Schema Modes in Eating Disorders
What are schema modes? And how do they relate to eating disorders?
My first therapist was working with the Cognitive Behavioral Therapy (CBT) model. We questioned my thoughts, reframed my feelings, and challenged my core beliefs. The underlying assumption of CBT is that if you can show someone that their thoughts and beliefs are not based on reality and that they are falling into certain thinking errors; they will slowly let go of those thoughts and beliefs. It was helpful in the beginning because it helped me see things from different perspectives. However, after a while, I just felt stuck. No matter how illogical my beliefs about my body were, I just couldn't shake them off. We could go on finding arguments against the thought ''You are more lovable when you are thinner'', but I felt it in my body that I was more lovable when I was thinner. I knew that my weight did not define my worth, but I just felt like it did. It was like my body did not follow my brain's logic.
Years later, I found a therapist who introduced me to the world of Schema Therapy (ST), which is built on the CBT model, but it is a more elaborated version of it.
Two important concepts in ST are schemas and modes. I always describe schemas as windows that we see the world through. When a schema is activated, it influences the way we think, behave, and interpret things. Modes, on the other hand, can be thought of as parts of ourselves. They can be categorized into three groups: child modes, adult modes, and maladaptive coping modes. Maladaptive coping modes come out when one of our (unhealthy) schemas gets activated. There are three ways we can cope with this unpleasant situation: avoid, surrender or overcompensate. When we surrender, we give in to the schema and our feelings get dictated by the schema. When we avoid a schema, we are running away from it. When we overcompensate, we take the opposite of what the schema claims as the truth.
What I absolutely loved about ST is that it helped me explain the ''illogical'' bodily feelings and behaviors that I had. It introduced me to my Vulnerable Child, who felt lonely and ashamed at a bodily felt level. I got to know my Punitive Parent, who was my inner critic, watching me and judging me every second of the day. I met my Detached Protector, who helped me through difficult emotions. Getting to know these parts of myself, understanding why and how they were formed in the first place really helped me put everything together and make sense of what I was going through, which brought on real change.
I wrote this diary entry to give you a sneak-peek of Schema Therapy in hopes that it will help you recognize little parts of yourself that you were not able to understand before.
Schema Modes in Eating Disorders
1. CHILD MODES
1A. Vulnerable Child: The vulnerable child represents the parts of ourselves that we feel are undeserving, unacceptable, and unloveable. This is the part that needs nurturance and protection. It is a child who feels invisible, rejected, and undeserving. They are ashamed of their emotions and needs and see them as being "needy". When we are in this mode, our negative emotions act as a filter that distorts our body image. Because of the "flaws" we see in our bodies, we feel defective and rejected. This mode is marked by ''bodily-felt'' senses.
1B. Angry Child: This child is consumed by anger as their needs were not satisfied or even considered. They mostly express themselves by lashing out or withdrawing. I knew that my Angry Child was present, when my plans for working out or dieting got disrupted or when my binge-purge rituals were interrupted.
1C. Impulsive Child: Our Impulsive Child acts on impulses to satisfy their needs immediately, cannot postpone pleasure. They have a lot of emotions that are not properly stored within and have a tendency to release them in an uncontrollable manner, without thinking of the consequences. I recognized my Impulsive Child's presence right before and during binge-eating episodes, I often describe it as "feeling out of control" and like "I will never be satisfied".
1D. Undisciplined Child: When this mode is active, we are unable to tolerate any discomfort, both physical and emotional. The Undisciplined Child may come out especially during eating disorder recovery when experiencing bloating or stomach issues.
1E. Happy Child: This is the mode that allows for play, joy, and creativity; it is often described as feeling safe, protected, joyful, and goofy, free to express oneself. They consider the body to be a positive component of oneself that should be used for fun, expression of feelings, and joyful activities. I feel like myself the most and I feel cheerful for almost no reason when my Happy Child comes out.
2. ADULT MODES
2A. Healthy Adult: This is the part of ourselves that is capable of providing and receiving nourishment and care. The Healthy Adult is able to show compassion towards themselves and others around them. Most importantly, they can experience and tolerate both uncomfortable and pleasant feelings in the body. They respect the body and see the body and mind as intertwined elements of one's self. We focus on strengthening the Healthy Adult in therapy. As a person who has recovered, when I feel a binge coming or right after a binge, I am making sure that my Healthy Adult is on the stage, showing me the compassion and respect I need.
The following modes are the "inner critic" that I always talk about in my previous diary entries.
2B. Demanding Parent: This mode is made up of the voices of our parents, family members, and peers. They have high standards and constantly pressure us to meet these standards. You can think of them as the watchman of ''behaving correctly'' and have extremely unrealistic standards about the way we should look and eat. We can recognize this mode when we start talking with ''shoulds'' and ''musts''.
2C. Punitive Parent: This embodies the criticism we have received in the past and their perceived meaning for us. When in this mode, we tend to talk very harshly to ourselves. This mode denies us of our emotional needs, makes us feel like we are undeserving. They accuse us of not being good enough, fat, or unattractive. They are not compassionate or forgiving. My Punitive Parent used to come to the scene when I received a comment on my body. I would take these comments as evidence for me not being skinny/good enough ''See, I told you: you are fat and ugly''.
3. MALADAPTIVE COPING MODES
3A. Compliant- /Helpless- Surrenderer: When in this mode, we try to gain approval and acceptance by acting passive, giving others control. This mode is characterized by the avoidance of expressing vulnerability but instead believing that you are in a helpless situation in which you have no chance of changing the circumstances. Eating disorder behaviors may act as a way of communicating needs in this mode.
3B. Detached Protector: This mode is all about numbing emotions, using dieting as a way to disengage from social relationships and the demands of daily life. It acts as a way to shut off strong emotions and bodily felt senses. When my Detached Protector came out, I emotionally distanced myself from people around me and dedicated myself to my new diet at the time.
3C. Detached Self-Soother: When this mode comes out, we do things that will soothe us or that will divert our attention away from the uncomfortable emotions we are experiencing. Detached Self-Soother often teams up with our Impulsive Child to deal with the negative schemas that were activated. They use binge eating and drinking, excessive exercising, purging to keep intense emotions at bay.
3D. Overcontroller*: The Overcontroller acts as an idealized version, that protects us from negative emotions like shame and humiliation; by focusing on fixing the situation. It considers everything that is not 100% necessary for survival (food, rest, pleasure) as self-indulgence. It protects our Vulnerable Child by keeping the ''order'', by making sure that we never encounter a situation again that may elicit such emotions (like another binge). My Overcontroller Self use to come out right after a binge; made me look up hundreds of diets online, calculated how many calories I need to eat and burn, planned out my next diet in detail. It also established certain rules ''From now on, you do not eat after 6'' or ''No carbs for you this week!'', promised me that I will feel good, on the condition that I strictly followed what it said.
* This mode has different subtypes like ''Perfectionist-'', ''Flagellating-'', ''Invincible-'', ''Self-aggrandizer-'' and ''Pollyanna-'' Overcompensator. They may not apply to everyone, you can look them up to see if you can relate to a specific one.
I want to wrap up by adding that these are really general and flexible descriptions of modes in Schema Therapy. Everyone has their own unique modes and they function differently in each individual. Also, it is important to note that these modes are not there to hurt us; it is the quite opposite actually, they are constantly on a watch-out to make sure we do not re-encounter or re-experience the childhood patterns that initially led to the development of our maladaptive schemas. They fail to differentiate past trauma from current circumstances or danger from safety. They come to be in a moment where we really needed them and at the time, they were very good at what they did: protecting us. However, these modes no longer serve us. We thank them for protecting our Child Selves when they really felt alone and scared. But as we strengthen our Healthy Adult, their services will no longer be needed.
If you are interested in Schema Therapy and in search of a self-help book, you can check out ''Reinventing Your Life'' by Jeffrey E. Young & Janet S. Klosko.
For reference, I used the book ''Schema Therapy for Eating Disorders: Theory and Practice for Individual and Group Settings'' edited by Susan Simpson and Evelyn Smith.