Low self-esteem

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

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