International Journal of Behavioral Sciences

International Journal of Behavioral Sciences

A Phenomenological Study of the Evolutionary Roots of Schemas and Stabilizing Factors of Grief in People with Psychopathological Grief during Schema Therapy

Document Type : Original Article

Authors
Department of Psychology and Educational Sciences, Faculty of Humanities, Khatam University, Tehran, Iran.
Abstract
Introduction: Although grieving is a common response to loss, it can become pathological and destructive for some people. Understanding the significance of early maladaptive schemas, which have roots in developmental experiences and temperament, is crucial for the effective treatment of complex grief. This study aimed to conduct a phenomenological exploration of the lived experiences of individuals with psychopathological grief and to illustrate how schema therapy techniques were perceived by them during treatment.
Method: This study employed a qualitative phenomenological design. The statistical population consisted of individuals diagnosed with psychopathological grief, from which three bereaved clients were selected through convenience sampling. Each participant underwent schema therapy during 10 one-hour sessions. Data collection involved diagnostic interviews based on DSM-5 criteria, open-ended semi-structured therapeutic interviews, and observational notes. All interviews were transcribed verbatim within 48 hours and analyzed using Colaizzi’s seven-step method. Triangulation and researcher consensus were used to enhance reliability and validity of findings.
Results: characterized by control and emotional deprivation, early life experiences such as unmet emotional needs and unresolved grief, and emotional temperament were marked by anxiety and inhibition. Participants reported that schema therapy facilitated greater emotional awareness, challenged maladaptive patterns, and fostered healthier coping strategies. These effects were described qualitatively through clients’ narratives rather than measured quantitatively.
Conclusion: The findings emphasize the importance of examining the transformational roots of schemas and the stabilizing factors of grief, highlighting the effectiveness of schema therapy in treating psychopathological grief and correcting the associated schemas. In practical terms, these results suggest that schema therapy can be applied as a clinical intervention to improve emotional awareness, restructure maladaptive schemas, and prevent recurrence of grief-related symptoms.
Keywords

1.   Sadock BJ. Kaplan & Sadock's synopsis of psychiatry: behavioral sciences/clinical psychiatry: Wolters Kluwer Philadelphia, PA; 2015.
2.   Enez Ö. Complicated grief: Epidemiology, clinical features, assessment, and diagnosis. Psikiyatride Güncel Yaklaşımlar. 2018;10(3):269-79. https://www.ceeol.com/search/article-detail?id=688537 
3.   Willcox R, Moller N, Clarke V. Exploring attachment incoherence in bereaved families’ therapy narratives: An attachment theory-informed thematic analysis. The Family Journal. 2019;27(3):339-47. https://doi.org/10.1177/1066480719853006
4.   Smid GE, Killikelly C, Wagner B. Grief Disorders: Clinical, Cultural, and Epidemiological Aspects. Frontiers Media SA; 2021. p. 681523. https://doi.org/10.3389/fpsyt.2021.681523
5.   Haasl B, Marnocha J. Bereavement Support Group Program for Children: Leader Manual and Participant Workbook: Taylor & Francis; 2014. https://doi.org/10.4324/9781315798516
6.   Glad KA, Stensland S, Czajkowski NO, Boelen PA, Dyb G. The longitudinal association between symptoms of posttraumatic stress and complicated grief: A random intercepts cross-lag analysis. Psychological Trauma: Theory, Research, Practice, and Policy. 2022;14(3):386. https://doi.org/10.1037/tra0001087
7.   Wagner B, Hofmann L, Grafiadeli R. The relationship between guilt, depression, prolonged grief, and posttraumatic stress symptoms after suicide bereavement. Journal of clinical psychology. 2021;77(11):2545-58. https://doi.org/10.1002/jclp.23192
8.   Tomita T, Kitamura T. Clinical and research measures of grief: A reconsideration. Comprehensive psychiatry. 2002;43(2):95-102. https://www.institute-of-mental-health.jp/thesis/pdf/thesis-03/thesis-03-12.pdf
9.   Bryant RA, Kenny L, Joscelyne A, Rawson N, Maccallum F, Cahill C, et al. Treating prolonged grief disorder: a randomized clinical trial. JAMA psychiatry. 2014;71(12):1332-9. doi:10.1001/jamapsychiatry.2014.1600
10. Eisma MC, Boelen PA, van den Bout J, Stroebe W, Schut HA, Lancee J, et al. Internet-based exposure and behavioral activation for complicated grief and rumination: A randomized controlled trial. Behavior therapy. 2015;46(6):729-48. https://doi.org/10.1016/j.beth.2015.05.007
11. Papa A, Sewell MT, Garrison-Diehn C, Rummel C. A randomized open trial assessing the feasibility of behavioral activation for pathological grief responding. Behavior Therapy. 2013;44(4):639-50. https://doi.org/10.1016/j.beth.2013.04.009
12. Boelen PA, Lenferink LIM. Symptoms of prolonged grief, posttraumatic stress, and depression in recently bereaved people: symptom profiles, predictive value, and cognitive behavioural correlates. Social Psychiatry and Psychiatric Epidemiology. 2020;55(6):765-77. https://doi.org/10.1007/s00127-019-01776-w
13. Young JE, Klosko JS, Weishaar ME. Schema therapy: A practitioner's guide: guilford press; 2006.
14. Pourpashang M, Mousavi S. The Effects of Group Schema Therapy on Psychological Wellbeing and Resilience in the Clients Under Substance Dependence Treatment. Journal of Client-Centered Nursing Care. 2021;7(2):159-66. 10.32598/JCCNC.7.2.366.1
15. Aye E, Mehdinezhad V, Jenaabadi H. The Effectiveness of Schema Therapy on Academic Buoyancy and Academic Burnout of Medical Students. Education Strategies in Medical Sciences. 2021;14(2):20-7. http://edcbmj.ir/article-1-2076-en.html
16. Young JE, Klosko JS, Weishaar ME. Schema therapy. New York: Guilford. 2003;254:653-8.
17. Boelen PA, Bout Jvd. Complicated Grief, Depression, and Anxiety as Distinct Postloss Syndromes: A Confirmatory Factor Analysis Study. American Journal of Psychiatry. 2005;162(11):2175-7. https://doi.org/10.1176/appi.ajp.162.11.2175
18. Stroebe M, Schut H, Boerner K. Cautioning Health-Care Professionals: Bereaved Persons Are Misguided Through the Stages of Grief. OMEGA - Journal of Death and Dying. 2017;74(4):455-73. https://doi.org/10.1177/0030222817691870
19. Tappel E. The relationship of recalled adverse parenting styles with schema modes throughout inpatient schema therapy: A clinical sample of patients with complex personality disorders: University of Twente; 2021.
20. Jacobs I, Wollny A, Seidler J, Wochatz G. A trait emotional intelligence perspective on schema modes. Scandinavian Journal of Psychology. 2021;62(2):227-36. https://doi.org/10.1111/sjop.12670
21. Ahmadi F, Goodarzi K, Farrokhi N, Roozbahani M. Comparison of the Effectiveness of Acceptance and Commitment Therapy and Schema Therapy on Resilience among Patients with Cardiovascular Disease: A Pilot Study. 2021. http://doi.org/10.22037/ch.v8i4.31463.
22. Shaban M, Peyvastegar M, Khosravi Z. The effectiveness of the localized model of schema therapy on changing the schema of therapists. Journal of psychologicalscience. 2021;20(100):511-20. https://psychologicalscience.ir/article-1-821-en.pdf
23. Tanbakouchian R, Zanganeh F, Bayat MR. Compare the Effectiveness of Emotion-Focused and Schema Therapy Approaches on Ambiguity Resilience, and Self-Control of Women with Marital Burnout. Journal of Research in Behavioural Sciences. 2021;19(1):1-12. 10.52547/rbs.19.1.1
24. Bidari F, Amirfakhraei A, Zarei E. Effectiveness of Schema Therapy on The Irrational Beliefs and Emotional Self-Regulation of the Women with Marital Conflict with Early Maladaptive Schemata. Psychological Achievements. 2021;28(2):241-64. https://doi.org/10.22055/psy.2021.35143.2602
25. Hemmati Sabet V, Hoseini SA, Afsharinia K, Arefi M. Comparison of the effectiveness of schema therapy and dialectical behavior therapy on temperament and character dimensions and cognitive emotion regulation strategies in patients with HIV. Iranian Evolutionary and Educational Psychology Journal. 2021;3(2):138-47. 10.52547/ieepj.3.2.138
26. Aalami M, Taimory S, Ahi G. The effectiveness of an integrated approach of schema therapy based acceptance and commitment therapy on marital conflicts and divorce tendency in divorce applicant couples. Journal of Research in Behavioural Sciences. 2020;18(1):132-41. DOI: 10.29252/rbs.18.1.132
27. Shute R, Maud M, McLachlan A. The relationship of recalled adverse parenting styles with maladaptive schemas, trait anger, and symptoms of depression and anxiety. Journal of Affective Disorders. 2019;259:337-48. https://doi.org/10.1016/j.jad.2019.08.048
28. Louis JP, Wood AM, Lockwood G. Psychometric validation of the Young Parenting Inventory-Revised (YPI-R2): Replication and Extension of a commonly used parenting scale in Schema Therapy (ST) research and practice. PloS one. 2018;13(11):e0205605. https://doi.org/10.1371/journal.pone.0205605
29. Louis JP, Wood AM, Lockwood G. Development and validation of the Positive Parenting Schema Inventory (PPSI) to complement the Young Parenting Inventory (YPI) for schema therapy (ST). Assessment. 2020;27(4):766-86. https://doi.org/10.1177/1073191118798464
30. Yu T, Hu J, Zhang L. Parental Bonding and College Freshmen’s Depression Symptoms in China: The Mediating Role of Neuroticism. 2022. DOI: https://doi.org/10.21203/rs.3.rs-1279092/v1
31. Yavuz BB, Aka BT. The mediating effect of humour in relation to early maladaptive schema domains and psychological wellbeing. 2021. DOI:10.5505/kpd.2021.21548