Imagery Assessment & Schema Therapy

Child with glasses on thinking and a thought bubble coming from his head

Imagery Assessment was the input for the ACT Counselling Services ‘Practising Schema Focused Therapy’ course yesterday evening. Again, on creating and delivering the input we were reminded how powerful imagery assessment is. Imagery Rescripting etc is arguably more powerful and we will focus on this in a future blog.

So what is the value of Imagery Assessment and why is it used in Schema Therapy?

It is important within the Assessment and Education phase of Schema Focused Therapy that the client’s Schemas are accurately identified. The mistake that a lot of Practitioners make is that they provide the client with extensive information and psycho-education as regards schemas. They then administer one or more inventories to help identify the client’s schemas. At this point if the client’s hypothesised schemas match with the high scoring schemas on the inventories then the Practitioner is satisfied that enough information has been gathered to state with surety that ‘this is one of your schemas.’

How are Schemas stored?

The above, of course, is not enough. How can it be? All of the above is related to logic, words and numbers. This is the fundamental flaw as schemas are stored deep in the reptilian part of our brains, in the amygdyla. Schemas are stored in early childhood with images and a high level emotion attached to them. Thus, they are not stored with any logic, words, numbers or explanations attached to them. As a result, schemas must be triggered and felt by the client on an emotional level before client and therapist can be sure that this is a schema belonging to the client.

Imagery Assessment is the main assessment methodology that is used to identify schemas accurately. To find out more about this technique, see how it is used, and practise using it, please refer to our ‘Practising Schema Focused Therapy’ short course information section of this website, where course information and booking instructions can be found.

 

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ACT Counselling’s New Schema Therapy Course…

Clock saying time to learn

Last night was the very first evening of the new ACT Counselling Services ‘Practising Schema Focused Therapy’ — an approach by Jeff Young 10 week course. This course has been a long time in coming as we have been asked to build upon our ‘Introduction to Schema Therapy’ one day CPD event for several years now. We are really pleased with the materials that we have written and it was good to get week 1 underway in order to give them their maiden voyage.

We were reminded in both the writing of the materials and in last night’s delivery of the complexity of Schema Therapy but also of the power to effect change in clients with complex and enduring Mental Disorders.

Last night saw us visit the educational phase involved in Jeff Young’s approach. There were a couple a few points that gave the course team cause for reflection. Firstly the unconscious drive with people with a personality diagnosis to continue to confirm the validity of the Schema, and any information which does not do so is either avoided, distorted or ignored. So the client with an Abandonment schema will unconsciously behave in a way that leaves them abandoned by others. The client with a Defectiveness schema will unconsciously behave in a way that confirms their ‘not good enough’ view of self through self sabotage or being overly perfectionistic.

Heads made up of cogs

The next point we wish to make is that of the gap between cognitions and Schemas. This leads to a cognition and emotion mis-match. So although the person with the Abandonment Schema knows that the evidence disputing their ‘people close to me will leave me’ cognitions to be true, IT DOES NOT FEEL LIKE IT. The person with the Mistrust/Abuse Schema knows the evidence disputing ‘my Partner will let me down’ is true, again, IT DOES NOT FEEL LIKE IT. It is this that leads to Schemas being largely worked on with affect and imagery. Cognitive disputing on its own will do very little to affect change.

The last point we wish to make and this is often insightful for Practitioners is that the first 7 Schemas are the core Schemas and the remaining 11 can be attempts to cope with the first 7. This often confuses Practitioners as the first 7 come from the Disconnection/Rejection domain and the remaining 11 come from other domains. The point is that domain 1 (the disconnection/rejection domain) is the conditions that lead to the formation of core schemas. The remaining 4 domains are the conditions of worth set by the family, classroom or playground for the client to escape the core schema. Still confused, then get in touch and enrol for our next course.

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Rules for Living Part 2

Human beings have an enormous amount of information to process on a daily basis through the senses and belief systems. If every experience was treated as a brand new experience or situation then life would be unbearable. We therefore learn to anticipate and predict. These anticipations and predictions are carried in the unconscious mind and enable us to live the majority of our lives on auto pilot. Examples of unconscious daily predictions are:
If i stand on the floor then it will take my weight
If i push the handle then the door will open
If i smile at someone then they will smile back
If i turn the key in the ignition then the car will start
What would or do we do if the predictions outlined above do not work? We have to think in order to generate new ones:
If i stand only on the beams then i’ll be supported
If i kick the door down then it will open
If i smile at most people then they will smile back
If i phone the AA then they will help me
Anything familiar about the structure of the above? Yes indeed, the same structure and exact same concept as ‘Rules for Living.’ We are of the opinion that the vast majority of people referring themselves for therapy, it is because their rules/predictions are either not working, causing too many problems, too exhausting or they have collapsed altogether. So therapy is that time of constructive revision, where the therapist and client collaboratively work together to generate new ones. The first point that we want to make is that if the client could have done this for them self then they would not be in therapy. The next point is the importance of a prediction, either positive or negative lying behind any behavioural experimentation. We are probably leaning mostly towards the CBT approach here; it is a scientific approach that sets experiments. An experiment must be testing something, this leads to lasting, enduring and elegant change.

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Rules for Living Part 1

Image saying do we have rules

The ACT Team are fresh from delivering another 3 day ‘Introduction to the Theory and Practice of Cognitive Behavioural Therapy’ course. As we have come to expect, the participants were a pleasure to work with and the time passed by so quickly.
The course requires participants to examine their own childhood experiences and the resulting self defeating behavioural patterns. The participants were quick to identify these and also quick to realise that it is not necessarily about completely changing the rules that drive the self defeating behaviours but just altering, adjusting or updating the rule. (more…)

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Solution Focused Practice

Man looking a stunning view of lake and mountains

I recently attended a conference on children’s services within Glasgow where 2 of the keynote speakers highlighted the need to shift away from “labelling” or diagnosing mental health problems in children and move towards “case formulations”. They proposed that we should be thinking from the outset, in partnership with the child and their family about what the difficulties are that need to change and what goals we would like to achieve (ie what changes do we want to see in the child’s mood, behaviour, presentation etc). We would then move on to think about how we are most likely to achieve these goals. (more…)

Categories: CBT
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Being Married to a CBT Therapist…

In the 10+ years that I have known my wife she has always been involved in helping people in some way, both in her professional life as well as her personal one. Throughout this time she has always had a fascination with what “makes people tick” and a real skill for developing relationships with people and getting them to see things from a different point of view. (more…)

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Anxiety and Internalised Rules

Hands holding a chestnut with a conquer in it

Whilst thinking about the shaping of the personality during childhood in our last blog, it occurred to me that it would be a disservice not to reflect on the connection between force feeding infants and the internalisation of beliefs, rules and values. Many of these will of course be crucial in developing the child as a family member and social human being. They will fit well with the child’s temperament and personality and will serve them well throughout their life. What about the ones that don’t fit though and cause the developing person endless psychological distress (varying levels). (more…)

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Thoughts from Diploma Course: WK 1; relapse prevention

First weekend of 2016 and the staff and students can’t believe how quickly time has gone! The usual post Christmas chat began, where people discussed what they did, or what little they did over the holiday. What they ate, drank, who they saw (because well its family and I need to visit), how stressful it is going round seeing everyone. A lot of people doing things that they really don’t want to do! (more…)

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Gestalt – a way of living. CPD Course.

Dirt track leading towards a sunset with trees and shrubs on either side

The ACT Team have an up and coming CPD event on 20/02/16 titled ‘Gestalt — a way of living.’ Whilst preparing the course materials we cannot help but remember the insight and power connected with this approach and its ability to help us as human beings make sense of our lives. (more…)

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Ellis’ Absolutistic Beliefs

Stones balanced on top of each other with sunset in background and stones reflection on the surface beneath

Still thinking about thinking, the ACT Team were recently discussing Albert Ellis who as many of our readers will know was the founder of Rational Emotive Behavioural Therapy (REBT), one of the approaches that influenced Aaron Beck’s development of CBT. (more…)

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