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What is Schema Therapy?

Schema Therapy (ST) is a flexible and comprehensive approach to therapy that focuses on understanding you as a person. It provides a helpful framework for us to make sense of some of the difficulties you might be experiencing. These might be difficulties with how you feel, your thought patterns, relationships, unhelpful behaviours, or a general dissatisfaction with your life.

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ST was developed in the 1980s by psychologist Jeffrey Young and can be understood as an integrative model that draws on a number of therapeutic approaches, including cognitive behavioural (CBT), psychodynamic, gestalt, and person-centred.

CBT has a strong evidence base and because of this tends to be the treatment of choice for many common difficulties such as anxiety and depression; when delivering ST, I would be able to work with you to incorporate many of the effective components of CBT to support with the changes you make. In addition, ST goes deeper and puts more of an emphasis on understanding the links between childhood experiences and the development of patterns in thinking, feeling and behaving.

ST asserts that it is our schemas that link our past to our present. In ST, a schema can be understood as a deeply held belief which is often out of our conscious awareness. Schemas affect how we think, feel, and behave, and are sometimes described as our blueprints or software. They help us to make sense of the world, and are the patterns that run throughout our life. A goal of schema therapy is to help you to become more aware of your schemas and then to provide you with tools to change on an intellectual, emotional and behavioural level.

Another important part of ST is the focus on emotional needs. ST believes that schemas develop from experiences when our emotional needs were not met. One of the overarching goals of ST is to help you to develop an awareness of these needs and, over the course of therapy, develop a variety of ways of meeting them.

What happens in schema therapy?
In the early sessions of ST, we would work together to build an understanding of your current problems and how they developed. A crucial element of this is making links between your early life experiences and your current problems. The process of therapy is active, and, right from the start we would use different therapeutic techniques. These can be divided into: (i) emotion focussed strategies that aim to connect you with the emotional level of your experience, and include imagery and chair work; (ii) cognitive techniques that aim to promote flexible and compassionate thinking; and (iii) behavioural techniques that help you to challenge fears and break behavioural patterns.

What I like about schema therapy?
I really like the comprehensiveness and flexibility of ST. It provides a framework for understanding how we function on a deeper level and helps us to spot the common thinking and behavioural traps that we can all fall into. As a therapist I can be creative and draw on a number of proven techniques that aim to address problems on a variety of levels. ST also encourages therapists to play an active role in the therapy and to bring an authentic and open approach to the therapeutic relationship. This can help create a genuine connection, which is often the foundation for lasting change.

 

To enquire about psychotherapy sessions with Dr John Burns, please contact him here, or to view our full clinical team, please click here.

 

Dr John Burns  is an experienced Consultant Clinical Psychologist registered with the British Psychological Society, Health and Care Professions Council, and the British Association of Behavioural and Cognitive Psychotherapies.  He is available at our Brighton & Hove Practice.

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“Should I stay, or should I go?” What does easing the lockdown mean to you?

I have found the Clash’s song of this title playing over in my mind when thinking about the current easing of the social lock down in the UK. It seems to me that we all, to some degree or another, now face a dilemma whether to stay or go.

Straight away, it is important to acknowledge the relationship of this dilemma to levels of freedom and privilege. It is true that some people have little or no choice about whether to go back into their workplace.  We all face very differing health concerns, with those in the ‘extremely vulnerable clinical group’ likely to feel greatest levels of concern and anxiety about going outside.  There has also been concerning, though unsurprising, expositions of inequalities in terms of health risks, with poorer and BAME people having greater chances of fatality.

However, in my experience these will not prevent them from experiencing similar kinds of conflicts at this time. It is a reality that a great many of us will, to some degree or another, be starting to wonder about how or when or whether we return to ‘normal’.

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I have been wondering myself about this dilemma but I am also interested in how it might tap into broader questions about how we think about ourselves in relationship to our worlds – both outside and inside.

There is no doubt this has been a strange and disturbing time and of course we are no way through it. The sudden exponential growth of the virus and pandemic was frightening, and many felt traumatised by the level of crisis and what felt like an intense threat to our mortality. The war metaphors and imagery referenced by our government, while perhaps intended to help rally a ‘blitz spirit’, in all likelihood, simply added to the terror already felt by many.

The orders to lock down came as a relief for many people. We had permission to retreat and protect ourselves against what had suddenly become a hostile world. This was and is a necessary response but one that also exacerbated the fear of the outside world engendered by the virus and the rhetoric used about it.

We all responded differently to the retreat and this of course varied at different times. There are those who found and continue to find the lock down liberating, others who found and find it oppressive.  Of course, we are also living in different circumstances which add or detract from the benefits of the protection it offers. For example, it has been widely reported that incidents of domestic violence and abuse have increased during this period. Many were able to work easily from home, many were not and there was, and is still, differences between the level of risk for those going into work. And many have lost work or continue to face this as an increasing prospect.

External factors aside, our relationship to the pandemic and the lock down response will also key into aspects of our own internal worlds. A reluctance to move out of lock down could arise for those of us who tend to use retreat as a defence. It makes sense that the bubble offered by the lock down could tap into and heighten historical ways of managing difficult realities through strategies of self-seclusion. At the same time, those of us who have particularly found the lack of purpose and activity in the lock down difficult may have developed defences around keeping busy as a means of warding away difficult or painful feelings.  This could lead to a manic response to the easing of restrictions – perhaps a rushing quickly back into the world and ‘normality’.

Of course, both states may be at play in us at different times, but I am wondering about our overall tendencies that will shape how we are likely to interpret, and respond to, this shift in government advice.

Reflecting on my starting title, I wonder now about the aptness of the Clash song. It seems the transition from lock down to ‘normality’ (whatever that means) is not going to be as either/or as staying or leaving a relationship. It looks likely anyway that we are going to experience further Covid outbreaks with many expert views suggesting the current easing as premature and a second wave imminent.  We can therefore most probably anticipate more lock downs, perhaps even soon.

So, it feels more appropriate to think about a dialectic in/out situation we find ourselves facing requiring complex navigations. How we proceed and find our way through these difficult and disturbing times and those ahead, will be dictated by many external factors but also our own internal worlds and their responses, conscious and unconscious, to the different experiences of this pandemic.

 

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.

 

Further reading by Claire Barnes

Silences in Therapy

Sibling Rivalry – Part 1

Sibling Rivalry – Park 2e

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Magnificent Monsters

“The passions, these “magnificent monsters” (Nietzsche, 1967, p. 521), can we consider them a gift in which something valuable can be learnt?

Below is a consideration of the multiple, dynamic, creative and sometimes conflicting forces of energy that are often competing for dominance within us – what Fredrick Nietzsche sometimes described as ‘the passions’. Others may describe them as drives, passions and impulses. They are always present and seemingly are what constitutes and influences much of what is our lived experience. Despite their force and significance, they can often go unnoticed and our knowledge of them is always incomplete. They sometimes emerge into our conscious awareness when we are awakened into our existence, for instance when we are confronted by experiences such as uncertainty, grief and love.

Feeling passionate can be both enthralling and scary. Passions are sometimes encountered as other worldly, because they can appear out of nowhere and stir us and shake the ground beneath our feet. Passions can cross the many boundaries of our lived experience. They can symbolise our strong emotional states including joy and suffering. Perhaps many people can relate to the passions felt in the first stages of falling in love, or the sudden earthquake of loss.

At times, we may find ourselves running away from them. This is perhaps born out of a sense of needing to escape from what is being experienced. Perhaps this can be influenced by our conditioned beliefs, rooted in religious and philosophical beliefs, which might espouse that passions are dangerous, uncivilised and something that need to be tamed, and/or eradicated.

Other times we may run towards them, feeling that despite the fear they might cause within us, their intensity and irreducible form feels like an opportunity to live more vitally and come-into-being.

As time passes, human beings seem to be moving into spaces where connection and desire are dampened down by our addiction to technology, self-preservation and control. Even therapy can find itself, unwittingly perhaps, offering ways to master the ever-arising encounter with thoughts, emotions and sensations, so that we might never have to feel perturbed. Other times therapy may be seen as providing an opportunity to self actualise, by integrating all that we apparently are. Perhaps all of this in some way is a strategy to defend against feeling unsafe and uncertain.

But what if moving out of uncertainty is not possible or even necessary? What if these passions are revealing our possibilities, our strengths, our potential to move and become? What if we need them to create, to learn, to feel alive within our uncertain world. What if really feeling them slowly and subtly before acting on them or attempting to eradicate them is important? What if becoming intimate with them and patiently listening to them is what is necessary?

Perhaps this is where therapy can facilitate; by providing a space to feel, to explore, to experiment so that maybe we can change the relationship. What is perhaps significant to consider, for a while at least, are the desires and possibilities they are revealing within us. As Clarice Lispector (2012) wrote: “Life, my love, is a great seduction in which all that exists seduces.” (p 55).

Perhaps some passions must sometimes be tamed in order to live within a collective space. However, within any taming I feel it is equally, if not more significant, to understand what is being felt and moved within us with curiosity and kindness so that we may experience this brief encounter with life more deeply and compassionately.

Maybe letting go of a need to control, just for a while, and trusting our continually changing movements, just for a bit, is all that has to happen?

With gratitude and inspiration from Nietzsche (1967) and Clarice Lispector (2012).

 

Susanna Petitpierre, BACP Registered, is an experienced psychotherapeutic counsellor, providing long and short term counselling. Her approach is primarily grounded in existential therapy and she works with individuals.  Susanna is available at our Brighton and Hove Practice and Lewes Practice.

 

Further reading by Susanna Petitpierre –

A consideration of some vital notions connected to Existential Therapies

Existential Therapy

Being embodied in Therapy: Feeling and listening to your body

 

References –

Lispector, C (2012) The Passion According to G.H. Trans, Idea Novey. London, Penguin

Nietzsche, F. (1967) The Will to Power, trans. Walter Kaufman London: Weidenfeld and

Nicolson.

 

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Corona Virus …… is in my garden!

Early in lockdown I turned  to my garden for the first time in a long time and my thoughts took an interesting turn which I wanted to share with you.

I spotted the jasmine shrub which had overgrown and was ‘invading’ my garden!  It had put deep star shaped roots all over the garden which were impossible to pull out. It was a ‘threat’, ‘invasive’, ‘runaway’, ‘contagious’.

I felt a mixture of feelings as I contemplated the consequences of my gardening neglect…..

….. overwhelm –it’s everywhere,

….. I’m not strong enough to beat it,

….. It’s spreading to my neighbours,

….. It will overpower and kill everything………maybe it will kill me…….

Kneeling on the infected earth,   demoralised, defeated and sweaty,  I  reflected awhile.

My garden had become a metaphor for the Coronavirus.

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I wondered how I could make use of this metaphor to help me to come to terms with this unprecedented shocking world situation which was turning mine and others’ lives upside down and inside out.

I realised that although I couldn’t personally make any inroads into conquering the Corona virus, my humble garden would be a  much smaller and more manageable project.

Renewed hope reconnected me to resilience and perseverance. I hacked and chopped, I cut and cleared,  I dug and dug with a fervour ignited by my hatred of this virus, this ‘C ‘ word.

I cleared, I sorted, I ordered.  I took a longer view.  I wouldn’t manage to clear this weed today but if I kept at it I might succeed. Onward.

And magically as my garden was transforming, becoming clear and free from jasmine chaos, so my mind was becoming  clear and free.  Clear spaces of rich brown fertile earth reappeared in my mind.

And in this clear space Creativity bloomed.  I began to imagine possibilities for planting, for creating a lush healthy future for my garden.  My garden became a visible and experiential  dis-confirmation of the prevailing world crisis. Where the news was predicting death doom and disaster, my garden foretold of  renewal, regeneration and growth.

My garden remains undeterred by Covid-19 and lockdown.  Ever since March 23rd it  has behaved exactly the same as it always has. Spring arrived as usual, the leaves unfurling from trees and shrubs, new life shooting up from the ground apparently back from the dead.  This absolute predictability, regularity, repetition, this infinite miracle of nature has offered comfort and connection for me in this time of isolation and powerlessness.

As a Dramatherapist I seek  to work with Metaphor, Symbol, Image as a way of re-presenting reality.  I seek to connect, those things which are held inside of us with those things which are on the outside.

 

Magdalena Whitehouse is an experienced HCPC Registered Drama Therapist, working with individuals, couples and  groups. Magdalena is available at our Brighton and Hove Practice.

Further reading by Magdalena Whitehouse –
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How body stability creates psychic stability

There is No Such Thing as a Baby

I frequently blog about the importance about including the body in the process of psychotherapy and how the unconscious resides in the body.  However, unlike many ‘body psychotherapists,’ I believe that the involvement of the body is more profound than identifying the presence of the body in the process. Let me explain using one of Donald Winnicott’s most famous quotes, “There is no such thing as a baby.”

Winnicott famously made this statement in 1947. On face value, it may seem somewhat absurd. After all, we have all seen babies and know they exist. However, the reality is far more complicated, because every baby that any one of us has ever seen is only visible because it is in a relationship with its primary carer (which for simplicity, I shall refer to as its mother).

A baby cannot exist alone but is essentially part of a relationship.  Babies exist in an absolute state of dependence, such that the infant (the word is taken from the Latin – ‘infans’ – not able to speak) has no knowledge of maternal care, as this would require the knowledge of ‘an other’ providing the care.  The baby therefore is essentially indivisible from its mother and thus cannot exist in its own right.  The infant’s experience relies on the mother’s ability to merge with, and adapt to, her baby.  Therefore, whenever we see a baby, we actually see a baby, its mother, the relationship between the two and also the wider social context within which that baby lives and has come to be.

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There is No Such Thing as a Body

The same principle can be applied to a body.  There is no such thing as a body in its own right.  A body is created, shaped, moulded and exists within the relationship that the mother of the owner of the body has had with it.  In other words, the body and how it is experienced by the person in the body is contingent on the relationship that the baby has with the mother and the wider environment. This then dictates the relationship that the owner of said body, has with him or herself (if any.)

Why Does the Body Matter?

Psychotherapy is about many things, but one of the primary tenets is that it is a relationship within which the client/patient can, through relating to the therapist, establish a relationship with themselves. Having a relationship with ourselves includes having a relationship with our body. However, I believe that too many psychotherapists assume that such a relationship is necessarily experienced as helpful by the client at the outset of therapy, or even possible.

The Body as an Enemy

If we come to inhabit, or embody, our bodies through the relationship with our mothers and the wider social context, and our mothers were abusive to us, then the experience of our body can be one of ambivalence (‘I don’t really care about my body”) through to experiencing the body as dangerous, attacking or not our own.

Examples of where internalised abuse/hatred is expressed towards the body include cutting and burning the skin through to anorexia and bulimia, to name a few.

Risk of Trauma

Assuming a pre-existing, or even conceptually possible positive relationship between a client and their body on the part of the psychotherapist is naive. At worst, it risks re-traumatising the client.

If, for the client, all that is bad resides in their body, then they need to slowly find a way to ‘meet’ their body in a different context and to tentatively form a different relationship with their body – to reclaim it from the ‘bad’ parent. The therapeutic process involves creating a different relationship with ourselves, one in which we are able to leave the echoes of past formative relationships behind. At the very least, we need to learn to think about ourselves as players in those stories in a different way. In the same way, we need to learn to relate to our body as our own and as our friend, guide and an integral part of us.

Mark Vahrmeyer is a UKCP-registered psychotherapist working in private practice in Hove and Lewes, East Sussex. He is trained in relational psychotherapy and uses an integrative approach of psychodynamic, attachment and body psychotherapy to facilitate change with clients.

Further reading

Body psychotherapy

What is attachment and why does it matter?

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