What is Schizoid Personality Disorder?

People with schizoid personality disorder lack a desire for intimacy, instead indifference to close relationships. Has little or no joy in being part of a family or social group. You can find more information below.

What is schizoid personality disorder?

People with schizoid personality disorder have profound contact disorders with other people. They have little ability to show emotions – especially joy – and therefore often appear harsh and rigid to others.

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They are usually in seclusion and have little or no social contact. They often fantasize, possibly to compensate for the lack of contact and constant social isolation.

In professional life, they often choose tasks for which they do not have to work with others because they can sometimes achieve good results there. They perceive externally imposed close social relationships or changes as threatening and then react with abrupt withdrawal.

Some of those affected develop depressed moods or fears over time. Some gradually realize that they are socially excluded and have no friends.

Others react with fear when forced to make more intense contact in private or at work. However, under favorable circumstances, the disorder may be alleviated, for example, if he or she trusts one (or more) other people.

case example

Daniel is 55 years old and works as a chemist. He reported that he watched a movie once a week for eight years and had sexual intercourse. Otherwise there is no personal connection. He states that he doesn’t understand why other people spend time together. Daniel sees himself as an inconspicuous person. However, he has been treated for fear several times over the past 40 years.

About his childhood, Daniel reports that his mother was seriously ill and spent a lot of time in clinics when he was two to four years old. At that time he lived with his grandmother. Then his mother died and he lived with his father and his new wife. She had barely known her father before and was rarely at home in the years that followed. During this time, Daniel has developed this attitude: “It’s not a good idea to bond with other people because they’re probably going to leave me again.” Even in his childhood and youth, Daniel avoided contact and relationships with others. He also reports that there is almost nothing he likes.

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During his chemistry studies, Daniel often experienced fear and panic attacks. This was also the case in his job when he had to take on tasks where he had to work with others.

Therapy encourages Daniel to spend more time with other people. He can do that, but he states that he doesn’t really understand why he should do it.

The difference between schizoid personality style and disorder

People with the schizoid personality style are lonely and unwilling to socialize. They prefer activities that they can do alone. Moreover, they are often indifferent to praise and criticism, and tend to be objective and alert.

Many of them live unmarried and work in occupations that can be applied alone. They are usually successful in these professions. They also use their time flexibly because they do not have social ties.

People with schizoid personality disorder, on the other hand, experience them much more intensely, and therefore they can sometimes indirectly harm themselves or their immediate surroundings. People with this disorder-level personality often need treatment. Comprehensive information about the treatment is given below.

How common is it?

It is estimated that less than one percent of the population is affected by schizoid personality disorder. It is therefore relatively rare compared to other personality disorders. Men are more likely to be affected than women.

Causes of schizoid personality disorder

As with other personality disorders, it is assumed to be caused by an interaction of biological, psychological, and environmental factors.

Those affected are believed to be genetically predisposed – because the disorder is more common in families where one member has schizophrenia. It is assumed that these people have a particularly high level of sensitivity and irritability due to genetic factors.

Additionally, if difficult circumstances such as parental emotional neglect, abuse, or psychological disorders are added in childhood, this may favor the development of the disorder.

From a psychoanalytic point of view, it is assumed that parents treat or mistreat these children. In addition, it is suspected that those affected repeatedly tried and failed to make contact with others during their childhood. This can cause them to become extremely withdrawn and avoid any contact now.

Another assumption is that people with schizoid personality disorder may experience emotions such as anger or fear, but are unable to express them appropriately, thus avoiding contacts and closer relationships altogether.

From the cognitive-behavioral perspective, it is assumed that those affected have difficulty recognizing feelings in others and therefore hardly react to emotional stimuli. Also, due to constant social isolation, they may have deficiencies in social skills and therefore have difficulty forming satisfactory relationships.

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Symptoms of schizoid personality disorder

According to the Diagnostic and Statistical Manual of Mental Disorders , its features include; There is a deep pattern of behavior characterized by disconnection in social relationships and limited expression of emotions. The disorder usually begins in late adolescence or early adulthood, but can manifest earlier and is sometimes noticed in a variety of situations.

Symptoms are not caused by an organic cause and often no other mental disorder occurs. According to the DSM, at least four of the following criteria must be met:

  • Those affected neither desire nor enjoy close relationships. This includes being a member of a family.
  • They prefer solitary ventures whenever possible.
  • They have little, if any, interest in sexual experiences with another person.
  • They take limited pleasure from only a few jobs.
  • They have no close friends or confidants other than their first-degree relatives.
  • They seem indifferent to praise and criticism.
  • They appear emotionally cold and distant or show only limited emotions.

Diagnosis of schizoid personality disorder

A trained mental health professional will typically diagnose schizoid personality disorder. This will begin with a physical exam to determine if any other problems are causing the symptoms, followed by a psychiatric evaluation. This, along with questionnaires to assess the person’s symptoms and thoughts, helps the mental health professional identify potential risk factors for schizoid personality disorder.

Responses from all tests will help the doctor or psychologist arrive at a diagnosis, but will also compare symptoms with criteria (we cited above) in the Diagnostic and Statistical Manual of Mental Disorders (DSM). A definitive diagnosis will be made if the person displays four or more of the characteristics listed for schizoid personality disorder.

schizoid personality disorder treatment

Treatment is usually as therapy, but in some cases medications may also be used.

psychotherapeutic approaches

Schizoid personality disorder can be treated with psychoanalytic or deep psychological or cognitive-behavioral therapy approaches. Psychotherapy can help patients change their behavior in small steps so they can reconnect with others and gradually experience them as fulfilling. In therapy, simple treatment goals are often chosen, with the focus often on changing existing problems and stressors.

Possible problems and possible solutions in psychotherapy

As a rule, affected persons rarely come to therapy on their own initiative. Many feel unhappy but do not complain, do not see themselves as mentally ill. Depression, anxiety, alcohol or drug use are often reasons to seek treatment.

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In therapy, patients often appear distant, indifferent, and often make little progress. They also find it difficult to establish a closer and trusting relationship with the therapist. That’s why the therapist works hard to build a trusting, sustainable relationship.

The therapist acts more actively and supportively than other patients; for example, it makes concrete recommendations for the next procedure. At the same time, he should not suffocate the patient by putting emotions in the foreground. Instead, the therapist may try to respond to the patient’s need for more distance.

Psychoanalytic and deep psychology-based therapy

The goal of psychoanalytic therapy for schizoid personality disorder is to get those affected to reconnect with people. Therapists treat these people with determination and patience.

On the other hand, therapy also takes into account the choice to be alone or withdraw from interpersonal relationships. For example, patients simply look for ways they can lead a fulfilling life, and the therapist helps with that.

cognitive behavioral therapy

In this therapy, patients are gradually driven to need contact again, opening up to emotional and interpersonal experiences. Then, step by step, they must make contact with others and at the same time allow emotions.

They can also practice being more aware of their emotions and experiencing positive emotions more often (for example, by doing pleasant activities).

Because those with schizoid personality disorder often act harshly and dismissively in contact, or withdraw quickly, they often receive negative reactions, such as criticism or a break in friendships. This point can also be addressed in therapy:

Patients learn what behaviors in others trigger these reactions – and can then be trained in social skills to change their behavior in a way that is more satisfying for themselves and others.

group therapy

People with schizoid personality disorder are usually very calm and can be treated in a group. If they find that the group accepts them and that you are safe there, group therapy can help. Gradually, it can help those affected become more socially involved and overcome fears of intimacy.

They may experience that social relationships in the group can also be positive and satisfying. They can also learn how to allow for new emotional experiences, accept feedback from others, and improve their social skills.

Treatment with drugs

Psychiatric medications are sometimes used to accompany psychotherapy in schizoid personality disorder – especially if other mental disorders such as severe depression, anxiety, or delusional symptoms occur simultaneously. However, the benefits of drugs in schizoid personality disorder have not yet been clearly proven.

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