A mixed methods study of schema modes amongst people living with disordered eating

Abstract

Background Schema therapy (ST) is a promising alternative therapy for the treatment of eating disorders (EDs). Schema modes (SMs) are a key component of ST and individuals with EDs have more maladaptive SMs and weaker healthy ones. Methods Aim was to explore schema modes within individuals living with disordered eating. Sixteen individuals without prior exposure to schema therapy completed the short form schema mode inventory for eating disorders questionnaire (SMI-ED-SF), then participated in semi-structured interviews discussing their high scoring modes. Results By thematic analysis, themes were: 1) Adverse family environments with the subthemes Trauma and the vulnerable and angry child and Unrealistic standards – Demand & Control, 2) Mode effects with the subthemes of On everyday life and On disordered eating, 3) Modes protective factors with the subthemes Emotion avoidance - Detach and Soothe and People pleasing - Compliance and Surrender and 4) Help Seeking with the subthemes Barriers to recovery, Dissatisfaction with treatment and ST as an alternative. Experiences were linked to the vulnerable child (VC) and angry child (AC) modes in their current lives and the employment of maladaptive modes to quell or block their activation and subsequent emotions. Discussion Participants found schema modes a positive and helpful way of way of understanding their disordered eating behaviours, despite that many reported prior negative experiences of other psychological therapy. This suggests that schema modes are a promising way of understanding and working with eating disorders.