Schema Therapy

ISSUE 14
Bulletin
Approaches to Family Work
Greetings!
Using Schema Therapy
In Issue 14 we bid Chris Hayes a fond farewell, and welcome Finally, Matthias Krüger, in his article Imaginative Family-Constellation-Description of the

Susan Simpson to the role as Secretary of the ISST board, Method and Case study, uses a case presentation to demonstrate a protocol creating an

and co-editor of the Schema Therapy Bulletin. Imaginative Family-Constellation to rescript painful or traumatic childhood experiences,

with the goal of relieving a patient of the burden of enmeshment with her family of origin.
This issue highlights the innovation of our membership in using Schema
This approach draws from the work of Bert Hellinger’s conceptualisation of the family
Therapy to work with families and family issues in different ways.
constellation.
Dr. Phil. Anousha Hadinia & Dipl.-Psych. Jan Kossack, in their article Schema-

Mode-based Family Therapy: a multigenerational & intercultural approach This work helps to heal parents’ early maladaptive schemas so
describe their work integrating schemas and modes into Andolfi’s family therapy
that parents are less likely to parent in response to their own
approach to create a Schema Mode Based, multigenerational family therapy.
triggers, and be better able to meet their children’s core needs.
Christof Loose, Schema Therapy for Parents
Using Young’s Schema Questionnaire, and Loose, Graaf & Zarbock Schema Questionnaire

designed for children, along with a number of creative experiential techniques, they work on For our Meet the Board Column this edition, Vivian Francesco shares an interview she carried

healing families by healing schemas. out with Susanne Vind, the new Vice President of the ISST.

In his article: Schema Therapy for Parents, Christof Loose outlines how by working with Our next issue will feature presentations from the recent ENLIGHT Conference held in

parents to understand their own schemas and modes, as well as the origins of these schemas/ Edinburgh in Spring 2019.

modes, therapists can help parents to learn to meet their own needs in addition to those of

their child. Loose illustrates this through a case presentation.

If you have an idea for an article for a future issue of the Schema Therapy Bulletin, or an event

that you would like listed in the Bulletin’s Calendar please let us know!

Lissa Parsonnet (USA) and Susan Simpson (Scotland), Co-Editors

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 INTERVIEWS WITH

Schema Therapists How did you first learn about Schema

Therapy?
How did you get your training in
schema therapy?
That was in 2003... I was originally Well I got it since I met Jeff and I
AN INTERVIEW WITH SUSANNE VIND
educated in group psychanalysis for arranged for him to come to Denmark
May 23,2019 3 years and then cognitive therapy numerous times. I also went to Cape
became popular in Denmark so I ed- Cod to attend one of the summer
ucated myself as a cognitive therapy schools with Jeff and Travis Atkinson
supervisor. All the time I was kind of featuring couple therapy probably
frustrated that the two lines of therapy in 2005. I attended the international
criticized each other. So, the first time training with Travis and Poul Perris
Jeffrey Young came to Denmark I in New York roughly in 2006 and was
thought, he has found a way to combine fortunate enough to have Jeff supervise
these two and use the best of them me throughout my training. Then I
and add the more experiential part, trained with Joan Farrell and Ida Shaw
and to me this is really what we want! in group schema therapy and now my
When I heard him for the first time practice includes individual, group and
I was hooked; I knew, this is my way. couples work along with training and
What role do you play on the ISST board? What made you want to accept that role? supervision.
I am the new Vice President of the ISST. This actually came to be when I found out I would be in
charge of the next conference in Copenhagen, Denmark. I had not thought about it because it is
such a small country but several people... approached
me about it and so I thought that would be neat. So
that’s how I got into both roles; by simply starting to “
..to make a conference for members to be
able to achieve a lot of inspiration, knowledge
organize! Also, I had organized lots of major workshops
and connection which fits with the core of
and conferences because I used to be the president of

”
schema therapy.
the CBT society. I was previously on the board of the
Danish Medical Specialists with 5,000 members for four
years, and so I had previous experience. Once I began thinking about this position, I thought, yes,
I would really like to do it... to make a conference for members to be able to achieve a lot of
inspiration, knowledge and connection which fits with the core of schema therapy.

Schema therapy’s original theory and approach,

is the beating heart around which we approach our
therapy and should consistently be the heart beating
in whichever way we use our therapy
Susanne Vind, Vice President ISST

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What do you see in the future for the evolution of schema therapy and the ISST?

I see that we will be growing at a fairly steep curve from now on internationally and I see that
we have an assurance of quality within the various programs going on throughout the world.
We will have a uniform base and we can always build on that while maintaining space for AN INTERVIEW WITH SUSANNE VIND
specific interests that each of us can add but the actual training program will have a uniform
by Vivian Francesco
base for quality control.
How do you get into your “happy child mode”?
I’m on the case conceptualization committee, the supervisor skills development committee
I really enjoy spending my free time outdoors playing golf, going for walks, going to the beach
and the quality assurance committee. I think it’s so important that we spend more time with
and being outside with friends. I just like to have nature around me... its really nice. And good
the supervisors which I know Jeff Conway is planning on already. We have created a webinar
music, happy songs... I like that.
for the new supervisors and that’s important to help them gain more self-assurance
I especially felt in my happy child at the gala in Edinburgh when the music was playing and all
How do you enjoy spending your free time? of us good friends were dancing in 2’s and 3’s and groups just losing ourselves in the music and
I spend my free time with close friends of many years and we play golf fun and laughter!
and have fun together. Its so nice to have that and you know I have
friends here as well as schema friends all over the world with whom
I communicate frequently and I appreciate that.

Are there any other thoughts or ideas you would like to share with the ISST family?

I appreciate so much the development of schema therapy over the years. The core value has
been maintained while at the same time expanding the various branches. So, the core value in
our hearts is keeping that feel in our therapy with our clients and supervision along with the
therapeutic approach. Schema therapy’s original theory and approach, including the mixing
in of reparenting, I think, is the beating heart around which we approach our therapy and
should consistently be the heart beating in whichever way we use our therapy.

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Forthcoming Dates for your Diary
ISST Conference

Copenhagen INSPIRE 2020 - May 28-30, 2020

ISST Webinar Series

(hosted by Susan Simpson, Chris Hayes and Andrew Phipps)

Topic: ‘Contextual Schema Therapy’

Presenter: Rob Brockman, Host: Andrew Phipps
Date: 8th July, 2300 UTC
(9th July, 0900, Australian Eastern Standard
Time; AEST).

Topic: ‘Treating chronic depression with

Schema Therapy’
Presenter: Ruth Holt, Host: Andrew Phipps
Date: 29th Aug, 2300 UTC
(30th August, 0900, Australian Eastern Standard
Time; AEST)

Topic: ‘A Closer Look at Enmeshment &

The Undeveloped Self’
Presenter: Jeff Conway, Host: Chris Hayes
Date: October 14th, 1230 UTC
(October 14, 0830 NYC (EDT))

Topic: ‘Transformational Chairwork and the

Four Dialogues
’Presenter: Scott Kellogg, Host: Susan Simpson
Date: 11th Dec 1500, UTC
(11th Dec, 1000, NYC).
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 ARTICLE

Imaginative Family-Constellation
DESCRIPTION OF THE METHOD AND CASE STUDY MAT THIA S KRÜGER , FRIEDRICHSHAFEN, GERMAN Y

positive effect (gain of self-efficacy and an altered “self-concept”), C A SE STUDY

followed by a deterioration. The therapeutic hypothesis is that
Brigitte S, 51 years old, was first psychiatrically treated as an
the dysfunctional emotional and behavioral patterns were so
inpatient at the age of 28. Since then, she has had 31 inpatient
strong, that the “positive irritation”, evoked by the imaginative
psychiatric hospitalisations, as well as several ambulant
constellation, which led the patient into “unknown possibilities”
psychotherapeutic treatments and stays in day treatment
could not last: she returned to her dysfunctional, but known and
clinics. She was diagnosed with Borderline Personality disorder
well trodden patterns and habits. Nevertheless, the imaginative
and Posttraumatic stress disorder. The main symptoms were
family constellation highlighted the long term goal of the therapy:
suicidality, self-harming behavior, depression and anxiety.
disentangling from the enmeshment of the family, establishing
a self-concept beyond the one of being a ‘victim’ and thereby Since the age of 41 she has received a pension due to severe
gaining self-efficacy. The therapeutic work must include all levels reduction of her earning capacity. At the time of treatment she
–emotional, cognitive, behavioral, in order that change can occur was working in a workshop for psychiatric disabled people. She
in a sustainable way. was living alone, supported by social-psychiatric services.

The family relations and early

THE THER APEUTIC H Y POTHE SIS IS THAT THE DYSFUNC TIONAL experiences in childhood were
EMOTIONAL AND BEHAV IOR AL PAT TERNS WERE SO S TRONG, harmful: she felt she was not loved
THAT THE “POSITIV E IRRITATION”, E VOKED BY THE IMAGINATIV E and accepted by her parents, who
CONS TELL ATION, WHICH LED THE PATIENT INTO “UNKNOWN gave her the feeling of “being
POSSIBILITIE S” COULD NOT L A S T
a burden” on them. She was
physically and sexually abused by
her elder brothers from the age of 6
This article describes the method of the “imaginative family
to 12. The sexual abuse first occurred via seduction, then physical
constellation”. The basic assumptions of, and rationale for
force. Despite this, she continued to visit her family several
this approach will be explained, and illustrated through a
times a year (she was living in an area 150 miles away from her
case study of a woman treated using this approach as part of a
hometown), even though this triggered memories associated with
schema therapy treatment plan.
the emotional, physical and sexual abuse. She still felt connected
The patient described in the case study was suffering from and bound to her family. She had built up a positive relationship
traumatic experiences in early childhood (abuse and neglect). with the children of her (formerly abusive) brother. Both parents
The imaginative family constellation was used to help the died a few years previously.
patient to overcome the internalisation processes which
occurred in the context of these early traumatic experiences. THE PSYCHOTHER APEUTIC APPROACH
The intervention was intended help her to break free from the
We worked with the patient employing a schema therapeutic
enmeshment with the family. The case study describes the
model for understanding and processing experiences.
therapeutic process that took place: a marked, but not lasting

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 Additionally, the ”imaginative family constellation“ was applied, in order to enable the patient to It is a “timeless” inner picture, which is simply “felt” and not necessarily “proved” by any outer reality.
ARTICLE: THE IMAGINATIV E FAMILY- CONS TELL ATION

experience the destructive, life-denying and self-esteem-lowering messages as ego-dystonic, and to

“give back” those attitudes to their original sources. Via this method the patient can be supported in Adopted from the Hellinger approach is the idea that there is somewhere that represents
“externalising” and processing these “poison” messages, which were internalised in the past through
“THE RIGHT PL ACE” OR AT LE A ST “A GOOD PL ACE” IN THE INNER FA MILY PICTURE ,
traumatic experiences. In other words this method can support the patient in defeating (overcoming)
as well as places where it is hard for the child to find a stable footing. In “the good place”
the “enmeshment”, which occurred in the context of the traumatic experience.
the child is not burdened by events, actions and processes that are not within his/her
THE R ATIONALE AND METHOD OF THE “IMAGINATIVE FAMILY CONSTELL ATION” responsibility and not “belonging to him/her”.

The “Imaginative Family constellation“ is based on the idea that children are highly dependent on their
family and potential care-givers, and therefore “enmeshment” is part of our evolutionary ‘program’.
The child is positioned in line and on the level with his/her siblings, not on the level of parents. When
The early experiences and the explicit and implicit messages of the relevant persons serve as elements
positioned in the ‘ideal’ position within the “ideal inner picture“ of the family, s/he is thankful for his
by which the child constructs its reality and self-concept. At this point it needs to be explained, why
parents “being parents” and “bringing him/her into life“ (but not necessarily thankful for their deeds)
– with similar experiences, different children internalise different messages and meanings. And it
and he takes the perspective that his parents are “behind him, looking on with a friendly perspective in
needs to be explained why some persons who have experienced trauma and neglect are successful in
terms of the way he/she chooses to go in life“ . In this position the child feels energised and encouraged
“handling the trauma“ by either not internalising as an attack on their self-esteem (“I am a worthless
to “make his own way“ – responsibly, free from enmeshment and problematic bondings.
person“) or by externalising the [formerly internalised] harming self-messages in a balanced way (“my
parents were not able to care for me as their child in a proper way and treated me in a very mean way; As a method, the “imaginative family constellation“
but therefore I am neither mean nor worthless”). is viewed as an individual psychotherapeutic
technique. The target area is the patient and his
THE “INNER REPRESENTATION” OF THE FAMILY inner representation of his/her family, as well as the
The inner representation of the family and the “place we give ourselves in this inner representation” is place where he/she positions him/her-self in that
seen as a mediating factor which can help to explain the phenomenon of why sometimes trauma and inner picture. This technique can support him/her
neglect contribute to a weak and negative self-esteem and a problematic self-concept (worthlessness) in disentangling enmeshment and freeing him/her-
- and sometimes they do not. self from the burden placed on him/her by another
person in the family system. “Giving back that burden” is therefore functionally corresponding to the
This approach recurs on aspects of the work of Bert Hellinger and his approach of “Family
“disempowerment” of the parental modes in the classical schema therapeutic work. The “power” of the
Constellations” (1).
dysfunctional parental messages results from being enmeshed with the parents.
The most relevant and basic idea adopted from Hellinger´s approach is that there is something
like an “inner representation“ of the family and that in this representation the relevant persons
are placed in accordance to their relationship to one another: some are closer, some are THE IMAGINATIVE FAMILY- CONSTELL ATION A S A SPECIAL FORM OF IMAGERY RESCRIPTING

more distant, some are “within view of the other“, some refuse this view. Implicitly we give As in schema work with the “Vulnerable Child”, in imaginative rescripting the child receives understand-
our self a position in this inner picture. The patient is asked to bring this “inner picture out” ing, caring and support from their own Healthy Adult and/or any other assisting person. In the imagina-
by using representative figures, putting them in relation to each other on a blank board. This tive family constellation the enmeshed child is guided to his “solved” and “good place” and receives en-
“representation” is the subjective felt “reality” of his/her inner-familiar relationships. This inner couragement from the Healthy Adult and the “assisting person” to give back the burdensome messages.
reality is not necessarily oriented to the amount of real contact between the family members. The assisting person in that case is the therapist, who has previously completed genogram work with
the patient, and analysed with him/her the pattern of enmeshment.

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 THE HELLINGER-ORIENTED STEPS:

1 RESPECTING THE PARENTS

The Child is getting to its strength, when it acknowledges,

In imaginative rescripting, it is not intended that that events After the process of describing and analysing the dynamics, the that the existence of its parents was the condition of its
ARTICLE: THE IMAGINATIV E FAMILY- CONS TELL ATION

which happened should be “worked through”, or that the therapist now actively makes suggestions as to how to change own existence. Because of them, the child stands in the line of
persons involved in the imagery should behave in a different way. this family constellation with the purpose to finding a “good life –coming from far behind. By respecting the parents in this
Indeed, it is not even important what the “truth” was in relation and appropriate place” for the patient. The therapist refers regard, the child gets connected to that “strength from far
to the “real behaviour” of the persons involved. It is considered here to the central theses of Bert Hellinger’s phenomenological behind”. That does not include the respect for their deeds.
more important that the ”intention” of the behaviour should be approach (keeping the ranking order according to the years
“felt” in the imaginative process. The imagery should enable of being part of the system, thankfulness from the children
the child to feel the difference between the enmeshed and the
dis-enmeshed position, and between “taking on a burden the
towards the parents for being parents (not for their deeds), such
that serious actions and guilt are not denied but acknowledged,
2 RESPECTING THE ORDERS

The child is getting to its strength, standing at its place

belongs to someone else” and “giving back the burden to whom so that it will not be transmitted to and borne by future
it belongs”. The underlying idea is, that the “solved position” generations. as a child –not claiming the upper position. It should
will feel right – in relation to all involved family members. The respect the parents on their parent-level and let them take the
client’s empowerment is based on the notion that people are responsibility for their decisions and deeds. Even if the parents
strengthened through the act of assuming their own path/ deeds were bad and evil, the child weakens its position, when it
destiny and allowing and facilitating each other to accomplish judges about its parents. By this it “saws on the branch on which
this. In this schema therapeutic oriented family-constellation it sits”. The adaequate attitude towards the parents, preventing
work, the focus is on the experience of the child. In the changed enmeshment, would be in this case: “ I am harmed and injured
inner picture (within the imaginative family constellation) the by Your deeds, which I don´t understand. I am not in the position
patient is no longer enmeshed, nor burdened by something that
to judge about You. I let the responsibility on Your side”. That is
belongs to someone else in the family system.
leading to the third step:
Based on this understanding, the Imaginative Family-
Constellations is structured in the following phases:

◊ In the first step the therapist together with the patient

Just as with Imaginative Rescripting, which is more focused
3 GIVING BACK THE BURDEN TO THEIR OWNERS

work on an understanding of the enmeshment, analysing the child takes the burden of other members of the
on the child’s unmet needs than on the exact details of what family for different reasons: there is a “conscience of
the genogram (hypotheses are developed as to why a parent
happened, this “alternative picture” is oriented to help the
was devaluating, guilt inducing, demanding, punitive). the clan”, which does not forget, when in former generations
“entangled child” to get out of its enmeshed position. That
The systemic dynamics are named and –if appropriate- there is unadjusted dept (when a family member was excluded,
strengthens his/her feeling of autonomy and responsibility for
symbolized (for example: the neglect and punishment, neglected or committed a crime). I child can be “chosen by the
his/her own life, freed from “other burdens and delegations”.
which was part of the father’s family culture is symbolized clan conscience” to take that guilt. But that kind of “given back
by a stone, which can be included in the imaginative family The steps and changes which are necessary to get to the the burden” is secondary concerning the imaginative family
constellation progress). “healthy position” are carried out by figures and symbols on the constellation in the context of a schematherapeutic treatment.
board, and a second time through imagery. The intention is to
◊ In a second step, the “dis-enmeshment” is enacted firstly Here the biographical burden of the parents is the relevant
promote a position in the inner picture in which the inner-child
through the movement of the representative figures on the point: This burden got transmitted to the child by model and
is both bonded/connected and freed (2), which then enables the
table, and secondly in an imaginative process in which these internalization processes: for example the fear of failure, the
patient to go his/her own way.
movements are repeated. merciless claims on oneself, the felt guilt for existing. These
attitudes are not primarily located in the child- they were given
to it. They are given back in the imaginative family constellation
to its owners

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 These steps serve the goals of autonomy and extracting the self from the enmeshed, dependent
ARTICLE: THE IMAGINATIV E FAMILY- CONS TELL ATION

BACK TO THE C A SE STUDY AND THE DESCRIPTION OF THE THER APEUTIC PROCESS:
position - which may have previously been expressed as hatred and aggression (and strengthening the
bonding in a paradoxical way).

What the patient wants “to give back” will be represented by a symbol (the patient finds a symbol or the THE IMAGINATIVE FAMILY CONSTELL ATION A S A METHOD WHICH
therapist makes suggestions) and will be “given back” to the relevant figure and figures on the family CONVE YS POWERFUL SCHEMA-MESSAGES AND SUPPORTS THE PATIENT
board.
TO TAKE RESPONSIBILIT Y
The changed inner picture is not a “to do list” in the sense of prescribed behavioural changes in patterns
of interaction within the lived reality. We do not explicitly recommend “clearing the air”, writing letters,
debating, accusing, forgiving - however, these change can evolve as a possible side effect. The main The work with this patient followed the description above: on the family board she set her brothers
effect is the changed, “deliberated” inner picture, strengthening and energising the Healthy Adult to and their parents at a distance from herself, but looking toward each other. Two “burdens“ were found:
follow his/her own inner direction. one burden was the “denying of the right to live“ coming from the parents. The other burden was the
physical and sexual abuse, and with it the implicit felt-sense message of unworthiness-coming from her
The link between the imaginative family constellation and the classical schema therapeutic chair work
brothers. The burdens were symbolically given back to their “origins” and it was possible for the child to
is that the changed inner picture enables the patient to understand better which burden “the Vulnerable
“stand up“ for herself.
Child” is bearing and which messages are in the repertoire of its inner critic and wherefrom they come.
With the view of his/her changed inner picture, s/he is able to deal better with it. After the two sessions (constellation with figures and symbols) and the taking of a photograph of
the “solution picture" as a kind of “memo-card", Ms. S. first described a clear emancipatory effect,
characterised by a more active, future-oriented, ego-strengthening experience. This feeling, associated
with a partly “new” self-conceptualisation, was described by Ms. S. with the words: “Now I don't want to
be a victim anymore". She appeared more active and open-minded and increasingly engaged in cultural
and social activities.

After a few days, however, she was plunged into a very

serious crisis: she experienced herself again helpless,
desperate, overwhelmed by the felt demands, “to stand
up for herself now” and “to live her own life and pursue
her own goals". “How is that supposed to work?”. In this
overstraining experience she reacted angrily, accusing
her therapists. That process ended in cancelling the
therapeutic commitment and a massive increase of
psychopathology (tension, desperation, helplessness,
anger towards herself and her therapists). Inpatient
treatment was needed.

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 OUR THER APEUTIC HYPOTHESES ON THIS PROCESS
ARTICLE: THE IMAGINATIV E FAMILY- CONS TELL ATION

Ms. S. had built up an extensive helper network in her “patient career" and objectively she had many resources at her
disposal (i.e. her own centrally located apartment, leisure facilities, support staff, protection/security, a creative workplace,
therapeutic connections). In “good times” she was able to use these as resources. But even then, she did not get the feeling
that this “made sense” to her and that “life was worth living”. The help she received and the caring she experienced from
professionals and peers never appeared to be enough. The dominant self-conceptualisation was the conviction that she was
the victim of her history and that “life treated her in an evil way”. That history prevented her from taking a proactive attitude
in her own life. Being a “victim” was in a way “anchored in her bones”. The different experience of not being a victim anymore
was overtaxing, new and not integrable in her existing self-concept. This “not-fitting” and incompatibility was the starting
point of the decompensation-process.
THE AUTHOR: DR. MATTHIAS KRÜGER,
We ended the treatment episode with the commitment that it could be useful to reconsider therapy again at a later point.
Psychological Psychotherapist,
It was suggested that perhaps this new experience and view of herself and her position in the family may need time to be
Director of the Psychiatric day clinic,
“digested“. This digestion could result in a self-conceptualisation beyond that of solely being a victim of traumatisation.
Friedrichshafen/Germany

Systemic family therapist (IGST),

Trainer and supervisor in schema therapy (ISST)
Concerning the method of the “Imaginative Family Constellation” we think that this intervention promotes strong messages
on an abstract “meaning”- level: It touches the foundations of the person’s self-concept and the sense of “how we are
standing in the world”.

Imaginative Rescripting deals with specific remembered events and situations alongside associated emotional experiences.
Its target is the level of “emotion”. The target of the Imaginative Family constellation is that of “meaning” and “identity”. Both
are interactively connected. The goal of therapy is to address the different “system levels” (3), and change is more likely to Literature:
happen and be sustained if the level of emotions, behaviour, cognitions and self-concept are ALL recognised and enhanced by
1. Hellinger B. Ordnungen der Liebe: ein Kursbuch/Bert
therapy. The interactions are top-down and bottom-up. The case presented here is an example that therapeutic interventions
Hellinger. Heidelberg: Carl-Auer-Systeme 1996
on an abstract “meaning”-level can be strong and change-inducing – however, this is not maintained if the processes on the
other levels have not yet developed at a level that this change can be integrated. 2. Stierlin, H. Delegation und Familie, Suhrkamp
Taschenbuch, 1982

3. Luhmann, N. Soziale Systeme-Grundriß

einer allgemeinenTheorie. Frankfurt am Main: Suhrkamp
Taschenbuch666, Wissenschaft 1988

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Schema-Coaching for Parents
I N T R O D U C T I O N

D E F I N I T I O N

When we talk about Schema-Coaching

for Parents (SCP) we mean a special form
of psycho-education and parent work in
addition to the child-focused therapy. In
parent coaching we talk, not just about the
child, but the PARENT’S core emotional
needs, adaptive and maladaptive schemas,
as well as functional and dysfunctional
modes. The children are obviously the
When children are the main clients, parents often the maladaptive patterns in the family focus, but we also want to support the most
and caregivers play an important role in become entrenched. These patterns then important people in the child’s life, and in
the therapy as well. Not only do parents reinforce the underlying schemas, and most cases that’s the parents or caregivers
need support in how to deal with the mode clashes. Therefore, schema therapy (here used interchangeably). Of course,
difficult behavior of their children, but also with children involves a kind of coaching of parents first need help in understanding
we often see mode and schema clashes the parents, or, more accurately, addressing the basic ideas of our approach. Parents
between parents and children that need parent’s early maladaptive schemas (EMS) also need to understand their children’s
addressing. Parents and children may share and unhelpful coping modes. As these are behavior and the needs behind their
similar or complementary maladaptive explored the parenting issues are more symptoms (Fig.1), but the SCP framework schema dispositions, but we won’t break
schemas (e.g. parent: self-sacrifice, child: deeply understood and the lack of happy suggests that in addition, parents need to the likely schema collusions between
grandiosity) and/or dysfunctional modes parent mode explained. The result of the learn about their own needs, schemas, and parent and child; the mode clashes that
(parent: compliant surrender, child: ongoing schema activation and mode modes. If we don’t support parents with often occur when children’s dysfunctional
overcompensation). As a result, they clashes: Family life may become a heavy these deeper insights, we might help the behavior triggers the caregiver’s EMS.
not only trigger each other, but when burden, for all members. children to understand and express their
dysfunctional coping styles get activated, core needs and deal with their modes and

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investigate each parent’s present schema define how the child’s

landscape (exploring each parent’s behavior triggers modes in
childhood using the YSQ-questionnaire, the parents (the “emotional
Couple interview, etc.) buttons” of the parents)

consider what kind of childhood the go back into the parent’s

parent’s own parents had (including childhood in order to
which schemas they had and still have) clarify which needs were
not met (e.g. using chair
work, imagery techniques)

sketch a ”schema-genogram“ use a family-board - a wooden

(over 3 generations) board with wooden figures that
represent family members, and - as
a further development - assign the
use the family-board in a
schema a figure/symbol in order to
double-layer-structure. The
get an impression of how the family
Figure 2 depicts a typical unhelpful interaction pattern between parent and child: ground floor of the model is
relationships change when the
the family constellation of
Mode-Clashes: the child’s dysfunctional behavior (upper arrow) is a result of a trigger, that schema enters and leaves the family
a parent (when the father/
activates a schema (wound), that leads to a certain mode within the child (left side of fig.2).
mother was a child) and the
The resulting behavior of the child is then a trigger for the parent, who is also struggling
first floor shows the current
with their own schema activation (wound) and modes, leading to a dysfunctional parent
family constellation (in the
mode, that again interacts with the child’s mode (lower arrow)
present). How does the
Graphic by P. Graaf. schema effect the family?
(described in the Case example
H O W E V E R . . .
below)
T H E R A P I S T S N E E D
G O A L O F S C P T O L E A R N T O

We aim to give insight into how a parent’s upbringing and childhood events – positive as Confront unhelpful parent Lead parents to see and Honor the efforts of
well as problematic – has resulted in a parent’s EMS, including “family schemas” that have behaviors. e.g. confront meet their own needs parents. This is important
been developed and fostered over generations. This deeper insight provides the parents unjust or harsh punishments and occasionally help to in addressing possible
with understanding and helps to disempower old (often trans-generational) maladaptive empathically and effectively postpone them in order feelings of guilt and brings
schemas and modes, finally helping them understand and meet their own emotional needs set limits on parental violence, to understand and meet relief from unrelenting
and their child’s needs (Fig. 1). physical or emotional neglect the needs of the child standards (perfectionism)

Share examples from their own Know their own schemas and modes well, so the therapist’s
lives if possible (appropriate schemas don’t collude with the child’s or their parent’s
self disclosure) schemas and prompt mode clashes.

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We usually need 10-15

sessions with the parent,
9 S T E P S O F S C P
conducted separately to
the child’s sessions; in the
first five weeks we ask the
Goal clarification Addressing parent’s schemas
parent to come twice a 1 6
and modes
(e.g. Who referred the family, what
week: one session for the are the expectations, etc.) (working with mode flash cards,
child, and another one chairwork, imagery etc.)

for the parent (without Investigation of parent resources Practical strategies for parents
2 7
the child present). After (e.g. Strengths and parent to deal with their child’s difficult
achievements) modes (mode management plan)
about 5 sessions the
frequency decreases, e.g.
Exploration of parent’s core Building or establishing positive
every fortnight, or less. 3
emotional needs, individually
8
family activities and rituals
Throughout therapy it and also as couple
(attachment, autonomy, etc.)
is absolutely necessary
that the parent feels the
therapist’s empathy and The following nine steps provide a 4
Education about the
9
Referral for further intervention
development and importance (couples therapy, parental
emotional warmth towards road map for SCP: of schemas and modes presence therapy, assertiveness
them; in the center of (Emotional buttons, pain points, training, etc.)
the therapy stands the coping strategies/modes)

emotional, and behavioral If the parent is currently emotionally

support of the parent. 5
Development and sharing overloaded and/or suffering from a
of a schema therapy diagnosable psychological disorder, it
conceptualization may be necessary to refer the parent
(using pictures such as fig.2 above) for psychotherapy.

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 Fig. 3b:

SCP Case Example

Family board,
upper level:
The schema
“self-sacrifice”
was deprived of
power; helping
the family to
come together
grandmother’s schema to be near to her. From and grow again.
on the other half of the family board; the then on, the mother was willing to allow the
grandmother (mother of the father) takes care father to take on more responsibility in the
of the two children and is placed next to them, parenting challenges (see fig. 3b).
having escaped from the parent’s conflict and FURTHER INFORM ATION A BOUT SCP:
Surprisingly, the mother didn’t need any
loud arguments about the how best to bring WE ARE ANTICIPATING THE PUBLIC ATION
training in how to guide her children or
up the children. OF “SCHEMA THER APY FOR CHILDREN
reinforce positive behavior. Her Caring-and AND ADOLE SCENTS” (EDITORS:
LOOSE,
After positioning the family members on Guidance-Mode (analogous to Healthy-Adult- GR A AF, Z ARBOCK , & HOLT ) IN 2019/ 2020
the board, and identifying the schema as a Mode) was well developed. Rather, the main BY PAV ILION PUBLISHER (UK). THIS BOOK
separate figure, we investigate the parent’s
Fig. 3a: Family board, double-layer-structure visualizes problem was the deep-seated need to be close CONTAINS THREE CHAPTERS OUTLINING
the impact of a schema in the here-and-now (upper childhood (in this case the mother). “when to her beloved grandmother, who represented
level), and the connection to the parent’s own childhood SCP IN MORE DE TAIL, WITH S TEP- BY-
you were a girl was there already a “self
(lower level) love and self-esteem in her S TEP INFORMATION AND TRE ATMENT
sacrifice” schema in your family?” childhood. S TR ATEGIE S. FOR GERMAN, DUTCH,
“Yes, my beloved Grandma had

A mother is suffering from a “self-sacrifice” it”, the mother agreed. She “when you were a girl was This example shows the ITALIAN, POLISH OR TURKISH SPE AKERS,

importance of understanding THE BOOK IS ALRE ADY AVAIL ABLE IN THE

talked, with tears in her eyes,
schema resulting in “entitlement” and there already a the roots of unhelpful parenting USUAL BOOK S TORE S. THERE IS AL SO A
about the sudden death of her
“insufficient self-control” schemas developing “self sacrifice” schema in behavior and maladaptive 38 - MINUTE V IDEO - B A SED LEC TURE ABOUT
grandmother, and how she wasn’t
in the children, causing a lot of trouble at
home, in school, and in other contexts. No one able to bid farewell to her. During your family? ” schemas in parents. Once schema
healing takes place, a much more
SCP AVAIL ABLE AT W W W.YOUTUBE.COM/

WATCH? V = V P 9OZQE ALTM

this conversation, we worked out
really understands why the mother is not able healthy side can often show up. If
that the mother felt connected to
to set limits on her children. She has already FOR FURTHER QUE S TIONS PLE A SE DON’ T
needed, further parent training
her grandmother, by taking over
attended parent training, but it helped only HE SITATE TO CONTAC T THE AUTHOR .
units can be added, but in many cases we
her pattern of relating (the “self-sacrifice”
for a short time. THANK YOU.
are impressed and often surprised by the
schema was facilitating a crucial need for
After clarification of goals, gathering positive competence and capacities of the parents,
attachment, enabling her to feel close to her ACKNOWLEDGEMENT: I’D LIKE TO THANK
strategies to tackle family issues, clarifying who are frequently referred to us with
grandmother). RUTH A . HOLT, WHO RE V ISED THE ARTICLE
needs, explaining the nature of schemas “hopeless or treatment-resistant” dynamics. AND HELPED WITH RE ADABILIT Y.
Having realized that, we wrote an actual letter
and modes, and exploring the interaction of
to the grandmother (even though of course
modes and schemas between parent and child
she couldn’t read it), thanking her for all that Author: Christof Loose (PhD); Diplom-Psychologist
(steps 1-5), we started working with the family
she had done, and finally bidding her farewell. Child and Adolescent Psychotherapist (CBT)
board (see fig.3a, upper level). The mother
The child’s father was willing to accompany his Advanced-level certified Schema Therapist for Children & Adolescents,
(large round figure) positioned herself near
wife to the cemetery, supporting her in finding and Adults; Trainer & Supervisor, ISST e.V.
the gap in the board (symbolizing the family
another way to feel close to her grandmother. Homepage: www.schematherapy-for-children.de (e.g. for info about
conflict) next to the “self-sacrifice” schema
(black figure); the husband (rectangular figure) After that the mother seemed to be at peace, trainings in ST-CA)
is escaping and separated from the family realizing that she didn’t need to copy her E-Mail: [email protected]

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 DR . PHIL . ANOUSHA HADINIA & DIPL .- PS YCH. JAN KOSS ACK

Schema-Mode-based Family Therapy

A M U LT I G E N E R A T I O N A L & I N T E R C U LT U R A L A P P R O A C H

Tony is 16 years old. His parents call the psychological practice and seek help because he is aggressive towards them and some-
times towards the siblings (2 and 4 years younger). Initially the parents seek only individual counseling for Tony, but are willing
to support the therapeutic process. The parents would be happy, if the adolescent boy could be helped or even “fixed”???

Requests like this are not uncommon, if you work in an Impressed by the approach of Mauricio Andolfi in his
area of counseling with children, adolescents and young “Accademia di Psicoterapia della Famiglia” in Rome, we tried
adults. We often experience parents bringing their children more and more to combine ST with Andolfi’s family therapy
to therapy, hoping that the therapist takes over the approach. Having in mind that families highly influence
responsibility to make sure the adolescent changes his or one`s development, we try to integrate the family in order to
her behavior. implement change in the family system. In the last few years
we used ST in many family therapy settings in Luxemburg and
Using Schema Therapy (ST) before individually with adults,
in Basel. We will describe here our experiences, the protocol
adolescents and children, we focussed more and more
we developed so far (as we also learn a lot from the families,
in the last few months using Jeffery Young’s approach in
it’s an on-going process of development) and some of the
working with family systems.
techniques used in Schema-Mode-based Family Therapy:

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 T H E S E T T I N G , T H E B O N D I N G , T H E D I A G N O S T I C
ARTICLE: SCHEMA - MODE- B A SED FAMILY THER APY

In Schema-Mode-based Family In addition to the observations during the sessions in the first phase, the family members
Therapy we start already in the get the ST Questionnaires by Jeffrey Young or the Schema Questionnaires by Loose, Graaf
telephone call to arrange the first & Zarbock for the children and adolescents. In this phase, we evaluate the questionnaires,
meeting by asking the family, the relationships between the family members, the family-life-events (“River-of-Life-
who should be present to support Exercise”) which had an impact on how the core emotional needs were met and what
the therapeutic process. Next modes the family members developed over time because of unmet core emotional needs.
to the adolescent, the parents,
the siblings, it is often the
AN IMPORTANT PART OF THIS PHA SE OF TRE ATMENT IS AL SO PROV IDING A PROPER AND CLE AR
grandparents, uncles or aunts,
UNDERS TANDING ABOUT THE SCHEMATHER APEUTIC CONCEPT. THE PS YCHOEDUC ATIONAL APPROACH IN THE SCHEMA MODE AWARENE SS AND MODE CHANGE IN THE FAMILY
who then come to the session.
BEGINNING HELPS TO GIV E E V ERY FAMILY MEMBER AN IDE A OF THE THER APEUTIC PROCE SS AND IT PROV IDE S
Andolfi describes in his work the Very soon in the therapeutic process we introduce the
S TRUC TURE IN A COMPLE X S YS TEM.
strong benefits of bringing in the i-modes (www.i-modes.com) of Prof. Dr. Bernstein to
three generations of a family to the family. We introduce the different coping styles to
improve a difficult situation or Inspired by Anna Mascellani we use the “gas station exercise” to start talking with the family about the family and the resulting healthy or dysfunctional
difficult relationships in a family. Of what everyone needs, to have a healthy and happy life. That leads us to introducing the core modes every family member developed throughout
course this approach is not always emotional needs and we start reflecting with the family how the needs were met for every family their lives. Every family member gets a set of i-modes
possible, therefore we then try to member. and tries to find the modes they can identify with.
invite the core family to the session, Later in the therapeutic process we use the i-modes
We also use the i-modes by Prof. Dr. Bernstein to show the pictures of the core needs, which make
and later on the 3rd generation in the beginning of the session as a tool to assess the
it easier for the adolescents and the parents to connect to feelings when speaking about the core
(grandparents) will participate. individual modes of every family member. Using the
emotional needs.
i-modes we do different exercises with the family to
In ST as well as in Andolfi’s family therapy approach the therapeutic relationship to the clients is explore and create awareness for the different mode-
very important to create changes. Inspired by Mauricio Andolfi we like to see the adolescent as clashes between the family members.
the co-therapist in Schema-Mode-based Family Therapy. As described above, the family often
The goal is to help the family members to get in
comes to therapy and defines the child/adolescent as the client. We try to change that perspective
contact with their own vulnerable child modes, which
from the very beginning by introducing the child or the adolescent as the one, who can help us to
are sometimes triggered by the family dynamics. For
understand the family system and who can help to initiate change in the family system, instead
the family members it is very helpful to understand
of being seen as the one, who is causing the problem. As in ST with couples, the goal is to see the
and see the vulnerable part of the others behind
unhealthy dynamic as the common “enemy“, not the individual him- or herself. This perspective of
some over-compensation or avoiding strategies. We
working together to change the unhealthy dynamic, leads to a healthy bonding within the family.
help the family with various exercises to reduce their
Hence their healthy modes get activated and help them change the family dynamic.
dysfunctional reaction triggered by the dysfunctional
coping strategies of another family member and
instead using healthy strategies to connect with their
vulnerable and healthy part.

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 Especially with the multi-generational approach to schemas, old wounds of the
parents can be addressed and sometimes healed, rather than focusing exclusively
ARTICLE: SCHEMA - MODE- B A SED FAMILY THER APY

on the child`s symtpoms, or projecting their own emotions onto the child or
adolescent.

Andolfi describes family sculpture exercises, in which by creating a sculpture of

the parents’ core memories from childhood, and then creating a sculpture of how
the family might appear, if the parents’ needs had been met. With this exercise we
try to create an emotional re-scripting and with that a
corrective emotional experience, as we do in imagery
work in individual ST. Thus the parents can create Generally, in work with couples or families, clients are much more
awareness of their own triggers and dysfunctional coping triggered in sessions than in individual therapy. The complexity of the
strategies that are being falsely directed to the child. family system and the individual relationships of the family members
can create a mode-clash – either between the parents and the children,
between the two parents or between the parents and the grandparents.
One example of using Schema Therapy within
A good therapeutic relationship with the family in these sessions is
the context of family therapy is that we use small,
very important. Staying connected with all family members can be a
little chairs (the kind used in Kindergarden) for the
challenge but is necessary to to stop mode clashes. Using empathic
vulnerable parts of the family members and we ask
confrontation can help them connect with their vulnerable parts and
each family member to put the little chair behind
lead to their functional modes.
their “usual” chair in the meeting and put the
picture or mode-card representing their vulnerable
child behind them on the little chair. Each time one
family member gets triggered during the session, we try to get in contact
with the vulnerable part of the family member and ask the person to switch
As mentioned above we learn a lot from the families we are working with and the protocol of the Schema-
to the little chair, exploring what emotions were triggered right now in the
Mode-based Family Therapy is an on-going development. For further information feel free to contact us
session and what they need in that moment. Also in this exercise, we try to
via our websites
help the family to notice when and how they get triggered and how they
www.hadinia.com or www.upgradeyourlife.lu. DR . PHIL . ANOUSHA HADINIA & DIPL .- PS YCH. JAN KOSS ACK can connect to their healthy parts in order to get their needs met within
the possibilities of a family system instead of giving in to dysfunctional
parts, which then lead to a mode clash.
References:
Andolfi, M. (2017). Multi-Generational Family Therapy: tools and resources for the therapist. New York, USA: Routledge
Bernstein, D. P. BERNSTEIN i-Modes. URL: https://www.i-modes.com/en/ (19/05/2019) That is just one example of our Schema-Mode-based Family Therapy
Bernstein, D. P. (2018). Using the iModes in Schema Therapy and beyond: 25 ways to make therapy more effective. URL: https:// approach. It is important to note that due to the complexity of the family
www.i-modes.com/en/products/ (19/05/2019)
system in family therapy, the continuity of the process gets interrupted
Loose, C., Graaf, P., Zarbock, G. (2013). Schematherapie mit Kindern und Jugendlichen. Weinheim, D: Beltz
more easily. Thus more repetitive work in terms of modes can be needed
Roediger, E. (2011). Praxis der Schematherapie: Lehrbuch zu Grundlagen, Modell und Anwendung. (2nd Edition) Stuttgart, D:
Schattauer in order to reach the goal of a healthier system and to bring structure into
Van Genderen, H., Rijkeboer, M. & Arntz, A. (2012). Theoretical Model: Schemas, Coping Styles and Modes. In M. v. Vreeswijk, the system.
J. Broersen & M. Nadort (Eds.), The Wiley-Blackwell Handbook of Schema Therapy: Theory, Research and Practice (pp. 27-40).
West Sussex, UK: John Wiley and Sons , Ltd.
Young, J. E., Klosko, J. S. & Weishaar, M. E. (2005). Schematherapie. Ein praxisorientiertes Handbuch. 2nd Edition. Paderborn,
D: Junfermann

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