Schema therapy

[carriewriting]

Hi, I'm starting this thread to document my experience with schema therapy for health anxiety and generalised anxiety.

So far I've just done the questionnaire, so haven't found out what schemas I have, but I suspect they are:


vulnerability to harm
emotional deprivation
defectiveness
emotional inhibition
social isolation
negativity/pessimism


Something that has emerged already just from giving the therapist my background is that been so focussed on my health fears that I didn't realise how afraid of everything else I am eg. money, personal safety, career, relationships, world events.

I have a friend who says schema therapy really helped them a lot, so I'm hoping it does the same for me.

[NoraB]

Following this thread with interest Carrie. X

[carriewriting]

Okay, I had another appointment yesterday and the schemas I tested strongly for weren't a surprise.

1. Vulnerability to harm
2. Emotional deprivation
3. Defectiveness/shame
4. Social isolation
5. Pessimism

It didn't come out on the test, but my therapist also thinks I have the self-sacrifice schema.

Things I've learned since starting this round of therapy (I've seen two other therapists in the past 10 years)

1. I have a lot more fear than I realised. I thought it was just health anxiety, but it's much broader than that.
2. I have a very limited range of emotions. Fear is my constant. I sometimes feel sad, but I rarely feel happy or angry and get scared when I do.
3. I am extremely independent. I take on a huge load in all areas of my life and don't feel I can ask for help. Not being able to take care of myself is a huge fear.

Lots to work on here and I'm really glad I've found this approach to therapy.

If you want to find out more I recommend Reinventing Your Life by Jeffrey.E.Young.

Another book I read that was eye opening for me was Daughter Detox: Recovering from an Unloving Mother and Reclaiming Your Life by Peg Streep.

[NoraB]

If you want to find out more I recommend Reinventing Your Life by Jeffrey.E.Young.

Cool. I was looking for another book for my Christmas list. :yesyes:

[carriewriting]

I'm sure you'll like it Nora :)

Today I was able to use some of the things I've learned so far in therapy and they really helped me.

Out of the blue I woke up this morning and the bottom of my sternum was really sore. It feels hard and swollen on the right side at the end. Too much poking and prodding to try and work out if it was sternum or an abdominal lump made it worse as the panic about all kinds of cancer flooded through me.

Usually this would have destroyed me all day. A 10/10 on the anxiety scale.

Instead I was able to keep it at about 5/10 by reminding myself of some of the things I've been talking about in therapy.

1. This is what I do. I find something wrong and go from zero to catastrophe in an instant. I don't need to do that.

2. If I get sick, someone will look after me.

3. I've had sore ribs for 15 years and have acid reflux/gastritis. A sore sternum is highly likely to be related one or both. It would be a big dose of bad luck for it not to be, but what will be, will be. If it was something serious, I wouldn't have to face it alone.

I still have a long way to go, but I feel like I'm on the right path.

[NoraB]

but I feel like I'm on the right path.

I think so too. Well done mate. X

[pulisa]

I'll second that. I think it's inevitable that there will be symptoms with HA but it's how you react to them which is significant in your attempt to manage your fear of a devastating diagnosis.

I'm very independent too but it can work against you and you can heap far too much pressure on yourself. Take comfort from the fact that you wouldn't be fighting any illness-mental or physical-on your own x

[carriewriting]

Thank you both. You have been the biggest help to me this year with your kind, but rational advice.

I'm still battling daily health fears, but trying to remember my therapist's advice to lower my estimation of the probability of a catastrophic event and raise my estimation of my capacity to cope.

I'm finding raising the estimation of my capacity to cope much easier than the lowering of the catastrophic event, but hopefully practice makes perfect :)

[carriewriting]

Time to put my therapy into practice. After almost a week of feeling pretty good about my health anxiety, tonight I've had a melt down.

I was cleaning out my desk and came across my neurologist report from a few months ago about my optic nerve. At my appointment I asked him about all my neuro fears, including dementia and he dismissed them all so I only skimmed through the report at the time, but now I've noticed one thing he's written and it's triggered my dementia fear big time.

I know this is probably part of the vulnerability to harm schema (fear of losing your mind). Also what was I thinking reading a medical report??

My initial reaction was to go back to my GP to ask about what he's written in the report, but then I ask myself would a person without health anxiety do that and I think the answer is no.

I have my next therapy appointment next week so can work through this further then.

[pulisa]

The answer certainly is no. Your neurologist is better informed than your HA.

There actually isn't anything to discuss here. You've come to your own conclusion on this.

[carriewriting]

I had another schema session yesterday and did an imagery re-scripting exercise. It's purpose was to teach me how to be compassionate to myself and build my self-esteem. We talked a bit about how I feel like my GP and other doctors think I'm crazy because of my health anxiety and how I hate going to them for health worries, because I'm ashamed, but at the same time can't help myself. My therapist asked what evidence I had that my GP or other doctors think that and I realised there was none, it was all my interpretation and assumption and based on my shame about my health anxiety.

That made me realise that I have a lot of assumptions about what people think of me that I don't have any proof is true.

And this negative way of thinking about myself feeds into my fear of being alone, of getting sick and having no one to look after me.

Apart from my big meltdown last week, my health anxiety has been relatively steady though. I'm using a new mantra "If something happens, I'll cope" when scary health thoughts pop into my head.

It's a work in progress, but I do feel progress is being made.

[carriewriting]

So I got through Christmas without succumbing to a big health anxiety spiral, but it was a close run thing. I have to say my therapy really helped get me over the line.

The exercise I did in my last session was about visualising myself as a child and I've been using that a lot this week.

I've been reminding myself that my anxiety is me as a child and in doing so I'm able to be more compassionate and less angry with myself for the strength and frequency of my health anxiety fears.

The other thing that's working well is putting distance between myself and my health anxiety. When the scary thoughts come I'm reminding myself that my life is a story and I'm watching it unfold. I don't have to fear it, just be interested in what happens next, good or bad. I'm finding this really calming.

So far the two biggest benefits of schema therapy have been recognising the level of fear I have in my life of all things (not just health) and recognising how much I engage in negative thinking. I'm starting to identify them both in daily life and that's helping my anxiety immensely.

[NoraB]

I have to say my therapy really helped get me over the line.

Good to hear! :yesyes:

[carriewriting]

So I started the year confident, positive and enthusiastic about the year ahead, but this weekend I've crashed and burned with an old fear resurfacing.

I'm pretty sure this is my vulnerability to harm and negativity schemas being triggered by my decisions to make changes in my life. I get so scared by the prospect of happiness or success and sabotage with HA is a pattern.


The good news is I have therapy this week and I haven't fallen back into Googling, but that might be because I read pretty much everything on the internet about this disease i fear during my breakdown in 2019 :wacko:

In the meantime it's back to scrubbing floors and cleaning windows for me.

[pulisa]

You haven't "crashed and burned", Carrie. You've recognised and pinpointed your triggers. You fear being optimistic for the future because if you are you'll jinx yourself and get your "just deserts" for having hope.

I don't know anything about schema therapy but i wouldn't try to beat these feelings into submission. These feelings currently have power over you but they are not based on fact, just fear. You made a plan to manage insecurities around care issues with any potential illness? Maybe having a visual prompt of what you discussed would help prevent a rapid spiral? Just writing down a series of bullet points with as little language as possible to get you back on track?

Please don't wear yourself out with the cleaning? x

[carriewriting]

Thanks Pulisa. I'm feeling calmer today. My therapist got in touch to change my appointment and we had a chat about what's been going on. She said we're also going to try some exposure and response therapy to help with my obsessive thoughts about illness. I do think I have an OCD component to my health anxiety, so I'm looking forward to tackling that too.

[pulisa]

I think that the majority of people have an OCD component to their HA so I'm sure your therapist will want to try some different techniques to see what you respond to best.

[carriewriting]

I've just had my 6th schema appointment. I did a visualisation exercise where I recalled a time when I was very afraid and then visualised what I needed in that moment eg. a hug, someone to help me, support me etc. The idea is now when I feel afraid eg. health anxiety I recall the comfort I felt in the visualisation.


My healthy anxiety is still pretty bad, but the therapy is definitely helping. When I fall into a spiral now I have a worksheet where I identify the schemas that are in play eg. vulnerability to harm, pessimism. I also write down what I'm thinking and that's been an eye opener. The way I think about myself during a spiral (and probably in general) is very harsh. I need to practice being nicer to myself.

Another thing that's come out in therapy is that I'm really focussed on "fixing" myself, both physically (weight, fitness), mentally (anxiety) and emotionally (relationships). This is part of the defectiveness/shame schema so we're going to be doing some more work on self-acceptance.

So that's where I'm up to. Next appointment is in 3 weeks so I'll share more then.

I did enjoy this video this week. https://www.youtube.com/watch?v=OL04RtVvA28 The look on the woman's face when the therapist suggest she think about her anxiety as an opportunity is priceless :) He's right though.

[carriewriting]

Session number 7 (I think) last week. We talked a lot about my need to feel prepared for the diagnosis of a serious illness. Hence hypervigilance, predicting bad test results and constant checking followed by extreme research on treatment, surgery, side effects etc. I feel like if I learn everything I can and "deal" with it, then I won't be out of control if it happens.

My therapist asked what did control give me? I said it was a feeling of being able to keep my "game face" on. Not breaking down and not being able to help my family deal with it my illness or impending death. Not being weak or vulnerable. Being strong.

Then she asked why I need to have my game face on? Why can't I break down or be vulnerable if something bad happens? Why do I always have to be strong?

I said because that's what everyone expects from me. I've always been super responsible. One year at my work Christmas party I even got an award for being "the glue that holds everyone together". My brother told my other brother I'm "the boss of the family" now my mum died. I do everything (birthdays, Christmas, finances, housekeeping, cooking, kid and pet wrangling). And much as it stresses me out, it also gives me positive reinforcement and validation. I struggle to connect with people so acts of service is how I do it, but at a big cost to myself.

So that was a lot of unpacking and food for thought. It's the self sacrifice schema at work with a bit of defectiveness schema thrown in for good measure.

I had thought my health anxiety was mainly fear of not having anyone to look after me, but it obviously goes a lot deeper than that.

I'm now working on putting myself first more often and letting myself express my emotions rather than stuffing them down all the time.

Slowly but surely I feel like I'm getting to the core of my health anxiety.

[carriewriting]

When I got the reminder about my appointment this week my first reaction was annoyance at myself because I knew I'd made no progress since my last appointment. At that one I'd talked about how I needed to be helping myself eating better, exercising more and getting more sleep. I hadn't been doing any of those things and my anxiety had been through the roof. But after thinking about it I realised I was being pretty hard on myself. The past 3 weeks have been really tough. I've been dealing with the stress of upcoming medical tests, a boy at my son's school took his own life and it's the anniversary of my mum's death. No wonder I was feeling low and comfort eating. So this appointment I vowed to be kind to myself between visits.

At this appointment we talked a lot about my negativity schema. How I believe only bad things happen to me and how that fuels my health anxiety. I've got a flash card that I'm going to use for the next few weeks to challenge my negative thoughts and overeating (which leads to more health anxiety). You can see the example flash card here http://www.johnbarletta.com/documents/FlashCard.pdf

[carriewriting]

Hello, long overdue check-in. I'm still going with the schema therapy and it's helping me a lot. One of the biggest ways it's helped is recognising my negative mindset and the role that plays in me expecting the worst in every situation. I now keep a diary of all the things I think will happen and then revisit it every month to see how many actually did.

Case in point with the COVID vaccine. The only one available to me is AstraZeneca and despite the stats being really small for a serious blood clot, I'm finding it really hard to make myself go and get the shot because I'm convinced I'll be the 4 in 100,000 or whatever the number is. I'm still holding out hope I might be able to get Pfizer or Moderna later in the year. Here in Aus people 50 and over can only get AZ at the moment. I have no issues at all with getting the other shots, I just really don't want AZ. Sigh, still some work to do there.

Health anxiety thoughts still plague me daily too. I'm still convinced my upcoming mammogram will show breast cancer and oral cancer has been my latest terror of choice (so many mouth lumps and bumps when you focus on it!) I've been reading and listening to Dale Carnegie's book "Stop Worrying, Start Living" every day and that's helping me manage my run away thoughts. "Remember, today is the tomorrow you worried about yesterday" is one of his statement that really resonates with me. I also remind myself that when I start worrying, I need to get busy.

[pulisa]

Good to see that you deleted that thread you started on the HA forum, Carrie. That's certainly progress.

What would you most like to be able to do if you were able to manage your HA successfully? How would you fill the "gap" left by HA?

As for the AZ jab, why do you think you would be one of the unlucky ones to get a severe reaction? What evidence do you have ? Why would you be singled out? Why not add that one to your diary list?

[carriewriting]

Thanks Pulisa, I really have made some big improvements in the past few months. I was talking to a friend of mine about it and said last week I had a few days where I almost felt optimistic :D Lately I'm finding my anxiety doesn't have as tight a grip on me. I still have all the thoughts, but I don't get as scared/upset/frustrated/depressed about them. The schema therapy has helped, but really the turning point was the Stop Worrying, Start Living book. That shifted something in my mind. I still think all the bad things will happen to me though, so there's still work to be done.

Re: the AZ vaccine, good idea. I've added it to my list and booked the appointment (again!)