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Schema Therapy for Borderline Personality Disorder

Schema Therapy, developed by Dr. Jeffrey Young, has been successfully used in the treatment of chronic depression, childhood trauma, eating disorders, family dysfunction, substance abuse and relapse prevention, and even criminal offenders, but has been developed specifically to treat personality disorders such as Borderline Personality Disorder.
People with Borderline Personality Disorder have failed to respond fully or successfully to traditional Cognitive-Behavioral Therapy treatments in the past. Other forms of therapy have also been unsuccessful in treating this particular population of clients.

Mainstream services have largely failed these clients as well, resulting in them feeling more abandoned, flitting from service to service and therapist to therapist. People with Borderline Personality Disorder have difficulty maintaining stable relationships, display inappropriate anger, are impulsive, and display recurrent and sometimes severe suicidal threats, gestures and/or behaviors. They may also suffer from identity disturbance, chronic feelings of emptiness and/or boredom, and display efforts to avoid real or imagined rejection and abandonment.

The approach of Schema Therapy is sympathetic and respectful towards the client; more humane and compassionate than those of other traditional therapies, where the therapist maintains a “safe” distance from the client. In Schema Therapy, the emphasis is very much on the relationship between the therapist and the client.

Schema Therapy is a combination of aspects from different therapies, including: Cognitive-Behavioral, Psychoanalytical, Attachment, Object Relations, Gestalt, and Constructivist. It expands on Cognitive-Behavioral Therapy by placing greater emphasis on explaining childhood and adolescent origins of the client’s psychological problems, emotional techniques, the client-therapist relationship, and on maladaptive (negative) or unhelpful coping behaviors.

A “schema” can be described as:

• a broad pervasive theme or pattern
• comprised of memories, emotions, cognitions and bodily sensations
• regarding oneself and one's relationships with others
• developed during childhood or adolescence
• elaborated throughout one's lifetime and
• dysfunctional to a significant degree

These early maladaptive schemas are self-defeating emotional and cognitive (thinking) patterns that begin early in our development and repeat throughout our lives. These schemas then cause self-defeating patterns or behaviors, such as: difficulty in relationships, intense anger, and attention-seeking behavior, which can lead to anxiety and depression. Unless the underlying schema has been changed or healed, the self-defeating behaviors will constantly repeat themselves, resulting in the client dipping in and out of anxiety and depression. Clients with Borderline Personality Disorder, especially, will find themselves limping from crisis to crisis and service to service with no stability in their lives.

Schema Therapy treatment for Borderline Personality Disorder clients focuses on identifying the maladaptive schemas and the lack of attachments, or the dysfunctional attachments, in the client’s childhood and adolescence. These deficits are then linked to present problems encountered in the client’s life. Through therapy, the therapist and the client will attempt to heal the dysfunctional schemas, which will result in less emotional difficulties and a more stable lifestyle.

About the Author

David Oliver is the founder of BorderlineCentral.com a one stop source of information on how to cope and deal with borderline personality disorder.

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