Trapped heart
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Not long ago, Jeffrey E. Young, PhD, a cognitive psychologist and clinical researcher at Columbia University Medical Center, met with a couple in crisis. The woman, let's call her Chloe, was brutally critical of her boyfriend, let's call him Dan. She thought Dan's teeth were ugly and wanted him to get them whitened; she thought his back was too hairy and complained that he wouldn't get regular waxing. It sent her into a rage when he was a few minutes late to pick her up on dates, even though Dan lived an hour away and traffic made exact arrival times nearly impossible. As Chloe continued with her onslaught, Young realized that Dan agreed with Chloe: Dan believed himself to be horribly flawed and thought Chloe was right to be angry with him. Although she was terribly critical of Dan, Young noted, Chloe loved him and was terrified of losing him.

If Young had been a Freudian therapist, he might have encouraged Dan and Chloe to speculate on the painful effect of childhood problems without suggesting specific ways to change their behavior. But Young began his career in the early '80s as a new therapy was gaining popularity—cognitive therapy, which teaches that how people think about events in their lives determines how they feel about them. Young, who studied with the man behind the therapy, Aaron T. Beck, was excited to be a part of a dynamic new method. But early on, he found that this approach alone was not enough to help clients with lifelong relationship troubles. "It was fine with people who'd been healthy and had problems only recently, but the majority of patients had problems that stemmed from their early life, and those people didn't respond well," he says.

Young began to spot a number of distinct, recurring patterns in his patients' psychological profiles—patterns laid down in early childhood that continued to shape their adult thoughts, actions, relationships, careers, and life choices. He called these habits "schemas," borrowing the ancient Greek word for "form," and he nicknamed them "lifetraps" to make it easier for his clients to understand both the concept and the risk of letting their schemas define them.

Although schema therapy began as an individual therapeutic strategy, it quickly turned into a couples therapy technique. "More than half the people we saw were coming in with problems with their relationship," Young says. "We thought, 'What if we got the partner in?' Once we did, we began to notice there was an interplay between them that was creating problems. One partner's schema would trigger the other's schema, and tensions would escalate." Some of the schemas dovetail—in a catastrophic way—each exacerbating the other. In fact, Young says, head-over-heels romantic attraction is often a sign of bad schema chemistry.

Young suspected that Dan suffered from the Defectiveness schema, which means that, when he was a child, his peers or family put him down, criticized him, and made him feel inferior. By asking questions in further sessions, he learned that Dan's mother favored his older brother and his father told him he was incompetent.

Chloe, on the other hand, was plagued by Unrelenting Standards. As a child, her family made her feel that, unless she was completely above reproach, she was a total failure. These are two of the 18 schemas Young has identified; a person may be affected or defined by any number of schemas—just as in astrology, people speak of an Aries who has a Cancer moon and Virgo rising. For instance, a patient may have the core schema of Emotional Deprivation and also be affected by the Abandonment and Self-Sacrifice schemas. (Take a quiz on common schemas.)