Comments on Schema-Focused Therapy

When I was told that I have BPD on Monday, my therapist got talking about maladaptive schemas. She apparently assumed I knew what they are. I had some idea, but did a quck search to find out anyway. They are beliefs about yourself that are maladaptive and that have usually been formed in childhood (although they can be formed later on too) and repeat themselves over and over, thereby influencing your coping mechanisms. The creators of schema therapy list 18 such schemas. The ones that most apply to me are:

• Abandonment/instability: the belief that you will be abandoned by important support people or that the relationship is unreliable or unstable.
• Mistrust/abuse: the belief that other people will aubse, hurt, humiliate, lie to or otherwise take advantage of you.
• Defectiveness/shame: the belief that you are defective, bad, unwanted, inferior or invalid.
• Dependence/independence: perceived inability to handle your everyday responsibilities without lots of help.

That last one is a bit tricky. While I know I'm depenednet, I don't know whether this is entirely due to my beliefs. I mean, overload comes into the equation too. I got a bit pissed when my therapist wrote in my treatment plan that I have a fear of failure and need to realistically learn to take on challenges. As if I'm not trying!

Then my therapist got talking about schema modes. I had some idea of what they were because my former therapist had talked about them when I first disclosed I had parts. Schema modes are the emotional states and coping responses we adopt when faced with life's challenges. I found it interesting that the Schame Therapy Institute says that they can also be seen as dissociative parts. The Institute lists several different schema modes, including the vulnerable child, the punitive parent, the detached protector and of course the healthy adult. I recognized almost all of them, but in fact have more than one of each. Yeah, I'm not going to abandon the DID concept just because it isn't my diagnosis anymore.

Now schema-focused therapy is used to identify and challenge these maladaptive schemas and to reinforce the healthy adult mode. The assessment phase is followed by the change phase, in which clients learn to challenge their schemas and gradually focus shifts from experiential change to behavioral change and preparing for ending therapy. My therapist put in my treatment plan that the current focus would be on learning about origins and continuation of schemas and that I would recognize my coping mechanisms and hopefully be able to shift them in an early stage.