Edwards David John Arthur
Department of Psychology, Rhodes University, Makhanda, South Africa.
Schema Therapy Institute, Cape Town, South Africa.
Front Psychol. 2022 Jan 20;12:763670. doi: 10.3389/fpsyg.2021.763670. eCollection 2021.
This article is situated within the framework of schema therapy and offers a comprehensive and clinically useful list of schema modes that have been identified as being relevant to conceptualizing complex psychological problems, such as those posed by personality disorders, and, in particular, the way that those problems are perpetuated. Drawing on the schema therapy literature, as well as other literature including that of cognitive behavior therapy and metacognitive therapy, over eighty modes are identified altogether, categorized under the widely accepted broad headings of Healthy Adult, Child modes, Parent modes and coping modes which are, in turn, divided into Surrender, Detached/Avoidant, and Overcompensator. An additional category is included: Repetitive Unproductive Thinking. This draws attention to the recognition by metacognitive therapists that such covert behaviors play a significant role in amplifying distress and perpetuating a range of psychological problems and symptoms. In addition to the modes themselves, several concepts are defined that are directly relevant to working with modes in practice. These include: default modes, blended modes, mode suites and mode sequences. Attention is also drawn to the way in which Child modes may be hidden "backstage" behind coping modes, and to the dyadic relationship between Child modes and Parent modes. Also relevant to practice are: (1) the recognition that Critic voices may have different sources and this has implications for treatment, (2) the concept of complex modes in which several submodes work together, and (3) the fact that in imagery work and image of a child may not represent a Vulnerable Child, but a Coping Child. The modes and mode processes described are directly relevant to clinical practice and, in addition to being grounded in the literature, have grown out of and proved to be of practical use in conceptualizing my own cases, and in supervising the cases of other clinicians working within the schema therapy framework.
本文处于图式疗法的框架内，提供了一份全面且具有临床实用性的图式模式清单，这些模式已被确定与概念化复杂心理问题相关，例如人格障碍所引发的问题，尤其是这些问题得以持续存在的方式。借鉴图式疗法文献以及包括认知行为疗法和元认知疗法在内的其他文献，总共识别出八十多种模式，它们被归类在广泛认可的大类之下，即健康成人模式、儿童模式、父母模式和应对模式，而应对模式又依次分为屈服模式、超脱/回避模式和过度补偿模式。还新增了一个类别：重复性无效思维。这提请人们注意元认知治疗师的认识，即这种隐蔽行为在加剧痛苦和使一系列心理问题及症状持续存在方面起着重要作用。除了模式本身，还定义了几个与在实践中运用模式直接相关的概念。这些概念包括：默认模式、混合模式、模式组和模式序列。还提请注意儿童模式可能隐藏在应对模式“后台”的方式，以及儿童模式与父母模式之间的二元关系。与实践也相关的有：（1）认识到批评性声音可能有不同来源，这对治疗有影响；（2）几种子模式共同起作用的复杂模式概念；（3）在想象工作中儿童的形象可能不代表脆弱儿童，而是应对儿童这一事实。所描述的模式和模式过程与临床实践直接相关，并且除了以文献为基础外，还源于我自己对病例的概念化，并在监督其他在图式疗法框架内工作的临床医生的病例方面证明具有实际用途。
