Читать книгу Schema Therapy for Borderline Personality Disorder - Hannie van Genderen - Страница 43

A cognitive technique that helps to gather more information about the schemas of the patient is the downward arrow technique which is extensively described in the literature on Cognitive Therapy. Therefore, this technique is only briefly summarized here.

When a patient formulates thoughts about themes that seem very important to explain the problems, the therapist can ask questions about the meaning of this thought. So, he doesn't start to explore or evaluate the evidence for this thought, but he asks, “what does this mean to you?” If the answer is not clear he repeats this question a few times. Most of the time the patient is not able to identify the underlying schema instantly, so the therapist can ask some more questions to reveal this. At first, he explains to the patient that he empathizes with her negative thoughts and feelings, but he also explains that he has some more questions to understand the problem of the patient even better. He could use the following questions:

 if this is really true so what?

 What's so bad about …?

 What's the worst part about …?

 What does that mean about you (others)?

The therapist can stop with this downward arrow technique when he discovers an important core belief on schema level and/or the patient shows a negative shift in affect.