Let us now examine some of the main characteristics of schemas. (From this point on, we use the terms “schema” and “Early Maladaptive Schema” virtually interchangeably.) Consider patients who have one of the four most powerful and damaging schemas from our list of 18 (see Figure 1.1 on pp. 14–17): Abandonment/Instability, Mistrust/Abuse, Emotional Deprivation, and Defectiveness/Shame. As young children, these patients were abandoned, abused, neglected, or rejected. In adulthood their schemas are triggered by life events that they perceive (unconsciously) as similar to the traumatic experiences of their childhood. When one of these schemas is triggered, they experience a strong negative emotion, such as grief, shame, fear, or rage.
Not all schemas are based in childhood trauma or mistreatment. Indeed, an individual can develop a Dependence/Incompetence schema without experiencing a single instance of childhood trauma. Rather, the individual might have been completely sheltered and overprotected throughout childhood. However, although not all schemas have trauma as their origin, all of them are destructive, and most are caused by noxious experiences that are repeated on a regular basis throughout childhood and adolescence. The effect of all these related toxic experiences is cumulative, and together they lead to the emergence of a full-blown schema.
Early Maladaptive Schemas fight for survival. As we mentioned earlier, this is the result of the human drive for consistency. The schema is what the individual knows. Although it causes suffering, it is comfortable and familiar. It feels “right.” People feel drawn to events that trigger their schemas. This is one reason schemas are so hard to change. Patients regard schemas as a priori truths, and thus these schemas influence the processing of later experiences. They play a major role in how patients think, feel, act, and relate to others and paradoxically lead them to inadvertently recreate in their adult lives the conditions in childhood that were most harmful to them.
Schemas begin in early childhood or adolescence as reality-based representations of the child’s environment. It has been our experience that individuals’ schemas fairly accurately reflect the tone of their early environment. For example, if a patient tells us that his family was cold and unaffectionate when he was young, he is usually correct, even though he may not understand why his parents had difficulty showing affection or expressing feelings. His attributions for their behavior may be wrong, but his basic sense of the emotional climate and how he was treated is almost always valid.
The dysfunctional nature of schemas usually becomes most apparent later in life, when patients continue to perpetuate their schemas in their interactions with other people even though their perceptions are no longer accurate. Early Maladaptive Schemas and the maladaptive ways in which patients learn to cope with them often underlie chronic Axis I symptoms, such as anxiety, depression, substance abuse, and psychosomatic disorders.
Schemas are dimensional, meaning they have different levels of severity and pervasiveness. The more severe the schema, the greater the number of situations that activate it. So, for example, if an individual experiences criticism that comes early and frequently, that is extreme, and that is given by both parents, then that individual’s contact with almost anyone is likely to trigger a Defectiveness schema. If an individual experiences criticism that comes later in life and is occasional, milder, and given by only one parent, then that individual is less likely to activate the schema later in life; for example, the schema may be triggered only by demanding authority figures of the critical parent’s gender. Furthermore, in general, the more severe the schema, the more intense the negative affect when the schema is triggered and the longer it lasts.
As we mentioned earlier, there are positive and negative schemas, as well as early and later schemas. Our focus is almost exclusively on Early Maladaptive Schemas, so we do not spell out these positive, later schemas in our theory. However, some writers have argued that, for each of our Early Maladaptive Schemas, there is a corresponding adaptive schema (see Elliott’s polarity theory; Elliott & Lassen, 1997). Alternatively, considering Erikson’s (1950) psychosocial stages, one could argue that the successful resolution of each stage results in an adaptive schema, whereas the failure to resolve a stage leads to a maladaptive schema. Nevertheless, our concern in this book is the population of psychotherapy patients with chronic disorders rather than a normal population; therefore, we focus primarily on the early maladaptive schemas that we believe underlie personality pathology.
FIGURE 1.1. Early maladaptive schemas with associated schema domains.
Disconnection and Rejection
(The expectation that one’s needs for security, safety, stability, nurturance, empathy, sharing of feelings, acceptance, and respect will not be met in a predictable manner. Typical family origin is detached, cold, rejecting, withholding, lonely, explosive, unpredictable, or abusive.)
Abandonment/Instability
The perceived instability or unreliability of those available for support and connection.
Involves the sense that significant others will not be able to continue providing emotional support, connection, strength, or practical protection because they are emotionally unstable and unpredictable (e.g., have angry outbursts), unreliable, or present only erratically; because they will die imminently; or because they will abandon the individual in favor of someone better.
Mistrust/Abuse
The expectation that others will hurt, abuse, humiliate, cheat, lie, manipulate, or take advantage. Usually involves the perception that the harm is intentional or the result of unjustified and extreme negligence. May include the sense that one always ends up being cheated relative to others or “getting the short end of the stick.”
Emotional Deprivation
The expectation that one’s desire for a normal degree of emotional support will not be adequately met by others. The three major forms of deprivation are:
Deprivation of Nurturance: Absence of attention, affection, warmth, or companionship.
Deprivation of Empathy. Absence of understanding, listening, self-disclosure, or mutual sharing of feelings from others.
Deprivation of Protection: Absence of strength, direction, or guidance from others.
Defectiveness/Shame
The feeling that one is defective, bad, unwanted, inferior, or invalid in important respects or that one would be unlovable to significant others if exposed. May involve hypersensitivity to criticism, rejection, and blame; self-consciousness, comparisons, and insecurity around others; or a sense of shame regarding one’s perceived flaws. These flaws may be private (e.g., selfishness, angry impulses, unacceptable sexual desires) or public (e.g., undesirable physical appearance, social awkwardness).
Social Isolation/Alienation
The feeling that one is isolated from the rest of the world, different from other people, and/or not part of any group or community.
Impaired Autonomy and Performance
(Expectations about oneself and the environment that interfere with one’s perceived ability to separate, survive, function independently, or perform successfully. Typical family origin is enmeshed, undermining of child’s confidence, overprotective, or failing to reinforce child for performing competently outside the family.)
Dependence/Incompetence
Belief that one is unable to handle one’s everyday responsibilities in a competent manner, without considerable help from others (e.g., take care of oneself, solve daily problems, exercise good judgment, tackle new tasks, make good decisions). Often presents as helplessness.
Vulnerability to Harm or Illness
Exaggerated fear that imminent catastrophe will strike at any time and that one will be unable to prevent it. Fears focus on one or more of the following: (A) Medical catastrophes (e.g., heart attacks, AIDS); (B) Emotional catastrophes (e.g., going crazy); (C) External catastrophes (e.g., elevators collapsing, victimization by criminals, airplane crashes, earthquakes).
Enmeshment/Undeveloped Self
Excessive emotional involvement and closeness with one or more significant others (often parents) at the expense of full individuation or normal social development. Often involves the belief that at least one of the enmeshed individuals cannot survive or be happy without the constant support of the other. May also include feelings of being smothered by or fused with others or insufficient individual identity. Often experienced as a feeling of emptiness and foundering, having no direction, or in extreme cases questioning one’s existence.
Failure
The belief that one has failed, will inevitably fail, or is fundamentally inadequate relative to one’s peers in areas of achievement (school, career, sports, etc.). Often involves beliefs that one is stupid, inept, untalented, lower in status, less successful than others, and so forth.
Impaired Limits
(Deficiency in internal limits, responsibility to others, or long-term goal orientation. Leads to difficulty respecting the rights of others, cooperating with others, making commitments, or setting and meeting realistic personal goals. Typical family origin is characterized by permissiveness, overindulgence, lack of direction, or a sense of superiority rather than appropriate confrontation, discipline, and limits in relation to taking responsibility, cooperating in a reciprocal manner, and setting goals. In some cases, the child may not have been pushed to tolerate normal levels of discomfort or may not have been given adequate supervision, direction, or guidance.)
Entitlement/Grandiosity
The belief that one is superior to other people; entitled to special rights and privileges; or not bound by the rules of reciprocity that guide normal social interaction. Often involves insistence that one should be able to do or have whatever one wants, regardless of what is realistic, what others consider reasonable, or the cost to others; or an exaggerated focus on superiority (e.g., being among the most successful, famous, wealthy) in order to achieve power or control (not primarily for attention or approval). Sometimes includes excessive competitiveness toward or domination of others: asserting one’s power, forcing one’s point of view, or controlling the behavior of others in line with one’s own desires without empathy or concern for others’ needs or feelings.
Insufficient Self-Control/Self-Discipline
Pervasive difficulty or refusal to exercise sufficient self-control and frustration tolerance to achieve one’s personal goals or to restrain the excessive expression of one’s emotions and impulses. In its milder form, the patient presents with an exaggerated emphasis on discomfort avoidance: avoiding pain, conflict, confrontation, responsibility, or overexertion at the expense of personal fulfillment, commitment, or integrity.
Other-Directedness
(An excessive focus on the desires, feelings, and responses of others, at the expense of one’s own needs in order to gain love and approval, maintain one’s sense of connection, or avoid retaliation. Usually involves suppression and lack of awareness regarding one’s own anger and natural inclinations. Typical family origin is based on conditional acceptance: Children must suppress important aspects of themselves in order to gain love, attention, and approval. In many such families, the parents’ emotional needs and desires—or social acceptance and status—are valued more than the unique needs and feelings of each child.)
Subjugation
Excessive surrendering of control to others because one feels coerced—submitting in order to avoid anger, retaliation, or abandonment. The two major forms of subjugation are:
Subjugation of needs: Suppression of one’s preferences, decisions, and desires.
Subjugation of emotions: Suppression of emotions, especially anger.
Usually involves the perception that one’s own desires, opinions, and feelings are not valid or important to others. Frequently presents as excessive compliance, combined with hypersensitivity to feeling trapped. Generally leads to a buildup of anger, manifested in maladaptive symptoms (e.g., passive-aggressive behavior, uncontrolled outbursts of temper, psychosomatic symptoms, withdrawal of affection, “acting out,” substance abuse).
Self-Sacrifice
Excessive focus on voluntarily meeting the needs of others in daily situations at the expense of one’s own gratification. The most common reasons are: to prevent causing pain to others; to avoid guilt from feeling selfish; or to maintain the connection with others perceived as needy. Often results from an acute sensitivity to the pain of others. Sometimes leads to a sense that one’s own needs are not being adequately met and to resentment of those who are taken care of. (Overlaps with concept of codependency.)
Approval-Seeking/Recognition-Seeking
Excessive emphasis on gaining approval, recognition, or attention from other people or on fitting in at the expense of developing a secure and true sense of self. One’s sense of esteem is dependent primarily on the reactions of others rather than on one’s own natural inclinations. Sometimes includes an overemphasis on status, appearance, social acceptance, money, or achievement as means of gaining approval, admiration, or attention (not primarily for power or control). Frequently results in major life decisions that are inauthentic or unsatisfying or in hypersensitivity to rejection.
Overvigilance and Inhibition
(Excessive emphasis on suppressing one’s spontaneous feelings, impulses, and choices or on meeting rigid, internalized rules and expectations about performance and ethical behavior, often at the expense of happiness, self-expression, relaxation, close relationships, or health. Typical family origin is grim, demanding, and sometimes punitive: performance, duty, perfectionism, following rules, hiding emotions, and avoiding mistakes predominate over pleasure, joy, and relaxation. There is usually an undercurrent of pessimism and worry that things could fall apart if one fails to be vigilant and careful at all times.)
Negativity/Pessimism
A pervasive, lifelong focus on the negative aspects of life (pain, death, loss, disappointment, conflict, guilt, resentment, unsolved problems, potential mistakes, betrayal, things that could go wrong, etc.) while minimizing or neglecting the positive or optimistic aspects. Usually includes an exaggerated expectation—in a wide range of work, financial, or interpersonal situations—that things will eventually go seriously wrong or that aspects of one’s life that seem to be going well will ultimately fall apart. Usually involves an inordinate fear of making mistakes that might lead to financial collapse, loss, humiliation, or being trapped in a bad situation. Because they exaggerate potential negative outcomes, these individuals are frequently characterized by chronic worry, vigilance, complaining, or indecision.
Emotional Inhibition
The excessive inhibition of spontaneous action, feeling, or communication, usually to avoid disapproval by others, feelings of shame, or losing control of one’s impulses. The most common areas of inhibition involve: (a) inhibition of anger and aggression; (b) inhibition of positive impulses (e.g., joy, affection, sexual excitement, play); (c) difficulty expressing vulnerability or communicating freely about one’s feelings, needs, and so forth; or (d) excessive emphasis on rationality while disregarding emotions.
Unrelenting Standards/Hypercriticalness
The underlying belief that one must strive to meet very high internalized standards of behavior and performance, usually to avoid criticism. Typically results in feelings of pressure or difficulty slowing down and in hypercriticalness toward oneself and others. Must involve significant impairment in pleasure, relaxation, health, self-esteem, sense of accomplishment, or satisfying relationships.
Unrelenting standards typically present as (a) perfectionism, inordinate attention to detail, or an underestimate of how good one’s own performance is relative to the norm; (b) rigid rules and “shoulds” in many areas of life, including unrealistically high moral, ethical, cultural, or religious precepts; or (c) preoccupation with time and efficiency, the need to accomplish more.
Punitiveness
The belief that people should be harshly punished for making mistakes. Involves the tendency to be angry, intolerant, punitive, and impatient with those people (including oneself) who do not meet one’s expectations or standards. Usually includes difficulty forgiving mistakes in oneself or others because of a reluctance to consider extenuating circumstances, allow for human imperfection, or empathize with feelings.
Note. Copyright 2002 by Jeffrey Young. Unauthorized reproduction without written consent of the author is prohibited. For more information, write to the Schema Therapy Institute, 36 West 44th Street, Suite 1007, New York, NY 10036.