Comparing FIML practice with Schema Therapy

Schema Therapy appears to be an effective treatment for people who are suffering with mental and emotion confusion.

An article published early this year claims:

A large scale randomized control trial shows Schema Therapy to be significantly more effective than two major alternative approaches to the treatment of a broad range of personality disorders. Schema Therapy resulted in a higher rate of recovery, greater declines in depression, greater increases in general and social functioning and had a lower drop out rate. The results indicated that Schema Therapy is also more cost-effective. (Source)

Psychological studies are notoriously unreliable and the source of the article linked above is the International Society of Schema Therapy, but still I think it is OK to to take their claims seriously.

Therapy is very difficult to study objectively and who else is going to promote Schema Therapy if not the people who believe in it? I am doing the same with my claims for FIML practice.

By comparing FIML and Schema, I hope to illustrate some of the values and drawbacks of both approaches to human suffering. I have chosen to do this with Schema Therapy (ST) because I just read something about it and it seems like a reasonable and workable approach.

ST seeks to correct “maladaptive schemas” that are defined as “self-defeating life patterns of perception, emotion, and physical sensation.” (Source)

Some comparisons with FIML:

1. ST is based on the notion of people having “personalities” and thus “personality disorders.” FIML largely rejects the notion of personality or finds it trivial. FIML claims that all adults without exception have “disordered” minds, habits, emotions, responses, and so on. There is no need for a concept of personality or to classify types of “disorder” based on an ideal “personality.”
2. ST claims that adults experiencing less than optimum psychological health use schemas to interact with the world around them. FIML largely agrees with this claim. We usually call schemas misinterpretations. We claim that adults frequently misinterpret what is being said and done around them. Some of these misinterpretations may have begun in childhood, but not all of them. Misinterpretations occur almost every time we interact with anyone. It is common for misinterpretations to occur several times per hour when two people interact. Some misinterpretations will go away on their own and some will cause serious disturbances in the relations between the two (or more) people interacting. Some misinterpretations will have serious ramifications beyond those two people. And some will have begun in childhood, but many childhood misinterpretations, though they may have become habitual, can be fairly easily corrected through FIML practice. They do not constitute a “personality disorder,” but rather a persistent or habitual way of mistakenly interpreting the world. In this sense, I agree that long-standing misinterpretations do look and act somewhat like “schemas,” though as described, I do not think they deserve reification as a classifiable entity called a “personality disorder.”
3. ST asserts the existence of “schema modes,” which seem to me to be definitions or indications of personality modalities. Some of ST’s schema modes are the angry child, the impulsive child, the abandoned child, and so on. FIML does not use the concept of personality, let alone identify anything like a personality mode or a schema mode of that type. FIML recognizes that misinterpretations are common and that they arise throughout life. FIML claims that misinterpretations arise at discrete moments. These moments may have occurred in childhood and they may have occurred at any other time since childhood. By classifying “personality types” or “schema modes” (as I understand them), FIML asserts that the unique tangle of an individual’s complex suffering will be distorted. FIML may use concepts like abandonment as a point of discussion and FIML may recognize that feelings of abandonment began in childhood, but FIML also claims that making “abandonment” into a classifiable “disorder” is misleading and that fixing the relevant misinterpretation will be hindered by classifying it in that way. FIML claims that reifying largely false “modalities” like “abandonment” only makes them worse while obscuring their true origins and much more importantly how they actually function in real-time.
4. ST uses a technique called “limited reparenting” which aims to correct unmet core needs that originated in childhood and that led to maladaptive schema. FIML does not require or use a therapist and FIML does not believe that maladaptive schema require “reparenting,” as ST claims.
5. ST claims that it is cost effective in that it can achieve good results in 50 sessions with a trained ST therapist. A drawback of FIML practice is it requires a suitable partner, and a suitable partner can be hard to find for many people. If a person is suffering and cannot find a suitable partner, ST would be a better choice than FIML. If a suitable partner exists and if both partners understand how to do FIML, I believe FIML will be a better choice in most cases. FIML claims that all human beings are mentally and emotionally disordered and that our disorders arise daily at discrete moments as misinterpretations. There is no end to the constant arising of misinterpretations and thus there can be no beneficial end to stopping FIML practice. FIML can begin to correct mental and emotional disorders within days or weeks, but the process of doing FIML should be ongoing throughout life. FIML is like cleaning your home, washing your dishes, brushing your teeth, bathing. It must be done frequently and cannot be ignored for long without maladaptive consequences.
6. ST claims to be able to create a “healthy adult” who is thoughtful, rational, happy and more. FIML also claims to be able to create a “healthy adult” with ST qualities, but FIML recognizes that the “interpersonality” of all adults requires constant monitoring. Once the major disorders of the pre-FIML person have been corrected, FIML recognizes that new disorders may arise at any time and that they must be addressed as they arise. Basically, I do not believe that there is such a thing as an ongoing “healthy adult” that can be created in 50 sessions with a therapist. Health requires constant attention with a caring partner, not brief training with a paid stranger.

I would recommend ST for anyone who cannot figure out how to do FIML or who cannot find a suitable FIML partner. For those that do understand FIML and do have a suitable partner, we claim that FIML practice will help you become far less disordered mentally and emotionally but that you must remain vigilant for the rest of your days. You cannot remain healthy for long if you allow misinterpretations to accumulate.