Common Schema Modes

As noted in Chapter 1, we have identified four main types of modes: Child modes, Maladaptive Coping modes, Dysfunctional Parent modes, and the Healthy Adult mode. Each type of mode is associated with certain schemas (except the Healthy Adult and Happy Child) or embodies certain coping styles.

In patients with borderline and narcissistic disorders, the modes are relatively disconnected, and the person is capable of experiencing only one mode at a time. Patients with BPD switch rapidly from mode to mode. Other patients, such as those with narcissistic personality disorder, switch less often and can be in one mode for a long time. For example, a patient with narcissistic personality disorder who is on a month-long vacation might spend the entire time in a detached self-soothing mode, pursuing novelty and excitement; in contrast, a patient with narcissistic personality disorder who is at work or at a party might spend the entire time in a self-aggrandizing mode.

Still other patients, such as those with obsessive-compulsive personality disorder, are rigidly locked in a single mode and almost never fluctuate. Regardless of where they are, who they are with, or what is happening to them, they are essentially the same: self-controlled, rigid, and perfectionistic. The frequency of shifts is important when we look at an individual patient, but it is not what defines a mode. Modes can either shift frequently for a given patient or stay relatively constant. Either extreme can lead to significant problems for the patient.

Child Modes

The Child modes are clearest in patients with BPD, who are themselves so much like children. We have identified four Child modes: the Vulnerable Child, the Angry Child, the Impulsive/Undisciplined Child, and the Happy Child (see Table 8.1). We believe that these Child modes are innate and that they represent the inborn emotional range of human beings. What happens in the early childhood environment may suppress or enhance a Child mode, but human beings are born with the capacity to express all four of them.

A patient in the Vulnerable Child mode might appear frightened, sad, overwhelmed, or helpless. This mode is like a young child in the world who needs the care of adults in order to survive but is not getting that care. The child desperately needs a parent and will tolerate just about anything to get one. (Marilyn Monroe captured the defenselessness of the Vulnerable Child). The specific nature of the wound to the Vulnerable Child depends on the schema: The parent leaves the child alone for long periods of time (the Abandoned Child), hits the child excessively (the Abused Child), withholds love (the Deprived Child), or harshly criticizes the child (the Defective Child). Other schemas that can be associated with this mode include Social Isolation, Dependence/Incompetence, Vulnerability to Harm or Illness, Enmeshment/Undeveloped Self, and Failure. Most schemas are part of the Vulnerable Child mode. For this reason, we regard the Vulnerable Child as the core mode for the purposes of schema work. Ultimately it is the mode that we are most concerned with healing.

The Angry Child has become enraged. Virtually all young children become angry at some point when their core needs are not being met. Although the parent might punish the child or otherwise squelch the response, rage is a normal reaction for a young child in this predicament. Patients in the Angry Child mode vent anger directly in response to perceived unmet needs or unfair treatment related to associated schemas, including Abandonment, Mistrust/Abuse, Emotional Deprivation, and Subjugation, among others. When a schema is triggered and the patient feels abandoned, abused, deprived, or subjugated, the patient becomes furious and might yell, lash out verbally, or have violent fantasies and impulses.

The Impulsive/Undisciplined Child acts impulsively to fill needs and pursue pleasure without regard to limits or concern for others. This mode is the child in a natural state, uninhibited and “uncivilized,” irresponsible and free. (Peter Pan, the eternal child, incarnates this mode.) The Impulsive/Undisciplined Child has low frustration tolerance and cannot delay short-term gratification for the sake of long-term goals. A person in this mode may appear spoiled, angry, careless, lazy, impatient, unfocused, or out of control. Associated schemas can include Entitlement and Insufficient Self-Control/Self-Discipline.

The Happy Child feels loved and contented. This mode is not associated with any Early Maladaptive Schemas because the child’s core needs are being met adequately. The Happy Child mode represents the healthy absence of schema activation.

Maladaptive Coping Modes

The Maladaptive Coping modes represent the child’s attempts to adapt to living with unmet emotional needs in a harmful environment. These coping modes were adaptive when the patient was a young child, but they are often maladaptive in the wider adult world. We have identified three broad types: the Compliant Surrenderer, the Detached Protector, and the Over-compensator (see Table 8.2). They correspond, respectively, to the coping processes of surrender, avoidance, and overcompensation.

The function of the Compliant Surrenderer is to avoid further mistreatment. The function of the other two modes, the Detached Protector and the Overcompensator, is to escape the upsetting emotions generated by schema eruption.

The Compliant Surrenderer submits to the schema as a coping style. Patients in this mode appear passive and dependent. They do whatever the therapist (and others) want them to do. Individuals in the Compliant Surrenderer mode experience themselves as helpless in the face of a more powerful figure. They feel they have no choice but to try to please this person to avoid conflict. They are obedient, perhaps allowing others to abuse them, neglect them, control them, or devalue them in order to preserve the connection or avoid retaliation.

The Detached Protector uses schema avoidance as a coping style. The coping style is one of psychological withdrawal. Individuals in the Detached Protector mode detach from other people and shut off their emotions in order to protect themselves from the pain of being vulnerable. The mode is like a protective armor or wall, with the more vulnerable modes hiding inside. In the Detached Protector mode, patients may feel numb or empty. They may adopt a cynical or aloof stance to avoid investing emotionally in people or activities. Behavioral examples include social withdrawal, excessive self-reliance, addictive self-soothing, fantasizing, compulsive distraction, and stimulation-seeking.

The Detached Protector mode is problematic for many of our characterological patients, especially those with BPD, and is often the most difficult mode to change. When these patients were young children, development of the Detached Protector mode was an adaptive strategy. They were trapped in a traumatic environment that created too much suffering, and it made sense for them to distance themselves, to detach and not to feel. As these children matured into adults and entered a less hostile or depriving world, it would have been adaptive to let go of the Detached Protector and become open to the world and their own emotions again. But these patients have become so accustomed to being in the Detached Protector mode that it is automatic, and they no longer know how to get out of it. Their refuge has become a prison.

Overcompensators use schema overcompensation as a coping style. They act as though the opposite of the schema were true.¹ For example, if they feel defective, they try to appear perfect and superior to others. If they feel guilty, they blame others. If they feel dominated, they bully others. If they feel used, they move to exploit others. If they feel inferior, they seek to impress others with their status or accomplishments. Some over-compensators are passive-aggressive. They appear overtly compliant while secretly getting revenge, or they rebel covertly through procrastination, backstabbing, complaining, or nonperformance. Other overcompensators are obsessive. They maintain strict order, tight self-control, or high levels of predictability through planning, excessive adherence to routines, or undue caution.

Dysfunctional Parent Modes

Dysfunctional Parent modes are internalizations of parent figures in the patient’s early life. When patients are in a Dysfunctional Parent mode, they become their own parent and treat themselves as the parent treated them when they were children. They often take on the voice of the parent in their “self-talk.” In Dysfunctional Parent modes, patients think, feel, and act as their parent did toward them when they were children.

We have identified two common types of Dysfunctional Parent modes (although some patients may exhibit other parent modes as well): the Punitive (or Critical) Parent and the Demanding Parent (see Table 8.3). The Punitive Parent angrily punishes, criticizes, or restricts the child for expressing needs or making mistakes. The most common associated schemas are Punitiveness and Defectiveness. This mode is especially prominent in patients with BPD or severe depression. Patients with BPD have a Punitive Parent mode in which they become their own abusive parent and punish themselves: For example, they say they are evil, dirty, or bad, and often punish themselves by cutting themselves. In this mode they are not Vulnerable Children; rather, they are Punitive Parents meting out punishment to the Vulnerable Child. Actually, they shift back and forth from the Punitive Parent to the Vulnerable Child, so that at some moments they are the child who is being abused, and at other moments they are their own parent perpetrating the abuse.

The Demanding Parent pressures the child to achieve unrealistically high parental expectations. The person feels that the “right” way to be is to be perfect and the “wrong” way to be is fallible or spontaneous. Often the associated schemas are Unrelenting Standards and Self-Sacrifice. This mode is very common in patients with narcissistic and obsessive-compulsive disorders. Patients shift into a Demanding Parent mode in which they set high standards for themselves and drive themselves to meet them. However, the Demanding Parent is not necessarily punitive: The Demanding Parent expects a lot but may not blame or punish. Most frequently, the child recognizes the parent’s disappointment and feels ashamed. Many patients have a combined Punitive and Demanding Parent mode, in which they both set high standards for themselves and punish themselves when they fail to meet them.

The Healthy Adult Mode

This mode is the healthy, adult part of the self that serves an “executive” function relative to the other modes. The Healthy Adult helps meet the child’s basic emotional needs. Building and strengthening the patient’s Healthy Adult to work with the other modes more effectively is the overarching goal of mode work.

Most adult patients have some version of this mode, but they vary drastically in how effective it is. Healthier, higher functioning patients have a stronger Healthy Adult mode; patients with more severe disorders usually have a weaker Healthy Adult mode. Patients with BPD often have almost no Healthy Adult mode, so the therapist must augment or help to create a mode that is extremely undeveloped.

Like a good parent, the Healthy Adult mode serves the following three basic functions:

1. Nurtures, affirms, and protects the Vulnerable Child.

2. Sets limits for the Angry Child and the Impulsive/Undisciplined Child, in accord with the principles of reciprocity and self-discipline.

3. Battles or moderates the maladaptive coping and dysfunctional parent modes.

During the course of treatment, patients internalize the therapist’s behavior as part of their own Healthy Adult mode. Initially, the therapist serves as the Healthy Adult whenever the patient is incapable of doing so. For example, if a patient is able to battle the Punitive Parent on his own, the therapist does not intervene. However, if the patient is unable to battle the Punitive Parent and instead attacks himself endlessly without defending himself, then the therapist intervenes and battles the Punitive Parent for the patient. Gradually the patient takes over the Healthy Adult Role. (This is what we mean by “limited reparenting.”)