Schizoid Personality Disorder
Symptoms
Schizoid personality disorder is characterized by a pattern of detachment from social relationships and a limited ability to relate to other people. Individuals with this disorder have a restricted range of expression of their emotions. This disorder is usually first experienced in early adulthood and can exhibit itself in a variety of contexts, as indicated by four or more of the following listed in the DSM IV:
- neither desires nor enjoys close relationships, including being part of a family
- almost always chooses solitary activities
- has little, if any, interest in having sexual experiences with another person
- takes pleasure in few, if any, activities
- lacks close friends or confidants other than first-degree relatives
- appears indifferent to the praise or criticism of others
- shows emotional coldness, detachment, or flattened affectivity
Treatment
As with all personality disorders, schizoid personality disorder is difficult to treat and no method of treatment will work quickly. Since personality disorders affect the core of an individual’s personality, treatment will take time and combine a variety of approaches to effect change. The treatment of choice is individual psychotherapy. However, individuals with this disorder are not likely to seek treatment unless they are pressured by external circumstance like family or court. Treatment will usually begin with short-term goals to help the individual solve the immediate crisis or problem, which motivated them to enter treatment. Individuals with Schizoid symptoms will then likely terminate therapy. Goals of treatment most often are solution-focused using cognitive behavioral therapy approaches.
Individuals with Schizoid Disorder maintain a distance from people in their lives, even those who are close to them like family. Clinicians work to help ensure the client's trust and feelings of safety in the therapeutic relationship. Acknowledging the client's boundaries are important and the therapist should not look to confront the client on these types of issues. The development of rapport and a therapeutic alliance will likely be a slow, gradual process. And this relationship may not ever fully develop as in seeing people with other disorders and conditions.
Cognitive behavioral exercises may be appropriate for some of the irrational thoughts that are negatively influencing the individual’s life. The therapeutic framework should be clearly defined at the commencement of treatment to build trust. Stability and support are the keys to successful treatment. If treatment proceeds too quickly the individual may feel “smothered” and then engage in “acting out” behavior.
Group therapy may also be a helpful treatment approach once the person has done individual psychotherapy. If group therapy is approached too early in treatment the individual will likely terminate because they will not be unable to tolerate the effects of being in a social group and receiving input from others. If, however, the individual has increased their ability to tolerate social relationships and if they have minimal social skills they may benefit from the interaction of a group.
Causes
The exact causes of personality disorders are not known. They may be cause by a combination of genetic and environmental factors that occur in early childhood.
An individual with schizoid personality disorder may have had a parent who was cold or unresponsive to their needs, or they may have grown up in a home where they did not experience love. People with schizoid personality disorder report that they were often labeled as being hypersensitive or thin-skinned in adolescence. These labels suggest that perhaps their needs were met with exasperation or scorn.
A family history that includes having a parent who has any of the disorders on the schizophrenic spectrum also increases the chances of an individual developing the disorder.