Schizoid personality disorder

Schizoid personality disorder is an extreme degree of the schizoid personality type. It develops if a schizoid person grows up in particularly unfavorable conditions. I have already written about the schizoid personality type, today I will write about schizoid disorder and its causes.

Schizoid personality disorder is included in both the American Psychiatric Association DSM 5 and ICD 10 classifications, which are most often used by domestic psychiatrists. Although I usually prefer to use the DSM, this time I will rely on the signs described in ICD 10, since there are more of them.

According to ICD 10, a diagnosis of schizoid disorder can be made if a person meets at least four criteria. I would say that any person with a schizoid personality type corresponds to four signs. A pronounced radical is not yet a personality disorder. In my opinion, schizoid disorder should be suspected if you meet 7-9 criteria.

Schizoid personality disorder: criteria

Few things are enjoyable. This means that there are very few activities to do, and maybe even just one activity that makes you happy. We are talking about a permanent property, and not about a temporary depressive period.
You are considered emotionally cold, distant, and show only a small range of emotions. You may have a lot of feelings for others inside, but you usually don't show them. People in a new company do not approach you; you usually sit in a corner alone. You may be told that you look arrogant or that you think you are smarter than those around you (you may indeed think so).
You are bad at expressing both tender, warm feelings towards others and anger at them. You may feel like an emotionless robot when you need to praise someone or tell them how you feel about them. People may think that you never get angry and that you are a very calm person. You really almost always hold back your emotions. In close relationships you can be very emotional, but not with friends and acquaintances.
When you are praised or scolded, it seems that you don’t care, you don’t show your feelings. Or you may actually not enjoy praise and not be upset by criticism, even within yourself.
You have little interest in sexual contact with other people.
You prefer to do almost everything alone. Other girls are teaming up to go to lunch together in the cafeteria, but you don’t understand why this is necessary, you can go alone. Coordinating your work with other people is difficult for you, so you prefer activities that you can do alone. You would rather read a book than go to a bar.
Excessive introspection and fantasizing. This means that it is as if there is an observer in your head who looks at your actions from the outside and analyzes them. You think a lot about your own and other people’s motives, about the events that happened. Internal dialogue does not torment you, it is familiar. You often imagine various unrealistic situations and spend a lot of time in these fantasies.
Lack of close friends (no more than one) or trusting relationships and unwillingness to have them. I don’t agree about the reluctance of schizoid people to enter into relationships. I have not yet seen a single schizoid person who did not suffer from loneliness and for whom people did not matter much. But yes, there may be no friends at all. There may not be a loved one. Most likely, a person with schizoid disorder has no more than one person with whom he communicates closely. Or maybe there will be no one at all (except relatives).
Unintentional disregard for social norms, lack of understanding of conventions and accepted rules. You often feel like you've fallen from the moon and don't understand basic things about social interaction. You wonder why people behave the way they do. It is difficult for you to take into account the hierarchy; you do not care how you dress.

What is the final result of diagnostics using R. Cattell’s method?

The methodology is represented by 105 professional questions. The questionnaire allows you to accurately diagnose the individual traits of a particular person, called “constitutional factors,” according to the method of R. Cattell. A prerequisite for diagnosing a patient is limited time. The technique allows us to identify the emotional, intellectual, and communicative properties, including the ability to self-regulate, of the diagnosed individual.

Thus, the psychologist receives the final result in the form of a psychographic profile of the individual.

This professional program is used in the work of various specialists: psychologists, teachers, doctors, personnel specialists, psychotherapists.

Other signs of schizoid personality disorder

The famous American psychoanalyst Nancy McWilliams wrote that classifications of diseases, such as the DSM, include only a short list of the most obvious, verifiable signs that the maximum number of people with a given disorder have. Psychotherapists in their practice usually use less obvious, but significant signs of personality disorders.

Schizoid personality disorder is most manifested in communication problems. The person seems to have difficulty understanding the small nuances of relationships, which is why he has to rely heavily on reason and logic. It's not clear how to get close to people. Why does everyone succeed in this easily, in any new group people laugh together and trust each other already on the second or third day, but you cannot even trust those with whom you have been communicating for many years?

It’s as if you are always tense and expect bad things from people, indifference, devaluation, attempts to suppress, a sharp change in attitude towards you. To avoid this, you use an avoidance strategy. You move away, become silent, move away, don’t come closer. This is a constant strategy, you will never be caught casually talking with someone.

You feel like other people are communicating at a different speed. That they rely on something in communication that you cannot rely on. You see that other people react to you in an unusual way, not the way they react to others, but you don’t know what causes it. As a result, you get used to having a lot of control over your facial expression, and most often it is blank and expressionless. Perhaps you really want to be closer to other people, but you don't know how to do it.

Diagnostics

Diagnosis of SPD mainly involves a psychopathological examination of the personality. To do this, the psychiatrist conducts testing and evaluates the result using diagnostic scales (ICD 10).

Various information about the patient is also important for making a diagnosis:

Objective anamnesis - questioning relatives, acquaintances (teachers, classmates), analysis of medical documentation;
Subjective analysis - clinical interview. The psychiatrist conducts a questioning of the patient, creating the most confidential atmosphere.

Questions stimulate the patient to tell his own story. The doctor delicately directs the conversation in the right direction. The anamnesis is collected according to the principle - from past to present. This allows us to establish that schizoid psychopathy manifested itself already in childhood. But at the moment, the symptoms have reached extremes, which interferes with the patient’s adaptation to society.

The study of cognitive functions in persons with schizoid psychopathy reveals a number of abnormalities. The cognitive profile differs from mentally healthy people. However, it is not similar to the cognitive impairment associated with schizophrenia.
Psychological diagnosis of cognitive impairment in personality disorders: a model of schizoid disorder / D. V. Romanov, A. A. Shishova – 2010. – 463 – 464 pp.

Laboratory and instrumental diagnostic methods are prescribed to differentiate the diagnosis:

EEG;
MRI or CT;
Hormonal screening.

In children, schizoid psychopathy manifests itself in the form of inappropriate behavioral reactions. Therefore, the sooner parents seek help from specialists, the more favorable the prognosis will be.

Schizoid and psychologist

As a psychologist, I observe that people with schizoid personality disorder tend to look away when talking about something. They can tell a lot. They have a lot of introspection and are eager to share it. They appreciate it when you give them a new idea. Even if they don't agree with it, they will remember it and think about it.

The most important problems that concern them are a constant feeling of insecurity and problems in communicating with people. These are interconnected problems, since it is people who pose the greatest danger. You can't be safe with them, you can't relax.

Moreover, it is typical for schizoids to always look for the reason within themselves. They are characterized by a request for therapy, such as: “My relationship is not working out, help me understand what I’m doing wrong.” Unfortunately, this comes with a constant feeling of “something is wrong with me.” It usually takes a lot of work for a schizoid to begin to notice the other person's contribution to conflicts and problems in the relationship.

Transference and countertransference

Schizoids avoid any form of intervention. The work of a psychologist should be structured in doses. However, with sufficient trust in the psychologist, they can create a fairly effective working alliance.

These clients may seek help because their isolation from society may be painful, or they may seek different social behavior.

One of the popular requests of schizoids to a psychologist is to work with depressive states. Or they may fear that they are on the path to madness, especially if those close to them do not understand the way they think or do not share their values.

A schizoid needs time to feel safe in a psychological setting.

It is important for a psychologist not to intrude and to work gradually with such clients. It is important to understand that it is often possible to hear complex, confusing messages from schizoids; they may not understand themselves.

Such a client may be afraid of emotional distance from the psychologist or other people. Although he prefers to leave them at some distance from himself.

They can present themselves in communications as an unattainable sage or an enlightened lama.

Schizoid personality disorder: causes

I will start with the reasons for the formation of the schizoid personality type. It is formed in the first six months of life and is associated with the inability of the mother to emotionally merge with the child. For some reason, the mother does not learn to understand the child intuitively with the help of mirror neurons, but unconsciously tries to avoid communication with him.

If there is no intuitive connection, the mother has to rationally guess why the child is crying, what he needs now. This fit is never exact. The connection between mother and baby is normally built on unconscious reactions and reflections of each other's emotions. If there is no precise fit, the baby's anxiety level increases.

This early anxiety underlies later insecurity problems. Schizoids' problem with insecurity is not related to traumatic events or betrayals. It is associated with numerous, everyday manifestations of indifference and neglect.

In addition, the absence of the mother’s accurate reflection of his emotions, which the baby needs, creates the feeling that the mother does not like the child, that he is somehow bad. This feeling of one's own badness is different from the narcissistic feeling of one's own insignificance, which develops much later.

In the future, everything depends on whether the schizoid child will have a loving relative, for example, a father or grandmother, who will show him attention and love until he grows up. It is very important what kind of relationships a child develops among his peers. A narcissistic environment is especially harmful for a schizoid child.

If communication with a group of peers at school does not work out, the schizoid will withdraw from communication. His communication skills will suffer greatly. Not having enough nonverbal communication with the mother in infancy already creates a poor foundation for communication. But if the group of peers does not fill the gap, then problems with communication in the future will be very serious.

As a rule, schizoid personality disorder is expressed in the desire to communicate with people only on the basis of the specific, unusual interests of the schizoid himself. Small talk, mutual fun and laughter will remain the most difficult things for a schizoid person, and yet, ultimately, most of the friendly contacts are built on them.

Psychological theories and schools

In the works of many psychiatrists one can find reflections that patients with personality disorders that are on the border between health and illness do not pose a danger to society and many of them are able to recover.

Descriptions of these patients are contained in the works of F. Pinel, a French physician and founder of psychiatry in France in the 17th century. An attempt to classify mental disorders can be seen in the works of D. Pritchard, an English doctor who lived in the 19th century.

The works of the Russian psychiatrist F.I. Herzog, published in 1846, indicate the connection between mental illnesses and heredity and the possibility of their cure. Progress in this area was made thanks to the works of the German psychiatrist W. Griesinger (1886) and G. Modelli (1871), who identified people with psychopathic conditions from the category of degenerative psychoses into a separate group.

In Russian psychiatry, the description of borderline states belongs to many scientists: V. M. Bekhterev, S. A. Sukhanov and many others. The scientist V. H. Kandinsky connected the formation of psychopathic characters with congenital mental anomalies.

V. M. Bekhterev noted that changes in the structure of the brain occur due to illnesses and personality defects.

Many psychiatrists have been involved in the systematization and classification of psychopathic personalities. Thus, E. Kretschmer created a classification based on the principle of “movement from illness to health.”

It is based on two polar groups:

endogenous psychoses, which included schizophrenia, manic-depressive psychoses;
personality anomalies, where various types of personality deviations, schizoids and cycloids were considered.

In Russian psychiatry, the classification created by P. B. Gannushkin has become widespread. In his works, psychopathic types received clinical definition.

According to a psychiatrist, schizoid traits in a person can develop to a borderline state between health and illness. But the presence of schizoid manifestations does not yet predetermine the occurrence of a state of psychosis.

Treatment of schizoid personality disorder

Schizoid personality disorder is treated with non-drug psychotherapy. Initially, I recommend individual psychotherapy. With schizoid personality disorder, it usually takes several years until results begin to bring changes in life. But if you also have borderline personality disorder, then you see results quite quickly.

After a year, two, three, I usually advise adding group therapy. Group therapy brings enormous benefits to schizoid people. This is where the missing communication skills are obtained. Personally, I recommend group gestalt therapy with a good, fairly safe trainer. Tough, provocative methods and trainers will not work.

But here you need to rely on your desire and willingness to be in a group. If you feel that it instills great fear in you or you do not see any meaning in it for yourself, then you should postpone this method or abandon it altogether.

The main part of the work is to expand our understanding of the motivation of other people’s behavior, our own inner world, our own and other people’s emotions. This is a slow, painstaking work of differentiating different psychological manifestations and finding meaning.

If you think you may have schizoid personality disorder and would like to change something in your life, you can contact me. I work quite a lot with schizoid people, especially women. Help from a psychologist for schizoid personality disorder

Inner world

Cold, inert, restrained on the outside, schizoautists are liberated and active on the inside. Their inner world is excessively rich. It seems that the patient’s emotional flow has lost its course and goes not into the outside world, but into the depths of it.

A person with such a disorder sees the world differently, with an original approach.

The man refused to eat raisins. Even the sight of dried fruit was disgusting to him. The reason for the whim is that the raisins reminded the “original” of a fly.

In each object, an autistic person, as patients with DS are also called, reveals an unlimited number of properties and possibilities, sees what others do not catch. She is able to look at things with a new perspective. By generating new, non-standard ideas, these individuals become creators and innovators.

Schizoid patients look at the world with different eyes. They evaluate the surrounding reality through their own special schemes and filters. Sometimes the conclusions of patients with SPD contradict reality. But they don’t care much about this - schizoids will stubbornly stand their ground. To express their reaction in this situation, Hegel is usually quoted: “So much the worse for reality.”

Wherever he is, the schizoid patient forms his own reality. He lives by his own laws, which determines antisocial behavior and withdrawal into himself. However, he can successfully adapt to the environment through the assimilation of recognized rules and norms of behavior.

With schizoid disorder, people tend to find unusual hobbies, plunging into them headlong. Among them there are collectors, athletes, inventors, lovers of historical facts, and specialized languages such as Chinese or Sanskrit. Original schizoids usually do not talk about their hobbies, avoiding ridicule and reproach.

Schizoid individuals are capable of becoming successful and socially useful. They make talented artists and inventors, scientists. But they can also be completely useless. This applies to eccentric craftsmen who invent a lot, but it is not clear what, or collectors of useless things.

Autistic individuals do not seek to bask in the rays of fame or pursue material wealth. In professional activities, they are passionately involved in what they love. But if they lose interest in it, they don’t stay in the workplace. Rejection of social rules complicates relationships in a team. Patients do not obey other people's laws, they do what they consider necessary. However, if such people find a loyal boss who is ready to tolerate their idiosyncrasies in exchange for fruitful work, a progressive union is born. However, many people with this disorder are not able to work under someone else’s supervision at all.

Another mandatory feature of a schizoid personality is withdrawal into fantasy. It replaces live communication. Fantasizing in schizoids is a protective and compensatory mechanism. In fantasies, they give free rein to their feelings, idealize and embellish their world.

Lack of emotional response to another person causes problems in the sexual sphere. Schizoids are accompanied by sexual apathy. The need for intimate relationships is reduced. This is due to the fact that such intimacy presupposes close emotional contact between partners, and affectively limited people are afraid of this.

The sex life of patients with SPD follows several scenarios:

avoidance of sexual relations;
frequent change of partners, one-night stand.

Many people do not start a family life or the husband starts an intimate relationship on the side. This allows him to reduce the emotional impact during intimacy.

If a person avoids physical contact, he goes into erotic fantasies or sexual perversions. Among schizoids there are sexual sadists. By hurting their partner, they try to provoke a negative reaction from him in this way. This eliminates the possibility of repeated contact with the former partner.

Definition

The schizoid type is a person cut off from reality who carefully protects personal space. What is important to him is the potential opportunity to spend a certain period of time alone, locked in his room. He will not qualify to live together with a partner in the same apartment. In his understanding, rare but regular meetings are the best option for maintaining a romantic relationship.

Psychologists believe that people with a schizoid type of character accentuation have reduced reserves of energy resources, which forces them to limit the number of aimless, meaningless, unprofitable contacts. They cannot stand and in every possible way avoid empty, pointless conversations, long-term conflicts, superficial communication without far-reaching prospects, and psychological manipulation.

Relationships with others

It is extremely important for women of a schizoid type to have the opportunity to retire in their own corner, since a large company irritates them and quickly tires them. If their personal boundaries, including physical ones, are violated, they can give an unpredictable, severe reaction. This is explained by their innate ability to stay away from others, to distance themselves from them in order to maintain their own peace and integrity.

Very often, a schizoid woman limits herself exclusively to work contacts, since it is not typical for her to acquire friendly connections and acquaintances. She is very difficult to establish friendly intimacy, easily breaks off contacts and, in fact, does not need them. Having little social experience, such a lady tends to distrust people, which is also reflected in new acquaintances.

In a work collective, a schizoid young lady can be easily recognized by her detachment, low activity in discussing work issues and restraint, amounting to coldness and formality. Such traits are often regarded by others as arrogance. All this often prevents schizoid women from achieving professional heights, since they tend to ignore the communication aspect in the work process.

If someone manages to “break through” the “defense” held by a schizoid and become a close person for her, such a friend can count on devotion and warmth. She never forgives betrayals, as well as betrayals.

Appearance and attitude to things

The way a schizoid woman dresses can rather be called strange. She can either mix a “cocktail” of incompatible styles into her outfit, or prefer nondescript, extremely modest clothes, which she wears, regardless of the setting and situation, be it a wedding ceremony or a walk in the yard. Being a born individualist, a young lady of this type will never sacrifice her comfort for the sake of social demands. If your favorite jeans look inappropriate at a celebration, she is unlikely to be concerned about this circumstance.

A certain sloppiness is very characteristic of schizoid women. You don’t need to renew your nail polish for a couple of months, and a sloppy ponytail instead of a neat hairstyle is the most common thing. You don’t have to pay any attention to appearance, because the main thing is not the form, but the content, the schizoid woman believes. It’s much easier to cover a stain on your trousers with a long jacket than to urgently change clothes and wash it - it’s so tedious, and why?

Sloppiness in clothing is complemented by the same chaos in everyday life. A schizoid woman’s apartment is her refuge, where only her rules reign. The dishes after dinner can be washed when the sink is overflowing, and rubbing the floors is pointless, since the dust also wants to rest and lie quietly - there is no need to disturb it. The next morning, a schizoid woman will put on the socks that she finds first, having completed a whole quest through a cluttered apartment. Her workplace will again not deviate from the general rule: in the eternal creative chaos that irritates everyone around, she herself can navigate perfectly.

Despite such disorder, schizoid women become strongly attached to their few but very beloved things, which are very difficult for them to part with. In old age, when this trait becomes more pronounced, schizoid “dens” become like a dump of all sorts of unnecessary things, but the Plyushkin ladies will never allow one of their relatives to clean up all this rubbish.

Treatment methods

To treat borderline conditions, antidepressants and antipsychotics are used, as well as drugs with nootropic effects and vitamin complexes. The doctor selects the type of drugs, dosage, and duration of therapy. Non-drug treatments include:

Diet food.
Sleep deprivation (limitation of duration).
Water procedures (contrast shower, water hardening).
Lateral therapy (zonal-lateral electrical stimulation - directed change, modulation of interaction between the hemispheres of the brain).
Physiotherapy.
Physiotherapy, reflexology.
Psychotherapy.

Treatment is indicated if people of the schizoid type experience difficulties in social adaptation that interfere with professional activities and personal life. In most cases, no correction is required. In order to communicate meaningfully and live comfortably next to such people, you need to be able to find an approach to them.

Relationships with the opposite sex

In relationships with the opposite sex, a woman of the schizoid type can be unpredictable. Fearing a violation of her inner peace, she is able to completely erase the annoying boyfriend from her life without explaining the reasons. A schizoid woman generally tends to easily give out reactions of escapism, running away from any traumatic situation.

A partner can count on reciprocity only on the condition that he is as patient, caring as possible and able to see behind the feigned cynicism - a common protective mask of schizoid women - a fragile and vulnerable, but extremely rich and amazing inner world.

If the partner is not distinguished by such sensitivity, insight and attentiveness, the schizoid may settle on the strategy of unemotional physical intimacy. The couple lives together, but for the man, the feelings and internal state of his detached partner remain a sealed secret. He can’t shake the feeling that she is “a cat walking on her own.”