Fortifying the Therapy Relationship in Schema Therapy with Some of the Most Challenging Patients by Wendy Behary

Fortifying the Therapy Relationship in Schema Therapy with Some of the Most Challenging Patients

By Wendy Behary

The therapy relationship can serve as a simulated version of a patient’s real-life experiences; interpersonal experiences that happen with others, as well as feelings about self.  In Schema Therapy, the therapy relationship is a powerful strategy unto itself, calling upon us to maintain a sturdy narrator and a healthy adult posture, which can provide a highly effective opportunity for schema investigation and schema healing. The therapy relationship offers a gateway to real-time awareness of the underlying pain and suffering that prompts schema activation and mode shifts. The therapy relationship promises plenty of opportunities for schema triggering for both the patient and the therapist. The therapist, in a healthy adult mode, can reflect upon and report resonant experiences that others (outside the treatment room) may feel.  The use of self-disclosure can act as a helpful reference for our patients to make sense out of their moment to moment activations and mode shifts. They are enabled of transforming maladaptive modes into healthy and adaptive ones. Coming from many years of experience, schema therapists find the therapy relationship to be one of the most important resources for dealing with some of the most challenging patients, for example, those with rigid narcissistic modes, angry modes, and deeply entrenched core schemas like defectiveness, enmeshment and mistrust. As we empathically attune to what is happening between us in the therapy relationship, schemas and modes can be identified and tracked, imagery, limited reparenting and re-scripting, can be bridged from this stance  From this solid connection, we are better able to integrate the many robust schema therapy experiential exercises and improve collaboration with our patients … leading to effective treatment outcomes.