SCHEMA THERAPY

Schema Therapy, developed by Jeffrey Young and his friends, is a holistic therapy which includes mainstream therapies such as cognitive behavioral therapy, Gestalt, object relations and psychoanalytic. Schema Therapy focuses on the long lasting chronic problems of individuals.  This method focuses on the core emotional needs of childhood.  Accordingly, every child needs a secure attachment, freedom to express needs and emotions, realistic limits, autonomy, spontaneity and play.

When things do not go right with the caretakers of the child, and when the basic emotional needs of the child are not met, early in life, early maladaptive schemas begin to develop. This leads to an upset psychological wellness state of mind, during the adult phase of life.  A unique approach of Schema Therapy which separates this method from the others is the limited repeating parenting notion. The therapist meets the client’s early unfulfilled basic emotional needs, within the limits of psychotherapy, and acts as a limited parent to the client once more, so that the client can be a good parent to herself/himself.

During  Schema Therapy, the notion of mode comes into attention, which is an internal state. When the schemas add up, modes are formed.  Vulnerable child modes, dysfunctional parent modes, and dysfunctional coping modes are the three different nonfunctioning kinds of identified schema modes.  Happy child mode and healthy adult modes are healthy, functional modes.

Schema therapy works towards the vulnerable child modes, trying to understand the inner child and remove the hurt, with specific techniques focusing on the neglected childhood scenes where the client feels comfortable with a parent figure, the therapist.  The goal in schema therapy is to limit the angry and impulsive child modes and to support the vulnerable child as well as encouraging the happy child mode.  Another aim is to strengthen the healthy adult mode.

COGNITIVE-BEHAVIORAL THERAPY (CBT)

According to Cognitive – Behavioral Therapy, the emotional reactions that a person displays to various situations shape up, due to the interpretation and the meanings derived from these situations.  This view is based on the fact that our thoughts affect our feelings, physical reactions and our behavior, when faced with a situation.

CBT says that, generally, the events themselves are not the reason for negative feelings which lead to sadness and worries.  Our emotions and reactions are affected by our interpretation of the situations.  For example: when a situation is interpreted as bad and dangerous, we may feel threatened, worried, sad or angry.  We may feel tense and go into defensive.  On the other hand, when we judge a situation as positive or pleasant, we may feel comfortable and happy reflecting on the body as peaceful.  How we perceive and interpret a situation is mostly related to what we have learned in our past lives. However, our thoughts may not always reflect the reality and this may be the basis for the situations that we face difficulty. CBT helps people reevaluate and change their thoughts and interpretations.

The main aim of CBT is to go over the daily matters, making the client aware of the biased and dysfunctional thoughts taking basis from old experiences and take the client to a sequence of change in his thoughts and acts. In this trip, the therapist and the client work collaboratively questioning, searching and discovering the experiences and the thoughts of the client. The therapist helps the client in achieving realistic and new views of life by the help of various scientifically proven methods.  The final aim of the therapy is to prepare the client to the post therapy period, when the client becomes his/her own therapist achieving certain skills in helping himself/herself.  For this reason, an important part of this period consists of some homework and exercises done outside the therapy sessions.

In a well structured format, CBT sessions last about 50 minutes once a week but this can be rearranged according to the arising needs, after a discussion with the client.  Although CBT covers a large scale of problems, it is a scientifically proven therapy approach especially on panic attack, exam anxiety, relationship problems, phobias, grief, post traumatic stress disorder, eating disorders, and obsessive compulsive disorder.

EMDR

EMDR (Eye Movement Desensitization and Reprocessing) developed in 1987 by Dr. Francine Shapiro is a holistic psychotherapy approach.  When it was accidentally discovered that the eye movements reduced the disturbing affects of strong uncomfortable thoughts; the effects of this method was scientifically studied on people subjected to traumatic experience. EMDR, which aims to desensitize negative emotions, beliefs and body sensations caused by different stressful and difficult life events such as war stress, natural disasters, sexual abuse, phobia, depression, anxiety, performance anxiety, body image disorder, grief, aims to reprocess these experiences in a positive way. EMDR therapy consists of 8 step protocols including examination of the memories and goals that are the source of the problems, preparation, evaluation, desensitization, placement, body scanning, closure and reassessment.

EMDR International Association: www.emdria.org

Shapiro, F. (2001). Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols and Procedures, 2nd Edition, Guilford Press, New York.

SYSTEMATIC THERAPY

We learn most of the attitude and behavior from the family in which we have been brought up or through the family ties that govern this culture.  Being a part of to these systems, we are in touch with the people and we interact with them.  Not only the family and the community, but sub systems like the workplace, education and social groups also affect us.  Systematic therapy, suggests the evaluation of the individuals according to the systems that they are a part of.  Psychotherapy studies the roots of our thoughts and conducts and provides a safe perimeter by reconstructing the non functional ones or rebuilding them. During this period, Systematic Therapy works with the systems that form the parts of the client.  The reasons why the client asks for therapy are examined, aiming at increasing the life quality of the client towards the determined targets.  Every system has a specific order.  For this reason, initially, the roles in which the client is subjected to through rules, limits, the relationships and the format of the members are investigated.  The aim at the end of this period is to have the client find out about his/her strong points, functional resources and increase the emotional endurance.  This method could be applied on the individuals, couples, and families.

COUPLE’S THERAPY

In couples’ therapy, the problems faced in a relationship is discussed and tried to be solved.  One of the basic aims is to make the feelings/thoughts or actions more understandable by their spouses and strengthen the communication between them.  The methods to be used in couple’s therapy are determined according to the needs of the individuals; however, in general, the basic steps are similar.  After getting acquainted with the partners, the therapist helps to name and identify the feelings and recognize them.

After establishing the past and the current experiences affecting the feelings, in order to find solutions and ease the conflicts, the therapist starts working with the couples.  The emotional conduct, problem solving, conflict management skills of the couples are strengthened in order to be a better team.  Although individual participation to the sessions could be suggested by the therapist, usually the participation of both parties is expected.  The frequency of the sessions are decided on how often the couples need to visit; however, the ideal frequency of the sessions is once a week. The main topics that are visited in couple’s therapy are as the following:

– Repeating conflicts

– Emotional disconnection

– Infidelity

– Conflict management

– Managing the family relations

– Ability to draw healthy borders

– Pre marriage consultancy

– Divorce/separation phases etc.

FAMILY THERAPY

Although living in the same family culture, differences, and in relation to this, disagreements may emerge in the family, among the family members.  Family therapy is a phase during which the conflicts and problems are solved, accompanied by a specialist.  It focuses on how the family system works, and the relationships of the family members with each other.  The main objective is to have the family members understand each other better and strengthen their relationships.  During the therapy, the subject to be worked on is determined by the help of the therapist and a treatment plan is formed.  Family therapy helps to reinforce the relationships of the family members and helps to overcome the difficulties and stresses in hard times.  The skills that are achieved during the therapy, help continue healthy and balanced relationships in the family.

The therapy period could sometimes continue by including all of the family members, some of the family members or only one member of the family.  How often the sessions will take place depends on the intensity of the subject matter or its level of emergency; however, the ideal frequency of the meeting is once a week.  Here are the subjects worked on, in general:

-In family disputes (conflicts) and problem solving

-In family stress management

-Parenting skills

-Roles in the family and setting (establishing) rules

-Drawing healthy boundaries

-Divorce and separation phases etc.

EMOTION FOCUSED COUPLE’S THERAPY

Attachment theory is the basis of Emotion Centered Couple’s Therapy devised by Dr. Susan Johnson and Dr. Lesley Greenberg in the beginning of the1980s (Johnson & Greenberg, 1985).

One of the initial aims of the Emotion Focused Couple’s Therapy is to examine the negative patterns and loops in the emotional reactions of the couples, having trouble in their relationships and rearranging them, so that, the couples could change by interacting and reaching to each other in communication.  In addition to this, it aims at rearranging the negative feelings of the partners, creating new interactions so that they can develop a positive and strong self confidence and establish a comfortable and secure communication with each other.

In Emotion Focused Couple’s Therapy, the role of the therapist is to connect the clients emotionally by communicating openly and candidly with each other, without aiming at protecting themselves, accusing each other in desperation and resorting to defense.  The clients are helped to establish an emotional tie and learn open and effective communication by understanding each other and their own fears and needs, expressing these feelings sincerely while getting closer to each other(Johnson & Johnson, 2004).

Johnson, S. & Greenberg, L. (1985). Emotional focused couples therapy: An outcome study. Journal of marital and Family Therapy, 11, 313-317.

Johnson, S. M., & Johnson, S. M. (2004). The practice of emotionally focused couple therapy: Creating connection. New York: Brunner-Routledge.

GOTTMAN’S COUPLE’S THERAPY

Gottman’s Couple’s Therapy is a couple’s therapy method, developed and proven by Prof. John Gottman’s scientific research methods.   Gottman’s Couple’s Therapy is a structured therapy and presents an eclectic form in its body consisting of various therapy approaches.

-It is an emotionally focused approach concentrating on the emotions that both partners bring to the session, aiming at establishing emotional repair and positive feeling formation.

-It is a behavioral approach, since it focuses on noticing the behavior/attitude patterns in the relationship and changing them.

-It is an approach to discover the meaning of mutual understanding in a relationship, sourcing from the differences in existence.

-It is a cognitive approach, focusing on the thoughts of the couples, about their relationships related to the emotions in a relationship.

-Although it is a couple’s therapy, it is also a narrative approach because it focuses on the partner’s personal past, relationship history, and the stories told by them.

-Since it sees the structure of the relationship and the couple as a system, it is a systematic approach too.

-It is a psychodynamic approach which gives importance to the analyses of the effects of early period and past experiences (like family and relationship etc) on today.

The goal in Gottman’s Couple Therapy is to gain the ability to conduct conflict management abilities of the couples, rather than solving the conflicts.  Developing skills for conflicts, friendship and abilities for intimacy and creating mutual meanings are the main objectives.

The therapy period which begins with the evaluation period, continues, with the structure of the relationship and its objective.  It consists of many techniques, in order to evaluate every stage of the strong relationship at home, and interfere if necessary.

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