Integrating schema-focused therapy & EMDR

Dr. Young has developed an integrative model that seems especialy appropriate for combining with EMDR. According to the theory proposed, eighteen Early Maladaptive Schemas (EMS) are at the core of personality disorders. An EMS is defined as an extremely broad, pervasive theme regarding oneself and one's relationship with others, developed during childhood and elaborated throughout one's lifetime, and dysfunctional to a significant degree. Shapiro's concept of childhood file folders would be analogous to the concept of schemas. These eighteen schemas are primarily unconscious but can be brought to awareness through various strategies, especially EMDR. This presentation will demonstrate how to integrate the use of Schema-Focused therapy with EMDR. In this model, Schema- Focused therapy serves as the primary conceptual framework for working with the client while EMDR is seen as the primary change technique. The first step in this process is a thorough history taking looking for both traumatic life events and the client's underlying vulnerabilities and schemas. History taking is accomplished both through client interviews and the use of Lazarus' Multimodal Life History Questionnaire. The Schema Questionnaire and the Parent Questionnaire developed by Young are given and scored. As part of this process, the therapist attempts to help the client discriminate memories representing primary trauma versus memories that represent life long issues. The EMDR model eliciting infonmtion - asking the client about specific events and problems, then obtaining Pictures, Negative and Positive Cognitions, Affect and Body Sensations as well as SUDS and VOC ratings - is used as soon as the client is comfortable. Collecting information this way without the use of Eye Movements has been shown to be a very effective way of tapping into the neural network where related memories are stored. The grouping of these memories often appears to be along such schema lines as Vulnerability, Defectiveness, Abandonment, etc. As the therapeutic relationship develops, clients are educated about EMDR and schemas. The last part of this process is the Case Conceptualization. This involves putting together the information from history taking, the schema questionnaire and the parent questionnaire and the client's in-session behavior to formulate a useful picture of client problems, likely problem origins, and recommended change techniques. Knowing what issues/themes your client is vulnerable to, tells you where to start your EMDR exploration. It also helps suggests where to probe when processing stops, i.e., what blocking beliefs may be present, what type of cognitive interweave to use, etc. Once the case conceptualization is complete, EMDR is used as always. However, the use of Schema Focused therapy with EMDR broadens the scope of EMDR. 1) Cognitive Therapy for Personalitv Disorders: A Schema-Focused Approach. Revised Ed. Professional Resource Press, Sarasota, FL, (813)366-7913; 2) Reinventing Your Life, J. Young and J. Klosko. New York, Plume, 1994.

Conference

English

Jeffrey Young
William Zangwill

Young, J., & Zangwill, W. (1995, June). Integrating schema-focused therapy & EMDR. Presentation at the EMDR Network Conference, Santa Monica, CA