EST/Emotional Schema Therapy

Application areas: Trans diagnostic, i.e. for depression, anxiety, anger, relationship problems.

Developed by Robert L. Leahy in 2012

EST is a treatment approach which could be integrated with any other psychotherapy model.

The model has evolved from CT, meta-cognitive therapy, ACT, DBT, CFT and ST. It looks at the client’s beliefs (schemas) about unpleasant feelings, which are often viewed as unbearable.

In EST, 14 dimensions of emotional schemas are taken into consideration: duration, control, comprehensibility, consensus, guilt and shame, rationality, simplistic view of emotions, values, expressions, validation, acceptance, blame, numbness and rumination.

People who find emotions difficult to experience may have negative beliefs in some or all of these areas. Examples are that the feelings won’t pass, are out of control, are bad, misunderstood by others, need to be avoided, etc.

A unique approach

The approach also addresses themes of ambivalence and jealousy. These beliefs can be found across various disorders.  

The model investigates concepts such as Emotional, Existential and Successful Perfectionism, Pure Mind, Constructive Discomfort and Incorporation and Containment.

Alternative explanations about emotions and coping skills are proposed for better emotional regulation, and a more satisfying life. Standard metaphors are incorporated as a therapeutic tool. Emotional schemas within the therapeutic relationship are also addressed.  

Clients are not only encouraged to tolerate negative feelings, but to positively link them to their core values. An example is to understand that sadness after a break-up as an indication of the value of relationships for the individual. The difficult feeling could thus help the individual to realise values, which could guide them to pursue what is meaningful to them.

Resources: by Stephen Holland
                    Leahy R. (2019). Emotional Schema Therapy, Guilford Press.
                    YouTube – EST: deepening the meaning of therapy part 1 & 2