THEORY Overview In treating patients with personality disorders, many cognitive therapists have encountered difficulties that necessitate modification of the short-term cognitive techniques outlined by Beck and his associates in treating depression (Beck et al., 1979). This paper presents a schema model for conceptualizing and treating cases in which characterological issues violate the assumptions of short-term cognitive therapy. In this approach, the important innovations and advantages pioneered by Beck are augmented with affective and interpersonal strategies. Two important characteristics of patients with personality disorders differentiate them from those with only Axis I disorders. The first is the presence of enduring, inflexible traits in personality disorders (DSM-III-R, p. 335). Millon (1981) emphasizes this point by specifying adaptive inflexibility and vicious circles as two major criteria for personality pathology: ". . . the alternative strategies the individual employs for relating to others, for achieving goals, and for coping with stress are not only few in number but appear to be practiced rigidly" (p. 9). He elaborates as follows on the process by which such patients perpetuate their self-defeating thoughts and behaviors: Maneuvers such as protective constriction, cognitive distortion, and behavior generalization are processes by which individuals restrict their opportunities for new learning, misconstrue essentially benign events, and provoke reactions from others that reactivate earlier problems (p. 9). Millon contrasts personality disorders with "symptom disorders" (Axis I disorders) such as depression. The latter "possess well-delineated clinical features that are less difficult to modify than the ingrained personal traits from which they arise" (p. 10). In addition, these traits often "feel right" (ego syntonic) to the individual who possesses them. Avoidance is a second important distinguishing feature of personality disorders. Whereas short-term cognitive therapy assumes that patients have relatively free access to their thoughts and feelings, patients with personality disorders usually avoid painful memories, associations, and feelings. This chronic avoidance may lead to a therapeutic impasse unless additional techniques are applied. Schema Model The schema model proposed here includes the following four constructs as an expansion of Beck's (1979) short-term cognitive approach: 1. Early maladaptive schemas. 2. Schema maintenance. 3. Schema avoidance. 4. Schema compensation. Our model is intended not as a comprehensive theory of personality or psychopathology, but rather as a "convenient clinical heuristic" (Segal, 1988). Early maladaptive schemas. Beck (1967) emphasized the importance of schemas in depression, defining a schema as "a [cognitive] structure for screening, coding, and evaluating the stimuli that impinge on the organism" (p. 283). Segal, drawing from a consensus of many researchers, provides the following definition of schemas: "organized elements of past reactions and experience that form a relatively cohesive and persistent body of knowledge capable of guiding subsequent perception and appraisals" (1988, p. 147). We define Early Maladaptive Schemas (EMSs) as extremely broad and pervasive themes regarding oneself and one's relationships with others, developed during childhood and elaborated throughout one's life. These schemas serve as templates for the processing of later experience. They are characterized by all of the following and are: 1. Early in origin and continuing throughout life, unless treated. EMSs appear to be the cumulative result of dysfunctional early experiences with parents, siblings, and peers, rather than of isolated traumatic events. 2. Capable of generating high levels of disruptive affect, extremely selfdefeating consequences, and/or significant harm to others. …