By Carol Goh
What is Schema Therapy?
Schema Therapy (Jeffrey Young et al.) was developed to treat complex difficulties such as personality disorders, bipolar disorder, and post-traumatic stress disorder (PTSD). It goes beyond talk therapy using experiential methods—guided imagery, chair work/dialogues, and corrective emotional experiences—to process unresolved wounds safely within the session.
Because it is experiential and does not require face-to-face encounters with people who hurt you, Schema Therapy is often effective when traditional talk therapies haven’t helped or when relapse occurs.
According to Young et al. (2003), unmet core emotional needs in childhood lead to schemas (enduring patterns of beliefs/feelings). The five core needs are:
- Secure attachment to others (safety, stability, nurturance, acceptance)
- Autonomy, competence, and identity
- Freedom to express valid needs and emotions
- Spontaneity and play
- Realistic limits and self-control
When these needs aren’t met, schemas and maladaptive coping styles form, feeding beliefs like:
- “I’m a failure.”
- “I’ll never succeed.”
- “I’m not good enough.”
- “No one will like me.”
- “I’m unworthy / unattractive.”
Schema domains: five broad categories
Schema Therapy groups unmet needs into five domains, comprising 18 maladaptive schemas (Young et al., 2003):
-
Disconnection / Rejection
- Abandonment/Instability
- Mistrust/Abuse
- Emotional Deprivation
- Defectiveness/Shame
- Social Isolation/Alienation
-
Impaired Autonomy and/or Performance
- Dependence/Incompetence
- Vulnerability to Harm or Illness
- Enmeshment/Undeveloped Self
- Failure
-
Impaired Limits
- Entitlement/Grandiosity
- Insufficient Self-Control/Self-Discipline
-
Other-Directedness
- Subjugation
- Self-Sacrifice
- Approval-Seeking/Recognition-Seeking
-
Over-Vigilance / Inhibition
- Negativity/Pessimism
- Emotional Inhibition
- Unrelenting Standards/Hyper-criticalness
- Punitiveness
How do schemas develop?
A compassionate lens helps: see the adult with trauma as a vulnerable inner child seeking safety and love. Behaviours that seem “needy” are often the inner child’s legitimate plea for care and protection. Without safe support, people may repeat cycles of hurt—turning toward those who harmed them or similar dynamics—because they lack healthier, reliable bonds.
Over time, adverse childhood experiences accumulate. As adults, triggers in the present activate old memory networks, producing outsized emotional reactions (often outside conscious awareness). Schema Therapy helps link past to present, giving the wounded parts of self the protection, validation, and nurturance they needed—so current patterns can change.
PTSD and complex trauma
When childhood wounds accumulate, they can crystallise into PTSD-like patterns. Schema Therapy works to unlock the roots of current symptoms by processing formative memories, reducing reactivity, and restoring a sense of safety and agency.
Borderline & bipolar: what research suggests
- A single-case study of a psychopathic inpatient treated with Schema Therapy showed the client could live independently post-treatment without judicial supervision or re-offending, suggesting potential effectiveness even in severe presentations (Chakhssi et al., 2014).
- Schema-focused cognitive therapy has also been described for bipolar disorder to reduce relapse vulnerability by addressing attitudes and schemas (Ball et al., 2003).
Goal of Schema Therapy: empower clients to express emotions experientially and stand up for their needs/rights in the safety of session work. Therapists join the childhood images, speak up for the client, and model healthy protection and nurturance. This can transform the world from unsafe to safe enough, rebuilding trust and connection.
Young et al. (2003) also note that healthy anger can provide strength to counter schemas—asserting boundaries and restoring a sense of justice.
Issues Schema Therapy is commonly used for
- Abandonment and rejection
- Humiliation/shame (appearance, performance)
- Bullying/cyberbullying (isolation, name-calling)
- Not meeting parental expectations (“I’m a failure,” “I’m not good enough”)
- Emotional, physical, or sexual abuse
Why experiential change matters
Schema-focused work often succeeds where advice or insight alone hasn’t, because it changes the emotional memory through lived, corrective experiences. Clients report feeling protected, comforted, nurtured, and affirmed, paving the way for healthier attachment, communication, and boundaries.
In summary: Schema Therapy has shown meaningful results for people living with long-standing, “stuck” beliefs and patterns—especially when other methods haven’t helped enough.
- Contact us to discuss whether Schema Therapy is suitable for you
- Book an appointment for in-person (Singapore) or online sessions
References
- Ball, J. R., Mitchell, P. B., Malhi, G. S., Skillecorn, A., & Smith, M. (2003). Schema-focused cognitive therapy for bipolar disorder: Reducing vulnerability to relapse through attitudinal change. Australian and New Zealand Journal of Psychiatry, 37(1), 41–48.
- Chakhssi, F., Kersten, T., de Ruiter, C., & Bernstein, D. P. (2014). Treating the untreatable: A single case study of a psychopathic inpatient treated with schema therapy. Psychotherapy, 51(3), 447–461. https://doi.org/10.1037/a0035773
- Young, J., Klosko, J. S., & Weishaar, M. E. (2003). Schema Therapy: A Practitioner’s Guide.
- Young, J. (2006). Schema Therapy. The Guilford Press.
The information in this article is for educational purposes and isn’t a substitute for professional advice, diagnosis, or treatment.
