Cognitive strategies increase the patient’s intellectual awareness that the schema is either not true or is greatly exaggerated. The therapist and patient begin by agreeing to view the schema as a hypothesis to be tested. They examine the evidence in the patient’s past and present life that supports and refutes the schema. Next, the therapist and patient generate alternative explanations for the evidence supporting the schema. The therapist attributes evidence from childhood to disturbed family dynamics, and evidence since childhood to schema perpetuation. The therapist helps the patient learn to conduct dialogues between the “schema side” and the “healthy side.”
Next, the therapist and patient list the advantages and disadvantages of the patient’s current coping styles, and the patient commits to attempting more adaptive behaviors. The patient practices healthy behaviors, first by using flash cards and later by filling out the Schema Diary form. The steps in the cognitive work fit together sequentially and build on one another. The cognitive work prepares the patient for the experiential, behavioral, and interpersonal work that lies ahead.
The therapist and patient continue doing cognitive work throughout the treatment process. As therapy progresses, patients add to the list of evidence against their schemas. For example, as Emily made more independent decisions and behaved more proactively at work, she accumulated successes. At one point, a board member of her project wanted to talk to her about the budget. Rather than feeling helpless and procrastinating, Emily prepared for the meeting. She role-played the meeting in her therapy session. She studied all the relevant facts. At the meeting, Emily responded to all of the board member’s questions and was able to suggest some new ideas. As Emily continued to progress, she amassed more evidence against her Subjugation schema. As she fought her schema and improved her coping responses, her life increasingly proved her schema wrong.