Schema Therapy: Why You Repeat Painful Patterns (And How to Change Them)
- Sara Tookey, PhD
- 5 hours ago
- 14 min read
Written by Dominika Komínková
Key Points:
Knowing something isn't true (e.g. "I am worthy of love") doesn't always change how it feels - this gap between head and heart is at the root of repeating patterns, not a personal failing
Schemas form when core emotional needs (safety, connection, acceptance, autonomy, healthy limits, play) go unmet, inconsistently met, or met with criticism - often in childhood
When schemas are triggered, people can shift through different "modes": the Vulnerable Child (holding the pain), the Critic (internalised harsh messages), and Coping modes (fight, flight, or freeze)
Painful patterns often repeat themselves not by choice, but because schemas quietly shape what feels familiar, safe, or possible - sometimes recreating the very pain they fear
The aim of Schema Therapy isn't to eliminate schemas or stop feeling triggered, but to strengthen the Healthy Adult mode - the part that can respond to triggers with awareness and compassion rather than automatic reaction
Why we keep repeating the same patterns and how Schema Therapy can help
“I know this isn’t good for me but I keep doing it.”
“I understand it logically… but I just don’t feel it.”
Whether this is your first time considering therapy, or you have had many therapy experiences before, you might find yourself caught in patterns that feel painful, frustrating, and difficult to change.
Perhaps you struggle with procrastination, avoidance, people-pleasing, overworking, or difficulty saying no and setting boundaries. Perhaps you fear rejection or abandonment, yet find yourself drawn to people who are emotionally unavailable. You might feel disconnected, misunderstood, never quite good enough, or weighed down by shame and self-criticism.
On a rational level, part of you may know these beliefs are not true. You may know that you are worthy of love, that you are not a failure, or that your needs matter. But emotionally, it can still feel true.
This gap between what you know logically and what still feels emotionally true can create an internal conflict. You may find yourself asking: “Why can’t I just stop this?”, “Why do I still feel this way?” or “What’s wrong with me?” Far from bringing relief, these questions often deepen shame, guilt, frustration, and self-criticism.
But these experiences actually make a lot of sense when we understand how emotional patterns develop, what keeps them going and why they continue into adulthood.
Schema Therapy offers a different way of exploring these experiences. Rather than seeing these patterns as something wrong with you, it helps us understand where they may have come from, what they were trying to do for you, and what might help now.
What is Schema Therapy?
Schema Therapy is a form of integrative psychotherapy that focuses on helping people understand and change deep-rooted and long-standing emotional patterns that continue to affect their lives, self-esteem, coping behaviours, and relationships. It can be particularly helpful for people who understand their problems intellectually but still find themselves repeating painful emotional or relationship patterns.
Schema Therapy draws from several therapeutic approaches, including attachment theory, Cognitive Behavioural Therapy (CBT), Gestalt therapy, psychodynamic therapy, and emotion-focused approaches (Young et al., 2003; Arntz & Jacob, 2012). In practice, this means therapy can involve talking and making sense of experiences, as well as experiential work that helps people connect with emotions, memories, body sensations, and different parts of themselves.
How Emotional Patterns Develop: schemas and unmet needs
Schemas
At the core of Schema Therapy are schemas: broad, long-standing patterns or themes made up of thoughts, emotions, memories, bodily sensations, and beliefs about ourselves and our relationships with others (Young et al., 2003). They usually develop during childhood or adolescence, particularly when our core emotional needs were not met.
Core emotional needs
Schema Therapy identifies several emotional needs that are fundamental for healthy emotional development:
feeling safe and protected
feeling loved and connected
being accepted for who you are
being able to freely express emotions and needs
developing confidence, independence, and a sense of self
having guidance, structure, and healthy limits
having space for play, spontaneity, and joy
When these needs are repeatedly unmet, inconsistently met, or met with criticism, rejection, shame, or punishment, schemas can gradually form over time.
This can happen through a lack of positive experiences - for example, when a child’s emotions are repeatedly dismissed, affection or connection feels inconsistent, or there is ongoing criticism, shame, pressure, or a sense of feeling different, misunderstood, or alone. These experiences can happen when caregivers are emotionally unavailable, unpredictable, overwhelmed, or struggling themselves.
Schemas can also develop through traumatic experiences, such as neglect, bullying, abuse, rejection, or other distressing life events where emotional needs repeatedly go unmet. For some people, these experiences extend beyond the family environment.
People from marginalised groups, including those who are neurodivergent, LGBTQIA++, from ethnic minority backgrounds, or living with disabilities, may be more likely to experience traumatic and dismissive experiences, including discrimination, exclusion, victimisation, or rejection (Cardoso et al., 2024; Donovan et al., 2024). These experiences can shape how safe, accepted, valued, or understood a person feels in themselves, and in the world around them. Over time, especially when they happen early in life or repeatedly, they can contribute to the development of negative schemas (Lian et al., 2023).
How children make sense of painful experiences
Children naturally try to make sense of what happens to them, what they feel, how others respond to them, and what those experiences might mean about who they are. At a young age, they do not yet have the understanding, perspective, or emotional maturity to recognise that some experiences were harmful, unfair, inconsistent, and not their fault.
Instead, children interpret painful experiences in the only way available to them, based on how they were treated, what they heard, what they felt, and the environment they grew up in. This can gradually lead to developing deeply held beliefs such as: “I’m too much”, “There must be something wrong with me”, or “People leave because I’m not lovable enough.”
These beliefs do not develop because they are true. They develop because, for a child trying to understand painful or confusing experiences, they can feel like the only explanation that makes sense at the time. Over time, they can become deeply ingrained and continue to shape how a person sees themselves, relationships, and the world around them.
Schemas as emotional “buttons”
One way to imagine schemas is as emotional buttons installed inside us. Each time a similar emotional experience happens and important emotional needs go unmet, that button can become bigger, more sensitive, and easier to activate.
In adulthood, situations that echo those original experiences, even in subtle ways, can trigger strong reactions. Receiving feedback at work might bring a wave of panic, shame, or shutdown. A delayed reply from someone important may activate fear of abandonment. Sitting alone while others talk nearby may bring a deep sense of not belonging.
You might notice it physically too: tightness in your chest, a knot in your stomach, heaviness in your body, tension in your throat, or the urge to disappear. The emotional reaction may feel bigger than the situation itself.
This is not because something is wrong with you, or because you are overreacting. It is because a schema connected to earlier experiences has been activated.
Some Common Schemas
Schema Therapy identifies 18 maladaptive schemas, each linked to unmet childhood needs. Although these schemas are described as maladaptive now, they were often adaptive at the time they developed, helping the child to cope with difficult experiences or unmet needs. It is often later, in adult life, that they become limiting and no longer helpful. Some common schemas include:
Abandonment: a fear that people will leave, withdraw, or stop loving you.
Defectiveness / Shame: a belief that something is fundamentally wrong, flawed, or unlovable about you.
Emotional Deprivation: a belief that your needs for love, care, support, or understanding will not be met.
Social Exclusion / Alienation: feeling different, disconnected, or as though you do not belong.
Self-Sacrifice: consistently prioritising others’ needs while neglecting your own.
Failure: a belief that you are inadequate, incapable, or destined not to succeed.
Most people have several schemas, and they often overlap and interact with one another.
Schema Modes: what happens when schemas get triggered
Schemas are not active all the time. When something triggers them, we can shift into different emotional states called schema modes. Modes are moment-to-moment emotional states, or parts of ourselves, that come online in response to what is happening around us (Arntz & Jacob, 2012).
Here is how this might look in real life for someone with a social exclusion schema.
Triggering situation: Imagine sitting alone at lunch while colleagues are talking together nearby. From the outside, this may look like a small moment. Internally, however, it may activate a much deeper emotional hurt connected to exclusion or not belonging.
Vulnerable Child mode
You might suddenly feel sadness, loneliness, shame, anxiety, or emotional heaviness. Physically, you might notice tightness in the chest, heaviness in the stomach, feeling small, or wanting to disappear. The thoughts might be: “I don’t belong”, “I’m different”, or “There’s something wrong with me.”
The Vulnerable Child mode holds the emotional pain connected to unmet needs.
Critic Mode
When the Vulnerable Child is activated, an Inner Critic often makes an appearance. In this situation, it might say: “Of course you don’t belong”, “You’re awkward”, “You’re too much”, “Nobody wants you there”, “You should stay quiet”, or “It’s your own fault.”
This usually further increases the emotional pain.
The Critic mode is usually made up from internalised messages absorbed through experiences with parents, peers, relationships, school, culture, or society. The Critic may sound punitive (attacking the Vulnerable Child for the way it feels), demanding, or guilt-inducing. It can feel like adding salt to the wound: the Critic knows exactly where it hurts.
Coping modes
When emotional pain becomes too much, we often shift into coping modes. These can be broadly understood through familiar survival responses:
a. Overcompensation (fight) mode: You may fight against the schema by doing the opposite. In the lunch example, you might push yourself to join the conversation, work hard to appear confident or interesting, or feel driven to prove yourself. Underneath, it might feel like: “If I prove myself enough, maybe I’ll finally belong.”
b. Avoidance (flight) mode: You may disconnect from the pain. You might reach for your phone, emotionally shut down, zone out, mentally check out, or leave early. Underneath, it might feel like: “If I don’t feel this, it won’t hurt.”
c. Surrender (freeze) mode: You may give in to the schema and behave as though it is true. You might stay quiet, assume you are not wanted, and minimise your own presence. Underneath, it might feel like: “It’s probably better not to join in.”
These are protective responses that originally helped us survive emotionally, even though later they keep painful patterns going.
Healthy Adult mode: The Healthy Adult is the part of you that can pause, recognise that something painful has been triggered, care for vulnerable parts of yourself, set limits on the Critic, and respond in a more balanced and compassionate way.
In the same lunch situation, the Healthy Adult might notice: “Part of me feels like I don’t belong here.” It can also recognise: “This situation has triggered something painful in me.” Instead of automatically believing the schema, this part can hold a more balanced perspective: “Feeling left out does not necessarily mean I don’t belong.”
It might respond to the Vulnerable Child with compassion and care: “I feel left out right now. It makes sense that this hurts.” It might also challenge the Critic: “That is the Critic speaking, it does not make it true.”, or respond with understanding to a coping mode: “It makes sense that part of me wants to hide right now.”
Rather than reacting automatically from a Coping mode, the Healthy Adult can make a more conscious choice about how to respond. You may choose to slow down your breathing and ground into your body, stay present instead of disconnecting, making brief eye contact, accept that joining may feel uncomfortable but still take a small step to join the conversation, or choose not to engage while doing so consciously (e.g., taking a break, reading something) rather than out of avoidance.
One of the main aims of Schema Therapy is strengthening the Healthy Adult mode. The aim is not to get rid of schemas or never feel triggered again. It is to develop a different relationship with the emotions, thoughts, body sensations, and reactions that arise when schemas become activated, so they no longer fully overwhelm or control you.
Quick Recap
Vulnerable Child - holds the emotional pain underneath ("I don't belong")
Critic - the harsh inner voice that often follows ("You're too much")
Coping modes - fight, flight, or freeze responses that help us survive the moment
Healthy Adult - the part that can notice all of this happening and respond with care and balance
Why patterns keep repeating
One of the painful things about schemas is that they tend to repeat themselves.
Although schemas can cause a lot of suffering, they often maintain themselves because they feel familiar and believable. They shape what we pay attention to, who we are drawn to, what we expect from other people, and how we behave in relationships.
For example:
If you have an abandonment schema, you might find yourself repeatedly drawn to emotionally unavailable partners
If you have a defectiveness schema, you might stay in relationships where you feel criticised or unseen
If you have a social exclusion schema, you might withdraw from others - which can reinforce the very feeling of not belonging
Schemas often recreate the very feelings they fear. This is not because we consciously choose painful situations, but because old emotional patterns can quietly guide what feels familiar, safe or possible.
How Schema Therapy works: what sessions actually look like
Schema Therapy works with insight, emotional change, and gradually shifting long-standing coping responses and ways of relating.
Early sessions often involve exploring childhood experiences, relationship patterns, emotional triggers, coping responses, and recurring emotional themes. Together, therapist and client begin to identify schemas and modes, developing a clearer understanding of how earlier experiences shaped current beliefs, emotional reactions, relationships, and ways of coping.
The aim is not to blame the past. It is to understand how these patterns developed, reduce unnecessary shame and self-blame, and begin responding to yourself in a more compassionate way.
Sessions also involve noticing schemas and modes in the present - how they show up in daily life, relationships, and sometimes within the therapeutic relationship itself. This can help you recognise patterns earlier, before automatically reacting from them.
Experiential work and emotional change
Schema Therapy uses experiential techniques to support deeper emotional change, beyond intellectual understanding. These may include imagery exercises, imagery rescripting, chair work, and mode dialogues.
Imagery rescripting, for example, may involve revisiting painful memories in a safe and supported way, exploring what emotional needs were missing in those experiences, and creating new emotional experiences where those needs are finally met.
Chair work and mode dialogues can help you recognise and separate different modes, such as the Vulnerable Child, the Critic, or coping modes, and begin developing a healthier internal dialogue.
Experiential work can help reduce the emotional intensity and influence of schemas, while strengthening the Healthy Adult mode.
Reconnecting with emotional needs
Many people have learned to disconnect from their emotional needs. Earlier experiences may have taught them that their emotions were too much, vulnerability was unsafe, their needs were unimportant, or that they had to cope alone. For some people, expressing feelings led to criticism, rejection, shame, or feeling misunderstood.
Schema Therapy helps people begin recognising and validating their emotional needs, responding to themselves with greater kindness and compassion, and gradually finding ways to meet those needs in the present. This may involve communicating needs more clearly, developing healthier boundaries and relationships, and learning to tolerate closeness, vulnerability, and emotional connection.
The therapeutic relationship
The therapeutic relationship is one of the core healing elements in Schema Therapy. Within a safe and consistent relationship, therapy can offer experiences of being understood, accepted, and genuinely cared for that may have been missing earlier in life.
For many people, therapy becomes one of the first places where emotional experiences are met differently: where feelings are taken seriously, vulnerability is not "too much", and parts of the self feel seen rather than criticised, dismissed, or shamed.
These experiences, repeated over time, can gradually soften schemas and strengthen the capacity to treat yourself with the greater compassion.
Working with coping patterns
Many coping responses - emotional shutdown, people-pleasing, perfectionism, avoidance, overworking, self-sacrifice - originally developed for understandable reasons. They may have helped someone survive emotionally in difficult environments or relationships.
For example:
emotional shutdown may have helped someone cope with criticism or conflict
people-pleasing may have helped maintain connection or avoid rejection
perfectionism or overworking may have developed as a way of trying to feel safe, valued, or accepted
emotional avoidance may have protected someone from overwhelming feelings
Part of Schema Therapy involves gradually recognising these patterns with curiosity and compassion rather than judgement, and developing more flexible and healthier ways of responding. This may include setting healthier boundaries, expressing emotions more openly, asking for support when needed, responding to yourself with less self-criticism and more compassion, and staying emotionally present instead of shutting down, avoiding, or overcompensating.
The aim is not perfection, but gradually developing more awareness and choice in how you respond to yourself, your emotions, and other people.
Working with the Critic
The Critic mode is not usually reduced through fighting, suppressing, or simply trying to think positively. Through gradually recognising the Critic, understanding where these critical messages came from, and learning to respond to them differently, the Critic can become less of a force that controls you and more of a voice you can recognise, understand, and choose not to believe - less of a beast and more of a background noise that no longer runs the show.
The Healthy Adult can begin to set limits on the Critic, challenge harsh or unrealistic messages, and respond to vulnerable parts of yourself with greater compassion, understanding, and emotional balance.
As therapy progresses
Schemas do not disappear overnight. But they can soften. This does not mean erasing difficult experiences or never feeling emotionally triggered again. Rather, the aim is to change the emotional meanings and patterns that developed around these experiences.
As therapy progresses, many people begin to understand themselves with more compassion, feel less controlled by shame, fear, or self-criticism, recognise triggers earlier, respond differently to emotional pain, and feel more emotionally connected to themselves and others.
Situations that previously felt overwhelming, rejecting, or emotionally painful can begin to feel more manageable over time.
Who can benefit from Schema Therapy?
Schema Therapy can be particularly helpful for people who feel stuck in repeating unhelpful relationship patterns, struggle with chronic shame and self-criticism, experience strong emotional reactions, feel emotionally disconnected or empty, have experienced trauma, neglect, or emotional invalidation, and/or have tried therapy before but still feel stuck emotionally.
It is commonly used to support people who struggle with anxiety, depression, relationship difficulties, complex trauma, personality-related difficulties, emotional dysregulation, and difficulties with self-worth and identity.
Something to Try
Next time you notice a strong emotional reaction to something small, try pausing and gently asking yourself:
Does this feel bigger than the situation itself?
What might this be connecting to?
You don't need to have the answer straight away. Just noticing is often the first step.
Meet The Author:
Dr Dominika Komínková is a clinical psychologist at True North Psychology specialising in Schema Therapy. She works with adults navigating long-standing patterns of shame, self-criticism, and relationship difficulties, helping them build a more compassionate relationship with themselves.
Think You Might Benefit from a Schema Therapy Approach?
If this resonates with you and you would like to talk things through, you are welcome to get in touch and book a free discovery call to explore what has been happening and get a sense of whether this approach might be right for you.
Note: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified mental health professional for personalised guidance.
WANT TO LEARN MORE?
If you would like to read more about Schema Therapy, the following two books are a good place to start.
Reinventing Your Life by Young and Klosko is a warm and widely used introduction to schemas.
Breaking Negative Thinking Patterns by Jacob, van Genderen, and Seebauer offers a more structured guide with practical exercises, based on the schema mode approach.
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References
Arntz, A., & Jacob, G. (2012). Schema therapy in practice: An introductory guide to the schema mode approach. Wiley-Blackwell.
Cardoso, B. L. A., et al. (2024). Sociocultural implications in the development of early maladaptive schemas in adolescents belonging to sexual and gender minorities. International Journal of Environmental Research and Public Health, 21(8), 971.
Donovan, E., Salim, S., & Charak, R. (2024). Conceptualizing exposure to cisheterosexism in early life: The case for sexual and gender minority adverse childhood experiences. International Society for Traumatic Stress Studies.
Jacob, G., van Genderen, H., & Seebauer, L. (2015). Breaking negative thinking patterns: A schema therapy self-help and support book. Wiley-
Blackwell.
Lian, A. E. Z., Chooi, W.-T., & Bono, S. A. (2023). A systematic review investigating the early maladaptive schemas (EMS) in individuals with trauma experiences and PTSD. European Journal of Trauma & Dissociation, 7(2), 100315.
Young, J. E., & Klosko, J. S. (1994). Reinventing your life. Plume.Young, J. E., Klosko, J. S., &
Weishaar, M. E. (2003). Schema therapy: A practitioner’s guide. Guilford Press.
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