- The perceived instability or unreliability of those available for support and connection.
- people wont be there for me
the expectation that others will hurt, abuse, humiliate, cheat, lie manipulate or take advantage
Schema: emotional deprivation and the 3 forms
- Expectation that one's desire for a normal degree of emotional support will not be adequately met
- deprivation of nurturance - absence of attention, affection, warmth, or companionship
- deprivation of empathy - absence of understanding, listening, self-disclosure, or mutual sharing of feelings
- deprivation of protection - absence of strength, direction, or guidance
- The feeling that one is defective, bad, unwanted, inferior, or invalid or that one would be unlovable to others if exposed
- i am flawed inside and nobody will love me in the know the real me
Schema: social isolation/alienation
the feeling that one is isolated from the rest of the world, different from other people, and/or not part of any group or community
- belief that one is unable to handle one's everyday responsibilities in a competent manner
- cannot cope with everyday life
Schema: vulnerability to harm or illness schema
- exaggerated fear that imminent catastrophe will strike at any time and that one will be unable to prevent it
- victim of fate/anything can go wrong at any moment and i am powerless
Schema: enmeshment/undeveloped self
forced closeness and feeling smothered
i cannot thrive or achieve/everything is a failure
- i am special and superior to others
- one feels like they should be able to do whatever they want
Schema: insufficient self-control/self-discipline
I cannot make myself do anything (work, school, etc.) and no distress tolerance
- excessive surrendering control to others because one feels coerced
- emotionally blackmailed to put other's needs first
excessive emphasis on gain approval, recognition, or attention from other people, or fitting in, at the expense of developing a secure sense of self
i need to do things for others to be a good person
excessive focus on the negatives in life
Schema: emotional inhibition
- hard time expressing one's self to others, usually to avoid disapproval of others, feeling shame, or losing control of one's impulses
- can be cold/distant
Schema: unrelenting standards/hypercriticalness
one must strive to meet very high internalized standards of behavior and performance, usually to avoid criticism
- the belief that people should be harshly punished for making mistakes
- usually includes difficulty forgiving mistakes in oneself or others
What are the three ways we adapt our schemas/schema coping styles, and which filter the presentation of those schemas?
- surrender (freeze) - giving in to the schema and repeating them over and over
- avoidance (flight) - finding ways to escape of block our schemas
- overcompensation (fight) - doing the opposite of what our schemas make us feel
broad pervasive patterns of beliefs about oneself in relation, formed in youth, derived from youthful negative experiences in which one's normative needs for care, safety, support, affection, etc. were not met, built up over one's life, that result in significant detriment to functionality and quality of life
At what age range do schema form?
5 through early teens
Define an automatic negative thought
simple declarative statements you make to yourself, usually about yourself, consistently negative, which most of the time go through your mind so quickly that they are unnoticed
What are the steps of a self-perpetuating feedback loop of thought, feeling, and behavior
schema ☞ event ☞ thoughts ☞ emotion ☞ body sensation ☞ behavior (back to thoughts and repeat) ☞ resulting in reinforced schema and thoughts
define selective attention
pay attention to events that only reinforce a schema, interpreting events in a way that reinforces a schema
Albert Ellis created what therapy?
Rational emotive therapy (RET) aka Rational emotive behavioral therapy (REBT)
Aaron Beck created what therapy?
Cognitive therapy or cognitive behavioral therapy (CBT)
Donald Meichenbaum created what type of therapy?
- self-instructional training
- stress inoculation therapy
Who was the psychoanalytic thinker who most foreshadowed the ideas of CBT?
Cognitive Distortion: magnification (catastrophizing) or minimization
exaggerate the importance of things, or inappropriately shrink things until they appear tiny
Cognitive Distortion: emotional reasoning
- assume that your negative emotions reflect the way things really are
- i feel, therefore it must be true
Cognitive Distortion: should statements
- motivate yourself with shoulds and shouldn'ts, musts and oughts are also offenders.
- the emotional consequence is guilt
Cognitive Distortion: labeling and mislabeling
- an extreme form of overgeneralization.
- instead of describing your error, you attach a negative label to yourself "i'm a loser"
- the same of someone else's behavior "he's a moron"
Cognitive Distortion: personalization
you see yourself as the cause of some negative external event for which, in fact, you were not primarily responsible
Cognitive Distortion: all-or-nothing thinking
- you see things in black and white categories
- if your performance falls short, you see yourself as a total failure
Cognitive Distortion: overgeneralization
you see a single negative event as a never-ending pattern of defeat
Cognitive Distortion: disqualifying the positive
- reject positive experiences by insisting they do not count for some reason
- you maintain a negative belief that is contradicted by your everyday experiences
Cognitive Distortion: jumping to conclusions and 2 versions of it
- you make a negative interpretation even though there are no definite facts that convincingly support your conclusion
- mind reading - arbitrarily conclude that someone is reacting negatively to you and do not bother to check it out
- the fortune teller error - you anticipate that things will turn out badly and feel convinced that your prediction is an already-established fact
Define cognitive restructuring
teaching clients to identify, analyze, correct, and rewrite automatic thoughts
What are the steps involved in cognitive restructuring
- think back to the most recent bad mood
- identify the emotions that were evoked
- rate the strength of the negative emotions
- identify and write down actual ANT's
- look at evidence for the thought being true
- explain cognitive distortions
- look at the evidence for the ANT is not true
- help the client come up with a replacement thought
- finally have the client re-rate the strength of the negative emotion
What is CBT's greatest success story?
treatment of panic disorder
How many sessions is the treatment for panic disorder?
describe each session of Zuercher-White's CBT treatment for panic disorder
- session 1 - assessment of anxiety symptoms and psychoeducation
- session 2 - covers breathing retaining or diaphramatic breathing
- sessions 4-6 are devoted to cognitive restructuring work
- sessions 7-9 we move on to the introceptive exposure model, which is training the client to elicit paic reponses, and then decondition that response
- sessions 10-12 provides a chance for the clients to continue meeting with the therapist to ensure exposure has worked and beginning the termination process
a fear response in the absence of actual danger
define safety signals
things clients do to make themselves feel safe from panic
What is activity scheduling and what is it used for?
- the most basic of CBT interventions
- used foremost for depression, but also for anxiety, personality disorders, and other issues
- it is designed to get depressed people doing potentially enjoyable activities
who developed schema therapy?
what are the differences between CBT and schema therapy?
schema therapy focuses more on the therapeutic relationship, working on patient affect, more discussion about childhood experiences , and the role of developmental processes
What is the main assumption of schema therapy?
early maladaptive schema are self-maintaining feedback loops
Who created DBT?
Marsha M. Linehan
Who are the target clients of DBT
- mostly borderline clients
- recently has been used with adolescence and chemical dependency treatment
What are the four stages of DBT?
- stage I - move the client towards sufficient behavior control to keep client alive and in treatment
- stage II - addresses the client's inhibited emotional experience
- stage III - focuses on problems in living, with a goal that clients have a life of ordinary happiness and unhappiness, getting off the roller coaster of dramatic events brought on by maladaptive coping styles
- stage IV - less clearly defined, but involves achieving a more profound sense of fulfillment