Off with Her Head! – Punitiveness

Despite the hiccups of last night I will not be deterred from finishing this last schema. Yay the last one! Going through each one of these has definitely given me a lot of insight into the method behind my madness. I hope you’ve taken something away from it as well. Now. Onto the last (very appropriate) schema!

Punitiveness

Typical Presentation of the Schema

These people believe that people – including themselves – should be harshly punished for their mistakes. They present as moralistic and intolerant, and find it extremely difficult to forgive mistakes in other people or in themselves. They believe that, rather than forgiveness, people who make mistakes deserve punishment. No excuses are permitted. People with this schema display an unwillingness to consider extenuating circumstances. They do not allow for human imperfection, and they have difficulty feeling any empathy whatsoever for a person who does something they view as bad or wrong. These people lack the quality of mercy.

This schema is a HUGE problem for me. However for me it is almost entirely self-directed. I forgive and allow for “imperfections” and mistakes in everyone around me…. But not for myself. Not ever. I have no mercy on myself. I absolutely allow for extenuating circumstances for others. After all, no one can control everything! Except I should have somehow foreseen these things and made contingencies in the eventuality that something went wrong. I allow for other peoples mistakes because I’m afraid of losing them. If I’m kind and understanding they won’t feel bad and need to leave me. I know I’m not going anywhere though. And if I don’t do things right, I won’t be good enough, worth enough, and that might be enough to make someone not want to stay. So I have to push myself. Sometimes that push needs to be more of a shove.  

Ok, one addendum. I can reach a snapping point with other people too (I mean obviously). Even I have my limits. When Evil-Ex would pull his manipulative, abusive bullshit I reached a point where I could no longer forgive him, and frankly, believed he deserved to be strung up by the balls. I don’t think this is undeserved though. It takes an extraordinarily long time for me to reach this point. I absorb a lot. Once I have though, the split is pretty complete and I have no more tolerance for anything they do at all.

The best way to detect this schema is by the punitive, blaming tone of voice these people use when someone has made a mistake, whether they are speaking about other people or about themselves. The origin of this punitive tone of voice is almost always a blaming parent who spoke in the same tone of voice. The tone conveys the implacable necessity of exacting punishment. It is the voice of the “fire and brimstone” preacher: heartless, cold, and contemptuous. It lacks softness and compassion. It is a voice that will not be satisfied until the wrongdoer has been punished. There is also the sense that the penalty the person wants to exact is too sever – that the punishment is greater than the crime. Like the Red Queen (Gah! This is wrong! The Red Queen and The Queen of Hearts are two different characters! It’s the Queen of Hearts that shouts this!) in Lewis Carrol’s Alice in Wonderland, shouting, “Off with his head!” for every minor infraction, the schema is undiscriminating and extreme.

My father would yell at me all the time ‘Girl! Watch that sharp tongue of yours’. He would tell me on an almost daily basis that my tone of voice was harsh and negative. I worked to successfully change this, but when I’m angry it slips right back into place.

Punitiveness is often linked to other schemas, especially Unrelenting Standards and Defectiveness. When patients have unrelenting standards and punish themselves for not meeting them, as opposed to simply feeling imperfect, they have both the Unrelenting Standards and Punitiveness schemas. When they feel defective and punish themselves for it, as opposed to simply feeling depressed or inadequate, they have both the Defectiveness and Punitiveness schemas. Most people with Borderline Personality Disorder have both Defectiveness and Punitiveness schemas: They feel bad whenever the feel defective, and they want to punish themselves for being bad. They have internalized their Punitive Parent as a mode, and they punish themselves for being defective, just as the parent used to punish them: They yell at themselves, cut themselves, starve themselves, or otherwise mete out punishment.

Trifecta! I have all three. Tell her what she’s won Johnny! Well Miss Haven, you’ve won a faaaaaabulous vacation to the depths of your own inner most hell … and because we like you so much we’ll throw in this box of razor blades as an added bonus!

Hey, at least I have a sense of humor.

Punishment. Punish myself. I feel the need to punish myself ALL the time. I’ve mentioned before that one of the reasons I cut and burn is because I feel like I have failed at something I believe I need to do. Or to keep me on track so that I don’t slip. I also cut because I believe I am a bad person and deserve to be punished. It is also motivation to be better. I berate myself, {used to} cut, starve, deny myself pleasurable activities, seclude myself from the supports I need, and I’m sure a number of other things that I just don’t have the mental capacity to recall at the moment.

Last night was the first time in a very long time that I had a nearly undeniable urge to cut (I didn’t. I restrained myself and didn’t give in to the impulse < — see,  progress). I should have known better than to let another guy into my life. Every time I tell myself I won’t allow it, won’t get close… and every time I forget. At least it’s not as bad this time. I haven’t let him get very close, and I’m not too attached yet. Believe it or not I still have a lot of distance between him and my heart. Everything just feels amplified with BPD. Sometimes a harsh reminder (read: punishment) is enough to keep that lesson clearly etched into my skin brain.

Goals of Treatment

The fundamental goal is to help people become less punitive and more forgiving, toward both themselves and others. To start it is important to learn that most of time there is little value in punishing people. Punishment is not an effective way to change behavior, particularly when compared to other methods, such as rewarding good behavior or modeling.

Each time a person expresses the desire to punish someone, it’s important to ask these questions:

“Were the person’s intentions good or bad? If the person’s intentions were good, doesn’t that count for something? Doesn’t the person deserve some forgiveness? If the person’s intentions were good, then how will punishment help? Isn’t the person likely to repeat the behavior when you’re not there to see? Even if the person behaves better next time, isn’t the cost too high? The punishment will have undermined the relationship and the person’s self-esteem. Is that what you want?” These questions guide people to discover that punishment is not the most beneficial approach.

People work toward building empathy and forgiveness for human beings in all their frailty and imperfection. They learn to consider extenuating circumstances and to have a balanced response when someone makes an error or fails to meet their expectations.

Ok, I have my abandonment fears theory. Why is it SO much harder to forgive myself than it is to forgive someone else? I’ve taken so much abuse from other people; you’d think the one person I could expect a little sympathy from would be myself.

Strategies Emphasized in Treatment

Cognitive strategies are important in building people’s motivation to change. The main strategy is educational: People explore the advantages and disadvantages of punishment versus forgiveness. They list both the consequences of punishing a person (or themselves) and of being more forgiving and encouraging the person to reflect on the behavior. Exploring the advantages and disadvantages helps the person accept intellectually that punishment is not an effective way to deal with mistakes. Becoming convinced on a cognitive level that the cost of the schema is greater than the benefit can help strengthen the persons resolve to battle the schema.

Because the schema is almost always the internalization of a parent’s Punitiveness schema, much experiential work focuses on externalizing and fighting the Punitive Parent mode. In imagery, people picture the parent talking to them in the punitive tone of voice. They talk back to the parent, saying, “I’m not going to list to you anymore. I’m not going to believe you anymore. You’re wrong, and you’re not good for me.” Doing imagery work with the Punitive Parent gives a person a way to distance from the schema and to make it feel less ego-syntonic. Rather than hearing the punitive voice of the schema as their own voice, they hear it as their parent’s voice. People can say to themselves: “This is not my voice that is punishing me; this is my parent’s voice. Punishment wasn’t healthy for me in childhood, and I’m not going to punish other people (or myself) anymore, especially the people I love.”

My problem here is, I don’t remember my parents yelling much at all; at least not until I was in middle school and high school. Then we SCREAMED at each other almost every day. My self-punishment started well before this. But when I was younger I just can’t recall. I don’t have a lot of memories from that age though so maybe. I do remember being spanked as a kid every now and again, but that was pretty rare and only for the bigger transgressions. I don’t think that would be enough to spark this. Then again, I can’t say either way.

The aim of behavioral strategies is to practice more forgiving responses in situations where people have urges to blame themselves or others. By practicing this they can compare whether the consequences match their dire predictions.

I don’t know how to forgive myself. I always feel like it’s my fault if something goes wrong because I put myself in that position. If a bad thing happens I have no one to blame but myself (even if it was someone else that hurt me < — I know this is faulty logic). I’m not even sure I see the point of forgiving myself. Will that help me make better decisions in the future? No. It would just feel like I’m not taking responsibility for my actions.

Special Problems with This Schema

This can be a difficult schema to change, particularly when it is combined with the Defectiveness schema. The person’s sense of moral indignation and injustice can be very inflexible. Maintaining the person’s motivation to change is the key to treatment. It’s important to stay focused on the costs and the benefits of the schema in terms of improved self-esteem and more harmonious interpersonal relationships.

My inner monologue is a capital B-I-T-C-H. < —- This is the more polite word I was thinking of actually. As bad as some people believe Borderlines are to others, that’s nothing compared to how bad we can be to ourselves. The way I treat myself is magnitudes worse than how I treat anyone else.

I’m not Perfect… Yet – Unrelenting Standards / Hypercriticalness

Another day another Schema. Just two more to go! The one we’re covering today is especially relevant for me.

Unrelenting Standards/Hypercriticalness

Typical Presentation of the Schema

People with this schema present as perfectionistic and driven. They believe that they  must continually strive to meet extremely high standards. These standards are internalized; therefore, unlike the Approval-Seeking/Recognition-Seeking schema, people with the unrelenting Standards schema do not as readily alter their expectations or behaviors based on the reactions of others. These people strive to meet standards primarily because they “should,” not because they want to win the approval of other people. Even if no one were ever to know, most of these people would still strive to meet the standards. People often have both the Unrelenting Standards and Approval-Seeking/Recognition-Seeking schemas, in which case they seek both to me very high standards and to win external approval.

If I were to hazard a guess I’d say that my brother has both of these, where I only have the Unrelenting Standards schema. Ok, I may have some Approval-Seeking in there as well, but I think it’s highly overshadowed by my need to meet the standards I believe I should reach. No one sets standards for me. I do. If what I do is not perfect, it’s not good enough. If I am not perfect, I am not good enough. I’ll make elaborate dishes of food, costumes, etc., and if I think there’s even a chance of them not meeting the standard I think they should I’ll scrap it all and toss them right out.

 It’s like I believe I’m only as good as my accomplishments.

The most typical emotional experienced by patients with the Unrelenting Standards schema is pressure. This pressure is relentless. Because perfection is impossible, the person must perpetually try harder. Beneath all the exertion, patients feel intense anxiety about failing – and failing means getting a “95” rather than a “100”. Another common feeling is hyper criticalness, both of themselves and of others. Most of these patients also feel a great deal of time pressure: There is so much to do and so little time. A common result is exhaustion.

This is perfectly me. When I was at University I would study from the time I woke up until I passed out in the Science and Engineering Library. If I received a homework assignment, quiz, or exam that wasn’t perfect I refused to let anyone know my score, even though I routinely scored higher than everyone else. Making any mistake at all filled me with shame that someone would judge my failing. Pressure. Everything feels like so much pressure. The anxiety starts in the pit of my stomach and seeps out through my pours until I’m weighted down by a wet blanket of my own expectations. The only relief is to be flawless…. Which never quite happens. Which always remains just out of reach.

It is difficult to have unrelenting standards, and it is often difficult to be with someone who has unrelenting standards. Another common feeling in people with this schema is irritability, usually because not enough is getting done quickly enough or well enough. Yet another common feeling is competitiveness. Most people who are classified as “type A” – that is, as demonstrating a chronic sense of time pressure, hostility, and competitiveness – have this schema.

Well I definitely have the irritability part down. If I ask someone to do something and it’s not done by precisely the time I need it done by, exactly how I need it to be done, I begin to fume. Consequently I tend to do a lot of things myself because at least I know I’ll do it right. Which doesn’t do anything to relieve the intense amount of pressure I already feel. However I am in no way competitive at all. Competition is the equivalent of being judged in my mind and I want to avoid judgments at all costs.

Often, people with the Unrelenting Standards schema are workaholics, working incessantly within the particular realms to which they apply their standards. The realms can be varied: school, work, appearance, home, athletic performance, health, ethics or adherence to rules, and artistic performance are some possibilities. In their perfectionism, these people often display inordinate attention to detail and often underestimate how much better their performance is relative to the norm. They have rigid rules in many areas of life, such as unrealistically high ethical, cultural, or religious standards. There is almost always an all-or-nothing quality to their thinking: People believe that either they have met the standard exactly or they have failed. They rarely take pleasure from success, because they are already focused on eh next task that must be accomplished perfectly.

People with this schema do not usually view their standards as perfectionistic. Their standards feel normal. They are just doing what is expected of them. In order to qualify as having a maladaptive schema, the person must have some significant impairment related to the schema. This could be a lack of pleasure in life, health problems, low self-esteem, unsatisfying intimate or work relationships, or some other form of dysfunction.

Lack of pleasure in life? Check. Low self-esteem? Check. Unsatisfying intimate or work relationships? Check. How about self-loathing? Or chronic disappointment? It’s funny, because I don’t view my standards as perfectionistic. I often say I don’t believe in perfection because to me perfection equates to stagnations. However, there’s always room to grow and improve. There’s always something more to learn. There’s always some way to make what I’m doing, better.

Goals of Treatment

The basic goal of treatment is to help people reduce their unrelenting standards and hyper criticalness. The goal is twofold: to get people to try to accomplish less, and to accomplish it less perfectly. Successfully treated people have more of a balance in their lives between accomplishment and pleasure. They play, as well as work, and do not worry as much about “wasting time” and feeling guilty about it. They take the time to connect emotionally to significant others and are able to allow something to be imperfect and still consider it worthwhile. Less critical of themselves and others, they are less demanding and more accepting of human imperfection, and are less rigid about rules. They come to realize that their unrelenting standards cost more than they gain: In trying to make one situation slightly better, they are making many other situations a lot worse.

Bleh.  Accomplish less and accomplish less perfectly? This sounds horrid. I actually can not fathom why I would want to do this. How can someone love me if I’m flawed and not the best that I can be?

Strategies Emphasized in Treatment

It’s important for people to learn to challenge their perfectionism. They learn to view performance as lying on a spectrum from poor to perfect – with many gradations in between – rather than as an all-or-nothing phenomenon. Conducting cost-benefit analyses of perpetuating their unrelenting standards is also helpful. They ask themselves: “If I were to do things a little less well, or if I were to do fewer things, what would the costs and benefits be?” Here the advantages of lowering standards can be highlighted – all the benefits that would accrue to their health and happiness, all the ways they are suffering as a result  of their unrelenting standards, and all the ways the schema is damaging their enjoyment of life and relationships with significant others. The cost of the schema is greater than the benefits: This conclusion is the leverage that can motivate a person to change. It’s also important to reduce the perceived risks of imperfection. Imperfection is not a crime. Making mistakes does not have the extreme negative consequences that people anticipate.

It feels like the consequences will be extreme though. If I feel like I’m not performing to the standard I should at work, I have a low lying dread that bubbles over into heart clenching anxiety that I will get fired. Taking breaks, taking lunch, this is all time I’m afraid someone will see me not working and I will get in trouble for because I am not utilizing every moment towards productivity. Don’t even try to convince me that taking vacation and sick days are ok. I feel guilty and like I’m practically guaranteed to get suspended or judged as being a slacker. And don’t even get me started about my appearance. Right now I am not at my ideal weight and I am hideous. I obsess and dwell on every perceived imperfection endlessly, regardless of the fact that no one else seems to see these things. I don’t want to go out in public if I’m not at my ideal place within my own skin.

The Unrelenting Standards schema seems to have two different origins, with different implications for treatment. The first and more common origin is the internalization of a parent with high standards.

The second origin of the Unrelenting Standards schema is as a compensation for the Defectiveness schema: People feel defective and then overcompensate by trying to be perfect.  

I think I qualify for both here. I know I feel defective, however I also had a father that pushed us to constantly achieve bigger and better standards.

Special Problems with This Schema

The biggest obstacle by far is the secondary gain that comes from the schema: There are so many benefits to doing things so well. Many people with this schema are reluctant to give up their unrelenting standards because, to them, it seems that the benefits far outweigh the costs. In addition, many people are afraid of embarrassment, shame, guilt, and their own self-criticalness, if they do not live up to the standards. The potential for negative affect seems so high that they are reluctant to risk lowering their standards even a little bit. Moving slowly can help these people, as can closely evaluating the outcomes of lowering the standards.

Embarrassment. Shame. Guilt. Self-Criticalness. Yep. Having these standards for the things that I do is proof that I have something to offer people. If I have nothing to offer, why will people stick around? I inherently feel like I’m a bad person. Being able to do these things is a way of proving that I have some good in me. Something good to offer. Something to keep people around. Something to keep them from leaving. Something for others to value in me. Why would I want to “fix” this? Why would I want to diminish the things that make me of value to other people?  Because the things that I can do for people does not actually comprise the entirety of my value. The few friends that I’ve talked to about this (Friend and Roommate) have told me that even if I were to never do any of the baking or cooking, or painting, or crafting, or whatever the things I do for other people, it wouldn’t change the fact that this is not all of who I am. They tell me I’m sweet, funny, loyal, an amazing listener, incredibly intelligent (with the most bizarre range of knowledge), caring… and all these other things. All these other things are the reasons people like having me around, not just because I make a killer pie. I don’t see it though. Or I do, but it’s lost in the shadow of my imperfections. You know the expression, “A chain is only as strong as its weakest link”? That’s how I feel about myself. I’m only as good as my worst flaw. And I’ve had a very flawed life. I think that’s the cost of being human though. I need to learn to let the past remain where it belongs, in the past. Maybe not forget it, definitely learn from it, but also let it go so I can move into the future with more knowledge that I can do things differently.

Big Girls Don’t Cry — Emotional Inhibition

 Another day, another, something.

Emotional Inhibition probably sounds like a contradiction in Borderline Personality Disorder. Often we can be explosive and the very embodiment of emotionality. For me this is of course true, however, it’s not constant. My Therapist has often said that that extreme end of the emotional spectrum is not  how most Borderlines walk through their day to day lives. For me I mire myself in a Detached Protector space. I was raised to keep my emotions inside. It’s not until I’ve kept them in for so long that I can no longer contain the emotional pressure that I flip my lid. At some point I went from emotionally inhibited as a child, to explosive and uncontrollable as an adolescent, to gaining a sense of self-awareness and back to my emotionally inhibited norm.

Emotional Inhibition

Typical Presentation of the Schema

These patients present as emotionally constricted and are excessively inhibited about discussing and expressing their emotions. They are effectively flat rather than emotional and expressive, and self-controlled rather than spontaneous. They usually hold back expressions of warmth and caring, and often attempt to restrain their aggressive urges. Many patients with this schema value self-control above intimacy in human interactions and fear that, if they let go of their emotions at all, they might completely lose control. Ultimately, they fear being overcome with shame or bringing about some other grave consequence, such as punishment or abandonment. Often, the over control is extended to significant others in the persons environment (the person tries to prevent significant others from expressing both positive and negative emotions), especially when these emotions are intense.

It’s not that I value intimacy less than self-control, but intimacy is a vulnerable place. Being in control presents a more impenetrable emotional defense. Unsurprisingly I have a tendency to be all emotional or all logical. All one, none of the other.

People inhibit emotions that it would be healthier to express. These are the natural emotions of the Spontaneous Child mode. All children have to learn to rein in their emotions and impulses in order to respect the rights of other people. However, patients with this schema have gone too far. They have inhibited and overcontrolled their Spontaneous Child so much that they have forgotten how to be natural and to play. The most common areas in which people are overcontrolled include inhibition o anger, inhibition of positive feelings such as joy, love, affection, and sexual excitement; excessive adherence to routines or rituals; difficulty expressing vulnerability or communicating fully about one’s feelings; and excessive emphasis on rationality while disregarding emotional needs.

::sigh:: Let’s see… Being spontaneous actually makes me anxious. Doing things at the last minute means I haven’t had time to prepare myself for it. I’ve taught myself to fight my way through this to an extent at least. Therapist asked me once to recall an experience when I felt joyful. I told her I wasn’t sure what joy was. Joy and love I believe I am almost incapable of feeling from another person. Joy is not hypomanic euphoria as far as I know. And I don’t think my obsessive love is the kind of love they mean. I absolutely don’t believe other people can associate these things with me.  I refuse to be vulnerable. Ironically on this blog it seems easy for me to lay out all of my emotional vulnerabilities to a bunch of complete strangers. In real life, this is something I absolutely cannot show. “Excessive emphasis on rationality while disregarding emotional needs,” I constantly undermine mine, and often other peoples, emotional needs. This is a big flaw of mine. I know it’s a learned trait as well. I was told so often to not express emotions, to suck it up, to toughen up, that something inside me feels like everyone should be able to do this.

People with the Emotional Inhibitions schema frequently meet the diagnostic criteria for obsessive-compulsive personality disorder.  In addition to being emotionally constricted, they tend to be overly devoted to decorum at the expense of intimacy and play, and are rigid and inflexible rather than spontaneous. People who have both the Emotional Inhibitions and Unrelenting Standards schemas are especially likely to meet diagnostic criteria for Obsessive-Compulsive Personality Disorder, because the two schemas together include almost all the criteria.

I definitely have my OCD tendencies. It was much, much worse when I was in middle school and high school. To this day I still have a few things that I have not been able to rid myself of. I can not be late, I must be on time. I have to eat with certain kinds of silver ware on certain kinds of flat ware (in my own home … restaurants and other people’s houses are different b/c I don’t have established patterns there), I eat certain food a specific way, there are probably more that I’m missing. If I didn’t follow my rituals or patterns – full on PANIC ATTACK. The world may as well be ending my anxiety was so I high I couldn’t breathe or stop the tears from falling. Which made it worse because my meticulously applied make up was now no longer precision drawn. Frustration.  I think this may have more to do with a need for structure and control than as part of emotional inhibition though. That’s just my guess.

The most common origin for the Emotional Inhibition schema is being shamed by parents and other authority figures when, as children,  patients spontaneously displayed emotion. This is often a cultural schema, in the sense that certain cultures place a high value on self-control. The schema often runs in families. The underlying belief is that it is “bad” to show feelings, to talk about them or act on them impulsively, whereas it is “good” to keep feelings inside. People with this schema usually appear to be self-controlled, joyless, and grim. In addition, as a result of a reservoir of unexpressed anger, they are frequently hostile or resentful.

Well, yeah. My dad loved me, he still does, I know he does, but he was the product of an unmedicated bipolar mother and a violently alcoholic father with a military upbringing. Growing up my dad was always very loving, I remember a lot of hugs, and the pictures of me sleeping on his chest, but anytime my emotions got the better of me or I had a tantrum or frustration, it was always: STOP! Even when my grandmother died when I was 7 years old I couldn’t allow myself to cry in front of anyone. I was 7 years old. Crying, sadness, fear, all feel shameful to me.  It doesn’t surprise me at all that this kind of emotional inhibition would lend itself to my hostility and resentfulness.

People with the Emotional Inhibition schema often become romantically involved with partners who are emotional and impulsive. We believe this is because there is a healthy part of them that wants in some way to let the Spontaneous Child inside of them emerge. When inhibited people marry emotional people, the couple sometimes becomes increasingly polarized over time. Unfortunately, sometimes the partners begin to dislike each other for the very qualities that first attracted them: The emotional partner scorns the reserve of the inhibited one, and the inhibited partner disdains the intensity of the emotional one.

Unsurprising to me, this is what drew me to Evil-Ex. Growing up believing that it was not acceptable to express my emotions, being different was frowned upon (though I actively rebelled against this – I still felt the social and personal pressure that people did not approve of my life style), acting out in a crowd was not ok, and having just received my graduate degree from a highly structured engineering program, I was emotionally repressed beyond measure.  … Evil-Ex was the embodiment of emotional enablers. When we were together we were flashy and creative. He was loud and the center of the party. He used to tell me my cool head was the perfect balance for his hot heart. In the end though we both highly resented each other. He had no concept of consequences or conscience. I was afraid to lose myself to passion, even though I wanted to. In a way I’m still looking for this. I look for people that can draw me out. That are more emotional, more social, than I am.

Goals of Treatment

The basic goal of treatment is to help people become more emotionally expressive and spontaneous. Treatment helps people learn how to appropriately discuss and express many of the emotions they are suppressing. People learn to show anger in appropriate ways, engage in more activities for fun, express affection, and talk about their feelings. They learn to value emotions as much as rationality, and to stop controlling the people around them, humiliating others for expressing normal emotions, and feeling shame about their own emotions. Instead, they allow themselves and others to be more emotionally expressive.

Part of my problem is that it’s not that I just have a problem expressing my emotions. I have a hard time determining what I’m feeling at all. When I’m stressed out I tend to detach from my emotional state. It’s impossible to express how you’re feeling when you aren’t able to determine what it is you’re feeling in the first place.

Strategies Emphasized in Treatment

Behavioral strategies are directed at helping people discuss and express both positive and negative emotions with significant others, and engage in more activates for fun.

Experiential work can enable people to access their emotions. By considering a situation from youth or childhood you can look at how a parent or caregiver suppressed emotional needs. As an adult it is possible to confront the parent and encourage the inner child to express their real feelings such as anger and love.  This can also be done with current and future situations.

Cognitive strategies help the person accept the advantages of being more emotional, and thereby make the decision to fight the schema. The process of fighting the schema is about seeking a balance on a spectrum of emotionality rather than as all-or-nothing. The goal is not for people to flip to the other extreme and become impulsively emotional; rather, the goal is for people to reach a middle ground.

I already do this. I flip from all one to all the other with no middle ground. I’m all logic, or all passion. At work I know my demeanor is pretty inflexible. I joke around but my humor is pretty dry. If I’m at work, hanging out with a group of people, it’s nearly impossible to ruffle me emotionally. If you put on music and I lose myself in the rhythm to dance, or if I’m having sex, there’s no left brain, I’m all emotion and heat.

Cognitive strategies can also help people evaluate the consequences of expressing their emotions. People with this schema are afraid that, if they express their emotions, something bad will happen. Often, what they fear is that they will be humiliated or made to feel ashamed. It is absolutely possible the see that it is possible to use good judgment about expressing emotions, so that this is not likely to happen, and allows them to feel more comfortable and willing to experiment.

This is definitely my problem. Especially when it comes to showing any kind of fear or sadness. I cannot, CANNOT, show vulnerability. When my co-worker told us he was leaving another male colleague said to me, “You and me can sit down and have a good cry together when he finally leaves.”

I responded with, “Please, I don’t cry.”

“Never?”

“No, never.”  I joke about having my tear ducts removed. I laugh and say things like, please, I’m practically a robot, tears would rust my system.

I do not come across as soft. I am strong and independent and a little insensitive. This is an image I cultivate especially for work. I’m afraid if I show “girly” emotions I will be judged as weak and my credibility will be destroyed and I won’t be taken seriously. Or someone will see this display of weakness which will allow them to believe they can try to take advantage of me. Or it will highlight the fact that “I’m not one of the guys”, different, an outsider. I hate it when the guys at work make a point of mentioning I’m a girl. It compounds the fact that I am out of place. Showing these softer emotions will drive the rift further.

There are a wealth of potential behavioral role plays and homework assignments. People can practice discussing their feelings with other people, appropriately expressing both positive and negative feelings, playing and being spontaneous, and doing activities designed for fun. Working with the partner can be useful. It can help to encourage both the person and the partner to express feelings in constructive ways.  Sometimes it also helps for the person to design tests of their negative predictions, writing down what they predict will happen if they express their emotions, and comparing it to what actually happens. In this way they can see that their fears will not become real.

Special Problems With This Schema

When people have been emotionally inhibited for virtually their entire lives, it is hard for them to begin acting differently. Expressing emotions feels so foreign to people with this schema – it is so contrary to what feels like their true nature – that they experience great difficulty doing it.

I’m not completely emotionally inhibited, especially if my anger gets the best of me, but I know I have a problem expressing emotions in a healthy manner. Even a pleasant emotion like when people do nice things for me, things I should be happy about I don’t feel happy. I appreciate what people do but I don’t attach an emotion to it. However I know that people expect to see an emotional response so I often affect what I think they need to see. I have this weird juxtaposition of knowing what I should feel, not actually feeling, but believing I should display it. It makes working in my head a little confusing sometimes.  

I’ve been working on this though. I think my actions tend to mismatch my words. I talk a tough game. When I’m one on one with a significant other though, I snuggle in close. It’s like I have a face I show the outside world, and one that only the people very closest to me can see.

Why Bother Reading This? Nothing Helps Anyways – Negativity/Pessimism

Happy Monday! Ok, maybe it’s more like, Monday! ::grumble grumble::  It is what it is I guess.

Back to the Schema of things. We’re getting into the final Domain: Over vigilance and Inhibition Domain.  I think this one is my favorite. And by favorite I mean, the one that I have the most problems in.

Negativity/Pessimism

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.



Look at Me, Look at ME! – Approval-Seeking/Recognition Seeking

Today I’m doing another Schema. I really just want to get these done. This one isn’t something I relate to so much. I think it’s more a characteristic of Narcissistic Personality Disorder than Borderline Personality Disorder. But it’s on the list so I feel obligated to include it. Feel free to skip to the end and just read my musings. The next few I’ll talk about are the good ones.

Approval-Seeking/Recognition Seeking

Typical Presentations of the Schema

These people place excessive importance on gaining approval or recognition from other people at the expense of fulfilling their core emotional needs and expressing their natural inclinations. Because they habitually focus on the reactions of others rather than on their own reactions, they fail to develop a stable, inner-directed sense of self.

There are two subtypes. The first type seeks approval, wanting everyone to like them; they want to fit in and be accepted. The second type seeks recognition, wanting applause and admiration. The latter are frequently narcissistic patients: They overemphasize status, appearance, money, or achievement as a means gaining the admiration of others. Both subtypes are outwardly focused on getting approval or recognition in order to feel good about themselves. Their sense of self-esteem is dependent on the reactions of other people, rather than on their own values and natural inclinations.

Alice Miller (1975) writes about the issue of recognition-seeking in Prisoners of Childhood. Many of the cases she present are individuals at the narcissistic end of this schema. As children, they learned to strive for recognition, because that was what their parents encouraged or pushed them to do. The parents obtained vicarious gratification, but the children grew more and more estranged from their genuine selves – from their core emotional needs and natural inclinations.

The subjects in Miller’s book have both the Emotional Deprivation and the Recognition-Seeking schemas. Recognition-seeking is often, but not always, linked with the Emotional Deprivation schema. However, some parents are both nurturing and recognition-seeking. In many families, the parents are very child-oriented and loving, but also very concerned with outward appearances. Children from these families feel loved, but they do not develop a stable, inner-directed sense of self: Their sense of self is predicated on the responses of other people. They have an undeveloped, or false, self, but it is not a true self. Narcissistic patients are at the extreme end of this schema, but there are many milder forms in which patients are more psychologically healthy yet still devoted to seeking approval or recognition to the detriment of self-expression.

            Typical behaviors include being compliant or people-pleasing in order to get approval. Some Approval-Seekers place themselves in a subservient role to get approval. Other individuals may feel uncomfortable around them because they seem so eager to please. Typical behaviors also include placing a great deal of emphasis on appearance, money, status, achievement, and success in order to obtain recognition from others. Recognition-seekers might fish for compliments  or appear conceited and brag about their accomplishments. Alternatively, they might be subtler, and surreptitiously manipulate the conversation, so that they can cite their sources of pride.

            Approval-Seeking/Recognition-Seeking is different from other schemas that might result in approval-seeking behavior. When patients display approval-seeking behavior, it is their motivation that determines whether the behavior is part of this or another schema. Approval-Seeking/Recognition- Seeking is different from Unrelenting Standards schema (even if the childhood origins may appear similar) in that patients with the Unrelenting Standards schema are striving to meet a set of internalized values, whereas approval-seeking patients are striving to obtain external validation. Approval-Seeking/Recognition-Seeking is different from the Subjugation schema in that the latter is fear-based, whereas the former is not. With the Subjugation schema, patients act in an approval-seeking way because they are afraid of punishment or abandonment, not primarily because they crave approval. The Approval-Seeking/Recognition-Seeking schema is different from the Self-Sacrifice schema in that it is not based on a desire to help others one perceives as fragile or needy. If patients act in an approval-seeking way because they do not want to hurt other people, then they have the Self-Sacrifice schema. The Approval-Seeking/Recognition-Seeking schema is different form the Entitlement/Grandiosity schema in that it is not an attempt to aggrandize oneself in order to feel superior to others. If patients act in an approval-seeking way as a means of gaining power, special treatment, or control, then they have the Entitlement schema.

Most Approval-Seekers probably would endorse conditional beliefs such as “People will accept me, if they approve of me or admire me,”  “I’m worthwhile if other people give m approval,” or “If I can get people to admire me, they will pay attention to me.” They live under this contingency: In order to feel good about themselves, they have to gain approval or recognition from others. Thus, these patients are frequently dependent on other people’s approval for their self-esteem.

The approval-Seeking/Recognition-Seeking schema is often, but no always, a form of overcompensation for another schema, such as Defectiveness, Emotional Deprivation, or Social Isolation. Although many patients use this schema to overcompensate for other issues, many other patients with this schema seek approval or recognition simply because they were raised this way; their parents placed a strong emphasis on approval or recognition. The parents set goals and expectations that were not based on the child’s inherent needs and natural inclinations, but rather on the values of the surrounding culture.

There are both healthy and maladaptive forms of approval-seeking. This schema is common in highly successful people in many fields, such as politics and entertainment. Many of the patients are skillful in intuiting what will gain them approval or recognition and can adapt their behavior in a chameleon-like way, in order to endear themselves to or impress people.

Strategies Emphasized in Treatment

Demonstrating the importance of expressing one’s true self rather than continuing to seek the approval of others is the first step. It is natural to want approval and recognition, but when this desire becomes extreme, it is dysfunctional. Patients can examine the pros and cons of the schema: They weight the advantages and disadvantages of discovering who they truly are and acting on that versus continuing to focus on gaining other people’s approval. In this way, patients can make the decision to fight the schema. If they continue to put all their emphasis on money, status, or popularity, then they are not going to enjoy life fully, they will continue to feel empty and dissatisfied. It is not worth it to “sell one’s soul” for approval or recognition. Approval and recognition are only temporarily satisfying. They are addictive and not fulfilling in a deep and lasting sense.

I don’t know. I don’t really have anything to say about this. In terms of this schema I think I would be someone that overcompensates. I prefer to avoid attention and therefore approval. I stay in the background so people won’t notice me. I am purposefully contradictory. I enjoy playing the devil’s advocate, even if the devil is a decision I don’t actually believe in. If I can push someone away, there’s no chance that they’ll be able to get close enough to hurt me. It’s not until someone becomes an obsession for me that I need their approval and recognition, but this comes from all those other places I think.

Oddly I think my brother falls into this category. My father pushed us so hard in athletics and activities. All these sports had judges and prizes. My brother was the golden child. He was the star athlete. He won every trophy, every blue ribbon, and every gold medal. His face was constantly in the newspaper. He was the leader, the head of the team, the president of his fraternity. He emphasizes wealth and status to a degree I can’t even fathom. I don’t care about these things at all.

In high school when I was a senior, he was a freshman. At that point I had fully rebelled against my parents, wore nothing but black and shock rock makeup/piercings, was completely Goth, the only Goth in my entire district in fact so I was terribly, ostentatiously different. Misunderstood by everyone. My brother was the golden child, star athlete, in his pressed and sporty clothes, whom everyone adored. Everyone knew us both, for very different reasons. We avoided each other. Me because I simply didn’t care and was consumed by my own preoccupations. Him, because as he once told me, he was embarrassed by how I dressed, “Why can’t you just be normal”. Why would I want to be?  To anyone that took the time to talk to me I was actually a very nice person with a lot of interesting things to talk about. I was sick of guys only interested in using me for my body or my looks. If you wanted to get close to me, you had to display a willingness to overlook the superficial and get to know me. Was that so bad? I don’t think so.

My brother and I get along fantastically now. I calmed down my outside image, and he has a more accepting mind towards things that are outside of the norm. I definitely think he falls into this Schema, but I don’t think it’s entirely maladaptive. Or unwarranted. I mean, he definitely has a need for attention and approval, but this is how we were raised. And to his credit, he’s also exceptionally good at the things he does and leading a life that is quite successful. I know he struggles with depression though which is a big indicator that all isn’t well in Beaver Cleaver land.

Until There’s Nothing Left – Self-Sacrifice

As it turns out I didn’t leave my Schema book at home, I just buried it in exactly the place it should have been ::headdesk:: There’s this new thing I’m trying, it’s called: Opening my eyes, before I fluster myself up too much. ::sigh::

So let’s bang on! Next Schema is Self-Sacrifice.

Self-Sacrifice

Typical Presentation of the Schema

People with this schema, like those with the Subjugation schema, display an excessive focus on meeting the needs of others at the expense of their own needs. However, unlike patients with the Subjugation schema, these patients experience their self-sacrifice as voluntary They do it because they want to prevent other people from experiencing pain, to do what they believe is right, to avoid feeling guilty or selfish, or to maintain a connection with significant others whom they perceive as needy. The Self-Sacrifice schema often results from what we believe to be a highly empathic temperament – an acute sensitivity to the pain of others. Some people feel the psychic pain of others so intensely that they are highly motivated to alleviate or prevent it. They do not want to do things or allow things to happen that will cause other people pain. Self-Sacrifice often involves a sense of over-responsibility for others. It thus overlaps with the concept of codependence.

Hmmm, I often do things for other people but not because I empathize with them. I do things because I’m afraid I’ll lose their approval and therefore my connection to them. If I’m honest it’s kind of selfishly motivated.

It is common for patients with this schema to have psychosomatic symptoms such as headaches, gastrointestinal problems, chronic pain, or fatigue. Physical symptoms may provide these patients with a way to bring attention to themselves, without having to ask for it directly and without conscious awareness. They feel permission to receive are or to decrease their care for others if they are “really sick”.  These symptoms may also be a direct result of the stress created by giving so much and receiving so little in return.

Nope. Not even a little. If I’m sick I refuse to admit it. I have an unreasonable tolerance for pain (I mean, hi, I’m a cutter). If I’m injured it’s likely that I’ll go even further out of my way to do something for other people just to ‘prove’ how little pain I’m in. In retrospect this strikes me as overcompensating. I have a severe aversion to letting people see manifestations of weakness in me.

People with this schema almost always have an accompanying Emotional Deprivation schema. They are meeting the needs of others; but their own needs are not getting met. On the surface, they appear content to self-sacrifice, but underneath, they feel a deep sense of emotional deprivation. Sometimes they feel angry at the objects of their sacrifice. Usually patients with this schema are giving so much that they end up hurting themselves.

Ah. Now here’s something I fight with. Here’s something I fight with a lot. I believe this is part of why I’m still as close to Friend as I am. Being around him and the wife is still heart wrenching for me, yet I go out of my way to do elaborate things to take care of them, or him specifically and her by default because there’s no way to avoid it if I want to take care of him. Half the time I’m over at their place I’m flipping moods between emotionally numb, angry, jealous, hurt, and intense frustration at the their cluelessness when they intentionally stab at my emotions. Do I show it? Do I tell them? No, I suppress. It’s not my place so I suffer inside and don’t let anyone know. This is where the wine comes in handy.

Often, these people believe that they do not expect anything back from others, but when something happens and the other person does not give as much back, they feel resentful. Anger is not inevitable with this schema, but people who self-sacrifice to a significant degree, and have people around them who are not reciprocating, usually experience at he least some resentment.

Gold Star for the psych book. This is a HUGE deal for Borderlines. I didn’t recognize this in myself for a very long time. I didn’t really see what I was doing until I recognized it in a Borderline friend of mine. She would give and give and give, proclaim her selflessness, and then hold up all her examples of giving as a reason why someone else should want to choose her or do something for her, and proceed to melt down when she wasn’t made the priority, even though she did all these things when no one asked it of her. That’s not to say her efforts weren’t appreciated, they certainly were, but her expectations that the other people should put their life on hold, or rearrange their heart for her because of all of these displays was just unreasonable. I have this problem too.  Where she would break down into a sea of tears and despair, I would rage and resent. She would redouble her efforts to win back their love and attention and make them appreciate her more. I would withdraw my attention, my affection, lash out (more subtlety now), guilt and show how hurt I was… you won’t do this one thing for me after all of that? Fine, fuck you, you don’t deserve anything anymore, ever, you’re not the person I thought you were, clearly you don’t give a shit about me or what I need, you’re a terrible friend that was probably just using me for your own purposes any…. Check out the Splitting! Either way, it’s something I now recognize as that classic Borderline manipulation. We don’t do it on purpose, but the wave of emotions that crash over us when we feel we’ve been taken advantage of because our needs aren’t being met after we’ve sacrificed so much is overwhelming.

As previously noted in Subjugation, it is important to distinguish self-sacrifice form subjugation. When people have the Subjugation schema, they surrender their own needs out of fear of external consequences. They are afraid that other people are going to retaliate or reject them. With the Self-Sacrifice schema, people surrender their own needs out of an inner sense or standard. Subjugated people experience themselves as being under the control of other people; self-sacrificing patients experience themselves as making voluntary choices.

My ordeal with Evil-Ex was Subjugation. My need to take care of everyone else in my life is Self-Sacrifice. At least I think it is. I recognize that my actions are my choice, which makes them voluntary, but there’s always a motivation behind it. That motivation is fear of losing the people I care about. Fear of being abandoned by the people I need around me. If I don’t do something for them, don’t give them a reason to need me in their life, what could possible make them want to keep me around? My shining personality? I don’t believe it, I need to make myself indispensable to someone’s life or else I’ll be easy to replace.

The origins of these two schemas are different as well. Although the two overlap, they are almost opposite in their origins. The origin of Subjugation is usually a domineering and controlling parent; with the Self-Sacrifice, the parent is typically weak, needy, a childlike, helpless, ill, or depressed. Thus, the former develops from interaction with a parent who is too strong, and the latter with a parent who is too weak or ill.

My father = too strong. My mother = too weak. I have always had a need to impress, please, and rebel against my father. My mother just makes me angry.

People with the Self-Sacrifice schema typically exhibit behaviors such as listening to others rather than talking about themselves; taking care of other people, yet having difficulty doing things for themselves; focusing attention on other people, yet feeling uncomfortable when attention is focus on them, and being indirect when they want something, rather than asking directly.

There can also be secondary gain with this schema. The schema has positive aspects and is only pathological when brought to an unhealthy extreme. Patients might feel a sense of pride in seeing themselves as caretakers. They might feel that they are good for behaving altruistically, that they are behaving in a morally virtuous way. (In contrast, sometimes the schema has a “never enough” quality, so that no matter how much self-sacrifices do, they still feel guilty that it is not enough.) Another potential source of secondary gain is that the schema might draw other people to them. Many people enjoy the empathy and help of the self-sacrifice. People with this schema usually have many friendships, although their own needs often are not being met in these relationships.

In terms of over compensatory behaviors, after self-sacrificing for a long time, some patients suddenly flip into excessive anger. They become enraged and cut off giving to the other person completely. When self-sacrificers feel unappreciated, they sometimes retaliate by conveying to the other person: “I’m not going to give you anything ever again.”

There we go. Yeah, I do this. It doesn’t usually last long. More often than not I get paranoid that if I withhold myself for too long I’ll be  abandoned and no longer needed so slip right back into the mode of doing things for other people. Only this time there’s an added layer of resentment underneath.

Goals of Treatment

One major goal is to teach that all people have an equal right to get their needs met. Even though these patients experience themselves as stronger than others, in reality, most of them have been emotionally deprived. They have sacrificed themselves and  have not gotten their own needs met in return. Therefore, they are needy – just as needy as most of the “weaker” people they devote themselves to helping. The primary difference is that these people do not experience their own needs, at least not consciously. They have usually blocked out the frustration of their own needs in order to continue self-sacrificing.

Which makes it important to help these people recognize that they have needs that are not being met, even though they are not aware of them; and that they have as much right to get their needs met as anyone else.

It’s also important to decrease the sense of over responsibility. Often these people exaggerate the fragility and helplessness of other people. If the person were to give less, the other person would usually still be fine. In most cases the other person is not going to fall apart or experience unbearable pain if the patient gives less.

Remedying the associated emotional deprivation is also important. To do this the person must learn to attend to their own needs, let other people meet their needs, ask for what they want more directly, and be more vulnerable instead of appearing strong most of the time.

Strategies Emphasized in Treatment

Awareness of other schemas that underlie Self-Sacrifice is important; Emotional deprivation for instance. Defectiveness is also a common linked schema: These people “Give more” because they feel “worth less” (Ugh, a world of yes). Abandonment can be a linked schema: People self-sacrifice in order to prevent the other person from abandoning them. Dependence can be a linked schema: Patients self-sacrifice so that the parent figure will stay connected to them and keep taking care of them. Approval-Seeking can be a linked schema; People take care of others to get approval or recognition.

Emotional Deprivation: Check

Defectiveness: Check

Abandonment: Check

It’s important for people with this schema to become aware of their emotional deprivation. Expressing sadness and anger about their unmet emotional needs is key. Behaviorally it’s necessary to learn to ask to have their needs met more directly, and to come across as vulnerable instead of strong. (I don’t like this idea at all). They need to learn to select partners who are strong and giving rather than weak and needy. In addition, learning to set limits on how much they give to others is important.

In a sense, this schema is the opposite of the Entitlement schema. The entitlement schema involves self-centeredness: the Self-Sacrifice schema involves other-centeredness. These two schemas “fit” together well in relationships:  Patients who have one of these schemas often end up with a partner who has the other. Another common combination is one partner with a Self-Sacrifice schema, and the other with Dependent Entitlement. The self-sacrificer does everything or the entitled partner.

HOLY CRAP! This is Friend and his wife. I have never met a woman that was so lazy, selfish and self-entitled and utterly incapable of doing anything for herself. He does everything for her so she doesn’t have to budge from the couch. That explains so much.

Special Problems with This Schema

One problem is that there is often a high cultural and religious value placed on self-sacrifice. Furthermore, self-sacrifice is not a dysfunctional schema within normal limits (Parents should take care of their children, loving partners and friends do things for one another). Rather, it is healthy to be self-sacrificing to a certain degree. It becomes dysfunctional when it is excessive. For a person’s self-sacrifice to be a maladaptive schema, the self-sacrifice has to be causing problems for the person. It has to be creating symptoms or creating unhappiness in relationships. There has to be some way it is manifesting itself as a difficult: Anger building up, the patient is experiencing psychosomatic complaints, feeling emotionally deprived, or otherwise suffering emotionally.

Wow, this was really really long today. Sorry! Hope you managed to get through it all. I guess I had a little bit of pent up feelings towards this schema.

Powerless Against You – Subjugation

Yesterday was a holiday for those of us in the US so I didn’t have therapy. Frankly I wish I had stayed in New York instead of travelling to see my family. For as annoying as going to therapy every week can be it’s better for me to maintain my structure than to throw myself off into triggering situations. So today I’ll throw another schema at you guys.

We’re moving into the Domain of Other-Directedness, specifically the schema of Subjugation.

Typical Presentations of the Schema

People with this schema allow other people to dominate htem. They surrender control to others because they feel coerced by the threat of either punishment or abandonment. There are two forms: The first is subjugations of needs, in which people suppress their own wishes and instead follow the demands of other people; and the second is s subjugation of emotions, in which people suppress their feelings (mainly anger) because they are afraid other people will retaliate against them. The schema involves the perception that one’s own needs and feelings are not valid and important to other people. The schema almost always leads to an accumulation of anger, which manifests in such maladaptive symptoms as passive-aggressive behavior, uncontrolled outbursts of anger, psychosomatic symptoms, withdrawal of affection, acting out, and substance abuse.

Oi! This is me all over the place. Every single thing: accumulation of anger, uncontrolled outbursts, psychosomatic, withdrawal of affection, acting out, alcohol abuse.

People with this schema usually present with a coping style of surrendering to the schema: They are excessively compliant and hypersensitive to feeling trapped.

Hypersensitive to feeling trapped! This is one of the biggest triggers that makes me push away in relationships.

They feel bullied, harassed, and powerless. They experience themselves as being at the mercy of authority figures: The authority figures are stronger and more powerful; therefore, the patients must defer to them. The schema involves a significant level of fear. At the core, people are afraid that if they express their needs and feelings, something bad is going to happen to them. Someone important is going to get angry with, abandon, punish, reject, or criticize them. These patients suppress their needs and feelings, not because they feel they should suppress them, but because they feel they have to suppress them. Their subjugation is not based on an internalized value or a desire to help others; rather, I is based upon the fear of retaliation. In contrast, the Self-Sacrifice, Emotional Inhibition, and Unrelenting Standards schemas are all similar in that people have an internalized value that it is not right to express personal needs or feelings: They believe it is in some way bad or wrong to express needs and feelings, so they feel ashamed or guilty when they do. People with these other three schemas do not feel controlled by other people.  They have an internal locus of control. On the other hand, people with the Subjugation schema have an external locus of control. They believe that they must submit to authority figures, whether they think it is right or not, or else they will be punished in some way.

I don’t know quite how this fits me. I always feel like people are trying to control me, judge me… and I resent it. It makes me extremely angry. I think this is one schema where I overcompensate. I rarely surrender to it so much as rail against it. Or I guess I do both. I fear that I’ll lose someone’s love or friendship so I allow them to exert their opinions or wishes, until the frustration becomes so overwhelming that I act out and flip. This used to be very explosive for me. Now I act in more, I withdraw my affections, refuse to share or give sympathy, and avoid the person(s) until my emotions slip again and I become afraid that I’m losing my connection to them.  

Another thought, is that this particular schema may have less to do with my Borderline tendencies and more to do with the abusive relationships I’ve been in. Especially with my Evil-Ex, I often felt like I had to give in to what he wanted or I would be punished. To be true, often I was punished when I had the audacity to do things that I wanted (like go out with a friend), that didn’t include him. I became so afraid of losing his love and losing the relative peace in our home that I would do anything I could to not disrupt the very tenuous stability we were able to establish.

Thinking about this pisses me the hell off.

Often this schema leads to avoidant behavior. People avoid situations where other people might control them, or where they might become trapped. Some people avoid committed romantic relationships because they experience these relationships as claustrophobic or entrapping. The schema can also lead to overcompensation such as disobedience and oppositionality. Rebelliousness is the most common form of overcompensation for subjugation.

Ah, here we go. I’m all three of these expressions: Surrender, Avoidance, Overcompensation. All brought about my different things, and different scenarios throughout my life. Growing up I always felt like my parents were trying to control me. They over structured my life so I had very little time to do anything other than school and the excessive amount of activities I was involved in. I rebelled. Hard core. I acted out and become utterly uncontrollable.

Goals of Treatment

The basic goal of treatment is to get patients to see that they have a right ot have their needs and feelings, and to express them. Generally, the best way to live is to express needs and feeling appropriately at the moment they occur, rather than waiting until later or not expressing them at all. As long as people express themselves appropriately, it is healthy to express needs and feelings and healthy people usually will not retaliate against them when they do. People who consistently retaliate against them when they express their needs and feelings are not beneficial people for them to choose for close involvements. We encourage patients to seek out relationships with people who allow them to express normal needs and feelings, and to avoid relationship with people who do not.

To this day I have no idea how to find a balance. I still believe my needs and feelings come second to the people around me. At the same time I resent this and believe my needs and feelings SHOULD be acknowledged. This resentment makes me very, very angry. I have no idea how to put this healthy expression of emotions, in the moment, in to practice though. I believe utterly that if I express my needs and feelings that the person I express them too will withdraw their affection and will no longer want to deal with me. 

Strategies Emphasized in Treatment

In terms of cognitive strategies, subjugated people have unrealistic negative expectations about the consequences of expressing their needs and feelings to appropriate significant others. It’s important for these people to understand that their expectations are exaggerated. It is also important to learn that they are acting in a healthy manner when they express their needs and feelings appropriately – even though their parents may have communicated that they were “bad” for doing so as children.

I know this is a problem for me. My father routinely told me to “suck it up and deal”, not to express any negative emotions. He would become very angry at me when I was upset and reacted in an unhappy manner. This taught me the necessity of hiding my emotions and feelings. This taught me to bottle it up and hold them all in.

A good strategy is to express anger and assert your rights through imagery and role play. In a safe environment, go over a scenario involving a controlling person, and work out how to exert your feelings by saying what it is you truly feel the need to express in those situations. Expressing anger is crucial. The more people are able to get in touch with their anger and vent it in imagery the more they will be able to fight the schema in their everyday. The purpose of expressing this anger is not purely for ventilation, but rather to help people feel empowered and to stand up for themselves. Anger supplies the motivation and momentum to fight the passivity that almost always accompanies subjugation.

Behaviorally it’s also important for people to select relatively non-controlling partners. Often, subjugated people are drawn to controlling partners. Working on selecting noncontrolling friends is also important.

Sometimes as a consequence of this schema the persons self is undeveloped. When someone has served the needs and preferences of others so assiduously they do not know their own needs and preferences, then these people need to work to individuate. Identifying their own natural inclinations and practice acting on those is important. For example, through imagery it is possible to recreate scenarios when a person suppress their needs and preferences, then aloud they can express what it is that they needed or wanted to do. They can imagine the consequences and work out what is reasonable to expect and what it out of proportion to the situations.

Special Problems with this Schema

As people experiment with expressing their needs and feelings, often they do it imperfectly. A the beginning, they might fail to assert themselves enough to be heard, or they might swing to the opposite extreme and become too aggressive. 

This is actually a fear of mine. I know I have a tendency to swing between these extremes. I won’t voice what I need enough, or I do become very aggressive.

When subjugated people first try to express their needs and feelings, they often say something like: “But I don’t know what I want. I don’t know what I feel.” In cases such as these where Subjugation is linked to an Undeveloped Self schema, the therapist can help patients develop a sense of self by showing them how to monitor their wishes and emotions.

Again, this is a problem I have. I can’t even count how many times my therapist has asked me how I felt about certain things, and my only response was “I don’t know how I feel”. I don’t know what I should feel, I don’t know what I’m allowed to feel, I don’t know what I have a right to feel.

Leap Before you Look – Insufficient Self Control/Discipline

“The trouble with immediate gratification is that it’s not quick enough” ~Carrie Fisher

Let’s skip the pleasantries and jump right in, shall we?

Insufficient Self-Control/Self-Discipline

Patients who have this schema typically lack two qualities: (1) self-control – the ability to appropriately restrain one’s emotions and impulses;  and (2) self-discipline – the ability to tolerate boredom and frustration long enough o accomplish tasks. These people are unable to restrain their emotions and impulses appropriately . In both their personal and work lives, they display a pervasive difficult in delaying short-term gratification for the sake of meeting long-term goals. They seem not to learn sufficiently from experience – from the negative consequences of their behavior. They either cannot or will not exercise sufficient self-control or self-discipline.

            At the extreme end of the spectrum of this schema are people who seem like badly brought up young children. In milder forms of the schema patients display an exaggerated emphasis on avoiding discomfort. They prefer to avoid most pain, conflict, confrontation, responsibility, and overexertion – even at the cost of their personal fulfillment or integrity.

            Typical behaviors include impulsivity, distractibility, disorganization, unwillingness to persist at boring or routine tasks, intense expression of emotion, such as temper tantrums or hysteria, and habitual lateness or unreliability. All of these behaviors have in common the pursuit of short-term gratification at the expense of long-term goals.

            Every child is probably born with an impulsive mode. It’s a natural part of every human being. However the failure to bring impulsivity under sufficient control and learn self-discipline is what is maladaptive. Children are by nature, uncontrolled and undisciplined. Through experiences in our families and in society as a whole, we learn how to become more controlled and disciplined. We internalize a Healthy Adult mode that can restrain the Impulsive Child in order to meet long-term goals. Sometimes another problem, such as ADHD, makes it hard for the child to accomplish this (this is not a schema issue).

            Often, there are no specific beliefs and feelings that go along with this schema. It is rare for patients with this schema to say, “It’s right to express all my feelings” or “I should act impulsively.” Rather, people experience the schema as being outside of their control. The schema does not feel ego-syntonic in the way that other schemas do. In fact, most people with this schema WANT to be more self-controlled and self-disciplined: They keep trying, but cannot seem to sustain their efforts for very long.

            The impulsive mode is also the mode in which a person can be spontaneous and uninhibited. A person in this mode can play, be light, and have fun. There is a positive side to the mode, but when it is excessive – when it is not balanced by other sides of the self – the cost exceeds the benefit, and the mode becomes destructive to the person.

Goals of Treatment

            The basic goal is to help patients recognize the value of giving up short-term gratification for the sake of long-term goals. The benefits of venting one’s emotions or doing what is immediately pleasurable are not worth the costs in career advancement, achievement, getting along with other people, and low self-esteem.

Strategies Emphasized in Treatment

            The basic idea is: Between the impulse and the action, you must learn to insert thought. It is important to learn to think through the consequences of giving in to the impulse before acting it out.

            Occasionally the Insufficient Self-Control/Self Discipline schema is linked with another schema that may be more primary. For example, sometimes the schema erupts because patients have suppressed too much emotion for too long. This often happens with the Subjugation schema. Over long periods of time, people with the Subjugation schema do not express anger when they feel it. Gradually, their anger accumulates, then suddenly bursts forth in an out-of-control way. When patients display a pattern of swinging between prolonged passivity and sudden fits of aggression, they often have underlying Subjugation schemas. If a person can learn to express what they need and feel appropriately in the moment the anger will not build up in the background. The less people suppress their needs and feelings, the less likely they become to behave impulsively.

In terms of this schema, this is exactly where my problem lies. From the age of 8 years old I was raised in the martial arts. Control and Discipline are two words that are deeply ingrained into my mindset. If you lose control, people get hurt. Outwardly I always appear in control. However for me, this also means suppression of my emotional states. I was told not to express my feelings, not to let people see my next move. So I suppress, subjugate, what I’m actually feeling. This is coupled with the fact that, despite how much I know my father loved me, he was the parent that was primarily responsible for me growing up and he taught me to “suck it up” and not show when things were upsetting to me. I don’t ever recall a time when he tried to understand what was upsetting me. I only remember being told to stop expressing any negative emotion. To this day, any time I feel any kind of emotion that is not ‘positive’ or ‘strong’ I hide it from showing and refuse to express it. I put on a tough face and let people believe that I am unphased. This would result in the most magnificent explosions of anger and violence from me. By the time I turned 12 I began to lose my ability to control my temper. My frustration tolerance was non existent. One morning I was having trouble getting my hair perfect (I was borderline OCD was many things) and put my fist through the bathroom wall in a fit of rage. I would having screaming arguments with my parents almost every single day. I broke down doors, put my fists through windows and walls, my rage was absolutely uncontrollable. It wasn’t just anger that was impulsive though. Stealing, vandalism, sex…. I needed to feel better and I needed to feel better now.

            It’s often helpful to imagine past and current scenes in which insufficient self-control or self-discipline was displayed. From here the scene can be revisited but from the perspective of how a Healthy Adult would act in the situation and exert self-control. This is especially important for people with Borderline Personality Disorder. Because of their Subjugation schemas, people with BPD feel that they are not allowed to express their needs and feelings. Whenever they do, they feel they deserve to be punished by their internalized Punitive Parent. They repeatedly suppress their needs and feelings. As time passed, their needs and feelings build up, beyond their ability to contain them, and then the person flips into the Angry Child mode in order to express them. They suddenly become enraged and impulsive. When this happens, it’s important to vent the frustration fully, treat the situation with empathy, but also reality-check to measure the magnitude of the reaction in proportion to the actual event that triggered it.

I also completely relate to this aspect of Subjugation and needing to punish myself. I absolutely do not believe that I could express what I needed or felt. Hell, I still feel like this. I feel like I have no right to expect others to think about what I need. It’s my responsibility and my responsibility alone to think of myself (though I desperately wish someone would, at least every now and again)… usually after I’ve thought about everyone else first. Letting other people know that I need things is akin to admitting to weakness. Weakness means being vulnerable. Being vulnerable means someone has the chance to take advantage of you. That is not acceptable. So I hold it all in. Bottle it all up. And that works. Until I’m shaken by something. The internal pressure becomes too much. And then it all explodes.

            When the lack of parental involvement in childhood is the origin of this schema it’s important to establish limits and set boundaries.

Special Problems with This Schema

            Sometimes the schema appears to be biologically based and therefore very hard to change with therapy alone, for example, when the patient has a learning problem such as ADHD. If the schema is biologically based, then even when patients are highly motivated and expend tgreat effort, they may be unable to develop sufficient self-control and self-discipline. In practice, it is often unclear how much the schema is linked to temperament and how much it is related to insufficient limits in childhood. Medication should be considered for patients who have persistent difficulty fighting the schema despite an apparent commitment to therapy.

I wonder if this isn’t why so many kids are diagnosed ADHD these days. Instead of taking a good look at the parents and the home life, doctors just jump to the conclusion that it’s biologically determined. They don’t stop to consider that maybe kids aren’t being raised with any/enough discipline or boundaries. Doctors don’t want to make a judgment and blame the parents so they avoid the potential for uncomfortable truths and push for the prescriptions instead.

It’s not the fall that kills you, or is it? – Failure

I’m ready for November to be over. I don’t want it anymore. I’ve never had a particular problem with November but I’m starting to get paranoid and obsessive and I just want it to stop. Ugh. I really didn’t want to write today but I forced myself to anyways. So here’s the next schema.

Failure

Typical Presentation of the Schema

Patients who have a Failure Schema believe that they have failed relative to their peers in areas of achievement such as a career, money, status, school, or sports. They feel that they are fundamentally inadequate compared to others at their level – that they are stupid, inept, untalented, ignorant, or unsuccessful, and that they inherently lack what it takes to succeed.

Typical behaviors of these patients include surrendering to the schema by sabotaging themselves or performing halfheartedly, avoidance behaviors such as procrastinating or not doing the task at all, and overcompensating behaviors such as working nonstop or otherwise overachieving. Over compensators with Failure schemas believe that they are not as smart or talented as other people, but they can make up for it by working extra diligently. They are often quite successful, yet still feel fraudulent. These patients appear successful to the outside world but feel underneath that they are on the brink of failing.

This is me all over. All three aspects: Surrender, Avoid, and Overcompensate. I cycle or shuffle through them all because I’m afraid I don’t have what I need to do what I need to do. Despite all the evidence to the contrary. I always feel like a fraud. No matter how well I know something, how well I’ve done something, no matter how much effort I’ve put towards accomplishing a task well.

            It is important to distinguish between the Failure and Unrelenting Standards schemas. Patients with the Unrelenting Standards schema believe they have failed to meet their own (or their parents’) high expectations, but they will acknowledge that they have done as well or better than the average person in the same occupation. Patients with the Failure Schema believe they have done worse than most others in their occupation, and very often they are right. Most patients with the Failure schema have not accomplished as much as the average person in their peer group. Failure has become a self-fulfilling prophecy in their lives. It is also important to distinguish between the Failure schema and the Dependence/Incompetence schema, which has more to do with daily functioning than with achievement. The Failure schema involves money, status, career, sports, and school; the Dependence/Incompetence schema involves everyday decision-making and taking care of oneself in daily life. The Failure schema often leads to a linked Defectiveness schema. Feeling like a failure in areas of achievement, the person feels defective.

This distinction is important for me. I constantly feel like a failure though I can admit when I have achieved some goal or accomplishment. I think I fit the Unrelenting Standards schema must closer in this respect. While I constantly fear I don’t measure up and am a failure or will fail, this has thus far never been proven true. My fear of failure creates an anxiety to succeed.

Sounds simple enough, right?

Goals for Treatment



The central goal of treatment is to help patients feel and become as successful as their peers (within the limits of their abilities and talents). This usually involves one of three scenarios. The first is increasing their level of success by building skills and confidence. Second, if they are, in fact, successful relative to their potential, it involves raising their appraisals of their level of success or changing perceptions of their peer group. The third scenario involves patients accepting unchangeable limitations in their abilities, while still feeling they have value.

Strategies Emphasized in Treatment

It is important to assess carefully the origin of the Failure schema for each patient, because the strategies the therapist emphasizes will depend on this assessment. Some patients have failure due to an innate lack of talent or intelligence. In these cases, the therapist tries to help the patient build skills and set realistic goals. Other patients have the talent and intelligence to succeed but have never applied themselves fully. Perhaps they have lacked direction or focused on the wrong areas. In these cases, the therapist aims to provide direction or to shift their focus to areas in which they have more natural talents. Perhaps patients have another disorder that has interfered with their development (such as ADD)., in which case the therapist needs to treat the other disorder. Perhaps they lack discipline: Many patients with the Failure schema also have the Insufficient Self-Control/Self-Discipline schema. In these cases, the therapist allies with the patient to fight Insufficient Self-Control/Self-Discipline schema. Perhaps patients are flooded with negative affect from another schema, such as Defectiveness or Emotional Deprivation, which they spend a lot of time and effort trying to avoid – by abusing drugs, drinking alcohol, playing the stock market, surfing the Internet, gambling, viewing pornography, or having sexual affairs –  and the avoidance interferes with their dedication to work. In these cases, treatment involves working on the underlying schemas. It is important to assess why the patient has failed, in order to design the proper treatment for the problem. In most cases, the cognitive and behavioral aspects of the treatment take precedence.

            Another cognitive strategy is to highlight patients’ successes and skills. Typically, patients with this schema have ignored their accomplishments and accentuated their failures. The therapist helps correct this bias by teaching patients to notice each time they are successful. It’s also important to set realistic long-term goals. 

Ugh. I hate it when Therapist does this. I hate it when she lists my positive attributes and ticks off all the things I’ve accomplished. It feels so phony. I hear these nice words and it feels hollow, like someone trying to make you feel better. All surface, no substance. I think Therapist hopes that with repetition I will begin to internalize these positive attributes as my own. Currently they belong to my not so evil doppelganger. I’m sure her life is lovely.

            Experiential techniques can be helpful in preparing patients to undertake behavioral change. In imagery, patients relive failure experiences from the past and express anger at the people who discouraged them, or mocked and devalued them for failing. Doing this helps patients reattribute the failure to the other person ‘s criticalness rather than to their own lack of ability. Getting angry at parents and others for not recognizing and accepting their strengths and limitations is an important part of the process of letting go of the schema emotionally.

Get angry. I like this strategy. I can’t say that my parents failed to realize my limitations and pushed me anyways. Well, I can and I can’t. They failed to recognize my emotional limitations. Physically, I’ve managed to accomplish everything I’ve set out to do. I may not be perfect the first time, but I push myself harder and harder until I get it and move on to the next even harder thing. Yeah, for me this is Unrelenting Standards, not so much Failure. But I can definitely get angry. Anger focused in an appropriate manner can be a very constructive tool. It’s a source of strength and motivation. I get caught up in being angry with myself. I get angry and blame myself for things that others have done because I believe “I’ve allowed” others to do those things to me, when really, I did not ask for it, it was not my choice. It was their doing, their fault. The blame is theirs. My anger should be for them as well.

            Alternatively, the patient’s parents may not have wanted the patient to succeed. Although the parents may have been unaware of it, they did not want the child to become too successful. They were afraid that the child would surpass or abandon them. The parents gave the child subtle messages that they would reject him or her or withdraw emotionally if the child became too successful. The child developed a “fear of success”. Experiential techniques help the patient identify this theme and relate to it emotionally. Getting angry with the Undermining Parent helps the patient understand that this was an unhealthy message, and one that the patient need no longer believe. Healthy parents do not punish their children for succeeding. Getting angry can help patients fight the view that people will reject them if they are too successful.

My parents certainly wanted me to succeed. I think I’m afraid of succeeding in my own way though. If I accomplish something it still means there’s more to go, something harder, something more challenging. One more opportunity for me to prove that I won’t measure up to what is expected of me. One more opportunity to fail. Not-so-amusingly, I also have an inability to say ‘No’ to projects, so while I may not want to do them for fear that I might fail at them, I also am incapable of saying ‘No’ and letting someone down or allowing them to believe that I can’t handle it, so I wind up with the task anyways. Then I balk and waver between doing it, pushing it around on my desk, finding other things that ‘are more important’, and finally tacking it with a single minded ferocity that gets it done efficiently and flawlessly.

            The behavioral part of the treatment is usually the most important. No matter how much progress patients make in the other areas, if they do not stop their maladaptive coping behaviors, they are going to keep reinforcing the schema. It’s necessary to replace behaviors that surrender to, avoid, or overcompensate for the schema, with more adaptive behaviors. Patients set goals, set grade tasks to meet them, and then carry out the tasks as assignments.

Behaviorally I act as though I will succeed. Hell, I act as though I’ve already succeeded at whatever I’m doing. Perception is important. If you appear successful people will believe you are successful, so hiding the insecurities is crucial.

Special Problems with This Schema

The most common problem is that patients persist in their maladaptive coping behaviors. They keep surrendering, avoiding, or overcompensating for the schema instead of trying to change. Patients are so convinced they are going to fail that they are reluctant to commit themselves fully to trying to succeed.

I can see my problems being in fooling the people that are trying to help me. I know what I’m supposed to say to appear as though I’m not a failure. I suppose it helps that I also have the evidence to back up these claims. For me it’s really just a feeling of failure. It’s not a reality of failure. Except in the reality of not being able to feel like a success. I fail and feeling properly. But we all knew that. That’s pretty much why we’re here. Regardless of how I feel I HATE admitting to being anything less than perfect, so admitting that I feel like a failure or a fraud is just out of the question.

*Schema Therapy: A Practitioner’s Guide by Young, Klosko, and Weisshaar

The Sky is Falling! – Vulnerability to Harm or Illness

Holy $h!t such a busy day. Non stop non stop rush rush rush. Met a cute guy though. And he’s from my alma mater. I actually found myself appreciating a nicely constructed male backside today. This is so not my style. Girls, yes. Guys? Not so much. But lemme tell you, he had a nice booty. So you’re probably wondering what this has to do with today’s schema. Absolutely nothing.

On that note. Today I’m talking about the Vulnerability to Harm or Illness Schema.

Vulnerability to Harm or Illness

Typical Presentation of the Schema

These people live their lives believing that catastrophe is about to strike at any moment. They are convinced that something terrible is going to happen to them that is beyond their control. They will suddenly be struck with a medical illness; there will be a natural disaster; they will become victims of crime; they will get into a terrible accident; they will lose all their money; or they will have a nervous breakdown and go crazy. The predominant emotion is anxiety, ranging from low-level dread to full blown panic attacks. These patients are not afraid of handling everyday situations, like patients who have Dependence schemas’ rather, they are afraid of catastrophic events.

            Most of these patients rely on avoidance or overcompensation to cope with the schema. They become phobic, restrict their lives, take tranquilizers, engage in magical thinking, perform compulsive rituals, or rely on “safety signals,” such as a person they trust, a bottle of water, or tranquilizers. All of these behaviors have the goal of stopping the bad thing from happening.

This strikes me as very OCD and Paranoid PD, not that it can’t present in other personality disorders or even those without. Again, this is not a schema I relate to very well. While yes, I do have massive panic and anxiety attacks, it’s usually triggered by a real situation or perceived threat (which ok, may not be strictly real). Meh, even that isn’t strictly true because I have an anxiety disorder and I’m very familiar with that constant low level of dread, but this is due to other schema triggers I believe. And I do have the fear that I’ll just have a nervous breakdown and go crazy, but let’s face it, that isn’t exactly irrational. I think my point here is, there’s a difference between having panic/anxiety attacks for different reasons, and having panic/anxiety attacks because you think a meteor is going to spontaneously crash through the atmosphere and land on your house. One is not necessarily this schema, the other is.  

Heh, in fact, I have a tendency to live like the world IS about to end and I want to do everything I can. Or if the world is going to end then there’s nothing I can do about it, I’m going to go out with my own kind of bang.

Goals of Treatment

The goals of treatment are to get patients to lower their estimations of the likelihood of catastrophic events and to raise their evaluations of their ability to cope. Ideally, patients come to recognize that their fears are greatly exaggerated and, even if a catastrophe did occur, they would be able to deal with it adequately. The ultimate goal of treatment is to convince patients to stop avoiding and overcompensating for the schema, and to face most of the situations they fear.

Strategies Emphasized in Treatment

            Patients explore the childhood origins of the schema and trace its pattern through their lives. They count the costs of the schema. Patients explore the changes they would make in their current lives if they were not overly afraid. It is important to spend time building motivation to change. The patient should stay focused on the long-term negative consequences of living a phobic lifestyle, such as lost opportunities for fun and self-exploration; and on the positive benefits of moving more freely in the world, such as a richer, fuller life.

            It’s important to do both cognitive and behavioral work to overcome this schema.

            Patients counter their exaggerated perceptions of danger. Challenging catastrophic thoughts – or ‘decatastrophizing” – helps them manage panic attacks and other anxiety symptoms. Cognitive strategies also build motivation by highlighting the advantages of changing.

            Behaviorally it’s important to face the situations that are feared by undergoing gradual and graduated exposure to phobic situations in homework (try to face it on paper before you face it in real life): Picture entering specific phobic situations and, with the assistance of the “healthy Adult” coping well. Anxiety management techniques such as breathing exercises, meditation, and flash cards help patients cope with the exposure as they go through them.

            Reassurance is important. It’s necessary for a person to know that they will be able to cope in a healthy way.

This sounds easier than it is. It’s been my experience that when you have an irrational fear, you pretty much know it’s irrational. However that doesn’t change how you feel or think or act. So just having someone tell you that what you’re doing is irrational is not going to change anything. And the longer you’ve done a particular coping strategy, the harder it’s going to be to undo all that habit and reform new, healthier, habits. However, that’s what time is for. You take the time. You work on it little by little with someone you can trust.

I think this is a problem that a lot of nuero-typical people have with the personality disordered. They think that since we’ve been told a better way, have had our problems pointed out, that it’s easy for us to change. Because their brains work in a fundamentally different way they just do not understand that we cannot always follow the path from point A to point B. We have monsters hiding down some paths that they can’t see.  

Special Problems with This Schema

            The greatest problem is that people with this schema are too afraid to stop avoiding and overcompensating. They resist giving up their protections against the anxiety of the schema. As we mentioned earlier, mode work can help patients strengthen the healthy part of them that yearns for a fuller life.

I can relate to this. I’ve mentioned before how I’m afraid to ‘lose’ my Borderline Personality Disorder, my depression, my anxiety…. It’s such an ingrained part of me that the prospect of living without something that I’ve had my entire life is just, foreign. I can’t wrap my head around it, and it’s scary. However I’m also not the kind of person that’s afraid to try new things. So I keep doing what I’m doing to get healthier, despite these irrational fears that I’ll lose a part of myself by healing. Being who I’ve always been is comfortable in it’s own dysfunctional kind of way. I don’t want to lose who I am. However, I think this is a faulty way of looking at it. I won’t be losing myself. I will always be me. I’ll just be me in a different stage of growth. Maybe it would help to look at all these coping mechanisms and faulty habits as skills or tools. You grow up learning how to use a certain tool a certain way. It’s not until years later that you realize you’ve been using it wrong, or there are better ways of utilizing that skill. It can be impossible to recognize the problem if it’s what you’ve always known. It’s not until you have someone that knows how to properly use the tool and can show you that there really is a better way of going about doing the work, that you finally can see a different way. It’s upgrading your toolbox. Toss out the broken screwdriver and trade up for the power drill.

Something like that.

*Schema Therapy: A Practitioner’s Guide – Young, Klosko, Weishaar