[Onward2wards]

I am intrigued by the concept of Schema Theory (you can look it up online, here is one link, and in the self-help book "Reinventing Your Life"), and how it overlaps with the idea that a lot of common psychological disorders are in fact a response to severe stress. I apologize for a long-ish post, but these concepts are helping me and I hope they will help you as well.

Schema Theory states that virtually everyone experiences important psychological needs going unmet at times, and that this can cause a complicated set of fears and negative expectations to form. These fears can be triggered by later events, at which time we experience a "schema mode" or state of mind in which we desperately try to alleviate the stress caused by these old fears through overcompensation, avoidance or capitulation.

This seems to tie in well with the "disorders as stress" theory:
Fight = Overcompensation (aggression, proving oneself, defensiveness, etc.)
Flight = Avoidance (procrastination, inhibition, panic, etc.)
Freeze = Capitulation (passivity, depression, learned helplessness, etc.)
I wonder if the cognitive/behavioral expressions (right) form a feedback loop with the emotional/physiological expressions (left)?

Here's an example:
Let's say people called you stupid repeatedly under specific circumstances earlier in your life. You began to develop a "complex" about it - in this case let's say an "Incompetency Schema". If in the present day you encounter events and people similar to the original event, you may experience a lot of stress and negative assumptions about your own competency, and then you may try to overcompensate by being defensive or by frantic attempts to prove your competency and intelligence. Or, you may have an urge to avoid those events and people, or to procrastinate on projects where you question your own competency to deal with them.

Since these common but ineffective coping methods don't adequately solve the problem, it only creates more stress and also feeds back into the original fears, thus keeping the schema active. The tricky thing about these coping methods is that they are based on potentially useful and understandable impulses, but they are overexpressed and/or used at the wrong times.

What happens when stress exceeds our ability to cope? Biologically we get hypervigilant, fatigued, physically ill, and our brains focus on potential threats. We don't consider positive things when we are in "survival mode", so things we normally enjoy don't feel so rewarding and everything negative seems closer and more "real". Stress eventually causes us to break down where we are most vulnerable - it can come out as anxiety disorders, depressed mood, apathy, you name it, these can all be seen as individual responses to overwhelming stress!

I think these processes I've described are why both medications (to fix potential stress-induced long term biological breakdowns, or at least temporarily buffer situational stress responses) combined with therapy (to come to grips with our recurrent triggers and automated negative thoughts and behaviors) have become the gold standard of treatment. Schemas = ineffective living = more chronic stress. Additional situational stress = an individually unique kind of breakdown. Of course we're all different, which is why some people respond more to meds and some more to therapy, and both are observed to be helpful for many people.

Schemas - there are currently 18 different kinds in Schema Theory - seem to tie in neatly with Personality Disorder concepts as well. Schemas are rated according to their severity. You can have more than one, obviously. A person could have for example, a Defectiveness and an Ostracism schema that are weak, and an Abandonment schema that is very strong (a "core schema"). I would think in that case the person might well have strong Borderline features to their personality. However another person with a core Abandonment schema coupled with a moderate Subjugation schema logically wouldn't have precisely the same symptoms. In addition, consider the three exaggerated compensating systems. Capitulating to Defectiveness won't operate the same as Avoiding or Overcompensating for a sense of Defectiveness.

It seems everyone has schemas, but not everyone has a personality disorder, obviously. I think PDs are one or more core schemas, probably with other more moderate intensity schemas supporting them in some way. Think of your mind as a garden full of weeds (schemas). What happens when a strong weed gets very big and other weeds begin to grow around it? It's going to look more like a tree after a while.

Schema Therapy (ST) apparently grew out of Cognitive Behavioral Therapy (CBT). CBT teaches a person to be more aware of, analyze and challenge their own recurrent assumptions and behaviors, so as to identify and correct things that aren't working for us but have become ingrained for whatever reason. ST seeks to address recurrent patterns of thought and behavior that almost "argue back" against CBT's logic, and which are therefore fairly resistant to CBT methods. ST seeks out the root cause of these patterns, what they mean to the individual experiencing them, and understanding which of the three maladaptive responses are in play (it could well be any or all), and has methods for understanding this process and healing it. I see ST it as CBT plus brief psychodynamics.

I'm really excited about looking at my own experiences with things like social anxiety, depression and rumination through this "lens" of Schemas+Stress. Things are beginning to make perfect sense (finally!!) I hope if you look into it you may get some useful insights as well.

[tinyrabbit]

That sounds great! It's come up in a few threads lately and I have to say I'm fascinated by it.

[glok]

Hello, Onward2wards. It is good you have found a treatment modality that excites you.