WEBVTT
1
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Welcome. Today we're going to be looking at schema therapy.
2
00:00:06.009 --> 00:00:09.019
So why do some individuals repeatedly enter relationships in which
3
00:00:09.050 --> 00:00:12.519
they feel abandoned, rejected, or emotionally neglected, even when they
4
00:00:12.560 --> 00:00:17.359
recognize that these patterns are harmful? Traditional CBT might examine
5
00:00:17.420 --> 00:00:22.359
the automatic thoughts contributing to these experiences. Schema therapy goes further,
6
00:00:22.699 --> 00:00:25.359
asking how these patterns developed and why they continue to
7
00:00:25.399 --> 00:00:28.500
influence behaviors decades later. You can see it has a
8
00:00:28.539 --> 00:00:32.909
lot of relationship to psychodynamic thinking. It was developed by
9
00:00:32.950 --> 00:00:36.049
Jeffrey Young during the 1990s and emerged partly from his
10
00:00:36.130 --> 00:00:39.789
observation that traditional cognitive therapy was sometimes insufficient for patients
11
00:00:39.829 --> 00:00:47.469
experiencing chronic psychological difficulties, especially personality disorders. So Young integrated
12
00:00:47.609 --> 00:00:52.789
CBT principles with attachment theory and psychodynamic concepts. At the
13
00:00:52.829 --> 00:00:55.729
center of his approach is a concept of early maladaptive schemas,
14
00:00:55.850 --> 00:01:00.590
enduring patterns, evolving memories, Emotions, belief, and bodily sensations are
15
00:01:00.609 --> 00:01:05.090
developed during childhood and adolescence. Young identified 18 early maladaptive
16
00:01:05.109 --> 00:01:09.329
schemas organized into five broad domains. These include disconnection and rejection,
17
00:01:09.390 --> 00:01:14.319
impaired autonomy and performance, impaired limits, other directedness, and overvigilance.
18
00:01:14.579 --> 00:01:17.189
Consider the abandonment schema, for instance. We'll take that one.
19
00:01:18.769 --> 00:01:22.439
The child who experiences inconsistent caregiving may develop the expectation
20
00:01:22.469 --> 00:01:25.719
that important relationships are inherently unstable. As an adult, that
21
00:01:25.760 --> 00:01:29.840
individual might become intensely anxious when a romantic partner does
22
00:01:29.879 --> 00:01:34.219
not respond immediately to a message. The emotional reaction may
23
00:01:34.260 --> 00:01:38.000
seem disproportionate to the situation because the present experience activates
24
00:01:38.040 --> 00:01:43.780
an established schema. Schema therapy also identifies three broad coping responses. Surrender,
25
00:01:43.810 --> 00:01:46.739
which occurs when individuals behave in ways that reinforce their schemas.
26
00:01:47.040 --> 00:01:51.319
Avoidance involves escaping situations or emotions that might activate painful beliefs.
27
00:01:52.299 --> 00:01:55.810
Overcompensation involves behaving in ways that appear opposite to the
28
00:01:55.890 --> 00:02:00.849
underlying schema. For example, someone with a defectiveness schema might
29
00:02:00.909 --> 00:02:08.680
repeatedly accept mistreatment. Avoid intimacy entirely. Or, third, compensate through
30
00:02:08.719 --> 00:02:14.020
perfectionism and superiority. Another important concept involves schema modes. Modes
31
00:02:14.219 --> 00:02:19.840
represent temporary emotional and behavioral states. Examples include the vulnerable
32
00:02:19.900 --> 00:02:25.340
child that could be activated, angry child, punitive parent, detached protector. Again,
33
00:02:25.360 --> 00:02:29.599
we see a lot of examples here reminiscent of Jungian style.
34
00:02:30.909 --> 00:02:38.610
Another one is re-decision therapies over here. Transactional from Byrne.
35
00:02:39.680 --> 00:02:42.199
Rather than viewing personality as a single fixed pattern, the
36
00:02:42.240 --> 00:02:45.879
therapist examines how individuals shift between the states. How does
37
00:02:46.039 --> 00:02:50.680
chemotherapy work, though? One central technique is limited reparenting. Within
38
00:02:50.719 --> 00:02:55.259
appropriate professional boundaries, the therapist provides a consistent validating relationship
39
00:02:55.879 --> 00:02:59.689
intended to address emotional needs that were inadequately met earlier
40
00:02:59.729 --> 00:03:04.289
in life. Another technique is imagery rescripting. Parents revisit distressing
41
00:03:04.330 --> 00:03:07.889
memories through guided imagery and introduce corrective experiences that challenge
42
00:03:07.930 --> 00:03:12.340
established meanings. Chair work allows patients to engage in dialogues
43
00:03:12.419 --> 00:03:15.240
between different schema modes. Now we're going back to Gestalt.
44
00:03:15.860 --> 00:03:20.039
Cognitive restructuring, CBT, and behavioral pattern breaking help patients develop
45
00:03:20.060 --> 00:03:25.409
healthier responses. What does the research show? Well, one study
46
00:03:26.169 --> 00:03:30.569
resulted promising results for schema therapy in borderline personality disorder.
47
00:03:30.610 --> 00:03:32.500
It's still not recognized as one of the best ones
48
00:03:32.759 --> 00:03:38.150
by far for borderline. A notable 2006 study, so 20
49
00:03:38.150 --> 00:03:41.789
years ago, found favorable outcomes for schema-focused therapy compared with
50
00:03:42.449 --> 00:03:47.509
transference-focused psychotherapy among patients with borderline personality disorder. However, important
51
00:03:47.550 --> 00:03:51.990
limitations were there. Many studies involved specialized therapists and relatively
52
00:03:52.030 --> 00:03:56.969
intensive treatment programs, potentially limiting generalizability. The evidence is also
53
00:03:57.009 --> 00:04:01.110
stronger for certain personality disorders than for many other conditions. Additionally,
54
00:04:01.150 --> 00:04:06.039
the mechanisms responsible for improvement remain uncertain Positive outcomes do
55
00:04:06.060 --> 00:04:10.370
not necessarily establish that all 18 proposed schemas represent distinct
56
00:04:10.409 --> 00:04:17.050
independently validated constructs. Nevertheless, schema therapy offers a clinically valuable
57
00:04:17.089 --> 00:04:22.019
framework for understanding persistent emotional and interpersonal difficulties. It's an
58
00:04:22.060 --> 00:04:23.740
interesting theory. That's it for today.
1
00:00:01.889 --> 00:00:04.429
Welcome. Today we're going to be looking at schema therapy.
2
00:00:06.009 --> 00:00:09.019
So why do some individuals repeatedly enter relationships in which
3
00:00:09.050 --> 00:00:12.519
they feel abandoned, rejected, or emotionally neglected, even when they
4
00:00:12.560 --> 00:00:17.359
recognize that these patterns are harmful? Traditional CBT might examine
5
00:00:17.420 --> 00:00:22.359
the automatic thoughts contributing to these experiences. Schema therapy goes further,
6
00:00:22.699 --> 00:00:25.359
asking how these patterns developed and why they continue to
7
00:00:25.399 --> 00:00:28.500
influence behaviors decades later. You can see it has a
8
00:00:28.539 --> 00:00:32.909
lot of relationship to psychodynamic thinking. It was developed by
9
00:00:32.950 --> 00:00:36.049
Jeffrey Young during the 1990s and emerged partly from his
10
00:00:36.130 --> 00:00:39.789
observation that traditional cognitive therapy was sometimes insufficient for patients
11
00:00:39.829 --> 00:00:47.469
experiencing chronic psychological difficulties, especially personality disorders. So Young integrated
12
00:00:47.609 --> 00:00:52.789
CBT principles with attachment theory and psychodynamic concepts. At the
13
00:00:52.829 --> 00:00:55.729
center of his approach is a concept of early maladaptive schemas,
14
00:00:55.850 --> 00:01:00.590
enduring patterns, evolving memories, Emotions, belief, and bodily sensations are
15
00:01:00.609 --> 00:01:05.090
developed during childhood and adolescence. Young identified 18 early maladaptive
16
00:01:05.109 --> 00:01:09.329
schemas organized into five broad domains. These include disconnection and rejection,
17
00:01:09.390 --> 00:01:14.319
impaired autonomy and performance, impaired limits, other directedness, and overvigilance.
18
00:01:14.579 --> 00:01:17.189
Consider the abandonment schema, for instance. We'll take that one.
19
00:01:18.769 --> 00:01:22.439
The child who experiences inconsistent caregiving may develop the expectation
20
00:01:22.469 --> 00:01:25.719
that important relationships are inherently unstable. As an adult, that
21
00:01:25.760 --> 00:01:29.840
individual might become intensely anxious when a romantic partner does
22
00:01:29.879 --> 00:01:34.219
not respond immediately to a message. The emotional reaction may
23
00:01:34.260 --> 00:01:38.000
seem disproportionate to the situation because the present experience activates
24
00:01:38.040 --> 00:01:43.780
an established schema. Schema therapy also identifies three broad coping responses. Surrender,
25
00:01:43.810 --> 00:01:46.739
which occurs when individuals behave in ways that reinforce their schemas.
26
00:01:47.040 --> 00:01:51.319
Avoidance involves escaping situations or emotions that might activate painful beliefs.
27
00:01:52.299 --> 00:01:55.810
Overcompensation involves behaving in ways that appear opposite to the
28
00:01:55.890 --> 00:02:00.849
underlying schema. For example, someone with a defectiveness schema might
29
00:02:00.909 --> 00:02:08.680
repeatedly accept mistreatment. Avoid intimacy entirely. Or, third, compensate through
30
00:02:08.719 --> 00:02:14.020
perfectionism and superiority. Another important concept involves schema modes. Modes
31
00:02:14.219 --> 00:02:19.840
represent temporary emotional and behavioral states. Examples include the vulnerable
32
00:02:19.900 --> 00:02:25.340
child that could be activated, angry child, punitive parent, detached protector. Again,
33
00:02:25.360 --> 00:02:29.599
we see a lot of examples here reminiscent of Jungian style.
34
00:02:30.909 --> 00:02:38.610
Another one is re-decision therapies over here. Transactional from Byrne.
35
00:02:39.680 --> 00:02:42.199
Rather than viewing personality as a single fixed pattern, the
36
00:02:42.240 --> 00:02:45.879
therapist examines how individuals shift between the states. How does
37
00:02:46.039 --> 00:02:50.680
chemotherapy work, though? One central technique is limited reparenting. Within
38
00:02:50.719 --> 00:02:55.259
appropriate professional boundaries, the therapist provides a consistent validating relationship
39
00:02:55.879 --> 00:02:59.689
intended to address emotional needs that were inadequately met earlier
40
00:02:59.729 --> 00:03:04.289
in life. Another technique is imagery rescripting. Parents revisit distressing
41
00:03:04.330 --> 00:03:07.889
memories through guided imagery and introduce corrective experiences that challenge
42
00:03:07.930 --> 00:03:12.340
established meanings. Chair work allows patients to engage in dialogues
43
00:03:12.419 --> 00:03:15.240
between different schema modes. Now we're going back to Gestalt.
44
00:03:15.860 --> 00:03:20.039
Cognitive restructuring, CBT, and behavioral pattern breaking help patients develop
45
00:03:20.060 --> 00:03:25.409
healthier responses. What does the research show? Well, one study
46
00:03:26.169 --> 00:03:30.569
resulted promising results for schema therapy in borderline personality disorder.
47
00:03:30.610 --> 00:03:32.500
It's still not recognized as one of the best ones
48
00:03:32.759 --> 00:03:38.150
by far for borderline. A notable 2006 study, so 20
49
00:03:38.150 --> 00:03:41.789
years ago, found favorable outcomes for schema-focused therapy compared with
50
00:03:42.449 --> 00:03:47.509
transference-focused psychotherapy among patients with borderline personality disorder. However, important
51
00:03:47.550 --> 00:03:51.990
limitations were there. Many studies involved specialized therapists and relatively
52
00:03:52.030 --> 00:03:56.969
intensive treatment programs, potentially limiting generalizability. The evidence is also
53
00:03:57.009 --> 00:04:01.110
stronger for certain personality disorders than for many other conditions. Additionally,
54
00:04:01.150 --> 00:04:06.039
the mechanisms responsible for improvement remain uncertain Positive outcomes do
55
00:04:06.060 --> 00:04:10.370
not necessarily establish that all 18 proposed schemas represent distinct
56
00:04:10.409 --> 00:04:17.050
independently validated constructs. Nevertheless, schema therapy offers a clinically valuable
57
00:04:17.089 --> 00:04:22.019
framework for understanding persistent emotional and interpersonal difficulties. It's an
58
00:04:22.060 --> 00:04:23.740
interesting theory. That's it for today.
