Academic journal article International Journal of Psychology and Psychological Therapy

Relationships between Early Maladaptive Schemas, Mindfulness, Self-Compassion, and Psychological Distress

Academic journal article International Journal of Psychology and Psychological Therapy

Relationships between Early Maladaptive Schemas, Mindfulness, Self-Compassion, and Psychological Distress

Article excerpt

The construct of early maladaptive schemas (EMSs) was introduced by Young (1990) to conceptualize the core psychological themes of patients with personality disorders or personality-related difficulties in living. These themes involve beliefs about the self and one's relationships with others. They are thought to develop in childhood and adolescence when basic and universal psychological needs (i.e., secure attachment, autonomy, realistic limits, self-directedness, and playfulness) are chronically frustrated. Over time, these experiences are integrated into the individual's sense of identity and perpetuated by maladaptive strategies used to cope with the painful emotions when an EMSs is activated by a situation relevant to the schema and in order to maintain a stable view of the self and the world. Maladaptive coping strategies include avoiding these situations totally (avoidance), acting as if the opposite of the schema were true (overcompensation), or surrendering to the schema (surrender) (Young, Klosko, & Weishaar, 2003). EMSs are considered dimensional and universal. Young (1999) has defined 18 specific EMSs, which are briefly described in the methods section. The combination of currently activated schemas and coping behaviors is termed schema mode. Several modes have been proposed (e.g., the vulnerable child, the detached protector, the punitive parent) (Young et al., 2003). Thus, while EMS is a trait-like concept, schema modes refer to the individual's current state. The focus of the present study is on EMSs.

In support of theory, investigations have shown that EMSs are associated with recollections of negative parenting practices, childhood trauma, and insecure attachment in childhood (Cecero, Nelson, & Gillie, 2004; Simard, Moss, & Pascuzzo, 2011; Thimm, 2010) and a variety of psychiatric diagnoses and psychological problems, including mood disorders, anxiety disorders, substance abuse, eating disorders, psychosis, and personality disorders (e.g., Barazandeh, Kissane, Saeedi, & Gordon, 2016; Koerner, Tallon, & Kusec, 2015; Kwak & Lee, 2015; Nilsson, Nielsen Straarup, & Halvorsen, 2015; Pugh, 2015; Shorey, Stuart, & Anderson, 2013; Sundag, Ascone, de Matos Marques, Moritz, & Lincoln, 2016). Moreover, findings from longitudinal studies suggest that EMSs remain stable over time (Blissett & Farrow, 2007; Renner, Lobbestael, Peeters, Arntz, & Huibers, 2012; Riso et al, 2006; Wang, Halvorsen, Eisemann, & Waterloo, 2010).

Schema therapy (ST) (Young, 1990; Young et al., 2003) was developed to treat EMSs, maladaptive coping styles, and maladaptive schema modes. The goal of ST is the weakening of all components of schemas and maladaptive behaviors so that patients can meet their emotional needs in adaptive ways (Young et al., 2003). To this end, cognitive, experiential, and behavioral techniques, along with a therapeutic relationship that is characterized by empathic confrontation and limited reparenting are used (Young et al., 2003). An increasing number of randomized-controlled trials suggests that ST is an effective treatment for personality disorders and other psychiatric disorders (e.g., Bamelis, Evers, Spinhoven, & Arntz, 2014; Carter et al., 2013; Giesen-Bloo et al., 2006; McIntosh et al., 2016). An important step in the treatment process is to identify when an EMS and associated coping responses are activated (Young et al., 2003). Mindfulness-based exercises are therefore increasingly integrated in ST to enhance awareness of schema processes and promote adaptive coping skills (Bricker & Labin, 2012; van Vreeswijk, Broersen, & Schurink, 2014).

The concept of mindfulness has its origins in Buddhist philosophy (Segal, Williams, Teasdale, & Kabat-Zinn, 2013) and has recently been adopted in Western psychology. Although there is still a lack of agreement on the precise definition of mindfulness (for a recent overview of different definitions see Williams, Dalgleish, Karl, & Kuyken, 2014) and differences between Buddhist and Western conceptualizations of mindfulness have been noted (Grossman & Van Dam, 2011; Keng, Smoski, & Robins, 2011), most definitions encompass two components: attentional focus on momentary experience and an accepting, nonjudgmental, and open attitude towards these experiences (Sauer et al. …

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