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Interplay between Patient and Therapist Schemas and Mode Maps 

by Galit Goren Gilad & Itay Shuv-Ami


What can we learn from the fact that different patients trigger very different modes in us?
Can the activated modes that arise in us tell us something of value about our patients and not just about ourselves?
Schema therapy’s traditional view focuses on the patient’s schemas and modes. Recently, more attention has been given to the investigation of the therapist’s own schemas and mode map - as explored in Joan Farrell and Ida Shaw’s innovative recent book.
We wish to show a third point of view - not merely focusing on the patient’s or the therapists activated modes, but rather on the interaction between these two mode maps.
In this skill class, we will discuss in depth the different ways in which therapists slide away from the healthy adult mode. We will explore different levels of awareness of the abduction, explore the degree of recognizability of the mode we have inhabited, or the schema activated, and examine the possibility of finding ourselves in modes unrecognizable to us from our own experience.
Last, we will introduce techniques that may facilitate understanding of the complex interaction between the modes, and how that understanding may be of therapeutic value in allowing us to deepen our understanding of the patient’s inner world.
During this skill class, the presenters will play out on stage different patients, and show the participants a way of mapping the complex interactions between the patient’s modes and their own. Participants will be invited to explore the activation of different modes in them. For instance, we will explore a scenario where patients can “push us”, so to speak, to flip out of the healthy adult mode straight into a mode that “suits” that patient’s mode map, such as a punitive parent or a detached protector mode. We will see that while most of these modes may be known to us, some of them may feel foreign, unfamiliar or odd, and will offer possible explanations for this strange phenomenon and suggest ways it can enrich our understanding of our patients.
At last, we know that we are often unaware of slipping out of the healthy adult mode, thus hindering the effectiveness of therapy. We will present three different levels of awareness to this process and suggest possible specific remedies for each level.

Background Experience in the Area of the Skill Class:
In the past several years, we are both working together to better understand these inevitable times in which all of us slip out of the healthy adult mode, considering both the various negative consequences, as well as the hidden therapeutic potential of this phenomenon. A case presentation introducing our work in this field was held at INSPIRE 2018 in Amsterdam and received positive regard and attention.

Target Audience:

Schema therapists interested in the complex interplay between the therapist's and the patient's schemas and modes.

Learning Objectives:

The participants will be able to examine and conceptualize the activation of the therapist’s own schemas and modes in the therapeutic encounter.
They will learn to recognize when such activations cause a “slip” from the therapist’s healthy adult mode, as well as to recognize different types of obstacles to such awareness.

They will learn to conceptualize these activations while taking into account the mutual influences of patient on therapist and vice versa. Finally, they will learn how these activations can potentially promote a deeper, more experiential understanding of the patient, greatly facilitating limited reparenting interventions.

Level of Experience Required for Participant:

Intermediate (Participants have had basic ST training)

About the Presenters:

Galit Goren Gilad

Galit Goren Gilad is a Clinical Psychologist. She is a couple therapist and a certified schema therapist. She works in a private clinic, and had taught schema therapy in psychiatric hospitals, psychotherapy training programs and educational psychology centers. She is a co-founder of the Israeli Schema Therapy Society and a member of its board.

Itay Shuv-Ami

Dr. Itay Shuv-Ami is a psychiatrist and psychotherapist. Formerly the acting director of the emergency room of the Tel Aviv Community Mental Health Center, he is currently in private practice in the Tel Aviv area. He teaches and supervises at the rehabilitative and clinical psychology programs at Bar Ilan University, and is a faculty member at the post graduate program in psychotherapy at Tel Aviv University . He taught workshops in Schema Therapy for Cluster C personality disorders and was the keynote speaker at the Israeli National Convention of Schema Therapy . He is a member of the task force for the foundation of the Israeli Schema Therapy Society.

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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