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Schema Therapy Dreamwork for Complex Trauma

by Samantha Flores Reynoso, Astrid Ingram Brooke, & Jordi Cid

General Overview

Mexican female, 28 years old, moderate level of functioning. Psychologist. Catholic

Diagnoses: Posttraumatic stress disorder (due to complex trauma)
Generalized anxiety disorder
Panic disorder with agoraphobia
Avoidant Personality disorder

Current mayor problems
Problem 1: Dificulty establishing intimate relationships
Life pattern: Avoids intimate contact specially with men. Has had several “love” relationships in which she doesn´t allow the partner to get closet o her. Avoids sexual relationships. Is afraid of being abused.

Problem 2: Anxiety, low self eficacy related to self protection
Life pattern: Develops panic attacks when she feels in danger specially in relation to going out late, meeting people, getting to know others, being stupid, inferior and not knowing how to protect herself from others.

Problem 3: Subjugation
Life patterns: pleases others to avoid being abandoned, or abused. She offers herself to do things for other even when not being asked for. Impossible for her to say no.

Problem 4:
Sleeping problems, continuous nightmares related to being injured, abused, being in danger and not knowing how to protect herself and not having someone to care and protect her.

Developmental origins
Mother subjugated and extremelly critical, emotionally inhibited. Very catholic
Father aisolated from the family, gets in touch occasionally, overworks
7th out of 7 children. Being the youngest, one of her sisters was in charge of taking care of her.
Suffered ADHD since early life, didn´t receive treatment but was stigmatized.

Core childhood memories and images
Being sexually abused by one of her brothers who later became a priest
Being ignored by the mother who spent a lot of time in church
Being afraid of men and mother being critical of that
Mother forcing her to serve others as religion states
Being rejected and criticized at school. Feeling lonely and defective
Being kidnapped and held hostage by a man who raped her
Being robbed, by handgun
Mother blaming her for all the above
Sister who cared for her, died in a car accident

Unmet core needs
Being loved, cared for, protection, feeling accepted and valuable.
Secure attachment, freedom to express valid needs and emotions
Safety and protection

Most relevant schemas related to origins and coping styles
Emotional deprivation: wasn´t cared for, wasn´t protected, nobody emphatized with her emotions nor her needs. She surrenders by not allowing other to care for her. And over-compensates in her profession.
Defectiveness/shame: suffered bullying at school and at home. Was sexually abused by brother and held responsible for that. Surrenders to it every time someone talks about mistakes, she avoids being met, showing others who she is and overcompensates being a perfect psychologist
Mistrust/abuse: suffered bullying at school and at home. Was sexually abused by brother and held responsible for that. Has been kidnapped, raped and robbed.
Social isolation: Rejected by school peers, felt different to rest of the family for what had happened to her. She avoids by not letting others get closet o her, she surrenders by letting others abuse her.
Subjugation: she was forced to do so by the brother. Always saw mom being subjugated to others too to avoid problems and mother forced her to subjugate to almost everybody. Now she surrenders almost all of the time.
Unrelenting standards: she coped being the perfect daughter, the perfect sister, and the perfect student at school. Now she completely surrenders to it by being the perfect psychologist.
Punishment: She was punished by several members of the family and always held responsible for what had happened to her. She now thinks she deserves punishment for Little mistakes and has difficulty forgiving others even if she surrenders to them.

Current schema triggers:
Being close to men
Being rejected or criticized
Being told about religion, forgiveness and the church
Whenever someone needs something she thinks she can help with
Working with sexually abused clients

Relevant schema modes
Abandoned child
Uncared/unloved child child
Lonely child
Fearful child
Defective child
Demanding and punitive parent
Guilt inducing parent
Subjugating parent
Compliant surrender
Self agrandizer
Perfectionistic overcontroller
Avoidant protector

Possible temperamental factors
Anxious temperament

Therapy relationship

Focuses on mode work and working with dreams to change the messages she got from all the trauma she has suffered. Dreamwork has being an emphasis of the work and has served to assess and modify cognitions, sensations, emotions and even behavior.

About the Presenters:

Samantha Flores Reynoso

Samantha Flores is a physician specialized in neuropsychiatry. She has a Master´s Degree in Cognitive Behavioral Therapy and she is a certified advanced schema therapist who who took the certification course in the New Jersey Schema Therapy Institute. 

She currently runs a private practice in psychiatry and psychotherapy. She works with a variety of diagnoses of psychiatric  and neuropsychiatric patients through medication and psychotherapy. She has a special interest in patients who suffer functional neurologic disorders and patients with chronic mental illness as well as personality disorders. She also teaches psychopharmacology to psychology students at the Universidad Autonoma de Guadalajara.

Astrid Ingram Brooke

Astrid Is a Clinical Psychologist currently practising in Windsor, England, United Kingdom. She is also an Advanced Level Schema Therapist, Supervisor and Trainer in Schema Therapy for Individuals, providing ISST-accredited training and supervision to NHS psychologists, forensic psychologists and other mental health professionals working in both the public sector and private practice.

Astrid grew up in England but lived for many years in Australia.   She studied at the University of Sydney and worked in in both public and private sectors in New South Wales, working in hospitals, university departments and primary care.   Her main clinical areas of interest were affective disorders, psychological management of chronic pain, and psychological trauma.    Astrid worked as a psychologist in university departments of psychological medicine on diverse projects such as anxiety disorders and menopause.   She set up three chronic pain management programmes in different organisations (public and private), providing both direct services to patients but also training staff to support patients coping with chronic pain conditions.    

Astrid worked for Davison Trahaire, a firm of private sector psychologists providing a range of psychological services to staff and emergency services first responders.   This included attending critical incidents such as armed holdups, fatalities at work, providing psychological first aid, supporting staff returning to work, and providing longer term assistance to employees in their workplace.    Astrid has worked in the field of psychological trauma for 29 years.

Astrid returned to England in 1991.   She studied at the University of Birmingham for her clinical doctorate, and at Aston University to obtain her Work Psychology and Business degree.    Astrid then worked in NHS in the West Midlands, providing psychological services for adults with a range of complex issues including BPD.

Astrid was a Consultant Clinical Psychologist for 13 years in Berkshire.  She worked in a service where there were patients with psychologically complex and long-term conditions, including BPD.   The pioneering work of successfully treating BPD using Schema Therapy in Holland and America inspired her to seek ST training in 2008 and later to become an ST trainer herself.

Astrid retired from the NHS in 2015.   She still finds Schema Therapy an inspirational approach for working with long term and complex psychological problems and she enjoys teaching, supporting and developing other professionals in their clinical practice.   Astrid continues to provide therapy, occasionally working with more complex conditions e.g. Dissociative Identity Disorder, and sometimes combining Schema Therapy with other therapies, such as EMDR, to address both emotional difficulties and psychosomatic conditions.

Jordi Cid

Jordi Cid Colom is Clinical Psychologist, Ph.D. He’s actual position is Coordinator for Mental Health & Addiction Programs in Girona, Spain. He works implementing, coordinating and assessing mental health programs. He is the head of Mental Health & Addiction Research Group in Institut d’Investigacions Biomediques de Girona (Idibgi). His research interest is the area of effectiveness, developing multi-site, multi-trial therapy programs in psychosis, suicide and personality disorders. He has been taken part in multiple European and national projects on service assessment and financing systems of refinement of long term care in Europe. Furthermore, he is the President of SCRITC, Catalan Society of Cognitive Behavioral Therapies, member of European Association for Cognitive Behavioural Therapies.

He is advanced certified trainer/supervisor in Schema therapist in Spain. His Schema therapy training and direction took place under the direct supervision of Jeff Young. He has been directly responsible for the translation of all questionnaires and worksheets in Schema Therapy from English to Spanish. He was awarded the translation rights for Jeff Young’s, Reinventing your Life. He was also the technical reviewer of Schema Therapy by Young, Klosko and Weishaar. The focus of his PhD was Spanish Validation of Young Schema Questionnaire-S2. He has conducted many schema therapy workshops in Spain since 2000. He is associate professor in Universitat de Girona and Universitat Oberta Catalunya. He teaches ST in several Universities in Spain, including: Universitat Autonoma de Barcelona, Universitat Internacinal de Catalunya, Universidad Miguel Hernández de Alicante and Universidad de Deusto.

Mr. Cid along with Mr. Carlos Rojas, are co-founders and co-directors of the The Latin American & Spanish (Bilingual) Certification Program in Individual Schema Therapy, approved by the ISST. They together with Mr. Matias Valente are leading figures in the development and organization of Schema Therapy in Spanish speaking countries. He has been involved in ISST society, he was the local organizer of ISST Summer School in Barcelona 2017.

Why Schema Therapy?

Schema therapy has been extensively researched to effectively treat a wide variety of typically treatment resistant conditions, including Borderline Personality Disorder and Narcissistic Personality Disorder. Read our summary of the latest research comparing the dramatic results of schema therapy compared to other standard models of psychotherapy.

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