This presentation will trace the history of Schema Therapy and its relevance in the treatment of addiction. Early Maladaptive Schemas often spring from emotional needs that were not met during childhood or adolescence.

2. ORIGINS
Initially introduced to treat personality disorders ( Jeffrey Young)
The Term Schema comes from Cognitive Psychology
Schema are deeply entrenched ideas about ourselves and the world, learned early in
life
Schemas are central to our sense of self. Schemas provide us with a sense of
security therefore we can cling to it even when it hurts us. They are comfortable
and predictable hence why it can feel so difficult to change. These early
maladaptive schemas, which result in substantial distress, are gradually being
documented as important vulnerabilities for substance abuse
Is addiction a personality disorder?
Definition of a personality disorder – Self destructive, life long patterns that bring
individuals tremendous unhappiness. These individuals can have long- term
problems with living, in addition to symptoms such as depression and anxiety

3. HOW SCHEMAS RELATE TO ADDICTION
When treating addiction we treat the outward symptoms i.e. Drugs,
alcohol, sex, gambling, food, sugar, internet, gaming etc, however we
must treat the inward symptoms (the underlying schemas or controlling
beliefs)
Another word used commonly instead of schemas, is lifetraps
Lifetrap (Schema therapy) is an outgrowth of cognitive therapy developed
by beck 1960s, many aspects of cognitive therapy are included in
Schema therapy
Although cognitive therapy is invaluable, it is not sufficient to change
lifelong patterns thus the development of schema therapy
Schema therapy is a combination of CBT, psychoanalytical and experiential
techniques
Most clients suffering from outward facing addictions have certain core
schemas (traps) that are reflected in many symptom areas

4. DIAGNOSIS
Addressing these core schemas can have a beneficial effect that
reverberate throughout many areas of the individuals life
The client can often use language that indicates he/she is stuck in a
schema (trap) ‘I have always been this way’, ‘I have always had this
problem’.
Schemas being hard to change are supported by cognitive behavioral , and
emotional elements. It determines how we feel, think, act and relate to
others
Lifetraps are usually developed as children as appropriate adaptions to the
immediate family environment. These patterns were realistic as a child,
the problem comes when we repeat these patterns when they no longer
serve a useful purpose. One of the key factors that contribute to the
development of lifetraps is temperament. Temperament is inborn, it is
our emotional make up. The way we are wired to respond to events.
Like other inborn traits temperament varies

5. THE FOUR MAIN CONCEPTS
Early maladaptive schemas – Core patterns of behavior that we tend to
repeatedly use throughout our lives
Schema Domain – Relate to the emotional needs of a child, if these needs
are not met in childhood, unhealthy schemas develop, which then
results in unhealthy behavior
Coping Styles – Are the way we adapt to schemas and early life
experiences. These are often unhealthy and tend to maintain or worsen
the problem
Schema Modes – Are emotional states that we all use from time to time.
They sometime lie dormant for a long time being activated by certain
triggers. While we can be in a dominant state for some time we can flip
over into other modes

6. CHILD MODES
Vulnerable child – feel lonely, sad, misunderstood, unsupported, defective,
deprived
Angry Child – Feels intensely angry, enraged, infuriated, frustrated, needs
not being met
Impulsive undisciplined child – acts on non core desires or impulses in a
selfish r uncontrolled manner, difficulty delaying short term
gratification, often feels intensely angry, enraged when impulses are not
met, appears spoiled
Happy Child – Feels loved, fulfilled , protected, nurtured, worthwhile,
understood, accepted, praised

7. MALADAPTIVE COPING MODES
Compliant Surrender – Acts in a passive, subservient, submissive, self –
seeking or self- deprecating around others out of fear of conflict or
rejection
Detached Protector – Cuts off needs and feelings, detaches emotionally
from people and rejects their help, feels withdrawn, distracted,
disconnected, depersonalised, empty or bored, persues distracting, self
soothing or self- stimulating activities in a compulsive way or to excess,
may adopt a cynical, aloof or pessimistic stance to avoid investing in
people or activities
Over- Compensator – feels and acts in an inordinately grandious,
aggressive, dominant, competitive, arrogant, haughtly, manipulative,
exploitative, attention seeking or status - seeking way. These feelings
and behavior are developed as an compensation or gratification for a
core unmet need

8. MALADAPTIVE PARENT MODES
Punitive Parent – Feels that oneself or others deserves punishment or blame and
often acts on these feelings by being blaming, punishing or abusive towards
self (e.g. self mutilation) or others. This mode refers to the style of which
rules are enforced rather than the nature of the rules
Demanding Parent – feels that the right way to be is to be perfect or achieve to a
very high level, to keep everything in order, to strive for high status, to be
humble, to put others needs ahead of ones own, or to be efficient or avoid
wasting time. The person feels that it is wrong to express one feelings or to
act spontanously. This mode refers to the nature of the internalized high
standards and strict rules, rather than the style with which these rules are
enforced
Healthy Adult – Nurtures, validates and affirms the vulnerable child mode, sets
limits for the angry and impulsive child modes, promotes and supports the
healthy child mode, combats and eventually replaces the maladaptive parent
modes, neutralizes or moderates the maladaptive parent modes. This mode
also performs healthy adult functioning such as parenting, taking
responsibility and committing, persues healthy adult activities such as sex,
intellectual, aesthetic, cultural interests, health interest. This mode is the
goal of full recovery from addiction

9. THE BENEFITS
Therapy must address all of these elements.
Change in only one or two realms will be less effective
Clients suffering from addiction often don’t arrive at their own solutions,
contrary to the approach of some therapies ( non – directive, Rogerian)
Schema therapy is a directive approach

10. THE SCHEMAS (LIFETRAPS)
There is often two different groups of Schema definitions that are referred
too – One group considers 18 in total individual schemas, however I
have used the questionaire within the self- help book by Jeffrey Young
(Reinventing your Life) which defines 11 core schemas
Abandonment
Mistrust and Abuse
Vulnerability
Dependence
Emotional Deprivation
Social Exclusion

11. CONTINUED SCHEMAS
Defectiveness
Failure
Subjugation
Unrelenting Standards
Entitlement
The full 18 include
Enmeshment, Self-Sacrifice, Approval-seeking, Insufficient self-control,
Emotional Inhibition, Negativity/Pessimism, Punitiveness

12. DIAGNOSING SCHEMAS (LIFETRAP)
We use a sequence of questions to diagnose each Schema
Total of 10 questions per schema
There is a marking scale from 1-6 for each question. 1- being completely
untrue of me, 6 – being this describes me perfectly
Once the individual schemas are identified we then begin to examine the
origins of the schema

13. THE SOLUTION
We identify the impact the Schema has in work, personal and intimate
relationships
Identify the danger signals in relationships
Identifying the key characteristics of the Schema (lifetrap)
Provide information on how to change the Schema (lifetrap)
Provide encouragement, reinforcing the benefits, ensuring ongoing
support to client in continuing actively to work on changing the
schemas (lifetrap)
It is increasingly recognized that family members, such as parents, play an
integral role in the treatment of substance abuse . This has resulted in
family-focused interventions becoming common components of
substance abuse treatment programs. In addition, recent research has
begun to examine the underlying risk factors for substance abuse, such
as early maladaptive schemas, among substance abusers and their
family members