Typical Presentation of the Schema
This is probably the most common schema we treat in our work, although patients frequently do not recognize that they have it. Patients with this schema often enter treatment feeling lonely, bitter, and depressed, but usually not knowing why; or they present with vague or unclear symptoms that later prove to be related to the Emotional Deprivation schema. These patients do not expect other people-including the therapist-to nurture, understand, or protect them. They feel emotionally deprived, and may feel that they do not get enough affection and warmth, attention, or deep emotions expressed. They may feel that no one is there who can give them strength and guidance. Such patients may feel misunderstood and alone in the world. They may feel cheated of love, invisible, or empty.
As we have noted, there are three types of deprivation:
- deprivation of nurturance, in which patients feel that no one is there to hold them, pay attention to them, and give them physical affection, such as touch and holding;
- deprivation of empathy, in which they feel that no one is there who really listens or tries to understand who they are and how they feel;
- deprivation of protection, in which they feel that no one is there to protect and guide them (even though they are often giving others a lot of protection and guidance).
The Emotional Deprivation schema is often linked to the Self-Sacrifice schema. Most patients with a Self-Sacrifice schema are also emotionally deprived.
Typical behaviours exhibited by these patients include not asking significant others for what they need emotionally; not expressing a desire for love or comfort; focusing on asking the other person questions but saying little about oneself; acting stronger than one feels underneath; and in other ways reinforcing the deprivation by acting as though they do not have emotional needs. Because these patients do not expect emotional support, they do not ask for it; consequently, usually they do not get it.
Another tendency we see in patients with an Emotional Deprivation schema is choosing significant others who cannot or do not want to give emotionally. They often choose people who are cold, aloof, self-centred, or needy, and therefore likely to deprive them emotionally. Other, more avoidant patients become loners. They avoid intimate relationships because they do not expect to get anything from them anyway. Either they stay in very distant relationships or avoid relationships entirely.
Patients who overcompensate for emotional deprivation tend to be overly demanding and become angry when their needs are not met. These patients are sometimes narcissistic. Because they were both indulged and deprived as children, they have developed strong feelings of entitlement to get their needs met. They believe they must be adamant in their demands to get anything at all. A minority of patients with the Emotional Deprivation schema were indulged in other ways as children. They were spoiled materially, not required to follow normal rules of behaviour, or adored for some talent or gift, but they were not given genuine love.
Another tendency in a small percentage of patients with this schema is to be overly needy. Some patients express so many needs so intensely that they come across as clinging or helpless, even histrionic. They may have many physical complaints-psychosomatic symptoms-with the secondary gain of getting people to pay attention to them and take care of them (although this function is almost always outside their awareness).
Goals of Treatment
One major goal of treatment is to help patients become aware of their emotional needs. It may feel so natural to them to have their emotional needs go unmet that they are not even aware that something is wrong. Another goal is to help patients accept that their emotional needs are natural and right. Every child needs nurturance, empathy, and protection, and, as adults, we still need these things. If patients can learn how to choose appropriate people and then ask for what they need in appropriate ways, then other people will give to them emotionally. It is not that other people are inherently depriving, it is that these patients have learned behaviours that either lead them to choose people who cannot give, or discourage people who can give from meeting their needs.
Strategies Emphasized in Treatment
There is a strong emphasis on exploring the childhood origins of this schema. The therapist uses experiential work to help patients recognize that their emotional needs were not met in childhood. Many patients never realized they were missing something, even though they had symptoms of missing something. Through imagery work, patients get in touch with the Lonely Child part of themselves and connect this mode to their presenting problems. In imagery, they express their anger and pain to the depriving parent. They list all their unmet emotional needs in childhood, and what they wish the parent had done to meet each one. The therapist enters images of childhood as the Healthy Adult, who comforts and helps the Lonely Child, and then the patient enters the image as the Healthy Adult, and comforts and helps the Lonely Child. Patients write a letter to the parent, for homework (which they do not send), about the deprivation uncovered through imagery work.
As with most of the schemas in the Disconnection and Rejection domain, the therapy relationship is central to the treatment of the schema. (The exception is the Social Isolation schema, which usually involves less emphasis on the patient-therapist relationship and more on the patient’s outside relationships.) The therapy relationship is often the first place these patients have ever allowed anyone to take care of, understand, and guide them. Through “limited reparenting,” the therapist provides a partial antidote to their emotional deprivation: a warm, empathic, and protective environment, where they can get many of their emotional needs met. If the therapist cares about and reparents the patient, then this will ease the patient’s sense of deprivation. As with the Abandonment schema, the therapy relationship provides a model that patients can then transfer to others in their lives outside therapy (a “corrective emotional experience” (Alexander, 1956). Like the Abandonment schema, there is a great deal of emphasis on the patient’s intimate relationships. The therapist and patient carefully study the patient’s relationships with significant others. Patients work on choosing appropriate partners and close friends, identifying their own needs, and asking to have these needs met in appropriate ways.
Cognitively, the therapist helps patients change their exaggerated sense that significant others are acting selfishly or depriving them. To counter the “black or white” thinking that fuels overreactions, the patient learns to discriminate gradations of deprivation to see a continuum rather than just two opposing poles. Even though other people set limits on what they give, they still care about the patient. Patients identify the unmet emotional needs in their current relationships.
Behaviourally, patients learn to choose nurturing partners and friends.
They ask their partners to meet their emotional needs in appropriate ways and accept nurturance from significant others. Patients stop avoiding intimacy. They stop responding with excessive anger to mild levels of deprivation and withdrawing or isolating when they feel neglected by others.
In the therapy relationship, the therapist provides a nurturing atmosphere with attention, empathy, and guidance, making special attempts to demonstrate emotional involvement (e.g., remembering the patient’s birthday with a card). The therapist helps the patient express feelings of deprivation without overreacting or remaining silent. The patient learns to accept the therapist’s limitations and to tolerate some deprivation, while appreciating the nurturing the therapist does provide. The therapist helps the patient connect feelings in the therapy relationship with early memories of deprivation, and to work on these experientially.
Special Problems with This Schema
The most common problem is that patients with this schema are so frequently unaware of it. Even though Emotional Deprivation is one of the three most common schemas we work with (Subjugation and Defectiveness schemas are the others), people often do not know that they have it. Because they never got their emotional needs met, patients often do not even realize that they have unmet emotional needs. Thus, helping patients make a connection between their depression, loneliness, or physical symptoms on the one hand, and the absence of nurturing, empathy, and protection on the other is very important. We have found that asking patients to read the Emotional Deprivation chapter of Reinventing Your Life (Young &: Klosko, 1993) can often help them recognize the schema. They can identify with some of the characters or recognize the behaviour of a depriving parent.
Patients with this schema often negate the validity of their emotional needs. They deny that their needs are important or worthwhile, or they believe that strong people do not have needs. They consider it bad or weak to ask others to meet their needs and have trouble accepting that there is a Lonely Child inside them who wants love and connection, both from the therapist and from significant others in the outside world.
Similarly, patients may believe that significant others should know what they need, and that they should not have to ask. All of these beliefs work against the patient’s ability to ask others to meet his or her needs. These patients need to learn that it is human to have needs, and healthy to ask others to meet them. It is human nature to be emotionally vulnerable. What we aim for in life is a balance between strength and vulnerability, so that sometimes we are strong and other times we are vulnerable. To only have one side-to only be strong-is to be not fully human and to deny a core part of ourselves.
Source: Schema Therapy: A Practitioner’s Guide
Jeffrey E. Young (Author), Janet S. Klosko (Author), Marjorie E. Weishaar