Lecture 12

Question 1

7 core needs

Answer 1

1. Stability, nurture and safety
2. Autonomy, sense of identity
3. Freedom to express emotion
4. Spontaneity and play
5. Realistic limits and self control

Proposed;
6. Fairness

7. Self-coherence/meaningful world

Question 2

St theory

Answer 2

Unmet core needs/trauma lead to creation of maladaptive schema

These schemas are activated by the environment (eg unfairness, very emotional not so much cognitive) , and that person has to cope with that activation (Temperament influences how you cope)

This puts individual in a schema mode.

Question 3

7 Maladaptive schemas under the core needs

Answer 3

1. Disconnection and rejection (abuse, unsafe)
2. Impaired autonomy and achievement (dependent, vulnerable, underdeveloped)
3. Hypervigilance and inhibition (Negativity, inhibition)
4. Other-directedness (self sacrifice, approval seeking)
5. Impaired limits (Entitlement/grandiosity, insufficient self-control)
6. Unfairness (injustice)
7. Lack of coherence (lack of meaningful world and self-coherence)

Question 4

Schema modes

Answer 4

Mode = the emotional-cognitive behavioural state
- combination of activated schema and coping with that schema
- Modes vary from functional (flexible) to dysfunctional (rigid)

Schema = Trait, Mode = State

Sudden switches of emotions are explained by the switch between different modes. These can be opposing

Question 5

3 types of dysfunctional coping

Answer 5

Surrender:
- Give into schema activation. Believe it’s true (resignation to the schema)
- Like vulnerable child, punitive parent.

Avoidance:
- Avoiding the activation of the schema
- Dominated by avoidance strategies, eg detachment, dissociation

Overcompensation:
- Believing the opposite, fooling yourself
- Coping by inverting the schema, eg self-grandiosity

Question 6

Schema mode model

Answer 6

Done with the patient to explain the activation of the schema modes.

All have healthy adult. Part of them that functions ‘normally’

During treatment, try to enhance the healthy adult and work against maladaptive coping modes.

Question 7

Principles

Answer 7

1. Idiosyncratic schema mode model is central
   - It offers patient and therapists a coherent and continuous understanding.
   - Guides the choice of techniques
2. Therapeutic relationship offers corrective experience
   - limited reparenting. Safety
3. Schema mode dictates what techniques to use
   - The mode that is active/last activated
4. Three focus points:
   - Past, therapeutic relationship and present outside therapy
5. Three channels of change
   - Experiential, cognitive, behavioural
6. Ultimate change is healing the vulnerable child and strengthening the healthy adult

Question 8

Treatment research

Answer 8

ST has lower dropout compared to lot of other types.

+ Deeper reduction of PD severity

In group therapy:
Most effective, but only in combo w individual treatment (lower severity + lower dropout)