• ​​Founder of the Couples Schema Therapy Special Interest Group of the International Society of Schema Therapy (ISST).
• Founder of the Schema Therapy – Organizational Development Special Interest Group of the International Society of Schema Therapy
• Has achieved Advanced and Trainer International ISST Certifications in Schema Therapy (Couples & Individual)
• Co-author: Schema Therapy with Couples. A Practitioner’s Guide to Healing Relationships (Wiley – Blackwell, London). This is the first published textbook devoted to Schema Therapy for couples. Click here for excerpts from the book on Amazon.

Dr. Simeone-DiFrancesco highlights some materials for you:

About Schema Therapy for children:  http://www.schematherapy-for-children.de/

Schema Therapy slide shows:  http://www.schematherapy.com/id29.htm

Arntz, A. Schema Therapy in Practice: An Introductory Guide to the Schema Mode Approach. Wiley-Blackwell, 2012.

Rafaeli, E., Bernstein, D., Young, J.  Schema Therapy: Distinctive Features (CBT Distinctive Features), Routledge, 2010.

A more thorough Schema Therapy Bibliography:

Pertinent Schema Therapy Research

(Please note, the two largest trials have ***.)
Note: materials below are taken with permission from Professor Lawrence Riso’s compendium.

Schema Therapy Defined (History, Definition, and Contrast with CBT; Schema  Therapy with Diverse Populations; Research Support; Core Emotional Needs; Schema Modes. 

Flanagan, C.M. (2014).  Unmet needs and maladaptive modes: A new way to approach longer-term problems. Journal of Psychotherapy Integration, 24(3), 208-222.

Heilemann, M.V., Pieters, H.C., Kehoe, P., & Yang, Q. (2011). Schema therapy, motivational interviewing, and collaborative-mapping as treatment for depression among low income, second generation Latinas. Journal of Behavior Therapy and Experimental Psychiatry, 42, 473-480.

 Schema Modes; Orienting the Patient

***Bamelis, L.M., Evers, S.M.A.A., Spinhoven, P., & Arntz, A. (2014). Results of a multicenter randomized controlled trial of the clinical effectiveness of schema therapy for personality disorders. American Journal of Psychiatry, 171, 305-322.

Roediger, E., Stevens, B.A., & Brockman, R. (2018). Contextual schema therapy: An integrative  approach to personality disorders, emotional dysregulation, and interpersonal functioning. (pp. 39-54).  Context Press, New Harbinger Publications.

Guided Imagery; Ethics and Guided Imagery

ten Napel-Schultz, M.C., Abma, T.A., Bemelis, L., & Arntz, A. (2011). Personality disorder patients’ perspectives on the introduction of  imagery within schema therapy: A qualitative study of patients’ experiences. Cognitive and Behavioral Practice, 18, 482-490.

Arntz, A. (2011).  Imagery rescripting for personality disorders. Cognitive and Behavioral Practice, 18, 466-481.

Guided Imagery (cont.); Limited Reparenting

Wheatley, J., & Hackmann, A. (2011). Using imagery rescripting to treat major depression:  Theory and practice. Cognitive and Behavioral Practice, 18, 444-453.

Rafeali, E., Bernstein, D., & Young, J. (2011). Schema therapy: Distinctive Features. (71-74).  New York, NY: Routledge/Taylor & Francis Group

Chair Work

Roediger, E., Stevens, B.A., & Brockman, R. (2018). Contextual schema therapy: An integrative approach to personality disorders, emotional dysregulation, and interpersonal functioning. (pp.  179-197).  Oakland, CA: Context  Press, New Harbinger Publications.

Pugh, M. (2017). Chairwork in cognitive behavioural therapy: A narrative review. Cognitive Therapy and Research, 41, 16-30.

Chair Work (cont.); Mindfulness and Schema Therapy

Roediger, E. (2012). Why are mindfulness and acceptance central elements for therapeutic change in schema therapy too? An  integrative perspective. In M. van Vreeswijk, M., J. Broersen,  & M. Nadort (Eds.),  The Wiley-Blackwell handbook of schema therapy:  Theory, research, and practice (pp. 230-239). Chichester, UK: Wiley-Blackwell.

Schema Therapy with Cluster B Personality Disorders; Schema Therapy Techniques

*** Giesen-Bloo, J., van Dyck, R., Spinhoven, P., van Tilburg, W., Dirksen, C. van Asselt, T.,  Arntz, A. (2006). Outpatient psychotherapy for borderline personality disorder: Randomized trial of schema-focused therapy vs transference-focused psychotherapy.  Archives of General Psychiatry, 63(6), 649-58.

Farrell, J., Shaw, I., & Reiss, N. (2012). Group schema therapy for borderline personality disorder patients:  Catalyzing schema and mode change.  In M. van Vreeswijk, M., J. Broersen, & M. Nadort (Eds.), The Wiley-Blackwell handbook of schema therapy: Theory, research, and practice  (pp. 341-358).  Chichester, UK: Wiley-Blackwell.

Schema Therapy with Cluster B Personality Disorders; Schema Therapy Techniques

Behary, W. (2012). Schema therapy for narcissism – A case study. In M. van Vreeswijk, M., J.  Broersen, & M. Nadort (Eds.),  The Wiley-Blackwell handbook of  schema therapy: Theory, research, and practice (pp. 81-90). Chichester, UK : Wiley-Blackwell.

Chakhssi, F., Kersten, T., de Ruiter, C, & Bernstein, D.P. (2014). Treating the untreatable:  A single case study of a psychopathic inpatient treated with schema therapy.  Psychotherapy, 51(3), 447-461.  doi : 10.1037/a0035773

Schema Therapy for Anxiety; Obsessive-Compulsive Personality Disorder, Schema Therapy Techniques

Wild, J., & Clark, D.M. (2011). Imagery rescripting of early traumatic memories in social phobia. Cognitive and Behavioral Practice, 18, 433-443.

Arntz, A. (2014). Imagery rescripting for posttraumatic stress disorder. In N. C. Thoma and D. McKay,  Working with Emotion in Cognitive-Behavioral Therapy: Techniques for Clinical Practice (pp.203 – 215).  New York, NY: Guilford Press.

Schema Therapy for Anxiety; Obsessive-Compulsive Personality Disorder, Schema Therapy Techniques

Hackmann, A. (2011). Imagery rescripting in posttraumatic stress disorder. Cognitive and Behavioral Practice, 18, 424-432.

Arntz, A. (2012). Schema therapy for cluster C personality disorders. In M. van Vreeswijk, M., J.  Broersen, & M. Nadort (Eds.),  The Wiley-Blackwell handbook of  schema therapy: Theory, research, and practice (pp. 397-414). Chichester, UK: Wiley-Blackwell.

Schema Therapy for Couples

Atkinson, T. (2012). Schema Therapy for couples: Healing partners in a relationship. In M. van Vreeswijk, M., J. Broersen, & M. Nadort (Eds.),  The Wiley-Blackwell handbook of schema therapy: Theory, research, and practice (pp. 323-336). Chichester, UK:  Wiley-Blackwell.

Roediger, E., Zarbock, G.,  Frank-Noyon, E., Hinrichs, J.  & Arntz, A.(2018): The effectiveness of imagery work in schema therapy with couples: a clinical experiment comparing the effects of imagery rescripting and cognitive interventions in brief schema couples therapy.  Sexual and Relationship Therapy, DOI: 10.1080/14681994.2018.1529411

Simeone-DiFrancesco, C., Roediger, E., & Stevens, B.(2015).Schema  Therapy with Couples.  A Practitioner’s Guide to Healing Relationships.  Chichester , UK: Wiley-Blackwell.

*In grateful appreciation to Dr. Lawrence Riso for his listing and categorization of these materials. (2019)

The experienced professional will find that Schema Therapy pulls together a number of psychotherapeutic approaches, psychodynamic, experiential, gestalt, cognitive-behavioral therapy, experiential, emotion focused therapies, and relational approaches.  It integrates them into one solid conceptual framework which allows both clinician and client to obtain a road map and drive it forward to accomplish the treatment goals.  Its integration is sophisticated and requires a high degree of intellectual astuteness and emotional flexibility.  In addition, an experienced clinician can use their already well-honed favorite tools and skills (such as EMDR, EFT techniques, Acceptance & Commitment protocols, etc.) and apply them within the Schema Therapy framework with exceptional results.

_________________

Jesus-Centered Schema Therapy™ Introduction

by Chiara Simeone-DiFrancesco, PhD.

 Schema Therapy is a cutting edge empirically validated therapy (see research list). Jesus- Centered Schema Therapy® is not a new stand-alone therapy. It follows APA best practices of providing culturally appropriate definitions to Schema Therapy’s conceptual base, and relevant content as applicable to the philosophical and religious foundations of Christianity.

Did you know that there is evidence-based research supporting religious integration? This research points to the superior performance of psychotherapy relationships and interventions tailored to client preferences. See: Norcross, JC (Ed). (2011)¹. Psychotherapy relationships that work: Evidence-based responsiveness.

When clients desire to incorporate their Christian values and beliefs into their therapy, Jesus- Centered Schema Therapy® has a framework robust enough to support this with appropriate informed consent of the client. Jesus-Centered Schema Therapy® (JC-ST) uses clear and logic-based definitions of non-arbitrary and inalienable human nature, rights and needs. It builds on concepts philosophically derived from observations of order and design in the universe that are attributed to God in great philosophies (Aristotle), and in culture and social sciences.

It supports the Christian belief that when we fit into God’s design for ourselves and relationships, justice, love and virtue spring forth. In so doing, it provides a religiously and culturally relevant model of Healthy Adult Mode that exemplifies a virtues-based application of basic Christianity. As with all positive psychologies, JC-ST prizes leaving others to apply as they wish. Negativism by moral judgment or guilt-laden messages is not the purview of a therapy that must respect the client’s autonomy. It is through autonomous trial and error, by the struggle of one’s process of evaluation and re-evaluation, that real growth is achieved.

Jesus-Centered Schema Therapy® presents a set of principles that flesh out and refine the Schema Therapy teaching of speaking from one’s positive-oriented “soft-side”. Our signature development of “Connect-Talk®” leading to Connect-Walk is one of its major components. Elucidating Jesus’ Model on building, in Gottman terms², a “Sound Relationship House” helps to produce an environment from which peace can develop. The boundaries that respect life and humanity stem from cooperation with objective design that creates a loving world. Jesus-Centered Schema Therapy® supports the Christian attribution of this Design to an infinitely loving, present and wise Divinity.

Very importantly, Jesus-Centered Schema Therapy® allows for experiencing healing re-parenting beyond the vehicles of the therapist or the client’s own Healthy Adult Mode. It can offer a real life

1 Norcross, JC (Ed). (2011). Psychotherapy relationships that work: Evidence-based responsiveness. Oxford University Press: New York, NY.

2 Gottman, John & Julie. See Sound Relationship House Theory. https://www.gottman.com/about/the-gottman-

method/

experience of connection with a loving Savior, in all His images: from infancy as a little One—gift from Heaven, to a young boy companion, to a teacher/mentor, to a crucified Savior, and to a glorious and triumphant risen Lord and Savior, conqueror of all hurt, harm, evil, injury and trauma. For the Christian therapist and client, these re-parenting experiences go far beyond imaginary re-scripts. They invite real encounters of Jesus-to-human connection and intervention.

There is nothing new in Jesus-Centered Schema Therapy®. It is actually the fulfillment of Schema Therapy principles that actively integrate interventions appropriate to Christian clients and using basic traditional understandings of Christian teaching on the nature of God, of humanity—on Who Jesus is and what He teaches and taught. It applies this therapeutically on an individualized and thoughtful basis. These employ the clinician’s trained judgment based on the context of the client of what may be helpful, and what would do no harm. In doing so, we espouse to “Principle-based ethics”³ as applied to the provision of all clinical services. On this, Beauchamp and Childress (2009)⁴ have written.

We apply Bloom’s taxonomy to risk management principles in working in the Jesus-Centered Schema Therapy® model, with emphasis on the higher three levels. Using these three, Analysis, Synthesis, and Evaluation, one can make appropriate judgments on how to use or not use concepts from a client’s particular culture and/or religion in a way that is helpful, or perhaps needs some adjustment to be functional. Jesus-Centered Schema Therapy® used appropriately may be helpful with inaccurate anthropomorphisms of who God is or what the Bible teaches, so that Punitive or Demanding Internal (or External) Critic Modes are redirected and identified as contradictory to Jesus’ model and teaching, that the child may have mis-absorbed at a young age. These are often unquestionably held onto and incorporated into self, much like other dysfunctional cognitions that were learned via adverse experiences in our developmental stages.

Using chairwork, guided imagery and other experiential and cognitive tools, these ‘no longer functional but perhaps previously useful’ attributions can be weakened and set aside. A client can come to see they may have assisted with attachment to a parenting figure in some manner (for example, the child learning unconsciously to keep the peace by attributing constant self-blame) but now as an adult noting that seeing the world this way is sabotaging both their needs and their spiritual connection with Jesus.

Lastly, Jesus-Centered Schema Therapy® utilizes the latent power in the Christian experience and unleashes it with full Healthy Adult creativity and Spirit-filled experience. Of course, the application is limited by the readiness and openness of the “receiver container”, just as with any therapy. But what Schema Therapy is, and can do, being Jesus-Centered, is like all aspects of Schema Therapy— situationally adapted and based on the receptivity and ongoing working relationship between therapist and client.

3 Kanpp, S., Youngren, J., VandeCreek, L., Harris, E., and Martin, J. (2013) “Assessing and Managing Risk in Psychological Practice: An Individualized Approach”. Rockville, MD: The Trust.

4 Beauchamp, T., & Childress, J. (2009). Principles of biomedical ethics (6^th ed.). New York, NY: Oxford University

Press.

Romans 12: 2 “Do not model yourselves on the behavior of the world around you, but let your behavior change by your new mind. This is the only way to discover the will of God and know what is good, what it is that God wants, what is the perfect thing to do.”⁵

Written by Dr. Chiara Simeone-DiFrancesco, Licensed Psychologist & Advanced & Trainer Internationally Certified in Schema Therapy by the International Society of Schema Therapy.

©Dialog International Press, LLC, All Rights Reserved; May 14, 2020. No portion of this document may be copied or reproduced without reference to the author and copyright holder. No more than three sentences may be excerpted or reproduced without written permission of the publisher.

Contact information: info@dialogpress.org website: https://dialogpress.org

ISBN: 978-1-937582-05-0

5 Scriptural quote taken from the Jerusalem Bible.

By
Chiara Simeone-DiFrancesco, Ph.D. (12-10-10 original)
Chair, ISST Committee on S.T. for Couples and Marriages

This article attempts to describe some of the unique contributions Schema Therapy for Couples
& Marriage offers. The process, very different from other therapies, is described along with an
explanation of the advantages of this approach. Hopefully the reader will get an idea of what to
expect if they should wish to pursue Schema Therapy (S.T.) for their most important relationship.
In addition, it is hoped that persons, hesitant about what possibly can be done with their
marriage or couple relationship, can be educated and inspired to give this approach a try –
especially as it is quite unlike cognitive or method oriented therapies. Professionals can learn
from this article what this therapy is like, and may become interested in participating in further
training to enhance what they are able to offer clients.
Key words: schema, Schema Therapy, Couples Therapy, Marital Therapy, needs, hope,
devotion; couples mode work.
Uses of Schema Therapy with Marriages & Couples
Schema Therapy for individuals and couples was first developed by Dr. Jeffrey Young. It can be
an instrument to heal mild to severe couples and marital relationship issues, indirect and overt
conflicts, inabilities to connect, lack of trust between partners, over-independence when couples
live separate lives, unsatisfying sexual relationships, lack of communication or dialogue,
negative communication, lack of shared interests values and goals, lack of emotional expression
or connection, angry reaction patterns, withdrawal and stone-walling, personality disorders,
affective disorders, interference in the relationship from substance abuse, sexual or other
addictions, abusive or punitive relationships, multiple affairs, personality clashes, and lack of
attachment. Through the tools that provide a developmental context for the unhealthy behaviors
that divide a relationship, Schema Therapy for Couples (ST-C) facilitates a development of
understanding followed by tender empathy. ST-C. can bring reconciliation and healing
forgiveness, finally addressing where deep wounds, distancing and even betrayal have mounted
up, even for years. Many different experiential opportunities allow clients to rebuild trust by
actual behavioral interactional changes practiced in and out of session. These target the areas
where reassurance is needed and reactionary rough edges need to be smoothed as couples learn
to master more effectively when they trigger each other.
ST-C can especially assist clients where they are ambivalent about their marriages. By
understanding the origin of the unhealthy coping behaviors of each partner, as well as engaging
1
the partner with hope, it gives an opportunity to see how the partner will respond in a very
positive and encouraging environment with the therapist who can empathize when the entire
puzzle is put together and even the worst of obnoxious behaviors are seen in that context, usually
learned ineffective and sometimes impulsive coping mechanisms that sabotage not only the
relationship, but sabotaged the relationships of possibly parents or other adults who passed on
this modeling, or otherwise failed to meet the child’s core Needs, with the frustrated child left to
their own ineffective devices that eventually catch up with her or him in their
marriage/relationships.
With the specific principles of “Connect-Talk”, drifting and detached couples when they work to
show their “soft-side” and learn how to express Needs versus react to situations, can become
vibrantly close and connected. In therapy the partners have the opportunity to learn the process
and principles of this “Connect-TalkSM” to work to fulfill not only their own Needs, but the
Needs of their partner. The therapist helps them to achieve this in a balanced and non
judgmental way that is compassionate and caring. I call this reciprocal reach-out “Couples
Target PracticeSM”, learning how to shoot cupid’s arrow of love right to the bull’s eye of the
partner’s unmet Need, that neglected area that causes him or her to feel lonely, hopeless and
discouraged.
The therapy room experience is quite different from many other types of therapies. Partners can
visualize the interactional cycle through the use of chairs placed around the room, each
representing an aspect of what happens in the typical or a specific clash or distancing episode(s).
It becomes a concrete visual representation that involves feelings, thoughts, body sensations that
happen when we become upset, and how actually behave or cope. This takes judgment and
blame off of the spouses/partners, and allows the spouses to ally together in helping the “inner
little feelings person” to get understood and validated, while at times blocking together the
unhealthy coping behaviors that get the relationship in trouble or escalate the clash. In this
manner, each partner joins the other on “the same side”. There does not have to be an argument
to prove the intentions or righteousness of the Need, as both can ally together with Needs, yet
even together resist unhealthy Wants that don’t benefit anyone in the long run. So, with ST-C
expect to be up and out of your normal client chairs with your therapist actively intervening, and
even moving around the room to the different “Mode-labeled” chairs that you will learn about.
It’s not boring to say the least, and the same old cycle and argument does not occur in the fashion
it would at home as though the repeat button was pushed.
The utilization of the client/therapist relationship
Through careful development of the therapist/client relationship the therapist, even with only
some small amount of openness from the clients can begin to offer couples hope and a way out
of helplessness. The Schema Therapist is positioned to visualize the distant route for healing –
how to bring the clients to the point of being able to make healthy, versus “summary” unhealthy
and uninformed conclusions regarding the relationship. Even in those cases that seem hopeless,
if the client chooses to not give up, the therapy protocol keeps on promoting every reasonable
effort. We never, however, agree with persons remaining in situations where the partners or
children are being endangered or threatened, as every human being has a right to self-protection
and safety.
S.T. for couples and marriages teaches, models, and allows the couple to experience things they
have always wanted to feel, and to actually find themselves doing what is healthy. By empathic
connection with the client, the therapist helps the client actually fight at an emotional gut level
unhealthy patterns called coping responses.
ST-C will show persevering partners how and what it means: to develop or stay in Healthy
Adult Mode; to productively use the Vulnerable Child Mode to eventually re-parent their own
inner “vulnerable child”; and to limitedly “re-parent” their spouse. The conceptualization of how
to accomplish passing on this re-parenting technique to the client, so that it helps the couple to
mutually heal self and partner by enabling them to de-escalate their recurring clashes, has great
potential. If clients cooperate with ongoing genuine care and interest (versus for example, an
ulterior motive of dumping the other no matter what), even hesitant persons have the potential to
re-discover (or perhaps discover for the first time) true love with their partner. What makes ST
C stand out from other therapies is that if the tools are applied according to the constructs, almost
any couple relationship has the potential to become good, of course given sufficient work and
commitment.
A therapy that diverges with consummate hope
This ST-C vision diverges from theories that state certain relationships are fundamentally
incompatible. They may be grievously difficult, but rarely ever fully hopeless. Though as
schema therapists we may hesitate to say “never”, given enough commitment to the process, it
seems an “almost never”. When the therapy proves ineffective, analysis points not to therapy
deficiency, but rather on the lack of persevering healthy attitudes, fortitude of the couple, and/or
the limits of the specific therapist in technique, insightful awareness, or personal ability to
accurately empathically intervene – rather than Schema Therapy itself.
This therapy proper is based on the highest principles of caring and genuine empathy. The
individual client, however fractured, is cared for, and this extends equally to both parties in the
relationship. This vision of “enduring hope commitment” is what sets Schema Therapy apart
from most other therapies. It refuses to capitulate to the client couples’ recurring emotions of
hopelessness, but encourages their step by step collaboration in fulfilling their ultimate need –
relational healing. The goal is to attach with love and hope to the person in whom they have
invested and made a commitment. It is usually the sad lack of hope that makes commitments
waiver. However, S.T.’s therapeutic tools initially challenge the effects of past pain, then re
shape disorder-personalities, and finally engage persons who heretofore were emotionally
detached, and in seemingly hopeless situations, to properly and newly attach with lives/families
rebuilt.
S.T. for Couples incorporates a foundational attitude of actioned but limited “re-parenting” to
fulfill a person’s unmet human Needs. This same technique is used in S.T. for couples and
marriages, between the therapist and each partner, between the individual Healthy Adult self and
their Vulnerable Child inner self, and between the partners themselves. This unique experiential
technique often impacts the emotional experiences of the couple in a permanent fashion for the
better.
The concepts of ST-C:
S.T. has an advantage of easy to grasp concepts, such as coping techniques, modes, and schemas.
These educate and make sense of past experiences to the client – and open the door to freely
speak about what they presently feel connects. These concepts allow the therapist and client to
communicate about the patterns that circumstantially developed inside an individual’s inner
world – and give clearer explanation of what is experienced – such as, body sensations, varied
feelings, their more aware thoughts and beliefs, and much more. When the client learns their
own patterns and the origin of how these came about, one’s whole life tends to make sense.
Better yet, the process, mutually applied, progressively gives the couple the tools that open ways
to intercept habitual negative interactions and personality patterns, and actually moves to change
them. Few therapies offer so strong a change potential, and at the same time create a culture of
mutual acceptance and understanding.
Most of the difficulties mentioned above are learned attitudes, behaviors that stem from
understandable past and present experiences, coupled within one’s genetic disposition in reacting
to specific “schemata” – the early maladaptive schema patterns that the clients individually
experienced during their early development. The resulting understanding provides both a key to
un-learning the maladaptive patterns while simultaneously learning a new non-judgmental
attitude of compassionate understanding. In the therapist-directed process each one discovers
how one’s partner and self are conditioned by what they experienced – and equally if not more
so, by what they failed to experience.
While a systematized research study of Schema Therapy for Couples with comparison data to
other therapies has not yet been conducted, many studies in the area of Schema Therapy are
currently underway. The statistics of S.T.’s effects with regard to its significant therapeutic
outcomes are being compiled, including those for group therapy and personality disorders.
Research articles with substantive outcomes can be found on the website of the International
Society of Schema Therapy.
Going for empathic understanding, not mere acceptance
Another valued positive contribution of ST for couples and marriages is that it clearly defines
and separates the behavior from the person by asserting that the concepts of acceptance are
priority to agreement. The “acceptance” that wishes to move to agreement must first go through
the channel termed “empathically-understand”. Once they experience the empathic
understanding of the therapist towards each of them, clients often feel moved by it. This
experience helps them to apply it to each other. What begins to make it do-able is that the client
observes the therapist confront unhealthy behaviors while at the same time being empathically
understanding. This newfound experience nudges the client out of a defensive stalemate,
bringing them up to be empathic, as empathy does no longer have connotations of compliant
surrender to what is destructive. Empathy disarms the guardedness and resistance that
confrontation produces if it stands alone. The example of empathic confrontation modeled by the
therapist, rings true to self for the giver, and stuns the receiver, much like a stance of Ju-Jitsu that
goes with, rather than against, an on-coming force.
This limited re-parenting attitude allows each to be capable of giving their partner growing and
learning time as each struggles to become their healthier selves – that is, once each recognizes
that caring does not mean agreeing with or accepting the offensive behavior itself.
Learning from what does not work
Schema Therapy actually developed essentially from existing relationship failures – not just from
the fact that some relationships and personalities present problems most difficult to reconcile –
but specifically from the failure of therapists, using cognitive methods, being able to reach
certain clients who essentially were stuck in relationship patterns that kept their needs unmet.
Other failures involved those who did not have the ability to even want to relate, those whose
emotional patterns and rough edges were so intense that any cognitive techniques were
ineffective in producing lasting effects when the couple got triggered – but most especially with
those clients who were never attached in a positive and secure way to a parent or to any human
being.
Such fractured clients often have little ability “to make up their minds” regarding
relationship choices in any way that is healthy. Left to themselves they only repeat unhealthy
patterns and self-destruct over and over.
These are some so-called “therapy failures” about which therapists might say…. “Well, we can’t
work harder or want it more than the client”, or alternately, “They need to make up their mind if
they want to stay on or leave…” All such messages essentially amount to the therapist backing
off and giving up by putting all the responsibility into the hands of the sick patient to heal
themselves, or even to want a healthy solution. Most clients have only a general idea of what
they need and have no expert ability to cope effectively over time and get their needs met with
any stability. They tend to either escape situations or fall back into familiar “ineffective tried
and failed” emotional coping patterns, because the foundational healthy self is simply not there.
S.T. for Couples and Marriages takes a dramatically different approach. This is described in the
sections below.
The Typical Initial Problem
Although the inability to attach or sustain closeness usually indicates severe cases of personality
disordered clients, especially those with Borderline Personality Disorder, it unfortunately also
presents itself in a milder form with many intimate relationships. In the latter, persons simply
have no clear vision of how or if things can change for the better, and they tend to cope in ways
almost guaranteed to cause a loss of faith in the partner and detour the relationship itself. Hence
the over 50% divorce rate. This result comes not necessarily because that is what the couples
really needed or wanted, but rather that they lost hope that anything even somewhat satisfactory
could possible exist with the said partner long term.
A therapy with a road map
Marriage failure is sort of like having a nightmare where one is lost in a town where the
ambience is familiar but where every road to “Happiness-by-Fulfillment” is strange, detoured
and misleading. Without a “road-map” and expert guidance, confidence, trust and understanding
succumb to dark immobility. For couples in a disordered and diseased relationship self-help is
a non or only partial answer. With the light of expert direction from a knowledgeable therapist
who accurately conceptualizes why you each get “stuck”, lost clients at least have a chance to go
down a new and productive path. The Schema Therapist offers a customized map and the
navigational assistance of creating new emotional experiences of satisfying relationship. Schema
Therapy for Couples and for Marriages places a therapeutic stent opening arteries clogged with
years of negativities and misunderstandings and allows the blood of positive reconciliation to
flow. Simply put, through ST-C couples and spouses labor to initiate or restore healthy
connection. ST-C is not magic, and persons always have their free will to choose to not
cooperate with each other or the therapist. In my view, God is the ultimate healer, and all
healing comes from Him. However, He gives us methods and tools at a human and professional
level, not only through ST-C, that cooperate with His graces. For those seeking, ST-C may
sublimely provide an open channel, an intensity of hope and nourishment in “Couples’
Relationship Re-Correction”.
The method
When a couple enters Schema Therapy for Couples, the following method is usually engaged.
The therapist starts out with a Couples Intake, a session designed to assess how the couple is
interacting, and what some of their issues, hurts and strengths are. This is followed by an
assessment phase that involves thorough inventories and interviews an extremely thorough
conceptualization of the unmet needs of each partner, and then proceeds to identify how these
multiple and varied unmet needs have formed substantive maladaptive patterns from childhood
usually, called “schemas” and their common triggers. A conceptualization then follows with the
clients’ main coping methods (how they behave given this {usually} early learned experience,
how they view themselves and other especially when these memories (like the internet “cloud”
are accessed. We note their predominant feelings (aka Child Modes) and thinking patterns
“Parent Modes”. And then we put this all together to understand how the modes that encompass
feelings, body sensations and thoughts, with resultant behaviors shift when they are triggered
(even without awareness).
Using the therapy relationship itself – the resultant connecting trust between therapist and client – the clinician analyzes what qualities to develop and focus on in a caring and genuine
therapeutic relationship with the individual partner in the couple relationship. The therapist
targets “unmet Vulnerable-Child core needs” in the client and educates the client both on what
this means and feels like, and tries to provide a limited experience of the antidote to these
schemas. For example, where a client has not been sufficiently affirmed in childhood to develop
self-confidence, the trusting relationship between client and therapist is utilized where the
therapist affirms and helps to create new, long-overdue, confidence-building experiences for the
client.
The therapist then devises a personal-customized “road map” that is offered to the client, and
with the latter’s informed consent proceeds to treatment. Whether or not clients at this point
understand how to get to their goal, the therapist navigates it with them, and the journey simply
begins to happen. As the therapy develops in this open and involved professional relationship
between client and therapist, the client begins to get not only a concept, but also a FEEL for what
it is to have an unmet need finally met. The therapist can co-parent a client to re-parent oneself
and experience what it is to have a relationship that is SAFE and FEELS like the good thing one
always needed.
This discovery is often a new experience – to have an emotional connection that creates a limited
dependency with another human for meeting needs – yet at the same time is completely
respectful and builds individuation, resilience, and the capacity to transfer this experience of
nurturing their own inner self into connecting with their partner.
The learning experience with the therapist becomes a bridge to an interdependent connection
with the partner, as well as a positive relationship commitment with one’s inner self to meet
one’s own needs.
Actually walking a client through this “road map to fulfill an unmet need”, eventually puts the
client in the long yearned – for position of being able to desire and obtain a true healing of
relationship with the partner one has already invested time, and even endured rejection,
emotional hurt and pain with. Who would want to waste that? All of the past – hurt,
misunderstanding and even abuse – can be transformed into gain and meaning, as two now –
bonding partners struggle to conquer and transcend past negativities.
On the other hand, what would result if unmet needs were set aside and foolishly endured? To
merely escape and not deal with one’s own past dynamics, either insures that the painful pattern
of unmet needs will break one’s current relationship, follows still unfulfilled to the next, or sadly
remains as the status quo state of life with the current partner.
Not dealing with one’s uncovered schema-driven patterns, guarantees that no ongoing
relationship will ever be safe either from the threat of one’s declarative decision to abandon it,
or to find oneself so abandoned.
How can love ever be love with such a threat ever present? Clients know only too well what it
feels like to have a one-sided conclusion imposed on them and acted upon by a negative partner.
How different it would be if there could only be open and effective dialog about corrective
possibilities, or at least a gentle exploration of them before a conclusion is unilaterally asserted.
A philosophy of hope, a therapy of hope
In a sense then, S.T. is a “philosophy” of hope and a consummate therapy of hope. It is a belief
that is based on the scientific observation that all persons have basic needs, especially the need
for a loving inner connection with themselves, and a healthy outer connection with another
positively-responding human. Every person has such basic human needs, whether acknowledged
or not. The point is that needs (as opposed to wants – casual, circumstantial desires) are
universal across all human beings, times and cultures, and it is this very fact that feeds the hope
of the two of you getting on the same page. The universality of needs, as opposed to wants, is
exactly the point on which partners always have to agree, unless they are unaware, confused, or
denying of their basic humanness.
Laying out the vision
It is axiomatic that all therapists must need to work toward what is truly best for their clients.
What a positive endeavor and framework it is to help bring them to the point of becoming their
healthy selves and connecting them to beloved others in healthy ways. A client needs a vision
encompassing their partner to see what might or could potentially happen for good with schema
healing, from the process of limited re-parenting, and from one’s development of Healthy Adult
Self. This will inspire perseverance in attaining true and lasting change. This basic awareness
can foster a solid and determined adult judgment on how to handle their relationship in a way
that will best benefit both.
S.T. is founded on the belief that this opportunity for healing and deep personality change lies
within all human beings. Of course, nothing positive happens unless the client decides to
engage and choose the behaviors and attitudes that lead to a commitment of love for one’s
partner. Success is never absolute, but the emotionally connecting relationship that is worked at
collaboratively by therapist and client with the tools S.T. provides has the strongest capacity to
urge a client’s will to engage.
No doubt the Schema therapist has a set obligation to walk alongside, carry, guide, and bring the
client from the vantage point of possibilities, to the gradation of probabilities, and finally into
realities, which is distinct from many other types of therapies. For the schema therapist, two
persons committed to following through in this manner of therapy, definitely “have
possibilities”, even if the battle to offset ingrained schemas is arduous. The “road map”
presented marks the way to a realistic goal, and though one must journey through bypasses and
detours to reach a “set-out-for” highway, hope can be sustained, as the therapist has witness
experience of major couple transformations.
Keys to accomplishment
The key to accomplishing such solid and significant marital and couple therapy is the intense
individual conceptualization work, which positions each partner to where they become healthy
enough to seriously assess whether their relationship is worth investing in. Such positive
positioning results from the clients’ simultaneous working on their self-focused healing goal that
is engaged with step by step supervision from the guiding therapist. The latter has a special role – serving two clients who want to be healthy and heal their unhealthy relationship and – serving
the relationship itself. The therapist has to be the therapist-ally of each separate partner, and the
ally-sponsor to the relationship itself. The schema therapist ordinarily conducts individual
intakes for each partner with a full schema conceptualization workup and history, as well as
numerous individual sessions as a base for the later joint couple sessions.
If the relationship itself does not have such an ally, then the couple may individually lose the
vision of what is possible. Hurt people often do not have a clear or hopeful vision of what can
be, just as a diseased heart patient cannot imagine how they can once again become physically fit
when they are at the moment so diseased and unfit. Generally, it is the doctor who knows the
reality and what can change, who gently leads the patient to desire it. The therapist must not fall
back and cave in to the passivity of those who are hope-deficient, feeling too discouraged except
to recoil in pain, hurt, depression and anger. It is in the individual sessions with emphasis on
personal change of one’s rough edges, where S.T. diverges dramatically from many other
therapies and offers new hope. Schema Therapy for Couples & Marriages is a consummate
therapy of reality-based hope.
In S.T. for Couples, the therapist, together with client cooperation, get to the healthy point of
being able to more accurately appraise the “possibilities” of the relationship engendered by
S.T.’s “limited re-parenting” connection with the client. This term refers to the aforementioned
close and open relationship the therapy creates between the therapist and client – where the client
almost inevitably experiences some degree of need fulfillment, empathy and comfort – the kind a
good parent would give a small child. It is affirming, objective and limit-setting. It would teach
and confront the growing child’s unhealthy attitudes and behaviors with a constant attitude of
warmth and caring. It allows for a child’s autonomy, or the ability to think, choose and act, yet
provides for safe learning and the support for correcting discovered mistakes. This stance is how
the clinician treats the adult client.
With this unique relationship with each partner, the Schema Therapist is positioned to intervene
in a way no current structured therapies appear to provide. The therapist becomes a mutually
accepted unifying bridge between the couple, and the therapist’s shedding of light into their pit
of darkness offsets their relative schemas that produce such hurt and hopelessness.
Re-parenting & the development of devotion
After the therapist assists the couple by bridging the two of them, the couple will learn by guided
experience and session-practice how to use S.T. themselves and actually “re-parent” each other
in a limited and mutually welcome way. With therapeutic coaching guidance they will learn to
empathically feel each other’s core schema origins, and to practice in being adept at avoiding
negative triggers. With flashcard reminders the couple rounds the corner and treats their partner
with a different schema sensitive approach which at a feelings level is geared to specifically de
escalate “schema clashes”.
It is this heart-felt image of “the little one” inside the re-parented partner that becomes more and
more difficult to forget, and oh so rewarding to remember. As all this mutual reconciling begins
to flow together, so does the limited re-parenting and filling of each other’s needs. Compromises
readily occur, clashes are reduced in intensity, the processing of the “regrettable incidents”
happen more quickly and easily, adrenalin is lowered through mutual soothing, and couples
spontaneously invent creative ways that they never imaged before.
Partners begin to be amazed that their reciprocal rough edges can be smoothed and that their
original hopes, trust and love begin again. This process of “mutual re-parenting” creates a love
that can best be described as “devotion”.
We believe that this quality of need-filling, emotionally compassionate, limited re-parenting
truly does resolve the past. It creates devotion. And, like a nucleus everything else orbits around
it. In fact, it has the potentiality of creating a sort of “nuclear reaction” in “Reinventing the
Couple”. In devotional love’s absence all learned techniques and tools tend to whirl off and
replace partners into their own former clashing orbits. That is precisely why women, especially,
tend to have a common limited belief about whether their partner can truly change and have the
patterns endure. They tend to hypothesize that if it wasn’t in the guy’s feelings to begin with, it
makes this newly learned personality pattern very unsafe to trust that it will last. The measuring
stick often tends to be the feelings, and they will often even state, don’t change “for me” – an
even more unsure development. Guys, who tend to be more pragmatic, usually conceptualize
another error, though in the opposite direction. They want to conquer it and learn it, convinced
that is all it will take. Then, when the emotions do get triggered, they are frustrated why the
“counseling” did not work. The truth is somewhere in the middle. It takes a lot more work than
a guy usually expects. On the other hand, the battle is indeed on the gut level, as women
intuitively often know. However, it is not as hopeless as she may think. When the guy’s
emotions of loneliness and incumbent abandonment face him, together with the possibility that
he might fail, then the emotions do push him to learn. And, when the leaning is at a re-parenting
level with the therapist, what was never “him” before can become a new desire, experience and
reality. In fact, he can become so emotionally engaged in this new healthy way of being, that
even if she does not believe in him any longer, he often may stay committed to his changes none
the less. When the partners each engage in an emotionally driven and cognitively
understood battle against their respective schemas with a re-parenting attitude towards
each other, then the schemas no longer dictate the outcome of the relationship, and
devotion blossoms.
Devotion emotionally arises from love initiated by gratitude, conceived through positive
experiences that powerfully supply the partners need for secure connection and a sense of
belonging. In its unifying force any thought of ending a mutually fulfilling relationship becomes
an unthinkable option, being totally against one’s perceived self-satisfaction and interest. The
perception that it is to one’s good to persevere in the relationship through all of its ups and
downs, ultimately comes from a sense of devotion. In this author’s opinion, Schema Therapy for
Couples and Marriages frequently creates such relational devotion.
Value for the couple & marriage even with one cooperator
Schema Therapy for Couples and Marriages has significant value even when only one partner
comes into therapy or cooperates. It is correctly stated that when only one person in a couple
becomes healthier, the relationship can be 50% or greater, changed and improved. It sets up one
partner as a seeker and attempting-reconciler. No matter if the “unhealthy other” engages in
retaliatory conflict as a result. In such a case, more open conflict might be healthier than where
one surrenders their humanness, natural rights and inner spirit out of fear of reprisal, rejection or
whatever. So, when a coupled-individual engages in personal and independent Schema Therapy,
one’s self value can and should be asserted, defended and attained unilaterally. One’s individual
growth is a variable under one’s own control and holds value regardless of even the other
partner’s inimical non-receptivity.
Some emotionally deprived partners might resist seeing value if their spouse does not come and
share in the “Couple’s Therapy”. But, if one becomes healthy enough to objectively reflect on
whether their own improvement has merit, S.T. time and effort will be well spent. This is hard
to face when love is not reciprocated, but even in spite of a less than desirable outcome, many
clients feel they attained personal gain, and stand on the hope that they might yet find a way to
get the other to participate and connect. Ultimately it is a healthy realization that even a loving
individual does not have complete control over the outcome of a relationship. It always takes
reciprocal effort. As opposed to some therapies that fall apart as soon as one partner stops
participating, S.T. seems to be uniquely strong in providing an individualistic therapeutic path of
improving the relationship, as well as an individual internalized perception of value in the time
and effort spent in therapy to improve the relationship, even if going it alone with therapy. This
can unilaterally stabilize a health-seeking client, for when (versus “if”) a partner is not receptive,
the other, determined not to go down to “ground zero”, can still focus on the base relationship
with self, formed by a healthy self-love and acceptance. This means that the individual within
the couple relationship learns increased self-worth by enhancing and strengthening their own
inner “dialog”. Their own self-affirmation and determination to set safety limits and boundaries,
along with developing their own sense of direction and determination to fill their own unmet
needs when no one else will – is truly healthful. Hope convinces the client that this can still be
accomplished with strong individual therapeutic work. A client can learn and come to this point
of internal positive attitude in Couples and Marital S.T. that does not require the agreement nor
consent of the partner. That indeed is liberating!
Tools of S.T.
Some of the tools S.T. uses in its couple and individual interventions are:
●Guided imagery
●Chair dialogues
●Mode identification and dialogues
●Using the relationship between therapist and client itself
●Cognitive conceptualizations of the schemas, coping mechanisms, and modes
●Tonal regulation
●De-escalation techniques for self and partner, individual and shared, when flooded.
●Extensive and focused history-taking
●Elucidation of core beliefs regarding self, others, the world, and philosophies of life
●Cognitive awareness and flashcards
●Role-playing
●Limit-setting
●Limited re-parenting
Capacity of the therapist
To be a couple’s therapist in S.T. one has to be: primarily, expert in individual Schema Therapy;
not fearful of intense affect from and with clients; very caring and committed/genuine;
sufficiently schema-healthy to either not be triggered or able to recover from triggering even if
from the client; intellectually capable to creatively understand and define the two realities, the
schema conceptualization of each client, discern how these clash, and develop a method to get
around the clashes.
A new emergence of hope and devotion
In conclusion, if done properly Schema Therapy for couples and marriages frequently engenders
a new emergence of hope. Many couples have found that it truly re-invented their relationship. It
allows for a measure of connection never previously experienced, embodying a special
experience full of hope that facilitates and guides partners to an interchange that both heals and
creates a sense of newfound devotion.
References
Young, J.E., Klosko, J.S., & Weishaar, M.E. (2003). Schema therapy. A practitioner’s guide.
New York: The Guilford Press.
Young, J.E., & Klosko, J.S. (1994). Reinventing your life. New York: Plume.
Dated 12/10/10