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The Schema Therapy Bulletin

The Official Publication of the 

International Society of Schema Therapy

CLUSTER-C: FROM ADDICTION TO CONNECTION

by Robin Spiro LCSW (USA)

Truus Kersten and Guido Sijbers focused their presentation on patients with Cluster C diagnoses:  those who are avoidant, dependent and/or obsessive compulsive.  These patients often avoid vulnerable emotions in general, anxietyin particular, through hidden addictions which serve as a Self-Soother or Self-Stimulator mode.  Often they are seen as process addictions like excessive and out of control time spent on video or computer games, porn or shopping. These patients may also present with a strong Detached Protector, Compliant Surrenderer and Perfectionistic Overcontroller mode.  

The presentation began with a youtube video defining addiction based on the work of Johann Hari.  Both entertaining and thought-provoking, the video posited that addiction is a symptom of disconnection in society and that the cure is meeting our innate needs for bonding and connection.

Truus and Guido described how to explore compulsive behaviors which could be Self-Soothers, learning about their origin, frequency, triggers and function, in a nonjudgmental way. During treatment the patient becomes aware of the costs associated with avoiding emotions through these behaviors, and the Healthy Adult is strengthened to tolerate emotion, provide empathy to the Vulnerable Child, and take control of the Self-Soother.

Using the case example of “John,” Guido and Truus developed a mode map and helped him see that his “hobby” of spending many hours on computer games was a Self-Soother mode.  They skillfully demonstrated through chair work how the therapist first respectfully learned about the Self-Soother’s perspective and function, i.e., keeping the patient away from intolerable experiences of social awkwardness and rejection. The vignette showed how stubborn a Self-Soother can be in believing in the necessity for its function. The therapist first modeled a Healthy Adult, asserting to the Self-Soother that he wanted to have a chance to learn to feel comfortable in social situations, and then the patient felt empowered to confront the Self-Soother.

Truus and Guido asked the audience to break into small groups to experience approaching our own avoidant Self-Soother modes under the direction of a facilitating “therapist,” and to develop a dialogue between our Healthy Adult and Self-Soother.  This consolidation of learning provided an opportunity to practice the skills they had demonstrated and to experience the feelings of the Self Soother, Healthy Adult and Therapist.

Want more? Watch the interview with Truus & Guido

Why Schema Therapy?

Schema therapy has been extensively researched to effectively treat a wide variety of typically treatment resistant conditions, including Borderline Personality Disorder and Narcissistic Personality Disorder. Read our summary of the latest research comparing the dramatic results of schema therapy compared to other standard models of psychotherapy.

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