Schema Therapy is a new and integrative way of treating chronic mental health issues and personality disorders. Our team of psychologists, clinical psychologists and therapists are trained in Schema Therapy and see clients in our Melbourne CBD rooms. We treat a range of issues with Schema Therapy including:
- anxiety disorders
- borderline personality disorder
- complex trauma
- eating disorders
- mood disorders such as depression and anxiety
Schema Therapy combines a few different evidence based therapies such as cognitive-behavioural therapy (CBT), psychoanalytic theories, attachment theory and gestalt therapy. At its core it is about identifying and changing deep patterns – known as schemas – that were formed in early life and continue to impact a person’s thoughts, feelings and behaviour into adulthood.
@covapsychology Part 2: @Cova Psychology | Psychologist Psychologist and trauma therapist Chris defines what a schema is. For more information about schemas and schema therapy see our website https://covapsychology.com/how-we-help/schema-therapy-at-cova-psychology/ if you’re looking to engage a psychologist Melbourne for schema therapy don’t hesitate to get in touch. #therapytiktok #mentalhealthawareness #mentalhealthmatters #foryoupage #psychologistsoftiktok #traumatherapy #wellnesstips #traumatok #ptsdawareness #depression #depressionanxiety #anxietydisorder #anxiety #stress #emotionalintelligence ♬ original sound - Cova Psychology | Psychologist
Table of Contents
Childhood Emotional Needs in Schema Therapy
Childhood emotional needs are what kids need to support healthy emotional and psychological development. These are the need for love, security, acceptance and validation. Let’s break this down: Firstly, kids thrive when they feel consistently nurtured, understood and valued by their caregivers and this helps them develop a secure attachment and self esteem. Alongside this they also need guidance, structure and the freedom to explore in a safe environment to develop autonomy and confidence. And finally they need empathy and encouragement to help them develop emotional regulation and resilience. When these needs are met kids are more likely to grow into emotionally healthy well adjusted adults but unmet needs can lead to long term emotional challenges often in the form of maladaptive beliefs or schemas. These challenges can show up as various mental health issues in adulthood.
Schema Therapy has identified 18 different schemas which are grouped into 5 domains. Each domain represents a core emotional need that was not met in early development. Schema Therapy can address these areas. Our Melbourne psychologists may also combine Schema Therapy with other therapies such as Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT) to suit individual needs. The 18 schemas are:
A. Disconnection and Rejection
This domain includes schemas about the belief that one’s needs for safety, stability, nurturance and acceptance will not be met in a predictable way.
Abandonment / Instability Schema
People with this schema fear that those close to them will not be able to provide the support and connection they need either because they are emotionally unstable or unreliable.
For example: Fatima has anxiety and panic attacks in her relationships. She is always worried that her partner will leave her even without any signs. Her fears make her clingy and overly dependent and strains her relationships.
Mistrust / Abuse Schema
This schema involves the expectation that others will intentionally hurt, abuse or take advantage of them. It comes from experiences of betrayal or exploitation and can lead to excessive suspicion or avoidance of close relationships. People with this schema have trouble trusting others and often expect the worst in interactions with others.
For example: John doesn’t have a partner and whilst he has lots of friends he is quite self sufficient in the sense he doesn’t really open up to them.
Emotional Deprivation Schema
People with this schema believe their emotional needs for nurturance, empathy and protection will never be met by others. They may feel chronically empty and lonely and often end up in relationships and withdraw emotionally.
For example: Sue ends up with boyfriends who cheat or are always off with their friends. She assumes this is “just how men are”.
Defectiveness / Shame Schema
People with this schema believe they are fundamentally flawed, defective or unlovable. They often feel shame and will go to great lengths to hide their perceived imperfections. This can lead to self-sabotaging behaviour, difficulty accepting compliments and hypersensitivity to criticism.
For example: Tommy is very self critical and is very sensitive to any feedback. He changes jobs frequently because he believes his workplace will “work out” he is incompetent (despite good performance).
Social Isolation/Alienation Schema
This schema is about feeling different from others and not belonging to any social group. People may feel isolated and believe they are inherently unlovable or unacceptable. This can lead to social withdrawal, loneliness and difficulty forming meaningful connections.
For example: Annanya feels like she is always on the outside. She finds it hard at work and at social gatherings to connect with others because she is very focused on her differences and has social anxiety.
B. Impaired Autonomy and Performance in Anxiety Disorders
This domain includes schemas that prevent one from functioning independently and performing well.
Dependence / Incompetence Schema
People with this schema believe they can’t handle daily tasks without significant help from others. This can lead to relying on others to make decisions and do tasks and avoiding new experiences or challenges because of fear of failure. A mental health plan can help with these issues by having access to funded counselling sessions through Medicare.
For example: In his 30s Alexander still lives at home and though he works part-time he still relies on his Mum for financial and practical support. He has never had a partner.
Vulnerability to Harm or Illness Schema
This schema is about an exaggerated fear that catastrophe will strike and one will be unable to prevent it. This might be medical illness, emotional collapse or other types of disasters. This can lead to hypervigilance and avoidance.
For example: Olive has health anxiety, constantly thinking she may have cancer and gets very worried about her children getting injured or sick.
Enmeshment/Undeveloped Self Schema
This schema is about being overly emotionally involved and close to significant others, often at the expense of one’s own identity and autonomy. People may have difficulty separating their own feelings and needs from others and end up in dependent relationships and lack of direction.
For example: Pascale can’t develop his own sense of self beyond his role in his family. Deep down he suspects he might be gay but can’t reflect on that further because he knows his parents wouldn’t approve.
Failure Schema
People with this schema believe they are fundamentally inadequate and will always fail. This can lead to chronic helplessness, low self esteem and avoiding challenges because of fear of failure.
For example: Megan believes she’s not that smart and won’t do well. She’s stayed in the same level at work despite her manager encouraging her to apply for more senior roles.
C. Impaired Limits
Schemas in this domain are about deficits in one’s internal limits, responsibility to others or inability to stick to long term goals.
Entitlement / Grandiosity Schema
This schema is about believing one is better than others and entitled to special treatment. People may disregard others’ needs and feelings and get frustrated when their desires aren’t met. This can lead to conflicts with others and difficulties with achieving realistic goals. Effective anger management can help with these issues by focusing on emotional regulation and improving relationships.
For example: Mark believes he’s very smart and doesn’t care what others might offer/say, leading to tensions both professionally and personally. Mark is quite isolated but can’t understand why.
Insufficient Self-Control / Self-Discipline Schema
People with this schema have no self control and can’t tolerate frustration or delays in gratification. They may display impulsive behaviour, struggle with goal achievement and have problems with addiction or procrastination.
For example: Ren has an online gambling addiction and works for a friend from high school who lets it slide when he doesn’t turn up for work sometimes.
D. Other-Directedness in Complex Trauma
This domain includes schemas about an excessive focus on others’ needs and desires at the expense of one’s own.
Subjugation Schema
This schema is about surrendering control to others out of fear of punishment or abandonment. People may suppress their own desires and emotions and end up with feelings of resentment and passive-aggressive behaviour.
For example: Maria suppresses her own needs and desires to avoid conflict with others. She feels trapped and resentful of this but is too anxious to assert herself. Relationship therapy can help with these issues by helping individuals work through their emotions and improve relationships.
Self-Sacrifice Schema
People with this schema feel a strong need to meet others’ needs, often at the expense of their own well-being. This can come from a desire to avoid guilt or to maintain self worth through caregiving. Chronic self sacrifice can lead to burnout, resentment and neglect of personal needs.
For example: Riley puts others’ needs before her own. She feels guilty when she says no to people and can’t even prioritise her own well being. Her partner is frustrated that she will get migraines because she’s so busy looking after others.
Approval-Seeking/Recognition-Seeking Schema
This schema is about seeking approval, recognition or attention from others. People base their self esteem on external validation and end up behaving in ways to impress others rather than pursuing their own true goals and desires.
For example: Humza is very focused on his corporate job even though it doesn’t give him much satisfaction, he feels it’s important to have a lot of income and buy nice things.
E. Over Vigilance and Inhibition
This domain includes schemas about suppressing spontaneous feelings and adhering to strict rules.
Negativity / Pessimism Schema
This schema is about focusing on the negative aspects of life and expecting failure or disappointment.
For example: Antoinette has a chronic negative outlook on life. Her thoughts are very “glass half empty” and she can’t cope with stress and often ends up in a depressive episode.
Emotional Inhibition Schema
This schema is about suppressing spontaneous emotions, impulses and actions to avoid disapproval or losing control.
For example: Joey doesn’t express his feelings. This works for him in his job but leads to emotional numbness, chronic dysthymia and problems in his romantic relationships.
Unrelenting Standards / Hypercritical Schema
People with this schema believe they must meet very high internalised standards of performance to avoid criticism or feeling inadequate. This can lead to perfectionism, chronic dissatisfaction and burnout. The constant striving for unattainable goals can lead to huge stress and prevent one from enjoying life. Therapies like Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT) and Schema Therapy can help with these issues by providing individualised support in a client centred and collaborative way.
For example: Jessica is very perfectionistic and has had to defer her uni studies because she’s so burnt out and can’t finish assignments.
Punitiveness Schema
This schema is about believing people should be punished harshly for mistakes or any area of weakness. People may be overly critical of themselves and others and end up feeling guilty, ashamed and angry.
For example: Michael is very judgemental of himself and his colleagues. He’s been spoken to by his manager for yelling at customers he considers “stupid”.
B. Impaired Autonomy and Performance in Anxiety Disorders
This domain includes schemas that interfere with one’s ability to function independently and perform adequately.
6. Dependence / Incompetence Schema
Individuals with this schema believe they are unable to handle everyday responsibilities competently without significant help from others. This can lead to reliance on others to make decisions and perform tasks, and avoidance of new experiences or challenges due to fear of failure. A mental health plan can be crucial in addressing these issues by providing access to counselling sessions funded through Medicare.
For example: In his 30s, Alexander still lives at home and though he works part-time, he still relies on his Mum a lot for both financial and practical support. He has never had a partner.
7. Vulnerability to Harm or Illness Schema
This schema involves an exaggerated fear that catastrophe will strike and that one will be unable to prevent it. This might relate to fears of medical illness, or emotional collapse, or other types of disasters. This can lead to hypervigilance and avoidance.
For example: Olive has significant health anxiety, constantly thinking she may have cancer, and gets very worried about her children getting injured or sick.
8. Enmeshment/Undeveloped Self Schema
This schema is characterised by excessive emotional involvement and closeness with significant others, often to the detriment of their own identity and autonomy. Individuals may have difficulty separating their own feelings and needs from those of others, leading to dependent relationships and a lack of personal direction.
For example: Pascale struggles to develop his own sense of self beyond his role within his family. Deep down he suspects he might be gay, but is unable to reflect on that further because he knows his parents would not approve.
9. Failure Schema
People with this schema believe they are fundamentally inadequate and will inevitably fail to achieve. This can result in chronic feelings of helplessness, low self-esteem, and avoidance of challenges due to this fear of failure.
For example: Megan believes she is not really that bright and won’t do that well. She has remained at the same level at work, despite her manager’s encouraging her to apply for more senior roles.
C. Impaired Limits
Schemas in this domain reflect deficits in a person’s internal limits, their responsibility to others, or an inability to stick to long-term goals.
10. Entitlement / Grandiosity Schema
This schema involves the belief that one is superior to others and entitled to special rights and privileges. Individuals may show disregard for the needs and feelings of others, and struggle with frustration when their desires are not met. This can lead to interpersonal conflicts and difficulties in achieving realistic goals. Effective anger management techniques can be crucial in addressing these issues by focusing on emotional regulation and improving interpersonal relationships.
For example: Mark believes he is incredibly smart and doesn’t have much interest in what others might offer/say, leading to tensions both professionally and personally. Mark is quite isolated but finds it hard to understand why.
11. Insufficient Self-Control / Self-Discipline Schema
People with this schema struggle with self-control and have difficulty tolerating frustration or delays in gratification. They may display impulsive behaviours, struggle with goal achievement, and have problems with addiction or procrastination.
For example: Ren struggles with an online gambling addiction and works for friend from high school who lets it pass when he doesn’t turn up for work sometimes.
D. Other-Directedness in Complex Trauma
This domain includes schemas related to an excessive focus on the needs and desires of others at the expense of one’s own needs.
12. Subjugation Schema
This schema involves excessive surrendering of control to others out of fear of negative consequences, such as punishment or abandonment. Individuals may suppress their own desires and emotions, leading to feelings of resentment and passive-aggressive behaviour.
For example: Maria frequently suppresses her own needs and desires to avoid conflict with others. She does feel trapped and resentful of this but is ultimately too anxious to assert herself. Relationship counselling can play a crucial role in addressing these issues by helping individuals navigate their emotions and improve their interpersonal connections.
13. Self-Sacrifice Schema
People with this schema feel a strong need to meet the needs of others, often to the detriment of their own well-being. This can stem from a desire to avoid guilt or maintain a sense of self-worth through caregiving. Chronic self-sacrifice can lead to burnout, resentment, and neglect of personal needs.
For example: Riley constantly puts others’ needs before her own. She feels guilty when saying no to people and finds it virtually impossible to prioritise her own well-being. Her partner feels frustrated that she will constantly suffer migraines because she is so busy looking after others.
14. Approval-Seeking/Recognition-Seeking Schema
This schema involves an excessive focus on gaining approval, recognition, or attention from others. Individuals may base their self-esteem on external validation, leading to behaviours aimed at impressing others, rather than pursuing their own authentic goals and desires.
For example: Humza is very focussed on his corporate job even though it doesn’t give him a lot of satisfaction, he feels it is important to have a lot of income and buy nice things.
E. Over Vigilance and Inhibition
This domain encompasses schemas related to an excessive emphasis on suppressing spontaneous feelings and adhering to rigid standards.
15. Negativity / Pessimism Schema
This schema involves focusing on the negative aspects of life and expecting failure or disappointment.
For example: Antoinette has a chronic negative outlook on life. Her thoughts are very “glass half empty” and she finds it hard to cope with stressful situations, often leading to a depressive episode.
16. Emotional Inhibition Schema
This schema involves the excessive inhibition of spontaneous emotions, impulses, and actions to avoid disapproval or losing control.
For example: Joey avoids expressing his feelings. Whilst this serves him well in his job, it leds to emotional numbness, chronic dysthymia and difficulties in his romantic relationships.
17. Unrelenting Standards / Hypercritical Schema
People with this schema believe they must meet very high internalised standards of performance to avoid criticism or feeling inadequate. This can lead to perfectionism, chronic dissatisfaction, and burnout. The constant striving for unattainable goals can result in significant stress and impair one’s ability to enjoy life. Therapeutic approaches such as Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Schema Therapy can be effective in addressing these issues by providing tailored support in a client-centered and collaborative environment.
For example: Jessica tends to be very perfectionistic and has had to defer her uni studies because she is so burnout and unable to complete assignments.
18. Punitiveness Schema
This schema involves a belief that people should be harshly punished for mistakes or any area of weakness. Individuals may be overly critical of themselves and others, leading to feelings of guilt, shame, and anger.
For example: Michael is very judgemental of both himself and his co-workers. He has been spoken to by his manager’s for yelling at customers who he perceives as “stupid”.
Conclusion
Reflect and see if any of these schemas apply to you. If you decide to do Schema Therapy, your therapist will ask you to fill out some questionnaires along with a clinical assessment to help you both figure out which schemas might be most relevant to you so you can work on a treatment plan for those patterns. Contact our friendly reception team to book an initial appointment with one of our Melbourne Psychologists to discuss your needs and develop a plan.
Dr. Sarah Valentine
Sarah is a Clinical Psychologist and co-director of Cova Psychology. She has worked in a range of settings in both the public and private sectors of mental health system in Melbourne over the past 20 years. Sarah is passionate about helping her clients heal trauma, is an experienced EMDR therapist and also incorporates Schema Therapy and Mentalisation Based Therapy (MBT) into her work. She is a board approved supervisor and mentor and enjoys supporting psychologists at all stages of their career.
