The Effectiveness of Emotional Schema Therapy on Defense Mechanisms, Emotional Distress Tolerance, and Psychosomatic Symptoms in Married Women with Psychosomatic Disorder Symptoms

Objective: This study aimed to examine the effectiveness of emotional schema therapy on defense mechanisms, emotional distress tolerance, and psychosomatic symptoms in married women with symptoms of psychosomatic disorder. Methods and Materials: This quasi-experimental study used a pretest–posttest design with a control group. The participants were married women with symptoms of psychosomatic disorder in Isfahan. Eligible participants were selected through convenience sampling and randomly assigned to an experimental group and a control group. The experimental group received eight 90-minute sessions of emotional schema therapy, while the control group received no psychological intervention during the study period. Data were collected using the Defense Style Questionnaire-40, the Distress Tolerance Scale, and the Psychosomatic Symptoms Questionnaire. Data were analyzed using multivariate analysis of covariance and follow-up ANCOVA tests. Findings: The multivariate results showed a significant overall effect of emotional schema therapy on the combined outcomes, Wilks’ Λ = .246, F(5, 24) = 14.68, p = .001, η² = .75. Follow-up analyses showed significant effects on mature defense, F(1, 28) = 9.73, p = .004, η² = .25; immature defense, F(1, 28) = 6.25, p = .010, η² = .18; neurotic defense, F(1, 28) = 14.90, p = .001, η² = .34; emotional distress tolerance, F(1, 28) = 32.58, p = .001, η² = .53; and psychosomatic symptoms, F(1, 28) = 4.54, p = .040, η² = .14. Conclusion: Emotional schema therapy improved defensive functioning, increased emotional distress tolerance, and reduced psychosomatic symptoms in married women with psychosomatic disorder symptoms. Therefore, it may be considered an effective intervention for improving emotional and somatic functioning in this population.