Schema Therapy for Avoidant Personality Disorder: Working with Dysfunctional Coping Modes

Schema Therapy (ST) is an integrative therapeutic approach for addressing personality disorders such as Avoidant Personality Disorder (AvPD). This approach emphasizes the identification and healing of Early Maladaptive Schemas (EMS) and the use of schema modes that contribute to the development of PDs. Schema modes are moment-to-moment reflections of emotional and behavioral states triggered by the activation of different EMS. They comprise thoughts, emotions, and behaviors. Coping modes, a subset of schema modes, are unconscious strategies employed to manage distress that obstructs access to an individual's vulnerabilities. This article illustrates the therapeutic process of ST in working through the dysfunctional coping modes of Ms. A, a 22-year-old female diagnosed with AvPD and Depression. It highlights the significant challenges encountered in therapy with respect to the client's detached and avoidant protector modes. Therapeutic interventions, such as limited reparenting and empathic confrontation, played a crucial role in addressing dysfunctional coping modes and facilitating access to clients' vulnerable child modes. This study further underscores the importance of considering therapeutic relationships when engaging with clients' coping strategies. Finally, the implications of addressing coping modes in the treatment of clients with AvPD are discussed. As a single-case study, its findings have limited generalizability due to the presence of other confounding factors, including the role of concurrent medication in the outcome.