Happy Monday! Ok, maybe it’s more like, Monday! ::grumble grumble:: It is what it is I guess.
Typical Presentation of the Schema
These people are negativistic and pessimistic. They display a pervasive, lifelong focus on the negative aspects of life, such as pain, death, loss, disappointment, betrayal, failure, and conflict, while minimizing the positive aspects. In a wide range of work, financial, and interpersonal situations, they have an exaggerated expectation that things will go seriously wrong. Patients feel vulnerable to making disastrous mistakes that will cause their lives to fall apart in some way – mistakes that might lead to financial collapse, serious loss, social humiliation, being trapped in a bad situation, or loss of control. They spend a great deal of time trying to make sure they do not make such mistakes and are prone to obsessive rumination. Their “default position” is anxiety. Typical feelings include chronic tension and worry, and typical behaviors include complaining and indecision. Patients with this schema can be difficult to be around because, no matter what one says, they always see the negative side of events. The glass is always half empty.
This “default position” of anxiety is definitely me. My medication has lessened the expression of this a lot but before it was just, horrendous. I don’t complain much at all, I feel like this would make me look weak so I have a definite attitude of dealing with my shit myself, but I have a really hard time making decisions. I’m always afraid that I’m going to make the wrong choice; if I had done something a different way it would have turned out better, if I’d taken a different approach the outcome would be A, B, C, or D, E, F, G,… if I choose this, what will someone think, or would they like something else better, or which way of doing things will give me the optimized benefit… but there are so many choices how do I know which one to pick?!? If I choose wrong me/someone could be disappointed, I won’t look my best, I’ll be judged poorly, I’ll be made fun of, it’s all over the place. Sometimes it’s not even a concrete worry, just an underlying tension that “I have to do this right” but how can you be sure which way is the ‘right way’?
I think this boils down to one simple fact: I don’t trust myself. I don’t trust myself to make good decisions. I’ve made so many bad decisions that have lead to some really tragic results that I’m positive these things will happen again, and again.
Treatment strategies depend on how the therapist conceptualizes the origins of the schema, which is primarily learned through modeling. In this case, the schema reflects a depressive tendency toward negativity and pessimism that the patient learned from a parent. The patient internalized the parent’s attitudes as a mode.
A second origin is a childhood history of hardship and loss. In this case, people are negativistic and pessimistic because they experienced so much adversity early in life. This is a more difficult origin to overcome. The people, often at a young age, lost the natural optimism of youth. Many of these people need to grieve for past losses. When personal misfortune is the origin of the schema, all of the treatment strategies are important.
I moved around when I was little, and lost all contact with my earliest friends. Then when we settled down and I reformed friendships they moved away, never to be seen from again. Or I would befriend people that were unpleasant and unreliable and be hurt because of it…. This happened a lot. And I mean A LOT. I absolutely expect people want something from me when they try to get close to me. I absolutely do not believe that people will have my best interest in mind. This I think couples with the Mistrust/Abuse schema a bit though. Just because I worry about it, doesn’t mean I’m not justified, right?
Cognitive techniques can help patients see that negative events in the past do not predict the occurrence of negative events in the future. < ——- Important to Remember
Alternatively, the schema might be an over compensation for the Emotional Deprivation schema. The patient complains in order to get attention or sympathy.
For some people, this may have a biological component and origin, perhaps related to obsessive-compulsive disorder or dysthymic disorder. These people might benefit from a trial of medication.
For me this is also likely because I have a Major Depressive mood disorder. It’s hard to look on the bright side of life when everything is always so grey and cloudy.
Goals of Treatment
The basic goal is to help people predict the future more objectively, that is, more positively. Some research suggests that the healthiest way to view life is with an “illusory glow”, that is, as slightly more positive than is realistic. A negative view does not appear to be as healthy or adaptive. Perhaps this is because, generally speaking, if one expects things to go wrong and is accurate, one does not feel much better. It has not helped very much to imagine the worst. It is probably healthier to go through life expecting things to go well – as long as one’s expectations are not so at odds with reality that one constantly has major disappointments.
This is how I know I have a problem here because I think this is silly. If you have a negative outlook that you’re not going to set yourself up for disappointment. If you expect the worst and things turn out well, that’s great! If you expect the worse and it happens, at least you’re prepared. Right? I think it would make me more sad to go around hoping for the best all the time and then being let down when things didn’t turn out so great. Don’t get me wrong, I have a lot of hope for things, but they’re things that I’m actively working on and feel a sense of control about.
It is not realistic to expect people to become carefree and optimistic; but at least they can move away from the extreme negative end toward a more moderate position. Some signs that people are recovering from this schema are they worry less frequently, have a more positive outlook, stop constantly predicting the worst outcome and obsessively ruminating about the future. They are no longer focused so obsessively on trying to avoid making mistakes. Rather, they make a reasonable effort to avoid mistakes, and focus more on fulfilling emotional needs and following their natural inclinations.
|Signs say “No”
I am famous for my endless ruminations and scenario creations. I work myself up into a fury over conversations and events that have never actually happened. I let my imagination run away with the worst outcomes for potential, but improbable, situations. It’s so stupid. I’ll start out having a normal conversation with someone (all in my head), and quickly something happens and the worst possible scenario happens. I hear the fight, I feel how I’ve been wronged, I feel how I’ll be hurt, how the other person will neglect what I need, and before I know it I’m pissed off and upset over something that never even happened! Productive? No, not even a little.
Strategies Emphasized in Treatment
Many cognitive techniques can be helpful: Identifying cognitive distortions, examining the evidence, generating alternatives, using flash cards, conducting dialogues between the schema-driven and the healthy sides. The therapist helps people make predictions about the future and observe how infrequently their negative expectations come true. It’s important to learn how to self-monitor negative, pessimistic thinking, and practice looking at their lives more objectively, based on logic and empirical evidence.
When people have a history of negative events, cognitive techniques are helpful to analyze these events and learn to distinguish the present and future from the past. If a past, negative event was controllable, it is possible to work together to correct the problem so that it does not happen again. If the event was not controllable, then the event has no bearing on the future. Logically, there is no basis for pessimism about a future event, even if the person has experienced uncontrollable negative events in the past.
This is where I’m struggling the most. Most of my negativity and pessimism revolve around people and my relationships. If it’s just something I’m setting out to do, a goal, whatever, I’m confident in my own abilities. But other people, relationships, are not predictable. They often do not turn out well. They turn around, they change, they become destructive, they want something from me,… people are too volatile. I’m too volatile. I suppose it doesn’t help that those negative events from my past keep seeming to reappear in my present. When something happens over and over it seems like something that should be kept in the front of your mind in order to gauge future events if you’re trying to make different decisions. It also makes me wonder what I’m doing wrong because if things keep happening over and over, the logical conclusion is that I’m doing something to invite these kinds of people into my life. Yeah they’re behavior may be wrong, but something about me allowed them into my world. That’s a problem that needs some investigating.
If the schema is serving a protective function, cognitive techniques can help challenge the idea that it is better to assume a negative, pessimistic perspective, so that they are not disappointed. This idea is usually incorrect: If people expect something to go wrong, and it does go wrong, they do not feel that much better having worried about it; if they expect something to go right and instead it goes wrong, they do not feel that much worse. Whatever they gain by anticipating negative outcomes does not outweigh the cost of living day-to-day with chronic worry and tension.
Ah, yes, as mentioned previously I definitely have internalized this. My Detached Protector is probably my most prominent mode. In theory I can see how this would work if you had a discrete number of events to worry about. But for someone with Borderline Personality Disorder, especially in relationships, every moment can have its own unique worry. We ruminate and think about all of them and how things can go wrong. One, you’re not disappointed, or at least the blow is lessened, but two, you’re prepared for any outcome so it doesn’t take you by surprise. If you think about how things can turn out, it’s not as big of a shock.
Instructing people not to complain to others can be a helpful behavioral homework assignment. When the schema is an overcompensations for the Emotional Deprivation schema, it’s important to teach people to ask others more directly to meet their emotional needs in relationships. Without any conscious awareness, they complain as a means of getting people to nurture them.. The reason that the chronic complaining we see in these people is so unresponsive to logical persuasion and evidence to the contrary is because the core issue is emotional deprivation: People are complaining to gain nurturance and empathy, not because they want practical solutions or advice. The self-defeating aspect of their complaining is that, after a while, other people get fed up with the complaining and become impatient or avoid them. Nevertheless, in the short run, the complaining often wins people sympathy and attention. If they learn to ask more directly for caring rather than seeking it through complaining, then they can begin to meet their emotional needs in a healthier way.
Limiting the time spent worrying by scheduling “worry time” is a behavioral strategy that may help as well. First you need to pay attention to when you start worrying, and then actively put it aside until a designated time set aside specifically for worrying.
I’ve had this suggested to me before.
Often people with this schema have lives oriented around survival rather than pleasure. Life is not about getting “good things” – it is about preventing “bad things”. It’s important to begin scheduling activities that are enjoyable, which will also help ease the amount of worrying done.
I feel like I spend my life seeking out “good things”, by which I mean good people and relationships, but at the same time, because I have no illusions that things can turn out badly I also want to prevent all the possible “bad things” at the same time. I want good things, but I’m afraid to let them in. Block.
Special Problems with This Schema
This is often a difficult schema to change. Often, patients cannot remember a time when they did not feel pessimistic, and cannot imagine feeling otherwise.
There can be a lot of secondary gain for the schema if the person receives attention fro complaining. It’s important to alter these contingencies as much as possible.
When the schema is hard to change as a result of a history of extremely negative life events, it is often helpful for people to grieve for past losses. Genuine grieving can relieve the pressure to complain. Grieving helps patients separate the present, where they (presumably) are safe and secure, from the past, where they underwent traumatic loss or damage.
Grieving is important. It’s something that I’m very bad at though. I bottle. I hold things in. I pretend things don’t bother me or affect me enough to have to grieve them.
I’m still having a hard time remembering that negative events in the past do not predict the occurrence of negative events in the future. Sure they may not predict them, but I’m so guarded and have such a need to protect myself that I expect them, and at the very least I need to look out for them. Being positive and having a more optimistic outlook is great and all, but self-preservation is important too. I think my Therapist would say there is a difference between healthy self-preservation and thinking the world is out to get you. She’d be right. But I’m still paranoid. I guess I still need to work on this one.
|I still think I’m a Realist.