Frozen child: schema therapy for a forensic patient in a service for men with a diagnosis of severe personality disorder
| Pages | 254-264 |
| Published date | 14 November 2016 |
| Date | 14 November 2016 |
| DOI | https://doi.org/10.1108/JFP-01-2016-0001 |
| Author | Asad Ul Lah,Jacqui Saradjian |
| Subject Matter | Health & social care,Criminology & forensic psychology,Forensic practice,Sociology,Sociology of crime & law,Law enforcement/correctional,Public policy & environmental management,Policing,Criminal justice |
Frozen child: schema therapy for a
forensic patient in a service for men with
a diagnosis of severe personality disorder
Asad Ul Lah and Jacqui Saradjian
Asad Ul Lah is a Resident and
Jacqui Saradjian is a
Consultant Clinical and
Forensic Psychologist, both at
The Fens Offenders Personality
Disorder Pathway Service,
HMP Whitemoor, March, UK.
Abstract
Purpose –Schema therapy has gone through various adaptations, including the identification of various
schema modes. The purpose of this paper is to suggest that there may be a further dissociative mode, the
“frozen child”mode, which is active for some patients, particularly those that have experienced extreme
childhood trauma.
Design/methodology/approach –The paper is participant observer case study which is based on the
personal reflections of a forensic patient who completed a treatment programme which includes
schema therapy.
Findings –The proposed mode, “frozen child”, is supported by theoretical indicators in the literature. It is
proposed that patients develop this mode as a protective strategy and that unless recognised and worked
with, can prevent successful completion of therapy.
Research limitations/implications –Based on a single case study, this concept is presented as a
hypothesis that requires validation as the use of the case study makes generalisation difficult.
Practical implications –It is suggested that if validated, this may be one of the blocks therapists have
previously encountered that has led to the view that people with severe personality disorder are “untreatable”.
Suggestions are made as to how patients with this mode, if validated, can be treated with recommendations
as to the most appropriate processes to potentiate such therapy.
Originality/value –The suggestion of this potential “new schema mode”is based on service user initiative,
arising from a collaborative enterprise between service user and clinician, as recommended in recent
government policies.
Keywords Personality disorder, Attachment strategies, Dissociation, Forensic patient, Schema mode,
Schema therapy, Service user perspective, Severe trauma, Successful treatment strategies
Paper type Case study
Introduction
There is increasing evidence as to the effectiveness of schema therapy (Young, 1990) in the
treatment of people who meet criteria for a diagnosis of personality disorder (Bamelis et al., 2014,
Gitta and Arntz, 2013). Based on attachment theory, schema theory proposes that personality
pathology develops from unmet core emotional needs in childhood leading to the development
of Early Maladaptive Schemas (EMS). EMS are the “lens”through which an individual makes
sense of experience, whi ch in turn dictates how tha t individual feels and beh aves.
Early maladaptive schema most often originate in infancy and early childhood and are formed
by and comprised of memories, emotions, cognitions, and bodily sensations. Initially,
18 maladaptive schema were identified (Young, 1990).
Received 4 January 2016
Revised 13 February 2016
6 April 2016
14 May 2016
Accepted 24 May 2016
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JOURNAL OF FORENSIC PRACTICE
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VOL. 18 NO. 4 2016, pp. 254-264, © Emerald Group Publishing Limited, ISSN 2050-8794 DOI 10.1108/JFP-01-2016-0001
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