Schema Therapy: An Effective Approach to Personality Disorder ...
Transcript of Schema Therapy: An Effective Approach to Personality Disorder ...
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Using Schema Therapy in
Executive Coaching
Iain McCormick PhD
Executive Coaching Centre
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Background
• APS conference on psychology and
spirituality as introduction to Schema
Therapy
• Read a great deal – consulted with my
peer mentor/supervisor
• Asked to help a senior executive with
perfectionism and another with a fear of
failure
• Schema Therapy provided useful
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Background to schema therapy
• A schema is an organised and
persistent pattern of thoughts,
feelings and behaviour
• Schema therapy is an evidence
based approach that aims to help
individuals minimise the impact of
unhelpful schema on their lives
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Schema Therapy
• Schema therapy was developed by Dr Jeffrey
Young for personality disorders, chronic
depression, and other difficult problems
• It integrates elements of cognitive therapy,
behaviour therapy, gestalt therapy and
mindfulness into one unified approach
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Core childhood needs
Acceptance and praise
Empathy
Love, nurturing and attention
Safety
Protection
Predictability
Validation of feelings and needs
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Early maladaptive schemas develop
when specific childhood needs are
not met
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What are early maladaptive schemas?
• Pervasive theme or pattern
• Memories, bodily sensations, emotions
and cognitions
• Developed during childhood/adolescence
and elaborated through lifetime
• Dysfunctional to a significant degree
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Schemas develop when
• Toxic frustration of needs
• Traumatisation, victimisation, mistreatment
• Over-indulgence
• Selective internalization or identification
• Temperament or neurobiology can play a
role
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Maladaptive Schemas
1. Abuse
2. Abandonment
3. Defectiveness
4. Dependence
5. Emotional deprivation
6. Punitiveness
7. Unrelenting standards
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Other schemas
Approval seeking
Entitlement
Enmeshment
Emotional inhibition
Insufficient self control
Negativity
Self-sacrifice
Social isolation
Vulnerability
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Schemas = Life-traps
They erupt when
triggered by everyday
events
They may not “fit” what is
needed in one’s adult life
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Goal of schema therapy
To help people get their core needs
met in an adaptive manner through
changing their maladaptive schemas
and coping styles
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Steps in schema coaching
1. Establish rapport, history taking, assessment of the
counterproductive behaviour pattern
2. Confirmation that client is willing to work on challenges
3. The identification of these patterns and their origins
4. Experience of full intensity of the emotions that surround
their origins – coach can intervene as Healthy Adult
5. Learn to challenge the persistent thought patterns
6. The use of mindfulness to let go of the painful emotions
7. Homework to reinforce the work done
8. Follow up sessions to ensure the changes are enduring
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Experiential techniques
• “Letters to parents” clients write a letter on how
the parent hurt them, summarizing their
memories, emotions, etc. Clients read these
letters to the coach, but usually do not actually
post them
• “Imagery Dialogues” - clients picture themselves
with their parents in an upsetting situation and
are encouraged to express strong affect about
how their parents mistreated them
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Flash Cards and the Schema Diary
Schema Therapy asks clients to develop flash cards which
have four sections:
1. Acknowledgment of a current maladaptive feeling, such
as a fear of talking to a member of the opposite sex
2. Identification of the schema – fear of rejection due to
Defectiveness schema
3. Reality testing – “Just because my mother criticised me
doesn’t mean I am defective”
4. Behavioral instruction – “I will talk to this person even
though I feel nervous because I have a chance of
getting into a relationship”
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Assessment
Multidimensional Perfectionism Scale (Hewitt, PL, and Flett, GL 1990)
1. Self-oriented perfectionism, - is a result of the client’s
own unreasonable work standards, however in
moderate levels is associated with greater productivity,
success in career, and conscientiousness
2. Other-oriented perfectionism, leads to problems of
delegating to others and often being seen by others as
highly critical/judgmental
3. Socially prescribed perfectionism, is associated with
greater risk of anxiety and depression if the person
experiences a major setback
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(Hewitt, P.L., & Flett, G.L. (1990)
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Scale
Before
coaching After coaching
Mindful Attention
Awareness Scale score
50 57
Mindful Attention
Awareness Scale score
level
Somewhat
lower than
average
Average
Brown, K.W. & Ryan, R.M. (2003)
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The client reports
• Being much better at being able to identify
perfectionistic patterns
• Being able to let go of past resentments and
frustrations
• Being more willing to positively receive feedback
from others about possible perfectionistic actions
• Getting positive feedback from her team about
being more relaxed, less demanding and less
sarcastic
• Being happier with her home life 19
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Using Schema Therapy in
Executive Coaching
Some content adapted from:
Joan Farrell, PhD
Program Director, Center for Borderline Personality
Disorder Treatment and Research, Indiana University School of
Medicine, Larue Carter Hospital
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