How does schema therapy help people who have experienced trauma?

Written by Counselling Psychologist Morag Paterson.

I am writing this because I am a psychologist who has been using schema therapy for 10 years and I have seen the long lasting and positive impacts that it can have on people who have experienced trauma.

What is schema therapy?

It’s a psychological therapy introduced by Jeffrey Young in 1990 which is based on the idea that all children have core needs and when these needs are not met, unhelpful schemas develop. Schemas are patterns of responses that influence how we see, feel and behave in the world. All children have a core need for: safety and stability, a reliable caregiver, autonomy and competence, expressing and managing emotions, boundaries and playfulness. For people who have experienced childhood trauma many of these needs may have been unmet. This leads to the development of certain schemas.

Every person is different but some of the common schemas that might be present include mistrust and abuse, abandonment, emotional deprivation and defectiveness/shame. When schemas are triggered, we react by going into a mode (state), for example, a vulnerable or angry child mode and this can be exacerbated by a critic or demanding mode. We may also go into a coping mode. Children who have experienced trauma had to find ways to cope with the harm and threats that they experienced, so they employed a coping style as a means of protection or management. Coping styles might include avoidance, detachment, self-soothing, people pleasing and over control through constant worry. The aim of schema therapy is to increase the size and power of the healthy adult mode.   

How does schema therapy help?

Clients gain a detailed understanding of how their current symptoms and behaviours are linked to their past. This clarity can be validating, liberating and can challenge their inner critic mode. Schema therapists aim to provide safety, understanding, care and nurturance where they try to meet clients’ needs as much as possible. This contributes towards repair and healing.  Imagery rescripting is a powerful strategy used to heal the inner child. This involves reliving some distressing past experiences, but the ending is changed where the therapist (and subsequently client) enters the image and provides the child with what they need. This can be a very emotional and healing experience. An empty chair technique is used, where the voices (modes) in our heads are put on chairs and they have a dialogue. This is effective because it gives a voice to the thoughts that can swirl and spiral in our heads, and the unhelpful voices can be challenged and reduced in power.  

Many cognitive and behavioural strategies are used and taught so clients walk away with a toolkit that can be used for life. This toolkit helps clients to get their needs met and to cope when some needs cannot be met. In summary, schema therapy has ingredients that can lead to powerful shifts in people who have had traumas, enabling them to lead happier and more fulfilled lives. 

Morag Paterson is a Counselling Psychologist committed to helping patients overcome difficulties and improve their quality of life through the development of a tool kit to manage triggers and responses.