Schema focused therapy
In schema therapy, a therapeutic approach developed by Jeffrey Young, schemas and modes are key
concepts used to understand how people cope with their issues and how old patterns of behavior
and thinking develop.
In schema therapy, the following basic emotional needs are essential for healthy psychological
development. When these needs are unmet, they can contribute to the development of maladaptive
schemas, which can influence a person’s thoughts, emotions, and behaviors in a negative way
throughout their life. Here is an explanation of each of the seven needs you mentioned:
1. Safety and Connection
• Need: The need for emotional and physical safety, a sense of security, and stable, reliable
connections with others. This involves feeling protected from harm and having secure
relationships where trust is present.
• Impact of Unmet Need: If this need is unmet, individuals may develop schemas related to
abandonment, mistrust, or vulnerability, which can lead them to feel unsafe, insecure, and
unable to trust others. They might also feel emotionally isolated.
2. Acceptance
• Need: The need to feel loved, accepted, and valued by others. This involves receiving
emotional support, validation, and positive regard from significant people in a person’s life.
• Impact of Unmet Need: When this need is not met, individuals may develop schemas of
defectiveness or shame, where they believe they are unworthy of love or attention. This can
lead to feelings of inferiority or rejection and can cause difficulties in forming healthy
relationships.
3. Autonomy
• Need: The need to develop independence, personal responsibility, and a sense of self-
sufficiency. It involves the ability to make choices, set goals, and solve problems
independently.
• Impact of Unmet Need: When autonomy is not nurtured, individuals may develop schemas
of dependence, failure, or vulnerability. They might feel incapable of managing their life or
overly reliant on others for guidance and decision-making.
4. Self-Expression
• Need: The need for personal expression, creativity, and the ability to share thoughts, feelings,
and desires freely. This includes expressing emotions and desires in an authentic, open way.
• Impact of Unmet Need: If this need is neglected, individuals may develop schemas of
emotional inhibition or suppression, where they feel unable to express themselves fully or
may suppress their emotions. This can lead to frustration, anger, or anxiety as they struggle
to communicate their true selves.
5. Boundaries
• Need: The need for clear, healthy boundaries in relationships, as well as the ability to
recognize and assert one’s limits. This includes both respecting others' boundaries and having
one's own respected.
• Impact of Unmet Need: When boundaries are not established, individuals may develop
schemas like entitlement, self-sacrifice, or overprotection. They might either feel
overwhelmed by others' demands or have difficulty respecting their own limits, leading to
emotional exhaustion or resentment.
6. Justice
• Need: The need for fairness, equal treatment, and justice in relationships and society. This
involves having one's rights respected and receiving equal opportunities and treatment.
• Impact of Unmet Need: When this need is unmet, individuals may develop schemas of
unfairness or entitlement, feeling that they have been treated unfairly or that they deserve
more than others. They may become resentful or have difficulty accepting situations where
they perceive unfairness.
7. Self-Coherence
• Need: The need to develop a coherent, stable sense of self and identity. This includes
understanding one’s values, goals, and life purpose and feeling confident in one's identity.
• Impact of Unmet Need: If this need is not fulfilled, individuals may experience confusion,
identity issues, or a lack of direction in life. They may develop schemas of identity confusion
or defectiveness, feeling disconnected from who they truly are or unsure of their place in the
world.
Summary
In schema therapy, these seven basic emotional needs are considered essential for healthy
psychological functioning. When these needs are unmet during childhood or adulthood, they can
lead to the formation of maladaptive schemas that influence behavior and emotions in negative
ways. The goal of schema therapy is to help individuals identify and address these unmet needs,
fostering healthier ways of thinking, feeling, and interacting with the world.
Schemas in Schema Therapy
Schemas are deeply ingrained, negative beliefs and patterns about oneself, others, and the world.
They usually develop in childhood or adolescence and may result from incomplete or traumatic
experiences. These schemas influence how a person views themselves, how they experience others,
and how they interpret the world.
These schemas can develop further and manifest in negative thoughts, feelings, and behaviors. They
can be hard to change because they are deeply rooted in the person.
Modes in Schema Therapy
A mode is a specific emotional state or "personality state" that a person can experience, usually in
response to situations that activate one of their schemas. Modes can be seen as different ways a
person feels or behaves depending on the context and the activation of a schema.
How Schemas and Modes Work Together
In schema therapy, the focus is on identifying the schemas and modes that develop through the
activation of those schemas. When a schema is triggered (e.g., by a stressful situation), it can activate
a specific mode. The goal of therapy is to make the patient aware of these processes and help them
develop healthier ways of responding by utilizing the healthy adult mode more effectively.
An important part of schema therapy is also breaking the vicious cycles of negative schemas and
dysfunctional modes, so that individuals can learn to cope with their emotions and behaviors in a
more mature and healthy way.
In summary:
• Schemas are core beliefs and patterns that influence how we experience the world.
• Modes are the different emotional states or behaviors we exhibit depending on how a
schema is activated.
Overview different maladaptive schemes
1. ABANDONMENT / INSTABILITY (AB)
The perceived instability or unreliability of those available for support and connection.
Involves the sense that significant others will not be able to continue providing emotional support,
connection, strength, or practical protection because they are emotionally unstable and
unpredictable (e.g., angry outbursts), unreliable, or erratically present; because they will die
imminently; or because they will abandon the patient in favor of someone better.
2. MISTRUST / ABUSE (MA)
The expectation that others will hurt, abuse, humiliate, cheat, lie, manipulate, or take
advantage. Usually involves the perception that the harm is intentional or the result of unjustified
and extreme negligence. May include the sense that one always ends up being cheated relative to
others or "getting the short end of the stick."
3. EMOTIONAL DEPRIVATION (ED)
Expectation that one's desire for a normal degree of emotional support will not be adequately met
by others. The three major forms of deprivation are:
A. Deprivation of Nurturance: Absence of attention, affection, warmth, or companionship.
B. Deprivation of Empathy: Absence of understanding, listening, self-disclosure, or mutual sharing
of feelings from others.
C. Deprivation of Protection: Absence of strength, direction, or guidance from others.
4. DEFECTIVENESS / SHAME (DS)
The feeling that one is defective, bad, unwanted, inferior, or invalid in important respects; or that
one would be unlovable to significant others if exposed. May involve hypersensitivity to criticism,
rejection, and blame; self-consciousness, comparisons, and insecurity around others; or a sense of
shame regarding one's perceived flaws. These flaws may be private (e.g., selfishness, angry impulses,
unacceptable sexual desires) or public (e.g., undesirable physical appearance, social awkwardness).
5. SOCIAL ISOLATION / ALIENATION (SI)
The feeling that one is isolated from the rest of the world, different from other people, and/or not
part of any group or community.
6. DEPENDENCE / INCOMPETENCE (DI)
Belief that one is unable to handle one's everyday responsibilities in a competent manner, without
considerable help from others (e.g., take care of oneself, solve daily problems, exercise good
judgment, tackle new tasks, make good decisions). Often presents as helplessness.
7. VULNERABILITY TO HARM OR ILLNESS (VH)
Exaggerated fear that imminent catastrophe will strike at any time and that one will be unable to
prevent it. Fears focus on one or more of the following: (A) Medical Catastrophes: e.g., heart attacks,
AIDS; (B) Emotional Catastrophes: e.g., going crazy; (C): External Catastrophes: e.g., elevators
collapsing, victimized by criminals, airplane crashes, earthquakes.
8. ENMESHMENT / UNDEVELOPED SELF (EM)
Excessive emotional involvement and closeness with one or more significant others (often
parents), at the expense of full individuation or normal social development. Often involves the belief
that at least one of the enmeshed individuals cannot survive or be happy without the constant
support of the other. May also include feelings of being smothered by, or fused with,
others OR insufficient individual identity. Often experienced as a feeling of emptiness and
floundering, having no direction, or in extreme cases questioning one's existence.
9. FAILURE TO ACHIEVE (FA)
The belief that one has failed, will inevitably fail, or is fundamentally inadequate relative to one's
peers, in areas of achievement (school, career, sports, etc.). Often involves beliefs that one is stupid,
inept, untalented, ignorant, lower in status, less successful than others, etc.
10. ENTITLEMENT / GRANDIOSITY (ET)
The belief that one is superior to other people; entitled to special rights and privileges; or not
bound by the rules of reciprocity that guide normal social interaction. Often involves insistence that
one should be able to do or have whatever one wants, regardless of what is realistic, what others
consider reasonable, or the cost to others; OR an exaggerated focus on superiority (e.g., being
among the most successful, famous, wealthy) -- in order to achieve power or control (not primarily
for attention or approval). Sometimes includes excessive competitiveness toward, or domination of,
others: asserting one's power, forcing one's point of view, or controlling the behavior of others in line
with one's own desires---without empathy or concern for others' needs or feelings.
11. INSUFFICIENT SELF-CONTROL / SELF-DISCIPLINE (IS)
Pervasive difficulty or refusal to exercise sufficient self-control and frustration tolerance to achieve
one's personal goals, or to restrain the excessive expression of one's emotions and impulses. In its
milder form, patient presents with an exaggerated emphasis on discomfort-avoidance: avoiding
pain, conflict, confrontation, responsibility, or overexertion---at the expense of personal fulfillment,
commitment, or integrity.
12. SUBJUGATION (SB)
Excessive surrendering of control to others because one feels coerced - - usually to avoid anger,
retaliation, or abandonment. The two major forms of subjugation are:
A. Subjugation of Needs: Suppression of one's preferences, decisions, and desires.
B. Subjugation of Emotions: Suppression of emotional expression, especially anger.
Usually involves the perception that one's own desires, opinions, and feelings are not valid or
important to others. Frequently presents as excessive compliance, combined with hypersensitivity to
feeling trapped. Generally leads to a build up of anger, manifested in maladaptive symptoms (e.g.,
passive-aggressive behavior, uncontrolled outbursts of temper, psychosomatic symptoms, withdrawal
of affection, "acting out", substance abuse).
13. SELF-SACRIFICE (SS)
Excessive focus on voluntarily meeting the needs of others in daily situations, at the expense of
one's own gratification. The most common reasons are: to prevent causing pain to others; to avoid
guilt from feeling selfish; or to maintain the connection with others perceived as needy . Often
results from an acute sensitivity to the pain of others. Sometimes leads to a sense that one's own
needs are not being adequately met and to resentment of those who are taken care of. (Overlaps
with concept of codependency.)
14. APPROVAL-SEEKING / RECOGNITION-SEEKING (AS)
Excessive emphasis on gaining approval, recognition, or attention from other people, or fitting in,
at the expense of developing a secure and true sense of self. One's sense of esteem is dependent
primarily on the reactions of others rather than on one's own natural inclinations. Sometimes
includes an overemphasis on status, appearance, social acceptance, money, or achievement -- as
means of gaining approval, admiration, or attention (not primarily for power or control). Frequently
results in major life decisions that are inauthentic or unsatisfying; or in hypersensitivity to rejection.
15. NEGATIVITY / PESSIMISM (NP)
A pervasive, lifelong focus on the negative aspects of life (pain, death, loss, disappointment,
conflict, guilt, resentment, unsolved problems, potential mistakes, betrayal, things that could go
wrong, etc.) while minimizing or neglecting the positive or optimistic aspects. Usually includes an
exaggerated expectation-- in a wide range of work, financial, or interpersonal situations -- that things
will eventually go seriously wrong, or that aspects of one's life that seem to be going well will
ultimately fall apart. Usually involves an inordinate fear of making mistakes that might lead to:
financial collapse, loss, humiliation, or being trapped in a bad situation. Because potential negative
outcomes are exaggerated, these patients are frequently characterized by chronic worry, vigilance,
complaining, or indecision.
16. EMOTIONAL INHIBITION (EI)
The excessive inhibition of spontaneous action, feeling, or communication -- usually to avoid
disapproval by others, feelings of shame, or losing control of one's impulses. The most common areas
of inhibition involve: (a) inhibition of anger & aggression; (b) inhibition of positive impulses (e.g., joy,
affection, sexual excitement, play); (c) difficulty expressing vulnerability or communicating freely
about one's feelings, needs, etc.; or (d) excessive emphasis on rationality while disregarding
emotions.
17. UNRELENTING STANDARDS / HYPERCRITICALNESS (US)
The underlying belief that one must strive to meet very high internalized standards of behavior and
performance, usually to avoid criticism. Typically results in feelings of pressure or difficulty slowing
down; and in hypercriticalness toward oneself and others. Must involve significant impairment
in: pleasure, relaxation, health, self-esteem, sense of accomplishment, or satisfying relationships.
Unrelenting standards typically present as: (a) perfectionism, inordinate attention to detail, or an
underestimate of how good one's own performance is relative to the norm; (b) rigid rules and
“shoulds” in many areas of life, including unrealistically high moral, ethical, cultural, or religious
precepts; or (c) preoccupation with time and efficiency, so that more can be accomplished.
18. PUNITIVENESS (PU)
The belief that people should be harshly punished for making mistakes. Involves the tendency to
be angry, intolerant, punitive, and impatient with those people (including oneself) who do not meet
one's expectations or standards. Usually includes difficulty forgiving mistakes in oneself or others,
because of a reluctance to consider extenuating circumstances, allow for human imperfection, or
empathize with feelings.
