Schema Therapy for Emotional Dysregulation: Theoretical Implication and Clinical Applications

Abstract

The term emotional dysregulation refers to an impaired ability to regulate unwanted emotional states. Scientific evidence supports the idea that emotional dysregulation underlies several psychological disorders as, for example: personality disorders, bipolar disorder type II, interpersonal trauma, anxiety disorders, mood disorders and post-traumatic stress disorder. Emotional dysregulation may derive from early interpersonal traumas in childhood. These early traumatic events create a persistent sensitization of the central nervous system in relation to early life stressing events. For this reason, some authors suggest a common endophenotypical origin across psychopathologies. In the last 20 years, cognitive behavioral therapy has increasingly adopted an interactive-ontogenetic view to explain the development of disorders associated to emotional dysregulation. Unfortunately, standard Cognitive Behavior Therapy (CBT) methods are not useful in treating emotional dysregulation. A CBT-derived new approach called Schema Therapy (ST), that integrates theory and techniques from psychodynamic and emotion focused therapy, holds the promise to fill this gap in cognitive literature. In this model, psychopathology is viewed as the interaction between the innate temperament of the child and the early experiences of deprivation or frustration of the subject’s basic needs. This deprivation may lead to develop early maladaptive schemas (EMS), and maladaptive Modes. In the present paper we point out that EMSs and Modes are associated with either dysregulated emotions or with dysregulatory strategies that produce and maintain problematic emotional responses. Thanks to a special focus on the therapeutic relationship and emotion focused-experiential techniques, this approach successfully treats severe emotional dysregulation. In this paper, we make several comparisons between the main ideas of ST and the science of emotion regulation, and we present how to conceptualize pathological phenomena in terms of failed regulation and some of the ST strategies and techniques to foster successful regulation in patients.

The Effects of Schema Therapy on Emotional Self-Awareness, Vulnerability, and Obsessive Symptoms Among Patients with Obsessive-Compulsive Disorder

“…These findings were in agreement with the findings reported by Dadomo et al, and Fassbinder et al, (18,19). According to Young, these two schemas are related to the fulfillment of basic human needs such as the needs for being loved by others, worthiness, attention, intimacy, care, self-expression, and emotion expression without any fear over punishment (7).…”

“…Any problem in each of these dimensions plays a significant role in the development of mental disorders. Schema therapy holds that cognitive therapy cannot regulate emotions and hence, experiential techniques are used to help patients express and manage their emotions as healthy and mature humans (18,19). , also reported the effectiveness of schema therapy in alleviating emotional inhibition, emotional deprivation, and symptoms among patients with social anxiety disorder (20,21).…”

Seeing emotions, reading emotions: behavioral and ERPs evidence of the effect of strategy and of regulation for pictures and words.

“…In daily life, we usually express emotions by means of words, and we react with emotions to other people Emotion regulation and ERP words. A case in point, is what happens during a psychotherapy session where the clinician uses language to elicit and regulate patients' emotions, and to understand the emotional states of patients by listening to their words [4,1,2]. Freud defined psychotherapy "a cure through words" [5]: a cure to help patients express and possibly regulate linguistic contents.…”

Cognitive-Behavioral Theory and Treatment of Antisocial Personality Disorder

“…After the deactivation, more adaptive and functional mode is introduced with some cognitive and experiential techniques which we will mention in the following chapters [33]. During this process, after identifying early maladaptive schemas, it is crucial to notice and validate the client's unmet emotional needs.…”

“…The last one "contended child" is the mode in which the basic needs of the child are met. Child modes are assumed to be universal and congenital [33].…”