An exploration of schema modes in bipolar disorder

Abstract

Schema Therapy (STB Young et al., 2003) was developed for working with individuals who experienced complex psychological difficulties and patterns of relating, and who were not responding to traditional CBT. Developed originally for those with a Borderline Personality Disorder diagnosis, ST, which includes schema mode work, has more recently been expanded for use with other populations. Research has begun to explore the potential relevance of ST to those with a Bipolar Disorder diagnosis. However, currently there is a gap in the research exploring the descriptive value of the schema mode construct for this population. As a pilot study, this original thesis aimed to qualitatively explore participant’s responses to Young Klosko and Weishaar’s (2003) original schema modes and to what extent their experiences were consistent or distinct from descriptions of these. Seven adults with a diagnosis of Bipolar Disorder took part in a semiSstructured interview. They were presented with eight cards, each displaying a description of one of Young, Klosko and Weishaar’s (2003) schema modes. Participants were then asked questions about each mode, which were based on a theoretical understanding of how modes are thought to operate. Interviews were transcribed and qualitative data was organised into eight matrices, one for each schema mode. Data were analysed for each matrix using Thematic Analysis. Being demanding of oneself, selfScriticism, anger and feeling separate to others appeared common themes across the sample. Difficulty regulating intense emotions was also highlighted. Stigma was identified as a factor which may influence some of these experiences. Whilst participants related to most of Young’s mode descriptions and described emotional and behavioural states that were consistent with these, themes from the Thematic Analysis also highlighted shared experiences across the sample that were not encompassed by Young’s descriptions of schema modes and how they are theorised to operate. Findings suggested that some of the thoughts, feelings and behaviours consistent with Young’s modes, might be experienced more intensely in particular mood states. Such experiences might be prolonged through the use of avoidance or rumination as a way of coping. The findings from the study were critically considered in relation to exploring the descriptive value of schema modes, which has not been done before. Limitations of the study were also discussed. Recommendations were made for future research in this area, and the clinical and societal level implications of the research findings were presented.