The Many of Many Rooms: How Schema Therapy can help you manage BPD

Why are schemas the source of so much identity confusion?

Schemas are cognitive patterns of thinking, which we use to organise and understand ourselves and the world around us. These childhood bundles of thoughts, feelings, memories and sensations, in time become rigid substructures in the adult psyche. The human mind is by nature schematic: Rather than having just one schema, it has many. Schemas not only colour our daily life, but in some cases, stop us seeing completely.

The idea is at least 2250 year history. Beginning with the Greek Stoic philosopher Chrysippus who spoke of “inference schemas” in mathmatics, the idea was soon followed up by the 18th century philosopher Immaneul Kant, then the Edwardian Neurologist Henry Head, and finally 20th century psychologists Jean Piaget and Aaron Beck. All in there on way were arguing for the existence of a blueprint in the mind, body or world from which life can structures itself.

Patterns on a Palimpsest

In 1990 American Psychologist, Dr Jeffrey E. Young created Schema Therapy, a revolutionary treatment programme designed to help individuals with Borderline Personality Disorder become “healthy adults.” For many years schema therapy was overshadowed by more tried and tested therapies like TFP and DBT. However in 2006, the results came in: Schema Therapy works. It’s not just because it’s offers practical treatment but because its theory of personality makes sense.

When Jeffrey Young, was a postdoctorate student working alongside renowned inventor of CBT Aaron Beck at Pennsylvania University, he became aware of certain limitations in traditional therapy. Cognitive-Behavioural Therapy in particular assumes clients will be rational, motivated and clever enough to know their own thoughts and feelings. In an intractable condition like BPD such assumptions are quickly laid to rest. Chronic identity diffusion and instability means we don’t know who we are, let alone how we feel, or what we think. Young believed individuals with Borderline Personality Disorder had deeply entrenched maladapative schemas: Once used as a means of survival, they have now become a chief cause of dysfunction

Schemas arise in youth ‘as reality based representations of the child’s enviroment.’ They are reactivated in adulthood via environmental cues, which trigger an unconscious response based on past experiences. Most individuals diagnosed with BPD, will have experienced varying levels of family dysfunction which inevitably shapes character. At the high end is abuse at the low end criticism. Either/or the results are the same: Maladaptive schemas are created and sustained through an invalidating environment. These patterns of thoughts (I’m worthless, I’m unlovable, I’m no good) feelings (fear, terror, anxiety) and sensations (shallow-breathing, heart-racing, dizziness) carry over into adulthood, and become lens from which we develop a world-view. The Borderline mind is trapped in a schematic prison of childhood suffering and can’t escape.

Lets say your boss threatens you with dismissal: This automatically recreates the feeling of rejection you experienced as a child at the hands of a parent — you feel abandoned. Perhaps your partner criticises you: This spontanouesly recollects you to the reprimands you received as a kid — you feel angry. By transference we then transfer our pain to others, and by counter transference they pass it back. This creates even higher levels of invalidation, pain and suffering. Memories are sticky: Over time thoughts, feelings, and sensations become glued to them. A schema is formed from such a bundle. Every year the burden gets heavier – we want to let go but don’t know how. According to Young there are 18 readily identifiable schemas in personality disorder.

The Mansion of Many Rooms

When you have Borderline Personality Disorder, it often feels like you have multiple personalities existing inside a single self. When triggered we switch between anger, sadness, shame, fear and disgust with such intensity to render the true self obsolete. Sometimes the change is so pronounced that we don’t just switch emotions, we switch characters. Our voice, style of speaking, gait, demeanour, thoughts, beliefs, dreams and memories change so dramatically that it frightens those around us. How many times have I been told: “It’s not you I’m looking at” “Your face changed,” “It was like looking at a mask?” — I’m sure you have your own examples. Don’t worry it’s not demonic possession, it’s switching, but your not switching between personalities your switching between schemas. Some people diagnosed with Dissassocitive Identity Disorder, (what the old timers call Multiple Personality Disorder) may call such schemas alters. Individuals with PTSD or Developmental Trauma Disorder may say they are flashbacks. In my opinion we’re using different words to conceptualise the same thing – with trauma the self broken into fragments and rogue schemas vie for control. Nevertheless the old adage: “Pull yourself together” in this case may be helpful – We have to form a stable identity, and we do so by indentifying the maladaptive schemas and uniting them into a single self.

With each schema you’ll also find an identity. Jeffrey Young called them modes, because they recall a specific mindset. Switching to a different mode is common in BPD. Here’s a listhow many belong to you?

Emptiness or Fullness.

The Romantic poet John Keats wrote that all artists must have “negative capability” to create a masterpiece. This lofty phrase simply means the artist must be empty so that life can flow through him. According to Keats being empty is a good thing: It is the origin of creativity— perhaps that’s why people with Borderline Personality Disorder are often gifted in areas of painting, drawing, writing or music. The dark side of emptiness is that if we’re truly empty, we may be unwittingly open to unwanted guests. However when we think of maladaptive schemas we should never consider them “wrong” or “bad” — at some stage in our life they helped us survive. As adults we attempt to banish them, but like petulant relatives they keep coming back. Schemas always return in the form of thoughts, feelings, bodily sensations, memories, dreams, perceptions. If that’s the case, better to invite them in and listen to what they are trying to say. Observe them closely, watch how they operate, understand what they want.

We all have an “inner child” but people with BPD seem to have more than one. These children – the schemas – continually intrude on the daily life, but what are they trying to tell us? Does the lonely child need befriending? Perhaps the angry child needs to be soothed? Maybe the vulnerable child needs protection, and the impulsive child needs holding? If we have a detached protector he or she needs to be engaged. If we have a punitive parent they should be challenged. The goal of Schema Therapy is to identify the maladaptive schemas, understand how they work and what caused them. We then work to create the “healthy adult” schema and strengthen it to the point it’s always in control

As someone recovering from BPD, I don’t know if the elimination of maladaptive schemas is entirely possible — I also wonder if it’s desirable? After all these schemas are the lost children of our childhood. We don’t have to banish or destroy them, we simply have to recognise them. In doing so we realise this sense of emptiness, is really a vision of fullness. We have so much treasure stored inside us — our hopes, dreams, and wishes, contrast with our bad memories and regrets – yet everything is valuable. We have the power to reinvent ourselves and move forward. We can gather up these old schemas and build a new identity, one which is healthy, adaptive and yet remains committed to the truth. When you first look inside yourself you’ll see chaos but on closer inspection patterns emerge — recognise them. All these fragments can be the material for a masterpiece — your own life.