In Centralized Cognitive Schema Therapy, we use experiential strategies such as guided imagery more than in cognitive-behavioral psychotherapy. These strategies are useful because they can help trigger emotions associated with maladaptive cognitive schemas and also allow the client to reproduce the parental figure within the safe framework of therapy. After 10 years of applying cognitive techniques and partially behavioral ones, and only 5 years of using this experiential strategy, I can say that the latter seems to produce the most profound changes in our clients. One thing is for the patient to understand at a rational level that they might have certain cognitive schemas stemming from their childhood, but it is entirely different for them to feel them, to remember how it was when they were children, and to associate this feeling with the problems they currently have. Young recalls in his book for therapists that such a technique of guided imagery transforms the idea of a cognitive schema from a cold cognition to a warm one.
It is important to help clients express their suffering about what happened to them in childhood, especially because the feeling of suffering is almost always mixed with anger. Sometimes it is difficult for them to accept this technique because they would feel too guilty if they were to do this exercise because they believe it is wrong to be angry with their parents and think their anger will hurt their parents, often saying, “My parents did everything they could.”
Such exercises help them understand that being angry with our parents does not mean that we believe they are “bad people” – going through stages of suffering during imagery helps clients differentiate the past and accept the fact that although sometimes their childhood was a painful period, they cannot turn back time and change that, but it can help them reframe all that suffering. And reframing helps negotiate a future. Sometimes it can even help them externalize that critical voice as being the parent’s and distance themselves from what seems to be their own voice. The limited reproduction of the parental figure helps them go back to that vulnerable child and teach him or her how to express needs, to give it a voice to ask healthily, now, in the present.
I wish therapists and clients alike much courage in their inner journey!