"I keep doing the same thing over and over. It's like I can't help myself."

Nina had been through three relationships that followed the same pattern: initial intense connection, growing anxiety that they'd leave, increasingly clingy behaviour, then abandonment that confirmed her worst fears. She could see the pattern, understood it was self-destructive, yet felt powerless to change it.

"It's like there's this voice that says 'Everyone leaves eventually—get them before they get you' or 'Prove you're worthy of staying,' and I can't turn it off."

This is what schema therapy addresses: the deeply ingrained patterns formed in childhood that continue influencing thoughts, feelings, and behaviour in adult life—often outside conscious awareness.

TL;DR: Key Takeaways

Schemas are core beliefs and patterns formed in childhood that shape adult life
Early maladaptive schemas (EMS) develop when childhood needs weren't met
18 common schemas organised into five domains (disconnection, autonomy, other-directedness, overvigilance, impaired limits)
Schema modes are temporary emotional states triggered by schemas
Schema therapy integrates cognitive, experiential, and relational techniques
Healing involves reparenting, challenging old patterns, and building new experiences
Particularly effective for personality disorders, chronic depression, and relationship patterns

What Schemas Are

Schemas are mental frameworks—patterns of thinking, feeling, and behaving—that organise our experience of ourselves, others, and the world.

Healthy schemas: "I'm lovable," "People are generally trustworthy," "I'm capable"

Maladaptive schemas: "I'm unworthy," "People always leave," "I must be perfect or I'm worthless"

Early Maladaptive Schemas (EMS) develop when core childhood needs aren't met—for safety, connection, autonomy, self-expression, or realistic limits. The child adapts by forming beliefs and coping strategies that made sense then but cause problems in adulthood.

Example: A child whose parents were unreliably available might develop an "abandonment schema"—expecting people to leave. As an adult, this creates relationship anxiety, clinginess, or pre-emptive distancing.

The 18 Early Maladaptive Schemas

Schema therapy identifies 18 common schemas organised into five domains:

Domain 1: Disconnection and Rejection

Abandonment/Instability: Belief that close relationships are unstable; people will leave, die, or behave unpredictably.

Origins: Inconsistent caregiving, parental loss, frequent moves

Mistrust/Abuse: Expectation that others will hurt, abuse, manipulate, or take advantage.

Origins: Abuse, betrayal, bullying

Emotional Deprivation: Belief that emotional needs won't be met by others.

Origins: Emotionally distant or unavailable parents

Defectiveness/Shame: Feeling fundamentally flawed, unworthy of love.

Origins: Criticism, rejection, comparison to siblings

Social Isolation/Alienation: Feeling different from others, not belonging anywhere.

Origins: Family dysfunction, being "different," lack of social opportunities

Domain 2: Impaired Autonomy and Performance

Dependence/Incompetence: Belief you can't handle daily responsibilities without help.

Origins: Overprotective or undermining parents

Vulnerability to Harm: Excessive fear that catastrophe will strike at any moment.

Origins: Anxious parents, early trauma, unpredictable environment

Enmeshment: Excessive emotional involvement with parents/others, poorly developed identity.

Origins: Intrusive parents, lack of boundaries

Failure: Belief you're inadequate compared to peers, will inevitably fail.

Origins: Critical parents, comparisons, impossibly high standards

Domain 3: Impaired Limits

Entitlement/Grandiosity: Insistence you're superior, entitled to special treatment.

Origins: Over-indulgence, lack of boundaries, excessive praise without reality

Insufficient Self-Control: Difficulty with self-discipline and frustration tolerance.

Origins: Lack of limits, no modeled self-control

Domain 4: Other-Directedness

Subjugation: Suppressing needs/feelings to please others or avoid consequences.

Origins: Controlling parents, conditional love

Self-Sacrifice: Excessively focusing on others' needs at expense of own.

Origins: Needy parents, "you must be the strong one"

Approval-Seeking: Basing self-worth on others' approval and recognition.

Origins: Conditional love based on performance/appearance

Domain 5: Overvigilance and Inhibition

Negativity/Pessimism: Pervasive focus on negative aspects; expecting worst outcomes.

Origins: Critical/pessimistic family environment

Emotional Inhibition: Excessive suppression of feelings and spontaneity.

Origins: "Don't be emotional," rigid family rules

Unrelenting Standards: Belief you must meet very high standards or face criticism.

Origins: Demanding parents, love based on achievement

Punitiveness: Belief people deserve harsh punishment for mistakes.

Origins: Punitive parents, harsh consequences for mistakes

Schema Coping Styles

People respond to schemas in three ways:

Surrender: Giving in to the schema—"Yes, I'm unlovable, so I'll accept poor treatment"

Avoidance: Avoiding situations that trigger the schema—"I'll never get close to anyone, so I can't be abandoned"

Overcompensation: Acting opposite to the schema—"I'll be perfectly self-reliant so no one sees my neediness"

All three maintain the schema rather than healing it.

Schema Modes

Modes are temporary emotional states triggered when schemas activate:

Child Modes:

Vulnerable Child: Feeling scared, hurt, lonely, overwhelmed
Angry Child: Rage at unmet needs
Impulsive/Undisciplined Child: Acting on impulses without restraint
Happy Child: Playful, spontaneous, joyful (healthy mode)

Dysfunctional Coping Modes:

Compliant Surrenderer: Submissive, people-pleasing
Detached Protector: Emotionally cut off, avoidant
Overcompensator: Controlling, aggressive, narcissistic

Dysfunctional Parent Modes:

Punitive Parent: Internal critic, harsh judgment
Demanding Parent: Unrealistic standards, pushing

Healthy Adult Mode:

Rational, balanced, protective of the vulnerable child, sets appropriate boundaries

Therapy aims to strengthen the Healthy Adult mode while healing wounded child modes and limiting dysfunctional modes.

How Schema Therapy Works

Schema therapy integrates cognitive, experiential, and relational approaches:

1. Schema Assessment

Identifying which schemas are active through:

Questionnaires (Young Schema Questionnaire)
Exploration of patterns in relationships and life
Understanding childhood experiences

2. Schema Education

Learning about schemas, where they came from, and how they operate now helps create distance: "This is my abandonment schema talking, not reality."

3. Cognitive Work

Challenging schema-driven thoughts:

Examining evidence for and against schema beliefs
Developing more balanced perspectives
Testing predictions in safe ways

4. Experiential Techniques

Imagery rescripting: Revisiting painful childhood memories in imagination, but changing the outcome—your Healthy Adult or therapist enters the scene to protect and validate the child you were.

Chair work: Dialogues between different modes (Vulnerable Child talks to Punitive Parent, Healthy Adult protects child)

Emotion-focused work: Connecting with and expressing feelings that were suppressed

5. Behavioural Pattern-Breaking

Identifying schema-driven behaviours
Practicing new responses
Building experiences that contradict schemas

6. Limited Reparenting

The therapy relationship provides a corrective experience—the therapist offers what was missing in childhood (within professional boundaries): validation, safety, appropriate limits, encouragement.

Schema Healing in Practice

Recovery involves:

Mourning what wasn't: Grieving unmet childhood needs—this wasn't your fault

Challenging beliefs: Schema beliefs feel like truth but are childhood conclusions, not facts

Building Healthy Adult: Developing the part of you that can parent your own vulnerable child—offering comfort, protection, reality-checking

New experiences: Deliberately seeking experiences that contradict schemas—if you believe people always leave, staying in relationships when they're difficult (if healthy)

Self-compassion: Meeting your needs without shame or apology

When Schema Therapy Helps

Schema therapy is particularly effective for:

Personality disorders: Especially borderline personality disorder
Chronic depression: When depression doesn't respond to standard treatments
Relationship patterns: Repeatedly choosing similar partners, same dynamics
Complex trauma: When trauma is relational and developmental
Eating disorders: Often rooted in schema activation
Substance use: When using substances to cope with schema pain

It's also valuable for anyone wanting to understand recurring life patterns and their origins.

Frequently Asked Questions

How is schema therapy different from CBT?

CBT focuses on current thoughts and behaviours. Schema therapy goes deeper—addressing core beliefs formed in childhood and using more experiential techniques. It's sometimes called "CBT on steroids" because it builds on CBT foundations but adds depth.

How long does schema therapy take?

Typically longer than standard CBT—often 1-2 years for significant schema change, though some benefit occurs earlier. Schemas are deeply ingrained; meaningful change takes time.

Can schemas ever fully go away?

Schemas don't disappear entirely but lose their power. With work, they become "background noise" rather than driving forces. You recognise them activating and can respond from Healthy Adult rather than being controlled by them.

Do I need to remember specific childhood events?

Not necessarily. While specific memories can be helpful, schemas can be addressed by recognizing patterns and their impact now, regardless of detailed memory.

Can I do schema work in short-term therapy?

Full schema therapy is longer-term, but understanding schemas can be helpful even in brief therapy, offering framework for understanding patterns.

Moving Forward

Nina, from the beginning, came to recognise her abandonment schema—formed when her father left the family when she was seven and her mother became emotionally unavailable through depression.

Through schema therapy, she mourned the security she needed but didn't get. She learned to recognise when her schema activated—the panic, the testing behaviours, the clinging. She developed her Healthy Adult who could reassure her Vulnerable Child: "You're safe now. This person hasn't left. The fear is old, not about now."

Relationships didn't suddenly become easy. But the compulsive patterns loosened. She could stay present even when anxious rather than being hijacked by the schema.

"The schema still activates sometimes," she reflected, "but it doesn't run my life anymore. I can notice it, understand where it came from, and choose a different response."

If you recognise yourself in recurring patterns—same relationship dynamics, similar conflicts, feelings that seem disproportionate to current situations—schema work might offer insight and healing. The patterns make sense once you understand their origins. And understanding them is the first step to changing them.

Ready to Explore Your Patterns?

Our integrative counselling approach incorporates schema therapy principles alongside other modalities. We help you understand the origins of recurring patterns, heal old wounds, and develop new ways of being in relationships and in yourself.

Sessions are available in person in Fulham (SW6) or online across the UK. Book a free 15-minute consultation to discuss how schema-informed therapy might help.

If you're struggling with thoughts of self-harm or suicide, please contact Samaritans immediately on 116 123, available 24/7.

Schema Therapy: Understanding Your Life Patterns