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What is Schema Therapy and How Does it Relate to Attachment?

Dr. Jeffrey Young and the Birth of Schema Therapy

Dr. Jeffrey Young is a big name in the field of psychology. Known for his work in Cognitive Behavioral Therapy (CBT) as a student and colleague of Dr. Aaron Beck, he later developed Schema Therapy (ST) in the 1980s and 90s as an innovative extension of traditional CBT approaches. Schema Therapy integrates elements from various schools of therapy, including cognitive-behavioral, attachment, Gestalt, and psychoanalytic therapies, among others.

While Schema Therapy incorporates some aspects of psychoanalysis, such as considering subconscious thoughts and emotions, it distinguishes itself by emphasizing the therapeutic relationship. In Schema Therapy, the therapist actively meets the patient's emotional needs and works closely with them to foster change. This therapeutic bond is often more engaged and emotionally supportive compared to traditional CBT.

Even though Schema Therapy builds on CBT techniques, it places a greater focus on emotional needs, attachment, interpersonal relationships, and understanding the development of psychological issues from early childhood and adolescence.

The Goal of Schema Therapy

It’s important to note that Schema Therapy is not designed to manage acute symptoms—sudden, severe issues that need immediate intervention. Instead, Schema Therapy targets chronic, long-standing dysfunctional behavioral patterns that have persisted throughout a person’s life. Treatment duration can vary, but for chronic issues like Borderline Personality Disorder, it may take up to three years, according to Dr. Young.

Schema Therapy is often effective in treating:

  • Depression

  • Eating disorders

  • Relational problems

  • Anxiety

  • Substance abuse

How Does Schema Therapy Work?

Schema therapists take a big-picture approach, looking for patterns across all the information that patients share. They strive to identify and organize pervasive dysfunctional behaviors and help patients understand their origins and evolution over time. This timeline gives patients a comprehensive view of how these behaviors developed and continue to affect their lives.

A key part of the Schema Therapy process is the secure and collaborative bond between the patient and the therapist. This relationship is crucial for helping patients tackle the core emotional needs that were not met during their early childhood, which often underlie their dysfunctional behaviors. Dr. Young calls this approach “Limited Reparenting,” where the therapist provides the emotional support that was missing in the patient’s upbringing.

The Four Components of Schema Therapy

Schema Therapy involves four main components:

  1. Core Emotional Needs: Essential emotional needs that must be met for healthy development.

  2. Early Maladaptive Schemas (EMS): Dysfunctional beliefs formed when core needs are not met during childhood.

  3. Maladaptive Coping Styles: Coping strategies developed to deal with these unmet needs, which persist into adulthood.

  4. Schema Modes: Temporary states or combinations of schemas and coping styles that become activated in response to life events.

The Development of Early Maladaptive Schemas

As children grow, they have core emotional needs such as safety, stability, and love. When these needs are not adequately met, children create beliefs to make sense of their environment. For example, a child might develop beliefs like “My needs are not important to others” or “Others will inevitably hurt me.” These beliefs are called early maladaptive schemas.

To cope with the painful emotions tied to these schemas, children develop maladaptive coping responses. While these strategies help them get through difficult experiences in childhood, they do not resolve the underlying schema. Instead, people continue to rely on these coping styles even in adulthood, long after they are necessary for survival.

Understanding Schema Modes

Schema modes are dynamic combinations of an individual’s schemas and coping styles that become activated in specific situations. They form the dysfunctional patterns that people exhibit throughout their lives. Unlike schemas or coping styles, schema modes can be either maladaptive or adaptive, and the goal of Schema Therapy is to guide patients away from maladaptive modes and toward healthy ones.

The Connection Between Attachment and Schema Therapy

Attachment theory plays a significant role in Schema Therapy. Here are four key connections between attachment and early maladaptive schemas:

  1. Secure Attachment as a Foundation: Both attachment theory and Schema Therapy emphasize that secure attachment is fundamental for psychological health. One of the core emotional needs in Schema Therapy is secure attachment, which forms the foundation of a healthy individual.

  2. Attachment and Exploration: Secure attachment is not just about safety and connection; it also provides a base for exploration. Just as attachment theory suggests that children need a secure base to explore the world, Schema Therapy emphasizes the need for autonomy, spontaneity, and play as part of healthy emotional development.

  3. Internal Working Models and Schemas: Attachment theory talks about an internal working model that children develop based on their interactions with caregivers. Similarly, Schema Therapy involves early maladaptive schemas—beliefs about oneself, relationships, and the world that shape how individuals interpret experiences.

  4. The Therapist as a Secure Base: In Schema Therapy, the therapist acts as a secure base for the patient, much like a caregiver does for a child. This is especially important for patients who grew up without secure attachments and may never have experienced a stable emotional bond.

Final Thoughts

Schema Therapy offers a comprehensive approach to treating chronic, deeply ingrained dysfunctional patterns by focusing on unmet emotional needs and using the therapeutic relationship as a central tool for healing. Its integration of attachment theory helps patients understand the origins of their struggles, recognize dysfunctional patterns, and move towards healthier, adaptive behaviors.

If you’re interested in learning more about Early Maladaptive Schemas and how they affect our lives, check out our detailed list of the 18 schemas developed by Dr. Young and his colleagues.

This blog post is based on the work of Dr. Jeffrey Young and his colleagues, as outlined in the book “Schema Therapy: A Practitioner’s Guide” (Young, Klosko, & Weishaar, 2003).


Taken from an article posted on attachmentproject.org

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