Dependence / Incompetence

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 relationships, 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

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, referred to as ‘coping styles’.

Schemas are enduring, foundational mental structures that play an essential role in cognitive processing, enabling humans to represent the

"Many people struggle with feeling dependent and incompetent, and it sounds as though this might be relevant to you too. Would you be willing to explore this schema more with me?"

Clinicians might begin by providing psychoeducation about dependence/incompetence and EMS more generally:

• Schemas are negative themes and patterns that start in your childhood and continue throughout your life. Some are very common.
• Schemas usually get stronger as time passes, becoming the negative filters people use to understand and predict the world. You could think of them as dark sunglasses – they color and distort our experiences in unhelpful ways.
• Schemas operate ‘behind the scenes’: we’re not usually aware of them or when they are active. However, with practice, you can become more aware of them. It is a bit like a theatre – you can learn to bring your backstage schemas to the main stage.
• One common schema

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