Frozen child: schema therapy for a forensic patient in a service for men with a diagnosis of severe personality disorder

Abstract

Purpose

Schema therapy has gone through various adaptations, including the identification of various schema modes. The purpose of this paper is to suggest that 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 paper is participant observer case study which is based on the personal reflections of a forensic patient who completed a treatment programme which includes schema therapy.

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.

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.

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.

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.

Citation

Lah, A.U. and Saradjian, J. (2016), "Frozen child: schema therapy for a forensic patient in a service for men with a diagnosis of severe personality disorder", The Journal of Forensic Practice, Vol. 18 No. 4, pp. 254-264. https://doi.org/10.1108/JFP-01-2016-0001