Coping Styles And Responses (Schema Therapy)

A brief introduction to schema therapy

Schema therapy is an integrative therapy initially developed for treating complex, longstanding, and diffuse psychological difficulties. It combines cognitive behavioral, attachment, gestalt, object relations, constructivist, psychoanalytic, and neurobiological approaches within a unifying conceptual model (Young, 1990, 1999; Young et al., 2003).

Additional interventions have since been outlined, such as EMDR (Young et al., 2002), mindfulness (van Vreeswijk et al., 2014), and body-focused methods (Briedis & Startup, 2020). Schema therapy expands on CBT by emphasizing the developmental origins of psychological problems, incorporating relational and experiential interventions, and targeting the maladaptive coping styles that perpetuate these difficulties (Young et al., 2003).

Early maladaptive schemas

EMS are defined as negative, pervasive themes or patterns regarding oneself and one’s relationship with others that are dysfunctional and self-defeating. Structurally, EMS are believed to consist of thoughts, memories, emotions, bodily sensations, and the meanings ascribed to them (Van Genderen et al., 2012). Importantly, behavior is not a component of schemas, but a response to their activation. In other words, EMS activation results in schema-driven actions (Young et al., 2003).

Interactions between a child’s temperament, parenting, sociocultural context, and significant life experiences (e.g., traumatic events) can give rise to unmet emotional needs, which form the basis of EMS. EMS are usually accurate representations of these early environments and lead to responses that help the child survive and adapt to these contexts (Farrell et al., 2014; Young et al., 2003). However, EMS become dysfunctional when they are indiscriminately and repeatedly applied to later life experiences.

[EMS] become dysfunctional because… they render all new situations, even ones that are profoundly different from the toxic early experiences, similarly toxic (even when in reality they are not), and… lead the person to maintain particular types of [toxic] environments or relationships, even when they can exert influence or choice and create other kinds of experiences.

(Rafaeli et al., 2011)

Schema perpetuation

EMS are remarkably obstinate: they “fight for survival”. Young and colleagues (2003) suggest the durability of EMS partly stems the need for ‘cognitive consistency’: people strive to maintain a stable view of themselves and the world, even if it is inaccurate and distressing. Moreover, EMS are often central to an individual’s sense of self, making the idea of a schematic “paradigm shift” extremely threatening (Beck et al., 2004; Young & Klokso, 1994):

Although [the client’s] schematic structure may be unrewarding and lonely, change means that [they] are in new territory... They are being asked not just to change a single chain of behaviors, or reframe a simple perception, but rather to give up who they are and how they have defined themselves for many years, and across many contexts.

Beck et al., 2004.

Several other factors account for why EMS persist and are strengthened over time.

• Cognitive factors. EMS act as cognitive filters, distorting information and generating unhelpful thinking styles (Young et al., 2003). For example, schema-consistent information is exaggerated, while schema-inconsistent information is filtered out (i.e., magnification and minimization). Other cognitive distortions linked to EMS perpetuation include selective abstraction, overgeneralization, and labeling (Da Luz et al., 2017; Young, 1999). Research indicates schema activation not only generates negative automatic thoughts, but that these appraisals in turn reinforce EMS (Calvete et al., 2013).
• Affective factors. Individuals often block painful emotions linked to their EMS. Consequently, EMS do not reach conscious awareness which prevents their disconfirmation (Young et al., 2003). Affect can also make schema-congruent perceptions feel true. Finally, schema maintenance processes and their centrality to the individual’s sense of self can engender hopelessness about change (Young, 1999).
• Behavioral factors. EMS lead to self-defeating behaviors, referred to as ‘coping responses’. For example, individuals might remain in toxic situations, provoke negative responses from others, or select partners that reinforce their EMS (Rafaeli et al., 2011).

Maladaptive coping styles

Coping styles refer to the characteristic ways individuals manage their EMS. Coping styles develop in childhood and operate outside of awareness, helping individuals adapt to their EMS, the intense affect accompanying them, and the environments in which they were formed (Rafaeli et al., 2011; Young et al., 2003). Much like EMS, factors that may influence the emergence of coping styles include temperament, modeling, conditioning, and culture (Loose et al., 2020; Nia & Sovani, 2014). Unfortunately, these adaptive responses to early life challenges tend to become inflexible and overgeneralized as time passes, which has negative consequences.

While coping styles are apparent in all individuals, they tend to be more rigid, extreme, and ‘overlearned’ in clinical groups (Beck et al., 2004), and are consequently more pronounced in these groups (e.g., Luck et al., 2005; Sheffield et al., 2009). Coping styles are also believed to be fairly consistent across situations, although they may change during their lifespan (Van Genderen et al., 2012). For instance, an individual with a mistrust/abuse EMS might seek out violent partners in early adulthood (a surrendering coping style), but disengage from intimate relationships altogether in later life (an avoidant coping style). Most importantly, coping styles perpetuate EMS by preventing their disconfirmation and the satisfaction of associated needs, turning the schema into a self-fulfiling prophecy (Askari, 2021).

Coping styles, in turn, give rise to idiographic ‘coping responses’ – the situation-specific manifestations of the client’s coping style. While coping styles are repetitious, coping responses are highly variable and may take the form of behavioral, cognitive, or emotional reactions to EMS activation (Simeone-DiFrancesco et al., 2015).

Variations in coping style explain why individuals with the same EMS present very differently (Rafaeli et al., 2011). Young and colleagues (Young & Klosko, 1994; Young et al., 2003) identify three coping styles, which have been reformulated by an international working group (Arntz et al., 2021). While most individuals use a mix of coping styles, some disorders are characterized by the predominance of one coping style, such as overcompensatory control or arrogance in narcissistic personality disorder (Rafaeli et al., 2011). They include:

Surrender, or resignation

Corresponding to the evolutionary ‘freeze’ or ‘fawn’ response, the surrender coping style describes the tendency to accept the core message of an EMS as true (Young et al., 2003; Arntz et al., 2021). This gives rise to a variety of idiosyncratic coping responses, including:

• Behaviors. The individual recreates experiences associated with EMS development. For example, they might seek partners resembling a depriving parent, tolerate abuse, or adopt a passive or dependent role in relationships.
• Thoughts. Information that supports the EMS is accepted, while disconfirmatory evidence is discounted or ignored. For example, an individual with a defectiveness EMS might minimize their positive qualities (“Being kind isn’t important”) while magnifying their perceived faults (“I’m such an horrible person”).
• Emotions. The individual feels the pain of their EMS directly and their emotional responses to associated triggers are often extreme and disproportionate. For example, an individual with a social isolation EMS might feel intense loneliness while interacting with others.

Avoidance, or escape

Corresponding to the evolutionary ‘flight’ response, avoidance describes how individuals arrange their lives so that their EMS are not triggered (Young et al., 2003; Young & Klosko, 1994). Associated coping responses include:

• Behaviors. The individual avoids situations or experiences that could trigger their EMS (e.g., specific activities or interactions with certain types of people). For example, an individual with a subjugation EMS might avoid situations that could lead to conflict.
• Thoughts. The individual avoids thinking about the EMS, blocks thoughts and images that trigger it, or denies traumatic events and memories associated with it. For example, an individual with a vulnerability to harm EMS might try to suppress thoughts about potential catastrophes.  At its most extreme, avoidant coping may manifest as dissociation or depersonalization.
• Emotions. Feelings linked to the EMS are smoothed over, suppressed, or disconnected from. Certain activities might be used to numb these painful emotions (e.g., overeating). For example, an individual with an abandonment EMS might drink excessively when they are alone.

Overcompensation, or inversion

Corresponding to the ‘fight’ response, the individual responds to schema activation by attacking, overcorrecting, or externalizing their EMS (Greenwald & Young, 1998; Young et al., 2003; Arntz et al., 2021). Associated coping responses include:

• Behaviors. The individual acts in a manner opposite to the EMS. For example, an individual with a mistrust/abuse EMS might exploit or abuse others.
• Thoughts. The individual denies that the EMS is true or even exists. For example, an individual with a pessimism EMS might deny their negative thoughts and try to think in an overly optimistic manner.
• Feelings. Emotions linked to the EMS are masked with opposite feelings (e.g., powerlessness is replaced with power, etc.). For example, an individual with a defectiveness EMS might shame others while taking excessive pride in themselves.

Finally, Askari (2021) has proposed three additional coping styles grounded in ethology and evolutionary psychology – indolence, mockery, and gaucherie.

Indolence

Corresponding to the evolutionary ‘faint’ response, the individual metamorphically collapses in response to EMS activation. Coping responses might include:

• Behaviors. The individual manages EMS activation by exhibiting incompetence, feigning exhaustion or vulnerability, or acting in a victimized manner. For example, an individual with an approval-seeking EMS might exaggerate symptoms of ill-health to gain attention.
• Thoughts. The individual focuses on their weaknesses, suffering, or personal sacrifices. For example, an individual with a failure to achieve EMS might dwell on their bad luck or misfortune in life.
• Feelings. The individual exaggerates unpleasant feelings during interactions to gain something from others (e.g., help or understanding). For example, an individual with a dependence/incompetence EMS might express anxiety or confusion during a task to elicit help.

Farce or Mockery

Corresponding to the clownish behaviors observed among some mammals, individuals with this coping style use humor or mockery to manage EMS activation. Coping responses might include:

• Behaviors. The individual uses comedy, self-mockery, or ridicules and insults others to make light of difficult situations and EMS activation. For example, an individual with a self-sacrifice EMS might joke while doing grueling or overwhelming tasks for others.
• Thoughts. The individual focuses on absurdities or faults in themselves, others, or current circumstances to fuel their humor or ridicule. For example, an individual with an entitlement/grandiosity EMS might mock and undermine a senior colleague in their mind.
• Feelings. Unpleasant feelings are replaced by the pseudo-pleasant feelings accompanying farce. For example, an individual with an emotional deprivation EMS might try to be funny when they feel ignored by their friend or partner.

Gaucherie

Corresponding to the ‘fumble’ reactions observed among some animals, some individuals find relief from EMS activation through intentional mistakes or mischief-making. Coping responses might include:

• Behaviors. The individual behaves in ways that are obstructive, sabotaging, controversial, or intentionally misguide others. For example, an individual with an insufficient self-control/self-discipline EMS might inconvenience others by attempting to do things beyond their competence.
• Thoughts. The individual refuses to learn from past errors and/or seeks to negatively impact others. For example, an individual with an emotional inhibition EMS might sing in a way that is deliberately loud and unpleasant.
• Feelings. The individual seeks emotional relief from EMS activation by causing trouble for themselves or and others. For example, an individual with a vulnerability to harm or illness EMS might give medical recommendations to others without sufficient knowledge, which causes more problems.

Complex interactions between inherited dispositional, environmental, and experiential factors shape which coping style an individual adopts (Rafaeli et al., 2011). Relevant factors include:

• Temperament. Children’s innate reactivity, emotionality, and sociability predispose them to certain coping styles (Young et al., 2003). For example, children with passive temperaments might be inclined to placate an abusive parent (i.e., surrendering). In contrast, aggressive children are more likely to fight back (i.e., overcompensating) (Cutland Green & Balfour, 2020). Some research supports the link between temperament and coping style. For instance, one study found that introverted individuals are significantly more likely to use avoidance coping strategies than overcompensation (Mairet et al., 2014).
• Modeling. Children’s early environments expose them to specific coping styles. Family members tend to manage adversity in distinctive ways, such as through self-criticism (surrendering), substance use (avoiding), or overcontrol (compensation). Children are often exposed to multiple coping models (e.g., an abusive parent and a victimized parent) and tend to internalize the coping behaviors of a parent with whom they identify (Young & Klosko, 1994; Young et al., 2003).
• Usefulness (or ‘goodness of fit’). Certain coping styles may be more adaptive in the child’s early environment. For instance, compensatory strategies (e.g., attacking) might risk antagonizing a violent parent, whereas surrendering is comparatively safer.
• Culture. Some coping styles appear to be more common in different cultures. For example, one study suggests that Indian women with depression tend to utilize more compensatory coping strategies than Iranian women (Nia & Solvani, 2014).

"Schemas are painful. For this reason, people develop ways of managing them, although they might not be aware of their ‘style’ of coping. Coping with a schema might include obvious actions, like avoiding particular situations or types of people, or more subtle things that take place in your mind, like agreeing with your self-critical thoughts. Can we explore how you tend to cope with your schema?"

This handout provides a general explanation of the ways people might cope with an early maladaptive schema. It can be used to introduce a discussion about the client’s own coping styles or responses to EMS.

• "Can you relate to idea of avoiding, counter-attacking, or surrendering to your schema?"
• "Which coping style do you tend to use? Is there one you identify the most with?"
• "When you were young, what did your parents do when they were upset or experienced problems? Do you respond to difficulties in a similar way?"
• "How did you survive the environment you grew up in? What did you do to get by? Do you try to get by in similar ways as an adult?"
• "How do you think, feel, and behave when you cope in that way?"
• "If I saw you while you were coping with your schema, what would I notice?"
• "What happens on the inside when you cope in that way?"

• Arntz, A., Rijkeboer, M., Chan, E., Fassbinder, E., Karaosmanoglu, A., Lee, C. W., & Panzeri, M. (2021). Towards a reformulated theory underlying schema therapy: Position paper of an international workgroup. Cognitive Therapy and Research, 45, 1007-1020. DOI: 10.1007/s10608-021-10209-5.
• Askari, A. (2021). New concepts in schema therapy: The six coping styles. Amir Askari.
• Beck, A. T., Freeman, A., & Davis, D. D. (2004). Cognitive therapy of personality disorders. Guilford Press.
• Briedis, J., & Startup, H. (2020). Somatic perspective in schema therapy: The role of the body in the awareness and transformation of modes and schemas. In G. Heath and H. Startup (Eds.), Creative methods in schema therapy: Advances and innovations in practice. Routledge, 60-75.
• Calvete, E., Orue, I., & Hankin, B. L. (2013). Early maladaptive schemas and social anxiety in adolescents: The mediating role of anxious automatic thoughts. Journal of Anxiety Disorders, 27, 278-288. DOI: 10.1016/j.janxdis.2013.02.011.
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