One of the key aims of cognitive therapy is to explore the underlying assumptions that people have of themselves and of significant others in their lives. The continued monitoring of critical situations week to week in therapy will soon provide the therapist with clear indications of the themes underlying a particular client's difficulties, information that can be supplemented with assessments of attitudes by tools such as the Dysfunctional Attitudes Scale (Weissman & Beck, 1978) and the Schema Questionnaire (Young, 1999). Let us imagine that we have a client, part of whose formulation is that he has a fear of success in competitive situations because of other people's envy that would ensue from his winning. Exploration of the origins of this schematic model might indicate that the client's father behaved in a very overbearing manner whenever there was a competitive situation in which the client was involved. The client may also back down or appear to withdraw statements in therapy in order to avoid imagined conflict with the therapist. The therapist therefore accrues information from a variety of past and present situations, including the therapeutic relationship, which supports the existence of this key self-defeating schematic model. This model had a particular value in a previous significant relationship, but, unfortunately, has been generalised now to cover all relationships that are perceived to be competitive. Having reached such clarity, the therapist has a variety of options, all of which probably should be explored in parallel.
First, there may be a number of experiments that can be set as homework in which the client puts to the test his belief that any competitive situation will lead to destructive attacks from other individuals; thus, there are many situations in which, in theory, there is no limit on the number of winners or losers because the outcome is primarily dependent on the individual's own performance (as in taking a driving test).
Second, the therapist may also explore the client's thoughts and feelings where schematic models become obvious in therapy—for example, in an apparent conflict over who is right in therapy. The therapist can also use these situations in therapy as indications of other past and present relationships and how significant others might react in relation to the client's actions; in addition, the client's perceptions of how the other person really feels about his winning can also be explored (cf. Safran & Segal, 1990).
Third, the therapist can help the client restrict the range of applicability of the self-other schematic model, or, alternatively, may help the client to develop a more sophisticated and appropriate mental model of why his father related to him in the way he did (cf. Padesky, 1994). In fact, his father reacted badly towards anyone's success, not just the client's; his father covered up his own feelings of being a failure by attacks on other people's success, not only his son's. Although the client had believed that he was the only one that his father had related to in this manner, he realised, when for the first time he began to talk to other relatives about his father's reactions, that they all shared his feelings, but were not prepared to fail in order to avoid his father's envy and destructive attacks.
This example illustrates that schematic models are complex, have their origins in the past, and typically relate self and one or more significant others in a rigid, repeating pattern. The themes involved in depression normally relate to issues of loss, failure, and shame. The self is viewed positively when an overinvested role or goal is being pursued successfully—for example, the perfect wife or mother, the high-flying student or executive who can deal with everything, or the would-be pop star who will finally get the recognition that she deserves. Unfortunately, the experience of events and difficulties that are a threat to such goals or roles leaves the person feeling worthless, unlovable, and shameful, because the self-concept is so bound up with them, and little or nothing else is seen to be of value.
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