Schema therapy Brighton and Lewes

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, the work would incorporate many of the effective components of CBT to support you with behavioural changes. 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 is schema psychotherapy?

Schema therapy is a flexible, integrative, evidence-based approach to therapy that offers a comprehensive framework for understanding long-standing emotional and relational difficulties. It’s designed to help individuals understand how their early life experiences have shaped their thinking, emotions, and behaviour and how it is linked to distress in adulthood.

Schema therapy is especially useful for those who haven’t seen much benefit from other therapeutic approaches like cognitive behavioural therapy (CBT).

What are schemas?

In therapy, schemas are emotional and cognitive patterns or core beliefs about oneself, others, or the world that are deeply ingrained. They’re often formed in childhood or adolescence and are shaped by unmet emotional needs or bad experiences. Schemas are typically outside of our conscious awareness.

Types of schemas may include, but are not limited to:

• Emotional deprivation
• Vulnerability
• Approval-seeking
• Negativity
• Mistrust

The development of schema therapy

Schema therapy was developed in the 1980s by psychologist Jeffrey Young. It can be understood as an integrative model that draws on a number of therapeutic approaches, and is essentially an extension of CBT. Dr. Young recognised that while CBT was effective for many, it didn’t address deeper-rooted problems that stemmed from early life experiences.

When is schema therapy used?

Schema therapy is effective for individuals who are experiencing long-term emotional difficulties, especially when other methods like CBT haven’t led to any lasting change. It’s commonly used to treat the following issues:

• Personality disorders, borderline personality disorder (BPD) in particular
• Eating disorders
• Anxiety
• Depression
• Intimacy issues
• Trauma
• Persistent low self-esteem

Schema therapy is often chosen when individuals recognise they are in a cycle of recurring patterns that feel hard to change.

Schema therapy modes

In schema therapy, therapists often refer to the different emotional and mental states that an individual shifts between. These are ‘modes’. These modes can either be healthy or problematic, and it’s essential to understand them in order to explain why you sometimes react in ways that don’t feel like yourself.

Modes are activated in response to triggers as they tend to be tied to past experiences. Here are some common schema modes that fall into broad categories:

Child modes

• Vulnerable Child: Feels hurt, abandoned, unloved, anxious, or worthless.
• Angry or Impulsive Child: Acts out frustrations, often without considering consequences.
• Happy Child: Feels safe, loved, and content (this is a mode to nurture!).

Maladaptive coping modes

• Detached Protector: Shuts down feelings, disconnects from others, may seem numb or distant.
• Compliant Surrenderer: Submits to others, ignores personal needs, avoids conflict.
• Overcompensator: Acts the opposite of how they feel inside—e.g., acts superior to cover up insecurity.

Maladaptive parent modes

• Punitive Parent: Harsh, critical inner voice—makes you feel “never good enough.”
• Demanding Parent: Pushes unrealistic standards, leading to perfectionism or burnout.

Healthy adult mode

• This is the overall goal of therapy. It is the mode that can understand and manage all the others with compassion, reason, and maturity. The healthy adult nurtures the vulnerable child, sets boundaries with critical voices, and makes grounded decisions.

How schema therapy works

Schema therapy works by using a strong therapeutic approach which makes the client feel comfortable and safe to open up. It emphasises empathic confrontation where the therapist responds to the client’s schemas and behaviours.

During sessions, schema therapists also attempt to meet some of the client’s emotional needs that went unmet in childhood. This technique is called ‘limited parenting’, which provides a safe and supportive environment to meet this need.

Schema therapy vs CBT

Schema therapy is essentially an extension of CBT, and digs further into early childhood experiences and the core beliefs that influence thoughts, feelings and behaviours. It combines CBT techniques such as cognitive restructuring, behavioural activation, and exposure therapy with experiential and interpersonal approaches.

Although CBT is effective for a wide range of mental health conditions like anxiety and depression, schema therapy is suited to those with personality disorders, chronic depression, and individuals who experience long-standing emotional and behavioural patterns that are affecting their day-to-day life.

Benefits of schema counselling

There are many benefits to schema therapy, including:

• A flexible approach – therapists draw from a wide range of proven techniques and tailor them to the client’s own needs and challenges.
• A holistic understanding – schema therapy allows individuals to explore deeper patterns behind thoughts, feelings, and behaviours.
• Active and supportive therapists – therapists take on an active and emotionally attuned role in the schema therapy process and build an open connection.
• Identify and change patterns – by identifying unhelpful patterns, clients can be more attuned to recurring ‘traps’ in thoughts and behaviours.

What to expect in your schema therapy sessions

First sessions

During the first session of schema therapy, we focus on building a rapport and understanding your background and presenting issues. During this time, your therapist will explore your history, emotional experiences, and potential schemas to make links between your early life experiences and current symptoms.

Your therapist will introduce the concept of schemas and modes and discuss your goals for therapy. The overall aim is to create a safe and comfortable environment for the client to explore their issues and begin the process of schema identification and change.

Ongoing sessions

During ongoing sessions, your therapist will use active therapeutic techniques, including:

• Emotion-focused strategies that aim to connect you with the emotional level of your experience. This includes imagery and chair work.
• Cognitive techniques that aim to promote flexible and compassionate thinking.
• Behavioural techniques that help you to challenge fears and break behavioural patterns.

Our schema therapists Brighton and Lewes

Our schema therapist, David Keighley, aims to develop a caring, safe, and nurturing relationship with each of his clients. He works with them to help them deal with life’s pressures in a healthier way in order to achieve a happy work-life balance. His approaches are tailored to each individual based on their presenting issues, personal strengths, and their early life experiences.

Why choose Brighton and Hove Psychotherapy

At Brighton and Hove Psychotherapy, we provide a safe and supportive environment for you to carry out deep psychological work. Each session is led by a highly trained schema therapist who tailors their approach based on your individual needs and issues. The flexibility in our approaches makes us one of the top practices in Brighton, Hove, Lewesand the surrounding areas.