Jacqui Saradjian
Director, 1,2,3 Working Together, UK
Title: Working with schema therapy to make significant therapeutic breakthroughs for forensic patients in a service for men with a diagnosis of severe personality disorder: Recognising the frozen child and strategies to ‘thaw’ him/her
Biography
Biography: Jacqui Saradjian
Abstract
Purpose: Schema therapy has gone through various adaptations, including the identification of various schema modes. This workshop suggests there may be a further dissociative mode, the ‘frozen child’ mode, which is active for some patients, particularly those that have experienced extreme childhood trauma.
Design/methodology/approach: The workshop is based on a participant observer case study including the personal reflections of a forensic patient who completed a treatment programme which includes schema therapy. This is backed up by various clinical case studies in which this concept has been used therapeutically.
Findings: The proposed mode, “frozen child”, is supported by theoretical indicators in the literature. It is proposed that patients develop this mode as a protective strategy and that unless recognised and worked with, can prevent successful completion of therapy. Using this concept therapeutically has led to significant therapeutic progress with those patients.
Research limitations/implications: Based on a single case study, this concept is presented as a hypothesis that requires validation as the use of the case study makes generalisation difficult. Nevertheless, supported by the clinical case studies it raises many interesting issues for consideration and discussion.
Practical implications: It is suggested that if validated, this may be one of the blocks therapists have previously encountered that has led to the view that people with severe personality disorder are “untreatable’. Suggestions are made as to how patients with this mode, if validated, can be treated with recommendations as to the most appropriate processes to potentiate such therapy. This will be discussed with regard to several clinical cases, including any cases brought by those attending the workshop.
Originality/value: The suggestion of this potential “new schema mode” is based on service user initiative, arising from a collaborative enterprise between service user and clinician, as recommended in recent government policies. The workshop will give a unique opportunity to have dialogue with an ex-offender who has completed the UK Offender with Personality Disorder Pathway from High Security to the community and, having genuinely changed, is now able to articulate the process of that engagement and change and what had previously stopped him and his peers from genuinely engaging with psychological services, along with a highly-experienced therapist who has written and delivered these programmes with outstanding results.