Schizoid personality disorder - symptoms and treatment
Theoretical reflections on the nature of schizoid personality disorder (SPD) have given rise to numerous discussions among psychiatrists and psychoanalysts. Today, this personality disorder is understood as a borderline type of mental organization, which, from the point of view of intrapsychic structure, is characterized by disunity of the inner self, namely, a mismatch between the emotional and intellectual spheres. Such people outwardly seem withdrawn, thoughtful, they practically do not express emotions at all, show indifference to social interactions (to praise or criticism, including), their behavior is usually non-standard, eccentric, and sometimes pretentious.
Individuals with this personality disorder often do not have access to what they are feeling, what they are thinking about and what needs they are experiencing at that moment. However, despite this combination of contradictory traits and actions, as well as a seemingly poor emotional palette, people with a schizoid organization are creative and capable of creating close relationships with other people (which, however, is quite rare). They, along with strong protection of their personal boundaries, are careful and respectful of the boundaries of others. Many of them find their calling in art, in theoretical and exact sciences, as well as in philosophical and spiritual knowledge.[1][2][5][6]
Prevalence of schizoid personality disorder
According to DSM-5 and modern research, the incidence of this disorder is about 5% of the entire world population.[4]
SPD is more often diagnosed in men. In a study of patients with depression, schizoid disorder was found in 3% of men and only 0.8% of women.[10] The reasons for this relationship are not entirely clear. Researchers have suggested that some symptoms of SPD are similar to traits traditionally considered feminine, leading clinicians to misdiagnose. But other scientists have refuted these hypotheses.[11]
Causes of schizoid personality disorder
The exact cause of SPD is unknown. Clinical experience suggests that these people are temperamentally hyper-reactive and easily react to even minor stimulation. Patients themselves usually characterize themselves as naturally sensitive, intuitive, and sensitive to the world. As children, they could wake up from any rustle; they hid and cowered from loud sounds or sudden movements of adults.
SPD, like other disorders, develops from childhood, but a final diagnosis is made only after adulthood, since a person's personality can change with age.[12]
Schizoid personality disorder in children and adolescents
Psychoanalysts' observations of newborns have shown that infants prone to a schizoid personality structure tense up and even lean back when caring parents try to hug them. Phenomenologically, this is the protection of one’s comfort and safety from the invasion of another, even a close person.
By the age of 3-4, these children show signs of schizoid disorder much more clearly: they choose quiet, calm, solitary games and have little need for the care of relatives. At an older age, they begin to ask philosophical questions (for example, about the origin of the world, etc.), show interest in the abstract, the unknown, the secret, as well as unusually explain everyday things and see the environment wider than others can do.
Children with SPD try to communicate less with others. As they grow up, they choose jobs that allow them to avoid interacting with people, even if such jobs are below their level of ability. They often sacrifice intimacy in order to maintain autonomy. Vague, impoverished or overly specific speech, limited eye contact and intonation make communication even more difficult.
Some people with schizoid disorder gravitate towards a traditional lifestyle, but most do not respond well to social stimuli. For this reason, they may become emotionally attached to inanimate objects or animals rather than people.[13][14]
The huge tragedy of schizoid children is the lack of empathy on the part of the people around them, even on the part of their parents. Their alienation, which also brings suffering, begins with a feeling of misunderstanding and devaluation by others.
Studies have shown that school-aged children with SPD had impaired empathy, had odd communication styles, and were prone to loneliness. They are also characterized by increased interpersonal sensitivity and mental rigidity, that is, a lack of flexibility in habits and behavior.
Contrary to the assumption of personality variability, signs of SPD were stable: many subjects were diagnosed with the disorder in adulthood. In addition, two children eventually developed schizophrenia.[15][16][17]
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.
Paranoid schizophrenia being treated in a clinic
At the Moscow center of psychiatry and psychotherapy “Preobrazhenie Clinic” you will receive everything you need for complete treatment of paranoid schizophrenia. The clinic’s specialists provide comprehensive treatment using the most effective methods. Both patients and loved ones receive assistance. You can find out the cost of services here.
Why should paranoid schizophrenia be treated?
The specialists of our clinic are attentive to each patient and are ready to help you in the fight against mental illness. Here you will receive all the necessary medical and psychological assistance, the patient will be prescribed medication and supportive psychotherapy. “Transfiguration Clinic” works so that you and your loved ones can return to a full life and forget about mental illness.
With us you will receive:
- rapid treatment with accurate diagnosis;
- attentiveness and understanding;
- psychological support for the patient’s loved ones;
- a full range of services for the rehabilitation of a patient with schizophrenia;
- anonymity of treatment and compliance with confidentiality conditions.
Specialists at the Transfiguration Clinic of psychiatry and psychotherapy in Moscow are ready to help your loved one and you at any time.
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.
Differential diagnosis
To correctly diagnose paranoid schizophrenia, it is necessary to exclude the possibility of developing delusional disorder, acute transient psychotic and schizoaffective disorders, dementia and other organic personality disorders.
Case history of a famous scientist
In 1958, at the age of 30, the famous mathematician John Nash showed the first signs of the disease and was diagnosed with paranoid schizophrenia. During this same period of his life, Nash made several discoveries in the field of mathematics. During his life, he was treated in psychiatric clinics several times. When the mathematician's health improved at age 34, he got a job at Princeton University.
At the age of 66, John Nash received the Nobel Prize in Economics. Thanks to John Nash's research, a new scientific approach emerged in mathematics.
The scientist learned to live with a diagnosis of paranoid schizophrenia. And this did not stop him from achieving success. His life story became the basis for the film A Beautiful Mind.
How to overcome schizophrenia?
Treatment of schizophrenia involves the use of a whole range of methods: drug treatment, psychological support, psychotherapy and social rehabilitation.
Treatment of paranoid schizophrenia
The first attack may mark the beginning of a long-term mental illness, or it may never occur again. The success of treatment largely depends on the time of detection of the disease: the earlier signs of schizophrenia are identified, the sooner treatment begins, the greater the likelihood of a positive prognosis and the higher the chances of long-term remission.
Paranoid schizophrenia is completely curable with modern means!
Anyone who wants to recover and receives the support of loved ones and caring people has every chance of curing their mental illness. According to general statistics, every fifth person in the world who suffers from schizophrenia, with the right approach to treatment, achieves long-term remission of 5 years or more. These people become full-fledged members of society and a reliable support in their family.
Research shows that if a patient participates in a special psychotherapy program, the patient’s likelihood of long-term remission increases sharply.
Treatment of paranoid schizophrenia is carried out under the supervision of a psychiatrist using medications (antipsychotics), psychotherapeutic methods under the guidance of a psychotherapist and a clinical psychologist. During treatment, the client undergoes a mandatory course of rehabilitation in the hospital and after discharge.
Prognosis in the treatment of paranoid schizophrenia
In our clinic, 90% of patients achieve a high degree of remission and can live and work on minimal doses of maintenance medications. Even when taking medications for a long time, patients can lead a normal life and realize their full potential. This requires a rehabilitation course in which the patient and his relatives participate. As statistics show, very often people who have suffered an illness can return to a busy life and become even more productive than the average person.
Psychological characteristics of the paranoid personality type
The leading characteristics of the paranoid personality type are suspicion, wariness, absence or a dull sense of humor.
A paranoid person treats his qualities as negative, projecting them externally. And then they are perceived as an external threat. We can say that everything that this person worries and worries about is within herself. For example, such a person may not realize that in some of his manifestations he is quite aggressive and, projecting this quality onto other people, notes these traits in them.
Also often in paranoids one can observe a consciousness of their own greatness.
A paranoid person must suffer greatly in order to seek psychological help; they are not inclined to trust strangers. And in this regard, they tend to avoid consultations with psychologists and trust few people.
Paranoid individuals often play political roles where their projective traits may be opposed to existing views. They can “climb onto an armored car” to prove something to someone. True, it is important to note that such people do not always exaggerate the real danger. However, they can also be ironic and suspicious.
Paranoid Self
The paranoid client despises his own humiliated personality. He has a high degree of fear, which leads to the fact that he constantly “monitors those around him,” observes their reactions, “keeps his finger on the pulse.” Paranoids believe that they are the target of everyone around them, that people think and talk only about them.
It is also important to note that paranoids have a high sense of guilt.
Statistically, a connection has been found between thoughts about homosexuality and paranoid personalities, this has been confirmed by some studies.
Paranoids can fight against existing authorities. Revenge and triumph provide a temporary and shallow sense of security and moral clarity.
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.
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.
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.
