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Borderline Personality Impulse Control with Schema Therapy
Borderline & Schema Therapy continuing education counselor CEUs

Section 6
Cognitive-Affective System in Borderline Personality Disorder

CEU Question 6 | CE Test | Table of Contents | Borderline
Social Worker CEUs, Counselor CEUs, Psychologist CEs, MFT CEUs

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On this track we will examine the characteristics of schema clusters: two or more schemas interfering with one client's life and interaction between schemas. Also, we will discuss indicators, such as trigger situations, that prompted a schema attack.

Schema Clusters
I have found that very rarely does one schema inhabit a client. More likely than not, a Borderline Personality diagnosed client suffers from a cluster of schemas that negatively affects their life. Schema clusters result when two or more schemas operate in a single personality. Penelope, age 35, was a BPD diagnosed client suffering from schema clusters.

Penelope had a husband, John, and two children. Her entire life centered around keeping John happy, making sure the kids didn't make him mad, and doing everything that would keep him with her while he ignored her needs.

Penelope's 3 Schemas
After extensive sessions, I found that Penelope was suffering from the following three schemas:
1. Deprivation
2. Abandonment and
3. Subjugation.

Penelope's deprivation schema stemmed from her refusal to tell John of his neglect towards her needs. Her abandonment schema made her so terrified of John leaving her alone, it soon fed her subjugation schema. To keep him, Penelope would do anything, even if it was degrading. As a result of this dysfunctional marriage, Penelope became resentful of John.

She stated, "He doesn't give a damn about me. I don't think he even loves me. It doesn't sound like he loves me, does it? I think the jackass might even be cheating on me. If he leaves me for her, I don't think I could go on living." As you can see, Penelope's schema disorder created a marriage that was a one-way street and threatened her own well-being.

Early Interaction
A second characteristic of schema clusters is interaction. Schemas that develop early on in childhood can become influential in developing a second schema later on.

Mary, age 24 and diagnosed with BPD, acquired an unlovability schema when her mother ignored her and expelled all her attention on Mary's three other sisters. When she began school, Mary noticed that she fell into her mother's favor when she brought home good grades. This appreciation shown by her mother was not the affection Mary should have been receiving during her developmental stage, but it was the closest she had ever come. She soon cultured a perfectionist schema, neurotically worrying about her grades, not for her own benefit and self-improvement, but for her mother's attention.

By high school, Mary slept about four hours a night to finally reach her goal of becoming valedictorian and achieving the ultimate reward from her mother. Mary stated, "I knew. I knew deep down she didn't really love me . She loved my sisters, and, even accounting for my exceptional GPA, I could never be those perfect angels in her eyes. It was disgusting. I guess it stemmed from her own narcissistic tendencies and her obsession with physical beauty, which I don't have, but I don't think that harlot even noticed when I got the scholarship to Duke. I was the ugly duckling and still am today."

Mary's perfectionist schema drove her to obsess over her mother's affections, but with mild success. As you can see, Mary's primary schema, unlovability, created a firm foundation for her secondary schema, that of perfectionist.

How to Detect a Schema
Now that we've discussed the characteristics of schema clusters, let's discuss how to detect a schema. As you may have observed, each schema has its own signature quality. Many times, this can be discovered through the schema's triggers and reactions.

Sixteen year old Mindy's triggers related to her deprivation schema. She stated, "As my boyfriend is saying good-bye, he'll talk about how busy he's going to be over the next few weeks, but doesn't mention that he'd like to get together again. He's avoiding me, and I know it. This is his way of telling me. He doesn't even get it when I give him the cold shoulder. It's like, duh, I can give rejection like you can dish it out."

I asked Mindy why she didn't just tell her boyfriend that she felt he was ignoring her needs. Mindy responded, "In my family, any expression of strong emotion was frowned upon as a 'dramatic display'. I learned to suppress these feelings. Telling people that I'm angry won't do anything. They'll either be terrified of me or ignore me completely. It's a universal truth." As you can see, Mindy has assimilated a self-fulfilling idea that no one will want to meet her needs because the world is cold and apathetic.

Technique: Feelings Block
To help Penelope, Mary, and Mindy address their schemas and better link their behavior to the past, I found the "Feelings Block" exercise helpful. I asked these three to look at a list of emotions and write about a time in the past that they felt this way and to explore the general feelings associated with the primary emotion. Mary addressed the feeling of perfectionism whose associated general feeling is inadequacy.

Mary related, "My dad once told me that when I took my first steps, my mother was too fascinated with my little sister's first communion dress to see it. He came home and found me walking. He asked her how long I'd been on my two feet and she said, 'Huh, she's walking now?' When I heard that story, I felt so incompetent and low. One of the greatest achievements in a person's life, and the woman who brought me into this world barely saw it. From then on, I felt embarrassed to be around other mothers that actually loved their children. I thought I might reach out, grab them, and scream, 'Will you be my mother?' I still feel that way sometimes."

By linking her past feelings of inadequacy, Mary can find the source of her perfectionist schema. Think of your Mary, Mindy, or Penelope. Would they benefit from the "Feelings Block" technique?

On this track, we discussed the characteristics of schema clusters: two or more schemas interfering with one client's life and interaction between schemas. Also, we discussed indicators, such as trigger situations, that prompted a schema attack.

Peer-Reviewed Journal Article References:
Cavicchioli, M., & Maffei, C. (2020). Rejection sensitivity in borderline personality disorder and the cognitive–affective personality system: A meta-analytic review. Personality Disorders: Theory, Research, and Treatment, 11(1), 1–12.

Lind, M., Jørgensen, C. R., Heinskou, T., Simonsen, S., Bøye, R., & Thomsen, D. K. (2019). Patients with borderline personality disorder show increased agency in life stories after 12 months of psychotherapy.
Psychotherapy, 56(2), 274–284.

Niedtfeld, I., Renkewitz, F., Mädebach, A., Hillmann, K., Kleindienst, N., Schmahl, C., & Schulze, L. (2020). Enhanced memory for negative social information in borderline personality disorder. Journal of Abnormal Psychology, 129(5), 480–491.

Online Continuing Education QUESTION 6
What are two characteristics of schema clusters? To select and enter your answer, go to
CE Test.

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