct means to accomplish goals 3. Recognition-seeking, Status-seeking: Overcompensates through

impressing, high achievement, status, attention-seeking, etc. 4. Manipulation, Exploitation: Meets own needs through covert

manipulation, seduction, dishonesty, or conning 5. Passive-aggressiveness, Rebellion: Appears overtly compliant while

punishing others or rebelling covertly through procrastination, pouting, “backstabbing,” lateness, complaining, rebellion, non-performance, etc.

6. Excessive Orderliness, Obsessionality: Maintains strict order, tight self-control, or high level of predictability through order & planning, excessive adherence to routine or ritual, or undue caution. Devotes inordinate time to finding the best way to accomplish tasks or avoid negative outcomes.

Surrender 7. Compliance, Dependence: Relies on others, gives in, seeks affiliation,

passive, dependent, submissive, clinging, avoids conflict, people-pleasing.

Avoidance 8. Social withdrawal, Excessive autonomy: Copes through social isolation,

disconnection, and withdrawal. May demonstrate an exaggerated focus on independence and self-reliance, rather than involvement with others. Sometimes retreats through private activities such as excessive tv watching, reading, recreational computing, or solitary work.

9. Compulsive Stimulation-seeking: Seeks excitement or distraction through compulsive shopping, sex, gambling, risk-taking, physical activity, novelty, etc.

10. Addictive Self-Soothing: Avoids through addictions involving the body, such as alcohol, drugs, overeating, excessive masturbation, etc.

11. Psychological Withdrawal: Copes through dissociation, numbness, denial, fantasy, or other internal forms of psychological escape