Alexandra Schosser and Liz Lacy respond to questions about how Schema Therapy can be used in therapy sessions.

Alexandra (00:01):
Okay. I think we are online now, so let’s wait for the participants to enter. Okay. Liz, thanks so much for this great presentation. I really enjoyed listening to it. Perhaps, ntil people , hve entered our room perhaps I ask a first question. How do we distinguish whether it is really addiction or narcissistic overcompensation?

Liz (00:33):
Good question. So very nice. So you, you’re going to really determine that, you know, it’s funny what I wanna say about that first, before I answer the question is sometimes even the patients coming in will ask that question, right? Because there’s such a high stigma on this particular addiction. People will say, so for example, one of my group even recently has said, how do we know that this is addiction? And I’m not just an. I have to tell you, right. That I’m not just a jerk. You know, and which is their shorthand for, how do I know it’s not just self-absorption really the best way to tell is have they tried to stop? And if they have, can they, if the answer is no, they can’t right, it’s going more toward addiction. The second piece is if they’ve had a lot of negative consequences to the behavior year and they still haven’t stopped, right?

Alexandra (01:47):
Those things are going to really lead us to much more toward addiction than entitlement. Cuz that’s what really, the question is, how do we know it’s not entitlement and it’s addiction? And sometimes it’s both, you know, sometimes it’s both particularly with the narcissist that I work with who also have the addiction you know, the mode will say they’re entitled to it, but once you get underneath the mode to the more vulnerable parts that feel the shame, they don’t really want to be doing it. So as you do the work, you really know more and or that it’s addiction rather than just a, an entitled mode. So hopefully

Alexandra (02:31):
That’s a question. Thank you ,sure. Sean wants to know if you could walk us in a bit of a greater detail through the example of creative imagery you gave, where you changed places with the patient who couldn’t stand up to the do give us a sense of the dialogue, what happened in this imagery? Thanks. sure. I certainly, sorry. I certainly see per with how we are Vivi our patients in imagery when we confront each for example, punitive

Liz (03:01):
Parents. Yes. great. And John, that’s a great question. And when I first approached this and first started to use this, I was a little bit nervous because putting myself in the imagery with the addiction, I wasn’t sure whether or not this patient was going to attach the sexuality to me or not. This is also somebody who in his, in his addiction would role play that the dominatrix was the therapist using information again, him. So it was a, it was very, very tricky. So when I, when I first started to bring in a healthy adult mode into the imagery, he, he couldn’t stand up to the dominatrix to tell her to stop and to stop the abuse and to shut off the computer. So then I came in, I came in to the image and, and I stood off to the side at first and I asked if I could speak to the dominatrix and I confronted the dominatrix, like you would a punitive parent mode.

Liz (04:25):
So there was dialogue there, but still the client was in a very subjugated state. Right. And he didn’t, he didn’t feel like he could shut off either the Dorix or me. Right. So he was in a subjugated state. So I said, David, so David, would you, would you mind if I traded places with you? And he said, okay. And he stood off to the side and I stood in front of the dominatrix and I said, I want you to provide her voice for, or me. Right. I want you to see her saying to me what she says to you and he started to do it. And he said, I CA and then he, he started saying, I can’t, I can’t, I can’t have her say that to you. And I said, why not? He said, it’s, it’s awful. It’s mean it’s terrible. I said, okay.

Liz (05:27):
So do we wanna, do we wanna tell her to stop? He said, yeah, we have to shut this off. We can’t, we can’t do this. I can’t let her do that to you. And like, that was the moment where he at least started to be able to stand up to the dominatrix because he didn’t wanna see me treated that way. It was, it was actually really beautiful moment in the, in the imagery. And then we were able to shut it off together and more and more. And we went back into that image a number of times until his healthy adult self could actually go in and shut it off.

Alexandra (06:05):
So, yeah. Great. Okay. We have another question. We have quite a lot of questions and I think we can’t address all of them right now, but the next one is from an example I wanted to ask if the impulsive child mode can be priest present, and if that’s the case, what’s its influence in sex addictions.

Liz (06:26):
So sorry. I just, some for some reason it cut out. I didn’t hear the, the very beginning of the question.

Alexandra (06:32):
I wanted to ask if the impulsive child mode can be present and if that’s the case it’s influenced in sex addiction,

Liz (06:40):
If the empathic child mode impulsive impulsive child mode. Oh. so the impulsive child mode is certainly is, can be part of sex addiction. You know, a lot of this is gonna depend on the conceptualization, right? So some people with the sex addiction are gonna have like very, very restricted upbringings where there was a lot of abuse. Others are, they were just sort of allowed to drift. Like, I think a lot of my client so much emotional deprivation, a lot of this population has it that they didn’t have a lot of parental oversight. So therefore, you know, they developed a pretty strong impulsive child mode. So a many times they, some clients will really identify with their child’s self as being the one that makes the call or gets on the internet because they started to get on the internet when they were eight years old, seven years old, because they be allowed to be alone. So that mode would therefore be present during the imagery or during the chair work. And we would either bring in themselves or another adult or me, it’s usually me at the beginning to help set healthy limits and then to deal with the anger from the impulsive child mode. So I hope that answers the question.

Alexandra (08:27):
Thank you. We have an interesting comment about the patient, but as a matter of time, I will only post the question and forward. You sure about the description of the patient? Do you have site educative material?

Liz (08:42):
Yes, but it’s it’s primarily, there are primarily things that I have put together because there’s not a, there’s not a lot about it. If anyone wants materials that I use, feel free to email me. If you have more questions that haven’t been answered today, feel free to email me at Lacey L a C Y Elizabeth Lacy com.

Alexandra (09:08):
And perhaps you could share your email address on the app

Liz (09:12):
Because oh, on the, oh yes, yes, yes. Right. Okay. Right. That would probably help. Yeah. Okay.

Alexandra (09:18):
I think we have time for, well, we have only one minute left. Okay. But perhaps I, I would still try. How do you work with adolescents with porn addiction? Probably it’s too much for one minute

Liz (09:35):
Quickly they’re less, they’re less progressed in the addiction model, right. So you’re going to be doing a lot of focus at the very beginning on meeting the original needs, decreasing shame, very, very similar. Right. But normalizing that the sexual feelings should be there. Right. And just helping them to kind of put it back in perspective that it should be that’s. I mean, it’s, it’s too hard to answer time.

Alexandra (10:06):
Yeah. This is really great. Thanks a lot. We’re unfortunately we have to finish now. I will forward you to remaining questions. Really. Thanks a lot for the great presentation and the opportunity to meet your life fear in this.

Liz (10:17):
Sure. It was fabulous. Thanks everybody. Okay. Bye.