One of Melissa’s more accomplished therapeutic achievements is gaining certification as an advanced certified individual schema therapist/supervisor. She is one of few certified at this level in Australia and internationally, by the International Society of Schema Therapy (ISST). Melissa’s certifications involved hours of supervision together with filming sessions, rated by independent assessors appointed by the ISST.
Melissa’s schema therapy is offered with a high level of skill and expertise. Schema therapy focuses on healing the origins of schemas, thereby reducing unhelpful ways of coping and helping you find improved potential. Anyone can benefit from schema therapy; it is particularly useful for addressing eating disorders, personality disorders, childhood traumas, addictions, unwanted sexual behaviours, relationship concerns, conflicting couples, workplace performance, and children with fears and low self-esteem.
What are schemas, and how do you know if you have them? Everyone to some degree has schemas — which develop as a result of unmet needs. No one goes through life with all their needs being met; for example, there would be times that you wouldn’t have felt safe, that people didn’t spend enough time with you, or if you were put down and made to feel like you weren’t good enough.
When these types of needs are not met, schemas can develop. Schemas are noticeable in our thoughts, body sensations, and feelings. They are like a filter through which you see life, and are often negative in nature. It is like putting a pair of glasses on and seeing the world through that lens. Some people may associate with several schemas while others may have fewer.
For information about the schemas, click on each of them below.
The perceived instability or unreliability of those available for support and connection. Involves the sense that significant others will not be able to continue providing emotional support, connection, strength, or practical protection because they are emotionally unstable and unpredictable (e.g., angry outbursts), unreliable, or erratically present; because they will die imminently; or because they will abandon the patient in favour of someone better.
Excessive emphasis on gaining approval, recognition, or attention from other people, or fitting in, at the expense of developing a secure and true sense of self. One’s sense of esteem is dependent primarily on the reactions of others rather than on one’s own natural inclinations. Sometimes includes an overemphasis on status, appearance, social acceptance, money, or achievement — as means of gaining approval, admiration, or attention (not primarily for power or control). Frequently results in major life decisions that are inauthentic or unsatisfying, or in hypersensitivity to rejection.
The feeling that one is defective, bad, unwanted, inferior, or invalid in important respects; or that one would be unlovable to significant others if exposed. May involve hypersensitivity to criticism, rejection, and blame; self-consciousness, comparisons, and insecurity around others; or a sense of shame regarding one’s perceived flaws. These flaws may be private (e.g., selfishness, angry impulses, unacceptable sexual desires) or public (e.g., undesirable physical appearance, social awkwardness).
The excessive inhibition or disconnection of spontaneous emotion, action, or expression, due to underlying shame/embarrassment. It involves inhibition of both negative impulses (e.g., anger, aggression, sadness) and positive impulses (e.g., joy, affection, sexual excitement, play), difficulty expressing vulnerability or communicating freely about one’s thoughts, feelings, and needs, or excessive emphasis on rationality over emotions. There may be a sense of pride in being ‘a rational person’, or the moral/ethical value in one’s stoicism.
Core beliefs/thoughts can include: ‘Showing emotions means I am weak/vulnerable’, ‘I am strong because I’m not swayed by my emotions’, ‘It is foolish to be emotional’. Diagnostic characteristics and clinical presentation can include alexithymia, anhedonia, dysthymia, perfectionism, schizotypal or avoidant personality disorders, autism spectrum.
Origins of this schema may have involved family/peer/cultural environments where:
The expectation that one’s desire for a normal degree of emotional support will not be adequately met by others. The three major forms of deprivation are:
Excessive emotional involvement and closeness with one or more significant others (often parents), at the expense of full individuation or normal social development. Often involves the belief that at least one of the enmeshed individuals cannot survive or be happy without the constant support of the other. May also include feelings of being smothered by, or fused with, others, or insufficient individual identity. Often experienced as a feeling of emptiness and floundering, having no direction, or, in extreme cases, questioning one’s existence.
The belief that one is superior to other people, entitled to special rights and privileges, or not bound by the rules of reciprocity that guide normal social interaction. Often involves insistence that one should be able to do or have whatever one wants, regardless of what is realistic, what others consider reasonable, or the cost to others. Or, there is an exaggerated focus on superiority (e.g., being among the most successful, famous, wealthy) — to achieve power or control (not primarily for attention or approval). Sometimes includes excessive competitiveness towards, or domination of, others: asserting one’s power, forcing one’s point of view, or controlling the behaviour of others in line with one’s own desires — without empathy or concern for others’ needs or feelings.
The belief that one has failed, will inevitably fail, or is fundamentally inadequate relative to one’s peers, in areas of achievement (e.g., school, career, sports). Often involves beliefs that one is stupid, inept, untalented, ignorant, lower in status, or less successful than others.
The excessive inhibition or disconnection of spontaneous emotion, action, or expression, due to a fear that one would otherwise lose control of their impulses resulting in dire consequences. This may include fears of being overwhelmed by emotions (e.g., panic, fear or despair), fears of others’ response (e.g., abandonment/rejection, ridicule, judgement), fears of harming self/others (e.g., if giving in to aggressive impulses or intrusive thoughts), fears of ‘overindulging’ (e.g., losing control of spending, eating). There may be an excessive preoccupation with one’s internal state and how one appears to others. This anxious/dysregulated presentation is distinct from the more shame/pride-based presentation of Emotional Constriction.
The diagnostic characteristics and clinical presentation include: disorders in which symptoms begin to take a life of their own (e.g., panic disorder, violence/sexual-based OCD, addiction, PTSD, bipolar, social anxiety, ADHD. The core beliefs/thoughts include: ‘If I show how I really feel it will hurt others’, ‘If I let my emotions go, I won’t be able to stop’, ‘Showing/expressing my emotions leads to damage’.
Origins of this schema may have involved family/peer/cultural environments where:
The belief that one is unable to handle one’s everyday responsibilities in a competent manner, without considerable help from others (e.g., take care of oneself, solve daily problems, exercise good judgement, tackle new tasks, make good decisions). Often presents as helplessness.
Pervasive difficulty or refusal to exercise sufficient self-control and frustration tolerance to achieve one’s personal goals, or to restrain the excessive expression of one’s emotions and impulses. In its milder form, one presents with an exaggerated emphasis on discomfort-avoidance: avoiding pain, conflict, confrontation, responsibility, or overexertion — at the expense of personal fulfilment, commitment, or integrity.
The expectation that others will hurt, abuse, humiliate, cheat, lie, manipulate, or take advantage. Usually involves the perception that the harm is intentional or the result of unjustified and extreme negligence. May include the sense that one always ends up being cheated relative to others or ‘getting the short end of the stick’.
A pervasive, lifelong focus on the negative aspects of life (pain, death, loss, disappointment, conflict, guilt, resentment, unsolved problems, potential mistakes, betrayal, things that could go wrong, etc.) while minimizing or neglecting the positive or optimistic aspects. Usually includes an exaggerated expectation– in a wide range of work, financial, or interpersonal situations — that things will eventually go seriously wrong, or that aspects of one’s life that seem to be going well will ultimately fall apart. Usually involves an inordinate fear of making mistakes that might lead to financial collapse, loss, humiliation, or being trapped in a bad situation. Because potential negative outcomes are exaggerated, these patients are frequently characterized by chronic worry, vigilance, complaining, or indecision.
Hypocriticalness towards others’ mistakes, suffering, or imperfections. Involves a belief that others should be punished or held accountable for their indiscretions, a tendency to ignore extenuating circumstances and naturally human error, and preoccupation with concepts of justice. There is often anger, impatience, and intolerance felt towards others and difficulties with empathising and forgiveness. This harsh externalised process may alienate the individual from relationships with others, which is in contrast to Punitiveness (Self). Origins of this schema may have involved environments where:
a) there was an excessive emphasis on adherence to rules, procedures, and regulations (e.g., military families, authoritarian parenting style);
b) caregivers modelled an externalised coping style (e.g., blamed others, fail to take responsibility for self) and/or cynical worldview;
c) the child was often unfairly blamed (e.g., the child was punished for another’s wrongdoing) or child witnesses injustices (e.g., bad things happening to “good” people and good things happen to “bad” people) Core beliefs/thoughts: “If people do the wrong thing, they should get what they deserve” “It’s all their fault” “It’s not fair” “There’s no excuse for mistakes” Diagnostic characteristics and clinical presentation: antisocial, narcissistic, borderline, or histrionic personality disorders, injustice-based PTSD or complex grief, anger/aggression.
Self-directed hypocriticalness towards one’s own mistakes, suffering, or imperfections. Involves a belief that one should be punished or held accountable in some way for failing to meet expectations, tendency to ignore extenuating circumstances, and an excessive sense of responsibility leading to self-blame, self-directed anger, and difficulty forgiving oneself. This internalised process may not necessarily be reflected in their expectations of others, thereby to some degree ‘preserving’ interpersonal relationships. Origins of this schema may have involved environments where: a) mistakes lead to dire/fatal consequences (e.g., war/military contexts); b) the child was severely punished for making mistakes or committing minor indiscretions; c) there was significant abuse (physical, emotional, psychological) with little/no provocation; d) caregivers were neglectful or abusive unless the child met exceedingly high standards (whether explicit or implicit) for behaviour/achievement Core beliefs/thoughts: “It’s all my fault” “I should have…” “There’s no excuse for my behaviour”, “I deserve to be punished” Diagnostic characteristics and clinical presentation: depression, anxiety, eating disorders, self-harm, perfectionism, OCD, guilt and shame-based PTSD or complex grief, BPD/CPTSD, ADHD.
Excessive focus on voluntarily meeting the needs of others in daily situations, at the expense of one’s own gratification. The most common reasons are to prevent causing pain to others; to avoid guilt from feeling selfish; or to maintain the connection with others perceived as needy. often results from an acute sensitivity to the pain of others. Sometimes leads to a sense that one’s own needs are not being adequately met and to resentment of those who are taken care of. (Overlaps with concept of co-dependency.)
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.
Excessive surrendering of control to others because one feels coerced – – usually to avoid anger, retaliation, or abandonment. The two major forms of subjugation are: a. Subjugation of Needs: Suppression of one’s preferences, decisions, and desires. b. Subjugation of Emotions: Suppression of emotional expression, especially anger. Usually involves the perception that one’s own desires, opinions, and feelings are not valid or important to others. Frequently presents as excessive compliance, combined with hypersensitivity to feeling trapped. Generally, leads to a build-up of anger, manifested in maladaptive symptoms (e.g., passive-aggressive behaviour, uncontrolled outbursts of temper, psychosomatic symptoms, withdrawal of affection, “acting out”, substance abuse).
The underlying belief that one must strive to meet very high internalized standards of behaviour and performance, usually to avoid criticism. Typically results in feelings of pressure or difficulty slowing down; and in hypocriticalness toward oneself and others. Must involve significant impairment in pleasure, relaxation, health, self-esteem, sense of accomplishment, or satisfying relationships. Unrelenting standards typically present as:
(a) perfectionism: inordinate attention to detail, or an underestimate of how good one’s own performance is relative to the norm;
(b) rigid rules and “shoulds” in many areas of life, including unrealistically high moral, ethical, cultural, or religious precepts; or
(c) preoccupation with time and efficiency, so that more can be accomplished.
Exaggerated fear that imminent catastrophe will strike at any time and that one will be unable to prevent it. Fears focus on one or more of the following:
(a) Medical Catastrophes: e.g., heart attacks, AIDS;
(b) Emotional Catastrophes: e.g., going crazy;
(c): External Catastrophes: e.g., elevators collapsing, victimized by criminals, airplane crashes, earthquakes.
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