The term schizoid is used colloquially and often facetiously to mean something like “being of two minds about something” or “appearing to have more than one personality.”
In psychiatry, however, the term is quite specific, and it definitely does not apply to your sister, who can’t make up her mind about where to go for lunch. The term is short for a condition known as “schizoid personality disorder.” But forget how we use schizoid; in some cases, disorder may not even be the right word.
People with schizoid personality disorder typically have few, if any, close friends and show little interest in intimate relationships of any kind, often including sexual relationships. They usually prefer to be by themselves and gravitate toward solitary pastimes and hobbies, such as collecting or computer games, that don’t require interacting with others.
Because they often don’t care about what others think of them (good or bad), people with schizoid personality disorder can appear to be self-absorbed. Because they are not interested in forming relationships, they may seem detached and aloof or just extremely quiet and conscientious.
However, they’re usually self-sufficient, and if they’re in a job that requires little social contact, or one in which relationships are limited to work, they can be quite successful. It’s also important to note that people with schizoid personality disorder are not violent. Because one of the hallmarks of the disorder is a lack of emotional expression, it can be difficult to make someone with schizoid personality disorder angry.
If this doesn’t sound like a disorder to you, much less an illness, you’re right. John Oldham is a former president of the American Psychiatric Association and the American College of Psychiatrists, and he’s proposed a new way of looking at this.
Oldham chaired the working group that wrote the section on personality disorders in the fifth and latest edition of the Diagnostic and Statistical Manual of Mental Disorders. That’s the book psychiatrists and other mental health professionals use to guide them in diagnosing and treating mental illnesses.
Oldham explains that schizoid personality disorder is, in most cases, more of a personality style than a disorder. Most medical disorders, such as depression and anxiety, as well as hypertension and diabetes, are “definitive, understandable, describable illnesses,” he says.
Personality disorders, on the other hand, are better understood as a part of a spectrum. “Schizoid,” Oldham says, “is best thought of as a set of personality traits that can be described phenomenologically and are present in varying degrees in some people.”
The personality style becomes a disorder only when it interferes with a person’s ability to function, to reach their goals or to live their life the way they want to. For example, a mathematician with a schizoid personality might be perfectly comfortable calculating in solitude.
However, if that personality style makes it difficult for them to teach, serve on committees, or do other work required to be successful in their job, then it becomes a disorder that needs treatment.
As you can imagine, people with this type of personality don’t often schedule appointments with therapists. However, says Oldham, they may seek treatment if their preferences aren’t working for them, and they get to the point where they’re willing to “bite the bullet and overcome their natural impulse to not open the door when the doorbell rings.”
They aren’t lining up to take part in clinical trials, either, he says. That means there’s not a lot of evidence on the success rate of various therapies. However, in cases where a patient wants to change, psychodynamic therapy or cognitive therapy can be helpful. You’re never going to turn this type of person into a social butterfly, but a good therapist and a motivated patient can successfully address the areas where a schizoid personality is causing problems.
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The causes of schizoid personality disorder are often attributed to childhood trauma, either physical or emotional. Either way, it causes the child not to trust the adults who are supposed to be caring for them. This can lead to the feeling that emotional relationships aren’t safe.
However, the disorder is slightly more common in people who have family members with schizophrenia, indicating that the tendency to this type of personality is likely hereditary, though childhood trauma, physical or emotional, can push a susceptible individual from the “personality style” end of the spectrum to the “disorder” end, Oldham says.
While they sound similar, Schizophrenia and schizoid personality disorder are different conditions. They do, however, share similar symptoms.
So next time you use the word schizoid, know that you’re talking about someone with a personality type that may or may not be a disorder. But in any case, they probably don’t want to talk to you about it.
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