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Susan Simpson

Susan Simpson

Susan Simpson, is a Clinical Psychologist at NHS Forth Valley Eating Disorder Service. She is Director of Schema Therapy Scotland, and Co-director of the Global Institute of Eating Disorders. Susan has provided training in Schema Therapy for over 20 years, and is actively involved in research in this field, with a particular focus on improving treatments for people with complex eating disorders and on therapist wellbeing. She has a longstanding interest in the nexus of human well-being and connectedness to nature. She is co-author and editor of Schema Therapy for Eating Disorders (Routledge, 2019) and Cambridge Guide to Schema Therapy (Cambridge University Press, 2023).  Her publications can be found at

  • Coping Modes in Disguise: Working with ‘Pseudo Vulnerability’.

    Co-Presented with Limor Navot

    One of the superpowers of schema therapy is reparenting. It is the depth of warmth, nurturance, and attunement we provide that helps heal our client’s schemas. But what happens when we unwittingly fall into the trap of reparenting a coping mode?

    Some coping modes can present a ‘false’ presentation of vulnerability. They can elicit powerful countertransference dynamics within us and the teams we work with. We can find ourselves with long-term clients who seem stuck, without any real work happening, and with no end point in sight. Other signs may include guilt feelings, an urge to find solutions, to work harder, or to ‘rescue’ our clients from their suffering and despair.

    These modes do not want to be challenged and are very powerful in disarming us from using empathic confrontation techniques. We may find ourselves tip-toeing around due to fears that the client is too fragile or that we are harming them. In this skills class, we will learn how to tell the difference between genuine child modes and pseudo vulnerability modes (among which, Complaining Protector, Attention/recognition seeking, Self-pity/victim, and a new mode: Helpless Surrenderer).

    We will demonstrate the use of empathic confrontation to bypass these modes, emphasizing the importance of tuning into our own countertransference reactions as a guide for interventions. This skill class, based on our recent article (Simpson & Navot, 2023) will provide therapists with the opportunity to identify and work therapeutically with pseudo-vulnerable modes and to reach the underlying authentic Vulnerable Child mode.

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