List of schema addressed in schema focused therapy

Here is a list of schema that can be identified and explored in schema focused therapy:

ABANDONMENT/INSTABILITY

Definition	The essence of this schema is the perceived instability or unreliability of those available for support and connection. It involves the sense that significant others will not be able to provide emotional support, connection, strength, or protection on an ongoing basis because they are emotionally unstable and therefore unpredictable or unreliable, because they are only present erratically, or because they will either die or abandon the client in favour of someone else.

Origins 	This schema develops when parents are extremely inconsistent in meeting the child’s needs. The parents may constantly fight or bicker or one or both parents may threaten to leave or actually may walk out. Early experiences of loss, due to divorce, separation, illness, or death are obvious circumstances that lay the groundwork for the elaboration of this schema, as are the experiences of being always left alone or in the charge of numerous and constantly changing caretakers. This schema could also arise in the context of an alcoholic household, in which either or both parents are inconsistent or unpredictable in their physical or emotional availability.

Client Characteristics  Because of their exaggerated fear of bieng left alone and abandoned, these clients are usually very clinging in relationships, sometimes to the point of unwarranted jealousy. They constantly seek reassurances about loyalty and commitment but are never satisfied by these reassurances. Predictably, these behaviours often become exasperating to their partners and can generate a desire by the partners to withdraw or leave. The more the client asks for reassurance, the more the partner tends to pull away, creating a self-escalating cycle and thereby maintaining the schema. Furthermore, these clients tend to select partners who are in some way unavailable, unpredictable or unstable.

Therapeutic Strategy    Therapy focuses on helping clients to identify and modify cognitive distortions concerning the likelihood of friends and partners leaving or abandoning them and the underlying belief that they will ultimately be alone. It is pointed out that their clinging and reassurance-seeking behaviours are ultimately self-defeating. Over time, they are helped to let go of the dysfunctional habits, which provide temporary relief but actually perpetuate the feelings of uncertainty and fear. On an experiential leave, they are helped to face their core insecurity, that is, their overwhelming fear of people’s feelings toward them changing and of being left alone. The therapy relationship provides these clients with a stable base. It is also a model of a relationship that persists over time and that provides consistent feedback and emotional support. Clients are encouraged to select partners who, like the therapist, are committed and stable and who will help them to consolidate their gains. ABUSE/MISTRUST

Definition	The essence of this schema involves the expectation that other people will hurt, abuse, humiliate, cheat, lie, manipulate, or take advantage of one. A fear of angry or violent outbursts from others is often also included in the schema. People holding this schema experience other people’s negative behaviours as intentional or as resulting from extreme and unjustifiable negligence.

Origins	This schema results from early childhood experiences of physical, sexual, or emotional abuse or from personal betrayal by parents or siblings. Children facing these behaviours often have to deal with trying to make sense of mixed messages, lies, broken promises and deceits, hypocrisies, or false affections.

Client Characteristics	     Abused clients are hypervigilant to harm, manipulation, or being cheated by others. They frequently distort events, read hidden meanings into statements, or attribute negative intentions to others’ behaviour. They can be accusatory, openly suspicious, and testing of others’ motives. If they think they are being cheated, they can behave in an unfeeling, cruel, or vengeful way. Predictably, they also hold back on even minor self-disclosures and can be dishonest and manipulative in their dealings with others. Many borderline personality disorder clients are trapped in such a self-perpetuating negative cycle.

Therapeutic Strategy therapy focuses on helping clients to understand and modify their biased perspective on other people and erroneous underlying beliefs concerning the malevolent nature of other people’s intentions. They are shown how their behaviour feeds the cycle of this schema and how to interact in a more open or less manipulative say.

The therapy relationship serves as an essential model of trust and honesty for these clients. A major task of the therapist with these clients is to help them overcome the constant sense of danger they feel from others as well as the legacy of rage and humiliation they carry from the betrayal and assaults they experience in early childhood. The quality of the therapy relationship, and of the experiential interventions, are crucial in paving the way for changes in the manner in which these clients interact with other people.

These clients also frequently need a great deal of patient guidance in selecting partners who will not be abusive to them and who will, through their personal honesty, help them to learn how to empathise with, rather then capitalise on, others’ feelings and weaknesses. These clients are helped to give other people the benefit of the doubt and, above all, to experience what it is to trust and be trusted. EMOTIONAL DEPRIVATION

Definition	Emotional deprivation involves the expectation that one’s desire for a normal degree of emotional support will not be met by others. The client may feel deprived of nurturance, protection, or empathy. Deprivation of nurturance involves the absence of attention, affection, and warmth from others. Absence of strength, direction, or guidance from significant others leads to deprivation of protection. When there is an absence of understanding, listening, self-disclosure, or mutual sharing of feelings and experiences with others, the client experiences deprivation of empathy.

Origins	As already has been described, emotionally deprived clients have usually experienced some form of emotional neglect during early childhood. Their parents are often cold, distant, nonempathic, weak and unavailable. Consequently, these client expect that others will not be there to meet their needs.

Client Characteristics   Depending on the specific nature of the deprivation (nurturance,  protection or empathy) these clients advertise their deprivation on both obvious and subtle ways. They can come across as demanding and controlling or can be cold, uncaring, insensitive, and withholding. Emotionally deprived clients often report high levels of loneliness. Frequently, they avoid intimacy and closeness or pull away from nurturance because its unfamiliarity generates discomfort. Predictably, they tend to choose partners who are either unwilling or unable to give emotional support.

These clients are often chronically dissatisfied or disappointed with others because of unrealistic or erroneous expectations concerning what others “should” give. Emotionally deprived people also err on the side of not asking for what they want and then being disappointed or angry when others do not read their mind or fulfil their unstated needs. They often place excessive emphasis on the giving or receiving of gifts, since they view gifts as concrete evidence of thoughtfulness and caring. These clients can also swing from being extravagant or self-indulgent to being depriving of both themselves and others.

Therapeutic Strategy  Therapy addressees these clients’ cognitive distortions and unrealistic expectations concerning the unavailability of others. It also aims at modifying the clients’ behaviour in the direction of eliciting more genuine empathy and warmth from others. The therapist acts as a model of such nurturance and empathy by being a person to whom these clients can show and with whom they can experience their vulnerability and hurt. The clients learn how pulling away and estranging themselves simply perpetuates the schema.

In the broader picture, these clients are helped to choose partners who are physically and emotionally available for them and who are capable of giving them the attention, love, support, guidance, or protection that they so badly need but find hard to ask for or accept. A patient, nurturing partner can be an enormous asset in helping these clients to heal their inner wounds and to experience what it is to feel safe, understood, and loved. FUNCTIONAL DEPENDENCE/INCOMPETENCE

Definition	This schema relates to the feeling of not being able to handle one’s everyday responsibilities competently or without considerable help from others. Everyday responsibilities are the numerous minor decisions, hassles, chores, and tasks that constitute and average day

Origins	This schema arises when parents do not encourage or allow a child to develop any sense of independence, competence, or self-sufficiency. To develop optimally without a sense of incompetence or undue dependence, children need parents who will permit them to increasingly assume appropriate independent responsibility and who will not interfere at the first sign of difficulty with the children’s efforts to accomplish tasks and acquire skills.

Client Characteristics  The clients constantly avoid new tasks or even minor decisions, consequently they present with a pervasive passivity. They ask for help and reassurance in everything they do and actually are more likely to make wrong decisions or exercise bad judgement than other people are because of lack of practice and exposure to decision making. However, these clients attribute even real experiences of success or mastery to luck or a fluke. Predictably, these clients choose partners who are either controlling or self-sacrificing and on whom they can become dependent.

Therapeutic Strategy  Therapy focuses on modifying the clients’ biased view of their own self-efficacy by helping them to identify cognitive distortions (such as minimisation or rationalisation of success experiences) and challenge underlying beliefs concerning their perceived inability to accomplish tasks independently. Because these clients frequently present such a passive image, lacking in drive and confidence, they are encouraged to take on new tasks and to gradually build up a repertoire of activities that they can undertake independently.

The therapist helps the clients to experientially confront their fear of failure and of functioning on their own as well as the shame of being so dependent. Within their current relationships, clients are encouraged to start taking more initiative. This change is frequently welcomed by a partner whose life has been curtailed by a client’s neediness and lack of autonomy; however, a controlling partner can sometimes resist this change. Since these clients tend to become dependent on the therapist also, it is essential that therapy provide a supportive and encouraging environment in which they can begin to experience and exercise personal control and responsibility, rather than a dominating relationship directed by the therapist. VULNERABILITY TO HARM AND ILLNESS

Definition	This schema involves an exaggerated fear that disaster -  financial, medical, criminal, or natural – will strike at any time and that one is unable to protect oneself from disaster.

Origins	This schema usually results from having overly protective parents who repeatedly conveyed the message “The world is a dangerous place.” The parents themselves usually had major vulnerability issues, worried excessively about the possibility of impending disasters, and catastrophised minor problems and mishaps.

Client Characteristics  These clients usually present with a whole range of unrealistic fears – of having a heart attack, of getting AIDS, of going crazy or broke, of being mugged, and so on. They frequently suffer from anxiety disorders (panic disorder, generalised anxiety disorder, phobias, or hypochondriasis). The inherent unpredictability and uncertainty of everyday living is extremely anxiety provoking to them. They are, therefore, overly self-protective, and they worry excessively about the well-being of others. In their efforts to maintain a fragile sense of control, they are very conservative and routine oriented; changes or risks of any kind are avoided if at all possible.

Therapeutic Strategy Therapy focuses on modifying the cognitive distortions related to the clients’ exaggerated perception of impending harm. The clients are then gradually encouraged to expose themselves to progressively more threatening situations (that is, a hierarchy of risks or changes). This kind of exposure increases their sense of control and desensitises them to their own anxiety reactions. Relaxation training is also frequently integrated into the intervention. Slowly, the clients gain some distance from their feelings of anxiety and come to view themselves and the world more objectively.

The role of the therapist is to provide a safe and nonthreatening place in which these clients can experience rather than avoid their overwhelming sense of vulnerability of fear. If they are in a relationship, the clients are advised to go out more, and particularly, to do more novel and spontaneous activities on their own.

ENMESHMENT/UNDEVELOPED SELF

Definition	The essence of this schema is excessive emotional closeness and involvement with one or more significant others at the expense of full individuation and normal social development. This schema often involves the belief that at least one of the enmeshed individuals cannot survive or be happy without the constant support or presence of the other. Enmeshed individuals often feel that they are fused, or share an identity with, the other; there is insufficient individual identity and inner direction. They can also feel smothered by the enmeshed other but experience a feeling of emptiness or floundering when alone.

Origins This schema can arise within the context of a totally enmeshed family unit, in which the world is the family and everything outside is perceived as somehow less real or less meaningful. More often, however, the child becomes enmeshed with one or both parents. If the parents are extremely controlling, subjugating, or over-protective, the child may find it impossible to develop a separate sense of self. Alternately, in a situation in which one parent is either physically or emotionally absent, the other enmeshing parent can overidentify with the child, who becomes an emotional substitute or any ally in the dysfunctional family triangle.

Client Characteristics   Depending on their degree of enmeshment, these clients find it extremely difficult to function separately from the family unit or enmeshing other. They spend a lot of time at home and usually remain living there well beyond the normal age for leaving the nest. They avoid outside contacts and relationships but when they do get involved in a relationship, they tend to immediately enmesh there also because their sense of boundaries is so inappropriate. They bond with this new person, who then becomes their raison d’être, and they transfer their need for constant interaction and mutual validation from the family to this person. This can result in the client having enormous feelings of guilt over “betraying” the enmeshed family members. The situation is often exacerbated by active criticism, accusations of disloyalty, or even threats of disinheritance or self-mutilation by the family members, who feel that they are losing a part of themselves.

Sometimes “hot” situations like these bring enmeshed clients into therapy. They have begun to feel smothered or trapped in their home situation but do not know how to extract themselves and feel very confused and lost when they try to venture forth alone. Or they have met someone new but fear the retribution of the enmeshed family member or the enormity of taking a commitment to someone else.

Therapeutic Strategy   Therapy focuses on normalising the client’s distorted view of what is an appropriate degree of closeness and identification in relationships. The behavioural focus of therapy is on helping clients to identify simple preferences and to make minor decisions and follow through with them. The idea is to help clients to develop a sense of self, of having an existence separate from the family or enmeshed other. The experiential focus of therapy is on helping clients face the guilt of betraying the enmeshed other and, more important, confront the fear of striking out alone and the core sense of emptiness and confusion over who they really are. Sometimes anger at having been innocently hooked into a dysfunctional bind at a very early age also needs to be addressed.

The therapy relationship is an essential ingredient in helping these clients to see that they can have a close and confiding  relationship (with the therapist) without losing their identity and furthermore, that boundaries and personal privacy are both appropriate and necessary in relationships. They are advised to gradually gain some distance – emotional and spatial – from the enmeshed other so that they can learn to differentiate their own needs and preferences and to exercise their decision-making abilities.

As a result of their lack of self-direction, these clients frequently have not taken advantage of opportunities to individuate in their career, social life, or broader areas of interest. They are guided and encouraged to branch out in these areas also. These clients tend to choose partners who initially thrive on their undivided love and attention but quickly feel smothered and pull away. They are helped to select partners who already have an adequate sense of autonomy and connectedness and who can help them to grow in the relationship both as a partner and as an individual.

DEFECTIVENESS/SHAME

Definition	This schema involves the feeling that one is inwardly defective, flawed, or invalid and that one is, therefore, fundamentally unlovable or unacceptable. Consequently, people who hold this schema have a deep sense of shame concerning their perceived internal inadequacies and a constant fear of exposure and further rejection by significant others.

Origins	This schema usually results from the experience of constant criticism, devaluation, or rejection by one or both parents. This behaviour results in the conviction that one is inherently unacceptable and unlovable.

Client Characteristics  Clients holding this schema expect rejection and blame from others. They are therefore hypersensitive even minor slights or criticisms. They are usually also very self-critical and exaggerate their own defects. By and large, they avoid intimacy and self-disclosure and therefore the risk of being exposed to rejection. They are inclined to choose critical partners who maintain the schema by being judgemental and evaluative. Sometimes they compensate by being critical and controlling and loud and domineering in their relationships or by creating a fantasy social persona – the narcissist. The only payoff for this compensating behaviour is negative attention, which in no way substitutes for their deep need for validation and acceptance; the fear of exposure remains ever present.

Therapeutic Strategy  Therapy focuses on teaching these patients to develop an inherent sense of self-worth. Cognitive distortions concerning their hypersensitivity to criticism, their exaggerations of the perceived negative tone of the remarks of others, and their expectations of rejection are all addressed. They are encouraged to gradually open up to significant others, to risk minor self-disclosures, and to listen more to what others have to say rather than immediately offering a judgement or evaluation.

The therapy relationship is of the utmost importance in slowly and gently helping these people to confront their deep inner sense of shame and worthlessness and their anger at those who so brutally rejected them. The role of the therapist is essentially one of accepting the client for what he or she truly is and of providing supportive and constructive feedback rather than criticism. Only in such an atmosphere of unconditional acceptance can these clients face their deepest, most painful feelings and begin to develop a sense of self-worth and of inherent value. These clients are encouraged to choose partners who are warm, reasonable, accepting, and nonjudgemental and who will be able to encourage their efforts to open up, reach out spontaneously, and listen and empathise rather than criticise and invalidate.

SOCIAL UNDESIRABILITY/ALIENATION

Definition	This schema involves the belief that one is outwardly undesirable to, or different from others. Clients may feel that they are ugly, sexually undesirable, poor in social skills, dull, boring, or low in status. Therefore, they feel self-conscious and insecure in social situations and have a sense of alienation or isolation from the rest of the world. These clients frequently feel that they do not fit in, that they are not part of any group or community.

Origins	This schema can result from repeated criticism of certain aspects of appearance or social presentation. It can also arise from experiences of being different or being treated differently from other children or family members. Sometimes children think that their whole family is different from other families. This is a familiar experience for children who grow up in an alcoholic household; they feel that their family has something to hide and is therefore less desirable than those of friends or peers.

Client Characteristics   These clients feel more comfortable when alone since social situations trigger self-consciousness and perceived pressure to perform or to pretend that they are enjoying themselves. They usually minimise their social contacts or stay on the periphery of groups. Alternately, some cope with their unfulfilled need to connect by exaggerating the differences between themselves and others. They advertise themselves as being different from the group, usually by highlighting the very characteristics they identify as setting them apart or by developing various eccentricities or manner or dress. This ensures that they remain apart. Yet another way these clients try to cope is to hide all differences and act like everyone else in order to fit in. Privately they remain feeling totally detached and alienated.

Therapeutic Strategy 	 Therapy focuses on helping these clients to recognise the similarities as well as the differences between themselves and others and the fact that it is their self-defeating behaviours, rather than any undesirable characteristic or aspect of their personality or appearance, that is usually maintaining their isolation. If necessary, they are trained in the basic social skills of initiating conversation, listening, and timing and pacing social interactions. It is usually loneliness that pushes these clients into therapy, and this same loneliness can act as leverage by motivating them to venture forth again with a new perspective and with tools to facilitate smoother social encounters.

The therapy relationship can provide direct feedback to these clients on their social and interactive skills as well as validation concerning their social desirability. Furthermore, it provides an opportunity for them to confront their core fear of always being on the outside and to experience with the therapist what it is like to really connect. They are also encouraged to integrate gradually into groups in their community, especially groups that facilitate active rather than passive participation. In selecting partners, they are advised to steer away from other loners and to work on meeting and developing relationships with people who are already well integrated into their group or community. FAILURE TO ACHIEVE

Definition	This schema involves the belief that one will inevitably fail or is fundamentally inadequate relative to one’s peers in areas of achievements. It often involves the related belief that one is stupid, inept, untalented, or ignorant.

Origins 	This schema often results from early criticism, usually by parents. For example, being constantly compared to siblings who are more successful at school or sports or being compared to high achieving parents can set the stage for later failure to achieve. This schema can also arise if parents do not give enough support, direction, or encouragement or do not provide enough discipline for the child to persist and succeed. Failure to achieve can also result from parents who are too demanding or set standards that are too high for the child; some children rebel against these excessive expectations by failing.

Client Characteristics   These clients usually present with a sense that they have failed in comparison to their peers, either at their job or at school. Often they actually are underachieving, but even clients whose performance is adequate or excellent still have considerable anxiety concerning the possibility of failure. Frequently, these clients have a specific belief that they are stupid or inept and that they have thus far managed to fool everyone.

Therapeutic Strategy  Therapy focuses on helping these clients to modify their distorted cognitions and expectations concerning the likelihood of failure and to see that this is the fear of failure – rather than any lack of ability or potential – that is usually holding them back. Since they are often inclined to spend excessive amounts of time in preparation and planning for projects but to avoid actually getting started, they are helped in planning a graded sequence of minitasks and then in working through these until the project is completed. SUBJUGATION

Definition	This schema involves an excessive surrendering of control over one’s own decisions and preferences – usually to avoid anger, retaliation, or abandonment. The subjugated person perceives that his or her desires are neither valid nor important to others. This perception often leads to anger at those who subjugate.

Origins	This schema usually results from living with very controlling or domineering patents who punish, threaten to punish, or withdraw from the child for expressing his or her needs and wants. Sometimes parents simply override, and therefore negate the child’s wishes by enforcing their own.

Client Characteristics Subjugated people frequently present a very compliant and unassertive picture. They exaggerate the likelihood of retribution if they express their needs rather than deferring to others. They are, therefore, excessively eager to please. Because they catastrophize the devastating impact of others’ anger, they avoid conflict and confrontation at all costs. They frequently harbour anger at those they perceive as subjugating them, but their inability to manage and express this anger sometimes translates into passive-aggressive behaviour.

Therapeutic Strategy The therapist helps these clients to identify their distorted beliefs concerning the feared consequences of expressing their needs and feelings. They are also taught assertion skills, which allow them to stand up for their rights in a nonaggressive, reasonable, and effective way. The therapist also helps them to confront and to ventilate their long-standing anger; only by doing this can they experience themselves as free agents.

Through their interactions with the therapist, these clients learn that by being direct and assertive, rather than passive or passive-aggressive, they can maintain their personal integrity without eliciting anger or retribution. These clients are inclined to choose controlling or narcissistic partners. The therapist helps them to choose people who are democratic, that is, who will foster their efforts to assert themselves and to be open about their needs and feelings within the relationship.

SELF-SACRIFICE : OVERRESPONSIBILITY

Definition	This schema involves a voluntary but excessive focus on meeting the needs of others at the expense of one’s own gratification. The most common reasons for this self-sacrifice are to prevent causing pain to others, to maintain the connection with others who are perceived as more needy, to avoid guilt, or to gain in self-esteem. Self-sacrifice often results from an acutely tuned sensitivity to the pain of others. However, it leads to a feeling that one’s own needs are not being met and sometimes to resentment of those for whom one sacrifices.

Origins	This schema can result from a child overidentifying with an emotionally needy parent and assuming the role of caretaker at an early age. Sometimes this role is required or expected, for example, in families where both parents are excessively caught up with their careers and the child must take care of younger siblings. Whatever the circumstances, these clients have assumed responsibility for the well-being and happiness of others at a very early age.

Client Characteristics By and large, these people always put the needs of  others first, and, in doing so, they tend to overextend and overcommit themselves. If they feel resentful that their needs are not being met by others, they may then feel guilty at their own selfishness. Guilt predominates – guilt that they caused the other person pain, guilt that they were not there when needed, guilt that they did not do the right thing, guilt that they let the other person down. Guilt is the primary force in maintaining the schema.

Therapeutic Strategy Therapy focuses on helping these clients to establish emotional boundaries between themselves and others whom they perceive as more needy than they are. Their exaggerated perception of others’ neediness and vulnerability and their compulsion to make things right are modified as well as the erroneous belief that they are somehow responsible for all of life’s unhappy people. They learn to identify their own limitations and thereby to set limits for themselves. Learning to acknowledge their own needs and to allow others to take care of them is often a difficult lesson.

The experiential focus of therapy is on helping these clients to deal with the overwhelming guilt or fear of losing approval if they switch their focus from others to themselves. Learning to stay with and tolerate the resulting inner tension, which is usually alleviated by relieving the pain of another, is perhaps the major focus and core goal of therapy. By confronting the intense affect triggered by the schema, these clients come to realise that they are not personally responsible for the happiness of others and, furthermore, that the schema is a self- perpetuating and  self-defeating endeavour.

The role of the therapist, as another caregiver, is to model how one can take care of the needs of another but also take care of oneself, emphasizing that this is not just acceptable but essential for a balance existence. These clients tend to select demanding and narcissistic partners or people who are needy, dependent, and deprived. They are encouraged to select people who are balanced and self-sufficient and who will help them establish a flexible receipt of give-and-take in the relationship. EMOTIONAL INHIBITION

Definition	This schema involves excessive inhibition of emotions and impulses – most frequently anger. The person expects the expression of emotions and impulses to result in loss of self-esteem, embarrassment, retaliation, abandonment, or harm to oneself or others.

Origins	Parents who discourage the expression of feelings especially anger, and who either directly or tacitly convey that emotional control is a more acceptable and commendable aspiration than expression, lay the foundations of emotional inhibition.

Client Characteristics Emotionally inhibited clients can seem cold and controlled or logical and pragmatic to the point of lacking spontaneity and sensitivity. This is because they are very uncomfortable round displays of even positive emotions. They find it extremely difficult to handle their own emotions and frequently harbour fears of losing control. Socially, they are often misconstrued as killjoys because their seriousness can make other people feel self-conscious and immature. Predictably, they tend to select partners who are also controlled and rigid and who therefore do not rock the emotional boat, although they may also choose the company or partnership of people who tend to be highly emotional and through whom they can vicariously experience emotional freedom.

Therapeutic Strategy Therapy focuses on helping these clients to deal with their distorted perception of emotions as signs of weakness;  their belief that expression of emotions will ultimately lead to rejection, retaliation, or embarrassment; or their belief that their expression will lead to total loss of control. Assertion training helps them to see that they can express their feelings, especially anger, in an effective manner.

In therapy, these clients are encouraged to experience and to express their feelings as they occur. The therapist also provides them with feedback on how he or she is feeling during the session and endeavours to be as human, humorous, and empathic as possible. The clients are guided to choose partners who are emotionally receptive and expressive and who will be able to both tolerate and encourage their newfound emotional freedom and experimentation. On a more general level, they are simply encouraged to have more fun, to experience life on an affective rather than exclusively intellectual or logical plane. UNRELENTING/UNBALANCED STANDARDS

Definition	This schema involves the relentless striving to meet high expectations of oneself at the expense of happiness, pleasure, relaxation, spontaneity, playfulness, health, and satisfying relationships. It often also includes unrealistic expectations of others. People who hold this schema place an undue emphasis on following strict personal rules of behaviour or morality, and ignore more basic needs for gratification and enjoyment. They may also be excessively focused on status, money, achievement, or recognition – again at the expense of inner peace and harmony.

Origins	Parents whose standards are very high and who deliver rewards such as love and attention contingent upon task completion or performance that meets high standards set the stage for unrelenting standards. Such parents often devalue the role of simple enjoyment and relaxation.

Client Characteristics Predictably, these clients are often very successful and accomplished, but they are also depressed and anxious or suffer from various psychosomatic complaints. They tend to exaggerate any deficits or flaws in themselves and to see things in rigid black-and-white categories. They work too hard, at the expense of feelings of well being, good health and relationships. As well as having unrealistic expectations of themselves, they also impose these rules on others.

In relationships, they look for perfection and can be very controlling and critical. Minor flaws in a partner are seen as unacceptable, and this viewpoint can put intolerable pressure on a less accomplished partner. Alternatively, they can choose partners who are also very driven and achievement oriented and who are also highly critical of them. In either case, these clients tend not to invest the necessary time in their relationships; career pursuits and achievements take priority. Breakups are common but are usually attributed to flaws or imperfections in the partner.

Therapeutic Strategy Therapy focuses on modifying and normalising these clients’ expectations of themselves and others and on shifting their exclusive focus on tangible achievements, such as money and status, to focus on investing more time in friendships, relationships and personal relaxation. They are helped to see that although high standards are commendable, in the extreme they are self-defeating – that they disadvantages outweigh the advantages. They need to plan a more realistic work schedule and to spend more time in leisure pursuits with partners and friends; this sometimes involves the clients’ acquiring time-management skills or learning to delegate responsibility to others.

Therapy serves as an arena within which to work on many of these issues. People who hold the schema of unbalanced standards often try to be “perfect patients” or put pressure on themselves or on the therapist to be cured as quickly as possible. Many of these clients can be helped to experience the underlying feelings of deep inadequacy that may be pushing them to prove themselves. They must learn to let go of the internalised voice of the parent which has never allowed them to feel that their achievements were enough or that they as individuals were good enough.

In therapy, these clients experience what it is like to be accepted and respected for themselves and not for who they are or what they have. Only then can these clients cease their constant evaluating, testing, and judging of themselves and others. Their partners do not have to be, and cannot be perfect either. They are encouraged to select people who have a balanced perspective on themselves and on their work and leisure. Learning to do things for pleasure rather than achievement is a very difficult lesson for these clients, but the positive feelings of well-being that result, rather than chronic pressure and anxiety, serve as major leverage.

ENTITLEMENT/SELF-CENTEREDNESS

Definition	Central to this schema is the feeling that one is entitled to whatever one wants – regardless of the cost to others or of what others or society might regard as reasonable.

Origins	These clients have usually experienced extreme overindulgence and lack of responsibility as children. Their parents may have been excessively permissive and not set limits (sometimes to assuage guilt over their inability to give to the child emotionally or because they were overly controlled or deprived as children themselves). Perhaps equally often, children develop this schema as a compensation for feelings of deprivation, defectiveness, or social undesirability.

Client Characteristics People who hold this schema are egocentric and narcissistic. They have an exaggerated view of their own rights and worth in relation to others and the world and also an under-developed sense of their moral and social obligations. These people can, therefore, come across as arrogant, selfish, demanding, and controlling. They lack empathy for others’ needs and tend to treat people carelessly. They often have an employment history of being fired because they could not get along with bosses or co-workers or of walking out when they did not get what they wanted.

These people often come into therapy (when they come for therapy at all) in the context of relationship difficulties. They may seek therapy, for example, when a partner is no longer able to cope with the individual’s constant criticism and control or with the social embarrassments resulting from the person’s disrespect for others’ rights or needs.

Therapeutic Strategy In therapy, these clients first need to understand how their exaggerated perception of their rights and their minimization of other’s needs is creating problems for them  - that it is perpetuating the sense of alienation or detachment that they frequently report. The therapist demonstrates how their egocentric strategies are self-defeating and do not meet their real needs for personal validation and closeness. The therapist models empathy based on mutual respect and limit setting. The therapist also ensures that these clients see that they are being treated the same as other clients, that the same rules concerning cancellation, fees, and so on apply to them. The therapist also helps them to increase their ability to empathize through taking the perspective of others. This perspective is particularly relevant in the context of relationship difficulties.

These clients tend to attract partners who are self-sacrificing, subjugated or deprived. They need to learn how to share and ideally, how to choose a partner who is able to assert himself or herself while respecting the rights of others and who, furthermore, can help the client to learn what it is to take another’s needs into consideration.

Frequently, these clients; narcissism is a fragile compensation for underlying core schemas in the domains of disconnection or undesirability. The main goal of therapy here is to help them face the pain of their underlying core schemas and to acknowledge their vulnerability and fragility.

INSUFFICIENT SELF-CONTROL/ SELF-DISCIPLINE

Definition	This schema involves pervasive difficulty exercising sufficient self-control or tolerating frustration long enough to achieve personal goals or to refrain from emotional outbursts or impulsive behaviours.

Origins	This schema can result from growing up in a household where limit setting was nonexistent or inconsistent, for example, where parents did not model self-control or adequately discipline the child or where one parent was very strict and the other very lax. This schema can also result from early attempts to deal with the intolerable feelings or tension or insecurity that can arise in the context of an unstable home base.

Client Characteristics These clients may exhibit problems of emotional and impulse control, overeating, alcohol and substance abuse, promiscuity, aggressive outbursts, and criminal behaviours. They may have demonstrated chronic difficulty meeting responsibilities, especially when sustained, disciplined performance was required. They usually have difficulty sacrificing short-term pleasure and excitement to gain longer-term success or gratification.

Therapeutic Strategy Therapy focuses on modifying the clients’ distorted belief that they must have, and can have, immediate gratification. The problem behaviour, whatever its manifestation, will also need to be dealt with through the appropriate cognitive or behavioural interventions. However, since these problem behaviours often serve to let the clients avoid underlying core affect, working on more central schema change is often necessary as well.