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How does Schema Therapy Help People with Antisocial Personality Disorder?

written by: Nicholas Kuvaas • edited by: jen2008 • updated: 10/26/2010

Antisocial personality disorder has been extremely difficult to treat in the past. However, through schema therapy, there now appears to be hope for those who suffer from this damaging mental illness.

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    Anti-Social Personality Disorder

    Often, they are referred to as sociopaths, criminals, and con men. While these terms do often coincide with anti-social personality disorder (aspd), people who suffer from it struggle at a personal level1. They lack empathy and are usually shallow and cynical. Others' feelings, rights, and safety are not important to them. It is these attitudes combined with a superficial charm that allows them to take advantage of others without any feelings of guilt or remorse. People who suffer from aspd are unlikely to have close personal relationships. Sufferers also do not conform to societal norms, are impulsive, show a reckless disregard for their own as well as others, and are generally irresponsible. For a personality disorder to be diagnosed, an individual has to be at least 18 years old, but anti-social personality disorder usually has precursors such as conduct disorder and operational defiant disorder. To see how it compares to borderline personality disorder, read // Even with these early warning signs, it has been difficult to treat effectively, but schema therapy offers some new hope for those who suffer from this debilitating disease.

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    What is Schema Therapy and Schema Theory?

    Schema therapy was developed by Jeffrey Young to combat personality disorders, chronic depression, and other problems2. It works by integrating many disciplines into one therapy. Among those included are cognitive therapy, behavioral therapy, object relations, and gestalt therapy. Overall, there are four maladaptive areas which are addressed by the schema therapy model. These include early maladaptive schemas, schema domains, coping styles, and schema modes. Schemas, in psychological terms, are a cognitive representation of the self, and they are important in this type of therapy.

    Early maladaptive schemas appear in childhood and develop through a interplay between a person's temperament and their interaction with family and peers. There are 18 identified maladaptive schemas which people become used to over time, and, in fact, they are comforting. However, these maladaptive schemas are self-defeating, and, according to this theory, they are repeated throughout someone's life. A person may even go to the lengths of distorting their views of events to fit this schemas.

    The schema domains portion takes these 18 maladaptive schemas and groups them into 5 domains which are disconnection and rejection, impaired autonomy and performance, impaired limits, other-directedness, and overvigilance and inhibition. Each represents a child's core needs, and the schemas interfere with these needs being met.

    Coping styles are used to adapt to schemas and negative childhood experiences. However, these coping styles are maladaptive, themselves, and include surrender, avoidance, and overcompensation. The shaping of which coping styles are used includes temperament at birth and modeling of a parent's behavior.

    Schema modes are the final area of schema theory. Schema modes are moment-to-moment emotional states and coping responses, and there are 10. We all experience them, according to therapy. However, these states and responses are also maladaptive and are triggered by emotional buttons. It is these four areas that schema therapy aims to rectify in people suffering from anti-social personality disorder.

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    Anti-Social Personality Disorder and Schema Therapy

    Anti-social personality disorder is unique because symptoms may appear. This fits well with the maladaptive schemas and later behavior. Examples include self-defeating behavior such as impulsiveness and the feeling that other's safety and rights don't matter, and these feelings seem normal after a long period of time, perhaps comforting. This is why these behaviors are so difficult to change. For more about treatments of aspd, see //

    Anti-social personality disorder and schema therapy are not standard in any way. However, schema therapy is more effective in treating anti-social personality disorder because it helps people to abandon maladaptive coping styles and help them back to their core feelings. This is an area where people with anti-social personality disorder are lacking. Also, it helps them heal early schemas which were manifested for disconnection and rejection, impaired performance and limits, and over vigilance. Finally, anti-social personality disorder is treated with schema therapy helping sufferers meet their emotional needs in everyday life in a way that doesn't exploit others or risk their safety.