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,






        Key Words:  Schemas, Cognitive science, Psychotherapy





        Running Head:  Schemas and Integration




        Acknowledgements:  Several anonymous reviewers deserve thanks

        for their extremely helpful comments on earlier drafts of this















               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.









               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,




                   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.




               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,




                   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).








               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




                   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




                   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




               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




               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.




                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.




               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.




               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






                  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.




                   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




                   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




                   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




                   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.




                   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.


































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