SCHEMAS IN THE COGNITIVE AND CLINICAL SCIENCES:

AN INTEGRATIVE CONSTRUCT

Dan J. Stein

Dept of Psychiatry,

College of Physicians and Surgeons and the

New York State Psychiatric Institute,

722 W 168 St,

NY, NY 10032

Correspondence concerning this article should be sent to Dan J.

Stein, M.B., Psychiatric Institute, 722 W 168 St, NY, NY,

10032.

Key Words: Schemas, Cognitive science, Psychotherapy

integration

Running Head: Schemas and Integration

Acknowledgements: Several anonymous reviewers deserve thanks

for their extremely helpful comments on earlier drafts of this

manuscript.

ABSTRACT

This paper is concerned in general with the

intersection of cognitive and clinical science and

in particular with schema theory. The use of

schema theory in the various subdisciplines of

cognitive science, as well as by cognitive-

behavioral clinicians and psychoanalytically

oriented clinicians is reviewed. It is argued

that schema theory, in both cognitive and clinical

sciences, allows a focus on mental structures,

their biological basis, their development and

change, and on the way in which they direct

psychological events. Schema theory not only

enables important advances in different clinical

schools, but it allows central clinical themes to

be tackled in convergent ways. It is concluded

that the schema construct allows integration

within cognitive science, within the clinic, and

between the two.

INTRODUCTION

Psychology has over the last few decades

witnessed a cognitive revolution, and the

multidisciplinary arena known as cognitive science

has increasingly come to the fore as a possible

unifying paradigm for the various psychological

sciences and schools. Workers within philosophy,

neuroscience, developmental psychology, cognitive

psychology, and social psychology have begun to

use similar constructs (Gardner, 1985).

Within the clinic, however, there remains

reluctance to accept a unified model of the mind.

Diverse theories and practices abound.

Nevertheless, some have argued that rigorous

research techniques and sophisticated theoretical

ideas have combined to foster a climate for a

unified, eclectic theory and practice of

psychotherapy (Beitman, Goldfried and Norcross,

1989).

There are some constructs, moreover, that are

being employed not only in the subdisciplines of

cognitive science but also in the clinic, and

indeed cognitive science appears to constitute a

paradigm to which diverse clinicians are attracted

(Bowers and Meichenbaum, 1984; Colby and Stoller,

1988; Ingram, 1986; Horowitz, 1988; Ruesch and

Bateson, 1968; Williams, Fraser, MacLeod, and

Matthews, 1988). Perhaps the most widely known of

the constructs used within both cognitive and

clinical science is that of schemas. It has been

argued that schemas are a heuristic and useful

concept in cognitive theory (Fiske and Linville,

1980). In this paper the suggestion is made that

schemas may be a heuristic and integrative notion

in clinical science. The argument procedes by

noting how cognitive scientists have used schema

theory to focus on the structures of the mind,

their biological basis, their development and

change, and the way in which they direct

psychological events. The paper then demonstrates

that schemas have been used by clinical scientists

to focus on analogous issues. It is concluded

that schemas constitute an important construct

that fosters integration within cognitive science,

within the clinic, and between the two.

COGNITIVE SCIENCE AND SCHEMA THEORY

The paper begins with a review of the use of

the schema concept in the various subdisciplines

of cognitive science. An historical perspective

is employed; the review begins with authors who

were important in laying the foundations for

cognitive science, and moves to a consideration of

contemporary workers.

a) Philosophy

Cognitive science may be viewed as an

enterprise that is concerned with the ways in

which the structures of the mind allow

representations of the world, and the ways in

which they process such representations. The

question of the mind's representation of the world

has long been posed by philosophy, and philosophy

may therefore be considered the founding

subdiscipline of cognitive science (Gardner,

1985).

One of the greatest philosophers, Kant,

employed the concept of the schema precisely in

order to discuss the possibility of knowledge.

Kant attempted to go beyond the impasse between

the empiricists, who argued that knowledge has its

origins in the external world, and the

rationalists, who argued that knowledge is a

product of the mind. He argued that schemas

interdigitate between properties of the mind (the

a priori categories) and raw sensory data (of a

posteriori experience). "This representation of a

universal procedure of the imagination in

providing an image for a concept, I entitle the

schema of the concept" (quoted in Gardner, 1985).

In more contemporary terms, mental schemas are

activated by the external world, and

simultaneously provide an interpretation of it.

b) Neuroscience

Cognitive science acknowledges that structures

of the mind have a biological basis, and

neuroscience is therefore an important

subdiscipline of cognitive science. Furthermore,

the neurologists Head and Holmes (1911) were among

the first to use the concept of the schema.

These workers were interested in the spatial

perceptions of patients of their bodies, and

referred to the basis of these as the postural

schema. The postural schema integrated sensations

which were triggered by postural change. In

lesions of the parietal lobe the schema may be

destroyed, with the possible outcome that patients

ignore part of their body, treating it as if it

were not their own. Conversely, an amputee may

have an intact brain schema, and therefore

experience movements in the missing phantom limb.

Today the more widely used term is the body schema

(Frederiks, 1969), and contemporary neuroscience

has advanced to the point where it can begin to

consider the biological underpinnings of more

complex schemas such as cognitive and affective

schemas (LeDoux, 1989).

c) Developmental Psychology

Although developmental psychology is not

usually considered one of the subdisciplines of

cognitive science, Piaget is one of the most

important figures in the prehistory of cognitive

science. The notion of the schema was central in

Piaget's work.

According to Piaget, the initial schemas of

the child comprise biologically based sensorimotor

reflexes which coordinate the child's interactions

with the environment. Gradually these biological

schemas allow adaptation to the environment by two

complementary processes. Via assimilation the

schema grasps some novel aspect of the

environnment, so modifying itself to cope with

the environment better. Via accomodation the

schema is differentiated and elaborated so as to

be consistent with the environment. With time,

the schemas are transformed to the point where the

organism reaches a new stage of development.

Piaget succeeds in providing a detailed

description of these transformations from the

point of sensorimotor schemas to the operations of

formal thought (Piaget, 1952).

d) Cognitive Psychology

The concept of the schema in contemporary

cognitive science is perhaps most directly

traceable to the work of the British cognitive

psychologist Bartlett (1932). Bartlett, a onetime

student of Head, was interested in memory, and in

particular in the notion that the context of an

experience had crucial effects on what was

retained and how well this was recalled.

Ebbinghaus had pioneered the experimental study of

memory using nonsense syllables, but this approach

did not seem adequate to Bartlett's concerns. A

conversation with Norbert Weiner, one of the

founding figures in cognitive science, gave

Bartlett an experimental methodology for

developing his ideas. Weiner's idea was to use

the Russian Scandal parlor game in which a story

is passed around the room, and then the original

and final versions compared. Bartlett found that

subjects showed consistent patterns of error in

the recall of narratives. Thus, for example, an

American Indian narrative would regularly be

revised by subjects until it came to resemble a

Western tale. Bartlett developed the construct of

the schema to explain this, describing a schema as

a component of memory which is formed from

encounters with the environment, and which

organizes information in specific ways. Such

schemas aid the recall of a typical (Western)

narrative, but systematically distort the recall

of an unusual (American Indian) narrative.

Bartlett (1932) wrote,

"Remembering is not the re-excitation of

innumerable fixed, lifeless, and

fragmentary traces. It is an

imaginative reconstruction, or

construction, built out of the relation

of our attitude towards a whole active

mass of past experience....It is thus

hardly ever really exact, even in the

most rudimentary cases of rote

recapitulation, and it is not at all

important that it should be so. The

attitude is literally an effect of the

organism's capacity to turn round up

upon its own "schemata" and is directly

a function of consciousness."

He defined a schema as

"an active organization of past

reactions or of past experiences which

must always be supposed to be operating

in any well-adapted organic repsonse.

Whenever there is any order or

regularity of behavior, a particular

response is possible only because it is

related to other similar responses which

have been serially organized, yet which

operate not singly as individual members

coming one after another, but as a

unitary mass."

A variety of definitions of schemas have been

offered subsequently. Thorndyke and Hayes-Roth

(1979) describe three universal assumptions made

by different authors: that a schema is an

organization of conceptually related elements

representing a prototypical abstraction of a

complex concept; that a schema gradually develops

from past experience; and that a schema guides the

organization of new information. A schema

comprises an architectural element (its structure)

and a propositional element (its content).

Cognitive schemas are involved in cognitive

operations (e.g. encoding, retrieval), in which

cognitive events (e.g. thoughts, images) are

produced and processed. Schemas are highly

interdependent and hierarchically organised, they

may involve verbal or nonverbal-elements, and they

may be more or less open to awareness (Craik and

Lockhart, 1972; Ingram and Kendall, 1986).

Schema theory has proven valuable in

accounting for a variety of psychological

phenomena. Schema theory has been used in

contemporary studies of memory (Schacter, 1989),

concept representation (Smith, 1989), problem

solving (VanLehn, 1989), movement (Jordan and

Rosenbaum, 1989) and language (Arbib et al, 1987).

Schemas have been found to facilitate recognition

and recall, to influence speed of information

processing and problem solving and allow for the

chunking of information into more meaningful units

to enable inference about missing data, and to

provide a basis for prediction and decision

making. It is thought that schemas engender bias

by relying on confirmatory evidence at the expense

of disconfirming evidence, but that this process

maintains schemas (Rumelhart, 1984; Meichenbaum

and Gilmore, 1984; Winfrey and Goldfried, 1986).

A variety of other constructs have been used

by cognitive scientists and their forerunners to

describe mental structures. Many bear a good deal

of family resemblance to the idea of schemas.

Notable examples include Abelson and Shank's

(1981) "scripts", Bandura's (1978) "self-systems",

Kelly's (1955) "personal constructs", Miller,

Galanter and Pribram's (1960) "plans", and

Minsky's (1975) "frames". The notion of the

connectionist network, currently extremely popular

in the field of artifical intelligence, has been

argued to represent a microlevel description of

the schema concept (Ben Zeev, 1988).

BETWEEN COGNITIVE AND CLINICAL SCIENCE

This review of the schema construct in

cognitive science demonstrates that schema theory

has been widely employed by cognitive scientists.

However, it may be objected that the very

diversity of the use of schema theory points to

the problematic nature of the schema concept.

Different cognitive scientists operationalize and

measure schemas in different ways. Similarly the

versatility of the concept may reflect only a lack

of theoretical rigor.

On the other hand the concept of schemas has

general heuristic value insofar as it allows

different cognitive scientists to theorize about

mental structures from the perspective of their

particular subdiscipline. The schema construct

allows different cognitive scientists to begin to

build an integrative framework that addresses such

questions as how the structures of the mind enable

representation, how they are based in biology, how

they develop and change, and how they account for

a variety of psychological phenomena.

Certainly there is room in schema research for

improvement in both empirical measurement and

theoretical rigor (Fiske and Linville, 1980;

Williams et al, 1988). Nevertheless, the

development of the schema concept as a broad

heuristic is important insofar as it represents a

move in cognitive science away from a molecular

and bottom-up approach (concentrating on the

elementary units of processing and on the

influence of the details of a task on

performance), and toward a molar and top-down

approach (highlighting the large-scale properties

of processing and the influence of strategies and

contexts on performance). Similarly schema theory

represents a move away from the laboratory and

artificial Ebbinghausian methodologies to a

concern with the investigation of day-to-day human

activity.

These shifts in cognitive science are

reflected in increasing interest in using schema

theory to investigate such phenomena as self and

other representation, and the representation of

emotion.

Schema theory has been applied to concepts of

the self by a number of workers (Markus, 1977;

Rogers, 1981). This research follows the line of

earlier work on schemas. Thus, self schemas are

viewed as generalizations about the self that

develop out of past experience and that organize

the processing of self-related information in the

social environment. This in turn results in

various forms of bias, but allows the maintenance

of a consistent self-concept (Greenwald, 1980).

Similarly a number of authors (Cantor and

Mischel, 1977; Fiske, 1981; Taylor and Crocker,

1982) have described evaluative schemas for

assessing others. In this kind of research,

schemas have been used as to explain such

phenomena as stereotypes and the reactions they

elicit.

Finally, schema theory has begun to grapple

with the problem of emotion. Early authors

suggested that affect and cognition are seperate

but interactive systems. Affect was argued to be

either postcognitive (Neisser, 1976; Mandler,

1975) or precognitive (Zajonc, 1980). On the

other hand, Leventhal (1982) and Greenberg and

Safran (1984) have offered schema models which

attempt to synthesize affect and cognition.

Leventhal (1982), for example, writes that

emotions "....can be regarded as a form of

meaning. They have significance for the person

experiencing and expressing them. Their meaning

has two aspects: they 'say' something about our

organismic state...and they 'say' something about

the environment". In this line of thinking,

schemas have both an ideational and an affective

component.

All these areas require further empirical and

theoretical development (Higgins and Bargh, 1987;

Klein and Kihlstrom, 1986). As cognitive

scientists begin to research these subjects, their

interests begin to approximate those of

clinicians. Let us move, then, to clinical theory

and practice.

CLINICAL SCIENCE AND SCHEMA THEORY

It has been demonstrated that cognitive

scientists use schema theory to address a number

of salient issues about mental structures. First,

structures of the mind enable representation.

Second, these structures are based in biology.

Third, structures develop and change. Fourth,

such structures may account for a variety of

psychological phenomena, including behavior,

cognition, and emotion.

With this range of issues in mind, it is not

difficult to see how schema theory may be useful

in the clinic. Psychopathology may involve, for

example, conflict (where underlying schemas are

somehow distorted) or deficit (where underlying

schemas are absent or underdeveloped).

Psychopathologists are interested, then, in

disturbed representations, in particular in

disturbances in representations of self, other,

and the interaction of self and other. Insofar as

these disturbances have a biological underpinning,

this too is of interest. The developmental

transformations which lead to such disturbances

are of course of great importance. Models of

psychopathology attempt to describe the psychic

structures that lead to abnormal behavior,

cognition, and emotion.

Similarly, psychotherapy may involve, for

example, transference (where the therapist is seen

through pre-existing schemas), resistance (where

pre-existing schemas undermine change) and

interpretation (where a meta-cognitive process of

disengagement from and reflection on the patient's

schemas occurs). Psychotherapists are interested,

then, in changes in representations of self and

other, and in the way in which psychotherapy leads

to such changes. Insofar as psychopharmacological

interventions help promote such changes in

representations, therapists will be interested in

how this occurs. Models of psychotherapy attempt

to describe the psychic structures that account

for various phenomena in psychotherapy that

involve behavior, cognition, and emotion.

While these concerns are common to different

psychopathologists and psychotherapists, many

concepts other than that of schemas are, of

course, employed to explain psychopathology and

psychotherapy. I want to show that although such

concepts may be useful, they may also be open to

transformation into, or subsumption under, schema

theory. It may be objected that this merely

constitutes the translation of different terms

into schema language. However, I want to argue

that schema theory allows different clinical

schools to include rigorous components of their

orientation and to discard less rigorous aspects,

and so enables advances in these schools.

Furthermore, schema theory fosters integration by

allowing central themes to be tackled in

convergent ways.

These arguments are made in the following

sections in terms of two divergent approaches in

modern clinical work, the cognitive-behavioral and

the psychoanalytic. Schema theory may be seen as

increasingly important in each school. It will be

suggested that schema theory enables important

advances within each school, and that it allows

important clinical themes to be considered in an

integrative way.

COGNITIVE-BEHAVIORAL THERAPY AND SCHEMAS

The initial behavioral model of

psychopathology and psychotherapy was that of

Watson. The exemplar discussed by Watson and his

students (Watson and Rayner, 1920) was the

induction and elimination of a fear of white rats

in an eleven month old boy, Albert B., with

techniques of conditioning and deconditioning. A

critique of this discussion is beyond the scope of

this paper, but it may be noted that such work

does not readily allow a focus on some of the

concerns that psychopathologists and

psychotherapists have been listed as having.

Mental structures are pointedly ignored,

constitutional factors are downplayed,

developmental processes are limited to those of

conditioning, and while behavioral events such as

phobias and learning are tackled, other complex

phenomena in psychopathology and psychotherapy

such as personality disorder, or resistance and

transferance, are ignored. It is not surprising,

then, that there has been a shift in clinical

behaviorism to more cognitive models.

While the early cognitive-behaviorists, such

as Ellis (1962), incorporated cognitions into

their theory, there was still a reluctance to

focus on the structures of the mind. Abnormal

cognitions resulted from cognitive distortions,

and the structures that produced cognitive

distortions were glossed over. There was a

corresponding neglect of the development of

cognitive distortions. It may be again be argued

that this view has difficulty in accounting for

complex kinds of psychopathology and for complex

phenomena in psychotherapy.

However, later cognitive-behaviorists have

become increasingly interested in structures of

the mind. Beck, for example, introduced the

schema concept in the context of depression (Beck,

1964, 1967), and more recently he and his

colleagues (1990) have elaborated the notion of

schemas in order to extend cognitive therapy to

the personality disorders. Other authors in the

cognitive-behavioral tradition have also employed

the notion of schemas (Arnkoff, 1980; Turk and

Speer, 1983; Goldfried and Robins, 1983; Greenberg

and Safran, 1984; Young, 1990), but Beck's is the

most extensive contribution.

Beck and his co-workers suggest that different

types of schemas have different functions. In

their view cognitive schemas are concerned with

abstraction, interpretation and recall, affective

schemas are responsible for the generation of

feelings, motivational schemas deal with wishes

and desires, instrumental schemas prepare for

action, and control schemas are involved with

self-monitoring and self-regulation. There are

also subsystems of schemas. Thus cognitive

schemas include schemas concerned with

self-evaluation and evaluation of others, schemas

concerned with memory and recall, and schemas

concerned with expectancies and predictions. They

argue that such schemas can be viewed as operating

in logical linear progression. A dangerous

stimulus activates a "danger schema", which in

turn activates affective , motivational, action,

and control schemas.

This framework is used to discuss development

and change. Schemas develop as a result of both

constitutional and environmental factors. A

particular schema may develop in response to

developmental experiences, or as a result of

identification with family members. Certain

patterns may be derived from or compensate for

such schemas. Therapists use cognitive, affective

and behavioral strategies to change cognitive,

affective, and behavioral schemas. Change

comprises a continuum from restructuring of

schemas to more subtle modifications.

This framework is also used to discuss

different kinds of psychopathology. Dysfunctional

thoughts, feelings, and behaviors are due to

schemas that produce consistently biased

judgements. The schemas of personality disorders

resemble those of the symptom disorders, but they

are involved in the everyday processing of

information, and are operative on a more

continuous basis.

Finally this model is used to discuss complex

aspects of psychotherapy. Schemas regarding

change, self, and others may impede therapy.

Schemas regarding the therapist may be labelled

transferance cognitions.

PSYCHOANALYTIC THERAPY AND SCHEMAS

Classical psychoanalytic theory posits that

psychopathology can be understood in terms of an

energetics model. Freud argued that the forces of

the unconscious are expressed, repressed, and

transformed, resulting in everyday behaviors and

in psychopathology. During development these

forces manifest in different configurations, and

developmental events may therefore affect later

dynamics in specific ways. Psychoanalysis leads

to insight into such dynamics, and allows for

their working through.

Modern analysts have increasingly rejected

this model, which is drawn from nineteenth century

science. Many have attempted to de-emphasize the

drive component of psychoanalytic theory, and to

focus on its relational aspects; on the self, the

object, and their interaction (Mitchell, 1988).

On this model, the past is important insofar as

previous relationships determine the nature of

future ones. Symptoms are explicable, for

example, in terms of relational deficits. Therapy

occurs within the context of an empathic

relationship, and so allows for growth.

Furthermore, in considering new models to

replace the energetic one, a number of

psychoanalysts have drawn on schema theory (Eagle,

1986; Slap and Saykin 1983; Wachtel, 1982).

Perhaps the most extensive contribution, however,

is that of Horowitz (1988, in press).

Horowitz (1988) suggests that every individual

has a repertoire of multiple schemas of self and

other. Self schemas include ways to gain pleasure

or avoid displeasure (motivational schemas),

positioning in relation to the world (role

schemas), and ways of helping a person decide

which of two motives to choose (value schemas).

Superordinate schemas that articulate self to

other schemas in ways that organize a script of

wishes, fears, and likely reactions are called

role relationship models. Schemas are applied

simultaneously along multiple parallel channels.

Shifts in schema activity are accompanied by

shifts in state of mind, and control processes

prevent the emergence of certain states of mind in

defensive fashion.

This model is again used to account for

development and change. Self-schemas develop from

a basis of genetic and environmental interaction.

Role relationship models develop in the context of

interpersonal behavioral patterns. Common issues

are those of love and care, power and control, and

sexuality and status.

The framework is also used to discuss

different kinds of psychopathology. Changes in

the environment may lead to a poor fit between

external reality and preexisting role-relationship

models. Emotional response to stress is due in

part to the discord between the new situation and

enduring schemas. In some people schemas and

patterns of control of schemas are inappropriate

and insistent. These constitute personality

problems.

Finally this model is used to account for the

phenomena of psychotherapy. In therapy the

schemas of the patient become manifest in the

role-relationship models between clinician and

patient. The therapeutic alliance allows the

patient to develop insight into such schemas, and

during a process of working through to gradually

replace or modify them.

AN INTEGRATIVE APPROACH

While schema theory may be increasingly

important in both cognitive-behavioral and

psychodynamic work, Beck and Horowitz approach

clinical theory and practice from widely divergent

positions. This is reflected in their assumptions

about schemas. Beck's view of schemas as

triggered in a linear fashion is consistent with

the focus of cognitive therapy on the automatic

cognitions that precede emotion. Horowitz's

division of schemas into motivational, role and

value schemas, on the other hand, reflects the

Freudian concern with the id, ego, and superego

structures. Furthermore, differences in

theoretical assumptions lead to divergent methods

for measuring schemas.

Nevertheless, as in the case of schema theory

in cognitive science, the schema concept may have

a broad heuristic value in the clinic insofar as

it allows different clinicians to approach common

concerns about mental structures, their

development, and their importance in understanding

psychopathology and psychotherapy. The work of

Beck and Horowitz on schemas converges on these

subjects.

This section attempts to illustrate the

heuristic value of schema theory in the clinic.

It is argued first that the cognitive-behaviorist

and psychoanalytic models each have distinct

advantages and disadvantages, and that schema

theory has potential for incorporating the

advantages and eschewing the disadvantages of

these schools. It is then suggested that schema

theory allows a number of important clinical

themes to be considered in an integrative way.

One advantage of behaviorism lies in is its

emphasis on a systematic and empirical approach.

The model presented here is consistent with the

idea that it is possible to study psychopathology

and psychotherapy in a systematic way, and to

provide empirical descriptions of psychological

phenomena. Clinicians have begun to devote

attention to the rigorous assessment of schemas

(Landau and Goldfried, 1981; Rudy and Merluzzi,

1984; Segal, 1988), and such methodologies are

important in research on the nature of

psychopathology and on the efficacy of

psychotherapy. Furthermore, while it may be

argued that the advance of clinical theory will

always be intimately tied to clinical practice,

schema theory allows for the incorporation of more

general experimental techniques and findings.

On the other hand, the cognitive-behavioral

tradition has increasingly chosen to theorize

about the mental structures that early

behaviorists wanted to ignore. Early cognitive-

behaviorists noted abnormal cognitions, but

continued to de-emphasize the structures

responsible for these cognitions, their

development, and their manifestation in the clinic

in the form of resistance and transferance.

Finally, modern cognitive- behavioral therapists

such as Guidano and Liotti (1983) have devoted a

good deal of attention to psychological

structures, to their development, and to their

importance in psychopathology and psychotherapy.

It is at this point that cognitive-behavioral

theory begins to employ a schema model.

In contrast to behaviorism, psychoanalysis

tackles mental structures without hesitation. In

many ways, Freud may be considered a cognitivist

who focused on mental structures, their growth and

change, and their consequences for behavior and

for the clinical situation.

On the other hand, Freud never really escaped

his natural science background. The theory of

drive permeates all his works. While the drive

model constitutes a good model for such phenomena

as movement and momentum, it fails to provide an

adequate account of the subtle meanderings and

manipulations of the mind. Drive and force are

too cumbersome for meaning and cognition.

Further, Freud's notion of drives is one which

conceives of the child's unconscious as identical

to that of the adult, and his notion of memory

traces is in terms of a passive perceptual

apparatus; his usual penetrating focus on

development and transformation blurrs at this

crucial point. Finally, the inherently conflicted

notion of an energy that is psychic exemplifies

Freud's failure to resolve the relation between

psyche and soma. Modern analysts have retained

aspects of drive theory, but have shifted their

emphasis to the construction of the self, of the

other, and of the space between them (Mitchell,

1988). This view rejects drives (as energetic or

psychological concepts), without going to the

opposite extreme of denying that psychoanalysis is

a science concerned with models. It is at this

point that psychodynamic theory begins to adopt a

schema model.

Given the kinds of approximations outlined

here, it is not surprising to find an overlap of

various techniques in clinical practice. Modern

cognitive therapists work with dreams and

spontaneous images (Young, 1990), while

psychoanalysts have become increasingly open to

the adoption of cognitive-behavioral techniques

(Wachtel, 1977).

Further, the possibility of increasing

theoretical integration emerges. By way of

example let us use schema theory to consider some

central focuses of psychotherapy - the

unconscious, drives and defenses, symptoms and

therapeutic change.

Insofar as schemas are not known to the

person, they are unconscious. The importance of

unconscious processes has become increasingly

apparent in cognitive science (Kihlstrom, 1988).

It is clear that the processes that take place out

of awareness are not only extremely important, but

can be scientifically described. While empirical

clinical research on the relation between schemas

and the unconscious is limited (Shevrin, 1988),

schema theory may be theoretically useful in the

clinic. Consider, for example, a female victim of

incest, who describes difficulties in

relationships with men, but who is largely unaware

of how these relationships reflect earlier

familial patterns. It is possible to

conceptualize this patient as having particular

schemas about herself, about men, and about her

interactions with men; schemas of which she may be

or less aware. Thus this patient may have schemas

in which atttention is given her by men only when

she is seductive, and in which all men are

untrustworthy. The patient may consciously deny

the presence of such schemas but nevertheless her

thoughts, feelings and actions may entail their

existence. Thus a clinical formulation is

constructed which posits particular unconscious

schemas, and which is employed to account for

consciously reported psychological phenomena.

This schema view of the unconscious discards the

classical analytic metaphor of the unfettered

beast lurking in the mind, as well as the modern

analytic metaphor of the damaged baby at the core

of the patient. It also departs from the

behaviorist avoidance of the unconscious. The

schema view, however, maintains the classic

analytic ideas of psychic determinism and of the

existence of unconscious processes, and also

conforms to the attempts of modern analysts and

behavioral-cognitive therapists to describe how

the past repeats itself unwittingly in the

present.

Insofar as schemas direct behaviors,

cognitions, and emotions in a particular way, they

result in repetitive patterns of behavior,

thought, and feeling. However, schemas develop in

adaptation to life, and can therefore be seen not

only as constrictive (defensive) but also as

creative (strategic). Thus in the patient

discussed earlier the schema in which all men are

viewed as untrustworthy, may have proved helpful

at home, but may have lead to inappropriate affect

in later relationships. Analysts may object to

this kind of thinking for it appears to downplay

the libidinal and aggressive phenomena which are

highlighted in analytic defense theory. Certainly

schema theory has only begun to theorize affect,

sexuality and aggression (Horowitz, 1988).

Nevertheless, the idea that schemas have defensive

and strategic aspects discards the classical

notion of energetic forces being defended against

by the ego, and downplays the modern analytic

emphasis on psychic deficit as accounting for the

repetitive patterns of the present. However, this

view can perhaps incorporate the classic analytic

concern with affect, as well as the modern

analytic and cognitive-behavioral emphasis on the

adaptive or strategic aspects of fixed patterns of

behavior, thought, and feeling.

Insofar as the behaviors, cognitions, and

emotions directed by schemas are abnormal, they

constitute symptoms. Psychotic symptoms may, for

example, point to the absence or lack of

development of certain symptoms (Perris, 1990).

Character symptoms may indicate the presence of

maladaptive schemas (Young, 1990). Dissociative

symptoms may point to a lack of integration

between schemas (Hilgard, 1977). Schemas in the

patient mentioned earlier may, for example, result

in personality features such as being overly

seductive, or being quick to anger. Further work

needs to be done on the way in which schema theory

acccounts for the range of clinical symptoms. It

is clear, however, that a schema theory of

symptoms contrasts with the classical analytic

notion of symptoms as dynamic compromise

formations, the modern analytic emphasis on

symptoms as the result of relational deficits, the

behaviorist concept of symptoms as

stimulus-response mediated, and the early

cognitivist description of symptoms as emerging

from cognitive distortions. Schema theory does,

however, follow psychoanalytic and

cognitive-behavioral theory insofar as they

emphasize the mental structures responsible for

symptoms.

What about therapeutic change? According to

schema theory, therapy involves an affective and

cognitive process in which a variety of techniques

are used to engage and explore schemas.

Subsequent events depend on the nature of the

pre-existing schemas. Some schemas may be

non-linguistic in nature, and these may then be

given a voice. Other schemas may be out of

awareness, and these may then be acknowledged.

The patient may be encouraged not to use a

particular schema or to develop compensatory

schemas (Ingram and Hollon, 1986). Alternatively

schema change can be fostered, either of more

superficial schemas or of deeper ones, using

emotive, cognitive and behavioral methods (Young,

1990). In the patient we have discussed, the

operation of schemas of seduction and mistrust

within the therapeutic relationship, and the way

in which they lead to particular thoughts and

feelings may be brought into awareness, and the

patient may be encouraged to practice new ways of

relating to others. This kind of theorizing

contrasts with the classic analytic model of cure

as the result of dynamic catharsis, the modern

analytic model of cure as the result of empathic

reparenting, and the cognitive-behavioral models

of reinforcement or relearning. Schema theory

nevertheless maintains the Freudian emphasis on

insight, the modern analytic emphasis on empathy,

and the cognitive notion of the remodelling of

mental structures. In similar vein, transferance

involves not so much a distorted neurotic

repetition, nor a genuine holding environment, but

rather an entry into and reshaping of the patterns

of the patient.

The cumulative effect of these sketches of the

clinical application of schemas hopefully

indicates the integrative potential of this

construct. Nevertheless much work remains to be

done. Each of these clinical sketches requires

theoretical expansion. Theoretical work at the

overlap of cognitive and clinical science, such as

the use of schemas to understand self and affect,

also requires further development (Williams et al,

1988). Furthermore, such theory must be

complemented by empirical research. If schemas

are to be accepted as real mental structures which

explain mental and clinical phenomena, then their

accurate definition, and documentation become

paramount. The operationalization and measurement

of deep constructs is, however, difficult (Segal,

1988). Schemas are measured only indirectly, for

example, by pencil-and-paper methodologies (Coyne

and Gotlib, 1986). Furthermore, different

cognitive scientists and clinicians have defined

schemas in somewhat different ways, with each

worker attaching his or her theoretical framework

to the construct. While schemas have a degree of

constancy, they may also be dynamic and

multifaceted, so exacerbating the difficulties of

the empiricist. In sum, both theoretical

innovation and detailed clinical observation will

be necessary in order to advance an adequate

account of schemas in the clinic.

SUMMARY

I have shown that schema theory is used by a

variety of cognitive theorists and clinicians. I

have suggested that schema theory allows a focus

on mental structures, their biological basis,

their development and change, and the way in which

they direct psychological events. These focuses

are important not only in cognitive science, but

also in the clinic.

Schema theory therefore allows cognitive

scientists and clinicians to conduct a convergent

discourse. Furthermore, schema theory may be

useful in allowing different clinicians to employ

a unified framework.

I have also indicated that a great deal of

work in both the cognitive and clinical sciences

remains to be done. Problems in the

operationalization and measurement of schemas

remain to be solved, and a variety of theoretical

areas need to be developed further.

Nevertheless, the use of schema theory in the

clinic opens up cognitive science to a whole

series of phenomena. The clinic confronts schema

theory with a variety of psychological structures

(cognitive and affective), processes (top-down or

molecular and bottom-up or molar), and forms of

representation (fantasies, dreams, hypnotic

recollections, hallucinations, delusions). Such a

confrontation benefits cognitive science insofar

as it shifts its focus away from the laboratory

and toward man in all his complexity.

Conversely, by looking at cognitive science,

clinicians may begin to incorporate empirical and

experimental methodologies. Cognitive theory may

provide a unified model of the mind to underpin an

unified clinical approach.

Hopefully this paper will encourage the

dialogue between the cognitive and clinical

sciences, and will encourage empirical and

theoretical research on schemas.

REFERENCES

Abelson, R.P. (1981). Psychological status

of the script concept. American Psychologist, 36,

715-729.

Arbib, M.A., Conklin, E.J., & Hill, J.C.

(1987). From schema theory to language. Oxford:

Oxford University Press.

Arnkoff, A. (1980). Psychotherapy from the

perspective of cognitive theory. In M.J. Mahoney

(Ed.), Psychotherapy process: Current issues and

future directions (pp. 339-361). New York:

Plenum Press.

Bandura, A. (1978). The self-system in

reciprocal determinism. American Psychologist,

33, 344-358.

Bartlett, F. (1932). Remembering. Cambridge:

Cambridge University Press.

Beck, A.T. (1964). Thinking and depression:

II. Theory and Therapy. Archives of General

Psychiatry, 10, 561-571.

Beck, A.T. (1967). Depression: Clinical,

experimental and theoretical aspects. New York:

Harper and Row.

Beck, A.T., Freeman, A., & Associates (1990):

Cognitive therapy of personality disorders. New

York: Guilford.

Beitman, B.D., Goldfried, M.R., & Norcross

J.C. (1989) The movement toward integrating the

psychotherapies: An overview. American Journal

of Psychiatry, 146, 138-147.

Ben-Zeev, A. (1988). The schema paradigm in

perception. Journal of Mind and Behavior, 9,

487-514.

Bowers, K.S., & Meichenbaum, D (Eds.).

(1984). The unconscious reconsidered. New York:

Wiley.

Cantor, N., Mischel, W. (1977). Traits as

prototypes: Effects on recognition memory,

Journal of Personality and Social Psychology, 35,

38-48.

Colby, K.M., & Stoller, R.J. (1988).

Cognitive science and psychoanalysis. Hillsdale:

Analytic Press.

Coyne, J.C., & Gotlib, I.H. (1986). Studying

the role of cognition in depression. Well trodden

paths and cul-de-sacs. Cognitive Therapy and

Research, 19, 794-812.

Craik, F.I.M., & Lockhart, R.S. (1972).

Levels of processing: A framework for memory

research. Journal of Verbal Learning and Verbal

Behavior, 11, 671-684.

Eagle, M.N. (1986). The psychoanalytic and

the cognitive unconscious. In R. Stern (Ed.),

Theories of the unconscious (pp. 155-190).

Hillsdale, Analytic Press.

Ellis, A. (1962). Reason and emotion in

psychotherapy. Secaucus: Lyle Stuart and Citadel

Press.

Fiske, S.T. (1981). Schema-triggered affect:

Application to social perception. In M.S. Clark

& S.T. Fiske (Eds.), Affect and cognition (pp.

55-78). Hillsdale: Erlbaum.

Fiske, S.T., Linville P.W. (1980). What does

the schema concept buy us? Personality and Social

Psychology Bulletin, 6, 543-557.

Frederiks, J.A.M. Disorders of the body

schema (1969). In P.J. Vinken & G.W. Bruyn

(Eds.), Handbook of clinical neurology 4.

Disorders of speech perception and symbolic

behavior (pp. 373-394). Amsterdam: Elsevier.

Gardner, H. (1985). The mind's new science:

A history of the cognitive revolution. New York:

Basic Books.

Goldfried, M.R., Robins C. (1983).

Self-schemata, cognitive bias, and the processing

of therapeutic experiences. In P.C. Kendall

(Ed.), Advances in Cognitive-Behavioral Research

and Therapy, vol 2 (pp. 33-80). San Diego:

Academic Press.

Greenberg, L.S., Safran, J.D. (1984).

Integrating affect and cognition: A perspective

on the process of therapeutic change. Cognitive

Therapy and Research, 8, 559-578.

Greenwald, A.F. (1980). The totalitarian

ego: Fabrication and revision of personal

history. American Psychologist, 35, 603-618.

Guidano, V.F., & Liotti, G. (1983). Cognitive

processes and emotional disorders: A structural

approach to psychotherapy. New York: Guilford.

Head, H., Holmes, G. (1911). Sensory

disturbances from cerebral lesions. Brain, 34,

102-254.

Higgins, E.T., & Bargh, J. (1987). Social

cognition and social perception. Annual Review of

Psychology, 38, 369-425.

Hilgard, E.R. (1977). Divided consciousness:

Multiple controls in human thought and action.

New York: Wiley.

Horowitz, M.J. (1988). Introduction to

psychodynamics: A new synthesis. New York:

Basic Books.

Horowitz, M.J. (in press). Person Schemas.

In M.J. Horowitz (Ed.), Person Schemas and

Maladaptive Interpersonal Behavior Patterns.

Chicago: University of Chicago Press.

Ingram, R.E. (Ed.). (1986). Information

processing approaches to clinical psychology. San

Diego: Academic Press.

Ingram, R.E., & Hollon, S.D. (1986) Cognitive

therapy of depression from an information

processing perspective. In R.E. Ingram (Ed.),

Information processing approaches to cognitive

psychology (pp. 261-284). San Diego: Academic

Press.

Ingram, R.E., & Kendall, P.C. (1986).

Cognitive clinical psychology: Implications of an

information processing Perspective. In R.E.

Ingram (Ed.), Information processing approaches to

clinical psychology (pp. 4-22). San Diego:

Academic Press.

Jordan, M.I., Rosenbaum, D.A. (1989).

Action. In M.I. Posner (Ed.), The foundations of

cognitive science (pp. 727-768). Cambridge: MIT

Press.

Kelly, G. (1955). The psychology of personal

constructs. New York: Norton.

Kihlstrom, J.F. (1987). The cognitive

unconscious, Science, 237, 1145-1151.

Klein, S.B., & Kihlstrom, J.F. (1986).

Elaboration, organization, and the self-reference

effect in memory. Journal of Experimental

Psychology, 115, 26-38.

Landau, R.J., Goldfried, M.R. (1981). The

assessment of semantic structure: A unifying

focus in cognitive, traditional, and behavioral

assessment. In P.C. Kendall & S.D. Hollon

(Eds.), Assessment stategies for

cognitive-behavioral interventions. San Diego:

Academic Press.

LeDoux J.E. (1989). Cognitive-Emotional

interactions in the brain. Cognition and Emotion,

3, 267-289.

Leventhal, H. (1982). The integration of

emotion and cognition: A view from the

perceptual-motor theory of emotion. In M.S.

Clarke & S.T. Fiske (Eds.), Affect and cognition

(pp. 121-156). Hillsdale: Erlbaum.

Mandler, G. (1975). Mind and emotion. New

York: Wiley.

Markus, H. (1977). Self-schemata and

processing information about the self. Journal of

Personality and Social Psychology, 35, 63-78.

Meichenbaum, D., & Gilmore, J.B. (1984). The

nature of unconscious processes: A

cognitive-behavioral perspective. In K.S. Bowers

& D. Meichenbaum (Eds.), The unconscious

reconsidered. New York: Wiley.

Miller, G., Galanter, E., & Pribram, K.

(1960). Plans and the structure of behavior. New

York: Holt, Rinehart & Winston.

Minsky, M. (1975). A framework for

representing knowledge. In P. Winston (Ed.), The

psychology of computer vision. New York:

McGraw-Hill.

Mitchell, S.A. (1988). Relational concepts

in psychoanalysis: An integration. Cambridge:

Harvard University Press.

Neisser, U. (1976). Cognition and Reality.

San Francisco: WH Freeman.

Perris, C. (1990). Cognitive therapy of

schizophrenia. New York: Guilford.

Piaget, J. (1952). The origins of

intelligence in children. New York:

International Universities Press.

Rogers, T.B. (1981). A model of the self as

an aspect of the human information processing

system. In N. Cantor & J.F. Kihlstrom (Eds.),

Personality, cognition, and social interaction

(pp. 193-213). Hillsdale: Erlbaum.

Rudy T.E., & Merluzzi, T.V. (1984).

Recovering social cognitive schemata:

Descriptions and applications of multidimensional

scaling for clinical research. In P.C. Kendall

(Ed.), Advances in cognitive-behavioral research

and therapy, vol 3 (pp. 61-102). San Diego:

Academic Press.

Ruesch, J. & Bateson, G. (1968).

Communication: The social matrix of psychiatry.

New York: Norton.

Rumelhart, D.E. (1984). Schemata and the

cognitive system. In R.S. Wyer & T.K. Scrull

(Eds.), Handbook of social cognition. Hillsdale:

Erlbaum.

Schacter, D.L. (1989). Memory. In M.I.

Posner (Ed.), The foundations of cognitive science

(pp. 683-726). Cambridge: MIT Press.

Segal, Z.V. (1988). Appraisal of the

self-schemata construct in cognitive models of

depression. Psychological Bulletin, 103, 147-162.

Shevrin, H. (1988). Unconscious conflict: A

convergent psychodynamic and electrophysiological

approach. In M.J. Horowitz (Ed.), Psychodynamics

and cognition (pp. 169-190). Chicago:

University of Chicago Press.

Slap, J.W., & Saykin, A.J. (1983). The

schema: Basic concept in a nonmetapsychological

model of the mind. Psychoanalysis and

Contemporary Thought, 6, 305-325.

Smith, E.E. (1989). Concepts and Induction.

In M.I. Posner (Ed.), The foundations of

cognitive science (pp. 501-526). Cambridge: MIT

Press.

Taylor, S., Crocker, J. (1982). Schematic

bases of social information processing. In E.T.

Higgins, C.P. Herman, & M.P. Zanna (Eds.),

Social cognition: The Ontario symposium on

personality and social psychology (pp. 81-134).

Hillsdale: Erlbaum.

Thorndyke, P.W., Hayes-Roth, B. (1979). The

use of schemata in the acquisition and

transference of knowledge. Cognitive Psychology,

11, 82-106.

Turk, D.C., & Speers M.A. (1983). Cognitive

schemata and cognitive processes in

cognitive-behavioral interventions: going beyond

the information given. In P.C. Kendall (Ed.),

Advances in cognitive-behavioral research and

therapy, vol 2 (pp. 1-31). San Diego: Academic

Press.

VanLehn, K. (1989). Problem solving and

cognitive skill acquisition. In M.I. Posner

(Ed.), The foundations of cognitive science

(pp.527-580). Cambridge: MIT Press.

Wachtel, P.L. (1977). Psychoanalysis and

behavior therapy: Toward an integration. New

York: Basic Books.

Wachtel, P.L. (1982). Resistance:

Psychodynamic and behavioral approaches. New

York: Plenum Press.

Watson, J.B., & Rayner, R (1920). Conditioned

emotional reactions. Journal of Experimental

Psychology, 3, 1-14.

Williams, J.M.G., Fraser, N.W., MacLeod, C.,

Matthews A. (1988). An information processing

analysis of the emotional disorders. New York:

Wiley.

Winfrey, L.P.L., & Goldfried, M.R. (1986).

Information processing and the human change

process. In R.E. Ingram (Ed.), Information

processing approaches to clinical psychology (pp.

241-260). San Diego: Academic Press.

Young E.J. (1990). Cognitive therapy for

personality disorders: A schema-focused approach.

Sarasota: Professional Resource Exchange.

Zajonc, R.B. (1980). Thinking and feeling:

Preferences need no inferences. American

Psychologist, 35, 151-175.