Experience a unique integrated approach
Although a person-centred approach underwrites all of my therapy work - 'you talk, I listen' - because I work with an integrative lens, there will be times when we decide to work with amore specialised approach or on more specific topics. Some of these are explained below.
Schemas
This is an approach that draws on some of the principles of Schema Therapy, an integrative approach designed to address chronic psychological difficulties that have not responded well to traditional cognitive-behavioural therapy (CBT). It combines elements from various therapeutic approaches, including CBT, psychodynamic therapy, attachment theory, and Gestalt therapy. The central concept of revolves around "early maladaptive schemas" (EMS), which are pervasive patterns of thought and emotion formed during childhood or adolescence through negative experiences with caregivers or significant others. These schemas shape core beliefs about oneself and relationships, often persisting throughout life and influencing behaviour and emotional responses.
Whilst these schemas may be helpful in giving the younger self a sense of continuing attachment to the caregivers or significant others as well as providing inner security and safety, they ultimately prove to be unhelpful later to the adult self. However, a natural resistance is built up to letting go of these schemas as ultimately, they enabled one to survive as a younger person and at some level it just doesn’t make sense for the self to let go of such safety ensuring behaviours
Understanding Early Maladaptive Schemas
There are 18 identified EMS, categorized into broad domains such as:
- Disconnection and Rejection: Includes schemas like Abandonment/Instability and Mistrust/Abuse.
- Defective Self/Low Self-Esteem: Encompasses beliefs such as Defectiveness/Shame and Failure.
- Impaired Autonomy/Performance: Features schemas like Dependence and Vulnerability to Harm/Illness.
- Unsocialized/Unreasonable Standards: Contains schemas such as Unrelenting Standards/Hyper-criticalness and Entitlement/Grandiosity.
- Over-vigilance/Inhibition: Includes Negativity/Pessimism and Emotional Inhibition.
Key Concepts of Schema Work
An initial assessment helps to identify their dominant schemas, and from their deeper therapeutic enquiry leads to understanding their origins, effects and impacts, and finally learning how to modify or "heal" them. This therapeutic process involves several key components.
1. Schema Mode Work: Clients learn to identify different "modes" or emotional and behavioural states they experience (I feel that this ties in well with Wounded Child and Internal Family Systems). These include:
- Child Modes: Represent unmet needs and core feelings e.g. vulnerable child
- Coping Modes: Strategies for dealing with schemas, such as Surrender, Avoidance, or Overcompensation e.g. critical inner parent
- Healthy Adult Mode: Represents adaptive functioning and self-care, which the therapy seeks to strengthen e.g. healthy adult
2. Experiential Techniques: These techniques help clients reconnect with and process emotions tied to their schemas. For instance, "Imagery Re-scripting" allows clients to vividly imagine past situations related to their schemas and re-script them with more nurturing experiences. This can lead to emotional release and new insights.
3. Cognitive Techniques: These involve challenging and reframing maladaptive thoughts and beliefs stemming from schemas. Clients learn to identify cognitive distortions and develop more balanced thinking patterns.
4. Behavioural Techniques: Focus on changing maladaptive behaviours that maintain schemas. This may include gradual exposure to triggering situations or practicing new, adaptive behaviours.
5. Therapeutic Relationship: The therapist provides a "limited reparenting" experience, offering empathy, validation, and support that may have been lacking in the client's early life. This corrective emotional experience is crucial for healing.
The Transformative Journey
Because of its depth and breath, this approach can be a long-term process, often lasting from one to several years, depending on the complexity of the client's issues. It is particularly effective for personality disorders, chronic depression, anxiety disorders, eating disorders, and relationship problems. By addressing the root causes of persistent psychological distress, this approach empowers individuals to develop healthier coping mechanisms, build fulfilling relationships, and live authentically. The journey involves not just intellectual understanding but a deep, visceral transformation, allowing the true self to emerge, vibrant and unburdened, ready to embrace life fully.
The concept of 'drip drip' trauma, also known as insidious trauma or developmental trauma, refers to the cumulative effect of ongoing, often subtle, negative experiences during childhood that can significantly impact an individual's development and long-term well-being. Unlike a single, acute traumatic event, this form of trauma involves a series of seemingly minor yet persistent negative experiences that erode a child's sense of safety, self-worth, and emotional regulation.
Key Characteristics of 'Drip Drip' Trauma
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Emotional Neglect: This pervasive form of trauma occurs when caregivers are physically present but emotionally unavailable. Children may seek comfort and validation but are met with indifference or criticism, leading them to feel unseen and unloved.
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Chronic Criticism and Shaming: Constant belittling or shaming from parents or authority figures can severely damage a child's self-esteem. Subtle forms of criticism, such as backhanded compliments or harsh disciplinary measures, teach children that they are not good enough, fostering a fear of failure.
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Inconsistent or Unpredictable Environments: Living in a chaotic home characterized by instability, such as parental conflict or substance abuse, creates chronic stress. Children may become hypervigilant, trying to anticipate adult moods to ensure their safety, which hinders their ability to develop trust.
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Witnessing Domestic Violence or Substance Abuse: Even if not directly targeted, children who witness domestic violence or parental addiction experience trauma. The constant tension and emotional distress creates an unsafe atmosphere, leading to feelings of responsibility for the situation.
Impact During Childhood
When these experiences go unrecognised as trauma, children often internalize the issues, believing they are the cause of the problems. This can manifest in various ways:
- Anxiety and Fear: A constant sense of unease and worry about abandonment or punishment.
- Withdrawal or Aggression: Children may become overly quiet or exhibit aggressive behavior as a means of asserting control.
- Difficulty with Relationships: Struggles to form secure attachments, leading to clinginess or pushing others away.
- Physical Symptoms: Manifestations of chronic stress, such as headaches, stomach aches, or sleep disturbances.
- Academic Struggles: Difficulty concentrating and decreased performance in school due to preoccupation with their home environment.
Long-Term Impact in Adulthood
The effects of 'drip drip' trauma can extend into adulthood, manifesting in various ways:
- Mental Health Challenges: Increased risk of anxiety disorders, depression, and complex PTSD.
- Relationship Difficulties: A tendency to repeat unhealthy patterns, difficulty with trust and intimacy, and a fear of abandonment.
- Low Self-Esteem and Self-Criticism: Chronic self-doubt and a harsh inner critic perpetuating feelings of inadequacy.
- Emotional Dysregulation: Difficulty managing emotions, leading to mood swings or emotional numbness.
- Physical Health Problems: Chronic stress can contribute to various physical health issues, including autoimmune diseases and chronic pain.
In essence, 'drip drip' trauma shapes a person's understanding of themselves and the world, creating a lens through which they perceive life long after the original experiences have ceased. Recognising these insidious forms of childhood adversity is crucial for understanding their profound and lasting impact on adult well-being.
Inner parts is an approach based around Internal Family Systems that offers a comprehensive understanding of the self as a system of distinct "parts," each with its own roles, beliefs, and motivations. This approach is practical, philosophical, and narrative-driven, providing a multifaceted perspective on healing, particularly concerning the inner wounded child.
Practical & Solution-Oriented Approach
Inner parts views the mind as a collection of parts rather than a singular entity. Central to this model is the "Self," which embodies inherent wisdom, compassion, and calm. The goal of Inner parts therapy is to connect with this Self, which guides the healing of other parts. The three main categories of parts are Managers, Firefighters, and Exiles.
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Managers are proactive and aim to maintain control, often manifesting as perfectionism or critical self-talk.
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Firefighters react to perceived threats, leading to impulsive behaviours like substance abuse or emotional outbursts.
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Exiles are the most vulnerable parts, holding the pain and trauma of past experiences, often referred to as the "inner wounded children."
The inner parts process involves identifying these parts, accessing the Self, unburdening the parts, and integrating the system. By doing so, individuals can offer compassion to their inner wounded child, validating their experiences and soothing their pain. This healing process fosters self-acceptance and emotional regulation, ultimately leading to a more harmonious inner life.
Philosophical & Reflective Perspective
From a philosophical standpoint, inner parts encourages a deep exploration of the self, promoting self-awareness and personal growth. The Self is seen as the essence of being, characterized by compassion and curiosity. The parts, including Managers, Firefighters, and Exiles, are viewed as fulfilling protective roles rather than being inherently good or bad.
The journey of inner parts therapy involves self-leadership, allowing the Self more space, and witnessing the motivations of each part. Healing the Exiles requires acknowledging their pain and offering the care that was previously missing. This process allows individuals to become the loving parent their inner child always needed, fostering a sense of wholeness and integration.
Narrative & Story-Driven Framework
Inner parts can also be understood through a narrative lens, where the mind is seen as a story populated by various characters. The Self acts as the wise narrator, while the parts represent different aspects of personality. The Exiles, as the wounded children, carry the burdens of past traumas and emotions.
The therapeutic journey in inner parts resembles a quest to reconnect with these lost characters. It involves meeting the parts, accessing the Self, unburdening the parts, and healing the Exiles. This narrative transformation shifts the story from one of pain to one of healing and resilience. As the Exiles heal, the Managers and Firefighters can relax, allowing for a narrative filled with peace, joy, and love.