At work, people with schizoid personality disorder are often brilliant at logical and abstract thinking. Problems tend to occur when they interact more closely with other people.
What is schizoid personality disorder?
Psychology refers to schizoid personality disorder as when people have problems making social connections with others, although the lines between personal traits and a disorder are blurred. People with schizoid personality disorder appear cool, aloof, emotionally distant to others and have difficulty expressing their feelings appropriately. They tend to avoid contact with other people and take refuge in fantasies, perhaps to compensate for the lack of a social environment. At work, they prefer activities where they can work alone; constant teamwork is not for them. They long for closeness, but are afraid of it at the same time. This can lead to a feeling of isolation. However, it is often not so much the affected person who suffers from the disorder, but their social environment.
Causes
In most personality disorders, there is a mixture of biological, genetic, and environmental influences. There appears to be a genetic predisposition, as schizoid personality disorder is more common in families where one family member has schizophrenia. Many people with this personality disorder are very sensitive by nature, coupled with being easily offended. A strict upbringing, neglect, or mental abuse may also play a role, or a personality disorder in one parent. Psychoanalysts suspect a rejecting attitude or maltreatment by the parents or frustration experiences during previous contact. It could also be a possible cause that the affected person can feel emotions such as fear and anger, but cannot express them appropriately and therefore tries to avoid contact.
Symptoms, complaints, and signs
The lines between personal idiosyncrasies and a disorder are sometimes very blurred; in schizoid personality disorder, it depends on whether the sufferer suffers from withdrawal or needs the withdrawal for their individual well-being. Psychology has established nine possible symptoms that are indicative of schizoid personality disorder:
- Low enjoyment of activities
- Reduced affects, emotional detachment
- Difficulty expressing warm, tender feelings or anger
- Apparent indifference to praise and criticism
- Low interest in sexual experiences with others
- Strong fantasies
- Preference for solitary activities
- Low desire for close social relationships
- Lowered sense of social norms
Diagnosis and course of the disease
Because the boundaries between personal characteristics and disorders are blurred, it is not easy to diagnose schizoid personality disorder. It is challenging even for professionals such as medical professionals and physicians. According to the ICD 10 list of criteria, at least three of the nine listed symptoms must be present for a definite diagnosis. This is complicated by various circumstances. Two clear symptoms are not enough, it is mandatory to have three. Some symptoms resemble those of other psychological or neurological diagnoses, for example, Asperger’s syndrome, which must be ruled out by the diagnosis. Sometimes multiple diagnoses are necessary because several disorders overlap and mask schizoid personality disorder. Symptoms also may not be brief, but must be persistent. Another complicating factor is that many affected individuals are able to compensate for behavioral abnormalities, temporarily suppress them, or hide them behind a façade.
Complications
The aloofness that is typical of people with schizoid personality disorder can lead to misunderstandings, especially in social situations. Other people may take the aloofness as disinterest or rejection. In addition, schizoid personalities often show only limited emotions. Therefore, they may appear cold or uncaring to others.In part, their emotions and needs remain unconsidered: On the one hand, many schizoid personalities do not express themselves explicitly enough in this regard; on the other hand, their emotional expressions are sometimes misunderstood or ignored. Without consistent friendships and relationships, schizoid personalities often feel marginalized, misunderstood, and lonely. The flattened emotional responses can also lead to problems in professional life. People with schizoid personality disorder sometimes feel stigmatized. Misunderstandings are also possible when schizoid personality disorder is confused with other mental illnesses, such as Asperger’s syndrome. Because schizoid personality disorder is rare and other disorders are known to lay people, such confusion happens frequently in everyday life. Complications can also arise during treatment if differential diagnosis is not taken into account. Other mental illnesses may develop as a complication. However, other mental disorders may also occur concurrently with or precede schizoid personality disorder. Many affected individuals also suffer from (major) depression. With or without depression, suicidality may occur as a severe complication of schizoid personality disorder.
When should you see a doctor?
People who have schizoid personality usually do not recognize it. They live in the belief that everything is fine with them. Rather, it is the environment that suffers from the symptoms of the personality disorder. Initiating a visit to the doctor with the affected person is extremely problematic. The relationship of trust must be very stable and able to withstand stress in order for a diagnosis to be made. However, a close relationship with another person is normally avoided by the affected person. Consultation with a physician is recommended as soon as behavioral abnormalities occur that are described as deviating from the norm. Emotional injuries as well as the inability to work in a team or to show consideration for other people, are considered characteristic of the personality disorder. There is cause for concern with reduced affect, lowered emotional participation in social interactions, and the development of vivid fantasies. Indifference to blows of fate, praise and criticism, inability for exchange of tender feelings, and sexual apathy indicate irregularities of the human psyche. Going it alone in the professional sphere or being a loner in private life are other signs attributed to schizoid personality disorder. A doctor is needed whenever the affected person or relatives suffer from the disorder.
Treatment and therapy
Treatment for schizoid personality disorder usually involves depth psychological, psychoanalytic, or cognitive-behavioral psychotherapy. Affected persons are thereby encouraged again to make contact with other people and to enjoy themselves. However, affected persons rarely start therapy voluntarily because they usually see no need for action. In therapy, they appear distant and uninvolved. Therefore, the therapist must ensure a trusting relationship and actively support the client more. At the same time, he must be careful not to overburden the client by too much emotional work, instead respecting his desire for distance and giving him the opportunity for written homework and e-mail contact. Psychoanalytically oriented psychotherapy pursues the goal that affected persons learn to re-establish contact with other people and to make this contact reliable and satisfying, while at the same time making living alone more satisfying. Cognitive behavioral therapy helps those affected to open up again to emotional interpersonal experiences and to better perceive their own feelings. In therapy, they also learn to deal with the feelings they trigger in others through their dismissive behavior and learn more appropriate strategies. Group therapy can be useful in reducing social anxiety. However, they must then feel comfortable in the group. Occasionally, psychotropic drugs are prescribed in parallel with psychotherapy for severe depression or delusions, but the positive benefits have not yet been clearly demonstrated.
Prevention
There is usually no specific prevention for personality disorders because they develop over a lifetime. When they do occur, it is important to recognize them early so that pathological behavior is not passed on from one generation to the next. It is also helpful if those affected do not abruptly withdraw from contacts, but openly communicate their needs with their social environment.
Aftercare
Mental illnesses require professional aftercare even after successful completion of therapy. Symptoms continue to accompany the affected person for years, in many cases for a lifetime. Especially after a stay in a psychiatric hospital, the patient must be integrated back into his or her everyday life and familiar surroundings. He cannot manage this step on his own. For this, he needs the supportive help of a psychotherapist. Schizoid personality disorders are accompanied by a conspicuous withdrawal into oneself. The affected person avoids acquaintances that he maintained before the onset of his illness. In the context of aftercare, it must be differentiated whether the social withdrawal is actually (still) disease-related or related to the patient’s personality. If the patient ends certain friendly ties but seems content in doing so, the therapist should accept the decision. A deliberate break in contact may even be necessary for the patient’s recovery. Friends who cannot take his illness into account or understand it as such have a negative effect on his mental equilibrium. In the event of a deterioration due to acute conditions, the attending specialist provides first aid. This professional point of contact gives the sick person a feeling of security. This makes it easier for him to return to everyday life. Relatives of the sufferer can also contact the therapist with specific questions.
What you can do yourself
Clear instructions for self-help are rare for schizoid personality disorder because, first, this personality disorder is not common and, second, it is often associated with social withdrawal. These characteristics make it difficult to work closely with self-help groups. In everyday life, persons with schizoid personality disorder suffer in many cases from the fact that they have only superficial contact with other people. In addition, their behavior is often misunderstood by other people. One approach to self-help can therefore be to make one’s own behavior comprehensible to one’s partner, family or other close people. One way is to verbalize one’s feelings when they cannot be expressed in any other way. Since schizoid personality disorder can lead to very different difficulties in everyday life, individual solutions are necessary. To identify such, it may be useful to ask confidants for feedback. What would help them to cope better with a (lack of) response? It is important to understand that schizoid personality disorder cannot be “eliminated” by this. However, it may make it more understandable to their partner and other immediate family members. How people best manage their daily lives with schizoid personality disorder can also be addressed in therapy. In behavior therapy in particular, therapists often give their patients homework assignments to help them incorporate the insights gained from therapy sessions into everyday life.