Meaningful cognitiveand simultaneously experiential technique for working with deepemotional schemas, formatted in childhood, is writing therapeutic letters. Inclusions of emotion regulation skills in the treatment especially forpatients with personality disorder enhance the efficacy of CBT. Therapeuticletters are intended to extend the work of therapy beyond the consultingroom door by continuing the meaning-making that occurred in a therapeuticconversation.

We usedtherapeutic letters to help the patient identify difficult feelings, processthem in a way that maybe they could not in a therapy session, and finally getrelease and freedom from them.

Typicaltherapeutic letters are address to important close persons from thepatient life, like parents, siblings, a partner and friends, children. Thepatient uses the letter to impress his/her feeling and needs, inclusivedefenses of his rights in past and present.

Patientwrites a letter at home, and he brings it then into the session and reads it tothe therapist. These letters are not intended to be sent to thatimportant person, but to process strong emotions inside the patient.

In fact thepatient writes a letter to his inner representation of an important person,who was connected with the development of the maladaptive schemas. Theletter-writing process is inherently collaborative and enables the patient towork at his or her own pace while also facilitating patient empowerment.