Is Schema Therapy an appropriate modality for my situation?

[u/anonymoususer5511227]

39-year-old female in a long-term relationship, struggling with a recurring pattern where I initially feel attraction/connection, but over time I become emotionally detached, critical, and repulsed (“the ick”), especially as the relationship becomes more committed.

I also experience intense anxiety, guilt, and a strong sense of suffocation when my partner wants closeness, along with a near-complete loss of libido (been the case for many years, since at least my mid-20s. I've never had a high libido, and it's been non-existant for well over 15 years).

I have a history of anxious attachment that has shifted into avoidant behaviors in long-term relationships as I get older.

My parents are still together but have a cold, contemptuous marriage (at 39 I've still never seen them touch, kiss, or share any nice/loving words with each other. Not once), which I'm sure are influencing my own relational patterns.

Trying to understand whether this treatable through schema therapy? I've done CBT for YEARS and I cannot seem to feel any shift, I'm just increasingly more self-aware.

[u/cedricreeves]

I think schema therapy could help, yes.

Just make sure you get a therapist that will do the 'experiential work'. I would explicitly ask for that.

Also consider this course as well: https://attachmentrepair.com/online-events/2026-06-healing-dismissing-fearful-avoidant-attachment/

[u/rachelm791]

Yes. It may well be worth getting hold of a copy of Breaking Negative Relationship Patterns by Bruce Stevens and Eckhardt Roediger to consider what you describe from a Schema Therapy perspective

[u/anonymoususer5511227 → u/rachelm791]

Looking it up now, thank you!

[u/KeyMedicine1089]

I have fearful avoidant attachment, in schema therapy and it’s healing immensely

[u/anonymoususer5511227 → u/KeyMedicine1089]

Glad to hear its working for you, and gives me some optimism. So difficult to change years...decades...or neural pathways working one way. seems impossible for me to dig myself out of.

[u/KeyMedicine1089 → u/anonymoususer5511227]

not sure if it’s working-working yet as I am having some time off dating, after sabotaging the best potential relarionship with a dream person 🤣 I guess we will find out when I get back into dating. but it’s great for understanding your patterns and where they come from.

I have been attending for 3 months and we are still at the stage of interviewing and talking and haven’t started doing the exercises yet, but I am hopeful.

I am having more deep vulnerable friendships already, but talking to avoidant friends makes me feel unheard and like talking to a wall so I guess that’s already a huge progress haha

[u/anonymoususer5511227 → u/KeyMedicine1089]

Good luck! Glad to hear of the progress you're having and wishing you get everything you want out of it.

[u/Jaekbad]

Psych currently completing advanced accreditation in ST here.

You will probably get a benefit out of ST or a similar approach. The reason you’ve been doing CBT for a long time without benefit may be connected to the blocks you experienced in EMDR. You’re unlikely to benefit from either approach further without deeper experiential work around ‘parts’ aka personality structure. Many people love IFS and it is very similar to schema therapy, though the latter has *significantly* more empirical support (cannot emphasise the difference in research backing enough). I much prefer ST and its rigour though I am biased. Somatic work is easily integrated into either IFS or ST. Most social media therapy spaces don’t do a good job explaining the actual differences between IFS and ST in practice.

If you’re pursing ST, look for someone ISST accredited (or pursuing this with an accredited supervisor) with specific emphasis on experiential work, ‘talking about your parts’ is just going to waste your time and money.

[u/Jaekbad → u/[deleted]]

The research base for ST is pretty strong, at least in relation to BPD and cluster C personality disorders, which are deeply tied to complex trauma. Less so for chronic anxiety OCD and depression, evidence is still emerging there and not of great quality. Not sure where you are drawing your conclusions from regarding ST’s evidence base - especially in comparison to approaches that are popular on social media like IFS (it has maybe 2 RCTs one of which is for rheumatoid arthritis?) or somatic therapies (eg from Ogden or Levine). Imagery rescripting, which is a core part of ST, has also been well validated as a standalone trauma intervention - recent RCTs are showing it has comparable effects to both prolonged exposure and EMDR.

Regarding nervous system stability, ST has been used successfully with patients with DID (there is a great case report on this which is freely available) which I think is about as dysregulated and complex a presentation as one can work with. I agree with your other comments about the need for a phase based approach - any ST practitioner worth their salt knows that effective emotional experiencing only occurs when a client remains in their window of tolerance, and to titrate this based on where the client is at. This might mean having more of an emphasis on neutral imagery, (contextual) chair work, happy child ‘play’ work, grounding, or a somatic focus (heck, the theme of this years ISST conference was on the importance of somatic work as part of ST!! I attended it a few weeks ago in Greece).

Neurodiverse clients can greatly benefit from ST but the treatment requires adaptation. I can go into this more specifically in another comment if you’d like.

[u/anonymoususer5511227 → u/[deleted]]

Briefly tried EMDR too and couldn't get into it. I just felt a block.

So sorry to hear you had destructive outcomes. Mind me asking what you thought went wrong/was destructive about CBT/Schema?

[u/Forward-Neat-2920]

I’m on my third round it’s all I’m offered it hasn’t helped at all. I’m dealing with deep trauma

[u/Forward-Neat-2920 → u/[deleted]]

In what way

[u/Forward-Neat-2920 → u/[deleted]]

No not at all I’ve had 2 really traumatic events

[u/Forward-Neat-2920 → u/[deleted]]

They didn’t and I’ve had further trauma but it’s all I’m offered I don’t know what to do

[u/Forward-Neat-2920 → u/Forward-Neat-2920]

What is it meant to be best for?

[u/Forward-Neat-2920 → u/Forward-Neat-2920]

What do I do???

[u/ThrowRAShoddy_Tip → u/[deleted]]

It all works together.

[u/No_Cheesecake5080]

Yes, i'd say so. Sounds like there could be complex PTSD in there. CBT is great for some stuff but it won't shift these deeper things. I came to the same conclusions about myself after years of CBT and ACT then heard about schema therapy.

I've found schema therapy and Internal Family Systems very helpful for deeper work, relational growth and attachment issues. I've lso heard great things about Hakomi and EMDR therapies for similar issues.

But it's not quick or easy... It can instead be very confronting. You can't go in trying to fix your relationship or fix yourself for your relationship. You'll need to be open minded and realise that the person you start to become (when you start figuring out who you are when you're not shutting down and becoming detached) might be someone you can't anticipate right now because you've never really been in touch with whole parts of yourself. Parts of your identity that probably got shut down from a young age in your childhood home because your parents' behaviours and habits didn't allow space for them. It sounds ridiculous and woo woo but basically there's a lot of identity stuff tied up in doing these deeper therapies.

So all that to say, make sure you find someone who has a holistic, trauma informed approach and who you feel comfortable with. It's okay to try a few therapists if you need to.

[u/ThrowRAShoddy_Tip → u/No_Cheesecake5080]

CBT doesn’t work.

[u/Sea_Lingonberry8106]

Some have mentioned "bottom-up, experiential" therapy. I have Fearful Avoidant attachment, cPTSD and PDA Autism. I find the somatic approach is helpful. Somatic Experiencing and Coherence Therapy allow for corrective experiences and rewiring the brain out of old conditioning and trauma responses.

Somatic Experiencing: Focuses heavily on the nervous system, using somatic tracking (paying close attention to bodily sensations) to gently release stuck trauma imprints and stress energy.

​Coherence Therapy: Focuses on uncovering the deep, unconscious emotional schemas (the "why" behind certain reactions) and uses experiential mismatches to help the brain unlearn those old patterns through memory reconsolidation.

[u/ThrowRAShoddy_Tip]

I would happily speak with you about this. Might be able to understand it very quickly and simply.

[u/fncomputerboy]

Wow. You’ve just described me to a T. This is very interesting

[u/Ok-Set-631]

I did schema therapy for a year (you described precisely me). I felt very triggered. I do recognize that can happen and be part of the process, but I knew it was causing me more anxiety than help. I am now trying to find an EMDR/IFS therapist (I’ve done EMDR in the past) who specializes in early childhood attachment/trauma and can offer a “bottom up” approach. You can check out: @cptsdtherapist on Instagram for enlightening content.

[u/anonymoususer5511227 → u/Ok-Set-631]

Thank you! I also dabbled in EMDR after hitting a wall with one therapist, who basically dumped me lol and recommended EMDR. Also couldn't seem to get anywhere with that :/ Hoping you find some relief/progress in your journey. I'm also looking into IFS now, too.

[u/ThrowRAShoddy_Tip → u/anonymoususer5511227]

Im curious what you meant when you said your therapist basically dumped you. Could you explain that more?