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The Schema Therapy Bulletin

The Official Publication of the 

International Society of Schema Therapy

Children and adolescents

Schema Therapy with Children and Adolescents an Extract of Mode Work 

Dr Christof Loose 

Child and Adolescent Psychotherapist

Heinrich-Heine-University Dusseldorf

Institute of Experimental Psychology dept. Clinical Psychology

Let‘s imagine, there is a boy named Felix. His parents notice that something is wrong with him. His teacher says that he tends to be aggressive. They decide that he needs some help. They look for a therapist who can help Felix. Then, Felix gets to know Chris. He is a psychologist and therapist for children and adolescents. After Felix‘s parents have asked him to help, he meets up with Felix. Chris encourages Felix to talk about himself and his world.  He is especially interested in all the different sides of Felix that come out at different times. He calls these different sides „parts“ or „modes“. He asks him: Felix, I am really interested in finding out about you, and about all of your different sides, or „modes“ as I call them. Which different sides of yourself have you noticed? Let‘s write that down, okay?“ Felix creates his own mode-sketch.

Fig. 1. Felix‘ modes in a sketch

Once we have a picture of all of the different sides of Felix, he then chooses a finger puppet  for each mode.

Fig. 2 Felix shows how he rates the popularity of his modes.

There is one thing that Felix knows for sure: His favourite is the contented mode. And he smiled a lot when telling that. And his least favourite is the sensitive and vulnerable one. Felix looks sad now. But what about the others? Let‘s have a closer look at them. “Modes, could you introduce yourselves, please?“

Hello! I go first, to get the least favourite over and done with: I‘m a part of Felix that many people consider to be too sensitive. As you can see, I‘m already pretty scruffy. I don‘t like that at all, because in fact, I want to be pretty and strong. However, in reality I‘m very, very sensitive. A lot of people call me the „vulnerable or hypersensitive Felix“.

Hello from me as well! I am the contented, sometimes happy, part of Felix. I come out when Felix feels good, and I look like joyfulness, giggling, and lots of fun and happiness.

Good day! I am another part of Felix. In fact, I am the clever & wise part. I know an answer to everything, and know about Felix‘s needs or what might help him in difficult situations. I usually look after him well, however sometimes I just don‘t know what to suggest to him.

Hi!  I am the „aggressive“ Felix. Nearly everyone shys away when I come out. I let Felix rage and yell. This often results in some problems... But he feels proud because NO ONE else is as powerful and strong as me.

Hey! I am the imaginative and fanciful part of Felix. When I am there, he is a fountain of fantastic ideas. Well, the others are „louder“ than me for sure and try harder to get his attention, but without me Felix would be SO BORED. And I help him with ideas to solve a lot of his problems, too.

[quiet] Ohhh, I hardly dare to speak. But I‘ll try... Hello... I am Felix‘s anxious and scared side. When I come out, Felix usually backs away. He feels insecure and sometimes he also feels ashamed and almost completely loses confidence in himself. 

Good day! I am the angry part of Felix, as you can tell from my facial expression. I often come out when others  are being unjust, unfair, or mean. I SIMPLY CANNOT STAND PEOPLE BEHAVING LIKE THAT, ESPECIALLY TOWARDS FELIX.

After Felix has talked about his modes and assigned finger puppets to them, Chris comes into play as a miniature figure. First, Chris turns to the scruffy, bedraggled, Raven, the vulnerable Felix, and comforts him, soothing the pain from all the difficult, horrible, times he has experienced. He provides the vulnerable Felix with a big patch and asks him, „what would help you to feel better right now?“ „At last, someone is taking care of me, and noticing all my pain and struggles!“, says the Raven, „First of all, I simply need your attention and comfort.“ The others don‘t even care about that!“ Chris sticks the patch on the Raven‘s upper body, like a medal, as he replies, „I would very much like to give you my attention and comfort. I‘d also like to help you get to know a bit more about your vulnerability and sensitivity, so I can help you to understand more and even feel a bit better about yourself. Would that be okay with you?“ And, as Felix nods his head, Chris begins to explain to him that his "vulnerability" is actually a special gift. A superpower called the “Super Sensor” that lets him feel what others are thinking and feeling, and also to notice if anything is wrong or unjust. Chris presents Felix with an antenna labelled "Super Sensor" as a sign of this special gift, this superpower.

The vulnerability or sensitivity, which many people have made out to be a bad thing, has now become a (positive) sensitivity, a “Super-Sensor” superpower. This already sounds much better to Felix. And because the “Super-Sensor" has done such a good job and reported all the injustice that took place in the world, Chris gives him an award: The Golden Antenna! He is really proud now! 

Fig. 3 Chris presents Felix with "Super Sensor" antenna

However, Felix does not like to brag about things so he decides to take the award off the antenna and place it out of sight. He knows about the award, others don’t need to see it, and it is more important to him that the wounds are well protected. Therefore a bandage is placed over the patch so that  everyone remembers that he has already been through a lot of injustice (that’s why he looks so scruffy) and – this part is extremely important- that he must be protected by others. Now that the vulnerable and sensitive part is protected, Chris introduces himself to the rest of the mode team. He would like to get to know the other parts better and asks a couple of them to come to the interview podium for a mode interview. 

First of all, he learns from the aggressive Felix that he prevents Felix from feeling like a misfit in class. He lets Felix roar and rage, in order to gain more respect from the others. Chris thanks him for his openness and also for trying to gain respect for Felix. However he makes clear that Felix will get into a lot of trouble, and that the respect is not so much respect as fear, and because of the fear, many children will be too scared to get close to Felix. Then Chris talks to the angry Felix, who made friends with the aggressive Felix in order to draw attention to himself. Unlike his parents and teacher, Chris praises the presence of the angry mode. In fact, feelings of anger are a natural reaction to injustice. These are at least partly legitimate. But he also makes it clear that the legitimate anger should make friends with other modes, otherwise Felix - if he only expresses his anger through the aggressive Felix - will always be the one who gets into trouble. Then Chris turns his attention to the anxious and scared Felix, who is scared of looking like a fool in front of the other children and becoming a victim. Chris now focuses on reducing how often the anxious and scared part comes out, while also helping angry Felix to make friends with, and receive support, from the other modes. 

Now Chris turns his attention to all the other modes and calls a mode council. It's like an inner family meeting, where all the important things can be discussed openly and safely. The mode council mainly discusses the vulnerable Felix who is "wounded" and in need of protection, and certainly does not deserve to be laughed at or ignored. And it is discussed that the vulnerable Felix has to be acknowledged as a “Super-Sensor", thus as a very important source of information! Without him the other modes would have no idea what kind of injustice is happening in the world out there, and that vulnerable Felix does not want to be the weak and unpopular mode all the time. That's just not fair, because he is doing such an important job, and doing it so well! And that he needs everyone’s help when he has something to say. 

Fig. 4: Mode Council

A basic rule is made: There is ALWAYS a reason behind vulnerable Felix appearing (i.e., when the big Felix is hypersensitive, perhaps in class). And in order to figure out the reason, he needs help, especially from the clever & wise mode. The angry and anxious Felixes both add that they sometimes feel left alone, and that is when they ask the aggressive Felix for "support“, because he will definitely do something, unlike the others who don’t respond at all, or only just a little bit. But this aggressive mode is really just an emergency mode, and needs to be kept only in case of an absolute, complete, dire, catastrophic, emergency!!  

The contented, imaginative and especially the clever & wise mode explain to the aggressive mode that they are going to take more care of the vulnerable, fearful and angry modes, and they apologize for having neglected the vulnerable, fearful and angry modes in the past. Then all the modes come together, led by clever and contented modes, who celebrate the importance of the vulnerable and sensitive mode. Everyone agrees that the raven can wear the Golden Antenna with pride and celebrate his achievements! And after a long, long time the vulnerable Felix finally feels that everything is okay with him. That he is not a pushover, loser or hypersensitive person. 

But he also understands now that he must learn to ask the others for help when he experiences injustice in the world outside. Thus all the modes can come together as friends, as a team led by the clever and wise mode, and all together can help to do something about injustices.

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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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