Introduction
Beck et al. (Reference Beck, Rush, Shaw and Emery1979) provided one of the first comprehensive clinical descriptions of a schema, employing a CBT perspective. Schemas were described as core beliefs that are primarily developed in childhood. The beliefs relate to the individual (e.g. ‘I am inadequate’) and their surroundings (‘everything always goes wrong’). When active, core beliefs influence the person's mood and style of thinking. Such schemas provide a person with a way of viewing himself in relation to other people and his world. They also allow a person to quickly assess and predict their future, and help to determine whether there are any potential threats to physical safety or self-esteem: ‘Thus, a schema constitutes the basis for screening out, differentiating and coding the stimuli that confront the individual’ (Beck et al. Reference Beck, Rush, Shaw and Emery1979, p. 13). While this description still represents the view of many clinicians (James et al. Reference James, Todd and Reichelt2009), the schema concept has been developed further by a number of therapists, such as Teasdale (Teasdale & Barnard, Reference Teasdale and Barnard1993) and Young (Young et al. Reference Young, Klosko and Weishaar2006). For example, some clinicians have taken a less negative perspective with respect to the concept, examining the positive role schemas play in both maintaining good mental health (James et al. Reference James, Kendell and Reichelt1999) and ensuring effective and efficient human functioning (Reason, Reference Reason, Fisher and Reason1988). Young's schema theory is particularly worth mentioning because it has broadened the notion of schema to include behavioural, visual and procedural features, in addition to the more standard ‘belief-orientated’ elements (Young et al. Reference Young, Klosko and Weishaar2006). This more expansive view contains some similar arguments to those being made by the authors in the present paper, although we think Schema theory fails to sufficiently utilize key ideas from some non-clinical areas, such as sport sciences.
In developing the rationale for the present paper, we begin by describing Beck's standardized CBT notion of schema, because this remains the most commonly held perspective as identified in a recent survey of clinicians (James et al. Reference James, Todd and Reichelt2009). In this view, schemas are associated with problematic rules, dysfunctional assumptions and compensatory strategies underpinning people's problems. Beck suggested that negative core beliefs in depression generally fall into two categories, either helplessness (e.g. ‘I am a failure’, ‘I am inadequate’, ‘I am weak’) or unlovability (e.g. ‘I am unwanted’, ‘I am different’, ‘I am defective’). At times of distress such beliefs can become active and interfere with the person's overall functioning: the person tends to hold these beliefs with conviction, applying them globally and absolutely. They may also filter information in a way that confirms the belief, by attending to negative information and disregarding the positive.
The relevance of such a concept to sportsmen and sportswomen is self-evident, with dysfunctional beliefs potentially having a major impact on performance. Consider beliefs such as ‘I can't handle pressure’, and ‘She's always going to be better than me’. These negative beliefs can form early on in someone's sports career, and may be re-inforced by inadequate coaching or poor practice routines (Whaley & Schroyer, Reference Whaley and Schroyer2010). For example, if someone believes they will always have a poor backhand, they may avoid using this stroke and over-compensate by training exclusively on the forehand. Whaley & Schroyer (Reference Whaley and Schroyer2010) have demonstrated the important role that self-schema play in maintenance and enhancement of sporting activities for both the young and older person. Further, a case study outlining how CBT approaches can be applied to sport is provided by Puig & Pummell (Reference Puig and Pummell2012). They describe how techniques described in Padesky & Greenberger's book Mind over Mood (Reference Padesky and Greenberger1995) may be used with an athlete experiencing negative cognitions about performance.
As the above sections show, the notion of schema ‘as dysfunctional beliefs’ has direct relevance to the sporting arena. However, because the notion of schema has also developed independently within the sports science literature, one wonders whether lessons may be learned to inform clinical practice. We believe that such investigations are particularly timely because (i) the BABCP 2012 Conference was the first occasion that full symposiums on ‘Sports and exercise’ featured in the conference programme, and (ii) the English Football Association (FA) have recently published a coaching manual stressing the influence of ‘practice’ on memory and neural-wiring in the context of skills development. The FA state that appropriate practice leads to: ‘Efficient “wiring” of nerve and muscle cells together’ (FA, 2012, p. 27). We are keen to see cross-fertilization of knowledge and ideas occurring in these fields rather than having parallel and independent developments happening in the areas of coaching and therapy.
Taking a different perspective
Before examining the sports perspective, it is worth noting that even within the clinical literature there remains much debate about the exact nature of schema (James, Reference James2003; James et al. Reference James, Southam and Blackburn2004). James et al. (Reference James, Reichelt, Freeston and Barton2007) describe schema as memories; representations laid down in the past that become reactivated under the relevant setting conditions (e.g. distress, anxiety, trauma). Note that this activation process is merely a description of the diathesis stress model. In the James et al. (Reference James, Todd and Reichelt2009) paper, schemas are described as multi-modal stored representations of a previous experience. The authors argued that schemas contain stored details about emotional, kinaesthetic, olfactory, sensory, physiological, neural and unconscious cognitive processes rather than being merely beliefs.
Similar to the Interactive Cognitive Subsystems model (Teasdale & Barnard, Reference Teasdale and Barnard1993) and the wider cognitive psychology concepts, James (Reference James, Laidlaw and Knight2008) views schemas as mental templates or memory structures both for actions and knowledge that develop from past experiences (practice). They vary in size depending on how much information the structure contains. An example of everyday schema development is the process of learning to drive a car. Initially, when first learning, the activity feels rather disjointed and each of the subunits of driving (steering, clutch control, gear stick change, etc.) requires conscious attention. Various pieces of information within the schema become active (verbal, non-verbal, sensory, etc.), but it requires practice to group the units into smooth sequences (i.e. a driving schema). Over time, these sequences will not require conscious attention but become automatic. In fact, once learned, over-focusing on the subunits (e.g. when to use the clutch) may lead to deterioration in performance. In the following discussion we will focus on views drawn from the field of sports sciences.
One of the first people to write coherently about schema was Bartlett (Reference Bartlett1932), who suggested that ‘Schema refers to an active organization of past experiences’ (p. 201). He used the notion of ‘schema’ to describe memory for movement in relation to tennis. He noted that these representations governed action sequences, but also permitted a degree of flexibility that was dependent on prevailing circumstances and environments: ‘When I make a stroke I do not, as a matter of fact, produce something absolutely new, and I never merely repeat something old. The stroke is literally manufactured out of the living visual and postural “schemata” of the moment and interrelationships’ (Bartlett, Reference Bartlett1932, p. 202).
Schmidt (Reference Schmidt1975) developed this concept into his own schema theory, which proposed that movements are performed via three processes: a Generalized Motor Programme (GMP), a Recall Schema, and a Recognition Schema. The GMP is the stored representation that governs a crude motion (i.e. serving a tennis ball, catching a rugby ball). Thus every time an individual attempts to undertake such activities, the physiology, skeletal and muscular features need to operate in unison to get our body parts into the correct position. However, because every flight of a ball varies, in order to either serve or catch successfully, fine tuning of the body positioning needs to be made prior to making contact with the ball. These adjustments are achieved via information stored in the Recall Schema. The final feature of Schmidt's theory is the Recognition Schema, which is a kinaesthetic feedback mechanism, providing information on how a particular motion feels. Schmidt saw the latter as being a crucial feature in correcting performance errors. The theory has some empirical support, but has required adaptation for different sports and environments (Lai et al. Reference Lai, Shea, Wulf and Wright2000; Schmidt, Reference Schmidt2003).
Both Bartlett and Schmidt suggest that if a person is to function well they must be able to adapt their performance to different situations and contexts. How are memories (i.e. recall and recognitions schema) elicited in such cases, when effective performance requires the triggering of the most appropriate schemas, in the correct order at the right time? Reason (Reference Reason, Fisher and Reason1988) suggests that schema retrieval can occur either via conscious recall, or through unconscious contextual cueing. In relation to the latter, the context in which the schema is triggered leads to the unconscious triggering of the next most appropriate schema in the person's repertoire. Taking soccer as an example, a goalkeeper will automatically catch a ball that is struck at him, an outfield player will attempt to strike the ball with a foot.
As described earlier, our actions and ability to perform various skills rely heavily on multi-modal memory. Having described the concept of schema from a number of theoretical perspectives it is deemed helpful to combine them within a single conceptual model (see Fig. 1). This model incorporates technical, cognitive-perceptual and psychological features, drawing directly on the notions of schema discussed above. By way of illustration, the diagram has been populated with empirical themes taken from Vrljic & Mallet (Reference Vrljic and Mallett2008) regarding some of the core-skills soccer coaches look for in young players.
Schema domains for assessing competence in soccer.
The next section will focus on the implications of using a schema perspective in order to promote excellence in sports performances, and the final section will examine how such perspectives might be of value in a mental health setting.
Implications
The relevance of the memory perspective has been recognized by the English Football Association youth programme, as outlined in its manual (FA Learning; FA, 2012). In the section on ‘The reason for practice and training’ it states:
As we develop and ‘learn’ motor skills (the ability to quicken a movement) they are stored in the brain as an Engram. This is in the pre-motor cortex of your brain [. . .]. To add a new movement to your bank of skills, it needs to be stored in your muscle memory. When your body performs a movement, nerve impulses ‘fire off’ in a given sequence. There has to be repetition of the sequence (movement pattern) over and over until that particular ‘Motor Engram’ is permanently ingrained in your ‘muscle memory’. (FA, 2012, p. 26)
Using a schema perspective in the arena of sports is also helpful in accounting for and managing difficulties when under pressure or when trying to change to a certain skill or behaviour. Indeed, rather than focusing on one area (beliefs or actions), the above model gives us the opportunity for more targeted interventions.
Every time a soccer player executes a skill, they are drawing on a stored representation of the skill. If it is a well-practised routine, the mechanics of the performance will be executed unconsciously. However, our model informs us that to be able to use the skill effectively, all aspects of the schema model need to be activated appropriately in a coherent manner in various settings and under different levels of psychological pressure.
To enable athletes to achieve such balanced activation, it is important for them not to focus exclusively on the motor skills, but develop such skills while practising augmenting cognitive and psychological routines. Indeed, while it is important to be able to strike a football well, and anticipate the movement of the goalkeeper, such abilities are irrelevant if the skill breaks down under the pressure of taking a penalty.
From our model, if we found that skills were breaking down under such pressure, it would suggest that we need to help the athlete to deal with the pressure of situations more effectively. This would not necessarily mean attempting to simulate high-pressure situations, rather it would mean actively teaching the player new coping skills during the performance of pressurized actions. For example, when working with penalty-takers, it may be found that accuracy drops when the penalty-taker is asked to perform in a match. Analysis may reveal that the previously smooth motor action is being disrupted because of cognitive interference (i.e. the player has self-doubt, and starts to engage in self-talk that is interfering with his performance – ‘I could place the ball there or maybe to the left as the goalkeeper is better diving to his right’, etc.). Such interference can lead to indecision, making him strike the ball in an indecisive frame of mind.
Consistent with our multi-modal model, to deal with this problem, one would break the penalty down into its component parts. First, we ensure he has the technical skills to kick the ball in the direction he intends to, and second, we help him develop the cognitive skills to deal with the interference. One technique to do this could be ‘mindfulness’ (Segal et al. Reference Segal, Williams and Teasdale2001); this involves helping clients to focus on movements or objects, and preventing the person being absorbed and affected by negative, self-critical thinking. In the above example of the footballer taking a penalty, this methodology teaches players to focus away from unhelpful thoughts (‘I’ll never make that shot’) and concentrate on actions.
By perceiving skills within a memory or schema perspective, we are also able to account for why athletes find it difficult to alter existing techniques and styles. A good example of this comes from golf. For example, every so often one hears of a professional golfer needing to change his technique in order to get an extra few metres on his drive. Indeed, it may have become evident during recent games that his existing style is not optimal (swing too flat, foot base too narrow, etc.). In such circumstances, the golfer needs to spend many hours practising the new swing in order for it to become the dominant schema representation of his golf swing. In memory terms, the new schema needs to be overlaid on top of the existing one. Performance is often poorer at such times of transition because the unconscious activation of the memory for the old swing interferes with the establishment of the new one. Until the new swing has become established as the dominant memory, a great deal of concentration will be required to suppress activation of the old schema.
Figure 1 may provide some guidance on establishing the transition from the old swing to the new one. Essentially, we first need to disrupt the automatic processing of the old swing, giving the schema supporting it a higher threshold of activation. In the simplest terms we are attempting to interfere with the processing of the original schema by breaking up the memory patterns. This can be done by using ‘self-talk’ techniques during the performance of golfing action (‘Just notice how stiff my arm is and how shallow my swing becomes’).
These memory concepts, and the effects of inappropriate training, are recognized in the FA's youth manual (FA, 2012). In the section on the impact of poor practice regimens, the manual states:
Inappropriate ‘fundamental practice’ will lead to bad habits or inefficient mechanics and therefore movement. These will become natural and comfortable. It is vital therefore that there is enough relevant and motivating repetition of these movements and actions to help the brain and muscles to remember what to do, eventually, automatically and without thought (Muscle Memory). (FA 2012, p. 27)
Following a period of disrupting the memory for the ‘original’ swing, we need to facilitate the development of the new schema (i.e. the swing that will eventually become the default memory – the one that should always be activated when addressing the ball on the tee). A common strategy for developing the new schema is to become aware of the changes required to convert the first technique to the second. In the present case to achieve the change, the golfer may need a slightly deeper bend in his leading arm as he swings the club. If so, a ‘self-talk/fade’ training strategy could be used during the performance of the new action. So he may say to himself: ‘Arm bend and swing’ as he practises his new stroke. In such a case, he would verbalize this action in the initial stages, and then fade the degree of self-talk over a period of time. The combination of self-talk and fading technique are well-recognized strategies in the training literature (Martin & Thomson, Reference Martin, Thomson, Luiselli and Reed2011). Once the new swing becomes established it will need to be practised in various ecologically valid conditions because evidence from the human factors literature informs us that under stress there is a tendency for people to revert to older more established schemas (Reason, Reference Reason, Harris and Morris1984, Reference Reason, Fisher and Reason1988).
Implications for clinicians
The above discussion has placed emphasis on how we can improve behaviour in a sporting context by breaking down an unhelpful schema into its subunits and addressing them in an orchestrated way. We are suggesting that examining schema structures and processes in a different field may help us to gain new insights in how to deal with schemas in therapy. For example, once we consider schemas as multi-modally stored memories, a belief such as ‘I am worthless’ will have several other forms of stored representation associated with its activation apart from the belief. Indeed, by only addressing one aspect of the schema network (i.e. the cognition) while omitting its behavioural and sensory entities, we might be leaving the person vulnerable to relapse. Therefore, in assessing a depressed person's difficulties we suggest the clinician might ask the person for any physical or sensory changes they have noticed when feeling low. One might consider extending the use of diaries to capture elements over and above the affect-cognition link
Akin to the golf example above, during the intervention phase, the task of the therapist is twofold: weakening the old schemas and establishing new ones. In addition to the normal CBT techniques of re-evaluating thoughts, the therapist might employ techniques to overlay the existing schema with a more functional one. This might involve the use of imagery, behavioural retraining, body posture retraining, memory re-conditioning techniques – all of these could be employed to change the significance of noises, scents and bodily sensations. The other thing that becomes evident is that any work to alter schemas requires practise, practise, practise, etc. Hence, a one-off behavioural experiment or an unfocused homework task will almost certainly not be effective in establishing a new schema repertoire. Further, in establishing a viable new schema, the features one wishes to promote will need to be practised in real-world settings, under the pressures and rigours of situations that previously triggered activation of the old schemas. This calls for the therapist to be more active, possibly taking the therapy out of the therapy room – and at times taking the role of a coach rather than a reflective therapist!
In summary, in theoretical terms we suggest our aim should be to ‘over-learn’ new styles of thinking and behaviour, and create new entry points for them so that they become the dominant schemas, i.e. those most likely to be activated when the person becomes depressed or anxious (Barber & De Rubeis, Reference Barber and DeRubeis1989). At the same time, activation points for the old schemas should be made less accessible, for example, through a change in routine (James et al. Reference James, Reichelt, Freeston and Barton2007). By establishing a new ‘memory’ in a range of modalities, the person is better protected against relapse. Techniques such as mindfulness training (Segal et al. Reference Segal, Williams and Teasdale2001) might also be employed to give the person some control in the event that the old schema is activated by activating a compensatory cognitive process. It has previously been noted that work used in the treatment of PTSD, which obviously deals with altering memories through the use of imagery techniques, is particularly relevant in the current context and much can be learned from the trauma literature (Hackmann & Holmes, Reference Hackmann and Holmes2004).
Mindfulness techniques have also been found to be useful in the strategy called self-monitoring. Self-monitoring refers to the ability to notice our own actions, curiosity to examine the effects of those actions, and willingness to use those observations to improve behaviour and thinking in the future. According to Epstein et al. (Reference Epstein, Siegel and Silberman2008), self-monitoring allows for the early recognition of cognitive biases, technical errors, and emotional reactions. It is important to highlight that numerous techniques commonly found in other therapeutic approaches (Schema therapy, Alexander Technique, Biofeedback, etc.) are likely to be useful in altering memories. Unfortunately, there is insufficient space to do justice to some of the potentially useful methods that already exist; however, the purpose of this paper has been to provide a rationale about how they could be brought together in the future within an agreed conceptual framework.
Finally, it is worth noting that while one can theorize about the relative merits of the various techniques described, without developing ways of measuring the impact of the approaches one is unable to assess their value. To this end, one could ask clients to adopt self-recording techniques to objectively evaluate treatment effects. Such recording has been used for many years by athletes in their attempts to improve performance (Kirschenbaum et al. Reference Kirschenbaum, Ordman, Tomarken and Holtzbauer1982). The feedback from the self-recording strategies can also serve to motivate people (therapists, clients, athletes) to adopt new approaches and refine schemas. Indeed, the value of self-observation as a way of enhancing learning is well-established, and has been used in a number of clinical settings to good effect, e.g. the treatment of eating problems (Murphy et al. Reference Murphy, Straebler, Cooper and Fairburn2010; Kong et al. Reference Kong, Beresford, Alfano, Foster-Schubert, Neuhouser, Johnson, Duggan, Wang, Xiao, Jeffery, Bain and McTiernan2012) and anxiety disorders (Craske & Taso, Reference Craske and Tsao1999; Mahoney, Reference Mahoney2013).
Conclusion
This paper has examined the value of schema perspectives in sporting and clinical practice. We believe that the memory concept is valuable both as a conceptual and training tool, providing trainers with ways of understanding, formulating and guiding performance. Uniquely, we have proposed an integrative model, drawing on different views of schema from a wide variety of specialisms. One of the key messages from the paper is the value of looking at key concepts from differing perspectives, and integrating relevant material to our current clinical practice. Whether we are a coach or clinician, we are both trying to improve our performance, making it stable, resilient and fit for purpose.
Declaration of Interest
None.
(1) Reviewing one's conceptual understanding of schemas, and recognizing the value of understanding the concept from a memory perspective.
(2) Acknowledging the role of effective practice techniques to support and consolidate clinical change.
(3) Recognizing the value of exploring the literature from related academic fields in helping to inform both our understanding and use of concepts in clinical settings.
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