Introduction to Mode Work

Dynamic Mode Model

Solutions come from here

Healthy Adult Emotional Regulation

(e.g. fulfilling child needs)

Energetic system Directing system

Dissconance
Child Modes Internal Activation
Parent Modes ‘Back Stage’
Schemas derive
from interpersonal
experiences

Coping Modes Visible Behavioural

Activation
‘Front Stage’

Clinical Symptoms Motivation for therapy

Maladaptive coping modes

— Resulting from internal activation
— Coping mode is visible behaviour
— – it persists as coping reactions to early childhood
experiences accompanied by secondary emotions
such as hatred, superiority, shame or guilt.

1
 Example:
• Surrendering to the Punitive Parent is an effort to support the need
for companionship in the attachment system.
• Overcompensation fighting with the Punitive Parent mode is an
effort to support the need for autonomy and esteem in the
assertiveness system.

We must be able to access the other systems – particularly the energetic

system of the Child Modes:-
— The Angry Child that is squashed by Compliant Surrender mode
must be able to start fighting

— The Vulnerable Child that is denied by the Overcompensating

modes must be able to express the fear and sadness of disconnection
of the attachment system.

The ‘Heart’ of Schema Therapy

— Specific Relationship (Limited Reparenting) – active,
directive, flexible, self-disclosure, modeling) limited re-
parenting de-pathologises the problem.
— Modes are ego syntonic (part of them) fixed like a rock,
so we need to externalise.
— If we have activation we have process – move the
elevator up and down.
— Limited Re-parenting requires the extensive use of
experiential techniques for every session - instead of
“talking about it”.

Dynamic mode work

‘Standing up’ narrator
Self Reflection mode, disidentification,
Thinking and Speaking not detaching

Take the Cognitive

elevator Intervention
up and
Empathic
down to Re-parenting
Confrontation
Support/Modelling
regulate Acceptance Limit Setting
the Inducing change
intensity Empathy

Limbic activation,
physiological Emotional Processing
change happens here Schema Activation

2
 Emotional Activation
— Clients are likely to experience strong and at times uncomfortable
emotions when experiencing Schema Therapy.
— When activated, Schemas can activate Modes which affects the
client’s own here and now emotional cognitive and physical state.
— Schema Modes are the combination of an activated Schema and
coping style. E.g. an activated Defectiveness Schema combined
with a Surrender coping style (accepting the Schema as truth) which
would lead to the triggering of the Vulnerable Child mode. In this
mode a person experiences some version of the shame, sense of
worthlessness, being wrong or bad, in some way that a child would
feel shamed when found unacceptable to a parent or caregiver.

Vulnerable Child Mode I

— The difference between normal feelings and
Child Modes is that Child Modes are activated
by very small incidents. The intensity of
negative emotions seems disproportionate to
the event.
— Moreover, it is really hard for a person in a
Child Mode to control those feelings and the
related actions.

3
 Vulnerable Child Mode II
— In this mode, a client’s needs for attachment
and safety are strongest.
— The mode that contains the schemas that
affect the client the most can trigger their
Coping Modes.

10

10

Angry Child I
— In the Angry Child Mode, lots of different
feelings can play a role. Its important to
understand the dominant angry child
feeling.
— Is it ‘blind rage’
or
defiant or stubborn?

11

11

Angry Child II

— Anger – intense annoyance or strong frustration.

The Angry Child says ‘I hate you! “
— Enraged- When rage is dominant, a client’s
anger expression may be completely out of
control. He/she may destroy or hurt others –
hitting, screaming.
— Defiance –People who had impaired autonomy
often develop a Defiant Child Mode.

12

12

4
 Impulsive Child Undisciplined Child

Excited, impulsive, easily Lost, bored, tired/fatigued,

frustrated
13 irritated, loses attention 13

13

What is the common ground for all Child

Modes?
— Similar to the Vulnerable Child Mode, the
AC/IC modes are triggered when we feel our
needs are not met.
— The common ground of these feelings and
actions is that they express needs in an
exaggerated or inappropriate way.

14

14

Mode flipping
— Very frequently, the Angry and Impulsive Child
Modes are accompanied by the Vulnerable
Child Mode.
— Example: Maybe you become very angry when
a friend cancels your date for the movies.
Afterwards, feelings of sadness, loneliness or
abandonment might come up. In this instance,
the Angry Child mode’s behaviour triggers the
Vulnerable Child.
15

15

5
 Happy Child

16

16

Contented Child
— Fun, light-heartedness, curiosity
— Doing things that are fun and playful.
— In the Contended Child Mode, a person feels attached
to other people and experiences closeness with them.
— It’s important to have a repertoire promoting our
Contented Child Mode so that you can balance
moments of stress and frustration.

17

17

18

18

6
 Dysfunctional Parent Modes are part of
the complex introjects of significant others
—Stored in explicit memory (appraisals)
—Internalized in the mirror neurons in 2-ways:
(1) as a persisting, self-directed voice beating
oneself up
(2) as a model of how to treat others.

19

19

Dysfunctional Parent Modes (I)

—Put another way, the dysfunctional parent

modes are the modes putting pressure on the
client, or making him or her feel unwanted or
rejected – like an inner voice telling the person
over and over again that he or she is not smart or
attractive enough to accomplish goals and be
accepted by others.

20

20

Other sources of this mode….authority Modes

— Children who are bullied or
excluded by their classmates
often develop a Punitive
Parent Mode. This can cause
lifelong feelings of rejection
and shame.
— Within families, it might be
grandparents or siblings who
make a child feel bad or
inadequate by criticizing or
ignoring, or abusing him or her.
21

21

7
 Dysfunctional Parent Modes II
1. Demanding Parent/Authority Modes
2. Guilt-Inducing Parent/Authority Modes
3. Punitive Parent / Authority Modes

22

22

Dysfunctional Authority or Critic/Parent Modes

Punitive and Demanding Critical Parent modes are

NOT strongly connected, however, the do often occur
together.

Ï Demanding Parent modes are most closely associated

with Overcompensator modes
Ï Punitive Parent modes are most closely associated with
Vulnerable and Angry Child modes

23 23

23

Demanding Parent Modes related to

feelings of failure
— Demanding Parent Modes are all about
Unrelenting Standards in regard to the self. When
the mode’s excessive demands cannot be fulfilled,
we feel like a failure.
Characterized by:
Ï High requirements
Ï Putting high pressure on self
Ï Not necessarily self – hatred
— Too high standards, too strict, feels put under pressure

24

24

8
 Demanding Parent Modes (with a focus on
achievement)
Ï Patients mainly experience pressure and feelings of failure
when they do not manage to meet their own expectations
regarding performance – e.g. professional/educational
achievements.
Ï High achievement and doing everything in the ‘right way’
Ï In some cases, not demanding towards child but
indirectly influenced child by modeling extreme striving for
achievement in own behaviour

25

25

Guilt-Inducing Punitive Parent Mode related

to feelings of guilt
— This Mode gives a person the feeling that he
or she is guilty of not fulfilling others’
expectations. Often arises where there has
been parentrification.
The most important messages are:-
— “you are responsible for making other people
happy”
— “you have to please and look after everyone”.

26

26

Punitive Parent Mode related to feelings of

self-hatred and denigration
ØThis Mode is less about demands and more
like an inner voice that simply denigrates and
devalues the self.
ØPunitive Parent mode messages are often
very broad and general
— It may say “You have always been like this,”
“you will never…….” or “you are
completely……” followed by negative
attributes such as “stupid” “bad” “ugly”.
27

27

9
 Punitive Parent Mode – forms of abuse
In the Punitive Parent mode people devalue, denigrate or even
hate themselves.
1) Sexual abuse - Sexually abused children are ashamed of what
has happened even though they are not to blame. Abused children
often feel that they deserve no better treatment – in a way, the assault
is proof that “they are obviously bad”.
Physical Abuse- perpetrator has a bad temper, is impulsive or sadistic
leading to severe psychological scars and strong Punitive Parent Modes.
(Physical abuse can also happen between classmates or siblings, with
terrible psychological consequences for the victim).
3) Emotional Abuse- Emotionally abusive parents may tell their child
that it is guilty, and responsible for their problems, e.g. parent may leave
the house, or announce intention to suicide.
4) Neglect: When neglected child feel that they are not worth of good
care they will probably internalise a strong Punitive Parent Mode.
28

28

Punitive Parent Mode – more forms of

abuse
5) Other severe punishments- such as being locked outside the house
naked, being excluded from meals or being locked away in a room on
their own.

6) Bullying: Bullying between classmates or peers can be an extreme

and long-lasting type of abuse. People often report bullying situations
that went on for years with the same people.

29

29

Punitive Parent Mode messages

The Punitive Parent mode can have different
‘messages’. They are almost all related to being
unlovable. Moreover, these messages can
attribute shame and disgust to the self for
addressing the needs that had been punished in
childhood.
People with a strong Punitive Parent Mode can
rarely see that their needs are right and important.
Hallmark = Restriveness
30

30

10
 Detecting a Punitive Parent Mode
— I am not allowed to do pleasant things like other people
because I am bad.
— I deserve punishment
— I have the urge to hurt myself (e.g. cutting myself)
— I cannot forgive myself
A person hates themselves most of the time, feels ashamed
of themselves, their feelings and needs, or thinks that
he/she cannot expect anyone to spend time with them.

31

31

32

32

Maladaptive Coping Modes

(‘Emergency Modes’)
ÏIn a Coping Mode, you can keep (all or some) feelings
far away.
ÏThis can be adaptive in survival or abuse situations
but if used too much, leads to chronic feelings of inner
emptiness - i.e. it has then become maladaptive .

ÏIn a Coping Mode Mode other core needs and

feelings are cut off :–

33 33

33

11
 ÏTHE MORE MALADAPTIVE COPING MODE
ACTIVATION, THE LESS THE HEALTHY ADULT
Ï Strengthening the Healthy Adult is NOT sufficient,
because Maladaptive coping modes negatively
influence, or rather reduce, the Healthy Adult.
ÏThe Healthy Adult does not negatively influence
(reduce) the Maladaptive Coping modes by cognitive
interventions.
ÏChange requires emotional & experiential
interventions.

34

34

Maladaptive Coping Modes

• “I am in charge” (“I don’t feel”).
• (Overcompensator)

• “I surrender to gain attachment” (“I give in….”)

• (Compliant Surrender)

• “I avoid
• E.g. passively (Detached Protector) as “freezing” behaviour
to avoid harm

• E.g. actively (Detached Self Soother or Self Stimulator) as

“flight” reaction to protect myself and my self esteem”.

Crucially, the dysfunctional coping leads to an increase of those

negative emotions that initiated this mode.
35 •

35

Maladaptive Coping modes

— Acting out in a child mode is perceived as “childish”.
The guiding core beliefs remain covert as well. The
only visible mode is the coping mode.
— Coping modes are elaborations of the biologically
based fight/freeze/flight surrender behaviour.
— Each prioritizes different core needs and has an
interpersonal “meaning,” defining the relationship
with another person (e.g. you, the therapist).

—36

36

12
 Compliant Surrenderer
— Functions to avoid further mistreatment through
being compliant, passive and dependent
— This person allows others to abuse, neglect, control,
devalues self - in order to preserve the connection or
avoid retaliation
— Feels helpless in the face of a more powerful figure
— Feels they have no choice but to try to please this
person to avoid conflict.

37

37

Avoidance Modes - Flight

Avoidant Protector
• a person is not present physically – for example, he
or she avoids social activities, work, or any
situation that is experienced as a threat that is
likely to trigger strong emotions. One of the places
this protector shows up is in achievement situations.
• Detached Protector
• Like a coat of armor or a wall with vulnerability hiding
inside. Person may feel numb, may appear cynical or
aloof
38

38

Avoidant Behaviour Patterns

— Distraction – excessive internet or phone use, watching
movies/TV, loud music, non-stop working, excessive
participation in sports
— Weakening perception - unpleasant feelings are avoided by
drinking alcohol, using drugs (to take the edge off!)
— Moaning and grumbling – monotonous stereotyped moaning,
grumbling, complaining, blaming others for everything.
Frequently these individuals don’t seem to suffer or be really
angry.
— Low expectation – Its another form of avoidance not to set
yourself any goals – then you don’t feel disappointed by
encountering problems reaching them.
39

39

13
 Angry Protector
Controlled anger, hostility, irritability

— When working with coping modes, identification of

the type of anger, is necessary - it enables effective
treatment
For example:
l Limit–setting will NOT work with Angry Protector
(because this mode wants to break connection with
you any way)

l Empathy will NOT work with the Bully Attack

because this mode wants you to hurt like they hurt.
40

40

Recognising the Detached Protector

1. The patient complains of not feeling anything
2. Non-verbal clues in session: flat affect, rigid posture,
internet surfing, isolated and socially avoidant
3. Therapist reactions to patient: boredom, fatigue,
difficulty concentrating, frustration.
4. Help rejecting complainer. They get pleasure from
complaining (lot of anger)
5. Schema Inventory Scores (SMI, YPI, YSQ) - avoidant
patient has low scores, detachment
6. Inventories are not definitive – combine with other
information

41

General Therapist Goals with Detachment

— Educate the patient about DP – including its origins and
functions
— Build trust
— Almost every session that a patient is in DP is a wasted
session.
— By-pass Detached Protector – or cannot do Limited
Re-parenting

42

14
 Bypassing Detached Protector
— INITIAL STEPS in by-passing DP
— Label the mode in the session
— Help patient recognise signs of the detached protector
— Default mode – label
— Why did they develop this? Find out:
— What was so bad that caused them to detach

— Link to a situation in childhood

— Empathise with its adaptive value

— Review pros and cons of detaching in the present, as an adult
— “How could we help you feel close to others when the wall is up?”
— “If you block your emotions – you cannot get your needs met.”
— PRACTICE DIALOGUES
— Between the DP and....
— “Why don’t you make the best case you can for staying detached”

43

Remembering Kim
— Can’t connect with people
— Flat affect
— Acting Strong (Don’t hesitate to tell the patient what you see)
— Concept of Little Kim
— What happened to little Kim
“She’s lost “...
— Imagery is the main way of accessing the child modes
Jeff: “Do you think you are saying that because you don’t want to
get into the sad side of you?”
“Tough Kim is not letting anyone love her. Unless I can get Tough
Kim to step aside so we can find Little Kim, we can’t find her and
care for her.”

44

Overcoming Obstacles
— E.g. Building trust
1. We have to earn their trust to get through the
Detached Protector.
2. Convey warmth, nurturance and caring.
3. Be a real person, don’t play the role of the therapist,
be honest, direct and genuine.
4. Don’t problem-solve, correct distortion, or give advice
in this stage.
5. Ask about previous experiences in therapy
6. Ask about positive and negative reactions to you as a
person – not just a therapist

45

15
 Therapists have modes too……

46

46

Overcompensating Coping Modes - Fight

• Protects by being unfriendly, cold or hostile
towards others, thus pushing them away to
protect from being hurt. For example:
• Bully/Attack if he/she feels hurt – retaliates to
hurt. Can be sarcastic, cynical, sometimes
passive/aggressive
• Self aggrandizer believes and acts as if better than
others.
• Activated when there is hurt (BA) or judgement
(SA).
47

47

Other Overcompensation Behaviours

ÏCan be passive-aggressive
Ï Appear overtly compliant while secretly getting revenge
Ï Rebel covertly through

Ï Procrastination, backstabbing, complaining,

nonperformance
ÏCan be obsessive
Ï Maintain strict order
Ï Tight self-control
Ï High levels of predictability through

Planning, excessive adherence to routines, or

undue caution
48 48

48

16
 Overcompensating Coping Modes:

1. Obsessive Compulsive Overcontroller

2. Perfectionistic
Overcontroller

3. Paranoid Overcontroller
Vigilant, mistrustful, alert

32

49

49

Overcompensating coping modes:

Bully / Attack
Aggressive, threatening, intimidating
Overcompensation can be viewed as a
partially healthy attempt to fight back
against the schema that overshoots
the mark so that the schema is
perpetuated rather than healed.

Ï It is healthy to fight back against the schema so long as the

behaviour is proportionate to the situation and takes into
account the feelings of others…….. But overcompensators
typically get locked into counterattacking.
50 50

50

Overcompensating coping modes:

Self Aggrandizer Conning Manipulator

Dominant, superior, powerful, Smooth, charming,

arrogant
51
pseudo-emotions
51

51

17
 Overcompensating Coping Modes:
Predator Mode

Cold, ruthless, sadistic

52

52

Overcompensating Coping Modes

— When we talk about overcompensation we talk about
how we behave as if the opposite of the messages of our
Parent Modes and Child Modes were true.
— We behave very self confidently although we may
actually feel insecure or may behave in a highly
dominant or assertive manner, sometimes aggressive or
controlling
— We show off or attack others although we may actually
feel inferior or helpless.
— We may initiate situations or experiences we actually
find extremely distressing or hard to deal with.
53

53

Detecting our own Overcompensation

Coping modes
§ Nevertheless…..when looking more deeply, most people feel that
overcompensation is not purely pleasant. Individuals do not feel really in
touch with themselves whilst overcompensating.
§ Individuals do not feel certain of what they actually need or want and
they are certainly not relaxed. The individual might sense that he/she is
talking too much or showing off but may not have a clue as to how to
stop it.
§ Like all other coping modes, the Overcompensating Coping Mode often
becomes active in distressing circumstances.
§ If you suspect that you sometimes react with overcompensation, try to
think back to a distressing situation. Remember how you felt and how you
reacted.
§ When other people criticise us because of our overcompensating
behaviours - too dominant, bossy, too loud or excitable we need to take it
seriously. Were there vulnerable feelings behind the dominant or
aggressive face? 54

54

18
 Functional, Healthy Modes
ÏContended Child Mode - Feels loved,
spontaneous, understood, connected,
content and satisfied.

Healthy Adult Mode – neutralises the

punitive/ parent modes, puts limits on
the demanding parent and impulsive
angry child, and nurtures, listens to and
cherishes the vulnerable child – meeting
core needs. Emotions and beliefs have to
be perceived mindfully, so that
spontaneous dysfunctional coping
55
impulses can be interrupted.

55

Area Healthy Adult Mode Dysfunctional Mode

Self Discipline
Self criticism
Pleasure – overdoing things
Fulfills duties and is
disciplined, but watches out
for limits and needs. E.g. he is
ambitious and completes tasks
but can also take breaks and
leave time for recovery
Can criticise self but without
self-hatred. E.g. can detect
own weaknesses and tries to
work on it, doesn’t think she is
worthless
Knows its important to enjoy
things, and not always be
disciplined, but doesn’t
exaggerate. E.g. grants self an
extravagant dinner from time
to time or buys expensive
shoes just for pleasure,
however expenses are never
beyond reasonable limits
Demanding Parent Mode –
overstrains and demands too
much discipline
E.g. He is ambitious and works
around the clock, has no
interests outside work, runs
high risk of burn out.
Punitive Parent Modes
exaggerates self-criticism
hating self, blocking self by
prohibitions. E.g. she thinks
she is worthless as soon as any
weakness becomes visible.
Undisciplined, Impulsive Child
Mode fulfills own needs
without consideration of
others or long term
consequences e.g. he buys
new clothes all the time
despite being in debt.
56

56

Area Healthy Adult Mode Dysfunctional Mode

Expressions of Anger
Avoidance of feelings
Taking control
Expresses anger in a socially
adequate way. E.g. tells
boyfriend in private when she is
upset
Can use avoidance as a strategy
but is not hindered by extreme
avoidance. E.g. is in contact with
own feelings but ‘switches off’
when moody boss has a bad day
and starts screaming.
Does not fear taking control, but
stays flexible and takes the
interests of others into account.
E.g takes over command when it
becomes obvious that things are
not coordinated, leaves the
command happily to others
when things work out.
Angry Child Mode has
uncontrolled outbursts of anger
with negative consequences. E.g
she explodes ‘ out of nothing’ at
a party after anger has been
accumulating for some time.
Avoidant Coping Mode avoids
any kind of emotion and keeps
the person from important
relationships, experiences and
developments. E.g is afraid of
criticism and therefore keeps
distance in all contacts, also
towards friends and reliable
friendly people.
Overcompensatory Modes
fixates and repeats on control,
imposes control on others and is
very inflexible. E.g. always
commands everything, everyone
around is annoyed.
57

57

19
Why is it necessary to balance focusing on
Schemas and Modes?
— Working with Schemas and Modes accomplish different
functions.
— When a therapist works with Schemas, he or she is working at a
deep level with core issues. There will be deep affect.
Attachment needs will be addressed and healed only when
work with Schemas.
— Mode work focuses on behavioural change.
— If want to change deep core processes and reactions, therapists
need to address a client’s Schemas.
— If focus on both, will see deeper healing.
— Working with both provides the only full conceptualization of a
client case.
— If work on both, can overcome life patterns that are so resistant
58
to change in therapy.
58

Problems occur when therapists focus only

on Modes (part I)
1. Emotions will still be intense and easily triggered after
therapy.
2. Symptoms associated with traumatic memories will
reoccur. When a therapist works only works with modes
traumatic memories will not be processed and there will be
no trauma healing.
3. Schemas trigger Modes, so if Schemas have not been
healed, coping modes (overcompensation, avoidance etc.
will remain because of unresolved core schemas and drive
coping.
4. Attachment problems will limit the quality of relationships.
NB. Real attachment is not easily accomplished
59
through techniques that are part of mode work.
59

Problems that occur when therapists focus

only on Modes (part II)
4. If you don’t know which Schemas a client has, the client is
unlikely to experience sufficient change.
5. Because mode work doesn’t focus on reparenting by the
therapist, the client won’t feel sufficiently understood or
validated at a deeper level.
6. Problematic coping behaviours continue as mode work causes
the therapist to causes a shift in problematic behaviours e.g.
shift angry or compensatory reactions into healthy responses,
and doesn’t allow healing and shared understanding of what
is driving these problematic reactions that are driven by the
schemas.
7. If you don’t understand the Schema that is driving the
Mode, you won’t understand what function the Mode is
60
fulfilling for the client.

60

20
 Problems that occur when therapists focus
only on Modes (part III)
8. Some therapists practicing Schema Therapists don’t prioritise
limited reparenting – and will only undertake this minimally.
9. Since it is the therapy bond that leads to Schema healing,
clients will not feel a strong enough connection to you.
10. If clients feel they are not changing quick enough, or that you
don’t understand them, ruptures in the therapy bond will
increase the frequency of drop out if mode work is the only
focus (the bond is not strong enough to deal with the
arguments that come up).
11. If you don’t understand the core needs, you will miss the
reason for the maladaptive problematic coping. When there
hasn’t been enough guidance, protection, autonomy clients
can’t easily get their core needs met - some core needs will not
be identified and will remain unmet / unfulfilled. 61

61

Problems that occur when therapists focus

only on Schemas (part I)
1. When too little Mode work takes place, negative life
patterns persist. If you don’t have a model to deal with
strong coping modes, clients will not experience change in
their outside lives.

2. Clients will continue to avoid trigger situations and engage

in destructive compensatory behaviours in their everyday
life.
E.g. If you only work on the Defectiveness Schema
through re- parenting in therapy, when something happens
that triggers Defectiveness in the client in their outside lives,
the client will be likely to still avoid the intense reactions
of the Schema and will engage in compensatory
reactions (e.g. strong defensive or controlling behaviours,
62
aloofness, criticizing others etc.)

Problems that occur when therapists focus only

on Schemas (part II)
3. Detached Protector, and other Modes prevent Schema change, and
block emotional connection. If client e is in DP mode most of the
time, you won’t be able to connect to the client, nor change the
Schemas. If you don’t use Mode work, you won’t be able to employ any
of the strategies of working with Schemas and core issues.
4. There will be insufficient progress for patients with affective
instability. Mode work was originally developed to work with BPD, as
clients were flipping from coping with strong feeling to coping with
another strong feeling and no progress could be made.
5. One of the problems with some clients are that the internalized
Punitive Parent and other dysfunctional parent modes are not
sufficiently addressed. These modes are particularly destructive to
clients and cannot be integrated. Unless you can get the PP mode
outside of the client, and expunge it, (become dystonic) then core
issues and needs cannot be met and Schema healing will not take 63
place.
63

21
 Problems that occur when therapists only
focus on Schemas (part III)
5. Parts of the self do not become fully integrated. Part of the self
are partially dissociated from each other (e.g. PDs) If therapist
is only working with the Schema part (primarily Vulnerable
Child), you are not working with the parts of the client that
have been split off and need to be healed (e.g. Angry Child). If
heal the VC mode alone this doesn’t mean you have been able
to heal other parts of the self.
Example: If don’t work with the separate part that is the
Compliant Surrenderer Mode, if only work on the Schema
of subjugation, and the client does not understand that there
is a separate part of themselves that must go along with what
everyone else wants, that is associated with the VC mode,
then client will not experience change.
64

64

Problems that occur when therapists focus only on

Schemas (part IV)
6. If we fail to engage in frequent Mode dialogues, then we will not engage with
the client who has a strong internal dialogue. Clients will not understand the
different parts of themselves that might be at odds with one another.
Example: A client who wants to have intimate relationships and start dating, (VC)
but doesn’t understand that there is also a part of themselves who might ‘hate’ all
men, or ‘hates’ all women – e.g. an Angry Child that has been split off. Even
though client and therapist understands that one child Mode (VC) might want to
be close to others, but doesn’t understand that there might be another part of the
client that is suspicious and angry with others (Angry Child Mode), that is leading
to other overcompensating coping modes, that leads the client to criticize the
prospective partner. If these two parts are not permitted to talk to one another in a
mode dialogue, facilitated by the therapist, then the client will come in after the
first date complaining how mean or selfish the person the met was. They will do
this repeatedly with almost every person they meet. The Vulnerable Child mode
wants connection desperately, but the other modes that are actively angry and
doesn’t want to get along with others. Clients f lip from one state to another and
will not meet either need. The dialogue allows for the person to resolve the
65
conf lict.

65

Problems that occur when therapists focus only on

Schemas (final)
7. Most Schemas are in the Vulnerable Child Mode. If only
focus on the Vulnerable Child, other Child modes might
be missed and unmet not prioritized with those same
strategies. These other child modes will not be treated if
your main focus is on nurturing and tending to the
Vulnerable Child modei.e. you might miss the needs of
the Angry, or Impulsive child for safety, reasonable limits,
guidance and validation.

66

66

22
 67

67

Steps to Empathic Confrontation

—1. Strengthen connection with patient and clarify your intent
—2. Name the maladaptive behaviour/mode and validate origin
—3. Empathy
— Acknowledge the reasons the behaviour developed (validation from life
story)
— Express concern that it does not get their needs met today (confront the
results of the behaviour).
—4. Assist in conscious decision-making regarding changing the
behaviour.
—5. Offer a correction – a behaviour that will get their needs met
today.
—6. Offer assistance in learning to make correction and opportunities
to practice this.
68

68

Step 1 – Strengthen connection with

patient
Reinforce or strengthen your connection with
him/her, and state your positive intention in
questioning their behaviour.

What you do:-

—Basic verbal and non-verbal cues
e.g. Move closer, ask patient to look at you for a moment, say
their name

69

69

23
 Step 2 – Name the maladaptive
behaviour and validate origin and
function of mode
Validate the biographical origins and
need to cope in this way

70

70

Step 3 – Empathise with the early

childhood need for this coping and
show concern for it blocking current
needs
— Empathise and acknowledge that the maladaptive
behaviour developed for understandable reasons in
their childhood when limited options were available,
but today it does not result in needs being met

71

71

Step 4: Offer correction

— Step Four: Offer correction – a behaviour that will get the
underlying need met today in adult life

What you do:

— Empathically confront Angry Protector but limit setting for
Bully Attack Mode.
— The emotion expressed in both is anger, but the underlying
need is different, thus requires a different correction

— For example: Offering connection to a patient in the Self

Aggrandizing mode
72

72

24
 Step 5 – Making the decision to change

— Step Five: help the patient to make the

decision to change mode behaviour is part of the
correction process of empathic confrontation.

73

73

Step 6 – Offer assistance

Step Six: Offer assistance in learning to make the

correction:

74

74

75

75

25