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The Schema Therapy Bulletin

The Official Publication of the 

International Society of Schema Therapy

THE RARELY ADDRESSED & RICHLY ENTANGLED CHALLENGE OF TREATING ENMESHMENT AND THE UNDEVELOPED SELF BY WENDY BEHARY & JEFF CONWAY 

REVIEW BY KATHLEEN NEWDECK (USA)

The workshop, presented by Wendy Behary and Jeff Conway, heightened our awareness of the importance of identifying, understanding and treating the enmeshment/undeveloped self schema, along with accompanying mode patterns.  They noted that, in the conceptualization phase, it is important to carefully assess for evidence of enmeshment/undeveloped self as it can be disguised, for example, as the defectiveness, self-sacrifice, subjugation, or abandonment schema.

 Dr. Jeffery Young defined the enmeshment/undeveloped self schema as, 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.” (Young, 2003)

Wendy and Jeff illustrated via video, lecture, and demonstration, how an enmeshed person is typically over-focused on the needs/feelings of others as a source of identity, thus forfeiting their own unique and idiosyncratic sense of self. There are several factors that contribute to the evolution of a patient’s enmeshment.  It may originate in a family that thrust the child into the role of caregiver or scapegoat. It may also arise from verbal and non-verbal cues that there will be serious consequences (rejection or abandonment, for example) if the individual separates from caregivers, or caregiver’s expectations.  As the patient matures, any attempts to become more autonomous are experienced as threatening to family and caregivers who reinforce their disapproval through the interpersonal dynamic of “psychic incest”, whereby the family uses obligation, guilt, and fear to maintain the (seeming loyalty) enmeshed relationship. The patient has to forgo the need for autonomy and    individuation.  

 Wendy and Jeff also spoke about the notion of empathic attunement and the      necessity for therapists to engage in an understanding of the experiences, feelings and challenges of a patient with an enmeshment schema.  Characteristically, these patients have difficulty making and trusting their own decisions, feel controlled by others, are overly involved with the lives of others, and cannot distinguish their emotions from those of their family.  It is important to understand the power of   “emotional blackmail”  (obligation, guilt, and fear) used by the family to keep the patient from pursuing independence and outside connections.

The presenters, in keeping with the conference theme, emphasized the importance of focusing attention on the enmeshment schema/mode pattern of submission to the schema and avoidance of interpersonal connections, and how this pattern “distorts and confuses one’s sense of self”, ultimately affecting the formation of stable and secure relationships.  They described how this might typically show up in the profiles of BPD and NPD patients.  As Wendy and Jeff noted, “Healing this pattern positively impacts one’s ability to intimately relate to another person”.

In summary, the treatment objectives need to focus on pattern identification and using various strategies (Therapy Relationship, Mode Work, and Imagery) targeted at expressing frustration and healthy entitlement about the right to have a “self”; taking graduated risks to “step outside the box”; grieving for anticipated and necessary losses in order to develop a healthy adult mode that can experience a resonant connection with authentic selfness and to fortify satisfying relationships.

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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