Our basic view is that schemas result from unmet core emotional needs in childhood. We have postulated five core emotional needs for human beings.2
Secure attachments to others (includes safety, stability, nurturance, and acceptance)
Autonomy, competence, and sense of identity
Freedom to express valid needs and emotions
Spontaneity and play
Realistic limits and self-control
We believe that these needs are universal. Everyone has them, although some individuals have stronger needs than others. A psychologically healthy individual is one who can adaptively meet these core emotional needs.
The interaction between the child’s innate temperament and early environment results in the frustration, rather than gratification, of these basic needs. The goal of schema therapy is to help patients find adaptive ways to meet their core emotional needs. All of our interventions are means to this end.
Toxic childhood experiences are the primary origin of Early Maladaptive Schemas. The schemas that develop earliest and are the strongest typically originate in the nuclear family. To a large extent, the dynamics of a child’s family are the dynamics of that child’s entire early world. When patients find themselves in adult situations that activate their Early Maladaptive Schemas, what they usually are experiencing is a drama from their childhood, usually with a parent. Other influences, such as peers, school, groups in the community, and the surrounding culture, become increasingly important as the child matures and may lead to the development of schemas. However, schemas developed later are generally not as pervasive or as powerful. (Social Isolation is an example of a schema that is usually developed later in childhood or in adolescence and that may not reflect the dynamics of the nuclear family.)
We have observed four types of early life experiences that foster the acquisition of schemas. The first is toxic frustration of needs. This occurs when the child experiences too little of a good thing and acquires schemas such as Emotional Deprivation or Abandonment through deficits in the early environment. The child’s environment is missing something important, such as stability, understanding, or love. The second type of early life experience that engenders schemas is traumatization or victimization. Here, the child is harmed or victimized and develops schemas such as Mistrust/Abuse, Defectiveness/Shame, or Vulnerability to Harm. In the third type, the child experiences too much of a good thing: The parents provide the child with too much of something that, in moderation, is healthy for a child. With schemas such as Dependence/Incompetence or Entitlement/Grandiosity, for example, the child is rarely mistreated. Rather, the child is coddled or indulged. The child’s core emotional needs for autonomy or realistic limits are not met. Thus parents may be overly involved in the life of a child, may overprotect a child, or may give a child an excessive degree of freedom and autonomy without any limits.
The fourth type of life experience that creates schemas is selective internalization or identification with significant others. The child selectively identifies with and internalizes the parent’s thoughts, feelings, experiences, and behaviors. For example, two patients present for treatment, both survivors of childhood abuse. As a child, the first one, Ruth, succumbed to the victim role. When her father hit her, she did not fight back. Rather, she became passive and submissive. She was the victim of her father’s abusive behavior, but she did not internalize it. She experienced the feeling of being a victim, but she did not internalize the feeling of being an abuser. The second patient, Kevin, fought back against his abusive father. He identified with his father, internalized his aggressive thoughts, feelings, and behavior, and eventually became abusive himself. (This example is extreme. In reality, most children both absorb the experience of being a victim and take on some of the thoughts, feelings, or behaviors of the toxic adult.)
As another example, two patients both present with Emotional Deprivation schemas. As children, both had cold parents. Both felt lonely and unloved as children. Should we assume that, as adults, both had become emotionally cold? Not necessarily. Although both patients know what it means to be recipients of coldness, they are not necessarily cold themselves. As we discuss later in the section on coping styles, instead of identifying with their cold parents, patients might cope with their feelings of deprivation by becoming nurturing, or, alternatively, they might cope by becoming demanding and feeling entitled. Our model does not assume that children identify with and internalize everything their parents do; rather, we have observed that they selectively identify with and internalize certain aspects of significant others. Some of these identifications and internalizations become schemas, and some become coping styles or modes.
We believe that temperament partly determines whether an individual identifies with and internalizes the characteristics of a significant other. For example, a child with a dysthymic temperament will probably not internalize a parent’s optimistic style of dealing with misfortune. The parent’s behavior is so contrary to the child’s disposition that the child cannot assimilate it.
Factors other than early childhood environment also play major roles in the development of schemas. The child’s emotional temperament is especially important. As most parents soon realize, each child has a unique and distinct “personality” or temperament from birth. Some children are more irritable, some are more shy, some are more aggressive. There is a great deal of research supporting the importance of the biological underpinnings of personality. For example, Kagan and his colleagues (Kagan, Reznick, & Snidman, 1988) have generated a body of research on temperamental traits present in infancy and have found them to be remarkably stable over time.
Following are some dimensions of emotional temperament that we hypothesize might be largely inborn and relatively unchangeable through psychotherapy alone.
Labile ↔ Nonreactive
Dysthymic ↔ Optimistic
Anxious ↔ Calm
Obsessive ↔ Distractible
Passive ↔ Aggressive
Irritable ↔ Cheerful
Shy ↔ Sociable
One might think of temperament as the individual’s unique mix of points on this set of dimensions (as well as other aspects of temperament that will undoubtedly be identified in the future).
Emotional temperament interacts with painful childhood events in the formation of schemas. Different temperaments selectively expose children to different life circumstances. For example, an aggressive child might be more likely to elicit physical abuse from a violent parent than a passive, appeasing child. In addition, different temperaments render children differentially susceptible to similar life circumstances. Given the same parental treatment, two children might react very differently. For example, consider two boys who are both rejected by their mothers. The shy child hides from the world and becomes increasingly withdrawn and dependent on his mother; the sociable one ventures forth and makes other, more positive connections. Indeed, sociability has been shown to be a prominent trait of resilient children, who thrive despite abuse or neglect.
In our observation, an extremely favorable or aversive early environment can override emotional temperament to a significant degree. For example, a safe and loving home environment might make even a shy child quite friendly in many situations; alternatively, if the early environment is rejecting enough, even a sociable child may become withdrawn. Similarly, an extreme emotional temperament can override an ordinary environment and produce psychopathology without apparent justification in the patient’s history.