The Therapy Scheme approach
In the Therapy scheme (Young et al. 2018), on the theoretical level, it is assumed that all of us, as human beings, have since the birth of fundamental needs. These are: safe attachment; autonomy, sense of competence and identity; Realistic limits and self -control; freedom to express fundamental emotions and needs; spontaneity and play. For our well -being it is central that these needs find space to be satisfied in our primary relationships.
However, it often happens that these needs are not adequately satisfied and this generates the formation of Early maladative schemes (SMP). They consist of memories, emotions and behaviors, which develop in childhood and which have reactivated automatically even in adulthood. They influence our behavior with repercussions on the levels of well -being and personal satisfaction.
The frustrated need at the base of the entry scheme: autonomy
A person who has not found satisfaction at the need for autonomy during childhood could develop, among others, one Inference scheme (Bacon & Conway, 2022).
But to understand that the child needs autonomy it is essential that the caregiver tunes into, that he understands and aligns with this need. That you try to go down to the other’s mind that you should take care of (“I’m not you, but I understand how it could be for you“).
The development of the scheme
When this does not happen, the entry scheme is structured, which will bring the child and then the adult future, to be involved in one or more relationships with the attachment figures that prevent the development of their identity.
There is often one feeling of emptiness and disorientationso much so that the person doesn’t know what to talk about. In extreme cases individuals with this scheme are limited to their physical existence.
The individual will continue to perceive, even in adulthood, excessive emotional involvement and closeness with one or more significant (often parents). This at the expense of full identification and normal social development.
Often with the belief that at least one of the individuals entangled It cannot survive or be happy without the constant support of the other.
How the patient is characterized with an entry scheme
In the clinical field we often find recurring modalities with which the entrying scheme is manifested in the patient:
- Excessive concerns for the family that manifests fears or emotional blackmail for growth or changes in the life of the child (for example a transfer or a work change).
- Strong need to ask the family or partner for permission to carry out activities or make decisions.
- Time spent exclusively with the family.
- Difficulty in making decisions.
- An exaggerated sense of loyalty (“Everything that matters is what that person wants from me wants“).
- Confusion between secrecy and privacy: some patients hold everything for themselves, in order not to hear the other threatening if they meet their needs (for example going to the gym). They are more likely to secrecy because they feel they keep control, otherwise the other would have demands that they cannot manage emotionally. As a consequence, however, the fault emerges because something is hidden and therefore the behavior is considered morally incorrect by those who commit it.
- Difficulty in differentiating the emotions of the partner or family from their own.
How the family system entangled is characterized
Often the entry scheme is born and expresses itself in a particular family system. A pathological context with typical characteristics that maintain it.
On the one hand, in an ideal family, parents form a separate system characterized by intimacy, sharing and conflicts. A closed system, but at the same time permeable, especially when the child grows.
Next to this there is the family system of the children whose adults take care of. Within their system, the children quarrel, test the rules, cooperate and is characterized by permeability because it needs direction and guide by parents (Minuchin, 1974).
Characteristics of the entangled system
In an entangled system (Minuchin, 2014), the parents’ system dominates that of the children to whom a role is given according to the needs of the caregiver:
- In the role of “Trophy”, the child is perceived as the favorite, so much so that he must always respond to this expectation under penalty of not being anymore and losing the esteem or love of the parents. He then learns to self -medication for the other.
- The “scapegoat” is the criticized, devalued son, who to survive these relational modalities must meet the needs of others in order not to feel less.
- The “disciple” is a role in which the message that the parent says is always correct, right and that must be submitted to its rules is conveyed.
- The “non-valid” characterized by a constant hyper-care. The parent replaces his son with continuous intrusions that prevent their autonomy (“I fit your shoes because you are not capable“).
- And finally the “surrogate”, which is the most common role underlying to the entry scheme: the son takes care of the parent thanks to a role inversion (adultization). The parent who does not feel capable asks more or less explicitly to the son to replace him in emotional and practical issues.
Typical parenting styles below the entry scheme
Inside the system we therefore find typical parenting styles that they frustrate the need for autonomy and tuning And they favor the structure of the entry scheme. These relational and educational methods are characterized by:
- an excessive involvement of a family member at the expense of the full identification of the child.
- Limitation of the autonomy of the children.
- Unhappy or easy to recognize personal borders (the parent shares his problems as if the child was an adult).
- A discrepant role is given to the child who goes beyond his function and his evolutionary stage.
- Expression of fragility that arouse concern in children, so much so that it prevent them from focusing on themselves and on one’s needs/interests.
- Demanding or overbearing caregiver.
- Careful figures that use catastrophisation as they transmit the message of not being able to survive without the other and its support.
If these styles meet a child with a highly sensitive, caring, empathic and intuitive temperament, it is easier for the scheme to be structured and the consequent dysfunctional behavioral methods.
Other schemes related to the experience of enforcement
In addition, in the face of the same parental style and frustrated need, different patterns can be structured, which in adulthood can be activated simultaneously.
For example, those most associated with the enforcement scheme I am:
- thecarrierificethat is to put their needs aside to satisfy those of others, under penalty of experimenting with guilt;
- The scheme of submission in which the person feels forced to put aside his needs in favor of those of others because he fears the consequences (for example denigration and humiliation);
- The scheme of dependence Which is the other side of the medal of the entry scheme: if the latter is the idea that the other cannot survive without me, in the dependence scheme, the person is afraid not to survive without the other.
Finally, even the emotional deprivation patterns (“There is no one who can satisfy my needs“,”I’m alone“) And distrust/abuse (in which the failure to tuning leads to perceiving the betrayal in the relationship) which are structured following the frustration of the need for attachment, are often recurring.
Understanding with a solid conceptualization of the case what patterns are activated in the certain circumstances allows, in therapy, to respond punctually to the frustrated need.
Treatment: recognition of needs and promotion of autonomy
The Therapy scheme has a lot to offer to treat the entry scheme and the relationships entangled.
First of all, the therapist provides, thanks to the limited repairing, a safe basis for the patient. The latter technique is used for satisfy the needs of the person and access the emotions of childhood through the use of the imagination or therapeutic relationship.
Access to the dissatisfied needs of autonomy and tuning helps the patient to develop a sense of trust in his own skills, of understanding, of the possibility of expression of anger in order to be more determined in pursuing his desires.
The therapist cultivate autonomy relating to the patient in order to give value to this need.
It is necessary to clarify with the patient what he wants to change, as sometimes there is no awareness of this (“Can we clarify together what would make it progress? What would make her feel satisfied“). For stimulate curiosity The genuine receptivity and interest is fundamental on the world with respect to any explorations or desires.
It is more important than never to inquire about satisfaction for the trend of therapy, leading the patient to participate active participating, also to prevent it from becoming compliant in order to be appreciated or recognized.
Even the homework, which allow to solidify what we do in the session, must be negotiated.
When the patient asks for advice, it is necessary to gently guide the decision -making process in order to make it come independently to the final decision. I wait that allows you to hear the choice as finally and consistent with itself.
The attitude is therefore authoritative, but not authoritarian or permissive.
Bibliography
- Bacon, I. & Conway, J. (2022). Co-dependency and EnmeHment-A fusion of concepts. International Journal of Mental Health and Addiction. Volume 21, Pages 3594–3603.
- Minuchin, S. (1974). Families and Family Therapy. Harvard University Press.
- Minuchin, S., Reiter, MD, Borda, C., Noferi, G. (2014). The art of family therapy. Astrolabio publishing house.
- Young, Je, Klosko, JS, Weishaar, Me (2018). Therapy scheme. Integrated cognitive-behavioral therapy for personality disorders. Erikson, Trento.
