Behavioral therapy with schema therapy

Behavioral therapy with schema therapy: treating current symptoms of psychological and psychosomatic complaints while taking into account the underlying causes

Behavioral therapy in combination with schema therapy represents a modern and effective approach within psychosomatic medicine and psychotherapy. It combines the structured, goal-oriented methodology of cognitive behavioral therapy with the depth psychological elements of schema therapy, which deals in particular with early learned emotional patterns and basic beliefs. This combination allows not only current symptoms to be treated, but also the underlying causes of psychological and psychosomatic complaints to be specifically identified and addressed. In behavioral therapy, the first step is to understand the interplay between thoughts, feelings and behavior. Patients are supported in identifying obstructive patterns of thought and action that contribute to the maintenance of their complaints. Through specific therapeutic interventions, these patterns can be changed and replaced with healthier alternatives. This takes place within a transparent, structured framework that is based on cooperation and traceability. Particularly in the context of psychosomatic illnesses, behavioral therapy offers a good opportunity to make the connection between mental stress and physical symptoms comprehensible and to gradually influence them.

Key elements of behavioural therapy treatment include:

Learning theory foundation
Behavioural therapy is based on learning theory and scientific findings about how behaviour, emotions and physical reactions can be learned and changed. Symptoms are understood as the result of previous learning processes that can be specifically modified through new experiences. Hebb's learning rule illustrates that neural connections are strengthened through repeated simultaneous activation. In a therapeutic context, this means that new patterns of thinking and behaviour can be permanently anchored in the brain through repeated practice and corrective experiences.

Diagnostics using standardised questionnaires and interviews
At the beginning of therapy, a differentiated diagnosis is made, which includes not only a detailed therapeutic interview but also the use of standardised questionnaires and structured interviews. These enable an objective assessment of symptoms, stress factors, psychosocial contexts and individual resources. On this basis, a well-founded therapy plan can be drawn up and the course of therapy can be evaluated in a comprehensible manner.

Clarification of objectives and therapeutic goals
In the next step, individual, realistic and verifiable therapy goals are formulated together with the patients. These goals provide orientation for the therapeutic process, promote motivation and transparency, and are regularly reviewed and adjusted as the process progresses. The focus is on symptom-related as well as functional and practical goals.

Behavioural therapy uses various methods to achieve its goals:

Behavioural analysis
Functional behavioural analysis is used to systematically examine typical problem situations. This involves analysing which internal and external triggers lead to symptoms, how people react to them and what short-term and long-term consequences arise from this. These analyses help to identify perpetuating patterns and change them in a targeted manner.

Cognitive work
A central focus is on identifying and modifying stressful thoughts, evaluations and basic assumptions. Dysfunctional cognitions (erroneous, negative or unrealistic thought patterns), for example about one's own body, one's own performance or interpersonal expectations, are questioned together and replaced by more helpful, realistic ways of thinking. This has a direct effect on emotional experience and behaviour.

Exposure therapy
Exposure therapy can be used for anxiety disorders, avoidance tendencies or somatoform complaints (pain, gastrointestinal problems, dizziness). This involves gradually and in a controlled manner seeking out feared situations, inner states or physical sensations in order to enable new, corrective experiences. The aim is to reduce anxiety, avoidance and excessive self-observation, and to strengthen confidence in one's own ability to cope.

Behavioural experiments
Behavioural experiments serve to test assumptions and expectations in everyday life in a practical way. Patients gather new experiences that can relativise or refute existing beliefs. This opens up new scope for action and a more flexible approach to stressful situations.

Self-management
The focus is on promoting self-management skills. Patients learn to better understand their symptoms, recognise triggers early on and independently apply helpful strategies. This strengthens personal responsibility and reduces dependence on therapeutic support in the long term. In this way, patients succeed in becoming their own therapists.

Behavioral therapy with schema therapy

“The healthy adult self”

Schema therapy expands this approach to include the aspect of biographical imprints. It assumes that many chronic emotional problems result from so-called schemas - stable patterns, usually developed in childhood, that have formed from unfavorable experiences in dealing with caregivers. These schemas influence experience and behavior well into adulthood and can be activated in stressful ways, especially in interpersonal relationships or during stress. Schema therapy not only works on these patterns cognitively, but also on an emotional level. Various techniques such as imaginative methods, chair dialogs or working with inner parts are used for this purpose. The aim is to strengthen the so-called “healthy adult self”, which is able to stand up for its own needs and regulate obstructive inner patterns.
This new integrative approach offers great advantages in our private practice for psychosomatic medicine and psychotherapy in Frankfurt. Many patients with psychosomatic complaints suffer not only from physical symptoms, but also from inner conflicts that they are often unable to clearly name or categorize. The combination of behavioral therapy and schema therapy makes it possible to understand and treat the symptoms on both the current and the deeper biographical level.

This creates a therapeutic space in which both structure and empathy, both change and acceptance play a role. This therapeutic approach is particularly important when dealing with chronic or difficult-to-understand complaints, because it is not only symptom-oriented, but also takes into account the entire experience of the person in their individual history.

Overall, behavioral therapy with schematherapeutic elements enables sustainable psychotherapeutic treatment that is both scientifically sound and humanly approachable. It not only promotes symptom reduction, but also the development of a more stable self-image, better relationship patterns and an improved quality of life - aspects that are often central to psychosomatic illnesses. This therapeutic approach therefore represents a valuable basis for the work in our modern psychotherapeutic practice, which aims to take equal account of body and soul. Please contact us for further information.

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