Schema Therapy Bulletin

October 2015: Schema Therapy in Healthcare Settings

This second issue of the Schema Therapy Bulletin focuses on the use of Schema Therapy with medically ill patients. Unlike in more traditional applications of the model, the primary focus of medically ill patients is on disease management or cure, and the relief of physical symptoms rather than on psychiatric symptoms, relationship issues or other psychosocial concerns.

Depression, anxiety, personality disorders, psychosocial stressors, and schema eruption, have the potential to impede or derail the adjustment to a medical diagnosis and treatment, and undermine optimal medical care. The clinicians writing in this issue have found schema therapy to be well suited to address psychosocial issues that arise from the diagnosis and treatment of medical illness.

This issue will also feature the first of our ongoing “Meet the ISST Board” column. Thanks to Vivian Francesco for spearheading this column and helping us all get to know the Board Members whose tireless work keeps the ISST vibrant, focused and growing.

Our next issue will focus on Schema Therapy with Couples.

Editors,

Lissa Parsonnet, PhD, LCSW (USA)

Chris Hayes, Clinical Psychologist (Australia)  

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— FEATURE ARTICLES INSIDE OCTOBER'S ISSUE —

Using the Schema Therapy Model to Help Patients Cope with a Cancer Diagnosis

by Lissa Parsonnet, PhD, LCSW

While nothing prepares a person for a diagnosis of cancer, one’s entire life experience prepares a person to cope with cancer or other serious illness. A cancer diagnosis can ignite feelings of fear, anxiety, confusion, anger, sadness and overwhelm. It also threatens a person’s identity as “healthy”, and catapults them into the new and unwanted identity of “cancer patient”. Webster’s on-line dictionary cites the origins of the word “patient” as the Latin word patiens, or the Greek word pema, meaning “to suffer” or “suffering”. How people adjust to this new identity of “sufferer”, will impact the medical care they seek and receive, the treatment decisions they make, and their emotional experience throughout the illness process. It will also impact their family and friends, as well their relationships with family, friends, colleagues and their health care team. CANCER DIAGNOSIS

Schema Therapy in Medical Settings

by Cesar A. Gonzalez

Schema theory posits that life experiences promote the development of adaptive and maladaptive schemas through conscious and non-conscious cognitive, affective, and somatic experiences and inform the perception of ourselves, the world, and our future. When our developmental needs are not met, the theory implies that we turn to conscious and non-conscious behaviors (whether adaptive or maladaptive) to promote survival in an attempt to meet our cognitive, affective, and somatic need for autonomy, relatedness, and competency. MEDICAL SETTINGS

Working with Patients who have Chronic Illness

by Elizabeth Lacy

Treating people who have chronic illnesses is challenging to say the least. Back when I was treating people with more traditional CBT, patients who were extremely sensitive to physical sensations and the threat, whether real or imagined, of serious illness would hit walls that seemed impenetrable with exposure therapies, cognitive reattribution or any other more traditional CBT. Schema Therapy helps break through the “walls” of shame and fear by offering more than cognitive-behavioral strategies.  By modelling and ultimately promoting the constructed enhancement of a healthy adult care-taking mode, changes occur deep at the root of the emotional system. The healthy adult facilitates the process of getting the core unmet needs of the vulnerable child (the one who implicitly experiences the longstanding shame and/or fear linked with early life issues) met, in an adaptive manner. Self-defeating patterns, and biased emotional beliefs gradually heal as schema links weaken, and become reorganized in the cotext of healthier and more effective outcomes. CHRONIC ILLNESS

Schema Therapy in Dermatology

by Alexandra Mizara

Skin disease is common, affecting approximately one quarter to one third of the UK population and represents the most frequent reason for people to consult their general practitioner. Despite their prevalence, the majority of dermatological conditions are often considered as ‘cosmetic’ or ‘non-life-threatening’ by the general public and the profound psychosocial impact that skin disease may exert on those affected is not often recognized. The role of psychological (di)stress in the onset, exacerbation and perpetuation of symptoms in skin diseases such as psoriasis, atopic eczema, acne, vitiligo, alopecia is now well established. DERMATOLOGY