This workbook has been developed specifically for the training Mindfulness and Schema Therapy. It provides structure and information about the sessions, and functions as an aid to help retain the knowledge acquired during training. At the following website, http://www.mfvanvreeswijk.com, patients can buy mindfulness exercises (audio files), like the ones in this book. We consider these required listening, as experience has shown the training to be more effective when participants practice on their own, outside of the group meetings.
The workbook is divided into eight sessions and two follow-up sessions. It includes explanations of the core concepts, including mindfulness, schemas, and modes, and discusses some of the questions pertinent to each session. Each of the exercises is described in detail. Some participants benefit from rereading the exercises after carrying them out. Homework for subsequent sessions is listed at the end of every session.
Session 1: Schemas, Modes, and Mindfulness Training
Schemas, schema modes, and schema coping
Schemas are deeply rooted, firmly anchored ways of perceiving ourselves, others, and the world around us. These ways of perceiving are shaped by life experiences. Schemas can be quite useful because they simplify our realities; they make the enormous amount of information we face on a daily basis more manageable. Schemas become a problem, however, when they turn into fixed patterns of thinking and perceiving, thus depriving us of the ability to make conscious decisions across various situations. Eventually we can lose the flexibility required for living our lives in healthy, appropriate ways.
Schemas are often triggered by specific situations or interactions with people, and may cause strong, painful emotions to arise. When one or more schemas are activated at the same time or in rapid succession, it is common to end up in a counterproductive mood or moods (i.e. modes). In such modes, our behavior is typically less healthy than it would be under different circumstances, or if another person was in the same situation.
Nineteen schemas and twenty modes have been identified in the general population thus far. They are listed in Table 9.1. For a more detailed description of each schema and mode, please refer to Appendix II-B.
aThese schemas are not yet identifiable using the Schema Questionnaire (YSQ).
bThese modes have not (yet) been added to the Schema Mode Inventory (SMI-1).
Frank’s example illustrates how Social Isolation/Alienation, Emotional Inhibition, and Defectiveness/Shame schemas can be manifested in the Vulnerable Child mode, after which Detached Protector and Detached Self-Soother coping modes are engaged. Frank maintains his schemas through the use of alcohol, which appears to make him more eloquent. This represents a schema avoidance strategy; one which enables him to conclude that his schemas are justified, and that he needs alcohol to interact with people.
In the example above, Frank demonstrates one of three schema-coping styles (ways of handling difficult/painful situations) by which schemas are upheld. There are three main strategies that allow schemas to survive: schema avoidance, schema overcompensation, and schema surrender.
Schema avoidance is behavior meant to escape from or prevent situations that can trigger schemas or bring them up in conversation. Examples of potential schema avoidance strategies include substance abuse, excessive computer use, hard work, sleep, daydreaming, and watching TV.
Schema overcompensation is much like shouting over the top of your schemas. In this form of behavior we deny vulnerability and ignore our sensitive areas. We do precisely what we find difficult, unpleasant, or frightening in an over-the-top way in order to prove our schemas wrong.
Schema surrender involves seeking out information that confirms a schema. Any facts that contradict our schemas are basically glossed over or ignored. We only notice those aspects of a situation that support our schemas.
The following example describes schema overcompensating and schema surrendering behavior in a woman with Insufficient Self-Control/Self-Discipline and Emotional Deprivation as her main schemas. Her predominant modes are the Vulnerable Child and Demanding Parent.
Training mindfulness and schema therapy
We are not truly aware of most of the things we do. When riding a bicycle, for example, we’re not constantly thinking about moving the left pedal with our left foot, and the right pedal with our right foot. Obviously this automatic pilot has its advantages: it permits us to do several things at once. But there are also disadvantages. We might cycle right past our destination if we are too busy thinking about something else.
Similar oversights can happen with schemas and modes. Ideally their purpose is to make our world easier to understand, and to guide our actions under different circumstances. But schemas and modes can become problematic when they run automatically and persistently. We end up losing sight of the fact that our schemas and modes are shaping our behavior. They deprive us of the ability to consciously decide how to act.
In the following eight weeks you will learn to recognize when your schemas and modes have been triggered. By becoming more aware of what happens when a schema is activated, you will develop greater mindfulness of yourself, others, and your environment. You will bring greater awareness to the unpleasant thoughts and feelings that accompany your schemas, instead of denying, avoiding, or giving in to them. The experience of your body will become a point of focus, and you will learn to perceive physical sensations with mindfulness and acceptance, rather than fear, sadness, or anger. Breathing will become an ever-present anchor to rely on when your schemas and modes are (strongly) triggered, helping you to recognize when you are in the grips of a mental event, which is distorting your view of reality. Developing the ability to watch schema-triggering moments from a mindful distance will allow you to react to situations in life with greater awareness.
This training is not intended to make your painful emotions, thoughts, and actions go away—though of course this would be a wonderful bonus. Rather than try to correct or escape your inner experiences, your goal will be to allow them and observe them. This approach will create more room for conscious decision making, letting you react to situations independently of your emotions, schemas, and modes.
Practice, Practice, Practice
Regular practice, both during and after training, is essential. Learning to respond mindfully to schemas and modes takes a lot of time and practice. You can’t expect something that has become engrained over years and years to simply disappear overnight. This process will contain moments of frustration or encounters with (painful) emotions you would rather avoid. These are normal reactions. The goal is to become aware of these moments, to recognize your schemas, and to understand that they will do anything to stay in control. Gradually you will develop the ability to decide between a life directed by schemas and modes, or a life directed by your own free will.
This book contains various exercises, some of which will prove more suitable for you than others. Try each of them more than once. Only after you have gone through all the exercises can you consciously determine which ones work best for you.
Body Scan exercise instructions
The Body Scan exercise is meant to increase your awareness of the sensations in your body, and to improve your ability to maintain that awareness. You will focus your attention on physical experiences as they arise; without reacting, wanting to change them, or accepting/rejecting them.
The Body Scan is not intended to make you relax or calm down. That may be a side effect but it is not the goal.
Say, for instance, you feel pain somewhere in your body. Direct your attention to that feeling. If the pain becomes stronger or weaker, become aware of that change. The goal is to become mindful of physical sensations and of how they change. Whatever you are sensing in a given moment, try not to change the experience in any way!
You will notice that whenever you try to focus on something, distractions eventually arise. This is to be expected, as is the nature of the mind. Our advice during these exercises is not to worry about distractions, and not to interpret them as failures. If you notice your thoughts trailing off, this means that you have actually succeeded in stepping out of automatic pilot mode—which is precisely the point! Simply pause, take notice, and come back to your original point of focus. And make sure to do so in a kind and gentle way. This exercise will run more smoothly if you gently bring your mind back to your breath each time you notice it has wandered, rather than judging yourself, which tends to lead to further distracting thoughts. With practice, your ability to recognize distracting thoughts will improve.
Emotions may also sidetrack your attention. You can bring yourself back on track through mindfulness of the body. This will ground your awareness in the physical component of your emotions, rather than the spiral of emotionally laden thoughts.
During the Body Scan, each moment and each part of your body entering awareness will present you with new experiences to be observed. Hold your attention over each successive area for the duration of a few breaths. You can use the rhythm of your breath for support, moving to a new area during the inhalation. We will prompt you with the words, “Breathe into the area … and out of it.” If at this point of the exercise your mind has already trailed off, then be mindful of what distracted you, as that is your actual experience at the time. Once you have reflected on the distraction, calmly return to the exercise. Even if you are sidetracked one thousand times, come back to the exercise—gently—another thousand times…
If you find listening to the audio file helpful for this exercise, you may use it for a while, but eventually you should be able to perform the body scan on your own. Practicing at your own pace will allow you to be more thorough and to spend extra time on areas experiencing more sensations. During the training the exercise is done while seated, but at home you may try it lying down. The important thing is to practice the body scan every day, and to do so without any expectations. Just turn it into a daily activity. Start afresh with each new exercise. Be curious about what sort of experiences your body presents, and how much detail about the bodily sensations you become aware of. The more mindful you become, the more you will notice connections between what happens in your body and what goes on in your mind. Moreover, as you become more adept at noticing physical sensations, so will it grow easier to respond to and take care of your body.
Homework
Many of the following handouts will be reused in several sessions. Please photocopy the forms.
Schemas and modes are often activated so quickly that we cannot recognize or understand what triggered them and how. Because of this we may feel as if something outside our control is pushing our buttons, leaving us with no control at all. However, a number of things happen before a schema is triggered, and we can become aware of them.
The Body Scan helps you become more mindful of the body’s physical sensations and the schema triggering and reaction patterns that may follow. The Mindfulness of Your Environment exercise provides a way to broaden your mindfulness to include what is happening around you as well. It can amplify or alter your attention and point of view. But whether there are such changes or not, the main objective is simply to be mindful. Before practicing this exercise with the group, we will first discuss our experiences with the Body Scan and Everyday Mindfulness exercises. See the example below:
The group discussion helps Dorothy become aware of how much time she spends worrying and how easily she gets distracted. She also recognizes her difficulty setting time apart for homework and other activities. Only after finishing all her work does she allow any time for herself (Unrelenting Standards/Hypocritical schema).
It is difficult to be mindful when we are worried or extremely busy. Busy activity puts the body in an action-oriented state, ready to fight or flee. Emotions like fear and anger can be amplified or not experienced at all. Our heart rate increases while our breathing speeds up and becomes shallow. Before we know it the mind is dragged down in a whirlpool of thoughts, causing us to lose a big chunk of external awareness. As a result we miss important (and not-so-important) signals in the environment—including evidence that contradict our schemas. We may overlook information that could have calmed us down, left us more at ease. In this chapter we pay close attention to the breath. Breathing serves as an exceptionally useful mindfulness aid.
When confronted with (actual or seemingly) threatening and distressing situations, we instinctively respond in one of three ways: fight, flee, or freeze. These responses are typically automatic. As the body readies itself for action, the breath quickens and becomes more shallow, pupils dilate, and muscles tense or freeze up. The fight, flight, or freeze response is an important survival mechanism, especially when the choice of response is made consciously and is appropriate for the situation. However, more often than not, these reactions are unconscious, and our automatic pilot can sometimes do more harm than good.
Schemas and modes are linked to coping strategies as well, of which there are also three. When automatically triggered over long periods of time they can lead to lasting damage. The three schema-coping strategies are schema avoidance (fleeing), schema overcompensation (fighting), and schema surrender (freezing).
Schema avoidance involves efforts to steer clear of anything that might cause sadness, anger, or fear. This is achieved by seeking distractions or by avoiding situations that may trigger the respective schemas.
Schema overcompensation works by drowning out one’s schemas by acting as if they hold no power or don’t exist. For instance, people who dread failure often work extremely hard in order to ensure success, telling themselves that it’s “a piece of cake.”
In schema surrender, one is constantly on the lookout for information that can legitimize one’s schemas. Everything about a situation is analyzed until some detail is found that confirms the schema in question. For instance, someone with the Mistrust and/or Abuse schema may not accept another person’s friendliness at face value. He will go to great lengths to identify a flaw in that person, something to support his schema.
The stories of Mark and Joanne illustrate how schema survival strategies frequently result in a constricted perspective while on automatic pilot.
This example shows Mark’s Unrelenting Standards/Hypocritical schema being triggered. He believes his girlfriend is overly demanding, just like his boss and his job in general. Feeling unappreciated, Mark goes into Vulnerable Child mode and flees in Detached Protector mode. He has developed a kind of tunnel vision, which causes him to only see things that confirm his schema. Even though escaping feels like his best option in the short term, it may cause him to miss situations that could contradict his schemas. The fact is that he himself decided to work through the night and work overtime the following day. And though Mark interprets his girlfriend’s inquiries as demands, she may just be worried about him working too hard, and misses spending time with him.
Joanne is used to operating in Compliant Surrender mode, always adapting to the needs of others and exhibiting schema-confirming behavior. Her reactions to situations are based on Subjugation, Self-Sacrifice, and Approval-Seeking schemas, which keep her from standing up for herself. Whenever she does take a stand, she does so by blaming and shouting like the Angry Child—a schema overcompensation strategy. Joanne’s intense reaction scares her girlfriend, whose apologies are then interpreted as confirmation of her schemas. But is Joanne’s anger justified? In automatic pilot she forgets that her friend was actually very grateful for all the support. Her friend had gotten used to seeing her every day, and wonders why they haven’t spoken for so long. In other words, she did not intend to accuse Joanne: she simply wanted to understand.
We all have schema-coping strategies, and each of us has a preferred style. We will spend part of this session identifying your go-to strategy for schema survival by filling out the Schema Coping Questionnaire (Appendix III-E).
Your final score on this questionnaire will provide insight into your schema-coping strategies. Some participants receive identical scores for each strategy. If that happens to be the case, try to see if you scored a greater number of fives and sixes on one strategy in particular. If so, does that strategy seem to be your schema-coping strategy of choice? If neither of these approaches provides you with a clear answer, try to use mindfulness on a daily basis to discover your schema-coping strategies.
After you have identified your main personal schema-coping strategy, try to think of a past situation in which it may have played a role. See if you can come up with some other behaviors that illustrate how you act out your main coping strategy once your schemas are triggered.
Exercises
Below are the scripts for two audio file exercises that are not covered in the group.
Reacting in Healthy Adult mode and Happy Child mode
Some situations can be difficult to handle with acceptance and mindfulness—especially when our schemas have been triggered and we are in a maladaptive mode. The automatic pilot can easily exacerbate situations, so it is important to stay vigilant of schemas and modes. It is equally important, however, to have an open and accepting point of view. In such a frame of mind the Healthy Adult and the Happy Child can successfully emerge. We all carry our Healthy Adult and Happy Child within us, but their development depends on life experience. If we grew up with inadequate role models to exemplify the Healthy Adult and give us healthy boundaries, then that part of us will not be well developed. If we spent much of our childhood on guard or taking care of someone, then we may be unaccustomed to feeling free and joyful, making it difficult to live in Happy Child mode.
The first step in leaving behind old schema thoughts and behaviors is to accept what is. Rather than responding with schema avoidance, surrender, or overcompensation, it is vital to face your loneliness and fear. Set boundaries on your anger and impulsiveness and uphold them with acceptance and determination. Permit yourself to make mistakes, not to always strive for perfection. Grant others the right to be imperfect and to respond in their own way, not how you want them to. Allow yourself to have fun. Do all these things with mindfulness, and recognize the fact that change takes time and may unfold differently from what you expect.
The above illustrates what can happen when a schema is triggered. All the ingredients for a failed interaction are there: the urge to drink, emotional demandingness, and an increasingly awkward conversation. When Frank becomes aware of his schemas and modes operating, the following events takes place:
Mindful interaction with loved ones
Discussions with partners, friends, and relatives can turn into never-ending arguments where both sides try to convince each other that one is right and the other wrong. This may take the form of calm conversation, or yelling and swearing, or even hitting and kicking. Another way that some people respond to conflict is by withdrawing, expressing displeasure through cold silence. Most arguments are not just about a current situation but involve sensitive areas related to past injury. Old wounds that were not necessarily inflicted by the present loved one, but reopened by current relationships nonetheless.
At first glance it appears that Evelyn is simply upset about a broken promise, and that George feels overwhelmed by his responsibilities toward others. However, there is more going on. After Evelyn and George have calmed down, they take some time to mindfully discuss what happened and which of their schemas were triggered. It emerges that Evelyn felt blown off (Emotional Deprivation), and George felt obliged to cater to others yet again (Subjugation).
If you and your partner, friend, or relative take time out during an argument and allow each other to mindfully observe which schemas have been triggered, you can avoid escalation of the conflict. Furthermore, assuming the perspective of the Healthy Adult will improve your ability to challenge your schemas. Your past experiences that led to the formation of your schemas do not have to be repeated; recognition of this fact enables you to navigate your way around them.
The schemas we develop over the course of our lives determine how we perceive the world, other people, ourselves, our bodies, our feelings, and our actions. Childhood neglect teaches us that people worry about their own needs but not enough about ours, and so we learn not to count on others. Those of us with Mistrust and/or Abuse schemas construe ambiguous situations as threatening, or we interpret physical sensations, such as butterflies in the stomach or tension in the neck, as signs of impending doom. Sadness can leave us feeling lonely and empty.
The past seems to haunt us through our schemas. But experiencing the same powerful emotions that we did in the past does not necessarily mean that we are experiencing those same situations. It is vital to remember that schemas are only thoughts—and thoughts are not facts. They are merely ideas; clusters of words that we ourselves put together. If we make the mistake of seeing thoughts as truth, we become prone to the kinds of scenarios described below.
Someone who is always judging herself and others, who is strict, demanding, and punitive, will constantly struggle with feelings of anger and resentment.
Someone who sees the world in black and white, who only thinks in extremes, will consistently feel disappointed and unhappy.
Someone who always expects perfection, who cannot tolerate error or pain, will repeatedly face failure, inadequacy, and shame. The truth is that perfection is not required for effective functioning or for feeling valued.
A person who is always apologizing will feel pressured to defend herself, to adapt to others, and to bow down to them. In reality, getting acceptance from others does not require us to excuse our every action.
Someone who is always explaining and justifying his every action forgets that we can’t always respond to criticism. Nor do we need to. In spite of our best efforts to avoid criticism, no one goes through life without it.
Blaming other people when things don’t go our way only serves to push them out of our lives. And pointing fingers doesn’t make us any less critical of our own shortcomings. The truth is that there is no such thing as a perfect human being. Everyone makes mistakes.
Always expecting the worst possible outcome is not a belief based on reality. Yes, the future is uncertain, but that does not mean the worst will come to pass.
Feeling tense, sad, angry, or afraid does not always mean there is reason for that feeling. For example, assuming that your anxiety is related to some impending danger will only make you more anxious. It will cause you to “freeze” (not knowing what to do), instead of having the presence of mind required to face potential problems.
Feeling a constant urge to be productive only leads to stress and frustration. Relatively few things in life truly require us to act; for everything else we have a choice.
Making mountains out of molehills when things go wrong tends to result in feelings of failure and defeat. Yes, things don’t always go our way, but that is not always a disaster.
Going on the defensive when criticized usually means that we feel personally attacked; as though our very identities have been assaulted. However, others may simply be offering constructive criticism. In any case, it is always up to us to decide how we react.
Some people respond to unpleasant events by recalling other negative events in the past. This way of thinking filters out the positive. People lose sight of pleasant experiences in the past and present, and their lives and future expectations become tainted by negativity.
Although we consider our view of the world to be accurate, it can often be significantly distorted. This is because situations are always interpreted through the lens of personal experience, or in other words, on the basis of schemas and modes. Pure objectivity is impossible, which makes misinterpretation an inevitable consequence of being a human being.
Remember the following:
Schemas are not facts. They are negative suggestions. Schemas are stories that we ourselves have written and we ourselves can change.
Many of the things that trouble us are issues everyone regularly deals with. Negative events are often not nearly as significant as our schemas make them out to be.
Try to let go of endlessly striving for success, victory, and perfection. It keeps you from being relaxed and enjoying interactions with other people.
Schemas come and go. Keep in mind that they appear and disappear automatically. Avoid spontaneous reactions by being mindful and taking your time to decide on a response.
Schemas are like self-fulfilling prophecies. The first step toward change is mindfully recognizing patterns in your thoughts, feelings, and actions (as well as those of others). Once you let go of your allegiance to your schemas, you can begin to break through the self-destructive behaviors that sustain them.
From intent to action
A fraction of a second elapses between our decision to act and the action that follows. We are usually unaware of the brief moment between forming our intention to act and then performing our intended action. It may seem like our response is automatic, but it is, in fact, unconscious.
This situation presents both Veronica and her neighbor with several opportunities for mindfulness; moments in which they could have reflected on intent, rather than leaping into action. As a result of their unconscious reacting, both were left feeling uncomfortable while the cigarette butt was left on the floor. Which moments of potential mindfulness can you identify in this example? Ask yourself the same question in respect to a situation from your past.
Session 7: Caring For Yourself Through the Healthy Adult and the Happy Child
The previous sessions have revolved around the experience of physical sensations, emotions, and thoughts as a foundation for developing schema and mode mindfulness. This session highlights the Healthy Adult and the Happy Child modes. We will reflect on the images of the Healthy Adult and the Happy Child, determining their presence in the body and exploring the experiences they bring up. No one will have the same experience. Some may find themselves unable to picture themselves as a Healthy Adult; others may realize they never knew real happiness as a child. Various emotions and bodily sensations may arise during this session, or none may occur at all. The key, as always, is to practice observing these experiences mindfully.
Exercises
Preparing for the future: doing-mode
In Session 5 we covered how you can respond to situations from the perspectives of the Healthy Adult and the Happy Child; how to handle schemas being triggered; and how to observe and become more mindful of events with greater kindness and acceptance. An important part of looking after yourself is to be aware of potential pitfalls (such as negative thoughts and behaviors), but also of your positive thoughts and the things that you do well. When your schemas are running and you are stuck in a mode, things that go wrong tend to swallow up your attention. Only the thoughts and perceptions that are consistent with our schema or mode make it into your conscious experience.
Sometimes our emotions take up all of our attention, so that we lose track of the positive memories and experiences we have had. In this session you will practice mindfulness of the Healthy Adult, focusing on letting go of schema-based thinking.
Exercise 7.2 involves being mindful in doing-mode. You will investigate which of your thoughts and actions are supportive of your schema, and which ones contradict or invalidate it. An example using Richard’s situation is provided below.
The following text is taken from an audio file exercise that was not covered in the group.
Daily mindfulness of schemas, modes, and the automatic pilot habit is a valuable practice for both the present and the future. It may take a long time for schema- and mode-related patterns of behavior to lose their influence, and to replace the tendency to operate in automatic pilot with continuous mindful reactions.
Over the course of the last seven sessions, you have acquired knowledge and skills concerning the operation of your schemas and modes, as well as the workings of your automatic pilot. For each session you have written a summary of the most important subjects that were covered. You can continue to refer to those summaries in the future. Select a number of exercises that you can see yourself practicing on a regular basis over the coming months and years. It will work to your advantage to prepare a plan of action, so now is a great moment to decide on some set days and times in the week that you can devote to mindfulness exercises. Make sure you write them down. Be mindful of the fact that, whatever the future may hold, you can always rely on your breath as an anchor to the present moment. The decision to avoid automatic pilot, to react with mindfulness of schemas and modes, is always yours to make. Your vigilance of the influence of schemas and modes is something you can bring into your social interactions as well. Mindfulness can function as a guide to inform the way you think, speak, and act around other people.
Mindfully interacting with loved ones in the future
Whenever disagreement arises between you and someone close, find a suitable moment for mindful reflection. Sometimes you or the other person may need a brief time-out; a dedicated break that allows you both to become mindful of the body, emotions, and whichever schemas and modes may have been triggered. A deliberate pause also permits (strong) emotions to subside. Once you have taken some time to calmly contemplate your experience, you can return to doing-mode in order to continue observing your experience through the following questions:
What are you feeling? Where in your body are your emotions most pronounced? Is there a knot in your stomach? Tension in your neck and/or shoulders? Trembling in your arms or legs? Are you jumping from one emotion to another, or are your feelings jumbled together? Do they remind you of a similar experience from the past?
What are you thinking? Try giving your feelings a “voice.” Pay attention to what might be feeding your emotions. Which thoughts may be aggravating them—or holding them off. You might become aware of, for example, the following kind of thinking: “I’m always left to my own devices. No one notices me.” What is it about your current situation that triggers such thoughts?
What are you doing in this situation? What mood are you in? Are your moods alternating? Do they cycle rapidly or do they linger? What does your mood make you feel like doing? What have you already done?
After taking a mindful break from the argument with your loved one, ask yourself what you gained. Did you gain insight into the schemas and modes influencing the situation? Are you open to discussing what happened? Even if you haven’t fully understood which of your buttons were pushed, going over it together can help to identify triggers and strengthen your relationship. Once you feel confident of your ability to address the situation with mindfulness of yourself and the other, set about the following actions:
Agree upon a moment when you can meet under calmer conditions. Make sure you both have enough time and attention for a conversation.
Explain to the other person which of your schemas were activated, and in which modes you ended up. Identify which of their actions triggered your schemas. Speak from the first-person perspective, noting that you are not attacking them, but simply explaining how their behavior affected you. Try to show them specifically how your schemas were activated. For example: “I’ve noticed that, when people don’t keep their promises or break the rules, my Emotional Deprivation schema gets triggered. This schema makes me feel neglected and rejected, to which I respond by becoming overly demanding or spiteful. That is what happened after you showed up late. I felt as though you had forgotten me—neglected me—just like my parents used to do. They were always off arguing and only worrying about themselves.”
Invite your loved one to describe their own experience. What schemas and modes did they end up in? How did your reactions affect them? Stay mindful and inquisitive during their response, and realize that everything you hear might help both of you to deal with schemas more effectively in the future.
Discuss how schema triggers can be avoided in the future, and how you can disconnect from schemas once they are up and running. How can you respond to one another’s needs with mutual respect? How will you confront schema triggers as a team? Lastly, is there anything more to discuss regarding the current situation?
Be patient if the same patterns continue to happen and they still activate your schemas and modes. You can’t expect them to disappear overnight. Also recognize that people grow at different rates. Perhaps you will experience considerable change in a short amount of time, but your partner may need more practice—or vice versa. The important thing is to continue to be mindful and curious about each situation with your loved one. Try to learn something new from every encounter.
Your loved one might be interested in trying some mindfulness exercises. If so, find an exercise you can both value and enjoy, and practice it together. Alternatively, if no exercise can be agreed upon, choose different ones to carry out separately. Either way is fine; working on a more mindful relationship is challenging enough as it is.
Exercises
Follow-up sessions
There will be two follow-up sessions. The first follow-up meeting will take place in one month’s time, with the second session scheduled two months later. Follow-up meetings are shorter than regular sessions and will last only one hour. Rather than imparting new techniques, the second follow-up session will focus on maintaining and developing previously learned skills, and will include evaluations. Time to discuss specific events or concerns within the group will be limited.
Today is the first of two follow-up sessions. This session is somewhat different from the previous meetings. We will meet for just one hour, which participants will use to reflect on their schema and mode mindfulness over the past month. We will address the following types of questions: In what ways have you been using the mindfulness exercises to become more aware of your schemas and modes? Which aspects of your practice have gone well thus far, and what has been more challenging? What do you plan to continue working on in the future? Have you considered how you will avoid falling back on the habit of reacting to schemas and modes on automatic pilot?
Continued development of a mindful orientation
You cannot expect your newly learned skills to work automatically after just eight training sessions. Consistent use of mindfulness skills in daily life requires extensive training and discipline. In this way it can be compared to playing a sport or an instrument. Stress or fatigue from the whirl of everyday life may lead you to put mindfulness on the back burner, allowing your habitual schema- and mode-based reactions to creep back; that is why we encourage you to keep practicing and developing these skills. You can view mindfulness practice as a kind of medicine which needs to be applied daily. What is your prescription? Short exercises or longer meditations? An exercise from the book? One that concentrates on schemas and/or modes? One meant to raise awareness of other people’s intentions? An exercise for cultivating mindfulness of the Healthy Adult? The time between the last training session and our first follow-up meeting can be used to contemplate which mindfulness exercises may benefit you most in the future.
Consider some potential strategies for staying on top of your mindfulness training in everyday life. Here are a few example strategies:
Download a mindfulness app on your smartphone. This type of app allows you to set reminders that go off during the day, prompting you to spend a few minutes in mindfulness or practicing a specific exercise. Performing a search for “mindfulness” in the App Store or Google Play store will result in numerous useful apps to choose from.
Use your smartphone’s agenda to set scheduled practice times throughout your day. Consider using an alarm to remind you.
Create a mindfulness exercise that is customized to your own particular needs. Your custom exercise may draw attention to any of the schemas and modes that play a role in your life. Determine the length of your exercise and the kind of language that suits your needs. You might want to ask someone to record the exercise on your phone, MP3 player, or laptop. Having a recording saved to your cell phone is particularly useful if you are often on the go.
Choose a fixed moment in the week to pause and reflect on the following: (a) Mindfully consider which schemas and modes have arisen over the past week; (b) Have I practiced any mindfulness exercises? (c) If not, which factors may have kept me from doing so? (d) What kind of goals can I set for this coming week?
Plan a weekly evaluation together with your partner or other significant person. It is often helpful to have someone there who can support your mindfulness endeavors.
Read the text for Follow-up Session 1 and practice the mindfulness exercise, The Healthy Adult Who Brings Mindfulness to Daily Life
Continue thinking of ways to support your mindfulness training on a daily basis. You can also use the suggestions mentioned in this text. Spend the coming month carrying out your plan(s) and strategies
Recently each of you met individually for an evaluation with one or both of the trainers. Today is our final meeting as a group. For some, the training received in this program will have adequately addressed your needs. Others will continue with their individual treatment plans. In today’s session there will be an evaluation, along with a renewed focus on the future.
Training evaluation
Schemas and modes tend to make you perceive yourself, others, and the world in black and white. This occurs automatically and independent from your awareness. Without realizing it, the Failure schema might be running in the background, causing you to feel very insecure. This schema can lead you to believe that you haven’t learned a thing from the Mindfulness and Schema Therapy training. In fact, participants regularly experience an increase in symptoms, schemas, and modes as the training ends. If this happens to you, do not be put off, as it is all part of the process. Even though the program is designed to help you become more mindful, you may actually notice a decrease in mindfulness as we approach the end of training. This may very well be a temporary side-effect; a personal reaction to the training coming to a close. Now is the time to be nonjudgmental, because it is precisely this kind of situation that can cause us to fall back on old habits and the automatic pilot. Remember to be mindful of the influence of your schemas and modes as we meet to evaluate the training and our results.
Continued recognition and monitoring of your schemas and modes
The mindfulness exercises are a great tool to help you continue being mindful of your schemas and modes on a daily basis. However, it is very easy to fall back on the automatic patterns of your schemas and modes, and sticking to your mindfulness exercises can be a real challenge. Staying disciplined requires hard work and persistence.
Participants often wonder whether they should keep practicing mindfulness exercises after the training is over. Do they need to use the downloaded audio files every time they practice? In our experience, participants usually find ways to practice that suit their own needs. The best approach is to pick a strategy that fits with your lifestyle. That said, we recommend practicing regularly throughout the week. You can compare mindfulness training to physical exercise; hitting the gym once a month for an intensive workout is far less effective than two normal sessions per week. Furthermore, it gets easier the more it becomes a habit, so regular weekly practice tends to be far less challenging than the occasional exercise.
Listening to the exercise recordings is not a requirement. Many people end up memorizing their favorite exercises. Find out what works best for you. The goal is simply to be mindful, and there are many paths to achieving that goal. In the same vein, it is not necessary to spend a lot of time on exercises. Some people choose to rely on three-minute mindfulness exercises, as they can easily fit them into their day-to-day schedules. Regular, short exercises are just as effective as longer meditations.
Besides your schemas and modes, we also recommend reflecting on real-life situations in which you clearly demonstrated mindfulness. Recognizing and acknowledging such events can really boost your self-confidence. The same goes for experiences that work like anti-venom on your schemas and modes. Say you have used the past week to focus on your own inner experience (or that of others), and you come to realize that, in certain situations, you could have been a little more warm and understanding. This kind of mindful insight is effectively an anti-venom for your schemas and modes.
Plans for the future
In this final session we invite you to reflect on the strategies you came up with during our previous meeting. Which parts of your plan were you able to carry out? Which parts worked well, and which didn’t? Without being judgmental, try to determine which strategies may have been ineffective. Is the mindfulness app on your phone a helpful tool? What came out of your plan to involve a significant other in your self-evaluation?
We recommend examining your strategy with a critical eye in order to decide what needs to be changed or fine-tuned for the future. Some people find it useful to write down their plans in a notebook. Others store them on their cell phones. Keep in mind that plans are never final, and strategies require frequent fine-tuning in order to keep them useful and up to date.
Session exercises
One of the two following exercises will be practiced during this session. The other exercise can be listened to at home.
This concludes our training program. We wish you lots of mindfulness in the future.
Appendix III-A Homework Sheet
Everyday Mindfulness
An important step in developing schema and mode mindfulness is becoming aware, on a daily basis, of what is happening around you. One way to achieve this is by carrying out routine activities with greater awareness. Some people practice mindfully brushing their teeth, while others bring mindfulness to eating meals, washing dishes, or grocery shopping. Select a daily activity that is short and simple, which you would like to engage in with more presence and attention. Specific personal interactions that occur on a regular basis are also an opportunity for mindfulness. Approach such interactions with the same quality of attention and curiosity that you brought to the Raisin exercise. Mindfully observe all the experiences that present themselves during your chosen activity.
Some examples of simple daily activities:
brushing your teeth
getting (un)dressed
putting in/removing your contact lenses
blow-drying your hair
applying your make-up
drying off after a shower
the first few bites of a meal
going up a flight of stairs
preparing and/or drinking a cup of coffee or tea
listening to music
preparing (part of ) a meal
walking from your train/bus/subway station or parking spot to your destination
(part of ) a conversation over dinner with your spouse and/or children
(part of ) a daily telephone conversation with a parent.
These activities can be carried out at a normal tempo, or they can be slowed down to allow for greater mindfulness. Try to practice one activity for several consecutive days. Start each exercise by focusing on the most immediate aspect of the activity, such as the contact between the toothbrush and your teeth, gums, and tongue. Then gradually expand your attention to include other elements of your experience, such as your arm moving the toothbrush, other parts of your body, sights, sounds, smells, flavors, thoughts, and feelings.
Please rate each of the following statements using the scale provided. Write the number in the blank that best describes your own opinion of what is generally true for you.
1
2
3
4
5
Never or very rarely true
Rarely true
Sometimes true
Often true
Very often or always true
_____ 1. When I’m walking, I deliberately notice the sensations of my body moving.
_____ 2. I’m good at finding words to describe my feelings.
_____ 3. I criticize myself for having irrational or inappropriate emotions.
_____ 4. I perceive my feelings and emotions without having to react to them.
_____ 5. When I do things, my mind wanders off and I’m easily distracted.
_____ 6. When I take a shower or bath, I stay alert to the sensations of water on my body.
_____ 7. I can easily put my beliefs, opinions, and expectations into words.
_____ 8. I don’t pay attention to what I’m doing because I’m daydreaming, worrying, or otherwise distracted.
_____ 9. I watch my feelings without getting lost in them.
_____ 10. I tell myself I shouldn’t be feeling the way I’m feeling.
_____ 11. I notice how foods and drinks affect my thoughts, bodily sensations, and emotions.
_____ 12. It’s hard for me to find the words to describe what I’m thinking.
_____ 13. I am easily distracted.
_____ 14. I believe some of my thoughts are abnormal or bad and I shouldn’t think that way.
_____ 15. I pay attention to sensations, such as the wind in my hair or sun on my face.
_____ 16. I have trouble thinking of the right words to express how I feel about things.
_____ 17. I make judgments about whether my thoughts are good or bad.
_____ 18. I find it difficult to stay focused on what’s happening in the present.
_____ 19. When I have distressing thoughts or images, I “step back” and am aware of the thought or image without getting taken over by it.
_____ 20. I pay attention to sounds, such as clocks ticking, birds chirping, or cars passing.
_____ 21. In difficult situations, I can pause without immediately reacting.
_____ 22. When I have a sensation in my body, it’s difficult for me to describe it because I can’t find the right words.
_____ 23. It seems I am “running on automatic” without much awareness of what I’m doing.
_____ 24. When I have distressing thoughts or images, I feel calm soon after.
_____ 25. I tell myself that I shouldn’t be thinking the way I’m thinking.
_____ 26. I notice the smells and aromas of things.
_____ 27. Even when I’m feeling terribly upset, I can find a way to put it into words.
_____ 28. I rush through activities without being really attentive to them.
_____ 29. When I have distressing thoughts or images I am able just to notice them without reacting.
_____ 30. I think some of my emotions are bad or inappropriate and I shouldn’t feel them.
_____ 31. I notice visual elements in art or nature, such as colors, shapes, textures, or patterns of light and shadow.
_____ 32. My natural tendency is to put my experiences into words.
_____ 33. When I have distressing thoughts or images, I just notice them and let them go.
_____ 34. I do jobs or tasks automatically without being aware of what I’m doing.
_____ 35. When I have distressing thoughts or images, I judge myself as good or bad, depending what the thought/image is about.
_____ 36. I pay attention to how my emotions affect my thoughts and behavior.
_____ 37. I can usually describe how I feel at the moment in considerable detail.
_____ 38. I find myself doing things without paying attention.
_____ 39. I disapprove of myself when I have irrational ideas.
Appendix III-C Homework Sheet
Cultivating Schema Mindfulness
This form contains questions that will help you evaluate the strength of your schemas. Rate the degree to which you observed each schema on a weekly basis. It may help to reflect on your experiences: What kind of thoughts, feelings, behaviors, and physical sensations did you observe? How frequently did you notice each schema popping up? At what intensity? Did you experience any changes while being mindful of your schemas? Go through each of your three schemas in this way.
After filling in your score, use the last part of the sheet to write down whatever may have helped you to become more mindful of your schemas, schema modes, and schema behavior over the past week. If you know what helped you respond differently in a given situation, that is, with more schema and mode awareness (acting more in Healthy Adult or Happy Child mode), then we recommend writing that down as well.
Schema mindfulness score
(fill in the schema below)
____________________________________________
Enter a mindfulness score reflecting the degree of mindfulness with which you observed the schema this week (0–10, where 0 represents no observation, and 10 represents exceptionally mindful observation).
Schema mindfulness score
(fill in the schema below)
____________________________________________
Enter a mindfulness score reflecting the degree of mindfulness with which you observed the schema this week (0–10, where 0 represents no observation, and 10 represents exceptionally mindful observation).
Schema mindfulness score
(fill in the schema below)
____________________________________________
Enter a mindfulness score reflecting the degree of mindfulness with which you observed this schema this week (0–10, where 0 represents no observation, and 10 represents exceptionally mindful observation).
The following has/have helped me develop greater mindfulness of my schemas, schema modes, and schema behavior:
(consider altered ways of perceiving emotions, but also physical sensations and different ways of behaving)
Using your own words, write a short summary of the mindfulness session you just completed. Taking notes in your own words has been shown to be an effective method for enhancing memory. Use this form to record important ideas and other things you may have learned.
Improving schema and mode mindfulness requires regular practice. To assist this process we recommend keeping track of how frequently you practice specific exercises. In the following list, check off each item you have practiced at least four times this week (including the exercises that were assigned).
Practiced more than four times?
(If not, state the reason why. Doing so promotes mindful decision-making.)
Exercise 1.1: The Raisin Exercise
Exercise 2.1: Mindfulness of Your Environment
Exercise 3.1: Three Minute Breathing Space
Exercise 3.2: Mindfulness of Painful Memories
Exercise 3.3: Mindful Walking
Exercise 4.1: Mindful Juggling
Exercise 4.2: Cultivating Schema Mindfulness
Exercise 4.3: Getting to Know Your Schemas
Exercise 5.1: Three Minute Schema Mindfulness
Exercise 5.2: Mindful Acceptance of Self and Other
Exercise 6.1: Walking with Mindful Intent
Exercise 6.2: Letting Go of Schemas
Exercise 7.1: Mindfulness of the Healthy Adult and the Happy Child
Exercise 7.2: Preparing for the Future
Exercise 7.3: What Do the Healthy Adult and the Happy Child Need?
Exercise 7.4: Mindfulness of Schemas as Mere Thoughts
Exercise 8.1: Mindfulness of Yourself as Child and Adult
Exercise 8.2: Juggling with Schema and Mode Mindfulness in Personal Interactions
Appendix III-E Schema Coping Questionnaire
Listed below are a number of statements that describe various (schema) behaviors. Read each statement carefully and evaluate to what extent it applies to you. Write a number between 1 and 6 next to each statement to indicate the score.
Scores:
Not at all applicable to me
Only slightly applicable to me
Moderately applicable to me
Significantly applicable to me
Highly applicable to me
Perfectly applicable to me
___ I try to avoid feeling pain, sadness, or anger.
___ I often get defensive when criticized by others.
___ I frequently think to myself, ‘I knew it…’, or ‘Just as I expected…’
___ I typically work very hard, even when I’m running on empty.
___ I prefer to do things on my own (without the assistance of others).
___ I withdraw from others whenever I feel unhappy or angry.
___ I believe I have good insight into the thoughts, feelings, and actions of others.
___ I often experience physical symptoms while under stress.
___ I regularly put the needs and desires of others above my own.
___ I spend a lot of time analyzing how people react to me.
___ I watch a lot of TV or spend hours on the computer as a way to distract myself.
___ I am very (self-) critical and constantly strive to have things running smoothly.
___ I am convinced that everything I worry about will (sooner or later) come to pass.
___ I often pretend to feel better than I actually I am.
___ I am often disappointed by others.
___ I normally go to sleep or seek distraction whenever I feel bad.
Scoring the schema coping strategies questionnaire: Items associated with each of the three schema-coping strategies are listed below. Average scores are calculated for each subscale. The frequency of fives and sixes in each subscale can also be counted. These figures indicate your dominant schema-coping strategy.