What is schizoid personality disorder (SPD)?
Schizoid personality disorder (SPD) is a pathological condition manifested by a combination of disharmonious characteristics of an individual, included in the DSM-5, ICD-10 and CCMD-3 classifiers.
They determine the personality structure, often congenital or acquired during life. Features of SPD are a tendency to immerse oneself in one's own fantasies, emotional alienation. Prevalence in the population is 3-5% (according to DSM-5). The final definition was introduced by Ernst Kretschmer in 1921. A German psychiatrist suggested a causal relationship between this personality disorder and schizophrenia. However, further foreign studies refute the theory. Domestic guidelines indicate that before the onset of the disease, approximately 40% of people had SPD.
Currently, the term “schizoid” is descriptive exclusively for this syndrome, that is, it is not identical to “schizophrenia.”
Facial expressions are devoid of liveliness and are limited to a set of standard expressions. The voice is little modulated, which is why the conversation is often conducted as if on one note. Clothing is stylized - it is either emphasized sophistication, aristocracy, or, conversely, deliberate negligence. Schizoids are people of extreme feelings and emotions; they either admire or hate. The hobbies of schizoids are most often peculiar, even original, and, as a rule, one-sided. The social significance of hobbies varies: for some, all their strength, thoughts and energy are directed towards achieving unimportant goals (for example, collecting); others, on the contrary, show remarkable energy and perseverance in creating sometimes very talented and valuable scientific concepts. However, in both cases, they remain completely indifferent to the needs of practical life, everyday interests, and the needs of the family.
Smulevich A.B. ‹‹Borderline mental disorders›› Schizoid personality disorder.
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.
Causes
It is impossible to identify the exact reasons for the formation of a schizoid personality type; research is still ongoing. The following risk factors are expected:
- genetic, that is, congenital, characteristics of the individual;
- the presence of any mental spectrum disorders in close relatives - the theory of hereditary predisposition;
- environmental factors - social status, local mentality, characteristics of growing up;
- the nature of the relationship of parents or guardians to the child in the process of personality formation;
- the cumulation of experiences from early childhood to the present - stress, fear, loneliness, neglect from others, any type of violence.
It is not possible to talk about a single etiology, since the topic remains poorly studied even in a professional environment. Therefore, you should not specifically look for the most “convenient” reasons that explain the characteristics of a particular person.
Each clinical case should be reviewed by a psychiatrist, who will be able to determine the individual set of prerequisites that served as the impetus for the formation of SPD.
Main features of schizoid accentuation
The first and main sign that distinguishes such people from everyone else is the lack of desire and ability to communicate with people around them. Moreover, this happens not because a person with schizoid accentuation cannot do this, but because he simply does not want it. That is, the need for any communication is completely absent. Instead, they prefer to be alone with themselves, to withdraw into themselves, in search of some answers to inexplicable questions. And such a life suits them completely.
Signs and symptoms of the disorder
Clinical signs of schizoid disorder are not always the same, since individuals are formed under the influence of different environmental factors. A person with SPD may have the following traits:
- decreased or lack of emotional understanding – weak empathy;
- is more respectful of other people's personal boundaries;
- interests and hobbies are related to solitude;
- reluctance to maintain active social contacts;
- care little about the opinions of others, but prefer honesty, pragmatism, and sincerity;
- does not like excessive attention;
- prefers non-contact forms of communication;
- does not tolerate talking about “nothing”, lies, hysterics;
- self-sufficiency in introversion, loneliness, isolation;
- tendency towards introspection - “immersion in oneself”;
- awkwardness, discomfort in the presence of a large number of people;
- a tendency to choose theoretical, exact professions, as well as those related to art and philosophy;
- non-standard, eccentric behavior - a strange choice of clothing for most, indifference to praise or criticism, a different perception of banal things from others;
- less sensitive - physical touch does not bring much pleasure;
- often, but not always, a weak sexual constitution, low sexual activity;
- there is no paranoia, distorted perceptions or cognitive impairment.
Social distancing is seen as a protective mechanism. People of this type often have a richer world of their own fantasies, developed abstract thinking, and a special perception of things invisible to others. They often prefer the company of animals, solitude in nature, and quiet places to live. A striking example of schizoid personalities are the following characters: Sherlock Holmes, Gregory House or Batman.
In men
Such men give the impression of being dispassionate loners, devoid of a sense of humor. At the same time, they are able to maintain a sufficient level of social activity, which is required for work or normal life activities.
Unlike autistic disorders, schizoids understand the emotions and feelings of other people, but do not strive for them, as they experience discomfort.
Outwardly “cold” behavior does not mean a lack of desire for at least minimal affection. Schizoids rarely marry, but from time to time they can find partners who respect their emotional boundaries. At the same time, they are more sensitive to separation, experience it more acutely and longer.
Among women
According to Russian guidelines, the schizoid personality type is half as common in women as in men (1:2). American classifiers (DSM-IV, DSM-5) do not provide reliable epidemiological data. The exact prevalence of SPD in the population is unknown, let alone the strong gender differences.
Schizoid women are full of contradictions. Feeling self-sufficient in their detachment, they may need a partner. On the surface they are unemotional, but inside they are impulsive, bright, imaginative personalities.
The priority in the life of such girls is not marriage, but personal comfort. They choose calm men or women who respect introversion. Often, schizoid individuals prefer impersonal sexual contacts by agreement, not allowing anyone to approach their inner “I”.
Object relations
The subjective life of schizoids is permeated with ambivalence regarding attachment. They crave intimacy even though they feel threatened by others. They seek distance to maintain their safety, but at the same time suffer from remoteness and loneliness.
The message of schizoids to the world looks something like this: “Come closer, I’m lonely, but stay at a distance, I’m afraid of being absorbed by you!”
These people are often indifferent to sex, but are able to have an orgasm; physiologically they are completely healthy. Selective in choosing partners, it takes more time to “warm up”. The closer the other person is, the more they perceive that sex means a trap. They are wary of any new connections. However, they may desire unattainable sexual objects, but are indifferent to the available ones.
The upbringing of these individuals could proceed in the pattern of “a schizoid man and an over-caring, suffocating mother.” Mom, most likely, “ruled the show” and controlled all processes in the family. A boundary-violating mother and an impatient, critical father. The child may be in a state of double clamping and emotionally false messages. We depend on care to protect our own “I” from approaching them. The double clamp manifests itself in the fact that one message is demonstrated verbally, and the child perceives another non-verbally. "I love you very much!" mother tells her little son, who has been waiting for her from work for a long time. And non-verbally, she strives to quickly complete communication with him simply because she is tired. The child is confused about which signal to perceive as reliable.
The childhood of schizoids is characterized by loneliness and isolation. Parents are distant, manifest themselves as oppressive and intruding, and a pattern of avoidance, distancing, and detachment is formed. Such children, and subsequently people, do not like to openly discuss their thoughts with someone or share their impressions. They do not like attention from society.
Appearance and behavior
Outwardly, a person with schizoid accentuation is also quite easy to identify. They usually have a cold attitude towards fashion. In terms of clothing style, they try to dress differently from everyone else, using very unusual combinations of clothing. Usually their appearance is absolutely not harmonious and paradoxical, and their facial expressions and body movements seem to be feigned and not real.
In terms of behavior, schizoids are very unnatural; visually they look sketchy, and they have no emotions at all. They are quite easy to spot among other people, since they seem to be aloof from everyone. They try to maintain a wall between the outside world and their own, inner world.
But there are other aspects of this nature. Typically, schizoids have a high level of intelligence, and therefore are very prone to creative development. Such people become excellent programmers, scientists, engineers, philosophers, designers, and so on.
But if a schizoid occupies the position of manager, then in most cases his decisions will be made absolutely without taking into account human factors and necessity. Compassion is not about them at all. Immediately that same high intellect plays a cruel joke on them, leading to the development of all kinds of perversions.
Schizoid character traits in adolescents
Schizoid accentuation manifests itself at its worst during puberty, and it is during adolescence that it brings many problems. At this age, the child’s communication with other peers and teenagers is very important. And it is quite difficult for schizoids to find that same contact with society and the world around them in general.
The main value of such teenagers lies in their own uniqueness, and their biggest fear is the possibility of losing themselves in such a big world. In their hearts, such children want to be in society and want to be accepted by them, but despite this desire, schizoids do not leave their protective shell so as not to stumble again.
As a result, such a lifestyle without any communication begins to become a habit that burdens the teenager. This leads to the fact that the child simply chooses between communication and a possible mistake, non-acceptance of society, his unique individuality.
Schizoids are never distinguished by a large number of friends, and those friends whom he managed to find must respect the personal space of the schizoid. Otherwise, he leaves his social circle. Difficulties also develop when communicating with members of the opposite sex.
Schizoids often avoid physical contact, especially with the opposite sex, and may not tolerate loud and harsh sounds and smells.
Therefore, when communicating with a schizoid teenager, it is important to take into account his individuality, trying to understand this approach, principles and aspirations. It is important to support the desire to develop in a creative direction and respect the personal space of such a teenager.
Treatment of schizoid psychopathy
Another serious problem of schizoid psychopathy is the lack of ability to somehow cure this pathology. It just so happens that personality and character traits haunt a person throughout his life. Therefore, the main therapy is usually aimed at improving the process of social adaptation. Psychologists and psychiatrists must help a person with schizoid psychopathy understand what emotions are, and must help them learn to cope with these emotions and not be afraid of them.
Treatment with drugs will not give any result, so the main emphasis should be on various methods of psychotherapy. Thus, cognitive therapy techniques will help in understanding one’s own emotions and will help a person learn to enjoy different events or what a person is doing.
To improve the social skills of a schizoid, it is better to refer him to group treatment, since it is in society that more gentle stimulation for communication occurs, while maintaining safe conditions that will not cause other psychological trauma.
In childhood and adolescence, it is important to provide support so that the child can adapt more easily and painlessly to the team; sometimes help is needed in finding a profession.
If schizoid psychopathy is of a moderate degree, and parents and specialists have provided comfortable conditions for the development and growth of the child and helped to choose the right type of activity, then there will be a favorable prognosis in the future. Such patients adapt more easily to society, work calmly surrounded by other people, and have close people and friends, albeit in small numbers.
