Letter Writing in Schema Therapy

Letter writing is a powerful experiential exercise that we can use in schema therapy to support the work of our clients. Some clients write letters spontaneously between sessions and some appreciate having letter writing encouraged by their therapist.

Letter writing in schema therapy

Clients can find that letter writing allows them to connect more deeply with emotional experiences as they contemplate a topic alone, outside of a session. Letter writing at home can act as a useful springboard for an imagery or chairwork exercise in therapy, or as a way of consolidating the work of the session.

The amount of structure required to scaffold the task will vary from client to client. It can be supportive to begin a letter in session that clients complete once the session ends. Other individuals prefer to do the task completely independently and it will unfold naturally. There is no right or wrong way to write a therapeutic letter but the more it can flow and develop naturally the better. As a therapist it is your job to try and get the balance right - enough structure that your client feels confident to have a go but not so much structure that they’re constrained or feel a pressure to get it right.

Letters can have many functions. Here are some ideas for how you and your clients can use letter writing in your schema therapy work.

Letters from the vulnerable child mode to parents and significant carers are a very powerful way of understanding the schemas and modes that developed. Ask your client to get into the shoes of a younger version of themselves and write to their parent/carer about how they are feeling and what they need. Potential prompts:

·      What is difficult for you at the moment?

·      What worries do you have about yourself?

·      How do you feel about this person?

·      What do you want from them?

·      How does it feel to not get what you need?

·      What do you do to try and get what you need?

·      If you could be totally honest, what would you say to the recipient?

In session extension: ask your client to read their letter aloud to you. Move into imagery by asking your client to close their eyes and imagine being this younger version of themselves. Offer limited reparenting to the child and speak to the parent/carer about what the child needed.

“I was shocked at how emotional and vulnerable I felt writing a letter from little me to my dad. It just flowed out of me, which was different to sessions where I sometimes felt inhibited by my worries about what my therapist thought of me.”

Letters from a coping mode to the therapist explore how coping modes are aiming to help the client, why the client needs them, when they originated and what their intentions are. These letters tend to have a similar format to the chair work coping mode interview and help clients recognise unmet needs in childhood and the ways in which they learnt to survive.

Extend the letter writing exercise using chair work

In session extension: Read the letter aloud from the coping mode chair. Ask the client to shift perspectives to the vulnerable child chair and explore their feelings about the presence of the coping mode now and in the past.

“Writing from my cut off mode helped me to understand why I am so fearful of letting it go. It feels really risky to let other people see how I am feeling.”

Letters from the angry child mode fulfil a need to express emotions about difficult events or relationships and for the impact to be recognised. The letter is most powerful when it is addressed to the person that ‘wronged’ the individual. However, please be clear with your client that this is a therapeutic task and the letter is not to be sent to the recipient.

The process helps to highlight unmet needs, leading to greater self-awareness. The letter can help to emotionally settle ‘unfinished business’ with those people the individual doesn’t have contact with anymore or where the consequences of fully expressing their thoughts and feelings with the person directly would be unhelpful.

In session extension: Read the letter aloud from the angry child mode chair, facing a chair that represents the recipient of the letter. The therapist can sit alongside the client to support and encourage the client to fully express their anger.

“I have held onto this anger for so many years now. It felt so liberating to tell my mum how much she had hurt me and not have to worry about how she might feel.”

Letter writing from the healthy adult is a helpful and varied experiential tool for developing the voice of this mode. The table describes some of the many ways letter writing can be used from mid to late therapy to help grow this mode. Often the healthy adult letter writing exercises follow an experiential exercise, to consolidate and extend the work done in session.

Letter	Aim
Healthy Adult to Vulnerable Child	Develop compassion and rescript memories
Healthy Adult to Coping Mode	Recognise downsides and ask to step back
Healthy Adult to Critic Mode	Asserting needs and protecting self
Healthy Adult to Ambivalent Present Self	Motivate change
Healthy Adult to Parents/Carers	Acceptance and forgiveness

Following imagery rescripting in session, the client can be asked to write to their vulnerable child about the experience from childhood that has been rescripted in session. The client is asked to describe to their vulnerable child how they would rescript the event: expressing their compassion, nurturing the child, offering physical comfort, standing up to antagonists and rescuing them from the situation.

This is a consolidation exercise, as clients often need support to be the healthy adult in difficult memories, and so I suggest using this task after they have practiced rescripting from their healthy adult mode in sessions. The letter provides a platform for practising the healthy adult voice both when nurturing the vulnerable child and when asserting needs within significant relationships.

“Writing to my little child about what happened when I was young and being the person that stepped in and rescued her felt really connecting. I’ve been ignoring her for most of my life but I'm working hard to feel warmth and care towards her now.”

Therapeutic letter writing is a versatile experiential tool that can be used within the framework of schema mode work to enhance therapy. If you haven’t used therapeutic letter writing in your schema therapy work, then please invite your clients to start writing so you can see the power of this tool for yourself. If you are already using therapeutic letter writing, I would love to hear about the ways in which you integrate this into your work.

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