The Importance of Attachment Theory in Schema therapy

Many schema therapists find it challenging to work with clients experiencing chronic relationship difficulties. This is often due to significant treatment resistance, much of which is rooted in painful early and adult relational experiences. Importantly, much of this resistance is linked to characterological problems—especially insecure attachment styles. Around 35–40% of the general population have an insecure attachment style, a figure that rises to nearly 80% in clinical populations (Carr et al., 2018). Our own research (Karantzas, Younan, & Pilkington, 2022), drawing from studies of over 3,000 individuals, shows that people with insecure attachment styles are 2–3 times more likely to endorse early maladaptive schemas (EMSs). In this presentation, we draw on models of attachment system dynamics, measures for assessing attachment, and research in the field of adult attachment and early maladaptive schemas to discuss how attachment patterns are associated with EMSs. We extend on this foundational work to provide insights regarding case conceptualisation, assessment, and treatment that can leverage the work of schema therapists, especially when working with clients who experience chronic relationship issues.