Anxiety

Defectiveness: the 'I'm not good enough' schema

How many times have your clients told you they were rubbish, useless, a failure or just not good enough in some fundamental way? If the people you work with are anything like the ones who visit my consulting room, I’m guessing the answer is very often. This kind of thinking is, clearly, extremely unhelpful for our clients – and can lead to low self-esteem, depression, eating disorders, anxiety disorders and many other psychological and life-limiting problems.

In schema therapy, we see one or more schemas at the root of these problems, particularly Defectiveness/Shame, which is perhaps the most common schema in our clients. This might form in early childhood, for example if we have parents who tell us we’re slow, or stupid, or a bit too chubby. We might get bullied by our siblings, or find it hard to measure up to them, especially if we’re the youngest. Or the schema might develop at school, if we have (especially undiagnosed) dyslexia, struggle with one or more subjects, or find it hard to make friends.

As children, we might start to think ‘Maybe I am a bit stupid,’ or ‘Why can’t I keep up with the other kids? Maybe it’s true - I am clumsy and useless at sports.’ These thoughts begin to coalesce into deeply held beliefs – the cognitive layer of a schema. We probably feel our confidence sinking through the floor, or a deep sense of shame at our perceived failings – this is the emotional part of the schema. And we feel those emotions in our bodies – shame can feel like a horrible prickling sensation in the skin, nausea or tightness in the throat. And this is the physiological part of the schema.

What then happens is that, as we get older, this psychological construct gets triggered by people, situations or events that remind us of the stressful events from our childhood. We fail our driving test and suddenly our Defectiveness schema gets triggered and we are gripped by intense feelings of worthlessness and shame, which are completely disproportionate to the situation (we could just take another test – it’s not such a big deal). This is how schemas operate, which is what makes them so painful and the root cause of every psychological problem your clients present with.

Schemas can be healed

The good news is that, although they are stubborn and hard to change, schemas can be healed. Using techniques like imagery and chair work, or the attachment-based relational approaches that make up ‘limited reparenting’, we can slowly but surely start to challenge and modify the schema. We might help to modify some of those unhelpful beliefs about being stupid or useless; work on the maladaptive modes that keep them behaving in self-destructive or self-limiting ways; help the client focus on and enjoy their successes, which they probably discount or ignore; keep pointing out their strengths and the things we especially like about them, to meet those parenting needs that were not met for them as children.

Using these techniques and ways of understanding a client’s problems, schema therapy offers a powerful, effective and deeply compassionate way of helping even the most hard-to-treat problems and presentations.

If you would like to know more come along to one of my upcoming Schema Therapy Skills workshops below. You can also call me on 07766 704210 or use the contact form to get in touch.

Warm wishes,

Dan

Upcoming Schema Therapy Skills workshops:

WORKING WITH IMAGERY: POWERFUL, TRANSFORMATIVE TECHNIQUES TO ENHANCE YOUR CLINICAL PRACTICE

In schema therapy, there is a strong emphasis on using experiential techniques such as imagery rescripting and chair work, which are seen as more effective and transformative than just talking about problems from the client’s past and present. This one-day workshop will teach you how imagery techniques can help rescript even the most traumatic experiences from your client’s childhood, such as incidences of abuse or neglect.

Cost: £180 including refreshments, all training materials and certificate of attendance confirming 6 CPD hours

Next date: 31st May 2019

WORKING WITH MODES: EMBRACING COMPLEXITY & ACHIEVING INTEGRATION

This one-day course will explain the concept of ‘modes’, which are different aspects of our personality that are activated in different situations and by particular triggers. In addition to a brief overview of the theory of schema therapy and schemas/modes, you will learn how to assess and formulate your clients’ modes, as well as specific techniques such as imagery and chair work for working with key modes.

Cost: £180 including refreshments, all training materials and certificate of attendance confirming 6 CPD hours

Next date: 21st June 2019

Overcoming fears and resistance in psychotherapy

One of the great contradictions of working with people who are suffering is that, of course, they want to stop suffering – that is why they come to see you in the first place and generally keep coming, week after week, hoping for change. But sometimes those same people seem to do everything in their power to resist actually changing. They might not do their homework, instead expecting you to provide some kind of therapeutic magic in a single hour a week. They may say, ‘I know you’re right, but…’ over and over. Or they may resist the change process in countless subtle ways, which are hard to detect without a keen eye on the transference and what’s actually happening in the room.

In schema therapy terms, we could say there is at least one part of them, the Healthy Adult mode, that very much wants change. This is the mode that brings them to therapy in the first place, even if they are scared, mistrustful or sceptical that you can actually make a difference after a lifetime of suffering. And this is the mode we want to work with, encourage and build throughout therapy – I often use the metaphor of a weak muscle that needs training to become stronger and more powerful in the person’s life.

But of course there is often at least one part (and often more, especially with complex cases) of them that absolutely does not want to change. In mode terms, this is commonly the Detached Protector, which tries to protect them by avoiding strong emotions, upsetting material, or intimate connections with other people. Detached Protectors keep people in their heads, where it’s safe, or make sure relationships are superficial and so non-threatening. Clearly, this part is not overly fond of the emotionally intense and relationally intimate process of long-term therapy…

And of course we want to help reduce the impact of this mode, in our clients’ lives and especially in the therapeutic process, because it blocks progress. But it’s crucial that we also respect the resistance, because this is a protector mode – it is blocking change for a reason. Perhaps the person finds their emotions overwhelming, so has learned to avoid or minimise them to feel safe. They may have had strong messages as a child that being rational was good and emotional bad or a sign of weakness.

The uncomfortable comfort zone

Some people fear that if they risk change, things might get even worse. Better to stay in what I call the ‘uncomfortable comfort one’ – it’s not very pleasant, but it is familiar and therefore safe. So we never want to push our clients to change, or rush them. Real change takes time, patience, encouragement, understanding. We can work with the modes that are blocking change in all sorts of ways – using imagery or chair work, for example.

But we need to work hard to help our clients’ Vulnerable Child feel safe first, which in real terms means lots of attunement, kindness, saying the right things and, more importantly, behaving in trustworthy ways. And then change, slowly and miraculously, occurs.

If you would like to know more about overcoming your client’s fears and resistance, come along to any of the workshops below. And if you have any questions about my workshops, call me on 07766 704210 or use the contact form to get in touch.

Warm wishes,

Dan

Upcoming Schema Therapy Skills workshops include:

WORKING WITH IMAGERY: POWERFUL, TRANSFORMATIVE TECHNIQUES TO ENHANCE YOUR CLINICAL PRACTICE

In schema therapy, there is a strong emphasis on using experiential techniques such as imagery rescripting and chair work, which are seen as more effective and transformative than just talking about problems from the client’s past and present. This one-day workshop will teach you how imagery techniques can help rescript even the most traumatic experiences from your client’s childhood, such as incidences of abuse or neglect.

Cost: £180 including refreshments, all training materials and certificate of attendance confirming 6 CPD hours

Next date: 31st May 2019

WORKING WITH MODES: EMBRACING COMPLEXITY & ACHIEVING INTEGRATION

This one-day course will explain the concept of ‘modes’, which are different aspects of our personality that are activated in different situations and by particular triggers. In addition to a brief overview of the theory of schema therapy and schemas/modes, you will learn how to assess and formulate your clients’ modes, as well as specific techniques such as imagery and chair work for working with key modes.

Cost: £180 including refreshments, all training materials and certificate of attendance confirming 6 CPD hours

Next date: 21st June 2019

Healing the Vulnerable Child mode

Schema therapy was initially developed by Jeffrey Young in the 1980s, focusing on a client’s core schema, such as Abandonment or Defectiveness. But as the model became more sophisticated, the focus increasingly turned to working with ‘modes’ – different aspects of a person’s personality that can show up as distinct entities. This is a similar concept to self-states, parts or sub-personalities in other modalities. Everyone has modes – and probably hundreds of different modes – but there are a few archetypal modes that everyone has. And the most important of these is the Vulnerable Child.

Using a Mode Map

One way to explain this to clients is to draw up a Mode Map, with five or six modes drawn as circles and given idiosyncratic names. Typically these include the Critic, Healthy Adult and ‘coping modes’ such as the Detached Protector or Self-Aggrandiser (common in narcissistic presentations). When drawing up this map I always leave the biggest circle for the Vulnerable Child, which we call ‘Little X’ (so mine is Little Dan). I explain this part to my clients like this:

‘This is the part of you that feels all of the strong emotions, like anxiety, hurt, jealousy or loneliness. It’s like an inner child that gets triggered when you feel stressed, hurt or threatened – and in those moments you feel these overwhelming emotions, like a child feels them. So this is why you feel small and powerless when your boss is shouting at you, because this young, vulnerable, sensitive part of you has been triggered and you feel like you’re six years old again, unable to defend yourself against your angry dad.’

CONTACTING the Vulnerable Child

I also explain that this is the part we want to heal, as it holds all of a client’s painful schemas and emotions. And I ask people to bring a photo of themselves when they were young, so we know exactly what Little Jane or Robert looks like. When we are doing imagery rescripting, I am directly contacting the Vulnerable Child, which is held in a person’s memory as they recall and re-experience an upsetting or traumatic incident from childhood.

I find some people just get this concept and love it, while others struggle with it. But over time everyone seems to relate to it and start saying things like, ‘Little Gina got really triggered at the weekend, because I felt left out by friends planning a trip,’ or ‘Little Tom was super-anxious before I made my speech, so I did a lot of calming him down and felt much better.’

Conceptualising people’s vulnerability, or painful emotions in this way can be incredibly powerful. It gives a voice to the part of them that they may have been ashamed of, or a dissociated part that they weren’t even aware of. It’s one of the signature ways of working that makes schema therapy such a warm, compassionate approach and means we can hold and help with even the most complex, hard-to-treat presentations.

If you would like to know more about working with your clients’ Vulnerable Child mode, come along to my one-day workshop, Working with Modes: Embracing Complexity & Achieving Integration.

And if you would like to know more about any of my workshops, call me on 07766 704210 or use the contact form to get in touch.

Warm wishes,

Dan

The magic of neuroplasticity – why childhood wounds can be healed

I spend a great deal of time teaching my clients about aspects of psychology that relate to them and their problems. In the early stages of therapy especially, there is a lot of psychoeducation – explaining about things like temperament, schemas and modes, the schema therapy model and how it will be able to help them, how their family dynamics impacted them as a child, what ‘core needs’ were not met in childhood, and so on.

Of course, during this pyschoeducation process we should always make things as clear and simple as possible. I remember attending a workshops with renowned cognitive therapist Helen Kennerley, who said, ‘As a cognitive therapist, things should be very complicated in your mind, but very simple for the client.’ Meaning, as therapists we have to hold a great deal of complexity in our minds – one or more therapy models, all the key details of our client’s history and our work together, what is occurring in the room at that moment, what we will do or say next – but what we tell the client should be, as far as possible, simple and jargon-free.

One of the key concepts I always explain to my schema therapy clients is ‘neuroplasticity’ (I know, I have broken my no-jargon rule already! But it’s an important term). That’s because I spend a great deal of time exploring their family history, all the upsetting or traumatic stuff that happened to them to create their painful schemas and maladaptive modes, how these psychological constructs work and affect them day to day... Honestly, after a while it all feels a bit hopeless and depressing, which is why I love neuroplasticity.

The ever-changing brain

I explain that psychologists used to think that our brains grew rapidly in the third trimester of pregnancy and first year of life (which is when the brain does grow at an astronomical rate), then throughout childhood and into adolescence; then, basically, you were done – that was your brain formed for life. But then they realised that was completely wrong! Neuroplasticity means that we have a plastic, or clay-like brain, which is being moulded and changed every single day of our lives.

I often tell them that, if they learned to tango aged 87, their brain would have to grow new ‘tango neurons’ to store that information. They would literally be growing new brain tissue and shaping their brain, even in their eighties. So none of the impact of traumatic stuff that has happened to them, including the schemas that then formed, is fixed or set in any way. It’s not easy to change, of course, but it it is eminently doable.

The power of hope

Now we have hope – and hope is like gold dust in therapy. Clients start to believe they can change; that all this weird schema therapy stuff might just help them, even if other therapies haven’t; that maybe they don’t have to be cyclically depressed for the next 50 years, or overwhelmingly anxious every time they leave the house. And we both end the session feeling that little bit happier and more hopeful!

If you would like to learn more about neuroplasticity and the changing brain, come along to one of my Schema Therapy Skills workshops, including the upcoming ones below. I hope to see you there!

Warm wishes,

Dan

WORKING WITH IMAGERY: POWERFUL, TRANSFORMATIVE TECHNIQUES TO ENHANCE YOUR CLINICAL PRACTICE

In schema therapy, there is a strong emphasis on using experiential techniques such as imagery rescripting and chair work, which are seen as more effective and transformative than just talking about problems from the client’s past and present. This one-day workshop will teach you how imagery techniques can help rescript even the most traumatic experiences from your client’s childhood, such as incidences of abuse or neglect.

Cost: £180 including refreshments, all training materials and certificate of attendance confirming 6 CPD hours

Next date: 31st May 2019

More details and how to book

WORKING WITH MODES: EMBRACING COMPLEXITY & ACHIEVING INTEGRATION

This one-day course will explain the concept of ‘modes’, which are different aspects of our personality that are activated in different situations and by particular triggers. In addition to a brief overview of the theory of schema therapy and schemas/modes, you will learn how to assess and formulate your clients’ modes, as well as specific techniques such as imagery and chair work for working with key modes.

Cost: £180 including refreshments, all training materials and certificate of attendance confirming 6 CPD hours

Next date: 21st June 2019

More details and how to book