Not sure if schema therapy is right for me

[anxiousrecoverer]

I have been doing person-centred counselling, which has helped me to identify emotions I am experiencing. Previously, my emotions were difficult for me to pin down, but through using art therapy I have been able to identify them. My conclusion really has been that one of the major emotions I feel is disappointment with life, feeling that my hopes and dreams have been repeatedly crushed.

In the past I have been relatively resilient and have always been able to pick myself back up, but this time I have only been partially successful. My current problems have lasted six years - they're not 100% anxiety based - but although I have pulled myself back up to being functional/successful externally, I feel my hope and optimism has been severely eroded and it's very difficult for me to believe I will ever feel satisfied, fulfilled or happy again. I did feel happy around six or seven years ago for about nine months, and I also felt happy for around six months to a year when I was 11, but these have been the only times I can identify. As I get older, the optimism that I will achieve that state again has waned and I'm starting to feel that it is hopeless. The more disappointments I receive in life, the harder it is to pull myself back and hold on to that belief that things could still work out for me.

Now, the person-centred counselling is great, but I've also recently been offered NHS therapy. We signed a therapy contract last week that said I would be receiving schema therapy, mindfulness-based CBT and DBT. I questioned the DBT as I do not have borderline personality disorder, but the therapist explained it was not solely used for BPD.

So far in the sessions (I've had four hours so far) the style has been very directive and I find her use of theoretical models a little forced at times. Recently she has used the child/good parent/punitive parent model for ego states, which I've heard of before, and I must admit that takes it a bit far for me. Although I understand the theory, something feels a little off about it and I really do feel like I'm having to force my experiences into the model. Another thing is that although she tells me which schemas she thinks I have, they only make sense to a certain extent and again I feel like my experiences are being forced into the model, which just doesn't really seem to capture to me the complexity of the issues.

I'm wondering it anyone else has had schema therapy and whether they had similar feelings?

[Tara67]

Hi, I had schema therapy but it was 15 years ago and maybe approaches have changed. From what I can remember I had 4 or 5 schemas people pleasing was one of my biggest at the time. I think as long as you get some benefit from it, it's worth a try. It's always good it identify what has triggered your emotions and how you deal with them, sorry I coldn't be more help, x

[anxiousrecoverer in reply to Tara67]

Thanks, I'm going to stick with it and see. I think my frustration partly comes from having had to wait two years to see this person and having already found person-centred counselling for myself, which was working, before I met the new therapist. I worry that it will be a waste of my time, because I've had directive therapy in the past and it wasn't the right thing for me. It is sort of good to find out where emotions have come from, but at the same time sometimes her explanation doesn't 100% fit. I've been told my main schemas are self sacrifice, unrelenting standards and vulnerability. But then the unrelenting standards one seems to describe my life years ago when I worked myself into the ground. I've since changed my mind about work and my aim now is to live the most enjoyable life possible and have as much fun as possible. Sometimes it feels like she goes back years into my earlier life, finds a schema, then assumes I have the same beliefs I had then....actually my beliefs have changed quite a lot as I've experienced more in life. I guess I should just tell her that really instead of moaning on the internet!

[warren218]

How do you arrange for that, what is the cost to take it up?

[anxiousrecoverer in reply to warren218]

I got it through the NHS. In the NHS trust I'm in they now put people through different stages, so you get frontline help, then more complex help, then a little more complex etc. Schema therapy was stage 4 out of 5 (called 'complex needs' I think) and I'm afraid I only got it because I have a long history. I also had to wait two years for it unfortunately! I think that when you first go to a doctor they normally put you on stage 1 or 2, which is self help and computerised CBT and if that doesn't help you get stage 3, which is a 12-week course of CBT with a therapist. If that doesn't help, I think you then go to stage four. In my case I managed to miss those stages because I've been in and out of the system since I was young and they just bumped me up!

[Punitiveparent]

Hello, I'm just coming to the end of a two year trial of Schema therapy, and although I've experienced several light bulb moments, on the whole I'd have to say that in my case - Schema therapy doesn't work.

I have borderline personality disorder, which was actually a revolation when it was diagnosed. For years I just thought I was severely depressed and couldn't find a way out of it.

I was enrolled onto a two year NHS trial, within a group. Several people dropped out of the trial, due to conflicts with the therapists themselves, and whilst I had the same conflicts, I chose to stay and see the therapy through. The reason for this was that one of the therapists proclaimed that the therapy would cure me if my BPD, and the behaviours I'd developed over a 40 year time frame in order to protect myself.

That was a pretty big claim, but being desperate for change, I was willing to try anything.

It's interesting to see that you felt that some of your experiences and emotions were being forced into the Schema model.

I've been feeling that for some time, and it's fair to say that one size certainly does not fit all in this case.

Two years on and I'm in no better a mind space than I was when I started the therapy. I lost all trust for the therapists when they started to distance themselves from the patients, totally ignoring any form of correspondence, and forcing blame for the lack of trust on the patients themselves.

How in the hell is that helping a group of people with severe mental health issues that are based around unmet human/childhood needs?

I really want to complain to someone in a higher position, but as I said, the therapists are not responding to any form of correspondence.

Disgusting.

[anxiousrecoverer in reply to Punitiveparent]

Hi

This was a few years ago now and it did actually become very helpful for me in the end.

I would say the actual schema part of it wasn't helpful. I still think it's too steeped in theory and it's very difficult to apply in real life because it feels quite removed in an academic sort of way. For instance, about 9 months after I had been discharged I hit a crisis. My former therapist had suggested I email her if any crises come up following discharge so I did so. She emailed back to suggest that the "emotional deprivation schema" was in play and it was only then that I realised I had no idea what that meant or what I was supposed to do about it. I guess because during the couple of years I was in therapy there were no crises, I'd been learning it in a kind of academic sense to prepare me for the future. But once I got there I realised that words like "emotional deprivation" mean nothing to me. That crisis was a couple of years ago now and I realise now that it would have been easier if she had said "loneliness". Because I do have trouble identifying emotions and calling loneliness "emotional deprivation" - I think they basically mean the same thing - just mystifies that sensation further for me. The main reason the crisis became very difficult to deal with was because I didn't have a clear concept of why I was upset or what kind of upset I was. I knew I was in a lot of pain, but I didn't know why I was in pain or what the pain meant or how I could soothe the pain. So it was a very frightening experience because it felt like the emotions had a mind of their own and were there just to hurt and demean me. knowing that what I felt was loneliness and having a good understanding of why I felt lonely would have been useful. So all in all, I think schema therapy needs to take its head of out of the books a little bit and use more layman's language because I think for people with little emotional awareness (who I guess are more likely to have therapies like schema), it would be useful to go back to basics and use normal words for emotions so you can learn to conceptualise them.

What was useful, however, was just hearing a different perspective over things. Some of the things I learned from schema therapy have really changed my outlook. But this was outside of the schema model itself, it was more just stuff my therapist said to me. For instance, the idea that emotions are important even if you can't think of a way to justify them. So if you're upset and you're not sure if you have right to be upset or if you're actually just being silly, then it doesn't matter because what matters is your welfare. And if you're upset then your welfare is at risk, so it's important regardless and should be seen as important by both me and the people around me. There were other useful things as well that were said to me, but it was really more stuff like that - stuff that would never have occurred to me but have significantly changed the way I look at things because they make logical sense.

Anyway, I've banged on. Overall, I'm on the fence about schema. I think direct use of the model isn't that useful because it's quite distanced from real life and therefore difficult to apply in the moment. But being taught stuff about perspectives was definitely useful.