ABANDONMENT/INSTABILITY SCHEMA (AB)

FORMULATION & TREATMENT GUIDE

DEFINITION & TREATMENT AIMS CLIENT PRESENTATION & UPBRINGING

Clients typically Clients may present as

Believe loved ones:  Being preoccupied with relationships
 Clinging to people/despair when others take
 Will die/vanish/leave them, stop loving them
distance (emotional or physical)
 Connection & support are unstable & unreliable
 Being controlling & vigilant to abandonment
 Have a preoccupation with close relationships and
 Having grief & anger towards those who left them
anticipate being abandoned
 Attracted to uncommitted/unreliable partners
Treatment aims to heal this schema
If clients have this schema look out for
 Reduce constant worry that they will be left by
 Subjugation, Dependence & Defectiveness/Shame
others
 Difficulties with anxiety or BPD
 Increase belief they will cope if others leave them
 Vulnerable/abandoned child mode at high levels
(no longer helpless like in childhood)
 Avoidant/overcompensating modes
 Reduce behaviour that compromises relationships
such as clinginess Upbringing
 Increase capacity to spend time alone
 Parental death or abandonment
 Unstable or unpredictable parental connection

TREATMENT STRATEGIES TO PROMOTE SCHEMA HEALING

Chairwork Limited reparenting throughout therapy

 Notice the angry child mode and ask them to
express anger (chair 1) to parents (empty chair 2)
who abandoned them in childhood
 Dialogue between the healthy adult mode (HAM)
(chair 1) and the vulnerable child mode (VCM)
(chair 2) with the HAM soothing and reassuring the
VCM. Therapist to play the HAM initially
 Contrast the positive intentions of the maladaptive
coping mode (i.e., avoidant, or overcompensating
modes) (chair 1) with the negative impact on the
VCM (chair 2). Coach client with HAM alternatives
Imagery (relevant child mode: the abandoned child)
 Rescript memories of abandonment with the
therapist as a stable figure. Address parent stating
the impact the parent’s abandonment/instability
has had on the child, comfort/meet needs, and
normalised need for secure attachment. Over time
the client’s HAM reparents the vulnerable child
Reparenting/healthy adult messages in imagery
 You will cope, it’s not like it was when you were
growing up when you depended on people for
your survival. You are not alone, you have (insert
supports)
 I’m here to support you
 The relationship is key to schema healing with the
therapist becoming a transitional secure base
 Schedule regular therapy appointments as
consistency is essential
 Set limits on behaviours that compromise
relationships such as being controlling
 Provide voice recordings or transitional objects to
help soothe the client when they feel abandoned
Cognitive
 Address inflated view that others will leave them
 De-catastrophise being alone
 Challenge disordered beliefs that perpetuate the
schema (i.e., being overcontrolling or avoiding)
 Identify and limit schema perpetuating
relationships
Behavioural
 Help the client identify and seek stable support
outside of therapy
 Help the client tolerate being alone through
graded exposure to alone time

SYNTHESIZED, ADAPTED AND EXPANDED FROM MY OWN CLINICAL EXPERIENCE AND THE FOLLOWING SOURCES
Arntz A. & Jacob, G (2012). Schema Therapy in Practice: An introductory Guide to the Schema Mode Approach. Chichester: Wiley-Blackwell.
Young, J.E., Klosko, J.S. & Weishaar, M.E. (2003). Schema Therapy: A Practitioner’s Guide: New York: Guilford Press.

Copyright © Tena Davies. This guide is licensed to Florina Anichitoae only and cannot be distributed to others.